Heterogeneities of the impact of public health policies on HIV/AIDS indicators in Brazil according to sociodemographic factors: A real-life study.

INTRODUCTION: The impact of specific policies on HIV care has been scarcely investigated. In this study we aimed to analyze the impact of the Treatment For All policy (TFA-2013) and the adoption of integrase strand transfer inhibitors (INSTIs-2017) as first-line therapy on clinical indicators of people living with HIV (PLHIV) in Brazil. METHODS: We assessed the public database of Brazil's Ministry of Health and extracted data from 2009 to 2019. We investigated the impact of TFA and INSTIs with a time-series analysis of four health indicators in PLHIV: antiretroviral treatment (ART) initiation with a CD4+ count >500/mm3 ; ART initiation <1 month after the first CD4+ measurement; viral load suppression (VLS); and treatment adherence. We explored trends over time by gender, age, macroregion of residency and municipal-level social vulnerability index. RESULTS: We included 753 316 PLHIV in 2019. Most were males (64.81%) in the 30-49 years age category (50.86%). We observed an overall improvement in all HIV clinical indicators, with notable impact of TFA on timely ART initiation and VLS, and mild impact of INSTIs on treatment adherence. Such improvements were heterogeneous, with remarkable gaps in gender, age and socioeconomic groups that have persisted over time. Indicators point to inferior outcomes among children, older adults, women and people living in socially vulnerable locations. CONCLUSIONS: Recent Brazilian public policies have had positive impacts on key HIV clinical indicators. However, our results highlight the need for specific policies to improve HIV care for children, older adults, women and socially vulnerable groups.

Separation of the heme protein cytochrome C using a 3D structured graphene oxide bionanocomposite as an adsorbent.

Proteins are of great importance for medicine and the pharmaceutical and food industries. However, proteins need to be purified prior to their application. This work investigated the application of a hydrogel bionanocomposite based on agar and graphene oxide (GO) for capturing cytochrome C (Cyto C) heme protein by adsorption from aqueous solutions with other proteins. Although applications of GO-based materials in adsorption are widely studied, the focus on semi-continuous processes remains limited. Adsorption experiments were carried out in batch and fixed bed columns. The effect of pH and ionic strength on adsorption was investigated, and there is evidence that electrostatic interactions between Cyto C and the nanocomposite were favoured at pH = 7; the adsorption capacity decreased as NaCl and KCl concentrations increased, ascribed to the weak electrostatic interaction between the protein and GO active sites in the bionanocomposite. All adsorption isotherm models (Langmuir, Freundlich, Sips) used gave suitable adjustments to the equilibrium experimental data and the kinetic models applied. The maximum adsorption capacity predicted by the Langmuir isotherm was ∼400 mgCytoC gadsorbent,dry-1, and the adsorption thermodynamics indicated a physisorption process. Tests were performed to evaluate the co-adsorption in batch, and the composite was effective in adsorbing Cyto C in solution with bovine serum albumin (BSA) and L-phenylalanine. Fixed bed tests were performed, and although protein adsorption onto nanoparticles can be challenging, the Cyto C adsorbed could be successfully recovered after desorption. Overall, the GO-based hydrogel was an effective method for cytochrome C adsorption, exhibiting a notorious potential for applications in protein separation processes.

Disparities in HIV continuum of care in the paediatric population: A real-life study in Brazil.

INTRODUCTION: Paediatric HIV follow-up is challenging, and treatment indicators are markedly far from Joint United Nations Programme on HIV/AIDS (UNAIDS) goals. In this study, we describe the 2019 Brazilian HIV cascade according to age categories and sociodemographic variables and address temporal trends between 2009 and 2019. METHODS: We obtained data from the Brazilian Ministry of Health monitoring database. Cascade outcomes included retention in care, antiretroviral use, and viral suppression. We assessed the effect of age on timely initiation of antiretroviral treatment (ART; initiation with CD4+ T-cell count ≥350 cells/mm3 or a first ART dispensation ≤30 days after the first CD4+ T-cell measurement) and detectable HIV viral load (>50 copies/mL) in univariable and multivariable analysis adjusted for sex, race, and social vulnerability index (SVI). Temporal trends in timely ART initiation and viral suppression were evaluated graphically. RESULTS: Among 771 774 people living with HIV, those in the youngest age categories had poorer indicators in the care cascade. Those in younger age groups, those with higher SVI, and those declaring Black and native Brazilian race/ethnicity had higher odds of having detectable viral load and delayed ART initiation. Although children living with HIV tend to start ART with higher CD4+ T-cell counts, time-series analysis suggests that improvements in treatment indicators seen in the adult population are not observed in the paediatric population. CONCLUSION: Our results highlight the challenges faced by children and adolescents living with HIV in achieving UNAIDS goals. Lower access to ART among children is a central barrier to improved paediatric care.

Interleukin-10 receptor signaling in innate immune cells regulates mucosal immune tolerance and anti-inflammatory macrophage function.

Intact interleukin-10 receptor (IL-10R) signaling on effector and T regulatory (Treg) cells are each independently required to maintain immune tolerance. Here we show that IL-10 sensing by innate immune cells, independent of its effects on T cells, was critical for regulating mucosal homeostasis. Following wild-type (WT) CD4(+) T cell transfer, Rag2(-/-)Il10rb(-/-) mice developed severe colitis in association with profound defects in generation and function of Treg cells. Moreover, loss of IL-10R signaling impaired the generation and function of anti-inflammatory intestinal and bone-marrow-derived macrophages and their ability to secrete IL-10. Importantly, transfer of WT but not Il10rb(-/-) anti-inflammatory macrophages ameliorated colitis induction by WT CD4(+) T cells in Rag2(-/-)Il10rb(-/-) mice. Similar alterations in the generation and function of anti-inflammatory macrophages were observed in IL-10R-deficient patients with very early onset inflammatory bowel disease. Collectively, our studies define innate immune IL-10R signaling as a key factor regulating mucosal immune homeostasis in mice and humans.

Clinical Outcomes of Combined Anterior Cruciate Ligament Reconstruction and Lateral Extra-articular Tenodesis Procedures in Skeletally Immature Patients: A Systematic Review From the SANTI Study Group.

BACKGROUND: The treatment of anterior cruciate ligament (ACL) tears in the pediatric population has changed significantly in the past few decades. Pediatric patients who underwent ACL reconstruction (ACLR) have a high risk of rerupture of up to 32%. The addition of lateral extra-articular procedures [lateral extra-articular tenodesis (LET)], already shown to be effective in reducing the risk of rerupture in adults, may also be effective in pediatric patients. The purpose of this study was to systematically review the clinical outcomes of ACLR+LET tenodesis in pediatric patients. METHODS: Data were collected from Pubmed, MEDLINE, Cochrane, and Scopus Databases according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Studies reporting the clinical outcomes of ACLR+LET in the pediatric population using autograft, return to play, growth disturbances, failure rate, and surgical complications were included. RESULTS: A total of 5 studies comprising 381 pediatric patients were included. Three main surgical techniques with common features were used. The mean age of all pediatric patients in the included studies was 11.73 years (range, 5.6 to 16) with a mean follow-up of 50.1 months. The overall graft failure rate of the included studies was 4.65%. The return to play was 95.11%. The mean Lysholm score was 94.51 and the mean Pediatric International Knee Documentation Committee (Pedi-IKDC) was 93.39. In all, 1.9% of the patients had a coronal plane deformity and 0.8% had a limb length discrepancy. 4.6% of the patients had a contralateral ACL tear. CONCLUSIONS: A combined ACLR+LET in pediatric patients showed a graft failure ranging from 0% to 13.6% at a mean follow-up of 50.1 months. This low graft failure rate is consistent with ACLR+LET in adults. Further investigations are needed to validate these findings and the potential role of LET in reducing graft rupture rates in this population. LEVEL OF EVIDENCE: Level IV-systematic review of level IV studies.

Recurrence of Primary Sclerosing Cholangitis After Liver Transplant in Children: An International Observational Study.

BACKGROUND AND AIMS: Recurrent primary sclerosing cholangitis (rPSC) following liver transplant (LT) has a negative impact on graft and patient survival; little is known about risk factors for rPSC or disease course in children. APPROACH AND RESULTS: We retrospectively evaluated risk factors for rPSC in 140 children from the Pediatric PSC Consortium, a multicenter international registry. Recipients underwent LT for PSC and had >90 days of follow-up. The primary outcome, rPSC, was defined using Graziadei criteria. Median follow-up after LT was 3 years (interquartile range 1.1-6.1). rPSC occurred in 36 children, representing 10% and 27% of the subjects at 2 years and 5 years following LT, respectively. Subjects with rPSC were younger at LT (12.9 vs. 16.2 years), had faster progression from PSC diagnosis to LT (2.5 vs. 4.1 years), and had higher alanine aminotransferase (112 vs. 66 IU/L) at LT (all P < 0.01). Inflammatory bowel disease was more prevalent in the rPSC group (86% vs. 66%; P = 0.025). After LT, rPSC subjects had more episodes of biopsy-proved acute rejection (mean 3 vs. 1; P < 0.001), and higher prevalence of steroid-refractory rejection (41% vs. 20%; P = 0.04). In those with rPSC, 43% developed complications of portal hypertension, were relisted for LT, or died within 2 years of the diagnosis. Mortality was higher in the rPSC group (11.1% vs. 2.9%; P = 0.05). CONCLUSIONS: The incidence of rPSC in this cohort was higher than previously reported, and was associated with increased morbidity and mortality. Patients with rPSC appeared to have a more aggressive, immune-reactive phenotype. These findings underscore the need to understand the immune mechanisms of rPSC, to lay the foundation for developing new therapies and improve outcomes in this challenging population.

The Sclerosing Cholangitis Outcomes in Pediatrics (SCOPE) Index: A Prognostic Tool for Children.

BACKGROUND AND AIMS: Disease progression in children with primary sclerosing cholangitis (PSC) is variable. Prognostic and risk-stratification tools exist for adult-onset PSC, but not for children. We aimed to create a tool that accounts for the biochemical and phenotypic features and early disease stage of pediatric PSC. APPROACH AND RESULTS: We used retrospective data from the Pediatric PSC Consortium. The training cohort contained 1,012 patients from 40 centers. We generated a multivariate risk index (Sclerosing Cholangitis Outcomes in Pediatrics [SCOPE] index) that contained total bilirubin, albumin, platelet count, gamma glutamyltransferase, and cholangiography to predict a primary outcome of liver transplantation or death (TD) and a broader secondary outcome that included portal hypertensive, biliary, and cancer complications termed hepatobiliary complications (HBCs). The model stratified patients as low, medium, or high risk based on progression to TD at rates of <1%, 3%, and 9% annually and to HBCs at rates of 2%, 6%, and 13% annually, respectively (P < 0.001). C-statistics to discriminate outcomes at 1 and 5 years were 0.95 and 0.82 for TD and 0.80 and 0.76 for HBCs, respectively. Baseline hepatic fibrosis stage was worse with increasing risk score, with extensive fibrosis in 8% of the lowest versus 100% with the highest risk index (P < 0.001). The model was validated in 240 children from 11 additional centers and performed well. CONCLUSIONS: The SCOPE index is a pediatric-specific prognostic tool for PSC. It uses routinely obtained, objective data to predict a complicated clinical course. It correlates strongly with biopsy-proven liver fibrosis. SCOPE can be used with families for shared decision making on clinical care based on a patient's individual risk, and to account for variable disease progression when designing future clinical trials.

Arthroscopic confirmation of femoral button deployment prevents soft tissue interposition in ACL reconstruction.

PURPOSE: The purpose of this study was to determine whether direct arthroscopic control of femoral buttons can prevent improper deployment and soft tissue interposition in anterior cruciate ligament (ACL) reconstruction. METHODS: A retrospective analysis of prospectively collected data from the SANTI study group database was performed. All patients who underwent ACL reconstruction using suspensive femoral fixation between 01/01/2017 and 31/12/2019 were included. Patient assessment included demographics, sports metrics, reoperations performed and femoral button-related specific complications such as iliotibial band (ITB) irritation and/or septic arthritis. Proper deployment of the button and soft tissue interposition were assessed on postoperative radiographs. RESULTS: A total of 307 patients underwent ACL reconstruction using adjustable femoral button fixation and were analyzed after a mean follow-up of 35.2 ± 11.0 months (14.3-50.2). The mean age was 39.5 ± 10.9-years old (range 13.3-70.6). Postoperative radiographs showed a correctly deployed femoral button without soft tissue interposition for all patients. No septic arthritis was reported. Nine patients (2.9%) suffered from lateral pain related to ITB irritation due to the button. Five of them had their symptoms resolve during rehabilitation. Ultrasound-guided corticosteroid infiltration was necessary for four patients after an average delay of 14.5 ± 4.8 months (11.7-21.7). Three patients were then symptom-free, but one required surgical removal of the implant 27.5 months after the surgery. Regarding unrelated femoral button complications, 15 patients (4.9%) underwent secondary arthroscopic procedures, including meniscectomy (1.6%), surgery for cyclops syndrome (2.6%) and revision ACLR (0.7%). CONCLUSION: Arthroscopic confirmation of femoral button deployment prevents soft tissue interposition without specific complications. LEVEL OF EVIDENCE: Level IV.

Prosopis juliflora piperidine alkaloid extract levels in diet for sheep change energy and nitrogen metabolism and affect enteric methane yield.

BACKGROUND: Ionophore antibiotics improve the efficiency of energy metabolism, which has driven their use as a feed additive in ruminants for decades. Currently, they have not been approved in many countries, generating a challenge for the immediate search for plant extracts with a similar mode of action on rumen metabolism. This study evaluated the effects of enriched Prosopis juliflora (mesquite) piperidine alkaloid extract (MPA) levels as an alternative phytoadditive to sodium monensin (MON) in sheep. RESULTS: The MPA diet did not differ from MON with regard to nutrient intake. A quadratic effect (P < 0.05) was observed for organic matter and neutral detergent fibre digestibility, with respective maximum point at 25.40 and minimum point at 0.95 mg kg-1 MPA. The MPA levels linearly decreased (P < 0.05) faecal nitrogen loss. MPA did not differ from MON with regard to nutrient digestibility, and MPA levels increased (P < 0.05) the proportion of digestible energy and metabolizability from dietary gross energy. The MPA levels linearly decreased (P < 0.05) enteric CH4 production, the yield showing lower (P < 0.05) energy loss as CH4 than MON. CONCLUSION: The results show that MPA levels of 17.3 and 27.8 mg kg-1 are enteric CH4 inhibitors and enhance energy and protein utilization, indicating a promising alternative to MON for ruminants. © 2022 Society of Chemical Industry.

Participation in clinical trials increases the detection of pre-malignant lesions during colonoscopy.

BACKGROUND: colorectal adenoma detection has been associated with the effectiveness of cancer prevention. Clinical trials have been designed to determine the role of several interventions to increase the detection of pre-malignant lesions. We hypothesized that colonoscopy in the setting of clinical trials has a higher pre-malignant lesion detection rate. METHODS: a cross-sectional study was performed that compared the detection of pre-malignant lesions in 147 randomly sampled non-research colonoscopies and 294 from the control group of two prospective trials. Outpatients aged 40-79 years, with no personal history of colorectal cancer (CRC) were included. RESULTS: baseline characteristics were similar between the two groups. The pre-malignant lesion detection rate in the trial vs control group was 65.6 % vs 44.2 % (OR 2.411; 95 % CI: 1.608-3.614; p < 0.001), the polyp detection rate was 73.8 % vs 59.9 % (OR 1.889; 95 % CI: 1.242-2.876; p = 0.003), the adenoma detection rate was 62.6 % vs 44.2 % (OR 2.110; 95 % CI: 1.411-3.155; p < 0.001) and the sessile serrated lesion detection rate was 17 % vs 4.1 % (OR 4.816; 95 % CI: 2.014-11.515; p < 0.001). The mean number of pre-malignant and sessile serrated lesions was 1.70 vs 1.06 (p = 0.002) and 0.32 vs 0.06 (p = 0.001) lesions per colonoscopy, respectively. There was no significant change in any of the study outcomes according to the multivariate analysis with each single potential confounder. CONCLUSIONS: patients involved in colonoscopy trials may benefit from higher quality examinations, as shown by the higher detection rates. Institutions should consider supporting clinical research in colonoscopy as a simple means to improve colonoscopy quality and colorectal cancer prevention.

Effects of ibuprofen during 42-km trail running on oxidative stress, muscle fatigue, muscle damage and performance: a randomized controlled trial.

Up to 75% of marathon runners ingest non-steroidal anti-inflammatory drugs (NSAIDs) during competition. Despite the doubt whether or not they contribute to performance, the effect of NSAID in endurance sports is unclear. We evaluated the effect of ibuprofen (IBU) use on oxidative stress, muscle damage, physical performance, and vertical jump of runners participating in a 42-km-trail running. The sample consisted of 12 men randomly divided into 2 groups: a placebo group (placebo) and an ibuprofen group (IBG). A 400-mg IBU capsule was administered to the IBG 15 min prior to the start of the trial and during the course after 5 h. In the intergroup analysis, placebo 70.1% increase (p < 0.0001; Cohen's d = 4.77) of the thiobarbituric acid reactive substances (TBARS); the IBG exhibited a 31.46% increase of the sulphhydryl groups (SH) (p = 0.024, Cohen's d = 0.27), 55% of squat jump (SJ) (p < 0.01; Cohen's d = 1.41) with no significant effect on creatine kinase (CK), pace, speed, and finish time. In summary, IBU had positive evidence on oxidative stress and muscle fatigue, but had no effect on physical performance and muscle damage.

A "Dirty" Footprint: Macroinvertebrate diversity in Amazonian Anthropic Soils.

Amazonian rainforests, once thought to be pristine wilderness, are increasingly known to have been widely inhabited, modified, and managed prior to European arrival, by human populations with diverse cultural backgrounds. Amazonian Dark Earths (ADEs) are fertile soils found throughout the Amazon Basin, created by pre-Columbian societies with sedentary habits. Much is known about the chemistry of these soils, yet their zoology has been neglected. Hence, we characterized soil fertility, macroinvertebrate communities, and their activity at nine archeological sites in three Amazonian regions in ADEs and adjacent reference soils under native forest (young and old) and agricultural systems. We found 673 morphospecies and, despite similar richness in ADEs (385 spp.) and reference soils (399 spp.), we identified a tenacious pre-Columbian footprint, with 49% of morphospecies found exclusively in ADEs. Termite and total macroinvertebrate abundance were higher in reference soils, while soil fertility and macroinvertebrate activity were higher in the ADEs, and associated with larger earthworm quantities and biomass. We show that ADE habitats have a unique pool of species, but that modern land use of ADEs decreases their populations, diversity, and contributions to soil functioning. These findings support the idea that humans created and sustained high-fertility ecosystems that persist today, altering biodiversity patterns in Amazonia.

Non-invasive Predictors of Esophageal Varices With a High Risk of Bleeding in Pediatric Cirrhotic Patients.

OBJECTIVES: To evaluate non-invasive predictive factors of varices with a high risk of bleeding in pediatric cirrhotic patients. METHODS: This retrospective, cross-sectional study included data from 158 children with cirrhosis, median age of 5.38 years (interquartile [IQ] 2.08-11.52 years), and no history of upper gastrointestinal bleeding. Patients underwent an endoscopy to screen for esophageal varices. Varices with a high risk of bleeding were defined as those with a medium to large caliber, presence of red spots, or the presence of gastric varices and identified as high-risk varices (HRV). Laboratory and clinical factors were evaluated as possible predictors of HRV. RESULTS: HRV were detected in 30 children (19%) after the first endoscopy. In the multivariate analysis, only the risk score (RS), as described by Park et al, and the aspartate aminotransferase-to-platelet ratio index (APRi) were predictive of HRV. The best non-invasive predictor of HRV was the RS with an area under the receiver operating characteristic curve of 0.764. When used a cut-off point of -1.2, the sensitivity of the RS was 90% and specificity was 53%. The use of RS or APRi correctly identified 96% of children with HRV. CONCLUSIONS: The described predictors allow the correct identification of patients with HRV. The association of RS >-1.2 or APRi >1.4 has a good sensitivity to identify HRV and to prevent unnecessary endoscopy in about one-third of children with no HRV.

Deploying an NFV-Based Experimentation Scenario for 5G Solutions in Underserved Areas.

Presently, a significant part of the world population does not have Internet access. The fifth-generation cellular network technology evolution (5G) is focused on reducing latency, increasing the available bandwidth, and enhancing network performance. However, researchers and companies have not invested enough effort into the deployment of the Internet in remote/rural/undeveloped areas for different techno-economic reasons. This article presents the result of a collaboration between Brazil and the European Union, introducing the steps designed to create a fully operational experimentation scenario with the main purpose of integrating the different achievements of the H2020 5G-RANGE project so that they can be trialed together into a 5G networking use case. The scenario encompasses (i) a novel radio access network that targets a bandwidth of 100 Mb/s in a cell radius of 50 km, and (ii) a network of Small Unmanned Aerial Vehicles (SUAV). This set of SUAVs is NFV-enabled, on top of which Virtual Network Functions (VNF) can be automatically deployed to support occasional network communications beyond the boundaries of the 5G-RANGE radio cells. The whole deployment implies the use of a virtual private overlay network enabling the preliminary validation of the scenario components from their respective remote locations, and simplifying their subsequent integration into a single local demonstrator, the configuration of the required GRE/IPSec tunnels, the integration of the new 5G-RANGE physical, MAC and network layer components and the overall validation with voice and data services.

Dietary nutrient restrictions in the post-weaning period change Santa Inês ewe lamb nutritional metabolic profile.

The objective of this study was to evaluate the metabolic profile of Santa Inês ewe lambs fed diets for early or late-maturing diets with or without nutrient restrictions. The experiment consisted of a 2 × 2 completely randomized factorial experiment with either early- or late-maturity feed formulation according to "Nutrient Requirements of Small Ruminants" with or without 15% crude protein (CP) and total digestible nutrients (TDN) restrictions in diets formulated, five replications, and 20 ewe lambs averaging 15.1±2.6 kg. Lambs on early-maturity diets consumed greater (P<0.05) dietary ether extract (EE), non-fibrous carbohydrates, and TDN than those on late-maturity diets. Lambs on early-maturity diets had 7.11% greater dry matter digestibility (DMD) compared to lambs fed late-maturity diets. Lambs fed late-maturity diets, in general, had greater intake (IN), excreted (EN), and retained (RN) N as well as greater RN/IN and EN/IN ratios. There were no differences in blood total protein or albumin among lambs fed for different finishing maturity targets. Diets designed for late-maturing lambs resulted in greater microbial N and CP as well as rumen and metabolizable, degradable, and undegradable rumen and metabolizable CP. The selection of diets for early or late maturity carcasses depends on the production system goals. Diets without restrictions are recommended for early-maturity carcass finishing while diets with 15% CP and TDN restriction are recommend for late-maturity finishing.

Multiband 5G NR system with photonic-assisted RF amplification.

We propose and report the implementation of a multiband and photonically amplified fifth-generation (5G) new radio (NR) system based on radio over fiber technology and four-wave mixing (FWM) nonlinear effect. A piece of highly nonlinear fiber has been employed to stimulate FWM, which enables photonics-assisted RF amplification up to millimeter waves. Experimental results demonstrate a uniform and stable 15 dB ultra-wideband gain for 4G and three 5G signals in the frequency range from 780 MHz to 26 GHz, coexisting in the transport network. The obtained digital performance has efficiently met the Third-Generation Partnership Project requirements, demonstrating the applicability of the proposed approach for using fiber-optic links to distribute and jointly amplify 4G and 5G signals in the optical domain.

Should patients with symptomatic cholelithiasis before 30 years of age be tested for ABCB4 gene mutations?

BACKGROUND AND AIMS: Low phospholipid-associated cholelithiasis syndrome (LPAC) is characterized by recurrent symptomatic cholelithiasis in young adults associated with ABCB4 gene mutations. Current diagnosing criteria are complex and heterogeneous, making this a largely underdiagnosed entity. Also, although recommended, genetic testing is not necessary for the diagnosis and its real advantages are not clear. The aim of our study was to explore the prevalence of ABCB4 mutations in symptomatic patients with cholelithiasis before the age of 30. METHODS: We conducted a multicentric prospective cohort study including patients with symptomatic cholelithiasis presenting before 30 years of age in 4 Portuguese centres between January 2017 and December 2019. ABCB4 gene was analyzed by next generation sequencing (NGS) including all exons and flanking regions. In 17/32 patients ABCB11 and ATP8B1 variants were also analyzed by NGS. RESULTS: Thirty-two patients were included (75% females, median age of symptom onset was 23 ± 5 years). We found that 8/32 (25%) patients had mutations in ABCB4 gene, 3/17 (18%) in ATP8B1 gene and 1/17 (6%) in ABCB11 gene. 44% (8/18) of patients with LPAC syndrome criteria had identified variants, while the prevalence of mutations in patients with symptoms onset before 30 as sole criteria was 29%. CONCLUSION: Our results suggest that LPAC should be systematically suspected and investigated in patients with symptomatic cholelithiasis before age of thirty, but genetic testing should only be attempted in patients complying with the more stringent LPAC criteria.

Effect of Ibuprofen on Muscle, Hematological and Renal Function, Hydric Balance, Pain, and Performance During Intense Long-Distance Running.

de Souza, RF, de Matos, DG, Ferreira, ARP, Chilibeck, P, Barros, NdA, de Oliveira, AS, Cercato, LM, da Silva, DS, and Aidar, FJ. Effect of ibuprofen on muscle, hematological and renal function, hydric balance, pain, and performance during intense long-distance running. J Strength Cond Res 34(7): 2076-2083, 2020-The aim of this study was to investigate the effect of prophylactic use of nonsteroidal anti-inflammatory drugs (i.e., ibuprofen) on physical performance, vertical jump, muscle biomarkers, liver, kidney, acute pain, and hydration status of participants in the 42-km Trail Running Challenge, a long-distance race integrated over mountain routes. The sample consisted of 20 men randomly divided into 2 groups: a control group (CG) and an experimental group (EG), with 12 completing the race (41.1 ± 8.8 years; 75.7 ± 12.1 kg) and included in the final analysis. The EG were administered an ibuprofen capsule (400 mg) 15 minutes before the beginning of the race and again after 5 hours of racing if the route was not yet completed. There were significant time main effects for creatine kinase (p = 0.001; f Cohen = 0.25), lactate dehydrogenase (p < 0.001; f Cohen = 2.05), aspartate aminotransferase (p = 0.002; f Cohen = 1.53), creatinine (p = 0.002; f Cohen = 2.24), urea (p = 0.001; f Cohen = 2.25), heart rate (p < 0.001; f Cohen = 4.88), and pain scores (p < 0.001; f Cohen = 1.93) all of which increased during the race. There was a group × time interaction for squat jump, which significantly decreased only in the CG (p = 0.045; f Cohen = 2.17). This may have been related to increased frequency of pain reported after the race in the gastrocnemius of the CG compared with the EG (p ≤ 0.05). It was concluded that ibuprofen intake did not reduce muscle damage during the competition but maintained leg muscular power performance (i.e., vertical jump), possibly by reducing gastrocnemius muscle pain.

Counteracting the contemporaneous proliferation of digital forgeries and fake news.

Fake news has been certainly the expression of the moment: from political round table discussions to newspapers to social and mainstream media. It is everywhere. With such an intense discussion and yet few effective ways to combat it, what can be done? Providing methods to fight back even the least harming hoax is a social responsibility. To look for authenticity in a wide sea of fake news, every detail is a lead. Image appearance and semantic content of text and images are some of the main properties, which can be analyzed to reveal even the slightest lie. In this vein, this work overviews some recent methods applicable to the verification of dubious content in text and images, and discusses how we can put them together as an option to curb away the proliferation of unverified and phony "facts". We briefly present the main idea behind each method, highlighting real situations where they can be applied and discussing expected results. Ultimately, we show how new research areas are working to seamlessly stitch together all these methods so as to provide a unified analysis and to establish the synchronization in space and time - the X-Coherence of heterogeneous sources of information documenting real-world events.

Milk production and composition, food consumption, and energy balance of postpartum crossbred Holstein-Gir dairy cows fed two diets of different energy levels.

The objective of this study was to evaluate the production, consumption, and energy balance parameters of primiparous 3/4 and 7/8 Holstein × Gir (HG) dairy cows fed two diets of differing energy levels during the postpartum period. At the beginning of the study, 28 days prepartum, the average weight of both genetic groups was 498 ± 12 kg and body condition score (BCS) was 3.5 ± 0.05. At the end of the study, 61 days postpartum, the 3/4 HG cows had higher weight and body condition scores than the 7/8 HG (456 ± 8 and 429 ± 8 kg and 3.13 ± 0.03 and 2.94 ± 0.03 BCS for 3/4 HG and 7/8 HG, respectively). Milk from cows fed the high-energy diet had higher percentages of fat, protein, lactose, and total dry extract than cows fed the low-energy diet. Cows fed the high-energy diet had higher net energy intake (95.3 ± 1.9 vs. 88.1 ± 2.1 MJ/day) and higher energy balance (3.64 ± 2.13 vs - 6.02 ± 2.30 MJ/day). The 3/4 HG cows displayed higher energy for maintenance (33.1 ± 0.4 MJ/day) than the 7/8 HG (31.5 ± 0.5 MJ /day). In conclusion, although the primiparous 3/4 HG were heavier than the 7/8 HG and had a higher body condition score, no differences in milk produced up to 60 days postpartum were observed. The higher energy diet during the postpartum period increased energy balance, resulting in higher production of milk fat, protein, and lactose.