Are mixtures of micro/nanoplastics more toxic than individual micro or nanoplastic contamination in the clam Ruditapes decussatus?

The abundance of micro (MPs) and nano (NPs) sized plastic particles in the ocean is concerning due to their harmful effects on marine life. The interactions between MPs and NPs in the marine environment and their impact on marine biota remain not fully understood. This study contributes with new insights into the interaction between polystyrene NPs (PSNPs) and polyethylene MPs (PEMPs) on the clam Ruditapes decussatus. Results showed ingestion of MPs and NPs by clams, with PSNPs demonstrating higher toxicity in hemolymph. While no genotoxicity was observed, clams treated with MPs and the mixture showed increased acetylcolinesterase (AchE) activity over time. Additionally, the antioxidant defense system mitigated oxidative stress, suggesting effective neutralization of reactive oxygen species. Hazard assessment indicated the greatest impact on clam digestive glands after ten days of exposure, with an antagonistic interaction between MPs and NPs noted.

Looking beyond the obvious: The ecotoxicological impact of the leachate from fishing nets and cables in the marine mussel Mytilus galloprovincialis.

Once in the marine environment, fishing nets and cables undergo weathering, breaking down into micro and nano-size particles and leaching plastic additives, which negatively affect marine biota. This study aims to unravel the ecotoxicological impact of different concentrations of leachate obtained from abandoned or lost fishing nets and cables in the mussel Mytilus galloprovincialis under long-term exposure (28 days). Biochemical biomarkers linked to antioxidant defense system, xenobiotic biotransformation, oxidative damage, genotoxicity, and neurotoxicity were evaluated in different mussel tissues. The chemical nature of the fishing nets and cables and the chemical composition of the leachate were assessed and metals, plasticizers, UV stabilizers, flame retardants, antioxidants, dyes, flavoring agents, preservatives, intermediates and photo initiators were detected. The leachate severely affected the antioxidant and biotransformation systems in mussels' tissues. Following exposure to 1 mg·L-1 of leachate, mussels' defense system was enhanced to prevent oxidative damage. In contrast, in mussels exposed to 10 and 100 mg·L-1 of leachate, defenses failed to overcome pro-oxidant molecules, resulting in genotoxicity and oxidative damage. Principal component analysis (PCA) and Weight of Evidence (WOE) evaluation confirmed that mussels were significantly affected by the leachate being the hazard of the leachate concentrations of 10 mg·L-1 ranked as major, while 1 and 100 mg·L-1 was moderate. These results highlighted that the leachate from fishing nets and cables can be a threat to the heath of the mussel M. galloprovincialis.

Palm density and grazing effects on plant communities: implications for livestock management in a Butia palm grove.

Some grasslands in ecotones with forests tend to be encroached by woody species, because of changes in climate and land use. Such structural changes in vegetation can be facilitated when the grassland community presents an autochthonous arboreal component, like Butia palms. We aim to identify the responses of taxonomic and functional diversity on grassland community with the occurrence of arborescent/arboreal species (autochthonous and encroaching) to palm density and grazing intensity. The study was conducted in a Butia odorata palm grove under cattle management, in Southern Brazil. To assess the taxonomic and functional composition we performed ordinations analysis with the vegetational data and using path analysis we assessed the causal relationships between variables of interest. Density of Butia odorata and woody plants were strongly positive related, suggesting a facilitation process in the establishment of arborescent plants on the grassland matrix. The abundance of less palatable plants and grazing pressure were inversely related, indicating a selection process induced by higher grazing intensity. We suggest that the grazing intensity management must be based on the autochthonous tree density, applying higher grazing intensity in areas with higher density of encroaching plants, in addition to maintaining other regions conducive to Butia palm regeneration through fallows.

Field study of metal concentrations and biomarker responses in resident oysters of an estuarine system in southern Brazil.

Pollutant exposure is considered an important factor responsible for the decline in marine biodiversity of Latin American coastal ecosystems. This threat has been detected in an estuarine system in southern Brazil, which prompted an investigation into the long-term biological effects of a chronic metal contamination on resident oysters from the Laguna Estuarine System (LES). Here, we present the species- and size-specific variations of biomarker responses (catalase, glucose-6-phosphate dehydrogenase, glutathione S-transferase, and protein carbonylation) in the gills and digestive gland of Crassostrea gigas and Crassostrea gasar. In parallel, concentrations of eight metals (Al, Cd, Cr, Cu, Fe, Mn, Pb, Zn) in soft tissues were measured. Our analyses revealed that the metal levels exhibited decreasing order in both species: Zn > Fe > Al > Cu > Mn > Cd. Except for Cu and Al, metal concentrations did not differ between oyster species. Biomarker results highlighted that C. gasar presented higher antioxidant responses, whereas C. gigas showed increased biotransformation upon exposure to LES pollutants, which varied according to the tissue. However, C. gasar showed a significant higher content of protein carbonylation but was not related to metals. In our research approach, the observation of metals presence and biomarkers-related responses are considered biologically relevant from an ecotoxicological perspective and serve as a baseline for future pollution studies in estuaries of Latin America. Finally, we recommend adopting a suite of biomarkers in both C. gasar and C. gigas, regardless their size and weight, as sentinel organisms in future regional biomonitoring studies in southern Brazil.

Multifunctional Hybrid MoS2-PEGylated/Au Nanostructures with Potential Theranostic Applications in Biomedicine.

In this work, flower-like molybdenum disulfide (MoS2) microspheres were produced with polyethylene glycol (PEG) to form MoS2-PEG. Likewise, gold nanoparticles (AuNPs) were added to form MoS2-PEG/Au to investigate its potential application as a theranostic nanomaterial. These nanomaterials were fully characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-ray diffraction (XRD), photoelectron X-ray spectroscopy (XPS), Fourier-transformed infrared spectroscopy (FTIR), cyclic voltammetry and impedance spectroscopy. The produced hierarchical MoS2-PEG/Au microstructures showed an average diameter of 400 nm containing distributed gold nanoparticles, with great cellular viability on tumoral and non-tumoral cells. This aspect makes them with multifunctional characteristics with potential application for cancer diagnosis and therapy. Through the complete morphological and physicochemical characterization, it was possible to observe that both MoS2-PEG and MoS2-PEG/Au showed good chemical stability and demonstrated noninterference in the pattern of the cell nucleus, as well. Thus, our results suggest the possible application of these hybrid nanomaterials can be immensely explored for theranostic proposals in biomedicine.

Mechanistic insights into the amidolysis of a phosphate triester: the antagonistic role of water.

The breakdown of O,O-diethyl-2,4-dinitrophenyl phosphate in formamide (FMD) solutions is assessed using kinetic studies and 31P nuclear magnetic resonance (NMR) analysis. Regiospecific nucleophilic amidolysis via P-O bond cleavage is observed, leading to non-toxic diester and FMD regeneration. In the systems evaluated, water plays an antagonistic role: while it is key for the breakdown of the reaction intermediate, it inhibits the nucleophilic activity of FMD by hydrogen bonding effects.

Xylobotryum portentosum (Mont.) Pat. (Xylobotryomycetes, Ascomycota): a rare fungal species newly found in Southeastern Brazil / Xylobotryum portentosum (Mont.) Pat. (Xylobotryomycetes, Ascomycota): uma espécie rara de fungo encontrada na Região Sudeste do Brasil

Abstract Xylobotrum portentosum (Mont.) Pat. is a striking Neotropical fungal species but it has been reported only a few times from Southern Brazil (States of Paraná and Santa Catarina), found in remnants of Atlantic Forest. Herein we report the species for the first time from the Southeastern Region of Brazil (State of São Paulo). A brief description and color photographs of the fresh specimen are presented.

Resumo Xylobotrum portentosum (Mont.) Pat. é uma espécie notável de fungo neotropical que foi registrada apenas poucas vezes para a Região Sul do Brasil (Paraná e Santa Catarina), encontrada em remanescentes de Mata Atlântica. Neste trabalho a espécie é reportada pela primeira vez para a Região Sudeste do Brasil (Estado de São Paulo). São apresentadas uma breve descrição e fotografias coloridas do espécime fresco.

ß-hydroxy-ß-methylbutyrate supplementation benefits the effects of resistance training on body fat reduction via increased irisin expression in white adipose tissue.

The effects of resistance training (RT) associated with calcium ß-hydroxyß-methylbutyrate (CaHMB) supplementation on the body composition and gene expression of cytokines related to skeletal muscle hypertrophy and adipose tissue metabolism were studied in rats. Male Wistar rats were divided into four groups of 12 animals: sedentary control (SC); sedentary supplemented (SS); resistance training control (RTC) and resistance training supplemented (RTS). Rats from RTC and RTS groups were submitted to an RT programme and those from SS and RTS groups received 1 mL of CaHMB (320 mg kg-1 day-1) by gavage, for 8 weeks. We evaluated: body composition; plasma lipid profile; the gene expression of interleukin (IL)-6, IL-10, IL-15 and fibronectin type III domain-containing protein 5 (FNDC-5) in skeletal muscle, and IL-6, mitochondrial uncoupling protein 1 (UCP-1) in white adipose tissue (WAT); and the concentration of irisin in WAT. Compared to RTC alone, the combination of CaHMB with RT (RTS) further reduced abdominal circumference (5.3%), Lee index (2.4%), fat percentage (24.4%), plasma VLDL cholesterol (16.8%) and triglycerides (17%) and increased the gene expression of FNDC-5 (78.9%) and IL-6 (47.4%) in skeletal muscle and irisin concentration (26.9%) in WAT. Neither RT nor CaHMB affected the protein percentage or the gene expression of IL-6 and UCP-1 in WAT and IL-10, IL-15 in skeletal muscle. In conclusion, CaHMB supplementation increased the beneficial effects of RT on body fat reduction and was associated with muscular genic expression of IL-6 and FNDC-5 and irisin concentration in WAT, despite the lack of change in protein mass and maximal strength.

Degradation of Organophosphates Promoted by 1,2,4-Triazole Anion: Exploring Scaffolds for Efficient Catalytic Systems.

Organophosphate (OP) pesticides are responsible for numerous human deaths every year. Nucleophilic substitution is an important method to mitigate the toxicity of obsolete stocks of OPs. Herein, the degradation of O,O-diethyl-2,4-dinitrophenyl phosphate (DEDNPP) and pesticide diethyl-4-nitrophenyl phosphate (Paraoxon) promoted by 1,2,4-triazole (TAZ) was investigated by means of kinetic studies, nuclear magnetic resonance (NMR) analyses, and theoretical calculations. Results showed fast degradation of OPs is promoted by the anionic form of the nucleophile (TAZ(-)) in pH > 8.5 (optimal at pH = 11). Rate enhancements of 106 and 105-fold in relation to neutral hydrolysis of DEDNPP and Paraoxon were observed, respectively, consistent with alpha-nucleophiles reactivity. TAZ(-) regioselectively promotes the degradation of DEDNPP via P-O bond break, forming a quickly hydrolyzable phosphorylated intermediate, regenerating the nucleophile. Calculations using M06-2X/6-311++G(d,p) level of theory revealed that the equivalent nitrogen atoms of TAZ(-) are the main nucleophilic center of the molecule. This study expands the knowledge on the reactivity of iminic compounds as detoxificant agents of OPs, indicating the efficiency and selectivity of TAZ(-) in aqueous medium, encouraging the design of novel TAZ-based catalysts.

Accuracy of three cone-beam CT devices and two software systems in the detection of vertical root fractures.

OBJECTIVES: The aim of this study was to compare the accuracy of vertical root fracture (VRF) detection using three tomography devices and two software systems in teeth with different endodontic fillings. METHODS: The sample consisted of 45 premolars divided into 3 groups: No filling (NF, n=15); Gutta percha (GP, n=15) and Metallic Post (MP, n=15). Cone-beam computed tomography (CBCT) images were acquired in Kodak 9000 3D, Orthopantomography 300 (OP300) and PreXion 3D devices, before and after induced root fractures. Two oral radiologists analyzed all images using InVivoDental and e-Vol DX software systems. The analysis was repeated after 15 days in 30% of the sample. Data analysis compared receiver operating characteristic (ROC) curves, as well the areas under the ROC curves. Accuracy, sensitivity, specificity, positive and negative predictive value were calculated according to each tomographic device and software. Intra- and interexaminer reliability were tested using the Kappa coefficient. RESULTS: The highest accuracy was seen in the image set from the PreXion 3D, using InVivo (0.96) or e-Vol DX (0.92) in image analysis. The OP300 device presented a similar performance of the PreXion 3D in teeth with different endodontic fillings. When using e-Vol DX, the accuracy of Kodak 9000 3D improved from 0.62 to 0.74. CONCLUSIONS: The PreXion 3D device is the most accurate when detecting VRF, with a performance similar to the OP300 in endodontic filled teeth. Kodak 9000 3D is indicated for teeth without fillings, with better accuracy using e-Vol DX software.

Competitive Reactivity of Tautomers in the Degradation of Organophosphates by Imidazole Derivatives.

The harmful impact caused by pesticides on human health and the environment necessitates the development of efficient degradation processes and control of prohibited stocks of such substances. Organophosphates (OPs) are among the most used agrochemicals in the world and their degradation can proceed through several possible pathways. Investigating the reactivity of OPs with nucleophilic species allows one to propose new and efficient catalyst scaffolds for use in detoxification. In light of the remarkable catalytic activity of imidazole (IMZ) at promoting dephosphorylation processes of OPs, the reactivity of 4(5)-hydroxymethylimidazole (HMZ) with diethyl-2,4-dinitrophenylphosphate (DEDNPP) and Paraoxon are evaluated by combining experimental and theoretical approaches. It is observed that HMZ is an efficient and regiospecific catalyst with reactivity modulated by competing tautomers. To propose an optimal IMZ-based catalyst, quantum chemical calculations were performed for monosubstituted 4(5)IMZ derivatives that might cleave DEDNPP. Both inductive effects and hydrogen bonding by the substituents are shown to influence barriers and mechanisms.

Residual effects of mental fatigue on subjective fatigue, reaction time and cardiac responses / Efectos residuales de la fatiga mental en la fatiga subjetiva, tiempo de reacción y respuestas cardíacas / Efeitos residuais da fadiga mental na fadiga subjetiva, tempo de reação e respostas cardíacas

This study investigated the residual effects of mental fatigue induced by the 30-minute incongruent Stroop Color Word task on subjectively perceived fatigue, reaction time, and heart rate variability (HRV) in 20 adult volunteers (10 men; 10 women). Dependent variables were assessed before, immediately after, and at 15, 30, 45, and 60 minutes after two conditions: (a) a 30-minute incongruent Stroop Color Word task (mental fatigue condition); or (b) a 30-minute control condition. At pre-testing, there were no significant differences between experimental conditions for any variable. However, there was a residual effect of mental fatigue on psychological responses for up to ~15 minutes after the experimental manipulation (p < 0.01). For the reaction time task, significant differences were observed only immediately after the mental fatigue, compared to the control condition (p < 0.0001). There were no significant differences between experimental conditions for any parameters of HRV at any testing period. In addition, there were no significant gender related differences at any period or in either condition for any variable. The data suggest that mental fatigue can alter psychological responses for up to ~15 min after its induction, and mental fatigue may impair cognitive reaction time performance without changing autonomic cardiac responses

Este estudio investigó los efectos residuales de la fatiga mental inducidos por 30 minutos Test de Stroop con palabra con color incongruente sobre la fatiga percibida subjetivamente, el tiempo de reacción y la variabilidad de la frecuencia cardíaca (HRV) en 20 voluntarios adultos (10 hombres, 10 mujeres). Las variables dependientes se evaluaron antes, inmediatamente después y a los 15, 30, 45 y 60 minutos después de dos condiciones: (a) Test de Stroop con palabra con color incongruente de 30 minutos (condición de fatiga mental); o (b) condición de control de 30 minutos. En la pre condiciones, no hubo diferencias significativas entre las condiciones experimentales para ninguna variable. Sin embargo, hubo un efecto residual de la fatiga mental en las respuestas psicológicas durante hasta ~ 15 minutos después de la manipulación experimental (p < 0,01). Para la tarea de tiempo de reacción, se observaron diferencias significativas solo inmediatamente después de la fatiga mental, en comparación con la condición de control (p < 0,0001). No hubo diferencias significativas entre las condiciones experimentales para ningún parámetro de HRV en ningún período. Además, no hubo diferencias significativas relacionadas con el género en ningún período ni en ninguna de las condiciones para ninguna variable. Los datos sugieren que la fatiga mental puede alterar las respuestas psicológicas hasta ~ 15 min después de su inducción, y la fatiga mental puede afectar el rendimiento del tiempo de reacción cognitiva sin cambiar las respuestas cardíacas autónomas

Este estudo investigou os efeitos residuais da fadiga mental induzida por 30 minutos do teste de Stroop com a palavra de cor incongruente na fadiga percebida de maneira subjetiva, tempo de reação e variabilidade da frequência cardíaca (VFC) em 20 voluntários adultos (10 homens; 10 mulheres). As variáveis dependentes foram avaliadas antes, imediatamente após e aos 15, 30, 45 e 60 minutos após duas condições: (a) teste de Stroop com a palavra de cor incongruente de 30 minutos (condição fadiga mental); ou (b) uma condição controle de 30 minutos. No pré-teste, não houve diferenças significativas entre as condições experimentais para qualquer variável. No entanto, houve um efeito residual da fadiga mental nas respostas psicológicas por até ~ 15 minutos após a manipulação experimental (p <0,01). Para o teste de tempo de reação, foram observadas diferenças significativas apenas imediatamente após a fadiga mental, em comparação com a condição controle (p <0,0001). Não houve diferenças significativas entre as condições experimentais para quaisquer parâmetros da VFC em qualquer período. Além disso, não houve diferenças significativas relacionadas ao gênero em qualquer período ou em qualquer condição para qualquer variável. Os dados sugerem que a fadiga mental pode alterar as respostas psicológicas por até 15 minutos após sua indução, e a fadiga mental pode prejudicar o desempenho cognitivo pela piora tempo de reação sem alterar as respostas autonômicas cardíacas

Novel anticancer PdII complexes: The effect of the conjugation of transferrin binding peptide and the nature of halogen coordinated on antitumor activity.

A series of PdII complexes with bis-(2-pyridylmethyl)glycine as a ligand of formula [PdX(bis-(2-pyridylmethyl)glycine)] where X = Cl, Br, I were prepared and the effect of the halogen nature in the antitumor activity of eight tumorigenic and one non-tumorigenic cell line was evaluated. The chloride derivative was further functionalized with a transferrin receptor binding peptide, generating the first PdII based metallopeptide. Its antitumor activity was also evaluated. However, among all the complexes, the chloride and iodine parent compounds showed the lowest GI50 values in the panel evaluated, and lowest GI50 than cisplatin in several cell lines. In contrast, the bromine derivative showed higher values of GI50 than chloride and iodine (around 30 - 50 µM). The same trend was observed for the bovine serum albumin binding constant with higher values for iodine, chlorine, and bromine in this order. In aqueous solution, the chloride is exchanged by water while the bromine and iodine are not. DNA was evaluated as a target and showed no significative interaction for all the compounds. The results suggest sulfur-rich proteins and not DNA as a target. This report represents the first PdII metallopeptide reported, its evaluation in solution and antitumor activity. This work opens the possibilities for further functionalization of PdII complexes and the importance of the halogen coordination in the design of novel metallodrugs.

Metal bioaccumulation, oxidative stress and antioxidant responses in oysters Crassostrea gasar transplanted to an estuary in southern Brazil.

The present study assessed the spatial and temporal variations on metal bioaccumulation and biochemical biomarker responses in oysters Crassostrea gasar transplanted to two different sites (S1 and S2) at the Laguna Estuarine System (LES), southern Brazil, over a 45-days period. A multi-biomarker approach was used, including the evaluation of lipid peroxidation (MDA) levels, and antioxidant defense enzymes (CAT, GPx, GR and G6PDH) and phase II biotransformation enzyme (GST) in the gills and digestive gland of oysters in combination with the quantification of Al, Cd, Cu, Pb, Fe, Ni and Zn in both tissues. The exposed oysters bioaccumulated metals, especially Al, Cd and Zn in gills and digestive gland, with most prominent biomarker responses in the gills. Results showed that GPx, GR and G6PDH enzymes offered an increased and coordinated response possibly against metal (Zn, Ni, Cd and Cu) contamination in gills. GST was inversely correlated to Cd levels, being its activity significantly lowered over the 45-d exposure periods at S2. On contrary, in digestive gland GST was slightly positively correlated to Cd, revealing a compensatory mechanism between tissues to protect oysters' cells against oxidative damages, since MDA levels also decreased. CAT also appeared to be involved in the cellular protection against oxidative stress, being increased in gills. However, CAT was negatively correlated to Al levels, which might suggest a possible inhibitory effect of this metal in the gills of C. gasar. Differences between tissues were evident by the Integrative Biomarker Responses version 2 (IBRv2) indexes, which showed different pattern between tissues when studying the sites and exposure periods separately. This study provided evidence for the effectiveness of using a multi-biomarker approach in oyster C. gasar to monitor estuarine metal pollution.

Improved predictive models for acute kidney injury with IDEA: Intraoperative Data Embedded Analytics.

BACKGROUND: Acute kidney injury (AKI) is a common complication after surgery that is associated with increased morbidity and mortality. The majority of existing perioperative AKI risk prediction models are limited in their generalizability and do not fully utilize intraoperative physiological time-series data. Thus, there is a need for intelligent, accurate, and robust systems to leverage new information as it becomes available to predict the risk of developing postoperative AKI. METHODS: A retrospective single-center cohort of 2,911 adults who underwent surgery at the University of Florida Health between 2000 and 2010 was utilized for this study. Machine learning and statistical analysis techniques were used to develop perioperative models to predict the risk of developing AKI during the first three days after surgery, first seven days after surgery, and overall (after surgery during the index hospitalization). The improvement in risk prediction was examined by incorporating intraoperative physiological time-series variables. Our proposed model enriched a preoperative model that produced a probabilistic AKI risk score by integrating intraoperative statistical features through a machine learning stacking approach inside a random forest classifier. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), accuracy, and Net Reclassification Improvement (NRI). RESULTS: The predictive performance of the proposed model is better than the preoperative data only model. The proposed model had an AUC of 0.86 (accuracy of 0.78) for the seven-day AKI outcome, while the preoperative model had an AUC of 0.84 (accuracy of 0.76). Furthermore, by integrating intraoperative features, the algorithm was able to reclassify 40% of the false negative patients from the preoperative model. The NRI for each outcome was AKI at three days (8%), seven days (7%), and overall (4%). CONCLUSIONS: Postoperative AKI prediction was improved with high sensitivity and specificity through a machine learning approach that dynamically incorporated intraoperative data.

Effects of walk training with self-selected intensity on biochemical markers and anthropometric variables in women with obesity.

To evaluate the effects of 12-weeks of walk training with self-selected intensity on lipid profile and anthropometric variables in women with obesity. Forty-eight women volunteers with obesity were randomly assigned into two training groups: self-selected walking group (SSWG; n=25) and control group (CG; n=23). There was improvement in biochemical markers only in the SSWG post-intervention (p<0.05), however no changes were verified in anthropometric variables (p>0.05). This study demonstrates that walking at self-selected intensity improved the lipid profile in women with obesity.

Effects of Transcranial Direct Current Stimulation on Psychophysiological Responses to Maximal Incremental Exercise Test in Recreational Endurance Runners.

Previous studies have suggested that transcranial direct current stimulation (tDCS) might improve exercise performance and alter psychophysiological responses to exercise. However, it is presently unknown whether this simple technique has similar (or greater) effects on running performance. The purpose of this study was, therefore, to test the hypothesis that, compared with sham and cathodal tDCS, anodal tDCS applied over the M1 region would attenuate perception of effort, improve affective valence, and enhance exercise tolerance, regardless of changes in physiological responses, during maximal incremental exercise. In a double-blind, randomized, counterbalanced design, 13 healthy recreational endurance runners, aged 20-42 years, volunteered to participate in this study. On three separate occasions, the subjects performed an incremental ramp exercise test from rest to volitional exhaustion on a motor-driven treadmill following 20-min of brain stimulation with either placebo tDCS (sham) or real tDCS (cathodal and anodal). Breath-by-breath pulmonary gas exchange and ventilation and indices of muscle hemodynamics and oxygenation were collected continuously during the ramp exercise test. Ratings of perceived exertion (RPE) and affective valence in response to the ramp exercise test were also measured. Compared with sham, neither anodal tDCS nor cathodal tDCS altered the physiological responses to exercise (P > 0.05). Similarly, RPE and affective responses during the incremental ramp exercise test did not differ between the three experimental conditions at any time (P > 0.05). The exercise tolerance was also not significantly different following brain stimulation with either sham (533 ± 46 s) or real tDCS (anodal tDCS: 530 ± 44 s, and cathodal tDCS: 537 ± 40 s; P > 0.05). These results demonstrate that acute tDCS applied over the M1 region did not alter physiological responses, perceived exertion, affective valence, or exercise performance in recreational endurance runners.

Left atrium and pulmonary artery compression due to aortic aneurysm causing heart failure symptoms.

Patients with thoracic aortic aneurysm (TAA) are mostly asymptomatic and TAA is rarely related to heart failure (HF). We report the case of an 80-year-old female patient, with type A TAA without dissection, with right pulmonary artery and left atrium compression, who presented with HF, preserved ejection fraction and acute pulmonary edema.

Periodontal disease severity in subjects with dementia: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVE: Despite clinical trials and reviews attempt to assess a possible relationship between dementia and periodontal disease, no meta-analysis has been performed and this issue remains undetermined. The aim of this study is to conduct a systematic review and meta-analysis to assess severity of periodontitis in subjects with dementia. METHODS: The search was conducted in Pubmed, Embase/MEDLINE. Two independent reviewers extracted data and assessed the risk bias (Newcastle-Ottawa scale). Meta-analyses were performed using the means of probing depth (PD) and clinical attachment loss (CAL) in patients with or without dementia. The mean difference were analyzed (P ≤ 0.05). RESULTS: Fourteen studies were included in the systematic review. In the qualitative analysis, most studies reported higher prevalence of periodontal disease in dementia patients. The studies had low risk of bias and two meta-analyses were performed for each parameter, including or not a cross-sectional study. The meta-analyses including the cross-sectional study demonstrated significant association between dementia and periodontal disease (mean difference: PD = 1.41; CAL = 1.40, P < 0.05), however, it wasn't confirmed when the cross-sectional study was removed (1.25 mm, P < 0.22) and CAL (1.20 mm, P < 0.22). CONCLUSION: Although the qualitative analysis have suggested worse periodontal conditions in dementia patients, due to different study types and the high heterogeneity among them, the meta-analysis does not support the association between dementia and severity of periodontal disease.

Progressively Enlarging Cerebellar Hematoma Concurrent with T-DM1 Treatment.

BACKGROUND: Trastuzumab emtansine, an antibody-drug conjugate commonly abbreviated as T-DM1, is accepted as effective therapy for trastuzumab-resistant metastatic HER2-positive breast cancer. T-DM1 significantly increases progression-free and overall survival when compared with lapatinib plus capecitabine in patients with HER2-positive breast cancer previously treated with trastuzumab and a taxane. Among the common side effects related to T-DM1, thrombocytopenia and mucosal hemorrhage are seen, although they are infrequently judged to be clinically significant. Intracranial hemorrhages are extremely rare, and only 3 cases of hematomas have been reported in association with T-DM1 and remote radiotherapy, 2 of them with progressive enlargement. OBJECTIVE: Herein we describe a patient who presented with a cerebellar hematoma that progressively enlarged over 8 months during treatment with T-DM1 and only a few months after whole-brain radiation therapy plus a stereotactic radiosurgery boost for a HER2-positive breast cancer cerebellar metastasis. The pathology of the hematoma was similar to that in previous cases and suggested a unique pathophysiology related to an interaction between T-DMI and radiation therapy. CONCLUSIONS: A progressively enlarging intraparenchymal hematoma can be seen just a few months after delivery of radiation therapy for a metastatic brain lesion in HER2-positive breast cancer patients who are receiving T-DM1. In such patients, even a small focus of hemorrhage on magnetic resonance images should prompt close follow-up with serial imaging.