Characterization of CRESS-DNA viruses in human vaginal secretions: An exploratory metagenomic investigation.

The Phylum Cressdnaviricota consists of a large number of circular Rep-encoding single-stranded (CRESS)-DNA viruses. Recently, metagenomic analyzes revealed their ubiquitous distribution in a diverse range of eukaryotes. Data relating to CRESS-DNA viruses in humans remains scarce. Our study investigated the presence and genetic diversity of CRESS-DNA viruses in human vaginal secretions. Vaginal swabs were collected from 28 women between 29 and 43 years old attending a fertility clinic in New York City. An exploratory metagenomic analysis was performed and detection of CRESS-DNA viruses was confirmed through analysis of near full-length sequences of the viral isolates. A phylogenetic tree was based on the REP open reading frame sequences of the CRESS-DNA virus genome. Eleven nearly complete CRESS-DNA viral genomes were identified in 16 (57.1%) women. There were no associations between the presence of these viruses and any demographic or clinical parameters. Phylogenetic analysis indicated that one of the sequences belonged to the genus Gemycircularvirus within the Genomoviridae family, while ten sequences represented previously unclassified species of CRESS-DNA viruses. Novel species of CRESS-DNA viruses are present in the vaginal tract of adult women. Although they be transient commensal agents, the potential clinical implications for their presence at this site cannot be dismissed.

Human norovirus in Brazil: an update of reports in different settings.

Norovirus is an important etiologic agent of acute gastroenteritis and has become even more relevant in Brazil after the implementation of the monovalent rotavirus vaccine in 2006 through the public health system, now representing a significant portion of the etiology of acute diarrheal diseases. Although diagnosing acute gastroenteritis caused by norovirus is a relatively simple process, and the infection tends to be self-limited, the virus can be considerably harmful to vulnerable populations, such as children, the elderly, and immunocompromised individuals. The spread of norovirus is also particularly favorable among such groups due to its mode of transmission, favored by cluttered environments such as in hospitals and densely populated regions. Additionally, norovirus' ability to spread through water and food creates the need for measures to ensure adequate sanitation and the development of effective measures to prevent outbreaks and severe manifestations of the disease. This review aims to address the main reports of human norovirus detected in Brazil over the years, focusing on clinical-hospital, food-related, and urban conglomerate contexts, including the circulating strains.

Towards accurate monitoring of water content in woody tissue across tropical forests and other biomes.

Forest ecosystems face increasing drought exposure due to climate change, necessitating accurate measurements of vegetation water content to assess drought stress and tree mortality risks. While Frequency Domain Reflectometry offers a viable method for monitoring stem water content by measuring dielectric permittivity, challenges arise from uncertainties in sensor calibration linked to wood properties and species variability, impeding its wider usage. We sampled tropical forest trees and palms in eastern Amazônia, to evaluate how sensor output differences are controlled by wood density, temperature and taxonomic identity. Three individuals per species were felled and cut into segments (total n = 262), within a diverse dataset comprising five dicotyledonous tree-and three monocotyledonous palm species on a wide range of wood densities. Water content was estimated gravimetrically for each segment using a temporally explicit wet-up/dry-down approach, and the relationship with the dielectric permittivity was examined. Woody tissue density had no significant impact on the calibration, but species identity and temperature significantly affected sensor readings. The temperature artefact was quantitatively important at large temperature differences which may have led to significant bias of daily and seasonal water content dynamics in previous studies. We established the first tropical tree and palm calibration equation that performed well for estimating water content. Notably, we demonstrated that the sensitivity remained consistent across species, enabling the creation of a simplified one-slope calibration for accurate, species-independent measurements of relative water content. Our one-slope calibration serves as a general, and species-independent standard calibration for assessing relative water content in woody tissue, offering a valuable tool for quantifying drought responses and stress in trees and forest ecosystems.

Análise da performance de graduandos ingressantes e concluintes do curso de odontologia na identificação humana pela análise de fotografias do sorriso / Analysis of the performance of incoming and outgoing dental students in human identification through the analysis of smile photographs

Introdução: Os dentes são órgãos de valor inestimável para a identificação humana, uma vez que são as estruturas mais estáveis, duras e resistentes do corpo. Com a existência progressiva para o uso de câmeras digitais para captar fotografias sociais, como as "selfie", em que o foco principal está direcionado no rosto do indivíduo, estas fotografias são capazes de prover material com capacidade para resolver casos de identificação humana. Objetivo: Demonstrar a importância das fotografias do sorriso no processo de identificação humana e comparar e verificar o desempenho de graduandos em Odontologia (ingressantes e concluintes) na identificação humana por meio da análise do sorriso. Material e Métodos: Este estudo utilizou a metodologia e banco de imagens do trabalho de Silva et al. (2012), e o público alvo que avaliou as imagens, modificada. Cada aluno participante da pesquisa analisou um grupo de 4 imagens projetadas, sendo 2 de sorriso (A e B) e 2 intrabucais (C e D). Dentre as 10 fornecidas para cada grupo de imagem, somente uma é compatível com cada fotografia projetada. Resultado: Após análise dos dados, foi possível verificar que 84,6% dos alunos ingressantes (número de 26 alunos) acertaram os testes A e B, e 95,6% dos concluintes (número de 23) acertaram os testes A e B. No teste C podemos observar que 61,5% dos alunos ingressantes acertaram o teste, e 69,6% dos concluintes obtiveram acertos. E, por fim, o teste D mostrou que os ingressantes obtiveram um total de 80,8% de acertos, enquanto todos concluintes (100%) acertaram o teste D. Os parâmetros mais citados foram a coloração dos dentes, a inclinação dental, a morfologia das incisais e o alinhamento incisal. Conclusão: Nesta pesquisa, tanto os alunos ingressantes como os concluintes demostraram capacidade para analisar as fotografias do sorriso na identificação humana. Os alunos ingressantes obtiveram um número maior de erros pelo fato de ainda não terem conhecimento teórico e técnico mais aprofundado em anatomia, tornando isso uma diferença entre ingressantes e concluintes

Introduction: Teeth are invaluable organs for human identification, as they are the most stable, hard and resistant structures in the body. With the progressive use of digital cameras to capture social photographs, such as the "selfie", in which the main focus is on the individual's face, these photographs are able to provide material capable of solving human identification cases. Objective: To demonstrate the importance of smile photographs in the process of human identification and to compare and verify the performance of undergraduate dental students (beginners and graduates) in human identification using smile analysis. Material and Methods: This study used the methodology and image bank of the work by SILVA R.F. et al. (2012), and the target audience that evaluated the images, modified. Each student participating in the study analyzed a group of 4 projected images, 2 of which were smiles (A and B) and 2 intraoral (C and D). Of the 10 provided for each image group, only one was compatible with each projected photograph. Results: After analyzing the data, it was possible to see that 84.6% of the incoming students (26 students) got tests A and B right, and 95.6% of the outgoing students (23) got tests A and B right. In test C we can see that 61.5% of incoming students got the test right, and 69.6% of outgoing students got it right. And finally, test D showed that the entrants got a total of 80.8% right, while all the graduates (100%) got test D right. The most cited parameters were tooth color, tooth inclination, incisal morphology and incisal alignment. Conclusion: In this study, both new students and graduates demonstrated their ability to analyze smile photographs in human identification. The new students had a higher number of errors, due to the fact that they did not yet have in-depth theoretical and technical knowledge of anatomy, making this a difference between new students and graduates

Orthopedic Injuries in Beach Tennis Players in Brazil.

Objective To analyze the epidemiological data of orthopedic injuries in beach tennis players. Methods We conducted a cross-sectional study, through a questionnaire, with 185 beach tennis players during tournaments and training sessions in two cities. The questionnaire comprised anthropometric data, as well as data on length of time practicing the sport and reported orthopedic injuries. Results We excluded 25 of the 185 interviewees. Of the 160 players studied, 51.9% were male and 48.1%, female. The average age was of 40.4 years, the average height was of 1.73 m, the average weight was of 75.6 kg, and the average body mass index (BMI) was of 25.2 kg/m 2 . Orthopedic injuries were reported by 48.8% of the participants, 30.0% in the lower limbs, 11.3% in the spine, and 25.0% in the upper limbs, with an incidence of 0.82 per one thousand hours of practice. Correlating the incidence of injuries with age, weight, height, and BMI, we only found relevance between the higher average age in patients with lower- and upper-limb injuries. Players who had no previous experience with other racket sports had fewer injuries. Other parameters, such as gender, use of the two-handed backhand , dominant side, participation in competitions, and practice of other sports did not show statistically significant differences. Conclusion Orthopedic injuries were found in almost half of the beach tennis players, primarily in the lower limbs. Age, experience with other racket sports, category, hours of training per week, and length of time playing the sport influenced the incidence of orthopedic injuries.

Voltage-Driven Fluorine Motion for Novel Organic Spintronic Memristor.

Integrating tunneling magnetoresistance (TMR) effect in memristors is a long-term aspiration because it allows to realize multifunctional devices, such as multi-state memory and tunable plasticity for synaptic function. However, the reported TMR in different multiferroic tunnel junctions is limited to 100%. This work demonstrates a giant TMR of -266% in La0.6Sr0.4MnO3(LSMO)/poly(vinylidene fluoride)(PVDF)/Co memristor with thin organic barrier. Different from the ferroelectricity-based memristors, this work discovers that the voltage-driven florine (F) motion in the junction generates a huge reversible resistivity change up to 106% with nanosecond (ns) timescale. Removing F from PVDF layer suppresses the dipole field in the tunneling barrier, thereby significantly enhances the TMR. Furthermore, the TMR can be tuned by different polarizing voltage due to the strong modification of spin-polarization at the LSMO/PVDF interface upon F doping. Combining of high TMR in the organic memristor paves the way to develop high-performance multifunctional devices for storage and neuromorphic applications.

Reconstruction of congenital pseudarthrosis of the radius with a vascularized tibial periosteal transplant: A case report.

Congenital pseudarthrosis of the forearm poses a considerable challenge because of its rarity. The objective of this report is to introduce a novel surgical technique for its treatment. Here, we document a case of congenital pseudarthrosis of the radius in a 3-year-old boy diagnosed with type-1 neurofibromatosis. The surgical treatment involved the excision of approximately 9 cm of native radial periosteum and a bifocal radius osteotomy, which was supplemented with a vascularized tibial periosteal transplant to facilitate bone healing. Anastomosis between the anterior tibial vessels and radial vessels was performed. No immediate or late postoperative complications were observed. After 3 weeks, a robust callus formation was observed, and during a follow-up examination 3 years and 4 months later, a wide range of active forearm rotation was noted. This report suggests that vascularized periosteal flaps show promise as a viable treatment option for congenital pseudarthrosis of the forearm. They offer an alternative to vascularized fibular grafts or single-bone forearm constructs.

Uncovering multiscale structure in the variability of larval zebrafish navigation.

Animals chain movements into long-lived motor strategies, exhibiting variability across scales that reflects the interplay between internal states and environmental cues. To reveal structure in such variability, we build Markov models of movement sequences that bridges across time scales and enables a quantitative comparison of behavioral phenotypes among individuals. Applied to larval zebrafish responding to diverse sensory cues, we uncover a hierarchy of long-lived motor strategies, dominated by changes in orientation distinguishing cruising versus wandering strategies. Environmental cues induce preferences along these modes at the population level: while fish cruise in the light, they wander in response to aversive stimuli, or in search for appetitive prey. As our method encodes the behavioral dynamics of each individual fish in the transitions among coarse-grained motor strategies, we use it to uncover a hierarchical structure in the phenotypic variability that reflects exploration-exploitation trade-offs. Across a wide range of sensory cues, a major source of variation among fish is driven by prior and/or immediate exposure to prey that induces exploitation phenotypes. A large degree of variability that is not explained by environmental cues unravels motivational states that override the sensory context to induce contrasting exploration-exploitation phenotypes. Altogether, by extracting the timescales of motor strategies deployed during navigation, our approach exposes structure among individuals and reveals internal states tuned by prior experience.

Detection and molecular characterization of chicken parvovirus and chicken megrivirus in layer breeders affected by intestinal dilatation syndrome.

RESEARCH HIGHLIGHTS: IDS presented pathognomonic dilatation of the jejunum up to Meckel's diverticulum.IDS caused weight loss, decreased egg production, and increased culling and mortality.Chicken parvovirus (ChPV) was consistently detected through PCR assays.Chicken megrivirus (ChMV) was consistently detected through viral metagenomics.

Development and Evaluation of Nutritional and Quality Standard of Beef Burger Supplemented with Pumpkin (Cucurbita moschata) Seed Flour.

The composition of pumpkin seeds includes bioactive compounds, proteins, polyunsaturated fatty acids, and dietary fibers. Thus, the objective of this research was to develop and evaluate the nutritional and quality standard of beef burgers supplemented with pumpkin seeds (Cucurbita moschata) added in different proportions. To process the pumpkin seed flour (PSF), the seeds were sanitized, dried in an oven, crushed, and sieved. Through such means, three formulations of beef burgers were prepared, named S (without the addition of PSF), F5 (with the addition of 5% (w/w) of PSF), and F10 (with the addition of 10% (w/w) of PSF). The respective results for burgers P, F5, and F10 were as follows (w/w): proteins 17.61%, 18.04%, 19.86%; lipids 12.19%, 12.42%, 14.55%; ash 1.77%, 1.86%, 1.94%; fibers 0%, 0.88%, 1.76%; phenolic compounds 39.55, 82.93, 90.30 (mg/g); and total antioxidant capacity 11.09%, 18.48%, 24.45%. Regarding the sensory analysis attributes, tasters gave sample F10 scores lower than 7. However, the standard and F5 samples showed results higher than 7 for all parameters. For the determination of shelf life, an expiration date of 30 days was established. It was observed that adding PSF to industrialized products adds nutritional value with the inclusion of polyunsaturated fats, phenolic compounds, and dietary fibers.

Advancements in biliopancreatic endoscopy: a comprehensive review of artificial intelligence in EUS and ERCP.

The development and implementation of artificial intelligence (AI), particularly deep learning (DL) models, has generated significant interest across various fields of gastroenterology. While research in luminal endoscopy has seen rapid translation to clinical practice with approved AI devices, its potential extends far beyond, offering promising benefits for biliopancreatic endoscopy like optical characterization of strictures during cholangioscopy or detection and classification of pancreatic lesions during diagnostic endoscopic ultrasound (EUS). This narrative review provides an up-to-date of the latest literature and available studies in this field. Serving as a comprehensive guide to the current landscape of AI in biliopancreatic endoscopy, emphasizing technological advancements, main applications, ethical considerations, and future directions for research and clinical implementation.

Ocular manifestations of Monkeypox virus (MPXV) infection with viral persistence in ocular samples: A case series.

OBJECTIVE: We describe the clinical presentation and ocular viral dynamics in patients with Monkeypox virus-related ophthalmic disease (MPXROD). METHODS: In this case series, we investigated five consecutive patients with confirmed mpox, diagnosed through a positive Monkeypox virus (MPXV) Polymerase Chain Reaction (PCR) test and presenting with ocular symptoms. They were referred from the Reference Center for Sexually Transmitted Infections in São Paulo (CRT) to the Uveitis Sector at the Federal University of São Paulo, between August and December 2022. We performed PCR testing on ocular samples and culture supernatants for MPXV in all patients. Viral sequencing was conducted in one of the cases. RESULTS: Replicating MPXV was identified in at least one ocular sample of all patients, between day 31 and day 145 after the onset of skin lesions. All patients presented with keratitis, 3 with uveitis (60%) and two exhibited hypopyon (40%). The onset of ocular symptoms occurred at a mean of 21.2 days after the appearance of the first skin lesion and persisted, on average, for 61,.6 days, with a worsening trend observed until the initiation of tecovirimat treatment. Tecovirimat treatment was administered to all patients, with initiation occurring between 31 and 145 days after the onset of skin lesions. MPXV genome sequencing of an isolate from one patient classified it as belonging to lineage B1 in clade IIb. CONCLUSION: This study reveals a late onset and persistence of sight threatening ocular disease, along with potential viral infectivity even after systemic resolution in mpox cases. These findings highlight the risk of ongoing transmission from individuals with prolonged ocular manifestations, particularly through ocular discharge.

CLIC4 Function in the Epithelial-Mesenchymal Transition of Epithelial Odontogenic Lesions.

BACKGROUND: Odontogenic lesions constitute a heterogeneous group of lesions. CLIC4 protein regulates different cellular processes, including epithelial-mesenchymal transition and fibroblast-myofibroblast transdifferentiation. This study analyzed CLIC4, E-cadherin, Vimentin, and α-SMA immunoexpression in epithelial odontogenic lesions that exhibit different biological behavior. METHODS: It analyzed the immunoexpression of CLIC4, E-cadherin, and Vimentin in the epithelial cells, as well as CLIC4 and α-SMA in the mesenchymal cells, of ameloblastoma (AM) (n = 16), odontogenic keratocyst (OKC) (n = 20), and adenomatoid odontogenic tumor (AOT) (n = 8). Immunoexpressions were categorized as score 0 (0% positive cells), 1 (< 25%), 2 (≥ 25% - < 50%), 3 (≥ 50% - < 75%), or 4 (≥ 75%). RESULTS: Cytoplasmic CLIC4 immunoexpression was higher in AM and AOT (p < 0.001) epithelial cells. Nuclear-cytoplasmic CLIC4 was higher in OKC's epithelial lining (p < 0.001). Membrane (p = 0.012) and membrane-cytoplasmic (p < 0.001) E-cadherin immunoexpression were higher in OKC, while cytoplasmic E-cadherin expression was higher in AM and AOT (p < 0.001). Vimentin immunoexpression was higher in AM and AOT (p < 0.001). Stromal CLIC4 was higher in AM and OKC (p = 0.008). Similarly, α-SMA immunoexpression was higher in AM and OKC (p = 0.037). Correlations in these proteins' immunoexpression were observed in AM and OKC (p < 0.05). CONCLUSIONS: CLIC4 seems to regulate the epithelial-mesenchymal transition, modifying E-cadherin and Vimentin expression. In mesenchymal cells, CLIC4 may play a role in fibroblast-myofibroblast transdifferentiation. CLIC4 may be associated with epithelial odontogenic lesions with aggressive biological behavior.

Genetic diversity and evolution of G12P[6] DS-1-like and G12P[9] AU-1-like Rotavirus strains in Brazil.

In the early 2000s, the global emergence of rotavirus (RVA) G12P[8] genotype was noted, while G12P[6] and G12P[9] combinations remained rare in humans. This study aimed to characterize and phylogenetically analyze three Brazilian G12P[9] and four G12P[6] RVA strains from 2011 to 2020, through RT-PCR and sequencing, in order to enhance our understanding of the genetic relationship between human and animal-origin RVA strains. G12P[6] strains displayed a DS-1-like backbone, showing a distinct genetic clustering. G12P[6] IAL-R52/2020, IAL-R95/2020 and IAL-R465/2019 strains clustered with 2019 Northeastern G12P[6] Brazilian strains and a 2018 Benin strain, whereas IAL-R86/2011 strain grouped with 2010 Northern G12P[6] Brazilian strains and G2P[4] strains from the United States and Belgium. These findings suggest an African genetic ancestry and reassortments with co-circulating American strains sharing the same DS-1-like constellation. No recent zoonotic reassortment was observed, and the DS-1-like constellation detected in Brazilian G12P[6] strains does not seem to be genetically linked to globally reported intergenogroup G1/G3/G9/G8P[8] DS-1-like human strains. G12P[9] strains exhibited an AU-1-like backbone with two different genotype-lineage constellations: IAL-R566/2011 and IAL-R1151/2012 belonged to a VP3/M3.V Lineage, and IAL-R870/2013 to a VP3/M3.II Lineage, suggesting two co-circulating strains in Brazil. This genetic diversity is not observed elsewhere, and the VP3/M3.II Lineage in G12P[9] strains seems to be exclusive to Brazil, indicating its evolution within the country. All three G12P[9] AU-1-like strains were closely relate to G12P[9] strains from Paraguay (2006-2007) and Brazil (2010). Phylogenetic analysis also highlighted that all South American G12P[9] AU-1-like strains had a common origin and supports the hypothesis of their importation from Asia, with no recent introduction from globally circulating G12P[9] strains or reassortments with local G12 strains P[8] or P[6]. Notably, certain genes in the Brazilian G12P[9] AU-1-like strains share ancestry with feline/canine RVAs (VP3/M3.II, NSP4/E3.IV and NSP2/N3.II), whereas NSP1/A3.VI likely originated from artiodactyls, suggesting a history of zoonotic transmission with human strains. This genomic data adds understanding to the molecular epidemiology of G12P[6] and G12P[9] RVA strains in Brazil, offering insights into their genetic diversity and evolution.

Cause-Specific Excess Mortality During the COVID-19 Pandemic (2020-2021) in 12 Countries of the C-MOR Consortium.

BACKGROUND: This study investigated cause-specific mortality rates in 12 countries during the COVID-19 pandemic in 2020 and 2021. METHODS: We collected weekly cause-specific mortality data from respiratory disease, pneumonia, cardiovascular disease (CVD) and cancer from national vital statistic databases. We calculated excess mortality for respiratory disease (excluding COVID-19 codes), pneumonia, and CVD in 2020 and 2021 by comparing observed weekly against expected mortality based on historical data (2015-2019), accounting for seasonal trends. We used multilevel regression models to investigate the association between country-level pandemic-related variables and cause-specific mortality. RESULTS: Significant reductions in cumulative mortality from respiratory disease and pneumonia were observed in 2020 and/or 2021, except for Georgia, Northern Ireland, Kazakhstan, and Ukraine, which exhibited excess mortality for one or both causes. Australia, Austria, Cyprus, Georgia, and Northern Ireland experienced excess cumulative CVD mortality in 2020 and/or 2021. Australia, Austria, Brazil, Cyprus, Georgia, Northern Ireland, Scotland and Slovenia, experienced increased crude cumulative cancer mortality during 2020 and/or 2021 compared to previous years. Among pandemic-related variables, reported COVID-19 incidence was negatively associated with increased cancer mortality, excess respiratory, (2020) and pneumonia (2021) mortality, and positively associated with respiratory and CVD mortality (2021). Stringency of control measures were negatively associated with excess respiratory disease, CVD, and increased cancer mortality (2021). CONCLUSIONS: This study provides evidence of substantial excess mortality from CVD, and notable reductions in respiratory disease and pneumonia in both years across most countries investigated. Our study also highlights the beneficial impact of stringent control measures in mitigating excess mortality from most causes in 2021.

Manufacturing process of liposomal Formation: A coarse-grained molecular dynamics simulation.

A method of producing liposomes has been previously developed using a continuous manufacturing technology that involves a co-axial turbulent jet in co-flow. In this study, coarse-grained molecular dynamics (CG-MD) simulations were used to gain a deeper understanding of how the self-assembly process of liposomes is affected by the material attributes (such as the concentration of ethanol) and the process parameters (such as temperature), while also providing detailed information on a nano-scale molecular level. Specifically, the CG-MD simulations yield a comprehensive internal view of the structure and formation mechanisms of liposomes containing DPPC, DPPG, and cholesterol molecules. The importance of this work is that structural details on the molecular level are proposed, and such detail is not possible to obtain through experimental studies alone. The assessment of structural properties, including the area per lipid, diffusion coefficient, and order parameters, indicated that a thicker bilayer was observed at higher ethanol concentrations, while a thinner bilayer was present at higher temperatures. These conditions led to more water penetrating the interior of the bilayer and an unstable structure, as indicated by a larger contact area between lipids and water, and a higher coefficient of lipid lateral diffusion. However, stable liposomes were found through these evaluations at lower ethanol concentrations and/or lower process temperatures. Furthermore, the CG-MD model was further compared and validated with experimental and computational data including liposomal bilayer thickness and area per lipid measurements.

WHAT IS THE EPIDEMIOLOGICAL PROFILE OF ACUTE HAND INFECTIONS AT A HOSPITAL IN SAO PAULO?

Objective: To determine the epidemiological profile of patients treated at a philanthropic hospital specialized in Orthopedics and Traumatology, located in a significant urban center, and evaluate the efficacy of initial empirical antibiotic treatment. Methods: Patients diagnosed with hand infections from September 2020 to September 2022 were included, excluding cases related to open fractures or post-surgical infections and those with incomplete medical records. The chi-square test was performed using STATISTICA ® software to correlate various variables. Results: A total of 34 patients participated, including 24 men and 10 women, with an average age of 41.9 years. Most male patients had Diabetes Mellitus, HIV, and drug addiction, and they resided in urban areas. Half of the patients did not report any apparent trauma. The most common infectious agent was Staphylococcus aureus*. Nearly 62% of patients required a change in the initial antibiotic regimen, with Penicillin being the most frequently substituted medication. Beta-lactam antibiotics and Quinolones were the most effective. Conclusion: These results suggest the importance of carefully evaluating the epidemiological profile of patients with acute hand infections and improving initial empirical treatment to ensure appropriate and effective therapy. Level of Evidence IV, Cross-Sectional Observational Study.

Objetivo: Determinar o perfil epidemiológico de pacientes atendidos em um hospital filantrópico referência em Ortopedia e Traumatologia localizado em um centro urbano importante, e avaliar a eficácia do tratamento antibiótico empírico inicial. Métodos: Foram incluídos pacientes com diagnóstico de infecção na mão, atendidos no período de setembro de 2020 a setembro de 2022, excluindo-se casos relacionados a fraturas expostas ou pós-cirúrgicas e aqueles com prontuários incompletos. Realizou-se o teste do qui-quadrado, utilizando o software STATISTICA ® para correlacionar diversas variáveis. Resultados: Participaram do estudo 34 pacientes, sendo 24 homens e 10 mulheres, com média de idade de 41,9 anos. A maioria era de homens, com alta incidência de diabetes mellitus, HIV e drogadição, que residiam em áreas livres. Metade não relatou trauma evidente. O agente infeccioso mais comum foi o Staphylococcus aureus. Aproximadamente 62% dos pacientes precisaram de troca do esquema inicial de antibióticos, sendo a penicilina o medicamento mais frequentemente substituído. Os antibióticos beta-lactâmicos e quinolonas foram os mais eficientes. Conclusão: Esses resultados sugerem a importância de avaliar cuidadosamente o perfil epidemiológico dos pacientes com infecções agudas na mão e aprimorar o tratamento empírico inicial para garantir uma terapia adequada e eficaz. Nível de Evidência IV, Estudo Observacional Transversal.

SARS-CoV-2 shedding, infectivity, and evolution in an immunocompromised adult patient.

This study aimed to provide further insight into the evolutionary dynamics of SARS-CoV-2 by analyzing the case of a 40-year-old man who had previously undergone autologous hematopoietic stem cell transplantation due to a diffuse large B-cell lymphoma. He developed a persistent SARS-CoV-2 infection lasting at least 218 days and did not manifest a humoral immune response to the virus during this follow-up period. Whole-genome sequencing and viral cultures confirmed a persistent infection with a replication-positive virus that had undergone genetic variation for at least 196 days after symptom onset.

Uncovering multiscale structure in the variability of larval zebrafish navigation.

Animals chain movements into long-lived motor strategies, resulting in variability that ultimately reflects the interplay between internal states and environmental cues. To reveal structure in such variability, we build models that bridges across time scales that enable a quantitative comparison of behavioral phenotypes among individuals. Applied to larval zebrafish exposed to diverse sensory cues, we uncover a hierarchy of long-lived motor strategies, dominated by changes in orientation distinguishing cruising and wandering strategies. Environmental cues induce preferences along these modes at the population level: while fish cruise in the light, they wander in response to aversive (dark) stimuli or in search for prey. Our method enables us to encode the behavioral dynamics of each individual fish in the transitions among coarse-grained motor strategies. By doing so, we uncover a hierarchical structure to the phenotypic variability that corresponds to exploration-exploitation trade-offs. Within a wide range of sensory cues, a major source of variation among fish is driven by prior and immediate exposure to prey that induces exploitation phenotypes. However, a large degree of variability is unexplained by environmental cues, pointing to hidden states that override the sensory context to induce contrasting exploration-exploitation phenotypes. Altogether, our approach extracts the timescales of motor strategies deployed during navigation, exposing undiscovered structure among individuals and pointing to internal states tuned by prior experience.