Optimal surgical timing for ear reconstruction with autologous cartilage: Analysis of the computed tomography scan characteristics of the ribs.

BACKGROUND: The approach to constructing the cartilage framework for ear reconstruction is sufficiently established. However, there is still no consensus about the age of initiation of surgical treatment. This study aims to assess the development and growth of the costal cartilage to determine the best age to perform ear reconstruction surgery. METHODS: Out of 107 patients, we used presurgical treatment data for 40 patients and medical records for 67 patients aged 5-40. Computed tomography (CT) scans were performed, and average parameters were calculated (length, width, thickness, cartilage density, and standard deviation in Hounsfield units) of the cartilaginous part of the 6th, 7th, 8th, and 9th ribs. RESULTS: The required values were reached at 9-10 years old. CONCLUSION: The criteria for starting surgical treatment in the Russian population was determined by the width of the 6th-7th ribs synchondrosis, which must be equal to the width of a healthy auricle, and the length of the 8th rib should be longer than 9 cm. Therefore, the optimal age for ear reconstruction with autologous costal cartilage is 10 years and older. However, reconstruction can be made earlier in specific cases, according to height and weight and the preoperative CT scan.

Sole microbiome progression in a hatchery life cycle, from egg to juvenile.

Recirculating aquaculture systems (RAS) pose unique challenges in microbial community management since they rely on a stable community with key target groups, both in the RAS environment and in the host (in this case, Solea senegalensis). Our goal was to determine how much of the sole microbiome is inherited from the egg stage, and how much is acquired during the remainder of the sole life cycle in an aquaculture production batch, especially regarding potentially probiotic and pathogenic groups. Our work comprises sole tissue samples from 2 days before hatching and up to 146 days after hatching (-2 to 146 DAH), encompassing the egg, larval, weaning, and pre-ongrowing stages. Total DNA was isolated from the different sole tissues, as well as from live feed introduced in the first stages, and 16S rRNA gene was sequenced (V6-V8 region) using the Illumina MiSeq platform. The output was analysed with the DADA2 pipeline, and taxonomic attribution with SILVAngs version 138.1. Using the Bray-Curtis dissimilarity index, both age and life cycle stage appeared to be drivers of bacterial community dissimilarity. To try to distinguish the inherited (present since the egg stage) from the acquired community (detected at later stages), different tissues were analysed at 49, 119 and 146 DAH (gill, intestine, fin and mucus). Only a few genera were inherited, but those that were inherited accompany the sole microbiome throughout the life cycle. Two genera of potentially probiotic bacteria (Bacillus and Enterococcus) were already present in the eggs, while others were acquired later, in particularly, forty days after live feed was introduced. The potentially pathogenic genera Tenacibaculum and Vibrio were inherited from the eggs, while Photobacterium and Mycobacterium seemed to be acquired at 49 and 119 DAH, respectively. Significant co-occurrence was found between Tenacibaculum and both Photobacterium and Vibrio. On the other hand, significantly negative correlations were detected between Vibrio and Streptococcus, Bacillus, Limosilactobacillus and Gardnerella. Our work reinforces the importance of life cycle studies, which can contribute to improve production husbandry strategies. However, we still need more information on this topic as repetition of patterns in different settings is essential to confirm our findings.

Educação Física no 1º Ciclo do Ensino Básico (1º CEB), Provas de Aferição e Pais: perceções globais / Physical Education in the elementary school, assessment tests and parentes: global perceptions / Las pruebas de evaluación en Educación Física en educación primaria: la opinión de los padres y tutores

As Provas de Aferição em Educação Física (PAEF) integram um processo de avaliação externa dos alunos e do currículo da Educação Física (EF) na escola do 1º Ciclo do Ensino Básico (1º CEB) em Portugal. Assim, a opinião dos pais e encarregados de educação (PEE) sobre as PAEF pode ser um fator relevante. Analisaram-se as perceções globais de 127 PEE dos alunos do 2º ano de escolaridade, recolhidas através de um questionário, com os dados tratados através de análise de conteúdo (categorias emergentes) e estatística. Os resultados evidenciaram que os PEE têm uma dispersão de perceções sobre as PAEF, que vão desde uma posição contrária e negativa até à sua apreciação positiva e fundamentada. Identificam também que estas podem ter um impacte futuro expressivo, monitorização da aprendizagem, do currículo e papel de avaliação formativa. Há necessidade de ampliar o conhecimento sobre a natureza e objetivos das PAEF e sua influência na valorização da área de EF na escola do 1º CEB.

The Assessment Tests in Physical Education (ATPE) are part of an external assessment process of students and the Physical Education (PE) curriculum in the Elementary School (ES) in Portugal. Thus, the opinion of parents and guardians (PG) about the ATPE can be a relevant factor. The global perceptions of 127 PEE of 2nd year students were analyzed, collected through a questionnaire, with the data processed through content analysis (emerging categories) and statistics. The results showed that the PG have a dispersion of perceptions about the ATPE, ranging from a contrary and negative position to a positive and reasoned assessment. They also identify that these can have a significant future impact, monitoring learning, the curriculum and the role of formative assessment. There is a need to expand knowledge about the nature and objectives of ATPE and its influence on valuing the PE area in the ES

Las Pruebas de Evaluación en Educación Física (PAEF) forman parte de un proceso de evaluación externa de los alumnos y del currículo de Educación Física (EF) en Escuela Primária en Portugal. Así, la opinión de los padres y tutores (PT) sobre el PAEF puede ser un factor relevante. Se analizaron las percepciones globales de 127 PT de alumnos de 2º año, recogidas a través de un cuestionario, siendo los datos procesados mediante análisis de contenido (categorías emergentes) y estadística. Los resultados mostraron que los PT tienen una dispersión de percepciones sobre el PAEF, que van desde una posición contraria y negativa hasta una valoración positiva y razonada. También identifican que estos pueden tener un impacto futuro significativo, monitoreando el aprendizaje, el currículo y el rol de la evaluación formativa. Existe la necesidad de ampliar el conocimiento sobre la naturaleza y objetivos del PAEF y su influencia en la valorización del área de EF en la Escuela Primária.

Exploring Freeze-Drying as Strategy to Enhance Viability of Faecalibacterium duncaniae DSM 17677 upon Aerobic Storage and Gastrointestinal Conditions

Faecalibacterium duncaniae is an intestinal commensal bacterium proposed as a next-generation probiotic due to its promising outcomes in the treatment and prevention of several human diseases, which demonstrate its multiple contributions to the host's health. However, its strict anaerobic nature has created several hurdles in the development of functional foods, nutraceuticals, and biotherapeutic products. Herein, we explored freeze-dried formulations containing prebiotics, cryoprotectants, and antioxidant agents as a technological strategy to enhance the viability of F. duncaniae DSM 17677 upon aerobic storage and gastrointestinal tract conditions. Our results indicate that freeze-dried F. duncaniae in a matrix containing inulin, sucrose, cysteine, and riboflavin survived at levels higher than 106 CFU/g and around 105 CFU/g after 1 and 4 days of aerobic storage at room temperature, respectively. Thus, the freeze-dried formulation with inulin, sucrose, cysteine, and riboflavin presents as a protective strategy to improve F. duncaniae viability under aerobic environments. Nevertheless, incorporation of a suitable coating aimed at protecting F. duncaniae against the detrimental gastrointestinal passage effects is urgently required, given its high susceptibility to extreme acidic pH values and bile.

Insights into the Antimicrobial Resistance Profile of a Next Generation Probiotic Akkermansia muciniphila DSM 22959.

Akkermansia muciniphila is a Gram-negative intestinal anaerobic bacterium recently proposed as a novel probiotic candidate to be incorporated in food and pharmaceutical forms. Despite its multiple health benefits, the data addressing its antimicrobial susceptibility profile remain scarce. However, the absence of acquired resistance in probiotic strains is a compulsory criterion for its approval in the qualified presumption of safety list. This study aimed at characterizing the A. muciniphila DSM 22959 strain's antimicrobial susceptibility profile using phenotypic and in silico approaches. To establish the phenotypic antimicrobial susceptibility profile of this strain, minimum inhibitory concentrations of eight antimicrobials were determined using broth microdilution and E-test methods. Additionally, the A. muciniphila DSM 22959 genome was screened using available databases and bioinformatics tools to identify putative antimicrobial resistance genes (ARG), virulence factors (VF), genomic islands (GI), and mobile genetic elements (MGE). The same categorization was obtained for both phenotypic methods. Resistance phenotype was observed for gentamicin, kanamycin, streptomycin, and ciprofloxacin, which was supported by the genomic context. No evidence was found of horizontal acquisition or potential transferability of the identified ARG and VF. Thus, this study provides new insights regarding the phenotypic and genotypic antimicrobial susceptibility profiles of the probiotic candidate A. muciniphila DSM 22959.

Reflexões acerca da maternidade entre mulheres usuárias de crack na cidade do Rio de Janeiro / Thoughts on the maternity among female crack users in the city of Rio de Janeiro

O artigo tem como objetivo discutir as vivências e decisões a respeito da maternidade no contexto da vulnerabilidade social, um tema complexo e desafiador e que vem nos convocando a reflexões. Atuamos com a realidade de um público invisibilizado, marcado pelo estigma da incapacidade para o exercício dessa função, por viverem nas ruas e serem usuárias de crack na cidade do Rio de Janeiro. Como principal aporte metodológico utilizamos questionários semiestruturados e narrativas colhidas em entrevistas livres, e pudemos reconhecer especificidades que atravessam a realidade de mulheres em situação de vulnerabilidade social e as expectativas quanto ao exercício maternidade. Mapeamos um cenário desconhecido, não apenas para o mundo acadêmico, mas também para as políticas públicas. Os dados quantitativos materializam um cenário pouco estudado e as narrativas nos trazem versões não reducionistas da maternidade entre mulheres em situação de risco e vulnerabilidade social. Tendo a Teoria Ator-rede como principal referencial teórico, os resultados encontrados apontam para formas transversais de exercer a maternidade no grupo estudado reconhecemos, bem como a importância de ações coletivas e integradas para que essas mulheres saiam da invisibilidade e exerçam suas escolhas. Discutimos também efeitos e desdobramentos da ausência de políticas públicas efetivas junto a esse público, reconhecendo a complexidade desse tema

The article aims to discuss the experiences and decisions regarding motherhood in the context of social vulnerability, a complex and challenging issue that has been calling us to reflect. We work with the reality of an invisibilized public, marked by the stigma of inability to exercise this function, for living on the streets and being crack users in the city of Rio de Janeiro. As main methodological support we used semi-structured questionnaires and narratives collected in free interviews, and we were able to recognize specificities that go through the reality of women in a situation of social vulnerability and the expectations regarding motherhood. We mapped out an unknown scenario, not only for the academic world, but also for public policies. The quantitative data materialize a little-studied scenario, and the narratives bring us non-reductionist versions of motherhood among women in situations of risk and social vulnerability. Having the Actor-Network Theory as the main theoretical reference, the results found point to transversal ways of exercising motherhood in the studied group we recognize, as well as the importance of collective and integrated actions for these women to come out of invisibility and exercise their choices. We also discuss the effects and consequences of the absence of effective public policies, recognizing the complexity of this theme.

Biological and Molecular Docking Evaluation of a Benzylisothiocyanate Semisynthetic Derivative From Moringa oleifera in a Pre-clinical Study of Temporomandibular Joint Pain.

Objective: Moringa oleifera possesses multiple biological effects and the 4-[(4'-O-acetyl-α-L- rhamnosyloxy) benzyl] isothiocyanate accounts for them. Based on the original isothiocyanate molecule we obtained a semisynthetic derivative, named 4-[(2',3',4'-O-triacetyl-α-L-rhamnosyloxy) N-benzyl] hydrazine carbothioamide (MC-H) which was safe and effective in a temporomandibular joint (TMJ) inflammatory hypernociception in rats. Therefore, considering that there is still a gap in the knowledge concerning the mechanisms of action through which the MC-H effects are mediated, this study aimed to investigate the involvement of the adhesion molecules (ICAM-1, CD55), the pathways heme oxygenase-1 (HO-1) and NO/cGMP/PKG/K+ ATP, and the central opioid receptors in the efficacy of the MC-H in a pre-clinical study of TMJ pain. Methods: Molecular docking studies were performed to test the binding performance of MC-H against the ten targets of interest (ICAM-1, CD55, HO-1, iNOS, soluble cGMP, cGMP-dependent protein kinase (PKG), K+ ATP channel, mu (µ), kappa (κ), and delta (δ) opioid receptors). In in vivo studies, male Wistar rats were treated with MC-H 1 µg/kg before TMJ formalin injection and nociception was evaluated. Periarticular tissues were removed to assess ICAM-1 and CD55 protein levels by Western blotting. To investigate the role of HO-1 and NO/cGMP/PKG/K+ ATP pathways, the inhibitors ZnPP-IX, aminoguanidine, ODQ, KT5823, or glibenclamide were used. To study the involvement of opioid receptors, rats were pre-treated (15 min) with an intrathecal injection of non-selective inhibitor naloxone or with CTOP, naltrindole, or norbinaltorphimine. Results: All interactions presented acceptable binding energy values (below -6.0 kcal/mol) which suggest MC-H might strongly bind to its molecular targets. MC-H reduced the protein levels of ICAM-1 and CD55 in periarticular tissues. ZnPP-IX, naloxone, CTOP, and naltrindole reversed the antinociceptive effect of MC-H. Conclusion: MC-H demonstrated antinociceptive and anti-inflammatory effects peripherally by the activation of the HO-1 pathway, as well as through inhibition of the protein levels of adhesion molecules, and centrally by µ and δ opioid receptors.

Spray-Drying Encapsulation of the Live Biotherapeutic Candidate Akkermansia muciniphila DSM 22959 to Survive Aerobic Storage.

Akkermansia muciniphila is regarded as a promising next-generation probiotic or live biotherapeutic candidate. Effective delivery strategies must be developed to ensure high enough viability of the probiotic strain throughout its industrial formulation, distribution chain, shelf-life, and, ultimately, the host's gastrointestinal tract, where it should exert its beneficial effect(s). Among the possible methodologies, spray-drying is considered industrially attractive regarding its costs, efficiency, and scalability, with the due parameter customization. In this study, spray-drying was explored as a one-step process to encapsulate A. muciniphila DSM 22959, testing the drying settings and three different dairy-based matrices. Microcapsule morphology and size was assessed, and viability throughout storage at 4 or 22 °C and simulated gastrointestinal passage was determined. Akkermansia muciniphila microencapsulation by spray-drying, using 10% skim milk and inlet/outlet temperatures of 150/65 °C, is effective in terms of viability stabilization, both during prolonged aerobic storage and exposure to simulated gastrointestinal passage. Akkermansia muciniphila viability was maintained at around 107 CFU/g up to 28 days at 4 °C under aerobic conditions with viability losses inferior to 1 log reduction. This methodology provides the necessary conditions to efficiently deliver the recommended dose of live A. muciniphila in the human gut as a live biotherapeutic product.

Chemical Composition and Potential Biological Activity of Melanoidins From Instant Soluble Coffee and Instant Soluble Barley: A Comparative Study.

In this work a comparative study of the chemical composition and potential biological activity of high molecular weight (HMW) melanoidins isolated from instant soluble coffee (ISC) and instant soluble barley (ISB) was performed. ISB HMW melanoidins were almost exclusively composed by an ethanol soluble (EtSn) melanoidin fraction composed by glucose (76% w/w) partially susceptible to in vitro digestion, whereas ISC was composed mainly by arabinogalactans (~41% w/w) and lower amounts of galactomannans (~14% w/w) presenting a range of ethanol solubilities and resistant to in vitro digestion. Melanoidins from ISC presented a significantly higher content of condensed phenolic compounds (17/100 g) when compared to ISB (8/100 g) showing also a higher in vitro scavenging of ABTS•+ (329 mmol Trolox/100 g vs. 124 mmol Trolox/100 g) and NO radicals (inhibition percentage of 57 and 26%, respectively). Nevertheless, ISB EtSn melanoidins presented, on average a higher inhibitory effect on NO production from LPS-stimulated macrophages. ISB melanoidins, up to 1 mg/mL, did not induce toxicity in Caco-2, HepG2 and RAW 264.7 cell lines while at the highest concentration ISC slightly reduced cell viability. Thus, consumption of a diet rich in ISC and ISB melanoidins may reduce the oxidative stress, the inflammatory levels and increase the protective effects against chronic inflammatory diseases.

Revealing antimicrobial resistance profile of the novel probiotic candidate Faecalibacterium prausnitzii DSM 17677.

Faecalibacterium prausnitzii, a resident anaerobic bacterium commonly found in healthy gut microbiota, has been proposed as a next generation probiotic with high potential for application in food matrices and pharmaceutical formulations. Despite its recognized health benefits, detailed information regarding its antimicrobial susceptibility profile is still lacking. However, this information is crucial to determine its safety, since the absence of acquired antimicrobial resistance is required to qualify a probiotic candidate as safe for human and animal consumption. Herein, the antimicrobial susceptibility profile of F. prausnitzii DSM 17677 strain was evaluated by integrating both phenotypic and in silico data. Phenotypic antimicrobial susceptibility was evaluated by determining minimum inhibitory concentrations of 9 antimicrobials using broth microdilution and E-test® methods. Also, the whole genome of F. prausnitzii DSM 17677 was analysed, using several databases and bioinformatics tools, to identify possible antibiotic resistance genes (ARG), genomic islands (GI) and mobile genetic elements (MGE). With exception of erythromycin, the same classification (susceptible or resistant) was obtained in both broth microdilution and E-test® methods. Phenotypic resistance to ampicillin, gentamycin, kanamycin and streptomycin were detected, which was supported by the genomic context. Other ARG were also identified but they seem not to be expressed under the tested conditions. F. prausnitzii DSM 17677 genome contains 24 annotated genes putatively involved in resistance against the following classes of antimicrobials: aminoglycosides (such as gentamycin, kanamycin and streptomycin), macrolides (such as erythromycin), tetracyclines and lincosamides. The presence of putative ARG conferring resistance to ß-lactams could only be detected using a broader homology search. The majority of these genes are not encoded within GI or MGE and no plasmids were reported for this strain. Despite the fact that most genes are related with general resistance mechanisms, a streptomycin-specific ARG poses the only potential concern identified. This specific ARG is encoded within a GI and a MGE, meaning that it could have been laterally acquired and might be transferred to other bacteria present in the same environment. Thus, our findings provide relevant insights regarding the phenotypic and genotypic antimicrobial resistance profiles of the probiotic candidate F. prausnitzii DSM 17677.

On species group Chira G. W. Peckham & E. G. Peckham, 1896: taxonomy and distribution updates (Araneae: Salticidae: Freyina)

Salticidae is the largest family of spiders in terms of described species. Chira Peckham & Peckham, 1896 is a genus with a Neotropical distribution, with 13 described species, but only six have both sexes known. Among the described species, 10 occur in Brazil, including Chira simoni Galiano, 1961 that has only the male described. The main objective of this work is to redescribe Chira simoni, 1961 and describe the female for the first time. The species Chira distincta Bauab-Vianna, 1983 is synonymized with Chira spinosa (Mello-Leitão, 1939), syn. nov. and Chira reticulata (Mello-Leitão, 1943) is synonymized with Chira thysbe Simon, 1902, syn. nov. A discussion about the groups of Chira species is presented, as well as new diagnoses and an update on the distribution of the genus Chira in the Neotropical region.

Clustering of loci controlling species differences in male chemical bouquets of sympatric Heliconius butterflies.

The degree to which loci promoting reproductive isolation cluster in the genome-that is, the genetic architecture of reproductive isolation-can influence the tempo and mode of speciation. Tight linkage between these loci can facilitate speciation in the face of gene flow. Pheromones play a role in reproductive isolation in many Lepidoptera species, and the role of endogenously produced compounds as secondary metabolites decreases the likelihood of pleiotropy associated with many barrier loci. Heliconius butterflies use male sex pheromones to both court females (aphrodisiac wing pheromones) and ward off male courtship (male-transferred antiaphrodisiac genital pheromones), and it is likely that these compounds play a role in reproductive isolation between Heliconius species. Using a set of backcross hybrids between H. melpomene and H. cydno, we investigated the genetic architecture of putative male pheromone compound production. We found a set of 40 significant quantitative trait loci (QTL) representing 33 potential pheromone compounds. QTL clustered significantly on two chromosomes, chromosome 8 for genital compounds and chromosome 20 for wing compounds, and chromosome 20 was enriched for potential pheromone biosynthesis genes. There was minimal overlap between pheromone QTL and known QTL for mate choice and color pattern. Nonetheless, we did detect linkage between a QTL for wing androconial area and optix, a color pattern locus known to play a role in reproductive isolation in these species. This tight clustering of putative pheromone loci might contribute to coincident reproductive isolating barriers, facilitating speciation despite ongoing gene flow.

A novel terpene synthase controls differences in anti-aphrodisiac pheromone production between closely related Heliconius butterflies.

Plants and insects often use the same compounds for chemical communication, but not much is known about the genetics of convergent evolution of chemical signals. The terpene (E)-ß-ocimene is a common component of floral scent and is also used by the butterfly Heliconius melpomene as an anti-aphrodisiac pheromone. While the biosynthesis of terpenes has been described in plants and microorganisms, few terpene synthases (TPSs) have been identified in insects. Here, we study the recent divergence of 2 species, H. melpomene and Heliconius cydno, which differ in the presence of (E)-ß-ocimene; combining linkage mapping, gene expression, and functional analyses, we identify 2 novel TPSs. Furthermore, we demonstrate that one, HmelOS, is able to synthesise (E)-ß-ocimene in vitro. We find no evidence for TPS activity in HcydOS (HmelOS ortholog of H. cydno), suggesting that the loss of (E)-ß-ocimene in this species is the result of coding, not regulatory, differences. The TPS enzymes we discovered are unrelated to previously described plant and insect TPSs, demonstrating that chemical convergence has independent evolutionary origins.

Commensal Obligate Anaerobic Bacteria and Health: Production, Storage, and Delivery Strategies.

In the last years several human commensals have emerged from the gut microbiota studies as potential probiotics or therapeutic agents. Strains of human gut inhabitants such as Akkermansia, Bacteroides, or Faecalibacterium have shown several interesting bioactivities and are thus currently being considered as food supplements or as live biotherapeutics, as is already the case with other human commensals such as bifidobacteria. The large-scale use of these bacteria will pose many challenges and drawbacks mainly because they are quite sensitive to oxygen and/or very difficult to cultivate. This review highlights the properties of some of the most promising human commensals bacteria and summarizes the most up-to-date knowledge on their potential health effects. A comprehensive outlook on the potential strategies currently employed and/or available to produce, stabilize, and deliver these microorganisms is also presented.

A major locus controls a biologically active pheromone component in Heliconius melpomene.

Understanding the production, response, and genetics of signals used in mate choice can inform our understanding of the evolution of both intraspecific mate choice and reproductive isolation. Sex pheromones are important for courtship and mate choice in many insects, but we know relatively little of their role in butterflies. The butterfly Heliconius melpomene uses a complex blend of wing androconial compounds during courtship. Electroantennography in H. melpomene and its close relative Heliconius cydno showed that responses to androconial extracts were not species specific. Females of both species responded equally strongly to extracts of both species, suggesting conservation of peripheral nervous system elements across the two species. Individual blend components provoked little to no response, with the exception of octadecanal, a major component of the H. melpomene blend. Supplementing octadecanal on the wings of octadecanal-rich H. melpomene males led to an increase in the time until mating, demonstrating the bioactivity of octadecanal in Heliconius. Using quantitative trait locus (QTL) mapping, we identified a single locus on chromosome 20 responsible for 41% of the parental species' difference in octadecanal production. This QTL does not overlap with any of the major wing color or mate choice loci, nor does it overlap with known regions of elevated or reduced FST . A set of 16 candidate fatty acid biosynthesis genes lies underneath the QTL. Pheromones in Heliconius carry information relevant for mate choice and are under simple genetic control, suggesting they could be important during speciation.

A Randomized Trial of the Close Reading and Creative Writing Program: An Alternative Educational Method for Adult Group Care Intervention in Type 2 Diabetes Management.

OBJECTIVES: Group care for individuals with diabetes is a recognized educational practice, but techniques from narrative medicine using of literary works have never been incorporated in these programs. We designed a new educational model (i.e. the Close Reading and Creative Writing program) of group care for individuals with diabetes incorporating close reading and creative writing in group education. A randomized trial was designed to evaluate this intervention. METHODS: A total of 49 individuals with type 2 diabetes, aged <85 years and with >6 years of school education, were randomized to 2 different group care dynamics: (a) a "control group," with a classical structured educational approach currently used at our institution; and (b) an "intervention group," with introduction of literary texts, narrative skills, close reading and creative writing. Evaluation included anthropometric measures, glycated hemoglobin (A1C) and questionnaires for psychological evaluation. Individual A1C levels in the 6-year period before the trial were collected from clinical records. RESULTS: A significant reduction of A1C was observed in the intervention group, showing noninferiority in relation to the classical approach. A significant decrease in A1C was observed in relation to the 6 previous years. A significant increase in satisfaction with the therapist and group process was observed. CONCLUSIONS: This is the first randomized trial designed to evaluate a group care intervention to manage type 2 diabetes using narrative techniques. The results suggest that this may be a useful model for more highly schooled individuals, and may represent an alternative for the educational process.

Evolving trends in next-generation probiotics: a 5W1H perspective.

In recent years, scientific community has been gathering increasingly more insight on the dynamics that are at play in metabolic and inflammatory disorders. These rapidly growing conditions are reaching epidemic proportions, bringing clinicians and researcher's new challenges. The specific roles and modulating properties that beneficial/probiotic bacteria hold in the context of the gut ecosystem seem to be key to avert these inflammatory and diet-related disorders. Faecalibacterium prausnitzii, Akkermansia muciniphila and Eubacterium hallii have been identified as candidates for next generation probiotics (NGPs) with exciting potential for the prevention and treatment of such of dysbiosis-associated diseases. The challenges of these non-conventional native gut bacteria lie mainly on their extreme sensitivity to O2 traces. If these strains are to be used successfully in food, supplements or drugs they need to be stable and active in humans. In the present review, we present an overall perspective of the most updated scientific literature on the newly called NGPs through the 5W1H (What, Why, Who, Where, When, and How) method, an innovative and attractive problem-solving approach that provides the reader an effective understanding of the issue at hand.

Uncovering Akkermansia muciniphila resilience or susceptibility to different temperatures, atmospheres and gastrointestinal conditions.

Data regarding Akkermansia muciniphila viability under stress remains scarce despite its beneficial potential. Therefore, the main goal was to assess A. muciniphila culturability when exposed to different temperatures, atmospheres and gastrointestinal simulated conditions. Cultivable cell numbers A. muciniphila remain high after refrigerated and room temperatures oxygen exposure, and gastrointestinal passage.

Respiratory Care for the Ventilated Neonate.

Invasive ventilation is often necessary for the treatment of newborn infants with respiratory insufficiency. The neonatal patient has unique physiological characteristics such as small airway caliber, few collateral airways, compliant chest wall, poor airway stability, and low functional residual capacity. Pathologies affecting the newborn's lung are also different from many others observed later in life. Several different ventilation modes and strategies are available to optimize mechanical ventilation and to prevent ventilator-induced lung injury. Important aspects to be considered in ventilating neonates include the use of correct sized endotracheal tube to minimize airway resistance and work of breathing, positioning of the patient, the nursing care, respiratory kinesiotherapy, sedation and analgesia, and infection prevention, namely, the ventilator-associated pneumonia and nosocomial infection, as well as prevention and treatment of complications such as air leaks and pulmonary hemorrhage. Aspects of ventilation in patients under ECMO (extracorporeal membrane oxygenation) and in palliative care are of increasing interest nowadays. Online pulmonary mechanics and function testing as well as capnography are becoming more commonly used. Echocardiography is now a routine in most neonatal units. Near infrared spectroscopy (NIRS) is an attractive tool potentially helping in preventing intraventricular hemorrhage and periventricular leukomalacia. Lung ultrasound is an emerging tool of diagnosis and can be of added value in helping monitoring the ventilated neonate. The aim of this scientific literature review is to address relevant aspects concerning the respiratory care and monitoring of the invasively ventilated newborn in order to help physicians to optimize the efficacy of care.

Hardy kiwifruit leaves (Actinidia arguta): An extraordinary source of value-added compounds for food industry.

The present study reports for the first time the identification and quantification of phenolic compounds, the antioxidant and antimicrobial activities as well as the in vitro radical scavenging activity and intestinal cell effects of A. arguta leaves extracts. Extractions were carried out under water, water:ethanol (50:50) and ethanol. The highest antioxidant activity were obtained in alcoholic extract (IC50 = 53.95 ±â€¯3.09 µg/mL for DPPH; 6628.42 ±â€¯382.49 µmol/mg dry weight basis for FRAP) while the phenolic profile confirmed by HPLC analysis revealed highest amounts of phenolic acids (hydroxycinnamic acid derivatives) and flavonoids (flavan-3-ol and flavonols derivatives). An excellent scavenging activity against reactive oxygen and nitrogen species were determined for all extracts as well as no adverse effects on Caco-2 and HT29-MTX cells in concentrations below 100 µg/mL and 1000 µg/mL, respectively. These results highlight the potentialities of hardy kiwi leaves valorization.