Evaluation of Hand Morphometry in Healthy Young Individuals from Different Countries / Evaluación de la Morfometría de la Mano en Individuos Jóvenes Sanos de Diferentes Países

SUMMARY: This study aims to examine the hand morphometry of healthy young individuals from different countries and investigate the differences between countries in typing of hand based on the morphometric values obtained. In the study, 16 different parameters, including two surface areas and 14 lengths, were measured from the right hand of 579 volunteers (250 females, 329 males) from 7 different countries (Turkey, Chad, Morocco, Gabon, Kazakhstan, Senegal and Syria). Factor analysis was performed on the parameters, cluster analysis was performed according to the factor score obtained, and the hand types in the study were determined. As a result of the study, four different hand types were defined, and the distribution of these types according to countries was analyzed. All parameters showed significant differences between countries in both genders (p<0.05). According to the results of the study, there was a difference between male and female hand types between countries. In females, the type 1 hand type was found only in Gabon, the type 2 hand type was found only in Senegal, the type 3 hand type was found in Turkey, Morocco and Kazakhstan, while the type 4 hand type was significantly distributed in Senegal and Gabon (X2 =104.62; df=18, p<0.05). In males, type 1 hand type was found in Turkey, type 2 hand type in Senegal and Gabon, type 3 hand type in Turkey, while type 4 hand type was significantly distributed in Morocco and Kazakhstan (X2 =76.964; df=18, p<0.05).

Este estudio tuvo como objetivo examinar la morfometría de la mano de individuos jóvenes sanos de diferentes países e investigar las diferencias en la mecanografía de la mano entre países en función de los valores morfométricos obtenidos. En el estudio, se midieron 16 parámetros diferentes, incluidas dos superficies y 14 longitudes, de la mano derecha de 579 voluntarios (250 mujeres, 329 hombres) de 7 países diferentes (Turquía, Chad, Marruecos, Gabón, Kazajstán, Senegal y Siria). Se realizó un análisis factorial de los parámetros, un análisis de conglomerados según la puntuación factorial obtenida y se determinaron los tipos de manos en el estudio. Como resultado, se definieron cuatro tipos diferentes de manos y se analizó la distribución de estos tipos según países. Todos los parámetros mostraron diferencias significativas entre países en ambos sexos (p<0,05). Según los resultados del estudio, hubo una diferencia entre los tipos de manos de los hombres y de las mujeres entre países. En las mujeres, el tipo de mano tipo 1 se encontró solo en Gabón, el tipo de mano tipo 2 se encontró solo en Senegal, el tipo de mano tipo 3 se encontró en Turquía, Marruecos y Kazajstán, mientras que la mano tipo 4 se distribuyó significativamente en Senegal y Gabón (X2=104,62; gl=18, p<0,05). En los hombres, el tipo de mano tipo 1 se encontró en Turquía, el tipo de mano tipo 2 en Senegal y Gabón, el tipo de mano tipo 3 en Turquía, mientras que la mano tipo 4 se distribuyó significativamente en Marruecos y Kazajstán (X2=76,964; gl=18, p <0,05).

Application of enhanced recovery after surgery for oral dryness prevention after endoscopic sinus surgery.

OBJECTIVE: To investigate the efficacy of cluster nursing intervention based on Enhanced Recovery After Surgery (ERAS) for xerostomia in chronic rhinosinusitis after nasal endoscopic surgery. METHODS: A total of 80 patients with chronic rhinosinusitis who underwent functional nasal endoscopic surgery between January 2020 and December 2021 were selected and randomly divided into a control group (n = 40) and an experimental group (n = 40). Patients in the control group were treated with general nursing, while ERAS-based cluster nursing intervention was adopted for the experimental group, in addition to general nursing. Xerostomia stage and comfort level were observed at 2 h, 6 h, 24 h and 48 h after surgery; negative emotions before and after nursing were also observed. RESULTS: After the intervention, the xerostomia stage and comfort level at 6, 24 and 48 after surgery were higher in the experimental group (p < 0.05). Negative emotions in the experimental group were lower after nursing (p < 0.001). The self-rating depression scale and self-rating anxiety scale scores increased after nursing in both two groups (p < 0.05). CONCLUSION: Enhanced recovery after surgery-based cluster nursing intervention can alleviate xerostomia, improve patients' comfort levels, reduce their negative emotions and accelerate postoperative recovery.

Seizure emergency code strategy: Improving treatment times and hospital outcomes for patients with urgent epileptic seizures.

OBJECTIVE: Timely treatment is one of the most relevant prognostic factors in patients with urgent epileptic seizures. Despite the available evidence, treatment times remain suboptimal. The aim of this study was to demonstrate the impact of the "seizure code" in an emergency department, focusing on both treatment times and hospital outcomes of patients with urgent epileptic seizures. METHODS: An ambispective cohort study was conducted in the emergency department of a public hospital in Bogotá, Colombia. Treatment times and hospital outcomes were evaluated both before and after the implementation of the seizure code. RESULTS: A total of 336 patients were included (94 in the pre-seizure code period and 242 in the post-seizure code period). Both cohorts were comparable in terms of clinical and demographic baseline characteristics. After the implementation of the seizure code, in-hospital treatment times improved among patients with status epilepticus and seizure cluster. For the group of patients with status epilepticus, the time from arrival to the first benzodiazepine decreased from a median of 100.5 min (IQR: 43-152.5) to a median of 20 min (IQR: 10-45) (p = .0063), and the time from arrival to the first non-benzodiazepine antiseizure medication decreased from a median of 155 min (IQR: 49-194) to a median of 39 min (IQR: 25-57) (p = .0071). For the group of patients with seizure cluster, the time from arrival to the first non-benzodiazepine antiseizure medication decreased from a median of 296 min (IQR: 112.5-409) to a median of 72 min (IQR: 46-111) (p < .001). The seizure code significantly decreased the risk of inappropriate benzodiazepine use (p = .0087), in-hospital seizure recurrence (p < .001), in-hospital mortality (p = .0074), and prolonged hospitalizations (more than 48 h) (p = .0475). SIGNIFICANCE: The seizure code shortens the time to treatment, reduces the length of hospital stay, decreases the risk of inappropriate benzodiazepine use, and lowers both the in-hospital seizure recurrence and in-hospital mortality among patients with urgent epileptic seizures.

Precision assessment of a hypertension prevalence survey.

BACKGROUND: Population surveys are crucial for public policy planning and provide valuable representative data. In the health sector studies to identify and assess the prevalence of Arterial Hypertension (AH), a chronic non-communicable disease (NCD), along with its associated risk factors have been conducted. OBJECTIVES: This study aims to assess the effectiveness of a population health survey in estimating the prevalence of arterial hypertension (AH) in the Sorocaba municipality between August 2021 and June 2023. METHODS: The analyzed performance indicator is the precision (design effect - deff) of AH prevalence in adults (≥ 18 years) and their exposure to primary risk factors. The total sample included 1,080 individuals from the urban area, deemed sufficient to estimate a deff of 1.5. This cluster-based study utilized census sectors as clusters, with data collected through household interviews, standardized questionnaires, and measurements of blood pressure and biometric parameters. The deff calculation formula used was weighted variance / raw variance. The Research Ethics Committee approved this study, with registration CAAE 30538520-1-0000-5373. RESULTS: The deff values ranged from 0.44 for chronic obstructive pulmonary disease to 1.63 for asthma, with a deff of 1.00 for AH prevalence. CONCLUSION: The study demonstrated good precision in its results, with high receptivity and cooperation from participants. The cost-effectiveness of the research deemed appropriate. The technique of selecting households within clusters (census sectors) based on detailed mapping and demographic data from the Instituto Brasileiro de Geografia e Estatística (IBGE) proved to be practical and efficient, suitable for replication in other municipalities and for studying other NCDs.

Claw lesion status in Brazilian commercial sow herds from 2013 to 2023.

Introduction: Claw lesions significantly contribute to lameness, greatly affecting sow welfare. This study investigated different factors that would impact the severity of claw lesions in the sows of Brazilian commercial herds. Methods: A total of 129 herds (n = 12,364 sows) were included in the study. Herds were in the Midwest, Southeast, or South regions of Brazil. Inventory sizes were stratified into 250-810 sows, 811-1,300 sows, 1,301-3,000 sows, and 3,001-10,000 sows. Herds belonged to Cooperative (Coop), Integrator, or Independent structures. The herd management was conducted either maintaining breeds from stock on-site (internal), or through purchase of commercially available genetics (external). Herds adopted either individual crates or group housing during gestation. Within each farm, one randomly selected group of sows was scored by the same evaluator (two independent experts evaluated a total of 129 herds) from 0 (none) to 3 (severe) for heel overgrowth and erosion (HOE), heel-sole crack (HSC), separation along the white line (WL), horizontal (CHW) and vertical (CVW) wall cracks, and overgrown toes (T), or dewclaws (DC) in the hind legs after parturition. The study assessed differences and similarities between herds using Principal Component Analysis (PCA) and Hierarchical Agglomerative Clustering (HAC) analysis. The effects of factors (i.e., production structure, management, housing during gestation, and region) were assessed using the partial least squares method (PLS). Results and discussion: Heel overgrowth and erosion had the highest prevalence, followed by WL and CHW, while the lowest scores were observed for T, DC, and CVW. Herds were grouped in three clusters (i.e., C1, C2, and C3). Heel overgrowth and erosion, HSC, WL, CHW, CVW, and T were decreased by 17, 25, 11, 25, 21, and 17%, respectively, in C3 compared to C1 and 2 combined. Independent structure increased the L-Index in all three clusters. Furthermore, individual housing increased the L-Index regardless of the cluster. The results suggest that shifting toward larger, more technologically advanced herds could potentially benefit claw health. Additionally, adopting group gestation housing appears to mitigate the adverse effects on claw health, although further validation is necessary, as Brazil has only recently transitioned from individual housing practices.

Ab initio investigation of the geometrical behavior in solution and electronic structure of the anion complexes [bis(1,3-dithiole-2-thione-4,5-dithiolate)M], for M = Bi(III), Sb(III), and Zn(II).

CONTEXT: 1,3-Dithiole-2-thione-4,5-dithiolate (dmit) ligands are known for their conductive and optical properties. Dmit compounds have been assessed for use in sensor devices, information storage, spintronics, and optical material applications. Associations with various metallic centers endow dmit complexes with magnetic, optical, conductive, and antioxidant properties. Optical doping can facilitate the fabrication of magnetic conductor materials from ground-state nonmagnetic cations. While most studied complexes involve transition-metal centers due to their diverse chemistry, compounds with representative elements are less explored in the literature. This study investigated the structural and electronic properties of bisdmit complexes with representative Bi(III), Sb(III), and Zn(II) cations. AIMD calculations revealed two new geometries for Bi(III) and Zn(II) complexes, diverging from the isolated geometry typically used in quantum chemical calculations. The coordination of acetonitrile molecules to the cationic centers of the complexes resulted in unstable structures, while the dimerization of the complexes was stable. SA-CASSCF/NEVPT2 calculations were applied to the structures of the isolated complexes and stable dimers, confirming the multireference character of the electronic structure of the three systems and the multiconfigurational character of the Bi(III) complex. The electronic spectra simulated by the STEOM-DLPNO-CCSD calculations accurately reproduced the experimental UV‒Vis spectra indicating the participation of the isolated Bi(III) dmit complex and its dimeric form in solution. METHODOLOGY: AIMD calculations of the dmit salts were conducted using the GFN2-xTB method with 60 explicit acetonitrile molecules as the solvent at 300 K for a total simulation time of 50.0 ps, with printing intervals of 0.5 fs. The final geometries were optimized employing the PBEh-3c compound method, incorporating implicit conductor-like polarizable continuum model (CPCM) solvation for acetonitrile. Local energy decomposition (LED) analysis at the DLPNO-CCSD(T)/Def2-TZVP level of theory was utilized to investigate the stability of the complex geometries identified by AIMD. The electronic structures of the complexes were assessed using the SA-CASSCF/NEVPT2/Def2-TZVP method to confirm the multiconfigurational and multireference nature of their electronic structures. Electronic spectra were analyzed using the STEOM-DLPNO-CCSD/Def2-TZVP method, with CPCM used to simulate an acetonitrile medium.

Exploration of Free Energy Surface of the Au10 Nanocluster at Finite Temperature.

The first step in comprehending the properties of Au10 clusters is understanding the lowest energy structure at low and high temperatures. Functional materials operate at finite temperatures; however, energy computations employing density functional theory (DFT) methodology are typically carried out at zero temperature, leaving many properties unexplored. This study explored the potential and free energy surface of the neutral Au10 nanocluster at a finite temperature, employing a genetic algorithm coupled with DFT and nanothermodynamics. Furthermore, we computed the thermal population and infrared Boltzmann spectrum at a finite temperature and compared it with the validated experimental data. Moreover, we performed the chemical bonding analysis using the quantum theory of atoms in molecules (QTAIM) approach and the adaptive natural density partitioning method (AdNDP) to shed light on the bonding of Au atoms in the low-energy structures. In the calculations, we take into consideration the relativistic effects through the zero-order regular approximation (ZORA), the dispersion through Grimme's dispersion with Becke-Johnson damping (D3BJ), and we employed nanothermodynamics to consider temperature contributions. Small Au clusters prefer the planar shape, and the transition from 2D to 3D could take place at atomic clusters consisting of ten atoms, which could be affected by temperature, relativistic effects, and dispersion. We analyzed the energetic ordering of structures calculated using DFT with ZORA and single-point energy calculation employing the DLPNO-CCSD(T) methodology. Our findings indicate that the planar lowest energy structure computed with DFT is not the lowest energy structure computed at the DLPN0-CCSD(T) level of theory. The computed thermal population indicates that the 2D elongated hexagon configuration strongly dominates at a temperature range of 50-800 K. Based on the thermal population, at a temperature of 100 K, the computed IR Boltzmann spectrum agrees with the experimental IR spectrum. The chemical bonding analysis on the lowest energy structure indicates that the cluster bond is due only to the electrons of the 6 s orbital, and the Au d orbitals do not participate in the bonding of this system.

Phaseolotoxin: Environmental Conditions and Regulatory Mechanisms Involved in Its Synthesis.

Phaseolotoxin is an antimetabolite toxin produced by diverse pathovars of Pseudomonas syringae which affects various plants, causing diseases of economic importance. Phaseolotoxin contributes to the systemic dissemination of the pathogen in the plant, therefore it is recognized as a major virulence factor. Genetic traits such as the Pht cluster, appear defining to the toxigenic strains phaseolotoxin producers. Extensive research has contributed to our knowledge concerning the regulation of phaseolotoxin revealing a complex regulatory network that involves processes at the transcriptional and posttranscriptional levels, in which specific and global regulators participate. Even more, significant advances in understanding how specific signals, including host metabolites, nutrient sources, and physical parameters such as the temperature, can affect phaseolotoxin production have been made. A general overview of the phaseolotoxin regulation, focusing on the chemical and physical cues, and regulatory pathways involved in the expression of this major virulence factor will be given in the present work.

Long COVID Clusters of Symptoms Persist beyond Two Years after Infection: Insights from the CARDIO COVID 20-21 Registry.

Long COVID presents with diverse symptoms after COVID-19. Different clusters of symptoms have been reported; however, their persistence beyond 2 years after COVID-19 remains unclear. In this cohort study, we prospectively evaluated individuals with previous severe COVID-19 presenting with long COVID at a two-year follow-up. We characterized the included patients and performed a cluster analysis of symptoms through multiple correspondence analysis and hierarchical clustering. A total of 199 patients with long COVID were included. The median age was 58 years (48-69), 56% were male, and the median follow-up time since the COVID-19 diagnosis was 26 months (IQR: 25, 27). Three symptom clusters were identified: Cluster 1 is characterized by fatigue, myalgia/arthralgia, a low prevalence of symptoms, and a lack of specific symptoms; Cluster 2 is defined by a high prevalence of fatigue, myalgia/arthralgia, and cardiorespiratory symptoms, including palpitations, shortness of breath, cough, and chest pain; and Cluster 3 is demonstrated a high prevalence of ageusia, anosmia, fatigue, and cardiorespiratory symptoms. Our study reinforces the concept of symptom clustering in long COVID, providing evidence that these clusters may persist beyond two years after a COVID-19 diagnosis. This highlights the chronic and debilitating nature of long COVID and the importance of developing strategies to mitigate symptoms in these patients.

Biosynthesis of Arcyriaflavin F from Streptomyces venezuelae ATCC 10712.

Indolocarbazoles are natural products with broad bioactivities. A distinct feature of indolocarbazole biosynthesis is the modification of the indole and maleimide rings by regioselective tailoring enzymes. Here, we study a new indolocarbazole variant, which is encoded by the acfXODCP genes from Streptomyces venezuelae ATCC 10712. First we characterise this pathway by expressing the acfXODCP genes in Streptomyces coelicolor, which led to the production of a C-5/C-5'-dihydroxylated indolocarbazole. We assign as a new product arcyriaflavin F. Second, we demonstrate the flavin-dependent monooxygenase AcfX catalyses the C-5/C-5' dihydroxylation of the unsubstituted arcyriaflavin A into arcyriaflavin F. Interestingly, AcfX shares homology to EspX from erdasporine A biosynthesis, which instead catalyses a single C-6 indolocarbazole hydroxylation. In summary, we report a new indolocarbazole biosynthetic pathway and a regioselective C-5 indole ring tailoring enzyme AcfX.

Antibacterial activity and biosynthetic potential of Streptomyces sp. PBR19, isolated from forest rhizosphere soil of Assam.

An Actinomycetia isolate, designated as PBR19, was derived from the rhizosphere soil of Pobitora Wildlife Sanctuary (PWS), Assam, India. The isolate, identified as Streptomyces sp., shares a sequence similarity of 93.96% with its nearest type strain, Streptomyces atrovirens. This finding indicates the potential classification of PBR19 as a new taxon within the Actinomycetota phylum. PBR19 displayed notable antibacterial action against some ESKAPE pathogens. The ethyl acetate extract of PBR19 (EtAc-PBR19) showed the lowest minimum inhibitory concentration (MIC) of ≥ 0.195 µg/mL against Acinetobacter baumannii ATCC BAA-1705. A lower MIC indicates higher potency against the tested pathogen. Scanning electron microscope (SEM) findings revealed significant changes in the cytoplasmic membrane structure of the pathogen. This suggests that the antibacterial activity may be linked to the disruption of the microbial membrane. The predominant chemical compound detected in the EtAc-PBR19 was identified as phenol, 3,5-bis(1,1-dimethylethyl), comprising 48.59% of the area percentage. Additionally, PBR19 was found to contain the type II polyketide synthases (PKS type II) gene associated with antibiotic synthesis. The predicted gene product of PKSII was identified as the macrolide antibiotic Megalomicin A. The taxonomic distinctiveness, potent antibacterial effects, and the presence of a gene associated with antibiotic synthesis suggest that PBR19 could be a valuable candidate for further exploration in drug development and synthetic biology. The study contributes to the broader understanding of microbial diversity and the potential for discovering bioactive compounds in less-explored environments.

Recognizing Patterns of Nature Contact Associated with Well-Being: An Exploratory Cluster Analysis.

Statement of Problem: Progressive urbanization has reduced human interactions with nature, raising concerns about its impact on mental well-being. Previous research has often focused on specific aspects of nature contact, neglecting its multifaceted dimensions and their effects on mental health, particularly in developing countries. Research Gap: There is a scarcity of studies exploring the comprehensive dimensions of nature contact, such as frequency, duration, intensity, and space naturalness, and their correlation with mental well-being in developing countries' urban settings. Purpose: This study aims to identify patterns of nature contact related to mental well-being in metropolitan areas of Brazil using exploratory cluster analysis, bridging the existing knowledge gap and informing targeted interventions to enhance mental health through nature contact. Method: An online survey collected data from 2136 participants in Brazil's metropolitan areas, focusing on their nature interaction patterns and mental health status using the Depression Anxiety and Stress Scale (DASS-21), hierarchical clustering with p-values via multiscale bootstrap resampling, and analysis of variance. Results and Conclusions: Three distinct groups were identified, showing varied patterns of nature contact and demographic profiles. Greater and more frequent nature contact was associated with lower levels of depression, anxiety, and stress. These findings suggest a beneficial relationship between nature contact and mental well-being. Practical Implications: The results underline the importance of urban planning and public health policies that facilitate access to natural spaces, highlighting socioeconomic factors as significant barriers to this access. Future Directions: Further research should explore causal relationships and consider the specific realities and challenges faced by residents of developing nations.

Prevalence of the Double Burden of Malnutrition among Adolescents: Associations with Lifestyle Behaviors and Clusters of Social Determinants.

The double burden of malnutrition (DBM) is a condition in which malnutrition coexists with overweight, reflecting a new layer of malnutrition. Our objectives were to assess prevalence; test associations between DBM and 24-hour movement behaviors; and investigate whether DBM is associated with clusters of social determinants. Methods: This multicenter cross-sectional study included 1152 adolescents (12 to 17 years old) from four Brazilian cities. Body mass index (BMI, kg/m2) was used to estimate overweight, and the adopted cutoff points took into account the curves established for age and sex: Z-score > 1 and ≤2 (overweight) and Z-score > 2 (obesity). The serum concentration of 25-hydroxyvitamin D [25(OH)D] was stratified into three levels: vitamin D deficiency ≤ 20 ng/mL; vitamin D insufficiency = 21-29 ng/mL; optimal vitamin D ≥ 30 ng/mL. We used multilevel Poisson regression models to estimate prevalence ratios (PRs) and their respective 95% confidence intervals (95%CI) and to analyze the association between DBM and covariates. A significance level of p < 0.05 was considered. Cluster analyses were performed by applying a combination of hierarchical and non-hierarchical methods. Results: A population prevalence of DBM of 7.3% (95% CI: 5.9-8.9) was revealed. A percentage of 19.2% (95% CI: 17.0-21.6) of adolescents were overweight, and 8.3% (95% CI: 6.8-10.1) were obese. A total of 41.5% (95% CI: 38.7-44.4) had vitamin D deficiency, and 25.8% (95% CI: 23.4-28.4) had vitamin D insufficiency. However, 24-hour movement behaviors were not associated with DBM. Adolescents living in the southern region of the country, from public schools whose mothers have higher education, have a 1.94 [PR = 2.94 (95% CI: 1.20-7.23)] times greater chance of developing DBM. These results highlight the importance of specific factors to improve the nutritional health of adolescents, considering the specific social determinants identified in this study.

Bruton's tyrosine kinase inhibitors in primary central nervous system lymphoma: New hopes on the horizon.

In this editorial, we comment on the article by Wang et al. This manuscript explores the potential synergistic effects of combining zanubrutinib, a novel oral inhibitor of Bruton's tyrosine kinase, with high-dose methotrexate (HD-MTX) as a therapeutic intervention for primary central nervous system lymphoma (PCNSL). The study involves a retrospective analysis of 19 PCNSL patients, highlighting clinicopathological characteristics, treatment outcomes, and genomic biomarkers. The results indicate the combination's good tolerance and strong antitumor activity, with an 84.2% overall response rate. The authors emphasize the potential of zanubrutinib to modulate key genomic features of PCNSL, particularly mutations in myeloid differentiation primary response 88 and cluster of differentiation 79B. Furthermore, the study investigates the role of circulating tumor DNA in cerebrospinal fluid for disease surveillance and treatment response monitoring. In essence, the study provides valuable insights into the potential of combining zanubrutinib with HD-MTX as a frontline therapeutic regimen for PCNSL. The findings underscore the importance of exploring alternative treatment modalities and monitoring genomic and liquid biopsy markers to optimize patient outcomes. While the findings suggest promise, the study's limitations should be considered, and further research is needed to establish the clinical relevance of this therapeutic approach for PCNSL.

Cluster analysis in fibromyalgia: a systematic review.

BACKGROUND: The multifaceted nature of Fibromyalgia syndrome (FM) symptoms has been explored through clusters analysis. OBJECTIVE: To synthesize the cluster research on FM (variables, methods, patient subgroups, and evaluation metrics). METHODS: We performed a systematic review following the PRISMA recommendations. Independent searches were performed on PubMed, Embase, Web of Science, and Cochrane Central, employing the terms "fibromyalgia" and "cluster analysis". We included studies dated to January 2024, using the cluster analysis to assess any physical, psychological, clinical, or biomedical variables in FM subjects, and descriptively synthesized the studies in terms of design, cluster method, and resulting patient profiles. RESULTS: We included 39 studies. Most with a cross-sectional design aiming to classify subsets based on the severity, adjustment, symptomatic manifestations, psychological profiles, and response to treatment, based on demographic and clinical variables. Two to four different profiles were found according to the levels of severity and adjustment to FMS. According to symptom manifestation, two to three clusters described the predominance of pain versus fatigue, and thermal pain sensitivity (less versus more sensitive). Other clusters revealed profiles of personality (pathological versus non-pathological) and psychological vulnerability (suicidal ideation). Additionally, studies identified different responses to treatment (pharmacological and multimodal). CONCLUSION: Several profiles exist within FMS population, which point out to the need for specific treatment options given the different profiles and an efficient allocation of healthcare resources. We notice a need towards more objective measures, and the validation of the cluster results. Further research might investigate some of the assumptions of these findings, which are further discussed in this paper.

Influence of psychometric and sleep quality features on painful mechanical sensitivity and pain modulation in patients with temporomandibular disorders.

Investigating the collective impact of psychometric properties and sleep quality on pain sensitivity in temporomandibular disorder (TMD) patients could improve clinical management strategies. OBJECTIVE: Assessing whether combined psychometric properties and sleep quality impact painful mechanical sensitivity and pain modulation in TMD patients. MATERIALS AND METHODS: A cross-sectional study using secondary data analysis of 77 TMD patients and 101 controls. All participants completed questionnaires characterizing their psychometric profile (anxiety, depression, stress and catastrophizing) and sleep quality, alongside psychophysical tests for painful mechanical sensory (mechanical pain threshold (MPT), pressure pain threshold (PPT), and wind-up ratio (WUR)) and conditioned pain modulation (CPM). Participants were grouped into "High distress" or "Low distress" categories based on psychometric properties and sleep quality using hierarchical cluster and k-means analyses. Multiple linear regression evaluated the influence of TMD, age, and the distress cluster on MPT, WUR, PPT, and CPM in masseter and thenar muscles. Differences were statistically significant when p < 0.05. RESULTS: The presence of TMD was the strongest predictor of mechanical painful sensitivity in the trigeminal region (MPT[F(3,174) = 51.902;p < .001;R2 = .463]; TMD presence (ß = -.682) / PPT[F(3,174) = 15.573;p < .001;R2 = .198] TMD presence (ß = -.452), and extra-trigeminal (MPT[F(3,174) = 35.897;p < .001;R2 = .382] TMD (ß = -.647) / CPM [F(3,174) = 4.106;p < .05;R2 = .050] TMD presence (ß = .197). Furthermore, neither the high distress group nor the low distress group were able to significantly influence the variation of the values of any of the psychophysical variables evaluated (p > .05). CONCLUSIONS: There is not a significant influence of impairment clusters based on psychological variables and sleep quality on painful mechanical sensitivity and pain modulation, regardless of the presence of TMD. CLINICAL RELEVANCE: This outcome suggests that psychosocial factors and sleep quality may not play a decisive role in the sensory-discriminative aspect of pain, particularly concerning painful TMD.

Do aluminum (Al)-hyperaccumulator and phosphorus (P)-solubilising species assist neighbouring plants sensitive to Al toxicity and P deficiency?

We aimed to evaluate the facilitation effects of an aluminum (Al) hyperaccumulator species bearing cluster roots, Gevuina avellana, on the seedling growth and performance of an Al-intolerant and phosphorus (P)-deficient-sensitive plant, Vaccinium corymbosum. For this, seedlings of G. avellana and V. corymbosum were grown alone or together as follows: i) two G. avellana seedlings, ii) one G. avellana + one V. corymbosum and iii) two V. corymbosum, in soil supplemented with Al (as Al2(SO4)3) and in the control (without Al supplementation). We determined relative growth rate (RGR), photosynthetic rate, chlorophyll concentration, lipid peroxidation and Al and nutrient concentration [Nitrogen (N), P, potassium (K), calcium (Ca), magnesium (Mg), sodium (Na), manganese (Mn), iron (Fe), copper (Cu), zinc (Zn), and sulfur (S)] in leaves and roots of both species. The results showed that, in general, G. avellana did not assist V. corymbosum to enhance its RGR nor reduce its Al uptake. However, G. avellana assisted V. corymbosum in enhanced N acquisition and, consequently, to increase its chlorophyll concentration and photosynthetic rate. Besides, V. corymbosum had lower lipid peroxidation in leaves when grown in the soil with high Al supplementation in association with G. avellana. Our results suggest a facilitating effect of G. avellana to V. corymbosum when grown in soils with high Al concentration, by enhancing chlorophyll concentrations and photosynthetic rate, and decreasing the oxidative damage to lipids.

Healthy Life Habits in Caregivers of Children in Vulnerable Populations: A Cluster Analysis.

Intervention programs aimed at mitigating the effects of chronic noncommunicable disease (CNDs) focus on promoting healthy lifestyle habits (HLH), especially in the early stages of life. Because of this, different typologies of caregivers have been identified according to HLH during middle childhood and adolescence. However, the available studies have focused on aspects such as nutrition, physical activity, and rest, ignoring other HLHs that are equally important for children's well-being. Likewise, few studies address HLH during the first five years of life and how caregivers affect children's health. In a sample of 544 caregivers of children aged zero to five years from low-income Colombian communities, we established a typology of attitudes toward different HLHs. The results indicate the presence of three clusters that grouped caregivers with (1) positive attitudes toward all HLHs, (2) toward some HLHs, and (3) relatively low positive attitudes toward all HLHs. Membership in clusters with less positive attitudes toward HLHs was also found to be associated with low educational levels and living in rural areas. This study detected profiles of caregivers who may have unhealthy lifestyles, so the results would allow social workers to design differential interventions on HLHs in non-industrialized countries.

High-Risk Areas for Congenital Zika Syndrome in Rio de Janeiro: Spatial Cluster Detection.

Brazil reported 18,282 suspected congenital Zika syndrome (CZS) cases up to 2018 and accounts for 61.4% of the total reported Zika cases in the Americas in the period. To detect high-risk areas for children with CZS in the city of Rio de Janeiro, we used cluster detection and thematic maps. We analyzed data using a Poisson model in Satscan 10.1.3 software. We also analyzed the records of children with CZS from 2015 to 2016 to describe the clinical and epidemiological maternal and child profile, as well as live births in 2016 and the social development index (SDI) by neighborhood. In 2015 and 2016, the incidence rates of CZS were 8.84 and 46.96 per 100,000 live births in the city, respectively. Severe congenital findings such as microcephaly and brain damage, osteoarticular impairment, ocular abnormalities, and hearing loss were observed in 47 children. The spatial distribution of CZS was concentrated in the north and west zones in heterogeneous neighborhoods. The neighborhoods with the highest occurrence of CZS cases were found to have the worst SDIs. Stascan detected three spatial clusters in the north zone, where the SDI is lower. The clusters presented high relative risks for CZS (7.86, 1.46, and 2.08), although they were not statistically significant. Our findings highlight a higher occurrence of CZS in areas with less favorable socioeconomic conditions.

Spatiotemporal Evolution of the Yellow Fever Epidemic in Southeast Brazil from 2016 to 2019.

Background: Yellow fever (YF) is a zoonotic disease transmitted by mosquitoes among humans and nonhuman primates. Although urban YF is eradicated, the sylvatic YF has reemerged in some areas of Brazil in the twenty-first century. From 2016 to 2019, a sylvatic YF epidemic occurred in Southeast Brazil, where it had been eradicated in the 1940s. Methods: This study's objective was to describe the epidemic in the states of the Southeast region, based on descriptive, cluster, and mobility analyses. Results: Both the descriptive and cluster analyses showed that the YF cases spread from the state of Minas Gerais southward, causing peaks in cases during the summer months. None of the state capitals was included in the clusters, but the connectivity between the municipalities in Greater Metropolitan São Paulo highlighted potential paths of spread. Despite differences in sociodemographic profiles between the Southeast and North of Brazil (the latter region considered endemic), the epidemiological profile was similar, except for patients' occupation, which was not related to rural work in the Southeast. Conclusion: The results contributed to our understanding of the paths by which YF spread across Southeast Brazil and the epidemiological profile in an area that had gone decades without autochthonous cases.