An Analysis of Drug-Related Problems in the Neurology Ward of a Tertiary Teaching Hospital: A Cross-Sectional Study.

Background and objective Drugs that act on the central nervous system have a high potential to cause drug-related problems (DRPs). A clinical pharmacist aided by collaborative efforts within an interdisciplinary healthcare team can prevent, detect, and resolve DRPs, thereby contributing to the promotion of medication safety and improving the quality of life of individuals under care. This study aimed to assess DRPs identified in the neurology ward of a tertiary hospital from February 2016 to November 2019. Methods This was a descriptive study with a cross-sectional and retrospective design involving secondary data collected from pharmaceutical care (PC) records. Student's t-tests, Pearson correlation coefficients, Poisson models, and logistic regression models were used to analyze the associations between age, number and type of medications, duration of hospitalization, and the occurrence of DRPs. Results A total of 130 patients were included in the study, and a total of 266 DRPs were detected, with 93 patients experiencing more than one DRP and 37 not presenting any DRPs. Necessity-related DRPs were the most prevalent (46.6%) type, followed by safety-related DRPs (28.6%). The prevalence of safety-related DRPs was higher in individuals older than 60 years (p<0.001). Conclusions Of note, 84.6% of the interventions suggested by pharmacists to resolve DRPs were accepted by the healthcare team. The high number of DRPs found underscores the importance of the clinical role of the pharmacist and interprofessional collaboration in the care of neurological patients, especially in the pharmaceutical follow-up of elderly individuals.

The Efficacy of Topical or Systemic Antibiotics as Adjuvants to Non-Surgical Periodontal Treatment in Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Background: Periodontitis and diabetes mellitus (DM) exhibit a bidirectional relationship and are globally significant systemic chronic conditions. The utilization of antibiotics alongside non-surgical periodontal treatment (NSPT) has been a subject of investigation in numerous clinical studies involving human subjects. Thus, the objective of this systematic review is to address the following question: "What is the efficacy of scaling and root planing (SRP) associated with antimicrobials in patients with type 2 DM and periodontitis?". Methods: A systematic review of the literature was conducted encompassing databases such as MEDLINE/PubMed, Scopus, and Web of Science up to July 2024. Additionally, alerts were configured to capture studies published from the initial search until manuscript submission. Randomized clinical trials assessing clinical periodontal parameters in DM patients undergoing SRP and receiving either topical or systemic antibiotics were compared against a control group (SRP only). Two investigators independently screened articles, extracted data, and evaluated their quality. The selection process, study characteristics, risk of bias, impact of antibiotics on clinical parameters, and certainty of evidence were elucidated in both textual and tabular formats. Meta-analysis was performed separately with forest plots generated for treatment modalities, period of evaluation, and type of antibiotics used. Results: Following the analysis of abstracts and full articles, a total of 30 randomized clinical trials were incorporated into this review, comprising 9 studies on the association of topical antibiotics and 21 studies on systemic antibiotic administration. The principal periodontal parameters assessed included probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI), and bleeding on probing (BoP). Conclusions: Analysis of the results led to the conclusion that adjunctive periodontal treatment with either topical or systemic antibiotics confers subtle clinical benefits. Nevertheless, owing to the heightened emergence of resistant bacteria and potential side effects, the use of antibiotic therapy in periodontal treatment should be judiciously administered.

Assessing Carbohydrate Counting Accuracy: Current Limitations and Future Directions.

Diabetes mellitus is a prevalent chronic autoimmune disease with a high impact on global health, affecting millions of adults and resulting in significant morbidity and mortality. Achieving optimal blood glucose levels is crucial for diabetes management to prevent acute and long-term complications. Carbohydrate counting (CC) is widely used by patients with type 1 diabetes to adjust prandial insulin bolus doses based on estimated carbohydrate content, contributing to better glycemic control and improved quality of life. However, accurately estimating the carbohydrate content of meals remains challenging for patients, leading to errors in bolus insulin dosing. This review explores the current limitations and challenges in CC accuracy and emphasizes the importance of personalized educational programs to enhance patients' abilities in carbohydrate estimation. Existing tools for assessing patient learning outcomes in CC are discussed, highlighting the need for individualized approaches tailored to each patient's needs. A comprehensive review of the relevant literature was conducted to identify educational programs and assessment tools dedicated to training diabetes patients on carbohydrate counting. The research aims to provide insights into the benefits and limitations of existing tools and identifies future research directions to advance personalized CC training approaches. By adopting a personalized approach to CC education and assessment, healthcare professionals can empower patients to achieve better glycemic control and improve diabetes management. Moreover, this review identifies potential avenues for future research, paving the way for advancements in personalized CC training and assessment approaches and further enhancing diabetes management strategies.

Portal thrombosis after surgical treatment of schistosomatic portal hypertension.

OBJECTIVE: Several studies have investigated the correlation between the effects of different surgical treatments and laboratory exams for schistosomal portal hypertension, especially concerning portal system thrombosis. The etiopathogenic factors of this thrombosis are not fully understood. In this study, the correlation between surgical treatment for schistosomal portal hypertension and the occurrence of postoperative portal system thrombosis was investigated. METHODS: A total of 61 patients who underwent surgical treatment for schistosomal portal hypertension were distributed into four groups: Patients in Group 1 (n=12) underwent portal variceal disconnection associated with splenic artery ligation and spleen preservation. Patients in Group 2 (n=20) underwent portal variceal disconnection and total splenectomy. Patients in Group 3 (n=20) underwent portal variceal disconnection with subtotal splenectomy, preserving the upper splenic pole supplied by the splenogastric vessels. Patients in Group 4 (n=9) underwent portal variceal disconnection with total splenectomy and autogenous splenic implants on the greater omentum. Late postoperative portal vein thrombosis was diagnosed using Doppler ultrasound. RESULTS: Over the 10-year follow-up, portal vein thrombosis occurred in 26 operated patients (42.6%), with no significant difference observed among the four surgical groups (p=0.217). Most of the thrombi only partially occluded the portal system veins. All the patients presented with a thrombus inside the portal vein. There was no difference in hematological and biochemical tests between groups with or without portal vein thrombosis. CONCLUSIONS: Portal vein thrombosis is often observed in the late postoperative period, irrespective of the surgical treatment employed, and is not associated with patient characteristics or any hematological and biochemical tests.

Aerobic Exercise in the Aquatic Environment Suppresses the Plasma Renin Activity in Individuals with Type 2 Diabetes: A Secondary Analysis of a Randomized Clinical Trial.

To compare the acute effects of aquatic walking/running versus dry-land walking/running on blood glucose and plasma renin activity (PRA) in individuals with type 2 diabetes, participants with type 2 diabetes performed deep-water or dry-land walking and/or running sessions in a swimming pool or on an athletics track, respectively. Both sessions comprised seven blocks of 3 min at 85-90% of the heart rate deflection point (HRDP), interspersed with 2 min at <85% HRDP, totaling 35 min, with a 48 h interval between sessions. PRA and blood glucose were assessed before and immediately after the sessions. Generalized estimation equations were used to verify the session effects, with the Bonferroni post hoc test, considering the significance level as 0.05. Twelve individuals (53.2 ± 8.9 years) diagnosed with type 2 diabetes for 6.3 ± 6.34 years participated in the study. A reduction in PRA was found only after the aquatic session (-7.75 ng/mL/h; -69%; p: 0.034), while both aquatic and dry-land sessions similarly reduced the blood glucose levels (aquatic: -38 mg/dL, -21%; dry-land: -26 mg/dL, -14%; time effect, p = 0.007). Despite yielding similar glycemic reductions as dry-land walking/running, aquatic walking/running led to an expressive decrease in PRA among individuals with type 2 diabetes.

Immunological Activity of Vaccine Systems Containing Liposomal Nanocarriers against Protozoan-Induced Diseases: A Systematic Review.

BACKGROUND: Neglected parasitic diseases constitute a broad spectrum of clinical conditions that, in the chronic phase, lack effective therapies for the target population. The utilization of vaccines based on liposomal nanocarrier systems is emerging, thereby enhancing clinical outcomes in various comorbidities. Consequently, this study aims to assess the immunological activity induced by liposomal nanocarriers against neglected parasitic diseases. METHODS: For the review, the Pubmed, Embase, and Lilacs databases were used using the descriptors vaccine, parasite, and liposome. The following inclusion criteria were adopted: in vivo and in vitro experimental articles. As exclusion criteria: book chapters, editorials, literature reviews and duplicate articles found during the database search. RESULTS: A total of 226 articles were identified, from which 34 were selected for review. The primary diseases identified included Babesia bovis, Entamoeba histolytica, Leishmania braziliensis, Leishmania donovani, Leishmania major, Leishmania infantum, Plasmodium falciparum, Plasmodium chabaudi, Plasmodium chabaudi, Plasmodium yoelii, Toxoplasma gondii and Trypanosoma cruzi. An elevation in cytokines such as GM-CSF, MCP-1, INF-γ, TNF-α, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12, and IL-17 was observed in the studies evaluated regarding the parasitic diseases. Furthermore, cytokines such as IL-4, IL-10, and TGF-ß were diminished with the administration of the vaccine systems in those studies. CONCLUSION: Therefore, the administration of liposomal nanovaccine systems can effectively ameliorate the clinical condition of patients by modulating their immunological profile.

Impact of a legumes diet on the human gut microbiome articulated with fecal and plasma metabolomes: A pilot study.

BACKGROUND & AIMS: Legumes intake is known to be associated with several health benefits the origins of which is still a matter of debate. This paper addresses a pilot small cohort to probe for metabolic aspects of the interplay between legumes intake, human metabolism and gut microbiota. METHODS: Untargeted nuclear magnetic resonance (NMR) metabolomics of blood plasma and fecal extracts was carried out, in tandem with qPCR analysis of feces, to assess the impact of an 8-week pilot legumes diet intervention on the fecal and plasma metabolomes and gut microbiota of 19 subjects. RESULTS: While the high inter-individual variability hindered the detection of statistically significant changes in the gut microbiome, increased fecal glucose and decreased threonine levels were noted. Correlation analysis between the microbiome and fecal metabolome lead to putative hypotheses regarding the metabolic activities of prevalent bacteria groups (Clostridium leptum subgroup, Roseburia spp., and Faecalibacterium prausnitzii). These included elevated fecal glucose as a preferential energy source, the involvement of valerate/isovalerate and reduced protein degradation in gut microbiota. Plasma metabolomics advanced mannose and betaine as potential markers of legume intake and unveiled a decrease in formate and ketone bodies, the latter suggesting improved energy utilization through legume carbohydrates. Amino acid metabolism was also apparently affected, as suggested by lowered urea, histidine and threonine levels. CONCLUSIONS: Despite the high inter-individual gut microbiome variability characterizing the small cohort addressed, combination of microbiological measurements and untargeted metabolomics unveiled several metabolic effects putatively related to legumes intake. If confirmed in larger cohorts, our findings will support the inclusion of legumes in diets and contribute valuable new insight into the origins of associated health benefits.

Combined Percutaneous and Endoscopic Ureterolithotripsy of Calcified Double J Stent.

In urological practice, the routine procedure of placing a double J stent aims to facilitate drainage of the upper urinary system. Despite its temporary nature and the necessity for timely removal, approximately 12% of these stents are retained in patients for extended durations due to various reasons. Forgotten ureteral stents can lead to complications that increase the morbidity and mortality of patients. This report discusses a case of the double J stent that became calcified due to prolonged use and needed to be removed in a combined procedure.

The HADDOCK2.4 web server for integrative modeling of biomolecular complexes.

Interactions between macromolecules, such as proteins and nucleic acids, are essential for cellular functions. Experimental methods can fail to provide all the information required to fully model biomolecular complexes at atomic resolution, particularly for large and heterogeneous assemblies. Integrative computational approaches have, therefore, gained popularity, complementing traditional experimental methods in structural biology. Here, we introduce HADDOCK2.4, an integrative modeling platform, and its updated web interface ( https://wenmr.science.uu.nl/haddock2.4 ). The platform seamlessly integrates diverse experimental and theoretical data to generate high-quality models of macromolecular complexes. The user-friendly web server offers automated parameter settings, access to distributed computing resources, and pre- and post-processing steps that enhance the user experience. To present the web server's various interfaces and features, we demonstrate two different applications: (i) we predict the structure of an antibody-antigen complex by using NMR data for the antigen and knowledge of the hypervariable loops for the antibody, and (ii) we perform coarse-grained modeling of PRC1 with a nucleosome particle guided by mutagenesis and functional data. The described protocols require some basic familiarity with molecular modeling and the Linux command shell. This new version of our widely used HADDOCK web server allows structural biologists and non-experts to explore intricate macromolecular assemblies encompassing various molecule types.

Unveiling the Structural Properties, Optical Behavior, and Thermoelectric Performance of 2D CsSn2Br5 Halide Obtained by Mechanochemistry.

Metal halide perovskites with a two-dimensional structure are utilized in photovoltaics and optoelectronics. High-crystallinity CsSn2Br5 specimens have been synthesized via ball milling. Differential scanning calorimetry curves show melting at 553 K (endothermic) and recrystallization at 516 K (exothermic). Structural analysis using synchrotron X-ray diffraction data, collected from 100 to 373 K, allows for the determination of Debye model parameters. This analysis provides insights into the relative Cs-Br and Sn-Br chemical bonds within the tetragonal structure (space group: I4/mcm), which remains stable throughout the temperature range studied. Combined with neutron data, X-N techniques permit the identification of the Sn2+ lone electron pair (5s2) in the two-dimensional framework, occupying empty space opposite to the four Sn-Br bonds of the pyramidal [SnBr4] coordination polyhedra. Additionally, diffuse reflectance UV-vis spectroscopy unveils an indirect optical gap of approximately ∼3.3 eV, aligning with the calculated value from the B3LYP-DFT method (∼3.2 eV). The material exhibits a positive Seebeck coefficient as high as 6.5 × 104 µV K-1 at 350 K, which evolves down to negative values of -3.0 × 103 µV K-1 at 550 K, surpassing values reported for other halide perovskites. Notably, the thermal conductivity remains exceptionally low, between 0.32 and 0.25 W m-1 K-1.

Acidochromic Free-Standing Multilayered Chitosan-Pyranoflavylium/Alginate Membranes toward Food Smart Packaging Applications.

Food smart packaging has emerged as a promising technology to address consumer concerns regarding food conservation and food safety. In this context, we report the rational design of azide-containing pyranoflavylium-based pH-sensitive dye for subsequent click chemistry conjugation toward a chitosan-modified alkyne. The chitosan-pyranoflavylium conjugate was characterized by infrared (ATR-FTIR), ultraviolet-visible (UV-vis), nuclear magnetic resonance (NMR) spectroscopies, and dynamic light scattering (DLS), as well as its thermodynamic parameters related to their pH-dependent chromatic features. The fabrication of thin-films through electrostatic-driven layer-by-layer (LbL) assembly technology was first screened by quartz crystal microbalance with dissipation monitoring (QCM-D) onto gold substrates, and then free-standing (FS) multilayered membranes from polypropylene substrate were obtained using a homemade automatic dipping robot. The membranes' characterization included morphology analysis and thickness evaluation, assessed by scanning electron microscopy (SEM), pH-responsive color change performance tests using buffer solutions at different pH levels, and biogenic amines-enriched model solutions, demonstrating the feasibility and effectiveness of the chitosan-pyranoflavylium/alginate biomembranes for food spoilage monitoring. This work provides insights toward the development of innovative pH-responsive smart biomaterials for advanced and sustainable technological packaging solutions, which could significantly contribute to ensuring food safety and quality, while reducing food waste.

Miltefosina comparada con Glucantime para el tratamiento de la leishmaniasis cutánea en niños: una revisión sistemática y metaanálisis / Miltefosine compared to Glucantime for the treatment of cutaneous leishmaniasis in children: a systematic review and meta-analysis / Miltefosina comparada ao Glucantime para o tratamento da leishmaniose cutânea em crianças: uma revisão sistemática e meta-análise

Objetivo: este estudio pretende realizar una comparación de la eficacia y los posibles efectos adversos asociados al uso de Miltefosina y Glucantime para el tratamiento de la leishmaniasis cutánea (LC) en niños. Método: se realizó una revisión sistemática de ensayos clínicos y estudios de cohortes, que evaluaran tratamientos de la LC en niños (≤12 años). Se efectuaron búsquedas estructuradas en PubMed, EMBASE, Cochrane, LILACS, Web of Science y SciELO. No se aplicaron restricciones en cuanto a etnia, país, sexo o año de publicación. Los idiomas se limitaron a inglés, español y portugués. Dos revisores independientes revisaron los artículos, extrajeron los datos y evaluaron el riesgo de sesgo. Se realizó un resumen cuantitativo de los estudios incluidos. Resultados: encontramos un total de 747 registros, que incluían 3 ensayos clínicos aleatorizados (ECA) y 1 estudio no aleatorizado. La mayoría de los artículos excluidos en la revisión de texto completo no informaban de los resultados por separado para los niños. En la LC americana (LCA), 4 estudios evaluaron la Miltefosina y el Glucantime. Su eficacia varió del 55,8 al 82,7 % y del 55 al 68,9 %, respectivamente. Conclusiones: en esta revisión sistémica y metaanálisis encontramos que la Miltefosina es mejor opción de tratamiento sistémico para CL en términos de curación clínica y menor efecto adverso al Glucantime administrado de forma sistémica, sin embargo, estas diferencias no fueron significativas.

Objective: this study aims to perform a comparison of the efficacy and potential adverse effects associated with the use of Miltefosine and Glucantime for the treatment of cutaneous leishmaniasis (CL) in children. Method: a systematic review of clinical trials and cohort studies evaluating treatments for CL in children (≤12 years) was conducted. Structured searches were performed in PubMed, EMBASE, Cochrane, LILACS, Web of Science, and SciELO. No restrictions were applied regarding ethnicity, country, gender, or year of publication. Languages were limited to English, Spanish, and Portuguese. Two independent reviewers screened articles, extracted data, and assessed the risk of bias. A quantitative summary of included studies was performed. Results: a total of 747 records were found, including 3 randomized clinical trials (RCTs) and 1 non-randomized study. Most articles excluded in the full-text review did not report results separately for children. In American CL (ACL), 4 studies evaluated Miltefosine and Glucantime. Their efficacy ranged from 55.8 to 82.7 % and from 55 to 68.9 %, respectively. Conclusions: in this systematic review and meta-analysis, we found that Miltefosine is a better systemic treatment option for CL in terms of clinical cure and fewer adverse effects compared to Glucantime administered systemically; however, these differences were not significant.

Objetivo: este estudo tem como objetivo realizar uma comparação da eficácia e dos possíveis efeitos adversos associados ao uso de Miltefosina e Glucantime para o tratamento da leishmaniose cutânea (LC) em crianças. Método: foi realizado uma revisão sistemática de ensaios clínicos e estudos de coorte que avaliaram tratamentos para LC em crianças (≤12 anos). Foram realizadas buscas estruturadas no PubMed, EMBASE, Cochrane, LILACS, Web of Science e SciELO. Não houve restrições quanto à etnia, país, sexo ou ano de publicação. Os idiomas foram limitados a inglês, espanhol e português. Dois revisores independentes revisaram os artigos, extraíram os dados e avaliaram o risco de viés. Foi feito um resumo quantitativo dos estudos incluídos. Resultados: encontramos um total de 747 registros, incluindo 3 ensaios clínicos randomizados (ECR) e 1 estudo não randomizado. A maioria dos artigos excluídos na revisão em texto completo não relatava resultados separados para crianças. Na LC americana (LCA), 4 estudos avaliaram Miltefosina e Glucantime. Sua eficácia variou de 55,8% a 82,7% e de 55% a 68,9%, respectivamente. Conclusões: nesta revisão sistemática e meta-análise, encontramos que a Miltefosina é uma melhor opção de tratamento sistêmico para LC em termos de cura clínica e menos efeitos adversos em comparação com o Glucantime administrado de forma sistêmica; no entanto, essas diferenças não foram significativas.

Assessment of oral hygiene and quality of life of children with autism spectrum disorder and their caregivers: an observational clinical study.

OBJECTIVE: This study aimed to evaluate the degrees of dependence and presence of bacterial plaque in children with autism spectrum disorder (ASD) and the quality of life of children and their caregivers. METHOD AND MATERIALS: This was a cross-sectional observational study. This study included 119 individuals with ASD and their caregivers. Data were collected through a sociodemographic questionnaire, WHOQOL-Bref, and Burden interview to measure quality of life and caregiver burden, respectively. The Autoquestionnaire Qualité de Vie Enfant Imagé questionnaire, adapted in game format, was applied to verify quality of life in children with ASD. An oral clinical examination evaluated the visible plaque index. The collected data were tabulated and organized for statistical analysis with a significance level of 5%. RESULTS: It was observed that 52% of the children had a severity of ASD level 1; 70% were dependent for general activities, and 65% were dependent for oral hygiene. Of the 77 children who thoroughly answered the questionnaire about their quality of life, 64.9% had good quality of life, and 35.1% had scores below 48, that is, low quality of life. In general, the caregivers generally presented quality of life with a rate of 60.95 (good) points on the scale. It was observed that gingival bleeding greater than 30% is two (ASD 2 + ASD 3) to three (ASD 3) times more likely to occur in patients who have higher levels of ASD (P < .004). CONCLUSION: It was concluded that the quality of life of individuals with ASD was good, that most children are dependent for their daily activities and oral hygiene, and that they showed reasonable plaque control. On the other hand, the caregivers presented low quality of life and moderate burden.

Assessment of differentially expressed genes from in vitro matured human oocytes: A bioinformatics approach.

OBJECTIVE: One of the techniques that has gained much attention is the in vitro maturation of oocytes for patients who use assisted reproduction techniques. However, its results are still inferior to controlled ovarian stimulation methodologies. Understanding the maturation mechanisms based on analyses can help improve this methodology's results. The work aims to identify the central genes differentially expressed in oocytes after in vitro maturation in the germinal vesicle and metaphase II stages. METHODS: This work is a computational analysis. The entire search will be conducted using the Gene Expression Omnibus (GEO) database. To carry out and obtain the data present in the work, an advanced research search was carried out in the GEO database within the period from January 1, 2013, to January 1, 2023. A total of 27 genomic data were available in the GEO database, of which only two were used. RESULTS: Two datasets were identified on the Gene Expression Omnibus database platform: registration data GSE158802 and GSE95477. From the analysis, we identified five downregulated and thirty-six upregulated genes; the central genes that correlated with the main gene proteins found were CLTA and PANK1. CONCLUSIONS: There was a differential regulation of gene expression. The most central ones are related to energy capture.

Analysis of clinical outcomes in older individuals who received pharmaceutical care and posthospital discharge follow-up.

BACKGROUND: Previous evidence underscores the need to assess potential clinical outcomes resulting from pharmaceutical care interventions and to monitor patient's progress to evaluate their clinical evolution, which is crucial for bolstering the relevance of implementing pharmaceutical care in healthcare services. AIMS: To conduct an in-depth analysis of pharmaceutical care practices in a geriatric ward and monitor the clinical outcomes of older people served. METHODS: This interventionist study was conducted in the geriatrics ward of a Brazilian university hospital. The research intervention occurred between January and May 2022, with a follow-up conducted for up to 90 days after patients' hospital discharge. Older patients in the geriatrics ward received pharmaceutical care, including medication reconciliation, medication review, and pharmacotherapeutic follow-up, aimed at identifying and resolving drug-related problems (DRPs). The clinical relevance of DRPs and pharmaceutical recommendations was evaluated. Additionally, analyses were conducted on mortality and rehospitalization outcomes in older patients at 30, 60, and 90 days following initial hospital discharge. RESULTS: Of the patients evaluated, a significant 88.3% exhibited at least one DRP (with an average of 2.6 ± 1.9 DRPs per patient), with the majority classified as need/indication problems (38.9%). The acceptance rate of pharmaceutical recommendations was 80.9%, with the majority categorized as very significant relevance (60.4%). DRPs were predominantly of serious clinical relevance (50.9%). In patients whose clinical indicators could be monitored, 95.5% showed some clinical response (in vital signs, laboratory tests and/or clinical status evolution) potentially related to resolved DRPs. Association analysis revealed that a higher number of medications in use before hospitalization correlated with a greater identification of DRPs during hospitalization (p = 0.03). At hospital discharge, 23.6% of patients were no longer using polypharmacy. In total, 16 patients (26.7%) died during the study period. Among patients who did not die during hospitalization (n = 54), 20 patients (37%) experienced rehospitalizations within 90 days following discharge. CONCLUSION: This study facilitated the consolidation of pharmaceutical care implementation in a geriatric ward. We conducted identification, evaluation, and proposed evidence-based solutions, as well as monitored cases for outcome analysis. It is anticipated that this methodology will inspire future research and the implementation of pharmaceutical care-related services.

Models to predict nitrogen excretion from beef cattle fed a wide range of diets compiled from South America.

The objective of this meta-analysis was to develop and evaluate models for predicting nitrogen (N) excretion in feces, urine, and manure in beef cattle in South America. The study incorporated a total of 1,116 individual observations of N excretion in feces and 939 individual observations of N excretion in feces and in urine (g/d), representing a diverse range of diets, animal genotypes, and management conditions in South America. The dataset also included data on dry matter intake (DMI; kg/d) and nitrogen intake (NI; g/d), concentrations of dietary components, as well as average daily gain (ADG; g/d) and average body weight (BW; kg). Models were derived using linear mixed-effects regression with a random intercept for the study. Fecal N excretion was positively associated with DMI, NI, nonfibrous carbohydrates, average BW, and ADG and negatively associated with EE and CP concentration in the diet. The univariate model predicting fecal N excretion based on DMI (model 1) performed slightly better than the univariate model, which used NI as a predictor variable (model 2) with a root mean square error (RMSE) of 38.0 vs. 39.2%, the RMSE-observations SD ratio (RSR) of 0.81 vs. 0.84, and concordance correlation coefficient (CCC) of 0.53 vs. 0.50, respectively. Models predicting urinary N excretion were less accurate than those derived to predict fecal N excretion, with an average RMSE of 43.7% vs. 37.0%, respectively. Urinary and manure N excretion were positively associated with DMI, NI, CP, average BW, and ADG and negatively associated with neutral detergent fiber concentration in the diet. As opposed to fecal N excretion, the univariate model predicting urinary N excretion using NI (model 10) performed slightly better than the univariate model using DMI (model 9) as predictor variable with an RMSE of 36.0% vs. 39.7%, RSR 0.85 vs. 0.93, and CCC of 0.43 vs. 0.29, respectively. The models developed in this study are applicable for predicting N excretion in beef cattle across a broad spectrum of dietary compositions and animal genotypes in South America. The univariate model using DMI as a predictor is recommended for fecal N prediction, while the univariate model using NI is recommended for predicting urinary and manure N excretion because the use of more complex models resulted in little to no benefits. However, it may be more useful to consider more complex models that incorporate nutrient intakes and diet composition for decision-making when N excretion is a factor to be considered. Three extant equations evaluated in this study have the potential to be used in tropical conditions typical of South America to predict fecal N excretion with good precision and accuracy. However, none of the extant equations are recommended for predicting urine or manure N excretion because of their high RMSE, and low precision and accuracy.

Multiscale Length Structural Investigation and Thermoelectric Performance of Double-Filled Sr0.2Yb0.2Co4Sb12: An Exceptional Thermal Conductivity Reduction by Filler Segregation to the Grain Boundaries.

Among thermoelectric materials, skutterudites are the most prominent candidates in the mid-temperature range applications. In the multiple-filled Sr0.2Yb0.2Co4Sb12 skutterudite, with Sr and Yb as fillers, we have enhanced the thermoelectric performance of CoSb3 through the reduction of lattice thermal conductivity and the optimization of carrier concentration and electrical conductivity. The high-pressure synthesis of the double-filled derivative promotes filling fraction fluctuation. This is observed by high angular resolution synchrotron X-ray diffraction, showing a phase segregation that corresponds to an inhomogeneous distribution of the filler atoms, located at the 2a positions of the cubic space group Im3̅. In addition, scanning transmission electron microscopy (STEM) combined with EELS spectroscopy clearly shows a segregation of Sr atoms from the surface of the grains, which is compatible with the synchrotron X-ray powder diffraction results. Mean square displacement parameters analysis results in Einstein temperatures of ∼94 and ∼67 K for Sr and Yb, respectively, and a Debye temperature of ∼250 K. The strong effect on resonant and disorder scattering yields a significantly lower lattice thermal conductivity of 2.5 W m-1 K-1 at 773 K. Still, good weighed-mobility values were obtained, with high filling fraction of the Yb and Sr elements. This drives a reduced electrical resistivity of 2.1 × 10-5 Ω m, which leads to a peak zT of 0.26 at 773 K. The analysis and results performed for the synthesized (Sr,Yb)-double filled CoSb3, shed light on skutterudites for potential waste-heat recovery applications.

Sustainable synthesis of bionanomaterials using non-native plant extracts for maintaining ecological balance: A computational bibliography analysis.

Biological approaches via biomolecular extracts of bacteria, fungi, or plants have recently been introduced as an alternative approach to synthesizing less or nontoxic nanomaterials, compared to conventional physical and chemical approaches. Among these biological methods, plant-mediated approaches (phytosynthesis) are reported to be highly beneficial for large-scale, nontoxic nanomaterial synthesis. However, plant-mediated synthesis of nanomaterials using native plant extract can lead to bioprospecting issues and deforestation challenges. On the other hand, non-native or invasive plants are non-indigenous to a particular geographic location that can grow and spread rapidly, ultimately disrupting the local and endogenous plant communities or ecosystems. Thus, controlling or eradicating these non-native plants before they damage the ecosystem is necessary. Even though mechanical, chemical, and biological approaches are available to control non-native plants, all these methods possess certain limitations, such as environmental toxicity, disturbance in the nutrient cycle, and loss of genetic integrity. Therefore, non-native plants were recently proposed as a novel sustainable source of phytochemicals for preparing nanomaterials via green chemistry, mainly metallic nanoparticles, as an alternative to native, agriculture-based, or medicinal plants. This work aims to cover a literature gap on plant-mediated bionanomaterial synthesis with an overview and bibliography analysis of non-native plants via novel data mining and advanced visualization tools. In addition, the potential of non-native plants as a sustainable, green chemistry-based alternative for bionanomaterial preparation for maintaining ecological balance, the mechanism of formation via phytochemicals, and their possible applications to promote their control and spread were also discussed. The bibliography analysis revealed that only an average of 4 articles have been published in the last 10 years (2013-2023) on non-native/invasive plants for nanomaterial synthesis, which shows the significance of this article.

In-Bath 3D Printing of Anisotropic Shape-Memory Cryogels Functionalized with Bone-Bioactive Nanoparticles.

Cryogels exhibit unique shape memory with full recovery and structural stability features after multiple injections. These constructs also possess enhanced cell permeability and nutrient diffusion when compared to typical bulk hydrogels. Volumetric processing of cryogels functionalized with nanosized units has potential to widen their biomedical applications, however this has remained challenging and relatively underexplored. In this study, we report a novel methodology that combines suspension 3D printing with directional freezing for the fabrication of nanocomposite cryogels with configurable anisotropy. When compared to conventional bulk or freeze-dried hydrogels, nanocomposite cryogel formulations exhibit excellent shape recovery (>95%) and higher pore connectivity. Suspension printing, assisted with a prechilled metal grid, was optimized to induce anisotropy. The addition of calcium- and phosphate-doped mesoporous silica nanoparticles into the cryogel matrix enhanced bioactivity toward orthopedic applications without hindering the printing process. Notably, the nanocomposite 3D printed cryogels exhibit injectable shape memory while also featuring a lamellar topography. The fabrication of these constructs was highly reproducible and exhibited potential for a cell-delivery injectable cryogel with no cytotoxicity to human-derived adipose stem cells. Hence, in this work, it was possible to combine a gravity defying 3D printed methodology with injectable and controlled anisotropic macroporous structures containing bioactive nanoparticles. This methodology ameliorates highly tunable injectable 3D printed anisotropic nanocomposite cryogels with a user-programmable degree of structural complexity.

Epidemiological and Clinical Aspects of Cutaneous and Mucosal Leishmaniases in Portugal: Retrospective Analysis of Cases Diagnosed in Public Hospitals and Reported in the Literature between 2010 and 2020.

Leishmania infantum, a zoonotic vector-born parasite, is endemic in the Mediterranean region, presenting mostly as visceral (VL), but also as cutaneous (CL) and mucosal leishmaniasis (ML). This study aimed to describe the epidemiological and clinical aspects of the CL and ML cases diagnosed in mainland Portugal between 2010 and 2020. Collaboration was requested from every hospital of the Portuguese National Health System. Cases were screened through a search of diagnostic discharge codes or positive laboratory results for Leishmania infection. Simultaneously, a comprehensive literature search was performed. Descriptive statistics and hypothesis testing were performed using IBM® SPSS® Statistics. A total of 43 CL and 7 ML cases were identified, with a predominance of autochthonous cases (86%). In CL, immunosuppressed individuals constituted a significant proportion of patients (48%), and in this group, disseminated CL (22%) and simultaneous VL (54%) were common. In autochthonous cases, lesions, mostly papules/nodules (62%), were frequently observed on the head (48%). The approach to treatment was very heterogeneous. ML cases were all autochthonous, were diagnosed primarily in older immunosuppressed individuals, and were generally treated with liposomal amphotericin B. The findings suggest a need for enhanced surveillance and reporting, clinical awareness, and diagnostic capacity of these forms of leishmaniasis to mitigate underdiagnosis and improve patient outcomes. A holistic One Health approach is advocated to address the multifaceted challenges posed by leishmaniases in Portugal and beyond.