Assessment of dosimetric sensitivity enhancement of xylenol orange Fricke gel by AuNPs: optical and MR imaging investigation.

Metallic nanoparticles, such as gold (Au, Z = 79) and silver (Ag, Z = 47) nanoparticles (AuNPs and AgNPs, respectively), possess strong surface plasmonic resonance (SPR) and high atomic number, which makes them ideal candidates for enhancing dosimeter sensitivity. In this study, we have inserted different mass percentages (from 0 to 0.015 wt%) of AuNPs into a gelatinous Fricke-xylenol-orange (FXO-f) gel matrix and irradiated it with doses ranging from 2 to 32 Gy, using a source of x-ray of low energy with an effective energy of 42 keV. Optical absorption increased significantly; sensitivity gains of up to 50% were achieved for the FXO-f gel matrix containing 0.011 wt% AuNPs. To elucidate the mechanism underlying this increased sensitivity, we also evaluated FXO-f gel matrixes containing AgNPs. AgNPs insertion into the FXO-f gel matrix did not enhance sensitivity, which suggested that the AgNPs plasmonic absorption band and the FXO-f gel matrix absorption band at 441 nm overlapped, to increase absorption even after the gel matrix was irradiated. To visualize the dose distribution, we recorded optical tomography and acquired 3D reconstruction maps. In addition, we analyzed the dose enhancement factor (DEF) by using magnetic resonance images. AuNPs insertion into the FXO-f gel matrix resulted in a DEF gain of 1.37, associated with the photoelectric effect originating from the increased number of free radicals.

Vulnerable newborn types: analysis of subnational, population-based birth cohorts for 541 285 live births in 23 countries, 2000-2021.

OBJECTIVE: To examine prevalence of novel newborn types among 541 285 live births in 23 countries from 2000 to 2021. DESIGN: Descriptive multi-country secondary data analysis. SETTING: Subnational, population-based birth cohort studies (n = 45) in 23 low- and middle-income countries (LMICs) spanning 2000-2021. POPULATION: Liveborn infants. METHODS: Subnational, population-based studies with high-quality birth outcome data from LMICs were invited to join the Vulnerable Newborn Measurement Collaboration. We defined distinct newborn types using gestational age (preterm [PT], term [T]), birthweight for gestational age using INTERGROWTH-21st standards (small for gestational age [SGA], appropriate for gestational age [AGA] or large for gestational age [LGA]), and birthweight (low birthweight, LBW [<2500 g], nonLBW) as ten types (using all three outcomes), six types (by excluding the birthweight categorisation), and four types (by collapsing the AGA and LGA categories). We defined small types as those with at least one classification of LBW, PT or SGA. We presented study characteristics, participant characteristics, data missingness, and prevalence of newborn types by region and study. RESULTS: Among 541 285 live births, 476 939 (88.1%) had non-missing and plausible values for gestational age, birthweight and sex required to construct the newborn types. The median prevalences of ten types across studies were T+AGA+nonLBW (58.0%), T+LGA+nonLBW (3.3%), T+AGA+LBW (0.5%), T+SGA+nonLBW (14.2%), T+SGA+LBW (7.1%), PT+LGA+nonLBW (1.6%), PT+LGA+LBW (0.2%), PT+AGA+nonLBW (3.7%), PT+AGA+LBW (3.6%) and PT+SGA+LBW (1.0%). The median prevalence of small types (six types, 37.6%) varied across studies and within regions and was higher in Southern Asia (52.4%) than in Sub-Saharan Africa (34.9%). CONCLUSIONS: Further investigation is needed to describe the mortality risks associated with newborn types and understand the implications of this framework for local targeting of interventions to prevent adverse pregnancy outcomes in LMICs.

Does the presence of third molars during sagittal split mandibular ramus osteotomy favour complications? Systematic review and meta-analysis.

The aim of this systematic review and meta-analysis was to assess whether the presence of inferior third molars during sagittal split mandibular ramus osteotomy increases the risk of intraoperative and postoperative complications. The PRISMA protocol was followed in this study, and the review was registered in the PROSPERO database (CRD42020147642). A search was conducted in the MEDLINE (PubMed), Web of Science, Cochrane Central, and Scopus databases on November 1, 2021. Nineteen articles were included, and the variables analysed were unfavourable fractures, infection, neurosensory disturbance, removal of osteosynthesis material, and duration of surgery. Meta-analyses were performed for the variables unfavourable fractures (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.58-1.57, P = 0.84), infection (RR 0.75, 95% CI 0.48-1.18, P = 0.21), and neurosensory disturbance (RR 1.55, 95% CI 0.61-3.91, P = 0.35); no statistically significant difference in the risk of these variables was found between the groups with and without third molars. The third molars did not increase the need to remove fixation material, but increased the surgery time. The presence of the third molar during sagittal split mandibular ramus osteotomy appears not to increase the risk of intraoperative and postoperative complications. The results presented here must be interpreted with caution due to the heterogeneity presented by the observational studies included.

Woody species distribution across a savanna-dry forest soil gradient in the Brazilian Cerrado / Distribuição de espécies arbóreas em gradiente de solo savana-floresta seca no Cerrado brasileiro

Although richness and distribution of woody species in the Cerrado physiognomies have been extensively studied, the shifts of woody species from savanna physiognomies to dry forests have not yet been addressed. Here, we investigate the effect of soil physical-chemical traits on the woody species turnover between adjacent cerrado stricto sensu and dry forest physiognomies. Woody species were surveyed, and soil and topographic variables measured, in 30 10×40 m plots systematically distributed, with 15 plots in each physiognomy. We found a spatially structured distribution of woody species, and differences of soil traits between cerrado stricto sensu and dry forest areas, mainly related to the aluminum saturation, base saturation, and available phosphorus. Aluminum saturation increased toward the savanna area, while base saturation increased toward the dry forest. Most woody species predominated in one physiognomy, such as Callisthene major in the cerrado stricto sensu and Anadenanthera colubrina in the dry forest. Only 20% of the species were widely distributed across both physiognomies or, not often, restricted to the intermediary values of the soil gradient. General results indicate that contrasting soil traits between cerrado stricto sensu and dry forest produce a strongly spatially organized and sharp transition in terms of species distribution between these physiognomies.

Embora a distribuição e a riqueza em espécies arbóreas nas fitofisionomias do Cerrado venham sendo bastante estudadas, a transição entre savanas e florestas deciduais ainda não foi abordada. Investigamos o efeito de características físico-químicas do solo sobre a distribuição de espécies arbóreas em região de contato entre cerrado sentido restrito e floresta estacional decidual (FED). As espécies arbóreas foram amostradas sistematicamente, e variáveis de topografia e características do solo foram medidas em 30 parcelas de 10×40 m, sendo 15 parcelas em cada fisionomia. A distribuição das espécies arbóreas foi espacialmente estruturada, e as características do solo diferiram entre as áreas de cerrado sentido restrito e FED, principalmente relacionadas à saturação de alumínio, saturação de bases e teores de fósforo. A saturação de alumínio aumentou em direção ao cerrado sentido restrito, enquanto a saturação de bases aumentou em direção à FED. A maioria das espécies arbóreas predominou em uma das fisionomias, como Callisthene major em cerrado sentido restrito e Anadenanthera colubrina em FED. Apenas 20% das espécies foram amplamente distribuídas em ambas as fisionomias ou, em poucos casos, restritas aos valores intermediários do gradiente de solo. Os resultados indicam um forte contraste de características do solo entre o cerrado sentido restrito e a FED, assim como uma transição acentuada e espacialmente organizada quanto à distribuição de espécies arbóreas.

Woody species distribution across a savanna-dry forest soil gradient in the Brazilian Cerrado

Abstract Although richness and distribution of woody species in the Cerrado physiognomies have been extensively studied, the shifts of woody species from savanna physiognomies to dry forests have not yet been addressed. Here, we investigate the effect of soil physical-chemical traits on the woody species turnover between adjacent cerrado stricto sensu and dry forest physiognomies. Woody species were surveyed, and soil and topographic variables measured, in 30 10×40 m plots systematically distributed, with 15 plots in each physiognomy. We found a spatially structured distribution of woody species, and differences of soil traits between cerrado stricto sensu and dry forest areas, mainly related to the aluminum saturation, base saturation, and available phosphorus. Aluminum saturation increased toward the savanna area, while base saturation increased toward the dry forest. Most woody species predominated in one physiognomy, such as Callisthene major in the cerrado stricto sensu and Anadenanthera colubrina in the dry forest. Only 20% of the species were widely distributed across both physiognomies or, not often, restricted to the intermediary values of the soil gradient. General results indicate that contrasting soil traits between cerrado stricto sensu and dry forest produce a strongly spatially organized and sharp transition in terms of species distribution between these physiognomies.

Resumo Embora a distribuição e a riqueza em espécies arbóreas nas fitofisionomias do Cerrado venham sendo bastante estudadas, a transição entre savanas e florestas deciduais ainda não foi abordada. Investigamos o efeito de características físico-químicas do solo sobre a distribuição de espécies arbóreas em região de contato entre cerrado sentido restrito e floresta estacional decidual (FED). As espécies arbóreas foram amostradas sistematicamente, e variáveis de topografia e características do solo foram medidas em 30 parcelas de 10×40 m, sendo 15 parcelas em cada fisionomia. A distribuição das espécies arbóreas foi espacialmente estruturada, e as características do solo diferiram entre as áreas de cerrado sentido restrito e FED, principalmente relacionadas à saturação de alumínio, saturação de bases e teores de fósforo. A saturação de alumínio aumentou em direção ao cerrado sentido restrito, enquanto a saturação de bases aumentou em direção à FED. A maioria das espécies arbóreas predominou em uma das fisionomias, como Callisthene major em cerrado sentido restrito e Anadenanthera colubrina em FED. Apenas 20% das espécies foram amplamente distribuídas em ambas as fisionomias ou, em poucos casos, restritas aos valores intermediários do gradiente de solo. Os resultados indicam um forte contraste de características do solo entre o cerrado sentido restrito e a FED, assim como uma transição acentuada e espacialmente organizada quanto à distribuição de espécies arbóreas.

Woody species distribution across a savanna-dry forest soil gradient in the Brazilian Cerrado / Distribuição de espécies arbóreas em gradiente de solo savana-floresta seca no Cerrado brasileiro

Abstract Although richness and distribution of woody species in the Cerrado physiognomies have been extensively studied, the shifts of woody species from savanna physiognomies to dry forests have not yet been addressed. Here, we investigate the effect of soil physical-chemical traits on the woody species turnover between adjacent cerrado stricto sensu and dry forest physiognomies. Woody species were surveyed, and soil and topographic variables measured, in 30 10×40 m plots systematically distributed, with 15 plots in each physiognomy. We found a spatially structured distribution of woody species, and differences of soil traits between cerrado stricto sensu and dry forest areas, mainly related to the aluminum saturation, base saturation, and available phosphorus. Aluminum saturation increased toward the savanna area, while base saturation increased toward the dry forest. Most woody species predominated in one physiognomy, such as Callisthene major in the cerrado stricto sensu and Anadenanthera colubrina in the dry forest. Only 20% of the species were widely distributed across both physiognomies or, not often, restricted to the intermediary values of the soil gradient. General results indicate that contrasting soil traits between cerrado stricto sensu and dry forest produce a strongly spatially organized and sharp transition in terms of species distribution between these physiognomies.

Resumo Embora a distribuição e a riqueza em espécies arbóreas nas fitofisionomias do Cerrado venham sendo bastante estudadas, a transição entre savanas e florestas deciduais ainda não foi abordada. Investigamos o efeito de características físico-químicas do solo sobre a distribuição de espécies arbóreas em região de contato entre cerrado sentido restrito e floresta estacional decidual (FED). As espécies arbóreas foram amostradas sistematicamente, e variáveis de topografia e características do solo foram medidas em 30 parcelas de 10×40 m, sendo 15 parcelas em cada fisionomia. A distribuição das espécies arbóreas foi espacialmente estruturada, e as características do solo diferiram entre as áreas de cerrado sentido restrito e FED, principalmente relacionadas à saturação de alumínio, saturação de bases e teores de fósforo. A saturação de alumínio aumentou em direção ao cerrado sentido restrito, enquanto a saturação de bases aumentou em direção à FED. A maioria das espécies arbóreas predominou em uma das fisionomias, como Callisthene major em cerrado sentido restrito e Anadenanthera colubrina em FED. Apenas 20% das espécies foram amplamente distribuídas em ambas as fisionomias ou, em poucos casos, restritas aos valores intermediários do gradiente de solo. Os resultados indicam um forte contraste de características do solo entre o cerrado sentido restrito e a FED, assim como uma transição acentuada e espacialmente organizada quanto à distribuição de espécies arbóreas.

Recycling nutrients in the beef supply chain through circular manuresheds: Data to assess tradeoffs.

Nutrient circularity can help supply chain participants meet sustainability targets. Across the segmented beef supply chain, opportunity exists to reinforce and introduce nutrient circularity by recycling surplus manure nutrients from cattle feedlots to lands where cattle feed is produced. We describe four datasets developed to evaluate options in U.S. and Canadian beef systems. The datasets delineate three "circular manuresheds," each encompassing a hay-grazing landscape where beef cattle are raised on grazingland and supplemented with hay grown nearby, and the distant feedlots where those cattle produce manure nutrients for potential import back to the hayfields. We selected the hay-grazing landscapes of New Mexico, USA; Florida, USA; and western Canada (Manitoba, Saskatchewan, Alberta, British Columbia) because of their significant grazingland production and potential to substitute feedlot manure for commercial fertilizer on hayfields. In each circular manureshed, the manure nutrients from major feedlot destinations could supply a considerable proportion of the P used by hay for grazing cattle: 34% of the P requirements in New Mexico, 36% in Florida, and 6% in western Canada. The average distance to return the resource was 647 km for New Mexico, 1,884 km for Florida, and 1,587 km for western Canada. These magnitudes and distances suggest that the New Mexico circular manureshed may be the most economically viable in the current agri-food system, but this reflects only part of a greater, multi-factor assessment of tradeoffs. The circular manureshed concept provides a platform for simultaneous consideration of competing factors for sustainability via circularity.

Nutrient circularity can help animal supply chain participants meet sustainability goals. The manureshed concept can help willing consortia operationalize nutrient circularity. Data delineate three circular manuresheds where feedlot manure is recycled onto hayfields in landscapes where feedlot cattle originated. Available nutrients and transport distances for the three circular manuresheds are calculated. These findings can inform a comprehensive assessment of tradeoffs of circular manureshed management.

P-FLUX: A phosphorus budget dataset spanning diverse agricultural production systems in the United States and Canada.

Quantifying spatial and temporal fluxes of phosphorus (P) within and among agricultural production systems is critical for sustaining agricultural production while minimizing environmental impacts. To better understand P fluxes in agricultural landscapes, P-FLUX, a detailed and harmonized dataset of P inputs, outputs, and budgets, as well as estimated uncertainties for each P flux and budget, was developed. Data were collected from 24 research sites and 61 production systems through the Long-term Agroecosystem Research (LTAR) network and partner organizations spanning 22 U.S. states and 2 Canadian provinces. The objectives of this paper are to (a) present and provide a description of the P-FLUX dataset, (b) provide summary analyses of the agricultural production systems included in the dataset and the variability in P inputs and outputs across systems, and (c) provide details for accessing the dataset, dataset limitations, and an example of future use. P-FLUX includes information on select site characteristics (area, soil series), crop rotation, P inputs (P application rate, source, timing, placement, P in irrigation water, atmospheric deposition), P outputs (crop removal, hydrologic losses), P budgets (agronomic budget, overall budget), uncertainties associated with each flux and budget, and data sources. Phosphorus fluxes and budgets vary across agricultural production systems and are useful resources to improve P use efficiency and develop management strategies to mitigate environmental impacts of agricultural systems. P-FLUX is available for download through the USDA Ag Data Commons (https://doi.org/10.15482/USDA.ADC/1523365).

Oral Health in the Population Assessment of Tobacco and Health Study.

Tobacco use is a well-established risk factor for multiple adverse oral conditions. Few nationally representative oral health data sets encompass the current diversity of tobacco and nicotine products. This investigation examines the validity of oral health measures in the Population Assessment of Tobacco and Health (PATH) Study to assess relationships between tobacco use and oral health. Cross-sectional data from PATH Study wave 4 (N = 33,643 US adults, collected 2016-2018) were used to obtain estimates for 6 self-reported oral conditions (e.g., bone loss around teeth, tooth extractions) and compared with analogous estimates from the National Health and Nutrition Examination Survey (NHANES) cycle 2017-2018 (N = 5,856). Within the PATH Study, associations were calculated between tobacco use status and lifetime and past 12-mo experience of adverse oral conditions using survey-weighted multivariable logistic regression. Nationally representative estimates of oral conditions between the PATH Study and NHANES were similar (e.g., ever-experience of bone loss around teeth: PATH Study 15.2%, 95% CI, 14.4%-15.9%; NHANES 16.6%, 95% CI, 14.9%-18.4%). In the PATH Study, combustible tobacco smoking was consistently associated with lifetime and past 12-mo experience of adverse oral health (e.g., exclusive cigarette smoking vs. never tobacco use, adjusted odds ratio [AOR] for loose teeth in past 12 mo: 2.02; 95% CI, 1.52-2.69). Exclusive smokeless tobacco use was associated with greater odds of loose teeth (AOR, 1.93; 95% CI, 1.15-3.26) and lifetime precancerous lesions (AOR, 3.85; 95% CI, 1.73-8.57). Use of other noncigarette products (e.g., pipes) was inconsistently associated with oral health outcomes. PATH Study oral health measures closely align with self-reported measures from NHANES and are internally concurrent. Observed associations with tobacco use and the ability to examine emerging tobacco products support application of PATH Study data in dental research, particularly to examine potential oral health effects of novel tobacco products and longitudinal changes in tobacco use behaviors.

miRNA-205-5p can be related to T2-polarity in Chronic Rhinosinusitis with Nasal Polyps.

BACKGROUND: microRNAs (miRNAs) are directly associated with inflammatory response, but their direct role in CRSwNP (chronic rhinosinusitis with nasal polyps) remains evasive. This study aimed to compare the expression of several miRNAs in tissue samples obtained from patients with CRSwNP and controls and to evaluate if miRNAs correlate to a specific inflammatory pattern (T1, T2, T17, and Treg) or intensity of symptoms in CRSwNP. METHODS: nasal polyps (from patients with CRSwNP - n=36) and middle turbinate mucosa (from control patients - n=41) were collected. Microarray determined human mature miRNA expression, and the results obtained were validated by qPCR. miRNAs that were differentially expressed were then correlated to cytokine proteins (by Luminex), tissue eosinophilia, and SNOT-22. RESULTS: After microarray and qPCR analyses, six microRNAs were up-regulated in CRSwNP samples when compared with controls: miR-205-5p, miR-221-3p, miR-222-3p, miR-378a-3p, miR-449a and miR-449b-5p. All these miRNAs are directly implicated with cell cycle regulation and apoptosis, and to a minor extent, with inflammation. Importantly, miR-205-5p showed a significantly positive correlation with IL-5 concentration and eosinophil count at the tissue and with the worst SNOT-22 score. CONCLUSIONS: miRNA 205-5p was increased in CRSwNP compared to controls, and it was especially expressed in CRSwNP patients with higher T2 inflammation (measured by both IL-5 levels and local eosinophilia) and worst clinical presentation. This miRNA may be an interesting target to be explored in patients with CRSwNP.

Agonistic Behavior Is Affected by Memory in the Dusky Damselfish Stegastes fuscus.

The ability to discriminate familiar from unfamiliar conspecifics has been demonstrated in several species of fish. Agonistic interactions are among the most frequent behaviors exhibited by territorial species and could offer useful information for the individual recognition process. In agonistic situations, memory may modulate the behavioral response and affect social dynamics, but few studies have explored the memory retention acquired during aggressive encounters. The present study investigated the memory retention of an agonistic encounter in the dusky damselfish Stegastes fuscus. The experimental procedure was divided into three parts: (1) Familiarization; (2) Recognition test; and (3) Memory test. During the familiarization phase, the fish were visually exposed to the same conspecific for 5 days (10 min per day) and the behavior was recorded. On the following day (conspecific recognition test), half of the animals were paired with the same conspecific and the other half with a different conspecific for 10 min, and the behavior was recorded. The fish were retested 5, 10, and 15 days after the test to evaluate memory retention. In the memory test, they were exposed to the same conspecific as before or to a different conspecific. We found that the damselfish reduced their agonistic displays when the stimulus fish was familiar, but when it was unfamiliar, the animals were more aggressive and only reduced their mnemonic response after 10 days. These results suggest that the recognition ability of damselfish can be affected by time and that it modulates agonistic response.

Avaliação da ação germicida da luz ultravioleta de cabine de segurança biológica frente às espécies bacterianas / Evaluation of the germicidal action of ultraviolet light in biosafety cabinet concerning bacterial species

RESUMO: Introdução: A cabine de segurança biológica (CBS) é um equipamento de proteção coletiva, utilizado para efe-tuar a contenção de aerossóis produzidos nos procedimentos laboratoriais. A CBS protege tanto os trabalhadores, quanto o material manipulado e o meio ambiente. Dispõe de lâmpadas de luz ultravioleta (UV) que possui ação germicida, alterando os ácidos nucleicos dos micro-organismos. Objetivo: O objetivo do presente estudo foi avaliar a ação germicida da luz UV da CBS classe II, tipo A2, frente à cultura de duas espécies de bactérias com diferentes condições de exposição a luz UV. Material e Métodos: Para o desenvolvimento da pesquisa foram utilizadas as bactérias Staphylococcus aureus ATCC 25923 e Klebsiella pneumoniae ATCC 10031, na concentração de 1,5x108 Unidades Formadoras de Colônias/ml (UFC/ml), que após a semeadura em biplacas de Petri foram expostas à luz UV em diferentes condições e tempos. Resultados: Os resultados obtidos revelaram que as espécies de bactérias apresentaram igual perfil de crescimento ou inibição quando submetidas às diferentes condições de exposição. As biplacas de Petri com as tampas abertas e protegidas ou não com embalagem de esterilização apresentaram, nos tempos 15 e 20 minutos, inibição bacteriana. Nas biplacas protegidas pelo papel alumínio e nas biplacas com a tampa fechada, independentemente do tempo e da condição, os micro-organismos apresentaram crescimento bacteriano. Conclusão: Com os resultados obtidos, sugere-se que a ação germicida da luz UV foi eficaz, garantindo a descontaminação adequada e assegurando a qualidade na biossegurança laboratoria. (AU)

ABSTRACT: Introduction: The biological safety cabinet (BSC) is a collective protective device used to hold aerosols produced in laboratory procedures. The BSC protects workers, material handling, and the environment. It relies on ultraviolet light (UV) lamps that have germicidal action, altering the nucleic acids of microorganisms. Objective: The objective of the present study was to evaluate the germicidal action of BSC class II type A2 UV light against the culture of two bacterial species with different conditions of exposure to UV light. Methods: For the research, the bacteria Sta-phylococcus aureus ATCC 25923 and Klebsiella pneumoniae ATCC 10031 were used, at a concentration of 1.5x108Colony Forming Units/ml (CFU/ml), which were seeded in Petri biplates. Use UV light under different conditions and times. Results: The bacterial species showed the same growth or inhibition profile when subjected to different exposure conditions. Petri dishes with the cover open and protected or not with sterilization packaging showed bacterial inhibition at 15 and 20 minutes. The microorganisms in the biplates protected by the aluminum foil and in the biplates with the cover on, regardless of the time and condition, showed bacterial growth. Conclusion: With the results obtained, it is suggested that the germicidal action of UV light was effective, ensuring adequate decon-tamination and ensuring quality in laboratory biosafety. (AU)

Woody species distribution across a savanna-dry forest soil gradient in the Brazilian Cerrado.

Although richness and distribution of woody species in the Cerrado physiognomies have been extensively studied, the shifts of woody species from savanna physiognomies to dry forests have not yet been addressed. Here, we investigate the effect of soil physical-chemical traits on the woody species turnover between adjacent cerrado stricto sensu and dry forest physiognomies. Woody species were surveyed, and soil and topographic variables measured, in 30 10×40 m plots systematically distributed, with 15 plots in each physiognomy. We found a spatially structured distribution of woody species, and differences of soil traits between cerrado stricto sensu and dry forest areas, mainly related to the aluminum saturation, base saturation, and available phosphorus. Aluminum saturation increased toward the savanna area, while base saturation increased toward the dry forest. Most woody species predominated in one physiognomy, such as Callisthene major in the cerrado stricto sensu and Anadenanthera colubrina in the dry forest. Only 20% of the species were widely distributed across both physiognomies or, not often, restricted to the intermediary values of the soil gradient. General results indicate that contrasting soil traits between cerrado stricto sensu and dry forest produce a strongly spatially organized and sharp transition in terms of species distribution between these physiognomies.

Cross Disciplinary Role Agreement is Needed When Coordinating Long-Term Opioid Prescribing for Cancer: a Qualitative Study.

BACKGROUND: Cancer pain is highly prevalent and often managed in primary care or by oncology providers in combination with primary care providers. OBJECTIVES: To understand interdisciplinary provider experiences coordinating opioid pain management for patients with chronic cancer-related pain in a large integrated healthcare system. DESIGN: Qualitative research. PARTICIPANTS: We conducted 20 semi-structured interviews with interdisciplinary providers in two large academically affiliated VA Medical Centers and their associated community-based outpatient clinics. Participants included primary care providers (PCPs) and oncology-based personnel (OBPs). APPROACH: We deductively identified 94 examples of care coordination for cancer pain in the 20 interviews. We secondarily used an inductive open coding approach and identified themes through constant comparison coming to research team consensus. RESULTS: Theme 1: PCPs and OBPs generally believed one provider should handle all opioid prescribing for a specific patient, but did not always agree on who that prescriber should be in the context of cancer pain. Theme 2: There are special circumstances where having multiple prescribers is appropriate (e.g., a pain crisis). Theme 3: A collaborative process to opioid cancer pain management would include real-time communication and negotiation between PCPs and oncology around who will handle opioid prescribing. Theme 4: Providers identified multiple barriers in coordinating cancer pain management across disciplines. CONCLUSIONS: Our findings highlight how real-time negotiation about roles in opioid pain management is needed between interdisciplinary clinicians. Lack of cross-disciplinary role agreement may result in delays in clinically appropriate cancer pain management.

Incidence and profile of benign epithelial tumors of salivary glands from a single center in Northeast of Brazil.

BACKGROUND: Benign tumors of the salivary glands are a group of lesions with varied histopathological and clinical spectrum. The aim was to determine the incidence and clinicopathological characteristics of benign salivary gland neoplasms diagnosed between 2007 and 2016 in a single center located in northeastern Brazil. MATERIAL AND METHODS: Records regarding sex, age, anatomical location, histopathological subtype and treatment were retrieved, and data were analyzed using the Stata/IC software (version 12.0). RESULTS: There were above 7,100 cases of neoplasms in the head and neck region, of which 403 corresponded to salivary gland neoplasms. Of these, 238 (59%) were benign, being pleomorphic adenoma (PA) the most frequent neoplasm (n=178; 74.8%), followed by Warthin's tumor (WT) (n=23; 9.7%). Overall, most cases occurred in females (n=136; 57.1%) and age ranged from 11 to 83 years. The parotid gland (n=188; 79%) was the most common anatomical site, and all patients were treated by surgical excision. Of the cases diagnosed as PA, malignant transformation to carcinoma ex-pleomorphic adenoma (CAEXPA) occurred in 7 (3.9%) cases. CONCLUSIONS: The present study confirmed the clinical and demographic profile of benign salivary gland neoplasms, which contributes to the continuous knowledge of current data about these lesions.

Biomechanical analysis in mandibular advancement and occlusal plane rotation with finite element analysis.

We used finite element analysis to assess stress on the cortical bone and plate fixation system, as well as mandibular resistance after sagittal split ramus osteotomy with different mandibular advancements and rotations of the occlusal plane. Three-dimensional mandibular models were obtained, and 6mm and 12mm advancements were planned associated with linear, clockwise, and counter-clockwise rotation of the angle of the occlusal plane. Each model was then fixed with one or two 2.0mm system plates and secured with four monocortical screws. A total of 12 models were built and subjected to a vertical load in the lower central incisor ranging from 50N to 500N in 50N increments. Results showed that the 12mm advancement was associated with higher stress on the bone and plate surface. Additionally, the models fixed with two plates exhibited lower plate stress than those fixed with a single plate. Counter-clockwise rotation of the angle of the mandibular plane in the 6mm advancement caused more plate stress, which did not occur in the 12mm advancement. This analysis has shown that change in the occlusal plane in large mandibular advancements does not act as an additional stress factor. These findings can help to better understand the tensions on bone and plate surfaces in patients who need large mandibular advancements that are associated with a change in the occlusal plane, and will aid better surgical planning.

Pontine Myelinolysis Caused by Hypovolemic Hypernatremia.

Introduction. Central pontine myelinolysis is characterized by the occurrence of acute demyelinating lesions of cells in the pons secondary to abrupt oscillations of serum osmolarity. Its exact incidence is not well defined, but studies show a prevalence of 0.25 to 0.5% in the general population, 2.5% in the intensive care unit, and up to 10% in patients with risk factors, such as chronic liver disease and hepatic transplantation, alcoholism, malnutrition, diuretic therapy, electrolyte imbalance, hypoglycemia, and hyperglycemia. Case Report. A 70-year-old white female with extranodal diffuse large B-cell non-Hodgkin's lymphoma (extensive mass on the left anterior chest wall), stage IVA, developed pontine myelinolysis secondary to hypovolemic acute hypernatremia, which occurred due to diarrhea caused by chemotherapy (rituximab, cyclophosphamide, doxorubicin, and vincristine). Discussion. Pontine myelinolysis occurs most often due to the rapid correction of chronic hyponatremia. But here, we describe a case of the disease secondary to the occurrence of hypovolemic acute hypernatremia in a patient with a hematological malignancy under treatment, who was on chronic treatment with thiazide diuretics and who presented with other electrolyte disturbances as risk factors for the development of pontine myelinolysis.

Difficulty in detecting low levels of polymyxin resistance in clinical Klebsiella pneumoniae isolates: evaluation of Rapid Polymyxin NP test, Colispot Test and SuperPolymyxin medium.

Polymyxins are important therapeutic options for treating infections, mainly those caused by carbapenem-resistant Klebsiella pneumoniae. Specific chemical characteristics of polymyxins make it difficult to perform antimicrobial susceptibility testing, especially within the clinical laboratory. Here we aimed to evaluate the performance of three phenotypic methods: Rapid NP Polymyxin Test, ColiSpot test and the SuperPolymyxin medium. To accomplish this, 170 non-duplicate clinical K. pneumoniae isolates were analysed (123 colistin-resistant and 47 susceptible). The sensitivity and specificity obtained for Rapid Polymyxin NP Test, Colispot and SuperPolymyxin medium were, respectively, 90% and 94%, 74% and 100%, and 82% and 85%. Very major errors occurred more frequently in low-level colistin-resistant isolates (MICs 4 and 8 µg/mL). Rapid Polymyxin NP proved to be a method capable of identifying colistin-resistant strains in acceptable categorical agreement. However, major errors and very major errors of this method were considered unacceptable for colistin-resistance screening. Although the Colispot test is promising and easy to perform and interpret, the results did not reproduce well in the isolates tested. The colistin-containing selective medium (SuperPolymyxin) showed limitations, including quantification of mucoid colonies and poor stability. Nevertheless, Colispot and SuperPolymyxin medium methods did not present acceptable sensitivity, specificity and categorical agreement. It is essential to use analytical tools that faithfully reproduce bacterial resistance in vitro, especially in last-line drugs, such as polymyxins, when misinterpretation of a test can result in therapeutic ineffectiveness.

Oral resveratrol supplementation improves Metabolic Syndrome features in obese patients submitted to a lifestyle-changing program.

AIMS: The aim of the present study was to evaluate the oral resveratrol effects associated with diet and physical training changes on anthropometric and biochemical parameters. MAIN METHODS: 25 individuals aged from 30 to 60 years old; with Body Mass Index (BMI) ≥ 30 kg/m2 were included in the study. Following the primary evaluation (anthropometric and clinical), the patients were randomly divided into 2 groups: (1) Placebo: Physical activity program + Diet + Placebo; (2) Resveratrol: Physical activity program + Diet + Resveratrol (RVS) (250 mg/day) for three months. Anthropometric and biochemical parameters were evaluated at baseline and after the treatment period. KEY FINDINGS: The main findings showed that the resveratrol supplementation improved total cholesterol (TC), High-density Lipoprotein cholesterol (HDL-c), Very-low density Lipoprotein cholesterol (VLDL-c), urea, creatinine and albumin serum levels. SIGNIFICANCE: These findings indicate that this polyphenol may be an option to potentiate the beneficial effects induced by dietary and physical activity programs in the Metabolic Syndrome (MetS) treatment.