Case report: persistent double dorsal aorta.

Persistent double dorsal aorta is an extremely rare congenital anomaly, with only 13 cases published to date. The objective of this study is to present this embryological variant as observed in the abdominal aorta of a patient. The anatomical description was written up on the basis of a review of electronic medical records and imaging exams. The patient in this case was an elderly 79-year-old man who presented at emergency with pain at rest in the left lower limb. He was admitted and laboratory tests and imaging exams were ordered. The variation was an imaging finding observed on angiotomography, consisting of complete separation of the abdominal aorta into two portions - a ventral and a dorsal, with different calibers - at the level of the third lumbar vertebra. There was also an anomalous origin of the inferior mesenteric artery.

Is the facial bone wall critical to achieving esthetic outcomes in immediate implant placement with immediate restoration? A systematic review.

BACKGROUND: Rehabilitation in the anterior region requires specific conditions for success, such as the presence of papilla, emergence profile, and balance between pink and white esthetic. OBJECTIVES: This systematic review aimed to evaluate the esthetic risk associated with immediate implant placement with immediate restoration in the anterior superior area, where the facial bone plate may be absent or deficient. MATERIAL AND METHODS: The search was done in PubMed, Embase, Cochrane, Lilacs, Scopus, Scielo, and Google Scholar databases. The investigation involved clinical studies and observational studies published between January 2012 and July 2023. Studies were excluded if there was less than 12-month follow-up, no immediate restoration or facial defect, heavy smokers, or systemic disease. The risk of bias was assessed using the ROBINS-I and Modified-Cochrane RoB tools. RESULTS: Twelve studies were included in this systematic review. The thinner the facial plate, the higher the alveolus's risk of gingival recession or shrinkage. There was an increased interproximal recession when the thin phenotype was associated with flap surgery. An increase in pink esthetic score (PES) was reached when immediate implant placement (IIP) and immediate restoration were done. Soft tissue augmentation achieved more gingival-level stability. Regardless of the initial phenotype, an esthetic outcome was delivered. The risk of bias was high in 1 study and moderate in 3 studies. CONCLUSION: It is possible to conclude that esthetic results and increased final PES or patient satisfaction index in IIP treatments associated with immediate restoration could be obtained even in buccal bone wall defects or gingival recession, regardless of their extension.

The Dimensionality of the Moral Foundations: Contributions from the Moral Foundations Sacredness Scale in Four Societies.

Moral Foundations Theory proposes that five innate modules offer an intuitive response that drives our moral judgments. Various instruments were developed to measure the five moral foundations, including the MFV and the MFQ-30 which focus on deliberative moral reasoning. This approach is limited because intuitions are more basic and affect-laden. The Moral Foundations Sacredness Scale (MFSS) was designed to elicit responses that more closely resemble these phenomena. However, studies have not converged on a factorial structure for the MFSS, and measurement invariance has never been assessed. Our study sought to evaluate these properties across four adult samples, via Exploratory Structural Equation Modeling, and the associations between the MFSS's scales and relevant constructs. We found that a two-factor solution, reflecting the individualizing and binding foundations, had a reasonable fit, and had invariance (configural, metric, and scalar) across gender, age groups, and (configural) four international samples. The scales were reliable, had construct validity with the MFQ-30, and criterion-related validity with the binding moderately predicting belief in God/spirit and religious behaviors. The convergence we found regarding the MFSS's factorial structure across groups has important implications for the dimensionality of these constructs, and - ultimately - for the development of Moral Foundations Theory.

Relato de caso: aorta dorsal dupla persistente / Case report: persistent double dorsal aorta

Resumo A aorta dorsal dupla persistente é uma anomalia congênita extremamente rara, com apenas 13 casos publicados até o presente momento. Este estudo tem como objetivo apresentar a variação embriológica observada em aorta abdominal do paciente. A descrição anatômica foi realizada a partir da revisão de prontuário eletrônico e exames de imagem. Desta forma, o presente caso refere-se a um paciente idoso de 79 anos admitido em atendimento hospitalar por queixa de dor em membro inferior esquerdo ao repouso. Foi solicitada a internação do mesmo, assim como exames laboratoriais e de imagem. Obtida como um achado de imagem a partir de angiotomografia, a variação consiste na completa separação em duas porções: uma ventral e outra dorsal, de calibres diferentes, da aorta abdominal, ao nível da terceira vértebra lombar. Isso ocorre em conjunto com a origem anômala da artéria mesentérica inferior.

Abstract Persistent double dorsal aorta is an extremely rare congenital anomaly, with only 13 cases published to date. The objective of this study is to present this embryological variant as observed in the abdominal aorta of a patient. The anatomical description was written up on the basis of a review of electronic medical records and imaging exams. The patient in this case was an elderly 79-year-old man who presented at emergency with pain at rest in the left lower limb. He was admitted and laboratory tests and imaging exams were ordered. The variation was an imaging finding observed on angiotomography, consisting of complete separation of the abdominal aorta into two portions - a ventral and a dorsal, with different calibers - at the level of the third lumbar vertebra. There was also an anomalous origin of the inferior mesenteric artery.

Resistance of glaze application on indirect restorative CAD/CAM materials against abrasive toothbrushing wear.

PURPOSE: The aim of this study was to evaluate the effect of toothbrushing on the surface roughness (Sa), roughness profile (Rv), gloss units (GU) and surface morphology of three glazed ceramics. MATERIALS AND METHODS: Specimens (n=7) from different CAD/CAM materials 1- Lithium disilicate-based glass ceramic (IPS e.max CAD); 2- Zirconia-reinforced lithium silicate glass ceramic (Celtra Duo) and 3- 6 mol% yttria partially-stabilized zirconia (InCoris) were evaluated. IPS e.max CAD and InCoris specimens were sintered and all the groups were pre-polished and glazed according to the manufacturer's recommendations: IPS Ivocolor Glaze Paste (Ivoclar Vivadent) or Universal Overglaze High Flu (Dentsply/Sirona). Sa, Rv, GU and morphology were analyzed before and after brushing at 30.000, 120.000 and 180.000 cycles. The data of Sa and GU were analyzed by ANOVA two-way and post-hoc Tukey's test (α=0.05). Rv was analyzed by Kruskal-Wallis and Student-Newman-Keuls. The surface morphology was analyzed qualitatively. RESULTS: The Sa decreased significantly after 180.000 toothbrushing cycles for all materials tested. CE showed higher Rv than EM and IN, and IN showed the highest GU after 180.000 toothbrushing cycles, which promoted a polishing effect for all materials. CONCLUSION: Long-term toothbrushing was not able to jeopardize the glazed-surface of all tested materials compared to unbrushed.

Evidence on the need for early identification of asymptomatic true abdominal aortic aneurysm in pregnancy: A case report.

Pregnant women are more likely to face cardiovascular disease than non-pregnant women. However, abdominal aortic aneurysm is an extremely rare complication of pregnancy. Abdominal aortic aneurysms in pregnancy are difficult to identify in the early stage and are often diagnosed only when the symptoms have manifested. We report the case of a multiparous 35-year-old patient with a history of abnormal ascending aorta and ruled-out Marfan syndrome by genetic testing. After a multidisciplinary medical team evaluation, she delivered a live baby by cesarean section at 37 weeks of gestation, and the abdominal aortic aneurysm was repaired simultaneously. This case offers evidence-based recommendations for obstetricians to carry out preventive imaging examination for pregnant women with similar risk factors and provide successful experience in prenatal examination for similar diseases.

Three joint temperament-character configurations account for learning, personality and well-being: normative demographic findings in a representative national population.

Introduction: A common practice in research and clinical practice is to use data considered representative of a target population to compare and understand the personality characteristics of specific groups or specific individuals. To this end, numerous studies have presented normative data for the temperament and character traits outlined in Cloninger's psychobiological model of personality. However, recent genomic evidence demonstrates that human personality is organized as a complex hierarchy that ascends beyond the individual traits to multi-trait profiles that regulate emotional reactivity (temperament profiles) or goals and values (character profiles), and then to three phenotypic networks, which integrate temperament profiles and character profiles, that regulate learning. Given this recent understanding, our aim was to provide a novel and more comprehensive description of personality features at a societal level (using a stratified sample representative of the Portuguese population) by considering personality at its higher levels of complexity. Methods: Toward this goal, a stratified sample of 2,443 Portuguese adults responded to the Revised Temperament and Character Inventory (TCI-R). Results: We summarize the prevalence of (a) temperament profiles, (b) character profiles, and (c) integrated temperament-character networks within the whole sample, as well as for men vs. women and different age groups separately. Independent of age and education, women were more likely to be capable of resourceful productivity and helpful cooperation combined with being more intuitive, meditative and creative than men. Independent of age and gender, individuals with a degree were also more likely to present these biopsychosocial features. We also found that the organized character profile was most typical of adults in their 40s. Finally, the distribution of personality profiles across age differed as a function of gender: for men the oldest individuals had the most coherent personalities while high personality integration was most prevalent for women in their 30s. Discussion: These results have strong implications for research and intervention. In particular, these results are relevant for understanding the epidemiology of interactions between personality, mental health and well-being, including their expressions in a national population as a function of demographic characteristics.

Atrial standstill associated with lamin A/C mutation: A case report.

The case report shares evidence for a better understanding of atrial standstill. This being a rare arrhythmogenic condition. This is a 46-year-old woman presented with multiple sites of arterial embolism, including lower extremity arteries, coronary artery, and cerebral artery. Unexpectedly, multiple arterial embolization in the patient was due to atrial standstill by transthoracic echocardiography and cardiac electrophysiological study. An additional family investigation revealed that the patient's brother and sister also suffered from this disease. In search of further understanding the case, we carried out the genetic testing of the family and a frame shift double-G insertion mutation at c.1567 in the LMNA gene was found in all the three individuals. The patient recovered well after anticoagulation therapy and left bundle branch area pacing. This report remarks on the importance of multiple sites of arterial embolism which should be wary of family atrial standstill.

Review on Geopolymers as Wellbore Sealants: State of the Art Optimization for CO2 Exposure and Perspectives.

Wellbores used in underground production and storage activities, including carbon capture and storage (CCS), are typically sealed using sealants based on Ordinary Portland Cement (OPC). However, leakage along these seals or through them during CCS operations can pose a significant threat to long-term storage integrity. In this review paper, we explore the potential of geopolymer (GP) systems as alternative sealants in wells exposed to CO2 during CCS. First, we discuss how key parameters control the mechanical properties, permeability, and chemical durability of GPs based on different starting materials as well as their optimum values. These parameters include the chemical and mineralogical composition, particle size, and particle shape of the precursor materials; the composition of the hardener; the chemistry of the full system (particularly the Si/Al, Si/(Na+K), Si/Ca, Si/Mg, and Si/Fe ratios); the water content of the mix; and the conditions under which curing occurs. Next, we review existing knowledge on the use of GPs as wellbore sealants to identify key knowledge gaps and challenges and the research needed to address these challenges. Our review shows the great potential of GPs as alternative wellbore sealant materials in CCS (as well as other applications) due to their high corrosion durability, low matrix permeability, and good mechanical properties. However, important challenges are identified that require further research, such as mix optimization, taking into account curing and exposure conditions and available starting materials; the development of optimalization workflows, along with building larger data sets on how the identified parameters affect GP properties, can streamline this optimization for future applications.

Update of dialysis initiation timing in end stage kidney disease patients: is it a resolved question? A systematic literature review.

BACKGROUND: The exact optimal timing of dialysis for ESKD patients remains unknown. This study systematically reviewed the available evidence with regard to the optimal initiation of maintenance dialysis in ESKD patients. METHODS: An electronic search was performed in Embase, PubMed and the Cochrane Library in order to find studies investigating associations between variables reference to "start of dialysis" and outcomes. Quality assessment and bias assessment were performed by the Newcastle-Ottawa scale and the ROBINSI tool. Due to the heterogeneity of studies, a meta-analysis could not be performed. RESULTS: Thirteen studies were included; four studies included only haemodialysis patients, three peritoneal dialysis, six both; study outcomes included mortality, cardiovascular events, technique failure, quality of life and others. Nine studies mainly focused on the optimal GFR of maintenance dialysis initiation; five studies showed none association between GFR and mortality or other adverse outcomes, two studies showed dialysis initiation at higher GFR levels were with poor prognosis, and 2 studies showed higher GFR levels with better prognosis. Three studies paid attention to comprehensive assessment of uremic signs and/or symptoms for optimal dialysis initiation; uremic burden based on 7 uremic indicators (hemoglobin, serum albumin, blood urea nitrogen, serum creatinine, potassium, phosphorus, and bicarbonate) were not associated with mortality; another equation (combination of sex, age, serum creatinine, blood urea nitrogen, serum albumin, haemoglobin, serum phosphorus, diabetes mellitus, and heart failure) based on fuzzy mathematics to assess the timing of haemodialysis initiation was accuracy to prognose 3-year survival; the third study found that volume overload or hypertension was associated with the highest risk for subsequent mortality. Two studies compared urgent or optimal start in dialysis, a study reported increased survival in optimal start patients, another reported no differences between Urgent-Start-PD and Early-Start-PD regarding 6-month outcomes. LIMITATIONS: Heterogeneity among the studies was quite high, with differences in sample size, variable and group characteristics; no RCT studies were included, which weakened the strength of evidences. CONCLUSIONS: The criteria for dialysis initiation were varied. Most studies proved that GFR at dialysis initiation was not associated with mortality, timing of dialysis initiation should not be based on GFR, assessments of volume load and patient's tolerance to volume overload are prospective approaches.

Association between specific social activities and depressive symptoms among older adults: A study of urban-rural differences in China.

Background: Engaging in social activities can help older persons with their depressed symptoms. Few studies, however, have looked into the connection between social interactions and depressed symptoms in Chinese older persons. The aim of this study was to investigate differences in older Chinese individuals' social activity involvement and depressive symptoms across urban and rural settings. Methods: A cross-sectional investigation using information from the 2018 China Health and Retirement Longitudinal Study (CHARLS), which was limited to older individuals aged 60 and over. Generalized linear models were constructed to assess the effects of participants' characteristics and specific social activities on CES-D scores. The association between specific social activities and depressed symptoms was investigated using multivariate logistic regression analysis. Results: In this study, it was discovered that older individuals had a prevalence of depressed symptoms of 36.2%, with rural older adults having a greater prevalence of depressive symptoms (39.7%) than urban older adults (30.9%). Our results showed that for urban respondents, providing help to others (not regularly. OR = 0.753, 95% CI: 0.579-0.980, P = 0.035), going to a sport (not regularly. OR = 0.685, 95% CI: 0.508-0.924, P = 0.013), and using the Internet (not regular. OR = 0.613, 95% CI: 0.477-0.789, P < 0.001; almost weekly. OR = 0.196, 95% CI: 0.060-0.645, P = 0.007) were all significantly and negatively associated with depressive symptoms, while for rural respondents, interacting with friends (not regularly. OR = 1.205, 95% CI: 1.028-01.412, P = 0.021) and using the Internet (not regularly. OR = 0.441, 95% CI: 0.278-0.698, P < 0.001) were significantly and negatively associated with depressive symptoms. Conclusions: According to our research, there is a cross-sectional relationship between participating in a specific social activity and depressed symptoms in Chinese older adults, and this relationship varies across urban and rural older adults. This suggests that taking part in specific social activities may be crucial for reducing depression symptoms in older persons, developing more focused interventions that might support healthy aging, and offering a guide for policymakers and activists working to improve the mental health of seniors.

Next-Generation Leishmanization: Revisiting Molecular Targets for Selecting Genetically Engineered Live-Attenuated Leishmania.

Despite decades of research devoted to finding a vaccine against leishmaniasis, we are still lacking a safe and effective vaccine for humans. Given this scenario, the search for a new prophylaxis alternative for controlling leishmaniasis should be a global priority. Inspired by leishmanization-a first generation vaccine strategy where live L. major parasites are inoculated in the skin to protect against reinfection-live-attenuated Leishmania vaccine candidates are promising alternatives due to their robust elicited protective immune response. In addition, they do not cause disease and could provide long-term protection upon challenge with a virulent strain. The discovery of a precise and easy way to perform CRISPR/Cas-based gene editing allowed the selection of safer null mutant live-attenuated Leishmania parasites obtained by gene disruption. Here, we revisited molecular targets associated with the selection of live-attenuated vaccinal strains, discussing their function, their limiting factors and the ideal candidate for the next generation of genetically engineered live-attenuated Leishmania vaccines to control leishmaniasis.

Effect of Educational Intervention on Knowledge and Level of Adherence among Hemodialysis Patients: A Randomized Controlled Trial.

Purpose: The purpose of the study was to assess the impact of an educational intervention on the level of knowledge and adherence to the treatment regimen among hemodialysis (HD) patients as well as to describe the association between these variables. Methods: In this randomized controlled trial, 160 HD patients at an HD centre of a 2030-bed tertiary teaching hospital in Southern India were randomly assigned into intervention (N = 80, received education and a booklet) and control (N = 80, received standard care) groups. Knowledge and adherence were measured preintervention and postintervention using a validated questionnaire for knowledge and the ESRD-AQ (End-Stage Renal Disease Questionnaire) for the level of adherence. The statistical analysis of the data was performed with the help of the Statistical Program SPSS version 19.0. The statistical significance level was set at 0.05. Results: The increase in knowledge on disease management, fluid adherence, and dietary adherence in the intervention group was significantly higher compared to the control group. There was no significant correlation between knowledge and adherence. Adherence improved for all the domains, i.e., dialysis attendance, episodes of shortening, adherence to medication, fluid restriction, and dietary restriction. Adherence to fluid and dietary restriction was statistically significant. This trail is registered with https://clinicaltrials.gov/ct2/show/CTRI/2018/05/014166.

Subjective well-being and school engagement before versus during the COVID-19 pandemic: What good are positive emotions?

The present study overcomes the limited empirical evidence on the association between well-being and school engagement in times of adversity by exploiting available data from two large and comparable samples of eighth graders; one obtained prior to the COVID-19 pandemic and the second obtained during the pandemic. Results suggest that adolescents were less engaged with their learning context during the pandemic, as well as lower in positive and negative affect, but slightly more satisfied with life. Through SEM we found a stronger positive association between positive affect and school engagement in the COVID-19 group compared with the pre-COVID-19 group. This finding highlights the important role of positive affect in supporting better academic functioning in the aftermath of a global crisis.

Disentangling the personality pathways to well-being.

Recent genomic, psychological, and developmental research shows that human personality is organized as a complex hierarchy that ascends from individual traits in many specific situations to multi-trait profiles in two domains that regulate emotional reactivity (temperament) or goals and values (character), and finally to three integrated temperament-character networks that regulate learning to maintain well-being in changing conditions. We carried out person-centered analyses of the components of subjective well-being (positive affect, negative affect, and life satisfaction) to personality in both adolescents (N = 1739) and adults (N = 897). Personality was considered at each level of its organization (trait, temperament or character profiles, and joint temperament-character networks). We show for the first time that negative affect and life satisfaction are dependent on the personality network for intentional self-control, whereas positive affect is dependent on the personality network for self-awareness that underlies the human capacities for healthy longevity, creativity, and prosocial values.

Antiplasmodial activity of coumarins isolated from Polygala boliviensis: in vitro and in silico studies.

Polygala boliviensis is found in the Brazilian semiarid region. This specie is little chemically and biologically studied. Polygala spp. have different metabolites, especially coumarins. Studies indicate that coumarins have antimalarial potential, denoting the importance of researching new active compounds from plants, since the resistance of Plasmodium strains to conventional therapy has increased. The present study aimed to evaluate the antiplasmodial activity of auraptene and poligalen against a chloroquine-resistant strain of Plasmodium falciparum. Coumarins were isolated from P. boliviensis by open column chromatography and identified by Nuclear Magnetic Resonance Spectroscopy. A cytotoxicity assay was carried out using MTT test, and the in vitro antiplasmodial activity was evaluated using the W2 strain. The antiplasmodial activity results found were IC50=0.171 ± 0.016 for auraptene and 0.164 ± 0.012 for poligalen; the selectivity indexes were 78.71 and 609.76, respectively. Inverse virtual screening in the BRAMMT database by OCTOPUS 1.2 was applied to coumarins to find potential P. falciparum targets and showed higher affinity energy of auraptene for purine nucleoside phosphorylase (PfPNP) and of poligalen for dihydroorotate dehydrogenase (PfDHODH). Molecular Dynamics studies (MD and MM-GBSA) approach were applied to calculate binding energies against selected P. falciparum targets and showed that all coumarins were stable at the binding site during simulations. Furthermore, energies were favorable for complexation. This is the first report of auraptene in P. boliviensis species and of in vitro antiplasmodial activity of auraptene and poligalen. In silico studies indicated that the mechanism of action of coumarins is the inhibition of PfPNP and PfDHODH.Communicated by Ramaswamy H. Sarma.

The Twenty Item Values Inventory (TwIVI) in Portuguese Adults: Factorial Structure, Internal Consistency, and Criterion-Related Validity.

The Schwartz Model of Basic Values is an influential framework that describes what people find important and worth pursuing in life. The model proposes that ten human values are found cross-culturally, and so significant efforts have gone into empirically testing these claims. While instruments such as the Portrait Values Questionnaire-40 (PVQ-40) reliably discriminated the full set of theorized values, briefer versions have either suffered from a lack of construct validity (PVQ-21) or from not having been put through a rigorous statistical test of its underlying structure (Twenty Item Values Inventory [TwIVI]) via confirmatory factor analysis (CFA). The present study, using a Portuguese sample of adults (n = 524), is the first to examine the factorial structure of the TwIVI via CFA. We apply a magnifying glass approach by testing two separate models, each covering five values, which reflect the Growth and Self-protective dimensions. Moreover, we provide evidences that the TwIVI is reliable and capable of capturing the theorized quasi-circumplex structure, and the cross-cultural gender differences and relative hierarchical importance of values. Finally, we establish criterion-related validity, with values correlating with political identity and social and economic issues.

Morphology of the brain base arteries of the giant anteater (Myrmecophaga tridactyla)

This study aimed to describe the brain base arteries of the Myrmecophaga tridactyla using ten cadavers of adults from this species, including five male and five female specimens. The arterial vascular bed was perfused via the thoracic aorta with a dyed natural latex solution, and the animals were fixed and preserved with a 10% formaldehyde buffered solution. The encephala were removed, and their vessels dissected. Basilar artery formation occurred by anastomosis of the thick ventral spinal artery with vertebral arteries. The basilar artery formed two arterial islands and gave bulbar and pontine branches, and cranial, middle, and caudal cerebellar arteries and ended by forking into its terminal branches, the caudal communicating arteries. The blood supply of the encephalon derived solely from the vertebrobasilar system, and the arterial circle of the brain was closed caudally and rostrally. The absence of participation of internal carotid arteries in encephalon irrigation, the island formations by the basilar artery, and the fusiform shape of the arterial circle of the brain are peculiar characteristics of the vascular anatomy of the brain base of M. tridactyla.

Reduction of retinal vessel density in non-exudative macular neovascularization: a retrospective study.

Purpose: The purpose of this study is to identify predictive activation biomarkers in retinal microvascular characteristics of non-exudative macular neovascularization (MNV) and avoid delayed treatment or overtreatment of subclinical MNV. The main objective is to contribute to the international debate on a new understanding of the role of retinal vessel features in the pathogenesis and progression of non-exudative MNV and age-related macular degeneration (AMD). A discussion on revising-related clinical protocols is presented. Methods: In this retrospective study, the authors included eyes with non-exudative MNV, eyes with exudative AMD, and normal eyes of age-matched healthy subjects. The parameters were obtained by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Results: In total, 21 eyes with exudative AMD, 21 eyes with non-exudative MNV, and 20 eyes of 20 age-matched healthy subjects without retinal pathology were included. Vessel density (VD) of the deep vascular complex (DVC) in eyes with non-exudative MNV was significantly greater than that in eyes with exudative AMD (p = 0.002), while for superficial vascular plexus (SVP) metrics, no VD differences among sectors were observed between eyes with non-exudative MNV and eyes with exudative AMD. Conclusion: The reduction in retinal vessel density, especially in the DVC, seems to be involved in or be accompanied by non-exudative MNV activation and should be closely monitored during follow-up visits in order to ensure prompt anti-angiogenic therapy. A discussion on applicable clinical protocols is presented aiming to contribute to new insights into ophthalmology service development which is directed to this specific type of patient and diagnosis.