Pierre Robin Sequence and Respiratory Distress: Long-Term Evolution in Patients Submitted to the Conservative Treatment.

BACKGROUND: Pierre Robin Sequence (PRS) is characterized by micrognathia, glossoptosis, cleft palate, and airway distress. The aims of initial treatment are the improvement of airway and feeding. There are many therapeutic options, including conservative techniques (prone positioning and nasopharyngeal tube) and invasive procedures (mandibular distraction and tracheostomy). In our center, initially conservative treatment is the rule and many patients have been treated with nasopharyngeal tube. OBJECTIVE: The aim was to analyze of the clinical evolution of respiratory distress in infants with PRS submitted to nonsurgical treatment. METHODS: A retrospective and observational descriptive evaluation was carried out with 56 patients with the PRS at Centro de Atendimento Integral ao Fissurado Labiopalatal (CAIF). 21 patients were selected to a transversal phase. RESULTS: The treatment has started in an average age of 1.5 months (±2.09) and 17 (94.4%) had respiratory distress at birth. Polysomnographic exams showed an average apnea/hypopnea index of 0.93, an average number of central apnea/hour of 0.3, an average number of obstructive apnea of 0.6 and an average oxygen saturation of 92%. There was the predominance of esthetic profile in class II with 16 (88.9%) patients in this group, and orthodontic profile in class II with 15 (83.3%) patients. CONCLUSION: The conservative treatment has presented remarkable results in the treatment of respiratory distress in bearers of PRS with a decrease of obstructive sleep events considering the growth of patient and the development of mandibular growth as well.

The SISBIOTA-Diptera Brazilian Network: A long-term survey of Diptera from unexplored Brazilian Western Arc of Amazon, Cerrado, and Pantanal

ABSTRACT The SISBIOTA-BRASIL was a three-year multimillion-dollar research program of the Brazilian government to document plants and animals in endangered/understudied areas and biomes in Brazil. Distributional patterns and the historical events that generated them are extensively unknown regarding Brazilian fauna and flora. This deficiency hinders the development of conservation policies and the understanding of evolutionary processes. Conservation decisions depend on precise knowledge of the taxonomy and geographic distribution of species. Given such a premise, we proposed to research the diversity of Diptera of the Brazilian western arc of Amazon, Cerrado, and Pantanal in the states of Mato Grosso, Mato Grosso do Sul, and Rondônia. Three important biomes of the South American continent characterize these Brazilian states: Amazon forest, Cerrado (Brazilian Savannah), and Pantanal. Besides their ecological relevance, these biomes historically lack intensive entomological surveys. Therefore, they are much underrepresented in the Brazilian natural history collections and in the scientific literature, which is further aggravated by the fact that these areas are being exponentially and rapidly converted to commercial lands. Our project involved over 90 collaborators from 24 different Brazilian institutions and one from Colombia among researchers, postdocs, graduate and undergraduate students, and technicians. We processed and analyzed nearly 300,000 specimens from ~60 families of Diptera collected with a large variety of methods in the sampled areas. Here, we provide a detailed overview of the genera and species diversity of 41 families treated. Our results point to a total of 2,130 species and 514 genera compiled and identified for the three states altogether, with an increase of 41% and 29% in the numbers of species and genera known for the three states combined, respectively. Overall, the 10 most species-rich families were Tachinidae, Cecidomyiidae, Tabanidae, Psychodidae, Sarcophagidae, Stratiomyidae, Bombyliidae, Syrphidae, Tephritidae, and Asilidae. The 10 most diverse in the number of genera were Tachinidae, Stratiomyidae, Asilidae, Mycetophilidae, Syrphidae, Tabanidae, Muscidae, Dolichopodidae, Sarcophagidae, and Chloropidae. So far, 111 scientific papers were published regarding taxonomic, phylogenetic, and biogeographical aspects of the studied families, with the description of 101 new species and three new genera. We expect that additional publications will result from this investigation because several specimens are now curated and being researched by specialists.

Near Field Models of Spatially-Fed Planar Arrays and Their Application to Multi-Frequency Direct Layout Optimization for mm-Wave 5G New Radio Indoor Network Coverage.

Two near field models for the analysis of spatially fed planar array antennas are presented, compared and applied to a multi-frequency wideband direct layout optimization for mm-Wave 5G new radio (NR) indoor network coverage. One model is based on the direct application of the radiation equations directly derived from the A and F vector potentials. The second model is based on the superposition of far field contributions of all array elements, which are modelled as rectangular apertures with constant field. Despite the different assumptions made to develop both models, the degree of agreement between them in the computation of the radiated near field is very high. The relative error between the models is equal or lower than 3.2% at a plane 13λ from the array, and it decreases as the near field is computed further away from the array. Then, the faster model is employed in a general direct layout optimization procedure to shape the electromagnetic near field for application in an indoor femtocell to provide coverage with constant power in a private office. Results show that a magnitude ripple better than 1.5 dB can be achieved in an enlarged coverage area covering the whole n257 band of the 5G NR, corresponding to a 10.7% relative bandwidth.

Prostate cancer disclosure and sexual orientation: Understanding outness to healthcare providers as a situational or consistent phenomenon.

OBJECTIVE: In this study, we investigated if outness is more a situational or a consistent characteristic in gay, bisexual, and other men who have sex with men (GBM) treated for prostate cancer and how the disclosure of sexual orientation impacts provider discussions of sexual side effects. METHODS: Data came from Restore, an online cross-sectional survey of 193 GBM prostate cancer survivors living in North America and were analyzed using various statistical models. RESULTS: Disclosure of sexual orientation and of living with prostate cancer were not significantly correlated. Participants who were out regarding sexual orientation were more likely to report that their surgeons and urologists discussed the sexual side effects of treatment. CONCLUSION: Outness appears to be a situational phenomenon. GBM prostate cancer survivors who were out regarding sexual orientation received more discussion surrounding sexual side effects of prostate cancer treatment from their providers. PRACTICE IMPLICATIONS: It is important for healthcare providers to inquire about patient's sexual orientation to provide holistic care to these patients to address health disparities within this group.

Determination of the Fluoride Content in Water of Aqueducts of Cauca (Colombia) by Ion Exchange Chromatography.

Water for human consumption is the main source of fluoride exposure. The concentration in water should not exceed 1 mg/L of fluoride since, at higher levels; it increases the risk of dental fluorosis, among other adverse effects. The fluoride content of 149 water samples from different aqueducts in Cauca (Colombia) has been determined by ion exchange chromatography with the aim of fluoride risk assessment. The rural area of the Municipality of Santander de Quilichao registered fluoride concentrations between 0.012 and 0.150 mg/L. The urban area of Santander de Quilichao recorded lower fluoride levels than the rural area (0.027-0.068 mg/L). The urban area of the Municipality of Cajibío registered fluoride levels of 0.082-0.186 mg/L. The highest levels of fluoride were found in Timbío (0.121-0.210 mg/L). The fluoride levels recorded in this study are not considered sufficient to trigger dental fluorosis. Likewise, optimal levels are not considered to protect the child population against dental caries. However, a monitoring plan of fluoride concentrations in water should be implemented to assure the quality and safe of the water.

Reflectarray antennas: a smart solution for new generation satellite mega-constellations in space communications.

One of the most ambitious projects in communications in recent years is the development of the so-called satellite mega-constellations. Comprised of hundreds or thousands of small and low-cost satellites, they aim to provide internet services in places without existing broadband access. For the antenna subsystem, reflectarrays have been proposed as a cheap solution due to their low profile and manufacturing costs, while still providing good performance. This paper presents a full design of a reflectarray antenna for mega-constellation satellites with a shaped-beam isoflux pattern for constant power flux in the surface of the Earth. A unit cell consisting of two stacked rectangular microstrip patches backed by a ground plane is employed, providing more than 360° of phase-shift. The generalized intersection approach optimization algorithm is employed to synthesize the required isoflux pattern in a 2 GHz bandwidth in Ku-band. To that purpose, a full-wave electromagnetic analysis is employed for the wideband design. The optimized reflectarray layout complies with the specifications of the isoflux pattern in the frequency band 16 GHz-18 GHz, demonstrating the capabilities of this type of antenna to provide a low-cost, low-profile solution for the user beam segment, including different types of shaped beams.

MicroRNA signatures discriminate between uterine and ovarian serous carcinomas.

Synchronous endometrial and ovarian malignancies occur in 5% of women presenting with endometrial cancer and 10% of patients presenting with ovarian malignancy. When a high-grade serous carcinoma concurrently involves both ovary and endometrium, pathological determination of whether they are synchronous primaries or metastatic tumors from one primary site can be challenging. MicroRNAs (miRNA) are 22-nucleotide noncoding RNAs that are aberrantly expressed in cancer cells and may inherit their cellular lineage characteristics. We explored possible differential miRNA signatures that may separate high-grade ovarian serous carcinoma from primary endometrial serous carcinoma. Forty-seven samples of histologically pure high-grade serous carcinoma of both uterine (16 case) and ovarian primaries (31 cases) were included. Expression of 384 mature miRNAs was analyzed using ABI TaqMan Low-Density Arrays technology. A random forest model was used to identify miRNAs that together could differentiate between uterine and ovarian serous carcinomas. Among 150 miRNAs detectable at various levels in the study cases, a panel of 11-miRNA signatures was identified to significantly discriminate between ovarian and uterine serous carcinoma (P < .05). A nested cross-validated convergent forest plot using 6 of the 11 miRNA signature was eventually established to classify the tumors with 91.5% accuracy. In conclusion, we have characterized a miRNA signature panel in this exploratory study that shows significant discriminatory power in separating primary ovarian high-grade serous carcinoma from its endometrial counterpart.

Effects of sodium nitroprusside in the prevention of schizophrenia-like symptoms induced by ketamine - A translational double-blind study

Abstract Background: Recent evidence has shown improvements in schizophrenia symptoms after the infusion of sodium nitroprusside (SNP), a nitric oxide (NO) donor. In the rat model of schizophrenia using ketamine injection, pretreatment with SNP seems to prevent behavioral changes associated with positive symptoms for up to one week. Objective: We investigated whether SNP would have preventative effects on psychogenic symptoms induced by ketamine in healthy subjects. Methods: Healthy subjects (N = 38) were assigned to distinct groups that received SNP in different doses (0.15, 0.25, and 0.5 mcg/kg/min). First, participants received an infusion of SNP or placebo over 75 minutes. After 10 minutes, they were injected for 1 minute with a bolus of 0.26 mg/kg of ketamine and a maintenance dose was started 5 minutes later, with 0.25 mg/kg/h of ketamine for 50 minutes. Results: Ketamine-induced psychopathological alterations induced were reduced by SNP, as assessed with the Brief Psychological Rating Scale. Scores in the objective subscale of the Clinician-Administered Dissociative States Scale were also lower in SNP sessions compared to placebo. SNP had protective effects against deterioration in facial emotion and identity recognition tasks induced by ketamine. Discussion: Our findings support the view that SNP has preventative properties against psychotic manifestations.

Implementation of transformed lenses in bed of nails reducing refractive index maximum value and sub-unity regions.

Transformation optics with quasi-conformal mapping is applied to design a Generalized Maxwell Fish-eye Lens (GMFEL) which can be used as a power splitter. The flattened focal line obtained as a result of the transformation allows the lens to adapt to planar antenna feeding systems. Moreover, sub-unity refraction index regions are reduced because of the space compression effect of the transformation, reducing the negative impact of removing those regions when implementing the lens. A technique to reduce the maximum value of the refractive index is presented to compensate for its increase because of the transformation. Finally, the lens is implemented with the bed of nails technology, employing a commercial dielectric slab to improve the range of the effective refractive index. The lens was simulated with a 3D full-wave simulator to validate the design, obtaining an original and feasible power splitter based on a dielectric lens.

Structured and disordered facets of the GPCR fold.

The seven-transmembrane (7TM) helix fold of G-protein coupled receptors (GPCRs) has been adapted for a wide variety of physiologically important signaling functions. Here, we discuss the diversity in the structured and disordered regions of GPCRs based on the recently published crystal structures and sequence analysis of all human GPCRs. A comparison of the structures of rhodopsin-like receptors (class A), secretin-like receptors (class B), metabotropic receptors (class C) and frizzled receptors (class F) shows that the relative arrangement of the transmembrane helices is conserved across all four GPCR classes although individual receptors can be activated by ligand binding at varying positions within and around the transmembrane helical bundle. A systematic analysis of GPCR sequences reveals the presence of disordered segments in the cytoplasmic side, abundant post-translational modification sites, evidence for alternative splicing and several putative linear peptide motifs that have the potential to mediate interactions with cytosolic proteins. While the structured regions permit the receptor to bind diverse ligands, the disordered regions appear to have an underappreciated role in modulating downstream signaling in response to the cellular state. An integrated paradigm combining the knowledge of structured and disordered regions is imperative for gaining a holistic understanding of the GPCR (un)structure-function relationship.

Prevalência de halitose em pacientes com periodontite crônica ou gengivite / Halitosis in patients with chronic periodontitis or gingivitis

Estima-se que 90% da população possui alguma forma de doença periodontal e que a halitose afeta cerca de 50% dessa. Apesar de evidências sugerirem a correlação entre halitose e doença periodontal, são escassos os estudos que confirmam a prevalência da halitose nesses pacientes. Soma-se a isso o fato de haver variações e divergências entre os trabalhos existentes. O objetivo desta pesquisa foi comparar a prevalência da halitose em pacientes com periodontite crônica e em pacientes com gengivite. Foram avaliados 51 pacientes com periodontite crônica (grupo 1) e 42 pacientes com gengivite associada a placa sem fatores de retenção (grupo 2). Os níveis intraorais de compostos sulfurados voláteis (CSV) foram medidos pelo monitor de sulfetos (Halímeter). Também foram avaliados o índice de placa (IP), a profundidade de sondagem (PS) e o nível de inserção clínica (NIC). Os resultados evidenciaram que houve diferença estatisticamente significativa entre os grupos 1 e 2 para os níveis do hálito e os demais parâmetros clínicos mensurados (p < 0,0001). Através da análise da matriz de correlação linear também foi constatada correlação positiva moderada significativa entre o hálito e IP (p=0,03), e entre hálito e PS (p=0,03). Concluiu-se que a doença periodontal contribuiu efetivamente para a ocorrência de halitose, e que o tipo e a severidade da doença interferiram na sua magnitude e expressão clínica.

Una rara presentación de la enfermedad de hirschsprung en el adulto / A rare presentation of adult hirschsprung disease

Objetivo: Presentación de un caso clínico de una patología bastante infrecuente, como es el síndrome de Waardenburg tipo IV, en un paciente intervenido en el servicio de Cirugía 2 del Hospital Domingo Luciani. IVSS, Caracas. Métodos: Paciente masculino de 32 años, quien consultó por presentar dolor y distensión abdominal. Al examen físico se evidenció desnutrición, retardo en el crecimiento, hipoacusia y distopia cantorum. Diagnóstico clínico: síndrome de Waardenburg, tipo IV. Resultados: Se practicó una laparotomía exploradora, evidenciándose gran dilatación pancolónica. Biopsias rectales compatibles con enfermedad de Hirschsprung. Un procedimiento de Soave fue realizado, con una ileostomía en asa. Actualmente en espera del cierre de la ileostomía Conclusión: El síndrome de Waardenburg es una rara enfermedad autosómica dominante de presentación clínica y genética heterogénea, de penetración variable. El tipo IV está asociado a enfermedad de Hisrchsprung(AU)

Objective: Presentation of a clinical case of a quite uncommon pathology, the Waardenburg's syndrome type IV, in a patient treated at Surgery 2 service of the Hospital Domingo Luciani. IVSS, Caracas. Methods: A 32 year old male patient, consulted for presenting pain and abdominal distention. Physical examination showed malnutrition, failure to thrive, hearing loss and dystopia cantorum. Clinical diagnosis: Syndrome Waardenburg type IV. Results: It was performed a laparotomy, showing a great pancolonic dilatation. Rectal biopsies compatible with Hirschsprung disease. A Soave procedure was done with a loop ileostomy. Currently waiting for ileostomy closure. Conclusion: Waardenburg syndrome is a rare autosomal dominant disease with heterogeneous clinical and genetic presentation of variable penetration. Type IV is associated with Hisrchsprung disease(AU)

Cancer microRNAs: from subtype profiling to predictors of response to therapy.

MicroRNAs (miRNAs) are key regulators of gene expression that regulate important oncogenes and tumor suppressors. Many miRNAs can also act as oncogenes or tumor suppressors, and thus the altered expression of miRNAs is a hallmark of many cancer types. Dysregulated miRNAs provide a potentially powerful new tool that could be used to enable the characterization of tumor environments and identify novel and important oncogenic pathways. More recently, there has been growing interest in the field of miRNAs as biomarkers of cancer risk, diagnosis and response to therapy. Understanding the associations between miRNA expression and cancer phenotypes, and the potential of miRNA profiling in clinical applications, promises to be highly rewarding in the field of cancer research.

Are cavum septum pellucidum abnormalities more common in schizophrenia spectrum disorders? A systematic review and meta-analysis.

Magnetic resonance imaging (MRI) studies have reported a variety of brain abnormalities in association with schizophrenia. These include a higher incidence of cavum septum pellucidum (CSP), which is consistent with a neurodevelopmental model for this disorder. In this meta-analytic review, we describe and discuss the main CSP MRI findings in schizophrenia spectrum disorders (SSDs) to date. We adopted as keywords cavum and schizophrenia or psychosis, and the inclusion criteria were articles in English, with samples of SSD patients compared to healthy subjects, which used MRI to assess CSP, without time limit. From 18 potential reports, fifteen were eligible to be part of the current review. These studies included 1054 patients with SSD and 866 healthy volunteers. Six out of 15 studies pointed to a higher prevalence of CSP of any size in SSD patients, while five out of 15 showed that subjects with SSD had a greater occurrence of a large CSP than healthy individuals. However, the meta-analysis demonstrated that only the incidence of a large CSP was significantly higher in SSD relative to healthy comparisons (odds ratio=1.59; 95%CI 1.07-2.38; p=0.02). Overall our results suggest that only a large CSP is associated with SSD while a small CSP may be considered a normal neuroanatomical variation. Our review revealed a large degree of variability in the methods employed across the MRI studies published to date, as well as evidence of publication bias. Studies in large, community-based samples with greater standardization of methods should clarify the true significance of CSP in SSD.

Penetrating axillary trauma in a survivor of the World Trade Center disaster.

Penetrating axillary trauma is classically associated with gunshot wounds or stab wounds, and it is a cause for concern because of the high risk of vascular injury. We report a case of penetrating axillary trauma to a victim of the World Trade Center disaster. In this case report, we discuss the CT and angiographic findings of both blunt and penetrating axillary injury, and present a diagnostic algorithm.