Analysis of Amyloid Fibrillation of Two Family 1 Glycoside Hydrolases.

The formation and analysis of amyloid fibers by two ß-glucosidases, BglA and BglB, belonging to the GH1 enzyme family, are reported. Both proteins have the (ß/α)8 TIM-barrel fold, which is characteristic of this family and is also the most common protein structure. BglA is an octamer, whereas BglB is a monomer. Amyloid fibrillation using pH and temperature as perturbing agents was investigated using fluorescence spectroscopy as a preliminary approach and corroborated using wide-field optical microscopy, confocal microscopy, and field-emission scanning electron microscopy. These analyses showed that both enzymes fibrillate at a wide range of acidic and alkaline conditions and at several temperature conditions, particularly at acidic pH (3-4) and at temperatures between 45 and 65 °C. Circular dichroism spectroscopy corroborated the transition from an α-helix to a ß-sheet secondary structure of both proteins in conditions where fibrillation was observed. Overall, our results suggest that fibrillation is a rather common phenomenon caused by protein misfolding, driven by a transition from an α-helix to a ß-sheet secondary structure, that many proteins can undergo if subjected to conditions that disturb their native conformation.

Heterogeneity of variance and genetic parameters for milk production in cattle, using Bayesian inference.

The goal of this study was to verify the effect of heterogeneity of variance (HV) on milk production in up to 305 days of lactation (L305) of daughters of Girolando, Gir and Holstein sires, as well as in the genetic evaluation of these sires and their progenies. in Brazil. The model included contemporary groups (consisting of herd, year and calving season) as a fixed effect, cow age at calving (linear and quadratic effects) and heterozygosity (linear effect) as covariates, in addition to the random effects of direct additive genetic and environmental, permanent and residual. The first analysis consisted of the single-trait animal model, with L305 records (disregarding HV). The second considered classes of standard deviations (SD): two-trait model including low and high classes (considering HV), according to the standardized means of L305 for herd-year of calving. The low SD class was composed of herds with SD equal to or less than zero and the high class with positive SD values. Estimates of (co)variance components and breeding values were obtained separately for each scenario using Bayesian inference via Gibbs sampling. Different heritability was estimated. Higher for the high DP class in the Gir (0.20) and Holstein (0.15) breeds, not occurring the same in the Girolando breed, with a lower value among the classes for the high DP (0.10). High values of genetic correlations were also found between low and high SD classes (0.88; 0.85 and 0.79) for the Girolando, Gir and Holstein breeds, respectively. Like the order correlations (Spearman) which were also high for the three breeds analyzed (equal to or above 0.92). Thus, the presence of HV had a smaller impact for L305 and did not affect the genetic evaluation of sires.

Growth curve mixed nonlinear models in quails.

Our aim was to evaluate the use and application of different nonlinear mixed models, as well as to compare them with approach in nonlinear fixed models, for describing the growth curve of meat-type quails according to gender. A total of 15,002 and 15,408 records of males and females were used, respectively. The body weights were regressed on age of the animals using nonlinear models (Brody; Gompertz; Logistic, Morgan-Mercer-Flodin, Richards and Von Bertalanffy). All model parameters were considered fixed, whereas parameters related to asymptotic weight and maturity rate were fitted as random effects. The Bayesian Information Criterion was used to find the model of best fit. For both genders, the model that used the Morgan-Mercer-Flodin function with the inclusion of asymptotic weight as a random effect was considered the best-fitting model because it reduced the residual variance and increased the accuracy. Based on the lower absolute growth rate and growth velocity of male quails compared to that of females, it can be inferred that males should be slaughtered later. Given the results of this study, it can contribute to the current knowledge about animal yield, specifically at the best moment to slaughter and, this sense, improv the quality genetic of the populations in time.

Factors Affecting Spontaneous Endocytosis and Survival of Probiotic Lactobacilli in Human Intestinal Epithelial Cells.

Mutualistic bacteria have different forms of interaction with the host. In contrast to the invasion of pathogenic bacteria, naturally occurring internalization of commensal bacteria has not been studied in depth. Three in vitro methods, gentamicin protection, flow cytometry and confocal laser scanning microscopy, have been implemented to accurately assess the internalization of two lactobacillus strains-Lacticaseibacillus paracasei BL23 and Lacticaseibacillus rhamnosus GG-in Caco-2 and T84 intestinal epithelial cells (IECs) under a variety of physiological conditions and with specific inhibitors. First and most interesting, internalization occurred at a variable rate that depends on the bacterial strain and IEC line, and the most efficient was BL23 internalization by T84 and, second, efficient internalization required active IEC proliferation, as it improved naturally at the early confluence stages and by stimulation with epidermal growth factor (EGF). IFN-γ is bound to innate immune responses and autolysis; this cytokine had a significant effect on internalization, as shown by flow cytometry, but increased internalization was not perceived in all conditions, possibly because it was also stimulating autolysis and, as a consequence, the viability of bacteria after uptake could be affected. Bacterial uptake required actin polymerization, as shown by cytochalasin D inhibition, and it was partially bound to clathrin and caveolin dependent endocytosis. It also showed partial inhibition by ML7 indicating the involvement of cholesterol lipid rafts and myosin light chain kinase (MLCK) activation, at least in the LGG uptake by Caco-2. Most interestingly, bacteria remained viable inside the IEC for as long as 72 h without damaging the epithelial cells, and paracellular transcytosis was observed. These results stressed the fact that internalization of commensal and mutualistic bacteria is a natural, nonpathogenic process that may be relevant in crosstalk processes between the intestinal populations and the host, and future studies could determine its connection to processes such as commensal tolerance, resilience of microbial populations or transorganic bacterial migration.

Mixed Models in Nonlinear Regression for Description of the Growth of Nelore Cattle.

Body weight records were used to characterize the growth curve of Nelore cattle. Body weight was regressed as a function of age, for both sexes, by using nonlinear models through the functions of Brody, Gompertz, Logistic, Richards, Meloun 1, Von Bertalanffy, and Von Bertalanffy. The quality of the model arrangements was evaluated by employing Akaike and Bayesian Schwarz information criteria. The Brody function provided the best adaptations by the evaluators and, considering the asymptotic weight and the maturation rate as random, a reduction in residual variance of 79% for males and 83% for females was obtained in relation to the models under fixed contexts. In males, the absolute and relative growth rates ranged from 0.921 to 0.261 kg/day and 2.39 to 0.08%, respectively. For the same rates, under another approach, females ranged from 0.922 to 0.198 kg/day and 2.55 to 0.06%, respectively. Males showed greater growth acceleration at the beginning of the growth trajectory, being equal to females at 397 days of age and from that age onward they presented lower estimates. The nonlinear regression model approach under the mixed-models context allows reduction of residual variance, increasing model accuracy.

Predictive Score for Carbapenem-Resistant Gram-Negative Bacilli Sepsis: Single-Center Prospective Cohort Study.

A clinical-epidemiological score to predict CR-GNB sepsis to guide empirical antimicrobial therapy (EAT), using local data, persists as an unmet need. On the basis of a case-case-control design in a prospective cohort study, the predictive factors for CR-GNB sepsis were previously determined as prior infection, use of mechanical ventilation and carbapenem, and length of hospital stay. In this study, each factor was scored according to the logistic regression coefficients, and the ROC curve analysis determined its accuracy in predicting CR-GNB sepsis in the entire cohort. Among the total of 629 admissions followed by 7797 patient-days, 329 single or recurrent episodes of SIRS/sepsis were enrolled, from August 2015 to March 2017. At least one species of CR-GNB was identified as the etiology in 108 (33%) episodes, and 221 were classified as the control group. The cutoff point of ≥3 (maximum of 4) had the best sensitivity/specificity, while ≤1 showed excellent sensitivity to exclude CR-GNB sepsis. The area under the curve was 0.80 (95% CI: 0.76-0.85) and the number needed to treat was 2.0. The score may improve CR-GNB coverage and spare polymyxins with 22% (95% CI: 17-28%) adequacy rate change. The score has a good ability to predict CR-GNB sepsis and to guide EAT in the future.

Cuidados de enfermagem à pessoa em situação crítica em contexto pré-hospitalar: uma proposta de Padrão de Documentação / Nursing care to the critically ill person in the pre-hospital setting: a proposal for a Documentation Standard

Os registos de enfermagem são estruturantes para a melhoria da qualidade em saúde, da valorização e da visibilidade da profissão. Na emergência pré-hospitalar (EPH), os enfermeiros ocupam um papel reconhecido e crucial no Sistema Integrado de Emergência Médica, na prestação de cuidados de enfermagem à pessoa em situação critica, nomeadamente nas Viaturas Médicas de Emergência e Reanimação (VMER). O progresso e a melhoria global da enfermagem enquanto ciência na arte do cuidar motivou-nos para o desenvolvimento deste estudo, que decorreu em contexto de VMER onde consideramos os registos de enfermagem determinantes na efetividade, na continuidade e na qualidade dos cuidados à pessoa em situação crítica. Visa-se com este estudo mapear a documentação dos cuidados prestados à Pessoa em Situação Crítica na EPH, analisar as potencialidades e condicionamentos dos padrões existentes na perspetiva dos utilizadores e peritos em estreito diálogo com a produção científica atual e construir uma proposta de padrão documental dos cuidados de Enfermagem à Pessoa em Situação Crítica em EPH. A sua realização teve lugar na região norte de Portugal. Trata-se de um estudo de abordagem qualitativa, de natureza exploratória e descritiva. A recolha dos dados foi realizada em duas fases. Numa primeira através de observação participante em duas VMER do Norte, com recurso a notas de campo e duas entrevistas semiestruturadas a enfermeiros ao serviço. Numa segunda fase com recurso a um focus group constituídos por oito peritos informantes estratégicos das VMER do Norte (seis) e dois peritos em parametrização, linguagem e taxonomia CIPE aplicada aos sistemas de informação. A análise da informação recolhida foi desenvolvida com recurso à técnica de análise de conteúdo definida por Bardin (2011). Todos os procedimentos formais e éticos inerentes ao estudo foram considerados. Os resultados demonstram que, nas VMER, os registos de enfermagem quase não existem, apesar dos cuidados prestados poderem ser traduzidos em linguagem padronizada, agregados ao sistema hospitalar de informação em saúde, sistematizados numa abordagem estruturada pela metodologia "ABCDE" do trauma do American College of Surgeons e da Emergency Nurses Association e assentes, genericamente, nas etapas do Processo de Enfermagem. Pelo contributo dos participantes percebemos que a utilização de um padrão documental estruturado, simples e amigo do utilizador poderá vira contribuir para o início dos registos nesta área e assim melhorar a continuidade, a qualidade dos cuidados prestados, a segurança do utente e a visibilidade da profissão. Com a futura implementação deste Padrão Documental agora construído, esperamos contribuir para a melhoria dos registos de enfermagem na prestação de cuidados à pessoa em situação crítica nas VMER, assente numa estratégia que oriente e simplifique a elaboração destes registos.

Nursing records contribute largely to the improvement of quality in health, bringing value and visibility to the profession. In pre-hospital emergency (PHE), nurses play a crucial part in the Medical Emergency Integrated System when it comes to assuring nursing care to the patient in a critical situation. As an example of this, we have the Major Emergency Response Vehicle (VMER). The evolution and overall improvement of nursing as a science in the art of caring has motivated us to develop this study. It took place in a VMER context, in which we consider the records to be major determinants in the efficiency and quality of care to the person in need. In this study, we are looking to map the documentation available in terms of care provided to the subject in a Critical Situation in PHE. We are also focused on analyzing the assets and liabilities of the existing patterns, through formal conversations with users and experts in the current scientific production, in order to create a standard document proposition for nursing care to the Subject in a Critical Situation in a PHE context, which, in the nurses' perspective, will allow a very noticeable improvement in the care that follows. The study, which took place in the north of Portugal, is centered on a qualitative approach, from a descriptive and exploratory perspective. The data gathering took place in two different stages. Firstly, it happened through the observation and participation in two VMER units, followed by two semi structured interviews with nurses working on the field. Secondly, we organized a meeting with a group of eight experts from the six VMER units in the north region and two parameterization, language and ICNP taxonomy experts. After being gathered, the intel was analyzed according to the content analysis technique defined by Bardin (2011). All the ethical and formal procedures were thoroughly respected. The results show that nursing records practically don´t exist in VMER units, even though the care given can be expressed and translated to a patterned language known as the "ABCDE" trauma method from the American College of Surgeons and Emergency Nurses Association. The contribution of everyone involved made us realize that the existence of a simple and structured document pattern may contribute largely to the visible improvement in the quality of care provided, as well as the safety of the subject and, finally, the visibility of the profession.We hope to contribute to the improvement of nursing records when it comes to caring for a patient in a critical situation in a VMER unit with the implementation of a strategy that will, not only guide, but also simplify the elaboration of these records.

Sexual dimorphism in the turtle Kinosternon scorpioides (Testudines: Kinosternidae) from Marajó Island, Brazilian Amazon / Dimorfismo sexual de la tortuga Kinosternon scorpioides (Testudines: Kinosternidae) en la isla de Marajó, Amazonia brasileña

Abstract Introduction: Morphometrics analysis is an efficient and low-cost technique used in studies of sexual dimorphism in turtles. Kinosternon scorpioides scorpioides, scorpion mud turtle, has a wide phenotypic variation, depending on the area of its occurrence. Objective: The objective of this work was to identify the anatomical sexual difference of K. s. scorpioides, adults and hatchlings, through morphometric analysis; and relate the weights of adult animals to environmental factors (temperature and rainfall) in Marajó Island, Brazil. Methods: The sample collection was carried out from March to September 2018, covering both the rainy season (January to July) and the dry season (August to December). For the biometric analysis, 95 adults and 21 hatchlings were used, in which the length and width of the carapace and plastron, height of the shell, and weight were measured (adults only). For the geometric morphometry analysis, 21 adults and 13 hatchlings were used, in which 27 coordinates of anatomical landmarks were inserted in each image of the carapace and 11 in the plastron. Hatchlings were sexed by histology which was enabled by the identification of the ovaries and testicles. Results: The results showed the existence of dimorphism in adults. The plastron and height were higher in females, which had a more rounded carapace than males. This characteristic may be related to the species' sexual strategy, where males impose copulation. Histologically, it was possible to identify the ovaries and testicles in the hatchlings, but there was no anatomical sexual difference, despite the tendency to differentiate in the analysis of carapace PCA. Conclusions: Sexual dimorphism in K. s. scorpioides may play an important role on its reproductive behavior, which is synchronized with environmental events. This fact suggests that the reproductive strategies of this species would be severely affected by changes in the ecosystem.

Resumen Introducción: La morfometría es una técnica eficiente y de bajo costo, utilizada en estudios de dimorfismo sexual en tortugas, mediante el marcado de puntos anatómicos. Este grupo incluye Kinosternon scorpioides scorpioides, con una amplia variedad fenotípica, dependiendo del área en la que se encuentra presente. Objetivo: Este estudio tuvo como objetivo identificar la diferencia sexual entre K. s. scorpioides, adultos y juveniles, a través del análisis morfométrico; y verificar la relación entre las medidas de peso para adultos y los factores ambientales (temperatura y precipitación) en la isla de Marajó, Brasil. Métodos: La recolecta se realizó de marzo a septiembre de 2018, cubriendo tanto la temporada de lluvias (enero a julio) como la estación seca (agosto a diciembre). Para el análisis biométrico, se utilizaron 95 animales adultos y 21 crías, en los que se midió la longitud y el ancho del caparazón y el plastrón, la altura del casco y el peso en adultos. Para la morfometría geométrica, se utilizaron 21 adultos y 13 juveniles, en los que se identificaron 27 coordenadas de puntos de referencia anatómicos en el caparazón y 11 en el plastrón. Los individuos recién eclosionados fueron sexados por histología de rutina, que permite identificar ovarios y testículos. Resultados: Los datos analizados mostraron que existe dimorfismo sexual en adultos. El plastrón y la altura fueron mayores en las hembras, que tenían un caparazón más redondeado que los machos. Esta característica puede estar relacionada con la estrategia sexual de la especie, donde los machos imponen la cópula. En los juveniles recién eclosionados fue posible identificar histológicamente los ovarios y los testículos, pero no hubo diferencias sexuales en relación con la morfometría corporal, a pesar de la tendencia a diferenciarse en el análisis de PCA de caparazón. Conclusiones: El dimorfismo sexual en K. s. scorpioides puede desempeñar un papel importante en su comportamiento reproductivo, que ocurre en sincronía con los eventos ambientales. Este hecho sugiere que las estrategias reproductivas de esta especie se verían gravemente afectadas por los cambios en el ecosistema.

Retrospective study of the concordance between clinical and histopathological diagnosis in oral pathology / Estudio retrospectivo de la concordancia entre diagnóstico clínico e histopatológico en patología oral

Objectives: Evaluate the agreement between the clinical and histopathological diagnosis of oral lesions in patients submitted to biopsies. Identify the most frequent oral lesions and their correlation with age, gender, and anatomical location. Methods: A retrospective study of 368 pathological examinations collected between 2008 and 2018, corresponding to biopsies performed at the Clínica Universitária Egas Moniz. A detailed analysis of the histopathological reports attached to the patients' files was made and the variables gender, age, anatomical site, clinical diagnosis, and histopathological diagnosis was evaluated. Results: The most affected gender was female (55%); the most common age group was 61-70 years old; The most biopsied anatomical location was the gum (23.9%); the five most common pathological entities were fibroma(26.4%),root cyst(8.7%),oral lichen planus(7.6%), hemangioma (6.3%) and oral leukoplakia (6.0%). On agreement, 74.5% of the cases were concordant and 25.5% discordant. The most concordant lesions were Radicular Cyst (90.6%), Traumatic Injury (87.5%), Hemangioma (82.6%), Fibroma (82.5%) and Mucocele (82.5%). Conclusion: this study proves a significant level of agreement between clinical and histopathological diagnosis in this particular area, consistently obtained in a ten years period of time.

Objetivos: Evaluar el nivel de acuerdo entre el diagnóstico clínico e histopatológico de lesiones orales en pacientes sometidos a biopsias. Identificar las lesiones orales más frecuentes y su correlación con la edad, el sexo y la ubicación anatómica. Métodos: Estudio retrospectivo de 368 exámenes patológicos recogidos entre 2008 y 2018, correspondientes a biopsias realizadas en la Clínica Universitária Egas Moniz. Se realizó un análisis detallado de los informes histopatológicos adjuntos a los archivos de los pacientes y se evaluaron las variables de género, edad, sitio anatómico, diagnóstico clínico y diagnóstico histopatológico. Resultados: El género más afectado fue femenino (55%); el grupo de edad más común fue de 61-70 años; La ubicación anatómica más biopsiada fue la encía (23,9%); las cinco entidades patológicas más comunes fueron fibroma (26,4%), quiste radicular (8,7%), liquen plano oral (7,6%), hemangioma (6,3%) y leucoplasia oral (6,0%). Según el grado de acuerdo, el 74,5% de los casos fueron concordantes y el 25,5% discordantes. Las lesiones más concordantes fueron Quiste Radicular (90,6%), Lesión Traumática (87,5%), Hemangioma (82,6%), Fibroma (82,5%) y Mucocele (82,5%). Conclusión: este estudio demuestra un nivel significativo de acuerdo entre el diagnóstico clínico e histopatológico en esta área en particular, obtenido consistentemente en un período de diez años de tiempo

Citizen science and online data: opportunities and challenges for snake ecology and action against snakebite

The secretive behavior and life history of snakes makes studying their biology, distribution, and the epidemiology of venomous snakebite challenging. One of the most useful, most versatile, and easiest to collect types of biological data are photographs, particularly those that are connected with geographic location and date-time metadata. Photos verify occurrence records, provide data on phenotypes and ecology, and are often used to illustrate new species descriptions, field guides and identification keys, as well as in training humans and computer vision algorithms to identify snakes. We scoured eleven online and two offline sources of snake photos in an attempt to collect as many photos of as many snake species as possible, and attempt to explain some of the inter-species variation in photograph quantity among global regions and taxonomic groups, and with regard to medical importance, human population density, and range size. We collected a total of 725,565 photos—between 1 and 48,696 photos of 3098 of the world's 3879 snake species (79.9%), leaving 781 “most wanted” species with no photos (20.1% of all currently-described species as of the December 2020 release of The Reptile Database). We provide a list of most wanted species sortable by family, continent, authority, and medical importance, and encourage snake photographers worldwide to submit photos and associated metadata, particularly of “missing” species, to the most permanent and useful online archives: The Reptile Database, iNaturalist, and HerpMapper.

Apicoectomy of Perforated Root Canal Using Bioceramic Cement and Photodynamic Therapy.

Root perforation is a common endodontic accident. Its management depends mainly on root canal disinfection and sealing the perforation area by preventing any communication with the periodontium to prevent recontamination. A patient was referred to treat root perforation due to a previous treatment of tooth #22. The diagnosis was symptomatic periapical periodontitis, and the treatment plan was to retreat the root canal of #22 and make a surgical intervention (apicoectomy) associated with antimicrobial photodynamic therapy as a complementary technique. Five mineral oxides (5MO) cement was used as a root-end filling material. The procedures were performed in two sessions and controlled in two visits (after 30 days and 12 months). A bone neoformation was observed at the periapical area of tooth #22. 5MO bioceramic cement was effective in inducing the repair of the periapical lesion and had the ability to seal the exposed periapical area of the tooth. Its success depended mainly on root canal and surgical site disinfection.

Study on Overload Injuries during Periods of Intense Physical Activity Complemented by Isokinetic Dynamometry Evaluation / Estudo das lesões de sobrecarga durante período intenso de atividade física complementado com avaliação por dinamometria isocinética

Abstract Objective The present study aims to measure the incidence of overload injuries in training soldiers, who are subjected to intense physical exercise, and to compare it with a control group. Next, it intends to verify whether there is any relationship between overload injuries and some neuromuscular function parameters. Methods Analytical, prospective observational study. Both the observational and the control group consisted of soldiers from the Portuguese Army. Clinical evaluation was performed by medical interview in the week prior to the beginning of a military parachuting course and in the week immediately after its completion. The neuromuscular performance was assessed by isokinetic dynamometry during the medical interview. Results With 44 of the 57 military personnel in training complaining of pain, the observational group had significantly more injuries than the control group (p< 0.001). Five complaints had traumatic origin and 39 were overload injuries. Of the 39 military personnel with overload injuries, 21 reported limited sports performance. However, isokinetic dynamometry showed no statistically significant differences in neuromuscular performance (p = 0.223 and p = 0.229). Conclusion Military personnel in training are prone to overload injuries, with an incidence rate > 70%. The implementation of strategies for injury monitoring and prevention is critical to promote health and physical capacity.

Resumo Objetivo Os autores pretendem medir a incidência de lesões de sobrecarga em militares em formação, que são submetidos a exercício físico intenso, e compará-la com um grupo controle. Posteriormente, pretende-se verificar se existe alguma relação entre a ocorrência de lesões de sobrecarga e alguns parâmetros da função neuromuscular. Métodos Estudo observacional prospectivo analítico. Grupo de observação e grupo controle constituídos por militares do Exército Português. A avaliação clínica foi feita por entrevista médica na semana que antecede o início do curso de paraquedismo militar e na semana imediatamente após o final do curso. Em simultâneo com a entrevista médica, foi realizada a avaliação da performance neuromuscular através da dinamometria isocinética. Resultados Com 44 dos 57 militares em formação a referir queixas álgicas, o grupo de observação apresentou significativamente mais lesões que o grupo controle (p < 0.001). Cinco queixas foram de origem traumática e 39 foram lesões de sobrecarga. Dos 39 militares com lesões de sobrecarga, 21 referiram limitação do rendimento esportivo. No entanto, na avaliação por dinamometria isocinética, não se verificaram diferenças estatisticamente significativas na evolução da performance neuromuscular (p = 0.223 e p = 0.229). Conclusão Os militares em formação são indivíduos propensos a sofrerem lesões de sobrecarga, tendo-se obtido uma taxa de incidência de lesões de sobrecarga na ordem dos 70%. A implementação de estratégias de monitoração e prevenção das lesões são fundamentais na promoção da saúde e da capacidade física.

Predictive factors for sepsis by carbapenem resistant Gram-negative bacilli in adult critical patients in Rio de Janeiro: a case-case-control design in a prospective cohort study.

BACKGROUND: Studies have investigated risk factors for infections by specific species of carbapenem-resistant Gram-negative bacilli (CR-GNB), but few considered the group of GNB species and most of them were performed in the setting of bacteremia or hospital infection. This study was implemented to identify risk factors for sepsis by CR- and carbapenem-susceptible (CS) GNB in intensive care unit (ICU) patients to improve management strategies for CR-GNB sepsis. METHODS: We developed a case-case-control study from a prospective cohort of patients with systemic inflammatory response syndrome (SIRS), sepsis-2 or sepsis-3 criteria in which blood and other sample cultures were collected and antimicrobial therapy was instituted, in an adult clinical-surgical ICU, at tertiary public hospital in Rio de Janeiro, from August 2015 through March 2017. RESULTS: Among the total of 629 ICU admissions followed by 7797 patient-days, after applying inclusion and exclusion criteria we identified 184 patients who developed recurrent or single hospital-acquired sepsis. More than 90% of all evaluable cases of sepsis and 87% of control group fulfilled the modified sepsis-3 definition. Non-fermenting bacilli and ventilator-associated pneumonia predominated as etiology and source of CR-GNB sepsis. While Enterobacteriaceae and intra-abdominal surgical site plus urinary-tract infections prevailed in CS-GNB than CR-GNB sepsis. Carbapenemase production was estimated in 76% of CR-GNB isolates. Multivariate logistic regression analysis revealed previous infection (mostly hospital-acquired bacterial infection or sepsis) (OR = 4.28; 95% CI 1.77-10.35), mechanical ventilation (OR = 4.21; 95% CI 1.17-15.18), carbapenem use (OR = 3.42; 95% CI 1.37-8.52) and length of hospital stay (OR = 1.03; 95% CI 1.01-1.05) as independent risk factors for sepsis by CR-GNB. While ICU readmission (OR = 6.92; 95% CI 1.72-27.78) and nosocomial diarrhea (OR = 5.32; 95% CI 1.07-26.45) were factors associated with CS-GNB sepsis. CONCLUSIONS: The investigation of recurrent and not only bacteremic episodes of sepsis was the differential of this study. The results are in agreement with the basic information in the literature. This may help improve management strategies and future studies on sepsis by CR-GNB.

Granular cell tumor of the breast: correlations between imaging and pathology findings.

OBJECTIVE: To review the imaging features of granular cell tumors of the breast (on mammography, ultrasound, and magnetic resonance imaging), establishing a pathological correlation, in order to familiarize radiologists with this entity and make them aware of the differential diagnoses, other than malignancy, of lesions with spiculated margins. MATERIALS AND METHODS: We reviewed the medical records (from a clinical-pathology database and picture archiving and communication system) of five patients with a pathologically confirmed diagnosis of granular cell tumor of the breast, treated at the Portuguese Oncology Institute of Lisbon, in the city of Lisbon, Portugal, between January 2012 and December 2018. RESULTS: All five tumors exhibited imaging features highly suggestive of malignancy (BI-RADS 5 lesions), namely spiculated margins, significant depth, and posterior acoustic shadowing (on ultrasound). One tumor showed a kinetic curve indicative of washout on magnetic resonance imaging, two were adherent to the pectoralis muscle, and one was accompanied by skin retraction. Pathology provided the definitive diagnosis in all cases. CONCLUSION: Granular cell tumors of the breast pose a diagnostic challenge because they can present with clinical and imaging features mimicking malignancy, and the diagnosis is therefore provided by pathology. Radiologists should be familiarized with this entity, so they can be aware of the fact that breast lesions with spiculated margins can be indicative of diagnoses other than malignancy.

OBJETIVO: Rever as características de imagem dos tumores de células granulares da mama (mamográficas, ultrassonográficas e de ressonância magnética), estabelecendo uma correlação anatomopatológica, no intuito de proporcionar aos radiologistas uma familiarização com esta entidade e alertar para outros diagnósticos diferenciais de lesões espiculadas além das malignas. MATERIAIS E MÉTODOS: Consulta dos processos clínicos (base de dados clínica, anatomopatológica e sistema de comunicação e arquivamento de imagens) de doentes seguidos no Instituto Português de Oncologia de Lisboa, com diagnóstico anatomopatológico confirmado de tumor de células granulares da mama, de janeiro de 2012 a dezembro de 2018. RESULTADOS: Todos os tumores exibiram características de imagem altamente sugestivas de malignidade (BI-RADS 5), nomeadamente espiculações, crescimento em profundidade e atenuação posterior (ultrassonografia), um mostrou um perfil cinético com washout na ressonância magnética, dois estavam aderentes ao músculo peitoral e um associava retração cutânea. O diagnóstico definitivo foi anatomopatológico. CONCLUSÃO: Os tumores de células granulares da mama constituem um desafio diagnóstico, pois podem apresentar características clínicas e de imagem que mimetizam malignidade, pelo que o diagnóstico é anatomopatológico. Os radiologistas devem estar familiarizados com esta entidade de forma a considerá-la nos diagnósticos diferenciais de lesões espiculadas, além das lesões malignas.

Granular cell tumor of the breast: correlations between imaging and pathology findings / Tumor de células granulares da mama: correlação anatomorradiológica

Abstract Objective: To review the imaging features of granular cell tumors of the breast (on mammography, ultrasound, and magnetic resonance imaging), establishing a pathological correlation, in order to familiarize radiologists with this entity and make them aware of the differential diagnoses, other than malignancy, of lesions with spiculated margins. Materials and Methods: We reviewed the medical records (from a clinical-pathology database and picture archiving and communication system) of five patients with a pathologically confirmed diagnosis of granular cell tumor of the breast, treated at the Portuguese Oncology Institute of Lisbon, in the city of Lisbon, Portugal, between January 2012 and December 2018. Results: All five tumors exhibited imaging features highly suggestive of malignancy (BI-RADS 5 lesions), namely spiculated margins, significant depth, and posterior acoustic shadowing (on ultrasound). One tumor showed a kinetic curve indicative of washout on magnetic resonance imaging, two were adherent to the pectoralis muscle, and one was accompanied by skin retraction. Pathology provided the definitive diagnosis in all cases. Conclusion: Granular cell tumors of the breast pose a diagnostic challenge because they can present with clinical and imaging features mimicking malignancy, and the diagnosis is therefore provided by pathology. Radiologists should be familiarized with this entity, so they can be aware of the fact that breast lesions with spiculated margins can be indicative of diagnoses other than malignancy.

Resumo Objetivo: Rever as características de imagem dos tumores de células granulares da mama (mamográficas, ultrassonográficas e de ressonância magnética), estabelecendo uma correlação anatomopatológica, no intuito de proporcionar aos radiologistas uma familiarização com esta entidade e alertar para outros diagnósticos diferenciais de lesões espiculadas além das malignas. Materiais e Métodos: Consulta dos processos clínicos (base de dados clínica, anatomopatológica e sistema de comunicação e arquivamento de imagens) de doentes seguidos no Instituto Português de Oncologia de Lisboa, com diagnóstico anatomopatológico confirmado de tumor de células granulares da mama, de janeiro de 2012 a dezembro de 2018. Resultados: Todos os tumores exibiram características de imagem altamente sugestivas de malignidade (BI-RADS 5), nomeadamente espiculações, crescimento em profundidade e atenuação posterior (ultrassonografia), um mostrou um perfil cinético com washout na ressonância magnética, dois estavam aderentes ao músculo peitoral e um associava retração cutânea. O diagnóstico definitivo foi anatomopatológico. Conclusão: Os tumores de células granulares da mama constituem um desafio diagnóstico, pois podem apresentar características clínicas e de imagem que mimetizam malignidade, pelo que o diagnóstico é anatomopatológico. Os radiologistas devem estar familiarizados com esta entidade de forma a considerá-la nos diagnósticos diferenciais de lesões espiculadas, além das lesões malignas.

The 2016 QSM Challenge: Lessons learned and considerations for a future challenge design.

PURPOSE: The 4th International Workshop on MRI Phase Contrast and QSM (2016, Graz, Austria) hosted the first QSM Challenge. A single-orientation gradient recalled echo acquisition was provided, along with COSMOS and the χ33 STI component as ground truths. The submitted solutions differed more than expected depending on the error metric used for optimization and were generally over-regularized. This raised (unanswered) questions about the ground truths and the metrics utilized. METHODS: We investigated the influence of background field remnants by applying additional filters. We also estimated the anisotropic contributions from the STI tensor to the apparent susceptibility to amend the χ33 ground truth and to investigate the impact on the reconstructions. Lastly, we used forward simulations from the COSMOS reconstruction to investigate the impact noise had on the metric scores. RESULTS: Reconstructions compared against the amended STI ground truth returned lower errors. We show that the background field remnants had a minor impact in the errors. In the absence of inconsistencies, all metrics converged to the same regularization weights, whereas structural similarity index metric was more insensitive to such inconsistencies. CONCLUSION: There was a mismatch between the provided data and the ground truths due to the presence of unaccounted anisotropic susceptibility contributions and noise. Given the lack of reliable ground truths when using in vivo acquisitions, simulations are suggested for future QSM Challenges.

Protocol for the use of legacy data and magnetic signature on soil mapping of São Paulo Central West, Brazil.

The demand for information on the soil resource to support the establishment of public policies for land use and management has grown exponentially in the last years. However, there are still difficulties to the proper use of already existing information for soil mapping. Here we aimed to establish a protocol for soil mapping using legacy data, magnetic signature and soil attributes evaluation. A total of 493 soil samples were collected at 0-0.20 m in the geological domain of Western Plateau of São Paulo State. This work has three parts: First, we performed a classification analysis using soil mapping units (SMU) extracted from conventional soil map and Support Vector Machines algorithm (SVM). As covariates, we used categorical information, such as geology, dissection and landform maps. Second, we used soil attributes to perform a cluster analysis using k-means as partitioning method. To choose the optimal number of clusters, the same number of SMU showed in the conventional soil map (e.g. 34 clusters) were used. The last step was to compare soil and clusters maps predicted by SVM with the conventional soil map. Results showed good performance of SVM for both classifications (clusters and SMU), with overall accuracy of 0.60 and 0.90 respectively. In addition, the distribution of soil attributes within each cluster was more homogeneous and well distributed than within SMU, showing that is very possible to use numerical classification for soil mapping. Future soil surveys could use cluster analysis as a preliminary evaluation for better understanding of tropical soil variations.

Association of polymorphisms of the ß-defensin 1 gene with nematode and protozoan infection traits in goat.

This study's purpose was to identify polymorphisms (SNP) in the goat ß-defensin 1 gene and to associate these SNPs with traits related to nematodean and protozoan infections in Anglo-Nubian goats from semiarid region of Brazil. A total of 184 animals were used for DNA extraction, PCR and DNA automatic sequencing. The association analyses included the fixed effects of animal age, bloodline and genotype of the SNP marker in the statistical model. The means of genotypes were compared by the Fisher test (P < 0.05). Twelve polymorphism genotypes were found: two in intron 1, seven in exon 2 and three in 3' untranslated region. The SNPs of exon 2 were responsible for amino acid substitutions in six genetic codes, and the changes in the 25th and 33rd codes affected the protein function. The SNP 1937 was significantly associated with number of protozoan oocysts, whereas SNP 2001 was associated with degree of anaemia (Famacha©). Polymorphism 2046, in turn, showed a significant association with Famacha© degree and number of protozoan oocysts. SNP 2140 associated with maximum EPG of the animal. Results from this study suggest that the ß-defensin 1 gene can be used as a molecular marker for selection of goats regarding the susceptibility to endoparasites infections.