Conventional Versus Traction-Assisted Endoscopic Submucosal Dissection for Esophageal, Gastric, and Colorectal Neoplasms: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Endoscopic submucosal dissection (ESD) is increasingly being utilized for the resection of superficial gastrointestinal neoplasms. However, the long procedure time poses a technical challenge for conventional ESD (C-ESD). Traction-assisted ESD (T-ESD) was developed to facilitate the procedure by reducing its duration. This study compares the efficacy and safety of C-ESD versus T-ESD in the treatment of esophageal, gastric, and colorectal neoplasms. Nine randomized controlled trials (RCTs) were analyzed. Traction-assisted ESD exhibited shorter mean dissection times for the esophagus and colorectal regions and lower perforation rates in colorectal cases. No significant differences were observed in en bloc resection or bleeding rates. Traction-assisted ESD proves to be more efficient in mean procedure time for esophageal and colorectal cases and safer in perforation rates for colorectal cases, but similar rates are noted for en bloc resection or bleeding.

Radiofrequency ablation for ampullary neoplasia with intraductal extension after endoscopic papillectomy: Systematic review and meta-analysis.

Background and study aims Noninvasive ampullary neoplasms may be removed by surgery or endoscopy. However, given the morbidity and mortality associated with surgery, endoscopic papillectomy (EP) is the preferred approach. Radiofrequency ablation (RFA) after EP has emerged as a promising alternative therapy to avoid surgery after incomplete EP. Our goal was to evaluate the efficacy and safety of RFA for residual or recurrent lesions with intraductal extension after endoscopic papillectomy. Patients and methods The inclusion criteria include clinical trials, cohort studies, and case series evaluating patients with residual or recurrent lesions with intraductal extension after EP treated with RFA. Case reports, duplicated data, and studies with follow-up periods < 10 months were excluded. The metanalysis evaluated adverse events, surgical conversion rate, clinical success and recurrence. Results Seven studies were selected, totaling 124 patients. RFA was associated with a clinical success rate of 75.7% (95% confidence interval [CI] 65.0-88.0%; I 2 = 23.484) in a mean follow-up period < 10 months. However, the biliary stricture rate was 22.2% (95% CI 12.1-28.4%; I 2 = 61.030), 14.3% of pancreatitis (95% CI 8.8-22.3%; I 2 < 0.001), 7.0% of cholangitis (95% CI 3.3-14.5%; I 2 < 0.001), 4.0% of bleeding (95% CI 1.7-9.3%; I 2 < 0.001), and recurrence of 24.3% (95% CI 16.0-35.0%; I 2 = 23.484). Conclusions RFA is feasible and appears to be effective for managing residual or recurrent lesions with intraductal extension after EP. However, long-term follow-up and high-quality studies are required to confirm our findings.

Correction: Intraductal radiofrequency ablation plus biliary stent versus stent alone for malignant biliary obstruction: a systematic review and meta-analysis.

[This corrects the article DOI: 10.1055/a-2204-8316.].

Lessons from the historical dynamics of environmental law enforcement in the Brazilian Amazon.

Here, we analyze critical changes in environmental law enforcement in the Brazilian Amazon between 2000 and 2020. Based on a dataset of law enforcement indicators, we discuss how these changes explain recent Amazon deforestation dynamics. Our analysis also covers changes in the legal prosecution process and documents a militarization of enforcement between 2018 and 2022. From 2004 to 2018, 43.6 thousand land-use embargoes and 84.3 thousand fines were issued, targeting 3.3 million ha of land, and totaling USD 9.3 billion in penalties. Nevertheless, enforcement relaxed and became spatially more limited, signaling an increasing lack of commitment by the State to enforcing the law. The number of embargoes and asset confiscations dropped by 59% and 55% in 2019 and 2020, respectively. These changes were accompanied by a marked increase in enforcement expenditure, suggesting a massive efficiency loss. More importantly, the creation of so-called conciliation hearings and the centralization of legal processes in 2019 reduced the number of actual judgments and fines collected by 85% and decreased the ratio between lawsuits resulting in paid fines over filed ones from 17 to 5%. As Brazil gears up to crack-down on illegal deforestation once again, our assessment suggests urgent entry points for policy action.

Intraductal radiofrequency ablation plus biliary stent versus stent alone for malignant biliary obstruction: a systematic review and meta-analysis.

Background and study aims Recurrent biliary stent occlusion and tumor ingrowth remain a major concern among patients with malignant biliary obstruction (MBO) with significant impact on patient morbidity and survival. Intraductal radiofrequency ablation (RFA) has emerged as a promising treatment that seeks to extend stent patency. This study aimed to evaluate the impact of RFA on overall survival (OS) and stent patency among patients with unresectable MBO. Methods A comprehensive search of electronic databases was performed for randomized controlled trials (RCTs) comparing RFA plus biliary stent (RFA+S) versus biliary stent alone (S-alone). Outcomes assessed included overall survival, stent patency, and adverse events (AEs) with mean difference (MD) calculated from pooled proportions. Subgroup analyses were performed for hilar strictures and cholangiocarcinoma (CCA). Results Six RCTs (n=439 patients) were included and demonstrated improved survival among patients who received RFA+S (MD 85.80 days; 95% confidence interval [CI] 35.02-136.58; I 2 =97%; P <0.0009). The pooled MD for total stent patency was 22.25 days (95% CI 17.38-61.87; I 2 =97%; P =0.27). There was no difference in AEs between RFA+S vs S-alone ( P >0.05). On subgroup analyses, RFA+S was associated with improved stent patency (MD 76.73 days; 95% CI 50.11-103.34; I 2 =67%; P <0.01) and OS (MD 83.14 (95% CI 29.52-136.77; I 2 =97%; P <0.01] for CCA. For hilar strictures, stent patency was improved among patients with RFA+S [MD 83.71 days (95% CI 24.85-142.56; I 2 =84%; P <0.01]. Conclusions RFA+S improved OS in the treatment of MBO when compared with S-alone. Moreover, the RFA therapy prolonged stent patency in hilar strictures and CCA, with similar rates of AEs.

Increased Amazon carbon emissions mainly from decline in law enforcement.

The Amazon forest carbon sink is declining, mainly as a result of land-use and climate change1-4. Here we investigate how changes in law enforcement of environmental protection policies may have affected the Amazonian carbon balance between 2010 and 2018 compared with 2019 and 2020, based on atmospheric CO2 vertical profiles5,6, deforestation7 and fire data8, as well as infraction notices related to illegal deforestation9. We estimate that Amazonia carbon emissions increased from a mean of 0.24 ± 0.08 PgC year-1 in 2010-2018 to 0.44 ± 0.10 PgC year-1 in 2019 and 0.52 ± 0.10 PgC year-1 in 2020 (± uncertainty). The observed increases in deforestation were 82% and 77% (94% accuracy) and burned area were 14% and 42% in 2019 and 2020 compared with the 2010-2018 mean, respectively. We find that the numbers of notifications of infractions against flora decreased by 30% and 54% and fines paid by 74% and 89% in 2019 and 2020, respectively. Carbon losses during 2019-2020 were comparable with those of the record warm El Niño (2015-2016) without an extreme drought event. Statistical tests show that the observed differences between the 2010-2018 mean and 2019-2020 are unlikely to have arisen by chance. The changes in the carbon budget of Amazonia during 2019-2020 were mainly because of western Amazonia becoming a carbon source. Our results indicate that a decline in law enforcement led to increases in deforestation, biomass burning and forest degradation, which increased carbon emissions and enhanced drying and warming of the Amazon forests.

Long-term follow-up after transoral outlet reduction following Roux-en-Y gastric bypass: Back to stage 0?

Background and study aims Significant weight regain affects up to one-third of patients after Roux-en-Y gastric bypass (RYGB) and demands treatment. Transoral outlet reduction (TORe) with argon plasma coagulation (APC) alone or APC plus full-thickness suturing TORe (APC-FTS) is effective in the short term. However, no study has investigated the course of gastrojejunostomy (GJ) or quality of life (QOL) data after the first post-procedure year. Patients and methods Patients eligible for a 36-month follow-up visit after TORe underwent upper gastrointestinal endoscopy with measurement of the GJ and answered QOL questionnaires (RAND-36). The primary aim was to evaluate the long-term outcomes of TORe, including weight loss, QOL, and GJ anastomosis (GJA) size. Comparisons between APC and APC-FTS TORe were a secondary aim. Results Among 39 eligible patients, 29 returned for the 3-year follow-up visit. There were no significant differences in demographics between APC and APC-FTS TORe groups. At 3 years, patients from both groups regained all the weight lost at 12 months, and the GJ diameter was similar to the pre-procedure assessment. As to QOL, most improvements seen at 12 months were lost at 3 years, returning to pre-procedure levels. Only the energy/fatigue domain improvement was kept between the 1- and 3-year visits. Conclusions Obesity is a chronic relapsing disease. Most effects of TORe are lost at 3 years, and redilation of the GJA occurs. Therefore, TORe should be considered iterative rather than a one-off procedure.

Effect of Smoke Exposure on Gene Expression in Bone Healing around Implants Coated with Nanohydroxyapatite.

This study evaluated the effect of smoke exposure on the expression of genes related to bone metabolism in implants coated with nanohydroxyapatite (NHA). A total of 36 rats were exposed to cigarette smoke for 60 days. The animals were allocated into three groups: machined implants (MAC), dual acid-etched implants (DAE), and NHA-coated implants (NHA). Implants were installed in the left tibia of the rats after 30 days of smoke exposure. The implants were retrieved 7 and 30 days after implantation, and the adjacent bone analyzed using a real-time polymerase chain reaction for gene expression of alkaline phosphatase (ALP), osteopontin (OPN), receptor activator of the nuclear factor kappa ligand (RANKL), osteoprotegerin (OPG), the RANKL/OPG ratio, osteocalcin (OCN) and runt-related transcription factor 2 (Runx2). After 7 days, Runx2, OPN and OPG expression demonstrated significantly higher levels for the NHA surface treatment relative to DAE and MAC surfaces. NHA presented the lowest RANKL and RANKL/OPG levels. After 30 days, NHA-coated implants showed significantly higher levels of Runx2, ALP, OPN, OPG, OC, RANKL and RANKL/OPG relative to DAE and MAC implants. The results indicated a greater osteogenic and high osteoclastic activity around NHA implants, in comparison to DAE and MAC implants.

Inter-sectoral prioritization of climate technologies: insights from a Technology Needs Assessment for mitigation in Brazil.

Technological development is key for national strategies to cope with the Paris Agreement's goals. Technology Needs Assessments (TNAs) aim to identify, prioritize, and diffuse climate change mitigation and/or adaptation technologies in developing countries. Their methodology includes a multi-criteria decision analysis (MCDA) framework but, although many countries already conducted a TNA, literature lacks discussions on country-specific processes for a TNA, as it usually follows a one-size-fits-all approach. This paper provides empirical evidence on the importance of country-driven processes that help shaping international programmes into country-specific needs and capabilities. It presents lessons learned from a tailored process for identification, prioritization, and selection of mitigation technologies in the scope of a TNA project for Brazil, an exceptional case of a developing country with strong capacity in integrated assessment modelling (IAM) scenarios for guiding its climate strategies. A previous IAM scenario result allowed pre-selecting technologies in six key economic sectors, while other TNAs prioritized no more than three. This allowed the elaboration of an overall ranking from the MCDA, in contrast to sectoral rankings that are mostly employed in other countries' TNAs. The overall ranking serves not only as a basis for the selection of priority technologies but also provides information on the integrated innovations framework for climate technologies in the country. Further specific findings of the tailored Brazilian TNA approach are discussed in the paper in order to call for the importance that a technology transfer project should not only be country-driven but also conducted through a country-specific process. Supplementary Information: The online version contains supplementary material available at 10.1007/s11027-022-10025-6.

Pre-harvest desiccation strategies of soybean culture: a scenario without paraquat.

The objective of this study was to evaluate the use of diquat, glufosinate ammonium, saflufenacil and flumioxazim, positioned alone and/or combined, in the pre-harvest desiccation of soybean crops. For this purpose, a field experiment was conducted, with application of the treatments in the phenological stage R 7.2 of soybean. At 3 DAA, the herbicides diquat and their combinations with flumioxazin and ammonium glufosinate, at all doses, resulted in defoliation and desiccation percentages greater than 90%. At 5 DAA, only the flumioxazin and glufosinate ammonium treatments, alone, did not show indices for harvesting. At 10 DAA, only the control differed from the other treatments in relation to desiccation, demonstrating the need to apply desiccants to enable harvest. The results indicate that the combination of herbicides may represent an alternative to reduce doses and increase the efficacy of isolated products through synergism, in addition to operational gains.

The Role of Neuroplasticity in Improving the Decision-Making Quality of Individuals With Agenesis of the Corpus Callosum: A Systematic Review.

Although individuals with agenesis of corpus callosum (ACC) possess intelligence coefficients within regular parameters, current studies have demonstrated decision-making compromise and potential negative social consequences. Furthermore, alternative pathways regarding brain connectivity in acallosal patients combined with cognitive therapy that would potentially mitigate such difficulties. Therefore, this study aimed to examine the current state of the art regarding brain foundations in the role of neuroplasticity by improving the decision-making quality in ACC. A systematic revision of literature was performed including studies conducted on non-syndromic ACC individuals and analyzing the impact of the potential role of neuroplasticity on the decision-making published to date. Studies with patients who underwent callosotomy were excluded. Experimental studies performed on animal models were included. During this period, 849 studies were identified; among them, 11 were eligible for qualitative analysis. Despite the paucity of evidence on this matter, patients with ACC present considerable decision-making difficulties mainly due to the functional connectivity impairment in the frontal lobes. Moreover, neuroplasticity was characterized by increased anterior commissure width as compared with controls. Notwithstanding, no studies were conducted on cognitive therapists managing this type of disease. Although the reorganization of inter-hemispheric bundles on anterior commissure has demonstrated the main natural neuroanatomic strategy in ACC, further evidence will be needed to clarify whether cognitive stimulus could improve the decision-making quality.

Composição química e atividades biológicas de extratos e frações de Guadua chacoensis (Rojas) Londoño & P.M. Peterson / Chemical composition and biological activities of extracts and fractions of Guadua chacoensis (Rojas) Londoño & P.M. Peterson

O Brasil é o país que possui a maior diversidade de bambus em todo o continente americano, com mais de 200 espécies catalogadas. Devido à alta resistência e durabilidade, essas espécies são muito utilizadas na construção civil e confecção de móveis e utensílios. No entanto, faltam estudos que investiguem a composição química e as atividades biológicas. Neste projeto foram avaliados extratos etanólicos de folhas e colmos de Guadua chacoensis (Rojas) Londoño & P.M. Peterson e frações em hexano, clorofórmio, acetato de etila e n-butanol. Também se obteve o óleo volátil, mas com um rendimento extremamente baixo (0,00079%). As frações dos extratos apresentaram teores de compostos fenólicos variando entre 1,92 e 15,80 µg EAG/mg. Esses compostos mostraram-se mais abundantes nas amostras de colmos. Em relação ao teor de flavonoides, as folhas apresentaram maior quantidade, variando entre 0,39 e 1,18 µg EQ/mg contra 0,17 a 0,34 µg EQ/mg nos colmos. Investigou-se a atividade antimicrobiana dos extratos, frações e óleo volátil frente cinco microrganismos: Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Candida albicans e Aspergillus brasiliensis. As amostras demonstraram potencial inibitório moderado a bom contra S. aureus e C. albicans, porém fraca para as demais espécies. Testou-se a capacidade antioxidante frente o radical DPPH e os resultados indicaram atividade antioxidante significativa, especialmente as frações acetato e butanol de colmos. As folhas apresentaram EC50 variando entre 67,5 e 124,0 µg/mL e os colmos entre 40,2 e 124 µg/mL. A inibição da enzima tirosinase, que está associada à produção de melanina, também se mostrou boa a uma concentração de 1 mg/mL, com o extrato bruto de colmos apresentando 43% de inibição, seguido pelas frações acetato (36%) e n-butanol (38%) de folhas. As análises por CG-MS detectaram pelo menos 44 compostos diferentes no óleo volátil, com vários terpenos e sesquiterpenos, e com ß-ionona sendo o componente majoritário (8,75%). As amostras de colmos e folhas apontaram grande diversidade de compostos, cerca de 20 para cada fração, onde os ácidos graxos como ácido palmítico e linoleico e seus ésteres derivados foram os mais abundantes. A análise dos perfis cromatográficos por CCD e CLAE revelaram a presença de ácido p-cumárico nos colmos de G. chacoensis. Esse composto tem relevante atividade antioxidante e de inibição da tirosinase. Também foi possível identificar a quercetagetina-7-O-glicosídeo, uma flavona glicosilada, com propriedades anti-inflamatorias e antidiabéticas. Desta forma, constatou-se que G. chacoensis apresenta grande diversidade de metabólitos secundários com atividades biológicas relevantes, como atividade antioxidante e clareadora, abrindo caminho para investigações mais profundas de suas aplicações, especialmente no segmento de cosméticos e produtos naturais

Brazil is the country with the greatest diversity of bamboo in the entire American continent, with more than 200 species catalogued. Due to their high resistance and durability, they are widely used in home construction and manufacture of furniture and utensils. However, studies investigating chemical composition and biological activities are absent. In this project, ethanol extracts from leaves and stems of Guadua chacoensis (Rojas) Londoño & P.M. Peterson and fractions in hexane, chloroform, ethyl acetate and n-butanol were evaluated. Volatile oil was also obtained, but with an extremely low yield (0.00079%). The fractions of the extracts presented contents of phenolic compounds varying between 1.92 and 15.80 µg GAE/mg. These compounds were more abundant in culm samples. In relation to the flavonoid content, leaves showed a greater amount, varying between 0.39 and 1.18 µg QE/mg against 0.17 to 0.34 µg QE/mg in culms. The antimicrobial activity of extracts, fractions and volatile oil were investigated against five microorganisms: Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Candida albicans and Aspergillus brasiliensis. The samples showed moderate to good inhibitory potential against S. aureus and C. albicans, but weak for the other species. The antioxidant capacity was tested against the DPPH radical and the results indicated significant antioxidant activity, especially acetate and butanol culm fractions. The leaves presented EC50 varying between 67.5 and 124.0 µg/mL and culms between 40.2 and 124 µg/mL. The inhibition of the enzyme tyrosinase, which is associated with the production of melanin, was also shown to be good at a concentration of 1 mg/mL, with the raw culm extract showing 43% inhibition, followed by acetate (36%) and n-butanol (38%) fractions of leaves. CG-MS analysis detected at least 44 different compounds in volatile oil, with several terpenes and sesquiterpenes, and with ß-ionone being the major component (8.75%). Culm and leaf samples showed great diversity of compounds, about 20 for each fraction, where fatty acids such as palmitic and linoleic acid and their derivative esters were the most abundant. The analysis of the chromatographic profiles by TLC and HPLC revealed the presence of p-coumaric acid in culms of G. chacoensis. This compound has relevant antioxidant and tyrosinase inhibiting activity. It was also possible to identify quercetagetine-7-O-glucoside, a glycosylated flavone, with anti-inflammatory and anti-diabetic properties. Thus, it was found that G. chacoensis presents a great diversity of secondary metabolites with relevant biological activities, such as antioxidant and whitening activity, opening ways for deeper investigations of its applications, especially in the segment of cosmetics and natural products

Interações medicamentosas de prescrições médicas em pacientes acometidos pelo coronavírus da síndrome respiratória aguda grave / Possible drug interactions in drug prescriptions of patients affected by sars-cov-2 / Posibles interacciones farmacológicas en la prescripción de medicamentos de pacientes afectados por sars-cov-2

Objetivo: Identificar as potenciais interações medicamentosas em prescrições médicas em pacientes acometidos por coronavírus da síndrome respiratória aguda grave. Método: Trata-se de um estudo descritivo, do tipo documental e retrospectivo realizado no período de abril a junho de 2020. Os dados foram coletados por meio de instrumento semi-estruturado, que abordou os medicamentos utilizados, dados sociodemográficos, e condições clínicas associadas. A análise dos dados efetivou-se numa abordagem quantitativa por estatística descritiva. Resultados: Verificou-se que os fármacos mais utilizados foram azitromicina, ondasetrona, enoxaparina e omeprazol. Ao avaliar as possíveis interações medicamentosas, constatou-se a média de 2,98 por cliente, sendo as de maior gravidade a ondasetrona e azitromicina; cloridrato de ondansetrona di-hidratado e fentanil, assim como midazolam e fentanil. Conclusão: Enfatiza-se a necessidade em avaliar os fármacos prescritos, bem como seus aprazamentos de forma que a assistência ao paciente seja realizada com o mínimo de danos. (AU)

Objective: To identify potential drug interactions of medical prescriptions in patients affected by severe acute respiratory syndrome coronavirus. Methods: This is a descriptive, documentary and retrospective study carried out from April to June 2020. Data were collected using a semi structured instrument, which addressed the drugs used, sociodemographic data, and associated clinical conditions. Data analysis was carried out using a quantitative approach using descriptive statistics. Results: It was found that the most used drugs were azithromycin, wavesetron, enoxaparin and omeprazole. When evaluating the possible drug interactions, an average of 2.98 per client was found, with the most severe being wavesetron and azithromycin; ondansetron hydrochloride dihydrate and fentanyl, as well as midazolam and fentanyl. Conclusion: The need to evaluate the prescribed drugs, as well as their schedules, is emphasized so that patient care is carried out with minimal damage. (AU)

Objetivo: Identificar posibles interacciones medicamentosas de prescripciones médicas en pacientes afectados por coronavírus síndrome respiratório agudo severo. Métodos: Se trata de un estudio descriptivo, documental y retrospectivo realizado de abril a junio de 2020. Los datos fueron recolectados mediante un instrumento semiestructurado, que abordó los fármacos utilizados, datos sociodemográficos y condiciones clínicas asociadas. El análisis de los datos se realizó mediante un enfoque cuantitativo utilizando estadística descriptiva. Resultados: Se encontró que los fármacos maus utilizados fueron azitromicina, wavesetron, enoxaparina y omeprazol. Al evaluar las posibles interacciones medicamentosas, se encontró un promedio de 2,98 por cliente, siendo los más graves el wavesetron y la azitromicina; hidrocloruro de ondansetrón dihidrato y fentanilo, así como midazolam y fentanilo. Conclusión: Se enfatiza la necesidad de evaluar los fármacos prescritos, así como sus horarios, para que la atención al paciente se lleve a cabo con el mínimo daño. (AU)

Synergistic effect and ultrastructural changes in Trypanosoma cruzi caused by isoobtusilactone A in short exposure of time.

Butanolides have shown a variety of biological effects including anti-inflammatory, antibacterial, and antiprotozoal effects against certain strains of Trypanosoma cruzi. Considering the lack of an effective drug to treat T. cruzi infections and the prominent results obtained in literature with this class of lactones, we investigated the anti-T. cruzi activity of five butanolides isolated from two species of Lauraceae, Aiouea trinervis and Mezilaurus crassiramea. Initially, the activity of these compounds was evaluated on epimastigote forms of the parasite, after a treatment period of 4 h, followed by testing on amastigotes, trypomastigotes, and mammalian cells. Next, the synergistic effect of active butanolides against amastigotes was evaluated. Further, metacyclogenesis inhibition and infectivity assays were performed for the most active compound, followed by ultrastructural analysis of the treated amastigotes and trypomastigotes. Among the five butanolides studied, majoranolide and isoobtusilactone A were active against all forms of the parasite, with good selectivity indexes in Vero cells. Both butanolides were more active than the control drug against trypomastigote and epimastigote forms and also had a synergic effect on amastigotes. The most active compound, isoobtusilactone A, which showed activity against all tested strains inhibited metacyclogenesis and infection of new host cells. In addition, ultrastructural analysis revealed that this butanolide caused extensive damage to the mitochondria of both amastigotes and trypomastigotes, resulting in severe morphological changes in the infective forms of the parasite. Altogether, our results highlight the potential of butanolides against the etiologic agent of Chagas disease and the relevance of isoobtusilactone A as a strong anti-T. cruzi drug, affecting different events of the life cycle and all evolutionary forms of parasite after a short period of exposure.

Characterization and plasticity of wharton's jelly mesenchymal stem cells of goat

Mesenchymal stem cells (MSCs), obtained from several anatomical sites, have already been described, characterized and used in therapeutic models for tissue repair. The umbilical cord mesenchymal stem cells, represented by cells from arteries and veins walls, as well as Wharton's jelly are easy to be obtained, highly available, require no invasive procedure, do not present risk to donors and do not present ethical limitation. The aim of this research was to analyze the plasticity of Wharton's jelly mesenchymal stem cells (WJ-MSCs) of goat, evaluating their behavior in vitro and characterizing them immunophenotypically. Thus, tests were performed on colony forming units, viability and cell growth curve, flow cytometry analysis and plasticity potential. Goat umbilical cord matrix cells exhibited fibroblastoid morphology with colony formation and self-renewal ability, always maintaining their undifferentiated state up to the eighth passage (P8). The growth curve kinetics exhibited the LAG, LOG, and DECAY phases, without displaying a PLATEAU phase. The plasticity assay demonstrated positive differentiation for osteogenic, adipogenic and chondrogenic lines, characterized by the synthesis of intracytoplasmic granules or extracellular matrix with the presence of calcium, lipids and proteoglycans. Flow cytometry demonstrated the expression of CD90 and CD105; absence of CD14 expression. It is concluded that the cell population isolated from the Wharton's jelly of goat constitutes a representative sample of mesenchymal stem cells, with great possibilities in the field of regenerative and reproductive medicine.

Influence of nano-hydroxyapatite coating implants on gene expression of osteogenic markers and micro-CT parameters. An in vivo study in diabetic rats.

This study evaluated the response of a nano-hydroxyapatite coating implant through gene expression analysis (runt-related transcription factor 2 (Runx2), alkaline phosphatase (Alp), osteopontin (Opn), osteocalcin (Oc), receptor activator of nuclear factor-kappa B (Rank), receptor activator of nuclear factor-kappa B ligand (Rank-L), and osteoprotegerin (Opg)). Three-dimensional evaluation (percent bone volume (BV/TV); percent intersection surface (BIC); bone surface/volume ratio (BS/BV); and total porosity (To.Po)) were also analyzed. Mini implants were surgically placed in tibias of both healthy and diabetic rats. The animals were euthanized at 7 and 30 days. Evaluating all factors the relative expression of Rank showed that NANO surface presented the best results at 7 days (diabetic rats). Furthermore the levels of Runx2, Alp, Oc, and Opn suggest an increase in osteoblasts proliferation, especially in early stages of osseointegration. %BIC in healthy and diabetic (7 days) depicted statistically significant differences for NANO group. BV/TV, BS/BV and To.Po demonstrated higher values for NANO group in all evaluated time point and irrespective of systemic condition, but BS/BV 30 days (healthy rat) and 7 and 30 days (diabetic rat). Microtomographic and gene expression analyses have shown the benefits of nano-hydroxyapatite coated implants in promoting new bone formation in diabetic rats.

Conhecimento de estudantes de enfermagem sobre parada cardiorrespiratória: estudo transversal / Conocimiento de los estudiantes de enfermería sobre parada cardiorrespiratoria: estudio transversal / Knowledge of nursing students on cardiorespiratory arrest: a cross-sectional study

Objetivo avaliar o conhecimento de estudantes de enfermagem sobre o atendimento ao paciente em parada cardiorrespiratória. Método estudo transversal com abordagem quantitativa, realizado com 136 acadêmicos do curso de enfermagem de uma instituição de ensino superior. Os dados foram coletados por meio de instrumento semiestruturado. A análise efetivou-se por meio da estatística descritiva e inferencial. Resultados os discentes que se autoavaliaram positivamente, mostraram um bom nível de conhecimento sobre a temática (r=0,29; p=0,001), assim como aqueles que haviam cursado a disciplina de primeiros socorros em períodos anteriores (p=0,012). As questões nas quais obtiveram erro foram aquelas a respeito das vias de administração da droga e suporte ventilatório em pacientes não intubados. Conclusão os discentes de enfermagem demonstraram um nível adequado de compreensão dos protocolos sobre o atendimento ao paciente em parada cardiorrespiratória e possuíam arcabouço teórico obtido na disciplina de primeiros socorros, bem como em cursos de aperfeiçoamento.

Objetivo evaluar el conocimiento de los estudiantes de enfermería sobre el cuidado de los pacientes en parada cardiorrespiratoria. Método estudio transversal con abordaje cuantitativo, realizado con 136 estudiantes de enfermería de una institución de educación superior. Los datos fueron recogidos por medio de un instrumento semiestructurado. El análisis se realizó a través de estadística descriptiva e inferencial. Resultados los estudiantes que se evaluaron positivamente mostraron un buen nivel de conocimiento sobre el tema (r=0,29; p=0,001), así como los que habían asistido al curso de primeros auxilios en períodos anteriores (p=0,012). Las preguntas en las que obtuvieron error fueron las relativas a las vías de administración del fármaco y soporte ventilatorio en pacientes no intubados. Conclusión los estudiantes de enfermería demostraron un adecuado nivel de comprensión de los protocolos sobre el cuidado de pacientes en parada cardiorrespiratoria y contaron con un marco teórico obtenido en la disciplina de primeros auxilios, así como en cursos de perfeccionamiento.

Objective to evaluate the knowledge of nursing students about the care of patients in cardiorespiratory arrest. Method cross-sectional study with quantitative approach, conducted with 136 nursing students from a higher education institution. Data were collected using a semi-structured instrument. The analysis was performed through descriptive and inferential statistics. Results the students who positively evaluated themselves showed a good level of knowledge about the theme (r=0.29; p=0.001), as well as those who had attended the first aid course in previous periods (p=0.012). The questions they made mistakes were those regarding the routes of administration of the drug and ventilatory support in non-intubated patients. Conclusion the nursing students demonstrated an adequate level of understanding of the protocols on the care of patients in cardiorespiratory arrest and had a theoretical framework obtained in the discipline of first aid, as well as in improvement courses

A spatially explicit index for mapping Forest Restoration Vocation (FRV) at the landscape scale: Application in the Rio Doce basin, Brazil.

Effectively implementing landscape-scale forest restoration on the ground is particularly challenging. Available decision-support tools particularly lack the ability to comprehensively incorporate biophysical, social and institutional dimensions in a spatially explicit manner from the pixel to the whole landscape. In order to contribute to fulfilling this gap, this paper has two major objectives. The first is to present a spatially explicit decision-support tool for mapping Forest Restoration Vocation (FRV) that includes socio-economic and institutional aspects in forest landscape restoration. The second is to discuss the ways in which the FRV has been applied in the Brazilian decision-making context. The FRV was used to prioritize areas for three different restoration modalities: assisted natural regeneration (passive restoration), forest plantation with native trees to conserve biodiversity and forest plantation for agroforestry systems (active restoration). The FRV is already being adopted as a planning tool to invest R$ 1.2 billion (approx. US$ 300 million) to restore 40,000 ha in the Rio Doce, Brazil-an area corresponding to 0.05% of the area of watershed. Due to the high level of degradation of the basin, there is a need to restore 1.6 Mha via forest plantations in riparian Areas of Permanent Preservation (APPs) while 30% of APPs can be effectively restored using natural regeneration. The FRV can be effective for gauging progress and monitoring forest restoration implementation metrics across the landscape and through time. There are however still problems in effectively assessing if the investment in forest restoration will generate impact in the long term and deliver the ecosystem services society depends on.

Antitrypanosomal butanolides from Aiouea trinervis.

In a search for new antitrypanosomal agents in the Brazilian flora, the ethanol extract of the xylopodium from Aiouea trinervis (Lauraceae) exhibited in vitro activity against the epimastigote forms of Trypanosoma cruzi, the etiological agent of Chagas disease. Bioassay-guided chromatographic fractionation of the ethanol extract afforded three butanolides, isoobtusilactone A (1), epilitsenolide C2 (2), and epilitsenolide C1 (3). Butanolides 1 and 3 were more active against T. cruzi epimastigotes than the reference drug benznidazole (by 8.9-fold and 3.2-fold, respectively), while 2 proved inactive. Compounds 1 and 3 showed low cytotoxicity in mammalian Vero cells (CC50> 156 µmol L-1) and high selectivity index (SI) values for epimastigotes (SI = 56.8 and 28.6, respectively), and 1 was more selective than benznidazole (SI = 46.5). Butanolide 1 at 24 µmol L-1 also led to cell cycle alterations in epimastigote forms, and inhibited the growth of amastigote cells in more than 70 %. In silico ADMET properties of 1 were also analyzed and predicted favorable drug-like characteristics. This butanolide also complied with Lipinski's rule of five and was not predicted as interference compound (PAINS). This is the first report on the isolation of these bioactive butanolides under the guidance of in vitro trypanocidal activity against T. cruzi.