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BACKGROUND: Implant-based breast reconstruction is the most prevalent form of breast reconstruction. Autologous fat grafting (AFG) was conceptualized as an alternative to implant-based breast reconstruction and was found to be a reliable reconstruction modality. However, usually, a few grafting rounds are required to create the desired shape and size of the breast. Current literature describes ample experience with AFG as an adjunct to implant-based breast reconstruction for improving appearance. However, the utilization of breast implants following initial AFG has been sparingly described. The primary advantage of this study is the creation of new fat tissue as a breast mound. The reconstruction is then concluded by inserting an implant into this new mound. This approach reduces the overall number of fat injections needed to achieve the desired outcome, as well as the total volume of the implant. METHODS: This IRB-approved retrospective study was conducted between January 2015 and December 2021. All women who underwent delayed breast reconstruction with AFG during this timeframe and wanted to complete it with a silicone implant as a last stage were included in the study. RESULTS: A total of 29 patients (33 breasts) underwent delayed breast reconstruction with AFG and a silicone implant as the final stage. In all cases, the results were satisfying without any major complications. Minor complications were observed with one patient and included an infection. CONCLUSIONS: The findings of this study have demonstrated the effectiveness of this procedure together with patient satisfaction, thus highlighting the potential advantages that this approach offers. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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En este trabajo describimos la construcción y valoración de la pertenencia a una barra brava de fútbol desde las voces de un grupo de exintegrantes. Desarrollamos entrevistas semi estructuradas con siete exintegrantes de la barra brava Trinchera Norte (Perú), que asistían a los esta-dios en la década de 1990 y ejercían un rol protagónico en la barra brava. Los participantes nos relatan que construyeron su pertenencia a partir de la interacción con un grupo de pares que compartían el interés por un equipo de fútbol. En este grupo se desarrollaron y definieron comportamientos que asumieron y que destacan en la actualidad. Así, valoran el compañerismo, la resiliencia, el orgullo y la lucha por sus metas e ideales como aprendizajes significativos que continúan aplicando en su vida. (AU)

In this paper, we describe the construction and assessment of membership to a football barra brava from the voices of a group of former members. We developed semi-structured interviews with seven former members of the barra brava Trinchera Norte(Peru), who attended the stadiums in the 1990s and played a leading role in the barra brava. The participants tell us that they built their membership from the interaction with a group of peers who shared an in-terest in a soccer team. In this group, behaviors that they assumed and that stand out today were developed and defined. Thus, they value camaraderie, resilience, pride and the fight for their goals and ideals as significant learning that they continue to apply in their lives. (AU)

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Objetivo: evaluar la seguridad y la efectividad de la cura CONAN, teniendo en cuenta la reducción del número de fugas, el estado de la piel periestomal y la calidad de vida percibida por el paciente. Método: estudio prospectivo no-randomizado de ámbito nacional, realizado en 54 unidades de estomaterapia, para evaluar la eficacia y seguridad de la cura CONAN consistente en el uso de dispositivo Easiflex® Confort Convex Light y de anillos moldeables Brava® en el postoperatorio precoz de pacientes con ostomía digestiva con pérdidas de efluente. La intención del estudio fue evaluar el efecto de esta estrategia para disminuir la pérdida, prevenir el deterioro de la piel periestomal y aumentar el bienestar de los pacientes al alta. Se compararon diferencias estadísticas entre estas variables empleando las pruebas t-test, Chi cuadrado, Mc Nemar y Bowker. Resultados: se evaluaron 257 pacientes y 244 completaron el estudio. Con la cura CONAN el número de fugas se redujo en el 56% de los pacientes y el número medio de fugas evolucionó de 3,4 ± 5,2 (V1) a 1,3 ± 2,3 (V2) (p< 0,0001). El 62% de los pacientes que tenía problemas en la piel dejó de tenerlos y la mejora en las condiciones de la piel fue muy evidente. La puntuación media DET cambió de 3,3 ± 3,3 (V1) a 1,6 ± 2,3 (V2) (p< 0,0001). La satisfacción media percibida por el paciente evolucionó de 5,1 ± 2 (V1) a 7,2 ± 1,7 (V2) (p< 0,0001). La proporción de pacientes con estoma protruido aumentó de 32,9% a 40% (p= 0,025). La mayoría de los pacientes retomó sus hábitos diarios: 67% pasear, 75% salir de casa, 55% descansar por la noche. El 92% de los participantes deseó seguir usando el dispositivo Easiflex® Convex Light. Conclusiones: los pacientes con ostomía digestiva y fuga de efluentes en el periodo postoperatorio temprano se benefician claramente del empleo del dispositivo convexo suave (Easiflex® Confort Convex Light) con anillo moldeable (Brava®). Se confirmó la seguridad y efectividad de este abordaje.(AU)

Objective: to assess the safety and efficacy of the CONAN cure, taking into account the reduction in the number of leaks, the status of peristomal skin, and the quality of life perceived by the patient. Method: a prospective non-randomized study at national level, conducted in 54 Stomal Therapy Units, in order to evaluate the efficacy and safety of the CONAN cure, consisting in the use of the Easiflex® Confort Convex Light device and Brava® moldable rings during the early post-surgical stage in patients with digestive system ostomy with effluent leaks. The study intended to evaluate the effect of this strategy on leak reduction, to prevent peristomal skin deterioration, and to increase the wellbeing of patients at discharge. Statistical differences were compared between these variables, using the t-test, Squared-chi, McNemar and Bowker tests. Results: there was an evaluation of 257 patients, and 244 completed the study. With the CONAN cure, the number of leaks was reduced in 56% of patients, and the mean number of leaks moved from 3.4 ± 5.2 (V1) to 1.3 ± 2.3 (V2) (p< 0.0001); skin problems disappeared in 62% of patients who presented them, and the improvement in skin condition was highly evident. There was a change in the mean DET score from 3.3 ± 3.3 (V1) to 1.6 ± 2.3 (V2) (p< 0.0001). The mean satisfaction perceived by the patient increased from 5.1 ± 2 (V1) to 7.2 ± 1.7 (V2) (p< 0.0001). The proportion of patients with protruding stoma increased from 32.9% to 40% (p= 0.025). The majority of patients resumed their daily habits: 67% going for walks, 75% going out of their house, and 55% resting at night; 92% of participants wanted to continue using the Easiflex® Convex Light device. Conclusions: patients with digestive system ostomy and effluent leak during their early post-surgical period could clearly benefit of using the soft convex device (Easiflex® Confort Convex Light) with moldable ring (Brava®). The safety and efficacy of this approach was confirmed.

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Mansa and Brava are olive autochthonous cultivars from Galicia, a new olive-growing zone from NW Spanish, from which high-quality extra virgin olive oils (EVOOs) are obtained. The oils obtained as by co-crushing Mansa and Brava olives in different proportions as by blending with others olives cultivars have different composition that influence in their sensory quality. The consumer acceptance of commercial oils elaborated with Local Galician cultivars was evaluated and a quality-mapping of olive oils was created. It was found that the both Local oils had good physical-chemical quality parameters. From sensory analysis viewpoint, Local-MB oils presented the highest intensity values for color, odor, taste, and flavor, and the consumers had a higher acceptance and preference by Picual, Local-MBPA (60% Mansa and Brava, 25% Picual, and 15% Arbequina and Local-MB (60% Mansa and 40% Brava) oils. A quality-mapping of olive oils indicate that attributes better scored from the consumer are high intensity for color, odor, taste and flavor, and pungent and floral series, and bitter is rejected by them.

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Resumen El fútbol es un deporte multitudinario y tiene en sus hinchas uno de sus principales soportes. Ellos se han reunido de diferentes formas y las barras bravas son los Grupos Organizados de Hinchas (GOH) más destacados en Colombia pues lograron visibilizarse a través de conductas violentas. El propósito del artículo es mostrar que la identificación de los hinchas con un equipo permite constituir, por medio de la competencia deportiva, las rivalidades y, además, la radicalidad de las barras bravas las transformó en enfrentamientos (verbales y físicos), denominados entre sus miembros como combate. Los hinchas que participen serán reconocidos por manifestar su aguante. Este tipo de expresiones se pueden comprender como manifestaciones violentas en el contexto del fútbol.

Abstract Football is a massive sport on which supporters' clubs are one of its keystone pillars. Supporters' groups have different shapes, between them "Barras bravas" are the most notorious because they stood out with his 'festive behaviour' and violent attitudes. This paper seeks to demonstrate that the fan empathize with the Football club allows to develop - using the sport competition - the Football rivalry and, besides, the live of the "Barras bravas" turned this rivalry in verbal and physical confrontation named, between them, as "combate" (kind of competition). Those who participate on "combates" are recognized because they showed his "aguante" (kind of resistance). This kind of expressions can be understood as violent attitudes in the Football life.

Resumo O futebol é um esporte de massa onde os seus torcedores resultam ser um pilar importante. Eles se agrupam de maneiras diferentes, desses grupos surgem as torcidas organizadas, desse jeito conseguiram ser reconhecidos por seu jeito, por seu comportamento festeiro e comportamento violento. Portanto, o objetivo deste artigo é mostrar como o torcedor por meio de um time pode chegar a apresentar uma rivalidade, confrontos entre seus membros como o "combate". Aqueles que participarem serão reconhecidos por demonstrar sua "aguante" (a resistência). Tais expressões podem ser entendidas como manifestações violentas no contexto do futebol.

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'Brava' and 'Mansa de Figueiredo' extra-virgin olive oils (EVOOs) are two varieties identified from north-western Spain. A systematic phenolic characterization of the studied oils was undertaken by LC-ESI-IT-MS. In addition, the role of dietary polyphenols from these EVOOs has been evaluated against the inhibition of key enzymes (α-glucosidase and α-amylase) in the management of diabetes mellitus (DM). Oleuropein and ligstroside derivatives comprised 83% and 67% of the total phenolic compounds in 'Brava' and 'Mansa de Figueiredo' EVOOs, respectively. The main secoiridoids from oleuropein were DOA (3,4-DHPEA-EDA, 59 and 22 mg kg-1, respectively) and the main isomer of OlAgl (3,4-DHPEA-EA, 74 and 23 mg kg-1). The main secoiridoids from ligstroside were D-LigAgl (p-HPEA-EDA or oleocanthal, 23 and 167 mg kg-1) and the main isomer of LigAgl (p-HPEA-EA, 214 and 114 mg kg-1). For α-glucosidase, both EVOO extracts displayed stronger inhibitory activity (IC50 values of 60 ±â€¯8 and 118 ±â€¯9 µg mL-1, respectively) than the commercial inhibitor acarbose (IC50 = 356 ±â€¯21 µg mL-1). Nevertheless, for α-amylase, only 'Brava' extracts showed anti-α-amylase capacity. A daily VOO intake lower than the requirements of EFSA seem to be enough to reach both 50% for α-glucosidase and 25% for α-amylase inhibition. These findings support the potential health benefits derived from Galician EVOOs that might be probably linked to the outstanding high concentration levels of phenolic acids and flavonoids.

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This study evaluated the safety of Lafoensia pacari A. St.-Hil. (Lythraceae) stem bark hydroalcoholic extract (LPE) through acute and subchronic toxicological assessments in mice. In the acute toxicity evaluation, a single 2000 mg/kg oral dose of LPE was administered to mice and clinical observations were conducted for 14 days. For subchronic toxicity, LPE doses (6.25-1000 mg/kg) were administered orally for 28 days and biochemical, hematological, histopathological analyses and renal and liver expression of Ki-67 were carried out. The acute oral toxicity evaluation of LPE showed no toxicity in mice and it was was classified as category 5 (LD50>2000-5000 mg/kg). In a repeated dose 28-day toxicity study, LPE (100-1000 mg/kg) led to an increase in reticulocytes, which suggests a possible proliferative effect on blood cells. In addition, LPE (400-1000 mg/kg) of produced alterations in biochemical parameters, although no microscopic changes were found in the organs analyzed. A normal expression of the Ki-67 cell proliferation indicator was observed in the kidney and liver tissues, which suggests that LPE does not bring about changes in the proliferative activity of these organs. In conclusion, LPE should be used with caution, particularly in larger doses over longer periods and also in combination with other medication.

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Cercosaurine lizards (subfamily Cercosaurinae of the family Gymnophthalmidae) represent a substantial component of the reptile fauna in the Neotropics. Several attempts have been made to reconstruct the phylogenetic relationships within this group, but most studies focused on particular genera or regions and did not cover the subfamily as a whole. In this study, material from the montane forests of Peru was newly sequenced. In combination with all cercosaurine sequences available on GenBank, an updated phylogeny of Cercosaurinae is provided. Monophyly was not supported for three of the currently recognised genera (Echinosaura, Oreosaurus, and Proctoporus). The genus Proctoporus is formed by five monophyletic groups, which should be used in future taxonomic revisions as feasible entities. Recognition of two previously identified undescribed clades (Unnamed clades 2 and 3) was supported and yet another undescribed clade (termed here Unnamed clade 4), which deserves recognition as an independent genus, was identified herein. Selvasaura brava, a new genus and new species of arboreal gymnophthalmid lizard is described from the montane forests of the Pui Pui Protected Forest, Provincia de Chanchamayo, Región Junín, Peru. The new species is characterised by its small size (SVL 42.1-45.9 mm), slender body, smooth head shields, presence of paired prefrontal shields, fused anteriormost supraocular and anteriormost superciliary shields, transparent not divided lower palpebral disc, slightly rugose subimbricate rectangular dorsal scales in adults (slightly keeled in juveniles), distinctly smaller but non-granular lateral scales, smooth squared to rectangular ventral scales, and hemipenial lobes large, distinct from the hemipenial body. Phylogenetic affinities of the new genus to the other cercosaurine genera, as well as basal phylogenetic relationships between the other cercosaurine genera remain unresolved.

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INTRODUCTION: Fat grafting for breast surgery, in reconstruction or aesthetics, gained a lot of popularity over the last years. As an addition to breast reconstruction with flaps or prosthesis, lipofilling improved the aesthetic result, increasing the patients' satisfaction rate. The demand for breast reconstruction using only fat grafting increased, because patients want a natural result in breast reconstruction and also the body contouring associated with liposuction of specified fat areas. The pre-expansion BRAVA(®) system has been used for several years in the United States to prepare the receiving site for lipofilling. We wanted to gain our own experience in associating BRAVA-lipofilling in breast reconstruction. The aim of our study is to evaluate the BRAVA efficiency as an adjuvant for fat grafting in breast surgery. MATERIAL AND METHODS: A retrospective study was undertaken, using a homogenous series of consecutive patients, operated by one surgeon (the first author), that had breast reconstruction using only fat grafts associated with BRAVA(®). RESULTS: The retrospective homogenous study identified 45 cases of breast surgery associating fat grafting alone with BRAVA(®) assistance. The number of intervention of fat grafting associating BRAVA(®) was 1 or 2 for conservative treatment sequelae or for flap reconstruction improvement, and 2 to 4 for immediate and delayed breast reconstruction. The total volume of fat grafting was 205 cc for the contralateral balancing, 317 cc for flap reconstructions, 531 cc for the conservative treatment sequelae, 790 cc for the immediate breast reconstruction and 1165 cc for the delayed breast reconstruction. The satisfaction rate of the surgical team and the patients was satisfying and very satisfied in 82% of cases, average in 8% of cases, and insufficient in 10% of cases. CONCLUSIONS: Breast reconstruction with fat grafting alone is, in our experience, a reliable and reproducible technique, that gives excellent and stable results. The high satisfaction rate of patients is explained by the supple and natural consistency of the new breast, with no added scars, associating the benefits of liposuction of the donor sites. The BRAVA(®) system seems to be, in cases with good indications, an adjuvant for receiving site preparation, making the reconstruction easier for the surgeon and for the patient. We believe that breast reconstruction with fat grafting alone is going to become more popular in the future. Associating fat grafting with BRAVA(®) creates a new way of natural breast reconstruction for the patients with mastectomy that want a stable result with less aggressive procedures. It is a new tool that is going to increase the autologous breast reconstruction in France.

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A technique of whole and partial breast reconstruction is described based on tissue-engineering principles. Brava-assisted external tissue expansion generates an in situ biological recipient scaffold that favors the survival of large volumes of autologous fat graft required for breast reconstruction. Also presented are the results of the authors' multicenter experience with this regenerative alternative in 488 patients over a 7-year period tracking surgical complications, patient satisfaction, efficacy, and costs.

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BACKGROUND: Grafting of autologous lipoaspirate for various clinical applications has become a common procedure in clinical practice. With an estimated mortality rate of 10-15 percent, fat embolism is among the most severe complications to be expected after lipofilling therapies. OBJECTIVE: The aim of this study was to determine the level of interstitial pressure after the injection of defined volumes of lipoaspirate into the subcutaneous tissue of female breasts. It was hypothesized, that interstitial pressure levels exceed the physiologic capillary pressure during lipofilling procedures and hence increase the potential risk for fat embolism. Further it was investigated if external tissue expansion has the potential to significantly reduce interstitial tissue pressure. METHODS: Interstitial pressure was monitored in 36 female patients, that underwent autologous fat injections into the breast. Measurements were conducted with a sensor needle connected to a pressure transducer (LogiCal Pressure Monitoring Kit, Smiths medical int. Ltd., UK). Patients were divided into 4 subcohorts differing in their pre-treatment regimen or local tissue conditions. Pre-treatment consisted of tissue expansion, achieved with the Brava™ (Brava LLC Miami, Fla., USA) vacuum-chamber. RESULTS: The increase in interstitial pressure after injection volumes of 100 ml (p = 0.006), 200 ml (p = 0.000) and between 100 ml and 200 ml (p = 0.004) respectively, were significant in non-mastectomized patients without pre-treatment. Patients pre-treated with Brava™ did not show such statistically significant differences in interstitial pressures before and after the injection of 100 ml and 200 ml of lipoaspirate (p = 0.178). The difference in interstitial pressure in mastectomized patients between 0 ml and 100 ml (p = 0.003), as well as 0 ml and 200 ml (p = 0.028) was significant. The difference in pressures between pre-treated patients and patients without pre-treatment did not differ significantly in the mastectomized patient cohort. CONCLUSION: During lipofilling procedures interstitial pressures are reached that exceed pressure limits defined as hazardous for fat embolism. To date it is unknown what pressure levels need to be considered critical for complications in soft tissue interventions. Further the results indicate higher interstitial pressures for patients that had undergone mastectomy, whereas pre-treatment with external tissue expansion seemed to diminish pressure values.

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To clarify the genetic relationships among the Lidia breed lineages and two main Portuguese Lidia bovine populations, Casta Portuguesa and Brava dos Açores, 24 autosomal microsatellites were analyzed in 120 samples. Brava dos Açores showed the highest observed and expected heterozygosity (0.73 and 0.70, respectively) while Casta Portuguesa showed the lowest observed and expected heterozygosity (0.51 and 0.50, respectively). The results of this study were compared with the previous microsatellites data from the main Lidia bovine lineages. Casta Portuguesa was the most genetically isolated Lidia bovine population as revealed by the average FST genetic distance value with respect to the other lineages (32%). All the populations of Portuguese Lidia had negative FIS values. The Neighbour-joining dendrogram grouped Casta Portuguesa in the same branch with Miura, which was supported by the STRUCTURE software. The results evidenced low levels of genetic diversity and high levels of genetic differentiation in Casta Portuguesa and high levels of genetic diversity in Brava dos Açores populations, probably due to the crossbreeding of different bovine lineages at origin, and genetic flow among herds.

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Species in the Myrtaceae family are used in folk medicine to treat gastrointestinal disorders, infectious diseases and hemorrhagic conditions and are known for their essential oil contents. Gas chromatography coupled with mass spectrometry (GC-MS) was used to characterize the chemical composition of essential oils of the leaves, stem bark and flowers of Myrcia tomentosa (Aubl.) DC., as well as to assess the chemical variability in the constituents of the essential oils of the leaf. Soil and foliar analyses were also performed to determine the mineral compositions. Principal component analysis (PCA) was used to examine the interrelationships between the obtained data. The most abundant component in the essential oils of the flowers was (2E,6E)-methyl farnesoate, whereas hexadecanoic acid was the most abundant essential oil component in the stem bark. The leaf essential oils showed seasonal variation in their chemical composition, with bicyclogermacrene and (2E,6E)-methyl farnesoate as the major chemical components. Forty-four constituents were identified, and only nine compounds were found in all of the samples. Sesquiterpenes were mainly produced in the flowers and leaves. The PCA showed a positive correlation between the oxygenated sesquiterpenes and the foliar nutrients Cu and P. Significant statistical correlations were verified between the climatic data, foliar nutrients and essential oil compositions.

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Stem-bark extracts, fractions and the isolated constituent, ellagic acid of Lafoensia pacari St. Hil. (Lythraceae) were in vitro assayed for antifungal activity against a panel of yeasts, hialohyphomycetes as well as dermatophytes with the microbroth dilution method. The EtOH extract and its fractions and ellagic acid exhibited activity against Candida spp and Saccharomyces cerevisiae with MIC values between 250-1000 µg/mL, but they showed no action against filamentous fungi and dermatophytes (MIC>1000 µg/mL). Active extracts were evaluated in Neurospora crassa hyphal growth inhibition and sorbitol assays and then the effect of ergosterol on the MIC of ellagic acid was studied. The active extracts and its fractions and ellagic acid showed a blotchy zone around the paper disk and induced malformations of the hypha. Besides, MIC of the ellagic acid against the Saccharomyces cerevisiae was raised from 62 to 250 µg/mL in the presence of sorbitol 0.8 M, suggesting that the ellagic acid would probably exert its action on fungal cell wall. These results indicate that ellagic acid might be the main active antifungal compound of Lafoensia pacari and further suggest that the mode of antifungal action of these extracts and ellagic acid could be associated with the inhibition of fungal cell wall.

Os extratos, frações e ácido elágico, isolados da entrecasca de Lafoensia pacari A. St.-Hil., Lythraceae, foram testados in vitro para atividade antifúngica, frente a um painel de leveduras, hialo-hifomicetos e dermatófitos, utilizando o método de microdiluição. O extrato EtOH, frações e ácido elágico exibiram atividade contra Candida spp. e Saccharomyces cerevisiae com valores de CIM entre 250-1000 µg/mL, porιm não mostraram ação contra fungos filamentosos e dermatófitos (CIM>1000 µg/mL). Os extratos ativos foram avaliados nos ensaios de inibição do crescimento das hifas de Neurospora crassa, no teste do sorbitol, e pelo estudo do efeito do ergosterol na CIM do ácido elágico. Os extratos ativos, frações e ácido elágico mostraram zonas manchadas ao redor dos discos de papel e induziram malformações nas hifas. Além disso, a CIM do ácido elágico contra Saccharomyces cerevisiae passou de 62 para 250 µg/mL na presença do sorbitol 0,8 M, sugerindo que o ácido elágico provavelmente poderia exercer ação na parede celular fúngica. Esses resultados indicam que o ácido elágico pode ser o principal composto antifúngico de Lafoensia pacari, sugerindo que o modo de ação antifúngico desses extratos e ácido elágico poderia estar associado à inibição da parede celular fúngica.