Oral cancer and oral potentially malignant disorders in patients with Fanconi anemia - A systematic review.

The purpose of the present study was to perform a systematic review focusing on oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) in Fanconi anemia (FA) individuals. Electronic searches were undertaken in five databases supplemented by manual scrutiny and gray literature. Case reports and/or cases series were included. The searches yielded 55 studies describing 112 cases of OSCC (n = 107) and/or OPMD (n = 5) in FA individuals. The mean age at diagnosis of OSCC/OPMD was 27.1 (±9.6) years, and females (51.8 %) were slightly more affected. Ulcer (n = 37) or mass (n = 25) were described as clinical presentations for OSCC and OPMD. White lesions (n = 4) were the most common manifestation in OPMD. Tongue (47.2 %) was the most frequent location. Sixty-one (54.5 %) individuals underwent HSCT. Surgical resection (n = 75) was the main treatment adopted. The estimated rate of OPMD malignant transformation was 1.8 % and recurrences following OSCC excision occurred in 26.8 % of individuals. Overall, at 60 months of follow-up, the probability of survival fell to 25.5 % and at 64 months the probability of recurrence increased to 63.2 %. The present data support the need for strict surveillance of patients with FA, even in the absence of OPMD, for early OSCC detection and reduction of mortality.

Safety-promoting interventions for the older person with hip fracture on returning home: A systematic review.

BACKGROUND: Older adults with a prior history of falls that results in hip fractures have difficulties in regaining pre-fracture functional capacity. Scientific evidence has shown benefits of the implementation of multidimensional rehabilitation programs, but this evidence is not systematized with regard to continuity of care after hospital discharge. OBJECTIVE: To identify interventions that promote safety and functional recovery of older adults with hip fractures after hospital discharge. METHOD: A systematic review was carried out according to Cochrane methodology. The research strategy was predefined for the MEDLINE and CINAHL databases. The identified articles were screened according to the eligibility criteria by two independent reviewers. The articles included in the bibliographic sample were evaluated for risk of bias. RESULTS: Of the 10,036 articles found, 10 were included in this systematic review. The safety-promoting interventions identified were: exercise training, occupational therapy/activities of daily living training, transfer and gait training, strengthening exercises, education on assistive device use, fall prevention education, nutritional assessment, environmental modifications/adjustments at home, use of an app, medication, self-care education, and support and counseling. CONCLUSIONS: In eight studies analyzed, exercise training emerged as the most effective intervention for promoting the safety of older adults after hip fractures on returning home. Three studies associated two or more interventions, which focused on exercise training, occupational therapy/training of activities of daily living, and conventional postoperative rehabilitation with transfer and gait training, strengthening exercises, education on assistive device use and discharge planning, aiming to achieve muscle strengthening and safe gait, associated with the performance of activities of daily living.

Effects of bisphenol A on murine salivary glands and human tumor cell lines.

Bisphenol A (BPA) is an endocrine-disrupting chemical with a potential role in endocrine cancers. However, the effects of BPA on the salivary glands have been barely explored. We investigated the impact of in vivo sub-chronic exposure to BPA and its in vitro effects on human salivary gland mucoepidermoid carcinoma cell lines. Male and female mice were exposed to BPA (30 mg/kg/day). Sublingual and submandibular salivary glands from an estrogen-deficiency model were also analyzed. BPA concentration in salivary glands was evaluated by gas chromatography coupled to ion trap mass spectrometry. Immunohistochemical analysis using anti-p63 and anti-α-SMA antibodies was performed on mouse salivary gland tissues. Gene expression of estrogen receptors alpha and beta, P63 and α-SMA was quantified in mouse salivary gland and/or mucoepidermoid (UM-HMC-1 and UM-HMC-3A) cell lines. Cell viability, p63 and Ki-67 immunostaining were evaluated in vitro. BPA disrupted the tissue architecture of the submandibular and sublingual glands, particularly in female mice, and increased the expression of estrogen receptors and p63, effects that were accompanied by significant BPA accumulation in these tissues. Conversely, ovariectomy slightly impacted BPA-induced morphological changes. In vitro, BPA did not affect the proliferation of neoplastic cells, but augmented the expression of p63 and estrogen receptors. The present data highlight a potential harmful effect of BPA on salivary gland tissues, particularly in female mice, and salivary gland tumor cells. Our findings suggest that estrogen-dependent pathways may orchestrate the effects of BPA in salivary glands.

Pooling Saliva Sample as an Effective Strategy for the Systematic CMV Screening of Newborns-A Multicentric Prospective Study.

BACKGROUND: Cytomegalovirus is the most common cause of congenital infections worldwide. Screening all newborns in the first 2 weeks of life is the only way to detect all cases of congenital infection, allowing the monitoring of children with asymptomatic infection at birth and early intervention. AIM: In this multicenter study, we aimed to evaluate the feasibility of using a saliva pool strategy for mass screening in 7 Portuguese hospitals, and to estimate the current prevalence of this congenital infection in these hospitals. METHODS: A total of 7033 newborns were screened between June 2020 and June 2022, and 704 pools of 10 saliva samples were analyzed by polymerase chain reaction (PCR). RESULTS: Of the 704 pools analyzed, 685 were negative and 19 had positive PCR results for cytomegalovirus. After individual PCR testing, 26 newborns had positive saliva results, of which 15 were confirmed by urine testing. Thus, this study's prevalence of congenital infection was 0.21% (95% confidence interval: 0.12%-0.35%). CONCLUSIONS: In this study, the pooling strategy proved to be effective for the systematic screening of newborns, although this low prevalence raises questions regarding the cost-effectiveness of implementing universal screening. However, this prevalence is probably the result of the control measures taken during the pandemic; therefore, the rates are expected to return to prepandemic values, but only a new study after the pandemic will be able to confirm this.

Importance of 24 h ambulatory blood pressure monitoring in patients with acromegaly and correlation with cardiac magnetic resonance findings.

INTRODUCTION: Arterial hypertension (AH) is prevalent in acromegaly, but few studies using 24-h ambulatory blood pressure monitoring (24 h-ABPM) suggest that its frequency may be different from office blood pressure (OBP). Left ventricular hypertrophy (LVH) is one of the most frequent cardiac abnormalities. Cardiac magnetic resonance (CMR) is considered the gold standard to evaluate the heart. OBJECTIVES: To compare the frequency of AH when measured by 24 h-ABPM and by OBP and to correlate BP with cardiac mass. METHODS: Patients over 18 years of age with acromegaly underwent OBP evaluation and were later referred to the 24 h-ABPM. Treatment-naïve patients were submitted to CMR. RESULTS: We evaluated 96 patients. From 29 non hypertensive patients by OBP, 9 had AH on 24 h-ABPM. In the group of patients with a previous diagnosis of AH by OBP, 25 had controlled BP and 42 had abnormal BP on 24 h-ABPM, when analyzed by OBP there were 28 with controlled BP. We observed a positive correlation between diastolic BP measured in 24 h-ABPM and IGF-I levels, but we did not observe the same correlation with age, sex, body mass index and GH levels. The CMR was performed in 11 patients. We found a positive correlation of left ventricular mass (LVM) and BP of 24 h-ABPM. In contrast, there was no correlation of OBP with CMR parameters. CONCLUSIONS: We observed, that 24 h-ABPM in acromegaly allows the diagnosis of AH in some patients with normal BP in OBP and also to allow a better treatment. 24 h-ABPM shows a better correlation with VM by CMR.

"Addressing the core trait of bipolar disorder": A concept analysis of mood-stabilizing drugs.

OBJECTIVE: The term "mood stabilizer" is controversial in the literature and criticized for being imprecise and overly inclusive, having its retirement suggested to avoid misuse. Nevertheless, it continues to be employed as it may still carry important meaning. METHODS: We employed document analysis for reviewing relevant definitions of mood stabilizer employed in the literature. Then, we clarify the meanings associated with the term by employing evolutionary concept analysis. Based on its results, we present a theoretical model for a mood stabilizer and further match it with evidence gathered from published meta-analyses and other sources for drugs used in the treatment of bipolar disorder. RESULTS: Concept analysis unearthed four attributes of a mood stabilizer that were nested into the following ascending hierarchy: "not worsening," "acute effects," "prophylactic effects," and "advanced effects." "Prophylactic effects" were often considered the core aspect of a legitimate mood stabilizer. CONCLUSION: The proposed model uses a hierarchy of attributes that take into account the complexity of the term and help to determine whether a drug is a mood stabilizer. Prophylaxis is pivotal to the concept, whose utility lies in implying a drug able to truly treat bipolar disorder, as opposed to merely targeting symptoms. Consistent use of the term could encourage investigation of drugs that modify long-term outcomes and illness trajectory, instead of simply approaching symptom clusters.

Quedas entre pacientes internados em um hospital público e de ensino: uma análise das notificações / Falls of patients admitted to a public and teaching hospital: an analysis of notifications / Caídas en pacientes ingresados en un hospital público y docente: análisis de las no-tificaciones

Objetivo: descrever o perfil das quedas notificadas de pacientes internados em um hospital público e de ensino. Método: estudo descritivo e retrospectivo, com análise estatística descritiva, inferencial e de correspondência múltipla dos dados de notificações do aplicativo Vigilância em Saúde e Gestão de Riscos Assistenciais Hospitalares sobre quedas de pacientes internados entre 2017 e 2019. Resultados: predominaram, dentre 153 notificações de quedas no período, as ocorridas no quarto, em unidades de atendimento cirúrgico, emergencial e clínico, sofridas por pacientes do sexo masculino, na faixa etária entre 20 e 59 anos. Nesta, destacaram-se os idosos. A abrasão foi o dano mais relatado. A análise de correspondência múltipla não apresentou significância. Conclusão: a análise dos eventos notificados contribuiu para o planejamento e a implantação do Programa Fall Tailoring Interventions for Patient Safety Brasil para aprimoramento da gestão dos riscos relacionados.(AU)

Objective: to describe the profile of reported falls of patients admitted to a public and teaching hospital. Method: descriptive and retrospective study, with descriptive, inferential, and multiple correspondence statistical analysis of notification data from the Health Surveillance and Hospital Care Risk Management app on falls of hospitalized patients between 2017 and 2019. Results: predominated, among 153 notifications of falls in the period, those occurring in the ward, in surgical, emergency, and clinical care units, suffered by male patients, aged between 20 and 59 years. In this, the elderly stood out. Abrasion was the most reported harm. Multiple correspondence analysis did not show significance. Conclusion: the analysis of reported events contributed to the planning and implementation of the Fall Tailoring Interventions for Patient Safety Program in Brazil to improve the management of related risks.(AU)

Objetivo: describir el perfil de las caídas de pacientes internados reportadas en un hospital público y de enseñanza. Método: estudio descriptivo y retrospectivo, con análisis estadístico descriptivo, inferencial y análisis de correspondencias múltiples de datos de notificación de la aplicación Vigilancia en Salud y Gestión de Riesgos de Atención Hospitalaria sobre caídas de pacientes hospitalizados entre 2017 y 2019. Resultados: predominó, entre 153 notificaciones de caídas en el período, las ocurridas en el dormitorio, en unidades quirúrgicas, de emergencia y de atención clínica, sufridos por pacientes del sexo masculino, con edades entre 20 y 59 años. En este último, se destacaron los adultos mayores. La abrasión fue el daño más reportado. El análisis de correspondencia múltiple no mostró significación. Conclusión: el análisis de los eventos notificados contribuyó para la planificación e implementación del Programa Fall Tailoring Interventions for Patient Safety en Brasil para mejorar la gestión de sus riesgos re-lacionados.(AU

Young People Awareness of Sexually Transmitted Diseases and Contraception: A Portuguese Population-Based Cross-Sectional Study.

Adolescents and young adults are an important target concerning reducing health-risk behavior adoption, including sexual health. Studying their knowledge concerning sexuality and their main counsellors, can be an important step in targeting an updated health promotion approach. This study characterized adolescents and young adults' knowledge and attitudes about sexually transmitted diseases (STDs), and contraception, prospecting for their main trusted counseling sources. We conducted a cross-sectional, population-based, self-report survey of 746 individuals aged between 14 and 24 years from Paredes, Portugal. The questionnaire included many dimensions, as demographic characteristics, youth behavior, currently sexually active status, main counselors concerning health topics, awareness, and knowledge about STDs and contraception. Mean age of the participants was 18.3 years, 50.5% of them had started their sexual activity. Males present themselves as more sexually active, starting earlier, and have more sexual partners than females. Participants reported an adequate knowledge perception about STDs and contraception methods, however we found different patterns on specific STDs and contraceptive methods, according to gender, age, and sexually active status. Our results help design specific interventions to reach youth, community, and healthcare providers, pointing out the value of bringing people to the center of health policies.

Diversity of Nematoda and Digenea from different species of characiform fishes from Tocantins River, Maranhão, Brazil.

During a survey of the helminth fauna of characiform fishes from the Tocantins River, Brazil, 185 fish specimens from 22 species were studied. Twelve species of Nematoda and nine species of Digenea were collected. Some of these helminth species were reported for the first time in their hosts, thus representing new host records: Procamallanus (Spirocamallanus) sp. in Bivibranchia notata, Brycon pesu, Chalceus macrolepidotus, Hemiodus microlepis and Hemiodus unimaculatus; Procamallanus (Spirocamallanus) inopinatus in Triportheus elongatus; Goezia sp. (larva) in Boulengerella cuvieri; Rhabdochona acuminata in Brycon pesu and Triportheus trifurcatus; Raphidascaris sp. (larva) in Caenotropus labyrinthicus; Cosmoxynema vianai in Cyphocharax gouldingi; Rondonia rondoni in Leporinus fasciatus and Mylesinus paucisquamatus; Klossinemella iheringi in Mylesinus paucisquamatus; Cucullanidae gen. sp. in Myloplus rubripinnis; Rhabdochona sp. in Triportheus elongatus; Alphamphistoma sp. in Myleus setiger; Chalcinotrema sp. in Cyphocharax gouldingi; Pacudistoma guianense in Hemiodus unimaculatus and Myleus torquatus; Pseudocladorchis cylindricus in Hemiodus unimaculatus; Dadaytrema oxycephala in Mylesinus paucisquamatus; Travassosinia dilatata in Myloplus asterias; and Genarchella genarchella in Raphiodon vulpinus. Studies identifying new hosts and new localities for parasites have contributed to the knowledge of local biodiversity. A list of previous records of helminths included in the present study, providing hosts, localities, and references, is presented here.

Placental model as an important tool to study maternal-fetal interface.

The placenta is a temporary organ that plays critical roles at the maternal-fetal interface. Normal development and function of the placenta is dependent on hormonal signaling pathways that make the placenta a target of endocrine disrupting chemical (EDC) action. Studies showing association between prenatal exposure, hormone disruption, and reproductive damage indicate that EDCs are developmentally toxic and can impact future generations. In this context, new placental models (trophoblast-derived cell lines, organotypic or 3D cell models, and physiologically based kinetic models) have been developed in order to create new approach methodology (NAM) to assess and even prevent such disastrous toxic harm in future generations. With the widespread discouragement of conducting animal studies, it has become irrefutable to develop in vitro models that can serve as a substitute for in vivo models. The goal of this review is to discuss the newest in vitro models to understand the maternal-fetal interface and predict placental development, physiology, and dysfunction generated by failures in molecular hormone control mechanisms, which, consequently, may change epigenetic programming to increase susceptibility to metabolic and other disorders in the offspring. We summarize the latest placental models for developmental toxicology studies, focusing mainly on three-dimensional (3D) culture models.

Correction: Validation of the Unesp-Botucatu composite scale to assess acute postoperative abdominal pain in sheep (USAPS).

[This corrects the article DOI: 10.1371/journal.pone.0239622.].

Safety-Promoting Interventions for the Older Person with Hip Fracture on Returning Home: A Protocol for a Systematic Review.

Ageing and physical frailty associated with decrease in muscle and bone mass lead to the older persons' vulnerability and increased risk of falling. It is estimated that one in every ten falls in this age group results in a fracture, leading to a downward spiral in their health status, causing greater dependence, with a progressive functional decline that makes it difficult to return to their functional and social status prior to the fracture. The aim of this study is to identify the available evidence on the interventions that promote the safety of older people with hip fracture after hospital discharge. A search will be performed in MEDLINE and CINAHL databases. Randomised and controlled studies that focus on functional assessment, performance in activities of daily living, level of concern about falls, risk and prevalence of falls, injuries secondary to falls, re-fracture rate and health-related quality of life in hip fracture patients will be included. Two authors will perform the study selection, data extraction, and quality assessment independently. Any disagreements will be resolved through discussion with a third researcher. Methodological quality of the included trials will be evaluated by the Cochrane risk-of-bias criteria, and the Standards for Reporting Interventions in Controlled Trials.

Diagnóstico situacional do tratamento de feridas na atenção primária no município de Belém-PA / Situational diagnosis of wound treatment in primary care in the city of Belém-PA / Diagnóstico situacional del tratamiento de heridas en atención primaria en el municipio de Belém-PA

Objetivo: Realizaro diagnóstico situacional do tratamento de feridas na Atenção Primária no município de Belém-PA. Método: estudo descritivo e exploratório, qualitativo, com amostra de 24 profissionais de enfermagem e 10 usuários do serviço de curativos, realizado entre maio e outubro de 2021. Resultados: das 12 unidades, 7 (58%) não possuem sala de curativos. Itens estruturais presentes nas 5 unidades: bancada com pia, biombo e maca. Sobre registro no prontuário, 5 (50%) registram: tempo, tipo da lesão, odor; 7 (70%) não registram: características perilesionais, margem e exsudato. A satisfação do usuário foi positiva para: acolhimento e cuidados. Avaliação neutra: estrutura física. Avaliação negativa: recursos materiais. Através dos discursos evidenciou-se a necessidade do protocolo para: organizar, avaliar, reabilitar, prevenir, tratar pé diabético e lesões. Considerações finais: O serviço de prevenção e tratamento de feridas apresenta problemáticas plausíveis de intervenções. Não está estruturado de forma responsiva e resolutiva às demandas. É salutar que a gestão municipal planeje ações e estratégias junto ao conselho de saúde, gerentes e profissionais para atender as melhorias necessárias.

Objective: To carry out a situational diagnosis of the treatment of wounds in Primary Care in the municipality of Belém-PA. Method: descriptive and exploratory study, qualitative, with a sample of 24 nursing professionals and 10 users of the dressing service, carried out between May and October 2021. Results: of 12 units, 7 (58%) did not have a bandagerooms. Structural items present in 5 units: bench with pia, bedside screensand maca. About the record in the medical record, 5 (50%) registered: time, type of injury; 7 (70%) not registered: perilesional characteristics, margin and exudate. User satisfaction was positive for:accommodation and care. Neutral assessment: physical structure. Negative assessment: material resources. Through ofspeeches, the need for a protocol is evidenced to:organize, assess, rehabilitate, prevent, treat diabetics and injuries. Final considerations: The injury prevention and treatment service presents plausible problems for interventions. Is not structured in a resolutive way to the demands. It's necessarythat the municipal management plans actions and strategies together with the health council, managers and professionals to attend to the necessary improvements.

Objetivo: Realizar el diagnóstico situacional del tratamiento de heridas en la Atención Primaria de la ciudad de Belém-PA. Método: estudio cualitativo, descriptivo y exploratorio, con una muestra de 24 profesionales de enfermería y 10 usuarios del servicio de tratamiento de heridas, realizado entre mayo y octubre de 2021. Resultados: de las 12 unidades, 7 (58%) no cuentan con unidad de tratamiento de heridas. Elementos estructurales presentes en las 5 unidades: banco con lavabo, mamparas hospitalarias y camilla. En cuanto al registro en la historia clínica, 5 (50%) registraron: tiempo, tipo de lesión, olor; 7 (70%) no registraron: características perilesionales, margen y exudado. La satisfacción de los usuarios fue positiva para: recepción y atención. Valoración neutra: estructura física. Valoración negativa: recursos materiales. A través de las intervenciones se evidenció la necesidad del protocolo para: organizar, evaluar, rehabilitar, prevenir, tratar pie diabético y lesiones. Consideraciones finales: El servicio de prevención y tratamiento de heridas tiene plausibles problemas de intervención. No está estructurado de manera receptiva y resolutiva alas demandas. Es saludable que la gestión municipal planifique acciones y estrategias junto con el consejo de salud, gestores y profesionales para afrontar las mejoras necesarias.

Lower prevalence of congenital cytomegalovirus infection in Portugal: possible impact of COVID-19 lockdown?

Cytomegalovirus (CMV) is the most frequent cause of congenital infection all over the world. Its prevalence ranges from 0.2 to 2.2%. Transmission from children to their pregnant mothers is a well-known risk factor, particularly if they attend a childcare centre. This study aims to compare the prevalence of CMV congenital infection (CMV_CI) in Portugal (Lisbon) between two studies, performed respectively in 2019 and 2020. In the 2019 study, performed in two hospitals, we found a 0.67% CMV_CI prevalence, using a pool strategy previously tested with saliva samples. In the 2020 study, using the same pool approach in four hospitals (the previous and two additional), and based on 1277 samples, the prevalence was 0.078%.Conclusion: The close temporal coincidence with COVID-19 lockdown suggests that these measures may have had a significant impact on this reduction, although other explanations cannot be ruled-out. What is Known: • Cytomegalovirus is the leading cause of congenital infection. • Behavioural measures decrease cytomegalovirus seroconversion in pregnant women. What is New: • From 2019 to 2020 there was a significant reduction in the prevalence of congenital CMV infection.

Description of a safe doppler ultrasound-guided technique for hyaluronic acid filler in the face-A method to avoid adverse vascular events.

BACKGROUND: Knowledge of facial anatomy is essential for professionals intending to inject hyaluronic acid (HA) into that region, but due to the considerable anatomical variations in region, it does not guarantee the complete safety of the procedure. Similarly, procedures widely disseminated among professionals, such as aspiration and the use of cannulas, do not ensure total safety against vascular occlusion events caused by the filler. OBJECTIVES: This article describes a technique for injecting hyaluronic acid into the face guided by Doppler ultrasonography (DUS) in order to ensure greater safety against vascular occlusion events secondary to the procedure. METHODS: We describe a Doppler ultrasound-guided filling technique, with an 18 MHZ transducer, consisting of three steps: arterial mapping, real-time ultrasound-guided filling, and assessing the perfusion. RESULTS: The described technique was performed in 480 patients and can be adopted in the routine of professionals who inject hyaluronic acid, especially in areas at high risk for vascular events. Its use results in greater safety against vascular occlusion events secondary to the procedure, without the need for prior aspiration. We conclude that there is a local vasodilation right after the filling that makes it difficult the possibility of extrinsic compression exerted by the filler on the vessel. Furthermore, the product moves to deep planes even with the bevel facing up (toward the epidermis). CONCLUSIONS: We believe that in the future the use of Doppler ultrasound-guided filling technique will be mandatory for professionals who intend to perform HA injection, to both ensure patient safety and provide legal protection for the professional.

Neuromotor activity inhibition in zebrafish early-life stages after exposure to environmental relevant concentrations of caffeine.

Caffeine (CAF), a neuroactive compound, has been found in surface waters at concentrations ranging from few nanograms up to micrograms and may induce adverse effects in aquatic vertebrates. Thus, the aim of this study was to evaluate the potential of CAF in affecting fish early-life stages in a wide concentration range, including occurring levels in surface waters. Specimens of zebrafish in early-life stages were exposed to CAF for 168 h and survival, developmental alterations, locomotor activity and acetylcholinesterase activity were evaluated. CAF induced mortality in embryos unable to hatch or in larvae after hatching (LC50 - 168 h = 283.2 mg/L). Tail deformities were observed in organisms exposed to concentrations ≥ 40 mg/L, while edemas were found at concentrations of 100 mg/L. CAF also decreased the total swimming time and distance moved of exposed organisms (LOEC = 0.0006 mg/L). Locomotor inhibition may be associated with an acetylcholinesterase inhibition observed at concentration ≥ 0.0088 mg/L. Therefore, the hazard of CAF for fish populations deserves further attention since unexpected effects on neuro-behavioral parameters occurs at concentrations often detected in natural aquatic ecosystems.

A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses.

Proper pain therapy requires adequate pain assessment. This study evaluated the reliability and validity of the Unesp-Botucatu horse acute pain scale (UHAPS), the Orthopedic Composite Pain Scale (CPS) and unidimensional scales in horses admitted for orthopedic and soft tissue surgery. Forty-two horses were assessed and videotaped before surgery, up to 4 hours postoperatively, up to 3 hours after analgesic treatment, and 24 hours postoperatively (168 video clips). After six evaluators viewing each edited video clip twice in random order at a 20-day interval, they chose whether analgesia would be indicated and applied the Simple Descriptive, Numeric and Visual Analog scales, CPS, and UHAPS. For all evaluators, intra-observer reliability of UHAPS and CPS ranged from 0.70 to 0.97. Reproducibility was variable among the evaluators and ranged from poor to very good for all scales. Principal component analysis showed a weak association among 50% and 62% of the UHAPS and CPS items, respectively. Criterion validity based on Spearman correlation among all scales was above 0.67. Internal consistency was minimally acceptable (0.51-0.64). Item-total correlation was acceptable (0.3-0.7) for 50% and 38% of UHAPS and CPS items, respectively. UHAPS and CPS were specific (90% and 79% respectively), but both were not sensitive (43 and 38%, respectively). Construct validity (responsiveness) was confirmed for all scales because pain scores increased after surgery. The cut-off point for rescue analgesia was ≥ 5 and ≥ 7 for the UHAPS and CPS, respectively. All scales presented adequate repeatability, criterion validity, and partial responsiveness. Both composite scales showed poor association among items, minimally acceptable internal consistency, and weak sensitivity, indicating that they are suboptimal instruments for assessing postoperative pain. Both composite scales require further refinement with the exclusion of redundant or needless items and reduction of their maximum score applied to each item or should be replaced by other tools.

Auramine dyes induce toxic effects to aquatic organisms from different trophic levels: an application of predicted non-effect concentration (PNEC).

The dyes Auramine and Auramine O are used in several industrial products, despite the scarce information regarding their ecotoxicity. The aim of the present study was to assess the acute and chronic toxicity of both dyes to aquatic organisms from different trophic levels (Raphidocelis subcapitata, Daphnia similis, Hydra attenuata, and Danio rerio) and calculate their predicted non-effect concentrations (PNEC). Auramine and Auramine O induced toxicity to all selected test organisms with L(E)C50 values ranging from 300 to 4800 ug/L. Both dyes induced inhibition in the growth rate of exposed algae, negatively affecting the reproduction of D. similis and induced deformities in H. attenuata (clubbed tentacles and shortened tentacles) and D. rerio (edemas, tail malformation and delay in yolk sac absorption). PNEC values of 0.92 µg/L and 4.0 µg/L were obtained for Auramine and Auramine O, respectively, based on results of the most sensitive test system (algae). Test results were analyzed using the Criteria of Reporting and Evaluating Ecotoxicity Data (CRED), confirming their reliability and relevance. Thus, PNEC values can be used in future risk assessments of those substances in freshwater systems.

Validation of the Unesp-Botucatu composite scale to assess acute postoperative abdominal pain in sheep (USAPS).

A scale with robust statistical validation is essential to diagnose pain and improve decision making for analgesia. This blind, randomised, prospective and opportunist study aimed to develop an ethogram to evaluate behaviour and validate a scale to assess acute ovine postoperative pain. Elective laparoscopy was performed in 48 healthy sheep, filmed at one preoperative and three postoperative moments, before and after rescue analgesia and 24 hours after. The videos were randomised and assessed twice by four evaluators, with a one-month interval between evaluations. Statistical analysis was performed using R software and differences were considered significant when p <0.05. Based on the multiple association, a unidimensional scale was adopted. The intra- and inter-observer reliability ranged from moderate to very good (intraclass correlation coefficient ≥ 0.53). The scale presented Spearman correlations > 0.80 with the numerical, simple descriptive, and visual analogue scales, and a correlation of 0.48 with the facial expression scale. According to the mixed linear model, the scale was responsive, due to the increase and decrease in pain scores of all items after surgery and analgesic intervention, respectively. All items on the scale demonstrated an acceptable Spearman item-total correlation (0.56-0.76), except for appetite (0.25). The internal consistency was excellent (Cronbach's α = 0.81) and all items presented specificity > 0.72 and sensitivity between 0.61-0.90, except for appetite. According to the Youden index, the cut-off point was ≥ 4 out of 12, with a diagnostic uncertainty zone of 4 to 5. The area under the curve > 0.95 demonstrated the excellent discriminatory capacity of the instrument. In conclusion, the Unesp-Botucatu pain scale in sheep submitted to laparoscopy is valid, reliable, specific, sensitive, with excellent internal consistency, accuracy, discriminatory capacity, and a defined cut-off point.