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1.
Nutrients ; 16(7)2024 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-38612950

RESUMO

The family context has been associated with children's weight status. This study aims to investigate the association of parents' adherence to the Mediterranean diet and family time with the weight status of children. The research is part of BeE-school, a cluster-randomized trial implemented in primary schools located in socially vulnerable contexts. A total of 735 children (380 boys and 355 girls) aged 6 to 10 participated in the study. Anthropometrics were assessed during school time, and weight status was categorized, while parents self-reported sociodemographic variables, adherence to the Mediterranean diet (MEDAS questionnaire), and family time. Children from families with higher education levels whose parents have a high adherence to the Mediterranean diet have lower odds of overweight/obesity (odds ratio (OR) 0.301, 95% CI 0.143-0.634, p = 0.002). Also, children from families with lower education levels who have more time together with their family have lower odds of overweight/obesity (OR 0.731, 95% CI 0.573-0.934, p = 0.012). The family environment, mainly family time together and adherence to the Mediterranean diet, exerts a significant influence on children's weight status. Professionals working in children's health should consider the family when fostering health-promoting behaviors.


Assuntos
Dieta Mediterrânea , Masculino , Criança , Feminino , Animais , Humanos , Abelhas , Sobrepeso/epidemiologia , Sobrepeso/prevenção & controle , Instituições Acadêmicas , Obesidade/epidemiologia , Obesidade/prevenção & controle , Pais , Tiletamina
2.
Vox Sang ; 2024 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-38597364

RESUMO

BACKGROUND AND OBJECTIVES: The isolation of neutrophils and subsequent detection of anti-human neutrophil antigens (HNA) antibodies are crucial in clinical medicine for the diagnosis of autoimmune neutropenia, neonatal alloimmune neutropenia (NAIN) and transfusion-related acute lung injury (TRALI). This study reports two cases of maternal anti-Fc-gamma-receptor-IIIb (FcγRIIIb) isoimmunization without NAIN symptoms and compares the efficiency of immunomagnetic negative selection (IMNS) with traditional dextran/Ficoll for neutrophil isolation in HNA serological assays. MATERIALS AND METHODS: Investigating two cases of maternal anti-FcγRIIIb isoimmunization, neutrophils from three donors were isolated from 8 mL of whole blood using IMNS and dextran/Ficoll. Serological assays included the granulocyte agglutination and immunofluorescence test, monoclonal antibody immobilization of granulocyte antigens and the LABScreen Multi (One Lambda). IMNS and dextran/Ficoll were compared in terms of cell yield, viability, time, cost and purity. RESULTS: Maternal anti-FcγRIIIb isoantibodies with FCGR3B gene deletion were detected in both cases. Newborns and fathers exhibited specific gene combinations: FCGR3B*02/FCGR3B*02 (Case 1) and FCGR3B*02/FCGR3B*03 (Case 2). IMNS outperformed dextran/Ficoll, yielding four times more neutrophils (average neutrophil counts: 18.5 × 103/µL vs. 4.5 × 103/µL), efficiently removing non-neutrophil cells and reducing processing time (30-40 min vs. 70-90 min), although it incurred a higher cost (2.7 times). CONCLUSION: Two cases of maternal anti-FcγRIIIb isoantibodies, unrelated to NAIN, were identified. Although neutropenia has not been described in these cases, we emphasize the importance of identifying asymptomatic cases with the potential for severe neutropenia. Additionally, IMNS is introduced as a rapid, high-yield, high-purity neutrophil isolation technique, beneficial for serological assays detecting anti-HNA antibodies.

3.
Am J Perinatol ; 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38301725

RESUMO

OBJECTIVE: Fetal growth restriction (FGR) is defined as an estimated fetal weight (EFW) or abdominal circumference (AC) <10th percentile (%ile) for gestational age (GA). An EFW <3rd %ile for GA is considered severe FGR (sFGR). It remains unknown if fetuses with isolated AC <3rd %ile should be considered sFGR. Our primary objective was to assess composite neonatal outcomes in fetuses with an AC <3rd %ile and overall EFW 3rd to 9th %ile compared with those with an EFW <3rd %ile. STUDY DESIGN: This retrospective cohort study was undertaken at a tertiary academic center from January 2016 to December 2021. Inclusion criteria were singleton fetuses with an EFW <3rd %ile (Group 1) or AC <3rd %ile with EFW 3rd to 9th %ile (Group 2) at 28 weeks' gestation or greater. Exclusion criteria were multiple gestations, presence of a major fetal anomaly, resolution of FGR, genetic syndrome, or infection. Composite neonatal outcome was defined by any of the following: neonatal intensive care unit admission >48 hours, necrotizing enterocolitis, sepsis, respiratory distress syndrome, mechanical ventilation, retinopathy of prematurity, seizures, intraventricular hemorrhage, stillbirth, or death before discharge. Small for gestational age (SGA) was defined as birth weight <10th %ile for GA. RESULTS: A total of 743 patients fulfilled our study criteria, with 489 in Group 1 and 254 in Group 2. The composite neonatal outcome occurred in 281 (57.5%) neonates in Group 1 and 53 (20.9%) in Group 2 (p < 0.01). The rates of SGA at birth were 94.9 and 75.6% for Group 1 and Group 2, respectively (OR 5.99, 95% confidence interval 3.65-9.82). CONCLUSION: Although AC <3rd %ile with EFW 3rd to 9th %ile is associated with a lower frequency of SGA and neonatal morbidity than EFW <3 %ile, fetuses with AC <3 %ile still exhibited moderate rates of these adverse perinatal outcomes. Consideration should be given to inclusion of an AC <3rd %ile with EFW 3rd to 9th %ile as a criterion for sFGR. However, prospective studies comparing delivery at 37 versus 38 to 39 weeks' gestation are needed to ensure improved outcomes before widespread adaptation in clinical practice. KEY POINTS: · The composite neonatal outcome occurred in 57.5% of fetuses with an overall EFW <3rd %ile and 20.9% of fetuses with an AC <3rd %ile but EFW 3rd to 9th %ile.. · Both groups demonstrated a high positive predictive value for SGA birth weight.. · Consideration should be given to inclusion of an AC <3rd %ile as a criterion for sFGR..

4.
J Insect Physiol ; 154: 104627, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38373613

RESUMO

Farnesol, a sesquiterpene found in all eukaryotes, precursor of juvenile hormone (JH) in insects, is involved in signalling, communication, and antimicrobial defence. Farnesol is a compound of floral volatiles, suggesting its importance in pollination and foraging behaviour. Farnesol is found in the resin of Baccharis dracunculifolia, from which honeybees elaborate the most worldwide marketable propolis. Bees use propolis to seal cracks in the walls, reinforce the wax combs, and as protection against bacteria and fungi. The introduction within a honeybee hive of a compound with potential hormonal activity can be a challenge to the colony survival, mainly because the transition from within-hive to outside activities of workers is controlled by JH. Here, we tested the hypothesis that exogenous farnesol alters the pacing of developing workers. The first assays showed that low doses of the JH precursor (0.1 and 0.01 µg) accelerate pharate-adult development, with high doses being toxic. The second assay was conducted in adult workers and demonstrated bees that received 0.2 µg farnesol showed more agitated behaviour than the control bees. If farnesol was used by corpora allata (CA) cells as a precursor of JH and this hormone was responsible for the observed behavioural alterations, these glands were expected to be larger after the treatment. Our results on CA measurements after 72 h of treatment showed bees that received farnesol had glands doubled in size compared to the control bees (p < 0.05). Additionally, we expected the expression of JH synthesis, JH degradation, and JH-response genes would be upregulated in the treated bees. Our results showed that indeed, the mean transcript levels of these genes were higher in the treated bees (significant for methyl farnesoate epoxidase and juvenile hormone esterase, p < 0.05). These results suggest farnesol is used in honeybees as a precursor of JH, leading to increasing JH titres, and thus modulating the pacing of workers development. This finding has behavioural and ecological implications, since alterations in the dynamics of the physiological changes associated to aging in young honeybees may significantly impact colony balance in nature.


Assuntos
Hormônios Juvenis , Própole , Abelhas , Animais , Hormônios Juvenis/metabolismo , Farneseno Álcool , Resinas Vegetais , Insetos/metabolismo
5.
J Ultrasound Med ; 43(5): 951-965, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38321827

RESUMO

OBJECTIVES: To synthesize the current evidence of maternal point-of-care ultrasound (POCUS) in obstetrics. A scoping review was conducted using PubMed, Clinicaltrials.gov, and the Cochrane library from inception through October 2023. METHODS: Studies were eligible for inclusion if they described the use of POCUS among obstetric or postpartum patients. Two authors independently screened all abstracts. Quantitative, qualitative, and mixed-methods studies were eligible for inclusion. Case reports of single cases, review articles, and expert opinion articles were excluded. Studies describing detailed maternal nonobstetric sonograms or maternal first trimester sonograms to confirm viability and rule out ectopic pregnancy were also excluded. Data were tabulated using Microsoft Excel and summarized using a narrative review and descriptive statistics. RESULTS: A total of 689 publications were identified through the search strategy and 12 studies met the inclusion criteria. Nine studies evaluated the use of lung POCUS in obstetrics in different clinical scenarios. Lung ultrasound (LUS) findings in preeclampsia showed an excellent ability to detect pulmonary edema (area under the receiver operating characteristic 0.961) and findings were correlated with clinical evidence of respiratory distress (21 of 57 [37%] versus 14 of 109 [13%]; P = .001). Three studies evaluated abdominal POCUS, two of the inferior vena cava (IVC) to predict postspinal anesthesia hypotension (PSAH) and fluid receptivity and one to assess the rate of ascites in patients with preeclampsia. Patients with PSAH had higher IVC collapsibility (area under the curve = 0.950, P < .001) and, in patients with severe preeclampsia, there is a high rate of ascites (52%) associated with increased risk of adverse outcomes. There were no studies on the use of subjective cardiac POCUS. CONCLUSION: POCUS use in the management of high-risk obstetrics has increased. LUS has been the most studied modality and appears to have a potential role in the setting of preeclampsia complicated by pulmonary edema. Cardiac and abdominal POCUS have not been well studied. Trials are needed to evaluate its clinical applicability, reliability, and technique standardization before widespread use.


Assuntos
Hipotensão , Pré-Eclâmpsia , Edema Pulmonar , Gravidez , Feminino , Humanos , Sistemas Automatizados de Assistência Junto ao Leito , Ascite , Reprodutibilidade dos Testes , Ultrassonografia/métodos , Cuidados Críticos
6.
Genet Mol Biol ; 47(1): e20230148, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38314880

RESUMO

In phytophagous insects, adaptation to a new host is a dynamic process, in which early and later steps may be underpinned by different features of the insect genome. Here, we tested the hypothesis that early steps of this process are underpinned by a shift in gene expression patterns. We set up a short-term artificial selection experiment (10 generations) for the use of an alternative host (Cicer arietinum) on populations of the bean beetle Zabrotes subfasciatus. Using Illumina sequencing on young adult females, we show the selected populations differ in the expression of genes associated to stimuli, signalling, and developmental processes. Particularly, the "C. arietinum" population shows upregulation of histone methylation genes, which may constitute a strategy for fine-tuning the insect global gene expression network. Using qPCR on body regions, we demonstrated that the "Phaseolus vulgaris" population upregulates the genes polygalacturonase and egalitarian and that the expression of an odorant receptor transcript variant changes over generations. Moreover, in this population we detected the existence of vitellogenin (Vg) variants in both males and females, possibly harbouring canonical reproductive function in females and extracellular unknown functions in males. This study provides the basis for future genomic investigations seeking to shed light on the nature of the proximate mechanisms involved in promoting differential gene expression associated to insect development and adaptation to new hosts.

7.
Hematol Transfus Cell Ther ; 46(1): 67-71, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38326179

RESUMO

To date, hydroxyurea is the only effective and safe drug that significantly reduces morbidity and mortality of individuals with Sickle cell disease. Twenty years of real-life experience has demonstrated that hydroxyurea reduces pain attacks, vaso-occlusive events, including acute chest syndrome, the number and duration of hospitalizations and the need for transfusion. The therapeutic success of hydroxyurea is directly linked to access to the drug, the dose used and adherence to treatment which, in part, is correlated to the availability of hydroxyurea. This consensus aims to reduce the number of mandatory exams needed to access the drug, prioritizing the requesting physician's report, without affecting patient safety.

8.
Am J Obstet Gynecol MFM ; 6(3): 101283, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38219949

RESUMO

BACKGROUND: Incorporation of umbilical artery Doppler in the surveillance of fetal growth restriction has been shown to reduce the risk of perinatal deaths. Systole/Diastole ratio, Pulsatility Index and Resistance Index are obtained upon Doppler interrogation of the umbilical artery however it is unknown which index predicts more advanced stages of placental deterioration. OBJECTIVE: This study aimed to examine risk factors for the development of absent or reversed end-diastolic velocity and the time intervals of deterioration from normal umbilical artery end-diastolic velocity (indicated by systole/diastole ratio, pulsatility index, or resistance index) to decreased and absent or reversed end-diastolic velocity in fetuses with early-onset severe fetal growth restriction. STUDY DESIGN: This was a retrospective cohort study performed from 2005 to 2020. All singleton pregnancies with severe (estimated fetal weight or abdominal circumference below the third percentile) and early-onset (diagnosed between 20 0/7 and 31 6/7 weeks of gestation) fetal growth restriction were included. Patients with fetal genetic or structural anomalies, suspected congenital infections, absent or reversed end-diastolic velocity at diagnosis, poor pregnancy dating, and absence of follow-up ultrasounds were excluded. Estimated fetal weight, abdominal circumference, and Doppler indices were reviewed longitudinally from diagnosis to delivery. To examine risk factors for absent or reversed end-diastolic velocity, we performed backward stepwise logistic regression and calculated odds ratios with 95% confidence intervals. Kaplan-Meier curves were compared using log-rank tests. RESULTS: A total of 985 patients met the inclusion criteria, and 79 (8%) progressed to absent or reversed end-diastolic velocity. Factors associated with development of absent or reversed end-diastolic velocity included gestational age at diagnosis (adjusted odds ratio, 4.88 [95% confidence interval, 2.55-9.37] at 20 0/7 to 23 6/7 weeks; adjusted odds ratio, 1.56 [95% confidence interval, 0.86-2.82] at 24 0/7 to 27 6/7 weeks compared with 28 0/7 to 31 6/7 weeks) and presence of chronic hypertension (adjusted odds ratio, 2.37 [95% confidence interval, 1.33-4.23]). Rates of progression from diagnosis of fetal growth restriction with normal umbilical artery Doppler to absent or reversed end-diastolic velocity were significant after 4 weeks from diagnosis (5.84% [95% confidence interval, 4.50-7.57]). Regarding the Doppler indices, the progression from normal values to abnormal indices was similar at 1 and 2 weeks. However, the rate of progression from normal to abnormal systole/diastole ratio compared with the rates of progression from normal to abnormal pulsatility index or resistance index was higher at 4 and 6 weeks. Deterioration from abnormal indices to absent or reversed end-diastolic velocity was shorter with abnormal resistance index and pulsatility index when compared with the systole/diastole ratio at 2, 4, and 6 weeks after diagnosis and at 6 weeks, respectively. CONCLUSION: Earlier gestational age at diagnosis and chronic hypertension are considered as risk factors for Doppler deterioration and development of absent or reversed end-diastolic velocity in the umbilical artery. With normal Doppler indices, significant deterioration and progression to absent or reversed end-diastolic velocity is unlikely until 4 weeks after diagnosis. Abnormal systole/diastole ratio seems to appear first. However, abnormal pulsatility index or resistance index was associated with absent or reversed end-diastolic velocity.


Assuntos
Retardo do Crescimento Fetal , Hipertensão , Gravidez , Humanos , Feminino , Lactente , Retardo do Crescimento Fetal/diagnóstico , Retardo do Crescimento Fetal/epidemiologia , Peso Fetal , Estudos Retrospectivos , Artérias Umbilicais/diagnóstico por imagem , Placenta , Feto
9.
Am J Obstet Gynecol MFM ; 6(3): 101302, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38281582

RESUMO

ChatGPT (Generative Pre-trained Transformer), a language model that was developed by OpenAI and launched in November 2022, generates human-like responses to prompts using deep-learning technology. The integration of large language processing models into healthcare has the potential to improve the accessibility of medical information for both patients and health professionals alike. In this commentary, we demonstrated the ability of ChatGPT to produce patient information sheets. Four board-certified, maternal-fetal medicine attending physicians rated the accuracy and humanness of the information according to 2 predefined scales of accuracy and completeness. The median score for accuracy of information was rated 4.8 on a 6-point scale and the median score for completeness of information was 2.2 on a 3-point scale for the 5 patient information leaflets generated by ChatGPT. Concerns raised included the omission of clinically important information for patient counseling in some patient information leaflets and the inability to verify the source of information because ChatGPT does not provide references. ChatGPT is a powerful tool that has the potential to enhance patient care, but such a tool requires extensive validation and is perhaps best considered as an adjunct to clinical practice rather than as a tool to be used freely by the public for healthcare information.


Assuntos
Pessoal de Saúde , Perinatologia , Humanos
10.
BMC Pediatr ; 23(1): 611, 2023 12 04.
Artigo em Inglês | MEDLINE | ID: mdl-38044450

RESUMO

BACKGROUND: Neonatal herpes simplex virus (HSV) infection is rare and has significant morbimortality rates. Approximately 85% of newborns are infected intrapartum, and risk factors for mother-to-child transmission include vaginal delivery, primary maternal infection, and prolonged rupture of membranes. Neonatal HSV can manifest with isolated mucocutaneous lesions, neurological involvement, or disseminated disease. In general, herpetic infection can cause blepharoconjunctivitis or keratitis. We report a rare case of congenital herpes with ophthalmologic manifestations and multisystemic involvement. CASE PRESENTATION: A preterm infant, born at 32 weeks and 2 days, with presumed neonatal infection developed intestinal and respiratory complications, as well as hyperemic lesions on the left nostril and oral mucosa. An ophthalmological assessment was requested and brought up the suspicion of HSV infection, indicating empirical treatment with endovenous acyclovir. Later, a new ocular examination was suggestive of panuveitis. Afterward, serum IgM antibodies to HSV-1 and HSV-2 were positive. Proper antiviral therapy led to an improvement in the condition. DISCUSSION: Neonatal herpes is associated with a high risk of persistent skin lesions, long-term neurological disability and other lasting sequelae. It is essential to consider HSV infection in cases of neonatal conjunctivitis, especially in patients with an epithelial defect and no improvement after initial treatment with topical or systemic antibiotics. CONCLUSIONS: In the management of neonatal HSV, early diagnosis is essential for the timely initiation of antiviral therapy. Our report highlights that ocular assessment can be crucial in the correct diagnostic investigation of this condition.


Assuntos
Doenças Fetais , Herpes Simples , Complicações Infecciosas na Gravidez , Feminino , Humanos , Recém-Nascido , Gravidez , Antivirais/uso terapêutico , Herpes Simples/diagnóstico , Herpes Simples/tratamento farmacológico , Recém-Nascido Prematuro , Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/tratamento farmacológico
11.
An Acad Bras Cienc ; 95(4): e20190284, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38055599

RESUMO

Studies and innovations on alternative feed additives, especially on homeopathic remedies have been highlighted in order to replace or reduce the use of antibiotics in pig production. This paper aimed to assess the addition of homeopathic products in pig diet and their effects on the growth performance, serum metabolites, nutrient and energy digestibility, carcass traits and meat quality. A total of 60 immunocastrated male pigs, weighing on average 30.91 ± 0.95 kg, were distributed in two treatments, 10 replicates and three animals/experimental unit. There was no effect (P≥0.05) of treatment on the growth performance and serum metabolites. The percentage of acid-insoluble ash recovered in the diet was greater (P≤0.01) in diets containing homeopathic products. The apparent digestible energy of diets containing homeopathic products was reduced (P≤0.01) in the growing phase and reduced (P≤0.01) the apparent digestibility coefficients of dry matter, crude protein, soluble neutral and acid detergent fibers, and gross energy in the growing and finishing phases. Pig that received diets with homeopathic products had higher (P≤0.05) amount of meat, percentage of meat and marbling. The use of homeopathic products in diets improves the percentage and quality of meat, as well as the marbling of the pig carcass, maintaining the performance.


Assuntos
Materia Medica , Masculino , Suínos , Animais , Ração Animal/análise , Dieta/veterinária , Nutrientes , Carne , Fenômenos Fisiológicos da Nutrição Animal
12.
Front Psychol ; 14: 1220536, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38125868

RESUMO

Literature has reported a decrease in students' engagement throughout schooling, but more worrying, is that elementary students already show signs of disengagement. This data sets the case to develop interventions at this school level. The narrative-based intervention "Yellow Trials and Tribulations" aimed to promote self-regulation has been proven to positively impact elementary students' school engagement. Acknowledging that classroom engagement is expected to be more closely related to learning and achievement than school engagement, the current study aims to extend the research of the mentioned intervention on elementary students' classroom engagement (i.e., behavioral, emotional, cognitive, and agentic dimensions), as well as on basic psychological needs (i.e., perceived autonomy, competence, and relatedness)-an antecedent of students' engagement. The current intervention was implemented by 4th-grade class teachers trained for that purpose and was assessed following a quasi-experimental design with pretest and posttest data collection. Participants were 90 students in the experimental group, and 91 in the comparison group. A multivariate analysis of variance with repeated measures was run for each construct. At the end of the intervention, children in the experimental group reported higher perceived competence and classroom engagement (all dimensions) than their counterparts in the comparison group (small and medium effect sizes were found). No follow-up was conducted to examine whether the intervention effects were long-lasting. Results are expected to support researchers' and educators' efforts to effectively implement the intervention, and maximize its benefits to students. For example, extra efforts could be made to help implementers better respond to students' psychological needs (in this case, perceived autonomy and relatedness), and consequently increase classroom engagement (especially behavioral and emotional engagement, which revealed lower effect sizes).

13.
Braz J Microbiol ; 2023 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-37964169

RESUMO

Farnesol is a natural essential oil with antimicrobial properties. Complexation of farnesol in chitosan nanoparticles can be useful to improve its bioavailability and potentiate its antifungal capabilities such as inhibition of hyphal and biofilm formation. The aim of this study was to develop and characterize chitosan nanoparticles with farnesol (NF) and evaluate their toxicity and antifungal action on C. albicans in vivo. The NF were prepared by the ionic gelation method and showed physicochemical characteristics such as diameter less than 200 nm, monodisperse distribution, positive zeta potential, spherical morphology, and stability after 120 days of storage. In the evaluation of toxicity in Galleria mellonella, NF did not reduce the survival rate, indicating that there was no toxicity in vivo at the doses tested. In the assays with G. mellonella infected by C. albicans, the larvae treated with NF had a high survival rate after 48 h, with a significant reduction of the fungal load and inhibition of the formation of biofilms and hyphae. In the murine model of vulvovaginal candidiasis (VVC), histopathological analysis showed a reduction in inflammatory parameters, fungal burden, and hyphal inhibition in mice treated with NF. The produced nanoparticles can be a promising alternative to inhibit C. albicans infection.

14.
Children (Basel) ; 10(11)2023 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-38002886

RESUMO

Self-regulated learning contributes to students' academic success and their future as citizens. However, self-regulation skills are seldom or poorly promoted during instruction. To address this gap, the current article reports data on the implementation of an evidence-based intervention (i.e., a narrative-based intervention called "Yellow Trials and Tribulations") in a disadvantaged school neighborhood. Prior studies showed positive results of this intervention in promoting elementary students' self-regulation skills. Still, the data are mainly quantitative and limited to students' reports or classroom observations made by researchers. Hence, the current study aimed to explore the implementers' and observers' perceptions of the impact of the intervention. Four elementary teachers implemented the intervention in their fourth-grade classes (N = 96 students). For each session, the implementers and observers completed a session sheet collaboratively, as well as individual final reports at the end of the intervention. The records were analyzed through a direct content analysis. The data indicated a perceived increase in knowledge and the use of self-regulation skills in the educational context and in daily life routines. Moreover, the data allowed for the identification of other positive gains of the intervention. The findings extended prior research while helping researchers to further understand the impact of the narrative-based intervention. The implications for research and educational practice are provided.

15.
Phys Med ; 114: 103148, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37801811

RESUMO

We investigate the potential of the Deep Dose Estimate (DDE) neural network to predict 3D dose distributions inside patients with Monte Carlo (MC) accuracy, based on transmitted EPID signals and patient CTs. The network was trained using as input patient CTs and first-order dose approximations (FOD). Accurate dose distributions (ADD) simulated with MC were given as training targets. 83 pelvic CTs were used to simulate ADDs and respective EPID signals for subfields of prostate IMRT plans (gantry at 0∘). FODs were produced as backprojections from the EPID signals. 581 ADD-FOD sets were produced and divided into training and test sets. An additional dataset simulated with gantry at 90∘ (lateral set) was used for evaluating the performance of the DDE at different beam directions. The quality of the FODs and DDE-predicted dose distributions (DDEP) with respect to ADDs, from the test and lateral sets, was evaluated with gamma analysis (3%,2 mm). The passing rates between FODs and ADDs were as low as 46%, while for DDEPs the passing rates were above 97% for the test set. Meaningful improvements were also observed for the lateral set. The high passing rates for DDEPs indicate that the DDE is able to convert FODs into ADDs. Moreover, the trained DDE predicts the dose inside a patient CT within 0.6 s/subfield (GPU), in contrast to 14 h needed for MC (CPU-cluster). 3D in vivo dose distributions due to clinical patient irradiation can be obtained within seconds, with MC-like accuracy, potentially paving the way towards real-time EPID-based in vivo dosimetry.


Assuntos
Dosimetria in Vivo , Radioterapia de Intensidade Modulada , Masculino , Humanos , Radiometria/métodos , Radioterapia de Intensidade Modulada/métodos , Dosagem Radioterapêutica , Estudos de Viabilidade , Algoritmos , Imagens de Fantasmas , Redes Neurais de Computação , Planejamento da Radioterapia Assistida por Computador/métodos
16.
Braz J Microbiol ; 54(3): 1783-1793, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37405625

RESUMO

Secondary fungal infections are frequently observed in COVID-19 patients. However, the occurrence of candiduria in these patients and its risk factors are underexplored. We evaluated the risk factors of candiduria in COVID-19 patients, including inflammatory mediators that could be used as prognostic markers. Clinical information, laboratory test results, and outcomes were collected from severely ill COVID-19 patients with and without candiduria. Candida species identification, antifungal susceptibility, and plasma inflammatory mediators' measurements were performed. Regression logistic and Cox regression model were used to evaluate the risk factors. A higher risk of longer hospitalization and mortality were observed in patients with candiduria compared to those with COVID-19 only. Candiduria was caused by Candida albicans, C. glabrata, and C. tropicalis. Isolates with intermediate susceptibility to voriconazole and resistant to caspofungin were identified. Classic factors such as the use of corticosteroids and antibacterials, the worsening of renal function, and hematological parameters (hemoglobin and platelets) were found to predispose to candiduria. The mediators IL-1ß, IL-1ra, IL-2, CXCL-8, IL-17, IFN-γ, basic FGF, and MIP-1ß were significantly increased in patients with COVID-19 and candiduria. Furthermore, IFN-γ, IL-1ra, and CXCL-8 were associated with the occurrence of candiduria in COVID-19 patients, whereas basic FGF, IL-1ß, and CXCL-8 were associated with the risk of death in these patients. Classical and immunological factors were associated with worse prognosis among patients with COVID-19 and candiduria. Some mediators, especially CXCL-8, can be a reliable biomarker of fungal coinfection and may guide the diagnostic and the treatment of these patients.


Assuntos
COVID-19 , Candidíase , Infecções Urinárias , Humanos , Proteína Antagonista do Receptor de Interleucina 1/uso terapêutico , Candidíase/microbiologia , Infecções Urinárias/microbiologia , Antifúngicos/uso terapêutico , Fatores de Risco , Candida glabrata
17.
Hematol., Transfus. Cell Ther. (Impr.) ; 45(supl.2): S91-S94, July 2023. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1514206

RESUMO

ABSTRACT Introduction: The Band 3 is a red blood cell protein that carries the Dia and Dib antigens from the Diego blood system. The SLC4A1 gene encodes Band 3; Band 3 Memphis is a polymorphism of normal Band 3 and has two variants, but only the variant II carries the Dia antigen. Objectives: Describe the frequencies of the DI*A and DI*B alleles and the Band 3 Memphis among blood donors, sickle cell disease (SCD) patients and Amazonian Indians. Methods: A total of 427 blood samples were collected and separated into three groups: 206 unrelated blood donors, 90 patients with SCD and 131 Amazonian Indians. We performed DI*A/B, normal Band 3 and Band 3 Memphis genotyping, using the Polymerase Chain Reaction Restriction Fragment Length Polymorphism (PCR-RFLP). Results: The frequency of the DI*A/DI*A genotype was 0.5% in blood donors and it was not found in other groups. The frequency of the DI*A/DI*B was higher in Amazonian Indians (33.6%) and the frequency of the DI*B/DI*B was highest in blood donors (92.2%). All 105 individuals tested were positive for the presence of normal Band 3 and of these individuals, only 5/105 (4.8%) presented the Band 3 Memphis mutation. Conclusion: We observed a higher frequency of the DI*B allele in blood donors and a low frequency of the DI*A/DI*A genotype in all groups studied. The Band 3 Memphis was found in a higher frequency in the blood donor group. Our findings highlight the importance of analyzing different population groups to gain a better understanding of the genetic association of blood group antigens.


Assuntos
Humanos , Anemia Falciforme , Doadores de Sangue , Cristalização , Eritrócitos
18.
Am J Perinatol ; 2023 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-37364597

RESUMO

OBJECTIVE: This study aimed to compare adverse maternal outcomes between pregnancies complicated by fetal growth restriction (FGR) and those without FGR. STUDY DESIGN: This was a secondary analysis of the data from the Consortium on Safe Labor, which was conducted from 2002 to 2008 in 12 clinical centers with 19 hospitals across 9 American College of Obstetricians and Gynecologists districts. We included singleton pregnancies without any maternal comorbidities or placenta abnormalities. We compared the outcomes of individuals with FGR with individuals without FGR. Our primary outcome was severe maternal morbidity. Our secondary outcome included various adverse maternal and neonatal outcomes. Multivariable logistic regression was performed to obtain adjusted odds ratios (aOR) and 95% confidence intervals (95% CI), adjusting for confounders. Missing values for maternal age and body mass index were imputed. RESULTS: Of 199,611 individuals, 4,554 (2.3%) had FGR and 195,057 (97.7%) did not have FGR. Compared with the individuals without FGR, individuals with FGR had increased odds of severe maternal morbidity (0.6 vs. 1.3%; aOR: 1.97 [95% CI: 1.51-2.57]), cesarean delivery (27.7 vs. 41.2%; aOR: 2.31 [95% CI: 2.16-2.48]), pregnancy-associated hypertension (8.3 vs. 19.2%; aOR: 2.76 [95% CI: 2.55-2.99]), preeclampsia without severe features (3.2 vs. 4.7%; aOR: 1.45 [95% CI: 1.26-1.68]), preeclampsia with severe features (1.4 vs. 8.6%; aOR: 6.04 [95% CI: 5.39-6.76]), superimposed preeclampsia (18.3 vs. 30.2%; aOR: 1.99 [95% CI: 1.53-2.59]), neonatal intensive care unit admission (9.7 vs. 28.4%; aOR: 3.53 [95% CI: 3.28-3.8]), respiratory distress syndrome (2.2 vs. 7.7%; aOR: 3.57 [95% CI: 3.15-4.04]), transient tachypnea of the newborn (3.3 vs. 5.4%; aOR: 1.62 [95% CI: 1.40-1.87]), and neonatal sepsis (2.1 vs. 5.5%; aOR: 2.43 [95% CI: 2.10-2.80]). CONCLUSION: FGR was associated with increased odds of severe maternal outcomes in addition to adverse neonatal outcomes. KEY POINTS: · FGR is associated with cesarean section.. · FGR is not associated with severe maternal morbidity.. · FGR is related to pregnancy-associated hypertension.. · FGR is associated with neonatal morbidity..

19.
Sci Rep ; 13(1): 3527, 2023 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-36864212

RESUMO

Phosphorus (P) is a plant macronutrient that is indispensable for maize (Zea mays L.) production. However, P is difficult to manage in weathered soils, and its fertilization practice has low efficiency because it becomes unavailable for absorption by plant roots. Symbiosis of plants with arbuscular mycorrhizal fungi increases plant growth and enhances P uptake from the soil that is not directly available to the roots. Thus, the objective of this study was to determine how inoculation with Rhizophagus intraradices and phosphate fertilization interacts and influences the development and productivity of second-crop maize. The experiment was conducted in Selvíria, Mato Grosso do Sul, Brazil, in 2019 and 2020, both in a Typic Haplorthox. A randomized block design in subdivided plots was used for the phosphate application during crop sowing (0, 25, 50, 75, and 100% concentrations of the recommended level), and the secondary treatments were the doses of mycorrhizal inoculant (0, 60, 120 and 180 g ha-1) applied to the seed using a dry powder inoculant containing 20,800 infectious propagules per gram of the arbuscular mycorrhizal fungus R. intraradices. Only in the first year of the experiment, inoculation and phosphate fertilization promoted benefits to the maize crop, indicating potential to increase yield.


Assuntos
Micorrizas , Fosfatos , Zea mays , Raízes de Plantas , Solo , Fertilização
20.
Front Psychol ; 14: 1012568, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36968727

RESUMO

Introduction: School educators are likely to explain the poor educational trajectories of students with Roma backgrounds related to the lack of parental support and interest in children's education. Aiming to understand further the patterns of Roma group's parental involvement in children's school life and their engagement experiences in school-related activities, the current research set an intervention supported by a culturally sensitive story-tool. Method: Grounded in the intervention-based research framework, 12 participants (i.e., mothers) from different Portuguese Roma groups participated in this study. Data was collected through interviews conducted pre-and postintervention. Eight weekly sessions were delivered in the school context, using a story-tool and hands- on activities to generate culturally significant meanings regarding attitudes, beliefs, and values toward children's educational trajectories. Results: Through the lens of acculturation theory, data analysis provided important findings under two overarching topics: patterns of parental involvement in children's school life and participants' engagement in the intervention program. Discussion: Data show the distinct ways Roma parents participate in children's education and the relevance of mainstream contexts providing an atmosphere likely to build collaborative relationships with parents to overcome barriers to parental involvement.

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