Reflective practice of nurse residents in the teaching-learning process in teaching hospitals.

OBJECTIVE: To analyze reflective practice in the teaching-learning process of nurses in residency programs in teaching hospitals in Minas Gerais, Brazil. METHODS: Case study, based on the reflective practice framework, conducted in two teaching hospitals. Observation and interviews were conducted with first and second-year residents, and five participants were included for in-depth analysis, with their data subjected to frequency distribution analysis and Critical Discourse Analysis. RESULTS: In 519 observed activities, elements of reflection were identified in 22.2%, especially active listening and expression of doubts. Discourses indicated practice as the best moment for teaching-learning due to its potential to generate reflections. Learning by doing and case discussion were considered potential strategies for reflective learning. CONCLUSION: Know-in-action reflection was evidenced as the predominant formative aspect for residents, with few opportunities for reflection on reflection-in-action.

Loxosceles amazonica Brown Spider venom: Insights into enzymatic activities, immunorecognition, and novel phospholipase D isoforms.

The Loxosceles genus represents one of the main arachnid genera of medical importance in Brazil. Despite the gravity of Loxosceles-related accidents, just a handful of species are deemed medically important and only a few have undergone comprehensive venom characterization. Loxosceles amazonica is a notable example of a potentially dangerous yet understudied Loxosceles species. While there have been limited reports of accidents involving L. amazonica to date, accidents related to Loxosceles are increasing in the North and Northeast regions of Brazil, where L. amazonica has been reported. In this work, we provide a complementary biochemical and immunological characterization of L. amazonica venom, considering its most relevant enzymatic activities and its immunorecognition and neutralization by current therapeutic antivenoms. Additionally, a cDNA library enriched with phospholipase D (PLD) sequences from L. amazonica venom glands was built and subsequently sequenced. The results showed that L. amazonica venom is well immunorecognised by all the tested antibodies. Its venom also displayed proteolytic, hyaluronidase, and sphingomyelinase activities. These activities were at least partially inhibited by available antivenoms. With cDNA sequencing of PLDs, seven new putative isoforms were identified in the venom of L. amazonica. These results contribute to a better knowledge of the venom content and activities of a synanthropic, yet understudied, Loxosceles species. In vivo assays are essential to confirm the medical relevance of L. amazonica, as well as to assess its true toxic potential and elucidate its related pathophysiology.

Ensino na Residência em Área Profissional da Saúde no Brasil: análise documental / Teaching in Residency in the Professional Health Area in Brazil: documental analysis

RESUMO Analisar discursivamente os objetivos educacionais presentes nos documentos oficiais referentes aos Programas de Residência em Área Profissional da Saúde. Análise de documentos oficiais brasileiros que configuram o ensino para os Programas de Residência em Área Profissional da Saúde. Busca realizada entre fevereiro e abril de 2023 em bancos de dados disponibilizados nos sites do Governo Federal do Brasil e do Sistema de Legislação da Saúde do Ministério da Saúde. Realizou-se Análise de Discurso Crítica, na perspectiva de Fairclough. Nove documentos oficiais abordavam os objetivos educacionais dos Programas de Residência em Área Profissional da Saúde. Os dados foram sistematizados em princípios, concepções, valores e estratégias educacionais que orientam os programas de residência e em modo de organização, a partir das atividades de ensino. Os objetivos educacionais dos Programas de Residência em Área Profissional da Saúde caminham rumo à formação técnica dos residentes, enquanto o discurso sobre o modelo educacional, expresso nas atividades de ensino, avança para a ampliação do conceito.

ABSTRACT Discursively analyze the educational objectives present in official documents referring to Residency Programs in the Professional Health Area. Analysis of official Brazilian documents that configure teaching for Residency Programs in the Professional Health Area. Search carried out between February and April 2023 in databases available on the websites of the Federal Government of Brazil and the Health Legislation System of the Ministry of Health. Critical Discourse Analysis was carried out, from Fairclough's perspective. Nine official documents addressed the educational objectives of Residency Programs in the Professional Health Area. The data were systematized into principles, conceptions, values, and educational strategies that guide the residency programs and organization mode, based on teaching activities. The educational objectives of Residency Programs in the Professional Health Area move towards the technical training of residents, while the discourse on the educational model, expressed in teaching activities, moves towards expanding the concept.

Malignant phyllodes tumor of the breast in ayoung patient ­ case report

Phyllodes tumor (PT) is an uncommon form of breast tumor. It occurs most commonly in women aged 35 to 65 years. The benign form represents about 85­90% of cases and only 10­15% of PTs are malignant. Clinically and radiologically, malignant phyllodes tumor (MPT) presents as regular, well-delimited, mobile nodules that are difficult to distinguish from fibroadenomas of the breast. The most important differential diagnoses of MPT include fibroadenoma, metaplastic carcinoma, and sarcoma. The prognosis of MPT exhibits a higher frequency of local recurrence and metastatic rate with larger tumors and inadequate surgical margins. The case presented here refers to a 24-year-old female patient, with a vast tumor in the right breast, with rapid and progressive growth, associated to local pain, and histological diagnosis of MPT. Surgery was the initial treatment, followed by adjuvant chemotherapy and radiotherapy. The purpose of this article was to report an atypical case of MPT of the breast in a very young woman as well as to make a brief literature review on this infrequent and dangerous disease. (AU)

Reflective practice of nurse residents in the teaching-learning process in teaching hospitals / Práctica reflexiva de residentes de enfermería en el proceso de enseñanza-aprendizaje en hospitales de enseñanza / A prática reflexiva de enfermeiros residentes no processo ensino-aprendizagem em hospitais de ensino

ABSTRACT Objective: To analyze reflective practice in the teaching-learning process of nurses in residency programs in teaching hospitals in Minas Gerais, Brazil. Methods: Case study, based on the reflective practice framework, conducted in two teaching hospitals. Observation and interviews were conducted with first and second-year residents, and five participants were included for in-depth analysis, with their data subjected to frequency distribution analysis and Critical Discourse Analysis. Results: In 519 observed activities, elements of reflection were identified in 22.2%, especially active listening and expression of doubts. Discourses indicated practice as the best moment for teaching-learning due to its potential to generate reflections. Learning by doing and case discussion were considered potential strategies for reflective learning. Conclusion: Know-in-action reflection was evidenced as the predominant formative aspect for residents, with few opportunities for reflection on reflection-in-action.

RESUMEN Objetivo: Analizar la práctica reflexiva en el proceso de enseñanza-aprendizaje de enfermeras en programas de residencia en hospitales de enseñanza en Minas Gerais, Brasil. Métodos: Estudio de caso, basado en el marco de la práctica reflexiva, realizado en dos hospitales de enseñanza. Se realizaron observaciones y entrevistas con residentes de primero y segundo año, y se incluyeron cinco participantes para un análisis en profundidad, cuyos datos fueron sometidos a análisis de distribución de frecuencia y Análisis Crítico del Discurso. Resultados: En 519 actividades observadas, se identificaron elementos de reflexión en un 22.2%, especialmente la escucha activa y la expresión de dudas. Los discursos indicaron que la práctica es el mejor momento para el aprendizaje debido a su potencial para generar reflexiones. Aprender haciendo y la discusión de casos fueron consideradas estrategias potenciales para el aprendizaje reflexivo. Conclusion: Se evidenció que la reflexión sobre la acción es el aspecto formativo predominante para los residentes, con pocas oportunidades para reflexionar sobre la reflexión en la acción.

RESUMO Objetivo: Analisar a prática reflexiva no processo ensino-aprendizagem de enfermeiros em programas de residência em hospitais de ensino de Minas Gerais, Brasil. Métodos: Estudo de caso, baseado no referencial da prática reflexiva, desenvolvido em dois hospitais de ensino. Realizaram-se observação e entrevista de residentes do primeiro e segundo ano, e incluídos, para análise em profundidade, cinco participantes, cujos dados foram submetidos à análise de distribuição de frequência e à Análise do Discurso Crítica. Resultados: Em 519 atividades observadas, houve identificação de elementos de reflexão em 22,2%, especialmente escuta com atenção operativa e expressão de dúvidas. Os discursos indicaram a prática como o melhor momento para o ensino-aprendizagem pelo potencial de produzir reflexões. Aprender fazendo e discussão de casos foram consideradas estratégias potenciais para a aprendizagem reflexiva. Considerações Finais: Evidenciou-se a reflexão conhecer-na-ação como a predominante na formação dos residentes, com poucas oportunidades para reflexão sobre a reflexão-na-ação.

Epidemiology of arthropods envenomation in Brazil: a public health issue.

Brazil is located between the Equator and Tropic of Capricorn, which allows diverse climates, reliefs, and habitats for arthropods, which sting represents a risk to human health and a public health issue. This manuscript updates the epidemiological data of cases of human envenoming by spiders, scorpions, and insects with medical relevance in Brazil from 2010 to 2021. Epidemiological data were taken using the Brazilian Notifiable Diseases Information System. Statistics of non-parametric data used the Kruskal-Wallis followed by the Nemenyi test. On average, more than 145,000 envenomation and 145 deaths are recorded annually, and more than 60% of deaths are caused by scorpion bites. When the number of deaths was pondered by the number of cases with each arthropod, bees kill the most. Most stings cause mild symptoms and affect men of working age. The incidence decreases during the colder months, which is better noticeable in regions with well-defined seasons. The distribution is distinct among the regions: Southeast, Northeast, and South have the highest rate of bites. The growing number of cases of envenomation reported annually is a serious public health concern, especially involving scorpions, and highlights the importance of studying arthropod venom and improving the therapies.

Partial characterization of Loxosceles anomala (Mello-Leitão, 1917) venom: A brown spider of potential medical concern.

The spider's genus Loxosceles (also known as "brown spiders") is one of the few ones of medical importance in Brazil, being Loxosceles anomala a species of common occurrence in the Southeast region. This species is usually smaller in size than the other members of the Loxosceles group. A single human accident involving L. anomala was reported to date and the clinical picture shared similar characteristics with accidents caused by other Loxosceles species. Despite the potential relevance of L. anomalafor loxocelism in Minas Gerais state, its venom activity has never been characterized. In this work, we provide a preliminary characterization of L. anomala venom, considering its most relevant enzymatic activities and its venom immunorecognition by current therapeutic antivenoms. The results showed that L. anomala venom is immunorecognised by therapeutic antivenoms and by anti-phospholipase D antibodies. Its venom also shows enzymatic activities (sphingomyelinase activity, fibrinogenolytic) described for other Loxosceles venoms. This work contributes to a better knowledge on the venom content and activities of synanthropic Loxosceles species that have the potential of causing relevant human accidents.

The relationship between temperament and dental fear and anxiety: a systematic review.

OBJECTIVE: To investigate the relationship between temperament traits and dental fear and anxiety (DFA) in children and adolescents by the means of a systematic review (PROSPERO #CRD42020207578). METHODS: The PEO (Population, Exposure, and Outcome) strategy was followed using children and adolescents as the population, temperament as the exposure, and DFA as the outcome. A systematic search for observational studies (cross-sectional, case-control, and cohort) without restrictions on year or language of publication was performed in seven databases (PubMed, Web of Science, Scopus, Lilacs, Embase, Cochrane, and PsycINFO) in September 2021. Grey literature search was performed in OpenGrey, Google Scholar, and in the reference list of included studies. Study selection, data extraction, and risk of bias assessment were carried out independently by two reviewers. The Fowkes and Fulton Critical Assessment Guideline was used to assess methodological quality of each study included. The GRADE approach was performed to determine the certainty of evidence of relationship between temperament traits. RESULTS: This study recovered 1362 articles, of which 12 were included. Despite the high heterogeneity of methodological aspects, qualitative synthesis by subgroups showed a positive association/correlation between emotionality, neuroticism, and shyness with DFA in children and adolescents. Different subgroups analysis showed similar results. Eight studies were classified as having low methodological quality. CONCLUSION: The main shortcoming of the included studies is the high risk of bias and a very low certainty of evidence. Within its limitations, children and adolescents with a temperament-like emotionality/neuroticism and shyness are more likely to present higher DFA.

Stromal Ascorbate Peroxidase (OsAPX7) Modulates Drought Stress Tolerance in Rice (Oryza sativa).

Chloroplast ascorbate peroxidases exert an important role in the maintenance of hydrogen peroxide levels in chloroplasts by using ascorbate as the specific electron donor. In this work, we performed a functional study of the stromal APX in rice (OsAPX7) and demonstrated that silencing of OsAPX7 did not impact plant growth, redox state, or photosynthesis parameters. Nevertheless, when subjected to drought stress, silenced plants (APX7i) show a higher capacity to maintain stomata aperture and photosynthesis performance, resulting in a higher tolerance when compared to non-transformed plants. RNA-seq analyses indicate that the silencing of OsAPX7 did not lead to changes in the global expression of genes related to reactive oxygen species metabolism. In addition, the drought-mediated induction of several genes related to the proteasome pathway and the down-regulation of genes related to nitrogen and carotenoid metabolism was impaired in APX7i plants. During drought stress, APX7i showed an up-regulation of genes encoding flavonoid and tyrosine metabolism enzymes and a down-regulation of genes related to phytohormones signal transduction and nicotinate and nicotinamide metabolism. Our results demonstrate that OsAPX7 might be involved in signaling transduction pathways related to drought stress response, contributing to the understanding of the physiological role of chloroplast APX isoforms in rice.

Scorpion envenomation in Brazil: Current scenario and perspectives for containing an increasing health problem.

Opportunistic scorpion species can colonize urban environments, establishing high-density communities that enhance the chances of human accidents. This scenario has been taking place in Brazil, in which some Tityus species have taken city centers, causing an explosion in the number of scorpion envenoming cases. The characteristics of this scorpionism epidemic in Brazil is discussed in the present work. The number of Brazilian scorpion stings has surpassed 120,000 cases in 2017, and has been maintained above this number ever since, representing a more than 3-fold increase in 10 years, which was higher than the number of cases for most of the neglected tropical diseases in the country. The escalation in scorpionism cases is even higher in some regions of Brazil. Fortunately, the proportion of mild cases has also increased in the analyzed period, as well as the number of victims seeking for medical attention within the first hour after the accident. The species Tityus serrulatus, Tityus stigmurus, Tityus bahiensis, and Tityus obscurus are traditionally accountable for most of the scorpion accidents in different regions of Brazil, but other species deserve to be closely watched. Despite scorpionism being a notable health problem in Brazil, accident prevention and pest control regarding this venomous animal have not been properly addressed by the scientific community nor by policy makers. Therefore, this review also aims to point possible fields of research that could help to contain the aggravation of the current scorpionism landscape in Brazil.

Self-regulated learning e ensino médico: revisão de literatura / Self-regulated learning and medical education: a literature review

Resumo: Introdução: A aprendizagem autorregulada (self-regulated learning - SRL) é o processo ativo que o aluno realiza para atingir seus objetivos de aprendizagem. No ensino médico, pelo fato de o ambiente clínico ser propício para o desenvolvimento da SRL, há potencial benefício na aplicação dessa ferramenta no processo de ensino-aprendizado, embora as diferenças em seus cenários de aplicação exijam uma análise mais aprofundada. Objetivo: Este artigo apresenta uma revisão da literatura sobre o histórico do desenvolvimento da SRL, sua aplicabilidade e avaliação em estudantes de Medicina por meio de escala validada, além dos fatores que a influenciam, como métodos de ensino e questões demográficas e socioculturais. Método: Realizou-se uma busca com o descritor self-regulated learning nas plataformas PubMed e SciELO e na revista Medical Education Online para artigos em inglês publicados entre 2010 e 2021. Resultado: A busca nas bases de dados resultou em 198 artigos, dos quais foram selecionados 100 para a análise crítica. Desses 100 artigos, selecionaram-se 31 que preenchiam os critérios desta revisão. Conclusão: A SRL é um conceito contemporâneo considerado pilar no processo educacional. Trata-se de ferramenta de grande valor em psicologia educacional. A aplicabilidade da SRL no contexto do ensino médico demonstra-se efetiva e traz consigo especificidades sobre a autorregulação do estudante de Medicina. Contudo, são necessários novos estudos acerca do tema, de modo a permitir o desenvolvimento de métodos instrucionais eficazes com sua utilização.

Abstract: Introduction: Self-regulated learning (SRL) is the active process that students perform to achieve their learning goals. In medical education, the development of SRL is favoured by the clinical environment, hence there is potential benefit in applying this tool in the teaching-learning process, although the differences in its application scenarios require deeper analysis. Objective: The aim of this article is to present a literature review on the development of SRL, its applicability and evaluation in medical students using a validated scale, and the factors that influence it, such as teaching methods and demographic and sociocultural issues. Method: A search was performed on the Pub-med and Scielo platforms and the online Medical Education Journal for articles in English published between 2010 and 2021 using the descriptors "Self-regulated learning". Results: The database search resulted in 198 articles, of which 100 were selected for critical analysis. Of these, 31 articles were selected based on meeting the criteria of this review. Conclusions: SRL is a contemporary educational concept and considered a pillar in the educational process. It is a valuable tool in educational psychology. Its applicability in the context of medical education proves to be effective and brings with it specificities in relation to the self-regulation of medical students. However, further studies on the subject are necessary to allow for the development of effective instructional methods to support its use.

Evaluation of clinical, pathological and epidemiological profile of patients with breast cancer in the microregion of Lavras ­ MG

Breast cancer is associated with high frequency and mortality in Brazilian women. There have been limited studies portraying the characteristics of breast cancer cases in the countryside of the state of Minas Gerais for a long period of time, a fact that will allow us to better understand the epidemiology of these tumors. This descriptive study aims to analyze the epidemiology and clinical features of patients with breast cancer treated at a public health service facility in Lavras, MG. Methods: This is a transversal study with 299 women diagnosed with breast cancer between 2002 and 2022, based on data collection from medical records and subsequent descriptive analysis. Results: There were a total of 317 cases, and 299 were eligible for the study. The mean age at diagnosis was 54.2 years, and 36.1% of the patients were under 50 years old at diagnosis. Positive family history was found in 17.0% of the patients. The diagnosis was made by clinical alteration detected on physical examination in 71.5% of cases, and lump was the most frequent type of lesion (89.0%). Invasive carcinoma was 93.1% of the cases, and the mean tumor size was 28.6 mm. The average time between first medical appointment and diagnosis was 63.2 days, and between diagnosis and beginning of treatment was 39.6 days. Conclusions: This study showed that a significant number of cases occurred in women outside the recommended age for screening in Brazil. Diagnosis was predominantly performed by clinical examination, with delays in obtaining the histological diagnosis, and the stage at diagnosis was high, and these facts were associated with the health system limitations (AU)

Implementation of a milking system and quality management for buffalo milk at an experimental station in Rio Grande do Sul, Brazil / Implementação de um sistema de ordenha e manejo da qualidade do leite bubalino em uma estação experimental no Rio Grande do Sul, Brasil

Buffalo milk production is an activity that has grown in recent years, mainly due to the physicochemical characteristics found in this type of milk, which is the second most produced in the world. The objective of this study was to implement a milking system and monitor the identity and quality standards of buffalo milk produced at the Experimental Agronomic Station of the Federal University of Rio Grande do Sul. Samples were collected fortnightly between June and November 2021, totaling ten collections. The means obtained at the end of the monitoring were 4.84 g/100 g for fat, 4.64 g/100 g for protein, 5.06 g/100 g for lactose, 15.26 g/100 g for total solids, 10.42 g/100g for non-fat solids, 0.18 g lactic acid/100 mL of milk for acidity, 1.037 g/cm3 for density, -0.533°C for cryoscopic index, 3.5 x 105 cells/mL for somatic cell count, and 8.0 x103 CFU/ml for standard plate count. Residues of antibiotics and antiparasitics were not found. An increase in the concentration and frequency of some fatty acids was observed, after an increment in the nutritional management of the animals, in addition to predominance of palmitic acid (C16:0) and oleic acid (C18:1- cis (n9)). The results indicate a significant improvement in the quality of the milk in the assessment period, due to the corrective actions that were established, and the standard plate count showed good agricultural practices as to milk sourcing and the hygiene of the materials, being below the limits required by NI 76. The buffalo milk produced by the herd at the Experimental Station showed physicochemical and microbiological results in accordance with the legislation, being a raw material to be explored in the prospection of derivative products.

A produção de leite bubalino é uma atividade que tem crescido nos últimos anos, principalmente devido às características físico-químicas apresentadas pelo leite, que é o segundo mais produzido no mundo. O objetivo deste trabalho foi implementar um sistema de ordenha e monitorar os padrões de identidade e qualidade do leite bubalino produzido na Estação Experimental Agronômica da Universidade Federal do Rio Grande do Sul. Amostras foram coletadas quinzenalmente entre os meses de junho e novembro de 2021, totalizando dez coletas. As médias obtidas ao final do monitoramento foram de 4,84 g/100 g para gordura, 4,64 g/100 g para proteína, 5,06 g/100g para lactose, 15,26 g/100 g sólidos totais, 10,42 g/100g para sólidos não gordurosos, 0,18 g ácido lático/100 mL de leite para acidez, 1,037 g/cm3 para densidade, -0.533°C para índice crioscópico, 3.5 x105 cél/mL para contagem de células somáticas e 8.0 x103 UFC/ml para contagem padrão em placa. Não foram identificados resíduos de antibióticos e antiparasitários. Observou-se aumento de concentração e frequência de alguns ácidos graxos, após incremento de manejo nutricional dos animais, além da predominância dos ácidos palmítico (C16:0) e oleico (C18:1- cis (n9). Os resultados indicam que houve uma melhora significativa na qualidade do leite no período avaliado, decorrente das ações corretivas que foram estabelecidas, e a contagem padrão em placa demonstrou boas práticas agropecuárias na obtenção do leite e na higienização dos materiais, estando abaixo dos limites exigidos pela IN 76. O leite de búfala produzido pelo rebanho da Estação Experimental apresentou resultados físico-químicos e microbiológicos de acordo com a legislação, sendo uma matéria-prima a ser explorada na prospecção de produtos derivados.

Phytochemical profile of Brazilian grapes (Vitis labrusca and hybrids) grown on different rootstocks.

Important factors may influence the bioactive compounds in grapes, including scion-rootstock interaction. Therefore, the bioactive compounds and antioxidant activity in grape skin and pulp fractions of 'Isabel Precoce', 'BRS Carmem', 'BRS Cora', 'BRS Violeta' and 'IAC 138-22 Máximo' were assessed. These cultivars, from genetic improvement programs in Brazil, have good adaptation to subtropical and tropical climate conditions, and can be widely used by winegrowers aiming at adding value to the grape. All grapevines were grafted onto 'IAC 766' and 'IAC 572' rootstocks under tropical conditions in Brazil. The highest concentration of bioactive compounds was found in skins of 'BRS Violeta', followed by 'IAC 138-22 Máximo', both grafted onto 'IAC 766'. There was a strong correlation between phenolic content and antioxidant properties, since antioxidant activity also decreased in the sequence: 'BRS Violeta' > 'IAC 138-22 Máximo' > 'BRS Cora' > 'BRS Carmem' > 'Isabel Precoce'. Skin from hybrid grapes ('BRS Violeta', 'IAC 138-22 Máximo', 'BRS Cora' and 'BRS Carmem') grafted in both rootstocks contains higher levels of (poly)phenolic compounds and antioxidant activity than 'Isabel Precoce' (V. labrusca). Skin from 'BRS Violeta' grafted onto 'IAC 766' stand out from the others due to their high content of bioactive compounds.

Linfoma cardíaco primário: o papel da multimodalidade de imagem na abordagem diagnóstica / Primary cardiac lymphoma: role of imaging multimodality in diagnosis

Massas intracardíacas constituem um desafio diagnóstico, já que os sintomas são comuns a patologias cardiovasculares ou não. Métodos ­ invasivos ou não ­ possibilitam o diagnóstico diferencial e a confirmação histológica, propiciando tratamento adequado. Para melhor compreender a importância da multimodalidade em imagem e a abordagem nos tumores cardíacos , relatamos o caso de um lifoma cardíaco primário, em que a abordagem multidisciplinar permitiu o rápido diagnóstico e seu tratamento, inclusive das intercorrências, com resposta inicial promissora, a despeito da evolução fatal durante a pandemia por SARS-CoV-2.(AU)

Intracardiac masses are a diagnostic challenge since their symptoms can be common to cardiovascular pathologies. Some methods, whether invasive or not, enable differential diagnosis, histological confirmation, and adequate treatment. To better understand the importance of imaging multimodality and the approach to managing cardiac tumors, we investigated a case of a primary cardiac lymphoma in which the multidisciplinary approach allowed rapid diagnosis and treatment, including of intercurrences, with a promising initial response despite fatal progression due to severe acute respiratory syndrome coronavirus 2 infection. (AU)

Free nipple graft: current indications and applications of a centenary breast surgery technique ­ an integrative review

Introduction: Free nipple graft is a mammaplasty technique first described about 100 years ago. Its indication, restricted to reduction mammoplasty earlier, has been expanding into areas in mastology intervention, such as transgender and oncological surgery. Aim: The aim of this study was to evaluate the efficacy and outcomes of the technique. Methods: Electronic literature search was conducted, using PubMed and LILACS databases. The search strategy consisted of the keywords, MeSH terms, and free text words and variants for the free nipple graft and its application in reduction and mammaplasty, transgender, and oncoplastic surgery. Results: A total of 397 articles were found and, after inclusion and exclusion criteria, 15 were selected. Their outcomes have been shown, despite lack of standardized scores, as well as clinical trials to postulate better scientific evidence on its use and indications, that the technique, analyzed in over 1290 patients, achieved high safety rates and reproducibility. Conclusion: Aesthetics and patients satisfaction were found positive, as recommended by the authors in different studies discussed in this article.

A Novel Saliva RT-LAMP Workflow for Rapid Identification of COVID-19 Cases and Restraining Viral Spread.

Rapid diagnostics is pivotal to curb SARS-CoV-2 transmission, and saliva has emerged as a practical alternative to naso/oropharyngeal (NOP) specimens. We aimed to develop a direct RT-LAMP (reverse transcription loop-mediated isothermal amplification) workflow for viral detection in saliva, and to provide more information regarding its potential in curbing COVID-19 transmission. Clinical and contrived specimens were used to optimize formulations and sample processing protocols. Salivary viral load was determined in symptomatic patients to evaluate the clinical performance of the test and to characterize saliva based on age, gender and time from onset of symptoms. Our workflow achieved an overall sensitivity of 77.2% (n = 90), with 93.2% sensitivity, 97% specificity, and 0.895 Kappa for specimens containing >102 copies/µL (n = 77). Further analyses in saliva showed that viral load peaks in the first days of symptoms and decreases afterwards, and that viral load is ~10 times lower in females compared to males, and declines following symptom onset. NOP RT-PCR data did not yield relevant associations. This work suggests that saliva reflects the transmission dynamics better than NOP specimens, and reveals gender differences that may reflect higher transmission by males. This saliva RT-LAMP workflow can be applied to track viral spread and, to maximize detection, testing should be performed immediately after symptoms are presented, especially in females.

The mitochondrial isoform glutathione peroxidase 3 (OsGPX3) is involved in ABA responses in rice plants.

Different environmental conditions can lead plants to a condition termed oxidative stress, which is characterized by a disruption in the equilibrium between the production of reactive oxygen species (ROS) and antioxidant defenses. Glutathione peroxidase (GPX), an enzyme that acts as a peroxide scavenger in different organisms, has been identified as an important component in the signaling pathway during the developmental process and in stress responses in plants and yeast. Here, we demonstrate that the mitochondrial isoform of rice (Oryza sativa L. ssp. Japonica cv. Nipponbare) OsGPX3 is induced after treatment with the phytohormone abscisic acid (ABA) and is involved in its responses and in epigenetic modifications. Plants that have been silenced for OsGPX3 (gpx3i) present substantial changes in the accumulation of proteins related to these processes. These plants also have several altered ABA responses, such as germination, ROS accumulation, stomatal closure, and dark-induced senescence. This study is the first to demonstrate that OsGPX3 plays a role in ABA signaling and corroborate that redox homeostasis enzymes can act in different and complex pathways in plant cells. SIGNIFICANCE: This work proposes the mitochondrial glutathione peroxidase (OsGPX3) as a novel ABA regulatory pathway component. Our results suggest that this antioxidant enzyme is involved in ABA-responses, highlighting the complex pathways that these proteins can participate beyond the regulation of cellular redox status.

Traços de temperamento estão associados ao medo e ansiedade odontológicos em crianças e adolescentes? Uma revisão sistemática / Temperament traits: are they associated to dental fear and anxiety? A systematic review

Essa revisão sistemática, foi realizada com o objetivo de verificar a associação e/ou correlação de traços de temperamento com o medo e ansiedade odontológicos de crianças e adolescentes. Registrada na plataforma PROSPERO (#CRD42020207578), seguiu-se a estratégia PEO para seu delineamento, na qual crianças e adolescentes foram a população de interesse (P), os temperamentos foram a exposição (E) e o medo/ansiedade odontológicos o desfecho (O). Foram incluídos estudos observacionais sem restrições de ano ou idioma de publicação. Foi realizada uma busca sistematizada, por dois pesquisadores independentes, nas seguintes bases de dados: PubMed, Web of Science, Scopus, Lilacs, Embase, Cochrane e PsycINFO, complementada por busca na literatura cinzenta, sendo atualizada até abril/2021. Os seguintes dados dos artigos incluídos foram extraídos e sintetizados: local, ano, desenho de estudo, local de realização da coleta de dados, características dos participantes, métodos de avaliação das variáveis exposição e desfecho, resultados e conclusão. A análise de qualidade foi realizada pelo critério de Fowkes e Fulton e a certeza da evidência pelo método GRADE. Do total de 1362 artigos recuperados, onze foram incluídos. A heterogeneidade dos dados inviabilizou a metaanálise. Síntese qualitativa por subgrupos demonstrou associação/correlação positiva entre os traços de temperamento de emocionalidade/neuroticismo, impulsividade e timidez com o medo/ansiedade odontológicos em crianças e adolescentes. Os traços de temperamento de extroversão e sociabilidade não foram associados/correlacionados com medo/ansiedade odontológicos. A qualidade metodológica dos estudos foi avaliada como baixa em 8 dos 11 artigos incluídos. A certeza da evidência encontrada foi classificada como muito baixa. Conclui-se que crianças e adolescentes com traços de temperamento como emocionalidade e timidez são mais propensos a apresentar maior medo e ansiedade odontológicos. Este resultado deve ser avaliado com cautela devido à alta heterogeneidade e ao alto risco de viés dos estudos, com muito baixa certeza de evidência.

This systematic review aims to verify the association/correlation of temperament traits with dental fear and anxiety (DFA) in children and adolescents (PROSPERO #CRD42020207578). the PEO strategy: children and adolescents (P-population), temperament (E-exposure), and DFA (O-outcome). Observational studies without restrictions on year or language of publication were included. A systematic search was performed, by two independent researchers, in seven databases and grey literature, up to April/2021. The following data of the included articles were extracted and synthesized: location, year, study design, place of data collection, characteristics of the participants, methods for exposure and outcome variables, results, and conclusion. The risk of bias assessment was performed by the Fowkes and Fulton criteria and the certainty of the evidence by the GRADE method. 1362 articles were recovered and 11 were included. Qualitative synthesis by subgroups showed positive association/correlation between temperament of emotionality/neuroticism and shyness with DFA in children and adolescents. Eight studies had low methodological quality. In conclusion, children and adolescents with temperament like emotionality/neuroticism and shyness are more likely to present higher DFA. This result should be evaluated with caution due to the high heterogeneity and low methodological quality of the studies, with very low certainty of evidence.