Cells,tissues,and organs are constantly subjected to the action of mechanical forces from the extracellular environment-and the nervous system is no exception.Cell-intrinsic properties such as membrane lipid compositi...Cells,tissues,and organs are constantly subjected to the action of mechanical forces from the extracellular environment-and the nervous system is no exception.Cell-intrinsic properties such as membrane lipid composition,abundance of mechanosensors,and cytoskeletal dynamics make cells more or less likely to sense these forces.Intrinsic and extrinsic cues are integrated by cells and this combined information determines the rate and dynamics of membrane protrusion growth or retraction(Yamada and Sixt,2019).Cell protrusions are extensions of the plasma membrane that play crucial roles in diverse contexts such as cell migration and neuronal synapse formation.In the nervous system,neurons are highly dynamic cells that can change the size and number of their pre-and postsynaptic elements(called synaptic boutons and dendritic spines,respectively),in response to changes in the levels of synaptic activity through a process called plasticity.Synaptic plasticity is a hallmark of the nervous system and is present throughout our lives,being required for functions like memory formation or the learning of new motor skills(Minegishi et al.,2023;Pillai and Franze,2024).展开更多
BACKGROUND Cirrhotic patients face heightened energy demands,leading to rapid glycogen depletion,protein degradation,oxidative stress,and inflammation,which drive disease progression and complications.These disruption...BACKGROUND Cirrhotic patients face heightened energy demands,leading to rapid glycogen depletion,protein degradation,oxidative stress,and inflammation,which drive disease progression and complications.These disruptions cause cellular damage and parenchymal changes,resulting in vascular alterations,portal hypertension,and liver dysfunction,significantly affecting patient prognosis.AIM To analyze the association between Child–Turcotte–Pugh(CTP)scores and di-fferent nutritional indicators with survival in a 15-year follow-up cohort.METHODS This was a retrospective cohort study with 129 cirrhotic patients of both sexes aged>18 years.Diagnosis of cirrhosis was made by liver biopsy.The first year of data collection was 2007,and data regarding outcomes were collected in 2023.Data were gathered from medical records,and grouped by different methods,including CTP,handgrip strength,and triceps skinfold cutoffs.The prognostic values for mortality were assessed using Kaplan–Meier curves and multivariate binary logistic regression models.RESULTS The coefficient for CTP was the only statistically significant variable(Wald=5.193,P=0.023).This suggests that with a negative change in CTP classification score,the odds of survival decrease 52.6%.The other evaluated variables did not significantly predict survival outcomes in the model.Kaplan–Meier survival curves also indicated that CTP classification was the only significant predictor.CONCLUSION Although different classifications showed specific differences in stratification,only CTP showed significant predictive potential.CTP score remains a simple and effective predictive tool for cirrhotic patients even after longer follow-up.展开更多
To improve understanding of the multifaceted nature of metabolic dysfunction-associated steatotic liver disease(MASLD),the American Association for the Study of Liver Diseases,in collaboration with the European Associ...To improve understanding of the multifaceted nature of metabolic dysfunction-associated steatotic liver disease(MASLD),the American Association for the Study of Liver Diseases,in collaboration with the European Association for the Study of the Liver and the Latin American Association for the Study of the Liver,proposed a broader and more flexible definition,highlighting the role of underlying metabolic dysfunction.MASLD represents the most common chronic liver disease worldwide;however,the impact of the disease goes beyond its epidemiological aspects.Currently,the impact on patients and healthcare syst-ems,due to hepatic and extrahepatic complications,is significant.Recent evidence has demonstrated that epigenetic regulation plays a key role in the development and progression of MASLD.This highly sophisticated regulatory system includes DNA methylation,histone modification,chromatin remodeling,and modulation of non-coding RNA,without causing changes in the primary DNA sequence.Diet,particularly the Westernized diet(characterized by high levels of processed foods,fats,and sugars,but deficient in vitamins and minerals),contributes to the pathogenesis of MASLD through epigenetic modulation at multiple levels.Given the association between diet,epigenetics,and MASLD,this review aims to present some micronutrients and their importance in the prevention and/or treatment of metabolically dysfunction-associated steatotic liver disease.展开更多
Potential interactive effects and trade-offs between drivers can regulate species diversity,affecting distributions by several orders of magnitude and distribution.The decomposition ofβ-diversity into turnover and ne...Potential interactive effects and trade-offs between drivers can regulate species diversity,affecting distributions by several orders of magnitude and distribution.The decomposition ofβ-diversity into turnover and nestedness could disentangle community assembly rules and offer the opportunity to encompass the processes that structure the communities and maintain theβ-diversity on the campo rupestre.We evaluatedα-andβ-diversity and species conservation status of rocky outcrop communities in the Parque Nacional da Serra do Cipó,as well as the decomposed component of theβ-diversity index.Due to the isolation characteristics of rocky outcrops,we expect to find high taxonomic turnover among the communities.The study was performed on five quartzitic rocky outcrops divided into two sampling stations.We used field expeditions and plant inventory data of shrubs and herbaceous layers.We recorded 286 angiosperms taxa among rocky outcrops of campo rupestre of Serra do Cipó.The structure andα-diversity showed significant differences among rocky outcrops and an evident oligarchic structure in the plant communities analyzed.Taxonomicβ-diversity showed high turnover with a significant contribution of the turnover component to this index.This pattern reflects the interplay between regional and local scale processes.Therefore,we believe this approach becomes a unified framework,which allows the comparison of diversity patterns and ecological processes in rocky outcrops ecosystems.We highlight the high percentage of not evaluated species for threats and the need to fill this lack.展开更多
Here we compare the efficacy of anti-obesity drugs alone or combined with exercise training on body weight and exercise capacity of obese patients.Randomized clinical trials that assessed the impact of any anti-obesit...Here we compare the efficacy of anti-obesity drugs alone or combined with exercise training on body weight and exercise capacity of obese patients.Randomized clinical trials that assessed the impact of any anti-obesity drug alone or combined with exercise training on body weight,body fat,fat-free mass and cardiorespiratory fitness in obese patients were retrieved from Pubmed and EMBASE up to May 2024.Risk of bias assessment was performed with RoB 2.0,and the GRADE approach assessed the certainty of evidence(CoE)of each main outcome.We included four publications summing up 202 patients.Two publications used orlistat as an anti-obesity drug treatment,while the other two adopted GLP-1 receptor agonist(liraglutide or tirzepatide)as a pharmacotherapy for weight management.Orlistat combined with exercise was superior to change body weight(mean difference(MD):−2.27 kg;95%CI:−2.86 to−1.69;CoE:very low),fat mass(MD:−2.89;95%CI:−3.87 to−1.91;CoE:very low),fat-free mass(MD:0.56;95%CI:0.40–0.72;CoE:very low),and VO_(2)Peak(MD:2.64;95%CI:2.52–2.76;CoE:very low).GLP-1 receptor agonist drugs combined with exercise had a great effect on body weight(MD:−3.96 kg;95%CI:−5.07 to−2.85;CoE:low),fat mass(MD:−1.76;95%CI:−2.24 to−1.27;CoE:low),fat-free mass(MD:0.50;95%CI:−0.98 to 1.98;CoE:very low)and VO_(2)Peak(MD:2.47;95%CI:1.31–3.63;CoE:very low).The results reported here suggest that exercise training remains an important approach in weight management when combined with pharmacological treatment.展开更多
Roads are a leading cause of habitat fragmentation and may reduce bird populations by increasing nest predation rates.However,few studies have investigated the effects of traffic volume on the reproductive success of ...Roads are a leading cause of habitat fragmentation and may reduce bird populations by increasing nest predation rates.However,few studies have investigated the effects of traffic volume on the reproductive success of roadside birds in the neotropics.Our goal was to evaluate the effects of spatial,temporal,and vehicle flow variations on the survival of artificial open-cup nests.The study was carried out in a nature reserve on the side of a highway during the breeding season(from October to March)in two restinga(sand-coastal plain)phytophysiognomies in southeastern Brazil:non-floodable(open)and floodable(closed).One hundred thirty nests were distributed along transects ranging from 3 m to 300 m from the highway in each vegetation type(totaling 260 nests).The nests were checked every three days for their status(depredated or intact)over 12 days,and new nests were subsequently placed near sampling points of depredated or successful nests.We estimated survival using logistic exposure generalized linear and additive mixed models.At the end of the 180 days of the experiment,33%of 6202 nests were successful.Nest survival was higher in open restinga than in closed restinga.In both habitats,nest survival was lowest mid-season and highest at the beginning and end.Survival rates peaked near the highway,declined up to 50 m away,then showed a slight increase.Finally,survival increased at moderate-to-high traffic volumes(∼22,000 vehicles/day),particularly in open restinga.We suggest that spatial,temporal,and habitat-specific highway impacts(e.g.,noise,vibration,visual stimuli)can lead to variations in the activity of nest predators,generating fluctuations in nest survival associated with predator behavior.展开更多
Developing low-permeability Coalbed Methane(CBM)reservoirs can significantly benefit from a comprehensive understanding of hydraulic fracture nucleation and propagation mechanisms,particularly in anthracite CBM reserv...Developing low-permeability Coalbed Methane(CBM)reservoirs can significantly benefit from a comprehensive understanding of hydraulic fracture nucleation and propagation mechanisms,particularly in anthracite CBM reservoirs.This study employs true-triaxial hydraulic fracturing experiments to investigate these mechanisms,with variables including injection flow rate,horizontal stress difference(σH-σh),and bedding orientation.Additionally,we conduct corresponding numerical cases to validate the experimental conclusions.The research also considers re-fracturing instances.For the first time,we utilize a combination of Kaiser tests and the stress transfer function in ANSYS Workbench finite element analysis to accurately restore the confining pressure of the coal sample.The findings suggest that a high initial injection flow rate during hydraulic fracturing can promote fluid leakage and aid in maintaining substantial fracture pressure.Enhanced fracturing efficiency can be achieved through higher injection rates,and it can ensure optimal fracturing efficiency,minimizing roof and floor fracturing in coal reservoirs to prevent fracturing fluid leakage.The presence of a high horizontal stress difference facilitates hydraulic fracture propagation along the direction of the maximum horizontal compressive stress,requiring a greater hydraulic pressure to produce more fracture systems in coal reservoirs.Additionally,a minor deviation in the wellbore injection direction from the bedding orientation assists in creating a complex hydraulic fractured network,although this also requires higher hydraulic pressure to initiate new fractures.In the case of multiple hydraulic fracturing,the second initiation pressure tends to be significantly higher than the first,indicating that a sequential increase in hydraulic pressure aids the formation of additional fractures.Moreover,a simplified numerical simulation has been conducted to corroborate the experimental findings.These insights are crucial in optimizing hydraulic fracturing processes to enhance the permeability of anthracite CBM reservoirs.展开更多
BACKGROUND Epulis fissuratum is an inflammatory fibrous hyperplasia characterized by pseudotumoral growth in the soft tissues of the oral mucosa.It is a multifactorial condition caused by factors such as poor oral hyg...BACKGROUND Epulis fissuratum is an inflammatory fibrous hyperplasia characterized by pseudotumoral growth in the soft tissues of the oral mucosa.It is a multifactorial condition caused by factors such as poor oral hygiene,prolonged use of ill-fitting dentures,continuous use of dentures without intervals of rest,and underlying systemic conditions such as diabetes mellitus and coagulation disorders.Although initially asymptomatic if left untreated,the lesion may result in complications such as ulcerations,secondary infections,and interference with speech,masticatory function,and oral aesthetics with significant adverse impact on the patient.CASE SUMMARY A 56-year-old female patient with no significant medical history presented to the dental clinic with tissue overgrowth and depression of the upper lip.She reported 30 years of continuous use of a complete maxillary denture without ever removing it.The management of this condition required a multidisciplinary approach to ensure accurate diagnosis and a strategic treatment plan tailored to her systemic health and the severity of the oral condition.The diagnosis of epulis fissuratum was confirmed through histopathological analysis.Treatment was implemented in two phases:Surgical and prosthetic.The surgical phase involved excision of the excess tissue and placement of a free gingival graft in the anterior maxillary vestibular area in order to deepen the vestibule and optimize the ridge for prosthetic rehabilitation.The prosthetic phase involved fabrication and placement of a new complete denture.CONCLUSION The multidisciplinary management of epulis fissuratum resulted in precise clinical diagnosis,effective soft tissue management,and appropriate prosthetic adjustments,thereby ensuring favorable long-term outcomes for the patient.展开更多
Hepatocellular carcinoma(HCC)is one of the most common causes of cancerrelated mortality.This particular type of cancer has the distinctive characteristic of mostly happening in individuals with an underlying liver di...Hepatocellular carcinoma(HCC)is one of the most common causes of cancerrelated mortality.This particular type of cancer has the distinctive characteristic of mostly happening in individuals with an underlying liver disease.This makes the management of patients more challenging,since physicians must take into consideration two different conditions,the chronic liver disease and the tumor.The underlying liver disease has several implications in clinical practice,because different kinds of chronic liver disease can lead to varying degrees of risk of developing HCC,obstacles in surveillance,and differences in the efficacy of the treatment against HCC.A shift in the prevalence of liver diseases has been evident over the last few years,with viral hepatitis gradually losing the leading position as cause of HCC and metabolic dysfunction-associated steatotic liver disease gaining importance.Therefore,in an era of personalized medicine,it is imperative that physicians are aware of the underlying liver disease of individuals with HCC and its impact in the management of their tumors.展开更多
Linoleic (LA) and α-linolenic acids (ALA) are considered essential fatty acids (EFA) because they are not produced by the human body. This way, EFAs sources must come from the diet. The primary dietary source of n-3 ...Linoleic (LA) and α-linolenic acids (ALA) are considered essential fatty acids (EFA) because they are not produced by the human body. This way, EFAs sources must come from the diet. The primary dietary source of n-3 fatty acids is ALA, found in seeds and seed oils. Other important sources are fish oils such as tuna, salmon and herring. Currently, numerous studies suggest possible benefits of essential fatty acids in human health, such as in cardiovascular, cognitive and eye health, and also during pregnancy and childhood. This paper also discusses the impact of fatty acids in human metabolism, and the available evidence regarding its risks. It addresses the relevant debate regarding a general ban of trans fatty acids (TFA) from the world food market, because of the cardiovascular risks associated with its consumption.展开更多
Background: In the context of the fight against HIV, a lack of skills in monitoring and evaluating the personnel in charge of activities has been identified at the national level. It was the subject of a priority axis...Background: In the context of the fight against HIV, a lack of skills in monitoring and evaluating the personnel in charge of activities has been identified at the national level. It was the subject of a priority axis of the national plan for monitoring and evaluating the fight against HIV (2006-2010) that was aimed at strengthening the capacities of actors in this area. To increase the critical mass of competent human resources in the short term, the National Institute of Public Health (NIPH) of Côte d’Ivoire organized monitoring and evaluation training sessions for healthcare professionals from 2011 to 2016. Methods: A single case study with multiple levels of analysis was carried out, combining a qualitative survey and a literature review. An evaluation was carried out six months after each training session. In addition, the results of the pre- and post-tests and of the daily and final evaluations that accompanied the various training sessions were used to provide further information. The qualitative data collected were analyzed using INVIVO 15 software. Results: Some 89 health professionals (69% men and 31% women) working at the national level (51% at the central level, including 58% in health programs) and in development partner agencies (37%) participated in this capacity building program. Most participants were senior health managers (56%), data managers (23%), and statisticians and computer scientists (10%). Almost all the trainings were financed by 16 technical and financial partners (85%), mainly the MEASURE Evaluation project (27%). Conclusion: M&E training, despite all its imperfections, has made it possible to identify M&E training needs at the national level and to increase the critical mass of national skills and to have some culture in M&E.展开更多
This investigation aims to study the El-Niño-Southern Oscillation (ENSO) events in these three phases: El Niño, La Niña, and neutral. Warm and cold events relate to the Spring/Summer seasons. This paper...This investigation aims to study the El-Niño-Southern Oscillation (ENSO) events in these three phases: El Niño, La Niña, and neutral. Warm and cold events relate to the Spring/Summer seasons. This paper will search for connections between the ENSO events and climate anomalies worldwide. There is some speculation that those events would be necessary for the climate anomalies observed worldwide. After analyzing the data from the reports to the ENSO, it shows almost periodicity from 1950-2023. We emphasized the occurrence of El Niño two years, when it was most prominent, and the climate anomalies (following NOAA maps), 2015 and 2023. The results indicated that the observed climate anomalies couldn’t be linked to the abnormal events observed. The worldwide temperatures in those years enhanced mostly in 2023. It shows an abnormal behavior compared with all the years scrutinized and analyzed since the records began. Therefore, there must be unknown factors beyond ENSO that rule the worldwide temperatures and the climate anomalies observed.展开更多
This research aims to analyze the communication process between the different participating actors in the port of Balboa,in the Panamanian Pacific.The starting hypothesis begins with the normal operation of the port i...This research aims to analyze the communication process between the different participating actors in the port of Balboa,in the Panamanian Pacific.The starting hypothesis begins with the normal operation of the port itself.Considering which strategic actions have potential development and which specific strategic actions are proposed for their improvement,the article begins with a discussion of the nature of ports in Panama and their relationships with the Panama Canal,followed by a literary review of all the effects that climate change may have on navigation on the Panamanian Pacific coast.Next,the implication between the coordination and cooperation between the port,the Panama Canal pilots,and the other actors involved with the arrival and departure of vessels from the port will be analyzed.In a third part,the results of the perception of a significant sample of these actors who were surveyed,which are related to the process,are presented.The document concludes with recommendations on how the Panamanian Pacific port can improve its individual interests through the application of improvements derived from the results of the surveys,for more efficient inter-institutional coordination and cooperation.展开更多
BACKGROUND The human immunodeficiency virus(HIV)continuum of care cascade illustrates the 90-90-90 goals defined by the Joint United Nations Program on HIV/acquired immunodeficiency syndrome(UNAIDS).The care cascade i...BACKGROUND The human immunodeficiency virus(HIV)continuum of care cascade illustrates the 90-90-90 goals defined by the Joint United Nations Program on HIV/acquired immunodeficiency syndrome(UNAIDS).The care cascade includes the following five steps:Diagnosis,linkage to care,retention in care,adherence to antiretroviral therapy(ART),and viral suppression.AIM To elaborate the HIV cascade of patients diagnosed with HIV at the Nossa Senhora da Conceição Hospital(HNSC)and to determine possible local causes for the loss of patients between each step of the cascade.METHODS This retrospective cohort study included patients diagnosed with HIV infection from January 1,2015 to December 31,2016 and followed up until July 31,2019.The data were analyzed by IBM SPSS software version 25,and Poisson regression with simple robust variance was used to analyze variables in relation to each step of the cascade.Variables with P<0.20 were included in multivariable analysis,and P<0.05 was considered significant.Pearson’sχ^(2) test was used to compare the groups of patients followed up at the HNSC and those followed up at other sites.RESULTS The results were lower than those expected by the UNAIDS,with 94%of patients linked,91%retained,81%adhering to ART,and 84%in viral suppression.Age and site of follow-up were the variables with the highest statistical significance.A comparison showed that the cascade of patients from the HNSC had superior results than outpatients,with a significant difference in the last step of the cascade.CONCLUSION The specialized and continued care provided at the HNSC was associated with better results and was closer to the goals set by the UNAIDS.The development of the HIV cascade using local data allowed for the stratification and evaluation of risk factors associated with the losses occurring between each step of the cascade.展开更多
AIM To assess the incidence of hepatocellular carcinoma(HCC) in chronic liver disease due to hepatitis B virus(HBV) or hepatitis C virus(HCV) coinfected with human immunodeficiency virus(HIV).METHODS A retrospective c...AIM To assess the incidence of hepatocellular carcinoma(HCC) in chronic liver disease due to hepatitis B virus(HBV) or hepatitis C virus(HCV) coinfected with human immunodeficiency virus(HIV).METHODS A retrospective cohort study was performed, including patients with chronic liver disease due to HBV or HCV, with and without HIV coinfection. Patients were selected in the largest tertiary public hospital complex in southern Brazil between January 2007 and June 2014. We assessed demographic and clinical data, including lifestyle habits such as illicit drug use or alcohol abuse, in addition to frequency and reasons for hospital admissions via medical records review.RESULTS Of 804 patients were included(399 with HIV coinfection and 405 monoinfected with HBV or HCV). Coinfected patients were younger(36.7 ± 10 vs 46.3 ± 12.5, P < 0.001). Liver cirrhosis was observed in 31.3% of HIV-negative patients and in 16.5% of coinfected(P < 0.001). HCC was diagnosed in 36 patients(10 HIV coinfected and 26 monoinfected). The incidence density of HCC in coinfected and monoinfected patients was 0.25 and 0.72 cases per 100 patient-years(95%CI: 0.12-0.46 vs 0.47-1.05)(long-rank P = 0.002), respectively. The ratio for the HCC incidence rate was 2.98 for HIV-negative. However, when adjusting for age or when only cirrhotic are analyzed, the absence of HIV lost statistical significance for the development of HCC. CONCLUSION In this study, the presence of HIV coinfection in chronic liver disease due to HBV or HCV showed no relation to the increase of HCC incidence.展开更多
Objective Pharmacopoeias regulate the manufacture of potentised pharmaceutical preparations used in different branches of complementary and integrative medicine.The physicochemical properties and biological activity o...Objective Pharmacopoeias regulate the manufacture of potentised pharmaceutical preparations used in different branches of complementary and integrative medicine.The physicochemical properties and biological activity of these preparations are often investigated in preclinical research,yet no guidelines for experimental research currently exist in this area.The present PrePoP guidelines aim to provide recommendations to promote high-quality,statistically sound,and reproducible preclinical research on potentised preparations.Methods Input was gathered from researchers nominated by the relevant scientific societies using a simplified Delphi consensus approach covering the most relevant aspects of basic research methodology in the field including appropriate controls,sample preparation and handling,and statistics.After three rounds of feedback,a consensus was finally reached on the most important aspects and considerations for conducting high-quality research on potentised preparations.Results We present a series of recommendations on a range of topics including experimental controls,system stability,blinding and randomisation,environmental influences,and procedures for the preparation of potentised samples and controls,and we address some specific challenges of this research field.Conclusion This expert consensus process resulted in a robust set of methodological guidelines for research on potentised preparations and provides a valuable framework that will inform and improve the quality of subsequent research in this emerging field.展开更多
Semiconductor photocatalysis holds great promise for renewable energy generation and environment remediation,but generally suffers from the serious drawbacks on light absorption,charge generation and transport,and str...Semiconductor photocatalysis holds great promise for renewable energy generation and environment remediation,but generally suffers from the serious drawbacks on light absorption,charge generation and transport,and structural stability that limit the performance.The core-shell semiconductorgraphene(CSSG)nanoarchitectures may address these issues due to their unique structures with exceptional physical and chemical properties.This review explores recent advances of the CSSG nanoarchitectures in the photocatalytic performance.It starts with the classification of the CSSG nanoarchitectures by the dimensionality.Then,the construction methods under internal and external driving forces were introduced and compared with each other.Afterward,the physicochemical properties and photocatalytic applications of these nanoarchitectures were discussed,with a focus on their role in photocatalysis.It ends with a summary and some perspectives on future development of the CSSG nanoarchitectures toward highly efficient photocatalysts with extensive application.By harnessing the synergistic capabilities of the CSSG architectures,we aim to address pressing environmental and energy challenges and drive scientific progress in these fields.展开更多
基金supported by PTDC-01778/2022-NeuroDev3D,iNOVA4Health(UIDB/04462/2020 and UIDP/04462/2020)LS4FUTURE(LA/P/0087/2020)。
文摘Cells,tissues,and organs are constantly subjected to the action of mechanical forces from the extracellular environment-and the nervous system is no exception.Cell-intrinsic properties such as membrane lipid composition,abundance of mechanosensors,and cytoskeletal dynamics make cells more or less likely to sense these forces.Intrinsic and extrinsic cues are integrated by cells and this combined information determines the rate and dynamics of membrane protrusion growth or retraction(Yamada and Sixt,2019).Cell protrusions are extensions of the plasma membrane that play crucial roles in diverse contexts such as cell migration and neuronal synapse formation.In the nervous system,neurons are highly dynamic cells that can change the size and number of their pre-and postsynaptic elements(called synaptic boutons and dendritic spines,respectively),in response to changes in the levels of synaptic activity through a process called plasticity.Synaptic plasticity is a hallmark of the nervous system and is present throughout our lives,being required for functions like memory formation or the learning of new motor skills(Minegishi et al.,2023;Pillai and Franze,2024).
文摘BACKGROUND Cirrhotic patients face heightened energy demands,leading to rapid glycogen depletion,protein degradation,oxidative stress,and inflammation,which drive disease progression and complications.These disruptions cause cellular damage and parenchymal changes,resulting in vascular alterations,portal hypertension,and liver dysfunction,significantly affecting patient prognosis.AIM To analyze the association between Child–Turcotte–Pugh(CTP)scores and di-fferent nutritional indicators with survival in a 15-year follow-up cohort.METHODS This was a retrospective cohort study with 129 cirrhotic patients of both sexes aged>18 years.Diagnosis of cirrhosis was made by liver biopsy.The first year of data collection was 2007,and data regarding outcomes were collected in 2023.Data were gathered from medical records,and grouped by different methods,including CTP,handgrip strength,and triceps skinfold cutoffs.The prognostic values for mortality were assessed using Kaplan–Meier curves and multivariate binary logistic regression models.RESULTS The coefficient for CTP was the only statistically significant variable(Wald=5.193,P=0.023).This suggests that with a negative change in CTP classification score,the odds of survival decrease 52.6%.The other evaluated variables did not significantly predict survival outcomes in the model.Kaplan–Meier survival curves also indicated that CTP classification was the only significant predictor.CONCLUSION Although different classifications showed specific differences in stratification,only CTP showed significant predictive potential.CTP score remains a simple and effective predictive tool for cirrhotic patients even after longer follow-up.
文摘To improve understanding of the multifaceted nature of metabolic dysfunction-associated steatotic liver disease(MASLD),the American Association for the Study of Liver Diseases,in collaboration with the European Association for the Study of the Liver and the Latin American Association for the Study of the Liver,proposed a broader and more flexible definition,highlighting the role of underlying metabolic dysfunction.MASLD represents the most common chronic liver disease worldwide;however,the impact of the disease goes beyond its epidemiological aspects.Currently,the impact on patients and healthcare syst-ems,due to hepatic and extrahepatic complications,is significant.Recent evidence has demonstrated that epigenetic regulation plays a key role in the development and progression of MASLD.This highly sophisticated regulatory system includes DNA methylation,histone modification,chromatin remodeling,and modulation of non-coding RNA,without causing changes in the primary DNA sequence.Diet,particularly the Westernized diet(characterized by high levels of processed foods,fats,and sugars,but deficient in vitamins and minerals),contributes to the pathogenesis of MASLD through epigenetic modulation at multiple levels.Given the association between diet,epigenetics,and MASLD,this review aims to present some micronutrients and their importance in the prevention and/or treatment of metabolically dysfunction-associated steatotic liver disease.
基金the Graduate Program in Ecology, Conservation and Wildlife Management (ECMVS)Institute of Biological Sciences (ICB)+1 种基金Department of Botany, Biodiversitas Foundation, Universidade Federal de Minas GeraisCoordenacao de Aperfeicoamento de Pessoal de Nível Superior (CAPES) for supporting this study
文摘Potential interactive effects and trade-offs between drivers can regulate species diversity,affecting distributions by several orders of magnitude and distribution.The decomposition ofβ-diversity into turnover and nestedness could disentangle community assembly rules and offer the opportunity to encompass the processes that structure the communities and maintain theβ-diversity on the campo rupestre.We evaluatedα-andβ-diversity and species conservation status of rocky outcrop communities in the Parque Nacional da Serra do Cipó,as well as the decomposed component of theβ-diversity index.Due to the isolation characteristics of rocky outcrops,we expect to find high taxonomic turnover among the communities.The study was performed on five quartzitic rocky outcrops divided into two sampling stations.We used field expeditions and plant inventory data of shrubs and herbaceous layers.We recorded 286 angiosperms taxa among rocky outcrops of campo rupestre of Serra do Cipó.The structure andα-diversity showed significant differences among rocky outcrops and an evident oligarchic structure in the plant communities analyzed.Taxonomicβ-diversity showed high turnover with a significant contribution of the turnover component to this index.This pattern reflects the interplay between regional and local scale processes.Therefore,we believe this approach becomes a unified framework,which allows the comparison of diversity patterns and ecological processes in rocky outcrops ecosystems.We highlight the high percentage of not evaluated species for threats and the need to fill this lack.
基金supported by Brazilian agencies CAPES(Finance Code 001)CNPq through PQ productivity scholarship.
文摘Here we compare the efficacy of anti-obesity drugs alone or combined with exercise training on body weight and exercise capacity of obese patients.Randomized clinical trials that assessed the impact of any anti-obesity drug alone or combined with exercise training on body weight,body fat,fat-free mass and cardiorespiratory fitness in obese patients were retrieved from Pubmed and EMBASE up to May 2024.Risk of bias assessment was performed with RoB 2.0,and the GRADE approach assessed the certainty of evidence(CoE)of each main outcome.We included four publications summing up 202 patients.Two publications used orlistat as an anti-obesity drug treatment,while the other two adopted GLP-1 receptor agonist(liraglutide or tirzepatide)as a pharmacotherapy for weight management.Orlistat combined with exercise was superior to change body weight(mean difference(MD):−2.27 kg;95%CI:−2.86 to−1.69;CoE:very low),fat mass(MD:−2.89;95%CI:−3.87 to−1.91;CoE:very low),fat-free mass(MD:0.56;95%CI:0.40–0.72;CoE:very low),and VO_(2)Peak(MD:2.64;95%CI:2.52–2.76;CoE:very low).GLP-1 receptor agonist drugs combined with exercise had a great effect on body weight(MD:−3.96 kg;95%CI:−5.07 to−2.85;CoE:low),fat mass(MD:−1.76;95%CI:−2.24 to−1.27;CoE:low),fat-free mass(MD:0.50;95%CI:−0.98 to 1.98;CoE:very low)and VO_(2)Peak(MD:2.47;95%CI:1.31–3.63;CoE:very low).The results reported here suggest that exercise training remains an important approach in weight management when combined with pharmacological treatment.
基金supports were provided by the Concessionária Rodovia do Sol/SA(RodoSol)the Conselho Nacional de Desenvolvimento Científico e Tecnológico(CNPq,grant:45.6446/2014/1)+2 种基金the São Paulo Research Foundation(FAPESP,Process Number#2024/13237-3)PD received a postdoctoral fellowship from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior(CAPES,grant:88887.469218/2019-00)CD is grateful to CNPq(Bolsa de Produtividade em Pesquisa,grant:308997/2023-9).
文摘Roads are a leading cause of habitat fragmentation and may reduce bird populations by increasing nest predation rates.However,few studies have investigated the effects of traffic volume on the reproductive success of roadside birds in the neotropics.Our goal was to evaluate the effects of spatial,temporal,and vehicle flow variations on the survival of artificial open-cup nests.The study was carried out in a nature reserve on the side of a highway during the breeding season(from October to March)in two restinga(sand-coastal plain)phytophysiognomies in southeastern Brazil:non-floodable(open)and floodable(closed).One hundred thirty nests were distributed along transects ranging from 3 m to 300 m from the highway in each vegetation type(totaling 260 nests).The nests were checked every three days for their status(depredated or intact)over 12 days,and new nests were subsequently placed near sampling points of depredated or successful nests.We estimated survival using logistic exposure generalized linear and additive mixed models.At the end of the 180 days of the experiment,33%of 6202 nests were successful.Nest survival was higher in open restinga than in closed restinga.In both habitats,nest survival was lowest mid-season and highest at the beginning and end.Survival rates peaked near the highway,declined up to 50 m away,then showed a slight increase.Finally,survival increased at moderate-to-high traffic volumes(∼22,000 vehicles/day),particularly in open restinga.We suggest that spatial,temporal,and habitat-specific highway impacts(e.g.,noise,vibration,visual stimuli)can lead to variations in the activity of nest predators,generating fluctuations in nest survival associated with predator behavior.
基金funded by the National Natural Science Foundation of China(No.42202155)China Postdoctoral Science Foundation(No.2021MD703807)+7 种基金Heilongjiang Provincial Postdoctoral Science Foundation(No.LBH-Z20121)financial support from the China Scholarship Council(No.202008230018)the Research Fund Program of Hubei Key Laboratory of Resources and Eco-Environment Geology(No.HBREGKFJJ-202309)funding by the DGICYT Spanish Project(grant no.PID2020-118999GB-I00)funded by the MCIN/AEI/10.13039/501100011033funding by the Ramón y Cajal fellowship(grant no.RyC-2018-026335-I)funded by the MCIN/AEI/10.13039/50110001103the European Social Fund-Investing in Your Future.
文摘Developing low-permeability Coalbed Methane(CBM)reservoirs can significantly benefit from a comprehensive understanding of hydraulic fracture nucleation and propagation mechanisms,particularly in anthracite CBM reservoirs.This study employs true-triaxial hydraulic fracturing experiments to investigate these mechanisms,with variables including injection flow rate,horizontal stress difference(σH-σh),and bedding orientation.Additionally,we conduct corresponding numerical cases to validate the experimental conclusions.The research also considers re-fracturing instances.For the first time,we utilize a combination of Kaiser tests and the stress transfer function in ANSYS Workbench finite element analysis to accurately restore the confining pressure of the coal sample.The findings suggest that a high initial injection flow rate during hydraulic fracturing can promote fluid leakage and aid in maintaining substantial fracture pressure.Enhanced fracturing efficiency can be achieved through higher injection rates,and it can ensure optimal fracturing efficiency,minimizing roof and floor fracturing in coal reservoirs to prevent fracturing fluid leakage.The presence of a high horizontal stress difference facilitates hydraulic fracture propagation along the direction of the maximum horizontal compressive stress,requiring a greater hydraulic pressure to produce more fracture systems in coal reservoirs.Additionally,a minor deviation in the wellbore injection direction from the bedding orientation assists in creating a complex hydraulic fractured network,although this also requires higher hydraulic pressure to initiate new fractures.In the case of multiple hydraulic fracturing,the second initiation pressure tends to be significantly higher than the first,indicating that a sequential increase in hydraulic pressure aids the formation of additional fractures.Moreover,a simplified numerical simulation has been conducted to corroborate the experimental findings.These insights are crucial in optimizing hydraulic fracturing processes to enhance the permeability of anthracite CBM reservoirs.
文摘BACKGROUND Epulis fissuratum is an inflammatory fibrous hyperplasia characterized by pseudotumoral growth in the soft tissues of the oral mucosa.It is a multifactorial condition caused by factors such as poor oral hygiene,prolonged use of ill-fitting dentures,continuous use of dentures without intervals of rest,and underlying systemic conditions such as diabetes mellitus and coagulation disorders.Although initially asymptomatic if left untreated,the lesion may result in complications such as ulcerations,secondary infections,and interference with speech,masticatory function,and oral aesthetics with significant adverse impact on the patient.CASE SUMMARY A 56-year-old female patient with no significant medical history presented to the dental clinic with tissue overgrowth and depression of the upper lip.She reported 30 years of continuous use of a complete maxillary denture without ever removing it.The management of this condition required a multidisciplinary approach to ensure accurate diagnosis and a strategic treatment plan tailored to her systemic health and the severity of the oral condition.The diagnosis of epulis fissuratum was confirmed through histopathological analysis.Treatment was implemented in two phases:Surgical and prosthetic.The surgical phase involved excision of the excess tissue and placement of a free gingival graft in the anterior maxillary vestibular area in order to deepen the vestibule and optimize the ridge for prosthetic rehabilitation.The prosthetic phase involved fabrication and placement of a new complete denture.CONCLUSION The multidisciplinary management of epulis fissuratum resulted in precise clinical diagnosis,effective soft tissue management,and appropriate prosthetic adjustments,thereby ensuring favorable long-term outcomes for the patient.
基金Supported by European-Latin American ESCALON Consortium,EU Horizon 2020 Program,No.825510National Institutes of Health,No.NIH R21 TW012390-01A1.
文摘Hepatocellular carcinoma(HCC)is one of the most common causes of cancerrelated mortality.This particular type of cancer has the distinctive characteristic of mostly happening in individuals with an underlying liver disease.This makes the management of patients more challenging,since physicians must take into consideration two different conditions,the chronic liver disease and the tumor.The underlying liver disease has several implications in clinical practice,because different kinds of chronic liver disease can lead to varying degrees of risk of developing HCC,obstacles in surveillance,and differences in the efficacy of the treatment against HCC.A shift in the prevalence of liver diseases has been evident over the last few years,with viral hepatitis gradually losing the leading position as cause of HCC and metabolic dysfunction-associated steatotic liver disease gaining importance.Therefore,in an era of personalized medicine,it is imperative that physicians are aware of the underlying liver disease of individuals with HCC and its impact in the management of their tumors.
文摘Linoleic (LA) and α-linolenic acids (ALA) are considered essential fatty acids (EFA) because they are not produced by the human body. This way, EFAs sources must come from the diet. The primary dietary source of n-3 fatty acids is ALA, found in seeds and seed oils. Other important sources are fish oils such as tuna, salmon and herring. Currently, numerous studies suggest possible benefits of essential fatty acids in human health, such as in cardiovascular, cognitive and eye health, and also during pregnancy and childhood. This paper also discusses the impact of fatty acids in human metabolism, and the available evidence regarding its risks. It addresses the relevant debate regarding a general ban of trans fatty acids (TFA) from the world food market, because of the cardiovascular risks associated with its consumption.
文摘Background: In the context of the fight against HIV, a lack of skills in monitoring and evaluating the personnel in charge of activities has been identified at the national level. It was the subject of a priority axis of the national plan for monitoring and evaluating the fight against HIV (2006-2010) that was aimed at strengthening the capacities of actors in this area. To increase the critical mass of competent human resources in the short term, the National Institute of Public Health (NIPH) of Côte d’Ivoire organized monitoring and evaluation training sessions for healthcare professionals from 2011 to 2016. Methods: A single case study with multiple levels of analysis was carried out, combining a qualitative survey and a literature review. An evaluation was carried out six months after each training session. In addition, the results of the pre- and post-tests and of the daily and final evaluations that accompanied the various training sessions were used to provide further information. The qualitative data collected were analyzed using INVIVO 15 software. Results: Some 89 health professionals (69% men and 31% women) working at the national level (51% at the central level, including 58% in health programs) and in development partner agencies (37%) participated in this capacity building program. Most participants were senior health managers (56%), data managers (23%), and statisticians and computer scientists (10%). Almost all the trainings were financed by 16 technical and financial partners (85%), mainly the MEASURE Evaluation project (27%). Conclusion: M&E training, despite all its imperfections, has made it possible to identify M&E training needs at the national level and to increase the critical mass of national skills and to have some culture in M&E.
文摘This investigation aims to study the El-Niño-Southern Oscillation (ENSO) events in these three phases: El Niño, La Niña, and neutral. Warm and cold events relate to the Spring/Summer seasons. This paper will search for connections between the ENSO events and climate anomalies worldwide. There is some speculation that those events would be necessary for the climate anomalies observed worldwide. After analyzing the data from the reports to the ENSO, it shows almost periodicity from 1950-2023. We emphasized the occurrence of El Niño two years, when it was most prominent, and the climate anomalies (following NOAA maps), 2015 and 2023. The results indicated that the observed climate anomalies couldn’t be linked to the abnormal events observed. The worldwide temperatures in those years enhanced mostly in 2023. It shows an abnormal behavior compared with all the years scrutinized and analyzed since the records began. Therefore, there must be unknown factors beyond ENSO that rule the worldwide temperatures and the climate anomalies observed.
文摘This research aims to analyze the communication process between the different participating actors in the port of Balboa,in the Panamanian Pacific.The starting hypothesis begins with the normal operation of the port itself.Considering which strategic actions have potential development and which specific strategic actions are proposed for their improvement,the article begins with a discussion of the nature of ports in Panama and their relationships with the Panama Canal,followed by a literary review of all the effects that climate change may have on navigation on the Panamanian Pacific coast.Next,the implication between the coordination and cooperation between the port,the Panama Canal pilots,and the other actors involved with the arrival and departure of vessels from the port will be analyzed.In a third part,the results of the perception of a significant sample of these actors who were surveyed,which are related to the process,are presented.The document concludes with recommendations on how the Panamanian Pacific port can improve its individual interests through the application of improvements derived from the results of the surveys,for more efficient inter-institutional coordination and cooperation.
文摘BACKGROUND The human immunodeficiency virus(HIV)continuum of care cascade illustrates the 90-90-90 goals defined by the Joint United Nations Program on HIV/acquired immunodeficiency syndrome(UNAIDS).The care cascade includes the following five steps:Diagnosis,linkage to care,retention in care,adherence to antiretroviral therapy(ART),and viral suppression.AIM To elaborate the HIV cascade of patients diagnosed with HIV at the Nossa Senhora da Conceição Hospital(HNSC)and to determine possible local causes for the loss of patients between each step of the cascade.METHODS This retrospective cohort study included patients diagnosed with HIV infection from January 1,2015 to December 31,2016 and followed up until July 31,2019.The data were analyzed by IBM SPSS software version 25,and Poisson regression with simple robust variance was used to analyze variables in relation to each step of the cascade.Variables with P<0.20 were included in multivariable analysis,and P<0.05 was considered significant.Pearson’sχ^(2) test was used to compare the groups of patients followed up at the HNSC and those followed up at other sites.RESULTS The results were lower than those expected by the UNAIDS,with 94%of patients linked,91%retained,81%adhering to ART,and 84%in viral suppression.Age and site of follow-up were the variables with the highest statistical significance.A comparison showed that the cascade of patients from the HNSC had superior results than outpatients,with a significant difference in the last step of the cascade.CONCLUSION The specialized and continued care provided at the HNSC was associated with better results and was closer to the goals set by the UNAIDS.The development of the HIV cascade using local data allowed for the stratification and evaluation of risk factors associated with the losses occurring between each step of the cascade.
文摘AIM To assess the incidence of hepatocellular carcinoma(HCC) in chronic liver disease due to hepatitis B virus(HBV) or hepatitis C virus(HCV) coinfected with human immunodeficiency virus(HIV).METHODS A retrospective cohort study was performed, including patients with chronic liver disease due to HBV or HCV, with and without HIV coinfection. Patients were selected in the largest tertiary public hospital complex in southern Brazil between January 2007 and June 2014. We assessed demographic and clinical data, including lifestyle habits such as illicit drug use or alcohol abuse, in addition to frequency and reasons for hospital admissions via medical records review.RESULTS Of 804 patients were included(399 with HIV coinfection and 405 monoinfected with HBV or HCV). Coinfected patients were younger(36.7 ± 10 vs 46.3 ± 12.5, P < 0.001). Liver cirrhosis was observed in 31.3% of HIV-negative patients and in 16.5% of coinfected(P < 0.001). HCC was diagnosed in 36 patients(10 HIV coinfected and 26 monoinfected). The incidence density of HCC in coinfected and monoinfected patients was 0.25 and 0.72 cases per 100 patient-years(95%CI: 0.12-0.46 vs 0.47-1.05)(long-rank P = 0.002), respectively. The ratio for the HCC incidence rate was 2.98 for HIV-negative. However, when adjusting for age or when only cirrhotic are analyzed, the absence of HIV lost statistical significance for the development of HCC. CONCLUSION In this study, the presence of HIV coinfection in chronic liver disease due to HBV or HCV showed no relation to the increase of HCC incidence.
文摘Objective Pharmacopoeias regulate the manufacture of potentised pharmaceutical preparations used in different branches of complementary and integrative medicine.The physicochemical properties and biological activity of these preparations are often investigated in preclinical research,yet no guidelines for experimental research currently exist in this area.The present PrePoP guidelines aim to provide recommendations to promote high-quality,statistically sound,and reproducible preclinical research on potentised preparations.Methods Input was gathered from researchers nominated by the relevant scientific societies using a simplified Delphi consensus approach covering the most relevant aspects of basic research methodology in the field including appropriate controls,sample preparation and handling,and statistics.After three rounds of feedback,a consensus was finally reached on the most important aspects and considerations for conducting high-quality research on potentised preparations.Results We present a series of recommendations on a range of topics including experimental controls,system stability,blinding and randomisation,environmental influences,and procedures for the preparation of potentised samples and controls,and we address some specific challenges of this research field.Conclusion This expert consensus process resulted in a robust set of methodological guidelines for research on potentised preparations and provides a valuable framework that will inform and improve the quality of subsequent research in this emerging field.
基金supported by the National Natural Science Foundation of China(61974125)the Open Innovation Fund for undergraduate students of Xiamen University(KFJJ-202411).
文摘Semiconductor photocatalysis holds great promise for renewable energy generation and environment remediation,but generally suffers from the serious drawbacks on light absorption,charge generation and transport,and structural stability that limit the performance.The core-shell semiconductorgraphene(CSSG)nanoarchitectures may address these issues due to their unique structures with exceptional physical and chemical properties.This review explores recent advances of the CSSG nanoarchitectures in the photocatalytic performance.It starts with the classification of the CSSG nanoarchitectures by the dimensionality.Then,the construction methods under internal and external driving forces were introduced and compared with each other.Afterward,the physicochemical properties and photocatalytic applications of these nanoarchitectures were discussed,with a focus on their role in photocatalysis.It ends with a summary and some perspectives on future development of the CSSG nanoarchitectures toward highly efficient photocatalysts with extensive application.By harnessing the synergistic capabilities of the CSSG architectures,we aim to address pressing environmental and energy challenges and drive scientific progress in these fields.
