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Fungal trunk disease (FTD) poses a significant threat to hazelnut (Corylus avellana L.) production worldwide. In Chile, the fungus Diplodia mutila, from the Botryosphaeriaceae family, has been frequently identified causing this disease in the Maule and Ñuble Regions. However, control measures for D. mutila remain limited. This research aimed to evaluate the effectiveness of chemical and biological fungicides against D. mutila under in vitro, controlled pot experiment, and field conditions. An in vitro screening of 30 fungicides was conducted. The effectiveness was assessed by measuring the length of vascular lesions in hazelnut branches inoculated with D. mutila mycelium disks under controlled and field conditions. Field trials were conducted in a hazelnut orchard in Ñiquén, Ñuble Region, Chile. The results showed that three biological and five chemical fungicides were selected in vitro with >31% inhibition after 14 days. In pot experiments, all fungicides reduced necrotic lesions on branches by 32% to 61%. In field experiments, the most effective systemic fungicides were fluopyram/tebuconazole, fluxapyroxad/pyraclostrobin, and tebuconazole, while the effectiveness of antagonists Pseudomonas protegens ChC7 and Bacillus subtilis QST713 varied with seasonal temperatures. Effective conventional and biological fungicides against D. mutila could be integrated into disease management programs to protect hazelnut wounds from infections.
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The muscle metaboreflex effect on pulmonary ventilation (VÌE) regulation is more apparent during rhythmic exercise than rest, possibly because this reflex interacts with other mechanisms regulating VÌE during voluntary contractions, such as central command. Therefore, we tested whether one part of central command, the descending component of motor execution (i.e., descending motor drive), and the muscle metaboreflex interact synergistically to regulate VÌE. Thirteen healthy adults (9 men) completed four experiments in random order under isocapnia. The muscle metaboreflex was activated by rhythmic handgrip exercise at 60% maximal voluntary contraction (MVC) force with the dominant hand. Then, the muscle metaboreflex remained active during a 4-minute recovery period via post-exercise circulatory occlusion (PECO), or it was inactivated, maintaining free blood flow to the dominant upper limb. During the last 2-minutes of the handgrip exercise recovery, participants either performed rhythmic voluntary plantar flexion with the dominant leg at 30% MVC torque to generate descending motor drive or the dominant leg's calf muscles were involuntarily activated by electrical stimulation at a similar torque level (i.e., without descending motor drive). VÌE increased to a similar level during handgrip exercise in all conditions (≈22 L/min, P = 0.364). PECO maintained VÌE elevated above recovery with free blood flow (≈17 L/min vs. ≈13 L/min, P = 0.009). However, voluntary and involuntary plantar flexion with or without PECO evoked similar VÌE responses (∆ ≈ 4 L/min, P = 0.311). Therefore, an interaction between descending motor drive and muscle metaboreflex is not ubiquitous for VÌE regulation during rhythmic exercise.
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AIM: The present study examined the leaching and cytotoxicity of bismuth from ProRoot MTA and aimed to identify whether bismuth leaching was affected by the cement base and the immersion regime used. METHODOLOGY: The leaching profile of bismuth was examined from ProRoot MTA and compared with hydroxyapatite containing 20% bismuth oxide as well as hydroxyapatite and tricalcium silicate to investigate whether bismuth release changed depending on the cement base. Bismuth leaching was determined after 30 and 180 days of ageing immersed in Dulbecco's modified Eagle's medium (DMEM) using mass spectroscopy (ICP-MS). The media were either unchanged or regularly replenished. The pH, surface microstructure and phase changes of aged materials were assessed. Wistar rat femoral bone marrow stromal cells (BMSCs) and cutaneous fibroblasts were isolated, cultured and seeded for cell counting (trypan blue live/dead) after exposure to non-aged, 30- and 180-days-aged samples in regularly replenished DMEM. Aged DMEM in contact with materials was also used to culture BMSCs to investigate the effect of material leachates on the cells. Gene expression analysis was also carried out after direct exposure of cells to non-aged materials. Differences between groups were statistically tested at a significance level of 5%. RESULTS: All materials exhibited alterations after immersion in DMEM and this increased with longer exposure times. The bismuth leached from ProRoot MTA as detected by ICP-MS. Aged ProRoot MTA samples exhibited a black discolouration and surface calcium carbonate deposition. ProRoot MTA influenced cell counts after direct exposure and its 180-days leachates reduced BMSC viability. After direct BMSC contact with non-aged ProRoot MTA an upregulation of metallothionein (MT1 and MT2A) expression and down-regulation of collagen-1a (Col-1a) and bone sialoprotein (BSP) expression was identified. CONCLUSIONS: Bismuth leaching was observed throughout 180-days observation period from all materials containing bismuth oxide. This negatively influenced cell viability and gene expression associated with bismuth exposure. This is the first study to report that metallothionein gene expression was influenced by exposure to ProRoot MTA.
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Bismuto , Compostos de Cálcio , Combinação de Medicamentos , Óxidos , Ratos Wistar , Materiais Restauradores do Canal Radicular , Silicatos , Bismuto/toxicidade , Animais , Silicatos/toxicidade , Compostos de Cálcio/toxicidade , Compostos de Cálcio/farmacologia , Compostos de Cálcio/química , Ratos , Óxidos/toxicidade , Materiais Restauradores do Canal Radicular/toxicidade , Teste de Materiais , Fibroblastos/efeitos dos fármacos , Compostos de Alumínio/toxicidade , Células Cultivadas , Durapatita , Células-Tronco Mesenquimais/efeitos dos fármacosRESUMO
When populations experience different sensory conditions, natural selection may favor sensory system divergence, affecting peripheral structures and/or downstream neural pathways. We characterized the outer eye morphology of sympatric Heliconius butterflies from different forest types and their first-generation reciprocal hybrids to test for adaptive visual system divergence and hybrid disruption. In Panama, Heliconius cydno occurs in closed forests, whereas Heliconius melpomene resides at the forest edge. Among wild individuals, H. cydno has larger eyes than H. melpomene, and there are heritable, habitat-associated differences in the visual brain structures that exceed neutral divergence expectations. Notably, hybrids have intermediate neural phenotypes, suggesting disruption. To test for similar effects in the visual periphery, we reared both species and their hybrids in common garden conditions. We confirm that H. cydno has larger eyes and provide new evidence that this is driven by selection. Hybrid eye morphology is more H. melpomene-like despite body size being intermediate, contrasting with neural trait intermediacy. Overall, our results suggest that eye morphology differences between H. cydno and H. melpomene are adaptive and that hybrids may suffer fitness costs due to a mismatch between the peripheral visual structures and previously described neural traits that could affect visual performance.
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Borboletas , Seleção Genética , Simpatria , Animais , Borboletas/anatomia & histologia , Borboletas/genética , Borboletas/fisiologia , Olho/anatomia & histologia , Panamá , Feminino , Masculino , Hibridização GenéticaRESUMO
This paper presents a unified model for combining beamforming and blind source separation (BSS). The validity of the model's assumptions is confirmed by recovering target speech information in noise accurately using Oracle information. Using real static human-robot interaction (HRI) data, the proposed combination of BSS with the minimum-variance distortionless response beamformer provides a greater signal-to-noise ratio (SNR) than previous parallel and cascade systems that combine BSS and beamforming. In the difficult-to-model HRI dynamic environment, the system provides a SNR gain that was 2.8 dB greater than the results obtained with the cascade combination, where the parallel combination is infeasible.
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Robótica , Humanos , Razão Sinal-Ruído , FalaRESUMO
Small slaughterhouses generate biowaste, which for economic reasons, is generally destined for composting. Inoculating appropriate microorganisms can improve biodegradation efficiency and mitigate odor generation during the composting process and can give rise to composts with neutral or pleasant odors. Therefore, the aim of this study was to compare the odor intensity reduction of compost generated with and without a formulated inoculum (Saccharomyces cerevisiae, Bacillus subtilis, and Rhodopseudomonas palustris). A set of experimental data was collected and analyzed according to the German "Verein Deutscher Ingenieure" odor protocol. The results showed that adding microorganisms was effective in reducing unpleasant odors in all three composts generated from swine, cattle, and poultry slaughterhouse by-products during both summer and winter seasons. Additionally, soil odor was predominant in composts that were inoculated in the two tested seasons (i.e., summer and winter). On the other hand, composts without inoculation had odors similar to peat for swine compost, ammonia for cattle compost, and manure for poultry compost, regardless of the season tested. Overall, composting process with appropriate inoculum can help in the correct disposal of slaughterhouse wastes by transforming organic matter into composts, which can have economic and environmental value as a soil conditioner and/or fertilizer.
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Compostagem , Animais , Bovinos , Suínos , Matadouros , Odorantes/prevenção & controle , Solo , Biodegradação Ambiental , EstercoRESUMO
The use of covers to protect blueberry orchards from adverse weather events has increased due to the variability in climate patterns, but the effects of rain covers and netting materials on yield and fruit quality have not been studied yet. This research evaluated the simultaneous effect of an LDPE plastic cover, a woven cover, and netting material on environmental components (UV light, PAR, NIR, and growing degree days (GDDs)), plant performance (light interception, leaf area index, LAI, yield, and flower development), and fruit quality traits (firmness, total soluble solids, and acidity) in two blueberry cultivars. On average, UV transmission under the netting was 11% and 43% higher compared to that under woven and LDPE plastic covers, while NIR transmission was 8-13% higher with both types of rain covers, with an increase in fruit air temperature and GDDs. Yield was 27% higher under the woven cover with respect to netting, but fruit firmness values under the netting were 12% higher than those of the LDPE plastic cover. Light interception, LAI, and flower development explained 64% (p = 0.0052) of the yield variation due to the cover material's effect. The obtained results suggest that the type of cover differentially affects yield and fruit quality in blueberries due to the specific light and temperature conditions generated under these materials.
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A respiratory distress estimation technique for telephony previously proposed by the authors is adapted and evaluated in real static and dynamic HRI scenarios. The system is evaluated with a telephone dataset re-recorded using the robotic platform designed and implemented for this study. In addition, the original telephone training data are modified using an environmental model that incorporates natural robot-generated and external noise sources and reverberant effects using room impulse responses (RIRs). The results indicate that the average accuracy and AUC are just 0.4% less than those obtained with matched training/testing conditions with simulated data. Quite surprisingly, there is not much difference in accuracy and AUC between static and dynamic HRI conditions. Moreover, the beamforming methods delay-and-sum and MVDR lead to average improvement in accuracy and AUC equal to 8% and 2%, respectively, when applied to training and testing data. Regarding the complementarity of time-dependent and time-independent features, the combination of both types of classifiers provides the best joint accuracy and AUC score.
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Robótica , Humanos , Dispneia , RegistrosRESUMO
OBJECTIVE: To determine the association between adjunct corticosteroid therapy and quality of life (QoL) outcomes in children with signs and symptoms of lower respiratory tract infection and clinical suspicion for community-acquired pneumonia (CAP) in the emergency department (ED). METHODS: Secondary analysis from a prospective cohort study of children aged 3 months to 18 years with signs and symptoms of LRTI and a chest radiograph for suspected CAP in the ED, excluding children with recent (within 14 days) systemic corticosteroid use. The primary exposure was receipt of corticosteroids during the ED visit. Outcomes were QoL measures and unplanned visits. Multivariable regression was used to evaluate the association between corticosteroid therapy and outcomes. RESULTS: Of 898 children, 162 (18%) received corticosteroids. Children who received corticosteroids were more frequently boys (62%), Black (45%), had history of asthma (58%), previous pneumonia (16%), presence of wheeze (74%), and more severe illness at presentation (6%). Ninety-six percent were treated for asthma as defined by report of asthma or receipt of ß-agonist in the ED. Receipt of corticosteroids was not associated with QoL measures: days of activity missed (adjusted incident rate ratio [aIRR], 0.84; 95% confidence interval [CI], 0.63-1.11) and days of work missed (aIRR, 0.88; 95% CI, 0.60-1.27). There was a statistically significant interaction between age (>2 years) and corticosteroids receipt; the patients had fewer days of activity missed (aIRR, 0.62; 95% CI, 0.46-0.83), with no effect on children 2 years or younger (aIRR, 0.83; 95% CI, 0.54-1.27). Corticosteroid treatment was not associated with unplanned visit (odds ratio, 1.37; 95% CI, 0.69-2.75). CONCLUSIONS: In this cohort of children with suspected CAP, receipt of corticosteroids was associated with asthma history and was not associated with missed days of activity or work, except in a subset of children aged older than 2 years.
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Asma , Pneumonia , Masculino , Criança , Humanos , Qualidade de Vida , Estudos Prospectivos , Corticosteroides/uso terapêutico , Asma/tratamento farmacológico , Pneumonia/tratamento farmacológicoRESUMO
In this study, we evaluated the morphology and morphometry of the layers that make up the follicular complex surrounding mature oocytes in the six fish species Auchenipterichthys longimanus, Ageneiosus ucayalensis, Hypophthalmus marginatus, Baryancistrus xanthellus, Panaqolus tankei and Peckoltia oligospila, belonging to the order Siluriformes, which inhabit the Amazon basin. On the basis of the morphology and thickness of the layers of the follicular complex, the species were divided into two groups: 1- A. longimanus, A. Ucayalensis and H. marginatus and 2 - B. xanthellus, P. tankei and P. oligospila. The total thickness of the layers that make up the follicular complex showed a difference between type III and IV oocytes for all species of each group. Differences in the theca layer, follicular cells and zona radiata between species and between groups were submitted to statistical analysis. Morphologically, group 1 showed columnar follicular cells and thin zona radiata. Meanwhile, group 2 displayed a layer of cuboidal-shaped follicular cells layer and thicker zona radiata. These differences may be related to the environment and reproductive behaviors, as group 1 migrates without parental care and has eggs that are generally smaller and abundant. While group 2, represented by loricariidae, inhabit lotic environments, have reproductive tactics of parental care and eggs that are generally large and in small numbers. Therefore, we can infer that the follicular complex in mature oocytes can predict the reproductive tactics of the species.
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BACKGROUND: Midwives' authorization to deliver the seven basic emergency obstetric and newborn care (BEmONC) functions is a core policy indicator in global monitoring frameworks, yet little evidence supports whether such data are captured accurately, or whether authorization demonstrates convergence with midwives' skills and actual provision of services. In this study, we aimed to validate the data reported in global monitoring frameworks (criterion validity) and to determine whether a measure of authorization is a valid indicator for BEmONC availability (construct validity). METHODS: We conducted a validation study in Argentina, Ghana, and India. To assess accuracy of the reported data on midwives' authorization to provide BEmONC services, we reviewed national regulatory documents and compared with reported country-specific data in Countdown to 2030 and the World Health Organization Maternal, Newborn, Child and Adolescent Health Policy Survey. To assess whether authorization demonstrates convergent validity with midwives' skills, training, and performance of BEmONC signal functions, we surveyed 1257 midwives/midwifery professionals and assessed variance. RESULTS: We detected discrepancies between data reported in the global monitoring frameworks and the national regulatory framework in all three countries. We found wide variations between midwives' authorization to perform signal functions and their self-reported skills and actual performance within the past 90 days. The percentage of midwives who reported performing all signal functions for which they were authorized per country-specific regulations was 17% in Argentina, 23% in Ghana, and 31% in India. Additionally, midwives in all three countries reported performing some signal functions that the national regulations did not authorize. CONCLUSION: Our findings suggest limitations in criterion and construct validity for this indicator in Argentina, Ghana, and India. Some signal functions such as assisted vaginal delivery may be obsolete based on current practice patterns. Findings suggest the need to re-examine the emergency interventions that should be included as BEmONC signal functions.
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Parto Obstétrico , Serviços Médicos de Emergência , Saúde Global , Saúde do Lactente , Serviços de Saúde Materno-Infantil , Tocologia , Adolescente , Criança , Feminino , Humanos , Recém-Nascido , Gravidez , Argentina , Parto Obstétrico/métodos , Gana , Índia , Tocologia/métodosRESUMO
INTRODUCTION: Genetic associations with Alzheimer's disease (AD) age at onset (AAO) could reveal genetic variants with therapeutic applications. We present a large Colombian kindred with autosomal dominant AD (ADAD) as a unique opportunity to discover AAO genetic associations. METHODS: A genetic association study was conducted to examine ADAD AAO in 340 individuals with the PSEN1 E280A mutation via TOPMed array imputation. Replication was assessed in two ADAD cohorts, one sporadic early-onset AD study and four late-onset AD studies. RESULTS: 13 variants had p<1×10-7 or p<1×10-5 with replication including three independent loci with candidate associations with clusterin including near CLU. Other suggestive associations were identified in or near HS3ST1, HSPG2, ACE, LRP1B, TSPAN10, and TSPAN14. DISCUSSION: Variants with suggestive associations with AAO were associated with biological processes including clusterin, heparin sulfate, and amyloid processing. The detection of these effects in the presence of a strong mutation for ADAD reinforces their potentially impactful role.
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Doença de Alzheimer , Clusterina , Humanos , Clusterina/genética , Colômbia , Doença de Alzheimer/diagnóstico , Mutação/genética , Amiloide , Presenilina-1/genética , Idade de InícioRESUMO
Actinoporins have emerged as archetypal α-pore-forming toxins (PFTs) that promote the formation of pores in membranes upon oligomerization and insertion of an α-helix pore-forming domain in the bilayer. These proteins have been used as active components of immunotoxins, therefore, understanding their lytic mechanism is crucial for developing this and other applications. However, the mechanism of how the biophysical properties of the membrane modulate the properties of pores generated by actinoporins remains unclear. Here we studied the effect of membrane fluidity on the permeabilizing activity of sticholysin I (St I), a toxin that belongs to the actinoporins family of α-PFTs. To modulate membrane fluidity we used vesicles made of an equimolar mixture of phosphatidylcholine (PC) and egg sphingomyelin (eggSM), in which PC contained fatty acids of different acyl chain lengths and degrees of unsaturation. Our detailed single-vesicle analysis revealed that when membrane fluidity is high, most of the vesicles are partially permeabilized in a graded manner. In contrast, more rigid membranes can be either completely permeabilized or not, indicating an all-or-none mechanism. Altogether, our results reveal that St I pores can be heterogeneous in size and stability, and that these properties depend on the fluid state of the lipid bilayer. We propose that membrane fluidity at different regions of cellular membranes is a key factor to modulate the activity of the actinoporins, which has implications for the design of different therapeutic strategies based on their lytic action.
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Venenos de Cnidários , Anêmonas-do-Mar , Animais , Fluidez de Membrana , Compostos Orgânicos/química , Bicamadas Lipídicas , Membrana Celular/metabolismo , Fosfatidilcolinas , Venenos de Cnidários/química , Anêmonas-do-Mar/químicaRESUMO
Human leukocyte antigen (HLA) class I and II loci are essential elements of innate and acquired immunity. Their functions include antigen presentation to T cells leading to cellular and humoral immune responses, and modulation of NK cells. Their exceptional influence on disease outcome has now been made clear by genome-wide association studies. The exons encoding the peptide-binding groove have been the main focus for determining HLA effects on disease susceptibility/pathogenesis. However, HLA expression levels have also been implicated in disease outcome, adding another dimension to the extreme diversity of HLA that impacts variability in immune responses across individuals. To estimate HLA expression, immunogenetic studies traditionally rely on quantitative PCR (qPCR). Adoption of alternative high-throughput technologies such as RNA-seq has been hampered by technical issues due to the extreme polymorphism at HLA genes. Recently, however, multiple bioinformatic methods have been developed to accurately estimate HLA expression from RNA-seq data. This opens an exciting opportunity to quantify HLA expression in large datasets but also brings questions on whether RNA-seq results are comparable to those by qPCR. In this study, we analyze three classes of expression data for HLA class I genes for a matched set of individuals: (a) RNA-seq, (b) qPCR, and (c) cell surface HLA-C expression. We observed a moderate correlation between expression estimates from qPCR and RNA-seq for HLA-A, -B, and -C (0.2 ≤ rho ≤ 0.53). We discuss technical and biological factors which need to be accounted for when comparing quantifications for different molecular phenotypes or using different techniques.
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Estudo de Associação Genômica Ampla , Antígenos de Histocompatibilidade Classe I , Humanos , RNA-Seq , Antígenos de Histocompatibilidade Classe I/genética , Antígenos HLA-C/genética , Reação em Cadeia da PolimeraseRESUMO
BACKGROUND: Global mechanisms have been established to monitor and facilitate state accountability regarding the legal status of abortion. However, there is little evidence describing whether these mechanisms capture accurate data. Moreover, it is uncertain whether the "legal status of abortion" is a valid proxy measure for access to safe abortion, pursuant to the global goals of reducing preventable maternal mortality and advancing reproductive rights. Therefore, this study sought to assess the accuracy of reported monitoring data, and to determine whether evidence supports the consistent application of domestic law by health care professionals such that legality of abortion functions as a valid indicator of access. METHODS AND FINDINGS: We conducted a validation study using three countries as illustrative case examples: Argentina, Ghana, and India. We compared data reported by two global monitoring mechanisms (Countdown to 2030 and the Global Abortion Policies Database) against domestic source documents collected through in-depth policy review. We then surveyed health care professionals authorized to perform abortions about their knowledge of abortion law in their countries and their personal attitudes and practices regarding provision of legal abortion. We compared professionals' responses to the domestic legal frameworks described in the source documents to establish whether professionals consistently applied the law as written. This analysis revealed weaknesses in the criterion validity and construct validity of the "legal status of abortion" indicator. We detected discrepancies between data reported by the global monitoring and accountability mechanisms and the domestic policy reviews, even though all referenced the same source documents. Further, provider surveys unearthed important context-specific barriers to legal abortion not captured by the indicator, including conscientious objection and imposition of restrictions at the provider's discretion. CONCLUSIONS: Taken together, these findings denote weaknesses in the indicator "legal status of abortion" as a proxy for access to safe abortion, as well as inaccuracies in data reported to global monitoring mechanisms. This information provides important groundwork for strengthening indicators for monitoring access to abortion and for renewed advocacy to assure abortion rights worldwide.
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Aborto Induzido , Aborto Legal , Gravidez , Feminino , Humanos , Fonte de Informação , Pessoal de Saúde , Política de SaúdeRESUMO
In recent years, natural products with biological activities have been increasingly researched. The elucidation of phytoconstituents is necessary for the development of drugs as a natural alternative for the treatment of various diseases. The work aimed to evaluate inâ vitro and in silico bioactivities of hexane (CCHE) and methanol (CCME) fractions of ethanolic extract from Centrosema coriaceum Benth (Fabaceae) leaves and elucidate their phytoconstituents. CCHE and CCME showed antifungal activity for Candida glabrata (MIC of 1000â µg/mL) with fungistatic effect and action in cell envelope by sorbitol and ergosterol assays. CCHE and CCME presented promising antioxidant activity against the DPPH radical with IC50 of 13.61±0.50 and 6.31±0.40â µg/mL, respectively, and relative antioxidant activity (RAA%) of 45.77±3.61/ 28.53±2.25 % for CCHE and 82.18±2.25/51.99±3.23 % for CCME when compared to rutin and quercetin, respectively. Moreover, these fractions demonstrated promising results for the inhibition of lipid peroxidation by ß-carotene/linoleic acid assay. For anti-inflammatory and cytotoxicity activities, CCHE and CCME significantly inhibited the production of nitric oxide and TNF-α, without toxicity on murine intraperitoneal macrophages, respectively. Esters, alkanes, steroids, tocopherols, and terpenes were identified in CCHE by GC/MS. Flavonoids, phenolic acids, and disaccharides were detected in CCME by UFLC-QTOF-MS and FACE. Furthermore, rutin was purified from CCME. In silico predictions evidenced that compounds present in both fractions have high affinity to the fungal membrane besides antioxidant and anti-inflammatory activities. Based on these observations, CCHE and CCME have a noteworthy potential for the design of novel antifungal and anti-inflammatory agents that should be explored in future studies.
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Antifúngicos , Antioxidantes , Camundongos , Animais , Antifúngicos/farmacologia , Antifúngicos/química , Antioxidantes/química , Extratos Vegetais/química , Rutina , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/químicaRESUMO
PURPOSE: Cubital tunnel syndrome is the second most common upper-extremity compressive neuropathy, and persistent symptoms can necessitate operative treatment. Surgical options include simple decompression and ulnar nerve transposition. The cause of wound dehiscence after surgery is not well known, and the factors leading to the development of these complications have not been previously described. METHODS: Patients undergoing ulnar nerve surgery from January 1, 2016, to December 31, 2019, were retrospectively evaluated for the development of wound dehiscence within 3 months of surgery. There were 295 patients identified who underwent transposition and 1,106 patients who underwent simple decompression. Patient demographics and past medical history were collected to evaluate the risk factors for the development of wound dehiscence. RESULTS: The overall rate of wound dehiscence following surgery was 2.5%. In the simple decompression group, the rate of wound dehiscence was 2.7% (30/1,106), which occurred a mean of 21 days (range, 2-57 days) following surgery. In the transposition group, the rate of wound dehiscence was 1.7% (5/295), which occurred a mean of 20 days (range, 12-32 days) following surgery. The difference in rates of dehiscence between the decompression and transposition groups was not significant. Five patients in the simple decompression group and 1 patient in the transposition group required a secondary surgery for closure of the wound. Age, body mass index, smoking status, and medical comorbidities were not found to contribute to the development of wound dehiscence. CONCLUSIONS: Wound dehiscence can occur following both simple decompression and transposition, even after postoperative evaluation demonstrates a healed wound. Surgeons should be aware of this possibility and specifically counsel patients about remaining cautious with, and protective of, their wound for several weeks after surgery. Dehiscence may be related to suboptimal vascularity in the soft tissue envelope in the posteromedial elbow. When it occurs, dehiscence can generally be treated by allowing healing by secondary intention. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
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Síndrome do Túnel Ulnar , Cotovelo , Humanos , Estudos Retrospectivos , Cotovelo/cirurgia , Descompressão Cirúrgica/efeitos adversos , Nervo Ulnar/cirurgia , Nervo Ulnar/fisiologia , Síndrome do Túnel Ulnar/cirurgia , Síndrome do Túnel Ulnar/diagnóstico , Complicações Pós-Operatórias/cirurgia , Resultado do TratamentoRESUMO
PURPOSE: Isolated diaphyseal ulna fractures can be treated nonsurgically or with open reduction and internal fixation (ORIF). It is unclear whether ORIF provides quicker and/or more predictable healing. The purpose of this study was to compare the healing characteristics of isolated diaphyseal ulna fractures after surgical and nonsurgical treatment. METHODS: All patients treated for an isolated diaphyseal (distal- or middle-third) ulna fracture between 2010 and 2018, with a minimum of 3 months of follow-up, were identified. Electronic medical records were reviewed to record patient demographics, assess the treatments used, and compare outcomes. We determined healing and nonunion rates, complications, reoperations, and final radiographic fracture alignment. RESULTS: Ninety-five patients were included with a median follow-up of 20 weeks. Of these, 56 patients were treated nonsurgically and 39 patients were treated with ORIF. At the time of the final follow-up, 51 of the 56 (91.1%) nonsurgically treated fractures had healed and 38 of the 39 (97.4%) surgically managed fractures had healed. There were 5 nonunions after nonsurgical treatment (8.9%) and 1 nonunion after ORIF (2.6%). Eleven patients (19.6%) treated nonsurgically required conversion to ORIF, whereas 4 patients (10.3%) treated with ORIF required reoperation. Middle-third fractures treated nonsurgically had a higher rate of nonunion (30.8%) compared with distal-third fractures treated nonsurgically (2.3%). CONCLUSIONS: The healing characteristics of isolated ulnar shaft fractures do not appear to differ substantially between surgical and nonsurgical treatment. However, nearly 20% of the patients treated nonsurgically may require eventual ORIF. Distal-third fractures may be at a higher risk of conversion to ORIF, and middle-third fractures may be at a higher risk of nonunion. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
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Fraturas Ósseas , Fraturas da Ulna , Humanos , Fixação Interna de Fraturas/efeitos adversos , Consolidação da Fratura , Fraturas Ósseas/cirurgia , Fraturas da Ulna/diagnóstico por imagem , Fraturas da Ulna/cirurgia , Fraturas da Ulna/complicações , Redução Aberta , Resultado do Tratamento , Estudos RetrospectivosRESUMO
Background: Dynamic, relational developmental systems-based models of development emphasize that developmentally-nurturant youth-adult relationships elicit in youth perceptions of being known and loved. Although such perceptions are foundations of positive youth development (PYD), such measures do not exist. Objective: We sought to create a theoretically-predicated measure of youth perceptions of being known and loved by capitalizing on data sets in two countries (Rwanda and El Salvador) wherein a multi-national study of PYD was being conducted by Compassion International (CI). Method: With Rwanda data (n = 1,204, M age = 11.84, 50% CI-supported), exploratory and confirmatory factor analyses enabled refining the measure for robustness and parsimony. Measures of intentional self-regulation, hopeful future expectations, transcendence, and contribution were used for validation of the known and loved measure within the nomological net of constructs proposed in the Lerner and Lerner PYD model. Confirmatory factor analyses supported the use of the model within the El Salvador data set (n = 1,205, M age = 13.03, 51% CI-supported). Results: Robust psychometric properties were established in both national settings. Measurement invariance was found across age, gender, urban-rural location, CI-enrollment status, and nations, and involved both mean differences and correlations among latent factors. Conclusions: The results provide evidence for a theory-predicated measure of youth perceptions of being known and loved and that scores for this construct covary within a nomological net specified in the Lerner and Lerner model of PYD. These findings serve international development organizations seeking theory-predicated measures for use in evaluating PYD programs in low- and middle-income countries. Supplementary Information: The online version contains supplementary material available at 10.1007/s10566-022-09725-6.