Mpox severity and associated hospitalizations among people with HIV and related immunosuppression in Brazil.

OBJECTIVES: This study aimed to analyze characteristics of mpox hospitalization in a Brazilian cohort, further exploring the impact of HIV on mpox-related outcomes and hospitalization. DESIGN: We conducted a descriptive analysis, comparing characteristics of individuals diagnosed with mpox according to hospitalization and HIV status, and described the mpox cases among those living with HIV. METHODS: This was a single-center, prospective cohort study conducted at a major infectious diseases referral center in Rio de Janeiro, Brazil, that enrolled participants older than 18 years of age diagnosed with mpox. Information was collected on standardized forms, including data on sociodemographic, behavioral, clinical and laboratory characteristics. For comparisons, we used chi-squared, Fisher's exact and the Moods median tests whenever appropriate. RESULTS: From June to December, 2022, we enrolled 418 individuals diagnosed with mpox, of whom 52% were people with HIV (PWH). PWH presented more frequently with fever, anogenital lesions and proctitis. The overall hospitalization rate was 10.5% ( n  = 43), especially for pain control. Among hospitalized participants, PWH had more proctitis and required invasive support. Mpox severity was related to poor HIV continuum of care outcomes and low CD4 + cell counts. All deaths ( n  = 2) occurred in PWH with CD4 + less than 50 cells/µl. CONCLUSION: HIV-related immunosuppression likely impacts mpox clinical outcomes. This is of special concern in settings of poor adherence and late presentation to care related to socioeconomic inequalities, such as Brazil. The HIV continuum of care must be taken into account when responding to the mpox outbreak.

Item analysis of the Child Neuropsychological Assessment Test (TENI): Classical test theory and item response theory.

The aim of this study was to analyze the psychometric properties of the Brazilian version of the Test de Evaluación Neuropsicologica Infantil (TENI) using classical test theory (CTT), item response theory (IRT), and differential item functioning (DIF) models. The visuospatial working memory, focused attention, and matrix reasoning subtasks were analyzed. A total of 553 children, aged between 3 and 9 years of age, from eight public and private schools from the urban area of Belo Horizonte were assessed. In general, all subtasks can be treated essentially as unidimensional. Items' discrimination and difficulties increased in the order of presentation, as they were planned, using CTT and IRT. Items with DIF were found in all tasks, with higher probabilities of answering items correctly for boys and for private school children. Our results corroborated the partial use of some TENI subtasks as a promising digital instrument for non-verbal neuropsychological assessment for children.

Salivary cortisol and eye temperature changes during endurance competitions.

BACKGROUND: The purpose of this study was to investigate the usefulness of salivary cortisol (SC) and eye temperature measured by infrared thermography (IRTET) as biomarkers to manage competitions more effectively and monitor horse welfare in endurance competitions. Based on previous studies, it was hypothesised that pre-exercise baseline SC and IRTET would be higher in younger or less experienced horses, and that post-exercise variation from baseline would be higher in the top finishers. RESULTS: Salivary cortisol measured in 61 competing at qualifier 40 km and 80 km rides showed an abrupt variation (93-256% rise) of the baseline SC levels [median ± interquartile range (IQR) = 0.27 ng/dl ± 0.36] obtained at the Pre-Inspection (PI) into Vet Gate (VG)1 independently of the covered distance, but modest or even lower in the subsequent Vet Gates, e.g. VG2 or VG3. The IRTET measured concomitantly in 16 horses showed significant (p < 0.05) higher levels at the PI in less experienced horses participating in the 40 km ride (median ± IQR = 35.7 °C ± 1.4) than their counterparts in the 80 km ride (median ± IQR = 35.0 °C ± 1.5), but not SC. Baseline SC levels at the PI of horses classifying in the Top5 in the 40 km ride category were significantly (p < 0.05) higher median ± IQR = 0.90 ng/ml ±0.61) when compared to horses positioned from 10th position on (median ± IQR = 0.16 ng/ml ±0.40). A lower IRTET in the PI was correlated with better placement (p < 0.05) and those in the Top5 (median ± IQR = 33.9 °C ± 0.0) had a significantly (p < 0.5) higher variation (+ 10.65%) into the last VG. CONCLUSION: Pre-exercise baseline IRTET levels, but not SC, were higher in less experienced horses in the 40 compared to their counterparts in the 80 km ride competitions. SC and IRTET showed different indications according to the competition. In the40 km ride competition, higher baseline pre-exercise SC levels seemed to be linked to a better classification outcome. In contrast, in the 80 km ride horses, the higher IRTET variation from pre-exercise into final Vet Gate was the parameter associated with a better performance. A more controlled environment and a larger sample are needed to confirm these results and monitor horse welfare in competitions.

Effects of self-employment on hospitalizations: instrumental variables analysis of social security data.

The importance of self-employment and small businesses raises questions about their health effects and public policy implications, which can only be addressed with suitable data. We explore the relationship between self-employment and health by drawing on comprehensive longitudinal administrative data to explore variation in individual work status and by applying novel instrumental variables. We focus on an objective outcome-hospital admissions-that is not subject to recall or other biases that may affect previous studies. Our main findings, based on a sample of about 6,500 individuals followed monthly from 2005 to 2011 and who switch between self-employment and wage work along that period, suggest that self-employment has a positive effect on health as it reduces the likelihood of hospital admission by at least half.

How Good Is the Phoneme Elision Test in Assessing Reading, Spelling and Arithmetic-Related Abilities?

OBJECTIVE: The aim of this study was to investigate the psychometric properties and diagnostic accuracy of phoneme elision task (PET). METHOD: We assessed cross-sectionally 470 Brazilian children (54.3% girls) aged between 7 and 11 years (mean age = 8.83, sd = 0.85), from the 2nd to 4th grades. Children were assessed in their phonemic awareness ability, as well as intelligence, general school achievement, both verbal and visuospatial working memory, single-word reading, and nonsymbolic magnitude comparison. Beyond the psychometric properties and diagnostic accuracy of PET, we also provided reference values. RESULTS: Our data suggest that PET is composed mainly of one single construct, with high item reliability and precision (KR-20 above 0.90). In general, items have acceptable discriminability, considering item-total correlations. Overall PET is generally a good screening tool for reading and spelling difficulties (SD), as well as to identify children with learning difficulties in the early grades. However, it is not a reliable measure for screening math learning difficulties. Finally, PET shows good convergent and divergent validity. CONCLUSIONS: We provide evidence about the psychometric properties and diagnostic accuracy of a PET. Results contribute to the assessment of phonemic awareness in Brazilian children, in both clinical and research contexts. The PET can be used as a screening tool for reading and SD, which could lead to early interventions.

The lack of neuropeptide Y-Y1 receptor signaling modulates the chemical and mechanical properties of bone matrix.

Genetic and pharmacological functional studies have provided evidence that the lack of Neuropeptide Y-Y1  receptor (Y1 R) signaling pathway induces a high bone mass phenotype in mice. However, clinical observations have shown that drug or genetic mediated improvement of bone mass might be associated to alterations to bone extracellular matrix (ECM) properties, leading to bone fragility. Hence, in this study we propose to characterize the physical, chemical and biomechanical properties of mature bone ECM of germline NPY-Y1 R knockout (Y1 R-/- ) mice, and compare to their wild-type (WT) littermates. Our results demonstrated that the high bone mass phenotype observed in Y1 R-/- mice involves alterations in Y1 R-/-  bone ECM ultrastructure, as a result of accelerated deposition of organic and mineral fractions. In addition, Y1 R-/- bone ECM displays enhanced matrix maturation characterized by greater number of mature/highly packed collagen fibers without pathological accumulation of immature/mature collagen crosslinks nor compromise of mineral crystallinity. These unique features of Y1 R-/-  bone ECM improved the biochemical properties of Y1 R-/-  bones, reflected by mechanically robust bones with diminished propensity to fracture, contributing to greater bone strength. These findings support the future usage of drugs targeting Y1 R signaling as a promising therapeutic strategy to treat bone loss-related pathologies.

In vitro degradation of polydimethylsiloxanes in breast implant applications.

BACKGROUND: The durability of breast implant material is associated with failure probability, increasing with time from implantation. The current study avoided the bias introduced by biological factors, to systematically investigate the degradation over time of shell materials. The same fundamental physical and chemical conditions were maintained (temperature and pH) throughout the study, to decouple biological aspects from the degradation process. METHODS: Six virgin implants of 2 brands were submitted to the in vitro degradation process, mechanical testing of shell materials, surface change analysis (via scanning electron microscopy [SEM]) and chemical composition analysis by Fourier transform infrared (FTIR) spectroscopy. RESULTS: FTIR results showed that the principal chemical bonds of the material remained intact after 12 weeks of degradation. Apparently the implants' shell structures remained unchanged. Despite this observation, there were statistically significant differences between strain at failure at different time points for the shells of both brands, translated into a stiffening of the material over time. CONCLUSIONS: Material stiffening is reported as an indicator of material degradation. This altered mechanical behavior, added to the mechanical friction from tissue-tissue and tissue-implant contact and to the external mechanical loading (physical activity), may alter the material performance in women's bodies. Ultimately these changes may affect the implants' durability. Further work is needed to understand the biological aspects of the degradation process and their impact on implant durability.

Biomechanical properties of breast tissue, a state-of-the-art review.

This paper reviews the existing literature on the tests used to determine the mechanical properties of women breast tissues (fat, glandular and tumour tissue) as well as the different values of these properties. The knowledge of the mechanical properties of breast tissue is important for cancer detection, study and planning of surgical procedures such as surgical breast reconstruction using pre-surgical methods and improving the interpretation of clinical tests. Based on the data collected from the analysed studies, some important conclusions were achieved: (1) the Young's modulus of breast tissues is highly dependent on the tissue preload compression level, and (2) the results of these studies clearly indicate a wide variation in moduli not only among different types of tissue but also within each type of tissue. These differences were most evident in normal fat and fibroglandular tissues.

Structural and thermal properties of polypropylene mesh used in treatment of stress urinary incontinence.

Besides material biocompatibility, it is possible to infer that both vaginal and urethral erosion rates associated with sub-urethral synthetic slings may be related to the mechanical properties of the meshes and also to their other properties. With the aim of understanding what distinguishes the different polypropylene meshes, used for the treatment of the stress urinary incontinence (SUI), their structural and thermal properties were investigated. Five different mesh types were tested (Aris, Auto Suture, Avaulta, TVTO and Uretex). Differential scanning calorimetry (DSC) and infrared spectroscopy (FTIR) tests were performed. Furthermore, geometry (electron microscope), linear density and relative density (pyknometer) of the meshes were investigated. The meshes are made of the isotactic polypropylene homopolymer. Aris mesh presented the smallest fibre diameter, linear density and the level of crystallinity among all the meshes used for the treatment of the SUI. This study shows that there is a direct relationship between the fibre diameter, linear density, level of crystallinity and flexural stiffness of the polypropylene meshes used for the treatment of the SUI.