Glial-restricted precursors stimulate endogenous cytogenesis and effectively recover emotional deficits in a model of cytogenesis ablation.

Adult cytogenesis, the continuous generation of newly-born neurons (neurogenesis) and glial cells (gliogenesis) throughout life, is highly impaired in several neuropsychiatric disorders, such as Major Depressive Disorder (MDD), impacting negatively on cognitive and emotional domains. Despite playing a critical role in brain homeostasis, the importance of gliogenesis has been overlooked, both in healthy and diseased states. To examine the role of newly formed glia, we transplanted Glial Restricted Precursors (GRPs) into the adult hippocampal dentate gyrus (DG), or injected their secreted factors (secretome), into a previously validated transgenic GFAP-tk rat line, in which cytogenesis is transiently compromised. We explored the long-term effects of both treatments on physiological and behavioral outcomes. Grafted GRPs reversed anxiety-like deficits and demonstrated an antidepressant-like effect, while the secretome promoted recovery of only anxiety-like behavior. Furthermore, GRPs elicited a recovery of neurogenic and gliogenic levels in the ventral DG, highlighting the unique involvement of these cells in the regulation of brain cytogenesis. Both GRPs and their secretome induced significant alterations in the DG proteome, directly influencing proteins and pathways related to cytogenesis, regulation of neural plasticity and neuronal development. With this work, we demonstrate a valuable and specific contribution of glial progenitors to normalizing gliogenic levels, rescuing neurogenesis and, importantly, promoting recovery of emotional deficits characteristic of disorders such as MDD.

A computational study of the negative LiIn modified anode and its interaction with ß-Li3PS4 solid-electrolyte for battery applications.

All-solid-state lithium batteries (ASSLBs) have sparked interest due to their far superior energy density compared to current commercial material, but the heightened reactivity of the negative Li electrode can compromise the long-term cyclability of the cell, calling for the introduction of passivating layers or alloy anodes. In this article, we aim to explain the outstanding stability of LiIn alloy-based anodes over extended cycling by comparing its bulk and interface properties to Li-metal. Using density functional theory, we conducted an in-depth analysis of the LiIn surfaces' formation and subsequent structural stability in interfaces with the solid electrolyte ß-Li3PS4. Several LiIn facets are shown to possess sufficient structural stability, with the (110) surface being the most stable. The stable interfaces established with the ß-Li3PS4(100) surface featured favorable adhesion energy, low strain energy, and little reconstruction. By comparing these interface properties with the bulk properties of Li-metal and LiIn, we highlighted the influence of the cohesion energy, Fermi energy level, and band position of the two materials in the long-term stability of their anodes under battery conditions.

Mapping and assessing coastal recreation cultural ecosystem services supply, flow, and demand in Lithuania.

Coastal recreation as a cultural ecosystem service (CES) is key to human wellbeing. However, anthropogenic impacts at the coast affect CES supply. Mapping and assessing CES can help achieve better coastal planning and management of the coast. Quantitative approaches for assessing and mapping CES are lacking, especially in coastal areas. We develop three quantitative models to assess and map coastal recreation CES supply, flow, and demand. We applied the developed models in the coastal region of Lithuania. The coastal recreation CES supply model comprises natural (e.g., naturalness) and cultural (e.g., points of interest) components. The input variables were (1) analysed for multicollinearity, (2) normalised and (3) overlayed using ArcGIS 10.8. An online survey was undertaken to assess and map CES flow and demand based on locations chosen by respondents where they perform recreation at the coast and the number of activities performed when visiting the coast. The coastal recreation CES supply model results showed that natural recreation is close to the coastline, forest areas, waterlines, and protected areas, while cultural recreation is highest in coastal urban areas. The supply model was validated (r2 = 0.11) based on the respondents' chosen coastal locations for recreation. The low validation allowed us to identify the mismatch between model results and respondents' preferences occurring in Klaipeda urban area. When removing respondents' points in Klaipeda urban area, the model validation increased (r2 = 0.36). CES flow results highlighted Palanga, Sventoji, and Nida as the prime coastal recreation locations. The results of CES demand show that respondents living in municipalities near the coastline (Baltic Sea and Curonian Lagoon) perform fewer activities when visiting the coast. For other municipalities, a demand pattern was not observed. Our results yielded important spatial information that can be useful for planners and decision-makers in the context of coastal management.

Glial restricted precursor cells in central nervous system disorders: Current applications and future perspectives.

The crosstalk between glial cells and neurons represents an exceptional feature for maintaining the normal function of the central nervous system (CNS). Increasing evidence has revealed the importance of glial progenitor cells in adult neurogenesis, reestablishment of cellular pools, neuroregeneration, and axonal (re)myelination. Several types of glial progenitors have been described, as well as their potentialities for recovering the CNS from certain traumas or pathologies. Among these precursors, glial-restricted precursor cells (GRPs) are considered the earliest glial progenitors and exhibit tripotency for both Type I/II astrocytes and oligodendrocytes. GRPs have been derived from embryos and embryonic stem cells in animal models and have maintained their capacity for self-renewal. Despite the relatively limited knowledge regarding the isolation, characterization, and function of these progenitors, GRPs are promising candidates for transplantation therapy and reestablishment/repair of CNS functions in neurodegenerative and neuropsychiatric disorders, as well as in traumatic injuries. Herein, we review the definition, isolation, characterization and potentialities of GRPs as cell-based therapies in different neurological conditions. We briefly discuss the implications of using GRPs in CNS regenerative medicine and their possible application in a clinical setting. MAIN POINTS: GRPs are progenitors present in the CNS with differentiation potential restricted to the glial lineage. These cells have been employed in the treatment of a myriad of neurodegenerative and traumatic pathologies, accompanied by promising results, herein reviewed.

Future scenarios impact on land use change and habitat quality in Lithuania.

Anticipating future land use and land cover (LULC) changes can improve our knowledge of the complexity of human-environment interactions that lead to transformations in the landscape. Therefore, it is key to understand these LULC changes under different scenarios and how they affect habitat quality (HQ) a key indicator for ecosystem services (ES) supply quality. This work aims to study the impacts of LULC changes under different scenarios: business as usual (A0), urbanisation (A1), land abandonment and afforestation (A2) and agriculture intensification (A3) in 2050. To simulate future LULC changes we applied the Cellular Automata (CA) method, and to assess HQ, the Integrated Valuation of Ecosystem Services and Trade-offs (InVEST) model was used. Spatial autocorrelation was assessed with a Moran's I index and the Getis Ord* hotspot analysis. The result showed that the LULC model calibration and validation were accurate (80%). Between 1990 and 2018 there was an increase in urban areas and forest and woodlands, which was reflected in the A0 scenario in 2050. Under the A1 scenario there was an increase in the urban area (4628 ha) compared to 2018, and in the most important cities (e.g., Vilnius, Kaunas, Klaipeda) in the scenario A2 there was an increase of 375,820 ha of woodland and forest. Finally, under the scenario A3, a large growth in cropland area (884,030 ha) was identified. HQ model had a better validation using three cover density data (r2 = 0.67), than with imperviousness (r2 = 0.26). A2 scenario showed the highest HQ and A3 scenario have the lowest HQ. The land uses of 1990, 2018, and A3 scenario had a clustered distribution while A0, A1 and A2 showed a random pattern. The results can support policy-makers by assessing the impact of future LULC changes in Lithuania.

Machine Learning Algorithms for Activity-Intensity Recognition Using Accelerometer Data.

In pervasive healthcare monitoring, activity recognition is critical information for adequate management of the patient. Despite the great number of studies on this topic, a contextually relevant parameter that has received less attention is intensity recognition. In the present study, we investigated the potential advantage of coupling activity and intensity, namely, Activity-Intensity, in accelerometer data to improve the description of daily activities of individuals. We further tested two alternatives for supervised classification. In the first alternative, the activity and intensity are inferred together by applying a single classifier algorithm. In the other alternative, the activity and intensity are classified separately. In both cases, the algorithms used for classification are k-Nearest Neighbors (KNN), Support Vector Machine (SVM), and Random Forest (RF). The results showed the viability of the classification with good accuracy for Activity-Intensity recognition. The best approach was KNN implemented in the single classifier alternative, which resulted in 79% of accuracy. Using two classifiers, the result was 97% accuracy for activity recognition (Random Forest), and 80% for intensity recognition (KNN), which resulted in 78% for activity-intensity coupled. These findings have potential applications to improve the contextualized evaluation of movement by health professionals in the form of a decision system with expert rules.

Mapping and assessment of landscape aesthetic quality in Lithuania.

Mapping and assessing landscape aesthetic quality (LAQ) at the national level can provide valuable insights to scientists and policymakers about the general condition of targeted cultural ecosystem service (CES). A generalised view based on unified methodological standards allows comparing LAQ between countries, thus facilitating international environmental management policies. LAQ can be assessed by combining subjective and objective metrics. This approach makes it challenging to map and assess the LAQ at national scale since it requires consensus-based methodologies to be reliably applicable in a broader geographic region. The national-scale studies related to LAQ are not common since they require high computational resources and differ in data accessibility. However, it is crucial to conduct broader LAQ studies to reveal the more general picture of LAQ condition and support (adjust) policy implementation at the national scale. More studies are needed to assess LAQ at the national level. This study aims to map and assess LAQ in Lithuania on the national scale. To achieve this aim, we adapted a LAQ mapping and assessment approach previously applied in Germany at the national scale. Based on previous work, we tested the methodology's transferability by applying it in a different geographical region by using local datasets. In this study, we partially modified sub-indicators calculation methods and performed an additional in-depth analysis to gather more information on LAQ accessibility and condition in Lithuania. Geographic Information Systems modeling and spatial statistics analysis allowed for achieving this aim. The results revealed that agricultural and urban areas had the lowest landscape diversity, naturalness, uniqueness, and LAQ in general, while areas with high ruggedness, forests, protected areas, natural monuments, and heritage sites had the highest LAQ scores. Viewshed analysis showed that a significant part of Lithuanian territory with the highest LAQ values have limited visibility due to terrain energy and undulation. Curonian spit and Nemunas riverbanks are few of high LAQ areas with high visual accessibility potential. The patches with high LAQ were clustered in protected areas, while the lowest LAQ values were observed in agricultural lands and urbanised areas. LAQ CES assessment is critical for higher quality environmental management regulation practices. High LAQ areas may need a better protection and provide wellbeing for the population, while low LAQ areas may require additional restoration effort. It also provides a better understanding of the LAQ condition and contributes to achieve national, European, and global goals related to landscape planning, management, and sustainable development.

Biomonitoring of surface water quality in the Chopim River within the Conservation Unit Campos de Palmas Wildlife Refuge, southern Brazil.

The Campos de Palmas Wildlife Refuge (RVS-CP) is a full protection conservation unit (CU) formed by private properties. The present study aimed to use the bioindicators Allium cepa L. (cytotoxicity and mutagenicity tests) and Eisenia fetida (avoidance test) to assess the quality of surface water of the Chopim River within the RVS-CP area and its surroundings during the four seasons of the year. To do so, water samples were collected at five points, four inside the RVS-CP area and a fifth point outside thereof. Samples from all sampling points had cytotoxic effect on A. cepa in at least one season of the year. Such a finding may be related to inadequate management practices (without land-use control) in the areas surrounding the sampling points such as forestry, native fields, pastures, agriculture, and housing areas. As for the animal bioindicator (E. fetida), only points 1 (in the winter) and 5 (in the autumn) were toxic. Concerning mutagenicity, points 1 and 4 (in the spring), 1 and 2 (in the summer), and 3 (in the autumn) showed mutagenic effect on A. cepa meristematic cells, therefore only within the RVS-CP area. Overall, these results show that biomonitoring can be an ally of the residents of the RVS-CP area in controlling management practices, aiming to bring together economic support and conservation of resources, especially water.

Citalopram Administration Does Not Promote Function or Histological Recovery after Spinal Cord Injury.

Citalopram is a selective serotonin reuptake inhibitor, and although widely used as an antidepressant, this drug has also demonstrated interesting repairing properties leading to motor recovery and pathology amelioration in animal models of stroke and degeneration. Here, we tested the efficacy of both 7-day and 8-week citalopram treatment in a contusive spinal cord injury (SCI) rat model. A combination of behavioral tests, histological and serum cytokine analysis was used to assess overall recovery. Despite promoting a mild reduction of inflammatory cells as well as an early, but transient increase of specific serum cytokines, citalopram administration showed no overall beneficial effects on motor performance or lesion extension. Our results do not support citalopram treatment as a therapeutic strategy for SCI.

Co-Transplantation of Adipose Tissue-Derived Stromal Cells and Olfactory Ensheathing Cells for Spinal Cord Injury Repair.

Patients suffering from spinal cord injury (SCI) still have a dismal prognosis. Despite all the efforts developed in this area, currently there are no effective treatments. Therefore, cell therapies have been proposed as a viable alternative to the current treatments used. Adipose tissue-derived stromal cells (ASCs) and olfactory ensheathing cells (OECs) have been used with promising results in different models of SCI, namely due to the regenerative properties of the secretome of the first, and the guidance capability of the second. Using an in vitro model of axonal growth, the dorsal root ganglia explants, we demonstrated that OECs induce neurite outgrowth mainly through cell-cell interactions, while ASCs' effects are strongly mediated by the release of paracrine factors. A proteomic analysis of ASCs' secretome revealed the presence of proteins involved in VEGF, PI3K, and Cadherin signaling pathways, which may be responsible for the effects observed. Then, the cotransplantation of ASCs and OECs showed to improve motor deficits of SCI-rats. Particular parameters of movement such as stepping, coordination, and toe clearance were improved in rats that received the transplant of cells, in comparison to nontreated rats. A histological analysis of the spinal cord tissues revealed that transplantation of ASCs and OECs had a major effect on the reduction of inflammatory cells close the lesion site. A slight reduction of astrogliosis was also evident. Overall, the results obtained with the present work indicate that the cotransplantation of ASCs and OECs brings important functional benefits to the injured spinal cord. Stem Cells 2018;36:696-708.

Combined effects of waterborne copper exposure and salinity on enzymes related to osmoregulation and ammonia excretion by blue crab Callinectes sapidus.

Copper is essential, but can be toxic to aquatic organisms when present in high concentrations. In freshwater crustaceans, copper inhibits enzymes related to ionic and osmoregulation and to the ammonia efflux, that leads to Na+ imbalance and inhibition of ammonia excretion. In the animals inhabiting estuarine or seawater, mechanisms of copper toxicity is not clear, but had been described as disruption of ionregulation and metabolism. To clarify the mechanism of copper toxicity in crustaceans inhabiting variable salinity, this work investigated whether copper affects ammonia excretion and enzymes used for ammonia balance and osmoregulation in the blue crab Callintectes sapidus acclimated to salinity 2 and 30 ppt. To achieve this, juveniles of the blue crab were exposed to 63.5 µg/L of copper at both salinities for 96 h. This is an environmentally realistic copper concentration. Results of ammonia efflux, free amino acids and Na+ concentrations in hemolymph, Na+/K+-ATPase, H+-ATPase and, carbonic anhydrase (CA) activities in gills were consistent with the osmoregulatory pattern adopted by the blue crab, which hyperosmoregulates at salinity 2 ppt and osmoconforms at 30 ppt. At 30 ppt copper reduced free amino acid in hemolymph of crabs, suggesting an effect of the metal on osmotic performance. At 2 ppt, copper significantly increased the H+-ATPase activity involved in ammonia excretion. This may be a compensatory response of crabs to maintain low levels of ammonia in their hemolymph; which can be increased by copper exposure. Results presented here are useful for the improvement of the Biotic Ligand Model (BLM) to predict copper toxicity for saltwater environments.

Effects of septorhinoplasty on smell perception.

PURPOSE: To assess whether significant changes in smell perception occur after septorhinoplasty, and evaluate whether septum deviation, allergic rhinitis, and surgical technique affect postoperative smell perception. METHODS: Thirty-four patients (> 18 years old) awaiting septorhinoplasty were included, while those with previous severe hyposmia or anosmia were excluded. The participants self-assessed their smell perception using a 100-mm visual analogue scale (VAS), where 0 mm indicated the inability to smell and 100 mm indicated normal smell perception. The University of Pennsylvania Smell Identification Test (UPSIT) was applied before the procedure, and 4 and 12 weeks after surgery. RESULTS: The UPSIT score showed no significant changes at 4 (p = 0.59; 95% CI - 0.35 to + 2) or 12 weeks (p = 0.16; 95% CI - 1.13 to + 0.66). A comparison of the VAS scores before and 4 weeks after surgery (p = 0.62; 95% CI - 0.63 to + 0.39) yielded similar results. However, the average VAS scores improved 12 weeks after surgery (p = 0.007; 95% CI + 0.22 to + 1.30). Olfactory function, measured using the UPSIT, was not influenced by open or closed surgical techniques (p ≥ 0.10), the presence or absence of rhinitis (p ≥ 0.15), or obstructive septum deviation (p ≥ 0.38). Twelve weeks after surgery, self-evaluated smell perception was better in patients who underwent a closed procedure rather than an open procedure (p = 0.006; 95% CI: -1.39 to -0.37). CONCLUSION: A validated test demonstrates that septorhinoplasty does not compromise smell perception 4 and 12 weeks after surgery. However, it might improve smell perception by the self-report observation.

Impact of mesenchymal stem cells' secretome on glioblastoma pathophysiology.

BACKGROUND: Glioblastoma (GBM) is a highly aggressive primary brain cancer, for which curative therapies are not available. An emerging therapeutic approach suggested to have potential to target malignant gliomas has been based on the use of multipotent mesenchymal stem cells (MSCs), either unmodified or engineered to deliver anticancer therapeutic agents, as these cells present an intrinsic capacity to migrate towards malignant tumors. Nevertheless, it is still controversial whether this innate tropism of MSCs towards the tumor area is associated with cancer promotion or suppression. Considering that one of the major mechanisms by which MSCs interact with and modulate tumor cells is via secreted factors, we studied how the secretome of MSCs modulates critical hallmark features of GBM cells. METHODS: The effect of conditioned media (CM) from human umbilical cord perivascular cells (HUCPVCs, a MSC population present in the Wharton's jelly of the umbilical cord) on GBM cell viability, migration, proliferation and sensitivity to temozolomide treatment of U251 and SNB-19 GBM cells was evaluated. The in vivo chicken chorioallantoic membrane (CAM) assay was used to evaluate the effect of HUCPVCs CM on tumor growth and angiogenesis. The secretome of HUCPVCs was characterized by proteomic analyses. RESULTS: We found that both tested GBM cell lines exposed to HUCPVCs CM presented significantly higher cellular viability, proliferation and migration. In contrast, resistance of GBM cells to temozolomide chemotherapy was not significantly affected by HUCPVCs CM. In the in vivo CAM assay, CM from HUCPVCs promoted U251 and SNB-19 tumor cells growth. Proteomic analysis to characterize the secretome of HUCPVCs identified several proteins involved in promotion of cell survival, proliferation and migration, revealing novel putative molecular mediators for the effects observed in GBM cells exposed to HUCPVCs CM. CONCLUSIONS: These findings provide novel insights to better understand the interplay between GBM cells and MSCs, raising awareness to potential safety issues regarding the use of MSCs as stem-cell based therapies for GBM.

Short communication: Identification of Corynebacterium bovis by MALDI-mass spectrometry.

Corynebacterium bovis is a mastitis-causing microorganism responsible for economic losses related to decrease in milk production. The aim of the study was identify Corynebacterium spp. strains recovered from milk samples of subclinical mastitis by using matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS). Samples were collected during a 10-mo mastitis-monitoring program in a high-production dairy farm. In this study, 80 strains were analyzed; from these 54 (67.5%) were identified at species level as Corynebacterium bovis, 24 (31.2%) isolates were identified at the genus level as Corynebacterium spp., and only 1 (1.35%) isolated had unreliable identification. Results demonstrated that MALDI-MS could be an important technique for the identification of Corynebacterium spp. in milk.

Impaired religiosity and spiritual distress in people living with HIV/AIDS. / Religiosidade prejudicada e sofrimento espiritual em pessoas vivendo com HIV/aids.

OBJECTIVE: To verify the inference of Nursing Diagnoses, Impaired religiosity and Spiritual distress in people living with HIV/AIDS. METHODS: This is a cross-sectional study with a quantitative approach, performed in a specialized Service CenteR of Recife, Pernambuco, from June to November 2015. The results related to 52 people living with HIV/AIDS and that were interviewed were analyzed by three nurse judges. RESULTS: Spiritual distress was estimated at 73.1% (38), Impaired religiosity at 36.5% (19), with an average number of defining characteristics of 3.88 ± 2.05 and 2.55±0.69. The main defining characteristic for Impaired religiosity was: "reports a need to reconnect with previous beliefs" (92.3%); and for Spiritual distress, it was: "Expresses a lack of purpose in life/expresses lack of meaning in life" (86.5%). CONCLUSIONS: The results point to the need to consider the religious-spiritual dimension in care protocols and research in nursing.

Performance of CKD-EPI equation to estimate glomerular filtration rate as compared to MDRD equation in South Brazilian individuals in each stage of renal function.

BACKGROUND: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation seems to correct the overdiagnosis of chronic kidney disease (CKD) provided by Modification of Diet in Renal Disease (MDRD) equation. However, this point has not been tested in some ethnic groups. This study investigated the performance of MDRD and CKD-EPI equations in South Brazilian individuals. METHODS: This cross-sectional study included 354 individuals including healthy volunteers, diabetic and non-diabetic individuals with or without CKD. Glomerular filtration rate (GFR) was measured by the 51Cr-EDTA single-injection method (51Cr-GFR). Accuracy (P30), bias, and Bland-Altman agreement plots were evaluated. RESULTS: In the group as a whole, 51Cr-GFR was 87±37 (6-187), CKD-EPI eGFR, 82±30 (6-152), and MDRD eGFR, 77±28 (6-156) mL/min/1.73 m2 (p<0.001 for all comparisons). Analyzing the subset of individuals with 51Cr-GFR <60 mL/min/1.73 m2, P30 values were, respectively, 76% and 84% for MDRD and for CKD-EPI (p<0.001) while for 51Cr-GFR ≥60 mL/min/1.73 m2, P30 values were 57.5% for both equations (p=1.000). For MDRD and CKD-EPI, mean bias were negative for GFRs <60 (-11 vs. -12, p=0.221) and positive for values >60 (16 vs. 9, p<0.001). In multivariate analysis, absolute bias was unfavorably influenced by measured GFR >60 (for MDRD) and being diabetic or younger (for CKD-EPI). CONCLUSIONS: CKD-EPI reduces GFR underestimation in individuals with GFRs >60, but still presents a quite low accuracy at this GFR range. Moreover, it tends to overestimate GFR in subjects with GFRs <60 mL/min/1.73 m2. CKD stages 1 and 2, diabetes and young age had a negative influence on the performance of the equations.

Intimate Partner Homicide: Comparison Between Homicide and Homicide-Suicide in Portugal.

Intimate partner homicide (IPH) is a tragic event. Studies involving the comparison between IPH and intimate partner homicide-suicide (IPH-S) are scarce, with few studies in Portugal about this issue. The current study aims to compare IPH and IPH-S perpetrators, the victim-perpetrator relationships dynamics, and homicide circumstances. The data was collected through the analysis of 78 judicial processes of IPH that occurred in Portugal, between 2010 and 2015. Of the cases, 51 were IPH, 20 were IPH-S cases, and seven were attempted suicide cases, being perpetrated in 84.6% (n = 66) for male perpetrators. Suicide after intimate homicide were all committed by men. All judicial processes analyzed refer to heterosexual relationships. Bivariate and multivariate analyses were performed to compare the groups concerning perpetrator and victim sociodemographic characteristics, victim-perpetrator dyadic dynamics, and crime circumstances. The results show mostly common trends between the two groups with some differentiating factors when compared individually (e.g., perpetrator professional status, criminal records). Regression logistic analysis showed no differences between IPH and IPH-S.

Benchmarking mobile applications for the health of people with Diabetes Mellitus.

OBJECTIVE: to map the content and features of mobile applications on the management of Diabetes Mellitus and their usability on the main operating systems. METHOD: benchmarking research. The mapping of apps, content, and resources on the Play Store and App Store platforms was based on an adaptation of the Joanna Briggs Institute's scoping review framework. For the usability analysis, the apps were tested for two weeks and the System Usability Scale instrument was used, with scores between 50-67 points being considered borderline, between 68-84, products with acceptable usability and above 85, excellent user acceptance and, for the analysis, descriptive statistics. RESULTS: the most prevalent contents were capillary blood glucose management, diet, oral drug therapy, and insulin therapy. As for resources, diaries and graphs were the most common. With regard to usability, two apps were considered to have excellent usability; 34, products with acceptable usability; 29, the resource may have some flaws but still has acceptable usability standards and 6, with flaws and no usability conditions. CONCLUSION: the content and resources of mobile applications address the fundamental points for managing Diabetes Mellitus with user-friendly resources, with usability acceptable to users and have the potential to assist in the management of Diabetes Mellitus in patients' daily lives.

From the Gut to the Brain: Is Microbiota a New Paradigm in Parkinson's Disease Treatment?

Parkinson's disease (PD) is recognized as the second most prevalent primary chronic neurodegenerative disorder of the central nervous system. Clinically, PD is characterized as a movement disorder, exhibiting an incidence and mortality rate that is increasing faster than any other neurological condition. In recent years, there has been a growing interest concerning the role of the gut microbiota in the etiology and pathophysiology of PD. The establishment of a brain-gut microbiota axis is now real, with evidence denoting a bidirectional communication between the brain and the gut microbiota through metabolic, immune, neuronal, and endocrine mechanisms and pathways. Among these, the vagus nerve represents the most direct form of communication between the brain and the gut. Given the potential interactions between bacteria and drugs, it has been observed that the therapies for PD can have an impact on the composition of the microbiota. Therefore, in the scope of the present review, we will discuss the current understanding of gut microbiota on PD and whether this may be a new paradigm for treating this devastating disease.

Evaluation of clinical and microbiological factors related to mortality in patients with Gram-negative bacterial infections treated with ceftazidime-avibactam: A prospective multicentric cohort study.

OBJECTIVES: This study aimed to evaluate the clinical and microbiological risk factors associated with mortality in patients treated with ceftazidime-avibactam for carbapenem-resistant Gram-negative bacterial infections. METHODS: This multicentric prospective cohort study included hospitalized adult patients with a microbiologically confirmed infection treated with ceftazidime-avibactam for ≥48 hours. The clinical and microbiological risk factors for 30-day mortality were evaluated using a Cox regression model. RESULTS: Of the 193 patients evaluated from the five tertiary hospitals, 127 were included in the study. Thirty-five patients (27.6%) died within 30 days. Infections with AmpC beta-lactamase-carrying bacteria were independently related to 30-day mortality (adjusted hazard ratio [aHR] 2.49, 95% confidence interval [CI] 1.28-4.84, P < 0.01) after adjusting for time from infection to antimicrobial prescription (P = 0.04). Further, these bacterial infections were also related to higher in-hospital mortality (aHR 2.17, 95% CI 1.24-3.78, P < 0.01). Only one patient developed resistance to ceftazidime-avibactam during treatment. CONCLUSIONS: Treatment with ceftazidime-avibactam had worse clinical outcomes in patients with infections with bacteria with chromosomally encoded AmpC beta-lactamase. However, these findings should be confirmed in future studies.