Ultrasound ability in early diagnosis of metatarsal stress fractures.

Stress fractures are common in young and active individuals, associated with aggressive or repetitive physical activity and their early detection is fundamental to optimise patient care, decrease complications and avoid unnecessary exams. Currently, magnetic resonance imaging is the standard of care for detecting these lesions. Recently, ultrasound has been getting an increasing interest for the detection of stress fractures. In this article, we describe a clinical case that involved a second metatarsal stress fracture diagnosed by ultrasound and review the literature regarding the use of ultrasound in the diagnosis of stress fractures, particularly of the metatarsals.

Associação do comportamento alimentar com o estado nutricional de gestantes de alto risco internadas em um centro de referência no nordeste / Association of eating behavior with the nutritional status of high-riskpregnant women admitted to a reference center in the Northeast

Introduction: Pregnancy is a period of physical and physiological changes that progresses without complications when free from factors that can compromise maternal and fetal health. Diabetes mellitus, high blood pressure, obesity and inadequate weight gain are the most common causes of gestational risk, and these can be strongly associated with the nutritional status, eating habits and behavior of the pregnant woman. Objective: To describe and associate eating behavior with the nutritional status of high-risk pregnant women admitted to a reference center in the Northeast. Materials and methods: This is a cross-sectional study carried out with patients admitted to high-risk wards at the Instituto de Medicina Integral Prof. Fernando Figueira – IMIP (Recife-PE), anthropometric data and data related to eating behavior were collected (TEMS instrument). Results: Around 56,4% of pregnant women had a prepregnancy BMI classified as overweight or obese, with only 16% classified as underweight. The evaluation of the evolution of weight gain demonstrated that 66.4% had insufficient weight gain, while 12,8% had high gestational weight gain. Discussion: When analyzing eating behavior through the TEMS instrument, the relationship of giving a good image when eating had a significant value (p < 0,05) as well as considerations of choosing healthy foods and related to obtaining energy are directly associated with the current BMI, therefore, note- It is clear that emotional, social, physiological and economic factors influence the choice of food. Conclusion: The high prevalence of overweight and obesity found in this population demonstrates the influence of eating behavior on nutritional status. Reinforcing the importance of preventive measures to identify risk factors and obtain adequate nutritional monitoring during pregnancy with the aim of reducing damage to health and promoting autonomy to make more appropriate and healthy food choices.(AU)

Introdução: A gestação é um período de mudanças físi-cas e fisiológicas que evolui sem complicações quando isentade fatores que podem acarretar no comprometimento dasaúde materna e fetal. O diabetes mellitus, hipertensão arte-rial, obesidade, ganho de peso inadequado são as mais fre-quentes causadoras do risco gestacional, podendo estas serfortemente associadas com o estado nutricional, hábito ecomportamento alimentar da gestante. Objetivo: Descrever e associar o comportamento alimen-tar com o estado nutricional de gestantes de alto risco inter-nadas em um centro de referência no Nordeste. Materiais e métodos: Trata-se de um estudo do tipotransversal realizado com pacientes internadas nas enferma-rias de alto risco do Instituto de Medicina Integral Prof.Fernando Figueira – IMIP (Recife- PE), foram coletados dadosantropométricos, dados relacionados ao comportamento ali-mentar (instrumento TEMS). Resultados: Cerca de 56,4% das gestantes tinham IMCpré-gestacional classificados em sobrepeso ou obesidade sendo apenas 16% classificadas como baixo peso. A avalia-ção da evolução do ganho ponderal demonstrou que 66,4%apresentaram um ganho de peso insuficiente, enquanto12,8% tiveram um ganho de peso gestacional elevado. Discussão: Ao analisar o comportamento alimentar atravésdo instrumento TEMS, a relação de passar uma boa imagemao se alimentar teve valor significativo (p < 0,05) bem comoconsiderações de escolher alimentos saudáveis e relacionadosa obter energia estão diretamente associados com o IMCatual, assim sendo, nota-se que fatores emocionais, sociais, fi-siológicos, econômicos influenciam na escolha dos alimentos. Conclusão: A elevada prevalência do excesso de peso eobesidade encontrada nessa população demonstra a influência do comportamento alimentar no estado nutricional.Reforçando a importância de medidas preventivas para identificar fatores de risco e obter um acompanhamento nutricio-nal adequado durante a gestação com...(AU)

Assignment of individual structures from intermetalloid nickel gallium cluster ensembles.

Poorly selective mixed-metal cluster synthesis and separation yield reaction solutions of inseparable intermetalloid cluster mixtures, which are often discarded. High-resolution mass spectrometry, however, can provide precise compositional data of such product mixtures. Structure assignments can be achieved by advanced computational screening and consideration of the complete structural space. Here, we experimentally verify structure and composition of a whole cluster ensemble by combining a set of spectroscopic techniques. Our study case are the very similar nickel/gallium clusters of M12, M13 and M14 core composition Ni6+xGa6+y (x + y ≤ 2). The rationalization of structure, bonding and reactivity is built upon the organometallic superatom cluster [Ni6Ga6](Cp*)6 = [Ga6](NiCp*)6 (1; Cp* = C5Me5). The structural conclusions are validated by reactivity tests using carbon monoxide, which selectively binds to Ni sites, whereas (triisopropylsilyl)acetylene selectively binds to Ga sites.

Two new species of Anacanthorus (Monogenoidea, Dactylogyridae) parasitizing serrasalmid fish in Brazil.

During studies on fish parasites, two new species of Anacanthorus were found parasitizing serrasalmid fishes, Anacanthorus simpliciphallus sp. n. from the hybrid Piaractus mesopotamicus x Piaractus brachypomus and Anacanthorus brandtii sp. n. from Serrasalmus brandtii. Anacanthorus simpliciphallus sp. n. resembles Anacanthorus reginae in the morphology of the male copulatory organ (MCO) and accessory piece but differs from A. reginae in terms of the smaller size of the accessory piece, which corresponds approximately half the size of the MCO and by the presence of a conspicuous metraterm, with a membranous terminal region. Anacanthorus brandtii sp. n. differs from Anacanthorus scapanus by the expansion of the accessory piece, from Anacanthorus jegui by the ratio MCO (male copulatory organ) /AP (accessory piece) and by the expansion of hook shank, from Anacanthorus sciponophallus and A. reginae by the ratio MCO/AP. Anacanthorus brandtii sp. n. can be distinguished from A. reginae and A. simpliciphallus sp.n. by the size of hooks which is similar in A. reginae and A. simpliciphallus sp. n. and dissimilar in A. brandtii sp. n. The two new species also differ from each other by the expansion of shank.

Dactylogyrids (Platyhelminthes, Monogenea) from the gill lamellae of doradids (Siluriformes) with description of five new species of Cosmetocleithrum and new geographical distribution for known species from the Neotropical Region, Brazil.

Five new species of Cosmetocleithrum were described parasitizing the gill filaments of neotropical doradid fishes. Cosmetocleithrum undulatum n. sp., Cosmetocleithrum brachylecis n. sp. and Cosmetocleithrum ludovicense n. sp. are described from Platydoras brachylecis from a market-place of São Luís, State of Maranhão, Brazil. Cosmetocleithrum sacciforme n. sp. and Cosmetocleithrum basicomplexum n. sp. are described from Oxydoras niger from Juruá River, State of Acre, Brazil. Cosmetocleithrum undulatum and Cosmetocleithrum brachylecis resemble Cosmetocleithrum falsunilatum Feronato, Razzolini, Morey & Boeger, 2022 mainly by the unique male copulatory organ (MCO) morphology but differ from these and all congeneric species mainly by the morphology of the MCO, accessory piece and hooks pairs. Cosmetocleithrum ludovicense is closer to Cosmetocleithrum confusus Kritsky, Thatcher & Boeger, 1986 and to Cosmetocleithrum akuanduba Soares, Santos Neto & Domingues, 2018 but differs from those mainly by the morphology of the accessory piece. Cosmetocleithrum sacciforme differs from all congeneric species mainly by the morphology of the accessory piece formed by a single plate of saccular appearance. Cosmetocleithrum basicomplexum also shares morphological characters with Cosmetocleithrum gigas Morey, Cachique & Babilonia, 2019 considering the size of the body and shape of the anchors, but differs mainly in the morphology of the bars and hooks. Besides the new species, new data are presented for Cosmetocleithrum leandroi Soares, Neto & Domingues, 2018, C. akuanduba and C. confusus regarding morphological characteristics and biogeography.

Title: Dactylogyridae (Platyhelminthes, Monogenea) des lamelles branchiales de Doradidae (Siluriformes) avec description de cinq nouvelles espèces de Cosmetocleithrum et nouvelle répartition géographique d'espèces connues de la région néotropicale au Brésil. Abstract: Cinq nouvelles espèces de Cosmetocleithrum sont décrites, parasitant les filaments branchiaux de poissons Doradidae néotropicaux. Cosmetocleithrum undulatum n. sp., Cosmetocleithrum brachylecis n. sp. et Cosmetocleithrum ludovicense n. sp. sont décrits de Platydoras brachylecis provenant d'un marché de São Luís, État du Maranhão, Brésil. Cosmetocleithrum sacciforme n. sp. et Cosmetocleithrum basicomplexum n. sp. sont décrits d'Oxydoras niger de la rivière Juruá, État d'Acre, Brésil. Cosmetocleithrum undulatum et Cosmetocleithrum brachylecis ressemblent à Cosmetocleithrum falsunilatum Feronato, Razzolini, Morey & Boeger, 2022 principalement par la morphologie unique de l'organe copulateur mâle (OCM), mais diffèrent de ces espèces et de toutes les espèces congénères principalement par la morphologie de l'OCM, de la pièce accessoire et des paires de crochets. Cosmetocleithrum ludovicense est proche de Cosmetocleithrum confusus Kritsky, Thatcher & Boeger, 1986 et de Cosmetocleithrum akuanduba Soares, Santos Neto & Domingues, 2018 mais en diffère principalement par la morphologie de la pièce accessoire. Cosmetocleithrum sacciforme se distingue de toutes les espèces congénères principalement par la morphologie de la pièce accessoire formée d'une seule plaque d'aspect sacculaire. Cosmetocleithrum basicomplexum partage également des caractères morphologiques avec Cosmetocleithrum gigas Morey, Cachique & Babilonia, 2019 compte tenu de la taille du corps et de la forme des anchors, mais en diffère principalement par la morphologie des barres et des crochets. Outre les nouvelles espèces, de nouvelles données sont présentées pour Cosmetocleithrum leandroi Soares, Neto & Domingues, 2018, C. akuanduba et C. confusus concernant les caractéristiques morphologiques et la biogéographie.

Influence of the ethical climate on workers' health among healthcare professionals: a systematic review.

OBJECTIVE: To evaluate the influence of the ethical climate on workers' health among healthcare professionals. METHOD: Systematic review and meta-analysis conducted in MEDLINE/PubMed, EMBASE, SciVerse Scopus (Elsevier), Cumulative Index to Nursing and Allied Health Literature and Web of Science. Trained reviewers performed the selection, data extraction, and assessment of methodological quality. Meta-analysis was applied for data synthesis. RESULTS: Among the 2644 studies, 20 were included for analysis, in which three (15.0%) articles were classified as high quality (score ≥ 80%), while 17 (85.0%) were classified as regular (score 50-79%). There was a moderate negative correlation between the ethical climate and overall moral distress (r=-0.43; 95%CI -0.50; -0.36) and the frequency of moral distress (r=-0.36; 95%CI -0.45; -0.25), as well as the positive and strong correlation between ethical climate and job satisfaction (r=0.71; 95%CI 0.39-0.88). CONCLUSION: The negative and positive perception of the ethical climate among healthcare professionals, respectively, influenced the increase in moral distress and job satisfaction.

Transmission-Blocking Vaccines for Canine Visceral Leishmaniasis: New Progress and Yet New Challenges.

Dogs with visceral leishmaniasis play a key role in the transmission cycle of Leishmania infantum to humans in the urban environment. There is a consensus regarding the importance of developing a vaccine to control this disease. Despite many efforts to develop a protective vaccine against CVL, the ones currently available, Leish-tec® and LetiFend®, have limited effectiveness. This is due, in part, to the complexity of the immune response of the naturally infected dogs against the parasite and the complexity of the parasite transmission cycle. Thus, strategies, such as the development of a transmission-blocking vaccines (TBVs) already being applied to other vector-borne diseases like malaria and dengue, would be an attractive alternative to control leishmaniasis. TBVs induce the production of antibodies in the vertebrate host, which can inhibit parasite development in the vector and/or interfere with aspects of vector biology, leading to an interruption of parasite transmission. To date, there are few TBV studies for CVL and other leishmaniasis forms. However, the few studies that exist show promising results, thus justifying the further development of this approach.

Severe infections in Portuguese patients with rheumatoid arthritis under biologic treatment - a multicenter, nationwide study (SIPPRA-B Study).

INTRODUCTION: Despite years of experience with biological disease modifying anti-rheumatic drugs (bDMARD) in rheumatoid arthritis (RA), little is known about differences in infectious risk among bDMARDs. The aim of this study was to assess the incidence and type of infections in RA patients on bDMARDs and to determine possible predictors. METHODS: A retrospective multicenter cohort study that included patients registered in the Rheumatic Diseases Portuguese Registry (Reuma.pt) with RA, and exposed to at least one bDMARD until April 2021. RA patients under bDMARD and with at least one episode of severe infection (SI), defined as infection that requires hospitalization, use of parenteral antibiotics or that resulted in death, were compared to patients with no report of SI. Demographic and clinical data at baseline and at the time of each SI were collected to establish comparisons between different groups of bDMARDs. Comparisons between different bDMARDs were assessed and logistic regression was performed to identify predictors of SI. RESULTS: We included 3394 patients, 2833 (83.5%) female, with a mean age at RA diagnosis of 45.5±13.7 years. SI was diagnosed in 142 of the 3394 patients evaluated (4.2%), totaling 151 episodes of SI. At baseline, patients with SI had a significantly higher proportion of prior orthopedic surgery, asthma, interstitial lung disease, chronic kidney disease and corticosteroid use, higher mean age and longer median disease duration at first bDMARD. Nine patients died (6.0%). Ninety-two SI (60.9%) occurred with the first bDMARD, the majority leading to discontinuation of the bDMARD within 6 months (n=75, 49.7%), while 65 (43.0%) restarted the same bDMARD and 11 (7.3%) switched to another bDMARD (6 of them to a different mechanism of action). In the multivariate analysis, we found that chronic kidney disease, asthma, infliximab, corticosteroid use, interstitial lung disease, previous orthopedic surgery, higher Health Assessment Questionnaire and DAS284V-ESR are independent predictors of SI. CONCLUSION: This study described the incidence and types of SI among Portuguese RA patients on biologics, identifying several predictors of SI, both globally and with different bDMARDs. Physicians should be aware of the real-word infectious risk in RA patients on bDMARDs when making treatment decisions.

CROSS-CULTURAL ADAPTATION OF THE HOSPITAL ETHICAL CLIMATE SURVEY TO BRAZIL.

Background and Purpose: Adapting cross-culturally the Hospital Ethical Climate Survey to Brazilian nurses. Methods: A methodological study comprising translation, back translation, multidisciplinary committee, expert panel, pilot test and validation of the instrument. The validation was carried out with 269 nurses of a university hospital in the South of Brazil. Results: In the validation step, the quadratic weighted Kappa test-retest and the correlation coefficient ranged from 0.15 to 0.74. All factor loadings were higher than 0.4, ranging from 0.445 to 0.859. The Portuguese version of the instrument had a 0.93 Cronbach's alpha and the confirmatory analysis demonstrated the model's suitability with five factors and 26 items validated. Conclusions: The version of the instrument adapted to Brazilian Portuguese was considered valid and reliable in this sample.

The Impact of the Virulence of Pseudomonas aeruginosa Isolated from Dogs.

Pseudomonas aeruginosa is a pathogenic bacterium that can cause serious infections in both humans and animals, including dogs. Treatment of this bacterium is challenging because some strains have developed multi-drug resistance. This study aimed to evaluate the antimicrobial resistance patterns and biofilm production of clinical isolates of P. aeruginosa obtained from dogs. The study found that resistance to various ß-lactam antimicrobials was widespread, with cefovecin and ceftiofur showing resistance in 74% and 59% of the isolates tested, respectively. Among the aminoglycosides, all strains showed susceptibility to amikacin and tobramycin, while gentamicin resistance was observed in 7% of the tested isolates. Furthermore, all isolates carried the oprD gene, which is essential in governing the entry of antibiotics into bacterial cells. The study also investigated the presence of virulence genes and found that all isolates carried exoS, exoA, exoT, exoY, aprA, algD, and plcH genes. This study compared P. aeruginosa resistance patterns worldwide, emphasizing regional understanding and responsible antibiotic use to prevent multi-drug resistance from emerging. In general, the results of this study emphasize the importance of the continued monitoring of antimicrobial resistance in veterinary medicine.

Assessing the functional diversity of rhizobacteria from cacao by partitioning root and shoot biomasses.

Plant-microbe interactions are critical for the sustainability of agricultural production. In this study, our aims were to characterize the genetic and functional diversity of the culturable bacterial community associated with the cacao rhizosphere and access their potential for growth promotion of cacao seedling. Culture-dependent and molecular methods were used to characterize the population densities and diversity of bacterial communities from soil and cacao plants at two locations and two plant ages. A total of 63 strains were identified through hsp60 sequencing. Pseudomonas and Enterobacter were the most abundant genera in association with the cacao rhizosphere, whereas Bacillus was more numerous in soil. Parameters of seedling growth promotion were evaluated 60 days after inoculation of seeds, with partition of the assessments into root and shoot weight. Each isolate showed beneficial, neutral or deleterious effects on plant growth, depending on the isolate and on the parts of plant assessed. Interestingly, although an apparent overall decrease in total biomass of seedlings (roots + shoots dry matters) was observed for the majority of isolates (89%), 94% of all isolates, in fact, revealed an increase in plant roots/shoots dry biomass ratio. Despite that part of the isolates (35%) appeared to significantly decrease plant height, and that 65% did not influence plant height (neutral effect), 18 had significantly increased root dry biomass; nevertheless, seven of these root growth-increasing isolates simultaneously decreased shoots-related growth parameters. The results of this study evidentiated the functional diversity of culturable cacao rhizobacteria and how the partitioning of roots and shoots in the assessment of plant growth parameters could reveal the biotechnological potential of these isolates for promoting growth of clones for rehabilitation of commercial cacao plantations. KEY POINTS: • The most common culturable bacteria in cacao roots were Pseudomonas and Enterobacter • Most culturable bacteria from cacao roots increased the root/shoot ratio • Roots and shoots should be examined separately to detect cacao beneficial bacteria.

Nurses' assessment of the ethical climate of a university hospital in the South of Brazil.

Background: Ethical climate can be defined as the healthcare professionals' perceptions of the ethical treatment of healthcare issues and human interactions in their work environment. A number of studies on ethical climate are being carried out in several countries. In Brazil, however, research on the matter is still incipient, especially among hospital nurses. Aim: To assess nurses' perception of the ethical climate in a university hospital in the South of Brazil. Methods: Cross-sectional study carried out with 269 nurses from a university hospital, using a sociodemographic and occupational profiling survey and the Hospital Ethical Climate Survey - Brazilian version. Data analysis was done through descriptive statistics. Results: The nurses' perception of the ethical climate was positive (3.68 ± 0.55). Among the five assessment factors, 'peers' had the highest score (4.07 ± 0.57), whereas 'physicians' had the lowest score (3.26 ± 0.70) for ethical climate. Conclusion: In general, the ethical climate was perceived as positive, with small variations between the factors of the instrument. Ethical climate could be enhanced through strategies that encourage interpersonal relationships. This study shows the importance of a positive ethical climate based on good relationships between healthcare professionals for ensuring better care.

A Review of Major Patents on Potential Malaria Vaccine Targets.

Malaria is a parasitic infection that is a great public health concern and is responsible for high mortality rates worldwide. Different strategies have been employed to improve disease control, demonstrating the ineffectiveness of controlling vectors, and parasite resistance to antimalarial drugs requires the development of an effective preventive vaccine. There are countless challenges to the development of such a vaccine directly related to the parasite's complex life cycle. After more than four decades of basic research and clinical trials, the World Health Organization (WHO) has recommended the pre-erythrocytic Plasmodium falciparum (RTS, S) malaria vaccine for widespread use among children living in malaria-endemic areas. However, there is a consensus that major improvements are needed to develop a vaccine with a greater epidemiological impact in endemic areas. This review discusses novel strategies for malaria vaccine design taking the target stages within the parasite cycle into account. The design of the multi-component vaccine shows considerable potential, especially as it involves transmission-blocking vaccines (TBVs) that eliminate the parasite's replication towards sporozoite stage parasites during a blood meal of female anopheline mosquitoes. Significant improvements have been made but additional efforts to achieve an efficient vaccine are required to improve control measures. Different strategies have been employed, thus demonstrating the ineffectiveness in controlling vectors, and parasite resistance to antimalarial drugs requires the development of a preventive vaccine. Despite having a vaccine in an advanced stage of development, such as the RTS, S malaria vaccine, the search for an effective vaccine against malaria is far from over. This review discusses novel strategies for malaria vaccine design taking into account the target stages within the parasite's life cycle.