Characterization of the patterns of care, access, and direct cost of systemic lupus erythematosus in Brazil: findings from the Macunaíma study.

BACKGROUND: A cost of illness (COI) study aims to evaluate the socioeconomic burden that an illness imposes on society as a whole. This study aimed to describe the resources used, patterns of care, direct cost, and loss of productivity due to systemic lupus erythematosus (SLE) in Brazil. METHODS: This 12-month, cross-sectional, COI study of patients with SLE (ACR 1997 Classification Criteria) collected data using patient interviews (questionnaires) and medical records, covering: SLE profile, resources used, morbidities, quality of life (12-Item Short Form Survey, SF-12), and loss of productivity. Patients were excluded if they were retired or on sick leave for another illness. Direct resources included health-related (consultations, tests, medications, hospitalization) or non-health-related (transportation, home adaptation, expenditure on caregivers) hospital resources.Costs were calculated using the unit value of each resource and the quantity consumed. A gamma regression model explored cost predictors for patients with SLE. RESULTS: Overall, 300 patients with SLE were included (92.3% female,mean [standard deviation (SD)] disease duration 11.8 [7.9] years), of which 100 patients (33.3%) were on SLE-related sick leave and 46 patients (15.3%) had stopped schooling. Mean (SD) travel time from home to a care facility was 4.4 (12.6) hours. Antimalarials were the most commonly used drugs (222 [74.0%]). A negative correlation was observed between SF-12 physical component and SLE Disease Activity Index (- 0.117, p = 0.042), Systemic Lupus International CollaboratingClinics/AmericanCollegeofRheumatology Damage Index (- 0.115, p = 0.046), medications/day for multiple co-morbidities (- 0.272, p < 0.001), SLE-specific drugs/day (- 0.113, p = 0.051), and lost productivity (- 0.570, p < 0.001). For the mental component, a negative correlation was observed with medications/day for multiple co-morbidities (- 0.272, p < 0.001), SLE-specific medications/day (- 0.113, p = 0.051), and missed appointments (- 0.232, p < 0.001). Mean total SLE cost was US$3,123.53/patient/year (median [interquartile range (IQR)] US$1,618.51 [$678.66, $4,601.29]). Main expenditure was medication, with a median (IQR) cost of US$910.62 ($460, $4,033.51). Mycophenolate increased costs by 3.664 times (p < 0.001), and inflammatory monitoring (erythrocyte sedimentation rate or C-reactive protein) reduced expenditure by 0.381 times (p < 0.001). CONCLUSION: These results allowed access to care patterns, the median cost for patients with SLE in Brazil, and the differences across regions driven by biological, social, and behavioral factors. The cost of SLE provides an updated setting to support the decision-making process across the country.

Does rest interval between unilateral exercise protocols influences on contralateral neuromuscular responses in untrained individuals?

INTRODUCTION: Effects on strength performance and muscle activation in the contralateral limb have been observed after training with the ipsilateral limb (IL). Cross fatigue effects in the contralateral limb (CL) can occur at intervals of up to 48 h after a training session performed with the ipsilateral limb. The objective of this study was to verify the effect of a training session in the ipsilateral limb, on the strength and activation of the muscles in the contralateral limb also submitted to the training protocol. METHODS: 10 untrained men (mean ± SD: age = 23.7 ± 4.9 years) performed unilateral knee extension with both limbs in equated protocols, in two conditions with different intervals between limbs - 20 min and 24 h. RESULTS: There were no differences in the comparison of the force produced between the pre x post interventions with the CL limb, as well as in the activation of the quadriceps during its performance. These results were similar for the two different intervals between the protocols. CONCLUSION: It was concluded that when the CL member performs the protocol after the IL, the responses in the CL depend mainly on the requirement imposed on the protocol performed by this member, without influence of the training protocol performed previously with the IL member.

Targeting neutrophil extracellular traps: A novel strategy in hematologic malignancies.

Neutrophil extracellular traps (NETs) have emerged as a critical factor in malignant hematologic disease pathogenesis. These structures, comprising DNA, histones, and cytoplasmic proteins, were initially recognized for their role in immune defense against microbial threats. Growing evidence suggests that NETs contribute to malignant cell progression and dissemination, representing a double-edged sword. However, there is a paucity of reports on its involvement in hematological disorders. A comprehensive understanding of the intricate relationship between malignant cells and NETs is necessary to explore effective therapeutic strategies. This review highlights NET formation and mechanisms underlying disease pathogenesis. Moreover, we discuss recent advancements in targeted inhibitor development for selective NET disruption, empowering precise design and efficacious therapeutic interventions for malignant hematologic diseases.

EGCG-like non-competitive inhibitor of DYRK1A rescues cognitive defect in a down syndrome model.

Overexpression of the chromosome 21 DYRK1A gene induces morphological defects and cognitive impairments in individuals with Down syndrome (DS) and in DS mice models. Aging neurons of specific brain regions of patients with Alzheimer's disease, DS and Pick's disease have increased DYRK1A immunoreactivity suggesting a possible association of DYRK1A with neurofibrillary tangle pathology. Epigallocatechin-3-gallate (EGCG) displays appreciable inhibition of DYRK1A activity and, contrary to all other published inhibitors, EGCG is a non-competitive inhibitor of DYRK1A. Prenatal exposure to green tea polyphenols containing EGCG protects from brain defects induced by overexpression of DYRK1A. In order to produce more robust and possibly more active analogues of the natural compound EGCG, here we synthetized new EGCG-like molecules with several structural modifications to the EGCG skeleton. We replaced the ester boun of EGCG with a more resistant amide bond. We also replaced the oxygen ring by a methylene group. And finally, we positioned a nitrogen atom within this ring. The selected compound was shown to maintain the non-competitive property of EGCG and to correct biochemical and behavioral defects present in a DS mouse model. In addition it showed high stability and specificity.

Vemurafenib induces senescence in acute myeloid leukemia and myelodysplastic syndrome by activating the HIPPO signaling pathway: implications for potential targeted therapy.

BACKGROUND: The outcome of Acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) remain dismal despite the development of treatment. Targeted therapy is gaining more and more attention in improving prognosis. METHODS: Expression of BRAF was analyzed by RT-qPCR in AML and MDS patients. Cells viability treated by drugs was measured by CCK-8 assay. Network pharmacology and RNA-sequence were used to analyze the mechanism of drugs and verified in vitro and xenograft tumor model. RESULTS: Here we showed that BRAF was overexpressed in AML and MDS patients, and correlated with poor prognosis. The BRAF inhibitor-Vemurafenib (VEM) could significantly induce senescence, proliferation inhibition and apoptosis in AML cells, which can be enhanced by Bortezomib (BOR). This inhibitory effect was also verified in CD34 + cells derived from AML patients. Mechanistically, we showed that VEM combined with BOR could turn on HIPPO signaling pathway, thereby inducing cellular senescence in AML cells and xenograft mouse. CONCLUSIONS: Taken together, our findings demonstrate a significant upregulation of BRAF expression in AML and MDS patients, which is associated with unfavorable clinical outcomes. We also discovered that the BRAF inhibitor Vemurafenib induces cellular senescence through activation of the HIPPO signaling pathway. Analysis of BRAF expression holds promise as a prognostic indicator and potential therapeutic target for individuals with AML and MDS.

Positive reading achievement outcomes in children who experience out-of-home care: Characteristics and predictors.

BACKGROUND: Children who enter out-of-home care ('care') are at increased risk for low academic achievement. Nonetheless, some children who have experienced out-of-home care achieve highly. Several qualitative studies of academically successful young adults with care histories have highlighted factors that may contribute to positive outcomes; however longitudinal cohort research is needed to identify characteristics and predictors of higher achieving younger children who experienced care. OBJECTIVE: To describe characteristics and circumstances of children with higher reading achievement who had entered care, and predictors of higher achievement. PARTICIPANTS AND SETTING: The study included 778 children from the Pathways of Care Longitudinal Study (POCLS) in New South Wales, Australia. METHODS: Prospective cohort data from interviews and linked administrative child protection and education data were used to identify factors associated with higher Year 3 reading achievement among Aboriginal and non-Aboriginal children that may assist in improving outcomes. RESULTS: Although a lower proportion than the general population, almost half (46 %) of children who entered care were in the higher achievement group. Higher achieving students were a diverse group and faced many adversities commonly found among children who experienced care generally. Multivariable logistic regression showed higher achievement in the cohort was significantly associated with: average or above cognitive ability, low externalizing behaviour, highly-educated carers, and non-Aboriginal students. Several supports and services were associated with higher achievement, but inconsistently across analyses. CONCLUSIONS: Results indicate potential interventions could target cognitive ability, wellbeing and environmental factors, and involve interventions directly with children and via carers to improve student outcomes.

Infants entering out-of-home care: Health, developmental needs and service provision.

BACKGROUND: There are rising numbers of infants entering out-of-home care due to child protection concerns. Research has found that infants entering care are at higher risk of developmental vulnerability and poor health problems. OBJECTIVES: To determine the prevalence of developmental vulnerability for children who entered care as infants, and the extent and likelihood of service provision in relation to their developmental vulnerability. PARTICIPANTS AND SETTING: This study includes children who entered care before the age of 1 year for the first time between May 2010 and October 2011 in New South Wales, Australia, and who received final Children's Court care and protection orders by 30 April 2013. METHODS: This is a prospective cohort study using interview data from the Pathways of Care Longitudinal Study (POCLS) as well as linked administrative child protection and health data. This study used standardised assessments (Age and Stages Questionnaire and the Brief Infant Toddler Social Emotional Assessment) included in the POCLS. Simple and multiple logistic regression analysis was conducted to investigate the likelihood of infants receiving professional services for developmental delays since placement. FINDINGS: A high proportion of children who entered care as infants were identified as developmentally vulnerable through health indicators (36 %) and standardised assessments (70 %). Only 17 % of infants in care received services for developmental delay, with 20 % and 15 % of those identified as developmentally vulnerable through standardised assessments and health-related variables receiving services, respectively. CONCLUSIONS: The findings point to the importance of developmental assessment of infants in care and the identification of developmental vulnerability and delays. The provision of early intervention services is essential for this group of high-risk infants and will be important in optimising their health, as well as social and emotional outcomes.

Structural and enzymatic evidence for the methylation of the ACK1 tyrosine kinase by the histone lysine methyltransferase SETD2.

SETD2 (SET-domain containing protein 2) is a histone methyltransferase (HMT) of the SET family responsible for the trimethylation of K36 of histone H3, thus producing the epigenetic mark H3K36me3. Recent studies have shown that certain SET family HMTs, such as SMYD2, SMYD3 or SETDB1 can also methylate protein kinases and therefore be involved in signaling pathways. Here we provide structural and enzymatic evidence showing that SETD2 methylates the protein tyrosine kinase ACK1 in vitro. ACK1 is recognized as a major integrator of signaling from various receptor tyrosine kinases. Using ACK1 peptides and recombinant proteins, we show that SETD2 methylates the K514 residue of ACK1 generating K514 mono, di or tri-methylation. Interestingly, K514 is found in a "H3K36-like" motif of ACK1 which is known to be post-translationally modified and to be involved in protein-protein interaction. The crystal structure of SETD2 catalytic domain in complex with an ACK1 peptide further provides the structural basis for the methylation of ACK1 K514 by SETD2. Our work therefore strongly suggests that ACK1 could be a novel non-histone substrate of SETD2 and further supports that SET HMTs, such as SETD2, could be involved in both epigenetic regulations and cell signaling.

Construction of a Guide for Assessment and Physiotherapeutic Management of Pain in Cancer Patients / Construction of a Guide for Assessment and Physiotherapeutic Management of Pain in Cancer Patients / Construção de um Guia para Avaliação e Manejo Fisioterapêutico da Dor em Pacientes com Câncer

Physiotherapy can contribute to control pain in cancer patients and educational strategies should be developed to increase physiotherapeutic actions in this context. Objective: To develop a guide for the assessment and physiotherapeutic management of cancer pain. Method: Study developed in three stages: 1. Descriptive analysis of sociodemographic, clinical, functional data, pain characteristics and physiotherapeutic treatments performed on cancer patients receiving palliative care; 2. Development of the preliminary version of the guide based on the results of the first stage and theoretical content; 3. Focus group formed by physiotherapists that resulted in the final version of the guide. Results: 62 patients were included, mainly females (69.3%). The most common tumor site was gynecological (25.8%) and half presented bone metastasis. Neuropathic pain (51.6%), located in the spine (29.0%) was the most prevalent type of pain. The physiotherapeutic treatments most used were: positioning (98.0%), kinesiotherapy (68.0%), walking (39.0%), orthoses (32.0%) and transcutaneous electrical nerve stimulation (21.0%). The focus group suggested changes and positively evaluated the preliminary version of the guide, highlighting that, in addition to an easy-to-understand language, it provided a comprehensive view of the methods for evaluating and physiotherapy treatment of pain.

A fisioterapia pode contribuir para o controle da dor em pacientes com câncer e estratégias educativas devem ser desenvolvidas para aumentar as ações fisioterapêuticas nesse contexto. Objetivo: Elaborar um guia para avaliação e manejo fisioterapêutico da dor no câncer. Método:Estudo desenvolvido em três etapas: 1. Análise descritiva de dados sociodemográficos, clínicos, funcionais, características da dor e tratamentos fisioterapêuticos realizados em pacientes com câncer em cuidados paliativos; 2. Desenvolvimento da versão preliminar do guia a partir dos resultados da primeira etapa e de conteúdo teórico na temática; 3. Realização de grupo focal composto por fisioterapeutas que originou a versão final do guia. Resultados: Foram incluídos 62 pacientes, principalmente do sexo feminino (69,3%). O sítio tumoral mais frequente foi o ginecológico (25,8%) e metade apresentou metástase óssea. O tipo de dor mais prevalente foi a neuropática (51,6%), localizada na coluna (29,0%). Os tratamentos fisioterapêuticos mais utilizados foram: posicionamento (98,0%), cinesioterapia (68,0%), deambulação (39,0%), uso de órteses (32,0%) e transcutaneous electrical nerve stimulation (21,0%). O grupo focal sugeriu alterações e avaliou positivamente a versão preliminar do guia, ressaltando que, além de ser elaborado com linguagem de fácil compreensão, possibilitou a visão integral sobre os métodos para avaliação e tratamento fisioterapêutico da dor.

La fisioterapia puede contribuir al control del dolor en pacientes con cáncer y se deben desarrollar estrategias educativas para incrementar las acciones fisioterapéuticas en este contexto. Objetivo:Desarrollar una guía para la evaluación y manejo fisioterapéutico del dolor oncológico. Método: Estudio desarrollado en tres etapas: 1. Análisis descriptivo de datos sociodemográficos, clínicos, funcionales, características del dolor y tratamientos fisioterapéuticos realizados a pacientes con cáncer que reciben cuidados paliativos; 2. Elaboración de la versión preliminar de la guía con base en los resultados de la primera etapa y contenidos teóricos sobre el tema; 3. Realización de un grupo focal compuesto por fisioterapeutas que dio como resultado la versión final de la guía. Resultados: Se incluyeron 62 pacientes, principalmente mujeres (69,3%). La localización tumoral más frecuente fue ginecológica (25,8%) y la mitad presentó metástasis óseas. El tipo de dolor más prevalente fue el neuropático (51,6%), localizado en la columna (29,0%). Los tratamientos fisioterapéuticos más utilizados fueron: posicionamiento (98,0%), kinesioterapia (68,0%), marcha (39,0%), uso de órtesis (32,0%) y estimulación nerviosa eléctrica transcutánea (21,0%). El grupo focal sugirió cambios y evaluó positivamente la versión preliminar de la guía, destacando que, además de estar elaborada en un lenguaje fácil de entender, proporcionó una visión integral de los métodos de evaluación y tratamiento fisioterapéutico del dolor.

Techno-economic Analysis and Optimization of Intensified, Large-Scale Hydrogen Production with Membrane Reactors.

Steam methane reforming (SMR) currently supplies 76% of the world's hydrogen (H2) demand, totaling ∼70 million tonnes per year. Developments in H2 production technologies are required to meet the rising demand for cleaner, less costly H2. Therefore, palladium membrane reactors (Pd-MR) have received significant attention for their ability to increase the efficiency of traditional SMR. This study performs novel economic analyses and constrained, nonlinear optimizations on an intensified SMR process with a Pd-MR. The optimization extends beyond the membrane's operation to present process set points for both the conventional and intensified H2 processes. Despite increased compressor and membrane capital costs along with electric utility costs, the SMR-MR design offers reductions in the natural gas usage and annual costs. Economic comparisons between each plant show Pd membrane costs greater than $25 000/m2 are required to break even with the conventional design for membrane lifetimes of 1-3 years. Based on the optimized SMR-MR process, this study concludes with sensitivity analyses on the design, operational, and cost parameters for the intensified SMR-MR process. Overall, with further developments of Pd membranes for increased stability and lifetime, the proposed SMR-MR design is thus profitable and suitable for intensification of H2 production.

What does Google Trends reveal about the proportion of waterpipe users in the Brazilian population?

OBJECTIVE: To analyze the relationship between internet search volume and the prevalence of waterpipe use among young Brazilians in 2019. METHODS: This was a descriptive study with data from Brazil in 2019, using the relative search volume on waterpipes extracted from Google Trends and the proportion of waterpipe users aged between 15 and 24 years, as measured by the National Health Survey (Pesquisa Nacional de Saúde - PNS), and aged between 13 and 17 years, as measured by the National Adolescent School-based Health Survey (Pesquisa Nacional de Saúde do Escolar - PeNSE). The relationship was assessed by means of Spearman's correlation. RESULTS: The point prevalence of waterpipe use across the Brazilian Federative Units (FUs) showed a moderate (r = 0.51; PNS) to strong correlation (r = 0.74 and r = 0.80; PeNSE) with the relative search volume (p-value < 0.05). CONCLUSION: Google Trends can support the monitoring system on waterpipe use in the FUs, providing additional information to existing population-based surveys. MAIN RESULTS: The search volume for waterpipes by states in Brazil, as measured by Google Trends, showed a moderate to high correlation with the respective proportions of current use and experimentation of waterpipe among the adolescent/young adult population. IMPLICATIONS FOR SERVICES: The use of Google Trends as a support to the monitoring system for waterpipe consumption in Brazil warrants further exploration in terms of the validity of additional information to existing population surveys. PERSPECTIVES: Expanding the use of Google Trends searches to assess its potential in monitoring other health risk products and detecting (or predicting) incidence or seasonality of health-related events.

Nursing Admission Form for Oncology Intensive Care Unit Patients: Production and Validation

Introduction: Assistive technology is aimed at improving the quality of nursing care for patients admitted to oncology intensive care units (ICUs). Objective: To develop a nursing admission form for patients admitted to an oncology intensive care unit. Materials and methods: This is a methodological study conducted in three stages: 1) an integrative literature review to compose the content of the research form, 2) content validation, which included the participation and approval of 15 specialists (nurses) using Pasquali's concordance validation method, and 3) presentation of the final version of the form. Results: A total of 20 articles were included in the review; the first version of the form was structured based on the thematic synthesis; 15 specialists participated in content validation and, after completion of the instrument, it was found that all the items had a content validation index ≥ 0.85; based on the suggestions, the admission form was organized into blocks of items: identification, brief history, admission conditions, and physical examination, with a total of four items. Conclusions: The nursing survey form for patients admitted to oncology ICUs is suitable for use by the nursing team at the time of patient admission, enabling data recording to support the planning and systematization of care in the oncology ICU setting.

Introducción: la tecnología asistencial pretende mejorar la calidad de los cuidados de enfermería a los pacientes ingresados en unidades de cuidados intensivos oncológicos. Objetivo: desarrollar un formulario de admisión de enfermería para pacientes ingresados en una unidad de cuidados intensivos oncológicos. Materiales y método: estudio metodológico realizado en tres etapas: 1a) revisión bibliográfica integradora para componer el contenido del formulario de investigación; 2a) validación del contenido, que contó con la participación y el juicio de 15 especialistas (enfermeros) mediante el método de validación por acuerdo de Pasquali; 3a) presentación de la versión final del formulario. Resultados: se incluyeron 20 artículos en la revisión; a partir de la síntesis temática, se estructuró la primera versión del formulario; 15 especialistas participaron en la validación de contenido y, tras completar el instrumento, se constató que todos los ítems tenían un índice de validación de contenido ≥ 0,85; con base en las sugerencias, el formulario de admisión se organizó en bloques de ítems: identificación, historia breve, condiciones de admisión y examen físico, con un total de cuatro ítems. Conclusiones: el formulario de investigación de enfermería para pacientes ingresados en unidades de cuidados intensivos oncológicos es adecuado para ser utilizado por el equipo de enfermería en el momento del ingreso de los pacientes, permitiendo registrar datos que apoyen la planificación y sistematización de los cuidados en el contexto de la unidad de cuidados intensivos oncológicos.

Introdução: a tecnologia assistencial visa melhorar a qualidade da assistencia de enfermagem aos pacientes admitidos em unidades de terapia intensivas oncológicas. Objetivo: desenvolver uma ficha de admissao de enfermagem para pacientes de unidade de terapia intensiva oncológica. Materiais e método: estudo metodológico realizado em tres etapas: 1a) revisao integrativa da literatura para compor o conteúdo da ficha de investigaçao; 2a) validaçao de conteúdo, que contou com a participaçao e o julgamento de 15 especialistas (enfermeiros) por meio do método de validaçao de concordância de Pasquali; 3a) apresentaçao da versao final da ficha. Resultados: na revisao, 20 artigos foram incluídos; a partir da síntese temática, foi estruturada a primeira versao da ficha; da validaçao de conteúdo, participaram 15 especialistas e, após o preenchimento do instrumento, verificou-se que todos os itens obtiveram índice de validaçao de conteúdo ≥ 0,85; com base nas sugestoes, a ficha de admissao foi organizada a partir dos blocos de itens: identificaçao, breve histórico, condiçoes de admissao e exame físico, com um total de quatro itens. Conclusões: a ficha de investigaçao de enfermagem para pacientes admitidos em unidades de terapias intensivas oncológicas está adequada para ser aplicada pela equipe de enfermagem no momento da admissao do paciente, o que possibilita o registro de dados para subsidiar o planejamento e a sistematizaçao da assistencia no contexto da unidade de terapia intensiva oncológica.

Analytical validation and diagnostic performance of the ASCL1/ZNF582 methylation test for detection of high-grade anal intraepithelial neoplasia and anal cancer.

DNA methylation testing on biopsies can detect high-grade anal intraepithelial neoplasia (HGAIN) in need of treatment and anal cancer. This study aimed to analytically validate and determine the diagnostic performance of a newly developed multiplex quantitative methylation-specific PCR, PreCursor-M AnoGYN (RUO), combining ASCL1, ZNF582 and a reference (ACTB) in one assay. Analytical validation was performed on two qPCR devices using predefined quality criteria. Diagnostic performance was determined on a cross-sectional series of 111 anal biopsies covering all stages of anal disease. Differences in methylation levels were assessed using the Kruskal-Wallis test. Area under the curve was determined using logistic regression analysis. Detection rates were calculated at predefined specificities for the cross-sectional and an additional longitudinal series of 23 HGAIN biopsies preceding anal cancer (i.e., progressive HGAIN). For both devices analytical quality criteria were met. ASCL1 and ZNF582 methylation levels increased with increasing severity of disease (p < 6*10-8). Diagnostic performance for AIN3+ was 0.81. All cancers and virtually all progressive HGAIN were detected at 70% and 80% specificity. In conclusion, the ASCL1/ZNF582 methylation test (PreCursor-M AnoGYN (RUO)) was demonstrated to be highly robust and reproducible. Moreover, it had excellent diagnostic accuracy to detect AIN3+ and can potentially be used to guide HGAIN management.

Agarose fibers with glycerol and graphene oxide and functional properties for potential application in biomaterials.

Agarose has numerous applications in biochemistry and medical textiles. This study aimed to produce agarose-graphene oxide-glycerol fibers and analyze their properties. The agarose gel was prepared by dissolving the polymer in 9:1 (v/v) dimethyl sulfoxide (DMSO): H2O, followed by spinning in an ethanol bath (1:1 (v/v) ethanol: H2O) at 20 °C. Fibers were obtained using 8 % (m/v) agarose, 2 % (m/v) glycerol, and 0.5 % and 1 % (m/v) graphene oxide (GO). The fibers had a titer of 18.32-32.49 tex and, a tenacity of 1.40-3.35 cN/tex. GO increased the thermal resistance by 79 %. The presence of glycerol and GO was confirmed and analyzed by FTIR and XPS. Fiber water absorption was decreased by 30 % with the GO addition. The weight loss increased by 55 % after glycerol addition, 51 % with GO addition, and 36 % with glycerol and GO simultaneous addition. Furthermore, GO exhibited 100 % inhibition for both S. aureus (gram-positive) and E. coli bacteria (gram-negative). Fiber F1, with only agarose, inhibited S. aureus by 34.93 %, F2 with 2 % glycerol by 48.72 %, F3 with 0.5 % GO by 63.42 %, and F4 with 2 % glycerol and 0.5 % GO by 30.65 %. However, the inhibition increased to 49.43 % with 1 % GO. The agarose fibers showed low inhibition for E. coli, ranging from 3.35 to 12.12 %.

Pectoralis major and triceps brachii cross-sectional area measured on different planes: the effect on the muscle size-strength relationship.

BACKGROUND: Magnetic resonance imaging (MRI) is a well-used technique to assess muscle size and can be acquired on different planes. Pectoralis major (PM) and triceps brachii (TB) muscles are often acquired and analyzed on the axial plane, however it is unknown if anatomical cross-sectional area (CSA) calculated from different planes will affect the muscle size-strength relationship. Thus, the first aim of the present study was to identify if the CSA of the PM and TB measured on different planes presents a similar muscle size-strength relationship. A secondary aim was to investigate if the quantification of CSA of the PM and TB muscles are similar between sagittal and axial plane. METHODS: Fifteen males underwent an MRI examination, and after that, one-repetition maximum (1RM) test was performed. RESULTS: There was a significant relationship between 1RM and PM CSA measured on the axial and sagittal plane (r≤0.81), while the relationship with TB CSA was only good on the axial plane (r=0.65) and not significant on the sagittal plane (r=0.27). ICC between planes was excellent for PM CSA (0.96) with Bland-Altman procedure showing agreement between planes (d=0.376; P=0.612). Contrarily, TB CSA ICC was week (0.07), with Bland-Altman procedure showing no agreement between planes (d=-24.49; P=0.022). CONCLUSIONS: CSA measured at axial plane from PM and TB muscles showed a significant relationship with 1RM, while only PM CSA on the sagittal plane showed a significant relationship with 1RM. Finally, it was demonstrated that PM images showed a great reliability between planes, which was not true for TB muscle.

Low-Grade Myofibroblastic Sarcoma of the Oral and Maxillofacial Region: An International Clinicopathologic Study of 13 Cases and Literature Review.

Low-grade myofibroblastic sarcoma (LGMS) represents an atypical tumor composed of myofibroblasts with a variety of histological patterns and with a high tendency to local recurrence and a low probability of distant metastases. LGMS has predilection for the head and neck regions, especially the oral cavity. This study aimed to report 13 new cases of LGMS arising in the oral and maxillofacial region. This study included LGMS cases from five oral and maxillofacial pathology laboratories in four different countries (Brazil, Peru, Guatemala, and South Africa). Their clinical, radiographic, histopathological, and immunohistochemical findings were evaluated. In this current international case series, most patients were females with a mean age of 38.7 years, and commonly presenting a nodular lesion in maxilla. Microscopically, all cases showed a neoplasm formed by oval to spindle cells in a fibrous stroma with myxoid and dense areas, some atypical mitoses, and prominent nucleoli. The immunohistochemical panel showed positivity for smooth muscle actin (12 of 13 cases), HHF35 (2 of 4 cases), ß-catenin (3 of 5 cases), desmin (3 of 11 cases), and Ki-67 (range from 5 to 50%). H-caldesmon was negative for all cases. The diagnosis of LGMS was confirmed in all cases. LGMS shows predominance in young adults, with a slight predilection for the female sex, and maxillary region. LGMS should be a differential diagnosis of myofibroblastic lesions that show a proliferation of spindle cells in a fibrous stroma with myxoid and dense areas and some atypical mitoses, supporting the diagnosis with a complementary immunohistochemical study. Complete surgical excision with clear margins is the treatment of choice. However, long-term follow-up information is required before definitive conclusions can be drawn regarding the incidence of recurrence and the possibility of metastasis.

Infant and Pre-birth Involvement With Child Protection Across Australia.

Infants (<1 year old) are the age group in Australia with the highest rate of involvement with child protection. Many jurisdictions across Australia and internationally are implementing policies focused on prenatal planning and targeted support. This study investigates Australian trends in prenatal and infant child protection notifications, substantiations and out-of-home care; and the extent of over-representation of Aboriginal and Torres Strait Islander infants. Data was provided by the Australian Institute of Health and Welfare for the period 1 July 2012-30 June 2019. Univariate Poisson regression analysis was conducted, reporting the percentage change in the incidence rate ratios. All Australian jurisdictions who collect and approved release of prenatal notification data experienced increases in the rates of children with prenatal notifications, with a 4% (IRR: 1.04(1.04-1.05)) overall increase per year across Australia. Approximately 33% of children had substantiated prenatal notifications. Rates of infant notifications and entry to care in Australia increased overall by 3% (IRR:1.03(1.03-1.04)) and 2% per year (IRR:1.02(1.01-1.03)), respectively. With rising numbers of families reported prenatally and during infancy, greater evidence of the effectiveness of policies, interventions and outcomes for children and families is required.

Cumulative incidence of child protection system contacts among a cohort of Western Australian Aboriginal children born 2000 to 2013.

BACKGROUND: Reducing the over-representation of Aboriginal children in the child protection system is a key target for the Australian government. OBJECTIVE: We aimed to provide more recent evidence on the population-level cumulative incidence of contacts for Aboriginal children with child protective services (CPS) in Western Australia (WA). PARTICIPANTS AND SETTING: Linked administrative data was provided for WA CPS between 2000 and 2015 for 33,709 Aboriginal children born in WA between 2000 and 2013. METHODS: Descriptive summaries and cumulative incidence estimates were used to examine changes in CPS contact trends over time and within sibling groups. RESULTS: There was an increase in early-childhood contacts for children born more recently, with 7.6 % and 2.3 % of children born in 2000-2001 having a notification and placement in out-of-home care by age one, respectively, compared to 15.1 % and 4.3 % of children born in 2012-2013. Among sibling groups where at least one sibling had a CPS contact, approximately half of children had their first contacts on the same date as another sibling. For children born after one of their siblings had been placed in out-of-home care, 31.9 % had themselves been placed in out-of-home care by age one. CONCLUSIONS: Multiple children tend to be placed into out-of-home care when at least one sibling is, which is likely to have a significant impact on families affected. The additional risk of placement also carries over to children born after the first removal in a sibling group, highlighting the need for further support to prevent future removals.