The efficacy of olfactory training in improving olfactory function: a meta-analysis.

PURPOSE: Study the efficacy of olfactory training in smell recovery. METHODS: An extensive search was performed through different databases in order to find articles analyzing the efficacy of olfactory training as a treatment for olfactory dysfunction. Methodological quality of primary studies within the final sample was assessed following PRISMA guidelines. Standardized mean differences in pre-post olfactory training groups, and also in experimental-control and pre-follow up if possible, were computed by Hedges' g effect size statistic. Each effect size was weighted by its inverse variance. RESULTS: Final sample was composed of 36 articles (45 pre-post effect sizes). Contrasts were performed separately for odor identification, odor discrimination, odor threshold and general olfactory function. Moderate to large and heterogeneous effect was obtained for olfactory function (g = 0.755, k = 45, SE = 0.093, CI 95% = [0.572, 0.937]), different moderators had a significant effects, such as, training duration, age and anosmia diagnosis. CONCLUSION: Olfactory training was found to have a positive and significant effect on rehabilitating the olfactory function.

The role of olfactory dysfunction in mild cognitive impairment and Alzheimer's disease: A meta-analysis.

PURPOSE: This comprehensive meta-analysis investigates the association between olfactory deficits in mild cognitive impairment (MCI) and Alzheimer's disease (AD). METHODS: A thorough search across databases identified articles analyzing olfactory status in MCI or AD patients. Methodological quality assessment followed PRISMA guidelines. Hedges' g effect size statistic computed standard mean differences and 95% confidence intervals. Moderator analysis was conducted. RESULTS: Among the included studies (65 for MCI and 61 for AD), odor identification exhibited larger effect sizes compared to odor threshold and discrimination, in both MCI and AD samples. Moderate effect size is found in OI scores in MCI (k = 65, SE = 0.078, CI 95% = [-1.151, -0.844]). Furthermore, compared to MCI, AD had moderate to large heterogeneous effects in olfactory identification (k = 61, g = -2.062, SE = 0.125, CI 95% = [-2.308, -1.816]). Global cognitive status is positively related to olfactory identification impairment in both MCI (k = 57, Z = 2.74, p = 0.006) and AD (k = 53, Z = 5.03, p < 0.0001) samples. CONCLUSION: Olfactory impairments exhibit a notable and substantial presence in MCI. Among these impairments, odor identification experiences the greatest decline in MCI, mirroring the primary sensory deficit observed in AD. Consequently, the incorporation of a straightforward odor identification test is advisable in the evaluation of individuals vulnerable to the onset of AD, offering a practical screening tool for early detection.

Animal models of Klebsiella pneumoniae mucosal infections.

Klebsiella pneumoniae is among the most relevant pathogens worldwide, causing high morbidity and mortality, which is worsened by the increasing rates of antibiotic resistance. It is a constituent of the host microbiota of different mucosa, that can invade and cause infections in many different sites. The development of new treatments and prophylaxis against this pathogen rely on animal models to identify potential targets and evaluate the efficacy and possible side effects of therapeutic agents or vaccines. However, the validity of data generated is highly dependable on choosing models that can adequately reproduce the hallmarks of human diseases. The present review summarizes the current knowledge on animal models used to investigate K. pneumoniae infections, with a focus on mucosal sites. The advantages and limitations of each model are discussed and compared; the applications, extrapolations to human subjects and future modifications that can improve the current techniques are also presented. While mice are the most widely used species in K. pneumoniae animal studies, they present limitations such as the natural resistance to the pathogen and difficulties in reproducing the main steps of human mucosal infections. Other models, such as Drosophila melanogaster (fruit fly), Caenorhabditis elegans, Galleria mellonella and Danio rerio (zebrafish), contribute to understanding specific aspects of the infection process, such as bacterial lethality and colonization and innate immune system response, however, they but do not present the immunological complexity of mammals. In conclusion, the choice of the animal model of K. pneumoniae infection will depend mainly on the questions being addressed by the study, while a better understanding of the interplay between bacterial virulence factors and animal host responses will provide a deeper comprehension of the disease process and aid in the development of effective preventive/therapeutic strategies.

Evaluation of rapid optimized flow cytometry crossmatch (Halifaster) in living donor kidney transplantation.

Kidney transplantation is often the preferred treatment for end-stage renal disease. However, the presence of preformed donor-specific antibodies (DSA), including those against HLA, can lead to antibody-mediated rejection and significantly impact transplant outcomes. The Flow Cytometry Crossmatch (FCXM) is a crucial tool in kidney transplantation, as it also enables the measurement of low levels of anti-HLA DSA antibodies. However, current methodologies for detecting these antibodies, however, are time-consuming and require extensive reagents. In this study, we analyzed the performance of the Halifaster FCXM protocol in 133 consecutive living kidney donor pairs, correlating these results with single antigen-based anti-HLA DSA results. Anti-HLA DSA was identified in 31 patients (23.3%). Both T and B lymphocyte FCXM assays demonstrated high sensitivity and specificity in detecting anti-HLA DSA. Furthermore, a Tree model to determine the levels of anti-HLA DSA to produce a flow crossmatch positivity, was developed offering an accuracy of 93% and 90% for T and B lymphocytes, respectively. Both approaches point to a thresh old of 1000-2000 MFI for T lymphocytes and 3000 MFI for B lymphocytes. Our findings indicate that the Halifaster protocol facilitates fast and efficient FCXM testing without compromising accuracy, marking a significant advancement in the field of kidney transplantation. The inclusion of HLA-specific antibody analysis underscores the protocol's comprehensive approach to improving transplant outcomes.

Tranexamic acid in bleeding reduction and operative time of nasal surgeries: systematic review and meta-analysis.

PURPOSE: Our study goal is to review the efficacy of tranexamic acid in reducing blood loss and operative time in nasal surgeries. METHODS: We included randomized clinical trials using oral or intravenous tranexamic acid, excluded non-randomized studies, topic administration, coagulopathy, and using other drugs interfering in the coagulation cascade. Online databases, National Library of Medicine (MEDLINE-PubMED), Latin American and Caribbean Literature on Health Sciences (Lilacs), Cochrane Library, Embase and Google Scholar were used to perform the search. The review was registered in PROSPERO by no CRD42022310977. Two authors, independently, selected the articles meeting the inclusion criteria. They extracted the data and used RevMan 5 software to perform the meta-analysis. RESULTS: Our search resulted in 16 RCTs that were included in the meta-analysis totalizing 1108 patients. Studies were evaluated resulting in a low risk of bias for the five domains. The use of tranexamic acid resulted in significant reduction in duration of surgery (DOS) and intraoperative blood loss (IBL) had significant reduction. The level of evidence according to GRADE System was high in all studies and variables. CONCLUSION: Tranexamic acid has an important role in reducing intraoperative blood loss and duration of surgery. Our study has some limitations due to the low number of RCTs available in the literature.

A utilização de torques resistentes ao movimento compensatório dos dentes anteriores no tratamento da Classe III no paciente adulto / The use of torques resistant to compensatory movement of anterior teeth in the treatment of Class III in adult patients

Este trabalho visou relatar o caso clínico de um paciente padrão III com mordida cruzada anterior, através de um tratamento compensatório com o uso de bráquetes que geram torques resistentes nos incisivos. O paciente JPCN, 42 anos, leucoderma, gênero masculino, procurou a clínica ortodôntica com a queixa principal de mordida cruzada anterior. Na análise extrabucal, observou-se a presença de padrão horizontal, simetria facial, maxila deficiente, ângulo nasolabial fechado, presença de selamento labial passivo e perfil côncavo com o lábio inferior à frente do superior. A prescrição utilizada foi a biofuncional, apresentado 0° de torque nos incisivos superiores e 10° nos incisivos inferiores. Foram realizados o alinhamento e nivelamento, mecânica de acentuação da curva de Spee no arco superior e reversão no arco inferior simultaneamente aos elásticos intermaxilares. Ao final do tratamento, foram observados correção da relação anteroposterior e intercuspidação dentária, trespasse horizontal e vertical normais, linhas médias coincidentes e selamento labial passivo. Concluiu-se que a utilização de torques resistentes nos incisivos gerados pelo uso de bráquetes da técnica biofuncional foi eficiente para manter uma boa inclinação desses dentes durante a correção damá oclusão de Classe III com o uso de elásticos intermaxilares (AU)

This study aimed to report the clinical case of a patient with pattern III with anterior crossbite, through a compensatory treatment with the use of brackets that generate resistant torques in the incisors. Patient JPCN, 42 years old, caucasian, male, came to the orthodontic clinic with the main complaint of anterior crossbite. In the extraoral analysis, it was observed the presence of a horizontal pattern, facial symmetry, deficient maxilla, closed nasolabial angle, presence of passive lip seal, and concave profile with the lower lip in front of the upper. The prescription used was the biofunctional, with 0° of torque on the upper incisors and 10° on the lower incisors. Alignment and leveling, orthodontic mechanics of Spee curve accentuation in the maxillary arch and reversal in the mandibular arch were performed simultaneously with intermaxillary elastics. At the end of the treatment, Class III correction, correction of the anteroposterior relationship and dental intercuspation, normal overbite and overjet, coinci-dent midlines and passive lip seal were observed. It was concluded that the use of resistant torques on the incisors promoted by the use of biofunctional technique brackets was efficient to maintain a good inclination of these teeth during the correction of Class III malocclusion with the use of intermaxillary elastics (AU)

Study of repertoire use reveals unexpected context-dependent vocalizations in bottlenose dolphins (Tursiops truncatus).

Dolphins are known for their complex vocal communication, not least because of their capacity for acoustic plasticity. Paradoxically, we know little about their capacity for flexible vocal use. The difficulty in describing the behaviours performed underwater while vocalizing makes it difficult to analyse the contexts of emissions. Dolphins' main vocal categories are typically considered to be used for scanning the environment (clicks), agonistic encounters (burst pulses) and socio-affiliative interactions (whistles). Dolphins can also combine these categories in mixed vocal emissions, whose use remains unclear. To better understand how vocalizations are used, we simultaneously recorded vocal production and the associated behaviours by conducting underwater observations (N = 479 events) on a group of 7 bottlenose dolphins under human care. Our results showed a non-random association between vocal categories and behavioural contexts. Precisely, clicks were preferentially emitted during affiliative interactions and not during other social/solitary contexts, supporting a possible complementary communicative function. Burst pulses were associated to high arousal contexts (agonistic and social play), pinpointing on their use as an "emotively charged" signal. Whistles were related to solitary swimming and not preferentially produced in any social context. This questions whistles' functions and supports their potential role as a distant contact call. Finally, mixed vocalizations were especially found associated with sexual (bust pulse-whistle-click), solitary play (burst pulse-whistle) and affiliative (click-whistle) behaviours. Depending on the case, their emission seems to confirm, modify or refine the functions of their simple counterparts. These results open up new avenues of research into the contextual use of dolphin acoustic signals.

Memory, Emotion, and Quality of Life in Patients with Long COVID-19.

(1) Background: Persistent COVID is characterized by the presence of fatigue, mental fog, and sleep problems, among others. We aimed to study cognitive abilities (attention, executive functions, memory, language) and psychological and emotional factors in a group of participants of the population with persistent COVID-19 and asymptomatic or non-COVID-19-infected patients; (2) Methods: A total of 86 participants aged 18 to 66 years (X = 46.76) took part in the study, with 57 individuals (66.27%) in the experimental group and 29 (33.73%) in the control group. A comprehensive assessment included neuropsychological evaluations, evaluations of anxious and depressive symptomatology, assessments of the impact of fatigue, sleep quality, memory failures in daily life, and the perceived general health status of the participants; (3) Results: significant differences between groups were found in incidental learning within the Key Numbers task (U = 462.5; p = 0.001; p = 0.022) and in the Direct Digit Span (U = 562; p = 0.022), but not in the Inverse Digit Span (U = 632.5; p = 0.105). Differences were also observed in the prospective memory task of the Rivermead Prospective Memory Tasks (from the Rivermead Behavioural Memory Test) in the recall of quotations (U = 610; p = 0.020) as well as in the recall of objects (U = 681.5; p = 0.032). Concerning the task of verbal fluency, significant differences were found for both phonological cues (p- and s-) (t = -2.190; p = 0.031) and semantic cues (animals) (t = -2.277; p = 0.025). In terms of the psychological impact assessment, significant differences were found in the emotional impact across all variables studied (fatigue, quality of sleep, memory lapses, and the perceived general health status), except for quality of life; (4) Conclusions: Our results suggest that the sequelae derived from persistent COVID may have an impact on people's lives, with higher levels of anxiety and depression, worse sleep quality, a greater number of subjective memory complaints, and a greater feeling of fatigue and impact on quality of life. Furthermore, poorer performance was observed in memory and verbal fluency.

Klotho in Cancer: Potential Diagnostic and Prognostic Applications.

Klotho proteins, αKlotho, ßKlotho, and γKlotho, exert tumor-suppressive activities via the fibroblast growth factor receptors and multiple cell-signaling pathways. There is a growing interest in Klotho proteins as potential diagnostic and prognostic biomarkers for multiple diseases. However, recent advances regarding their roles and potential applications in cancer remain disperse and require an integrated analysis. The present review analyzed research articles published between 2012 and 2022 in the Cochrane and Scopus scientific databases to study the role of Klotho in cancer and their potential as tools for diagnosing specific cancer types, predicting tumor aggressiveness and prognosis. Twenty-six articles were selected, dealing with acute myeloid leukemia and with bladder, breast, colorectal, esophageal, gastric, hepatocellular, ovarian, pancreatic, prostatic, pulmonary, renal, and thyroid cancers. αKlotho was consistently associated with improved prognosis and may be useful in estimating patient survival. A single study reported the use of soluble αKlotho levels in blood serum as a tool to aid the diagnosis of esophageal cancer. γKlotho was associated with increased aggressiveness of bladder, breast, and prostate cancer, and ßKlotho showed mixed results. Further clinical development of Klotho-based assays will require careful identification of specific tumor subtypes where Klotho proteins may be most valuable as diagnostic or prognostic tools.

Could olfactory identification be a prognostic factor in detecting cognitive impairment risk in the elderly?

Aging contributes to the deterioration of the olfactory system in humans. Several studies indicate that the olfactory identification test alone may function as a screening test for olfactory dysfunction and they are more feasible to apply in clinical practice. Olfactory identification may be a predictor for cognitive impairment. Multiple studies have considered the use of odor identification as a measure to identify the conversion from normality to mild cognitive impairment or dementia. The objectives were (i) to elucidate the associations between cognitive status and olfactory identification performance in aging; (ii) understand the predictive value of olfactory capacity in identifying subjects with cognitive impairment risk; and (iii) to study how cognitive status and olfactory identification relate with other variables of wellness in aging, such as functional capabilities and clinical measures. For this purpose, a group of 149 participants (77.15 ± 7.29 years; 73 women of 76.7 ± 8 years and 76 men of 77.6 ± 6.52 years) were recruited and were subjected to a sociodemographic questionnaire, a psychological screening tool of general cognitive status, an olfactory identification evaluation, and clinical measures. The participants were divided into groups based on their cutoff scores of previous scientific reports about the Spanish version of Montreal Cognitive Assessment. Our results indicate an age-associated decline in olfactory identification ability and intensity of odor perception. The predictive ability of olfactory identification scores for the risk of mild and severe impairment is around 80%. Olfactory identification decreases with cognitive function. Performance in odor identification is associated with impairment of episodic memory and executive functions. These findings further our current understanding of the association between cognition and olfaction, and support olfactory assessment in screening those at higher risk of dementia.

[Cesarean section and association with intelligence quotient in adolescents: contribution from the RPS Cohort Consortium (Ribeirão Preto, Pelotas and São Luís), Brazil]. / Nascer de cesariana e associação com quociente de inteligência em adolescentes: contribuição do Consórcio de Coortes RPS (Ribeirão Preto, Pelotas e São Luís), Brasil.

This study aimed to evaluate the association between cesarean section and intelligence quotient (IQ) in adolescents from the Municipality of São Luís, Maranhão State, Brazil. This is a longitudinal study using data from the São Luís birth cohort, started in 1997. The approach occurred in the third phase of the cohort, in 2016, with adolescents aged 18 and 19 years. The exposure variable was mode of delivery and the outcome variable was IQ, measured by applying the third version of the Wechsler Adult Intelligence Scale (WAIS-III). In the data analysis, the average IQ was verified according to the covariates and multivariate linear regression was used. To control confounding factors, a theoretical model was elaborated using the directed acyclic graph. The confounding variables were socioeconomic variables at birth and perinatal variables. Their average IQ was 101.4. In the crude analysis, the IQ of adolescents born by cesarean section was 5.8 points higher than those born by vaginal delivery (95%CI: 3.8; 7.7, p ≤ 0.001), with statistical significance. In the multivariate analysis, the value decreased to 1.9 (95%CI: -0.5; 3.6, p = 0.141), without statistical significance. The result of the study showed that cesarean section is not associated with the IQ of adolescents in this sample and reflects that the differences can be explained by other factors, such as socioeconomic and perinatal aspects.

O objetivo do estudo foi avaliar a associação entre a cesariana e o quociente de inteligência (QI) em adolescentes do Município de São Luís, Maranhão, Brasil. Trata-se de um estudo longitudinal utilizando dados da coorte de nascimento em São Luís, iniciado no ano de 1997. A abordagem ocorreu na terceira fase da coorte, em 2016, com adolescente aos 18 e 19 anos de idade. A variável de exposição foi a via de nascimento e a variável de desfecho foi o QI, mensurada a partir da aplicação da terceira versão da Escala de Inteligência Wechsler para Adultos (WAIS-III). Na análise dos dados verificou-se a média do QI segundo as covariáveis e utilizou-se a regressão linear multivariada. Para controlar os fatores de confundimento foi elaborado um modelo teórico utilizando o gráfico acíclico dirigido. As variáveis confundidoras foram as socioeconômicas no momento do nascimento e as variáveis perinatais. A média do QI dos adolescentes foi 101,4. Na análise bruta, o QI dos adolescentes nascidos de cesariana foi 5,8 pontos maior em relação aos nascidos de parto vaginal (IC95%: 3,8; 7,7, p ≤ 0,001), com significância estatística. Na análise multivariada, o valor reduziu para 1,9 (IC95%: -0,5; 3,6, p = 0,141), sem significância estatística. O resultado do estudo mostrou que a cesariana não está associada ao QI dos adolescentes nessa amostra e reflete que as diferenças encontradas podem ser explicadas por outros fatores, como aspectos socioeconômicos e perinatais.

El objetivo del estudio fue evaluar la asociación entre la cesárea y el cociente de inteligencia (CI) en adolescentes del Municipio de São Luís, Maranhão, Brasil. Este es un estudio longitudinal que utiliza datos de la cohorte de nacimiento en São Luís, que comenzó en 1997. El abordaje ocurrió en la tercera fase de la cohorte, en 2016, con adolescente a los 18 y 19 años de edad. La variable de exposición fue la vía de nacimiento y la variable de resultado fue el CI, medido a partir de la aplicación de la tercera versión de la Escala de Inteligencia para Adultos (WAIS-III). En el análisis de datos se verificó el CI medio según las covariables y se utilizó la regresión lineal multivariada. Para controlar los factores de confusión se elaboró un modelo teórico utilizando el gráfico acíclico dirigido. Las variables de confusión fueron las socioeconómicas en el momento del nacimiento y las variables perinatales. El coeficiente intelectual promedio de los adolescentes fue de 101,4. En el análisis bruto, el CI de los adolescentes nacidos de cesárea fue 5,8 puntos mayor en relación a los nacidos de parto vaginal (IC95%: 3,8; 7,7, p ≤ 0,001), con significancia estadística. En el análisis multivariado, el valor se redujo a 1,9 (IC95%: -0,5; 3,6, p = 0,141), sin significación estadística. El resultado del estudio mostró que la cesárea no está asociada con el coeficiente intelectual de los adolescentes en esta muestra y refleja que las diferencias encontradas pueden explicarse por otros factores, como los aspectos socioeconómicos y perinatales.

Xylans extracted from branches and leaves of Protium puncticulatum: antioxidant, cytotoxic, immunomodulatory, anticoagulant, antitumor, prebiotic activities and their structural characterization.

This work aimed to isolate and characterize xylans from branches and leaves of Protium puncticulatum, in addition to evaluating its in vitro biological and prebiotic potential. The results showed that the chemical structure of the obtained polysaccharides is similar being classified as homoxylans. The xylans presented an amorphous structure, in addition to being thermally stable and presenting a molecular weight close to 36 g/mol. With regard to biological activities, it was observed that xylans were able to promote low antioxidant activity (< 50%) in the different assays evaluated. The xylans also showed no toxicity against normal cells, in addition to being able to stimulate cells of the immune system and showing promise as anticoagulant agents. In addition to presenting promising antitumor activity in vitro. In assays of emulsifying activity, xylans were able to emulsify lipids in percentages below 50%. Regarding in vitro prebiotic activity, xylans were able to stimulate and promote the growth of different probiotics. Therefore, this study, in addition to being a pioneer, contributes to the application of these polysaccharides in the biomedical and food areas. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-023-03506-1.

Nascer de cesariana e associação com quociente de inteligência em adolescentes: contribuição do Consórcio de Coortes RPS (Ribeirão Preto, Pelotas e São Luís), Brasil / Cesarean section and association with intelligence quotient in adolescents: contribution from the RPS Cohort Consortium (Ribeirão Preto, Pelotas and São Luís), Brazil / Parto por cesárea y asociación con cociente de inteligencia en adolescentes: contribución del Consorcio de Cohorte RPS (Ribeirão Preto, Pelotas y São Luís), Brasil

O objetivo do estudo foi avaliar a associação entre a cesariana e o quociente de inteligência (QI) em adolescentes do Município de São Luís, Maranhão, Brasil. Trata-se de um estudo longitudinal utilizando dados da coorte de nascimento em São Luís, iniciado no ano de 1997. A abordagem ocorreu na terceira fase da coorte, em 2016, com adolescente aos 18 e 19 anos de idade. A variável de exposição foi a via de nascimento e a variável de desfecho foi o QI, mensurada a partir da aplicação da terceira versão da Escala de Inteligência Wechsler para Adultos (WAIS-III). Na análise dos dados verificou-se a média do QI segundo as covariáveis e utilizou-se a regressão linear multivariada. Para controlar os fatores de confundimento foi elaborado um modelo teórico utilizando o gráfico acíclico dirigido. As variáveis confundidoras foram as socioeconômicas no momento do nascimento e as variáveis perinatais. A média do QI dos adolescentes foi 101,4. Na análise bruta, o QI dos adolescentes nascidos de cesariana foi 5,8 pontos maior em relação aos nascidos de parto vaginal (IC95%: 3,8; 7,7, p ≤ 0,001), com significância estatística. Na análise multivariada, o valor reduziu para 1,9 (IC95%: -0,5; 3,6, p = 0,141), sem significância estatística. O resultado do estudo mostrou que a cesariana não está associada ao QI dos adolescentes nessa amostra e reflete que as diferenças encontradas podem ser explicadas por outros fatores, como aspectos socioeconômicos e perinatais.

This study aimed to evaluate the association between cesarean section and intelligence quotient (IQ) in adolescents from the Municipality of São Luís, Maranhão State, Brazil. This is a longitudinal study using data from the São Luís birth cohort, started in 1997. The approach occurred in the third phase of the cohort, in 2016, with adolescents aged 18 and 19 years. The exposure variable was mode of delivery and the outcome variable was IQ, measured by applying the third version of the Wechsler Adult Intelligence Scale (WAIS-III). In the data analysis, the average IQ was verified according to the covariates and multivariate linear regression was used. To control confounding factors, a theoretical model was elaborated using the directed acyclic graph. The confounding variables were socioeconomic variables at birth and perinatal variables. Their average IQ was 101.4. In the crude analysis, the IQ of adolescents born by cesarean section was 5.8 points higher than those born by vaginal delivery (95%CI: 3.8; 7.7, p ≤ 0.001), with statistical significance. In the multivariate analysis, the value decreased to 1.9 (95%CI: -0.5; 3.6, p = 0.141), without statistical significance. The result of the study showed that cesarean section is not associated with the IQ of adolescents in this sample and reflects that the differences can be explained by other factors, such as socioeconomic and perinatal aspects.

El objetivo del estudio fue evaluar la asociación entre la cesárea y el cociente de inteligencia (CI) en adolescentes del Municipio de São Luís, Maranhão, Brasil. Este es un estudio longitudinal que utiliza datos de la cohorte de nacimiento en São Luís, que comenzó en 1997. El abordaje ocurrió en la tercera fase de la cohorte, en 2016, con adolescente a los 18 y 19 años de edad. La variable de exposición fue la vía de nacimiento y la variable de resultado fue el CI, medido a partir de la aplicación de la tercera versión de la Escala de Inteligencia para Adultos (WAIS-III). En el análisis de datos se verificó el CI medio según las covariables y se utilizó la regresión lineal multivariada. Para controlar los factores de confusión se elaboró un modelo teórico utilizando el gráfico acíclico dirigido. Las variables de confusión fueron las socioeconómicas en el momento del nacimiento y las variables perinatales. El coeficiente intelectual promedio de los adolescentes fue de 101,4. En el análisis bruto, el CI de los adolescentes nacidos de cesárea fue 5,8 puntos mayor en relación a los nacidos de parto vaginal (IC95%: 3,8; 7,7, p ≤ 0,001), con significancia estadística. En el análisis multivariado, el valor se redujo a 1,9 (IC95%: -0,5; 3,6, p = 0,141), sin significación estadística. El resultado del estudio mostró que la cesárea no está asociada con el coeficiente intelectual de los adolescentes en esta muestra y refleja que las diferencias encontradas pueden explicarse por otros factores, como los aspectos socioeconómicos y perinatales.

Associação entre discriminação percebida e atividade física entre adolescentes / Association between perceived discrimination and physical activity among adolescents

Resumo A discriminação percebida é um importante produtor de estresse e trauma social e pode ter efeitos negativos sobre a saúde física e mental das pessoas expostas a ela. Este estudo visa analisar a associação direta e indireta entre discriminação percebida e prática de atividade física, mediada por transtornos mentais comuns de adolescentes. Trata-se de pesquisa transversal, com 2.484 adolescentes (18 e 19 anos) de uma coorte de São Luís, Maranhão. Modelos de equações estruturais foram utilizados para verificar o efeito direto da discriminação percebida sobre a atividade física (AF) e seu efeito indireto mediado pelos Transtornos Mentais Comuns (TMC). O potencial do sexo como variável modificadora de efeitos também foi testado. A discriminação percebida esteve associada a maiores níveis de AF nas mulheres (CP - Coeficiente padronizado direto =0,105, p-valor=0,005), e associada a menor AF por via indireta pelos TMC entre homens (CPindireto =-0,024, p-valor=0,017) e mulheres (CPindireto =-0,024, p-valor=0,015). Os achados mostram que nesta população de adolescentes houve associação entre discriminação percebida e AF, demonstrando que seus efeitos podem alterar comportamentos de saúde e o sexo pode modificar a relação entre essas variáveis.

Abstract Perceived discrimination is a major producer of stress and social trauma and can have negative effects on the physical and mental health of those exposed to it. This study aims to analyze the direct and indirect association between perceived discrimination and physical activity, mediated by common mental disorders in adolescents. This is a cross-sectional study with 2,484 adolescents (aged 18 and 19 years old) from a cohort in São Luís, Maranhão. Structural equation models were used to verify the direct effect of perceived discrimination on physical activity (PA) and its indirect effect mediated by common mental disorders (CMD). The potential of sex to act as an effect-modifying variable was also tested. Discrimination was associated with higher levels of PA in women (SC - Standardized Coefficient direct =0.105, p-value=0.005), and indirectly associated with lower PA via CMT among men (SCindirect =-0.024, p-value=0.017) and women (SCindirect =-0.024, p-value=0.015). Our findings show the association between perceived discrimination and PA in this population of adolescents, attesting that its effects can alter health behaviors and that gender can modify the relation between these variables.

Association between perceived discrimination and physical activity among adolescents. / Associação entre discriminação percebida e atividade física entre adolescentes.

Perceived discrimination is a major producer of stress and social trauma and can have negative effects on the physical and mental health of those exposed to it. This study aims to analyze the direct and indirect association between perceived discrimination and physical activity, mediated by common mental disorders in adolescents. This is a cross-sectional study with 2,484 adolescents (aged 18 and 19 years old) from a cohort in São Luís, Maranhão. Structural equation models were used to verify the direct effect of perceived discrimination on physical activity (PA) and its indirect effect mediated by common mental disorders (CMD). The potential of sex to act as an effect-modifying variable was also tested. Discrimination was associated with higher levels of PA in women (SC - Standardized Coefficient direct =0.105, p-value=0.005), and indirectly associated with lower PA via CMT among men (SCindirect =-0.024, p-value=0.017) and women (SCindirect =-0.024, p-value=0.015). Our findings show the association between perceived discrimination and PA in this population of adolescents, attesting that its effects can alter health behaviors and that gender can modify the relation between these variables.

A discriminação percebida é um importante produtor de estresse e trauma social e pode ter efeitos negativos sobre a saúde física e mental das pessoas expostas a ela. Este estudo visa analisar a associação direta e indireta entre discriminação percebida e prática de atividade física, mediada por transtornos mentais comuns de adolescentes. Trata-se de pesquisa transversal, com 2.484 adolescentes (18 e 19 anos) de uma coorte de São Luís, Maranhão. Modelos de equações estruturais foram utilizados para verificar o efeito direto da discriminação percebida sobre a atividade física (AF) e seu efeito indireto mediado pelos Transtornos Mentais Comuns (TMC). O potencial do sexo como variável modificadora de efeitos também foi testado. A discriminação percebida esteve associada a maiores níveis de AF nas mulheres (CP - Coeficiente padronizado direto =0,105, p-valor=0,005), e associada a menor AF por via indireta pelos TMC entre homens (CPindireto =-0,024, p-valor=0,017) e mulheres (CPindireto =-0,024, p-valor=0,015). Os achados mostram que nesta população de adolescentes houve associação entre discriminação percebida e AF, demonstrando que seus efeitos podem alterar comportamentos de saúde e o sexo pode modificar a relação entre essas variáveis.

Biological activities and physicochemical characterization of alkaline lignins obtained from branches and leaves of Buchenavia viridiflora with potential pharmaceutical and biomedical applications.

In this work, we investigated in vitro different biological activities of alkaline lignins extracted from the species Buchenavia viridiflora, a tree from the Amazon rainforest used as a wood product. The chemical composition results for the twig and leaves were, respectively (%): cellulose (30.88 and 24. 28), hemicellulose (21.62 and 23.03), lignin (29.93 and 25.46), extractives (13.06 and 20.52), and ash (4.51 and 6.72). The yield was higher for the lignin of the branches (67.9 %) when compared to the leaves (60.2 %). Lignins are of the GSH type, low molecular weight and thermally stable. They promoted moderate to low antioxidant activity, highlighting the lignin of the branches, which presented an IC50 of 884.56 µg/mL for the DPPH assay and an IC50 of 14.08 µg/mL for ABTS. In the cytotoxicity assays, they showed low toxicity against macrophage cells (IC50 28.47 and 22.58 µg/mL). In addition, they were not cytotoxic against splenocytes and erythrocytes at concentrations ranging from 100 to 6.25 µg/mL. These were able to promote splenocyte proliferation and induce the production of anti-inflammatory cytokines. And inhibit the growth of tumor cells with IC50 ranging from 12.63 to values >100 µg/mL and microbial at a concentration of 512 µg/mL. Finally, they showed antiparasitic activity by inhibiting the growth of chloroquine-sensitive and resistant Plasmodium falciparum strains. These findings reinforce that the lignins in this study are promising for potential pharmaceutical and biomedical applications.

Klebsiella pneumoniae Biofilms and Their Role in Disease Pathogenesis.

The ability to form biofilms is a crucial virulence trait for several microorganisms, including Klebsiella pneumoniae - a Gram-negative encapsulated bacterium often associated with nosocomial infections. It is estimated that 65-80% of bacterial infections are biofilm related. Biofilms are complex bacterial communities composed of one or more species encased in an extracellular matrix made of proteins, carbohydrates and genetic material derived from the bacteria themselves as well as from the host. Bacteria in the biofilm are shielded from immune responses and antibiotics. The present review discusses the characteristics of K. pneumoniae biofilms, factors affecting biofilm development, and their contribution to infections. We also explore different model systems designed to study biofilm formation in this species. A great number of factors contribute to biofilm establishment and maintenance in K. pneumoniae, which highlights the importance of this mechanism for the bacterial fitness. Some of these molecules could be used in future vaccines against this bacterium. However, there is still a lack of in vivo models to evaluate the contribution of biofilm development to disease pathogenesis. With that in mind, the combination of different methodologies has great potential to provide a more detailed scenario that more accurately reflects the steps and progression of natural infection.

Long-Lasting Olfactory Dysfunction in Hospital Workers Due to COVID-19: Prevalence, Clinical Characteristics, and Most Affected Odorants.

Hospital workers have increased exposure risk of healthcare-associated infections due to the frontline nature of their work. Olfactory dysfunction is highly prevalent. The objectives for this investigation are to study the prevalence of long-lasting olfactory dysfunction associated with COVID-19 infection in hospital workers during the first pandemic wave, to identify clinical characteristics and associated symptomatology, and to analyze how many patients with COVID-19 infection had developed olfactory dysfunction during infection and maintained a reduced olfactory function for approximately 10 weeks after diagnosis. Between June and July of 2020, a cross-sectional study was carried out at the Hospital Central de la Cruz Roja San José and Santa Adela in Madrid, Spain. One hundred sixty-four participants were included, of which 110 were patient-facing healthcare staff and 54 were non-patient-facing healthcare staff. Participants were split into three groups, according to COVID-19 diagnosis and presence of COVID-19 related olfactory symptomatology. Participants were asked to complete a structured online questionnaire along with Sniffin' Stick Olfactory Test measurements. In this study, 88 participants were confirmed for COVID-19 infection, 59 of those participants also reported olfactory symptomatology. The prevalence of COVID-19 infection was 11.35%, and the prevalence for olfactory dysfunction was 67.05%. Olfactory dysfunction associated with COVID-19 infection leads to long-lasting olfactory loss. Objective assessment with Sniffin' Stick Olfactory Test points to odor identification as the most affected process. Lemon, liquorice, solvent, and rose are the odors that are worst recognized. Mint, banana, solvent, garlic, coffee, and pineapple, although they are identified, are perceived with less intensity. The findings of this study confirmed a high prevalence of SARS-CoV-2 infection among the hospital workers.

Therapeutic management of subcutaneous phaeohyphomycosis and chromoblastomycosis in kidney transplant recipients: a retrospective study of 82 cases in a single center.

BACKGROUND: Melanized fungi are a distinct group of pathogens that cause infections like chromoblastomycosis and phaeohyphomycosis, especially in a state of immunosuppression including solid organ transplant recipients. Guidelines for the treatment of these infections are lacking, and there is no available standard recommendation. OBJECTIVE: To evaluate the therapeutic aspects of subcutaneous melanized fungal infections in kidney transplant recipients. METHODS: A retrospective medical record was performed for kidney transplant recipients with melanized fungal infection evaluated in a single institution from January 1996 to December 2018. RESULTS: Eighty-two episodes were noticed in our series. The treatment of subcutaneous phaeohyphomycosis was managed by surgical excision without antifungal therapy in 34 cases (34/68; 50%), and the association of both methods occurred in 18 cases (18/68; 26.5%). A complete surgical excision without antifungal therapy was observed in six (6/14; 42.9%) episodes of chromoblastomycosis, and combined treatment was possible in three (3/14; 21.4%) cases. Five episodes of chromoblastomycosis and 16 episodes of phaeohyphomycosis were managed only with antifungal therapy. CONCLUSION: Management depends on the dermatologic lesion, immunosuppression condition, and anatomical cleavage plane. The sample size is still small in order to dictate a guideline, but it can be hard to execute a larger study given the rarity of this group of infections.

Lignin from Morinda citrifolia leaves: Physical and chemical characterization, in vitro evaluation of antioxidant, cytotoxic, antiparasitic and ultrastructural activities.

In this work, we investigated in vitro the antioxidant, cytotoxic and anti-leishmanial activities of a lignin extracted from the leaves of Morinda citrifolia. Initially, an analysis of the composition of the sheets was performed, then the lignin was obtained by alkaline delignification and characterized by different techniques: elemental analysis, FT-R, UV-vis, HSQC-NMR, thermal analysis, Py-GC/MS and by GPC. The results showed that the leaves had in their composition cellulose (31.29%), hemicellulose (25.01%), lignin (18.34%), extractives (14.39%) and ash (10.03%). The lignin extraction yield was 89.8%. The lignin obtained is of the GSH type with the following contents 79.39%, 13.58% and 7.03% respectively. Furthermore, it is low molecular weight and thermally stable. It had a phenolic content of 93.3 mg GAE/g and low antioxidant activity. In macrophage cytotoxicity assays, it presented a CC50 of 31.0 µg/mL, showing less toxicity than amphotericin B. In assays against the promastigote forms of Leishmania amazonensis, lignin presented an IC50 of 29.56 µg/mL, a less effective concentration than amphotericin B (IC50 = 0.14 µg/mL). However, it was able to promote inhibition of the parasites, a fact confirmed by structural changes. These findings reinforce that M. citrifolia lignin is a promising macromolecule for use as an antiparasitic and antioxidant agent.