Influenza A infections: predictors of disease severity.

Influenza affects approximately 10% of the world's population annually. It is associated with high morbidity and mortality rates due to its propensity to progress to severe acute respiratory infection, leading to 10-40% of hospitalized patients needing intensive care. Characterizing the multifactorial predictors of poor prognosis is essential for developing strategies against this disease. This study aimed to identify predictors of disease severity in influenza A-infected (IFA-infected) patients and to propose a prognostic score. A retrospective cross-sectional study was conducted with 142 IFA-infected out- and inpatients treated at a tertiary hospital between 2010 and 2018. The viral subtypes, hemagglutinin mutations, viral load, IL-28B SNPs, and clinical risk factors were evaluated according to the patient's ICU admission. Multivariate analysis identified the following risk factors for disease severity: neuromuscular diseases (OR = 7.02; 95% CI = 1.18-41.75; p = 0.032), cardiovascular diseases (OR = 5.47; 95% CI = 1.96-15.27; p = 0.001), subtype (H1N1) pdm09 infection (OR = 2.29; 95% CI = 1.02-5.15; p = 0.046), and viral load (OR = 1.43; 95% CI = 1.09-1.88; p = 0.009). The prognosis score for ICU admission is based on these predictors of severity presented and ROC curve AUC = 0.812 (p < 0.0001). Our results identified viral and host predictors of disease severity in IFA-infected patients, yielding a prognostic score that had a high performance in predicting the IFA patients' ICU admission and better results than a viral load value alone. However, its implementation in health services needs to be validated in a broader population.

Morphophysiological changes of Acca sellowiana (Myrtaceae: Myrtoideae) saplings under shade gradient / Alterações morfofisiológicas em mudas de Acca sellowiana (Myrtaceae: Myrtoideae) sob gradiente de sombreamento

Abstract Understanding morphological and physiological changes under different light conditions in native fruit species in juveniles' stage is important, as it indicate the appropriate environment to achieve vigorous saplings. We aimed to verify growth and morphophysiological changes under shade gradient in feijoa (Acca sellowiana (O. Berg) Burret) to achieve good quality saplings adequate to improve cultivation in orchards. The saplings were grown for twenty-one-month under four shading treatments (0%, 30%, 50%, and 80%). Growth, photosynthetic pigments, gas exchanges, chlorophyll fluorescence, and leaf anatomy parameters were evaluated. Saplings under full sun and 30% shade had higher height and diameter growth and dry mass accumulation due to higher photosynthesis rate. As main acclimatization mechanisms in feijoa saplings under 80% shade were developed larger leaf area, reduced leaf blade thickness, and enhanced quantum yield of photosystem II. Even so, the net CO2 assimilation and the electron transport rate was lower and, consequently, there was a restriction on the growth and dry mass in saplings under deep shade. Therefore, to obtain higher quality feijoa saplings, we recommend that it be carried out in full sun or up to 30% shade, to maximize the sapling vigor in nurseries and, later, this light environment can also be used in orchards for favor growth and fruit production.

Resumo A verificação de mudanças morfológicas e fisiológicas sob diferentes condições luminosas em espécies frutíferas nativas em estágio juvenil é importante, uma vez que indicam o ambiente adequado para a formação de mudas com alto vigor. Objetivou-se verificar o crescimento e as alterações morfofisiológicas sob gradiente de sombreamento em mudas de feijoa (Acca sellowiana (O. Berg) Burret) para obter mudas de boa qualidade, adequadas para fomentar os plantios da espécie em pomares. As mudas foram cultivadas por vinte e um meses sob quatro tratamentos de sombreamento (0%, 30%, 50% e 80%). Foram avaliados parâmetros de crescimento, pigmentos fotossintéticos, trocas gasosas, fluorescência da clorofila e anatomia foliar. Mudas a pleno sol e 30% de sombra apresentaram maior crescimento em altura, diâmetro e acúmulo de massa seca, devido à maior taxa de fotossíntese. Como principais mecanismos de aclimatação sob 80% de sombra, as mudas desenvolveram maior área foliar, redução da espessura do limbo foliar e aumento do rendimento quântico do fotossistema II. Mesmo assim, a assimilação líquida de CO2 e a taxa de transporte de elétrons foram menores e, consequentemente, houve restrição ao crescimento e acúmulo de massa seca das mudas no maior nível de sombreamento. Portanto, para a obtenção de mudas de feijoa de maior qualidade, recomendamos que seja realizada a pleno sol ou até 30% de sombra, para maximizar o vigor das mudas em viveiros e, posteriormente, este ambiente de luz também pode ser utilizado em pomares para favorecer o crescimento e a produção de frutos.

Morphophysiological changes of Acca sellowiana (Myrtaceae: Myrtoideae) saplings under shade gradient

Abstract Understanding morphological and physiological changes under different light conditions in native fruit species in juveniles stage is important, as it indicate the appropriate environment to achieve vigorous saplings. We aimed to verify growth and morphophysiological changes under shade gradient in feijoa (Acca sellowiana (O. Berg) Burret) to achieve good quality saplings adequate to improve cultivation in orchards. The saplings were grown for twenty-one-month under four shading treatments (0%, 30%, 50%, and 80%). Growth, photosynthetic pigments, gas exchanges, chlorophyll fluorescence, and leaf anatomy parameters were evaluated. Saplings under full sun and 30% shade had higher height and diameter growth and dry mass accumulation due to higher photosynthesis rate. As main acclimatization mechanisms in feijoa saplings under 80% shade were developed larger leaf area, reduced leaf blade thickness, and enhanced quantum yield of photosystem II. Even so, the net CO2 assimilation and the electron transport rate was lower and, consequently, there was a restriction on the growth and dry mass in saplings under deep shade. Therefore, to obtain higher quality feijoa saplings, we recommend that it be carried out in full sun or up to 30% shade, to maximize the sapling vigor in nurseries and, later, this light environment can also be used in orchards for favor growth and fruit production.

Resumo A verificação de mudanças morfológicas e fisiológicas sob diferentes condições luminosas em espécies frutíferas nativas em estágio juvenil é importante, uma vez que indicam o ambiente adequado para a formação de mudas com alto vigor. Objetivou-se verificar o crescimento e as alterações morfofisiológicas sob gradiente de sombreamento em mudas de feijoa (Acca sellowiana (O. Berg) Burret) para obter mudas de boa qualidade, adequadas para fomentar os plantios da espécie em pomares. As mudas foram cultivadas por vinte e um meses sob quatro tratamentos de sombreamento (0%, 30%, 50% e 80%). Foram avaliados parâmetros de crescimento, pigmentos fotossintéticos, trocas gasosas, fluorescência da clorofila e anatomia foliar. Mudas a pleno sol e 30% de sombra apresentaram maior crescimento em altura, diâmetro e acúmulo de massa seca, devido à maior taxa de fotossíntese. Como principais mecanismos de aclimatação sob 80% de sombra, as mudas desenvolveram maior área foliar, redução da espessura do limbo foliar e aumento do rendimento quântico do fotossistema II. Mesmo assim, a assimilação líquida de CO2 e a taxa de transporte de elétrons foram menores e, consequentemente, houve restrição ao crescimento e acúmulo de massa seca das mudas no maior nível de sombreamento. Portanto, para a obtenção de mudas de feijoa de maior qualidade, recomendamos que seja realizada a pleno sol ou até 30% de sombra, para maximizar o vigor das mudas em viveiros e, posteriormente, este ambiente de luz também pode ser utilizado em pomares para favorecer o crescimento e a produção de frutos.

Campomanesia xanthocarpa (Myrtaceae: Myrtoideae) seedlings reveal morpho-physiological plasticity under shade conditions.

Plants exposed to different light intensities generate physiological, morphological, and anatomical changes conducting to plasticity. Thus, this characteristic establishes the ability of plants to present phenotypic adjustments by the same genotype under different environmental conditions. The objective of this study was to verify the morphophysiological alterations in Campomanesia xanthocarpa (Mart.) O. Berg (guabiroba) seedlings cultivated in different shading levels. The seedlings were grown for 21 months under full sun or 30%, 50%, and 80% under shading. Growth, photosynthetic pigments, gas exchange rate, chlorophyll fluorescence, and leaf anatomy were evaluated. In all the treatments subjected to shading, plasticity mechanisms involved structural and physiological changes such as an increase in leaf area and chlorophyll content (total and Chl a), reduction in leaf thickness, and increased gas exchange and quantum yield of photosystem II. The guabiroba seedlings can be cultivated in full sun or different shading environments; even under high shading intensity (80%), the plants showed vigor similar to those produced in a sunny environment. These results confirmed our hypothesis about guabiroba acclimation capacity to shading, noteworthy information for nurseries, orchards, agroforestry systems, or forest restoration in a wide range of light environments.

Optimum threshold of the 4Kscore for biopsy in men with negative or indeterminate multiparametric magnetic resonance imaging.

Objective: The study aims to identify the optimal 4Kscore thresholds to determine the need for a prostate biopsy when multiparametric magnetic resonance imaging (MRI) (mpMRI) is negative or indeterminate. Materials and methods: We analysed retrospective data from men in eight different institutions who underwent an mpMRI, 4Kscore and prostate biopsy for evaluation of prostate cancer. We selected men with a negative (PIRADS ≤2) or indeterminate (PIRADS 3) mpMRI. 4Kscore values were categorized into ranges of 1-7, 8-19, 20-32 and greater than 32. We evaluated the proportion of men with grade group 2 or higher (GG2+) cancer in groups defined by PIRADS and 4Kscore. We also evaluated the number of biopsies avoided and GG2+ cancer missed in each group reported depend on 4Kscore cutoff points. Results: Among 1111 men who had an mpMRI, 4Kscore and biopsy, 625 of them had PIRADS ≤3 on mpMRI: 374 negative (PIRADS ≤2) and 251 indeterminate (PIRADS 3). In men with a negative mpMRI, we found a 4Kscore cut-point of 33 resulted in an increased risk of GG2+ cancer on biopsy. In patients with an equivocal lesion on mpMRI, men with a 4Kscore cutoff ≥8 had a greater risk of GG2+ cancer on biopsy. Decision curve analysis supported the proposed cut-points in each mpMRI group. Conclusions: In men with negative and indeterminate mpMRI, we found the best 4Kscore threshold to determine the need for biopsy to be 33 and 8 respectively. Future prospective studies in independent populations are needed to confirm these findings.

Psychiatric polygenic risk as a predictor of COVID-19 risk and severity: insight into the genetic overlap between schizophrenia and COVID-19.

Despite the high contagion and mortality rates that have accompanied the coronavirus disease-19 (COVID-19) pandemic, the clinical presentation of the syndrome varies greatly from one individual to another. Potential host factors that accompany greater risk from COVID-19 have been sought and schizophrenia (SCZ) patients seem to present more severe COVID-19 than control counterparts, with certain gene expression similarities between psychiatric and COVID-19 patients reported. We used summary statistics from the last SCZ, bipolar disorder (BD), and depression (DEP) meta-analyses available on the Psychiatric Genomics Consortium webpage to calculate polygenic risk scores (PRSs) for a target sample of 11,977 COVID-19 cases and 5943 subjects with unknown COVID-19 status. Linkage disequilibrium score (LDSC) regression analysis was performed when positive associations were obtained from the PRS analysis. The SCZ PRS was a significant predictor in the case/control, symptomatic/asymptomatic, and hospitalization/no hospitalization analyses in the total and female samples; and of symptomatic/asymptomatic status in men. No significant associations were found for the BD or DEP PRS or in the LDSC regression analysis. SNP-based genetic risk for SCZ, but not for BD or DEP, may be associated with higher risk of SARS-CoV-2 infection and COVID-19 severity, especially among women; however, predictive accuracy barely exceeded chance level. We believe that the inclusion of sexual loci and rare variations in the analysis of genomic overlap between SCZ and COVID-19 will help to elucidate the genetic commonalities between these conditions.

Drug Permeability - Best Practices for Biopharmaceutics Classification System (BCS)-Based Biowaivers: A workshop Summary Report.

The workshop "Drug Permeability - Best Practices for Biopharmaceutics Classification System (BCS) Based Biowaivers" was held virtually on December 6, 2021, organized by the University of Maryland Center of Excellence in Regulatory Science and Innovation (M-CERSI), and the Food and Drug Administration (FDA). The workshop focused on the industrial, academic, and regulatory experiences in generating and evaluating permeability data, with the aim to further facilitate implementation of the BCS and efficient development of high-quality drug products globally. As the first international permeability workshop since the BCS based biowaivers was finalized as the ICH M9 guideline, the workshop included lectures, panel discussions, and breakout sessions. Lecture and panel discussion topics covered case studies at IND, NDA, and ANDA stages, typical deficiencies relating to permeability assessment supporting BCS biowaiver, types of evidence that are available to demonstrate high permeability, method suitability of a permeability assay, impact of excipients, importance of global acceptance of permeability methods, opportunities to expand the use of biowaivers (e.g. non-Caco-2 cell lines, totality-of-evidence approach to demonstrate high permeability) and future of permeability testing. Breakout sessions focused on 1) in vitro and in silico intestinal permeability methods; 2) potential excipient effects on permeability and; 3) use of label and literature data to designate permeability class.

The genomics of visuospatial neurocognition in obsessive-compulsive disorder: A preliminary GWAS.

BACKGROUND: The study of Obsessive-Compulsive Disorder (OCD) genomics has primarily been tackled by Genome-wide association studies (GWAS), which have encountered troubles in identifying replicable single nucleotide polymorphisms (SNPs). Endophenotypes have emerged as a promising avenue of study in trying to elucidate the genomic bases of complex traits such as OCD. METHODS: We analyzed the association of SNPs across the whole genome with the construction of visuospatial information and executive performance through four neurocognitive variables assessed by the Rey-Osterrieth Complex Figure Test (ROCFT) in a sample of 133 OCD probands. Analyses were performed at SNP- and gene-level. RESULTS: No SNP reached genome-wide significance, although there was one SNP almost reaching significant association with copy organization (rs60360940; P = 9.98E-08). Suggestive signals were found for the four variables at both SNP- (P < 1E-05) and gene-levels (P < 1E-04). Most of the suggestive signals pointed to genes and genomic regions previously associated with neurological function and neuropsychological traits. LIMITATIONS: Our main limitations were the sample size, which was limited to identify associated signals at a genome-wide level, and the composition of the sample, more representative of rather severe OCD cases than a population-based OCD sample with a broad severity spectrum. CONCLUSIONS: Our results suggest that studying neurocognitive variables in GWAS would be more informative on the genetic basis of OCD than the classical case/control GWAS, facilitating the genetic characterization of OCD and its different clinical profiles, the development of individualized treatment approaches, and the improvement of prognosis and treatment response.

Colchicine reduces the activation of NLRP3 inflammasome in COVID-19 patients.

OBJECTIVE: To evaluate whether colchicine treatment was associated with the inhibition of NLRP3 inflammasome activation in patients with COVID-19. METHODS: We present a post hoc analysis from a double-blinded placebo-controlled randomized clinical trial (RCT) on the effect of colchicine for the treatment of COVID-19. Serum levels of NOD-like receptor protein 3 (NLRP3) inflammasome products-active caspase-1 (Casp1p20), IL-1ß, and IL-18-were assessed at enrollment and after 48-72 h of treatment in patients receiving standard-of-care (SOC) plus placebo vs. those receiving SOC plus colchicine. The colchicine regimen was 0.5 mg tid for 5 days, followed by 0.5 mg bid for another 5 days. RESULTS: Thirty-six patients received SOC plus colchicine, and thirty-six received SOC plus placebo. Colchicine reduced the need for supplemental oxygen and the length of hospitalization. On Days 2-3, colchicine lowered the serum levels of Casp1p20 and IL-18, but not IL-1ß. CONCLUSION: Treatment with colchicine inhibited the activation of the NLRP3 inflammasome, an event triggering the 'cytokine storm' in COVID-19. TRIAL REGISTRATION NUMBERS: RBR-8jyhxh.

Modeling functional network topology following stroke through graph theory: functional reorganization and motor recovery prediction.

The study of functional reorganization following stroke has been steadily growing supported by advances in neuroimaging techniques, such as functional magnetic resonance imaging (fMRI). Concomitantly, graph theory has been increasingly employed in neuroscience to model the brain's functional connectivity (FC) and to investigate it in a variety of contexts. The aims of this study were: 1) to investigate the reorganization of network topology in the ipsilesional (IL) and contralesional (CL) hemispheres of stroke patients with (motor stroke group) and without (control stroke group) motor impairment, and 2) to predict motor recovery through the relationship between local topological variations of the functional network and increased motor function. We modeled the brain's FC as a graph using fMRI data, and we characterized its interactions with the following graph metrics: degree, clustering coefficient, characteristic path length, and betweenness centrality (BC). For both patient groups, BC yielded the largest variations between the two analyzed time points, especially in the motor stroke group. This group presented significant correlations (P<0.05) between average BC changes and the improvements in upper-extremity Fugl-Meyer (UE-FM) scores at the primary sensorimotor cortex and the supplementary motor area for the CL hemisphere. These regions participate in processes related to the selection, planning, and execution of movement. Generally, higher increases in average BC over these areas were related to larger improvements in UE-FM assessment. Although the sample was small, these results suggest the possibility of using BC as an indication of brain plasticity mechanisms following stroke.

MicroRNAs miR-629-3p, miR-1202 and miR-1225-5p as potential diagnostic and surgery outcome biomarkers for mesial temporal lobe epilepsy with hippocampal sclerosis.

BACKGROUND: Mesial temporal lobe epilepsy (MTLE) is a symptomatic epilepsy syndrome clinically characterized by high prevalence, pharmacoresistance, good surgical prognosis and hippocampal sclerosis (HS); however, no singular criteria can be considered sufficient for the MTLE-HS diagnosis. MicroRNAs (miRNAs) are small non-coding molecules that act as important gene-expression regulators at post-transcriptional level. Evidences on the involvement of miRNAs in epilepsy pathogenesis as well as their potential to be employed as biomarkers claim for investigations on miRNAs' applicability as epilepsy diagnosis and prognosis biomarkers. Consequently, the present study aimed to evaluate the applicability of three specific miRNAs as biomarkers of diagnosis and surgical outcomes in adult patients with MTLE-HS. METHOD: Hippocampus, amygdala and blood samples from 20 patients with MTLE-HS were analyzed, 10 with favorable surgical prognosis (Engel I) and 10 with unfavorable surgical prognosis (Engel III-IV). For the control groups, hippocampus and amygdala from necropsy and blood samples from healthy individuals were adopted. The miRNAs expression analysis was performed using Real-Time Quantitative Polymerase Chain Reaction for miRNAs highlighted from microarray as being involved in GABAergic neurotransmission. RESULTS: The miRNAs miR-629-3p, miR-1202 and miR-1225-5p were found to be hyper-expressed in MTLE-HS patients' blood. CONCLUSIONS: Our data suggest the existence of three circulating miRNAs (miR-629-3p, miR-1202 and miR-1225-5p) that could possibly act as additional tools in the set of factors that contribute to MTLE-HS diagnose.

Factors affecting executive function performance of Brazilian elderly in the Stroop test.

Aging is related to a decrease in physiological abilities, especially cognitive functions. To unravel further evidence of age-related cognitive decline, we analyzed which physical and functional variables are predictors of cognitive performance in a sample of 498 Brazilian elderly (67.26% women). To do so, we used the Stroop test as a tool to evaluate executive functions and the General functional fitness index (GFFI) to evaluate the functional fitness of the participants. A linear regression analysis revealed that female sex (ß=-0.097; t=-2.286; P=0.023), younger age (ß=0.205; t=4.606; P<0.0001), more years of education (ß=-0.280; t=-6.358; P<0.0001), and higher GFFI (ß=-0.101; t=-2.347; P<0.02) were predictors of better cognitive performance. Body mass index (kg/m2) and nutritional status (underweight, eutrophic, overweight, or obese) were not predictors of cognitive performance. Interestingly, among the GFFI tasks, muscle strength influenced the test execution time, both in upper and lower limbs (elbow flexion: ß=-0.201; t=-4.672; P<0.0001; sit-to-stand: ß=-0.125; t=-2.580; P<0.01). Our findings showed that: 1) women performed the Stroop test faster than men; 2) the older the person, the lower was the cognitive performance; 3) the higher the education, the better the test execution time; and 4) higher scores in the GFFI were associated with a better performance in the Stroop test. Therefore, gender, age, education, and functional fitness and capacity were predictors of cognitive performance in the elderly.

Children's exposure to size-fractioned particulate matter: Chemical composition and internal dose.

The health effects of the particulate matter (PM) depend not only on its aerodynamic diameter (AD) and chemical composition, but also on the time activity pattern of the individuals and on their age. The main objective of this work was to assess the exposure of children to aerosol particles by using personal instruments, to study the particle size and composition of the inhaled PM, and to estimate their transport and deposition into the human respiratory tract (HRT). The average daily PM2.5 exposure was 19 µg/m3 and the size fractions with the greatest contribution to PM2.5 concentrations were 1 < AD <2.5 µm and AD <0.25 µm. Results indicated a contribution of 9% from the mineral aerosol, 7.2% from anthropogenic sulphate, 6.7% from black carbon and 5% from anthropogenic trace elements to the daily exposure to PM2.5. The levels of mineral and marine elements increased with increasing particle size, while anthropogenic elements were present in higher concentrations in the finest particles. Particle size has been shown to influence the variability of daily dose deposited between the extrathoracic and alveolar-interstitial zones. On average, 3% of the PM deposited in the bronchial region, whereas 5% to 8% were found in the bronchiolar region. The level of physical activity had a significant contribution to the total daily dose.

Morphophysiological changes of Acca sellowiana (Myrtaceae: Myrtoideae) saplings under shade gradient.

Understanding morphological and physiological changes under different light conditions in native fruit species in juveniles' stage is important, as it indicate the appropriate environment to achieve vigorous saplings. We aimed to verify growth and morphophysiological changes under shade gradient in feijoa (Acca sellowiana (O. Berg) Burret) to achieve good quality saplings adequate to improve cultivation in orchards. The saplings were grown for twenty-one-month under four shading treatments (0%, 30%, 50%, and 80%). Growth, photosynthetic pigments, gas exchanges, chlorophyll fluorescence, and leaf anatomy parameters were evaluated. Saplings under full sun and 30% shade had higher height and diameter growth and dry mass accumulation due to higher photosynthesis rate. As main acclimatization mechanisms in feijoa saplings under 80% shade were developed larger leaf area, reduced leaf blade thickness, and enhanced quantum yield of photosystem II. Even so, the net CO2 assimilation and the electron transport rate was lower and, consequently, there was a restriction on the growth and dry mass in saplings under deep shade. Therefore, to obtain higher quality feijoa saplings, we recommend that it be carried out in full sun or up to 30% shade, to maximize the sapling vigor in nurseries and, later, this light environment can also be used in orchards for favor growth and fruit production.

Septo-optic dysplasia: Ophthalmological abnormalities in a series of 5 cases.

Septo-optic dysplasia (SOD) is a rare congenital condition of unknown cause, with a characteristic triad that includes optic nerve hypoplasia, pituitary function abnormalities and midline brain defects, in addition to a broad spectrum of symptoms and associations. A total of five clinical cases are presented, four of which met the complete classic triad. All of them showed a wide variety of ophthalmological, endocrinological and neurological alterations. Within the ophthalmological spectrum of SOD, papillary hypoplasia and ocular motility alterations (nystagmus, strabismus) stand out. Other less frequent ones may also appear, such as pupillary alterations, microphthalmia and coloboma. Given the suspicion of SOD, brain MRI scan should be performed, as well as consultation with the paediatric department in order to complete the study and indicate, if necessary, systemic treatment.

Displasia septoóptica: alteraciones oftalmológicas en una serie de 5 casos / Septo-optic dysplasia: ophthalmological abnormalities in a series of 5 cases

La displasia septoóptica (DSO) es una entidad congénita, rara, de causa desconocida, con una tríada característica que incluye hipoplasia de nervio óptico, anomalías en la función hipofisaria y defectos en la línea media cerebral, además de un amplio espectro de manifestaciones y asociaciones.Se presenta una serie de cinco casos clínicos, de los cuales cuatro presentaron la tríada clásica completa. Todos mostraron gran variedad de alteraciones oftalmológicas, endocrinológicas y neurológicas.Dentro del espectro oftalmológico de la DSO, destacan la hipoplasia papilar y las alteraciones de la motilidad ocular (nistagmos estrabismo). También pueden aparecer otras menos frecuentes, como son alteraciones pupilares, microftalmia y coloboma.Ante la sospecha de DSO, conviene realizar una resonancia magnética cerebral y una interconsulta con el servicio de pediatría para completar el estudio e indicar, si fuera preciso, tratamiento sistémico.

Septo-optic dysplasia (SOD) is a rare congenital condition of unknown cause, with a characteristic triad that includes optic nerve hypoplasia, pituitary function abnormalities and midline brain defects, in addition to a broad spectrum of symptoms and associations.A total of five clinical cases are presented, four of which met the complete classic triad. All of them showed a wide variety of ophthalmological, endocrinological and neurological alterations.Within the ophthalmological spectrum of SOD, papillary hypoplasia and ocular motility alterations (nystagmus, strabismus) stand out. Other less frequent ones may also appear, such as pupillary alterations, microphthalmia and coloboma.Given the suspicion of SOD, brain MRI scan should be performed, as well as consultation with the paediatric department in order to complete the study and indicate, if necessary, systemic treatment.

Assessment of children's exposure to carbonaceous matter and to PM major and trace elements.

Particulate matter (PM) pollution is one of the major environmental concerns due to its harmful effects on human health. As children are particularly vulnerable to particle exposure, this study integrates the concentration of PM chemical compounds measured in the micro-environments (MEs) where children spend most of their time to assess the daily exposure and inhaled dose. PM samples were analysed for organic and elemental carbon and for major and trace elements. Results showed that the MEs that contribute most to the children's daily exposure (80%) and inhaled dose (65%) were homes and schools. Results indicated that the high contribution of particulate organic matter (POM) indoors indicate high contributions of indoor sources to the organic fraction of the particles. The highest concentrations of PM chemical compounds and the highest Indoor/Outdoor ratios were measured in schools, where the contribution of mineral elements stands out due to the resuspension of dust caused by the students and to the chalk used in blackboards. The contribution of the outdoor particles to inhaled dose (24%) was higher than to the exposure (12%), due to the highest inhalation rates associated with the activities performed outdoor. This study indicates the importance of indoor air quality for the children's exposure and health.

Standardization of a high-performance RT-qPCR for viral load absolute quantification of influenza A.

Influenza is an acute viral infectious respiratory disease worldwide, presenting in different clinical forms, from influenza-like illness (ILI) to severe acute respiratory infection (SARI). Although real-time quantitative polymerase chain reaction (qPCR) is already an important tool for both diagnosis and treatment monitoring of several viral infections, the correlation between the clinical aspects and the viral load of influenza is still unclear. This lack of clarity is primarily due to the low accuracy and reproducibility of the methodologies developed to quantify the influenza virus. Thus, this study aimed to develop and standardize a universal absolute quantification for influenza A by reverse transcription-quantitative PCR (RT-qPCR), using a plasmid DNA. The assay showed efficiency (Eff%) 98.6, determination coefficient (R2) 0.998, linear range 10^1 to 10^10, limit of detection (LOD) 6.77, limit of quantification (LOQ) 20.52 copies/reaction. No inter and intra assay variability was shown, and neither was the matrix effect observed. Serial measurements of clinical samples collected at a 72h interval showed no change in viral load. By contrast, immunocompetent patients have a significantly lower viral load than immunosuppressed ones. Absolute quantification in clinical samples showed some predictors associated with increased viral load: (H1N1)pdm09 (0.045); women (p = 0.049) and asthmatics (p = 0.035). The high efficiency, precision, and previous performance in clinical samples suggest the assay can be used as an accurate universal viral load quantification of influenza A. Its applicability in predicting severity and response to antivirals needs to be evaluated.

Factors affecting executive function performance of Brazilian elderly in the Stroop test

Aging is related to a decrease in physiological abilities, especially cognitive functions. To unravel further evidence of age-related cognitive decline, we analyzed which physical and functional variables are predictors of cognitive performance in a sample of 498 Brazilian elderly (67.26% women). To do so, we used the Stroop test as a tool to evaluate executive functions and the General functional fitness index (GFFI) to evaluate the functional fitness of the participants. A linear regression analysis revealed that female sex (β=-0.097; t=-2.286; P=0.023), younger age (β=0.205; t=4.606; P<0.0001), more years of education (β=-0.280; t=-6.358; P<0.0001), and higher GFFI (β=-0.101; t=-2.347; P<0.02) were predictors of better cognitive performance. Body mass index (kg/m2) and nutritional status (underweight, eutrophic, overweight, or obese) were not predictors of cognitive performance. Interestingly, among the GFFI tasks, muscle strength influenced the test execution time, both in upper and lower limbs (elbow flexion: β=-0.201; t=-4.672; P<0.0001; sit-to-stand: β=-0.125; t=-2.580; P<0.01). Our findings showed that: 1) women performed the Stroop test faster than men; 2) the older the person, the lower was the cognitive performance; 3) the higher the education, the better the test execution time; and 4) higher scores in the GFFI were associated with a better performance in the Stroop test. Therefore, gender, age, education, and functional fitness and capacity were predictors of cognitive performance in the elderly.