Performance of non-formalin fixed paraffin embedded samples in hybrid capture and amplicon next-generation sequencing panels.

BACKGROUND: Genomic profiling using next-generation sequencing (NGS) is fundamental for driving prognostic and therapy in cancer. Formalin-fixed paraffin embedded (FFPE) tissue is the widely used material, whereas non-FFPE may represent an alternative. However, studies comparing the NGS performance of non-FFPE materials to FFPE are still lacking in the literature. The objective of this study was to characterize in non-FFPE preparations the nucleic acid yield and NGS performance on both a capture-based and an amplicon-based NGS platform. NGS quality metrics obtained from non-FFPE preparations were compared to FFPE. METHODS: We analyzed the cellularity and nucleic acid yield in 111 tumors from non-FFPE preparations. In addition, comprehensive hybrid capture panel sequencing metrics obtained from DNA and RNA libraries were compared between independent non-FFPE and FFPE samples. A paired comparison between non-FFPE and FFPE samples was performed to analyze concordance in mutant allele detection using an amplicon panel. RESULTS: The mean target coverage from DNA libraries was 2× higher in non-FFPE samples than in FFPE. The detection of exogenous DNA was 2.5× higher in non-FFPE than in FFPE. Conversely, a lower performance was observed in non-FFPE RNA libraries in comparison to FFPE DNA libraries with no impact in minimum standard cutoffs. The variant allele detection in non-FFPE was found to be comparable to that of FFPE tumor samples in matched samples. CONCLUSIONS: Non-FFPE was demonstrated to be a suitable material for DNA and RNA library preparations using a comprehensive NGS panel. This is the first study reporting library quality metrics according to the TSO500 analysis pipeline.

Modelo lógico para o plano de enfrentamento à covid-19: contribuições para a avaliação / Logical Model for a plan to tackle COVID-19: contributions to evaluation

Resumo Este estudo tem como objetivo apresentar o processo de elaboração e validação do modelo lógico do plano de contingência para enfrentamento da covid-19 do Hospital Universitário de Brasília (HUB-UnB/Ebserh). É parte de um estudo de avaliabilidade, de metodologia qualitativa, desenvolvido de forma participativa, com os interessados pela avaliação (gestores e profissionais de saúde) no hospital e foi realizado entre julho 2020 e fevereiro de 2021. Todos os produtos foram validados pelos interessados. O modelo lógico validado é composto por sete componentes e 18 atividades e 109 produtos. Os componentes foram 'Gestão', 'Assistência', 'Força de Trabalho', 'Vigilância', 'Apoio e Insumos Estratégicos', 'Ensino, Pesquisa e Extensão' e 'Comunicação'. A cultura da avaliação em saúde tem grande importância para demonstrar a efetividade e o impacto das intervenções e apoiar os gestores na tomada de decisão. O uso de modelos lógicos permite a visualização da racionalidade da intervenção, apresentando seu funcionamento e o vínculo entre as relações causais e seus elementos.

Abstract This study aimed to present the process to develop and validate the logical model of the Contingency Plan to face COVID-19 at the University Hospital of Brasília (HUB-UnB/Ebserh). It is part of an evaluability study, with a qualitative methodology, developed in a participatory way, with those interested in the evaluation (managers and health professionals) at the hospital and was carried out between July 2020 and February 2021. All products were validated by interested parties. The validated logical model is composed of seven components and 18 activities and 109 products. The components were 'Management', 'Assistance', 'Workforce', 'Surveillance', 'Support and Strategic Supplies', 'Teaching, Research and Extension' and 'Communication'. The culture of health assessment is of great importance to demonstrate the effectiveness and impact of interventions and support managers in decision-making. The use of logical models allows the visualization of the rationality of the intervention, presenting its operation and the link between the causal relations and its elements.

Sistematização da assistência de enfermagem: percepção de uma equipe multiprofissional na atenção primária à saúde / Sistematización de la atención de enfermería: la percepción de un equipo multiprofesional en atención primaria de la salud / Systematization of nursing care: the perception of a multiprofessional team within the primary health care scope

Objetivo: analisar a percepção da equipe multiprofissional acerca da sistematização da assistência de enfermagem na atenção primária à saúde. Método: estudo de análise temática reflexiva, com abordagem qualitativa, fundamentado no estudo de caso único, realizado no ano de 2021. O cenário constituiu-se de unidade básica de saúde, onde participaram 14 colaboradores da equipe multiprofissional. A coleta de dados foi realizada por meio de entrevistas semiestruturadas, utilizando gravadores digitais, seguindo a análise de dados indutiva. O estudo foi aprovado eticamente. Resultados: foram extraídas duas categorias empíricas referindo-se ao conhecimento da equipe face as atribuições do enfermeiro na atenção primária, bem como as facilidades e as dificuldades enfrentadas pelo enfermeiro no cotidiano de trabalho na implementação da sistematização da assistência de enfermagem. Considerações finais: a sistematização da assistência de enfermagem ainda apresenta incipiente para a equipe multiprofissional, tornando inviável a aplicação desta ferramenta pelo enfermeiro no seu processo de trabalho.

Objetivo: analizar la percepción del equipo multiprofesional acerca de la Sistematización de la Atención de Enfermería en Atención Primaria de la Salud. Método: estudio de análisis temático reflexivo con enfoque cualitativo, fundamentado en el estudio de un único caso y realizado en el año 2021. El escenario de la investigación fue una unidad básica de salud en la que participaron 14 trabajadores del equipo multiprofesional. Los datos se recolectaron por medio de entrevistas semiestructuradas, utilizando grabadoras digitales y siguiendo la técnica de análisis inductivo de datos. El estudio contó con la debida aprobación ética. Resultados: se extrajeron dos categorías empíricas referidas al conocimiento del equipe frente a los deberes de los enfermeros en Atención Primaria, al igual que las facilidades y dificultades enfrentadas por los enfermeros en la rutina de trabajo al implementar la Sistematización de la Atención de Enfermería. Consideraciones finales: la Sistematización de la Atención de Enfermería sigue siendo incipiente para el equipo multiprofesional, lo que impide que los enfermeros apliquen esta herramienta en su proceso de trabajo.

Objective: to analyze the multiprofessional team perception regarding the Systematization of Nursing Care in Primary Health Care. Method: a reflective thematic analysis study with a qualitative approach based on a single case study carried out in 2021. The scenario consisted of a basic health unit and the participants were 14 staff members from its multiprofessional team. Data collection was carried out through semi-structured interviews using digital recorders and following an inductive data analysis. The study was ethically approved. Results: two empirical categories were extracted, one referring to the team's knowledge about nurses' duties in Primary Health Care and the other related to the facilitating factors and difficulties faced by nurses in their daily effort to implement the Systematization of Nursing Care. Final considerations: the Systematization of Nursing Care still proved to be incipient for the multiprofessional team, making it unfeasible for nurses to apply this tool in their work process.

COVID-19 y Enfermedades Autoinmunes Sistémicas ¿cuál es la relación y sus consecuencias?

Introducción: Los pacientes portadores de enfermedades autoinmunes sistemas constituyen una población vulnerable para el desarrollo de infección por COVID-19. Objetivo: Determinar la frecuencia de infección por COVID-19 en los pacientes asistidos en la policlínica, su severidad y su relación con el tratamiento inmunosupresor. Conocer el número de brotes y la tasa de vacunación de nuestra población. Metodología: Estudio transversal de pacientes asistidos en una unidad de enfermedades autoinmunes sistémicas en el período abril 2020-julio 2021. Resultados: Se analizaron 59 pacientes, 19 tuvieron brote de la enfermedad en el último año. 12 tuvieron infección por COVID-19, uno ingresó a cuidados moderados. La mediana de edad de los pacientes infectados fue de 35 años. 55 recibieron vacunación completa. Conclusiones: No se encontró una asociación entre la infección por COVID-19 y brotes de la enfermedad así como tampoco una mayor tasa de hospitalización ni muerte. Los pacientes con Lupus fueron los más vulnerables. La tasa de controles media (presencial/telefónica) fue alta para la totalidad de la población así como la tasa de vacunación.

Introduction: Patients with autoimmune system diseases constitute a vulnerable population for the development of SARS-CoV-2 infection. Objectives: To determine the incidence of SARS-CoV-2 infection in patients seen at the polyclinic. Methodology: Cross-sectional study patients assisted in an autoinmune disease center in the period April 2020-July 2021. Results: 59 patients were analyzed, 19 had flares of the disease in the last year. 12 had SARS CoV-2 infection, 1 was admitted to moderate care. The median age of infected patients was 35 years. 55 received full vaccination. Conclusions: No association was found between COVID-19 infection and diseases flares as well as an increased rate of hospitalization or death. Lupus patients were the most vulnerable. The controls rate (face-to-face/telephone) was high for the entire population as well as the vaccination rate.

Introdução: Pacientes com doenças autoimunes constituem uma população vulnerável ao desenvolvimento da infecção por COVID-19. Objetivo: Determinar a frequência da infecção por COVID-19 em pacientes atendidos na policlínica, sua gravidade e sua relação com o tratamento imunossupressor. Conheça o número de surtos e a taxa de vacinação da nossa população. Metodologia: Estudo transversal. Apresenta 59 pacientes atendidos em unidade EAS no período de abril de 2020 a julho de 2021. Resultados: Foram analisados ​​59 pacientes, 19 tiveram surto da doença no último ano. 12 tiveram infecção por COVID-19, 1 foi internado em cuidados moderados. A idade média dos pacientes infectados foi de 35 anos. 55 receberam vacinação completa. Conclusões: não foi encontrada associação entre infecção por covid-19 e surtos da doença, nem maior taxa de hospitalização ou morte. Pacientes com lúpus eram os mais vulneráveis. A taxa média de controlo (presencial/telefone) foi elevada para toda a população, bem como a taxa de vacinação.

Use of 5-Alpha Reductase Inhibitors in Dermatology: A Narrative Review.

Finasteride and dutasteride are 5-alpha reductase selective inhibitors (5ARIs). They were introduced as therapeutic agents for the treatment of benign prostatic hyperplasia in 1992 and 2002, respectively; finasteride has also been approved for the treatment of androgenetic alopecia since early 2000. These agents inhibit the conversion of testosterone (T) to 5α-dihydrotestosterone (5α-DHT), limiting steroidogenesis and playing a crucial role in the physiological function of the neuroendocrine system. Therefore, it has been proposed that blocking androgen synthesis with the use of 5ARIs would be beneficial in the treatment of various diseases related to states of hyperandrogenism. This review describes the dermatological pathologies in which 5ARIs have been used as part of the treatment, evaluation of the efficacy, and knowledge of the safety profile. Specifically, we discuss the application of 5ARIs in androgenetic alopecia, acne, frontal fibrosing alopecia, hirsutism, and the implications of adverse events associated with its use to inform about the applications of 5ARIs in general dermatology practice.

The early evolution of COVID-19 incidence and mortality among people aged under 80 years or 80 years and above after COVID-19 vaccine implementation in the state of Bahia, Brazil.

This study evaluates the early effects of COVID-19 vaccine implementation in the number of cases and deaths due to COVID-19 among those aged < 80 years or ≥ 80 years in the state of Bahia, Brazil. For that, we used data from the Bahia state Secretary of Health platform of cases and deaths due to COVID-19 in all age groups, between March 2020 and May 2021, when 82% of COVID-19 vaccines were CoronaVac. Overall, there were 1,012,200 cases and 21,241 deaths due to COVID-19, of which, respectively, 2.3% and 25.3% occurred in patients aged ≥ 80 years. The median proportion of deaths in those ≥ 80 years decreased from 29.8% (27.8%-30.4%) in the pre- to 18.8% (15.6%-18.8%) in the post-vaccine periods (p = 0.04). Significant reduction in the median proportion of deaths from COVID-19 among those aged ≥ 80 years after COVID-19 vaccine implementation was found, which suggests CoronaVac effectiveness against death from COVID-19 in the elderly.

Emoji as promising tools for emotional evaluation in orthodontics.

BACKGROUND: Emoji are pictograms frequently used in social networks capable of expressing emotions. These tools can provide insights into people's behavior that could not be obtained with the use of textual communication. Recently, emoji have been introduced to various research fields as successful alternatives to word-based questionnaires for measure emotional responses. The objective of this study was to preliminarily evaluate the discriminating ability and relationship of these tools with different occlusal conditions/malocclusions. METHODS: Online surveys were applied to adult individuals (n = 201; mean age = 27.4 ± 5.7; 37.3% males, 62.7% females). Subjects issued acceptance scores (10-point scale) and expressed their emotional status using a 30-emoji list in relation to nine occlusal conditions: C1-crowding, C2-anterior open bite, C3-interincisal diastema, C4-increased overjet + deep bite (Class II div. 1), C5-anterior crossbite (Class III), C6-ideal occlusion, C7-unilateral posterior crossbite, C8-anterior open bite plus bilateral posterior crossbite plus crowding, and C9-deep bite (Class II div. 2). Cochran's Q and McNemar tests were used to compare the frequencies of choice of emoji between conditions. Correspondence analyses were applied to assess the association between occlusal conditions and emoji. Kendall's correlation coefficient was calculated to evaluate the relationship between mean acceptance scores and frequency counts of each emoji. RESULTS: The frequency of choice between conditions showed a significant difference for 25 of the 30 emoji (P < 0.05), indicating an adequate discriminating ability of these tools. Emoji were grouped predominantly based on their emotional valence (positive/negative) and arousal/activation (high/low). Positive emoji were associated with the most accepted conditions (i.e., C6, C3), while negative emoji with the most rejected ones (i.e., C8, C1, C2). Although only weak, positive correlations between acceptance and positively valenced emoji, and negative correlations between acceptance and negatively valenced emoji were observed (P < 0.05). CONCLUSIONS: Emoji have an adequate discriminatory ability and would allow determining emotional profiles in the face of different occlusal conditions. Further research is necessary to consolidate the use of these tools in an instrument that allows measuring emotional responses.

Characterization of reproductive proteins in the Mexican fruit fly points towards the evolution of novel functions.

Seminal fluid proteins (Sfps) modify female phenotypes and have wide-ranging evolutionary implications on fitness in many insects. However, in the Mexican fruit fly, Anastrepha ludens, a highly destructive agricultural pest, the functions of Sfps are still largely unknown. To gain insights into female phenotypes regulated by Sfps, we used nano-liquid chromatography mass spectrometry to conduct a proteomic analysis of the soluble proteins from reproductive organs of A. ludens. The proteins predicted to be transferred from males to females during copulation were 100 proteins from the accessory glands, 69 from the testes and 20 from the ejaculatory bulb, resulting in 141 unique proteins after accounting for redundancies from multiple tissues. These 141 included orthologues to Drosophila melanogaster proteins involved mainly in oogenesis, spermatogenesis, immune response, lifespan and fecundity. In particular, we found one protein associated with female olfactory response to repellent stimuli (Scribble), and two related to memory formation (aPKC and Shibire). Together, these results raise the possibility that A. ludens Sfps could play a role in regulating female olfactory responses and memory formation and could be indicative of novel evolutionary functions in this important agricultural pest.

Probiotics and dairy products in dentistry: A bibliometric and critical review of randomized clinical trials.

The oral environment is an essential part of the human microbiome. The consumption of probiotic products may improve the oral microbiota and reduce the risk of diseases. This paper presents a bibliometric and critical review of randomized clinical trials (RCTs) that used probiotics to analyze oral parameters in humans. RCTs carried out with no age, gender, and ethnicity restrictions and published in the pre-COVID-19 period were included. Furthermore, the utilization of probiotic dairy products to improve oral health is discussed. The bibliometric review demonstrated that 'Microbiology,' 'Dental caries,' and 'Streptococcus mutants' were the most highlighted keywords. Furthermore, Sweden and India have the highest number of publications. The most prevalent outcomes were 'salivary parameters,' 'periodontal disease,' and 'dental caries.' The most used vehicles for probiotic administration were pharmaceutical formulas and dairy products. The administration of probiotic dairy products could modify the oral microbiota (reductions in S. mutans counts), influence the caries development and periodontal disease in children, adolescents, adults, and the elderly, and improve gingival health. The main probiotic dairy products investigated were milk, fermented milk, yogurt, kefir, curd, and cheese. Lacticaseibacillus paracasei SD1 was the most used probiotic culture. The studies demonstrated that the probiotic effect lasted 2-4 weeks after discontinuing consumption. However, the results depended on the subject type, study design, probiotic strain and concentration, and dairy product type. In conclusion, probiotic dairy products are promising alternatives to improve oral health.

Impact of meningococcal C conjugate vaccine on incidence of invasive meningococcal disease in an 18-year time series in Brazil and in distinct Brazilian regions.

OBJECTIVE: To evaluate the impact of meningococcal C conjugate (MCC) vaccine in Brazil. METHODS: Ecological study assessing all invasive meningococcal disease (IMD) and meningococcal C disease (MenC) cases reported in all age groups, from 2001 to 2019. MCC was implemented in 2010. Data were collected on the DATASUS platform. Joinpoint regression was performed to assess the annual percent change (APC) of the incidence rate. RESULTS: Invasive meningococcal disease incidence decreased in all Brazilian regions from 2001 onwards, without apparent additional reduction attributable to MCC vaccine in the North, Northeast and South. The higher and statistically significant APC reduction in all age groups, in the North and South, and in children <5 years, in the Northeast, occurred between 2001 and 2011 (-15.4%), 2004 and 2012 (-14.4%), and 2001 and 2013 (-10.3%), respectively, before MCC vaccine implementation. Annual incidence of MenC in children under 5 years significantly fell in the North (-6.8%; 2011-2018), Southeast (-40.6%; 2010-2015) and Midwest (-48.6%; 2010-2014), which may be attributable to MCC implementation. CONCLUSION: Invasive meningococcal disease and MenC behaved differently after MCC vaccine implementation in Brazil during this 18-year time-series analysis. This suggests that the control of IMD should be based on multiple public health care measures and considered on a regional basis.

Probiotic fermented milks: Children's emotional responses using a product-specific emoji list.

This study aimed to develop and validate a product-specific emoji list and use this list to analyse children's emotional responses associated with the consumption of probiotic fermented milks prepared with different probiotic strains. Furthermore, the overall liking of the products was studied during a sensory test. Six formulations were studied: Bifidobacterium BB12 (BB), Lactobacillus acidophilus L3 (LA3), Lactobacillus acidophilus LA 05 (LA5), Lactobacillus delbrueckii subsp. lactis (LL), Lacticaseibacillus casei 01 (LC), and Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus (CONV). A total of 132 children (7-14 years old) participated in two study phases: development (n = 32) and validation (n = 100) of the list. Fifteen emoji were selected to be included in the product-specific list, which had a high frequency of citations in the first phase. The formulations with the highest overall liking (LL, BB, LC and CONV) were correlated with positive emoji, while the least-liked formulations (LA3 and LA5) were associated with negative emoji. Furthermore, the utilisation of emoji enabled the differentiation among formulations with similar overall liking. Therefore, this study developed and validated an emoji list to be used in the evaluation of fermented milks by children. The results suggest that the type of probiotic culture impacted the sensory characteristics of fermented milks, supporting the use of Bifidobacterium, L. lactis or L. casei in these products.

Improvement of ethanol production in fed-batch fermentation using a mixture of sugarcane juice and molasse under very high-gravity conditions.

Ethanol fermentation in very high gravity (VHG) saves energy consumption for ethanol distillation. As the technology offers high ethanol yield and low waste generation and it can be operated at low cost, it could be more efficient at an industrial scale than other ethanol production methods. This work studied ethanol production using a fed-batch bioreactor with a working volume of 1.5 L. The main objective of this research was evaluate the effects of temperature, sugar concentration, and cellular concentration using a Central Composite Design (CCD). Experimental conditions were selected using the surface response technique obtained from the CCD, and the results were validated to test the reproducibility. The following operating conditions were selected: temperature of 27.0 °C, sugar concentration 300.0 g/L, and cell concentration 15.0% (v/v). Under these conditions, after 30 h of fermentation the ethanol concentration, productivity and yield were 135.0 g/L, 4.42 g/(L·h) and 90.0%, respectively. All sugar was completely consumed.

Applying a complex adaptive systems approach to the evaluation of a school-based intervention for intimate partner violence prevention in Mexico.

Despite calls for evaluation practice to take a complex systems approach, there are few examples of how to incorporate complexity into real-life evaluations. This article presents the case for using a complex systems approach to evaluate a school-based intimate partner violence-prevention intervention. We conducted a post hoc analysis of qualitative evaluation data to examine the intervention as a potential system disruptor. We analysed data in relation to complexity concepts particularly relevant to schools: 'diverse and dynamic agents', 'interaction', 'unpredictability', 'emergence' and 'context dependency'. The data-two focus groups with facilitators and 33 repeat interviews with 14-17-year-old students-came from an evaluation of a comprehensive sexuality education intervention in Mexico City, which serves as a case study for this analysis. The findings demonstrate an application of complex adaptive systems concepts to qualitative evaluation data. We provide examples of how this approach can shed light on the ways in which interpersonal interactions, group dynamics, the core messages of the course and context influenced the implementation and outcomes of this intervention. This gender-transformative intervention appeared to disrupt pervasive gender norms and reshape beliefs about how to engage in relationships. An intervention comprises multiple dynamic and interacting elements, all of which are unlikely to be consistent across implementation settings. Applying complexity concepts to our analysis added value by helping reframe implementation-related data to focus on how the 'social' aspects of complexity influenced the intervention. Without examining both individual and group processes, evaluations may miss key insights about how the intervention generates change, for whom, and how it interacts with its context. A social complex adaptive systems approach is well-suited to the evaluation of gender-transformative interventions and can help identify how such interventions disrupt the complex social systems in which they are implemented to address intractable societal problems.

Gingival fibroblasts behavior on bioactive zirconia and titanium dental implant surfaces produced by a functionally graded technique.

Adding a biological apatite layer to the implant surface enhances bone healing around the implant. Objective This study aimed to characterize the mechanical properties and test human gingival fibroblasts behavior in contact with Zirconia and Titanium bioactive-modified implant materials. Methodology 6 groups were considered: Titanium (Ti6Al4V), Ti6Al4V with 5% HA and 5% ßTCP, Zirconia (YTZP), YTZP with 5% HA and 5% ßTCP. For each group, we produced discs using a novel fabrication method for functionally graded materials, under adequate conditions for etching and grit-blasting to achieve equivalent surface microroughness among the samples. Surface roughness (Ra, Rz), water contact angle, shear bond strength, and Vickers hardness were performed. Human gingival fibroblasts immortalized by hTERT gene from the fourth passage, were seeded on discs for 14 days. Cell viability and proliferation were assessed using a resazurin-based method, and cellular adhesion and morphology using field emission gun scanning electron microscopy (FEG-SEM). After 3 days of culture, images of fluorescent nucleic acid stain were collected by confocal laser scanning microscopy (CLSM). Results Results were presented as mean ± standard deviation (SD). We compared groups using one-way ANOVA with Tukey's post-hoc test, and significance level was set at p<0.05. After 14 days of culture, cell viability and proliferation were significantly higher in YTZP group than in other groups (p<0.05). Samples of YTZP-ßTCP presented significantly higher wettability (p<0.05); yet, we observed no improvement in cell behavior on this group. Fibroblast spreading and surface density were more evident on YTZP specimens. Adding calcium-phosphate bioactive did not alter the tested mechanical properties; however, Ti6Al4V material shear bond strength was statistically higher than other groups (p<0.05). Conclusion Adding bioactive materials did not improve soft-tissue cell behavior. When compared to other zirconia and titanium groups, pure zirconia surface improved adhesion, viability and proliferation of fibroblasts. Cell behavior seems to depend on surface chemical composition rather than on surface roughness.

Molecular responses to freshwater limitation in the mangrove tree Avicennia germinans (Acanthaceae).

Environmental variation along the geographical space can shape populations by natural selection. In the context of global warming and changing precipitation regimes, it is crucial to understand the role of environmental heterogeneity in tropical trees adaptation, given their disproportional contribution to water and carbon biogeochemical cycles. Here, we investigated how heterogeneity in freshwater availability along tropical wetlands has influenced molecular variations of the black mangrove (Avicennia germinans). A total of 57 trees were sampled at seven sites differing markedly in precipitation regime and riverine freshwater inputs. Using 2,297 genome-wide single nucleotide polymorphic markers, we found signatures of natural selection by the association between variations in allele frequencies and environmental variables, including the precipitation of the warmest quarter and the annual precipitation. Additionally, we found candidate loci for selection based on statistical deviations from neutral expectations of interpopulation differentiation. Most candidate loci within transcribed sequences were functionally associated with central aspects of drought tolerance or plant response to drought. Moreover, our results suggest the occurrence of the rapid evolution of a population, probably in response to sudden and persistent limitations in plant access to soil water, following a road construction in 1974. Observations supporting rapid evolution included the reduction in tree size and changes in allele frequencies and in transcript expression associated with increased drought tolerance through the accumulation of osmoprotectants and antioxidants, biosynthesis of cuticles, protection against protein degradation, stomatal closure, photorespiration and photosynthesis. We describe a major role of spatial heterogeneity in freshwater availability in the specialization of this typically tropical tree.

Unidad de enfermedades autoinmunes: experiencia de un centro / Autoimmune Diseases Unit: experience of a center / Unidade de doenças autoimunes: experiência de um centro

Resumen: Introducción: Las enfermedades autoinmunes sistémicas son un grupo de enfermedades de baja prevalencia, cuya patogenia está basada en la pérdida de la auto-tolerancia. A pesar de su baja incidencia y prevalencia, la profundización en el estudio y conocimiento de estas enfermedades ha permitido importantes avances diagnósticos y terapéuticos en los últimos años, constituyendo un desafío en la práctica clínica. Objetivo: determinar la prevalencia y características clínico-humorales de estas patologías en la Policlínica de Enfermedades Autoinmunes del Hospital Pasteur, en el periodo 2016 -2019. Resultados: El total de población fue de 62 pacientes., 55/62 (88%) son mujeres. La más prevalente fue Lupus Eritematoso Sistémico, representando un 32% de esta población (20/62), la artritis reumatoide en un 21% (13/62), la esclerosis sistémica en un 8% (5/62), vasculitis sistémica 8% (5/62), Overlap 6% (4/62), Bechet 5% (3/62). Conclusiones: Se destaca un claro predominio del lupus y de la artritis reumatoide como enfermedades más prevalentes, así como un incremento mantenido de otras patologías menos habituales. Es de suma importancia fomentar el desarrollo de unidades especializadas en estas enfermedades para poder mejorar y protocolizar el manejo de estos pacientes.

Abstract: Introduction: Systemic Autoimmune Diseases are a group of low-prevalence diseases whose pathogeny is based on the loss of self-tolerance. Despite their low incidence and prevalence, deepening the study and knowledge of these diseases has enabled significant diagnostic and therapeutic advances in recent years, constituting a challenge in clinical practice. Objective: to determine the prevalence and clinical-humoral characteristics of these pathologies in the Polyclinic of Autoimmune Diseases of Pasteur Hospital, in the period 2016 -2019. Results: The total population was 62 patients., 55/62 (88%) were women. Most prevalent was Systemic Lupus Erythematosus (SLE), representing 32% of this population (20/62), Rheumatoid Arthritis by 21% (13/62), Systemic Sclerosis by 8% (5/62), Systemic vasculitis 8% (5/62), Overlap syndrome 6% (4/62), Bechet 5% (3/62). Conclusions: Lupus and rheumatoid arthritis as more prevalent diseases, as well as a maintained increase in other less common diseases. It is very important to promote the development of specialized units in these área, in order to improve and protocol the management of these patients.

Resumo: Introdução: As doenças autoimunes sistêmicas são um grupo de doenças de baixa prevalência, cuja patogênese se baseia na perda de autotolerância. Apesar de sua baixa incidência e prevalência, o aprofundamento no estudo e conhecimento dessas doenças permitiu importantes avanços diagnósticos e terapêuticos nos últimos anos, constituindo um desafio na prática clínica. Objetivo: determinar a prevalência e as características clínico-humorais dessas patologias no Hospital Pasteur Polyclinic of Autoimmune Diseases, no período 2016-2019. Resultados: a população total foi de 62 pacientes, 55/62 (88%) são mulheres. O mais prevalente foi o lúpus eritematoso sistêmico (LES), representando 32% dessa população (20/62), artrite reumatoide em 21% (13/62), esclerose sistêmica em 8% (5 / 62), vasculite sistêmica 8% (5/62), sobreposição de 6% (4/62), Bechet 5% (3/62). Conclusões: Uma clara predominância de lúpus e artrite reumatoide destaca-se como as doenças mais prevalentes, bem como um aumento sustentado de outras patologias menos comuns. É de extrema importância promover o desenvolvimento de unidades especializadas nessas doenças, a fim de melhorar e protocolar o manejo desses pacientes.

Gingival fibroblasts behavior on bioactive zirconia and titanium dental implant surfaces produced by a functionally graded technique

Abstract Adding a biological apatite layer to the implant surface enhances bone healing around the implant. Objective This study aimed to characterize the mechanical properties and test human gingival fibroblasts behavior in contact with Zirconia and Titanium bioactive-modified implant materials. Methodology 6 groups were considered: Titanium (Ti6Al4V), Ti6Al4V with 5% HA and 5% ßTCP, Zirconia (YTZP), YTZP with 5% HA and 5% ßTCP. For each group, we produced discs using a novel fabrication method for functionally graded materials, under adequate conditions for etching and grit-blasting to achieve equivalent surface microroughness among the samples. Surface roughness (Ra, Rz), water contact angle, shear bond strength, and Vickers hardness were performed. Human gingival fibroblasts immortalized by hTERT gene from the fourth passage, were seeded on discs for 14 days. Cell viability and proliferation were assessed using a resazurin-based method, and cellular adhesion and morphology using field emission gun scanning electron microscopy (FEG-SEM). After 3 days of culture, images of fluorescent nucleic acid stain were collected by confocal laser scanning microscopy (CLSM). Results Results were presented as mean ± standard deviation (SD). We compared groups using one-way ANOVA with Tukey's post-hoc test, and significance level was set at p<0.05. After 14 days of culture, cell viability and proliferation were significantly higher in YTZP group than in other groups (p<0.05). Samples of YTZP-ßTCP presented significantly higher wettability (p<0.05); yet, we observed no improvement in cell behavior on this group. Fibroblast spreading and surface density were more evident on YTZP specimens. Adding calcium-phosphate bioactive did not alter the tested mechanical properties; however, Ti6Al4V material shear bond strength was statistically higher than other groups (p<0.05). Conclusion Adding bioactive materials did not improve soft-tissue cell behavior. When compared to other zirconia and titanium groups, pure zirconia surface improved adhesion, viability and proliferation of fibroblasts. Cell behavior seems to depend on surface chemical composition rather than on surface roughness.

Local adaptation of a dominant coastal tree to freshwater availability and solar radiation suggested by genomic and ecophysiological approaches.

Local adaptation is often a product of environmental variations in geographical space and has implications for biodiversity conservation. We investigated the role of latitudinal heterogeneity in climate on the organization of genetic and phenotypic variation in the dominant coastal tree Avicennia schaueriana. In a common garden experiment, samples from an equatorial region, with pronounced seasonality in precipitation, accumulated less biomass, and showed lower stomatal conductance and transpiration, narrower xylem vessels, smaller leaves and higher reflectance of long wavelengths by the stem epidermis than samples from a subtropical region, with seasonality in temperature and no dry season. Transcriptomic differences identified between trees sampled under field conditions at equatorial and subtropical sites, were enriched in functional categories such as responses to temperature, solar radiation, water deficit, photosynthesis and cell wall biosynthesis. Remarkably, the diversity based on genome-wide SNPs revealed a north-south genetic structure and signatures of selection were identified for loci associated with photosynthesis, anthocyanin accumulation and the responses to osmotic and hypoxia stresses. Our results suggest the existence of divergence in key resource-use characteristics, likely driven by seasonality in water deficit and solar radiation. These findings provide a basis for conservation plans and for predicting coastal plants responses to climate change.

Signet ring cell carcinoma of the rectum: atypical metastatic presentation.

Colorectal cancer is the third most common cancer in the world and the fourth most common cause of death related to cancer. Signet ring cell carcinoma represents an uncommon histological type for rectal cancer with less than 1% of all rectal neoplasms. It usually behaves aggressively and has an inferior prognosis. We present the case of a young man diagnosed with signet ring cell rectal carcinoma. He underwent neoadjuvant therapy with partial response, had surgery with curative intent and showed local recurrence after only 3 months. Disease progression happened only weeks after recurrence with metastasis to vertebrae, extraocular muscles, bone marrow and skin. He is currently receiving palliative chemotherapy.

Extremophiles as a Model of a Natural Ecosystem: Transcriptional Coordination of Genes Reveals Distinct Selective Responses of Plants Under Climate Change Scenarios.

The goal of this research was to generate networks of co-expressed genes to explore the genomic responses of Rhizophora mangle L. populations to contrasting environments and to use gene network analysis to investigate their capacity for adaptation in the face of historical and future perturbations and climatic changes. RNA sequencing data were generated for R. mangle samples collected under field conditions from contrasting climate zones in the equatorial and subtropical regions of Brazil. A gene co-expression network was constructed using Pearson's correlation coefficient, showing correlations among 78,364 transcriptionally coordinated genes. Each region exhibited two distinct network profiles; genes correlated with the oxidative stress response showed higher relative expression levels in subtropical samples than in equatorial samples, whereas genes correlated with the hyperosmotic salinity response, heat response and UV response had higher expression levels in the equatorial samples than in the subtropical samples. In total, 992 clusters had enriched ontology terms, which suggests that R. mangle is under higher stress in the equatorial region than in the subtropical region. Increased heat may thus pose a substantial risk to species diversity at the center of its distribution range in the Americas. This study, which was performed using trees in natural field conditions, allowed us to associate the specific responses of genes previously described in controlled environments with their responses to the local habitat where the species occurs. The study reveals the effects of contrasting environments on gene expression in R. mangle, shedding light on the different abiotic variables that may contribute to the genetic divergence previously described for the species through the use of simple sequence repeats (SSRs). These effects may result from two fundamental processes in evolution, namely, phenotypic plasticity and natural selection.