ß-1,3-Glucan recognition by Acanthamoeba castellanii as a putative mechanism of amoeba-fungal interactions.

In this study, we conducted an in-depth analysis to characterize potential Acanthamoeba castellanii (Ac) proteins capable of recognizing fungal ß-1,3-glucans. Ac specifically anchors curdlan or laminarin, indicating the presence of surface ß-1,3-glucan-binding molecules. Using optical tweezers, strong adhesion of laminarin- or curdlan-coated beads to Ac was observed, highlighting their adhesive properties compared to controls (characteristic time τ of 46.9 and 43.9 s, respectively). Furthermore, Histoplasma capsulatum (Hc) G217B, possessing a ß-1,3-glucan outer layer, showed significant adhesion to Ac compared to a Hc G186 strain with an α-1,3-glucan outer layer (τ of 5.3 s vs τ 83.6 s). The addition of soluble ß-1,3-glucan substantially inhibited this adhesion, indicating the involvement of ß-1,3-glucan recognition. Biotinylated ß-1,3-glucan-binding proteins from Ac exhibited higher binding to Hc G217B, suggesting distinct recognition mechanisms for laminarin and curdlan, akin to macrophages. These observations hinted at the ß-1,3-glucan recognition pathway's role in fungal entrance and survival within phagocytes, supported by decreased fungal viability upon laminarin or curdlan addition in both phagocytes. Proteomic analysis identified several Ac proteins capable of binding ß-1,3-glucans, including those with lectin/glucanase superfamily domains, carbohydrate-binding domains, and glycosyl transferase and glycosyl hydrolase domains. Notably, some identified proteins were overexpressed upon curdlan/laminarin challenge and also demonstrated high affinity to ß-1,3-glucans. These findings underscore the complexity of binding via ß-1,3-glucan and suggest the existence of alternative fungal recognition pathways in Ac.IMPORTANCEAcanthamoeba castellanii (Ac) and macrophages both exhibit the remarkable ability to phagocytose various extracellular microorganisms in their respective environments. While substantial knowledge exists on this phenomenon for macrophages, the understanding of Ac's phagocytic mechanisms remains elusive. Recently, our group identified mannose-binding receptors on the surface of Ac that exhibit the capacity to bind/recognize fungi. However, the process was not entirely inhibited by soluble mannose, suggesting the possibility of other interactions. Herein, we describe the mechanism of ß-1,3-glucan binding by A. castellanii and its role in fungal phagocytosis and survival within trophozoites, also using macrophages as a model for comparison, as they possess a well-established mechanism involving the Dectin-1 receptor for ß-1,3-glucan recognition. These shed light on a potential parallel evolution of pathways involved in the recognition of fungal surface polysaccharides.

Plant-based diets benefit aerobic performance and do not compromise strength/power performance: a systematic review and meta-analysis.

Plant-based diets have emerged as athletic performance enhancers for various types of exercise. Therefore, the present study evaluated the effectiveness of plant-based diets on aerobic and strength/power performances, as well as on BMI of physically active individuals. This systematic review and meta-analysis was conducted and reported according to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. A systematic search of electronic databases, including PubMed, Web of Science and SPORTDiscus, was performed. On the basis of the search and inclusion criteria, four and six studies evaluating the effects of plant-based diets on aerobic and strength/power performances in humans were, respectively, included in the systematic review and meta-analysis. Plant-based diets had a moderate but positive effect on aerobic performance (0·55; 95 % CI 0·29, 0·81) and no effect on strength/power performance (-0·30; 95 % CI -0·67, 0·07). The altogether analyses of both aerobic and strength/power exercises revealed that athletic performance was unchanged (0·01; 95 % CI -0·21, 0·22) in athletes who adopted plant-based diets. However, a small negative effect on BMI (-0·27; 95 % CI -0·40, -0·15) was induced by these diets. The results indicate that plant-based diets have the potential to exclusively assist aerobic performance. On the other hand, these diets do not jeopardise strength/power performance. Overall, the predicted effects of plant-based diets on physical performance are impactless, even though the BMI of their adherents is reduced.

Biochemical characterization of an esterase from Thermobifida fusca YX with acetyl xylan esterase activity.

BACKGROUND: Esterases (EC 3.1.1.X) are enzymes that catalyze the hydrolysis ester bonds. These enzymes have large potential for diverse applications in fine industries, particularly in pharmaceuticals, cosmetics, and bioethanol production. METHODS AND RESULTS: In this study, a gene encoding an esterase from Thermobifida fusca YX (TfEst) was successfully cloned, and its product was overexpressed in Escherichia coli and purified using affinity chromatography. The TfEst kinetic assay revealed catalytic efficiencies of 0.58 s-1 mM-1, 1.09 s-1 mM-1, and 0.062 s-1 mM-1 against p-Nitrophenyl acetate, p-Nitrophenyl butyrate, and 1-naphthyl acetate substrates, respectively. Furthermore, TfEst also exhibited activity in a pH range from 6.0 to 10.0, with maximum activity at pH 8.0. The enzyme demonstrated a half-life of 20 min at 70 °C. Notably, TfEst displayed acetyl xylan esterase activity as evidenced by the acetylated xylan assay. The structural prediction of TfEst using AlphaFold indicated that has an α/ß-hydrolase fold, which is consistent with other esterases. CONCLUSIONS: The enzyme stability over a broad pH range and its activity at elevated temperatures make it an appealing candidate for industrial processes. Overall, TfEst emerges as a promising enzymatic tool with significant implications for the advancement of biotechnology and biofuels industries.

Healthcare Students' Perceptions About Approaching Spirituality in Their Training and Patient Care: Online, Cross-Sectional Survey.

Objective: Recent scientific literature points out that religiosity and spirituality play a relevant role in many aspects of life, including health issues. We aimed to evaluate the healthcare students' perceptions about approaching spirituality in their training and patient care in Brazilian universities. Methods: A cross-sectional observational study was conducted following the STROBE guidelines. Through an anonymous online survey, adult healthcare students from two universities in the city of Pelotas (Brazil) answered a questionnaire about their perceptions on approaching spirituality in their training and patient care. Chi-squared tests were performed, and P ≤ .05 was considered statistically significant. Results: A total of 163 students were included in the analysis. Most believed that spirituality is important for their training (74.8%) and patient care (84%). However, a minority had had contact with the theme of spirituality during their training (48.5%) or had experienced a situation in which the spiritual aspects of a patient were addressed (47.2%). The students from the private university had more contact with the theme of spirituality in healthcare during their training. Nursing students had significantly more contact with the theme of spirituality in healthcare (P = .008) and had experienced more situations in which the spiritual aspects of a patient were addressed (P = .031) than other students. Conclusion: Most students believed that the theme of spirituality in healthcare is important for their training and patient care. However, they still had insufficient contact with it during their education. More studies with greater statistical power are needed to better understand this situation globally.

TEMPROT: protein function annotation using transformers embeddings and homology search.

BACKGROUND: Although the development of sequencing technologies has provided a large number of protein sequences, the analysis of functions that each one plays is still difficult due to the efforts of laboratorial methods, making necessary the usage of computational methods to decrease this gap. As the main source of information available about proteins is their sequences, approaches that can use this information, such as classification based on the patterns of the amino acids and the inference based on sequence similarity using alignment tools, are able to predict a large collection of proteins. The methods available in the literature that use this type of feature can achieve good results, however, they present restrictions of protein length as input to their models. In this work, we present a new method, called TEMPROT, based on the fine-tuning and extraction of embeddings from an available architecture pre-trained on protein sequences. We also describe TEMPROT+, an ensemble between TEMPROT and BLASTp, a local alignment tool that analyzes sequence similarity, which improves the results of our former approach. RESULTS: The evaluation of our proposed classifiers with the literature approaches has been conducted on our dataset, which was derived from CAFA3 challenge database. Both TEMPROT and TEMPROT+ achieved competitive results on [Formula: see text], [Formula: see text], AuPRC and IAuPRC metrics on Biological Process (BP), Cellular Component (CC) and Molecular Function (MF) ontologies compared to state-of-the-art models, with the main results equal to 0.581, 0.692 and 0.662 of [Formula: see text] on BP, CC and MF, respectively. CONCLUSIONS: The comparison with the literature showed that our model presented competitive results compared the state-of-the-art approaches considering the amino acid sequence pattern recognition and homology analysis. Our model also presented improvements related to the input size that the model can use to train compared to the literature methods.

Thermal Profiles in Water Injection Wells: Reduction in the Systematic Error of Flow Measurements during the Transient Regime.

This article presents an analytical solution for calculating the flow rate in water injection wells based on the established thermal profile along the tubing. The intent is to minimize the intrinsic systematic error of classic quasi-static methodologies, which assume that all thermal transience on well completion has passed. When these techniques are applied during the initial hours of injection well operation, it can result in errors higher than 20%. To solve this limitation, the first law of thermodynamics was used to define a mathematical model and a thermal profile was established in the injection fluid, captured by using distributed temperature systems (DTSs) installed inside the tubing. The geothermal profile was also established naturally by a thermal source in the earth to determine the thermal gradient. A computational simulation of the injection well was developed to validate the mathematical solution. The simulation intended to generate the fluid's thermal profile, for which data were not available for the desired time period. As a result, at the cost of greater complexity, the systematic error dropped to values below 1% in the first two hours of well operation, as seen throughout this document. The code was developed in Phyton, version 1.7.0., from Anaconda Navigator.

Study of the Materials and Techniques of a Rare Papier-Mâché Mushroom Model Crafted in H. Arnoldi Factory.

The Natural History and Science Museum of the University of Porto houses a collection of 45 models of fungi in papier-mâché from the 19th-century, which were used at the university until 2015 as didactic models. For the first time, the materials and techniques used in the production of a Boletus edulis model were studied (vernacular name: cep, porcini). These sculptures, made to life-size scale, are painted in colors similar to those of the represented species (white, brown, and light brown). They are fixed to a rectangular base, which is painted black, and to which moss has been pasted. To fully characterize each color, at the molecular level, a multi-analytical approach was used, combining energy-dispersive x-ray fluorescence spectroscopy (micro-XRF) with fingerprinting techniques of Raman microscopy (microRaman and handheld Raman) spectroscopy and microFourier transform infrared spectroscopy (microFTIR). The papier-mâché was prepared with a groundwood paper to which kaolin and a quartz-based material have been added to reinforce the structure. Raman microscopy also identified carbon black in it, which is possibly responsible for its grey color. The white color was unequivocally identified as lithopone by microRaman. This white paint was prepared in a proteinaceous tempera, with calcium carbonate having been identified as filler (by microFTIR). In the brown color, iron was identified by microXRF, pointing to the use of ocher, which was not possible to identify by microRaman and microFTIR. Regarding the black rectangular base, the moss was fixed using a collagen-based glue. The binding medium in this black is possibly a mixture of drying oil and protein. Again, XRF detected iron as the main element, but it was not possible to acquire a Raman spectrum due to the high fluorescence of the binder/varnish. Others, such as the writing inks, will also be discussed. The colors identified are in line with the best materials available for use by artists of that time. This new knowledge is fundamental to informing the choice of the best conservation strategies for the preservation of these extraordinary models.

Protein-binding approaches for improving bioaccessibility and bioavailability of anthocyanins.

Color is an important characteristic of food. Over the last 15 years, more attention has been paid to natural colorants because of the rising demand for clean-label food products. Anthocyanins, which are a group of phytochemicals responsible for the purple, blue or red hues of many plants, offer a market advantage. In addition, anthocyanin-rich foods are associated with protection against cardiovascular disease, thrombosis, diabetes, cancer, microbial-based disorders, neurological disorders, and vision ailments. However, the real health value of anthocyanins, whether as a natural colorant or a functional ingredient, is dependent on the ultimate bioaccessibility and bioavailability in the human body. Many animal and human clinical studies revealed that, after intake of anthocyanin-rich foods or anthocyanin extracts, only trace amounts (< 1% of ingested content) of anthocyanins or their predicted metabolites were detected in plasma after a standard blood draw, which was indicative of low bioavailability of anthocyanins. Protein binding to anthocyanins is a strategy that has recently been reported to enhance the ultimate bioactivity, bioaccessibility, and bioavailability of anthocyanins as compared to anthocyanins delivered without a protein carrier. Therefore, in this review, we address anthocyanin properties in food processing and digestion, anthocyanin-protein complexes used in food matrices, and changes in the bioaccessibility and bioavailability of anthocyanins when bound into anthocyanin-protein complexes in foods. Finally, we summarize the challenges and prospects of this delivery system for anthocyanin pigments.

Nutrient uptake in supplemented substrate by oyster mushroom.

Spent mushroom substrate (SMS) is a promising alternative for supplementing oyster mushroom substrate, replacing conventional cereal bran. Therefore, the objective was to evaluate the production of Pleurotus ostreatus supplemented with Lentinula edodes' SMS, through the nutritional analysis of the substrate. Wheat straw was used as substrate and supplemented with rice bran (RB) or SMS in 0%, 7%,15% and 30%. Ca, K, Mg, Mn, Zn, Cu and Fe contents of the cultivation substrates (before and after harvest) were determined through atomic absorption spectrophotometry. Mycelial growth (cm²/day), mycelial time colonization (days), number of clusters, number of pileus, average clusters weight (g), pileus lenght (cm) and width (cm), productivity (1st, 2nd and 3rd flush) (%), biological efficiency (%) of mushrooms were evaluated. Results indicated mycelial growth was higher (0.87 cm²/day compared to the Control) when the substrate was supplemented regardless of the source. The proportions of 15% of SMS achieved the highest biological efficiency (107% - 15% SMS versus 66% - Control). The only nutrients that showed differences in absorption were Ca, K and Mn, in which substrates supplemented with SMS had greater absorption of Ca (5.37 g.kg- 1 versus 1.94 g.kg- 1 in Control) while substrates supplemented with RB absorbed more K (6.56 g.kg- 1 versus 3.74 g.kg- 1 in Control). The mineral composition of the substrate has a direct impact on the growth and yield of P. ostreatus, highlighting the potential of SMS as a alternative to traditional bran supplementation.

Acute and chronic effects of physical exercise on IgA and IgG levels and susceptibility to upper respiratory tract infections: a systematic review and meta-analysis.

This systematic review and meta-analysis aimed at evaluating acute and chronic effects of physical exercise on IgA and IgG levels, as well as its relationship with the susceptibility to develop upper respiratory tract infections (URTI). This systematic review and meta-analysis was conducted and reported in accordance with PRISMA statement. A systematic search of PubMed, Web of Science, and EMBASE was performed in July 2020. This systematic review and meta-analysis included studies in which participants performed acute exercise or chronic physical training and were subjected to analyses of URTI incidence and concentrations of IgA and IgG. The selected studies for systematic review were divided into the following three groups: (I) trials that evaluated the effects of acute exercise in sedentary subjects, (II) trials that evaluated the effects of acute exercise in athletes/trained individuals, and (III) trials that evaluated the effects of chronic physical training on the incidence of URTI, as well as on the levels of IgA and IgG. Acute exercise increases the IgA levels in trained subjects but does not affect its levels in untrained subjects. Such increase in IgA levels induced by acute exercise is greater in trained individual that performed ultramarathon. On the other hand, chronic physical training reduces IgA levels in both trained and untrained subjects, does not change IgA levels in non-military subjects, besides from not affecting IgG levels. The present systematic review and meta-analysis indicates that acute exercise positively influences IgA levels in trained individuals, being this effect pronounced when a strenuous exercise such as ultramarathon is executed. Chronic physical training, in turn, does not affect IgG levels.

Enzyme-Catalyzed Spiroacetal Formation in Polyketide Antibiotic Biosynthesis.

A key step in the biosynthesis of numerous polyketides is the stereospecific formation of a spiroacetal (spiroketal). We report here that spiroacetal formation in the biosynthesis of the macrocyclic polyketides ossamycin and oligomycin involves catalysis by a novel spiroacetal cyclase. OssO from the ossamycin biosynthetic gene cluster (BGC) is homologous to OlmO, the product of an unannotated gene from the oligomycin BGC. The deletion of olmO abolished oligomycin production and led to the isolation of oligomycin-like metabolites lacking the spiroacetal structure. Purified OlmO catalyzed complete conversion of the major metabolite into oligomycin C. Crystal structures of OssO and OlmO reveal an unusual 10-strand ß-barrel. Three conserved polar residues are clustered together in the ß-barrel cavity, and site-specific mutation of any of these residues either abolished or substantially diminished OlmO activity, supporting a role for general acid/general base catalysis in spiroacetal formation.

Bioprotective potential of lactic acid bacteria and their metabolites against enterotoxigenic Escherichia coli.

Escherichia coli is one of the main pathogens that impacts swine production. Given the need for methods for its control, the in vitro effect of lactic acid bacteria (LAB) and their metabolites against E. coli F4 was evaluated through cell culture and microbiological analysis. The strains Limosilactobacillus fermentum 5.2, Lactiplantibacillus plantarum 6.2, and L. plantarum 7.1 were selected. To evaluate the action of their metabolites, lyophilized cell-free supernatants (CFS) were used. The effect of CFS was evaluated in HT-29 intestinal lineage cells; in inhibiting the growth of the pathogen in agar; and in inhibiting the formation of biofilms. The bioprotective activity of LAB was evaluated via their potential for autoaggregation and coaggregation with E. coli. The CFS did not show cytotoxicity at lower concentrations, except for L. fermentum 5.2 CFS, which is responsible for cell proliferation at doses lower than 10 mg ml-1. The CFS were also not able to inhibit the growth of E. coli F4 in agar; however, the CFS of L. plantarum 7.1 resulted in a significant decrease in biofilm formation at a dose of 40 mg ml-1. Regarding LAB, their direct use showed great potential for autoaggregation and coaggregation in vitro, thus suggesting possible effectiveness in animal organisms, preventing E. coli fixation and proliferation. New in vitro tests are needed to evaluate lower doses of CFS to control biofilms and confirm the bioprotective potential of LAB, and in vivo tests to assess the effect of LAB and their metabolites interacting with animal physiology.

Preanalytical quality improvement - an interdisciplinary journey, on behalf of the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE).

Since the beginning of laboratory medicine, the main focus was to provide high quality analytics. Over time the importance of the extra-analytical phases and their contribution to the overall quality became evident. However, as the initial preanalytical processes take place outside of the laboratory and mostly without its supervision, all professions participating in these process steps, from test selection to sample collection and transport, need to engage accordingly. Focusing solely on intra-laboratory processes will not be sufficient to achieve the best possible preanalytical quality. The Working Group for the Preanalytical Phase (WG-PRE) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) has provided several recommendations, opinion papers and scientific evidence over the past years, aiming to standardize the preanalytical phase across Europe. One of its strategies to reach this goal are educational efforts. As such, the WG-PRE has organized five conferences in the past decade with the sole focus on preanalytical quality. This year's conference mainly aims to depict the views of different professions on preanalytical processes in order to acquire common ground as basis for further improvements. This article summarizes the content of this 6th preanalytical conference.

Phenotypic investigation of 4-nitrophenylacetyl- and 4-nitro-1H-imidazoyl-based compounds as antileishmanial agents.

Cutaneous leishmaniasis (CL) is a spectrum of clinical manifestations characterized by severe skin ulcerations that leads to social stigma. There are limited treatment options for CL, and the available drugs are becoming less efficacious due to drug resistance. More efficacious and safer antileishmanial drugs are needed. In this study, the biological effect of seven synthetically accessible nitroaromatic compounds was evaluated in vitro against amastigotes of Leishmania amazonensis, followed by in vivo evaluation using mouse models of CL. Two compounds (6 and 7) were active against amastigotes in vitro [half-maximal effective concentration (EC50): 4.57 ± 0.08 and 9.19 ± 0.68 µm, respectively], with selectivity indexes >50, and the other compounds were not selective. In vivo, compounds 6 and 7 (10 mg kg−1, twice a day for 14 days) failed to reduce skin lesion sizes and parasite loads determined by light microscopy of lesion imprints and quantitative polymerase chain reaction. Nevertheless, the in vitro leishmanicidal efficacy sustained their use as templates for nitroimidazole-based antileishmanial drug discovery programmes focusing on analogues with more suitable properties.

Assessing Remotely Piloted Aerial Systems in the characterization of rocky shores for oil spills environmental sensitivity mapping, northern São Paulo littoral, Brazil.

The Environmental Sensitivity Index (ESI) for oil spills was developed to assist coordinators to evaluate oil spill impact along shorelines and also to coordinate the allocation of resources during and after the incident, aiming to reduce environmental damage and consequences. Recently, Remotely Piloted Aerial Systems (RPAS) are being used in a wide range of areas, since they complement traditional remote sensing data (e.g., satellite images) and offer a rapidly, precise, detail and high-resolution images that fit well for environmental studies. Herein, the use of high-resolution RPAS images for ESI analysis of rocky shores in the Brazilian territory was performed. Using RPAS images, with their higher-resolution compared with ArcGIS Pro Basemap satellite images, increased the detailed of ESI analysis for oil spills, increasing the number of regions in the rocky shore that are more sensitive to oil spills. The RPAS images were able to decrease the number of areas that were less sensitive to oil spills, and increase areas that are more sensitive to oil spills. This increase is important, since they were not detected in the ESI analysis using conventional ArcGIS Pro Basemap satellite images. The RPAS images permit to delineate precisely rocky shores, improving ESI interpretation in rocky shores.

Trends in cervical cancer mortality rate in women aged 20 years and older in Brazil from 2005 to 2019.

The objective of this study was to analyze the trend of the age standardized mortality rate (ASMR) for cervical cancer in Brazil between 2005 and 2019 and investigate its association with the Socio-demographic Index (SDI), an indicator of development status strongly correlated with health outcomes. We conducted an ecological time-series study using data from the Mortality Information System of the Ministry of Health. Trend analyses were performed using Prais-Winsten regression. The association between the SDI and ASMR was evaluated using simple linear regression. Between 2005 and 2019, 105,472 deaths from cervical cancer were recorded. The ASMR was 10.18 deaths/100,000 women. The North region presented the highest magnitude (20.23 deaths/100,000 women) and the Southeast region the lowest (7.83 deaths/100,000 women). We observed a decreasing trend of the ASMR for cervical cancer in the country. The Northeast, Central-West and Southeast regions showed a decreasing trend; South stationary trend and the North region showed an increasing trend. Most of the states showed a stationary or decreasing trend. It was found that the SDI was inversely associated with the ASMR and Annual Percent Change (APC). In conclusion, we observed a decreasing trend of ASMR for cervical cancer and inverse association with SDI in Brazil.

Overexpression of TcNTPDase-1 Gene Increases Infectivity in Mice Infected with Trypanosoma cruzi.

Ecto-nucleoside triphosphate diphosphohydrolases (NTPDases) are enzymes located on the surface of the T. cruzi plasma membrane, which hydrolyze a wide range of tri-/-diphosphate nucleosides. In this work, we used previously developed genetically modified strains of Trypanosoma cruzi (T. cruzi), hemi-knockout (KO +/−) and overexpressing (OE) the TcNTPDase-1 gene to evaluate the parasite infectivity profile in a mouse model of acute infection (n = 6 mice per group). Our results showed significantly higher parasitemia and mortality, and lower weight in animals infected with parasites OE TcNTPDase-1, as compared to the infection with the wild type (WT) parasites. On the other hand, animals infected with (KO +/−) parasites showed no mortality during the 30-day trial and mouse weight was more similar to the non-infected (NI) animals. In addition, they had low parasitemia (45.7 times lower) when compared with parasites overexpressing TcNTPDase-1 from the hemi-knockout (OE KO +/−) group. The hearts of animals infected with the OE KO +/− and OE parasites showed significantly larger regions of cardiac inflammation than those infected with the WT parasites (p < 0.001). Only animals infected with KO +/− did not show individual electrocardiographic changes during the period of experimentation. Together, our results expand the knowledge on the role of NTPDases in T. cruzi infectivity, reenforcing the potential of this enzyme as a chemotherapy target to treat Chagas disease (CD).

Reliability of a Clinical Test for Measuring Eccentric Knee Flexor Strength Using a Handheld Dynamometer.

CONTEXT: Eccentric knee flexor strength assessments have a key role in both prevention and rehabilitation of hamstring strain injuries. OBJECTIVE: To verify the reliability of a clinical test for measuring eccentric knee flexor strength during the Nordic hamstring exercise using a commercially available handheld dynamometer. DESIGN: Reliability study. SETTING: Physical Therapy Laboratory, Federal University of Health Sciences of Porto Alegre (Brazil). PARTICIPANTS: Fifty male amateur athletes (soccer or rugby players; 24 [3] y). MAIN OUTCOME MEASURES: Eccentric knee flexor strength. RESULTS: When compared with a load cell-based device, the clinical test using a handheld dynamometer provided smaller force values (P < .05) with large effect sizes (.92-1.21), moderate intraclass correlation (.60-.62), typical error of 30 to 31 N, and coefficient of variation of 10% to 11%. Regarding the test-retest reproducibility (2 sessions separated by 1 week), the clinical test provided similar force values (P > .05) with only small effect sizes (.20-.27), moderate to good correlation (.67-.76), typical error of 23 to 24 N, and coefficient of variation of 9% to 10%. CONCLUSION: The clinical test with handheld dynamometer proposed by this study can be considered an affordable and relatively reliable tool for eccentric knee flexor strength assessment in the clinical setting, but results should not be directly compared with those provided by load cell-based devices.

Telehealth to support referral management in a universal health system: a before-and-after study.

BACKGROUND: Management of patient flow within a healthcare network, allowing equitable and qualified access to healthcare, is a major challenge for universal health systems. Implementation of telehealth strategies to support referral management has been shown to increase primary care resolution and to promote coordination of care. The objective of this study was to assess the impact of telehealth strategies on waiting lists and waiting times for specialized care in Brazil. METHODS: Before-and-after study with measures obtained between January 2019 and February 2020. Baseline measurements of waiting lists were obtained immediately before the implementation of a remotely operated referral management system. Post-interventional measurements were obtained monthly, up to six months after the beginning of operation. Data was extracted from the database of the project. General linear models were applied to assess interaction of locality and time over number of cases on waiting lists and waiting times. RESULTS: At baseline, the median number of cases on waiting lists ranged from 2961 to 12,305 cases. Reductions of the number of cases on waiting lists after six months of operation were observed in all localities. The magnitude of the reduction ranged from 54.67 to 88.97 %. Interaction of time measurements was statistically significant from the second month onward. Median waiting times ranged from 159 to 241 days at baseline. After six months, there was a decrease of 100 and 114 waiting days in two localities, respectively, with reduction of waiting times only for high-risk cases in the third locality. CONCLUSIONS: Adoption of telehealth strategies resulted in the reduction of number of cases on waiting lists. Results were consistent across localities, suggesting that telehealth interventions are viable in diverse settings.

Convolutional Neural Networks to Estimate Dry Matter Yield in a Guineagrass Breeding Program Using UAV Remote Sensing.

Forage dry matter is the main source of nutrients in the diet of ruminant animals. Thus, this trait is evaluated in most forage breeding programs with the objective of increasing the yield. Novel solutions combining unmanned aerial vehicles (UAVs) and computer vision are crucial to increase the efficiency of forage breeding programs, to support high-throughput phenotyping (HTP), aiming to estimate parameters correlated to important traits. The main goal of this study was to propose a convolutional neural network (CNN) approach using UAV-RGB imagery to estimate dry matter yield traits in a guineagrass breeding program. For this, an experiment composed of 330 plots of full-sib families and checks conducted at Embrapa Beef Cattle, Brazil, was used. The image dataset was composed of images obtained with an RGB sensor embedded in a Phantom 4 PRO. The traits leaf dry matter yield (LDMY) and total dry matter yield (TDMY) were obtained by conventional agronomic methodology and considered as the ground-truth data. Different CNN architectures were analyzed, such as AlexNet, ResNeXt50, DarkNet53, and two networks proposed recently for related tasks named MaCNN and LF-CNN. Pretrained AlexNet and ResNeXt50 architectures were also studied. Ten-fold cross-validation was used for training and testing the model. Estimates of DMY traits by each CNN architecture were considered as new HTP traits to compare with real traits. Pearson correlation coefficient r between real and HTP traits ranged from 0.62 to 0.79 for LDMY and from 0.60 to 0.76 for TDMY; root square mean error (RSME) ranged from 286.24 to 366.93 kg·ha-1 for LDMY and from 413.07 to 506.56 kg·ha-1 for TDMY. All the CNNs generated heritable HTP traits, except LF-CNN for LDMY and AlexNet for TDMY. Genetic correlations between real and HTP traits were high but varied according to the CNN architecture. HTP trait from ResNeXt50 pretrained achieved the best results for indirect selection regardless of the dry matter trait. This demonstrates that CNNs with remote sensing data are highly promising for HTP for dry matter yield traits in forage breeding programs.