Significant and distinct impacts of sleeve gastrectomy and Roux-en-Y gastric bypass on esophageal acid exposure, esophageal motility, and endoscopic findings: a systematic review and meta-analysis.

BACKGROUND: The lack of standardized objective assessment of esophageal physiology and anatomy contributes to controversies regarding the effects of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) on gastroesophageal reflux disease. This study aimed to investigate esophageal acid exposure, esophageal motility, and endoscopic findings before and after SG and RYGB. METHODS: This was a systematic review and meta-analysis of studies reporting at least 1 objective measure of esophageal physiology and/or esophagogastroduodenoscopy (EGD) at baseline and after SG or RYGB. The changes in pH test, manometry, and EGD parameters were summarized. RESULTS: Acid exposure time (AET) and DeMeester score (DMS) significantly increased after SG (mean difference [MD]: 2.1 [95% CI, 0.3-3.9] and 8.6 [95% CI, 2.0-15.2], respectively). After RYGB, both AET and DMS significantly decreased (MD: -4.2 [95% CI, -6.1 to -2.3] and -16.6 [95% CI, -25.4 to -7.8], respectively). Lower esophageal sphincter resting pressure and length significantly decreased after SG (MD: -2.8 [95% CI, -4.6 to -1.1] and -0.1 [95% CI, -0.2 to -0.02], respectively). There were no significant changes in esophageal manometry after RYGB. The relative risks of erosive esophagitis were 2.3 (95% CI, 1.5-3.5) after SG and 0.4 (95% CI, 0.2-0.8) after RYGB. The prevalence rates of Barrett esophagus changed from 0% to 3.6% after SG and from 2.7% to 1.4% after RYGB. CONCLUSION: SG resulted in the worsening of all objective parameters, whereas RYGB resulted in the improvement in AET, DMS, and EGD findings. Determining the risk factors associated with these outcomes can help in surgical choice.

Is there an association between family structure and the oral health of socially vulnerable children?

The aim of this study was to evaluate the impact of the family structure on the oral health status of socially vulnerable children in the Federal District of Brazil. A total of 471 schoolchildren with a mean age of 8.12 (± 0.90) years were examined for dental caries using the CAST instrument. Dental biofilm and oral pain were also registered. Children's guardians were interviewed about socioeconomic variables and oral hygiene habits. The association between oral pain in the previous 30 days and the child's maximum CAST score were analyzed using the Pearson chi-squared test. Multivariate Poisson regression models with robust variance were used to determine the predictors of presence of biofilm, oral pain, and caries severity. The prevalence of cavitated dentin lesions was 43.74% and, both dentin and enamel lesions, 52.87%; for both dentitions. An association between pain and severe nontreated carious lesions was found (p < 0.0001). The family structure was not related to the presence of dental caries, but a significant association was found between low maternal education and severe carious lesions (PR = 1.41; p = 0.0077) and oral pain (PR = 1.47; p = 0. 0335); not owning a residence and frequency of toothbrushing were also associated with the substantial presence of biofilm (PR = 1.13, p = 0.0493 and PR = 1.18, p = 0.0470; respectively). For socially vulnerable children, variables related to the socioeconomic status of the families were more relevant than the family structure in relation to their oral health status.

Is silver diamine fluoride effective in reducing dentin hypersensitivity? A systematic review.

Background: The purpose of this systematic review was to assess the clinical efficacy (sensitivity reduction) and safety (gum damage) of silver diamine fluoride (SDF) as a tooth desensitizer for adults. Methods: The search strategy was developed and adapted from 12 databases. Two independent reviewers selected the studies in consensus with a third reviewer. Randomized clinical trials with adult volunteers affected by dentin hypersensitivity (DH), and receiving treatment with SDF were included. Studies with volunteers testing tooth whitening products, using some type of desensitizer, or taking analgesic or anti-inflammatory medication were excluded. The risk of bias was assessed according to the RoB 2 tool, and confidence in cumulative evidence, according to GRADE. Results: Only 3 articles were included. The average pain assessed using the visual analog scale was lower in the SDF groups than in the short-term control groups (24h to 7 days) (P=0.0134 and P=0.0015) of the two studies. The third study evaluated a combination of SDF and a CO2 laser, compared to using only SDF, and found no statistical difference between the two (P=0.74). Inflammation and gingival staining were also evaluated in two of the three studies. No adverse effects were reported. All the included studies had a high risk of bias, and the certainty of the evidence was very low. Conclusion: SDF can be used as a safe and effective tooth desensitizer in adults, with good results, as was achieved in a short-term follow-up. However, more studies with longer evaluation periods are required.

Association between chemosensory impairment with neuropsychiatric morbidity in post-acute COVID-19 syndrome: results from a multidisciplinary cohort study.

Preliminary methodologically limited studies suggested that taste and smell known as chemosensory impairments and neuropsychiatric symptoms are associated in post-COVID-19. The objective of this study is to evaluate whether chemosensory dysfunction and neuropsychiatric impairments in a well-characterized post-COVID-19 sample. This is a cohort study assessing adult patients hospitalized due to moderate or severe forms of COVID-19 between March and August 2020. Baseline information includes several clinical and hospitalization data. Further evaluations were made using several different reliable instruments designed to assess taste and smell functions, parosmia, and neuropsychiatric disorders (using standardized psychiatric and cognitive measures). Out of 1800 eligible individuals, 701 volunteers were assessed on this study. After multivariate analysis, patients reporting parosmia had a worse perception of memory performance (p < 0.001). Moderate/severe hypogeusia was significantly associated with a worse performance on the word list memory task (p = 0.012); Concomitant moderate/severe olfactory and gustatory loss during the acute phase of COVID-19 was also significantly associated with episodic memory impairment (p = 0.006). We found a positive association between reported chemosensory (taste and olfaction) abnormalities and cognition dysfunction in post-COVID-19 patients. These findings may help us identify potential mechanisms linking these two neurobiological functions, and also support the speculation on a possible route through which SARS-CoV-2 may reach the central nervous system.

Does use of animal therapy during dental care help to reduce anxiety in children and adolescents? A systematic review.

BACKGROUND: Animal-assisted therapy (AAT) is considered a useful technique to reduce anxiety in children and adolescents in medical settings. AIM: To investigate whether the use of AAT helps to reduce anxiety during dental care in children and adolescents. DESIGN: Systematic review that included randomized and nonrandomized clinical trials with children up to 18-years of age undergoing dental appointments. The databases Embase, Cochrane, Pubmed/Medline, LILACS, PsycInfo, Scopus, and Web of Science were searched including gray literature. Random-effects meta-analyses using mean difference (MD) and narrative synthesis (vote counting) were implemented. Risk of bias was assessed using RoB2 for randomized clinical trials. The certainty of the evidence was performed using GRADE. RESULTS: A total of 1103 references were identified, and after a two-phase selection, three studies were included. Anxiety, behavior, and pain were the outcomes. A meta-analysis with 146 participants was performed for anxiety at three time points: before treatment (MD -0.40, CI: -1.06 to 0.26; I2  = 0%; p = .24), during treatment (MD -3.64, CI: -11.18 to 3.91; I2  = 94%; p = .34), and after treatment (MD -5.97, CI: -17.08 to 5.14; I2  = 98% p = .29). There was no difference during dental treatment with or without ATT (dogs), as well as for narrative analysis for any outcome. The risk of bias was high mainly because of the randomization and outcome measurement. CONCLUSION: There is no evidence to support or refute that the presence of AAT during dental care can help reduce anxiety in children (5-11 years). Studies with larger samples are suggested. Protocol registration (CRD42021293593).

A comprehensive benchmark investigation of quantum chemical methods for carbocations.

The application of various density functional approximations (DFAs) and an emphasis on popular methods without any consensus have prevailed in computational studies dedicated to carbocations. More importantly, an extensive and rigorous benchmark investigation on density functionals for the class is still lacking. To close this gap, we present a comprehensive benchmark study of quantum chemical methods on a series of classical and nonclassical carbocations, the CARBO33 dataset. We evaluate a total of 107 DFT methods from all rungs giving particular attention to double hybrid density functionals as the potential of the class has been largely undermined in the context of carbocations. To support our findings, DLPNO-CCSD(T) at the complete basis set (CBS) limit and W1-F12 are used as reference methods. Our results indicate that the composite CBS-QB3 method performs poorly and should not be adopted for target energies. Oftentimes, the tested DFAs of a lower rung perform better than several DFAs in a higher rung of Perdew's "Jacob's ladder". Nonetheless, double hybrids DSD-PBEP86-NL and ωB97X-2-D3(BJ) stand out by showing the overall best performance. Among the hybrids evaluated, about half of them show mean absolute deviation (MAD) below 1.1 kcal mol-1, including the popular hybrids M06-2X and mPW1PW91. In this family, MN15-D3(BJ) performs particularly well (MAD = 0.77 kcal mol-1) displaying reliable results across various tests. Highly popular B3LYP exhibited one of the worst performances (MAD = 4.74 kcal mol-1), and we do not recommend its application to carbocations. We also assess the 24 general-purpose basis sets of single- up to quadruple-ζ quality. The best compromise between accuracy and computational cost is achieved with cc-pVTZ followed by def2-TZVP. Computations on larger structures of general interest, including terpene carbocations, are also presented for selected DFT methods confirming general trends in the results.

Is there an association between family structure and the oral health of socially vulnerable children?

Abstract The aim of this study was to evaluate the impact of the family structure on the oral health status of socially vulnerable children in the Federal District of Brazil. A total of 471 schoolchildren with a mean age of 8.12 (± 0.90) years were examined for dental caries using the CAST instrument. Dental biofilm and oral pain were also registered. Children's guardians were interviewed about socioeconomic variables and oral hygiene habits. The association between oral pain in the previous 30 days and the child's maximum CAST score were analyzed using the Pearson chi-squared test. Multivariate Poisson regression models with robust variance were used to determine the predictors of presence of biofilm, oral pain, and caries severity. The prevalence of cavitated dentin lesions was 43.74% and, both dentin and enamel lesions, 52.87%; for both dentitions. An association between pain and severe nontreated carious lesions was found (p < 0.0001). The family structure was not related to the presence of dental caries, but a significant association was found between low maternal education and severe carious lesions (PR = 1.41; p = 0.0077) and oral pain (PR = 1.47; p = 0. 0335); not owning a residence and frequency of toothbrushing were also associated with the substantial presence of biofilm (PR = 1.13, p = 0.0493 and PR = 1.18, p = 0.0470; respectively). For socially vulnerable children, variables related to the socioeconomic status of the families were more relevant than the family structure in relation to their oral health status.

Estresse, depressão e ansiedade em mães de autistas: Revisão nacional / Stress, depression and anxiety in mothers of autism: National review

A proposta deste estudo foi identificar, na literatura brasileira, a presença e a intensidade de estresse, depressão e ansiedade em mães de indivíduos com Transtorno do Espectro Autista (TEA). Trata-se de uma pesquisa de revisão sistemática, desenvolvida a partir de produções publicadas nas bases de dados bibliográficas BVS (Biblioteca Virtual em Saúde), Portal de Periódicos CAPES e Pepsic (Periódicos Eletrônicos de Psicologia), sem restrição de tempo. Do procedimento de busca, resultaram nove artigos para o banco final de análise. Os resultados evidenciam que as mães são afetadas significativamente pelo estresse, sendo constatada a presença do constructo na maioria do público-alvo, com predominância total de sintomas psicológicos e a prevalência de fases alarmantes de estresse. Em relação à depressão e ansiedade, os estudos demonstraram divergências quanto aos resultados. Tendo em vista os inúmeros aspectos que influenciam no desenvolvimento de determinados constructos, assim como nos resultados das pesquisas, embora a presença de depressão e ansiedade, além de altos níveis de estresse, tenham sido constatados nas pesquisas nacionais, não é possível afirmar que o transtorno seja a principal causa. A atual pesquisa permitiu demonstrar, ainda, a escassez de estudos brasileiros de determinado cunho. Assim, evidenciou a necessidade de investigações nacionais que se dediquem a esse público, de forma a embasar, fidedignamente, intervenções que visem a promoção de saúde mental e maior qualidade de vida.

The proposal of this study it was to identify, in the Brazilian literature, the presence and intensity of stress, depression and anxiety in mothers of individuals with Autism Spectrum Disorder (ASD). It is about a research of systematic review, developed on productions published in the bibliographic databases BVS (Biblioteca Virtual em Saúde), Portal de Periódicos CAPES and Pepsic (Periódicos Eletrônicos em Psicologia), without time restriction. The search procedure resulted in nine articles for the final analysis database. The results demonstrate that mothers are significantly affected by stress, with the presence of the construct in most of the target audience, with a total predominance of psychological symptoms and the prevalence of alarming phases of stress. In relation to depression and anxiety, the studies demonstrated divergences regarding the results. Considering the numerous aspects that influence the development of certain constructs, as well as the results of research, although the presence of depression and anxiety, in addition to high levels of stress, have been found in national research, it is not possible to say that the disorder be the main cause. The present research also made it possible to demonstrate the scarcity of Brazilian studies of a certain nature. Thus, it highlighted the need for national investigations dedicated to this public, in order to reliably support interventions aimed at promoting mental health and better quality of life.

A Quorum Sensing-Regulated Type VI Secretion System Containing Multiple Nonredundant VgrG Proteins Is Required for Interbacterial Competition in Chromobacterium violaceum.

The environmental pathogenic bacterium Chromobacterium violaceum kills Gram-positive bacteria by delivering violacein packed into outer membrane vesicles, but nothing is known about its contact-dependent competition mechanisms. In this work, we demonstrate that C. violaceum utilizes a type VI secretion system (T6SS) containing multiple VgrG proteins primarily for interbacterial competition. The single T6SS of C. violaceum contains six vgrG genes, which are located in the main T6SS cluster and four vgrG islands. Using T6SS core component-null mutant strains, Western blotting, fluorescence microscopy, and competition assays, we showed that the C. violaceum T6SS is active and required for competition against Gram-negative bacteria such as Pseudomonas aeruginosa but dispensable for C. violaceum infection in mice. Characterization of single and multiple vgrG mutants revealed that, despite having high sequence similarity, the six VgrGs show little functional redundancy, with VgrG3 showing a major role in T6SS function. Our coimmunoprecipitation data support a model of VgrG3 interacting directly with the other VgrGs. Moreover, we determined that the promoter activities of T6SS genes increased at high cell density, but the produced Hcp protein was not secreted under such condition. This T6SS growth phase-dependent regulation was dependent on CviR but not on CviI, the components of a C. violaceum quorum sensing (QS) system. Indeed, a ΔcviR but not a ΔcviI mutant was completely defective in Hcp secretion, T6SS activity, and interbacterial competition. Overall, our data reveal that C. violaceum relies on a QS-regulated T6SS to outcompete other bacteria and expand our knowledge about the redundancy of multiple VgrGs. IMPORTANCE The type VI secretion system (T6SS) is a contractile nanomachine used by many Gram-negative bacteria to inject toxic effectors into adjacent cells. The delivered effectors are bound to the components of a puncturing apparatus containing the protein VgrG. The T6SS has been implicated in pathogenesis and, more commonly, in competition among bacteria. Chromobacterium violaceum is an environmental bacterium that causes deadly infections in humans. In this work, we characterized the single T6SS of C. violaceum ATCC 12472, including its six VgrG proteins, regarding its function and regulation. This previously undescribed C. violaceum T6SS is active, regulated by QS, and required for interbacterial competition instead of acute infection in mice. Among the VgrGs, VgrG3, encoded outside the main T6SS cluster, showed a major contribution to T6SS function. These results shed light on a key contact-dependent killing mechanism used by C. violaceum to antagonize other bacteria.

Estado nutricional e condições de saúde de Agentes Comunitários de Saúde / Estado nutricional y condiciones de salud de los agentes comunitarios de salud / Nutritional status and health conditions of Community Health Agents

Objetivo: avaliar perfil sociodemográfico, medidas antropométricas e condições de saúde dos Agentes Comunitários de Saúde de um município do Médio Norte de Mato Grosso. Método: estudo quantitativo, observacional do tipo descritivo, desenvolvido com 34 indivíduos, selecionados por conveniência. Dados coletados nos meses de fevereiro e março de 2020, com instrumento sociodemográfico, condições de saúde e medidas antropométricas. Análise das variáveis descritas por frequência absoluta e relativa. Resultados: os participantes dessa pesquisa eram predominantemente do sexo feminino, com idade variável entre 23 e 56 anos. A maioria possuía ensino superior completo concluído e tinha renda familiar menor ou igual a dois salários-mínimos. A avaliação antropométrica revelou que a 44% apresentavam Obesidade classe I, II ou III e 73,4% apresentavam risco elevado ou muito elevado para doenças cardiovasculares. Conclusões: a avaliação indica que o excesso de peso e a obesidade abdominal foram os principais acometimentos à saúde desses profissionais.(AU)

Objective: to evaluate the sociodemographic profile, anthropometric measures, and health conditions of Community Health Agents in a municipality in the Middle North of Mato Grosso. Method: this is a quantitative, observational, descriptive study, developed with 34 individuals, selected for convenience. Data collected in February and March 2020, with a sociodemographic instrument, health conditions and anthropometric measurements. Analysis of the variables described by absolute and relative frequency. Results: the participants in this research were predominantly female, aged between 23 and 61 years old. Most had completed high education and had a family income less than or equal to 2 minimum wages. Anthropometric assessment revealed that 44.1% had class I, II or III obesity and 76.5% had high or very high risk for cardiovascular disease. Conclusions: the evaluation indicates that overweight and abdominal obesity were the main health problems of these professionals.(AU)

Objetivo: evaluar el perfil sociodemográfico, medidas antropométricas y condiciones de salud de los Agentes Comunitarios de Salud en municipio del Medio Norte de Mato Grosso. Método: se trata de un estudio cuantitativo, observacional, descriptivo, desarrollado con 34 individuos, seleccionados por conveniencia. Datos recolectados en febrero y marzo de 2020, con instrumento sociodemográfico, condiciones de salud y medidas antropométricas. Análisis de las variables descritas por frecuencia absoluta y relativa. Resultados: los participantes de esta investigación fueron predominantemente mujeres, con edades comprendidas entre los 23 y los 61 años. La mayoría había completado la educación secundaria y tenía un ingreso familiar menor o igual a 2 salarios mínimos. La evaluación antropométrica reveló que el 44,1% tenía obesidad clase I, II o III y el 76,5% tenía alto o muy alto riesgo de enfermedad cardiovascular. Conclusiones: la evaluación indica que el sobrepeso y la obesidad abdominal fueron los principales problemas de salud de estos profesionales.(AU)

Code-switching in parents' everyday speech to bilingual infants.

Code-switching is a common phenomenon in bilingual communities, but little is known about bilingual parents' code-switching when speaking to their infants. In a pre-registered study, we identified instances of code-switching in day-long at-home audio recordings of 21 French-English bilingual families in Montreal, Canada, who provided recordings when their infant was 10 and 18 months old. Overall, rates of infant-directed code-switching were low, averaging 7 times per hour (6 times per 1,000 words) at 10 months and increasing to 28 times per hour (18 times per 1,000 words) at 18 months. Parents code-switched more between sentences than within a sentence; this pattern was even more pronounced when infants were 18 months than when they were 10 months. The most common apparent reasons for code-switching were to bolster their infant's understanding and to teach vocabulary words. Combined, these results suggest that bilingual parents code-switch in ways that support successful bilingual language acquisition.

Enquadro e banco dos réus: racismo e sistema de justiça / Arresto y el juicio: el racismo y el sistema de justicia / Stop-and-frisk and dock: racism and justice system

Resumo A partir de reflexões que analisam o racismo como elemento estruturante do Brasil e de algumas teorias criminológicas, buscamos neste artigo analisar de que forma as questões raciais operam no sistema de justiça criminal. Seguimos os rastros de duas decisões jurídicas que, ao sinalizarem que um réu branco "não possui o estereótipo padrão de bandido" (Tribunal de Justiça de São Paulo [TJSP], 2016) e que um réu negro é "seguramente integrante do grupo criminoso, em razão da sua raça" (Tribunal de Justiça do Paraná [TJPR], 2020), apontaram explicitamente o componente racial como critério de diferenciação. A análise desse mecanismo revela um continuum de práticas e equipamentos, como em abordagens policiais e audiências de custódias, que fixam o sujeito negro no lugar de suspeição e perigo.

Resumen A partir de reflexiones que analizan el racismo como elemento estructurante en Brasil y de algunas teorías criminológicas, buscamos en este artículo analizar cómo operan las cuestiones raciales en el sistema de justicia penal. Seguimos el rastro de dos decisiones judiciales que, al señalar que un acusado blanco "no tiene el estereotipo estándar de un criminal" (Tribunal de Justiça de São Paulo [TJSP], 2016) y que un acusado negro es "seguramente miembro del grupo criminal, en razón de su raza" (Tribunal de Justiça do Paraná [TJPR], 2020), señalaron explícitamente el componente racial como criterio de diferenciación. El análisis de este mecanismo revela un continuo de prácticas y equipamientos, como en los acercamientos policiales y audiencias de custodia, que fijan al sujeto negro en el lugar de la sospecha y el peligro.

Abstract Based on reflections that analyze racism as a structuring element in Brazil and on some criminological theories, we seek to analyze how racial issues operate in the criminal justice system. We followed the trail of two legal decisions that, by signaling that a white defendant "does not have the standard stereotype of a criminal" (Tribunal de Justiça de São Paulo [TJSP], 2016) and that a black defendant is "surely a member of the criminal group, because of his race" (Tribunal de Justiça do Paraná [TJPR], 2020) they explicitly pointed to the racial component as a criterion of differentiation. The analysis of this mechanism reveals a continuum of practices and equipment, as in police approaches and custody hearings, which fix the black subject in the place of suspicion and danger.

Association of inflammatory and coagulation biomarkers with mortality in patients aged 60 years or older and hospitalized with COVID-19 / Associação entre biomarcadores inflamatórios e da coagulação com mortalidade em pacientes com 60 anos de idade ou mais hospitalizados com COVID-19

Objectives: To analyze the association of inflammatory and coagulation biomarkers with mortality in geriatric patients with COVID-19. Methods: This is a retrospective cohort study of 206 patients aged 60 years or older who were hospitalized with COVID-19 at an intensive care unit. The analyzed variables were age, sex, length of hospital stay, and inflammatory biomarkers (C-reactive protein, neutrophil-to-lymphocyte ratio, procalcitonin, fibrinogen, ferritin, and d-dimer). We constructed a receiver operating characteristic curve and analyzed the area under the curve to evaluate the accuracy of biomarkers associated with mortality in patients with COVID-19. Results: Mean age was 72 (± 8) years. There were 101 deaths (49% of the total sample), which were significantly more frequent (p = 0.006) in the older age groups and were distributed as follows: 37.50% (60 ­ 69 years old); 50% (70 ­ 79 years old); 67.50% (80 ­ 89 years old); and 75% (over 90 years old). Mortality was associated with increased serum levels of procalcitonin, neutrophil-to-lymphocyte ratio, C-reactive protein, and d-dimer, and decreased fibrinogen levels. Neutrophil-to-lymphocyte ratio occupied the largest area under the receiver operating characteristic curve (area under the curve 0.859) in this group. Conclusions: In this study, inflammatory biomarkers neutrophil-to-lymphocyte ratio, procalcitonin, C-reactive protein, and d-dimer were associated with mortality in older patients with COVID-19 hospitalized at an intensive care unit, and neutrophil-to-lymphocyte ratio presented the best accuracy.

Objetivos: Analisar associação de biomarcadores inflamatórios e da coagulação com mortalidade em pacientes geriátricos com COVID-19. Metodologia: Estudo do tipo coorte retrospectiva de 206 pacientes com 60 anos de idade ou mais internados em unidade de terapia intensiva (UTI) com COVID-19. As variáveis analisadas foram idade, sexo, tempo de permanência hospitalar e biomarcadores inflamatórios, sendo esses proteína C reativa (PCR), relação neutrófilo-linfócitos (RNL), procalcitonina, fibrinogênio, ferritina e D-dímero. Empregou-se a curva ROC, com análise da área sob a curva (ACR), para avaliar a acurácia dos biomarcadores associados à mortalidade nos pacientes com COVID-19. Resultados: A média de idade foi de 72 (± 8) anos. Ocorreram 101 óbitos (49,02% da amostra total), significativamente mais frequente (p = 0,006) nas faixas etárias mais elevadas, distribuídos por faixa etária: 37,50% (60 ­ 69 anos); 50% (70 ­ 79 anos); 67,50% (80 ­ 89 anos); e 75% (nos maiores de 90 anos). A mortalidade foi associada a aumento dos níveis séricos dos biomarcadores procalcitonina, relação neutrófiloslinfócitos (RNL), proteína C reativa (PCR) e D-dímero, bem como diminuição dos níveis de fibrinogênio. A RNL ocupou a maior área sob a curva ROC (ACR 0,859) nesse grupo. Conclusões: Neste estudo, os biomarcadores inflamatórios RNL, procalcitonina, PCR e D-dímero foram associados com mortalidade em pacientes idosos portadores de COVID-19 internados em UTI, e a RNL foi a que apresentou a melhor acurácia.

Adaptação transcultural do Team Member Perspectives of Person-centered Care (TM-PCC) em pessoas idosas institucionalizadas / Cross-cultural adaptation of the Team Member Perspectives of Person-Centered Care (TM-PCC) in institutionalized older adults

Resumo Objetivo Realizar a tradução, retrotraduação para o português falado no Brasil e a adaptação transcultural do instrumento Team Member Perspectives of Person-Centered Care (TM-PCC) e ainda, a sua validade de constructo. O objetivo do TM-PCC é avaliar a frequência de comportamentos e de práticas de cuidados centrados no indivíduo segundo os profissionais que atuam nas Instituições de Longa Permanência para Idosos (ILPIs). Método Foram seguidos o processo de tradução, retrotraduação e adaptação transcultural por meio da equivalência semântica, idiomática, experiencial e conceitual realizado por cinco juízes especialistas da área de Geriatria e da Gerontologia e, por fim, aplicou-se o instrumento piloto em 49 profissionais de quatro ILPIs de três estados brasileiros. Resultados Após a avaliação realizada pelos juízes especialistas, obteve-se discordância quanto aos termos "previous associations", "fufilling relationships" e "incorporate this caring into my daily routine", os quais foram substituídos por "histórias pregressas", "relações satisfatórias", e "incorporar esse cuidado na minha rotina diária". Após as correções e revisões, o questionário foi reenviado aos juízes, obtendo-se 100% de concordância. Observou-se boa compreensão das questões durante a aplicação piloto e boa consistência interna por meio do alfa de Cronbach= 0,78. Conclusão O TM-PCC pode ser ferramenta útil para avaliação dos cuidados centrados ao indivíduo em ILPIs, no Brasil, segundo a avaliação de profissionais. Isso possibilitará ao gestor ou profissional supervisor de cuidados, planejar e desenvolver intervenções educacionais e de gestão voltadas a promoção dos cuidados centrados ao indivíduo nas ILPI.

Abstract Objective carry out the translation and back-translation into Brazilian Portuguese, and the cross-cultural adaptation of the instrument called Team Member Perspectives of Person-Centered Care (TM-PCC), as well as its construct validity. The objective of the TM-PCC is to assess the frequency of behaviors and care practices centered on the individual according to professionals who work in Long-Term Care Facilities for Older Adults (ILPIs). Method The process of translation, back-translation, and cross-cultural adaptation was followed through semantic, idiomatic, experiential, and conceptual equivalence carried out by five expert judges in the field of Geriatrics and Gerontology, with the pilot instrument being administered to 49 professionals from four ILPIs in three Brazilian states Results After the assessment was conducted by the expert judges, disagreement was found regarding the terms "previous associations," "fulfilling relationships," and "incorporate this caring into my daily routine," which were replaced by"histórias pregressas" (past stories), "relações satisfatórias" (satisfactory relationships), and "incorporar esse cuidado na minha rotina diária" (incorporate this care into my daily routine). After these corrections and revisions, the questionnaire was sent back to the judges, who were in total agreement. Good understanding of the questions was observed during the pilot application and good internal consistency through Cronbach's alpha (0.78 Conclusion The TM-PCC can be a useful tool for assessing individual-centered care in ILPIs in Brazil, according to the assessment of professionals. This will enable patient care managers or supervisors to plan and develop educational and management interventions aimed at promoting individual-centered care in ILPIs.

The MarR family regulator OsbR controls oxidative stress response, anaerobic nitrate respiration, and biofilm formation in Chromobacterium violaceum.

BACKGROUND: Chromobacterium violaceum is an environmental opportunistic pathogen that causes rare but deadly infections in humans. The transcriptional regulators that C. violaceum uses to sense and respond to environmental cues remain largely unknown. RESULTS: Here, we described a novel transcriptional regulator in C. violaceum belonging to the MarR family that we named OsbR (oxidative stress response and biofilm formation regulator). Transcriptome profiling by DNA microarray using strains with deletion or overexpression of osbR showed that OsbR exerts a global regulatory role in C. violaceum, regulating genes involved in oxidative stress response, nitrate reduction, biofilm formation, and several metabolic pathways. EMSA assays showed that OsbR binds to the promoter regions of several OsbR-regulated genes, and the in vitro DNA binding activity was inhibited by oxidants. We demonstrated that the overexpression of osbR caused activation of ohrA even in the presence of the repressor OhrR, which resulted in improved growth under organic hydroperoxide treatment, as seem by growth curve assays. We showed that the proper regulation of the nar genes by OsbR ensures optimal growth of C. violaceum under anaerobic conditions by tuning the reduction of nitrate to nitrite. Finally, the osbR overexpressing strain showed a reduction in biofilm formation, and this phenotype correlated with the OsbR-mediated repression of two gene clusters encoding putative adhesins. CONCLUSIONS: Together, our data indicated that OsbR is a MarR-type regulator that controls the expression of a large number of genes in C. violaceum, thereby contributing to oxidative stress defense (ohrA/ohrR), anaerobic respiration (narK1K2 and narGHJI), and biofilm formation (putative RTX adhesins).

Do Double-Hybrid Exchange-Correlation Functionals Provide Accurate Chemical Shifts? A Benchmark Assessment for Proton NMR.

A benchmark density functional theory (DFT) study of 1H NMR chemical shifts for data sets comprising 200 chemical shifts, including complex natural products, has been carried out to assess the performance of DFT methods. Two new benchmark data sets, NMRH33 and NMRH148, have been established. The meta-GGA revTPSS performs remarkably well against the NMRH33 benchmark set (mean absolute deviation (MAD), 0.10 ppm; maximum deviation (max), 0.26 ppm) with the smallest MAD of all evaluated functionals. The best-performing double-hybrid density functional (DHDF), revDSD-BLYP (MAD, 0.16 ppm; max, 0.35 ppm), performs similarly to hybrid-GGA methods (e.g., mPW1PW91/6-311G(d) (MAD, 0.15 ppm; max, 0.36 ppm)), but at a considerably higher computational cost. The results indicate that currently available double-hybrid DFT methods offer no benefit over GGA (including hybrid and meta) functionals in the calculation of 1H NMR chemical shifts.

Generation, contraction, and polarisation of Gaussian basis sets for atomic and molecular calculations using the generator coordinate method with polynomial discretisation: atoms from Na through Cl.

The polynomial Generator Coordinate Hartree-Fock Gaussian basis sets, pGCHF, for the atoms Na, Mg, Al, Si, P, S, and Cl were generated using the generator coordinate method based on polynomial integral expansion to discretise the Griffin-Wheeler-Hartree-Fock equations. The pGCHF basis sets were contracted with the CONTRACT program based on the Davidson contraction model through which a set of 9s8p functions for the atoms Na through Cl were obtained. Polarisation exponents generated using the POLARIZATION program were added to the contracted pGCHF Gaussian basis sets. Molecular calculations at the DFT level of theory showed that the pGCHF basis sets can be used to calculate the atomisation energy with accuracy comparable to the well-established pcseg-3, def2-QZVP, and Sapporo-QZP basis sets; also, the complete basis set (CBS) limit estimate was obtained with the pcseg-3/pcseg-4 basis sets.

Prevalence and factors associated with anxiety among university students of health sciences in Brazil: findings and implications / Prevalência e fatores associados à ansiedade entre universitários de ciências da saúde no Brasil: achados e implicações

OBJECTIVE: The aim was to evaluate the prevalence and factors associated with anxiety disorders among university students of health sciences at Federal University of Ouro Preto, Brazil. METHODS: A cross-sectional study between March to June 2019. Data were collected through a self-administered questionnaire including sociodemographic, academic, family and behavioral issues. The Beck Anxiety Inventory was used to assess anxiety. Estimates were obtained through the prevalence ratio and Poisson multivariate analysis. RESULTS: Four hundred and ninety-three students participated with a mean age of 23.1 and predominantly women (79.9%). All students had some degree of anxiety, with the frequency of the severe, moderate and mild forms being 28.0%, 29.8% and 27.0%, respectively. The factors associated with anxiety included having suffered psychological and/or physical violence in childhood, having suicidal thoughts, having a deceased parent, living with parents, being dissatisfied with the course and being in the exam period. CONCLUSIONS: The prevalence of anxiety was high in our study and family problems prior to entering university seem to significantly influence the degree of anxiety, which may compromise the student's academic and social performance.

OBJETIVO: O objetivo foi avaliar a prevalência e os fatores associados aos transtornos de ansiedade em estudantes universitários de ciências da saúde da Universidade Federal de Ouro Preto, Brasil. MÉTODOS: Estudo transversal, entre março e junho de 2019. Os dados foram coletados por meio de questionário autoaplicável, incluindo questões sociodemográficas, acadêmicas, familiares e comportamentais. O Inventário de Ansiedade de Beck foi usado para avaliar a ansiedade. As estimativas foram obtidas por meio da razão de prevalência e análise multivariada de Poisson. RESULTADOS: Participaram 493 alunos com idade média de 23,1 anos e predominância do sexo feminino (79,9%). Todos os alunos apresentaram algum grau de ansiedade, sendo a frequência da forma grave, moderada e leve de 28,0%, 29,8% e 27,0%, respectivamente. Os fatores associados à ansiedade foram: ter sofrido violência psicológica e/ou física na infância, ter pensamentos suicidas, ter pai falecido, morar com os pais, ter insatisfação com o curso e estar em período de provas. CONCLUSÕES: A prevalência de ansiedade foi elevada em nosso estudo e os problemas familiares anteriores ao ingresso na universidade parecem influenciar significativamente no grau de ansiedade, podendo comprometer o desempenho acadêmico e social do discente.

Gasoline-station workers in Brazil: Benzene exposure; Genotoxic and immunotoxic effects.

Chronic exposure to benzene is a risk factor for hematological malignancies. Gasoline-station workers are exposed to benzene in gasoline, via both inhalation and dermal contact (attendants and managers) or inhalation (workers in the on-site convenience stores and offices). We have studied the exposure of these workers to benzene and the resulting genotoxic and immunotoxic effects. Levels of urinary trans, trans-muconic acid were higher among gasoline-station workers than among office workers with no known exposure to benzene (comparison group). Among the exposed workers, we observed statistically significant biological effects, including elevated DNA damage (comet assay); higher frequencies of micronuclei and nuclear buds (CBMN assay); lower levels of T-helper lymphocytes and naive Th lymphocytes; lower CD4 / CD8 ratio; and higher levels of NK cells and memory Th lymphocytes. Both groups of exposed workers (inhalation and inhalation + dermal routes) showed similar genotoxic and immunotoxic effects.