Reasons and Expectations for Seeking Spiritual Treatment in Brazilian Spiritist Centers: A Qualitative Study.

The objective of this study is to identify the main motivations and expectations for seeking spiritual treatment (ST) in  spiritist centers. This is a qualitative study developed at two spiritist centers in the state of Mato Grosso, Brazil. ST was considered as the set of activities that use magnetic current as the main treatment method. We observed that most of the participants first sought treatments from health professionals and that, after insufficient results, they went in search of ST. Their treatments take place simultaneously and, for the participants, they complement each other. The motivations that led the participants to ST ranged from physical reasons to mental health complaints and even family conflicts. One possibility for investing in this type of treatment is due to the participants' desire for a more comprehensive approach, and not as a mere solution to the problem that directly afflicts them.

Comparative analysis of temporomandibular joint morphology in degenerative joint disease: A cone-beam CT study in patients with and without arthralgia.

This cross-sectional study aimed to compare, by using Cone-Beam Computed Tomography (CBCT), temporomandibular joint (TMJ) morphology among patients with degenerative joint disease (DJD) with or without arthralgia, as well as a control group. METHODS: Thirty-one patients and their respective CBCT TMJ exams were assessed. These individuals were selected from an Orofacial Pain Service and classified into three groups based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): group 1 (10 patients with TMJ DJD and arthralgia), group 2 (11 patients with TMJ DJD without pain), and group 3 (the control group, consisting of 10 healthy individuals without any signs or symptoms of TMD). A second examiner, who was calibrated and blinded for the patient's diagnosis, evaluated the CBCT images. RESULTS: Group 1 showed a statistically significant association with the variables of erosion (p = 0.003) and osteophyte (p = 0.04) on the condyle surface, as well as concentric condyle position with reduced joint space (p = 0.01). The Kappa concordance index between the clinical diagnosis of DC/TMD and CBCT images was k = 0.134 (p ≤ 0.001). CONCLUSION: The presence of erosion, osteophyte, and concentric condyle position with reduced joint space was statistically associated with DJD and ongoing TMJ joint pain.

Larvicidal activity of coumarin derivatives on Toxocara canis larvae, cytotoxicity analysis, and in silico bioavailability studies.

Human toxocariasis is a neglected anthropozoonosis with global distribution. Treatment is based on the administration of anthelmintics; however, their effectiveness at the tissue level is low to moderate, necessitating the discovery of new drug candidates. Several groups of synthetic compounds, including coumarin derivatives, have demonstrated bioactivity against fungi, bacteria, and even parasites, such as Dactylogyrus intermedius, Leishmania major, and Plasmodium falciparum. The aim of this study was to evaluate the effect of ten coumarin-derived compounds against Toxocara canis larvae using in vitro, cytotoxicity, and in silico tests for selecting new drug candidates for preclinical tests aimed at evaluating the treatment of visceral toxocariasis. The compounds were tested in vitro in duplicate at a concentration of 1 mg/mL, and compounds with larvicidal activity were serially diluted to obtain concentrations of 0.5 mg/mL; 0.25 mg/mL; 0.125 mg/mL; and 0.05 mg/mL. The tests were performed in a microculture plate containing 100 T. canis larvae in RPMI-1640 medium. One compound (COU 9) was selected for cytotoxicity analysis using J774.A1 murine macrophages and it was found to be non-cytotoxic at any concentration tested. The in silico analysis was performed using computational models; the compound presented adequate results of oral bioavailability. To confirm the non-viability of the larvae, the contents of the microplate wells of COU 9 were inoculated intraperitoneally (IP) into female Swiss mice at 7-8 weeks of age. This confirmed the larvicidal activity of this compound. These results show that COU 9 exhibited larvicidal activity against T. canis larvae, which, after exposure to the compound, were non-viable, and that COU 9 inhibited infection in a murine model. In addition, COU 9 did not exhibit cytotoxicity and presented adequate bioavailability in silico, similar to albendazole, an anthelmintic, which is the first choice for treatment of human toxocariasis, supporting the potential for future investigations and preclinical tests on COU 9.

Oral health in individuals with cystic fibrosis: A cross-sectional study.

Cystic Fibrosis (CF) is an autosomal recessive disease characterized by the production of thick and viscous mucus progressively affecting various organs and systems, with recurrent respiratory infections. The aim of this study was to learn about the oral health characteristics in CF patients. METHODOLOGY: Data, such as sociodemographic, general and oral health, were collected from the medical records of CF patients aged 0 to 18 years old. The number of patients with tooth decay, prevalence of developmental defects of enamel (DDE), classification of dental occlusion, sialometry, salivary pH and oral microbial profile and respiratory secretions evaluations were recorded. RESULTS: Most patients had pancreatic insufficiency (84.2%), malnutrition (60%), respiratory problems (75.4%) and genotyping of the F508del (66.7%). Regarding the medications used, 96.5% used vitamins and electrolyte replacement, 84,02% used pancreatic enzymes, 64.9% used dornase alfa and 47% were using antibiotics. The percentage of patients with tooth decay was 19.3%, 47% had DDE, low salivary flow and basic salivary pH. The most prevalent microorganisms found on tongue biofilm and respiratory secretions were SA and PA. There was a positive association between the presence of bacteria and fungi found on both the tongue and respiratory secretions. The presence of fungi on the tongue biofilm was significantly associated with the use of antibiotics. CONCLUSIONS: These findings underscore the importance of dentists focusing on prevention and on the specific needs of the patient as well.

Natalizumab extended interval dosing: what about wearing-off effect?

BACKGROUND: Up to two thirds of patients with multiple sclerosis (MS) under natalizumab report a resurgence of symptoms at the end of the natalizumab cycle (wearing-off (WO) effect). At the outbreak of COVID-19, in line with the international recommendations for MS management, our centre switched all clinically stable patients on natalizumab therapy for more than one year from standard interval dosing (SID) to extended interval dosing (EID) with every six weeks infusions. This study aimed to evaluate the impact of EID in WO in MS patients under natalizumab. METHODS: An observational retrospective study in patients with MS under natalizumab on EID was conducted. A questionnaire regarding current (on EID) and past (on SID) experience of WO effect was applied. RESULTS: Seventy-six patients were included. No significant differences were found in the annual relapse rate after the switch to EID (p = 0.083). However, there was a significant increase in the proportion of patients complaining of WO from 38.2% to 56.6% (p = 0.001). Moreover, patients with WO on SID, referred a significant increase in severity (p = 0.019) and duration of WO symptoms (p = 0.029), due to an anticipation of the symptoms relative to the day of natalizumab infusion (p = 0.019), when switching to EID. Symptoms improved with treatment maintenance in 23.3% of patients; instead, a reduction in interval dosing was needed in 54.8% with symptom improvement. CONCLUSION: WO affects a significant proportion of MS patients under natalizumab. Its prevalence, severity, and duration increase on EID, therefore despite clinical effectiveness maintenance of this posology should be individualized.

The larvicidal effect of the supernatant of Lactobacillus acidophilus ATCC 4356 on Toxocara canis.

Human toxocariasis is a parasitic anthropozoonosis that is difficult to treat and control. A previous study carried out with Lactobacillus acidophilus ATCC 4356 revealed that the cell free supernatant (CFS) of this probiotic killed 100% of Toxocara canis larvae in vitro. The present study aimed to investigate the characteristics of the CFS of L. acidophilus ATCC 4356, which may be involved in its larvicidal effects on T. canis. L. acidophilus ATCC 4356 was cultured, and lactic and acetic acids present in the CFS were quantified by high performance liquid chromatography (HPLC). The levels of pH and H2O2 were also analyzed. To assess the larvicidal effect of the CFS, this was tested pure and diluted (1:2 to 1:128) on T. canis larvae. High concentrations of lactic and acetic acids were detected in the CFS. The acidity of the pure CFS was observed at pH 3.8, remaining acidic at dilutions of 1:2 to 1:16. Regarding the in vitro larvicidal effect, 100% death of T. canis larvae was observed using the pure CFS and 1:2 dilution. Based on these results, it can be inferred that the presence of higher concentrations of organic acids and low pH of the medium contributed to the larvicidal activity of the CFS of L. acidophilus ATCC 4356. In addition, the maintenance of the larvicidal effect, even after dilution, suggests a greater chance of the larvicidal effect of this CFS against T. canis in vivo.

Secondary bruxism: A valid diagnosis or just a coincidental finding of additional masticatory muscle activity? A narrative review of literature.

INTRODUCTION: Bruxism is defined as a repetitive masticatory muscle activity that can manifest it upon awakening (awake bruxism-AB) or during sleep (sleep bruxism-SB). Some forms of both, AB and SB can be associated to many other coexistent factors, considered of risk for the initiation and maintenance of the bruxism. Although controversial, the term 'secondary bruxism' has frequently been used to label these cases. The absence of an adequate definition of bruxism, the non-distinction between the circadian manifestations and the report of many different measurement techniques, however, are important factors to be considered when judging the literature findings. The use (and abuse) of drugs, caffeine, nicotine, alcohol and psychoactive substances, the presence of respiratory disorders during sleep, gastroesophageal reflux disorders and movement, neurological and psychiatric disorders are among these factors. The scarcity of controlled studies and the complexity and interactions among all aforementioned factors, unfortunately, does not allow to establish any causality or temporal association with SB and AB. The supposition that variables are related depends on different parameters, not clearly demonstrated in the available studies. OBJECTIVES: This narrative review aims at providing oral health care professionals with an update on the co-risk factors and disorders possibly associated with bruxism. In addition, the authors discuss the appropriateness of the term 'secondary bruxism' as a valid diagnostic category based on the available evidence. CONCLUSION: The absence of an adequate definition of bruxism, the non-distinction between the circadian manifestations and the report of many different measurement techniques found in many studies preclude any solid and convincing conclusion on the existence of the 'secondary' bruxism.

Efeitos do tratamento espiritual na saúde física e mental de frequentadores de centros espíritas: estudo longitudinal controlado / Effects of spiritual treatment on the physical and mental health of attendees at spiritist centers: a controlled longitudinal study

Os elevados índices de estresse, ansiedade, depressão e outras condições de saúde mental têm preocupado as autoridades de saúde devido ao seu crescimento vertiginoso na contemporaneidade. Diante disso, é mister planejar estratégias de enfrentamento e ações de prevenção e de promoção da saúde. A Organização Mundial de Saúde tem sugerido a abrangência do olhar para as possibilidades de interlocução entre profissionais e serviços de saúde com outras fontes de cuidado que a população pode estar inserida, como as instituições religiosas. O espiritismo, terceira maior religião brasileira em número de adeptos, desde sua gênese, possui uma estreita relação com os processos de saúde-doença-cuidado, bem como com os itinerários e recursos de cura. Embora a literatura científica reconheça a importância da dimensão da religiosidade/espiritualidade (R/E) nos desfechos em saúde, ainda são pouco estudados os processos de tratamento espiritual (TE) desenvolvidos no espiritismo. Diante disso, o objetivo geral desta Tese foi analisar os efeitos de tratamentos espirituais na saúde mental de frequentadores de centros espíritas. Para responder esse e outros objetivos específicos, a Tese foi composta por quatro estudos independentes: o Estudo 1 buscou conhecer a frequência e o perfil de frequentadores do TE; o Estudo 2, a partir de uma revisão de escopo, reuniu as evidências científicas disponíveis sobre o passe espírita; o Estudo 3, de caráter misto, buscou conhecer os motivos pela busca do TE e avaliar seus efeitos em 51 frequentadores que compuseram o grupo estudo em comparação com 49 pessoas no grupo controle; e, por fim, o Estudo 4 visou conhecer as possibilidades terapêuticas oferecidas às pessoas que procuram por TE na região centro-oeste brasileira. A revisão de literatura (Estudo 2), evidenciou que o passe espírita parece ter efeitos positivos sobre a saúde dos indivíduos, sendo que os estudos instigam a expansão desse campo de pesquisa. Os Estudos 1 e 3, de caráter empírico, ocorreram em dois centros espíritas da cidade de Cuiabá, estado de Mato Grosso, Brasil. Os resultados do Estudo 1 revelaram que mais mulheres procuram o TE. Os efeitos positivos do TE, no Estudo 3, deram-se nos construtos bem-estar psicológico, estresse, depressão e religiosidade não organizacional. Os motivos citados para a busca do TE (Estudo 3) foram muito variados, envolvendo problemas de saúde física, mental e espiritual. Os desfechos positivos também foram mencionados pelos participantes nos dados qualitativos, além da prática de um itinerário terapêutico concomitante entre tratamentos biomédicos e espirituais. Por fim, o Estudo 4 corroborou os resultados do Estudo 3, demonstrando a variedade de terapias utilizadas nos centros espíritas com as pessoas que procuram por assistência, além da preocupação, nesses ambientes, que os TE ocorram em consonância com os ofertados pelos equipamentos formais de saúde. O fato do TE pesquisado ser padronizado e descrito na literatura espírita pode contribuir para a construção de evidências mais sólidas no campo da R/E e saúde. Entretanto, sugere-se que estudos vindouros devam ser realizados com amostras maiores e mais homogêneas.

The high rates of stress, anxiety, depression, and other mental health conditions have raised concerns among health authorities due to their rapid growth in contemporary times. In light of this, it is essential to plan coping strategies and health promotion and prevention actions. The World Health Organization has suggested the importance of considering the possibility of collaboration between healthcare professionals and services with other sources of care that the population may be involved in, such as religious institutions. Spiritism, the third-largest religion in Brazil in terms of followers, has maintained a close relationship with the processes of health-disease-care, as well as with healing pathways and resources since its inception. While scientific literature recognizes the importance of the dimension of religiosity/spirituality (R/S) in health outcomes, the processes of spiritual treatment (ST) developed within Spiritism have been little studied. Therefore, the general objective of the Thesis was to analyze the effects of spiritual treatments on the mental health of attendees at Spiritist centers. To address this and other specific objectives, the Thesis was composed of four independent studies: Study 1 aimed to understand the frequency and profile of ST attendees; Study 2, through a scoping review, gathered available scientific evidence on spiritual passes; Study 3, of a mixed nature, aimed to understand the reasons for seeking ST and evaluate its effects on 51 attendees who formed the study group compared to 49 individuals in the control group; and finally, Study 4 aimed to understand the therapeutic possibilities offered to people seeking ST in the central-western region of Brazil. The literature review (Study 2) showed that spiritual passes appear to have positive effects on individuals' health, and the studies encourage the expansion of this research field. Studies 1 and 3, empirical in nature, took place in two Spiritist centers in the city of Cuiabá, MT. The results of Study 1 revealed that more women seek ST. The positive effects of ST, in Study 3, were observed in the constructs of psychological well-being, reduced stress, improved depression, and non-organizational religiosity. The reasons cited for seeking ST (Study 3) were quite varied, involving physical, mental, and spiritual health issues. Positive outcomes were also mentioned by participants in the qualitative data, as well as the practice of a concomitant therapeutic path between biomedical and spiritual treatments. Finally, Study 4 corroborated the results of Study 3, demonstrating the variety of therapies used in Spiritist centers by people seeking assistance, as well as the concern in these environments that ST is provided in accordance with the offerings of formal healthcare facilities. The fact that the researched ST is standardized and described in Spiritist literature can contribute to the construction of stronger evidence in the field of R/S and health. However, it is suggested that future studies should be conducted with larger and more homogeneous samples.

Prevalence, Incidence, and Mortality of Multiple Sclerosis in Coimbra, Portugal.

Multiple sclerosis (MS) is the most common chronic inflammatory, demyelinating, and neurodegenerative disease of the central nervous system in young adults, representing the leading cause of nontraumatic disability in this population. The rising prevalence of MS worldwide makes it critical to recognize the absolute number of patients with MS, demanding the execution of a sustainable healthcare policy. In Portugal, only six studies evaluating MS rates were published, disclosing a prevalence of 64 cases per 100,000 persons and an incidence of 3.1 cases per 100,000 persons/year, but the mortality rates have not been reported. Thus, this observational, cross-sectional study aimed to assess MS prevalence, incidence, and mortality in the city of Coimbra, a region in the center of Portugal. Patients who fulfilled McDonald's Diagnosis Criteria (2017) for MS were recruited. Inclusion criteria were defined according to prevalence, incidence, and mortality studies. The baseline demographic and clinical characterization of the prevalence study population was performed. The MS prevalence rate in Coimbra was 143.45 cases per 100,000 inhabitants. Between 2018 and 2021, the cumulative incidence was 8.52 new cases per 100,000 persons/year. The mortality rate between 2018 and 2021 was 2.84 deaths per 100,000 inhabitants. MS prevalence and incidence in Coimbra are higher than reported in previous similar studies and comparable to Europe's mean prevalence and incidence.

Level of knowledge of pediatric dentists on awake and sleep bruxism in children / Nível de conhecimento de odontopediatras sobre bruxismo em vigília e do sono em crianças

Objetivo: Avaliar o conhecimento dos odontopediatras sobre o bruxismo em crianças e discutir o tema de acordo com as evidências científicas atuais. Material e Métodos: 425 odontopediatras preencheram um formulário online composto por 17 afirmações sobre bruxismo em crianças durante a vigília e o sono. Os dados foram interpretados de duas formas distintas: conhecimento do participante e conhecimento das afirmações. O conhecimento do participante foi considerado aceitável quando pelo menos 10 das 17 afirmações foram respondidas corretamente. O conhecimento das afirmações foi considerado satisfatório quando foi respondido corretamente por, pelo menos, 70% dos participantes. Resultados: O número médio de respostas corretas foi de 9,73 (±3,41). Cinquenta e dois por cento dos participantes demonstraram conhecimentos aceitáveis e apenas 4 afirmações obtiveram uma percentagem de respostas consideradas satisfatórias. Conclusão: O conhecimento dos odontopediatras sobre o bruxismo em crianças em vigília e durante o sono é deficiente, sugerindo-se a educação continuada sobre o tema, a fim de evitar diagnósticos equivocados e condutas inadequadas (AU)

Objective: To evaluate the knowledge of pediatric dentists concerning bruxism in children and explore the subject according to the latest scientific evidence. Material and Methods: Four hundred and twenty-five pediatric dentists filled out an online form comprising 17 statements regarding awake and sleep bruxism in children. Data was analyzed in two distinct ways: participant's knowledge and statements knowledge. Participant ́s knowledge was considered acceptable when at least 10 out of 17 statements were correctly answered. Statements knowledge was considered satisfactory when correctly answered by, at least, 70% of the participants. Results: The average of correct answers was 9.73 (±3.41). Fifty-two percent of the participants showed acceptable knowledge and only 4 statements obtained a percentage of answers considered satisfactory. Conclusion: The knowledge of pediatric dentists regarding awake and sleep bruxism in children is deficient, and continuous education concerning this topic is suggested to avoid misdiagnosis and inadequate management (AU)

Correction: Detection and measurement of butterfly eyespot and spot patterns using convolutional neural networks.

[This corrects the article DOI: 10.1371/journal.pone.0280998.].

Case report: Diagnostic and therapeutic challenges of fungal endocarditis by Trichosporon asahii in a child with congenital heart defects.

Background: patients with congenital cardiopathies are the main group at risk for infective endocarditis (IE) in the pediatric population. Fungal etiology is responsible for 2%-4% of all IEs, and the Trichosporon genus is an increasingly prevalent cause of infections in human beings. Case presentation: We describe a 9-year-old male with multiple surgical procedures to correct congenital cardiopathy defects, including insertion of RV-PA conduit, who was admitted due to suspicion of pneumonia and needed a surgical approach after being diagnosed with a mycotic pseudoaneurysm in the right ventricle's outflow tract, with dilation of the RV-PA conduit. The conduit was removed and antifungal treatment was started with Voriconazole after the agent was identified (T. asahii), with satisfactory therapeutic response. Approximately 4 years later, the patient was readmitted, presenting with intermittent fever, associated with nocturnal diaphoresis, dry cough, anxiety and chest pain. Vegetations consistent with T. asahii were evidenced in the RV-PA conduit, and a surgical approach was once again necessary. Discussion: diagnostic methods and treatment of T. asahii endocarditis aren't yet standardized, and recurrent surgical approaches are needed due to the inefficacy of antifungal treatment.

Factors associated with severe acute respiratory syndrome in pregnant/postpartum women with COVID-19 receiving care at referral centers in northeastern Brazil: Secondary analysis of a cohort study.

Background: At the beginning of the COVID-19 pandemic, the greater risks associated with the new SARS-CoV-2 pathogen in pregnant women were as yet unclear. This study analyzed factors associated with severe acute respiratory syndrome (SARS) in pregnant/postpartum women with COVID-19. Methods: A prospective and retrospective cohort study was conducted in eight referral centers in northeastern Brazil between April 2020 and December 2021 involving pregnant/postpartum women with a positive COVID-19 RT-PCR test. A multivariate analysis was then conducted using a hierarchical logistic regression model to evaluate the association between the independent variables and the presence of SARS. Findings: Of 611 patients included, 522 were pregnant and 83 were postpartum, at the time of admission. Criteria for SARS were present in 215 patients (35·2%). Factors associated with SARS included overweight and/or obesity (adjusted odds ratio/AOR: 1·95; 95%CI: 1·21-3·12; p = 0·0054), parity ≥2 (AOR: 1·72; 95%CI: 1·21-2·45; p = 0·0025), gestational age <34 weeks (AOR: 3·54; 95%CI: 2·47-5·07; p < 0·0001) and duration of symptoms >7 days (AOR: 1·97; 95%CI: 1·35-2·89; p = 0·0004). SARS increased the likelihood of requiring oxygen therapy (RR = 8·80; 95%CI: 6·25-12·40; p = 0·0000), mechanical ventilation (RR = 8·15; 95%CI: 4·67-14·21; p = 0·0000), and admission to an ICU (RR = 6·54; 95%CI: 4·70-9·11; p = 0·0000), and of maternal near miss (RR = 10·82; 95%CI: 1·20-22·47; p = 0·0000) and maternal death (RR = 8·12; 95%CI: 3·11-21·09; p = 0·0000). Interpretation: In patients with COVID-19, parity ≥2, overweight/obesity, gestational age <34 weeks and duration of symptoms >7 days increased the risk of SARS. Cesarean sections, oxygen therapy, and mechanical ventilation were more common in patients with SARS.

Cellular Pathophysiology of Leptospirosis: Role of Na/K-ATPase.

Inada and Ido identified Leptospira sp. as the pathogen responsible for Weil's Disease in 1915. Later, it was confirmed that Leptospira causes leptospirosis. The host microorganism's interaction at the cellular level remained misunderstood for many years. Although different bacterial components have been isolated and purified, the complexity of the molecular interactions between these components and the host and the molecular mechanisms responsible for the systemic dysfunctions still needs to be fully unveiled. Leptospirosis affects virtually all animal species. Its cellular pathophysiology must involve a ubiquitous cellular mechanism in all eukaryotes. Na/K-ATPase is the molecular target of the leptospiral endotoxin (glycolipoprotein-GLP). Na/K-ATPase dysfunctions on different types of cells give rise to the organ disorders manifested in leptospirosis. Concomitantly, the development of a peculiar metabolic disorder characterized by dyslipidemia, with increased levels of circulating free fatty acids and an imbalance in the fatty acid/albumin molar ratio, triggers events of cellular lipotoxicity. Synergistically, multiple molecular stimuli are prompted during the infection, activating inflammasomes and Na/K-ATPase signalosome, leading to pro-inflammatory and metabolic alterations during leptospirosis. Leptospirosis involves diverse molecular mechanisms and alteration in patient inflammatory and metabolic status. Nonetheless, Na/K-ATPase is critical in the disease, and it is targeted by GLP, its components, and other molecules, such as fatty acids, that inhibit or trigger intracellular signaling through this enzyme. Herein, we overview the role of Na/K-ATPase during leptospirosis infection as a potential therapeutic target or an indicator of disease severity.

Experimental pain thresholds and psychosocial features across menstrual cycle in myofascial orofacial pain compared to healthy individuals: cross-sectional study / Limiares de dor experimental e características psicossociais ao longo do ciclo menstrual na dor miofascial orofacial em comparação com indivíduos saudáveis: estudo transversal

ABSTRACT BACKGROUND AND OBJECTIVES: The hormonal impact on pain perception during the menstrual cycle is a major focus of study, and further elucidation in temporomandibular disorders (TMD) field is necessary. Thus, this cross-sectional study evaluated experimental pain thresholds, psychosocial features, and clinical pain report on TMD women across menstrual cycle versus healthy controls. METHODS: A total of 220 women's clinical files were screened, with 80 selected and divided into control group (healthy individuals, n=40) and TMD group (myofascial pain, n=40). Regarding the menstrual cycle phases, the files were divided into Pre-Luteal and Luteal. The Perceived Stress Scale (PSS), Pain Catastrophizing Scale (PCS), Mechanical Pain Threshold (MPT), Wind-up (WUR), Pressure Pain Threshold (PPT), Conditioned Pain Modulation (CPM) and Visual Analogue Scale (VAS) were analyzed at a 5% significance level, by Two-Way ANOVA test and post hoc Tukey test. RESULTS: PSS and PCS were significantly different between TMD and control group (p<0.001), regardless of menstrual cycle. Healthy individuals in the Luteal phase presented higher MPT values compared to the other phases (p<0.001). PPT showed significant difference across menstrual phases (p=0.022), but no differences in multiple comparisons. VAS values showed no difference between menstrual cycle phases (p=0.376). CONCLUSION: Finally, healthy individuals in the Luteal phase have higher MPT and PPT values on the orofacial region. Pain report in patients with TMD showed no difference throughout the menstrual cycle, showing that small alterations on experimental pain thresholds may not be clinically relevant. The presence of chronic pain seems to be more related to psychosocial features than hormonal fluctuations.

RESUMO JUSTIFICATIVA E OBJETIVOS: O impacto do ciclo menstrual na percepção da dor é um foco importante de estudo, sendo necessária uma maior elucidação na disfunção temporomandibular (DTM). Assim, este estudo transversal avaliou limiares de dor experimental, características psicossociais e relatos de dor em mulheres com DTM ao longo do ciclo menstrual, comparadas com controles saudáveis. MÉTODOS: 220 prontuários de mulheres foram analisados, sendo 80 selecionados para os grupos de controle (saudáveis, n=40) e DTM (dor miofascial, n=40). Nas fases do ciclo menstrual, as pacientes foram divididas nas categorias Pré-Luteal e Luteal. Os instrumentos Escala de Estresse Percebido (PSS), Escala de Pensamentos Catastróficos (PCS), Limiar de Dor Mecânica (MPT), Wind-up Ratio (WUR), Limiar de Dor à Pressão (PPT), Modulação Condicionada da Dor (CPM) e Escala analógica visual (EAV) foram analisados com nível de significância de 5%, pelos testes ANOVA de dois fatores e Tukey post hoc. RESULTADOS: As escalas PSS e PCS foram significativamente diferentes entre os grupos DTM e controle (p<0,001), independentemente do ciclo menstrual. Indivíduos saudáveis na fase luteal apresentaram MPT maior em comparação com outras fases (p,0,001). O PPT mostrou diferença significativa entre as fases menstruais (p=0,022), sem diferença nas comparações múltiplas. Os valores da EAV não apresentaram diferença entre as fases menstruais (p=376). CONCLUSÃO: Indivíduos saudáveis na fase luteal têm MPT e PPTl maior na região orofacial. Os relatos de dor em pacientes com DTM não mostraram diferença ao longo do ciclo menstrual, indicando que pequenas alterações nos limiares experimentais podem ser clinicamente relevantes. A presença de dor crônica parece estar mais relacionada com características psicossociais do que com flutuações hormonais.

Immunomodulation in the intestinal mucosa of mice supplemented with Lactobacillus rhamnosus (ATCC 7469) and infected with Toxocara canis.

Toxocariasis is an anthropozoonosis caused by the helminth Toxocara canis that shows different clinical manifestations as visceral, ocular, or neurological toxocariasis forms. Probiotics have been studied as alternatives to prevent and treat this parasitosis. Lactobacillus rhamnosus is a prospect that presents immunomodulatory activity that acts to strengthen the intestinal barrier. In this context, the main objective of this study was to evaluate the protective capacity and immunomodulatory action of the probiotic Lactobacillus rhamnosus at the level of the intestinal mucosa in different stages of T. canis infection (acute and chronic). Mice were supplemented by oral gavage with 1 × 107 UFC/mL L. rhamnosus for 15 days before inoculation with 100 embryonated eggs of T. canis. Euthanasia of mice was conducted at three different time points: 2, 15 and 30 days post-inoculation (PI). The brain, lungs and liver were collected to evaluate the intensity of infection. The small intestines were removed, and mucosal cells of the duodenum were collected to perform gene analysis of IFN-γ, IL-10, IL-4 and IL-13 by real-time polymerase chain reaction (qPCR). Jejunum and ileum segments were analysed by histological techniques. A reduction of 51% in infection intensity was observed in the tissue of supplemented animals evaluated 2 days PI; however, analysis of groups 15 and 30 days PI did not show a protective effect. The intestinal mucosa of supplemented animals presented an inflammatory process that initiated at 2 days PI, persisted at 15 days PI and had regressed at 30 days PI. IL-13 transcription was increased in the probiotic group 2 days after supplementation ended; however, the same increase was not observed in the group that was supplemented and infected. Toxocara canis modulated the local immune system, with suppression of IFN-γ at 2 days PI and increased levels of IL-4 and IL-10 at 15 days PI. These results indicate that, under the studied conditions, the protective effect of Lactobacillus rhamnosus against infection caused by T. canis is not related to IL-4, IL-10 or IFN-γ but could be influenced by IL-13 action at 2 days PI. The probiotic stimulated immune cell recruitment to the intestinal mucosa, which can be involved in the diminished capacity of larval penetration in the mucosa, resulting in the reduced infection intensity observed during acute infection.

Maternal γδ T cells shape offspring pulmonary type 2 immunity in a microbiota-dependent manner.

Immune development is profoundly influenced by vertically transferred cues. However, little is known about how maternal innate-like lymphocytes regulate offspring immunity. Here, we show that mice born from γδ T cell-deficient (TCRδ-/-) dams display an increase in first-breath-induced inflammation, with a pulmonary milieu selectively enriched in type 2 cytokines and type 2-polarized immune cells, when compared with the progeny of γδ T cell-sufficient dams. Upon helminth infection, mice born from TCRδ-/- dams sustain an increased type 2 inflammatory response. This is independent of the genotype of the pups. Instead, the offspring of TCRδ-/- dams harbors a distinct intestinal microbiota, acquired during birth and fostering, and decreased levels of intestinal short-chain fatty acids (SCFAs), such as pentanoate and hexanoate. Importantly, exogenous SCFA supplementation inhibits type 2 innate lymphoid cell function and suppresses first-breath- and infection-induced inflammation. Taken together, our findings unravel a maternal γδ T cell-microbiota-SCFA axis regulating neonatal lung immunity.

Detection and measurement of butterfly eyespot and spot patterns using convolutional neural networks.

Butterflies are increasingly becoming model insects where basic questions surrounding the diversity of their color patterns are being investigated. Some of these color patterns consist of simple spots and eyespots. To accelerate the pace of research surrounding these discrete and circular pattern elements we trained distinct convolutional neural networks (CNNs) for detection and measurement of butterfly spots and eyespots on digital images of butterfly wings. We compared the automatically detected and segmented spot/eyespot areas with those manually annotated. These methods were able to identify and distinguish marginal eyespots from spots, as well as distinguish these patterns from less symmetrical patches of color. In addition, the measurements of an eyespot's central area and surrounding rings were comparable with the manual measurements. These CNNs offer improvements of eyespot/spot detection and measurements relative to previous methods because it is not necessary to mathematically define the feature of interest. All that is needed is to point out the images that have those features to train the CNN.

Common mental disorders in medical students: prevalence and associated factors / Transtornos mentais comuns em estudantes de medicina: prevalência e fatores associados

Abstract Objectives: This study aimed to estimate the prevalence of Common Mental Disorders (CMD) among medical students and identify the factors associated with this disorder. Methods: A cross-sectional study was conducted with all medical students, enrolled from the 1st to the 8th semesters in a public university, in the state of Bahia, Brazil. We used a self-administered questionnaire that included SRQ-20 (Self-Reporting Questionnaire), IPAQ (International Physical Activity Questionnaire - long form) and sociodemographic, school, occupational and health variables. The multivariate analysis was performed using COX Regression for cross-sectional studies. Results: We evaluated 556 students (289 women and 267 men), representing 90.2% of the target population. The overall prevalence of CMD found was 53.3%, 78.8% of students reported feeling nervous, 56.8% experienced poor sleep quality, and 6.5% had suicidal thoughts. After the multivariate analysis, the following factors maintained their association with a higher prevalence of CMD: having no previous undergraduate degree (PR=1.49), having an unfavorable self-perception of health (PR=1.53), not having failed disciplines (PR=1.20), and being a smoker (PR=1.19). Physical activity did not have a protective effect on CMD in this study. Conclusions: The prevalence of CMD among medical students was high and mainly associated with an unfavorable self-perception of health. The results highlight the need for strengthening institutional policies aimed at preventing psychological distress among students.

Resumo Objetivo: Este estudo teve como objetivo estimar a prevalência de transtornos mentais comuns (TMC) entre estudantes de Medicina e os fatores associados a esse agravo. Método: Trata-se de um estudo de corte transversal, do tipo censo, realizado com estudantes de Medicina, do primeiro ao oitavo semestre, de uma universidade pública na Bahia. Utilizou-se um questionário autoaplicável contendo Self-Reporting Questionnaire (SRQ-20), International Physical Activity Questionnaire (IPAQ - forma longa) e variáveis sociodemográficas, escolares, ocupacionais e de saúde. A análise multivariada foi efetuada usando a regressão de Cox para estudos transversais. Resultado: Avaliaram-se 556 estudantes (289 mulheres e 267 homens), o que representa 90,2% da população-alvo. A prevalência geral de TMC encontrada foi de 53,3%, 78,8% dos estudantes afirmaram que se sentem nervosos, 56,8% mencionaram que dormem mal, e 6,5% apontaram que têm ideias de acabar com a própria vida. Após análise multivariada, os seguintes fatores mantiveram associação com maior prevalência de TMC: não possuir graduação prévia (49% a mais de TMC), ter uma autopercepção de saúde desfavorável (53%), não ser dessemestralizado (20%) e fazer uso de tabaco (19%). Neste estudo, atividade física não teve efeito protetor para os TMC. Conclusão: A prevalência de TMC entre os estudantes de Medicina mostrou-se elevada e se associou principalmente à autopercepção de saúde desfavorável. Os resultados obtidos demonstram a necessidade de que as políticas institucionais voltadas à saúde mental e à diminuição do sofrimento psíquico dos estudantes sejam mantidas e ampliadas.

Mortality and Deep Vein Thrombosis in the Gamma Variant of Covid 19 and Lung Injury.

Purpose: The SARS-CoV-2 disease predisposes infected individuals to thrombosis, the underlying mechanisms of which are not fully understood. The balance between pro-coagulant factors and natural coagulation inhibitors in critically ill patients with Covid-19 is fundamental to the prevention and treatment of complications. The aim of the present study was to investigate the pulmonary injury patterns in Covid-19 having higher mortality in the presence of deep vein thrombosis in comparison to patients without venous thrombosis and determine the Gamma variant. Methods: A retrospective study was conducted involving the evaluation of 200 medical records of patients with Covid-19 and a clinical suspicion of deep vein thrombosis (DVT) at the intensive care unit of a public hospital. The sample was divided into two groups of patients were formed - those positive and those negative for DVT. Statistical analysis involved the use of Fisher's exact test, the paired t-test and chi-square test. Results: Patients with DVT had more severe lung injuries (greater than 70%) compared to those without DVT (p = 0.003). Lesions affecting 50% to 70% of the lung area occurred in little more half of the group with DVT and just under half in the group without DVT (p = 0.5). Pulmonary lesions affecting less than 50% of the lung occurred more in patients without DVT (p = 0.0001). The Gamma variant increased prevalence of the both DVT and mortality (p=0.0001). Conclusion: Deep vein thrombosis is an aggravating factor of mortality in patients with SARS-CoV-2, and the Gamma variant is an aggravating factor of both thrombotic events and mortality.