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1.
Trauma Case Rep ; 52: 101062, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38957172

ABSTRACT

Decision-making regarding limb amputation represents a significant clinical challenge, especially when the initial evaluation does not coincide with the criteria established in scales used worldwide, as is the case of the MESS scale. This article presents the case of a 24-year-old female patient who was transferred to a university hospital after a road traffic accident with severe and large lesions in the left lower limb. Despite a poor initial prognosis and in-hospital complications, including multiple surgical procedures and foot drop, a favorable recovery was achieved with complete anatomical salvage of the limb at risk. The multidisciplinary approach and intensive rehabilitation were instrumental in achieving a satisfactory functional recovery. This case highlights the importance of considering factors beyond amputation scale scores, as well as the need for comprehensive care to improve outcomes in patients with complex extremity injuries.

2.
BMC Pediatr ; 24(1): 422, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38956483

ABSTRACT

INTRODUCTION: In highly multiracial populations with inadequate newborn screening, knowledge of the various phenotypic presentations of Cystic Fibrosis (CF) can help reach an early diagnosis. This study aims to describe phenotypes and genotypes at the time of CF diagnosis in a state in the Northeast Region of Brazil. METHODS: Retrospective cross-sectional study. Clinical data were extracted from the medical records of CF patients. Clinical, laboratory, and genotypic characteristics were described for patients admitted to a tertiary referral center between 2007 and 2021. RESULTS: Fifty-eight (58) patients were included in the study, 53.5% of whom were diagnosed through clinical suspicion. The median age at diagnosis was 4.7 months (IQR: 1.5-14.8 months). Five patients had false-negative results in the newborn screening. Faltering growth was the most frequent clinical manifestation. Bronchiectasis and a history of pneumonia predominated in those older than ten, while thinness, underweight, and electrolyte imbalances were more frequent in children under two. Sequencing of the CFTR gene identified 27 genotypes, with at least one class I-III variant in all patients, and nine variants that are rare, previously undescribed, or have uncertain significance (619delA, T12991, K162Q, 3195del6, 1678del > T, 124del123bp, 3121-3113 A > T). The most frequent alleles were p.Phe508del, p.Gly542*, p.Arg334Trp, and p.Ser549Arg. CONCLUSIONS: Malnutrition and electrolyte imbalances were the most frequent phenotypes for children < 2 years and were associated with genotypes including 2 class I-III variants. Rare and previously undescribed variants were identified. The p.Gly542*, p.Arg334Trp, and p.Ser549Arg alleles were among the most frequent variants in this population.


Subject(s)
Cystic Fibrosis Transmembrane Conductance Regulator , Cystic Fibrosis , Genotype , Phenotype , Humans , Cystic Fibrosis/genetics , Cystic Fibrosis/diagnosis , Brazil , Cross-Sectional Studies , Retrospective Studies , Male , Female , Infant , Cystic Fibrosis Transmembrane Conductance Regulator/genetics , Infant, Newborn , Neonatal Screening , Child, Preschool , Mutation
3.
BMC Genomics ; 25(1): 674, 2024 Jul 07.
Article in English | MEDLINE | ID: mdl-38972970

ABSTRACT

BACKGROUND: Sponges (phylum Porifera) constantly interact with microbes. They graze on microbes from the water column by filter-feeding and they harbor symbiotic partners within their bodies. In experimental setups, sponges take up symbionts at lower rates compared with seawater microbes. This suggests that sponges have the capacity to differentiate between microbes and preferentially graze in non-symbiotic microbes, although the underlying mechanisms of discrimination are still poorly understood. Genomic studies showed that, compared to other animal groups, sponges present an extended repertoire of immune receptors, in particular NLRs, SRCRs, and GPCRs, and a handful of experiments showed that sponges regulate the expression of these receptors upon encounter with microbial elicitors. We hypothesize that sponges may rely on differential expression of their diverse repertoire of poriferan immune receptors to sense different microbial consortia while filter-feeding. To test this, we characterized the transcriptomic response of two sponge species, Aplysina aerophoba and Dysidea avara, upon incubation with microbial consortia extracted from A. aerophoba in comparison with incubation with seawater microbes. The sponges were sampled after 1 h, 3 h, and 5 h for RNA-Seq differential gene expression analysis. RESULTS: D. avara incubated with A. aerophoba-symbionts regulated the expression of genes related to immunity, ubiquitination, and signaling. Within the set of differentially-expressed immune genes we identified different families of Nucleotide Oligomerization Domain (NOD)-Like Receptors (NLRs). These results represent the first experimental evidence that different types of NLRs are involved in microbial discrimination in a sponge. In contrast, the transcriptomic response of A. aerophoba to its own symbionts involved comparatively fewer genes and lacked genes encoding for immune receptors. CONCLUSION: Our work suggests that: (i) the transcriptomic response of sponges upon microbial exposure may imply "fine-tuning" of baseline gene expression as a result of their interaction with microbes, (ii) the differential response of sponges to microbial encounters varied between the species, probably due to species-specific characteristics or related to host's traits, and (iii) immune receptors belonging to different families of NLR-like genes played a role in the differential response to microbes, whether symbionts or food bacteria. The regulation of these receptors in sponges provides further evidence of the potential role of NLRs in invertebrate host-microbe interactions. The study of sponge responses to microbes exemplifies how investigating different animal groups broadens our knowledge of the evolution of immune specificity and symbiosis.


Subject(s)
Microbial Consortia , Porifera , Symbiosis , Transcriptome , Symbiosis/genetics , Porifera/microbiology , Porifera/genetics , Animals , Microbial Consortia/genetics , Gene Expression Profiling , Mediterranean Sea
4.
Bol. latinoam. Caribe plantas med. aromát ; 23(4): 552-567, jul. 2024. ilus, tab, graf
Article in English | LILACS | ID: biblio-1538061

ABSTRACT

Ethnobotany approached through ethnoeducation allows for the preservation of the cultural heritage of indigenous communities. In this way, the ethnobotanical knowledge of primary school students from the Paniquita Indigenous Community was recognized, regarding the cultural knowledge of medicinal plants and their significance in the conservation of the biocultural heritage. This research had a qualitative, ethnographic approach. The sample consisted of ten students who were part of a focus group, ethnobotanical walks, and participatory workshops with drawings since they stimulate students' creative and dynamic thinking and strengthen interculturality. Twenty-one plants were reported, which are used to relieve sore throats, headaches, and stomach aches, as well as to treat diarrhea and fever, to prevent flu, and as a purgative. All the medicinal plants mentioned grow in the community and are either cultivated or wild, which also shows the students' knowledge of the ir territory. These findings reflect the importance of ethno-education and ethnobotany at school and how historical reconstruction processes are generated from these settings, where indigenous ancestral knowledge is made visible.


La etnobotánica abordada desde la etnoeducación permite mantener el legado cultural de los pueblos originarios. De esta manera, se reconoció el conocimiento etnobotáni co de los estudiantes de primaria de la Comunidad Indígena Paniquita, sobre el conocimiento cultural de las plantas medicinales y su importancia para la conservación del patrimonio biocultural. La investigación tuvo un enfoque cualitativo y etnográfico. La muestra estuvo conformada por diez estudiantes que formaron parte de un grupo focal, caminatas etnobotánicas y talleres participativos con dibujos, ya que estimulan el pensamiento creativo y dinámico de los estudiantes y fortalecen la interculturalidad. Se reportaron 21 plantas que se utilizan para aliviar dolores de garganta, cabeza y estómago, así como para tratar la diarrea y la fiebre, para prevenir la gripe y como purgante. Todas las plantas medicinales mencionadas crecen en la comunidad y son cultivadas o silvestres, lo que también demuestra el conocimiento que los estudiantes tienen de su territorio. Estos hallazgos reflejan la importancia de la etnoeducación y la etnobotánica en la escuela y cómo se generan procesos de reconstrucción histórica desde estos escenarios, donde se visibiliza el conocimiento ancestral indígena.


Subject(s)
Ethnobotany , Herbal Medicine , Colombia , Medicine, Traditional
5.
BMC Nurs ; 23(1): 439, 2024 Jun 26.
Article in English | MEDLINE | ID: mdl-38926730

ABSTRACT

BACKGROUND: Advanced practice nursing has emerged as a result of the evolution of healthcare systems, the changing needs of the population and the academic development of nursing, as well as sociodemographic and epidemiological changes. The aim of this study is to describe the professional experiences of Spanish advanced practice nurses in specific positions within the healthcare system in order to better understand the development and characteristics of this specialised nursing role. METHODS: A descriptive qualitative study was conducted. Fourteen advanced practice nurses from healthcare centres participated. Semi-structured interviews were carried out. Braun and Clarke's method for reflexive thematic analysis was followed. The Atlas. Ti version 22 program was used for technological support. The COREQ checklist was used to optimise the reporting of this qualitative study. RESULTS: From the analysis of the data collected, three themes and six subthemes were extracted: 1) Advanced practice nursing on the rise: (a) The driving forces in the development of advanced practice nursing, (b) Barriers to the development of advanced practice nursing; 2) Advanced practice nurses as a response to the population's needs: (a) The development of a new professional nursing role, (b) The patient at the centre of care in advanced practice nursing; 3) Training as the foundation for advanced practice nursing: (a) Expert nurses in a specific context, (b) Differences in the level of training depending on the context. CONCLUSION: Advanced practice nurses have faced countless barriers and difficulties that have impeded them from demonstrating their importance and effectiveness within the healthcare system. A stable regulatory framework for the functions of advanced practice nurses is required to promote care, training and research in the field of advanced practice nursing. Health institutions need to promote the role of advanced practice nurses, facilitate the employment of new professionals, and establish new areas of practice. TRIAL REGISTRATION: Not applicable.

6.
Exp Gerontol ; : 112485, 2024 Jun 12.
Article in English | MEDLINE | ID: mdl-38876448

ABSTRACT

The natural polyphenol resveratrol (RSV) might counteract the skeletal muscle age-related loss of muscle mass and strength/function partly acting on mitochondria. This work analysed the effects of a six-week administration of RSV (50 mg/kg/day) in the oxidative Soleus (Sol) skeletal muscle of old rats (27 months old). RSV effects on key mitochondrial biogenesis proteins led to un unchanged amount of SIRT1 protein and a marked decrease (60 %) in PGC-1α protein. In addition, Peroxyredoxin 3 (PRXIII) protein decreased by 50 %, which on overall suggested the absence of induction of mitochondrial biogenesis by RSV in old Sol. A novel direct correlation between PGC-1α and PRXIII proteins was demonstrated by correlation analysis in RSV and ad-libitum (AL) rats, supporting the reciprocally coordinated expression of the proteins. RSV supplementation led to an unexpected 50 % increase in the frequency of the oxidized base OH8dG in mtDNA. Furthermore, RSV supplementation induced a 50 % increase in the DRP1 protein of mitochondrial dynamics. In both rat groups an inverse correlation between PGC-1α and the frequency of OH8dG as well as an inverse correlation between PRXIII and the frequency of OH8dG were also found, suggestive of a relationship between oxidative damage to mtDNA and mitochondrial biogenesis activity. Such results may indicate that the antioxidant activity of RSV in aged Sol impinged on the oxidative fiber-specific, ROS-mediated, retrograde communication, thereby affecting the expression of SIRT1, PGC-1α and PRXIII, reducing the compensatory responses to the age-related mitochondrial oxidative stress and decline.

7.
Psychoneuroendocrinology ; 167: 107102, 2024 Jun 10.
Article in English | MEDLINE | ID: mdl-38896988

ABSTRACT

Type 2 Diabetes mellitus (T2DM) is a metabolic disorder characterized by chronic hyperglycemia, resulting from deficits in insulin secretion, insulin action, or both. Whilst the role of insulin in the peripheral nervous system has been ascertained in countless studies, its role in the central nervous system (CNS) is emerging only recently. Brain insulin has been lately associated with brain disorders like Alzheimer's disease, obsessive compulsive disorder, and attention deficit hyperactivity disorder. Thus, understanding the role of insulin as a common risk factor for mental and somatic comorbidities may disclose novel preventative and therapeutic approaches. We evaluated general metabolism (glucose tolerance, insulin sensitivity, energy expenditure, lipid metabolism, and polydipsia) and cognitive capabilities (attention, cognitive flexibility, and memory), in adolescent, young adult, and adult male and female TALLYHO/JngJ mice (TH, previously reported to constitute a valid experimental model of T2DM due to impaired insulin signaling). Adult TH mice have also been studied for alterations in gut microbiota diversity and composition. While TH mice exhibited profound deficits in cognitive flexibility and altered glucose metabolism, we observed that these alterations emerged either much earlier (males) or independent of (females) a comprehensive constellation of symptoms, isomorphic to an overt T2DM-like phenotype (insulin resistance, polydipsia, higher energy expenditure, and altered lipid metabolism). We also observed significant sex-dependent alterations in gut microbiota alpha diversity and taxonomy in adult TH mice. Deficits in insulin signaling may represent a common risk factor for both T2DM and CNS-related deficits, which may stem from (partly) independent mechanisms.

8.
Cell Death Dis ; 15(6): 407, 2024 Jun 11.
Article in English | MEDLINE | ID: mdl-38862500

ABSTRACT

Methicillin-resistant Staphylococcus aureus (MRSA) is the most common causative agent of acute bacterial skin and skin-structure infections (ABSSSI), one of the major challenges to the health system worldwide. Although the use of antibiotics as the first line of intervention for MRSA-infected wounds is recommended, important side effects could occur, including cytotoxicity or immune dysregulation, thus affecting the repair process. Here, we show that the oxazolidinone antibiotic linezolid (LZD) impairs wound healing by aberrantly increasing interleukin 1 ß (IL-1ß) production in keratinocytes. Mechanistically, LZD triggers a reactive oxygen species (ROS)-independent mitochondrial damage that culminates in increased tethering between the endoplasmic reticulum (ER) and mitochondria, which in turn activates the NLR family pyrin domain-containing 3 (NLRP3) inflammasome complex by promoting its assembly to the mitochondrial surface. Downregulation of ER-mitochondria contact formation is sufficient to inhibit the LZD-driven NLRP3 inflammasome activation and IL-1ß production, restoring wound closure. These results identify the ER-mitochondria association as a key factor for NLRP3 activation and reveal a new mechanism in the regulation of the wound healing process that might be clinically relevant.


Subject(s)
Endoplasmic Reticulum , Inflammasomes , Interleukin-1beta , Mitochondria , NLR Family, Pyrin Domain-Containing 3 Protein , Wound Healing , NLR Family, Pyrin Domain-Containing 3 Protein/metabolism , Mitochondria/metabolism , Mitochondria/drug effects , Wound Healing/drug effects , Endoplasmic Reticulum/metabolism , Endoplasmic Reticulum/drug effects , Humans , Animals , Inflammasomes/metabolism , Interleukin-1beta/metabolism , Reactive Oxygen Species/metabolism , Mice , Keratinocytes/metabolism , Keratinocytes/drug effects , Mice, Inbred C57BL
9.
Blood Adv ; 2024 Jun 06.
Article in English | MEDLINE | ID: mdl-38842448

ABSTRACT

Treatment with direct oral anticoagulants (DOAC) in atrial fibrillation (AF) patients is effective and safe. However, bleeding complications still occur. Whether the measurement of DOAC levels may further improve treatment efficacy and safety is still an open issue. In the "Measure and See" (MAS) Study (#NCT03803579) venous blood was collected 15-30 days after DOAC initiation in AF patients who were then followed for one year to record the occurrence of major and clinically relevant non-major bleeding. DOAC plasma levels were measured in one laboratory, and results were kept blind to patients and treating doctors. Trough DOAC levels were assessed in 1657 patients [957 (57.7%) and 700 treated with standard and low-dose, respectively]. Fifty bleeding events were recorded during 1606 years of follow-up (3.11% pt/yrs). Fifteen bleeding events (4.97% pt/yrs) occurred in patients with C-trough standardized values in the highest activity class (> 0.50); whereas 35 events (2.69% pt/yrs) occurred in those with values in the two lower classes ( 0.50, p= 0.0401). Increasing DOAC levels and low-dose DOAC use were associated with increased bleeding risk in the first three months of treatment. 19% of patients receiving low doses had standardized activity values in the highest class. More bleeding occurred in patients treated with low (4.3% pt/yrs) than standard (2.2% pt/yrs; p= 0.0160) dose DOAC. Early measurement of DOAC levels in AF patients identified many subjects with high activity levels despite the low doses use and had more bleeding risk during the first 3 months of treatment.

11.
Article in English | MEDLINE | ID: mdl-38928905

ABSTRACT

There are several difficulties in evaluating interventions seeking to promote public health policies. In this article, we analyzed the promotion of the use of telemedicine during COVID-19 in Brazil. Using the random promotion method with instrumental variables, we showed that the policy of promoting telemedicine was adequate, with intense use of this type of care. Our results showed that telemedicine works if it is encouraged in the population. We contributed to the discussion of public health policies and their impact on the population's health in times of health crisis, such as during the COVID-19 pandemic.


Subject(s)
COVID-19 , Health Policy , Telemedicine , Brazil , COVID-19/epidemiology , COVID-19/prevention & control , Humans , SARS-CoV-2 , Pandemics
12.
Microorganisms ; 12(6)2024 Jun 14.
Article in English | MEDLINE | ID: mdl-38930581

ABSTRACT

Sourdough production is a complex fermentation process. Natural sourdough fermentation without standardization causes great variability in microbial communities and derived products. Starter cultures have emerged as alternatives to natural fermentation processes, which could improve bakery quality and produce bioactive compounds. This study aimed to evaluate the impacts of freeze-drying on the production and viability of sourdoughs with Lactiplantibacillus pentosus 129 (Lp) and Limosilactobacillus fermentum 139 (Lf), as well as their effects on the quality of long-fermentation bread. These strains were selected based on their better performance considering acidification and exopolysaccharide production capacity. Sourdough with Lp and Lf were propagated until the 10th day, when physicochemical and microbiological parameters were determined. The produced sourdoughs were freeze-dried, and bread samples were produced. The freeze-drying process resulted in high survival rates and few impacts on the metabolic activity of Lp and Lf until 60 days of storage. Incorporating Lp and Lf improved the microbiological and physicochemical properties of sourdough and long-fermentation breads. Tested freeze-dried sourdoughs led to reduced bread aging (higher specific volume and decreased starch retrogradation) and increased digestibility. The results show the potential of the freeze-dried sourdoughs produced with Lp and Lf as innovative strategies for standardizing production protocols for the bakery industry, especially for producing long-term fermentation bread.

13.
Braz J Anesthesiol ; 74(4): 844513, 2024.
Article in English | MEDLINE | ID: mdl-38740135

ABSTRACT

There is growing interest in using cannabinoids across various clinical scenarios, including pain medicine, leading to the disregard of regulatory protocols in some countries. Legislation has been implemented in Brazil, specifically in the state of São Paulo, permitting the distribution of cannabinoid products by health authorities for clinical purposes, free of charge for patients, upon professional prescription. Thus, it is imperative to assess the existing evidence regarding the efficacy and safety of these products in pain management. In light of this, the São Paulo State Society of Anesthesiology (SAESP) established a task force to conduct a narrative review on the topic using the Delphi method, requiring a minimum agreement of 60% among panelists. The study concluded that cannabinoid products could potentially serve as adjuncts in pain management but stressed the importance of judicious prescription. Nevertheless, this review advises against their use for acute pain and cancer-related pain. In other clinical scenarios, established treatments should take precedence, particularly when clinical protocols are available, such as in neuropathic pain. Only patients exhibiting poor therapeutic responses to established protocols or demonstrating intolerance to recommended management may be considered as potential candidates for cannabinoids, which should be prescribed by physicians experienced in handling these substances. Special attention should be given to individual patient characteristics and the likelihood of drug interactions.


Subject(s)
Cannabinoids , Pain Management , Humans , Cannabinoids/adverse effects , Cannabinoids/therapeutic use , Brazil , Pain Management/methods , Anesthesiology , Societies, Medical , Delphi Technique , Acute Pain/drug therapy
14.
J Agric Food Chem ; 72(22): 12459-12468, 2024 Jun 05.
Article in English | MEDLINE | ID: mdl-38771934

ABSTRACT

A series of 19 novel eugenol derivatives containing a 1,2,3-triazole moiety was synthesized via a two-step process, with the key step being a copper(I)-catalyzed azide-alkyne cycloaddition reaction. The compounds were assessed for their antifungal activities against Colletotrichum gloeosporioides, the causative agent of papaya anthracnose. Triazoles 2k, 2m, 2l, and 2n, at 100 ppm, were the most effective, reducing mycelial growth by 88.3, 85.5, 82.4, and 81.4%, respectively. Molecular docking calculations allowed us to elucidate the binding mode of these derivatives in the catalytic pocket of C. gloeosporioides CYP51. The best-docked compounds bind closely to the heme cofactor and within the channel access of the lanosterol (LAN) substrate, with crucial interactions involving residues Tyr102, Ile355, Met485, and Phe486. From such studies, the antifungal activity is likely attributed to the prevention of substrate LAN entry by the 1,2,3-triazole derivatives. The triazoles derived from natural eugenol represent a novel lead in the search for environmentally safe agents for controlling C. gloeosporioides.


Subject(s)
Carica , Colletotrichum , Eugenol , Fungicides, Industrial , Molecular Docking Simulation , Plant Diseases , Triazoles , Colletotrichum/drug effects , Eugenol/pharmacology , Eugenol/chemistry , Carica/chemistry , Fungicides, Industrial/pharmacology , Fungicides, Industrial/chemistry , Fungicides, Industrial/chemical synthesis , Triazoles/chemistry , Triazoles/pharmacology , Triazoles/chemical synthesis , Plant Diseases/microbiology , Plant Diseases/prevention & control , Structure-Activity Relationship , Drug Design , Fungal Proteins/chemistry , Molecular Structure
15.
Braz J Microbiol ; 55(2): 1735-1744, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38727922

ABSTRACT

AIMS: To develop and characterize a functional lactose-free ice cream with added ginger and honey, evaluate the survival of Lacticaseibacillus casei CSL3 under frozen storage and the simulated gastrointestinal tract (GIT), as well as antioxidant activity and product acceptability. METHODS AND RESULTS: The survival of Lacticaseibacillus casei CSL3 was evaluated for 180 days, under frozen storage, and GIT at 60 days. At 15 days of storage, proximal composition, antioxidant activity, color, pH, acidity, fusion, density, overrun, and sensory analysis were performed. Ice cream was an effective food matrix for maintaining the viability of CSL3, with concentrations > 7 log CFU g- 1 during storage and GIT. In addition, the analysis showed overrun and prebiotic characteristics through high values of antioxidant activity and phenolic compounds, good acceptability, and purchase intention. CONCLUSIONS: The product has satisfactory market potential (acceptance rate of 95.19% and purchase intention rate > 96%), and it could become another means of inserting probiotics in food.


Subject(s)
Honey , Ice Cream , Lacticaseibacillus casei , Probiotics , Zingiber officinale , Honey/analysis , Zingiber officinale/chemistry , Ice Cream/microbiology , Ice Cream/analysis , Lacticaseibacillus casei/chemistry , Lacticaseibacillus casei/metabolism , Probiotics/chemistry , Humans , Antioxidants/chemistry , Lactose/metabolism , Gastrointestinal Tract/microbiology , Food Storage , Microbial Viability/drug effects
16.
Arq Bras Cardiol ; 121(4): e20240113, 2024 Feb.
Article in Portuguese, English | MEDLINE | ID: mdl-38695411
17.
Radiol Med ; 2024 May 09.
Article in English | MEDLINE | ID: mdl-38724697

ABSTRACT

PURPOSE: To investigate the feasibility of an artificial intelligence (AI)-based semi-automated segmentation for the extraction of ultrasound (US)-derived radiomics features in the characterization of focal breast lesions (FBLs). MATERIAL AND METHODS: Two expert radiologists classified according to US BI-RADS criteria 352 FBLs detected in 352 patients (237 at Center A and 115 at Center B). An AI-based semi-automated segmentation was used to build a machine learning (ML) model on the basis of B-mode US of 237 images (center A) and then validated on an external cohort of B-mode US images of 115 patients (Center B). RESULTS: A total of 202 of 352 (57.4%) FBLs were benign, and 150 of 352 (42.6%) were malignant. The AI-based semi-automated segmentation achieved a success rate of 95.7% for one reviewer and 96% for the other, without significant difference (p = 0.839). A total of 15 (4.3%) and 14 (4%) of 352 semi-automated segmentations were not accepted due to posterior acoustic shadowing at B-Mode US and 13 and 10 of them corresponded to malignant lesions, respectively. In the validation cohort, the characterization made by the expert radiologist yielded values of sensitivity, specificity, PPV and NPV of 0.933, 0.9, 0.857, 0.955, respectively. The ML model obtained values of sensitivity, specificity, PPV and NPV of 0.544, 0.6, 0.416, 0.628, respectively. The combined assessment of radiologists and ML model yielded values of sensitivity, specificity, PPV and NPV of 0.756, 0.928, 0.872, 0.855, respectively. CONCLUSION: AI-based semi-automated segmentation is feasible, allowing an instantaneous and reproducible extraction of US-derived radiomics features of FBLs. The combination of radiomics and US BI-RADS classification led to a potential decrease of unnecessary biopsy but at the expense of a not negligible increase of potentially missed cancers.

18.
Int J STD AIDS ; : 9564624241252186, 2024 May 08.
Article in English | MEDLINE | ID: mdl-38720580

ABSTRACT

Aims: To assess the cumulative rate of HIV Pre-Exposure Prophylaxis (PrEP) users in Brazil since its 2018 implementation and to analyze the association between PrEP usage and state-level structural factors. Methods: A nationwide ecological study from 2018 to 2022 was conducted, examining the 5-year cumulative rate of PrEP users in relation to demographic, socioeconomic, and healthcare infrastructure variables. Multiple linear regression analysis identified significant predictors of PrEP utilization. Results: Between 2018 and 2022, 124,796 individuals used PrEP, with a cumulative rate of 61.5 per 100,000 population. The highest usage was in Minas Gerais, São Paulo, and Santa Catarina, while the lowest was in Distrito Federal, Maranhão, and Alagoas. Regression analysis showed that higher PrEP usage was associated with lower population density, a younger median age, a lower male to female ratio, and reduced social vulnerability. Additionally, PrEP usage was positively associated with the density of medical doctors and the number of dispensing units. Conclusions: The study reveals significant regional disparities in PrEP usage across Brazil, influenced by socioeconomic and healthcare factors. It highlights the need for targeted public health strategies to enhance PrEP access and uptake, especially in socially vulnerable regions.

19.
Rev Esc Enferm USP ; 58: e20230329, 2024.
Article in English, Portuguese | MEDLINE | ID: mdl-38767845

ABSTRACT

OBJECTIVE: To assess the cognitive cost of work for military police officers in the state of Rio de Janeiro. METHOD: This is a cross-sectional study with a quantitative approach, carried out with 446 military police officers, of both sexes, distributed between non-commissioned officers and officers, in the 7th, 15th, 20th, 24th and 41st Military Police Battalions. An instrument was used to depict sociodemographic, work, lifestyle and health conditions and a scale for assessing the human cost of work, which analyses the demands of the job through physical, cognitive and affective costs. The data was organized, processed and analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 13.1. RESULTS: The cognitive cost had the highest means, with severe results (µ = 3.86; SD = 0.86), representing greater demands in relation to the human cost of work among military police officers in the state of Rio de Janeiro and significant associations in relation to obesity, cognitive alterations in attention and memory, age and hours of sleep. CONCLUSION: In assessing the human cost of work, the cognitive cost was the most demanding in the work context of the military police officers surveyed, presenting a serious risk of illness.


Subject(s)
Cognition , Military Personnel , Police , Humans , Cross-Sectional Studies , Male , Female , Adult , Military Personnel/psychology , Brazil , Young Adult , Middle Aged
20.
Gac Sanit ; 38: 102395, 2024 May 22.
Article in English | MEDLINE | ID: mdl-38781777

ABSTRACT

OBJECTIVE: To construct and validate a questionnaire about the attitude of university students toward health promotion. METHOD: A cross-sectional study. A questionnaire of 14 questions was designed and administered to 1486 first-year undergraduates. The principal axes factoring method with oblique rotation was applied and a confirmatory factor analysis was carried out. Reliability was calculated through internal consistency with Cronbach's alpha and item-total correlation for the global scale and its subscales. RESULTS: A 14-item scale was constructed, with two dimensions. Its Cronbach's alpha was 0.872, and 0.852, and 0.718 for its subscales. The adjustment values of the confirmatory factor analysis were adequate. CONCLUSIONS: The attitude towards health promotion scale has shown to have adequate psychometric properties. It is an instrument that will help to detect referents and health assets for future interventions.

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