Near infrared spectroscopy for cooking time classification of cassava genotypes.

Cooking time is a crucial determinant of culinary quality of cassava roots and incorporating it into the early stages of breeding selection is vital for breeders. This study aimed to assess the potential of near-infrared spectroscopy (NIRS) in classifying cassava genotypes based on their cooking times. Five cooking times (15, 20, 25, 30, and 40 minutes) were assessed and 888 genotypes evaluated over three crop seasons (2019/2020, 2020/2021, and 2021/2022). Fifteen roots from five plants per plot, featuring diameters ranging from 4 to 7 cm, were randomly chosen for cooking analysis and spectral data collection. Two root samples (15 slices each) per genotype were collected, with the first set aside for spectral data collection, processed, and placed in two petri dishes, while the second set was utilized for cooking assessment. Cooking data were classified into binary and multiclass variables (CT4C and CT6C). Two NIRs devices, the portable QualitySpec® Trek (QST) and the benchtop NIRFlex N-500 were used to collect spectral data. Classification of genotypes was carried out using the K-nearest neighbor algorithm (KNN) and partial least squares (PLS) models. The spectral data were split into a training set (80%) and an external validation set (20%). For binary variables, the classification accuracy for cassava cooking time was notably high ( R C a l 2 ranging from 0.72 to 0.99). Regarding multiclass variables, accuracy remained consistent across classes, models, and NIR instruments (~0.63). However, the KNN model demonstrated slightly superior accuracy in classifying all cooking time classes, except for the CT4C variable (QST) in the NoCook and 25 min classes. Despite the increased complexity associated with binary classification, it remained more efficient, offering higher classification accuracy for samples and facilitating the selection of the most relevant time or variables, such as cooking time ≤ 30 minutes. The accuracy of the optimal scenario for classifying samples with a cooking time of 30 minutes reached R C a l 2   = 0.86 and R V a l 2 = 0.84, with a Kappa value of 0.53. Overall, the models exhibited a robust fit for all cooking times, showcasing the significant potential of NIRs as a high-throughput phenotyping tool for classifying cassava genotypes based on cooking time.

The relationship between the level of vitamin D and ruptured intracranial aneurysms among patients with high sun exposure.

Non-traumatic subarachnoid hemorrhage (SAH) accounts for 3-5% of acute strokes. Intracranial aneurysm is the most common cause of non-traumatic SAH. Vitamin D influences the cardiovascular system, including the formation and rupture of cerebral aneurysms. To evaluate the serum vitamin D level in patients living in the tropical zone who suffered aneurysmal subarachnoid hemorrhage and its correlation with demographic and neurological characteristics. This is an analytical cross-sectional study to assess the serum level of vitamin D in a study population of 99 patients treated and diagnosed with aSAH in a public hospital in Recife-PE over a period of 12 months. In the study sample, composed of individuals with high sun exposure due to the lifestyle they lead in a tropical region, we observed hypovitaminosis D (85.9%), with a median of 19.9 ng/ml, although the majority of individuals are skin with high concentration of melanin (Fitzpatrick skin type IV and V). In addition, rates of sun exposure are high to all patients (Solar Index 9.03 P50). Most individuals were female (79.8%); there was no statistical difference in solar exposure/solar index between genders. As for the neurological repercussions, there was no statistical relevance in the clinical prognostic scales evaluated. As the sample was composed mainly of individuals whose economic activity is agriculture, the values of solar index found are vastly higher than those of other studies conducted in high latitude regions. In line with the literature review, some aspects were raised with the objective of justifying such findings that go from the base of the poor diet of these individuals, the increase of melanin in the skin and genetic alterations that directs us to possible mechanisms of natural photoprotection to high sun exposure. Thus, we had a vast majority (85%) of hypovitaminosis D, which in fact makes us wonder if there is any influence of calcitriol on vitamin D receptors in vascular walls and in the cardiovascular system as a whole, which influence bleeding events of this nature. As for the neurological repercussions, measured using assessment scales (Glasgow coma scale, WFNS scale, Hunt-Hess and Fisher's tomographic scale) there was no significant difference in the results. As it is only a descriptive study, the causal relationship of the facts cannot be established. However, in a population exposed to high sun exposure and affected by aneurysmal SAH, there is a significant rate of hypovitaminosis D, which supports the hypothesis that vitamin D plays a role in vascular pathologies, such as cerebral aneurysms and SAH.

Flowering induction in cassava using photoperiod extension premature pruning and plant growth regulators.

Cassava (Manihot esculenta Crantz) is a vital crop for food and economic security in many regions of the world. Despite the economic and social importance of cassava, challenges persist in developing superior varieties that meet the needs of farmers in terms of agronomic performance, nutritional quality, and resistance to pests and diseases. One of the main obstacles for genetic improvement is the lack of synchronization in flowering and the abortion of young flowers, making planned crosses and progeny production difficult. Therefore, the aim of this study was to evaluate the effect of photoperiod, premature pruning, and growth regulators on cassava flowering under low-altitude conditions in Brazil. Eight cassava clones with contrasting flowering capacity were assessed in Cruz das Almas, Bahia, using two photoperiods (ambient condition and extended photoperiod with red light for 12 hours), premature pruning at the first and second branching levels (with and without pruning), and the application of growth regulators: 0.5 mM 6-benzyladenine (BA) and 4.0 mM silver thiosulfate (STS) (with and without). Plots were assessed weekly for the number of female (NFF) and male (NMF) flowers, height of the first branching (H1B, in cm), number of days to the first branching (ND1B), and the number of branching events up to 240 days after planting (NOB). The extended photoperiod did not promote an increase in the number of flowers but allowed for precocity in cassava flowering, reducing the onset of flowering by up to 35 days, and significantly increasing the number of branches, which is closely related to flowering. The use of pruning and plant growth regulators (PGR) resulted in an increase in NFF from 2.2 (control) to 4.6 and NMF from 8.1 to 21.1 flowers. Therefore, under hot and humid tropical conditions at low altitudes in the Recôncavo of Bahia, manipulating the photoperiod and using premature pruning and plant growth regulators can accelerate cassava flowering, benefiting genetic improvement programs.

Near-infrared spectroscopy for early selection of waxy cassava clones via seed analysis.

Cassava (Manihot esculenta Crantz) starch consists of amylopectin and amylose, with its properties determined by the proportion of these two polymers. Waxy starches contain at least 95% amylopectin. In the food industry, waxy starches are advantageous, with pastes that are more stable towards retrogradation, while high-amylose starches are used as resistant starches. This study aimed to associate near-infrared spectrophotometry (NIRS) spectra with the waxy phenotype in cassava seeds and develop an accurate classification model for indirect selection of plants. A total of 1127 F2 seeds were obtained from controlled crosses performed between 77 F1 genotypes (wild-type, Wx_). Seeds were individually identified, and spectral data were obtained via NIRS using a benchtop NIRFlex N-500 and a portable SCiO device spectrometer. Four classification models were assessed for waxy cassava genotype identification: k-nearest neighbor algorithm (KNN), C5.0 decision tree (CDT), parallel random forest (parRF), and eXtreme Gradient Boosting (XGB). Spectral data were divided between a training set (80%) and a testing set (20%). The accuracy, based on NIRFlex N-500 spectral data, ranged from 0.86 (parRF) to 0.92 (XGB). The Kappa index displayed a similar trend as the accuracy, considering the lowest value for the parRF method (0.39) and the highest value for XGB (0.71). For the SCiO device, the accuracy (0.88-0.89) was similar among the four models evaluated. However, the Kappa index was lower than that of the NIRFlex N-500, and this index ranged from 0 (parRF) to 0.16 (KNN and CDT). Therefore, despite the high accuracy these last models are incapable of correctly classifying waxy and non-waxy clones based on the SCiO device spectra. A confusion matrix was performed to demonstrate the classification model results in the testing set. For both NIRS, the models were efficient in classifying non-waxy clones, with values ranging from 96-100%. However, the NIRS differed in the potential to predict waxy genotype class. For the NIRFlex N-500, the percentage ranged from 30% (parRF) to 70% (XGB). In general, the models tended to classify waxy genotypes as non-waxy, mainly SCiO. Therefore, the use of NIRS can perform early selection of cassava seeds with a waxy phenotype.

Image-based phenotyping of cassava roots for diversity studies and carotenoids prediction.

Phenotyping to quantify the total carotenoids content (TCC) is sensitive, time-consuming, tedious, and costly. The development of high-throughput phenotyping tools is essential for screening hundreds of cassava genotypes in a short period of time in the biofortification program. This study aimed to (i) use digital images to extract information on the pulp color of cassava roots and estimate correlations with TCC, and (ii) select predictive models for TCC using colorimetric indices. Red, green and blue images were captured in root samples from 228 biofortified genotypes and the difference in color was analyzed using L*, a*, b*, hue and chroma indices from the International Commission on Illumination (CIELAB) color system and lightness. Colorimetric data were used for principal component analysis (PCA), correlation and for developing prediction models for TCC based on regression and machine learning. A high positive correlation between TCC and the variables b* (r = 0.90) and chroma (r = 0.89) was identified, while the other correlations were median and negative, and the L* parameter did not present a significant correlation with TCC. In general, the accuracy of most prediction models (with all variables and only the most important ones) was high (R2 ranging from 0.81 to 0.94). However, the artificial neural network prediction model presented the best predictive ability (R2 = 0.94), associated with the smallest error in the TCC estimates (root-mean-square error of 0.24). The structure of the studied population revealed five groups and high genetic variability based on PCA regarding colorimetric indices and TCC. Our results demonstrated that the use of data obtained from digital image analysis is an economical, fast, and effective alternative for the development of TCC phenotyping tools in cassava roots with high predictive ability.

Increasing cassava root yield: Additive-dominant genetic models for selection of parents and clones.

Genomic selection has been promising in situations where phenotypic assessments are expensive, laborious, and/or inefficient. This work evaluated the efficiency of genomic prediction methods combined with genetic models in clone and parent selection with the goal of increasing fresh root yield, dry root yield, as well as dry matter content in cassava roots. The bias and predictive ability of the combinations of prediction methods Genomic Best Linear Unbiased Prediction (G-BLUP), Bayes B, Bayes Cπ, and Reproducing Kernel Hilbert Spaces with additive and additive-dominant genetic models were estimated. Fresh and dry root yield exhibited predominantly dominant heritability, while dry matter content exhibited predominantly additive heritability. The combination of prediction methods and genetic models did not show significant differences in the predictive ability for dry matter content. On the other hand, the prediction methods with additive-dominant genetic models had significantly higher predictive ability than the additive genetic models for fresh and dry root yield, allowing higher genetic gains in clone selection. However, higher predictive ability for genotypic values did not result in differences in breeding value predictions between additive and additive-dominant genetic models. G-BLUP with the classical additive-dominant genetic model had the best predictive ability and bias estimates for fresh and dry root yield. For dry matter content, the highest predictive ability was obtained by G-BLUP with the additive genetic model. Dry matter content exhibited the highest heritability, predictive ability, and bias estimates compared with other traits. The prediction methods showed similar selection gains with approximately 67% of the phenotypic selection gain. By shortening the breeding cycle time by 40%, genomic selection may overcome phenotypic selection by 10%, 13%, and 18% for fresh root yield, dry root yield, and dry matter content, respectively, with a selection proportion of 15%. The most suitable genetic model for each trait allows for genomic selection optimization in cassava with high selection gains, thereby accelerating the release of new varieties.

Reproductive barriers in cassava: Factors and implications for genetic improvement.

Cassava breeding is hampered by high flower abortion rates that prevent efficient recombination among promising clones. To better understand the factors causing flower abortion and propose strategies to overcome them, we 1) analyzed the reproductive barriers to intraspecific crossing, 2) evaluated pollen-pistil interactions to maximize hand pollination efficiency, and 3) identified the population structure of elite parental clones. From 2016 to 2018, the abortion and fertilization rates of 5,748 hand crossings involving 91 parents and 157 progenies were estimated. We used 16,300 single nucleotide polymorphism markers to study the parents' population structure via discriminant analysis of principal components, and three clusters were identified. To test for male and female effects, we used a mixed model in which the environment (month and year) was fixed, while female and male (nested to female) were random effects. Regardless of the population structure, significant parental effects were identified for abortion and fertilization rates, suggesting the existence of reproductive barriers among certain cassava clones. Matching ability between cassava parents was significant for pollen grains that adhered to the stigma surface, germinated pollen grains, and the number of fertilized ovules. Non-additive genetic effects were important to the inheritance of these traits. Pollen viability and pollen-pistil interactions in cross- and self-pollination were also investigated to characterize pollen-stigma compatibility. Various events related to pollen tube growth dynamics indicated fertilization abnormalities. These abnormalities included the reticulated deposition of callose in the pollen tube, pollen tube growth cessation in a specific region of the stylet, and low pollen grain germination rate. Generally, pollen viability and stigma receptivity varied depending on the clone and flowering stage and were lost during flowering. This study provides novel insights into cassava reproduction that can assist in practical crossing and maximize the recombination of contrasting clones.

Identification and validation of mutation points associated with waxy phenotype in cassava.

BACKGROUND: The granule-bound starch synthase I (GBSSI) enzyme is responsible for the synthesis of amylose, and therefore, its absence results in individuals with a waxy starch phenotype in various amylaceous crops. The validation of mutation points previously associated with the waxy starch phenotype in cassava, as well as the identification of alternative mutant alleles in the GBSSI gene, can allow the development of molecular-assisted selection to introgress the waxy starch mutation into cassava breeding populations. RESULTS: A waxy cassava allele has been identified previously, associated with several SNPs. A particular SNP (intron 11) was used to develop SNAP markers for screening heterozygote types in cassava germplasm. Although the molecular segregation corresponds to the expected segregation at 3:1 ratio (dominant gene for the presence of amylose), the homozygotes containing the SNP associated with the waxy mutation did not show waxy phenotypes. To identify more markers, we sequenced the GBSS gene from 89 genotypes, including some that were segregated from a cross with a line carrying the known waxy allele. As a result, 17 mutations in the GBSSI gene were identified, in which only the deletion in exon 6 (MeWxEx6-del-C) was correlated with the waxy phenotype. The evaluation of mutation points by discriminant analysis of principal component analysis (DAPC) also did not completely discriminate the waxy individuals. Therefore, we developed Kompetitive Allele Specific PCR (KASP) markers that allowed discrimination between WX and wx alleles. The results demonstrated the non-existence of heterozygous individuals of the MeWxEx6-del-C deletion in the analyzed germplasm. Therefore, the deletion MeWxEx6-del-C should not be used for assisted selection in genetic backgrounds different from the original source of waxy starch. Also, the alternative SNPs identified in this study were not associated with the waxy phenotype when compared to a panel of accessions with high genetic diversity. CONCLUSION: Although the GBSSI gene can exhibit several mutations in cassava, only the deletion in exon 6 (MeWxEx6-del-C) was correlated with the waxy phenotype in the original AM206-5 source.

Effect of F1 and F2 generations on genetic variability and working steps of doubled haploid production in maize.

For doubled haploid (DH) production in maize, F1 generation has been the most frequently used for haploid induction due to facility in the process. However, using F2 generation would be a good alternative to increase genetic variability owing to the additional recombination in meiosis. Our goals were to compare the effect of F1 and F2 generations on DH production in tropical germplasm, evaluating the R1-navajo expression in seeds, the working steps of the methodology, and the genetic variability of the DH lines obtained. Sources germplasm in F1 and F2 generations were crossed with the tropicalized haploid inducer LI-ESALQ. After harvest, for both induction crosses were calculated the haploid induction rate (HIR), diploid seed rate (DSR), and inhibition seed rate (ISR) using the total number of seeds obtained. In order to study the effectiveness of the DH working steps in each generation, the percentage per se and the relative percentage were verified. In addition, SNP markers were obtained for genetic variability studies. Results showed that the values for HIR, ISR, and DSR were 1.23%, 23.48%, and 75.21% for F1 and 1.78%, 15.82%, and 82.38% for F2, respectively. The effectiveness of the DH working step showed the same percentage per se value (0.4%) for F1 and F2, while the relative percentage was 27.2% for F1 and 22.4% for F2. Estimates of population parameters in DH lines from F1 were higher than F2. Furthermore, population structure and kinship analyses showed that one additional generation was not sufficient to create new genotype subgroups. Additionally, the relative efficiency of the response to selection in the F1 was 31.88% higher than F2 due to the number of cycles that are used to obtain the DH. Our results showed that in tropical maize, the use of F1 generation is recommended due to a superior balance between time and genetic variability.

Cassava yield traits predicted by genomic selection methods.

Genomic selection (GS) has been used to optimize genetic gains when phenotypic selection is considered costly and difficult to measure. The objective of this work was to evaluate the efficiency and consistency of GS prediction for cassava yield traits (Manihot esculenta Crantz) using different methods, taking into account the effect of population structure. BLUPs and deregressed BLUPs were obtained for 888 cassava accessions and evaluated for fresh root yield, dry root yield and dry matter content in roots in 21 trials conducted from 2011 to 2016. The deregressed BLUPs obtained for the accessions from a 48K single nucleotide polymorphism dataset were used for genomic predictions based on the BayesB, BLASSO, RR-BLUP, G-BLUP and RKHS methods. The accessions' BLUPs were used in the validation step using four cross-validation strategies, taking into account population structure and different GS methods. Similar estimates of predictive ability and bias were identified for the different genomic selection methods in the first cross-validation strategy. Lower predictive ability was observed for fresh root yield (0.4569 -RR-BLUP to 0.4756-RKHS) and dry root yield (0.4689 -G-BLUP to 0.4818-RKHS) in comparison with dry matter content (0.5655 -BLASSO to 0.5670 -RKHS). However, the RKHS method exhibited higher efficiency and consistency in most of the validation scenarios in terms of prediction ability for fresh root yield and dry root yield. The correlations of the genomic estimated breeding values between the genomic selection methods were quite high (0.99-1.00), resulting in high coincidence of clone selection regardless of the genomic selection method. The deviance analyses within and between the validation clusters formed by the discriminant analysis of principal components were significant for all traits. Therefore, this study indicated that i) the prediction of dry matter content was more accurate compared to that of yield traits, possibly as a result of the smaller influence of non-additive genetic effects; ii) the RKHS method resulted in high and stable prediction ability in most of the validation scenarios; and iii) some kinship between the validation and training populations is desirable in order for genomic selection to succeed due to the significant effect of population structure on genomic selection predictions.

DIFFICULTIES IN COLLECTING DATA ON DUCTAL CARCINOMA IN SITU AT A POPULATION-BASED CANCER REGISTRY / Dificuldades na coleta de dados de carcinoma ductal in situ em um Registro de Câncer de Base Populacional

Objective: To verify data-coding accuracy for ductal carcinoma in situ at the Goiânia population-based cancer registry in the Brazilian state of Goiás. Methods: Ecological time series analysis of cases coded as ductal carcinoma in situ in the state cancer database (ONCOSIS), considering data from the Goiânia population-based cancer registry, from 1994 to 2010. Results: Of 376 cases originally coded as ductal carcinoma in situ, 115 were excluded following a review of the pathology reports. These exclusions referred to cases of lobular carcinoma in situ (n=21), Paget's disease (n=4), invasive carcinoma (n=08), ductal carcinoma in situ associated with invasive carcinoma (n=14), microinvasive carcinoma (n=21), records on non-residents in Goiânia, and duplicated data (n=46). Conclusion: Many cases needed recoding and, as a consequence, altered the initial database. Standardizing pathology reports and training data collection staff are crucial steps to avoid omissions and errors when transcribing cases of ductal carcinoma in situ in a population-based cancer registry database.

Objetivo: Verificar a acurácia da codificação dos dados de carcinoma ductal in situ dentro do Registro de Câncer de Base Populacional de Goiânia, Goiás - Brasil. Métodos: Estudo ecológico de série temporal de casos codificados como carcinoma in situ da mama, pelo programa (ONCOSIS) do Registro de Câncer de Base Populacional de Goiânia, entre 1994 e 2010. Posteriormente realizou­se busca individual dos laudos histopatológicos de CDIS. Resultados: De 376 casos de CDIS, foram excluídos 115 casos após a revisão dos laudos anatomopatológicosas. As exclusões referem-se a carcinoma lobular in situ (21), Doença de Paget (4), carcinoma invasor (08); CDIS associado a carcinoma invasor (14); microinvasor (21), pacientes com endereço fora de Goiânia e dados duplicados (46). Conclusão: Há um grande número de casos que precisam ser recodificados, alterando o banco inicial. A padronização de laudos e o treinamento dos coletadores são etapas importantes para que não haja informações desconhecidas ao transcrever o CDIS para as fichas do RCBP.

Modeling copy number variation in the genomic prediction of maize hybrids.

KEY MESSAGE: Our study indicates that copy variants may play an essential role in the phenotypic variation of complex traits in maize hybrids. Moreover, predicting hybrid phenotypes by combining additive-dominance effects with copy variants has the potential to be a viable predictive model. Non-additive effects resulting from the actions of multiple loci may influence trait variation in single-cross hybrids. In addition, complementation of allelic variation could be a valuable contributor to hybrid genetic variation, especially when crossing inbred lines with higher contents of copy gains. With this in mind, we aimed (1) to study the association between copy number variation (CNV) and hybrid phenotype, and (2) to compare the predictive ability (PA) of additive and additive-dominance genomic best linear unbiased prediction model when combined with the effects of CNV in two datasets of maize hybrids (USP and HELIX). In the USP dataset, we observed a significant negative phenotypic correlation of low magnitude between copy number loss and plant height, revealing a tendency that more copy losses lead to lower plants. In the same set, when CNV was combined with the additive plus dominance effects, the PA significantly increased only for plant height under low nitrogen. In this case, CNV effects explicitly capture relatedness between individuals and add extra information to the model. In the HELIX dataset, we observed a pronounced difference in PA between additive (0.50) and additive-dominance (0.71) models for predicting grain yield, suggesting a significant contribution of dominance. We conclude that copy variants may play an essential role in the phenotypic variation of complex traits in maize hybrids, although the inclusion of CNVs into datasets does not return significant gains concerning PA.

Visual Outcomes and Aberrometric Changes With Topography-Guided Photorefractive Keratectomy Treatment of Irregular Astigmatism After Penetrating Keratoplasty.

PURPOSE: To evaluate the visual acuity and keratometric and aberrometric changes in patients with corneal transplants (PKP), who underwent topography-guided photorefractive keratectomy (TG-PRK) with mitomycin C (MMC). METHODS: In this case study, 15 patients with spherical equivalents ranging from -11.00 to -0.25 diopters (D) who underwent penetrating corneal transplantation and had irregular astigmatism ranging from -7.5 to -2.0 D underwent TG-PRK with MMC. Corneal topography and wavefront of all patients were measured preoperatively and 12 months postoperatively. RESULTS: Twelve months after TG-PRK with MMC, 46% of eyes achieved a best spectacle-corrected visual acuity (BSCVA) of 20/20 compared with 1 eye preoperatively (P = 0.0221, χ test). The BSCVA did not improve in 1 patient and increased by 1 line or more in all others. Astigmatism decreased significantly (P = 0.003) from 5.10 ± 0.4 D to 3.37 ± 0.06 D, the corneal best-fit sphere increased and keratometry measurements flattened significantly (P = 0.0001 for both comparisons), and the corneal total root mean square aberrations and trefoil decreased significantly (P = 0.0077 and P = 0.0054, respectively) from 9.11 ± 2.56 µm to 7.58 ± 3.15 µm and 2.00 ± 1.2 to 1.38 ± 0.27 µm, respectively, as measured by wavefront aberrometry. CONCLUSIONS: Twelve months postoperatively, the BSCVA improved significantly, the lines of vision increased, and astigmatism, corneal best-fit sphere, mean keratometry, corneal thickness, corneal root mean square total, and corneal spherical aberrations decreased. TG-PRK with MMC is a good alternative for correcting post-PKP cases with irregular astigmatism with elevated higher-order aberrations.

Effect of a light-emitting timer device on the blink rate of non-dry eye individuals and dry eye patients.

PURPOSE: To evaluate blink rate effects by a novel light-emitting diode (LED) timer device (PISC) on non-dry eye (DE) subjects and DE patients during a reading task on liquid crystal display (LCD) screens, in different environmental conditions. METHODS: This was a case-control study that included 15 DE patients and 15 non-DE subjects as controls. Participants had their blink rates measured while they read an electronic format text. These tasks were performed in four different conditions: with and without a LED timer device in two visits, and with and without air conditioning. All participants completed the Ocular Surface Disease Index and were examined by best spectacle-corrected visual acuity exam, biomicroscopy, Schirmer test 1, fluorescein staining and break-up time and lissamine green staining (Oxford scale grading). RESULTS: Outcomes between reading tasks conditions were compared independently for each group and blink rate frequency was higher in tasks with LED timer device, with and without air conditioning, for the DE group (p<0.0001), and with air conditioning for the control group (p<0.05). CONCLUSIONS: An LED timer device increased blink frequency for DE and control groups. Further studies need to be carried out in order to evaluate long-term effects of this new device, as well as its assessment with different reading scenarios.

[Temporal evolution of breast cancer stages in a population-based cancer registry in the Brazilian central region]. / Evolução temporal dos estádios do câncer de mama ao diagnóstico em um registro de base populacional no Brasil central.

PURPOSE: To analyze the temporal changes of breast cancer staging at diagnosis among women living in Goiânia, Goiás, Brazil, between 1989 and 2003. METHODS: Retrospective and descriptive study in which the cases were identified from the Population-Based Cancer Registry of Goiânia for the period from 1989 to 2003. The variables studied were age, diagnostic method, topographic sublocation, morphology and breast cancer staging. Frequency analyses were carried out on the variables and means, and the medians for the age were determined. The SPSS(R) 15.0 software was used for statistical analyses. RESULTS: A total of 3,204 breast cancer cases were collected. The mean age was 56 years (sd+/-16 years). With regard to clinical staging, 45.6% of the cases were found to be localized in the breast, with an increased rate of 19.25% between the first and the third five-year period (p<0.001; CI 95%=0.14-0.23) and 10.2% of cases were with distant metastases. However, a reduction of 17.74% for metastatic cases in the same interval (p<0.001 e CI 95%=0.14-21) was observed. The in situ case rate was 0.2% in 1989-1993 and increased to 6.2% in 1999-2003 (p<0.001, IC95%=4.9-7.4). CONCLUSION: The diagnostic profile of breast cancer in the city of Goiânia is changing. Substantial increases in the number of early breast cancer cases are being found in relation to the number of advanced cases.

Evolução temporal dos estádios do câncer de mama ao diagnóstico em um registro de base populacional no Brasil central / Temporal evolution of breast cancer stages in a population-based cancer registry in the Brazilian central region

OBJETIVO: Analisar a mudança temporal do estádio clínico do câncer de mama ao diagnóstico em mulheres residentes em Goiânia entre 1989 e 2003. MÉTODOS: estudo retrospectivo, utilizando-se a base de dados do Registro de Câncer de Base Populacional de Goiânia. As variáveis estudadas foram: idade, diagnóstico histológico, localização do tumor, tipo histológico e estádio clínico da doença. O período estudado foi dividido em três quinquênios: de 1989 a 1993, de 1994 a 1998 e de 1999 a 2003. Utilizou-se o teste Z para comparação das frequências da extensão ao diagnóstico por quinquênio. RESULTADOS: foram identificados 3.204 casos de câncer de mama. A média de idade foi de 56 anos (dp±16 anos). Quanto ao estádio da doença, evidenciou-se que 45,6% dos casos eram localizados na mama, com aumento de 19,2% entre o primeiro e o terceiro quinquênio (p<0,001; IC95%=0,14-0,23) e 10,2% de casos eram metastáticos, Entretanto, foi observada uma redução de 17,7% para os casos metastáticos no mesmo período (p<0,001; IC95%=0,14-0,21). A taxa de casos in situ entre 1989 e 1993 foi de 0,2%, aumentando para 6,2% em 1999-2003 (p<0,001; IC95%=4,9-7,4). CONCLUSÃO: observou-se um aumento dos casos de carcinoma in situ e de carcinomas invasores localizados somente na mama em detrimento de uma redução dos casos com metástases linfonodais e à distância.

PURPOSE: To analyze the temporal changes of breast cancer staging at diagnosis among women living in Goiânia, Goiás, Brazil, between 1989 and 2003. METHODS: Retrospective and descriptive study in which the cases were identified from the Population-Based Cancer Registry of Goiânia for the period from 1989 to 2003. The variables studied were age, diagnostic method, topographic sublocation, morphology and breast cancer staging. Frequency analyses were carried out on the variables and means, and the medians for the age were determined. The SPSS® 15.0 software was used for statistical analyses. RESULTS: A total of 3,204 breast cancer cases were collected. The mean age was 56 years (sd±16 years). With regard to clinical staging, 45.6% of the cases were found to be localized in the breast, with an increased rate of 19.25% between the first and the third five-year period (p<0.001; CI 95%=0.14-0.23) and 10.2% of cases were with distant metastases. However, a reduction of 17.74% for metastatic cases in the same interval (p<0.001 e CI 95%=0.14-21) was observed. The in situ case rate was 0.2% in 1989-1993 and increased to 6.2% in 1999-2003 (p<0.001, IC95%=4.9-7.4). CONCLUSION: The diagnostic profile of breast cancer in the city of Goiânia is changing. Substantial increases in the number of early breast cancer cases are being found in relation to the number of advanced cases.

A exposição ocupacional como fator de risco no câncer de cavidade oral e orofaringe no Estado de Goiás / The occupational exposition as a risk factor in oral and oropharyngeal cancer in the State of Goiás

Introdução: Estudos dos fatores de risco para os cânceres de boca e orofaringe constituem-se em relevante ferramenta para políticas de promoção e prevenção da saúde. Alguns fatores, como o tabagismo e o etilismo, são amplamente estudados; outros, como a ocupação, carecem de mais estudos. Objetivos: Verificar os fatores de riscos associados ao câncer de boca e orofaringe. Métodos: Estudo caso-controle multicêntrico entre o RCBP-Goiânia e a IARC. Os casos foram selecionados no Serviço de Cabeça e Pescoço do Hospital Araújo Jorge, Goiânia. Os controles foram pacientes de dois hospitais da Rede Pública Estadual de Saúde, não especializados em Oncologia, em Goiânia. Foram avaliadas as exposições, classificadas conforme a descrição do IARC (1987). Foram utilizados os testes de qui-quadrado e o teste T de Student, quando aplicáveis. A associação entre a variável dependente (câncer) e as variáveis independentes (as exposições aos agentes carcinogênicos) foi estimada pelo cálculo da OR bruta e da ajustada por tabagismo, por etilismo e por origem de residência, com IC de 95%. Resultados: Foram selecionados 200 (41,8%) pacientes considerados casos e 279 controles (58,2%). A análise multivariada demonstrou que a fumaça de cromatos, os pigmentos, os pó de algodão, o aerosol de animais, os pesticidas e a poeira de madeira foram fatores de risco independentes para o câncer de boca e orofaringe. Conclusão: A exposição ocupacional às substâncias carcinogênicas em ambientes de trabalho também são fatores de risco para o câncer de boca e orofaringe; portanto, a adoção de uma política de prevenção pelos órgãos fiscalizadores do trabalho, bem como campanhas mais efetivas contra o hábito de fumar e o uso de bebidas alcoólicas podem promover a redução desse tipo de câncer em grandes populações.

Introduction: Researches about the risk factors for oral and oropharyngeal cancer constitute in a relevant tool for politics of health promotion and prevention. Some factors as tobacco smoking and alcohol are widely studied; others such as occupation ask for further research. Objective: To verify the risk factors associated to oral and oropharyngeal cancer. Methods: a prospective multicentric case-control between RCBP- Goiânia and IARC. The cases were selected from the Head and Neck Service at Araújo Jorge Hospital, Goiânia. The controls were patients from two public hospitals not specialized in Oncology, in Goiânia. The expositions classified according to IARC's description (1987) were evaluated. The chi-squared test and Student's T test were used, when applicable. The association between the dependent variable (cancer) and the independent variables of exposition to the carcinogenic agents were estimated by calculating the gross OR and adjusted by tobacco smoking, alcohol and residence origin with a 95% IC. Results: 200 patients (41.8%) considered cases and 279 (58.2%) controls were selected. The multivariated analysis showed that chromate smoke, pigments, cotton powder, animals' aerosol, pesticides and wood dust were independent risk factors to oral and oropharyngeal cancer. Conclusion: The occupational exposition to carcinogenic substances in work environment are risk factors to oral and oropharyngeal cancer. Therefore, the adoption of prevention politics by the work controlling agencies, as well as more effective campaigns against the smoking habit and the use of alcoholic beverages may promote the reduction of this kind of cancer in large populations.

Correlação entre os níveis de proteína C reativa ultra-sensível e as características clínicas e laboratoriais em mulheres com síndrome do ovário policístico / Correlation of high sensitivity C-reactive protein levels and clinical and laboratory parameters in polycystic ovary syndrome patients

OBJETIVO: avaliar a concentração plasmática da proteína C reativa ultra-sensível (PCRus) e a sua correlação com variáveis clínicas, hormonais e metabólicas em pacientes portadoras da síndrome do ovário policístico (SOP). Métodos: estudo transversal, que incluiu 46 pacientes portadoras de síndrome do ovário policístico, diagnosticadas segundo os critérios de Rotterdam (2003), e 44 pacientes controle, que foram submetidas a dosagem da PCRus. O índice de massa corporal (IMC), a idade, a circunferência abdominal e os níveis de insulina de jejum, de testosterona, do HOMA-IR (homeostasis model assessment-insulin resistance) e do colesterol total, além de frações foram correlacionados aos níveis de PCR, utilizando-se análise de regressão multivariada. RESULTADOS: as portadoras da SOP apresentavam idade, IMC, circunferência abdominal, insulina de jejum, HOMA-IR, colesterol total e lipoproteína de baixa densidade (LDL) em concentrações plasmáticas superiores às do controle. Houve diferença significante nos níveis da PCRus entre o grupo da SOP (2,7±2,17 mg/dL) e o controle (1,6±1,49 mg/dL), p<0,05. Quando os níveis da PCRus foram categorizados em baixo (<1,0 mg/L), médio (1-3,0 mg/L) e elevado (3,0 mg/L) risco cardiovascular, 28,3 por cento das portadoras da SOP apresentaram níveis da PCRus para baixo risco, 34,8 por cento para médio e 37 por cento para elevado risco cardiovascular. A prevalência da síndrome metabólica foi mais elevada entre as portadoras da SOP (30,4 por cento), quando comparadas ao grupo controle (6,8 por cento). Após o ajuste das variáveis de confusão, por um modelo de regressão linear multivariada stepwise, a presença da SOP mostrou efeito independente das outras variáveis sobre os níveis da PCRus. CONCLUSÕES: os níveis da PCRus foram mais elevados nas mulheres portadoras da SOP. A SOP tem efeito independente na determinação dos níveis plasmáticos da PCR.

PURPOSE: to evaluate the ultra-sensitive C-Reactive Protein level (us-CRP) in patients with Polycystic Ovary Syndrome (PCOS), and the correlation of clinical and laboratory parameters with the us-CRP level. Methods: in this cross-sectional study, 46 women with Polycystic Ovary Syndrome, according to the Rotterdam criteria, and 44 control women have been included. Serum was analyzed for C reactive protein (CRP) levels. Body mass index (BMI), age, circumference waist, HOMA-IR, total, low and high density lipoprotein cholesterol, triglycerides, glucose, testosterone and insulin levels were correlated to CRP level through a linear regression model. RESULTS: PCOS patients not only were older and had higher BMI, but their waist circumference, fasting insulin, HOMA-IR, total and LDL cholesterol were also higher, as compared to the women from the control group. A significant difference was observed in the us-CRP level between the PCOS (2.7 mg/dL±2.17) the control (1.6 mg/dL±1.49) groups. When us-CRP levels were categorized as of low (<1.0 mg/L), moderate (1-3.0 mg/L) and high (3.0 mg/L) risk for cardiovascular episodes, only 28.3 percent women with PCOS had us-CRP levels defined as low, 34.8 percent as moderate and 37 percent as high risk. The prevalence of Metabolic Syndrome was higher in the women with PCOS (30.4 percent) than in the women from the control group (6.8 percent). Through a stepwise linear regression model, only waist circumference, presence of metabolic syndrome and age had a confounding effect in the relation between us-CRP and PCOS. After adjustment for confounding factors, PCOS showed an independent effect on us-CRP level. CONCLUSIONS: the us-CRP levels were higher in the PCOS women than in the healthy controls. By a regression model, PCOS showed an independent effect on us-CRP level.

Tendência da incidência e da mortalidade do câncer de mama em Goiânia: análise de 15 anos (1988-2002) / Incidence and mortality trends for breast cancer in goiânia: analysis of 15 years (1988-2002)

Os autores se propõem a avaliar a tendência da incidência e da mortalidade por câncer de mama em Goiânia, Goiás, Brasil, no período de 15 anos. Os valores absolutos de casos novos de câncer de mama, por ano, foram cruzados com o número de habitantes para o respectivo ano (Instituto Brasileiro de Geografia e Estatística - IBGE). O cálculo da incidência e da mortalidade foi feito dividindo-se o número de casos novos, ou óbitos, por ano, pelo número de habitantes para o respectivo ano. Os valores foram ajustados por sexo e idade, de acordo com o padrão internacional. Para verificar a tendência, foi realizada a análise polinomial para a incidência e a mortalidade. No período de 1988 a 2002, foram registrados 2.904 novos casos. A taxa ajustada para a população mundial foi de 31,88/100.000 em 1988, tendo aumentado progressivamente para 51,35/100.000 em 2002 (R2 = 0,10). A taxa ajustada de mortalidade foi de 14,87/100.000 em 1988, chegando a 25,09/100.000 em 1993 e caindo para 18,18/100.000 em 2002 (R2 = 0,12). A taxa de incidência por câncer de mama na cidade de Goiânia teve uma tendência discreta de aumento. Já a mortalidade manteve-se inalterada durante o período de 1988 a 2002, porém com discreta redução nos últimos sete anos.

The authors propose to evaluate the trend of incidence and mortality rates for breast cancer in Goiânia, Goiás, Brazil, for a period of 15 years. Absolute values of new breast cancer cases per year were crossed with the number of inhabitants for the corresponding year (Instituto Brasileiro de Geografia e Estatística - IBGE). The values were adjusted for sex and age, according to international standards. Incidence and mortality rates were calculated by dividing the number of new cases, or deaths, by years, by the number of inhabitants for the corresponding year. The trend was verified by means of a polynomial analysis for both the incidence and the mortality. During that period 2,904 cases were recorded. The adjusted rate for the world population was 31.88/100,000 in 1988, and that figure increased to 51.35/100,000 in 2002 (R2 = 0.10). The adjusted mortality rate was 14.87/100,000 in 1988, increasing to 25.09/100.000 in 1993 and decreasing to 18.18/1 00,000 in 2002 (R2 = 0.12). A slight increase was verified in the incidence rate of breast cancer in Goiânia. A1though mortality remained unchanged from 1988 through 2002, a very discrete decline was detected for the last seven years.

Retropulsion and vertigo in the Chiari malformation: case report

We describe a rare case of a 30 year-old woman with intense vertiginous sensation, lack of body balance and a tendency to fall backwards, making it necessary for two people to sustain her. The magnetic resonance imaging of the craniocervical junction evidenced tonsilar herniation at the inferior level of C1, and during the operation performed in sitting position, we observed crowding of the cerebellar tonsils at the level of C3. After the osteo-dural-neural decompression, the symptomatology remitted on the same day of the operation.

Descrevemos um caso raro de mulher de 30 anos com intensa sensação vertiginosa, desequilíbrio do corpo e tendência à queda para trás, sendo necessário o auxílio de duas pessoas para ampará-la. A ressonância nuclear magnética da junção craniovertebral evidenciou herniação tonsilar ao nível da borda inferior de C1 e, durante a operação, em posição sentada, foi observado o deslocamento craniocaudal das tonsilas cerebelares ao nível de C3. Após a descompressão ósteo-duro-neural, houve regressão da sintomatologia, no dia da operação.