Stool Glycoproteomics Signatures of Pre-Cancerous Lesions and Colorectal Cancer.

Colorectal cancer (CRC) screening relies primarily on stool analysis to identify occult blood. However, its sensitivity for detecting precancerous lesions is limited, requiring the development of new tools to improve CRC screening. Carcinogenesis involves significant alterations in mucosal epithelium glycocalyx that decisively contribute to disease progression. Building on this knowledge, we examined patient series comprehending premalignant lesions, colorectal tumors, and healthy controls for the T-antigen-a short-chain O-glycosylation of proteins considered a surrogate marker of malignancy in multiple solid cancers. We found the T-antigen in the secretions of dysplastic lesions as well as in cancer. In CRC, T-antigen expression was associated with the presence of distant metastases. In parallel, we analyzed a broad number of stools from individuals who underwent colonoscopy, which showed high T expressions in high-grade dysplasia and carcinomas. Employing mass spectrometry-based lectin-affinity enrichment, we identified a total of 262 proteins, 67% of which potentially exhibited altered glycosylation patterns associated with cancer and advanced pre-cancerous lesions. Also, we found that the stool (glyco)proteome of pre-cancerous lesions is enriched for protein species involved in key biological processes linked to humoral and innate immune responses. This study offers a thorough analysis of the stool glycoproteome, laying the groundwork for harnessing glycosylation alterations to improve non-invasive cancer detection.

Effect of fish-oil supplementation on the glycemic and lipidemic profiles of pregnant women: a systematic review and meta-analysis.

CONTEXT: Pregnant women have physiological metabolic changes in glycemic and lipid profiles that are essential for fetal development. OBJECTIVE: The aim of this systematic review was to analyze the effects of fish-oil-capsule supplementation on the glycemic and lipid profiles of pregnant women. DATA SOURCES: A systematic search was conducted of the MEDLINE (by PubMed), Embase, Cochrane Library (CENTRAL) databases and gray literature, including preprints for all relevant studies published in English, with no date restrictions. DATA EXTRACTION: The estimated pooled results were analyzed using a random-effects model and represented by mean differences (MDs) and corresponding 95% confidence intervals (CIs). The analyses were performed with R software, version 4.2.1, using the "Meta" packages, versions 6.0-0. DATA ANALYSIS: Fifteen eligible studies were included after screening. In a pooled analysis, overall fish-oil supplementation had no effect on parameters compared with placebo. In the subgroup analysis, fish-oil supplementation may be beneficial in insulin (MD: -2.11 IU/mL; 95% CI: -3.86, -0.36) and homeostasis model assessment of insulin resistance (HOMA-IR) (MD: -0.71; 95% CI: -1.14, -0.29) indices, with heterogeneity (I2 =0%) among pregnant women with diabetes mellitus. In the subgroup with doses of eicosapentaenoic acid (EPA) below 200 mg, there was a reduction in HOMA-IR in the intervention group (MD: -0.60; 95% CI: -1.14, -0.06). CONCLUSION: Pregnant women taking fish-oil capsules showed significant beneficial changes in the subgroups of type 2 diabetes and EPA dosages below 200 mg for insulin and HOMA-IR.

Lack of Annexin A1 Exacerbates Inflammatory Response in Acute Endometritis Model.

Annexin A1 (AnxA1) is a glucocorticoid-inducible protein and an important endogenous modulator of inflammation. However, its effect in the endometrial microenvironment is poorly explained. This study aimed to evaluate the role of endogenous AnxA1 in an endometritis mouse model induced by lipopolysaccharide (LPS). Female C57BL/6 wild-type (WT) and AnxA1-/- mice were divided into two groups: SHAM and LPS. To induce endometritis, mice received a vaginal infusion of 50 µL of LPS (1 mg/mL) dissolved in phosphate-buffered saline. After 24 h, the mice were euthanized, and blood and uteri samples were collected. The endometrium inflammatory scores were significantly increased in the LPS-treated group. AnxA1-/- mice from the LPS group demonstrated a significant increase in the number of degranulated mast cell levels compared to AnxA1-/- SHAM mice. The Western blotting analysis revealed that a lack of AnxA1 promoted the upregulation of NLRP3 and pro-IL-1ß in the acute endometritis animal model compared to WT LPS animals. LPS-induced endometritis increased the number of blood peripheral leukocytes in both WT and AnxA1-/- mice compared with SHAM group mice (p < 0.001). AnxA1-/- mice also showed increased plasma levels of IL-1ß (p < 0.01), IL-6, IL-10, IL-17, and TNF-α (p < 0.05) following LPS-induced endometritis. In conclusion, a lack of endogenous AnxA1 exacerbated the inflammatory response in an endometritis model via NLRP3 dysregulation, increased uterine mast cell activation, and plasma pro-inflammatory cytokine release.

Effect of cannabis and subproducts on anthropometric measures: a systematic review and meta-analysis.

BACKGROUND: Obesity poses a significant public health challenge. Research has examined the impact of cannabis and subproducts on health but varying results have hindered a consensus. AIM: This study aimed to evaluated the effects of cannabis and subproducts on body measurements. METHODS: For searching randomized controlled trials evaluating cannabis and/or subproducts use and changes in anthropometric measures, a systematic search at MEDLINE, Embase, Cochrane Library and Web of Science was conducted until March 2023. The outcomes included changes in body weight, body mass index (BMI) and waist circumference (WC). Meta-analysis was realized using R software (version 4.2.1). RESULTS: In general, cannabis use reduced weight by 1.87 kg (95% CI: -3.71 to -0.03) and WC (mean difference = -2.19, 95% CI: -4.44 to 0.06). When examining subgroups, longer follow-up periods were associated with a more pronounced BMI reduction (mean difference = -1.10, 95% CI: -2.23 to 0.03). Cannabinoid CB1 exhibited an increase in body fat (mean difference = 1.70, 95% CI: 0.66-2.74). CONCLUSION: These findings suggest that cannabis and subproducts could be considered adjuncts in obesity treatment by helping to reduce relevant anthropometric measurements.

Bibliographic mapping of animal genetic resources and climate change in farm animals.

Bibliometric mapping is a tool that allows you to visualize the academic production, as well as the publication trends over the years. In this study, we carried out the bibliometric mapping of citation, co-occurrence of keywords, co-citation, and bibliographic coupling for "animal genetic resources" and "climate change." Scopus was used to obtain the publication information and VOSViewer software to produce the maps. A total of 1171 documents were found from authors in 129 countries from 1975 to 2022. The USA, UK, and China are the top three countries producing scientific research on the topics of animal genetic resources and climate change. China is the country with the most recent publications. The USA, the UK, and China stood out in almost all the analyses, but other Asian and Latin American countries appear more recently and are becoming more important in this scenario. Most of the work is related to studies involving animal adaptation, conservation, and genetic diversity; however, in recent years, there has been an increasing amount of research involving genetic engineering, such as the use of genetic sequencing and single nucleotide polimorphism (SNP). This study can help to understand new research trends in the area of animal genetic resources and climate change and can assist in the development of future actions within the research community.

Use of thermography and physiological rate to assess heat tolerance in cattle breeds.

Thermography has grown in use in recent years. It is a valuable tool for measuring animal heat tolerance under heat stress conditions since it is a non-invasive, safe and practical methodology. Physiological variables such as respiration rate and eye temperature, and environmental variables such as air temperature and wet bulb temperature were analysed in animals from nine cattle breeds (Angus, Braford, Brangus, Canchim, Charolais, Hereford, Nelore, Simmental and Santa Gertrudis) and one bubaline (Mediterranean) at Rio Grande do Sul, Brazil. Positive correlations were observed between air temperature and respiration rate and eye temperature. Furthermore, the breed strongly influenced the eye temperature and respiration rate of the animals. Eye temperature showed strong correlation with air temperature and wet bulb temperature. Simmental and Nelore animals presented higher eye temperature values. Simmental presented alteration in respiratory rate before the other breeds and Nelore was the last breed to present this alteration. The inflection points in the broken line analysis indicated the environmental temperature limits at which breeds begin to change their respiration to compensate for environmental variation. The use of thermography has proven to be a technique with possible application to evaluate the temperature of animals. Logistic regression analysis allows us to observe how each breed behaves with the temperature change. Using respiration rates and eye temperatures it was possible to identify physiological limits for comfort in different breeds of bovine. In the future it would be interesting to conduct additional studies using other physiological variables and also other indices of climatic conditions.

BODY COMPOSITION ASSESSED BY DUAL-ENERGY X-RAY ABSORPTIOMETRY ON METABOLIC PROFILE AND CARDIOVASCULAR RISK IN OBESE PATIENTS PRIOR TO BARIATRIC SURGERY.

BACKGROUND: Fat, muscle, and bone are endocrine organs capable of affecting the metabolic profile and cardiovascular risk. Relating these components is important to the establishment of early intervention strategies for overweight patients. AIMS: This study aimed to evaluate the influence of body mass components on the metabolic profile and cardiovascular risk in the preoperative period of bariatric surgery. METHODS: A cross-sectional study was conducted with patients admitted for bariatric surgery at a university hospital in the city of Recife, Brazil, between 2018 and 2019. Body composition was determined using dual-energy x-ray absorptiometry. Cardiovascular risk was assessed using the Framingham risk score. Data were collected on anthropometric, clinical, and lifestyle characteristics. The lipid profile (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides), blood glucose, and vitamin D were determined using the standard methods of the hospital laboratory. RESULTS: A total of 60 patients were analyzed, 86.7% of whom had comorbidities, 33.3% had moderate/high cardiovascular risk, and 71.4% had vitamin D insufficiency/deficiency. Lower lean body mass (adjusted PR 3.24; 95%CI 1.19-5.77) was independently associated with the severity of obesity. The body mass index and waist circumference were negatively correlated with lean body mass (r=-0.52; p<0.01)/r=-0.36; p<0.01). Lean body mass was negatively correlated with fat mass (r=-0.26; p<0.05), trunk fat (r=-0.29; p<0.05), fasting glucose (r=-0.26; p<0.05), and bone mineral density (r=-0.26; p<0.05). A total of 84.2% of individuals with less trunk fat tended to have low cardiovascular risk (p=0.05). However, physical inactivity (adjusted PR 2.14; 95%CI 1.19-5.54) and the risk of alcohol dependence (adjusted PR 2.41; 95%CI 1.76-4.15) were the only variables independently associated with cardiovascular risk. CONCLUSION: Obese patients in the preoperative period of bariatric surgery with less trunk fat tended to have low cardiovascular risk. However, the other components of body mass were also not associated with cardiovascular risk.

Examining the factors associated with functional capacity of community-dwelling older adults using the ICF framework: a cross-sectional study from the Frailty in Brazilian Older Adults Study (FIBRA).

BACKGROUND: There are many factors associated with functioning and disability in older adults and these relationships are not clear. OBJECTIVE: To explore the factors associated with functional capacity of older adults using the framework of the International Classification of Functioning, Disability, and Health (ICF). METHODS: This is a cross-sectional study with a dataset from a survey of 1 377 community-dwelling older adults (≥ 65 years) in a middle-income country. Three functional outcomes were selected to represent the functioning domains: 1) muscle strength for body function; 2) walking speed for activity; and 3) advanced activities of daily living (ADL) for participation. Demographic, clinical, and social information was selected to represent the domains of health conditions and contextual factors (i.e. personal and environmental factors). Multivariate models tested the impact of these factors on each outcome. RESULTS: Depressive symptoms, age, and physical activity were associated with the three outcomes. Muscle strength was also associated with urinary incontinence, visual deficits, female sex, and employment. Walking speed was also associated with urinary incontinence, obesity, fractures due to falls, female sex, health professionals' visits, and walking aid devices. Advanced ADL were also associated with stroke, visual deficits, education, employment, health perception, social support, and walking aid devices. CONCLUSION: Functional capacity of older adults is associated with some non-modifiable factors, such as age and sex. The modifiable factors must be addressed by health professionals and policymakers in the geriatric area, especially depression, obesity, physical inactivity, and social support.

First report of fungal meningoencephalitis by Penicillium chrysogenum in Brazil.

INTRODUCTION: Fungal infections of the central nervous system present a variety of clinical syndromes, such as meningitis, encephalitis, raised intracranial pressure with a nonspecific presentation, and, in the last two decades, have increased the incidence of these fungal infections. Fungal meningoencephalitis is frequently associated with Cryptococcus, but this report stands out for presenting one species of Penicillium genus. OBJECTIVES: Here, we present the first case of meningoencephalitis associated with brain injury caused by Penicillium chrysogenum, in a patient who is immunocompetent and was admitted to Hospital Naval Marcílio Dias, Rio de Janeiro, Brazil. METHODS: To identify the fungal species, we performed phenotypic and genotypic methodologies, from the culture to the sequencing of internal transcribed spacer region, and ß-tubulin gene, a rare fungus in cerebrospinal fluid cultures, belonging to the genus Penicillium, was identified. CONCLUSION: We highlight the importance of the first report of meningoencephalitis caused by P. chrysogenum in a patient who is immunocompetent, registered in Brazil. We also emphasize the need for further studies to determine an effective treatment with the least possible side effects for patients infected by fungi that are rarely related to the most severe forms of invasive infections.

Body composition assessed by dual-energy x-ray absorptiometry on metabolic profile and cardiovascular risk in obese patients prior to bariatric surgery / Composição corporal avaliada pela absortometria radiológica de dupla energia sobre o perfil metabólico e o risco cardiovascular em obesos antes da cirurgia bariátrica

ABSTRACT BACKGROUND: Fat, muscle, and bone are endocrine organs capable of affecting the metabolic profile and cardiovascular risk. Relating these components is important to the establishment of early intervention strategies for overweight patients. AIMS: This study aimed to evaluate the influence of body mass components on the metabolic profile and cardiovascular risk in the preoperative period of bariatric surgery. METHODS: A cross-sectional study was conducted with patients admitted for bariatric surgery at a university hospital in the city of Recife, Brazil, between 2018 and 2019. Body composition was determined using dual-energy x-ray absorptiometry. Cardiovascular risk was assessed using the Framingham risk score. Data were collected on anthropometric, clinical, and lifestyle characteristics. The lipid profile (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides), blood glucose, and vitamin D were determined using the standard methods of the hospital laboratory. RESULTS: A total of 60 patients were analyzed, 86.7% of whom had comorbidities, 33.3% had moderate/high cardiovascular risk, and 71.4% had vitamin D insufficiency/deficiency. Lower lean body mass (adjusted PR 3.24; 95%CI 1.19-5.77) was independently associated with the severity of obesity. The body mass index and waist circumference were negatively correlated with lean body mass (r=-0.52; p<0.01)/r=-0.36; p<0.01). Lean body mass was negatively correlated with fat mass (r=-0.26; p<0.05), trunk fat (r=-0.29; p<0.05), fasting glucose (r=-0.26; p<0.05), and bone mineral density (r=-0.26; p<0.05). A total of 84.2% of individuals with less trunk fat tended to have low cardiovascular risk (p=0.05). However, physical inactivity (adjusted PR 2.14; 95%CI 1.19-5.54) and the risk of alcohol dependence (adjusted PR 2.41; 95%CI 1.76-4.15) were the only variables independently associated with cardiovascular risk. CONCLUSION: Obese patients in the preoperative period of bariatric surgery with less trunk fat tended to have low cardiovascular risk. However, the other components of body mass were also not associated with cardiovascular risk.

RESUMO RACIONAL: O tecido adiposo, músculos e ossos representam órgãos endócrinos, capazes de interferir no perfil metabólico e risco cardiovascular. Relacionar esses componentes será importante para estratégias de intervenção precoce, em obesos. OBJETIVOS: Avaliar a influência dos compartimentos da massa corporal, sobre o perfil metabólico e risco cardiovascular, no pré-operatório de cirurgia bariátrica. MÉTODOS: Estudo transversal, com pacientes admitidos para cirurgia bariátrica, em hospital universitário. A composição corporal foi avaliada pela absortometria radiológica de dupla energia e o risco cardiovascular pelo escore de risco de Framingham. Foram analisadas variáveis antropométricas, clínicas e de estilo de vida. Foi avaliado perfil lipídico (colesterol total, HDL-c, LDL-c, triglicerídeos), glicemia e vitamina D, utilizando a metodologia padrão. RESULTADOS: Foram analisados 60 pacientes, 86,7% apresentavam comorbidades, 33,3% risco cardiovascular moderado/elevado e 71,4% insuficiência/deficiência de vitamina D. Menor massa corporal magra associou-se à gravidade da obesidade. O índice de massa corpórea e a circunferência da cintura correlacionaram-se negativamente com a massa corporal magra (r=-0,52; p<0,01)/r=-0,36; p<0,01). A massa corporal magra correlacionou-se negativamente com a massa gorda (r=-0,26; p<0,05), gordura troncular (r=-0,29; p<0,05), glicemia de jejum (r=-0,26; p<0,05) e densidade mineral óssea (r=-0,26; p<0,05). Ao todo, 84,2% dos indivíduos com menos gordura troncular apresentaram tendência a baixo risco cardiovascular (p=0,05). Contudo, inatividade física (razão de prevalência ajustada 2,14; IC95% 1,19-5,54) e risco de dependência alcoólica foram as únicas variáveis independentemente associadas ao risco cardiovascular. CONCLUSÕES: Os pacientes obesos em pré-operatório de cirurgia bariátrica com menos gordura troncular, apresentaram tendência a baixo risco cadiovascular. Contudo, o risco cardiovascular também não foi associado aos demais componentes da massa corporal.

Serviço-escola de psicologia da Unifesp: campos de estágio, ações e especificidades / UNIFESP's psychology service-school: internship field, actions, and specificities / Serviço-escola de psicologia de la Unifesp: campos de prácticas profesionales, acciones y especificidades

O Serviço-Escola de Psicologia (SEP) da Unifesp foi constituído com o intuito de transcender o tradicional funcionamento das clínicas-escola, superando a atomização da Psicologia em áreas e oferecendo serviços integrados à rede. Isso possibilita uma formação interdisciplinar, pluralista, generalista, não tecnicista, crítica, permitindo a compreensão e atuação do psicólogo em diversos contextos socioculturais. O objetivo do artigo é descrever, avaliar e problematizar as ações do SEP da Unifesp, em relação à oferta de campos de estágio e ações desenvolvidas neles. É um estudo transversal, baseado em metodologia predominantemente quantitativa e descritiva. O levantamento de dados foi realizado por meio de dois questionários online respondidos por todos os supervisores. Os dados quantitativos foram submetidos à análise estatística descritiva. Os resultados evidenciaram maior incidência das ações no município de Santos e, em menor grau, em outros municípios da Baixada Santista e na cidade de São Paulo. A maioria das atividades de estágios não se limita ao espaço físico de atendimento clínico do Serviço-Escola, ocorrendo junto às instituições públicas ou às instituições ligadas ao terceiro setor na região, relacionadas, direta ou indiretamente, com a promoção de políticas públicas. A pluralidade de recursos utilizados (grupos, atendimento individual, acompanhamento terapêutico, oficinas, matriciamento, entre outros) revela uma ampliação do repertório de competências e habilidades. A variedade de oferta de projetos e campos de estágio, públicos-alvo atendidos, assim como a diversidade e flexibilidade de ações e estratégias desenvolvidas, apontam um movimento de congruência em relação às diretrizes curriculares nacionais e ao inovador Projeto Pedagógico do curso.(AU)

UNIFESP's Psychology Service-School (SEP) was founded with the objective of going beyond the traditional functioning of school-clinics, overcoming the atomization of Psychology in areas and offering services integrated to the network. This enables an interdisciplinary, pluralist, generalist, non-technicist, and critical training, allowing psychologists' understanding and action in different sociocultural contexts. This article aims to describe, evaluate, and discuss the actions of UNIFESP's SEP regarding the offer of internship fields and the actions developed in those fields. It is a cross-sectional study, based on a predominantly descriptive and quantitative methodology. The data was surveyed with two online questionnaires answered by all supervisors. Quantitative data were submitted to descriptive statistical analysis. The results showed a higher incidence of actions in the municipality of Santos and, to a lesser extent, in other municipalities of the Baixada Santista and in the city of São Paulo. Most internship activities are not limited to the physical space of the service-school's clinical care and take place alongside public institutions or institutions linked to the third sector in the area, directly or indirectly related to the promotion of public policies. The plurality of resources (groups, personal care, therapeutic monitoring, workshops, matrix support, among others) reveals an expansion of competences and skills repertoire. The variety of projects and internship fields offers, of target audiences served, as well as the diversity and flexibility of the developed actions and strategies point to a congruence movement relating to national curricular guidelines and to the innovative pedagogical project of the course.(AU)

El Serviço-Escola de Psicologia (SEP) de la Unifesp (Universidade Federal de São Paulo, Brasil) buscó trascender el funcionamiento tradicional de las clínicas universitarias, superar la atomización de la Psicología en áreas y ofrecer servicios integrados a la red. Esto permite una formación interdisciplinar, pluralista, generalista, sin tecnicismos, crítica, lo que posibilita a los/las psicólogos/as comprender y actuar en diferentes contextos socioculturales. Este artículo pretendió describir, evaluar y problematizar las acciones del SEP Unifesp respecto a la oferta de campos de prácticas profesionales y acciones desarrolladas. Es un estudio transversal, con metodología predominantemente cuantitativa y descriptiva. Los datos se recolectaron de dos cuestionarios en línea respondidos por los/las supervisores/as. Se les aplicaron un análisis estadístico descriptivo. Hubo más acciones en la ciudad de Santos (Brasil) que en otros municipios de la región metropolitana de la Baixada Santista y en la ciudad de São Paulo. La mayoría de las prácticas profesionales no se limita a la atención clínica del SEP, ocurriendo en instituciones públicas o vinculadas al tercer sector en la región, directa o indirectamente, relacionadas con la promoción de políticas públicas. La pluralidad de recursos (grupos, atención individual, acompañamiento terapéutico, talleres, soporte matricial, entre otros) revela un amplio repertorio de competencias y habilidades. La variada oferta de proyectos y campos para prácticas profesionales, los públicos destinatarios atendidos, así como la diversidad y flexibilidad de acciones y estrategias desarrolladas apuntan a una congruencia respecto a los lineamientos curriculares nacionales y al innovador proyecto pedagógico del curso.(AU)

Risco de queda relacionado a medicamentos em hospitais: abordagem de aprendizado de máquina / Riesgo de caída relacionado con medicamentos en hospitales: enfoque de aprendizaje de máquina / Drug-related fall risk in hospitals: a machine learning approach

Resumo Objetivo Comparar o desempenho de modelos de aprendizado de máquina com o Medication Fall Risk Score (MFRS) na previsão de risco de queda relacionado a medicamentos prescritos. Métodos Trata-se de um estudo caso-controle retrospectivo de pacientes adultos e idosos de um hospital terciário de Porto Alegre, RS, Brasil. Medicamentos prescritos e classes de medicamentos foram investigados. Os dados foram exportados para o software RStudio para análise estatística. As variáveis foram analisadas por meio dos algoritmos de Regressão Logística, Naive Bayes, Random Forest e Gradient Boosting. A validação do algoritmo foi realizada usando validação cruzada de 10 vezes. O índice de Youden foi a métrica selecionada para avaliar os modelos. O projeto foi aprovado pelo Comitê de Ética em Pesquisa. Resultados O modelo de aprendizado de máquina que apresentou melhor desempenho foi o desenvolvido pelo algoritmo Naive Bayes. O modelo construído a partir de um conjunto de dados de um hospital específico apresentou melhores resultados para a população estudada do que o MFRS, uma ferramenta generalizável. Conclusão Ferramentas de previsão de risco que dependem de aplicação e registro adequados por parte dos profissionais demandam tempo e atenção que poderiam ser alocados ao cuidado do paciente. Modelos de previsão construídos por meio de algoritmos de aprendizado de máquina podem ajudar a identificar riscos para melhorar o atendimento ao paciente.

Resumen Objetivo Comparar el desempeño de modelos de aprendizaje de máquina con Medication Fall Risk Score (MFRS) para la previsión del riesgo de caída relacionado con medicamentos prescriptos. Métodos Se trata de un estudio caso-control retrospectivo de pacientes adultos y adultos mayores de un hospital terciario de Porto Alegre, estado de Rio Grande do Sul, Brasil. Se investigaron los medicamentos prescriptos y las clases de medicamentos. Los datos fueron exportados al software RStudio para el análisis estadístico. Las variables se analizaron a través de los algoritmos de regresión logística Naive Bayes, Random Forest y Gradient Boosting. La validación del algoritmo se realizó usando validación cruzada de 10 veces. El índice de Youden fue la métrica seleccionada para evaluar los modelos. El proyecto fue aprobado por el Comité de Ética en Investigación. Resultados El modelo de aprendizaje de máquina que presentó el mejor desempeño fue el desarrollado por el algoritmo Naive Bayes. El modelo construido a partir de un conjunto de datos de un hospital específico presentó mejores resultados en la población estudiada que el MFRS, una herramienta generalizada. Conclusión Herramientas de previsión de riesgo que dependen de la aplicación y el registro adecuados por parte de los profesionales demandan tiempo y atención que podría ser destinado al cuidado del paciente. Modelos de previsión construidos mediante algoritmos de aprendizaje de máquina pueden ayudar a identificar riesgos para mejorar la atención al paciente.

Abstract Objective To compare the performance of machine-learning models with the Medication Fall Risk Score (MFRS) in predicting fall risk related to prescription medications. Methods This is a retrospective case-control study of adult and older adult patients in a tertiary hospital in Porto Alegre, RS, Brazil. Prescription drugs and drug classes were investigated. Data were exported to the RStudio software for statistical analysis. The variables were analyzed using Logistic Regression, Naive Bayes, Random Forest, and Gradient Boosting algorithms. Algorithm validation was performed using 10-fold cross validation. The Youden index was the metric selected to evaluate the models. The project was approved by the Research Ethics Committee. Results The machine-learning model showing the best performance was the one developed by the Naive Bayes algorithm. The model built from a data set of a specific hospital showed better results for the studied population than did MFRS, a generalizable tool. Conclusion Risk-prediction tools that depend on proper application and registration by professionals require time and attention that could be allocated to patient care. Prediction models built through machine-learning algorithms can help identify risks to improve patient care.

Histomorphometric analysis of the endometrium in an ectopic model of endometriosis in mice.

Objective: Evaluate histomorphometry of ectopic and eutopic endometrial tissues in receptor mice. Method: Eighteen female Balb/c were divided into 3 groups, 6 animals each: GI Control, no procedure; GII - Sham, animals that had the same procedures as GIII without receiving the ectopic endometrial implant. Instead, they received saline solution; GIII - endometriosis model, animals had surgical intervention with an ectopic endometrial implant. GI and GIII mice were treated with 17ß-estradiol, 100 µg/kg each. All animals were euthanized to collect uterine horns, which were fixed in 4% paraformaldehyde, embedded in paraffin, stained with Hematoxilin and Eosin and submitted to histomorphometric analyzes. Data underwent one-way ANOVA followed by Tukey's test. Results: Local tissue growth, showing important lesions and adhesions, as well as dark cysts were noticed. In GIII group, there was an increase in number of blood vessels and glands (GIII ≥ GI and GIII p > .001). Thickening of the GIII endometrial epithelial was also evident (GIII ≥ GI and GIII. p > .001). We also noticed an increase in the number of eosinophils (GIII (GIII ≥ GI and GIII. p > .001). Conclusion: Easy to perform model, capable of reproducing morphological endometriosis characteristics. From our findings, there was an increase of endometrial thickness as well as an increase in the eosinophils population.

Multi-Agent Interaction to Assist Visually-Impaired and Elderly People.

A voice-controlled smart home system based on conversational agents can address the specific needs of older people, proactively providing support, compensating for cognitive decline, and coping with solitude, among other features. In particular, Multi-Agent Systems (MAS) platforms provide considerable support for complex adaptive systems that are naturally distributed and situated in dynamic environments, such as Ambient intelligence (AmI) applications. Such autonomous intelligent agents are capable of independent reasoning and joint analysis of complex situations to support high-level interaction with humans, besides providing typical characteristics of MAS, such as cooperation and coordinated action. In this context, we developed an approach using a MAS previously evaluated for visually impaired users, where most of the system's functionalities are also helpful for the elderly. Our methodology is based on the four steps of the interactive design process. As a result, we determined that our approach has elements that allow for natural interaction with users, and we identified and discussed improvements and new features for future work. We believe that our findings can point to directions for building AmI systems that are capable of more natural interaction with users.

Isoflavone Protects the Renal Tissue of Diabetic Ovariectomized Rats via PPARγ.

Diabetes associated with post-menopause is related to a worse condition of kidney disease. Taking into consideration that this disorder may be regulated by estrogenic mediators, we evaluated the renal protective effect of isoflavone. We investigated the role of the PPARγ in the pathogenesis of the disease. For this study, we used diabetic female rats in a postmenopausal model through ovariectomy. The animals were treated with isoflavone or 17ß-estradiol. A dosage was administered to bring on blood glycemia, and through immunohistochemistry, we evaluated the immunoreactivity of PPARγ in the endometrium and renal tissue. We analyzed the immunoreactivity of renal injury molecule KIM-1 and the collagen and glycogen densities in the kidney. Through bioinformatics analysis, we observed PPARγ and COL1A1 gene expression under the influence of different glucose doses. In particular, we observed that isoflavone and 17ß-estradiol regulate blood glycemia. Renal injury was inhibited by isoflavone, observed by a reduction in KIM-1, along with glycogen accumulation. These benefits of isoflavone may be associated with PPARγ overexpression in the kidneys and endometrium of diabetic ovariectomized rats.

Association between being underweight and excess body weight before SARS coronavirus type 2 infection and clinical outcomes of coronavirus disease 2019: Multicenter study.

OBJECTIVES: The present study aimed to identify associations between extremes in body weight status (underweight and excess body weight) before a COVID-19 diagnosis and clinical outcomes in patients infected with SARS coronavirus type 2. METHODS: A multicenter cohort study was conducted in eight different states in northeastern Brazil. Demographic, clinical (previous diagnosis of comorbidities), and anthropometric (self-reported weight and height) data about individuals who tested positive for COVID-19 were collected. Outcomes included hospitalization, mechanical ventilation, and death. Multivariable logistic regression models, adjusted based on age, sex and previous comorbidities, were used to assess the effects of extremes in body weight status on clinical outcomes. RESULTS: A total of 1308 individuals were assessed (33.6% were elderly individuals). The univariable analyses showed that only hospitalization was more often observed among underweight (3.2% versus 1.2%) and overweight (68.1% versus 63.3%) individuals. In turn, cardiovascular diseases were more often observed in all clinical outcomes (hospitalization: 19.7% versus 4.8%; mechanical ventilation: 19.9% versus 13.5%; death: 21.8% versus 14.1%). Based on the multivariable analysis, body weight status was not associated with risk of hospitalization (underweight: odds ratio [OR]: 1.10; 95% confidence interval [CI] 95%, 0.50-2.41 and excess body weight: OR: 0.81; 95 CI, 0.57-1.14), mechanical ventilation (underweight: OR: 0.92; 95% CI, 0.52-1.62 and excess weight: OR: 0.90; 95% CI, 0.67-1.19), and death (underweight: OR: 0.61; 95% CI, 0.31-1.20 and excess body weight: OR 0.88; 95% CI, 0.63-1.23). CONCLUSIONS: Being underweight and excess body weight were not independently associated with clinical outcomes in patients with COVID-19 in the herein analyzed cohort. This finding indicates that the association between these variables may be confounded by both age and comorbidities.

Validation and cross-cultural adaptation of the Brazilian Portuguese version of the questionnaire for the assessment of pelvic floor disorders and their risk factors during pregnancy and postpartum.

INTRODUCTION AND HYPOTHESIS: Pelvic floor dysfunction may be treated and prevented during pregnancy and postpartum, as it decreases women's quality of life. The aim of the present study was to translate and validate the Brazilian Portuguese questionnaire for the assessment of pelvic floor disorders and their risk factors during pregnancy and postpartum. METHODS: This is a cross-sectional study. Two translators fluent in German translated the German version of the questionnaire into English. The back translation was performed by two other translators. The final version was tested on Brazilian pregnant/puerperal women. The participants answered the questionnaire twice, with an interval of 7-10 days between sessions. They also completed the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). To evaluate the test-retest reliability, we used the intraclass correlation coefficient (ICC), Cronbach's alpha coefficient, to test the internal consistency, and Pearson's linear correlation to assess construct validity. RESULTS: Sixty-six women were included (77% pregnant; 23% puerperal women), with a mean age of 26.5 ± 5.8 years and a body mass index of 26.4 ± 5.7 kg/cm2. There were no missing ceiling or floor effects. The construct validity presented a moderate correlation with the role physical domain of the SF-36 (r = -0.48), the ICC test-retest showed good reliability of 0.72, and the internal consistency was 0.71. CONCLUSIONS: These results provide evidence that the questionnaire for the assessment of pelvic floor disorders and their risk factors during pregnancy and postpartum is a valid and reliable instrument when utilized in Brazilian pregnant and postpartum women.