Randomized, double-blind, sham-controlled trial to evaluate the efficacy and tolerability of electroconvulsive therapy in patients with clozapine-resistant schizophrenia.

There is no established treatment for patients with clozapine-resistant schizophrenia (CRS). Clozapine augmentation strategies with antipsychotics or others substances are effective in comparison with placebo while and Electroconvulsive therapy (ECT) showed to be effective in comparison with treatment as usual (TAU) but not with placebo (sham-ECT). In the present double- blind randomized controlled trial, we compared 40 outpatients who received 20 sessions of ECT (n = 21) or sham-ECT (n = 19) (age = 37.40 ± 9.62, males = 77.5 %, illness duration = 14.95 ± 8.32 years, mean total Positive and Negative Syndrome Scale (PANSS) = 101.10 ± 24.91) who fulfilled well-defined CRS criteria including baseline clozapine plasma levels ≥350 ng/mL. The primary outcome was the ≥50 % PANSS Total Score reduction; secondary outcomes were the scores of the PANSS subscales, PANSS five-factor dimensions, PANSS-6 and the Calgary Depression Rating Scale (CDRS). Treatment response was analyzed by percentage reduction, Linear Mixed Models and effect sizes. At baseline both groups showed no differences except for years of school education (included as a covariate). At endpoint, only 1/19 of the completers (5.26 %) in the ECT group and 0/17 in the sham-ECT group showed a ≥50 % total PANSS score reduction. Both groups showed no significant differences of the total PANSS score (F = 0.12; p = 0.73), Positive (F = 0.27, p = 0.61), Negative (F = 0.25, p = 0.62), and General Psychopathology scores (F = 0.01, p = 0.94) as well for all PANSS five factors, the PANSS-6 and CDRS. Thus, the present study found no evidence that ECT is better than Sham-ECT in patients with CRS. Future sham-ECT controlled studies with larger sample sizes are warranted to test the efficacy of ECT for patients with CRS.

Ultrasonographic scores for ileal Crohn's disease assessment: Better, worse or the same as contrast-enhanced ultrasound?

BACKGROUND: Intestinal ultrasound (IUS) is an increasingly used non-invasive tool to evaluate Crohn's disease (CD) activity. Recently, two IUS scores that evaluate inflammatory activity have emerged: the Simple Ultrasound Activity Score for CD (SUS-CD) and the International Bowel Ultrasound Segmental Activity Score (IBUS-SAS). We aimed to compare the accuracy of SUS-CD, IBUS-SAS and contrast-enhanced ultrasound (CEUS) in predicting inflammatory activity in the terminal ileum in ileocolonoscopy in CD patients. METHODS: Retrospective study including all consecutive CD patients submitted to IUS with CEUS directed to the terminal ileum performed by a single operator between April 2016 and March 2020. Segmental SUS-CD and IBUS-SAS were calculated. A time-intensity curve of the contrast bowel wall enhancement was created with measurement of peak intensity using CEUS. The CD endoscopic activity in ileocolonoscopy was graded by Simple Endoscopic Score for CD (SES-CD) as inactive (SES-CD < 7) or active (SES-CD ≥ 7). RESULTS: Fifty patients were included, 54.0% were female, with mean age of 34 ± 12 years, and most had isolated ileal disease (60.0%), and a nonstricturing, nonpenetrating behaviour (44.0%). Most of the patients (60.0%) had active endoscopic disease (SES-CD ≥ 7). SUS-CD and IBUS-SAS were not different between patients with active or inactive endoscopic disease (p = 0.15; 0.57, respectively), having a poor accuracy to correlate endoscopic activity (area under de curve (AUC) 0.62; 0.55, respectively). Peak intensity in CEUS was significantly different in patients with active or inactive endoscopic disease (p = 0.004), having a good accuracy to correlate endoscopic activity (AUC 0.80). CONCLUSION: Unlike CEUS, SUS-CD and IBUS-SAS were not able to accurately correlate endoscopic activity in terminal ileum in CD. Therefore, CEUS is a non-invasive emerging method that should be increasingly integrated in the ultrasonographic evaluation of CD patients.

Mineral and natural films change the physical-chemical properties of grapes and modulate oviposition behaviour of Ceratitis capitata Wiedemann (Diptera: Tephritidae).

The Mediterranean fruit fly, Ceratitis capitata (Wiedemann), is one of the main pests of fruit, worldwide, and the use of population suppression method with low environmental impact is an increasingly strong requirement of the consumer market. The aim of this study was to evaluate the effect of mineral and natural films on the physical-chemical properties of grapes (Vitis vinifera L.), cultivar Itália, and oviposition behaviour of C. capitata. Fruits were immersed in suspensions (100 and 200 g L-1) of mineral (kaolin Surround®WP, kaolin 607, kaolin 608, kaolin 611 and talc) and natural films (chitosan, cassava starch, potato starch and guar gum 5.0 g L-1) and distilled water (control). After drying, fruits were exposed to C. capitata pairs of males and females for 24 h in choice and non-choice tests; the number of punctures with and without eggs, eggs per fruit and behavioural response of fly to treated and untreated fruits were recorded. Results obtained in this study are promising, given the scientific evidence that films of mineral particles such as kaolin (Surround®, 607, 608 and 611) changed the firmness, luminosity, chroma and hue angle of grapes and reduced the oviposition of C. capitata. In addition, our results also showed that natural polymers do not deter C. capitata females, but rather seem to stimulate oviposition.

The clinical implications of computerised fluid dynamic modelling in rhinology.

BACKGROUND: The nose is a dynamic organ and is the first point of contact between inhaled air and mucosal surfaces. Within the nasal cavity, there are changes of air flow and pressure occurring during the respiratory cycle, as well as exchanges of heat and humidity, and important immune responses to inhaled antigens and allergens. METHODOLOGY: This review is a summary for rhinologists covering what is known about airflow within the nose and sinuses and the impact of pathology and treatments on the physical environment of the nasal cavity. The review will concentrate largely on the significant contribution that computational fluid dynamics has had on this field. RESULTS: The complex anatomical structure of the nasal cavity provides an aerodynamic environment that guides the airflow throughout the nasal cavities. However, anatomical or inflammatory changes can modify the air flow, heat and humidity exchanges, with negative consequences on nasal physiology. Restoration of normal airflow is a key goal to achieve success in the treatment of nasal diseases. CONCLUSIONS: Computational fluid dynamics is a method of analysis originating from engineering which has been adapted for rhinology. Although still an expensive and laborious technique, it may become a viable diagnostic tool in the future for studying nasal physiology.

IRRADIATOR SYSTEM FOR MANGANESE SULFATE BATH EFFICIENCY MEASUREMENTS USING A PLUTONIUM-BERYLLIUM NEUTRON SOURCE.

This study describes the use of a neutron irradiator system based on a plutonium-beryllium neutron source for MnSO4 solution activation for use to determine the MSB system efficiency. Computational simulations using Monte Carlo code were performed to establish the main characteristics of the irradiator system. Among the simulated geometries and volumes, semi-cylindrical shape with 84.5 cm3 of MnSO4 solution yielded the best option to be built. Activity measurements were performed with a high-pure germanium detector to validate the new irradiation system. Results showed an average efficiency and uncertainty of the experimental standard deviation of the mean: 5.742 × 10-4 ± 0.036 × 10-4 (coverage factor k = 1), for MSB system. Efficiency value obtained shows good correlation to other published methods (i.e. a relative difference of 0.07%). This alternative metrological method demonstrated the utility of neutron sources for the irradiation of solutions in metrology laboratories providing a cost-efficient alternative to nuclear reactors or particle accelerators.

241Am-Be(α,n) CHARACTERIZATION FOR A NEW LABORATORY FACILITY IN BRAZIL.

The Laboratório de Ciências Radiológicas is developing an irradiator for neutron survey meters calibration. Part of this work is related to the characterization of the neutron source that will be used in the irradiator. Therefore, a source of 241Am-Be(α,n) was characterized according to the following attributes: neutron energy distribution, anisotropy and emission rate. In order to make these values into high-level metrological references traceable by the Bureau International des Poids et Mesures, these measurements were taken at the Neutron Laboratory part of the Laboratório Nacional de Metrologia das Radiações Ionizantes. Results obtained for the source spectrum have strong adherence to the reference spectrum established by ISO 8529-1. The new laboratory for neutron calibration will allow calibration in an approximate ambient dose equivalent ranging 20-4500 µSv/h.

Vibronic spectra of protonated hydroxypyridines: contributions of prefulvenic and planar structures.

Various hydroxypyridine derivatives are endogenous or synthetic photosensitizers which could contribute to solar radiation damage. The study of their excited states could lead to a better understanding of their action mechanisms. We present here the ultraviolet (UV) spectra of the protonated 2-, 3- and 4-hydroxypyridine. These spectra were obtained with an experimental device coupling an electrospray ion source with a cold quadrupole ion trap and a time of flight mass spectrometer. They display well resolved vibrational structures, with a clear influence of the position of the OH group. These results are interpreted with excited states calculations at the coupled cluster CC2 level.

Subtraction of subcutaneous fat to improve the prediction of visceral adiposity: exploring a new anthropometric track in overweight and obese youth.

BACKGROUND: The efficiency of traditional anthropometric measurements such as body mass index (BMI) or waist circumference (Waist C) used to replace biomedical imaging for assessing visceral adipose tissue (VAT) is still highly controversial in youth. HYPOTHESIS AND OBJECTIVES: We evaluated the most accurate model predicting VAT in overweight/obese youth, using various anthropometric measurements and their correlation with different body fat compartments, especially by testing, for the first time in youth, the hypothesis that subtracting the anthropometric measurement the most highly correlated with subcutaneous abdominal adipose tissue (SAAT) and less correlated possible with VAT from an anthropometric abdominal measurement highly correlated with visceral and total abdominal adipose tissue (TAAT), predicts VAT with higher accuracy. SUBJECTS AND METHODS: VAT and SAAT data resulted from magnetic resonance imaging (MRI) analysis performed on 181 boys and girls (7-17 y) from Diabetes & Endocrinology Care Paediatrics Clinic in Luxembourg. Height, weight, abdominal diameters, waist, hip, and thigh circumferences were measured with a view to developing the anthropometric VAT predictive algorithms. RESULTS: In girls, subtracting proximal thigh circumference (Proximal Thigh C), the most closely correlated anthropometric measurement with SAAT, from Waist C, the most closely correlated anthropometric measurement with VAT was instrumental in improving VAT prediction, in comparison with the most accurate single VAT anthropometric surrogate. [Formula: see text] Residual analysis showed a negligible estimation error (5 cm2 ). In boys, Waist C was the best VAT predictor. CONCLUSIONS: Subtraction of abdominal subcutaneous fat is important to predict VAT in overweight/obese girls.

Microbiological Quality Assessment by PCR and Its Antibiotic Susceptibility in Mangrove Crabs (Ucides cordatus) from Guanabara Bay, Rio de Janeiro, Brazil.

The bacteriological quality of crabs from three different mangroves (Itaóca, Suruí, and Piedade) from Rio de Janeiro state, Brazil, was investigated using conventional and molecular methods. The results revealed high counts for total coliforms in meat and hepatopancreas samples. PCR analyses identified 25 Escherichia coli colonies in the Itaóca, Piedade, and Suruí samples, detecting 13 enterotoxigenic colonies and 9 enteroaggregative colonies. Respectively, 12, 11, and 21 Vibrio parahaemolyticus strains were detected in the Itaóca, Piedade, and Suruí samples. Two V. cholerae strains were detected in the Piedade samples. The E. coli strains isolated in the present study showed resistance to gentamicin. E. coli strains from the Piedade samples showed 33% resistance to chloramphenicol and the strains also showed multiresistance to several antimicrobial agents with a MAR index ranging from 0.12 to 0.31. Vibrio strains from Piedade, Itaóca, and Suruí showed 86%, 78%, and 85% resistance, respectively, to ampicillin. The isolated Vibrio strains showed multiresistance to several antimicrobial agents, with a MAR index ranging from 0.12 to 0.25. The presence of these organisms in crab meat is an indication of microbial contamination, which may pose health risks to consumers when improperly cooked.

Linking surgical specimen length and examined lymph nodes in colorectal cancer patients.

AIM: The number of examined lymph nodes (NLN) was associated with survival of stages II and III colorectal cancer (CRC) patients. Guidelines recommend examining at least 12 lymph nodes. This study investigated the influence of surgical specimen length on lymph node harvest and compliance with international guidelines. MATERIALS AND METHODS: This population-based study included 4,724 cases of surgically treated CRC that were diagnosed from 2002 to 2008. Multivariate analyses were performed for the main study variables (age, gender, diagnosis at screening or in symptomatic patients, cancer site, staging, grading, number of positive nodes, neo-adjuvant treatment for rectal cancer, hospital were surgery was performed). Fractional polynomial models investigated the relationship between continuous variables and outcomes. RESULTS: The NLN increased over time reaching ≥12 NLN in 64% of cases at the end of the study period. More NLN were associated with young age, right colon cancer, pT3-T4 disease, stages II and III and high grade. Fewer NLN were associated with short surgical specimen length and neo-adjuvant treatment in rectal cancer patients. Use of laparoscopy increased sharply over time. CONCLUSIONS: NLN increased over time in accordance with international guidelines. Surgical specimen length correlated with NLN which may determine therapeutic choices, particularly in stage II colon cancer. When harvested lymph nodes are under 10 in number and all are negative, chemotherapy is always recommended. As specimen lengths <20 cm were associated with a high risk of inadequate NLN counts, patients are at risk of over-treatment.

Thermal neutron calibration channel at LNMRI/IRD.

The Brazilian Metrology Laboratory of Ionizing Radiations (LNMRI) standard thermal neutron flux facility was designed to provide uniform neutron fluence for calibration of small neutron detectors and individual dosemeters. This fluence is obtained by neutron moderation from four (241)Am-Be sources, each with 596 GBq, in a facility built with blocks of graphite/paraffin compound and high-purity carbon graphite. This study was carried out in two steps. In the first step, simulations using the MCNPX code on different geometric arrangements of moderator materials and neutron sources were performed. The quality of the resulting neutron fluence in terms of spectrum, cadmium ratio and gamma-neutron ratio was evaluated. In the second step, the system was assembled based on the results obtained on the simulations, and new measurements are being made. These measurements will validate the system, and other intercomparisons will ensure traceability to the International System of Units.

Avaliação in vitro do potencial antimicrobibiano do decoto de cascas de romã (Punica granatum L. ) sobre amostras de saliva de escolares / In vitro assessment of the antimicrobial effects of pomegranate (Punica granatum L.) peel decoction on saliva samples

Existem vários esforços para o desenvolvimento de produtos capazes de reduzir ou eliminar os microrganismos patogênicos presentes na cavidade oral. A literatura relata uma série de efeitos adversos associados ao uso contínuo destes produtos, dentre eles vômitos, diarreia e o escurecimento da dentina. A indução da resistência microbiana é um dos fatores de destaque relacionado ao uso destes produtos. Neste trabalho, o decocto de romã (Punica granatum L.), obtido a partir das cascas do fruto, foi utilizado para avaliação de seu potencial antimicrobiano sobre cepas de Pseudomonas aeruginosa, Candida albicans e Enterococcus faecalis, sendo ativos contra os dois primeiros microrganismos. A aplicação do decocto sobre os microrganismos presentes em amostras de saliva de crianças mostrou halos de inibição semelhantes ao obtido com a solução de clorexidina a 0,12%. A atividade antimicrobiana do decocto de romã aponta esta preparação como uma fonte em potencial para o desenvolvimento de produtos de uso oral...

Several products have been developed to eliminate or reduce potential pathogenic microorganisms of the oral microbiome. The continuous use of these synthetic products can result in side effects such as vomiting, diarrhea, darkening of the teeth and the induction of microbial resistance. Pomegranate (Punica granatum) peel decoction was tested to assess its antimicrobial activity. In vitro analysis showed the decoction had antimicrobial activity against strains of Pseudomonas aeruginosa and Candida albicans, but none was detected against Enterococcus faecalis. When tested on saliva samples from children, the decoction showed great potential in reducing the load of microorganisms, the inhibition haloes produced with saliva samples being similar to those of the antimicrobial control (0.12% chlorhexidine). The pomegranate peel decoction in water could thus provide a promising source for developing solutions for use against oral diseases...

Placental hydroxymethylation vs methylation at the imprinting control region 2 on chromosome 11p15.5.

In addition to methylated cytosines (5-mCs), hydroxymethylcytosines (5-hmCs) are present in CpG dinucleotide-enriched regions and some transcription regulator binding sites. Unlike methylation, hydroxymethylation does not result in silencing of gene expression, and the most commonly used methods to study methylation, such as techniques based on restriction enzymatic digestion and/or bisulfite modification, are unable to distinguish between them. Genomic imprinting is a process of gene regulation where only one member of an allelic pair is expressed depending on the parental origin. Chromosome 11p15.5 has an imprinting control region (ICR2) that includes a differentially methylated region (KvDMR1) that guarantees parent-specific gene expression. The objective of the present study was to determine the presence of 5-hmC at the KvDMR1 in human placentas. We analyzed 16 third-trimester normal human placentas (chorionic villi). We compared two different methods based on real-time PCR after enzymatic digestion. The first method distinguished methylation from hydroxymethylation, while the other method did not. Unlike other methylation studies, subtle variations of methylation in ICRs could represent a drastic deregulation of the expression of imprinted genes, leading to important phenotypic consequences, and the presence of hydroxymethylation could interfere with the results of many studies. We observed agreement between the results of both methods, indicating the absence of hydroxymethylation at the KvDMR1 in third-trimester placentas. To the best of our knowledge, this is the first study describing the investigation of hydroxymethylation in human placenta using a genomic imprinting model.

Placental hydroxymethylation vs methylation at the imprinting control region 2 on chromosome 11p15.5

In addition to methylated cytosines (5-mCs), hydroxymethylcytosines (5-hmCs) are present in CpG dinucleotide-enriched regions and some transcription regulator binding sites. Unlike methylation, hydroxymethylation does not result in silencing of gene expression, and the most commonly used methods to study methylation, such as techniques based on restriction enzymatic digestion and/or bisulfite modification, are unable to distinguish between them. Genomic imprinting is a process of gene regulation where only one member of an allelic pair is expressed depending on the parental origin. Chromosome 11p15.5 has an imprinting control region (ICR2) that includes a differentially methylated region (KvDMR1) that guarantees parent-specific gene expression. The objective of the present study was to determine the presence of 5-hmC at the KvDMR1 in human placentas. We analyzed 16 third-trimester normal human placentas (chorionic villi). We compared two different methods based on real-time PCR after enzymatic digestion. The first method distinguished methylation from hydroxymethylation, while the other method did not. Unlike other methylation studies, subtle variations of methylation in ICRs could represent a drastic deregulation of the expression of imprinted genes, leading to important phenotypic consequences, and the presence of hydroxymethylation could interfere with the results of many studies. We observed agreement between the results of both methods, indicating the absence of hydroxymethylation at the KvDMR1 in third-trimester placentas. To the best of our knowledge, this is the first study describing the investigation of hydroxymethylation in human placenta using a genomic imprinting model.

Epidemiology of HPV-related female cancers in the Umbria region of Italy: pre-vaccination period.

The authors describe the incidence and mortality rates of human papillomavirus (HPV)-related female cancers in Umbria (Italy) in the pre-vaccination period from 1978-2008. Joinpoint regression was applied on age-adjusted incidence and mortality rates to evaluate temporal trends. Mouth and pharynx cancers incidence and mortality trends decreased about three percent per year. For anus and anal canal cancer, incidence and mortality trends presented a non-significant decrease. For malignant neoplasm of vulva, a significant change was found in incidence trend: the annual percentage change decreased from 2001 (- 1.8%). Mortality trend showed a non-significant decrease. Incidence and mortality rates from vaginal cancer were non-significantly decreased. For malignant neoplasm of cervix uteri, incidence rates showed a significant decrease by 2.1% per year. Mortality rates decreased as well, although non-significantly. HPV-related cancers consistently decreased in Umbria. This trend may be a consequence of safer sexual behavior. For cervical cancer, a combination of opportunistic and programmed screening led to a much-reduced disease burden. It is expected that the implementation of vaccination in the future will lead to a further decrease of HPV-related cancer incidence and mortality.

Slow-release nutrient capsules for microorganism stimulation in oil remediation.

As the concern towards environmental deterioration grows worldwide, new technological achievements become essential for all countries. Among the technologies with great potential of bioremediation is microencapsulation of active material. Several studies have investigated the use of controlled release of active materials as a way of biostimulation and supplying the nutrients necessary for the bioremediation process. In fact, as the use of microorganisms has a great potential in degrading crude oils, this work aims to use that technology and to associate it to produce controlled-release capsules of nitrogen, phosphorus, and potassium (N, P, and K) for bioremediation purposes. For the capsule formulation, polymers of sodium alginate, Capsul®, and the commercial fertilizer NPK from Sempre Verde Inc. were used. Crude oil was the only carbon source and mineral medium for microorganism growth. Controlled-release nutrient capsules, with 4 mm in diameter, made of 3.0 % alginate (w/v) and 4.0 % Capsul® (w/v) were produced. Those capsules were used in association with a microbial consortium, in a liquid phase bioremediation process, having degraded 43.6 % of the total hydrocarbon within 240 h, evidencing thus as a promising tool for hydrocarbon bioremediation.

Convergence of adaptive BEM for some mixed boundary value problem.

For a boundary integral formulation of the 2D Laplace equation with mixed boundary conditions, we consider an adaptive Galerkin BEM based on an [Formula: see text]-type error estimator. We include the resolution of the Dirichlet, Neumann, and volume data into the adaptive algorithm. In particular, an implementation of the developed algorithm has only to deal with discrete integral operators. We prove that the proposed adaptive scheme leads to a sequence of discrete solutions, for which the corresponding error estimators tend to zero. Under a saturation assumption for the non-perturbed problem which is observed empirically, the sequence of discrete solutions thus converges to the exact solution in the energy norm.

Daño celular en una población infantil potencialmente expuesta a pesticidas / Cell Damage in a Pediatric Population Potentially Exposed to Pesticides

Los pesticidas pueden producir efectos agudos o crónicos en la salud humana. Muchos de ellos pueden provocar daño en el material genético. Esta modificación en la información genética se ha relacionado con un alto riesgo de padecer cáncer. El objetivo del presente trabajo es indagar el daño en el material genético de una población infantil expuesta potencialmente a pesticidas en el ambiente. El diseño metodológico fue de tipo observacional y transversal. Participaron en el estudio 48 niños expuestos potencialmente a pesticidas y 46 niños no expuestos. Se obtuvo muestra de la mucosa bucal para determinar daño en el material genético a través de la frecuencia de micronúcleos (MN). Se encontró en el grupo expuesto potencialmente a pesticidas un promedio mayor de micronúcleos (5,1±2,9 vs 1,8±2,0; p<0,0001), un promedio mayor de células binucleadas, (3,5±2,7 vs 1,4±1,4; p<0,0001), mayor frecuencia de cariorrexis (18,2±18,4 vs 5,8±18,4; p<0,004) y picnosis (24,8± 18,0 vs 17,1±8,3; p<0,03). El 40% (19/47) de los niños expuestos potencialmente a pesticidas tuvieron un tiempo de exposición de 6 años. Esta investigación aporta evidencias de daño genético en la población expuesta potencialmente a pesticidas en el ambiente Palabras claves: Genotoxicidad- pesticidas -niños-medio ambiente.

Pesticides can cause acute or chronic effects on human health. Many pesticides can cause damage to genetic material. These changes in genetic information have been associated with an increased risk of cancer. The objective of this study is to investigate damage to genetic material in a population of children potentially exposed to pesticides in the environment. The study design was observational and cross sectional. We studied 48 children potentially exposed to pesticides and 46 unexposed children. Samples of the oral mucosa were obtained to determine damage to genetic material using micronucleus frequency (MN).Higher average micronucleus counts were found in the group potentially exposed to pesticides (5.1±2.9 vs. 1.8±2.0, p <0.0001), along with a higher average of binucleate cells (3.5±2.7 vs. 1.4±1.4 p <0.0001), higher frequency of karyorrhexis (18.2±18.4 vs. 5.8± 18.4, p <0.004) and pyknosis (24.8±18.0 vs. 17.1±8.3; p <0.03).Of the children potentially exposed to pesticides, 40% (19/47) had an exposure time of 6 years. This study provides evidence of genetic damage in the population potentially exposed to pesticides in the environment.