Early results of eTEP access surgery with preperitoneal repair of primary midline ventral hernias and diastasis recti. A 33 patient case series of "PeTEP".

BACKGROUND: This article aims to share the initial experience of the preperitoneal eTEP approach and its potential benefits in a selected group of patients. The eTEP Rives-Stoppa is a proven minimally invasive surgical technique for the treatment of ventral midline and off-midline hernias that has shown to be a solid, durable, and reproducible repair. The preperitoneal eTEP repair is a surgical technique that brings together the extraperitoneal access surgery with a preperitoneal repair for primary midline hernias avoiding posterior rectus sheath division and preservation of the retrorectus space while being able to treat simultaneous diastasis recti. METHODS: The analysis included 33 patients operated with the preperitoneal eTEP approach from September 2022 to September 2023 in patients with primary small to medium (< 4 cm) midline hernias, single or multiple defects with or without diastasis recti. Age, gender, hernia characteristics, operative time, and surgical site occurrences will be discussed, as well as fine details and landmarks in the operative technique. RESULTS: 33 consecutive patients were operated, 19 female (57.5%) and 14 males (42.5%) between 32 and 63 years of age, the most common comorbidity found was obesity (BMI > 30). In 70% of the cases, operative time was 90 min ± 25 min. The average hospital stay was one day, while 12 went home the same day, and so far, no reoccurrences have been reported. CONCLUSIONS: We believe the preperitoneal eTEP approach for small to medium primary midline hernias is an effective and solid repair that combines excellent features of proven surgical techniques and eliminates the need for posterior rectus sheath division while saving the retrorectus space, among other benefits that will be discussed. The reproducibility of the technique remains to be proven.

Comparing psychological versus pharmacological treatment in emotional disorders: A network analysis.

Transdiagnostic group cognitive behavioural therapy (TD-GCBT) is more effective in improving symptoms and severity of emotional disorders (EDs) than treatment as usual (TAU; usually pharmacological treatment). However, there is little research that has examined the effects of these treatments on specific symptoms. This study used Network Intervention Analysis (NIA) to investigate the direct and differential effects of TD-GCBT + TAU and TAU on specific symptoms of anxiety and depression. Data are from a multicentre randomised clinical trial (N = 1061) comparing TD-GCBT + TAU versus TAU alone for EDs. The networks included items from the PHQ-9 (depression) and GAD-7 (anxiety) questionnaire and mixed graphical models were estimated at pre-treatment, post-treatment and 3-, 6- and 12-month follow-up. Results revealed that TD-GCBT + TAU was associated with direct effects, mainly on several anxiety symptoms and depressed mood after treatment. New direct effects on other depressive symptoms emerged during the follow-up period promoted by TD-GCBT compared to TAU. Our results suggest that the improvement of anxiety symptoms after treatment might precipitate a wave of changes that favour a decrease in depressive symptomatology. NIA is a methodology that can provide fine-grained insight into the likely pathways through which treatments exert their effects.

Myxococcus xanthus predation: an updated overview.

Bacterial predators are widely distributed across a variety of natural environments. Understanding predatory interactions is of great importance since they play a defining role in shaping microbial communities in habitats such as soils. Myxococcus xanthus is a soil-dwelling bacterial predator that can prey on Gram-positive and Gram-negative bacteria and even on eukaryotic microorganisms. This model organism has been studied for many decades for its unusual lifecycle, characterized by the formation of multicellular fruiting bodies filled with myxospores. However, less is known about its predatory behavior despite being an integral part of its lifecycle. Predation in M. xanthus is a multifactorial process that involves several mechanisms working synergistically, including motility systems to efficiently track and hunt prey, and a combination of short-range and contact-dependent mechanisms to achieve prey death and feed on them. In the short-range attack, M. xanthus is best known for the collective production of secondary metabolites and hydrolytic enzymes to kill prey and degrade cellular components. On the other hand, contact-dependent killing is a cell-to-cell process that relies on Tad-like and type III secretion systems. Furthermore, recent research has revealed that metals also play an important role during predation, either by inducing oxidative stress in the prey, or by competing for essential metals. In this paper, we review the current knowledge about M. xanthus predation, focusing on the different mechanisms used to hunt, kill, and feed on its prey, considering the most recent discoveries and the transcriptomic data available.

Isolated melanoma cells in sentinel lymph node in stage IIIA melanoma correlate with a favorable prognosis similar to stage IB.

BACKGROUND: The American Joint Committee on Cancer 8th edition (AJCC v8) defines sentinel lymph nodes (SLN) containing any tumor cells as positive SLN. Consequently, even thin melanomas with isolated tumor cells (ic) in SLN are classified as stage IIIA, making them candidates for adjuvant therapy. OBJECTIVES AND ENDPOINTS: We aimed to evaluate survival outcomes of melanoma stage IIIA (ic) and compare them with stage IIIA with lymph node (LN) metastases > 0.1 mm. Primary endpoints were relapse-free survival (RFS) and distant metastases-free survival (DMFS). Secondary endpoint was melanoma specific survival (MSS). RESULTS: The discovery cohort from the Department of Dermatology, University Hospital Tuebingen, included 237 patients; confirmation cohort included 143 patients from the DeCOG trial. The Tuebingen cohort included 95 patients with stage IIIA (ic) and 142 patients with stage IIIA. The DeCOG trial included 39 patients with stage IIIA (ic) and 104 patients with stage IIIA. In the Tuebingen cohort, 10-year RFS rates for stage IIIA (ic) and IIIA were 84% (95% CI 75-94) and 49% (95% CI 39-59), respectively (p < 0.001). 10-year DMFS rates for stage IIIA (ic) and IIIA were 89% (95% CI 81-97) and 56% (95% CI 45-67), respectively; (p < 0.001). In the DeCOG cohort, 10-year RFS for stage IIIA (ic) and stage IIIA were 88% (95% CI 78-99) and 35% (95% CI 7-62), respectively; (p = 0.009). 10-year DMFS for stage IIIA (ic) and IIIA was 88% (95% CI 77-99) and 60% (95% CI 39-80), respectively (p = 0.061). CONCLUSION: Stage IIIA (ic) melanoma exhibits a prognosis similar to stage IB. Recommendation of adjuvant therapy in Stage IIIA (ic) warrants thorough discussion.

Augmenting MEK inhibitor efficacy in BRAF wild-type melanoma: synergistic effects of disulfiram combination therapy.

BACKGROUND: MEK inhibitors (MEKi) were shown to be clinically insufficiently effective in patients suffering from BRAF wild-type (BRAF WT) melanoma, even if the MAPK pathway was constitutively activated due to mutations in NRAS or NF-1. Thus, novel combinations are needed to increase the efficacy and duration of response to MEKi in BRAF WT melanoma. Disulfiram and its metabolite diethyldithiocarbamate are known to have antitumor effects related to cellular stress, and induction of endoplasmic reticulum (ER) stress was found to synergize with MEK inhibitors in NRAS-mutated melanoma cells. Therefore, we investigated the combination of both therapeutics to test their effects on BRAF-WT melanoma cells and compared them with monotherapy using the MEKi trametinib. METHODS: The effects of combined therapy with disulfiram or its metabolite diethyldithiocarbamate and the MEKi trametinib were evaluated in a series of BRAF-WT melanoma cell lines by measuring cell viability and apoptosis induction. Cytotoxicity was additionally assessed in 3D spheroids, ex vivo melanoma slice cultures, and in vivo xenograft mouse models. The response of melanoma cells to treatment was studied at the RNA and protein levels to decipher the mode of action. Intracellular and intratumoral copper measurements were performed to investigate the role of copper ions in the antitumor cytotoxicity of disulfiram and its combination with the MEKi. RESULTS: Diethyldithiocarbamate enhanced trametinib-induced cytotoxicity and apoptosis induction in 2D and 3D melanoma culture models. Mechanistically, copper-dependent induction of oxidative stress and ER stress led to Janus kinase (JNK)-mediated apoptosis in melanoma cells. This mechanism was also detectable in patient-derived xenograft melanoma models and resulted in a significantly improved therapeutic effect compared to monotherapy with the MEKi trametinib. CONCLUSIONS: Disulfiram and its metabolite represent an attractive pharmaceutical approach to induce ER stress in melanoma cells that potentiates the antitumor effect of MEK inhibition and may be an interesting candidate for combination therapy of BRAF WT melanoma.

Deaths of U.S. Citizens Undergoing Cosmetic Surgery - Dominican Republic, 2009-2022.

Although infections resulting from cosmetic surgery performed outside the United States have been regularly reported, deaths have rarely been identified. During 2009-2022, 93 U.S. citizens died after receiving cosmetic surgery in the Dominican Republic. The number of deaths increased from a mean of 4.1 per year during 2009-2018 to a mean of 13.0 during 2019-2022 with a peak in of 17 in 2020. A subset of post-cosmetic surgery deaths occurring during peak years was investigated, and most deaths were found to be the result of embolic events (fat emboli or venous thromboembolism) for which a high proportion of the patients who died had risk factors, including obesity and having multiple procedures performed during the same operation. These risk factors might have been mitigated or prevented with improved surgical protocols and postoperative medical care, including prophylactic measures against venous thromboembolism. U.S. citizens interested in receiving elective cosmetic surgery outside the United States should consult with their health care professionals regarding their risk for adverse outcomes. Public health authorities can support provider education on the importance of preoperative patient evaluation and the potential danger of performing multiple cosmetic procedures in one operation.

Evaluation of pro-regenerative and anti-inflammatory effects of isolecanoric acid in the muscle: Potential treatment of Duchenne Muscular Dystrophy.

Duchenne muscular dystrophy (DMD) is a devastating degenerative disease of skeletal muscles caused by loss of dystrophin, a key protein that maintains muscle integrity, which leads to progressive muscle degeneration aggravated by chronic inflammation, muscle stem cells' (MuSCs) reduced regenerative capacity and replacement of muscle with fibroadipose tissue. Previous research has shown that pharmacological GSK-3ß inhibition favors myogenic differentiation and plays an important role in modulating inflammatory processes. Isolecanoric acid (ILA) is a natural product isolated from a fungal culture displaying GSK-3ß inhibitory properties. The present study aimed to investigate the proregenerative and anti-inflammatory properties of this natural compound in the DMD context. Our results showed that ILA markedly promotes myogenic differentiation of myoblasts by increasing ß-Catenin signaling and boosting the myogenic potential of mouse and human stem cells. One important finding was that the GSK-3ß/ß-Catenin pathway is altered in dystrophic mice muscle and ILA enhances the myofiber formation of dystrophic MuSCs. Treatment with this natural compound improves muscle regeneration of dystrophic mice by, in turn, improving functional performance. Moreover, ILA ameliorates the inflammatory response in both muscle explants and the macrophages isolated from dystrophic mice to, thus, mitigate fibrosis after muscle damage. Overall, we show that ILA modulates both inflammation and muscle regeneration to, thus, contribute to improve the dystrophic phenotype.

3D-printed low-cost choke corrugated Gaussian profile horn antenna for Ka-band.

In this work, a fully 3D-printed choke corrugated Gaussian profile horn antenna (GPHA) using high-conductive filaments and a low-cost modular 3D-printing technique is implemented. The choke corrugated GPHA operates in the Ka-band, with a central frequency of 28 GHz. Although the antenna can be printed in one piece as its dimensions are within the printing limits, four pieces compose the three sections of the final 3D-printed antenna. The numerical simulations and measurements of the antenna show a good agreement, validating the possibility of cost-effective modular fabrication of this complex type of antennas.

Construção de aplicativo móvel como estratégia para adesão medicamentosa de idosos / Construction of a mobile application as a strategy for medication adherence in the elderly population

Objetivo: Descrever o processo de desenvolvimento de um aplicativo como estratégia para promover a adesão medicamentosa de idosos. Métodos: Pesquisa metodológica de produção tecnológica. Foram seguidas as etapas de levantamento de dados, montagem de banco de dados e desenvolvimento do software. Realizou-se uma revisão narrativa da literatura sobre o tema. Resultados: Para o desenvolvimento da ferramenta tecnológica realizou-se inicialmente um protótipo do aplicativo. O objetivo central foi criar um programa de aplicação para lembrar o horário de medicamentos através de avisos sonoros e informações na tela, com foco na autonomia do processo saúde-doença do público idoso, utilizando-se de uma linguagem acessível, com fontes grandes e legíveis, com cores específicas para a tela de fundo e os Ooblets adequados para o entendimento do público-alvo. Conclusão: O aplicativo contribui na adesão medicamentosa por parte dos idosos, além de auxiliar os cuidadores sobre o uso correto, horário adequado e dosagem correta. A tecnologia proposta proporciona a corresponsabilização dos longevos no seu processo saúde-doença e adesão à terapêutica prescrita. Descritores: Tecnologia; Saúde do Idoso; Polimedicação; Cuidados de Enfermagem.

Objective: To describe the process of developing an application as a strategy to promote medication adherence in the elderly population.Methods:Methodological research of technological production. The steps of data survey, database assembly and software development were followed. A narrative review of the literature on the theme was performed.Results:In order to develop the technological tool, a prototype of the application was initially made. The central objective was to create an application program to remember the medication schedule through sound warnings and on-screen information, focusing on theautonomy of the health-disease process of the elderly population, using an accessible language, with large and legible fonts, with specific colors for the background screen and Ooblets suitable for the understanding of the target audience.Conclusion: Theapplication contributes to medication adherence by the elderly patients, in addition to helping caregivers regarding the correct use, appropriate time, and correct dosage. The proposed technology provides the co-responsibility of the elderly citizens in their health-disease process and adherence to the prescribed therapy. Descriptors:Technology; Health of the Elderly; Polypharmacy; Nursing Care.

Hemodynamic response function description in patients with glioma.

INTRODUCTION: Functional magnetic resonance imaging is a powerful tool that has provided many insights into cognitive sciences. Yet, as its analysis is mostly based on the knowledge of an a priori canonical hemodynamic response function (HRF), its reliability in patients' applications has been questioned. There have been reports of neurovascular uncoupling in patients with glioma, but no specific description of the Hemodynamic Response Function (HRF) in glioma has been reported so far. The aim of this work is to describe the HRF in patients with glioma. METHODS: Forty patients were included. MR images were acquired on a 1.5T scanner. Activated clusters were identified using a fuzzy general linear model; HRFs were adjusted with a double-gamma function. Analyses were undertaken considering the tumor grade, age, sex, tumor location, and activated location. RESULTS: Differences are found in the occipital, limbic, insular, and sub-lobar areas, but not in the frontal, temporal, and parietal lobes. The presence of a glioma slows the time-to-peak and onset times by 5.2 and 3.8 % respectively; high-grade gliomas present 8.1 % smaller HRF widths than low-grade gliomas. DISCUSSION AND CONCLUSION: There is significant HRF variation due to the presence of glioma, but the magnitudes of the observed differences are small. Most processing pipelines should be robust enough for this magnitude of variation and little if any impact should be visible on functional maps. The differences that have been observed in the literature between functional mapping obtained with magnetic resonance vs. that obtained with direct electrostimulation during awake surgery are more probably due to the intrinsic difference in the mapping process: fMRI mapping detects all recruited areas while intra-surgical mapping indicates only the areas indispensable for the realization of a certain task. Surgical mapping might not be the gold standard to use when trying to validate the fMRI mapping process.

Understanding the combining ability of nutritional, agronomic and industrial traits in soybean F2 progenies.

Obtaining soybean genotypes that combine better nutrient uptake, higher oil and protein levels in the grains, and high grain yield is one of the major challenges for current breeding programs. To avoid the development of unpromising populations, selecting parents for crossbreeding is a crucial step in the breeding pipeline. Therefore, our objective was to estimate the combining ability of soybean cultivars based on the F2 generation, aiming to identify superior segregating parents and populations for agronomic, nutritional and industrial traits. Field experiments were carried out in two locations in the 2020/2021 crop season. Leaf contents of the following nutrients were evaluated: phosphorus, potassium, calcium, magnesium, sulfur, copper, iron, manganese, and zinc. Agronomic traits assessed were days to maturity (DM) and grain yield (GY), while the industrial traits protein, oil, fiber and ash contents were also measured in the populations studied. There was a significant genotype × environment (G × A) interaction for all nutritional traits, except for P content, DM and all industrial traits. The parent G3 and the segregating populations P20 and P27 can be used aiming to obtain higher nutritional efficiency in new soybean cultivars. The segregating populations P11 and P26 show higher potential for selecting soybean genotypes that combine earliness and higher grain yield. The parent G5 and segregant population P6 are promising for selection seeking improvement of industrial traits in soybean.

Transcriptional Regulators Controlling Virulence in Pseudomonas aeruginosa.

Pseudomonas aeruginosa is a pathogen capable of colonizing virtually every human tissue. The host colonization competence and versatility of this pathogen are powered by a wide array of virulence factors necessary in different steps of the infection process. This includes factors involved in bacterial motility and attachment, biofilm formation, the production and secretion of extracellular invasive enzymes and exotoxins, the production of toxic secondary metabolites, and the acquisition of iron. Expression of these virulence factors during infection is tightly regulated, which allows their production only when they are needed. This process optimizes host colonization and virulence. In this work, we review the intricate network of transcriptional regulators that control the expression of virulence factors in P. aeruginosa, including one- and two-component systems and σ factors. Because inhibition of virulence holds promise as a target for new antimicrobials, blocking the regulators that trigger the production of virulence determinants in P. aeruginosa is a promising strategy to fight this clinically relevant pathogen.

Microenvironmental Snail1-induced immunosuppression promotes melanoma growth.

Melanoma is an aggressive form of skin cancer due to its high metastatic abilities and resistance to therapies. Melanoma cells reside in a heterogeneous tumour microenvironment that acts as a crucial regulator of its progression. Snail1 is an epithelial-to-mesenchymal transition transcription factor expressed during development and reactivated in pathological situations including fibrosis and cancer. In this work, we show that Snail1 is activated in the melanoma microenvironment, particularly in fibroblasts. Analysis of mouse models that allow stromal Snail1 depletion and therapeutic Snail1 blockade indicate that targeting Snail1 in the tumour microenvironment decreases melanoma growth and lung metastatic burden, extending mice survival. Transcriptomic analysis of melanoma-associated fibroblasts and analysis of the tumours indicate that stromal Snail1 induces melanoma growth by promoting an immunosuppressive microenvironment and a decrease in anti-tumour immunity. This study unveils a novel role of Snail1 in melanoma biology and supports its potential as a therapeutic target.

Feasibility study of a mobile application (ACT-ON) to complement acceptance and commitment therapy (ACT) intervention in cancer patients.

OBJECTIVE: Psychological and physical distress commonly affect cancer patients. Acceptance and commitment therapy (ACT) has shown promising results when it comes to ameliorating symptoms that may develop as a result of this. Meanwhile, it has come to light that the impact of psychological interventions may be enhanced by the use of mobile applications. However, to date no mobile applications have been developed to support ACT-based interventions in cancer patients. The aim of the present study is to develop and test the usability of a mobile application designed to complement face-to-face ACT-based therapy in a group of cancer patients undergoing treatment. MATERIALS AND METHODS: A total of thirty-nine patients were recruited to participate in this pilot study. Participants had to be: 18 years of age or over, currently undergoing treatment for breast, lung or colorectal cancer, in stage I-III, a smartphone user with daily internet access. The intervention sessions were administered for a period of eight weeks, one hour per week to groups of four to six participants. Patients had the ACT-ON mobile application at their disposal, which provided them with access to therapy-related activities: mindfulness, metaphors and exercises to clarify values. RESULTS: The application obtained adequate adoption (61.54%) and usage (54.17%) rates. Usability and ease of learning scores were as follows: good usability (M = 79.81, SD = 11.87); high usability (M = 80.53, SD = 14.04); ease of learning (M = 37.5, SD = 23.85). DISCUSSION: This is the first study to develop and evaluate the usability of an application designed to support ACT-based interventions in cancer patients undergoing treatment. The results show that the ACT-ON app is a feasible tool which achieves high levels of usability. However, said results ought to be confirmed by studies that include a larger number of cancer patients.

A Rare Complication of Gastrointestinal Bleeding: Jejunal Diverticulosis. A Case Report

Introduction: Small intestine diverticula are a rare condition with an incidence of 0.6% to 2%. Their location at the level of the jejunum is a rare alteration, and their diagnosis is often delayed due to low clinical suspicion. The clinical manifestation of this pathology is related to the development of complications -15% to 30% of patients, with approximately 10% requiring surgical intervention. Clinical case: We present a case of a middle-aged adult patient who experienced a complication due to a bleeding jejunal diverticulum. The patient underwent surgical management, which resulted in a satisfactory outcome. Objective: This article aims to describe jejunal diverticulosis, a rare condition that can have a significant impact on affected individuals. Emphasizing its clinical suspicion as a differential diagnosis for gastrointestinal bleeding is crucial. Additionally, we discuss diagnostic methods and highlight various therapeutic options, including surgical management.

Introducción: los divertículos del intestino delgado presentan una incidencia del 0,6% al 2%, su localización a nivel del yeyuno es una alteración poco frecuente y, dada su baja sospecha clínica, se retrasa el diagnóstico oportuno. La manifestación clínica de esta patología se encuentra relacionada con el desarrollo de complicaciones, las cuales ocurren entre el 15% y el 30% de los pacientes, y el 10% de estos pacientes requiere manejo quirúrgico. Caso clínico: un paciente adulto medio cursó con una complicación secundaria a la presencia de un divertículo del yeyuno sangrante, al cual se le dio un manejo quirúrgico con un resultado satisfactorio. Objetivo: este artículo tiene como objetivo describir la diverticulosis yeyunal que, aunque poco frecuente, puede generar un compromiso importante en quien la padece, lo que prioriza su sospecha clínica como diagnóstico diferencial causante de hemorragia gastrointestinal, así como dilucidar métodos diagnósticos y estar al tanto de las diferentes opciones terapéuticas que existen, incluido el manejo quirúrgico.

Features and Long-Term Outcomes of Stage IV Melanoma Patients Achieving Complete Response Under Anti-PD-1-Based Immunotherapy.

BACKGROUND: Immune checkpoint inhibition (ICI) has changed the melanoma treatment spectrum. Few studies have examined the characteristics and long-term outcomes of patients achieving complete response (CR) under ICI. MATERIALS AND METHODS: We evaluated patients with unresectable stage IV melanoma treated with first-line ICI. The characteristics of those achieving CR were compared with those not achieving CR. Progression-free survival (PFS) and overall survival (OS) were assessed. Late-onset toxicities, response to second-line treatment, the prognostic value of clinicopathologic features, and blood markers were examined. RESULTS: A total of 265 patients were included; 41 (15.5%) achieved CR, while 224 (84.5%) had progressive disease, stable disease, or partial response. At the therapy start, those who had CR were more likely to be older than 65 years of age (p = 0.013), have a platelet-to-lymphocyte ratio below 213 (p = 0.036), and have lower lactate dehydrogenase levels (p = 0.008) than those not achieving a CR. For those who discontinued therapy after CR, the median follow-up time after CR was 56 months (interquartile range [IQR] 52-58) and the median time from CR to therapy end was 10 months (IQR 1-17). Five-year PFS after CR was 79% and 5-year OS was 83%. Most complete responders had a normalization of S100 at the time of CR (p < 0.001). In simple Cox regression analysis, age below 77 years at CR (p = 0.04) was associated with better prognosis after CR. Eight patients received second-line ICI; disease control was seen in 63%. Late immune-related toxicities occurred in 25% of patients, most being cutaneous immune-related toxicities. CONCLUSIONS: Response, according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria, is, until now, the most important prognostic factor, and CR is a valid surrogate marker for long-term survival in patients treated with ICI. Our results highlight the importance of investigating the optimal therapy duration in complete responders.

The molecular mechanisms of the bacterial iron sensor IdeR.

Life came to depend on iron as a cofactor for many essential enzymatic reactions. However, once the atmosphere was oxygenated, iron became both scarce and toxic. Therefore, complex mechanisms have evolved to scavenge iron from an environment in which it is poorly bioavailable, and to tightly regulate intracellular iron contents. In bacteria, this is typically accomplished with the help of one key regulator, an iron-sensing transcription factor. While Gram-negative bacteria and Gram-positive species with low guanine-cytosine (GC) content generally use Fur (ferric uptake regulator) proteins to regulate iron homeostasis, Gram-positive species with high GC content use the functional homolog IdeR (iron-dependent regulator). IdeR controls the expression of iron acquisition and storage genes, repressing the former, and activating the latter in an iron-dependent manner. In bacterial pathogens such as Corynebacterium diphtheriae and Mycobacterium tuberculosis, IdeR is also involved in virulence, whereas in non-pathogenic species such as Streptomyces, it regulates secondary metabolism as well. Although in recent years the focus of research on IdeR has shifted towards drug development, there is much left to learn about the molecular mechanisms of IdeR. Here, we summarize our current understanding of how this important bacterial transcriptional regulator represses and activates transcription, how it is allosterically activated by iron binding, and how it recognizes its DNA target sites, highlighting the open questions that remain to be addressed.

Psychological distress predicts quality of life in the first months of cancer diagnosis in cancer caregivers.

In cancer caregivers, anxiety and depression may negatively impact quality of life. Information regarding correlations and the predictive capacity of anxiety and depression with regard to the domains of quality of life of caregivers 6 months after a patient's cancer diagnosis is sparse. Sixty-seven caregivers of cancer patients were recruited and completed the Hospital Anxiety and Depression Scale (HADS) and the Short-Form Health Survey (SF-36) 30-45 days (T1) and 180-200 days (T2) after diagnosis. Depression and anxiety (T1) correlated with quality of life in terms of general health, vitality, social functioning, as well as role limitations due to emotional problems, and mental health (T2). Depression scores at T1 predicted general health, vitality, social functioning, role limitations due to emotional problems and mental health. Although these results are interesting, it must be noted that the sample size was somewhat limited and that the patients' cancer types may have influenced the results obtained. Psychological distress, particularly depression, correlated with and acted as a predictor for changes in the different domains of quality of life, highlighting the relevance of the evaluation of psychological distress in cancer caregivers shortly after cancer diagnosis. These results underscore the importance of differentiating between the different domains in the evaluation of impairments of quality of life in cancer caregivers.

Performance of Pantaneira breed cows in precision grazing system.

Use of a grazing system that takes into account the ingestive behavior of animals and the physiological characteristics of plants maximizes land use and promotes positive effects on the environment. In this sense, the objective of this study was to evaluate the performance of Pantaneira breed cows, kept in rotated grazing in Mombasa grass (Megathyrsus maximum), with different grazing times. Fifty animals were divided into two treatments: Continuous T1: 24 h and T2-Inverted: 12 h. The experiment lasted 98 days, being determined the production and nutritional quality of the forage, digestibility, intake, and performance of the animals. The design was randomized blocks at 5% probability, with the means compared by the F test. The design used was completely randomized at 5% probability by the T test. There was no significant difference for biomass production (P > 0.05). However, after grazing the Inverted group, the forage showed a lower percentage of leaves and an increase in neutral detergent fiber and acid contents and total carbohydrates, and a reduction in crude protein and ether extract values, as well as a higher digestibility (P < 0.05). The animals of the Continuous group intaked more forage (P < 0.05). The Inverted group had a higher average daily weight gain, in addition to a lower feed conversion (P < 0.001). The animals in the Control group spent more time eating (P < 0.0001) and sleeping (P < 0.0001), while the animals of the Inverted group spent more time in idleness (P < 0.0001) and interacting (P < 0.05). There was no difference in rumination time between treatments (P > 0.05). It was concluded that Inverted grazing improved the quality of Mombasa grass and the performance of cows.

Endocrine-disrupting substances: I. Relative risks of PFAS in drinking water.

Concentrations of per and polyfluorinated alkyl substances (PFAS) in drinking water are significantly lower than in vivo levels of the native target hormone. These concentrations are orders of magnitude lower than the hormone in question, particularly when corrected for transactivation. A pregnant woman can excrete about 7,000 µg/day of total estrogens. A low-dose oral contraceptive pill contains 20 µg estradiol. Soy-based baby formula contains phytoestrogens equivalent to a low-dose oral contraceptive pill. A woman on a low-dose oral hormone replacement therapy consumes about 0.5-2 mg/day of one or more estrogens. The levels of endocrine-disrupting substances (EDSs) exposure by oral, respiratory, or dermal routes have the potential to make removing PFAS from drinking water due to its estrogenic activity divert valuable resources. These levels become even less of a threat when their estrogenic potencies are compared with those of the target hormones present as contaminants in water and even more so when compared with levels commonly present in human tissues. The fact that PFAS constitute a tiny fraction compared to exposure to phytoestrogens makes the effort even more insignificant. If PFAS are to be removed from drinking water, it is not due to their estrogenic activity.