Association between nutrition intake and muscle mass in adult inpatients receiving nutrition support: A prospective cohort study.

OBJECTIVE: The present study aimed to evaluate the association between muscle mass variation, estimated by different equations, during hospitalization with the energy and protein intake and clinical and nutrition outcomes of patients using nutrition support. METHODS: A prospective observational study with patients older than 18 years in use of enteral and/or parenteral nutrition therapy and monitored by the Nutritional Therapy Committee between December 14, 2021, and December 14, 2022. Data were collected from the electronic records and were applied in 11 equations to estimate the four different portions of muscle mass of patients receiving nutrition support at the beginning and the end of hospitalization. RESULTS: A total of 261 patients were evaluated, with a median age of 61.0 (49.0-69.75) years, and 106 were women (40.6%). According to the nutrition diagnosis, several participants had severe malnutrition (39.5%). The most muscle mass estimation equations indicated a reduction of muscle mass during hospitalization. All patients presented negative energy and protein balances during hospitalization, but greater protein intake increased the lean soft tissue. Also, the greater the number of infections, metabolic complications, and scheduled diet interruption, the greater was the chance of losing muscle mass. CONCLUSION: There can be an association between the variation in muscle mass and energy and protein intake during hospitalization of patients using nutrition support. In addition, variation in muscle mass was associated with complications from nutrition support. The results emphasize the importance of anthropometric measurements to estimate muscle mass when other methods are not available.

The last resort requirement under REACH: From principle to practice.

REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals) is a European Union regulation that aims to protect human health and the environment from the risks posed by chemicals. Article 25 clearly states that: "[i]n order to avoid animal testing, testing on vertebrate animals for the purposes of this Regulation shall be undertaken only as a last resort." In practice, however, the standard information requirements under REACH are still primarily filled using animal studies. This paper presents examples illustrating that animal testing is not always undertaken only as a last resort. Six over-arching issues have been identified which contribute to this: (1) non-acceptance of existing animal or non-animal data, (2) non-acceptance of read-across, (3) inflexible administrative processes, (4) redundancy of testing, (5) testing despite animal welfare concerns and (6) testing for cosmetic-only ingredients. We, members of the Animal-Free Safety Assessment (AFSA) Collaboration, who work together to accelerate the global adoption of non-animal approaches for chemical safety assessment, herein propose several recommendations intended to aid the European Commission, the European Chemicals Agency and registrants to protect human health and the environment while avoiding unnecessary animal tests - truly upholding the last resort requirement in REACH.

Validation and reliability analysis of the Questionnaire on the Emotional Impact of Vertigo-CIEV version translated to the Brazilian Portuguese language. / Análise de validação e confiabilidade do Questionário Emocional da Vertigem-CIEV em versão traduzida para o Português-Brasileiro.

PURPOSE: To determine the internal consistency and reliability of the "Questionário de Impacto Emocional da Vertigem (CIEV)" and to validate the instrument with respect to the Dizziness Handicap Inventory (DHI) in a sample of individuals with balance disorders. METHODS: 38 subjects participated in the study, males and females, aged from 23 to 85 years, who presented dizziness, vertigo, and/or falls complaints and attended to the Vestibular Disorders clinic at the University Hospital. Individuals with hearing complaints and/or tinnitus unrelated to dizziness, previous psychiatric comorbidities, and/or cognitive impairments were excluded. We performed an anamnesis and collected complementary data from the medical records. After that, the self-perception questionnaires, DHI, and CIEV, were applied. Statistical analysis was performed in which the Cronbach's alpha verified the internal consistency of the CIEV. Reliability and validity of the CIEV related to the DHI were calculated using Intraclass Correlation Index (ICC) and Pearson's correlation test, respectively. RESULTS: There was a statistically significant correlation between the scores obtained, for both reliability and validation analysis (p<0.001). The mean ICC showed a moderate correlation between the total scores (0.695) and a strong correlation with the physical, emotional, and functional DHI domains (0.706 to 0.869), being the emotional aspect the highest degree (0.869). Pearson's correlation showed strong correlation between the total scores (r=0.820) and varied from moderate to strong, with strongest correlations to the DHI emotional domain (r=0.788). CONCLUSION: The outcomes illustrate important contribution to validation parameters to consider clinical use of the CIEV in the Brazilian population, aiming to identify emotional aspects in patients with balance disorders.

OBJETIVO: Determinar a consistência interna e confiabilidade do "Questionário de Impacto Emocional da Vertigem-CIEV" e validar o instrumento em relação ao Dizziness Handicap Inventory (DHI), em uma amostra de pacientes com distúrbio do equilíbrio corporal. MÉTODO: Participaram 38 sujeitos, idades entre 23 e 85 anos, ambos os sexos, com queixas relacionadas à tontura, desequilíbrios e/ou quedas, atendidos em um ambulatório de Otoneurologia do Hospital Universitário. Foram excluídos sujeitos com queixas auditivas e/ou zumbido sem tontura associada, comorbidades psiquiátricas prévias e/ou comprometimento cognitivo que impedisse a compreensão dos questionários. Foi realizada anamnese, levantamento de prontuário para caracterização da amostra e aplicados os questionários de autopercepção, DHI e CIEV. O alfa de Cronbach verificou a consistência interna do CIEV e a confiabilidade e validade do CIEV em relação ao DHI foram calculadas pelo Índice de Correlação intraclasse (ICC) e teste de Correlação de Pearson, respectivamente. RESULTADOS: Houve correlação estatisticamente significante entre os escores obtidos, tanto à análise de confiabilidade quanto de validação (p<0,001). O ICC médio demonstrou moderada correlação para o escore total (0,695) e forte correlação com os domínios físico, emocional e funcional do DHI (0,706 a 0,869) sendo o maior grau para o domínio emocional (0,869). A Correlação de Pearson demonstrou grau forte para o escore total (r=0,820) e variação de moderado a forte para os domínios, com melhor resultado também para o domínio emocional do DHI (r=0,788). CONCLUSÃO: Os achados representam parâmetros importantes de contribuição para a validação do CIEV para uso clínico na população brasileira, direcionado para a identificação de aspectos emocionais em pacientes com distúrbios do equilíbrio corporal.

Normal Trichoscopic Findings after Hair Transplantation in Androgenetic Alopecia: A Prospective Case Series.

Background: Trichoscopy can be very useful for evaluation for hair transplantation (HT), helping rule out simulators of androgenetic alopecia (AGA). There are only a few reports about normal trichoscopic findings after HT. Objective: The aim of this study was to evaluate donor and recipient area trichoscopy after FUE in HT without complications in AGA patients. Method: A prospective study was carried out with 10 patients, for 24 weeks, with photographic follow-up, using FotoFinder®. Patients were evaluated from week 1 (w1) to week 8 weekly, then, at week 12 and week 24 post-HT. Results: Main results were perifollicular crusts, donor area erythema, recipient area erythema, perifollicular erythema, white circles, perifollicular whitish halos, repilation black dots, dystrophic hairs, folliculitis, yellow dots. We discussed the meaning of each of these findings in the period in which they occurred. Conclusion: Normal trichoscopic findings in post-transplant patients have not been well established yet. Our findings are an attempt to define a normal pattern. Future studies with a longer follow-up may be necessary to corroborate these results.

Neomycin: sources of contact and sensitization evaluation in 1162 patients treated at a tertiary service

Abstract Background: Neomycin is used in several over-the-counter pharmaceutical formulations in Brazil. In Europe and Canada, where it is not freely available, its sensitization frequency is lower than in the United States, where this does not occur. Objective: To present the frequency of sensitization to neomycin observed in a tertiary hospital and the pharmaceutical formulations sold in Brazil containing neomycin. Method: Retrospective analysis of positive results to neomycin, obtained through patch tests performed in a tertiary hospital, from 2009 to 2018 and investigation of topical drugs and vaccines containing neomycin in Brazilian databases available on the internet. Results: Among 1,162 patients, 71 (6%) had positive reactions to neomycin, 65% female and 35% male individuals, 46% were over 50 years old, and 24% had a personal history of atopy. The dermatitis lasted from four months to 20 years. Lesions were located in 69% of the patients on the upper limbs, in 55% they were on the lower limbs, and in 42% they were disseminated in more than 4 sites. Polysensitization was detected in 55% of cases. Of these, 28% were linked to sensitization to rubber allergens and 27% to potassium bichromate. A total of 158 topical presentations of neomycin were found: 79 ointments, 58 creams, 10 ophthalmic solutions, seven otological solutions, one oral solution, two nasal solutions, and one antiseptic powder, in addition to 11 types of vaccines. Study limitations: Retrospective study. Conclusion: Sensitization to neomycin occurred in 6% of the studied population, affecting more females aged over 50 years, with skin lesions located mainly on the upper and lower limbs, in the context of chronic contact dermatitis. Neomycin was found in 135 formulations, most of them available over the counter, as well as in 11 miscellaneous vaccines.

Neomycin: sources of contact and sensitization evaluation in 1162 patients treated at a tertiary service.

BACKGROUND: Neomycin is used in several over-the-counter pharmaceutical formulations in Brazil. In Europe and Canada, where it is not freely available, its sensitization frequency is lower than in the United States, where this does not occur. OBJECTIVE: To present the frequency of sensitization to neomycin observed in a tertiary hospital and the pharmaceutical formulations sold in Brazil containing neomycin. METHOD: Retrospective analysis of positive results to neomycin, obtained through patch tests performed in a tertiary hospital, from 2009 to 2018 and investigation of topical drugs and vaccines containing neomycin in Brazilian databases available on the internet. RESULTS: Among 1,162 patients, 71 (6%) had positive reactions to neomycin, 65% female and 35% male individuals, 46% were over 50 years old, and 24% had a personal history of atopy. The dermatitis lasted from four months to 20 years. Lesions were located in 69% of the patients on the upper limbs, in 55% they were on the lower limbs, and in 42% they were disseminated in more than 4 sites. Polysensitization was detected in 55% of cases. Of these, 28% were linked to sensitization to rubber allergens and 27% to potassium bichromate. A total of 158 topical presentations of neomycin were found: 79 ointments, 58 creams, 10 ophthalmic solutions, seven otological solutions, one oral solution, two nasal solutions, and one antiseptic powder, in addition to 11 types of vaccines. STUDY LIMITATIONS: Retrospective study. CONCLUSION: Sensitization to neomycin occurred in 6% of the studied population, affecting more females aged over 50 years, with skin lesions located mainly on the upper and lower limbs, in the context of chronic contact dermatitis. Neomycin was found in 135 formulations, most of them available over the counter, as well as in 11 miscellaneous vaccines.

ECHA ARN documents: chemical grouping without a toxicological rationale.

The EU chemical strategy for sustainability (CSS) plans to use chemical grouping to "prioritise (…) substances for restrictions for all uses through grouping, instead of regulating them one by one". Thus, toxicological grouping will become a key tool used by regulatory authorities in Europe. Over the last 2 years, ECHA has published a high number of documents labelled "Assessment of Regulatory Needs (ARN)" which are based on groups of chemicals based on structural considerations. The ARN documents are legally non-binding, yet they present the public impression of a conclusion about restrictions for groups or sub-groups of chemicals and hence may set a precedent for further binding actions. ECHA has set out definitions on what is considered a group in REACH Annex XI. However, as shown in this commentary based on five examples, the ARN do not follow these principles and propose toxicological groupings without taking into consideration mode of action and the toxicological information on the chemicals. Given the emphasis on grouping projected by the CSS, the groupings in the ARN set an unfortunate precedent on what a toxicological group means and they do not follow clear scientific standards or established toxicological principles. They also lead to a public image of guilt by association for chemicals, without any recourse for registrants to establish the scientific basis for their safe use, as presented within REACH registrations.

Spawning, egg and larval description of the brazilian basslet Gramma brasiliensis Sazima, Gasparini & Moura, 1998 in captivity.

Brazilian basslet Gramma brasiliensis is a fish highly appreciated by the marine ornamental industry. There is an increasing interest in the development of a breeding protocol for this species. However, descriptions of the reproductive biology, eggs and larval development are scarce. This study was the first to describe the spawning, eggs and larvae of G. brasiliensis in captivity, including mouth size information. Six spawning events produced egg masses with 27, 127, 600, 750, 850, and 950 eggs. Larger egg masses showed embryos with at least two different developmental stages. Eggs are spherical (∼1.0 mm diameter), held together by filaments entangling chorionic projections. Larvae with fewer than 12 hph (hours post-hatch) presented 3.55 mm standard-length, well developed eyes, fully absorbed yolk sac, an inflated swim bladder and mouth opened. Exogenous feeding on rotifers began within 12 hph. The average mouth width at first feeding was 0.38 mm. The first settled larva was noted by day 21. This information should help to determine appropriate diets and prey-shift time during the larviculture of the species.

Análise de validação e confiabilidade do Questionário Emocional da Vertigem-CIEV em versão traduzida para o Português-Brasileiro / Validation and reliability analysis of the Questionnaire on the Emotional Impact of Vertigo-CIEV version translated to the Brazilian Portuguese language

RESUMO Objetivo Determinar a consistência interna e confiabilidade do "Questionário de Impacto Emocional da Vertigem-CIEV" e validar o instrumento em relação ao Dizziness Handicap Inventory (DHI), em uma amostra de pacientes com distúrbio do equilíbrio corporal. Método Participaram 38 sujeitos, idades entre 23 e 85 anos, ambos os sexos, com queixas relacionadas à tontura, desequilíbrios e/ou quedas, atendidos em um ambulatório de Otoneurologia do Hospital Universitário. Foram excluídos sujeitos com queixas auditivas e/ou zumbido sem tontura associada, comorbidades psiquiátricas prévias e/ou comprometimento cognitivo que impedisse a compreensão dos questionários. Foi realizada anamnese, levantamento de prontuário para caracterização da amostra e aplicados os questionários de autopercepção, DHI e CIEV. O alfa de Cronbach verificou a consistência interna do CIEV e a confiabilidade e validade do CIEV em relação ao DHI foram calculadas pelo Índice de Correlação intraclasse (ICC) e teste de Correlação de Pearson, respectivamente. Resultados Houve correlação estatisticamente significante entre os escores obtidos, tanto à análise de confiabilidade quanto de validação (p<0,001). O ICC médio demonstrou moderada correlação para o escore total (0,695) e forte correlação com os domínios físico, emocional e funcional do DHI (0,706 a 0,869) sendo o maior grau para o domínio emocional (0,869). A Correlação de Pearson demonstrou grau forte para o escore total (r=0,820) e variação de moderado a forte para os domínios, com melhor resultado também para o domínio emocional do DHI (r=0,788). Conclusão Os achados representam parâmetros importantes de contribuição para a validação do CIEV para uso clínico na população brasileira, direcionado para a identificação de aspectos emocionais em pacientes com distúrbios do equilíbrio corporal.

ABSTRACT Purpose To determine the internal consistency and reliability of the "Questionário de Impacto Emocional da Vertigem (CIEV)" and to validate the instrument with respect to the Dizziness Handicap Inventory (DHI) in a sample of individuals with balance disorders. Methods 38 subjects participated in the study, males and females, aged from 23 to 85 years, who presented dizziness, vertigo, and/or falls complaints and attended to the Vestibular Disorders clinic at the University Hospital. Individuals with hearing complaints and/or tinnitus unrelated to dizziness, previous psychiatric comorbidities, and/or cognitive impairments were excluded. We performed an anamnesis and collected complementary data from the medical records. After that, the self-perception questionnaires, DHI, and CIEV, were applied. Statistical analysis was performed in which the Cronbach's alpha verified the internal consistency of the CIEV. Reliability and validity of the CIEV related to the DHI were calculated using Intraclass Correlation Index (ICC) and Pearson's correlation test, respectively. Results There was a statistically significant correlation between the scores obtained, for both reliability and validation analysis (p<0.001). The mean ICC showed a moderate correlation between the total scores (0.695) and a strong correlation with the physical, emotional, and functional DHI domains (0.706 to 0.869), being the emotional aspect the highest degree (0.869). Pearson's correlation showed strong correlation between the total scores (r=0.820) and varied from moderate to strong, with strongest correlations to the DHI emotional domain (r=0.788). Conclusion The outcomes illustrate important contribution to validation parameters to consider clinical use of the CIEV in the Brazilian population, aiming to identify emotional aspects in patients with balance disorders.

New insight into the role of oxygen supply for surfactin production in bench-scale bioreactors using induced surface aeration.

Surfactin biosurfactant produced by Bacillus sp. has been studied, because it has enormous potential in several applications in the oil and cosmetics industry. The cultivation conditions for obtaining this bioproduct, however, still require attention, as, for example, parameters related to oxygen supply and consumption. In this study, different volumetric oxygen transfer coefficient (KLa) levels (0-11.56 h-1) were tested in bench-scale bioreactor for surfactin biosurfactant production by Bacillus velezensis H2O-1, using induced surface aeration. While conditions close to anaerobiosis showed insignificant production of surfactin, an intermediated KLa condition (4.24 h-1) generated the best surfactin concentration (579.6 mg L-1), with a volumetric productivity of 11.9 mg L-1 h-1. These results showed that the oxygen demand to produce surfactin is not high, being possible to use induced surface aeration strategy in bioreactors, minimizing foam formation. In addition, in all KLa conditions tested, surfactin homologues C14 and C15 had higher relative abundance. Nevertheless, the KLa parameter seems to have had minimal influence on affecting the relative abundances of surfactin homologues produced. Particularly noteworthy in this study is the possibility of producing surfactin using a low-cost and scale-up feasible aeration strategy, unlike the foam collection strategies developed in other studies to obtain this bioproduct.

Bovine Lactoferrin Induces Cell Death in Human Prostate Cancer Cells.

Bovine lactoferrin (bLf) is a multifunctional protein widely associated with anticancer activity. Prostate cancer is the second most frequent type of cancer worldwide. This study was aimed at evaluating the influence of bLf on cell viability, cell cycle progression, reactive oxygen species (ROS) production, and rate of apoptosis in the human prostate cancer cell line (DU-145). MTT assay and trypan blue exclusion were used to analyze cell viability. Morphological changes were analyzed through optical microscopy after 24 h and 48 h of bLf treatment. FITC-bLf internalization and cellular damage were observed within 24 h by confocal fluorescence microscopy. Cell cycle analyses were performed by flow cytometry and propidium iodide. For caspases 3/7 activation and reactive oxygen species production evaluation, cells were live-imaged using the high-throughput system Operetta. The cell viability assays demonstrated that bLf induces cell death and morphological changes after 24 h and 48 h of treatment compared to control on DU-145 cells. The bLf internalization was detected in DU-145 cells, G1-phase arrest of the cell cycle, caspase 3/7 activation, and increased oxidative stress on bLf-treated cells. Our data support that bLf has an important anticancer activity, thus offering new perspectives in preventing and treating prostate cancer.

Protective Immunity of COVID-19 Vaccination with ChAdOx1 nCoV-19 Following Previous SARS-CoV-2 Infection: A Humoral and Cellular Investigation.

Infections caused by SARS-CoV-2 induce a severe acute respiratory syndrome called COVID-19 and have led to more than six million deaths worldwide. Vaccination is the most effective preventative measure, and cellular and humoral immunity is crucial to developing individual protection. Here, we aim to investigate hybrid immunity against SARS-CoV-2 triggered by the ChAadOx1 nCoV-19 vaccine in a Brazilian cohort. We investigated the immune response from ChAadOx1 nCoV-19 vaccination in naïve (noCOVID-19) and previously infected individuals (COVID-19) by analyzing levels of D-dimers, total IgG, neutralizing antibodies (Nabs), IFN-γ (interferon-γ) secretion, and immunophenotyping of memory lymphocytes. No significant differences in D-dimer levels were observed 7 or 15 days after vaccination (DAV). All vaccinated individuals presented higher levels of total IgG or Nabs with a positive correlation (R = 0.88). Individuals in the COVID-19 group showed higher levels of antibody and memory B cells, with a faster antibody response starting at 7 DAV compared to noCOVID-19 at 15 DAV. Further, ChAadOx1 nCoV-19 vaccination led to enhanced IFN-γ production (15 DAV) and an increase in activated T CD4+ naïve cells in noCOVID-19 individuals in contrast with COVID-19 individuals. Hence, our data support that hybrid immunity triggered by ChAadOx1 nCoV-19 vaccination is associated with enhanced humoral response, together with a balanced cellular response.

Children's Perspectives on Using Serious Games as a Complement to Promoting Their Social-Emotional Skills.

The use of serious games may be an appealing and complementary way to motivate curriculum-based social and emotional learning (SEL); still, investigation into this potential usefulness is scarce. This study aims to address the usefulness of serious games within the program 'Me and Us of Emotions'. Specifically, we analyzed the differences in children's satisfaction in sessions that did or did not use serious games as a complement to the intervention, explored the contribution of using serious games to the global satisfaction with the program, and explored children's qualitative feedback regarding the sessions. The participants were 232 children (122 boys and 110 girls) aged between 8 and 12 years old (M = 9.09, SD = 0.80). The measures were based on the subjective appraisals of the sessions made by the participating children, including quantitative and qualitative assessments of the degree of satisfaction of the participants. The results showed that there were similar levels of satisfaction with the sessions that did or did not use serious games as a complement to the program. However, only satisfaction with the sessions that used serious games (and not satisfaction with the sessions that did not use them) contributed significantly to explaining both the enjoyment of the activities and the interest in the subjects. Satisfaction with serious games was significantly and positively associated with fun, easiness, ability to understand the session, and ability to cope with emotions. Qualitative analysis showed three main themes, namely: positive aspects, negative aspects, and opportunities for improvement of the program. Overall, these results indicate that children's satisfaction with the 'Me and Us of Emotions' program is related to serious games, suggesting the relevance of using this complementary tool more often when intervening with younger generations.