Nutritional, chemical and functional potential of Inga laurina (Fabaceae): A barely used edible species.

Inga laurina is a plant species which produces edible fruits, and until now there is little information available concerning its nutritional, chemical and bioactive composition. In this study, we evaluated for the first time the proximate composition and mineral contents in its fruit (peel, pulp and seed), that is the traditionally consumed part. The seeds obtained the highest protein (19.52 g/100 g), carbohydrate (22.5 g/100 g) and mineral contents, mainly Cu, Cr, P, Mn, Se and Zn. The peel and pulp were excellent sources of fiber (4.5 and 11.05 g/100 g) as well as mineral content, with Cr and Cu standing out in the pulp. This study is notably the first to provide a detailed assessment of the nutritional compositions of traditionally consumed and not consumed parts of this fruit. Sensory analysis of the pulp was also performed, which indicated good acceptance. The antioxidant properties were characterized in the fruit, peels and leaves. The ABTS test showed that leaf supernatant hydroethanolic crude extract (EC50 = 2.70 µg/mL) and its corresponding ethyl acetate (EC50 = 1.68 µg/mL) and butanol (EC50 = 2.48 µg/mL) partitions presented higher antioxidant potential compared to the control Ginkgo biloba (EC50 = 12.17 µg/mL). The most active precipitate extract regarding DPPH was from the peel (EC50 = 13.30 µg /mL) and the most active partition was the ethyl acetate (EC50 = 13.37 µg/mL), both with better activity compared to the control Ginkgo biloba (EC50 = 46.97 µg/mL). The ethyl acetate partition (EC50 = 13.45 µg/mL) and butanol partition (EC50 = 7.97 µg/mL) from the leaves showed the highest antioxidant capacity. Thus, extracts and partitions from the peels and leaves were studied from a phytochemical point of view due to presenting the best results for antioxidant capacity. The presence of phenolic compounds such as myricetin-3-O-rhamnopyranoside, myricetin-3-O-(2″-O-galloyl)-rhamnopyranoside and myricetin-3-O-(2″,4″-di-O-galloyl)-arabinopentoside-methyl ether were observed in the leaf crude extract and polar partitions, being reported for the first time in the Inga genus and Fabaceae family. Moreover, quercetin, quercetin-3-O-galatoctoside, quercetin-3-O-rhamnopyranoside, quercetin-3-O-(2″-O-galloyl)-rhamnoside, and quercetin tri-hexose were identified in the peel crude extract and ethyl acetate partition, in which the galloyl derivative of quercetin was identified for the first time in I. laurina fruit peels. GC-MS enabled separating and identifying substances such as palmitic and stearic acids, and ethyl oleate. It is possible to conclude that I. laurina pulp can be a supplementary food as a source of phenolic compounds, and the other organs of the plant (leaves and peel) are rich in flavonoids with great antioxidant capacity, making this species a promising source of antioxidants.

Transitioning from static to suspension culture system for large-scale production of xeno-free extracellular vesicles derived from mesenchymal stromal cells.

Extracellular vesicles (EVs) derived from mesenchymal stromal cells (MSCs) have shown increasing therapeutic potential in the last years. However, large production of EV is required for therapeutic purposes. Thereby, scaling up MSC cultivation in bioreactors is essential to allow culture parameters monitoring. In this study, we reported the establishment of a scalable bioprocess to produce MSC-EV in suspension cultures using spinner flasks and human collagen-coated microcarriers (3D culture system). We compared the EV production in this 3D culture system with the standard static culture using T-flasks (2D culture system). The EV produced in both systems were characterized and quantify by western blotting and nanoparticle tracking analysis. The presence of the typical protein markers CD9, CD63, and CD81 was confirmed by western blotting analyses for EV produced in both culture systems. The cell fold-increase was 5.7-fold for the 3D culture system and 4.6-fold for the 2D culture system, signifying a fold-change of 1.2 (calculated as the ratio of fold-increase 3D to fold-increase 2D). Furthermore, it should be noted that the total cell production in the spinner flask cultures was 4.8 times higher than that in T-flask cultures. The total cell production in the spinner flask cultures was 5.2-fold higher than that in T-flask cultures. While the EV specific production (particles/cell) in T-flask cultures (4.40 ± 1.21 × 108 particles/mL, p < 0.05) was higher compared to spinner flask cultures (2.10 ± 0.04 × 108 particles/mL, p < 0.05), the spinner flask culture system offers scalability, making it capable of producing enough MSC-EV at a large scale for clinical applications. Therefore, we concluded that 3D culture system evaluated here serves as an efficient transitional platform that enables the scaling up of MSC-EV production for therapeutic purposes by utilizing stirred tank bioreactors and maintaining xeno-free conditions.

Following the footsteps of Burmeister's leaf frog (Phyllomedusa burmeisteri) in the Atlantic forest of Brazil.

Amphibians are organisms which mainly have a biphasic life cycle. When at the larval stage, their habitat is generally aquatic, and when adults, they become terrestrial. Pond-breeding amphibians are sensitive to some disturbances in their environment which lead to the decline of a population. The interactions between the species and their environment are performed through movement. Movement ecology combines and explains the movement data of organisms with biotic and abiotic factors and because of this, knowing the movement of these creatures is of great ecological importance. We used the spool-and-line methodology in individuals of the treefrog Phyllomedusa burmeisteri, at the Reserva Ecologica Michelin, located in the southern region of Bahia in Brazil to study their movement patterns in different environments inside and outside of the forest. We monitored 19 P. burmeisteri individuals that presented a mean total movement distance of 2160.76 cm (S.D. 1152.42). We found no significant difference in the trajectories of individuals in forested and open areas, as well as a positive relationship between the distances individuals moved and their weight only in forested areas. no relationship between distance and weight of these individuals. We observed that individuals followed non-linear paths and the number of steps from one place to another varied among individuals. Our movement ecology data allows us to answer questions about short-term movement patterns of Phyllomedusa burmeisteri. This is the first step to start understanding the spatial cognition of treefrogs from the Atlantic Forest and to fill gaps about life habits of these frogs. Information on the movement patterns of a species, as well as its home range can help to create conservation strategies, regarding the creation or delimitation of protected areas, for example.

Potential performance of a 0 h/1 h algorithm and a single cut-off measure of high-sensitivity troponin T in a diverse population: main results of the IN-HOPE study.

AIMS: Chest pain is a major cause of medical evaluation at emergency department (ED) and demands observation to exclude the diagnosis of acute myocardial infarction (AMI). High-sensitivity cardiac troponin assays used as isolated measure and by 0- and 1-h algorithms are accepted as a rule-in/rule-out strategy, but there is a lack of validation in specific populations. METHODS AND RESULTS: The IN-HOspital Program to systematizE Chest Pain Protocol (IN-HOPE study) is a multicentre study that prospectively included patients admitted to the ED due to suspected symptoms of AMI at 16 sites in Brazil. Medical decisions of all patients followed the standard approach of 0 h/3 h protocol, but, in addition, blood samples were also collected at 0 and 1 h and sent to a central laboratory (core lab) to measure high-sensitivity cardiac troponin T (hs-cTnT). To assess the theoretical performance of 0 h/1 h algorithm, troponin < 12 ng/L with a delta < 3 was considered rule-out while a value ≥ 52 or a delta ≥ 5 was considered a rule-in criterion (the remaining were considered as observation group). The main objective of the study was to assess, in a population managed by the 0 h/3 h protocol, the accuracy of 0 h/1 h algorithm overall and in groups with a higher probability of AMI. All patients were followed up for 30 days, and potential events were adjudicated. In addition to the prospective cohort, a retrospective analysis was performed assessing all patients with hs-cTnT measured during the year of 2021 but not included in the prospective cohort, regardless of the indication of the test. A total of 5.497 patients were included (583 in the prospective and 4.914 in the retrospective analysis). The prospective cohort had a mean age of 57.3 (± 14.8) and 45.6% of females with a mean HEART score of 4.0 ± 2.2. By the core lab analysis, 74.4% would be eligible for a rule-out approach (45.3% of them with a HEART score > 3) while 7.3% would fit the rule-in criteria. In this rule-out group, the negative predictive value for index AMI was 100% (99.1-100) overall and regardless of clinical scores. At 30 days, no death or AMI occurred in the rule-out group of both 0/1 and 0/3 h algorithms while 52.4% of the patients in the rule-in group (0 h/1 h) were considered as AMI by adjudication. In the observation group (grey zone) of 0 h/1 h algorithm, GRACE discriminated the risk of these patients better than HEART score. In the retrospective analysis, 1.091 patients had a troponin value of <5 ng/L and there were no cardiovascular deaths at 30 days in this group. Among all 4.914 patients, the 30-day risk of AMI or cardiovascular death increased according to the level of troponin: 0% in the group < 5 ng/L, 0.6% between 5 and 14 ng/L, 2.2% between 14 and 42 ng/L, 6.3% between 42 and 90 ng/L, and 7.7% in the level ≥ 90 ng/L. CONCLUSION: In this large multicentre study, a 0 h/1 h algorithm had the potential to classify as rule-in or rule-out in almost 80% of the patients. The rule-out protocol had high negative predictive value regardless of clinical risk scores. Categories of levels of hs-cTn T also showed good accuracy in discriminating risk of the patients with a very favourable prognosis for cardiovascular death in the group with value < 5 ng/L. CLINICALTRIALS.GOV: NCT04756362.

Potential performance of a 0 h/1 h algorithm and a single cut-off measure of high-sensitivity troponin T in a diverse population: main results of the IN-HOPE study

BACKGROUND: Chest pain is a major cause of medical evaluation at emergency department (ED) and demands observation to exclude the diagnosis of acute myocardial infarction (AMI). High-sensitivity cardiac troponin assays used as isolated measure and by 0 h and 1 h algorithms are accepted as a rule-in/rule-out strategy but there is a lack of validation in specific populations. METHODS: The IN-HOspital Program to systematizE chest pain protocol (In Hope study) is a multicentre study that prospectively included patients admitted to the ED due to suspected symptoms of AMI at 16 sites in Brazil. Medical decisions of all patients followed the standard approach of 0/3-h protocol but, in addition, blood samples were also collected at 0 and 1 hour and sent to a central laboratory (core lab) to measure high-sensitivity troponin T (hs-cTnT). To assess the theoretical performance of 0/1-h algorithm, troponin < 12 ng/L with a delta <--- 3 was considered rule out while a value ≥ 52 and/or a delta ≥ 5 was considered a rule in criteria (the remaining were considered as observation group). The main objective of the study was to assess, in a population managed by the 0/3-h protocol, the accuracy of 0/1-h algorithm overall and in groups with higher probability of AMI. All patients were followed for 30 days, and potential events were adjudicated. In addition to the prospective cohort, a retrospective analysis was performed assessing all patients with hs-cTnT measured during the year of 2021 but not included in the prospective cohort, regardless the indication of the test. RESULTS: A total of 5.497 patients were included (583 in the prospective and 4.914 in the retrospective analysis). The prospective cohort had a mean age of 57.3 (± 14.8) and 45.6% of females with a mean HEART score of 4.0 ± 2.2. By the core lab analysis, 74.4% would be eligible for a rule-out approach (45.3% of HEART score > 3) while 7.3% would fit the rule-in criteria. In this rule-out group, the negative predictive value for index AMI was 100% (99.1-100) overall and regardless clinical scores. At 30 days, no death or AMI occurred in the rule-out group of both 0/1 and 0/3-hour while 52.4% of the patients in the rule-in group (0/1-hour) were considered as AMI by adjudication. In the observation group (grey zone) of 0/1- hour algorithm, GRACE discriminated the risk of these patients better than HEART score. In the retrospective analysis, 1.091 patients had a troponin value < 5 ng/L and there were no cardiovascular deaths at 30 days in this group. Among all 4.914 patients, the 30-day risk of AMI or cardiovascular death increased according to the level of troponin: 0% in the group < 5 ng/L, 0.6% between 5 and 14 ng/L, 2.2% between 14 and 42 ng/L, 6.3% between 42 and 90 ng/L and 7.7% in the level ≥ 90 ng/L. CONCLUSIONS: In this large multicentre study, a 0/1-h algorithm had the potential to classify as rule in or out almost 80% of the patients. The rule-out protocol had high negative predictive value regardless of clinical risk scores. Categories of levels of hs-cTn T also showed good accuracy in discriminating risk of the patients with a very favourable prognosis for cardiovascular death in the group with values < 5 ng/L.

MicroRNA qPCR normalization in Nile tilapia (Oreochromis niloticus): Effects of acute cold stress on potential reference targets.

The Nile tilapia (Oreochromis niloticus) is one of the most important cultured fish worldwide, but tilapia culture is largely affected by low temperatures. Recent studies suggest that microRNAs (miRNAs) regulate cold tolerance traits in fish. In general, qPCR-based methods are the simplest and most accurate forms of miRNA quantification. However, qPCR data heavily depends on appropriate normalization. Therefore, the aim of the present study is to determine whether the expression of previously tested, stably expressed miRNAs are affected by acute cold stress in Nile tilapia. For this purpose, one small nuclear RNA (U6) and six candidate reference miRNAs (miR-23a, miR-25-3, Let-7a, miR-103, miR-99-5, and miR-455) were evaluated in four tissues (blood, brain, liver, and gills) under two experimental conditions (acute cold stress and control) in O. niloticus. The stability of the expression of each candidate reference miRNA was analyzed by four independent methods (the delta Ct method, geNorm, NormFinder, and BestKeeper). Further, consensual comprehensive ranking of stability was built with RefFinder. Overall, miR-103 was the most stable reference miRNA in this study, and miR-103 and Let-7a were the best combination of reference targets. Equally important, Let-7a, miR-23a, and miR-25-3 remained consistently stable across different tissues and experimental groups. Considering all variables, U6, miR-99-5, and miR-455 were the least stable candidates under acute cold stress. Most important, suitable reference miRNAs were validated in O. niloticus, facilitating further accurate miRNA quantification in this species.

Study of the upper pole after subtotal splenectomy in rats.

PURPOSE: To evaluate macro/microscopic viability of the upper pole (UP) in rats after 80 days of subtotal splenectomy preserving the upper pole (SSPUP). METHODS: Twenty-five male Wistar rats were submitted to SSPUP. After 80 days, the rats were euthanized, and the remaining UP was evaluated macroscopically regarding appearance, color, consistency, length, width, thickness, and presence of fibrosis/necrosis; and microscopically regarding presence of red and white pulp, fibrosis/necrosis. RESULTS: Two rats died during surgery and were removed from the statistical analysis. There was statistically significant increase in length and width between the pre and postoperative in the experimental group, with no significant difference in thickness. In the manipulation group, the macroscopic appearance of the spleen was normal in pre and postoperative, with viability preserved. In the experimental group, two UP of the spleen were not found during the second surgery. Macroscopically, it was observed absence of fibrosis and necrosis in all cases. Microscopically, the white and red pulp were intact in both groups. Two spleens of rats in the manipulation group presented areas with fibrosis and necrosis focus, which were not enough to be considered inviable. CONCLUSIONS: The UP of the spleen remained viable in 91.3% of the cases.

Educação crítica em diabetes no município de Itanhaém: uma pesquisa-ação amparada pelo pensamento de Paulo Freire / Critical education in diabetes in Itanhaém city: an action research supported by theory of Paulo Freire

Introdução: O diabetes mellitus tipo 2 (DM) atinge centenas de milhões de pessoas e representa um grande desafio para os sistemas de saúde. Diferenciando-se das principais diretrizes de educação em diabetes, a educação popular em saúde no SUS adota uma abordagem pedagógica crítica. Materiais e Métodos: Pesquisa qualitativa do tipo pesquisa-ação baseada no modelo freireano de Círculos de Cultura em uma Unidade de Saúde da Família no município de Itanhaém-SP. Resultados e Discussão: Pessoas com diabetes e profissionais de saúde discutiram temas relacionados à DM, com foco em alimentação saudável, políticas públicas e determinantes sociais de saúde. Conclusão: A pedagogia crítica resolveu situações cotidianas e se mostrou capaz de progredir para temas complexos de ordem político-estrutural que favorecem o aperfeiçoamento e o enfrentamento das iniquidades sociais.

Exposure of pregnant women and their children to pyrethroid insecticides in Rio de Janeiro, Brazil.

Background: Pyrethroids are commonly used insecticides in Brazil. Gestational and early childhood exposure to pyrethroids has been linked to adverse health effects, including neurodevelopmental delays, behavioral issues, and endocrine disruption. This study evaluated the exposure of pregnant women and their children to pyrethroid insecticides in Rio de Janeiro, Brazil. Methods: Creatinine-adjusted levels of the pyrethroid metabolites 3-phenoxy benzoic acid (3-PBA) and 4-fluoro-3-phenoxybenzyl acid (4-FPBA) were measured in the urine of 142 pregnant women and their children at birth and in the first, third, and 6th months of life. Results: The geometric mean (GM) and 95% confidence interval (95% CI) of 3-PBA and 4-FPBA urinary concentrations in pregnant women were 0.50 (0.37-0.67) and 0.37 (0.05-2.90) ng/mg, detected in 47.2 and 10.6%, respectively. Urinary concentrations of 3-PBA in the children were 0.18 (0.15-0.23) ng/mg at birth, 0.36 (0.08-1.56) ng/mg at 1-month-old, 0.68 (0.36-1.27) ng/mg at 3-month-old, and 1.36 (0.77-2.42) ng/mg at 6-month-old, and the detection rates were respectively 10.8, 9.4, 20.9, and 20.7%. Discussion: This study is one of the few that has evaluated the urinary concentrations of pyrethroids in newborns and children in their 1st year of life. The results of this study show that children's exposure to pyrethroids significantly increases after birth.

REVIEW OF ARTICULATED ELBOW ORTHOTICS FOR JOINT STIFFNESS REHABILITATION.

Joint stiffness is the most common complication in elbow injuries, presenting several etiologies and pathophysiological mechanisms that hinder treatment and prognosis. Prevention and treatment of joint contracture depend on the cause of stiffness, and early intervention should modify its outcomes. The methods used may be conservative or surgical, alone or in combination, according to each individual situation. Objective: Review articles on articulated elbow orthosis for joint stiffness rehabilitation. Methods: A literature review was conducted in journals available at the PubMed, Medline and LILACS databases, using the following Health Science Descriptors (DeCS): orthotic devices; braces; elbow; elbow joint; contracture; joint disorders. It sought to retrieve and analyze studies with the highest level of evidence that have already been conducted on articulated elbow orthosis for joint stiffness rehabilitation. Results: After applying the inclusion and exclusion criteria, four articles were included from PubMed and none from Medline or LILACS. Of the four PubMed articles, two were systematic reviews and two were randomized clinical trials. Conclusion: Articulated elbow orthoses can benefit joint stiffness treatment, improving range of motion and pain, showing superior effect compared to non-articulated plaster orthotics. Level of Evidence III, Systematic Review of Level III Studies.

A rigidez articular é a principal complicação do cotovelo, afetando o tratamento e o prognóstico. O manejo da contratura articular se baseia na sua etiologia, e a intervenção precoce deve modificar o desfecho dessa complicação. Objetivo: Revisar artigos sobre órtese articulada de cotovelo para reabilitação de rigidez articular. Métodos: Foi realizada uma revisão bibliográfica em periódicos disponíveis do PubMed, Medline e LILACS, utilizando os Descritores em Ciências da Saúde (DeCS): aparelhos ortopédicos; braquetes; cotovelo; articulação do cotovelo; contratura; e transtornos da articulação. A intenção foi estabelecer e conhecer estudos de alto poder de evidência já realizados, que tenham tido como referência a temática de órteses articuladas de cotovelo para reabilitação de rigidez articular. Resultados: Após a aplicação dos critérios de inclusão e exclusão, revisaram-se artigos indexados no PubMed, Medline e LILACS, encontrando-se quatro artigos pelo PubMed e nenhum pelo Medline ou LILACS. Dos quatro artigos, dois eram revisões sistemáticas e dois eram ensaios clínicos randomizados. Conclusão: Órteses articuladas de cotovelo podem ser benéficas no tratamento de rigidez articular, sendo sugerido que melhoram amplitude de movimentos (ADM) e dor, inclusive com efeito superior em relação às órteses não articuladas gessadas. Nível de Evidência III, Revisão Sistemática de Estudos de Nível III.

Exposure to salinity induces oxidative damage and changes in the expression of genes related to appetite regulation in Nile tilapia (Oreochromis niloticus).

Variations in water salinity and other extrinsic factors have been shown to induce changes in feeding rhythms and growth in fish. However, it is unknown whether appetite-related hormones mediate these changes in Nile tilapia (Oreochromis niloticus), an important species for aquaculture in several countries. This study aimed to evaluate the expression of genes responsible for appetite regulation and genes related to metabolic and physiological changes in tilapia exposed to different salinities. Moreover, the study proposed to sequence and to characterize the cart, cck, and pyy genes, and to quantify their expression in the brain and intestine of the fish by quantitative polymerase chain reaction (qPCR). The animals were exposed to three salinities: 0, 6, and 12 parts per thousand (ppt) of salt for 21 days. Furthermore, lipid peroxidation, reactive oxygen species, DNA damage, and membrane fluidity in blood cells were quantified by flow cytometry. The results indicated an increased expression of cart, pyy, and cck and a decreased expression of npy in the brain, and the same with cck and npy in the intestine of fish treated with 12 ppt. This modulation and other adaptive responses may have contributed to the decrease in weight gain, specific growth rate, and final weight. In addition, we showed oxidative damage in blood cells resulting from increasing salinity. These results provide essential data on O. niloticus when exposed to high salinities that have never been described before and generate knowledge necessary for developing biotechnologies that may help improve the production of economically important farmed fish.

Chronic cold exposure modulates genes related to feeding and immune system in Nile tilapia (Oreochromis niloticus).

Nile tilapia is the fourth most produced species in the global aquiculture panorama. This species requires water temperatures higher than 16 °C to grow and survive, and so, little is known about the effects of low temperatures on genes related to food intake and inflammatory responses. This study brought insights about the modulation of genes in different tissues of Nile tilapia chronically exposed to low temperatures. Thus, sixty animals were divided in two experimental groups: a control group in which the animals remained at the optimum temperature of 24 °C; and an exposed to cold group, in which a decrease in the water temperature was applied until reaching 15 °C. These conditions were maintained for 28 days. Blood samples were collected for flow cytometry analysis, while brain, spleen, liver, and kidney tissues were collected for total RNA extraction, followed by quantitative PCR (RT-qPCR). For genes related to feeding process pathway, it was observed an upregulation in pyy and a downregulation of npy and cart gene expression. Also, pro-inflammatory cytokine genes were modulated in the spleen, kidney and liver with a higher expression of il-1b and tnfα and a reduction in the il-8 and nf-κß gene expressions in the group exposed to 15 °C. The fish exposed to cold presented higher serum cortisol levels than the ones from control group. The blood cell analysis showed a lower level of membrane fluidity and a higher DNA fragmentation and cell disruption in the group exposed to cold. These findings suggest an important effect of a stressful situation in the tilapia organism due to cold exposure. This study brings insights on tilapia wellbeing under low temperature stress. It can be a first step to understanding the appropriate way to cope with cold impacts on aquaculture.

7-Chloro-4-(Phenylselanyl) Quinoline Is a Novel Multitarget Therapy to Combat Peripheral Neuropathy and Comorbidities Induced by Paclitaxel in Mice.

Paclitaxel-induced peripheral neuropathy (PIPN) is a very common and complex painful condition related to paclitaxel (PTX) exposure, severely impacting patients' quality of life, and contributing to the emergence of clinical signs of anxiety and cognitive loss. At present, no sufficient treatment options are available for PIPN and its exact pathophysiology remains unclear. Based on the therapeutic potential of the 7-chloro-4-(phenylselanyl) quinoline (4-PSQ), we assessed its ability to reverse PIPN and its comorbities induced by PTX. The effect of 4-PSQ was evaluated on pathophysiological processes involved in PIPN, such as oxidative stress (oxidative damage and antioxidant enzymes), neuroinflammation (mRNA expression levels of nuclear factor-kappa B, interleukin-1beta, tumor necrosis factor-alpha, and inducible nitric oxide synthase), and calcium homeostasis (Ca2+ATPase activity) in the spinal cord, cerebral cortex, and hippocampus of mice. Male Swiss mice received PTX (2 mg/kg) or vehicle by intraperitoneal route (days 1, 2, and 3). Oral administration of 4-PSQ (1 mg/kg) or vehicle was performed on days 3 to 14. It was observed that 4-PSQ reduced the mechanical and thermal hypersensitivities induced by PTX. Likewise, 4-PSQ reduced both anxious behavior and cognitive impairment in mice with PIPN. We believe that effects of 4-PSQ may be associated, at least in part, with the modulation of oxidative stress, reduction of neuroinflammation, and normalizing Ca2+ATPase activity in the spinal cord, cerebral cortex, and hippocampus of mice with PIPN. Taken together, the 4-PSQ might be a good prototype for the development of a more effective drug for the treatment of PIPN and its comorbities.

Long-term resolution of type 2 diabetes after biliopancreatic diversion and duodenal switch procedure: a retrospective analysis from a high-volume institution.

BACKGROUND: Biliopancreatic diversion with duodenal switch (BPD-DS) has been shown to result in better weight loss than other bariatric procedures. Very limited data are available, especially long term, in terms of the resolution of diabetes. OBJECTIVE: The objective of this study was to evaluate the long-term resolution (>5 years) of type 2 diabetes after BPD-DS. SETTING: Academic hospital. METHODS: This is a retrospective chart review of patients with diabetes who underwent primary BPD-DS at our institution from 2010 to 2015. Data for that cohort were collected until January 2021. RESULTS: A total of 151 patients who had met the criteria were included in the final analysis. More than 1 year of follow-up data was available for 94% of patients, and more than 5 years of follow-up data was available for 51%. Most of the patients (98.1%) had either partial or complete resolution or improvement. CONCLUSION: Patients with type 2 diabetes who underwent BPD-DS had profound improvement of their diabetes postoperatively. A significant percentage experienced complete resolution, with most of the remaining patients having demonstrated much improvement in their condition.

Floristic composition, pollination and seed-dispersal systems in a target cerrado conservation area / Composição florística, modos de polinização e dispersão de sementes de uma área de cerrado relevante para conservação

Abstract: Cerrado remnants can hold an important diversity of plant species of environmental and ecological relevance. We presented a checklist of vascular plants based on 12 years of inventory carried out in 36 plots (10 m x 2 m; 0.18 ha in total) and during unsystematic walks in a remnant area of cerrado sensu stricto located at Itirapina municipality, state of São Paulo, southeastern Brazil. The list comprised 195 plant species, corresponding to 54 families and 131 genera. The richest families were Fabaceae (25 species), Asteraceae (16), Myrtaceae (16), Rubiaceae (11), Bignoniaceae and Malpighiaceae (10 each), Melastomataceae (9), and Erythroxylaceae, Sapindaceae and Annonaceae (6). Predominant life forms included shrubs and trees, with 68% of the species, followed by lianas with 12%, sub-shrub and herbs with 10% each. Bees were the dominant pollinators (67,5%) and the majority of species had seeds dispersed by animals (56.8%), mostly by birds, followed by wind (33.3%) and self-dispersed (11.2%). More than 60% of the total species were classified as "typical" Cerrado species. Bowdichia virgilioides was the only species classified as Near Threatened (NT) and 157 were regarded as Data Deficient (DD). Our dataset provides floristic, structural, and ecological information for one of the targeted areas for Cerrado survey at São Paulo state, contributing to the understanding of diversity patterns and future conservation and restoration actions in this threatened hotspot.

Resumo: Apresentamos uma lista de verificação de plantas vasculares baseada em 12 anos de inventário realizado em 36 parcelas (10 m x 2 m; 0,18 ha no total) e caminhadas assistemáticas em uma área remanescente de cerrado sensu stricto localizada em Itirapina, município do estado de São Paulo, sudeste do Brasil. A lista é composta por 195 espécies de plantas, correspondendo a 54 famílias e 131 gêneros. As famílias mais ricas foram Fabaceae (25 espécies), Asteraceae (16), Myrtaceae (16), Rubiaceae (11), Bignoniaceae e Malpighiaceae (10 cada), Melastomataceae (9) e Erythroxylaceae, Sapindaceae e Annonaceae (6). As formas de vida predominantes incluíram arbustos e árvores (33,7% das espécies), seguidas por lianas (12%), arbustos e ervas (10%). As abelhas foram os polinizadores dominantes (67,5%) e o principal modo de dispersão foi a zoocoria (56,8%), representada principalmente por pássaros, seguida por vento (33.3 %) e auto (11.2 %). Mais de 60% das espécies encontradas foram classificadas como espécies "típicas" de Cerrado. Bowdichia virgilioides foi a única espécie pertencente a uma categoria de ameaça "Quase Ameaçada (NT)", sendo 157 delas classificadas na categoria "Deficiente de Dados (DD)". Nosso conjunto de dados fornece informações florísticas, estruturais e ecológicas para uma das áreas-alvo do levantamento do Cerrado no estado de São Paulo, sudeste do Brasil, contribuindo para a compreensão dos padrões de diversidade e futuras ações de conservação neste hotspot ameaçado.

DNA microarray for forensic intelligence purposes: High-density SNP profiles obtained directly from casework-like samples with and without a DNA purification step.

SNP analyses from a forensic intelligence perspective have proven to be an important tool to restrict the number of suspected offenders and find missing persons. DNA microarray assays have been demonstrated as a potential feature in forensic analysis, like such as forensic genetic genealogy. The objective of this study was to describe the results from DNA microarray assay from saliva samples deposited on a glass surface collected from by a double swab technique, commonly applied in crime scenes. Eighteen samples from the same person were subjected to Infinium® Global Screening Array-24 v1.0 (~642.824 SNP markers) in two different protocols - with or without the DNA purification procedure. The measured genotype was compared with a Consensus Genotype, obtained from standard control samples, and the parameters such as Call Rate and GenCall Scores were evaluated. Results showed that the Call Rate parameter is enough to estimate the probability of obtaining a correct genotype in the SNP assay. Reliable genotypes with a confidence level of more than 90% (at least 90.15%) were observed in Call Rates above 69.41%, regardless of the experimental condition. Our data demonstrate that DNA Microarray from samples collected under conditions such as those found at crime scenes can generate high-density SNP genetic profiles with a confidence level greater than 90%. Enzymatic adjustments and protocol changes may enable DNA microarray assays for crime analysis and investigation purposes eliminating the purification step in the future. Our data suggest that DNA microarray can support criminal investigation teams from a forensic intelligence perspective.

Educação crítica em diabetes no município de Itanhaém: uma pesquisa-ação amparada pelo pensamento de Paulo Freire / Critical education in diabetes in Itanhém city: an action research supported by theory of Paulo Freire

Introdução: O Diabetes Mellitus é uma doença crônica, endêmica e potencialmente mutilante, além de constituir-se fator de risco para a principal causa de morte no Brasil e no mundo ­ a doença cardiovascular. Suas bases fisiopatológicas incluem influências genéticas e ambientais. O tratamento proposto é complexo e divide-se em tratamento medicamentoso e tratamento não-medicamentoso. Como parte integrante do tratamento não medicamentoso temos as chamadas "mudanças do estilo de vida" e "educação em diabetes". Os protocolos e diretrizes que embasam a atuação clínica de médicos endocrinologistas valorizam o autocuidado e a autonomia, porém em uma perspectiva behaviorista, utilizando-se de um modelo tecnicista de educação. Em contrapartida, propostas educativas baseadas na pedagogia crítica comprometem-se com a democracia, o respeito aos diferentes saberes e a busca pelo fim das iniquidades sociais. Objetivos: Criar coletivamente um programa educativo em diabetes através da Pedagogia Crítica no município de Itanhaém. Método: Estudo qualitativo do tipo pesquisa-ação. Em uma Unidade Básica de Saúde realizamos encontros entre profissionais de saúde e pessoas com Diabetes Mellitus ou seus familiares para desenvolver ações educativas em diabetes utilizando-se da Pedagogia Crítica, com o referencial teórico de Paulo Freire. Seguimos o modelo de Círculos de Cultura, objetivando a transição da curiosidade ingênua para a curiosidade epistemológica, a identificação das situações-limite e o vislumbramento do inédito viável, em um ambiente democrático. Resultados e discussão: No primeiro encontro realizamos o levantamento das temáticas significativas e as reuniões seguintes pautaram-se nesses temas e em outros que surgiram no decorrer do período. As reuniões ocorreram quinzenalmente (salvo exceções), duraram cerca de 90 minutos e contaram com a participação conjunta de profissionais de saúde, pessoas com diabetes e/ou seus familiares. Para cada encontro utilizamos codificações diferentes (reportagens, teatro, manipulação de objetos, etc.) a fim de provocar o interesse e estimular a participação. As reuniões partiram de problemas reais e cotidianos e se desenvolveram no sentido de, além de encontrar soluções práticas às demandas colocadas, buscar as bases estruturantes das adversidades e as possiblidades de 9 enfrentamento destas estruturas. A restrição alimentar mostrou-se a principal fonte de preocupação e sofrimento. A partir deste mote discutimos alimentação saudável, craving, determinantes sociais de saúde, políticas públicas, sistemas de produção e comercialização dos alimentos, legislações, reformas tributária e agrária. As outras temáticas desenvolvidas foram: sofrimento na doença crônica, estigmas do DM, conceito de normal e patológico, paternalismo, patriarcado, biopoder e neoliberalismo. Conclusão: A pedagogia crítica oportunizou vivências de atividades educativas em diabetes que responderam à expectativa da população de resolver questões de natureza cotidiana, mas que, não se limitando a elas, também promoveram reflexões de ordem político-estrutural, que podem dar origem à ampliação da participação popular e, consequentemente, contribuir para o aperfeiçoamento do SUS.

Crisis, work and nursing: an ethnographic narrative of the coronavirus pandemic in Primary Care in Spain / Crisis, trabajo y enfermería: una narrativa etnográfica de la pandemia de coronavirus en Atención Primaria en España / Crise, trabalho e enfermagem: narrativa etnográfica da pandemia por coronavírus na Atenção Primária da Espanha

ABSTRACT Objective: to narrate the experience of facing a long economic and political crisis and the experience of the arrival process of the coronavirus pandemic in a Spanish healthcare center. Methods: this is a descriptive qualitative study with ethnographic analysis, with data collection through interviews, participant observation and field diary records. Results: the immersion in the context allowed us to identify two axes of domain: "The crisis, work in the community and the territory in Primary Care"; "The inevitability of being a nurse in facing a health crisis". Final considerations: the narrative portrays the ethics in field research, tensions and values of nursing work in crisis situations. Nurses' experiences are presented in narratives of dissatisfaction and difficulties, but with the support of values related to guaranteeing assistance to users and cooperation and solidarity in the collective organization of workers to face the COVID-19 crisis.

RESUMEN Objetivo: narrar la experiencia de afrontar una larga crisis económico-política y la experiencia del proceso de llegada de la pandemia de coronavirus en un centro sanitario español. Métodos: se trata de un estudio cualitativo descriptivo con análisis etnográfico, con recolección de datos a través de entrevistas, observación participante y registros de diario de campo. Resultados: la inmersión en el contexto permitió identificar dos ejes de dominio: "La crisis, el trabajo en la comunidad y el territorio en Atención Primaria"; "De la inevitabilidad de ser enfermero ante la crisis sanitaria". Consideraciones finales: la narrativa retrata la ética en la investigación de campo, las tensiones y los valores del trabajo de enfermería en situaciones de crisis. La experiencia de las enfermeras se presenta en narrativas de insatisfacción y dificultades, pero con el respaldo de valores relacionados con garantizar la asistencia a los usuarios y la cooperación y solidaridad en la organización colectiva de los trabajadores para enfrentar la crisis del COVID-19.

RESUMO Objetivo: narrar a experiência do enfrentamento de uma longa crise econômico-política e a vivência do processo da chegada da pandemia do coronavírus em um centro de saúde espanhol. Métodos: trata-se de estudo descritivo qualitativo com análise etnográfica, com coleta de dados por entrevistas, observação participante e registros em diário de campo. Resultados: a imersão no contexto permitiu identificar dois eixos de domínio: "a crise, o trabalho na comunidade e o território na Atenção Primária"; "da inevitabilidade do ser enfermeiro no enfrentamento da crise sanitária". Considerações finais: a narrativa retrata a ético na pesquisa de campo, tensões e valores do trabalho da enfermagem em conjuntura de crise. A experiência dos enfermeiros é trazida em narrativas de insatisfação e dificuldades, porém com a sustentação de valores relacionados à garantia da assistência aos usuários e de cooperação e solidariedade na organização coletiva dos trabalhadores para enfrentamento da crise da COVID-19.

Review of articulated elbow orthotics for joint stiffness rehabilitation / Revisão de órteses articuladas de cotovelo para reabilitação de rigidez articular

ABSTRACT Joint stiffness is the most common complication in elbow injuries, presenting several etiologies and pathophysiological mechanisms that hinder treatment and prognosis. Prevention and treatment of joint contracture depend on the cause of stiffness, and early intervention should modify its outcomes. The methods used may be conservative or surgical, alone or in combination, according to each individual situation. Objective: Review articles on articulated elbow orthosis for joint stiffness rehabilitation. Methods: A literature review was conducted in journals available at the PubMed, Medline and LILACS databases, using the following Health Science Descriptors (DeCS): orthotic devices; braces; elbow; elbow joint; contracture; joint disorders. It sought to retrieve and analyze studies with the highest level of evidence that have already been conducted on articulated elbow orthosis for joint stiffness rehabilitation. Results: After applying the inclusion and exclusion criteria, four articles were included from PubMed and none from Medline or LILACS. Of the four PubMed articles, two were systematic reviews and two were randomized clinical trials. Conclusion: Articulated elbow orthoses can benefit joint stiffness treatment, improving range of motion and pain, showing superior effect compared to non-articulated plaster orthotics. Level of Evidence III, Systematic Review of Level III Studies.

RESUMO A rigidez articular é a principal complicação do cotovelo, afetando o tratamento e o prognóstico. O manejo da contratura articular se baseia na sua etiologia, e a intervenção precoce deve modificar o desfecho dessa complicação. Objetivo: Revisar artigos sobre órtese articulada de cotovelo para reabilitação de rigidez articular. Métodos: Foi realizada uma revisão bibliográfica em periódicos disponíveis do PubMed, Medline e LILACS, utilizando os Descritores em Ciências da Saúde (DeCS): aparelhos ortopédicos; braquetes; cotovelo; articulação do cotovelo; contratura; e transtornos da articulação. A intenção foi estabelecer e conhecer estudos de alto poder de evidência já realizados, que tenham tido como referência a temática de órteses articuladas de cotovelo para reabilitação de rigidez articular. Resultados: Após a aplicação dos critérios de inclusão e exclusão, revisaram-se artigos indexados no PubMed, Medline e LILACS, encontrando-se quatro artigos pelo PubMed e nenhum pelo Medline ou LILACS. Dos quatro artigos, dois eram revisões sistemáticas e dois eram ensaios clínicos randomizados. Conclusão: Órteses articuladas de cotovelo podem ser benéficas no tratamento de rigidez articular, sendo sugerido que melhoram amplitude de movimentos (ADM) e dor, inclusive com efeito superior em relação às órteses não articuladas gessadas. Nível de Evidência III, Revisão Sistemática de Estudos de Nível III.

Avaliação do padrão craniofacial de indivíduos do nordeste brasileiro portadores de apneia obstrutiva do sono ­ estudo cefalométrico / Assessment of craniofacial pattern from northeast Brazil individuals with obstructive sleep apnea ­ cephalometric study

Resumo A identificação de padrões craniofaciais associados à Apneia Obstrutiva do Sono (AOS) continua a despertar interesse na medida em que os predisponentes anatômicos podem divergir entre grupos populacionais. O objetivo do estudo foi identificar o padrão craniofacial e as principais características cefalométricas de indivíduos brasileiros com AOS nascidos no estado do Ceará ­ Nordeste do Brasil. Materiais e Métodos: Foram triados 50 voluntários cearenses com diagnóstico polissonográfico de AOS, os quais se submeteram à avaliação clínica, polissonográfica e cefalométrica. O grupo controle foi composto por 25 indivíduos cearenses adultos com oclusão dentária normal, sem relatos de sinais e/ou sintomas relacionados à AOS. Resultados: O grupo com AOS apresentou alterações nas estruturas anatômicas esqueletais, principalmente, um posicionamento inferior do osso hioide (p=0.001) e retrusão mandibular (p=0.012). Alterações também foram observadas nas dimensões dos tecidos moles faríngeos, principalmente, aumento no comprimento (p=0.001) e largura do palato mole (p=0.001), com diminuição do espaço aéreo póstero-superior (p=0.001). Apenas as variáveis cefalométricas SNA (posição anteroposterior da maxila) ­ (p=0.739) e EAP (espaço aéreo faríngeo inferior) ­ (p=0.268) não apresentaram diferenças entre os grupos. Conclusão: Grandezas cefalométricas representativas do posicionamento de estruturas esqueléticas e das dimensões de tecidos moles faríngeos se mostraram significativamente diferentes, quando um grupo de indivíduos com AOS foi comparado à indivíduos de um grupo controle. (AU)

Abstract The identification of craniofacial patterns associated to the Obstructive Sleep Apnea (OSA) continues to arise interest, especially since anatomical predisposing factors differ from group to group. The aim of this study was to identify the craniofacial patterns and cephalometric characteristics in Brazilian individuals with OSA born in Ceará ­ Northeast Brazil. Materials and Methods: fifty OSA volunteers diagnosed with a polysomnography were selected. The control group consisted of 25 adults from Ceará with normal dental occlusion and without reports of OSA signs or symptoms. All participants were submitted to clinical, polysomnographic, and cephalometric evaluation. Results: Individuals diagnosed with OSA showed alterations in skeletal anatomical structure, mainly a lower positioning of hyoid bone (p=0.001) and mandibular retrusion (p=0.012). Alterations have also been observed in the pharyngeal soft tissue dimensions, mainly an increase in soft palate length (p=0.001) and width (p=0.001) causing a reduction in posterosuperior airway (p=0.001). Only the cephalometric variables SNA (anteroposterior position of the maxilla) ­ (p=0.739) and EAP (inferior pharyngeal airspace) ­ (p=0.268) did not present differences between the groups. Conclusion: Cephalometric measurements representative of the positioning of skeletal structures and the dimensions of pharyngeal soft tissues were significantly different when a group of subjects with OSA was compared to subjects of a control group.(AU)