Autophagy degrades immunogenic endogenous retroelements induced by 5-azacytidine in acute myeloid leukemia.

The hypomethylating agent 5-azacytidine (AZA) is the first-line treatment for AML patients unfit for intensive chemotherapy. The effect of AZA results in part from T-cell cytotoxic responses against MHC-I-associated peptides (MAPs) deriving from hypermethylated genomic regions such as cancer-testis antigens (CTAs), or endogenous retroelements (EREs). However, evidence supporting higher ERE MAPs presentation after AZA treatment is lacking. Therefore, using proteogenomics, we examined the impact of AZA on the repertoire of MAPs and their source transcripts. AZA-treated AML upregulated both CTA and ERE transcripts, but only CTA MAPs were presented at greater levels. Upregulated ERE transcripts triggered innate immune responses against double-stranded RNAs but were degraded by autophagy, and not processed into MAPs. Autophagy resulted from the formation of protein aggregates caused by AZA-dependent inhibition of DNMT2. Autophagy inhibition had an additive effect with AZA on AML cell proliferation and survival, increased ERE levels, increased pro-inflammatory responses, and generated immunogenic tumor-specific ERE-derived MAPs. Finally, autophagy was associated with a lower abundance of CD8+ T-cell markers in AML patients expressing high levels of EREs. This work demonstrates that AZA-induced EREs are degraded by autophagy and shows that inhibiting autophagy can improve the immune recognition of AML blasts in treated patients.

Mpox outbreak in Rio de Janeiro, Brazil: A translational approach.

Mpox is a zoonotic disease historically reported in Africa. Since 2003, limited outbreaks have occurred outside Africa. In 2022, the global spread of cases with sustained interhuman transmission and unusual disease features raised public health concerns. We explore the mpox outbreak in Rio de Janeiro (RJ) state, Brazil, in an observational study of mpox-suspected cases from June to December 2022. Data collection relied on a public healthcare notification form. Diagnosis was determined by MPXV-PCR. In 46 confirmed cases, anti-OPXV IgG was determined by ELISA, and seven MPXV genomes were sequenced. A total of 3095 cases were included, 816 (26.3%) with positive MPXV-PCR results. Most positive cases were men in their 30 s and MSM. A total of 285 (34.9%) MPXV-PCR+ patients live with HIV. Eight were coinfected with varicella-zoster virus. Anogenital lesions and adenomegaly were associated with the diagnosis of mpox. Females and individuals under 18 represented 9.4% and 5.4% of all confirmed cases, respectively, showing higher PCR cycle threshold (Ct) values and fewer anogenital lesions compared to adult men. Anti-OPXV IgG was detected in 29/46 (63.0%) patients. All analyzed sequences belonged to clade IIb. In RJ state, mpox presented a diverse clinical picture, represented mainly by mild cases with low complication rates and prominent genital involvement. The incidence in females and children was higher than usually reported. The observation of a bimodal distribution of Ct values, with few positive results, may suggest the need to review the diagnostic criteria in these groups.

A Survey of PAPR Techniques Based on Machine Learning.

Orthogonal Frequency Division Multiplexing (OFDM) is the modulation technology used in Fourth Generation (4G) and Fifth Generation (5G) wireless communication systems, and it will likely be essential to Sixth Generation (6G) wireless communication systems. However, OFDM introduces a high Peak to Average Power Ratio (PAPR) in the time domain due to constructive interference among multiple subcarriers, increasing the complexity and cost of the amplifiers and, consequently, the cost and complexity of 6G networks. Therefore, the development of new solutions to reduce the PAPR in OFDM systems is crucial to 6G networks. The application of Machine Learning (ML) has emerged as a promising avenue for tackling PAPR issues. Along this line, this paper presents a comprehensive review of PAPR optimization techniques with a focus on ML approaches. From this survey, it becomes clear that ML solutions offer customized optimization, effective search space navigation, and real-time adaptability. In light of the demands of evolving 6G networks, integration of ML is a necessity to propel advancements and meet increasing prerequisites. This integration not only presents possibilities for PAPR reduction but also calls for continued exploration to harness its potential and ensure efficient and reliable communication within 6G networks.

Effect of ZrO2 paste, surface treatments, and storage on Weibull characteristics and resin bond strength to zirconia.

The objective is to evaluate the effect of different surface treatments and storage on the shear strength of ultratranslucent zirconia. 36 blocks of ultra-translucent zirconia were fabricated (7x7x2mm) and sintered. Then, divided into 12 groups according to the "surface treatment" (C -Primer; Al -Sandblasting with Al2O3 + Primer; Si -Silicate + Primer; Gl -Glaze + HF + Primer; Z -Zirlink; Zp -Zirlink + Primer) and "storage" factors (ST-with 150 days/37º and without). After surface treatment, five cylinders (Ø=2mm; h=2.0mm) of resin cement (n=15) were constructed in each ceramic block; at the end, the shear strength test was performed (1mm/min, 50Kgf), and analysis of surface failures. 60 additional samples (2x2x2mm) were made for extras analysis (surface roughness, MEV, and EDS). Bond strength and surface roughness data were statistically evaluated by ANOVA (2 factors/1 factor), Tukey test (5%), and Weibull analysis, respectively. ANOVA (2-way) revealed that all factors were statistically significant for bond strength. The silicatization groups (SiST: 30.47AMPa; Si: 29.21AMPa) showed the highest bond strength values, regardless of storage (Tukey's test). While the groups treated with Zirlink (ZST: 2.76FMPa; Z: 5.27EFMPa) showed the lowest values, just similar to the GlST group (5.14EFMPa). The Weibull modulus (m) showed a statistical difference between groups (p=0.000). ANOVA (1 factor) revealed that the "surface treatment" factor (p=0.0000) was statistically significant for surface roughness. Therefore, the application of Zirlink and Glaze on pre-sintered zirconia did not promote efficient adhesion of the ultratranslucent zirconia to the resin cement, even when associated with a primer containing MDP.

The oral health impact profile and well-being on mothers and preschool children.

OBJECTIVES: to verify the contribution of mothers' oral health impact profile to their children's oral health profile and the contribution of mothers' well-being and the caries index (dmft) to children's well-being. METHODS: This is a cross-sectional observational study. Mothers and pre-school children enrolled in public schools in the municipality of Araraquara-SP took part. The Oral Health Impact Profile Questionnaire (OHIP-14), Satisfaction with Life Scale (SWLS), Early Childhood Oral Health Impact Scale (ECOHIS) and the Autoquestionnaire Qualité de Vie Enfant Imagé (AUQEI) were used. To diagnose caries, a clinical examination was carried out to calculate the dmft index. Path analysis was carried out and the path coefficients were estimated (ß) and evaluated using the z-test (α = 5%). RESULTS: 443 children took part (5.19 ± 0.64 years; 52.4% boys) with an mean dmft of 1.31 ± 2.19. The mean age of the mothers was 33.4 ± 7.01 years. There was a significant impact of dmft and maternal well-being on the child's subjective well-being (s2explained = 43%). The mothers' oral health impact profile and the child's caries experience had a significant influence on both the child (OHIP: ß = 0.22; p < 0.001; dmft: ß = 0.48; p < 0.001) and the family (OHIP: ß = 0.29; p < 0.001; dmft: ß = 0.32; p < 0.001). The child's dmft (ß=-0.10; p = 0.005) and the mothers' subjective well-being (ß=-0.61; p < 0.001) had a significant impact on the child's subjective well-being. CONCLUSION: The mothers' oral health impact profile and the child's caries experience had an impact on both the child and the family. Mothers' subjective well-being and caries experience should be considered when assessing the subjective well-being of Brazilian preschool children.

Melatonin improves the viability and ultrastructure of bovine oocyte-granulosa complexes of in vitro cultured early antral follicles.

This study aims to investigate the effects of melatonin on follicular growth, viability and ultrastructure, as well as on the levels of mRNA for antioxidant enzymes, reactive oxygen species (ROS) and meiotic progression in oocytes from in vitro cultured bovine early antral follicles. To this end, isolated early antral follicles (500-600 µm) were cultured in TCM-199+ alone or supplemented with 10-6 , 10-7 or 10-8 M melatonin at 38.5°C with 5% CO2 for 8 days. Follicle diameters were evaluated at days 0, 4 and 8 of culture. At the end of culture, ultrastructure, chromatin configuration, viability (calcein-AM and ethidium homodimer-1 staining), and the levels of ROS and mRNA for catalase (CAT), superoxide dismutase (SOD) and peroxiredoxin 6 (PRDX6) and glutathione peroxidase (GPx) were investigated in oocyte-granulosa cell complexes (OGCs). The results showed that early antral follicles cultured with 10-6 and 10-8 M melatonin had a progressive and significant increase in their diameters throughout the culture period (p < .05). Additionally, oocytes from follicles cultured with 10-7 or 10-8 M melatonin had increased fluorescence for calcein-AM, while those cultured with 10-6 or 10-7 M had reduced fluorescence for ethidium homodimer-1. Different from follicles cultured in other treatments, those cultured with 10-8 M melatonin had well-preserved ultrastructure of oocyte and granulosa cells. Melatonin, however, did not influence the levels of ROS, the mitochondrial activity, oocyte meiotic resumption and expression mRNA for SOD, CAT, GPX1 and PRDX6. In conclusion, the presence of 10-8 M melatonin in culture medium improves viability and preserves the ultrastructure of oocyte and granulosa cells of early antral follicles cultured in vitro.

Histoplasmosis in HIV/AIDS patients in Amazonas, Northern Brazil.

Histoplasmosis is commonly observed in AIDS patients as a neglected opportunistic disease that has an important relationship with environmental factors. The present study described the clinical characteristics of HIV/AIDS patients diagnosed with disseminated histoplasmosis in a tertiary healthcare facility in Manaus, Amazonas, Brazil, and evaluated the patients' homes and urban environmental samples as a source of exposure to Histoplasma capsulatum. A review of medical records from 2017 to 2019 of patients with HIV/AIDS associated with histoplasmosis was carried out, as well as the collection of environmental samples in the homes of these patients. These samples were subjected to DNA extraction and then subjected to qPCR. A total of 62 patients diagnosed with HIV/AIDS and histoplasmosis were identified, which corresponds to 4.5% (n = 62/1372) of the HIV/AIDS cases detected in the period. Of these, 68% (n = 42/62) were male, with a mean age of 36 years and low education. In 47% (n = 29/62) of the cases, the diagnosis of HIV/AIDS and histoplasmosis occurred simultaneously. Mortality was 45% (n = 28/62), and 68% (n = 42/62) of these patients did not regularly use highly active antiretroviral therapy. The main symptoms found were respiratory, gastrointestinal, and weight loss, and in 81% (n = 50/62), the place of residence was in an urban area. A total of 57 environmental samples were analyzed, and the presence of Histoplasma capsulatum was not detected in any of the analyzed samples. There was a high mortality rate in the studied group of patients with AIDS and histoplasmosis. Most patients reported residing in urban areas of Manaus, with no history of travel to other areas previously known as being high risk for histoplasmosis.

A Single-System Ectopic Ureter in a Child: A Challenge for Early Diagnosis.

An ectopic ureter is an uncommon anomaly, usually associated with a duplicated urinary system. Up to 20% of ectopic ureters occur in a single system. In females, only 25% of ectopic ureters insert into the vagina and usually cause urinary incontinence, which can be confused with vaginal discharge. The diagnostic investigation includes urinary tract ultrasound, DMSA, and urethrocystography, which evaluate renal morphology and function, determining factors for surgical treatment decision that aims to preserve renal function, prevent the recurrence of infections, and reestablish urinary continence. The rarity of this anomaly and the delay in recognizing symptoms are factors related to late diagnosis.

Analyzing the psychological variables linked to performance in beach volleyball: an integrative review and practical recommendations / Análisis de las variables psicológicas vinculadas al rendimiento en voleibol playa: una revisión integradora y recomendaciones prácticas / Análise das variáveis psicológicas ligadas ao desempenho no voleibol de praia: uma revisão integrativa e recomendações práticas

Beach volleyball is an important team sport in which physical, technical, tactical,and psychological/social aspects are fundamental to sporting performance. However, this is the first review to analyse scientific production on psychological variables in beach volleyball. This is an integrative review in which a systematic search was carried out in five electronic databases (PubMed/MEDLINE, SPORTDiscus/EBSCO, SciELO, Scopus and BIREME) until September 2022. The terms used were "beach volleyball" OR "voleibolde praia" OR "vôlei de praia". In addition, the search included research with athletes, acute and chronic outcomes, and studies of various methods (e.g.,experimental, observational) involving psychological variables. The initial search identified 652 articles, and after the manual search and application of the inclusion criteria, 18 studies were integrated into a final synthesis.Most of the studies were published between 2011 and 2022 (n= 14; 77.78%). Observational design was the main method used (n= 10; 55.56%). The studies were grouped into nine major topics for synthesis: stress situation, activation levels, concentration, goal orientation and motivation, mental fatigue and performance, anxiety,and performance, discouraging environments, relationships between team members, coping strategies. In general, social relationships and self-control appear significant for performance; thus,coaches must serve as role models for players and sports psychologists can aid in monitoring psychological variables, team dynamics, and develop psychological skills.(AU)

El vóleyplaya es un importante deporte de equipo en el que los aspectos físicos, técnicos, tácticos y psicológicos/sociales son fundamentales para el rendimiento deportivo. Sin embargo, esta es la primera revisión que analiza la producción científica sobre variables psicológicas en vóleyplaya. Se trata de una revisión integradora en la que se realizó una búsqueda sistemática en cinco bases de datos electrónicas (PubMed/MEDLINE, SPORTDiscus/EBSCO, SciELO, Scopus y BIREME) hasta septiembre de 2022. Los términos utilizados fueron "beach volleyball" OR "voleibol de praia" OR "vôlei de praia". Además, la búsqueda incluyó investigaciones con atletas, intervenciones agudas y crónicas, estudios de diversos métodos (e.g., experimentales, observacionales) que implicaran variables psicológicas. La búsqueda inicial identificó 652 artículos y, después de la búsqueda manual y la aplicación de los criterios de inclusión, 18 estudios se integraron en una síntesis final. La mayoría de los estudios fueron publicados entre 2011 y 2022 (n= 14; 77.78%). El diseño observacional fue el principal método utilizado (n= 10; 55.56%). Los estudios se agruparon en nueve grandes temas para la síntesis: situación de estrés, niveles de activación, concentración, orientación a objetivos y motivación, fatiga mental y rendimiento, ansiedad y rendimiento, entornos desalentadores, relaciones entre los miembros del equipo, estrategias de afrontamiento. Las relaciones sociales y el autocontrol parecen ser importantes para el rendimiento, por lo quelos entrenadores deben comportarse como modelos para los deportistas. Además, los psicólogosdeportivos pueden ayudar a controlar las variables psicológicas, la dinámica del equipo y a desarrollar habilidades psicológicas.(AU)

O voleibol de praia é um importante esporte coletivo em que aspectos físicos, técnicos, táticos e psicológicos/sociais são fundamentais para o desempenho esportivo. No entanto, esta é a primeira revisão que teve como objetivo analisar a produção científica sobre variáveis psicológicas no voleibol de praia. Essa é uma revisão integrativa em que foi realizada uma busca em cinco bases de dados eletrônicas (PubMed/MEDLINE, SPORTDiscus/EBSCO, SciELO, Scopus e BIREME) até setembro de 2022, de forma sistemática. Os temos usados foram “beach volleyball” OU “voleibol de praia” OU “vôlei de praia”. Além disso, foram incluídos nessa busca pesquisas com atletas, intervenções agudas e crônicas, estudos de vários métodos (e.g., experimental, observacional) que envolviam variáveis psicológicas. A busca inicial identificou 652 artigos, após a busca manual e aplicação dos critérios de inclusão, 18 estudos foram integrados a uma síntese final. A maioria dos estudos foi publicada entre 2011 e 2022 (n= 14; 77.78%). O desenho observacional foi o principal método utilizado (n= 10; 55.56%). Os estudos foram agrupados em nove grandes tópicos para síntese: situação de estresse, níveis de ativação, concentração, orientação para metas e motivação, fadiga mental e desempenho, ansiedade e desempenho, ambientes desanimadores, relacionamento entre as partes da equipe, estratégias de enfrentamento. As relações sociais e o autocontrole parecem importantes para o desempenho, portanto treinadores devem se comporta como modelo para os atletas. Além disso, psicólogos do esporte podem ajudar a monitorizar as variáveis psicológicas, na dinâmica da equipa e desenvolver de competências psicológicas.(AU)

Application of the ICU Mobility Scale in patients submitted to cardiac surgery / Aplicação da ICU Mobility Scale em pacientes submetidos à cirurgia cardíaca

Abstract Introduction Early mobilization is an alternative used in the Intensive Care Unit (ICU) to reduce the effects of immobility. The Intensive Care Unit Mobility Score (IMS) is applied to assess mobility status. Objective To determine the functional level of ICU patients submitted to cardiac surgery using the IMS scale. Methods This is an analytical observational study carried out with adult ICU patients submitted to cardiac surgery. Data on the use of vasoactive drugs, functional level through IMS, duration of mechanical ventilation and length of ICU stay were collected from the physiotherapy routine form and recorded on a specific instrument developed for the study. The data obtained from the IMS scale score on the postoperative days in the ICU were used to classify the patients' mobility during the hospitalization period. Descriptive statistics were used to present the data. Results A total of 69 patients were evaluated, 43% of whom were men, and all had an SMI of 0 on the first postoperative day. Classification on the scale increased over the course of hospitalization (IMS between 7 and 10), despite the use of vasoactive drugs in 54.6% of the individuals. Conclusion Patients submitted to cardiac surgery admitted to the ICU had moderate-to-high mobility levels throughout their stay and at discharge from the ICU.

Resumo Introdução A mobilização precoce é uma alternativa utilizada em Unidades de Terapia Intensiva (UTIs) na tentativa de reduzir os efeitos decorrentes do imobilis-mo. A escala de mobilidade em UTIs ou Intensive Care Unit Mobility Score (IMS) é aplicada para avaliar o nível de mobilidade. Objetivo Verificar por meio da escala IMS o nível de funcionalidade de pacientes submetidos à cirurgia cardíaca internados em uma UTI. Métodos Trata-se de um estudo observacional analítico realizado em UTI com pacientes adultos submetidos à cirurgia car-díaca. Foram coletados da ficha de rotina da fisioterapia informações quanto ao uso de drogas vasoativas, nível funcional por meio da IMS, tempo de ventilação mecânica e de internação na UTI, e registrados em instrumento específico desenvolvido para o estudo. Os dados obtidos do escore da escala IMS nos dias de pós-operatório na UTI foram utilizados para classificar a mobilidade dos pacientes durante o período de internação. Utilizou-se estatística descritiva para a apresentação dos dados. Resultados Foram avaliados 69 pacientes, 43% eram do sexo masculino e todos apresentavam IMS 0 no primeiro dia de pós-operatório. A classificação na escala aumentou com o decorrer do período de internação (IMS entre 7 e 10), apesar do uso de drogas vasoativas em 54,6%. Conclusão Os pacientes submetidos à cirurgia cardíaca internados na UTI apresentaram níveis de mobilidade de moderado a alto ao longo da internação e na alta da UTI.

Real-time changes in rib cage expansion and use of abdominal mechanical stimulation in newborns: a quasi-experimental study / Mudanças na expansibilidade torácica com o uso de estímulo mecânico na região abdominal em recém-nascidos: um estudo quase-experimental

ABSTRACT Objective: To assess the rib cage expansion and respiratory rate in newborns using an abdominal stabilization band. Methods: The study included 32 newborns of both genders, with gestational age between 35 and 41 weeks. The abdominal stabilization band was used for 15 minutes between the xiphoid process and the anterosuperior iliac crest, with an abdominal contention 0.5cm smaller than the abdominal circumference. The rib cage expansion was evaluated by a breathing transducer (Pneumotrace II™) three minutes before using the band, during the use (15 minutes), and ten minutes after removing the band. The Shapiro-Wilk test verified data normality, and the Wilcoxon test compared the variables considering rib cage expansion and respiratory rate. Significance was set to p<0.05. Results: There was an increase in respiratory rate when comparing before and ten minutes after removing (p=0.008) the abdominal stabilization band, as well as when comparing during its use and ten minutes after its removal (p=0.001). There was also an increase in rib cage expansion when comparing before and during the use of the abdominal stabilization band (p=0.005). Conclusions: The use of the abdominal stabilization band promoted an increase in the rib cage expansion and respiratory rate in the assessed newborns and may be a viable option to improve the respiratory kinematics of this population.

RESUMO Objetivo: Avaliar a expansibilidade torácica e a frequência respiratória em recém-nascidos que fizeram uso de uma faixa de estabilização abdominal. Métodos: O estudo incluiu 32 recém-nascidos de ambos os sexos, com idade gestacional entre 35 e 41 semanas. A faixa de estabilização abdominal foi mantida por 15 minutos entre o processo xifoide e a espinha ilíaca anterossuperior, com contenção abdominal 0,5 cm menor do que a circunferência abdominal. A expansibilidade torácica foi avaliada por um transdutor piezoelétrico (Pneumotrace II™) 3 minutos antes do uso da faixa, durante 15 minutos, e 10 minutos após sua retirada. A normalidade das variáveis foi testada pelo teste de Shapiro-Wilk e a análise comparativa da expansibilidade torácica e da frequência respiratória foi realizada por meio do teste t pareado, considerando-se p<0,05. Resultados: Houve aumento da frequência respiratória quando comparados os tempos antes do uso da faixa e 10 minutos após a retirada (p=0,008), bem como quando comparados os tempos durante o uso e 10 minutos após a retirada da faixa (p=0,001). Houve aumento da expansibilidade torácica quando comparados os tempos antes e durante o uso da faixa (p=0,005). Conclusões: O uso da faixa de estabilização abdominal conferiu aumento da expansibilidade torácica e da frequência respiratória nos recém-nascidos estudados, podendo ser uma opção viável para a melhora da cinemática respiratória dessa população.

Effect of ZrO2 paste, surface treatments, and storage on Weibull characteristics and resin bond strength to zirconia

Abstract The objective is to evaluate the effect of different surface treatments and storage on the shear strength of ultratranslucent zirconia. 36 blocks of ultra-translucent zirconia were fabricated (7x7x2mm) and sintered. Then, divided into 12 groups according to the "surface treatment" (C -Primer; Al -Sandblasting with Al2O3 + Primer; Si -Silicate + Primer; Gl -Glaze + HF + Primer; Z -Zirlink; Zp -Zirlink + Primer) and "storage" factors (ST-with 150 days/37º and without). After surface treatment, five cylinders (Ø=2mm; h=2.0mm) of resin cement (n=15) were constructed in each ceramic block; at the end, the shear strength test was performed (1mm/min, 50Kgf), and analysis of surface failures. 60 additional samples (2x2x2mm) were made for extras analysis (surface roughness, MEV, and EDS). Bond strength and surface roughness data were statistically evaluated by ANOVA (2 factors/1 factor), Tukey test (5%), and Weibull analysis, respectively. ANOVA (2-way) revealed that all factors were statistically significant for bond strength. The silicatization groups (SiST: 30.47AMPa; Si: 29.21AMPa) showed the highest bond strength values, regardless of storage (Tukey's test). While the groups treated with Zirlink (ZST: 2.76FMPa; Z: 5.27EFMPa) showed the lowest values, just similar to the GlST group (5.14EFMPa). The Weibull modulus (m) showed a statistical difference between groups (p=0.000). ANOVA (1 factor) revealed that the "surface treatment" factor (p=0.0000) was statistically significant for surface roughness. Therefore, the application of Zirlink and Glaze on pre-sintered zirconia did not promote efficient adhesion of the ultratranslucent zirconia to the resin cement, even when associated with a primer containing MDP.

Resumo O objetivo é avaliar o efeito de diferentes tratamentos superficiais e do envelhecimento na resistência ao cisalhamento da zircônia ultratranslúcida. Foram confeccionados 36 blocos de zircônia ultratranslúcida (7x7x2mm) e sinterizados. Em seguida, divididos em 12 grupos de acordo com o "tratamento de superfície" (C-Primer; Al-Jateamento com Al2O3+Primer; Si-Silicato+Primer; Gl -Glaze+HF+Primer; Z-Zirlink; Zp-Zirlink+Primer) e fatores de "armazenamento" (ST-com, 150 dias/37º e sem). Após o tratamento superficial, foram construídos cinco cilindros (Ø=2mm; h=2,0mm) de cimento resinoso (n=15) em cada bloco cerâmico; ao final foi realizado o ensaio de resistência ao cisalhamento (1mm/min, 50Kgf) e análise de falhas superficiais. Foram confeccionadas 60 amostras adicionais (2x2x2mm) para análises extras (rugosidade superficial, MEV e EDS). Os dados de resistência de união e rugosidade superficial foram avaliados estatisticamente por ANOVA (2 fatores/1fator), teste de Tukey (5%) e análise de Weibull, respectivamente. ANOVA (2 fatores) revelou que todos os fatores foram estatisticamente significativos para a resistência de união. Os grupos de silicatização (SiST: 30,47AMPa; Si: 29,21AMPa) apresentaram os maiores valores de resistência de união, independente do armazenamento (Tukey). Enquanto os grupos tratados com Zirlink (ZST: 2,76FMPa; Z: 5,27EFMPa) apresentaram os valores mais baixos, apenas semelhantes ao grupo GlST (5,14EFMPa). O módulo de Weibull (m) apresentou diferença estatística entre os grupos (p=0,000). A ANOVA (1 fator) revelou que o fator "tratamento superficial" (p=0,0000) foi estatisticamente significativo para rugosidade superficial. Portanto, a aplicação de Zirlink e do Glaze na zircônia pré-sinterizada não promoveu adesão eficiente da zircônia ultratranslúcida ao cimento resinoso, mesmo quando associada a primer contendo MDP.

Mental health nursing care for people with diabetes mellitus: An integrative review. / Atención de enfermería en salud mental a personas con diabetes mellitus: revisión integrativa.

OBJECTIVE: evaluate the evidence available on mental health nursing care for people with diabetes mellitus at different levels of health care. METHOD: integrative literature review. The search was conducted in five databases. The sample consisted of 14 studies. The studies were exported to the EndNote manager and their data to a Microsoft Excel spreadsheet. The methodological quality of the studies was evaluated using tools proposed by the Joanna Briggs Institute. Sampling, categorization, evaluation, interpretation of the results, and synthesis of the included studies were carried out by two reviewers independently. The descriptive analysis of the results is presented in three categories. RESULTS: self-care guidelines enhanced by the social support network, encompassing physical and psychological tools and strategies; therapeutic communication and psychotherapy strategies, focusing on psychotherapy and therapeutic communication; and self-management interventions, addressing self-care based on behavioral theories. CONCLUSION: the synthesis of knowledge revealed that guidelines for self-care enhanced by the social support network, psychotherapy and therapeutic communication strategies, and self-management interventions are positive interventions that contribute to people with mental disorders and diabetes mellitus in the prevention of diseases.

Diversity of Neotropical stalked-puffball: Two new species of Tulostoma with reticulated spores.

Species of the genus Tulostoma are easily recognizable by the presence of a spore sac, with a mouth from which spores are released, attached to a stipe. Tulostoma is a species-diverse genus with a worldwide distribution, and some attempts were made to delimitate species and to evaluate reliable taxonomic-informative characteristics for species identification. However, there is a notable information gap regarding Neotropical species, especially for geographic distribution and DNA data, which hampers further understanding of the infrageneric diversity, evolution, and ecology of this genus. Based on morphological analysis, molecular phylogenetics and geographic distribution, we propose here two new species of Tulostoma with reticulated spores, from the two threatened Brazilian geographical areas, Atlantic Forest and "campos rupestres" (rupestrian grassland), as well as we provide notes on the taxonomic rank of Tulostoma exasperatum var. ridleyi.

Real-time changes in rib cage expansion and use of abdominal mechanical stimulation in newborns: a quasi-experimental study.

OBJECTIVE: To assess the rib cage expansion and respiratory rate in newborns using an abdominal stabilization band. METHODS: The study included 32 newborns of both genders, with gestational age between 35 and 41 weeks. The abdominal stabilization band was used for 15 minutes between the xiphoid process and the anterosuperior iliac crest, with an abdominal contention 0.5cm smaller than the abdominal circumference. The rib cage expansion was evaluated by a breathing transducer (Pneumotrace II™) three minutes before using the band, during the use (15 minutes), and ten minutes after removing the band. The Shapiro-Wilk test verified data normality, and the Wilcoxon test compared the variables considering rib cage expansion and respiratory rate. Significance was set to p<0.05. RESULTS: There was an increase in respiratory rate when comparing before and ten minutes after removing (p=0.008) the abdominal stabilization band, as well as when comparing during its use and ten minutes after its removal (p=0.001). There was also an increase in rib cage expansion when comparing before and during the use of the abdominal stabilization band (p=0.005). CONCLUSIONS: The use of the abdominal stabilization band promoted an increase in the rib cage expansion and respiratory rate in the assessed newborns and may be a viable option to improve the respiratory kinematics of this population.

Atención de enfermería en salud mental a personas con diabetes mellitus: revisión integrativa / Mental health nursing care for people with diabetes mellitus: An integrative review / Cuidados de enfermagem em saúde mental para pessoas com diabetes mellitus: revisão integrativa

Objetivo: evaluar las evidencias disponibles en la literatura sobre la atención de enfermería en salud mental a personas con diabetes mellitus en los diferentes niveles de atención de salud. Método: revisión integrativa de la literatura. Búsqueda en cinco bases de datos. Muestra de 14 estudios, exportados al gerenciador EndNote®. Los datos se organizaron en planilla de Microsoft Excel®. La calidad metodológica de los estudios fue evaluada mediante herramientas propuestas por el Joanna Briggs Institute. Las etapas de muestreo, categorización, evaluación, interpretación de resultados y síntesis de los estudios incluidos fueron realizadas por dos revisores de manera independiente y ciega. El análisis descriptivo de resultados está presentado en tres categorías. Resultados: recomendaciones para autocuidado reforzado por la red de apoyo social, incluyendo herramientas y estrategias de los ámbitos físico y psíquico; estrategias de comunicación terapéutica y psicoterapia, haciendo foco en la psicoterapia y la comunicación terapéutica; e intervenciones de autogestión/autogerenciamiento, abordando el autocuidado en base a teorías conductuales. Conclusión: la síntesis de conocimientos reveló que las pautas de autocuidado reforzadas por la red de apoyo social, las estrategias de comunicación terapéutica y psicoterapia y las intervenciones de autogestión/autogerenciamiento son intervenciones positivas que ayudan a las personas con diabetes mellitus y trastornos mentales a prevenir complicaciones.

Objective: evaluate the evidence available on mental health nursing care for people with diabetes mellitus at different levels of health care. Method: integrative literature review. The search was conducted in five databases. The sample consisted of 14 studies. The studies were exported to the EndNote manager and their data to a Microsoft Excel spreadsheet. The methodological quality of the studies was evaluated using tools proposed by the Joanna Briggs Institute. Sampling, categorization, evaluation, interpretation of the results, and synthesis of the included studies were carried out by two reviewers independently. The descriptive analysis of the results is presented in three categories. Results: self-care guidelines enhanced by the social support network, encompassing physical and psychological tools and strategies; therapeutic communication and psychotherapy strategies, focusing on psychotherapy and therapeutic communication; and self-management interventions, addressing self-care based on behavioral theories. Conclusion: the synthesis of knowledge revealed that guidelines for self-care enhanced by the social support network, psychotherapy and therapeutic communication strategies, and self-management interventions are positive interventions that contribute to people with mental disorders and diabetes mellitus in the prevention of diseases.

Objetivo: avaliar as evidências disponíveis sobre os cuidados de enfermagem em saúde mental para pessoas com diabetes mellitus nos diferentes níveis de atenção à saúde. Método: revisão integrativa da literatura. Busca realizada em cinco bases de dados. Amostra composta por 14 estudos. Os estudos foram exportados para o gerenciador EndNote, e seus dados, para uma planilha desenvolvida pelo Microsoft Excel. A qualidade metodológica dos estudos foi avaliada por meio de ferramentas propostas pelo Joanna Briggs Institute. Etapas de amostragem, categorização, avaliação, interpretação dos resultados e síntese dos estudos incluídos foram realizadas por dois revisores de forma independente e mascarada. A análise descritiva dos resultados é apresentada em três categorias. Resultados: orientações para o autocuidado potencializadas pela rede de suporte social, englobando ferramentas e estratégias no âmbito físico e psíquico; estratégias de comunicação terapêutica e psicoterapia, focalizando a psicoterapia e a comunicação terapêutica; e intervenções de autogestão/ autogerenciamento, abordando o autocuidado com base em teorias comportamentais. Conclusão: a síntese do conhecimento revelou que as orientações para o autocuidado potencializadas pela rede de suporte social, estratégias de comunicação terapêutica e psicoterapia e intervenções de autogestão/autogerenciamento são intervenções positivas que auxiliam as pessoas com transtornos mentais e diabetes mellitus na prevenção de agravos.

Molecular mechanism of glutaminase activation through filamentation and the role of filaments in mitophagy protection.

Glutaminase (GLS), which deaminates glutamine to form glutamate, is a mitochondrial tetrameric protein complex. Although inorganic phosphate (Pi) is known to promote GLS filamentation and activation, the molecular basis of this mechanism is unknown. Here we aimed to determine the molecular mechanism of Pi-induced mouse GLS filamentation and its impact on mitochondrial physiology. Single-particle cryogenic electron microscopy revealed an allosteric mechanism in which Pi binding at the tetramer interface and the activation loop is coupled to direct nucleophile activation at the active site. The active conformation is prone to enzyme filamentation. Notably, human GLS filaments form inside tubulated mitochondria following glutamine withdrawal, as shown by in situ cryo-electron tomography of cells thinned by cryo-focused ion beam milling. Mitochondria with GLS filaments exhibit increased protection from mitophagy. We reveal roles of filamentous GLS in mitochondrial morphology and recycling.

Relationship Involving Sexual Function, Distress Symptoms of Pelvic Floor Dysfunction, and Female Genital Self-Image.

OBJECTIVE: To assess the relationship involving sexual function (SF), the distress symptoms caused by pelvic floor dysfunction (PFD), and female genital self-image (GSI). MATERIALS AND METHODS: We assessed the GSI, SF and PFD distress symptoms by the Female Genital Self-Image Scale (FGSIS), the Female Sexual Function Index (FSFI), and the Pelvic Floor Distress Inventory (PFDI-20) respectively. Data were analyzed by multiple linear regression. RESULTS: Among the 216 women (age: 50.92 ± 16.31 years) who participated in the study, 114 were sexually active in the previous 4 weeks. In the total sample (p < 0.001; adjusted R2 = 0.097) and among sexually active women (p = 0.010; adjusted R2 = 0.162), the distress symptoms caused by pelvic organ prolapse (POP) were related to the GSI. Among sexually active women, sexual desire also was related to the GSI (p < 0.001; adjusted R2 = 0.126). CONCLUSION: The findings of the present study provide additional knowledge about female GSI and suggest that SF and POP distress symptoms should be investigated together with the GSI in the clinical practice.

OBJETIVO: Avaliar a relação entre a função sexual (FS), o incômodo provocado pelos sintomas de disfunção do assoalho pélvico (DAP) e a autoimagem genital (AIG) feminina. MATERIAIS E MéTODOS: A AIG, a FS e incômodo causado pelos sintomas de DAP foram avaliados pela Genital Self-Image Scale (FGSIS), pelo Female Sexual Function Index (FSFI) e pelo Pelvic Floor Distress Inventory (PFDI-20), respectivamente. Os dados foram analisados por regressão linear múltipla. RESULTADOS: Das 216 mulheres (idade: 50,92 ± 16,31 anos) que participaram do estudo, 114 eram sexualmente ativas nas últimas 4 semanas. Na amostra total (p < 0,001; R2 ajustado = 0,097) e entre as mulheres sexualmente ativas (p = 0,010; R2 ajustado = 0,162), o incômodo provocado pelos sintomas de prolapso de órgãos pélvicos (POP) relacionou-se à AIG. Entre as mulheres sexualmente ativas, o desejo sexual também se relacionou à AIG (p < 0,001; R2 ajustado = 0,126). CONCLUSãO: Os achados deste estudo fornecem conhecimento adicional sobre a AIG feminina e sugerem que a FS e o incômodo causado pelos sintomas de POP devem ser investigados juntamente com a AIG na prática clínica.

The Early Childhood Oral Health Impact Scale (ECOHIS): psychometric properties and application on preschoolers.

Background: The concept of oral health related to quality of life involves the impact that oral health has on an individual's well-being. The Early Childhood Oral Health Impact Scale (ECOHIS) was developed to measure the impact of oral health problems on the lives of children and their families. Objective: To evaluate the psychometric properties of ECOHIS applied to mothers of preschool children and estimate the influence of demographic characteristics, caries experience, and plaque index on the ECOHIS score. Methods: The fit of ECOHIS to the data was assessed by confirmatory analysis. Chi-square for degrees of freedom ratio (χ2/df), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA) were used. Reliability was estimated by the ordinal coefficients alpha (α) and omega (ω). The factorial invariance was estimated by the difference in CFI (ΔCFI). Comparisons of the ECOHIS mean scores according to the demographic characteristics, caries experience, and plaque index was performed using analysis of variance (ANOVA). Results: A total of 371 children participated in the study. Mothers' mean age was 33.0 (SD = 7.04) years. The ECOHIS presented a good fit to the data (χ2/df = 4.31; CFI = 0.95; TLI = 0.94; RMSEA = 0.09) and a strict model invariance. Children without caries and from higher income class had lower oral health impact. Conclusion: The data obtained with the ECOHIS were valid, reliable, and invariant. Children with caries experience and from lower income families had a greater impact of oral problems.

Continuous removal of caffeine in a horizontal-flow anaerobic immobilized biomass bioreactor: identification of transformation products.

Anaerobic bioreactors are an efficient technology for the biodegradation of emerging contaminants in environmental matrices. In this work, a horizontal-flow anaerobic immobilized biomass (HAIB) bioreactor was used to remove caffeine (CAF), which is frequently found in various aqueous matrices. The acrylic bench top bioreactor, with dimensions of 100 × 5.00 cm, was operated with a hydraulic retention time (HRT) of 12 h, during 45 weeks, under mesophilic conditions. The operation was performed in 4 phases: without CAF addition (phase I); CAF spiked at 300 µg L-1 (phase II); CAF at 600 µg L-1 (phase III); and CAF at 900 µg L-1 (phase IV). Samples of bioreactor influent and effluent were analyzed by liquid chromatography/tandem mass spectrometry (LC-MS/MS). The bioreactor removed organic matter (OM) and CAF with efficiencies of 88 and 93%, respectively. The first-order apparent removal constant (Kapp) values for OM and CAF were 0.419 and 0.304 h-1, respectively. Five transformation products (TPs) were identified, with m/z 243, 227, 211, and 181 (two products). The HAIB bioreactor is a suitable system for the removal of CAF present in wastewater, even at a concentration level of µg L-1.