Influence of preconception body mass index on perinatal outcomes after metabolic and bariatric surgery.

INTRODUCTION: Metabolic and bariatric surgery (MBS) is a very effective weight loss intervention, although does not invariably reverses the obesity status. Our aim was to evaluate whether despite successful weight loss after MBS, persistence of obesity at time of conception still carries additional risks of adverse perinatal pregnancy outcomes. METHODS: Retrospective study comparing pregnancy outcomes of women previously submitted to MBS with a preconception (PC) body mass index BMI < 30 kg/m2 or PC BMI ≥ 30 kg/m2. RESULTS: Eighty pregnancies (n = 80) were included, 49 from women with a PC BMI < 30 kg/m2 and 31 with a PC BMI ≥ 30 kg/m2. Gestational weight gain was significantly lower (9.72 ± 7.10 vs. 13.81 ± 7.16 respectively; p = 0.01) and neonatal intensive care unit admissions were significantly higher (5% vs. 0% respectively; p = 0.02) in women with PC BMI ≥ 30 kg/m2 as compared to those with PC BMI < 30 kg/m2. There were no statistically significant differences in gestational diabetes, anemia, fetal growth restriction, prematurity rate, mode of delivery or birth weight between groups. CONCLUSION: Perinatal outcomes of pregnancies after MBS may be significantly influenced by PC BMI. The benefits of MBS induced weight loss on obesity-associated adverse pregnancy outcomes can be maximized if the obesity status can be reverted before pregnancy.

MobilityAnalyser: A novel approach for automatic quantification of cell mobility on periodic patterned substrates using brightfield microscopy images.

BACKGROUND AND OBJECTIVE: Surface topography of biomaterials has been shown to have an effect on cells behaviour. Cell-material interactions can be visually characterized by assessing both cell shape and spreading at initial time-points and, its migration patterns, as a response to the underlying topography. Whilst many have reported the study of cell migration and shape with fluorescence labelling, the focus on evaluating cells response to surface topography is to observe, under real-time conditions, interactions between cells and surfaces. In this manuscript we present a novel approach to automatically detect and remove periodic background patterns in brightfield microscopy images in order to perform automatic cell mobility analysis. METHODS: The developed software, MobilityAnalyser, performs automatic tracking of unmarked cells and allows the user to manually correct any incorrectly detected or tracked cell. Human Mesenchymal Stem Cells (hMSCs) trajectory, migration distance, velocity and persistence were evaluated over line and pillar micropatterned SiO2 films and on a flat SiO2 control substrate. RESULTS: The developed software proved to be effective in automatically removing background patterns of both line and pillar shapes and in performing cell detection and tracking. MobilityAnalyser accurately measured cell mobility in a fraction of the time required for manual analysis and eliminated user subjectivity. The results obtained with the software confirmed how different topographies affect cell trajectory, migration pathways and velocities, with a statistically significant increase for micropatterned surfaces, when compared with the flat control. The persistence parameter also proved the influence of both patterns on the directionality of cell movement. CONCLUSIONS: MobilityAnalyser is an automatic tool that removes periodic background patterns, detects and tracks cells, and provides cell mobility parameters that characterize the response of cells to different surface topographies. The software is freely available at: https://drive.google.com/open?id=1Fbb321ogLD19SlRjceMETNUqDHgpeBPl.

An objective comparison of cell-tracking algorithms.

We present a combined report on the results of three editions of the Cell Tracking Challenge, an ongoing initiative aimed at promoting the development and objective evaluation of cell segmentation and tracking algorithms. With 21 participating algorithms and a data repository consisting of 13 data sets from various microscopy modalities, the challenge displays today's state-of-the-art methodology in the field. We analyzed the challenge results using performance measures for segmentation and tracking that rank all participating methods. We also analyzed the performance of all of the algorithms in terms of biological measures and practical usability. Although some methods scored high in all technical aspects, none obtained fully correct solutions. We found that methods that either take prior information into account using learning strategies or analyze cells in a global spatiotemporal video context performed better than other methods under the segmentation and tracking scenarios included in the challenge.

Leading to Crafting: The Relation Between Leadership Perception and Nurses' Job Crafting.

Whenever individuals adapt their jobs to make them closer of their personal preferences, they are performing job crafting. This study aims to investigate if the way nurses perceive their leaders' behaviors is related with job crafting development. To do so, a quantitative analysis was conducted among a group of 325 Portuguese nurses. Results indicate that the perception of an empowering leader was found to be strongly related with the increase of challenges in the work environment, and with the development of stronger relations with direct managers and co-workers, which are two job crafting dimensions. The perception of a directive leader was found to be positively related with the avoidance of performing hindering tasks. Strengthening relations with direct managers and co-workers was found to be particularly related to leadership perception. Theoretical and practical implications are discussed.

Is there any association between Sarcoidosis and infectious agents?: a systematic review and meta-analysis.

BACKGROUND: During the last few years, investigators have debated the role that infectious agents may have in sarcoidosis pathogenesis. With the emergence of new molecular biology techniques, several studies have been conducted; therefore, we performed a meta-analysis in order to better explain this possible association. METHODS: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement from the Cochrane collaboration guidelines. Four different databases (Medline, Scopus, Web of Science, and Cochrane Collaboration) were searched for all original articles published from 1980 to 2015. The present meta-analysis included case-control studies that reported the presence of microorganisms in samples of patients with sarcoidosis using culture methods or molecular biology techniques. We used a random effects or a fixed-effect model to calculate the odds ratio (OR) and 95% confidence intervals (CI). Sensitivity and subgroup analyses were performed in order to explore the heterogeneity among studies. RESULTS: Fifty-eight studies qualified for the purpose of this analysis. The present meta-analysis, the first, to our knowledge, in evaluation of all infectious agents proposed to be associated with sarcoidosis and involving more than 6000 patients in several countries, suggests an etiological link between Propionibacterium acnes and sarcoidosis, with an OR of 18.80 (95% CI 12.62, 28.01). We also found a significant association between sarcoidosis and mycobacteria, with an OR of 6.8 (95% CI 3.73, 12.39). Borrelia (OR 4.82; 95% CI 0.98, 23.81), HHV-8 (OR 1.47; 95% CI 0.02, 110.06) as well as Rickettsia helvetica, Chlamydia pneumoniae, Epstein-barr virus and Retrovirus, although suggested by previous investigations, were not associated with sarcoidosis. CONCLUSION: This meta-analysis suggests that some infectious agents can be associated with sarcoidosis. What seems clear is that more than one infectious agent might be implicated in the pathogenesis of sarcoidosis; probably the patient's geographical location might dictate which microorganisms are more involved. Future investigations and more clinical trials are need to bring these evidences to a more global level.

Macrophage interactions with polylactic acid and chitosan scaffolds lead to improved recruitment of human mesenchymal stem/stromal cells: a comprehensive study with different immune cells.

Despite the importance of immune cell-biomaterial interactions for the regenerative outcome, few studies have investigated how distinct three-dimensional biomaterials modulate the immune cell-mediated mesenchymal stem/stromal cells (MSC) recruitment and function. Thus, this work compares the response of varied primary human immune cell populations triggered by different model scaffolds and describes its functional consequence on recruitment and motility of bone marrow MSC. It was found that polylactic acid (PLA) and chitosan scaffolds lead to an increase in the metabolic activity of macrophages but not of peripheral blood mononuclear cells (PBMC), natural killer (NK) cells or monocytes. PBMC and NK cells increase their cell number in PLA scaffolds and express a secretion profile that does not promote MSC recruitment. Importantly, chitosan increases IL-8, MIP-1, MCP-1 and RANTES secretion by macrophages while PLA stimulates IL-6, IL-8 and MCP-1 production, all chemokines that can lead to MSC recruitment. This secretion profile of macrophages in contact with biomaterials correlates with the highest MSC invasion. Furthermore, macrophages enhance stem cell motility within chitosan scaffolds by 44% but not in PLA scaffolds. Thus, macrophages are the cells that in contact with engineered biomaterials become activated to secrete bioactive molecules that stimulate MSC recruitment.

Cyanobacteria use micro-optics to sense light direction.

Bacterial phototaxis was first recognized over a century ago, but the method by which such small cells can sense the direction of illumination has remained puzzling. The unicellular cyanobacterium Synechocystis sp. PCC 6803 moves with Type IV pili and measures light intensity and color with a range of photoreceptors. Here, we show that individual Synechocystis cells do not respond to a spatiotemporal gradient in light intensity, but rather they directly and accurately sense the position of a light source. We show that directional light sensing is possible because Synechocystis cells act as spherical microlenses, allowing the cell to see a light source and move towards it. A high-resolution image of the light source is focused on the edge of the cell opposite to the source, triggering movement away from the focused spot. Spherical cyanobacteria are probably the world's smallest and oldest example of a camera eye.

Cyanobacteria are blue-green bacteria that are abundant in the environment. Cyanobacteria in the oceans are among the world's most important oxygen producers and carbon dioxide consumers. Synechocystis is a spherical single-celled cyanobacterium that measures about three thousandths of a millimetre across. Because Synechocystis needs sunlight to produce energy, it is important for it to find places where the light is neither too weak nor too strong. Unlike some bacteria, Synechocystis can't swim, but it can crawl across surfaces. It uses this ability to move to places where the light conditions are better. It was already known that Synechocystis cells move towards a light source that is shone at them from one side, which implies that the cyanobacteria can "see" where the light is. But how can such a tiny cell accurately detect where light is coming from? Schuergers et al. tracked how Synechocystis moved in response to different light conditions, and found that the secret of "vision" in these cyanobacteria is that the cells act as tiny spherical lenses. When a light is shone at the cell, an image of the light source is focused at the opposite edge of the cell. Light-detecting molecules called photoreceptors respond to the focused image of the light source, and this provides the information needed to steer the cell towards the light. Although the details are different, and although a Synechocystis cell is in terms of volume about 500 billion times smaller than a human eyeball, vision in Synechocystis actually works by principles similar to vision in humans. Schuergers et al.'s findings open plenty of further questions, as other types of bacteria may also act as tiny lenses. More also remains to be learnt about how the cyanobacteria process visual information.

Optimized Heart Sampling and Systematic Evaluation of Cardiac Therapies in Mouse Models of Ischemic Injury: Assessment of Cardiac Remodeling and Semi-Automated Quantification of Myocardial Infarct Size.

Cardiac therapies are commonly tested preclinically in small-animal models of myocardial infarction. Following functional evaluation, post-mortem histological analysis is essential to assess morphological and molecular alterations underlying the effectiveness of treatment. However, non-methodical and inadequate sampling of the left ventricle often leads to misinterpretations and variability, making direct study comparisons unreliable. Protocols are provided for representative sampling of the ischemic mouse heart followed by morphometric analysis of the left ventricle. Extending the use of this sampling to other types of in situ analysis is also illustrated through the assessment of neovascularization and cellular engraftment in a cell-based therapy setting. This is of interest to the general cardiovascular research community as it details methods for standardization and simplification of histo-morphometric evaluation of emergent heart therapies. © 2015 by John Wiley & Sons, Inc.

Prognostic value of skin lesions in sarcoidosis: clinical and histopathological clues.

BACKGROUND: Although tremendous advances have been made, a significant gap exists between the vast knowledge accumulated concerning sarcoidosis in recent years and our understanding of this disease. OBJECTIVE: Describe the main clinical and histopathological findings associated with cutaneous sarcoidosis and to investigate the relationship of these skin lesions with systemic involvement. METHODS: A retrospective review of 41 patients who were diagnosed with cutaneous sarcoidosis was done. RESULTS: The study included 34 females and 7 males. Systemic disease occurred frequently in patients with lupus pernio and nodulo-plaque type lesions. Systemic symptoms were observed more commonly in patients with raised serum ACE levels (84.6% vs. 40%; p<0.05). Our study also indicated that patients with skin lesions that were associated with systemic symptoms had a more chronic form of the disease than patients with only cutaneous lesions (91.6% vs. 29.4%; p<0.001). Additionally, complete resolution of cutaneous lesions was observed more frequently in patients with no associated systemic symptoms (66.6% vs. 23.5%; p<0.05). Interestingly, we found that patients with a moderate/severe granulomatous infiltrate in their biopsies had a more severe clinical presentation during the course of the disease, with a more generalized skin involvement (65.6% vs. 30%) as well as a more chronic course of the disease (56.3% vs. 30%). Another interesting histopathological finding observed was the presence of a grenz zone in 20 cases (47.6%). CONCLUSION: A correct and methodical clinicopathological correlation is important for our clinical practice because it can give us useful clues to the diagnosis and prognosis of this disease.

Influência da técnica Scientific Stretching for Sports (3S) realizada em piscina terapêutica na flexibilidadeda coluna vertebral e membros inferiores / Influence of the Scientific Stretching for Sports (3S) held in therapeutic pool on spinal and lower limbs flexibility

Objetivo: Apresentar um método terapêutico combinado queassocia os efeitos da técnica 3S, considerada por alguns autorescomo uma modalidade de Facilitação Neuromuscular Proprioceptiva(FNP), aos efeitos gerados pela água aquecida. Métodos: Foramselecionados 14 adultos do sexo masculino, saudáveis e sedentários,com idade entre 17 e 28 anos e que passaram pelo treinamento deflexibilidade estabelecido para os ganhos de flexão do tronco, flexãodorsal e plantar do tornozelo, flexão do joelho, flexão e extensão doquadril. Os indivíduos foram distribuídos aleatoriamente em doisgrupos: G1 no qual foi aplicada a técnica 3S e G2 no qual a técnica3S foi aplicada em piscina terapêutica aquecida. Ambos os grupos foramsubmetidos a avaliações biofotogramétrica para os movimentoseleitos, utilizando os posicionamentos do Flexiteste, antes e depoisdo programa de treinamento, que constou de 11 sessões. Resultados:A pesquisa demonstrou que os dois grupos estudados apresentaramganhos de flexibilidade muscular, sendo, porém mais efetivo parao G1 quando se compararam as variações de amplitude articularentre os momentos pré e pós-terapia dos dois grupos. Conclusão:Conclui-se, portanto que a aplicação da técnica 3S em meio aquáticonão se mostrou mais efetiva do que sua aplicação convencional (emsolo) apesar de ter se demonstrado uma técnica efetiva para o ganhode flexibilidade para alguns grupos musculares (flexores dorsais dostornozelos, extensores dos quadris e dos joelhos).

Objective: To provide a therapeutic method that combines theeffects of technical 3S, considered by some authors as a form ofProprioceptive Neuromuscular Facilitation (PNF), to the effectsgenerated by warm water. Methods: Were selected 14 healthy andsedentary males adults, 17 to 28 years old, and went throughflexibility training set for gains in trunk flexion, ankle and plantardorsiflexion, knee flexion, hip flexion and extension. Subjects wererandomly assigned into 2 groups: G1 in which was applied thetechnique 3S and G2 in which was applied the 3S technique in atherapeutic heated pool. Both groups were assessed for movementphotogrammetry elected using the positions of Flexitest before andafter the training program, which consisted of 11 sessions. Results:The study demonstrated that both groups improved muscle flexibility,but this was more effective for the G1 when comparing thechanges in range of motion between the pre-and post-therapy in thetwo groups. Conclusion: We concluded therefore that the applicationof 3S technique in water was not more effective than their conventionalapplication despite having been shown an effective techniqueto gain flexibility for some muscle groups (ankles dorsiflexors, hipsand knees extensors).

MIQuant--semi-automation of infarct size assessment in models of cardiac ischemic injury.

BACKGROUND: The cardiac regenerative potential of newly developed therapies is traditionally evaluated in rodent models of surgically induced myocardial ischemia. A generally accepted key parameter for determining the success of the applied therapy is the infarct size. Although regarded as a gold standard method for infarct size estimation in heart ischemia, histological planimetry is time-consuming and highly variable amongst studies. The purpose of this work is to contribute towards the standardization and simplification of infarct size assessment by providing free access to a novel semi-automated software tool. The acronym MIQuant was attributed to this application. METHODOLOGY/PRINCIPAL FINDINGS: Mice were subject to permanent coronary artery ligation and the size of chronic infarcts was estimated by area and midline-length methods using manual planimetry and with MIQuant. Repeatability and reproducibility of MIQuant scores were verified. The validation showed high correlation (r(midline length) = 0.981; r(area) = 0.970 ) and agreement (Bland-Altman analysis), free from bias for midline length and negligible bias of 1.21% to 3.72% for area quantification. Further analysis demonstrated that MIQuant reduced by 4.5-fold the time spent on the analysis and, importantly, MIQuant effectiveness is independent of user proficiency. The results indicate that MIQuant can be regarded as a better alternative to manual measurement. CONCLUSIONS: We conclude that MIQuant is a reliable and an easy-to-use software for infarct size quantification. The widespread use of MIQuant will contribute towards the standardization of infarct size assessment across studies and, therefore, to the systematization of the evaluation of cardiac regenerative potential of emerging therapies.

Brown plaques on the lower back.

A 12-year-old girl presented with a 2-year history of a 10 cm area of asymptomatic brown coalescent plaques of coalescent, linearly arranged papules on the lower back. No other physical or systemic abnormality was detected. Routine laboratory investigations, including thyroid function tests, were normal. The histopathological examination revealed hyperkeratosis, papillomatosis, and elongated rete ridges in the epidermis. On special staining (Alcian blue), mucin deposition was seen in the papillary dermis. The remaining dermis was normal. A diagnosis of Mucinous Nevus was made.

Lupus miliaris disseminatus faciei: a case report.

UNLABELLED: A 33-year-old man presented to our clinic with asymptomatic red-brown, dome-shaped papules, distributed bilaterally on the central area of the face (forehead, lower portions of the eyelids, nasolabial folds, and perioral areas) these had evolved over a period of about 1 year. A skin biopsy, taken from a lesion on the forehead, revealed an epithelioid cell granuloma with central necrosis and surrounding lymphocytic infiltrate with multinucleate giant cells. The chest X-ray and the results of the laboratory studies were within normal limits; the Mantoux test was negative. The patient was treated with minocycline 100 mg/day for 4 months. There was significant clinical improvement, but papular lesions remained on the forehead. Later on, treatment with systemic steroids for 7 months resulted in the resolution of most lesions. COMMENT: Lupus miliaris disseminatus faciei (LMDF) is an uncommon, chronic, inflammatory dermatosis characterized by red-to-yellow or yellow-brown papules of the central face, particularly on and around the eyelids. Originally, LMDF was considered to be a variant of lupus vulgaris or a tuberculid because of the histology, but there has been no evidence to date supporting a link to tuberculosis. Some authors consider LMDF to be a granulomatous forms of rosacea. However, our case supports the concept that it is a distinct entity.

[Cutaneous endometriosis--clinical case report]. / Endometriose cutânea - a propósito de um caso clínico.

CASE REPORT: A 26-year-old woman presented with a history of a dark red, asymptomatic, firm, dome-shaped tumor, approximately 2.5 cm in diameter. The nodule had been developing for one year near a scar in the lower abdominal wall. Her past medical history was significant for a caesarean section five years prior to presentation. Histopathological examination revealed numerous glands of various sizes exhibiting small to large lumina, surrounded by a cellular, edematous stroma composed of spindle-shaped cells or round large cells admixed with lymphocytes, plasma cells, and few eosinophils. COMMENT: Cutaneous endometriosis is a well recognized but uncommon entity, representing approximately 1 percent of all cases of ectopic endometrial tissue. It may arise spontaneously within the umbilicus or inguinal region, but the majority of lesions develop on surgical excisions of the abdominal and genital regions (cesarean sections, hysterectomy, laparotomy, laparoscopy, and episiotomy) in women of reproductive age. The pathogenesis of cutaneous endometriosis is still not clear and several theories have been put forward to explain its development. Despite its clinical rarity, cutaneous endometriosis is a well-known condition to dermatopathologists. Nevertheless, they should be aware of those unusual metaplastic changes that may represent a diagnostic pitfall.