Medidas espectrais e cepstrais em mulheres com disfonia comportamental / Spectral and cepstral measurements in women with behavioral dysphonia

RESUMO Objetivo Investigar se existem diferenças nas medidas acústicas cepstrais e espectrais entre mulheres com disfonia comportamental com e sem lesão laríngea, bem como verificar se existe correlação entre tais medidas e o julgamento perceptivo-auditivo da qualidade vocal. Método Participaram 78 mulheres com disfonia comportamental sem lesão laríngea (DCSL) e 68 com disfonia comportamental com lesão laríngea (nódulos vocais) (DCCL). Foram extraídas as medidas CPP (cepstral peak prominence), CPPS (cepstral peak prominence smoothed), declínio espectral e H1-H2 (diferença entre a amplitude do primeiro e do segundo harmônico), assim como o julgamento perceptivo-auditivo (JPA) do grau geral de desvio vocal (GG), graus de rugosidade (GR), de soprosidade (GS) e de tensão (GT). Resultados Mulheres com DCCL apresentaram maiores valores de H1-H2 e menores valores no CPP e CPPS, em relação às mulheres com DCSL. As vozes mais desviadas apresentaram menores valores do CPP e CPPS. As vozes soprosas apresentaram menores valores de CPP e CPPS, assim como maior valor de H1-H2 em relação às vozes rugosas. Houve correlação negativa fraca entre o CPP e o GR, negativa moderada com o GG e negativa forte com o GS. O CPPS apresentou correlação negativa moderada com o GG, GR e GS. A medida H1-H2 apresentou correlação positiva fraca com o GS. Houve correlação positiva fraca entre o declínio espectral e o GT. Conclusão As medidas acústicas H1-H2, CPP e CPPS apresentam diferenças entre mulheres com DCSL e DCCL. Além disso, há correlação entre as medidas cepstrais e espectrais e os diferentes parâmetros do JPA.

ABSTRACT Purpose To investigate whether there are differences in cepstral and spectral acoustic measures between women with behavioral dysphonia with and without laryngeal lesions and verify whether there is a correlation between such measures and the auditory-perceptual evaluation of voice quality. Methods The sample comprised 78 women with behavioral dysphonia without laryngeal lesions (BDWOL) and 68 with behavioral dysphonia with laryngeal lesions (vocal nodules) (BDWL). Cepstral peak prominence (CPP), cepstral peak prominence-smoothed (CPPS), spectral decrease, and H1-H2 (difference between the amplitude of the first and second harmonics) were extracted. They were submitted to the auditory-perceptual evaluation (APE) of the grade of hoarseness (GH), roughness (RO), breathiness (BR), and strain (ST). Results BDWL women had higher H1-H2 values and lower CPP and CPPS values than BDWOL women. More deviant voices had lower CPP and CPPS values. Breathy voices had lower CPP and CPPS values and higher H1-H2 values than rough ones. There was a weak negative correlation between CPP and RO, a moderate negative correlation with GH, and a strong negative correlation with BR. CPPS had a moderate negative correlation with GH, RO, and BR. H1-H2 had a weak positive correlation with BR. There was a weak positive correlation between spectral decrease and ST. Conclusion H1-H2, CPP, and CPPS were different between BDWOL and BDWL women. Furthermore, cepstral and spectral measures were correlated with the different APE parameters.

Availability and price of fruits and vegetables in the surroundings of food and nutrition public establishments.

BACKGROUND: Inequalities of access to healthy food reinforce the need to strengthen public policies on Food and Nutritional Security. In this context, Food and Nutrition Public Establishments, which are public spaces for distribution and commercialization of healthy foods, stand out. However, in middle-income countries there is little monitoring of the impacts of public policies on food environments, which are fundamental for strengthening these actions. Thus, the purpose of the study was to evaluate the availability and price of fruits and vegetables in areas with and without Food and Nutrition Public Establishments. METHODOLOGY: A cross-sectional study carried out in Belo Horizonte, Brazil. Audits were conducted in the retail food environment of a representative sample of Food and Nutrition Public Establishments (n = 10) and corresponding census sectors, without Food and Nutrition Public Establishments (n = 10). Information was collected on the availability and price of the most consumed fruits and vegetables in Belo Horizonte. The food retailers were grouped into fresh food retailers and mixed food retailers. The Chi-Square test was used to compare the availability of fruits and vegetables between areas. The Mann Whitney test was used to compare the prices of fruit and vegetables and the price differences between fresh food retailers and mixed food retailers between areas. RESULTS: 148 food retailers were audited, including 17 Food and Nutrition Public Establishments. In fresh food retailers, the availability of vegetables was higher in areas with Food and Nutrition Public Establishments (p = 0.024). In mixed food retailers there was low availability of fruit and vegetables in both areas (34.0% vs. 26.2%; p>0.05). The price difference between fresh food retailers and mixed food retailers differed significantly between areas (p<0.001). In general, fresh food retailers had lower prices than mixed food retailers only in areas with Food and Nutrition Public Establishments. CONCLUSIONS: The presence of Food and Nutrition Public Establishments was associated with the availability of vegetables, and with lower prices in fresh food retailers compared with mixed food retailers. Monitoring and understanding the impacts of public policies on the food environment are essential to register trends and provide relevant information to civil society and government authorities.

Spectral and cepstral measurements in women with behavioral dysphonia. / Medidas espectrais e cepstrais em mulheres com disfonia comportamental.

PURPOSE: To investigate whether there are differences in cepstral and spectral acoustic measures between women with behavioral dysphonia with and without laryngeal lesions and verify whether there is a correlation between such measures and the auditory-perceptual evaluation of voice quality. METHODS: The sample comprised 78 women with behavioral dysphonia without laryngeal lesions (BDWOL) and 68 with behavioral dysphonia with laryngeal lesions (vocal nodules) (BDWL). Cepstral peak prominence (CPP), cepstral peak prominence-smoothed (CPPS), spectral decrease, and H1-H2 (difference between the amplitude of the first and second harmonics) were extracted. They were submitted to the auditory-perceptual evaluation (APE) of the grade of hoarseness (GH), roughness (RO), breathiness (BR), and strain (ST). RESULTS: BDWL women had higher H1-H2 values and lower CPP and CPPS values than BDWOL women. More deviant voices had lower CPP and CPPS values. Breathy voices had lower CPP and CPPS values and higher H1-H2 values than rough ones. There was a weak negative correlation between CPP and RO, a moderate negative correlation with GH, and a strong negative correlation with BR. CPPS had a moderate negative correlation with GH, RO, and BR. H1-H2 had a weak positive correlation with BR. There was a weak positive correlation between spectral decrease and ST. CONCLUSION: H1-H2, CPP, and CPPS were different between BDWOL and BDWL women. Furthermore, cepstral and spectral measures were correlated with the different APE parameters.

OBJETIVO: Investigar se existem diferenças nas medidas acústicas cepstrais e espectrais entre mulheres com disfonia comportamental com e sem lesão laríngea, bem como verificar se existe correlação entre tais medidas e o julgamento perceptivo-auditivo da qualidade vocal. MÉTODO: Participaram 78 mulheres com disfonia comportamental sem lesão laríngea (DCSL) e 68 com disfonia comportamental com lesão laríngea (nódulos vocais) (DCCL). Foram extraídas as medidas CPP (cepstral peak prominence), CPPS (cepstral peak prominence smoothed), declínio espectral e H1-H2 (diferença entre a amplitude do primeiro e do segundo harmônico), assim como o julgamento perceptivo-auditivo (JPA) do grau geral de desvio vocal (GG), graus de rugosidade (GR), de soprosidade (GS) e de tensão (GT). RESULTADOS: Mulheres com DCCL apresentaram maiores valores de H1-H2 e menores valores no CPP e CPPS, em relação às mulheres com DCSL. As vozes mais desviadas apresentaram menores valores do CPP e CPPS. As vozes soprosas apresentaram menores valores de CPP e CPPS, assim como maior valor de H1-H2 em relação às vozes rugosas. Houve correlação negativa fraca entre o CPP e o GR, negativa moderada com o GG e negativa forte com o GS. O CPPS apresentou correlação negativa moderada com o GG, GR e GS. A medida H1-H2 apresentou correlação positiva fraca com o GS. Houve correlação positiva fraca entre o declínio espectral e o GT. CONCLUSÃO: As medidas acústicas H1-H2, CPP e CPPS apresentam diferenças entre mulheres com DCSL e DCCL. Além disso, há correlação entre as medidas cepstrais e espectrais e os diferentes parâmetros do JPA.

Signal Amplification for Cell-Free Biosensors, an Analog-to-Digital Converter.

Toehold switches are biosensors useful for the detection of endogenous and environmental RNAs. They have been successfully engineered to detect virus RNAs in cell-free gene expression reactions. Their inherent sequence programmability makes engineering a fast and predictable process. Despite improvements in the design, toehold switches suffer from leaky translation in the OFF state, which compromises the fold change and sensitivity of the biosensor. To address this, we constructed and tested signal amplification circuits for three toehold switches triggered by Dengue and SARS-CoV-2 RNAs and an artificial RNA. The serine integrase circuit efficiently contained leakage, boosted the expression fold change from OFF to ON, and decreased the detection limit of the switches by 3-4 orders of magnitude. Ultimately, the integrase circuit converted the analog switches' signals into digital-like output. The circuit is broadly useful for biosensors and eliminates the hard work of designing and testing multiple switches to find the best possible performer.

Use of brewer's residual yeast for production of bacterial nanocellulose with Gluconacetobacter hansenii.

Bacterial nanocellulose (BNC) has attained elevated interest due to its versatile structure and high resistance characteristics. Accordingly, efforts have been made in order to reduce its production costs, such as the employment of its by-products as a nutrient broth to yield the microorganism. Residual brewer's yeast is an excellent recourse, due to its high nutritional value and availability. Therefore, research which aimed to contribute to the development of a low cost, efficient and biosustainable technology for BNC production with Gluconacetobacter hansenii was carried out. BNC was obtained from residual brewer's yeast hydrolysate at pH 7.0 and five days of incubation at 30 °C in static culture. The hydrolysate was characterized by the amount of sugars, fatty acids, total proteins and ash content. Subsequently, BNC obtained was characterized in terms of yield, carbon conversion ratio, hydrodynamic size, crystallinity, morphology, Fourier-transform infrared spectroscopy, and surface analysis. Residual brewer's yeast hydrolysate proved to be efficient in BNC production via gluconeogenesis with consumption of alanine, threonine and glycerol, obtaining 1.9 times the yield of the chemically defined broth adopted as standard. Additionally, properties observed in the obtained BNC were equal to those obtained from conventional chemical medium. The research contributed to bacterial nanocellulose production using by-products from the brewing industry.

EMACO for treatment of gestational trophoblastic neoplasia: A multinational multicenter study.

OBJECTIVE: To investigate the efficacy and toxicity of etoposide, methotrexate, actinomycin D alternating with cyclophosphamide, and vincristine (EMACO) for treatment of gestational trophoblastic neoplasia, and for factors independently associated with EMACO resistance and disease-specific death in an international cohort. METHODS: Medical records of GTN patients who received EMACO during 1986-2019 from gestational trophoblastic disease centers from four countries including the USA, Thailand, Hungary, and Brazil, were retrospectively reviewed. Among 335 GTN patients, 266 patients who received EMACO as primary chemotherapy were included in the primary treatment group, and 69 patients who received EMACO after relapse/resistance to single-agent chemotherapy were included in the prior treatment group. RESULTS: Three-quarters (76.1%) of all patients achieved remission, and the survival rate was 89%. The prior treatment group had better outcomes than the primary treatment group relative to remission rate (87.0% vs. 73.3%, p = 0.014) and number of EMACO cycles to achieve remission (3 vs. 6 cycles, p < 0.001). Sustained remission increased to 87.2% in EMACO-resistant patients treated with later-line chemotherapy. Number of metastatic organs ≥2 (adjusted odds ratio [aOR]: 2.33, p = 0.049) was the only independent predictor of EMACO resistance among overall patients. Interval from index pregnancy ≥7 months (aOR: 4.34, p = 0.001), and pretreatment hCG >100,000 IU/L (aOR: 2.85, p = 0.028) were independent predictors of EMACO resistance in the high-risk subgroup. The only factor independently associated with disease-specific death was EMACO resistance (aOR: 176.04, p < 0.001). CONCLUSIONS: EMACO is an effective treatment for GTN. Number of metastatic organs and EMACO resistance were the independent predictors of EMACO resistance and disease-specific death, respectively.

Current chemotherapeutic options for the treatment of gestational trophoblastic disease.

INTRODUCTION: Gestational trophoblastic neoplasia (GTN) is a rare tumor that arises from trophoblastic tissues with high remission rates after chemotherapy treatment. GTN can develop from any gestational events, such as miscarriage, ectopic pregnancy, and preterm/term pregnancy, but is more frequent after hydatidiform mole. The sensitivity of this tumor to chemotherapy and the presence of an exceptional tumor marker allow high remission rates, especially when patients are treated in referral centers. AREAS COVERED: Observational, retrospective, prospective, systematic reviews, and meta-analysis studies focusing on GTN treatment. We searched PubMed, Medline, and the Library of Congress from January 1965 to May 2022. EXPERT OPINION: Early GTN diagnosis allows low-toxic and highly effective treatment. Even multimetastatic disease has high rates of remission with multiagent regimen chemotherapy. Surgery is reserved for uterine disease in patients who have completed childbearing, in cases of chemoresistance to multiagent regimens or in the rare cases of placental site trophoblastic tumor or epithelioid trophoblastic tumor. While resistance is managed by salvage chemotherapy, cases with limited clinical response to sequential regimens have been successfully treated with immunotherapy.

Influence of COVID-19 pandemic on molar pregnancy and postmolar gestational trophoblastic neoplasia: An observational study.

OBJECTIVE: To assess whether the incidence and aggressiveness of molar pregnancy (MP) and postmolar gestational trophoblastic neoplasia (GTN) changed during the COVID-19 pandemic. DESIGN: Observational study with two separate designs: retrospective multicentre cohort of patients with MP/postmolar GTN and a cross-sectional analysis, with application of a questionnaire. SETTING: Six Brazilian Reference Centres on gestational trophoblastic disease. POPULATION: 2662 patients with MP/postmolar GTN treated from March-December/2015-2020 were retrospectively evaluated and 528 of these patients answered a questionnaire. METHODS: Longitudinal retrospective multicentre study of patients diagnosed with MP/ postmolar GTN at presentation and a cross-sectional analysis, with application of a questionnaire, exclusive to patients treated during the period of study, to assess living and health conditions during the COVID-19 pandemic compared with previous years. MAIN OUTCOME MEASURES: The incidence of MP/postmolar GTN. RESULTS: Compared with the last 5 pre-pandemic years, MP/postmolar GTN incidence remained stable during 2020 (COVID-19 pandemic). Multivariable logistic regression, adjusted for the patient age, showed that during 2020, presentation with MP was more likely to be >10 weeks of gestation (adjusted odds ratio [aOR] 2.50, 95% confidence interval [CI] 1.90-3.29, P < 0.001), have a pre-evacuation hCG level ≥100 000 iu/l (aOR 1.77, 95% CI 1.38-2.28, P < 0.001) and time to the initiation of chemotherapy ≥7 months (aOR 1.86, 95% CI 1.01-3.43, P = 0.047) when compared with 2015-2019. CONCLUSIONS: Although the incidence of MP/postmolar GTN remained stable during the COVID-19 pandemic in Brazil, the pandemic was associated with greater gestational age at MP diagnosis and more protracted delays in initiation of chemotherapy for postmolar GTN.

Aliivibrio fischeri L-Asparaginase production by engineered Bacillus subtilis: a potential new biopharmaceutical.

L-Asparaginase (L-ASNase) is an enzyme applied in the treatment of lymphoid malignancies. However, an innovative L-ASNase with high yield and lower side effects than the commercially available preparations are still a market requirement. Here, a new-engineered Bacillus subtilis strain was evaluated for Aliivibrio fischeri L-ASNase II production, being the bioprocess development and the enzyme characterization studied. The pBS0E plasmid replicative in Bacillus sp and containing PxylA promoter inducible by xylose and its repressive molecule sequence (XylR) was used for the genetic modification. Initially, cultivations were carried out in orbital shaker, and then the process was scaled up to stirred tank bioreactor (STB). After the bioprocess, the cells were recovered and submitted to ultrasound sonication for cells disruption and intracellular enzyme recovery. The enzymatic extract was characterized to assess its biochemical, kinetic and thermal properties using L-Asparagine and L-Glutamine as substrates. The results indicated the potential enzyme production in STB achieving L-ASNase activity up to 1.539 U mL-1. The enzymatic extract showed an optimum pH of 7.5, high L-Asparagine affinity (Km = 1.2275 mmol L-1) and low L-Glutaminase activity (0.568-0.738 U mL-1). In addition, thermal inactivation was analyzed by two different Kinect models to elucidate inactivation mechanisms, low kinetic thermal inactivation constants for 25 ºC and 37 ºC (0.128 and 0.148 h-1, respectively) indicate an elevated stability. The findings herein show that the produced recombinant L-ASNase has potential to be applied for pharmaceutical purposes.

Lippia origanoides essential oil induces tocolytic effect in virgin rat uterus and inhibits writhing in a dysmenorrhea mouse model.

ETHNOPHARMACOLOGICAL RELEVANCE: The species Lippia origanoides Kunth, popularly known as "salva-de-marajó", is used in Brazilian traditional "quilombola" communities to treat menstrual cramps and uterine inflammation. AIM OF THE STUDY: Evaluate the spasmolytic activity of Lippia origanoides essential oil (LOO) on experimental models of uterine conditions related to menstrual cramps and investigate its mechanism of action. MATERIALS AND METHODS: Virgin rat-isolated uterus was mounted in the organ bath apparatus to evaluate the spasmolytic effect of LOO on basal tonus and contractions induced by carbachol, KCl, or oxytocin. We used pharmacological agents to verify the relaxation mechanism of LOO. The evaluation of uterine contractility in virgin rats, after treatment with LOO for three consecutive days, was carried out by the construction of a concentration-response curve with oxytocin or carbachol. The primary dysmenorrhea animal model was replicated with an injection of estradiol cypionate in female mice for three consecutive days, followed by intraperitoneal application of oxytocin. RESULTS: LOO relaxed the rat uterus precontracted with 10-2 IU/mL oxytocin (logEC50 = 1.98 ± 0.07), 1 µM carbachol (logEC50 = 1.42 ± 0.07) or 60 mM KCl (logEC50 = 1.53 ± 0.05). It was also able relax uterus on spontaneous contractions (logEC50 = 0.41 ± 0.05). Preincubation with glibenclamide, propranolol, phentolamine or L-NAME in contractions induced by carbachol did not alter significantly the relaxing effect of LOO. However, in the presence of 4-aminopyridine, CsCl or tetraethylammonium there was a reduction of LOO potency, whereas the blockers methylene blue, ODQ, aminophylline and heparin potentiated the LOO relaxing effect. Preincubation with LOO in a Ca2+ free medium at concentrations of 27 µg/mL or 81 µg/mL reduced the contraction induced by carbachol. The administration of LOO for 3 days did not alter uterus contractility. The treatment with LOO at 30 or 100 mg/kg intraperitoneally, or 100 mg/kg orally, inhibited writhing in female mice. The association of LOO at 10 mg/kg with nifedipine or mefenamic acid potentiated writhing inhibition in mice. CONCLUSIONS: The essential oil of L. origanoides has tocolytic activity in rat isolated uterus pre-contracted with KCl, oxytocin, or carbachol. This effect is possibly related to the opening of potassium channels (Kir, KV, and KCa), cAMP increase, and diminution of intracellular Ca2+. This relaxant effect, probably, contributed to reduce the number of writhings in an animal model of dysmenorrhea being potentiated by nifedipine or mefenamic acid. Taken together, the results here presented indicate that this species has a pharmacological potential for the treatment of primary dysmenorrhea, supporting its use in folk medicine.

Folinic acid rescue during methotrexate treatment for low-risk gestational trophoblastic neoplasia - How much is just right?

OBJECTIVE: To compare the outcomes of patients with low-risk gestational trophoblastic neoplasia (GTN) treated with 8-day methotrexate (MTX) with two different regimens of folinic acid (FA). METHODS: Retrospective cohort study of low-risk GTN followed at Rio de Janeiro Federal University, from January/2000-December/2019 with 8-day MTX with FA at 0.1 mg/kg versus 15 mg fixed dose. RESULTS: Among 667 patients with low-risk GTN, 323 were treated with FA at 0.1 mg/kg and 142 with FA at 15 mg fixed dose. The weight-based and fixed dose groups were comparable in terms of clinical profile but did differ in the hCG pretreatment level (8883 versus 5127 IU/L, p < 0.01) and FIGO risk score 5/6 (3.4% versus 18.3%, p < 0.01), respectively. Despite this, there was no difference in the remission rate in first-line treatment (76.8 versus 81%, p = 0.33), although FA at 0.1 mg/kg had a significantly higher number of chemotherapy cycles to remission (5 versus 4, p < 0.01), need to delay chemotherapy due to toxicity (6.8 versus 2.8%, p < 0.01) and time to remission, (12 versus 8 weeks, p < 0.01), respectively. A logistic regression analysis showed that the different FA rescue regimens appeared comparable in terms of achieving remission in first-line chemotherapy for low-risk GTN (OR:5.16, CI95%:0.84-31.64, p = 0.08). CONCLUSION: FA with 15 mg fixed dose as compared to 0.1 mg/kg of FA was associated with similar primary remission rate, relapse or death among low-risk GTN treated with 8-day MTX. This regimen is highly practical, reduces visits to health facilities, appears equally safe and may be preferable with the 8-day MTX regimen in the treatment of low-risk GTN.

L-asparaginase production review: bioprocess design and biochemical characteristics.

In the past decades, the production of biopharmaceuticals has gained high interest due to its great sensitivity, specificity, and lower risk of negative effects to patients. Biopharmaceuticals are mostly therapeutic recombinant proteins produced through biotechnological processes. In this context, L-asparaginase (L-asparagine amidohydrolase, L-ASNase (E.C. 3.5.1.1)) is a therapeutic enzyme that has been abundantly studied by researchers due to its antineoplastic properties. As a biopharmaceutical, L-ASNase has been used in the treatment of acute lymphoblastic leukemia (ALL), acute myeloblastic leukemia (AML), and other lymphoid malignancies, in combination with other drugs. Besides its application as a biopharmaceutical, this enzyme is widely used in food processing industries as an acrylamide mitigation agent and as a biosensor for the detection of L-asparagine in physiological fluids at nano-levels. The great demand for L-ASNase is supplied by recombinant enzymes from Escherichia coli and Erwinia chrysanthemi. However, production processes are associated to low yields and proteins associated to immunogenicity problems, which leads to the search for a better enzyme source. Considering the L-ASNase pharmacological and food importance, this review provides an overview of the current biotechnological developments in L-ASNase production and biochemical characterization aiming to improve the knowledge about its production. KEY POINTS: • Microbial enzyme applications as biopharmaceutical and in food industry • Biosynthesis process: from the microorganism to bioreactor technology • Enzyme activity and kinetic properties: crucial for the final application.

Predictors for single-agent resistance in FIGO score 5 or 6 gestational trophoblastic neoplasia: a multicentre, retrospective, cohort study.

BACKGROUND: Patients with gestational trophoblastic neoplasia who have an International Federation of Gynaecology and Obstetrics (FIGO) risk score of 5 or 6 usually receive non-toxic single-agent chemotherapy as a first-line treatment. Previous studies suggest that only a third of patients have complete remission, with the remaining patients requiring toxic multiagent chemotherapy to attain remission. As stratification factors are unknown, some centres offer multiagent therapy upfront, resulting in overtreatment of many patients. We aimed to identify predictive factors for resistance to single-agent therapy to inform clinicians on which patients presenting with a FIGO score of 5 or 6 are likely to benefit from upfront multiagent chemotherapy. METHODS: We did a multicentre, retrospective, cohort study of patients with gestational trophoblastic neoplasia presenting with a FIGO score of 5 or 6, who received treatment at three gestational trophoblastic neoplasia reference centres in the UK, Brazil, and the USA between Jan 1, 1964, and Dec 31, 2018. All patients who had been followed up for at least 12 months after remission were included. Patients were excluded if they had received a non-standard single-agent treatment (eg, etoposide); had been given a previously established first-line multiagent chemotherapy regimen; or had incomplete data for our analyses. Patient data were retrieved from medical records. The primary outcome was the incidence of chemoresistance after first-line or second-line single-agent chemotherapy. Variables associated with chemoresistance to single-agent therapies were identified by logistic regression analysis. In patient subgroups defined by choriocarcinoma histology and metastatic disease status, we did bootstrap modelling to define thresholds of pretreatment human chorionic gonadotropin concentrations and identify groups of patients with a greater than 80% risk (ie, a positive predictive value [PPV] of 0·8) of resistance to single-agent chemotherapy. FINDINGS: Of 5025 patients with low-risk gestational trophoblastic neoplasia, we identified 431 patients with gestational trophoblastic neoplasia presenting with a FIGO risk score of 5 or 6. All patients were followed up for a minimum of 2 years. 141 (40%) of 351 patients developed resistance to single-agent treatments and required multiagent chemotherapy to achieve remission. Univariable and multivariable logistic regression revealed metastatic disease status (multivariable logistic regression analysis, odds ratio [OR] 1·9 [95% CI 1·1-3·2], p=0·018), choriocarcinoma histology (3·7 [1·9-7·4], p=0·0002), and pretreatment human chorionic gonadotropin concentration (2·8 [1·9-4·1], p<0·0001) as significant predictors of resistance to single-agent therapies. In patients with no metastatic disease and without choriocarcinoma, a pretreatment human chorionic gonadotropin concentration of 411 000 IU/L or higher yielded a PPV of 0·8, whereas in patients with either metastases or choriocarcinoma, a pretreatment human chorionic gonadotropin concentration of 149 000 IU/L or higher yielded the same PPV for resistance to single-agent therapy. INTERPRETATION: Approximately 60% of women with gestational trophoblastic neoplasia presenting with a FIGO risk score of 5 or 6 achieve remission with single-agent therapy; almost all remaining patients have complete remission with subsequent multiagent chemotherapy. Primary multiagent chemotherapy should only be given to patients with metastatic disease and choriocarcinoma, regardless of pretreatment human chorionic gonadotropin concentration, or to those defined by our new predictors. FUNDING: None. TRANSLATION: For the Portuguese translation of the abstract see Supplementary Materials section.

Perfil alimentar e percepção de escolares sobre alimentação servida em escolas municipais segundo a vulnerabilidade à saúde / Food pattern and perception of students about food served in municipal schools according to health vulnerability

Objetivo: Analisar o perfil alimentar e a percepção de escolares sobre a alimentação servida nas escolas, segundo a vulnerabilidade à saúde. Métodos: Trata-se de estudo transversal, realizado com uma amostra representativa de alunos do Ensino Fundamental da rede municipal de Belo Horizonte. A vulnerabilidade à saúde foi determinada pelo Índice de Vulnerabilidade à Saúde dos setores censitários das escolas. Foram coletadas informações referentes ao perfil alimentar e à percepção sobre a alimentação escolar. Foi utilizado o Teste Qui-quadrado de Pearson para determinar diferenças segundo o Índice de Vulnerabilidade à Saúde. Resultados: Foram entrevistados 3.557 alunos. Os alunos das escolas com menor vulnerabilidade apresentaram o hábito de comprar alimentos em estabelecimentos próximos à escola (p=0,01); perceberam em menor proporção a alimentação escolar como variada (p<0,001), o tempo para comer como suficiente (p<0,001) e a importância da alimentação escolar (p=0,02). Conclusão: O perfil alimentar e a percepção da alimentação variaram segundo a vulnerabilidade das escolas. Nas escolas de menor vulnerabilidade, os alunos compraram mais alimentos no entorno e apresentaram menor aceitação e valorização da alimentação escolar. Sugere-se a investigação de fatores associados (socioeconômicos e ambientais) para compreensão das condições que influenciam o adequado fornecimento da alimentação escolar a todos os estudantes.

Objective: analyze the dietary profile and perception of students about the food served in schools, according to health vulnerability. Methods: This is a cross-sectional study, carried out with a representative sample of Elementary School students from the Municipal Network of Belo Horizonte. Health vulnerability was determined by the Health Vulnerability Index (HVI) of the census sectors of schools. Eating habits and perceptions of meals served in the school were collected. Pearson's Chi-squared test was used to determine differences according to the Health Vulnerability Index. Results: 3,557 students were interviewed. Students from schools with less vulnerability had the habit of buying food in stores close to the school (p = 0.01); a smaller proportion of the students perceived the school meals as varied (p <0.001), the eating time as sufficient (p<0.001), and the importance of food served in municipal schools (p=0.02). Conclusion: The food profile and perception of food varied according to the school's vulnerability. In schools with less vulnerability, students bought more food in the surroundings and showed less acceptance and appreciation of school food. The investigation of socio-economic and environmental factors is warranted to understand the conditions that may influence the adequate supply of school meals to all students.

Dataset for supporting a modular autoinduction device for control of gene expression in Bacillus subtilis.

Modular and tuneable genetic tools for Metabolic Engineering fuels the development of chassis for the efficient production of biocompounds at industrial scale. We have constructed an autoinduction device for gene expression in Bacillus subtilis based on the LuxR/I quorum sensing system [1]. Here, we present raw and processed data regarding to B. subtilis growth measured as OD600, performed in three different scales: microcultivation on 96-well plates (200 µL), test tubes (12 mL), and Erlenmeyer flasks (50 mL). We also present raw and processed data on gene expression measured as GFP fluorescence (485/535 nm), luminescence and riboflavin production. Measurements were performed on a microplate reader Tecan 200 PRO (iControl software) and on spectrophotometer (Thermo Fisher Scientific GENESYS 10S UV-Vis). Processed data are presented as product/OD600, maximum and minimum promoter activity, fold of induction, and the induction OD600.

A modular autoinduction device for control of gene expression in Bacillus subtilis.

Intense synthesis of proteins and chemicals in engineered microbes impose metabolic burden, frequently leading to reduced growth and heterogeneous cell population. Thus, the correct balance between growth and production is important. Such balance can be engineered through dynamic control of pathways, but few broadly applicable tools are available to achieve this. We present an autonomous control of gene expression mediated by quorum sensing in Bacillus subtilis, able to self-monitor and induce expression without human supervision. Two variations of the induction module and seven of the response module were engineered generating a range of induction folds and strengths for gene expression control. Our strongest response promoter is 2.5 and 3.2 times stronger than the well-characterized promoters PsrfA and Pveg, respectively. We applied our strongest autoinduction device for the production of the vitamin B2. This study presents a toolbox of autoinduction modules for B. subtilis that is modular and tunable.

The copper-inducible copAB operon in Xanthomonas citri subsp. citri is regulated at transcriptional and translational levels.

Upstream open reading frames (ORFs) are frequently found in the 5'-flanking regions of genes and may have a regulatory role in gene expression. A small ORF (named cohL here) was identified upstream from the copAB copper operon in Xanthomonascitri subsp. citri (Xac). We previously demonstrated that copAB expression was induced by copper and that gene inactivation produced a mutant strain that was unable to grow in the presence of copper. Here, we address the role of cohL in copAB expression control. We demonstrate that cohL expression is induced by copper in a copAB-independent manner. Although cohL is transcribed, the CohL protein is either not expressed in vivo or is synthesized at undetectable levels. Inactivation of cohL (X. citri cohL polar mutant strain) leads to an inability to synthesize cohL and copAB transcripts and consequently the inability to grow in the presence of copper. Bioinformatic tools predicted a stem-loop structure for the cohL-copAB intergenic region and revealed that this region may arrange itself in a secondary structure. Using in vitro gene expression, we found out that the structured 5'-UTR mRNA of copAB is responsible for sequestering the ribosome-binding site that drives the translation of copA. However, copper alone was not able to release the sequence. Based on the results, we speculate that cohL plays a role as a regulatory RNA rather than as a protein-coding gene.

Spasmolytic and antidiarrheal activities of Lippia thymoides (Verbenaceae) essential oil.

Lippia thymoides ('alecrim-do-mato' or 'alecrim-do-campo') is used in Brazilian folk medicine to treat various illnesses, including diarrhea. This work aimed to evaluate in vitro spasmolytic and in vivo antidiarrheal activities of the L. thymoides essential oil (OOS) and to correlate with the traditional use of this plant. In isolated guinea-pig ileum, OOS presented a concentration-dependent spasmolytic activity in preparations pre-contracted with KCl 40 mM [EC50 = 16.89 (11.56-24.66) µg/mL], and antagonized phasic contractions induced by 1 µM carbachol [IC50 = 42.71 (37.35-48.83) µg/mL] or histamine [IC50 = 32.38 (27.44-38.20) µg/mL]. In mice, OOS at 400 mg/kg reduced intestinal transit, at 200 and 400 mg/kg reduced total stool mass and at 400 mg/kg reduced intestinal fluid accumulation. It was shown that the antidiarrheal effect of OOS is related to the inhibition of smooth muscle contraction and may be due to the presence of major compound ß-caryophyllene in this essential oil.

Relaxant effect of Lippia origanoides essential oil in guinea-pig trachea smooth muscle involves potassium channels and soluble guanylyl cyclase.

ETHNOPHARMACOLOGICAL RELEVANCE: Lippia origanoides H.B.K. is an aromatic species used in folk medicine to treat respiratory diseases, including asthma. AIM OF THE STUDY: The aim of this work was to evaluate the relaxing potential and mechanism of action of the L. origanoides (LOO) essential oil in isolated guinea-pig trachea. MATERIALS AND METHODS: Leaves from L. origanoides were collected at experimental fields under organic cultivation, at the Forest Garden of Universidade Estadual de Feira de Santana. Essential oil was extracted by hydrodistillation, analyzed by GC/FID and GC/MS and the volatile constituents were identified. Spasmolytic activity and relaxant mechanism of LOO were assayed in isolated guinea-pig trachea contracted with histamine, carbachol or hyperpolarizing KCl. RESULTS: Chemical analysis revealed the presence of carvacrol (53.89%) as major constituent. LOO relaxed isolated guinea-pig trachea pre-contracted with KCl 60 mM [EC50 = 30.02 µg/mL], histamine 1 µM [EC50 = 9.28 µg/mL] or carbachol 1 µM [EC50 = 51.80 µg/mL]. The pre-incubation of glibenclamide, CsCl, propranolol, indomethacin, hexamethonium, aminophylline or L-NAME in histamine-induced contractions did not alter significantly the relaxant effect of LOO. However, the presence of 4-aminopyridine, tetraethylammonium or methylene blue reduced LOO effect, while the presence of dexamethasone or atropine potentialized the LOO relaxant effect. LOO pre-incubation inhibited carbachol-evoked contractions, with this effect potentialized in the presence of sodium nitroprusside and blocked in the presence of ODQ. CONCLUSIONS: The relaxant mechanism of LOO on the tracheal smooth muscle possibly involves stimulating of soluble guanylyl cyclase with consequent activation of the voltage-gated and Ca2+-activated K+ channels.

Parasitoses intestinais e pediculose: prevenção em crianças na idade escolar / Intestinal parasitosis and pediculosis: prevention in school-aged children

Objetivos: relatar a experiência das atividades de um projeto de extensão que teve como principal proposta a prevenção de parasitoses intestinais e pediculose desenvolvidas em escolares do município de Juiz de Fora. Desenvolvimento: o projeto baseou-se em visitar três escolas, sendo duas da rede pública (Escola Municipal Tancredo Neves, Escola Estadual Fernando Lobo) e uma privada (Escola Adventista de Juiz de Fora) e divulgar de forma lúdica, por meio de jogos, vídeos e palestras, assuntos relacionados a curiosidades sobre a biologia dos parasitos, transmissão, sintomatologia e, principalmente, prevenção dessas parasitoses, bem como exposição dos agentes. Nas escolas trabalhadas, as crianças demonstraram, através de jogos de perguntas e respostas e relatos próprios, ter compreendido os conceitos básicos de transmissão e prevenção das parasitoses, gerando mudanças de hábitos de higiene. Conclusão: conclui-se que é possível despertar o interesse das crianças pela prevenção das parasitoses intestinais e pediculose, introduzindo-se hábitos de higiene e cuidados que contribuem para o controle da transmissão dessas parasitoses.

Obejctives: to relate the experience of the activities of an extension project that had the prevention of intestinal parasitosis and pediculosis developed in schools of Juiz de Fora city as its main purpose. Development: the project was based in visiting three schools: two public schools (Escola Municipal Tancredo Neves, Escola Estadual Fernando Lobo) and one private school (Escola Adventista de Juiz de Fora), disseminating in a playful way, through games, videos and speeches, subjects related to the biology of parasites, transmission, symptoms and mainly prevention of parasitosis, as well as exposition to agents. The children in school demonstrated they understand the basic notions of transmission and prevention of parasitosis, generating hygiene changes through question and answer games and their own reports. Conclusion: it is concluded that it is possible to arouse children's interest in intestinal parasitosis and pediculosis prevention, introducing hygiene habits and care that contribute to controlling the transmission of such parasitosis.