Biological invasions are a population-level rather than a species-level phenomenon.

Biological invasions pose a rapidly expanding threat to the persistence, functioning and service provisioning of ecosystems globally, and to socio-economic interests. The stages of successful invasions are driven by the same mechanism that underlies adaptive changes across species in general-via natural selection on intraspecific variation in traits that influence survival and reproductive performance (i.e., fitness). Surprisingly, however, the rapid progress in the field of invasion science has resulted in a predominance of species-level approaches (such as deny lists), often irrespective of natural selection theory, local adaptation and other population-level processes that govern successful invasions. To address these issues, we analyse non-native species dynamics at the population level by employing a database of European freshwater macroinvertebrate time series, to investigate spreading speed, abundance dynamics and impact assessments among populations. Our findings reveal substantial variability in spreading speed and abundance trends within and between macroinvertebrate species across biogeographic regions, indicating that levels of invasiveness and impact differ markedly. Discrepancies and inconsistencies among species-level risk screenings and real population-level data were also identified, highlighting the inherent challenges in accurately assessing population-level effects through species-level assessments. In recognition of the importance of population-level assessments, we urge a shift in invasive species management frameworks, which should account for the dynamics of different populations and their environmental context. Adopting an adaptive, region-specific and population-focused approach is imperative, considering the diverse ecological contexts and varying degrees of susceptibility. Such an approach could improve and refine risk assessments while promoting mechanistic understandings of risks and impacts, thereby enabling the development of more effective conservation and management strategies.

Recent advances in availability and synthesis of the economic costs of biological invasions.

Biological invasions are a global challenge that has received insufficient attention. Recently available cost syntheses have provided policy- and decision makers with reliable and up-to-date information on the economic impacts of biological invasions, aiming to motivate effective management. The resultant InvaCost database is now publicly and freely accessible and enables rapid extraction of monetary cost information. This has facilitated knowledge sharing, developed a more integrated and multidisciplinary network of researchers, and forged multidisciplinary collaborations among diverse organizations and stakeholders. Over 50 scientific publications so far have used the database and have provided detailed assessments of invasion costs across geographic, taxonomic, and spatiotemporal scales. These studies have provided important information that can guide future policy and legislative decisions on the management of biological invasions while simultaneously attracting public and media attention. We provide an overview of the improved availability, reliability, standardization, and defragmentation of monetary costs; discuss how this has enhanced invasion science as a discipline; and outline directions for future development.

Absorb bioresorbable vascular scaffold outcomes following implantation with routine intravascular imaging guidance.

OBJECTIVES: We sought to describe the outcomes of BVS use from a single-center experience in which scaffold implantation was guided by intravascular imaging (ultrasound and/or optical coherence tomography) to identify and treat mechanical factors potentially related to BVS failure. BACKGROUND: The Absorb bioresorbable vascular scaffold (BVS) has been associated with an unexpectedly high incidence of thrombosis. METHODS: Between 11/2014 and 10/2016, 100 patients were treated with BVS. Intravascular imaging assessment before and after BVS implantation was performed in all cases. RESULTS: Mean age was 58.1 years; 88% were male, 31% had diabetes, and 28% presented with acute coronary syndromes. A total of 171 lesions in 141 vessels were treated with 190 BVS (mean 1.9 scaffolds/patient). Further intervention following intravascular imaging to optimize BVS implantation was required in 31% of patients. Procedure success was 100%. All patients completed a 1-year follow-up. The 1-year rate of target lesion failure was 4%, and there were no cases (0%) of scaffold thrombosis, myocardial infarction, or death. CONCLUSIONS: In this real-world experience, the use of intravascular imaging to guide BVS implantation was associated with a high 1-year event-free survival rate, with no scaffold thrombosis.

Hematopoietic Stem Cell Transplantation Without the Use of Blood Components by the Patient's Choice: Experience of 2 Brazilian Centers.

Hematopoietic stem cell transplantation (HSCT) has been used to treat many malignant and nonmalignant hematologic conditions; however, the use of HSCT in patients who refuse blood transfusions has rarely been described in the literature, and no data have been published concerning haploidentical HSCT without the use of blood products. The aim of this study is to describe the experience of a Brazilian group in performing 21 HSCTs without the use of blood components in the first 100 days after transplantation, which is the period corresponding to the greatest risk of toxicity for this procedure. We developed 21 HSCTs without transfusion support in 19 patients admitted to 2 Brazilian transplantation centers. The patients were subjected to stem cell mobilization and different conditioning regimens. No mortality related to the procedure occurred among the transplant recipients. The global survival rate after 100 days, which is the period related to the immediate toxicity of HSCT, was 94.7%, and the median duration of follow-up was 980 days, with an overall survival rate of 68.4%. Thus, refusal of blood transfusion is not an absolute contraindication for HSCT. This therapy is feasible in specific situations when the patient clearly expresses a desire to avoid blood transfusions and when favorable clinical conditions are achievable with strict, specialized medical monitoring.

Zooplankton community attributes in an oligo-mesotrophic reservoir: A comparative study of two sampling strategies.

Studies of the limnetic zooplankton in Brazilian freshwater have been done using several sampling strategies which are frequently associated to personal preferences, system constraints and objectives of the studies. It is known that a better sampling technique exists for each group of investigated zooplankton. So, the challenge is to provide a good sampling method for all groups at once. Regarding this theme we are contributing by pointing out the merits and demerits of two collecting methods of zooplankton widely used in many studies in Brazilian reservoirs to clarify the information about communities' structure in past published and non-published biological data and also find a more useful sampler for future studies. Two simultaneous strategies were used with a 68µm-plankton net: filtration of water collected at sub-surface by bucket and vertical hauls throughout the euphotic zone. A total of 133 taxa was found with both strategies. Rotifers (69 taxa) comprised the group with the highest richness, followed by protozoans (31 taxa), cladocerans (30 taxa) and copepods (5 taxa). Paired t-tests showed significant difference for richness despite none for density in whole period. Spatially, sampling strategies differed in abundance and composition of zooplankton at most sites sampled (except for L1- shallowest site and L4 - deepest site). Temporally, both samplers showed the highest mean abundances at thermal stratification period. In general, the extent of spatial data collected throughout the vertical gradient provided better estimations in the limnetic area for the attributes analyzed: zooplankton density, richness, specific diversity, equitability and cumulative richness. Zooplankton sampling by vertical hauls through the euphotic zone was more efficient, but in order to obtain integrated data and according to the collector's curve it might be useful to adopt both methodologies.

Morphological study of Socorro Island Merino sheep and its crosses with hair breeds.

A study was conducted with the objective to characterize the morphology of Socorro Island Merino sheep. A total of 67 sheep, 62 females, 26 purebred and 36 crossbred with hair breeds, and five males were scored for 10 body measurements in addition to live weight, and four racial and seven functional indices were calculated. The influence of sex and crossbreeding on the body measurements and indices was analyzed by one-way analysis of variance, and morphological harmony was determined using Spearman correlation. With exception of rump length, body measurements and live weight were significantly greater in males than in females. Sexual dimorphism was 1.21, with males being 78 % heavier than females. Socorro Island Merino sheep were dolichocephalous, elipometric, with a convex curve rump, and with a high and low morphological harmony for females and males, respectively. They had undefined zootechnical aptitude tended toward dairy phenotype as long as crossbreeding with hair breeds did not affect their functional or productive aptitude. It can be concluded that Socorro Island Merino sheep is a new biotype of the Merino breed, which is necessary to preserve and evaluate as a source of genetic characteristics such as adaptation to harsh environmental conditions.

Optimizing single-tube nested PCR for enhanced genotyping of single cells and in vitro produced bovine embryos.

Single-tube nested PCR (STnPCR) is a technique that improves nested PCR, reducing potential contamination and false-positive results, enhancing the amplification sensitivity. Despite being commonly used for the detection of microorganisms, STnPCR can be a valuable tool for bovine genotyping, encompassing essential targets as ROSA26 and TSPY, pivotal in the fields of animal reproduction, genetic improvement, and transgenic research. The objective of this study was to improve and innovate STnPCR for gene detection in cattle. We aimed to detect the ROSA26 and TSPY genes using low-concentration DNA samples, including single cells, small cell groups (one to five cells), in vitro-produced embryos, and bovine tissue samples. Moreover, we refined STnPCR for gene detection in up to single cells by conducting sensitivity testing with different concentration ratios of internal and external primers. Successful amplification of the ROSA26 and TSPY genes was achieved across all tested primer concentrations, even in single cells, with more consistent results observed at lower primer concentrations. Additionally, simultaneous gene amplification was achieved through STnPCR multiplexing, representing the first study of multiplex STnPCR in cattle. These outcomes not only confirm its effectiveness in detecting genetic markers for animal genetic improvement and transgenic elements but also pave the way for its widespread adoption in reproductive studies in bovines.

Taming the terminological tempest in invasion science.

Standardised terminology in science is important for clarity of interpretation and communication. In invasion science - a dynamic and rapidly evolving discipline - the proliferation of technical terminology has lacked a standardised framework for its development. The result is a convoluted and inconsistent usage of terminology, with various discrepancies in descriptions of damage and interventions. A standardised framework is therefore needed for a clear, universally applicable, and consistent terminology to promote more effective communication across researchers, stakeholders, and policymakers. Inconsistencies in terminology stem from the exponential increase in scientific publications on the patterns and processes of biological invasions authored by experts from various disciplines and countries since the 1990s, as well as publications by legislators and policymakers focusing on practical applications, regulations, and management of resources. Aligning and standardising terminology across stakeholders remains a challenge in invasion science. Here, we review and evaluate the multiple terms used in invasion science (e.g. 'non-native', 'alien', 'invasive' or 'invader', 'exotic', 'non-indigenous', 'naturalised', 'pest') to propose a more simplified and standardised terminology. The streamlined framework we propose and translate into 28 other languages is based on the terms (i) 'non-native', denoting species transported beyond their natural biogeographic range, (ii) 'established non-native', i.e. those non-native species that have established self-sustaining populations in their new location(s) in the wild, and (iii) 'invasive non-native' - populations of established non-native species that have recently spread or are spreading rapidly in their invaded range actively or passively with or without human mediation. We also highlight the importance of conceptualising 'spread' for classifying invasiveness and 'impact' for management. Finally, we propose a protocol for classifying populations based on (i) dispersal mechanism, (ii) species origin, (iii) population status, and (iv) impact. Collectively and without introducing new terminology, the framework that we present aims to facilitate effective communication and collaboration in invasion science and management of non-native species.

Towards effective management of the marine-origin Prymnesium parvum (Haptophyta): A growing concern in freshwater reservoirs?

Freshwater ecosystems are highly susceptible to harmful algal blooms (HABs), which are often caused by monospecific dense blooms. Effective preventive management strategies are urgently needed to avoid wide-ranging and severe impacts often resulting in costly damage to resources and unsustainable management options. In this study, we utilized SDM techniques focused on Prymnesium parvum, one of the most notorious HABs species worldwide. We first compare the climatic space occupied by P. parvum in North America, Europe and Australia. Additionally, we use MaxEnt algorithm to infer, for the first time, the potentially suitable freshwater environments in the aforementioned ranges. We also discuss the risks of invasion in reservoirs - prone habitats to persistent blooms of pests and invasive phytoplanktonic species. Our results show populations with distinctive niches suggesting ecophysiological tolerances, perhaps reflecting different strains. Our model projections revealed that the potential extent for P. parvum invasions is much broader than its current geographic distribution. The spatial configuration of reservoirs, if not sustaining dense blooms due to non-optimal conditions, favors colonization of multiple basins and ecoregions not yet occupied by P. parvum. Our models can provide valuable insights to decision-makers and monitoring programs while reducing the resources required to control the spread of P. parvum in disturbed habitats. Lastly, as impact magnitude is influenced by toxicity which in turn varies between different strains, we suggest future studies to incorporate intraspecific genetic information and fine-scale environmental variables to estimate potential distribution of P. parvum.

Morphological Description and Live Weight Prediction from Body Measurements of Socorro Island Merino Lambs.

The aim of this study was to describe the morphology and estimate live weight from body measurements of Socorro Island Merino lambs. A group of Socorro Island Merino lambs was recorded from birth to year for live weight, rump width, rump length, withers height, body length, cannon bone perimeter, and chest girth, width, and depth. The effect of the lamb type on body measurements and live weight was analyzed using ANOVA, Pearson's correlation analysis was performed to estimate the relationship between body measurements and live weight, multiple linear regressions were fitted to obtain prediction equations of live weight from the body measurements and finally, chest girth was used to generate prediction equations using linear and exponential models. At birth and at year, differences were observed in body measurements, especially those related to the thoracic region, with crossbred males showing the highest values. Live weight was correlated with almost all the body measurements, with the highest coefficients observed with chest girth, chest width, and chest depth. Live weight can be accurately predicted from multiple regression equations using several body measurements, but using only chest girth (CG) as a predictor, the exponential equation W0-365 = 0.9142 exp(0.0462 CG) showed the best accuracy.

From ecological functions to ecosystem services: linking coastal lagoons biodiversity with human well-being.

In this review we highlight the relevance of biodiversity that inhabit coastal lagoons, emphasizing how species functions foster processes and services associated with this ecosystem. We identified 26 ecosystem services underpinned by ecological functions performed by bacteria and other microbial organisms, zooplankton, polychaetae worms, mollusks, macro-crustaceans, fishes, birds, and aquatic mammals. These groups present high functional redundancy but perform complementary functions that result in distinct ecosystem processes. Because coastal lagoons are located in the interface between freshwater, marine and terrestrial ecosystems, the ecosystem services provided by the biodiversity surpass the lagoon itself and benefit society in a wider spatial and historical context. The species loss in coastal lagoons due to multiple human-driven impacts affects the ecosystem functioning, influencing negatively the provision of all categories of services (i.e., supporting, regulating, provisioning and cultural). Because animals' assemblages have unequal spatial and temporal distribution in coastal lagoons, it is necessary to adopt ecosystem-level management plans to protect habitat heterogeneity and its biodiversity, ensuring the provision of services for human well-being to multi-actors in the coastal zone.

Unveiling the hidden economic toll of biological invasions in the European Union.

Background: Biological invasions threaten the functioning of ecosystems, biodiversity, and human well-being by degrading ecosystem services and eliciting massive economic costs. The European Union has historically been a hub for cultural development and global trade, and thus, has extensive opportunities for the introduction and spread of alien species. While reported costs of biological invasions to some member states have been recently assessed, ongoing knowledge gaps in taxonomic and spatio-temporal data suggest that these costs were considerably underestimated. Results: We used the latest available cost data in InvaCost (v4.1)-the most comprehensive database on the costs of biological invasions-to assess the magnitude of this underestimation within the European Union via projections of current and future invasion costs. We used macroeconomic scaling and temporal modelling approaches to project available cost information over gaps in taxa, space, and time, thereby producing a more complete estimate for the European Union economy. We identified that only 259 out of 13,331 (~ 1%) known invasive alien species have reported costs in the European Union. Using a conservative subset of highly reliable, observed, country-level cost entries from 49 species (totalling US$4.7 billion; 2017 value), combined with the establishment data of alien species within European Union member states, we projected unreported cost data for all member states. Conclusions: Our corrected estimate of observed costs was potentially 501% higher (US$28.0 billion) than currently recorded. Using future projections of current estimates, we also identified a substantial increase in costs and costly species (US$148.2 billion) by 2040. We urge that cost reporting be improved to clarify the economic impacts of greatest concern, concomitant with coordinated international action to prevent and mitigate the impacts of invasive alien species in the European Union and globally. Supplementary Information: The online version contains supplementary material available at 10.1186/s12302-023-00750-3.

A periodized model for exercise improves the intra-hospital evolution of patients after myocardial revascularization: a pilot randomized controlled trial.

OBJECTIVE: To compare models of the postoperative hospital treatment phase after myocardial revascularization. DESIGN: A pilot randomized controlled trial. SETTING: Hospital patients in a hospital setting. SUBJECTS: Thirty-two patients with indications for myocardial revascularization were included between January 2008 and December 2009, with a left ventricular ejection fraction (LVEF) ≥50%, 1-second forced expiratory volume (FEV(1)) ≥60 and forced vital capacity (FVC) ≥60% of predicted value. INTERVENTIONS: Patients were randomly placed into two groups: one performed prescribed exercises according to the model proposed by the American College of Sports Medicine (ACSM) and the other according to a periodized model. MAIN MEASURES: Partial pressure of O(2) (P o (2)) and arterial O(2) saturation (Sao (2)), percentage of predicted FVC and total distance on the six-minute walking test (6MWT). RESULTS: Twenty-seven patients were re-evaluated upon release from the hospital (ACSM = 14 and PP = 13). Five patients extubated for more than 6 hours in the postoperative period were excluded from the sample. In the preoperative period the variables P o (2), Sao (2), % FVC and 6MWT were similar. In the postoperative period, a reduction was observed for all parameters in both groups. Upon comparison of the groups, a difference was observed in P o (2) (ACSM = 68.0 ± 4.3 vs. PP = 75.9 ± 4.8 mmHg; P < 0.001), Sao (2) (ACSM = 93.5 ± 1.4 vs. PP = 94.8 ± 1.2%; P = 0.018) and 6MWT (ACSM = 339.3 ± 41.7 vs. PP = 393.8 ± 25.7 m; P < 0.001). There was no difference in % FVC. CONCLUSION: Patients after myocardial revascularization following a periodized model of exercise presented a better intra-hospital evolution when compared to those using the ACSM model.

Effect of supplemental yeast culture and physiological factors on colostrum and milk composition of Pelibuey ewes.

The effects of supplemental yeast culture, litter size, stage and number of lactation on milk composition were studied in Pelibuey ewes. Twenty ewes were randomly assigned to one of two dietary treatments. Ten control ewes grazed on guinea grass (Panicum maximum) and were supplemented with concentrate. A further ten ewes received the same diet with 14 g/head/day of yeast culture (Saccharomyces cerevisiae). Colostrum was collected within 24 h after parturition, and subsequently, milk samples were collected at fortnightly intervals (7, 21, 35, and 49 days). Total solids content averaged 32% in colostrum and 12.5% in milk. Colostrum of primiparous ewes had higher total solids content than that of ewes with more than five lactations. However, ewes with more than five lactations produced milk with higher net energy, total solids, protein, and casein than ewes with fewer lactations. Milk at 7 days had a significantly higher content of energy, total solids, and fat than milk at 21, 35, and 49 days. Total solids content was lower for ewes rearing one lamb than larger litter sizes. Supplementation with yeast culture did not affect the composition of colostrum and milk, which was mainly affected by the stage and number of lactation.

The global social-economic dimension of biological invasions by plankton: Grossly underestimated costs but a rising concern for water quality benefits?

Planktonic invasive species cause adverse effects on aquatic biodiversity and ecosystem services. However, these impacts are often underestimated because of unresolved taxonomic issues and limited biogeographic knowledge. Thus, it is pivotal to start a rigorous quantification of impacts undertaken by planktonic invasive species on global economies. We used the InvaCost database, the most up-to-date database of economic cost estimates of biological invasions worldwide, to produce the first critical assessment of the economic dimension of biological invasions caused by planktonic taxa. We found that in period spanning from 1960 to 2021, the cumulative global cost of plankton invasions was US$ 5.8 billion for permanent plankton (holoplankton) of which viruses encompassed nearly 93%. Apart from viruses, we found more costs related to zooplankton (US$ 297 million) than to the other groups summed, including myco- (US$ 73 million), phyto- (43 million), and bacterioplankton (US$ 0.7 million). Strikingly, harmful and potentially toxic cyanobacteria and dinoflagellates are completely absent from the database. Furthermore, the data base showed a decrease in costs over time, which is probably an artifact as a sharp rise of novel planktonic alien species has gained international attention. Also, assessments of the costs of larval meroplanktonic stages of littoral and benthic invasive invertebrates are lacking whereas cumulative global cost of their adults stages is high up to US$ 98 billion billion and increasing. Considering the challenges and perspectives of increasing but unnoticed or neglected impacts by plankton invasions, the assessment of their ecological and economic impacts should be of high priority.

Climate change and niche unfilling tend to favor range expansion of Moina macrocopa Straus 1820, a potentially invasive cladoceran in temporary waters.

Non-native species' introductions have increased in the last decades primarily due to anthropogenic causes such as climate change and globalization of trade. Moina macrocopa, a stress-tolerant cladoceran widely used in bioassays and aquaculture, is spreading in temporary and semi-temporary natural ponds outside its natural range. Here, we characterize the variations in the climatic niche of M. macrocopa during its invasions outside the native Palearctic range following introduction into the American continent. Specifically, we examined to what extent the climatic responses of this species have diverged from those characteristics for its native range. We also made predictions for its potential distribution under current and future scenarios. We found that the environmental space occupied by this species in its native and introduced distribution areas shares more characteristics than randomly expected. However, the introduced niche has a high degree of unfilling when displacing its original space towards the extension to drier and hotter conditions. Accordingly, M. macrocopa can invade new areas where it has not yet been recorded in response to warming temperatures and decreasing winter precipitation. In particular, temporary ponds are more vulnerable environments where climatic and environmental stresses may also lower biotic resistance. Supplementary Information: The online version contains supplementary material available at 10.1007/s10750-022-04835-7.

Trends in bariatric surgeries in the Brazilian Federative Units, 2009-2019: a descriptive study.

OBJECTIVE: our objective is to describe the epidemiological distribution of hospitalizations and postoperative deaths, as well as the trends of bariatric surgeries performed by SUS in all Brazilian federative units (FUs) from an analysis of the period from 2009 to 2019. METHODS: This is an observational, descriptive ecological time-series study with quantitative and descriptive analysis, based on secondary data. The period analyzed was from 2009 to 2019. We collected, from DATASUS, data from obese men and women who were hospitalized after undergoing bariatric surgery. Prais-Winsten regression was performed to identify the trends. RESULTS: In the period, 83,829 bariatric surgeries were performed, of which 161 resulted in death, representing 0.19% of the procedures. We found an increasing trend in the number of surgeries for Brazil (ß=0.04; p<0.001), but 11 FUs showed a stationary trend and three, decreasing ones (six UFs did not have enough data to enter the analysis). In the North and Northeast regions, stationary trends prevailed, while in the Center-West, the decreasing trends, and in the South and Southeast, the increasing ones. CONCLUSIONS: we found an evident disparity between regions, suggesting deficiencies in access to health. By demonstrating which FUs and demographic characteristics have the lowest rates of surgeries, our study is able to direct public policies towards a more egalitarian Brazilian public health.

Application of 5% Lidocaine Adhesive Patch in Painful Surgical Scars: Clinical Trial.

Objective The present paper aims to evaluate the use of a 5% lidocaine patch to treat neuropathic pain after orthopedic procedures in comparison with therapeutic massage over surgical incisions. Methods This is a prospective, randomized clinical trial with 37 patients who underwent orthopedic surgery from January 2015 to February 2017. The study included subjects aged 13 to 70 years old who underwent foot and ankle orthopedic surgery and presented neuropathic pain or hypersensitivity at the surgical incision site for at least 90 days after the procedure. All patients were assessed for pain (using the visual analog scale [VAS]) and quality of life (with the SF-36 questionnaire) at the beginning of the treatment and after 30, 60, and 90 days. Results Although the treatment improved pain in both groups, subjects using the lidocaine patch presented greater pain reduction over time. There were no statistically significant differences in the SF-36 questionnaire, with no significant evidence regarding functional capacity, physical aspects, vitality, emotional aspects, social aspects, general health condition, and mental health. The great advantage of the patch was the degree of personal satisfaction of the patients, with statistical relevance, probably due to the easy application and psychological effect of a drug therapy. Conclusion Lidocaine patches and massages are effective treatment methods for reducing scar tissue pain, with similar outcomes. The patches improved the degree of patient satisfaction. Level of Evidence 1. Prospective randomized clinical trial.

Immediate analgesic effect of two modes of transcutaneous electrical nerve stimulation on patients with chronic low back pain: a randomized controlled trial.

OBJECTIVE: To compare and assess the immediate analgesic effects of conventional and burst transcutaneous electrical nerve stimulation in patients with chronic low back pain. METHODS: We conducted a three-arm single-blinded randomized controlled trial. A total of 105 patients with non-specific chronic low back pain aged between 18 and 85 years were randomly assigned into the following groups: Placebo Group (sham electrical stimulation), Conventional TENS Group (continuous stimulation at 100Hz for 100µs with sensory intensity), and Burst TENS Group (stimulation at 100Hz modulated at 2Hz for 100µs with motor-level intensity). All groups received a single application of transcutaneous electrical nerve stimulation for 30 minutes. The outcomes, namely, pain intensity, quality of pain, and pressure pain threshold were measured by the visual analog scale, McGill pain questionnaire, and algometry, respectively. The patients were evaluated before and immediately after the transcutaneous electrical nerve stimulation application. RESULTS: Pain intensity (visual analog scale score) and quality of pain (McGill pain questionnaire score) significantly decreased (p<0.05) in Intervention Groups (Conventional TENS Group and Burst TENS Group). A positive effect was observed in the interventions compared to the Placebo Group in all domains of the McGill pain questionnaire (p<0.05), excepting for the pain intensity. Pressure pain threshold significantly increased (p<0.05) immediately after the transcutaneous electrical nerve stimulation application in both Intervention Groups, but not in the Placebo Group. For significant difference was found during assessment when comparing both Intervetion Group. CONCLUSION: Both transcutaneous electrical nerve stimulation modes were effective for pain modulation. Moreover, there was an increase in the pressure pain threshold. No significant results were found to indicate the best mode for the treatment of chronic low back pain.Clinical Trial Registration: RBR-59YGRB.

Platelet-rich plasma vs bone marrow aspirate concentrate: An overview of mechanisms of action and orthobiologic synergistic effects.

The use of orthobiologics as a novel therapy for the treatment of numerous musculoskeletal disorders has increased considerably over the past decade. Currently, there are multiple alternatives available as suitable treatments; however, the use of autologous blood-derived products such as platelet-rich plasma (PRP), bone marrow aspirate (BMA) and BMA concentrate (BMAC), specifically, is expanding. Although many investigations attempted to demonstrate the effectiveness of these therapies, even with positive results, the literature lacks standardized protocols and overall accuracy in study designs, which leads to variance and difficulty in reproducibility of protocols. The efficacy of PRP for the treatment of cartilage, bone and muscle tissues is well known. Although BMAC has generated optimistic results for the same purposes, its applicability in clinical trials is still relatively recent when compared to PRP. Both products demonstrate the potential to set forth reparative processes, each in their own distinct mechanism. The combination of these biological products has been previously proposed, yet little is known about their synergism. Evidence indicates that growth factor, cytokine, and chemokine profiles seen in both PRP and BMAC vary but are likely to work synergistically to enhance musculoskeletal healing. BMAC products seem to work well without PRP; however, the addition of PRP to BMAC has been shown to act as a rich and natural source of culture medium for stem cells located either peripherally or in the bone marrow itself. Nevertheless, additional variables associated with the use of BMAC and PRP in orthopedics must be further evaluated in order to consolidate the efficacy of this therapeutic strategy.