Hydropower development has become an important driver of habitat loss and fragmentation across lowland tropical forests.Despite ample evidence on the detrimental effects of insular habitat fragmentation on biodiversit...Hydropower development has become an important driver of habitat loss and fragmentation across lowland tropical forests.Despite ample evidence on the detrimental effects of insular habitat fragmentation on biodiversity,invertebrate taxa,that may be critical to ecosystem functioning,have been overlooked.We assessed the assemblage-level responses of social wasps to forest insularization induced by the Balbina Hydroelectric Dam in Central Brazilian Amazonia.Employing Malaise trapping,we captured wasps on 27 forest islands and three continuous forests.We constructed Generalized Linear Models and employed a model selection approach to examine the impact of local variables(fire severity(FIRE)and basal area of pioneer tree species(PIONEER))and landscape-scale variables(amount of habitat(COVER))on patterns of species richness,composition,and body size of wasps.A total of 374 individuals(29 species)were collected across all sampling sites.COVER was the main predictor of species richness,while PIONEER was the only variable that explained variation in community composition,with a negative effect on body size.Our results add evidence to the pervasive impacts of large hydroelectric dams on tropical forest biodiversity,and suggest that social wasps,among other invertebrates,can be used as bioindicators in infrastructure development projects.展开更多
Rationale: Co-infection of human immunodeficiency virus(HIV) and Leishmania spp. has impact on clinical and therapeutic outcomes of leishmaniases. Most studies do not present the identification of Leishmania species c...Rationale: Co-infection of human immunodeficiency virus(HIV) and Leishmania spp. has impact on clinical and therapeutic outcomes of leishmaniases. Most studies do not present the identification of Leishmania species causing American tegumentary leishmaniasis in co-infections. In the Americas, Leishmania(L.) Viannia(V.) braziliensis and L.(V.) guyanensis have been identified. Patient concerns: In this study, two cases of American tegumentary leishmaniasis in patients infected with HIV are described. Patients presented several lesions with rapid dissemination and mucosal involvement. Diagnosis: Disseminated cutaneous leishmaniasis caused by L. amazonensis was identified by molecular test. Interventions: The patients were treated with conventional therapies for HIV infection and American tegumentary leishmaniasis. Outcomes: In co-infection, the clinical manifestations are atypical and the treatment response can be impaired. Lessons: These cases show that HIV infection impacts L. amazonensis infection and point to the relevance of identifying Leishmania species, which can lead to a better patient management.展开更多
Background: Cutaneous squamous cell carcinoma is a common malignant neoplasm that affects areas that are exposed to the sun in fair-skinned people. It occurs less frequently on the lower limbs where other etiological ...Background: Cutaneous squamous cell carcinoma is a common malignant neoplasm that affects areas that are exposed to the sun in fair-skinned people. It occurs less frequently on the lower limbs where other etiological factors are involved. Objective: To determine the epidemiological aspects of cutaneous squamous cell carcinoma of the lower limbs in Goinia. Methodology: Forty-three cases of cutaneous squamous cell carcinoma of the lower limbs from the Cancer Registry of the Population Base of Gois, for the period between 1995 and 1999, were included in the study. Results: Among the cases of cutaneous squamous cell carcinoma registered in this 5-year interval, 43 (4.6%) represented cases affecting the lower limbs. Of these individuals, seven (16.3%)were male and 36 (83.7%)-female (P < 0.001). Those in the age group of 60 years and above represented 90.7%of the cases (P < 0.001). None of the patients had metastasis. Conclusion: Cutaneous squamous cell carcinomas on the lower limbs are more frequently seen in women older than 60 years of age, and they rarely metastasize.展开更多
Amazonian fruits are outstanding in quality. They are consumed as true delicacies of nature by the Brazilian population. Besides their attractive attributes, i.e. appearance, different textures and distinctive flavors...Amazonian fruits are outstanding in quality. They are consumed as true delicacies of nature by the Brazilian population. Besides their attractive attributes, i.e. appearance, different textures and distinctive flavors, their nutritional value is diversified in the type of calories and the functional food ingredients. In addition to being very palatable, Amazonian fruits provide energy-rich macronutrients (lipids, proteins and carbohydrates), micronutrients (minerals, water-soluble vitamins and fat-soluble vitamins), prebiotics (dietary fibers, especially pectin), bioactive substances (carotenoids and polyphenols), variety in the diet and improvement in the organoleptic properties and digestibility of (mixed) foods. This study first aimed to review concepts applicable to nutritional constituents and caloric contents of Amazonian fruits. It also attempted to clarify the potential use of these fruits in metabolic disorders (i.e. diabetes mellitus and/or obesity). To fulfill these purposes, 12 fruits were chosen for their dietetic significance in the Brazilian Amazonia.展开更多
The upland rice productivity in the state of Rond?nia is still low, in view of the potential of culture. The use of cultivars adapted to different regions and more responsive to fertilizer employed is an essential pra...The upland rice productivity in the state of Rond?nia is still low, in view of the potential of culture. The use of cultivars adapted to different regions and more responsive to fertilizer employed is an essential practice which can change that. The aim of this study was to evaluate the agronomic characteristics and productivity of two upland rice cultivars with nitrogen, phosphorus and potassium (N-P-K) doses in two municipalities in the southern state of Rondonia region. The experimental design was a randomized block design with four replications in a factorial 2 × 2 × 5, with the first factor composed of two cultivars (hybrid Ecco and conventional farming AN Cambará), the second factor, the environment of the two municipalities, Cerejeiras and Vilhena and the third factor of five doses of N-P-K (0-0-0, 30-40-30, 60-60-60, 90-90-90 and 120-100-120 kg·ha-1). The characteristics evaluated were: tillering, number of integers and sterile grains per panicle, weight of 1000 grains, grain yield (kg·ha-1) and whole grain yield. There was no triple interaction between the three factors for any of the traits. The hybrid Ecco has higher tillering ability than AN Cambara and presents fewer sterile grains per panicle, heavier 1000 grains and hence greater productivity. For both cultivars, the highest yields are obtained with a dose of 120-100-120 kg·ha-1 N-P-K. For the Ecco, the productivity is achieved with this dose and the dose of 90-90-90 kg·ha-1 is statistically similar. There is no difference in productivity between the municipalities when the dose of N-P-K is less than 60-60-60 kg·ha-1. The highest yield of whole grains in function of N-P-K fertilization is obtained in Cerejeiras.展开更多
Here we present new data on the major and trace element compositions of silicate and oxide minerals from mantle xenoliths brought to the surface by the Carolina kimberlite,Pimenta Bueno Kimberlitic Field,which is loca...Here we present new data on the major and trace element compositions of silicate and oxide minerals from mantle xenoliths brought to the surface by the Carolina kimberlite,Pimenta Bueno Kimberlitic Field,which is located on the southwestern border of the Amazonian Craton.We also present Sr-Nd isotopic data of garnet xenocrysts and whole-rocks from the Carolina kimberlite.Mantle xenoliths are mainly clinopyroxenites and garnetites.Some of the clinopyroxenites were classified as GPP–PP–PKP(garnet-phlogopite peridotite,phlogopite-peridotite,phlogopite-K-richterite peridotite)suites,and two clinopyroxenites(eclogites)and two garnetites are relicts of an ancient subducted slab.Temperature and pressure estimates yield 855–1102℃ and 3.6–7.0 GPa,respectively.Clinopyroxenes are enriched in light rare earth elements(LREE)(La_(N)/Yb_(N)=5–62;Ce_(N)/Sm_(N)=1–3;where N=primitive mantle normalized values),they have high Ca/Al ratios(10–410),low to medium Ti/Eu ratios(742–2840),and low Zr/Hf ratios(13–26),which suggest they were formed by metasomatic reactions with CO_(2)-rich silicate melts.Phlogopite with high TiO_(2)(>2.0 wt.%),Al_(2)O_(3)(>12.0 wt.%),and FeOt(5.0–13.0 wt.%)resemble those found in the groundmass of kimberlites,lamproites and lamprophyres.Conversely,phlogopite with low TiO_(2)(<1.0 wt.%)and lower Al_(2)O_(3)(<12.0 wt.%)are similar to those present in GPP-PP-PKP,and in MARID(mica-amphibole-rutile-ilmenite-diopside)and PIC(phlogopite-ilmenite-clinopyorxene)xenoliths.The GPP-PP-PKP suite of xenoliths,together with the clinopyroxene and phlogopite major and trace element signatures suggests that an intense proto-kimberlite melt metasomatism occurred in the deep cratonic lithosphere beneath the Amazonian Craton.The Sr-Nd isotopic ratios of pyrope xenocrysts(G3,G9 and G11)from the Carolina kimberlite are characterized by high ^(143)Nd/^(144)Nd(0.51287–0.51371)and eNd(+4.55 to+20.85)accompanied with enriched ^(87)Sr/^(86)Sr(0.70405–0.71098).These results suggest interaction with a proto-kimberlite melt compositionally similar with worldwide kimberlites.Based on Sr-Nd whole-rock compositions,the Carolina kimberlite has affinity with Group 1 kimberlites.The Sm-Nd isochron age calculated with selected eclogitic garnets yielded an age of 291.9±5.4 Ma(2σ),which represents the cooling age after the proto-kimberlite melt metasomatism.Therefore,we propose that the lithospheric mantle beneath the Amazonian Craton records the Paleozoic subduction with the attachment of an eclogitic slab into the cratonic mantle(garnetites and eclogites);with a later metasomatic event caused by proto-kimberlite melts shortly before the Carolina kimberlite erupted.展开更多
We identified that oncological treatments in general (chemotherapies, immunotherapies and radiotherapies) frequently cause peripheral neuropathy, including cramps, characterized by excess protons due to metabolic and ...We identified that oncological treatments in general (chemotherapies, immunotherapies and radiotherapies) frequently cause peripheral neuropathy, including cramps, characterized by excess protons due to metabolic and neuronal factors, such as sudden changes in pH, uremia and aspects that affect neuromotor functions. Such situations and others like them are often neglected in treatment, which naturally concerns itself with the main problem: Cancer. Sometimes toxic solutions are implemented that have comorbid side effects, such as duloxetine (standard treatment). Based on monitoring of cancer patients who used the non-toxic product, called “Magicramp® Electrostatic Charge Reduction Cushion” (MECRC), approved in Europe more than 10 years ago, we carried out a controlled test in Brazil. In this clinical trial, we hypothesized that reducing excessive ionic charges (electrostatic charge), which is one of the side effects often described in the literature as “Chemotherapy-Induced Peripheral Neuropathy” (CIPN), would decrease or eliminate cramping, under the hypothesis that such elimination would prevent or attenuate muscular vulnerability to action impulses, and increase the power of relaxation through the same mechanism. In this double-blind and randomized clinical trial, 40 (forty) adult patients with muscle cramps caused by oncological treatments were tested, evaluating the degree of efficiency of the product that aims to reduce muscle cramps, by eliminating and/or reducing excess loads electrostatic ionic. Data from the clinical research conducted in this study are available online at https://doi.org/10.7910/DVN/QUS94U.展开更多
Landslides are highly dangerous phenomena that occur in different parts of the world and pose significant threats to human populations. Intense rainfall events are the main triggering process for landslides in urbaniz...Landslides are highly dangerous phenomena that occur in different parts of the world and pose significant threats to human populations. Intense rainfall events are the main triggering process for landslides in urbanized slope regions, especially those considered high-risk areas. Various other factors contribute to the process;thus, it is essential to analyze the causes of such incidents in all possible ways. Soil moisture plays a critical role in the Earth’s surface-atmosphere interaction systems;hence, measurements and their estimations are crucial for understanding all processes involved in the water balance, especially those related to landslides. Soil moisture can be estimated from in-situ measurements using different sensors and techniques, satellite remote sensing, hydrological modeling, and indicators to index moisture conditions. Antecedent soil moisture can significantly impact runoff for the same rainfall event in a watershed. The Antecedent Precipitation Index (API) or “retained rainfall,” along with the antecedent moisture condition from the Natural Resources Conservation Service, is generally applied to estimate runoff in watersheds where data is limited or unavailable. This work aims to explore API in estimating soil moisture and establish thresholds based on landslide occurrences. The estimated soil moisture will be compared and calibrated using measurements obtained through multisensor capacitance probes installed in a high-risk area located in the mountainous region of Campos do Jordão municipality, São Paulo, Brazil. The API used in the calculation has been modified, where the recession coefficient depends on air temperature variability as well as the climatological mean temperature, which can be considered as losses in the water balance due to evapotranspiration. Once the API is calibrated, it will be used to extrapolate to the entire watershed and consequently estimate soil moisture. By utilizing recorded mass movements and comparing them with API and soil moisture, it will be possible to determine thresholds, thus enabling anticipation of landslide occurrences.展开更多
Objective: This case report aimed to demonstrate a possible neuromuscular effect of Latarjet nerves transection or truncal vagotomy, in association with sleeve gastrectomy plus antrojejunostomy, in order to reproduce ...Objective: This case report aimed to demonstrate a possible neuromuscular effect of Latarjet nerves transection or truncal vagotomy, in association with sleeve gastrectomy plus antrojejunostomy, in order to reproduce a Roux-en-Y gastric bypass (RYGB) mechanistic principles, in patients with previous Sleeve Gastrectomy (SG) who had had weight regain, with or without concomitant gastroesophageal reflux disease (GERD). Background: Sleeve gastrectomy (SG) is one of the most frequently performed bariatric operations worldwide. Nevertheless, weight regain and gastroesophageal reflux disease (GERD) have been consistently demonstrated, in association with this technique, which may require a revisional procedure. RYGB is an option in such a situation but, implies in gastrointestinal exclusions, which represents a shortcoming of this revision. Surpassing this inconvenient would be of great value for the patients. Methods: We describe herein two cases of SG revision for weight regain and GERD, with a follow-up of one year. Gastroesophageal reflux disease was evaluated by validated questionnaire, upper endoscopy, seriography, high resolution manometry (HRM) and impedance pHmetry (I-pHmetry), in the pre and postoperative periods. A re-Sleeve Gastrectomy with antrojejunal anastomosis was done in both cases, after informed consents. The Latarjet nerves were transected in one case, due to a bleeding in the left gastric vessels and a truncal vagotomy was required in the other, to appropriately treat an associated hiatal hernia. Results: In the postoperative evaluation it was observed a pyloric spasm in both cases, during seriography and endoscopy, kept until the one-year follow-up. There was unidirectional contrast flow to the gastrointestinal anastomosis, filling the jejunal limb, in radiologic contrast study. No contrast passed through the pylorus. Nonetheless, the duodenum was kept endoscopically accessible. In the one-year evaluation, weight loss was adequate and GERD resolution was obtained in both cases, confirmed by endoscopic and functional esophageal assessment, together with symptoms questionnaire. Conclusion: The association of Latarjet nerves sectioning or truncal vagotomy with re-sleeve gastrectomy plus gastrointestinal anastomosis (antrojejunal), in a revision for a failed sleeve, can represent a technical approach, to reproduce RYGB results, without exclusions and with duodenum endoscopic accessibility maintenance. It maybe could be applied for primary surgeries. Additional studies are necessary to confirm this hypothesis.展开更多
Tropical regions have provided new insights into how ecological communities are assembled.In dry coastal communities,water stress has been hypothesized to determine plant assembly structure by favoring preadapted line...Tropical regions have provided new insights into how ecological communities are assembled.In dry coastal communities,water stress has been hypothesized to determine plant assembly structure by favoring preadapted lineages from neighboring ecosystems,consistent with functional clustering.However,it is unclear whether this hypothesis is sufficient to explain how coastal communities in tropical ecosystems are assembled.Here,we test whether water stress or other factors drive community assembly in woody plant communities across the coastal zone of Brazil,a tropical ecosystem.We characterized functional and phylogenetic structures of these communities and determined the underlying environmental factors(e.g.,water stress,historical climate stability,edaphic constraints,and habitat heterogeneity)that drive their community assembly.Assemblages of coastal woody species show geographically varied patterns,including stochastic arrangements,clustering,and overdispersion of species relative to their traits and phylogenetic relatedness.Topographic complexity,water vapor pressure,and soil nutrient availability best explained the gradient in the functional structure.Water deficit,water vapor pressure,and soil organic carbon were the best predictors of variation in phylogenetic structure.Our results support the water-stress conservatism hypothesis on functional and phylogenetic structure,as well as the effect of habitat heterogeneity on functional structure and edaphic constraints on functional and phylogenetic structure.These effects are associated with increased phenotypic and phylogenetic divergence of woody plant assemblages,which is likely mediated by abiotic filtering and niche opportunities,suggesting a complex pattern of ecological assembly.展开更多
Despite its enormous benefits,mining is respon-sible for intense changes to vegetation and soil properties.Thus,after extraction,it is necessary to rehabilitate the mined areas,creating better conditions for the estab...Despite its enormous benefits,mining is respon-sible for intense changes to vegetation and soil properties.Thus,after extraction,it is necessary to rehabilitate the mined areas,creating better conditions for the establishment of plant species which is challenging.This study evaluated mineral and organic fertilization on the growth,and carbon and nitrogen(N)metabolism of two Crotalaria species[Cro-talaria spectabilis(exotic species)and Crotalaria maypu-rensis(native species from Carajás Mineral Province(CMP)]established on a waste pile from an iron mine in CMP.A control(without fertilizer application)and six fertilization mixtures were tested(i=NPK;ii=NPK+micronutrients;iii=NPK+micronutrients+organic compost;iv=PK;v=PK+micronutrients;vi=PK+micronutrients+organic compost).Fertilization contributed to increased growth of both species,and treatments with NPK and micronutrients had the best results(up to 257%cf.controls),while organic fertilization did not show differences.Exotic Crotalaria had a greater number of nodules,higher nodule dry mass,chlorophyll a and b contents and showed free ammonium as the predominant N form,reflecting greater increments in biomass compared to native species.Although having lower growth,the use of this native species in the rehabilitation of mining areas should be considered,mainly because it has good development and meets current government legislation as an opportunity to restore local biodiversity.展开更多
Liver cancer is the sixth most commonly diagnosed cancer worldwide,with hepatocellular carcinoma(HCC)comprising most cases.Besides hepatitis B and C viral infections,heavy alcohol use,and nonalcoholic steatohepatitis(...Liver cancer is the sixth most commonly diagnosed cancer worldwide,with hepatocellular carcinoma(HCC)comprising most cases.Besides hepatitis B and C viral infections,heavy alcohol use,and nonalcoholic steatohepatitis(NASH)-associated advanced fibrosis/cirrhosis,several other risk factors for HCC have been identified(i.e.old age,obesity,insulin resistance,type 2 diabetes).These might in fact partially explain the occurrence of HCC in non-cirrhotic patients without viral infection.HCC surveillance through effective screening programs is still an unmet need for many nonalcoholic fatty liver disease(NAFLD)patients,and identification of pre-cirrhotic individuals who progress to HCC represents a substantial challenge in clinical practice at the moment.Patients with NASHcirrhosis should undergo systematic HCC surveillance,while this might be considered in patients with advanced fibrosis based on individual risk assessment.In this context,interventions that potentially prevent NAFLD/NASH-associated HCC are needed.This paper provided an overview of evidence related to lifestyle changes(i.e.weight loss,physical exercise,adherence to healthy dietary patterns,intake of certain dietary components,etc.)and pharmacological interventions that might play a protective role by targeting the underlying causative factors and pathogenetic mechanisms.However,well-designed prospective studies specifically dedicated to NAFLD/NASH patients are still needed to clarify the relationship with HCC risk.展开更多
Background: HPV infection represents an important etiologic factor for Oropharyngeal Squamous Cell Carcinoma (OPSCC). The different ethnic backgrounds could be related to different susceptibility to Human Papillomavir...Background: HPV infection represents an important etiologic factor for Oropharyngeal Squamous Cell Carcinoma (OPSCC). The different ethnic backgrounds could be related to different susceptibility to Human Papillomavirus (HPV). The aim of our study was to assess the whole of genetic ancestry in HPV status in OPSCC patients. Methods: We conducted a cross-sectional study on patients with OPSCC admitted to the Barretos Cancer Hospital, Brazil from 2014 to 2019. Of these, DNA extraction was performed on 40 patients and genetic ancestry was assessed using a specific panel of 46 informative ancestry markers. Results: We observed a predominance of European ancestry (63%), followed by African (18%), Amerindian (9%) and Asian (8%) both in the OPSCC HPV-positive and HPV-negative group. We did not find any statistically significant differences between the HPV-positive and HPV-negative OPSCC groups in relation to European (p = 0.499), African (p = 0.448), Asian (p = 0.275) or Amerindian (p = 0.836) ancestry. Conclusions: We found a predominance of European ancestry, both in the HPV-positive and HPV-negative groups. In our study, we did not find statistically significant differences between HPV-positive or HPV-negative groups in relation to ancestry.展开更多
Obesity has been growing in Brazil and in the world. It is reaching epidemic proportions, and bariatric surgery is the most effective treatment for patients with this disease. Among the procedures described in the lit...Obesity has been growing in Brazil and in the world. It is reaching epidemic proportions, and bariatric surgery is the most effective treatment for patients with this disease. Among the procedures described in the literature, ileal surgeries such as biliopancreatic diversion with duodenal switch (BPD-DS) and single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) present better long-term results in terms of weight loss and comorbidities control. However, there are concerns regarding long term nutritional problems with these procedures. In this case report the aim is to demonstrate the technical feasibility of preserving an extended duodenal bulb segment, in the SADIS-S procedure, when there are difficulties in dissecting the retrobulbar region, as occurred here, due to fibrosis in this area. This assures the maintenance of the proposed surgical technique, in such a situation. The dissection and transection of the duodenum was done 7 cm distally to the pylorus, under endoscopic view, proximally to the papillae, where the tissue was normal. Additionally, due the importance of the duodenal mucosa on minerals and trace elements absorption and the release of important hormones in this region, this case report elicits the evaluation of the impact of this technical modification, which occurred casually, in the nutritional, hormonal and metabolic results, long term. In this case report, the extended duodenal length has demonstrated reasonable weight loss, adequate comorbidities control and good nutritional status, so far. These aspects must be evaluated in the long term, by clinical trials.展开更多
Obesity has been growing worldwide, reaching epidemic proportions. Bariatric surgery is the most effective and durable treatment for severe obesity and related diseases. Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gast...Obesity has been growing worldwide, reaching epidemic proportions. Bariatric surgery is the most effective and durable treatment for severe obesity and related diseases. Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG) are the most frequently performed bariatric operations, with long-term good results, in terms of weight loss and comorbidities control. Gastroesophageal Reflux Disease (GERD) is commonly associated with obesity. In general, it precludes the indication of sleeve gastrectomy, since this technique has a refluxogenic potential, as shown in many studies. In such cases, RYGB is considered the best surgery, reaching good weight loss and gastroesophageal reflux disease control. The drawback of this technique is that it leaves the remnant stomach, the duodenum, and the proximal part of the jejunum inaccessible. Besides, RYGB makes transoral endoscopic access to the biliary tree impossible. For all these reasons, this bariatric technique is not indicated in cases of gastric polyposis, gastric dysplasia, or strong family history of cancer, among others. We report a case of a morbidly obese patient with intense GERD, for whom a RYGB was precluded due to her strong family history of cancer, even knowing that it would be the best choice for reflux disease control. Instead, SG was chosen, even knowing it could worsen the gastroesophageal reflux disease. The patient signed an informed consent, after being fully enlightened about the risks. During the surgery, a small subserosal whitish lesion was detected, near the pylorus, on the anterior wall of the antrum. Thinking in a Gastrointestinal Stromal Tumor (GIST), it was resected, with a 2 cm safety margin, leaving a 4 to 5 cm hole on the gastric wall. The decision to maintain the proposed sleeve gastrectomy was made, to avoid leaving a remnant stomach, in a patient with such a strong family history of cancer. In the area of the resected lesion, an intraoperative decision was made not to just close the big gastric hole, being afraid of causing some anatomic or functional disturbance in gastric emptying. Instead, we decided to use the gastric opening to construct a Roux-en-Y antrotrojejunal anastomosis, with a 50 cm alimentary limb and a 200 cm biliopancreatic limb. Accordingly, it was performed a sleeve gastrectomy, associated with an antrojejunostomy in a Roux-en-Y fashion. The patient had an uneventful postoperative course. In the second year, she achieved normal weight and good nutritional status, without gastroesophageal reflux symptoms complaints. Seriography study shows that most of the contrast material passes through the antrojejunal anastomosis, instead of the pylorus, while the duodenum is endoscopically patent. This case report shows an unexpected surgical finding that led to a tactic of adding a Roux-en-Y gastric bypass in the antrum, associated with a sleeve gastrectomy, a strategy that may be adopted in cases of morbidly obese patients with important GERD, for whom gastrointestinal exclusions are contraindicated. To confirm this hypothesis, controlled studies are needed.展开更多
N-11-azaartemisinins potentially active against Plasmodium falciparum are designed by combining molecular electrostatic potential (MEP), ligand-receptor interaction, and models built with supervised machine learning m...N-11-azaartemisinins potentially active against Plasmodium falciparum are designed by combining molecular electrostatic potential (MEP), ligand-receptor interaction, and models built with supervised machine learning methods (PCA, HCA, KNN, SIMCA, and SDA). The optimization of molecular structures was performed using the B3LYP/6-31G* approach. MEP maps and ligand-receptor interactions were used to investigate key structural features required for biological activities and likely interactions between N-11-azaartemisinins and heme, respectively. The supervised machine learning methods allowed the separation of the investigated compounds into two classes: cha and cla, with the properties ε<sub>LUMO+1</sub> (one level above lowest unoccupied molecular orbital energy), d(C<sub>6</sub>-C<sub>5</sub>) (distance between C<sub>6</sub> and C<sub>5</sub> atoms in ligands), and TSA (total surface area) responsible for the classification. The insights extracted from the investigation developed and the chemical intuition enabled the design of sixteen new N-11-azaartemisinins (prediction set), moreover, models built with supervised machine learning methods were applied to this prediction set. The result of this application showed twelve new promising N-11-azaartemisinins for synthesis and biological evaluation.展开更多
During the SARS-Cov-2 or COVID-19 clinical course pandemic of the coronavirus family, we observed symptoms of the respiratory tract, fever, cough, sore throat, and fatigue. The most common symptoms were loss of smell ...During the SARS-Cov-2 or COVID-19 clinical course pandemic of the coronavirus family, we observed symptoms of the respiratory tract, fever, cough, sore throat, and fatigue. The most common symptoms were loss of smell and taste and, when aggravated, it could develop into pneumonia and even death. We selected 40 former COVID-19 patients, who answered a questionnaire with questions about the symptoms and complications after they were cured and which symptoms remained or appeared after the total isolation quarantine for a specific time. Among the answers, the most cited was about “forgetting”. Another observation noted was the number of cases in children, which surprised us, considering that, at the beginning of the pandemic, the danger was more related to the elderly population and those with comorbidities.展开更多
The family farmer’s knowledge about floodplains agroecosystems dynamics is part of agrobiodiversity conservation cognitive strategies. This is because the conservation in floodplains is conditioned by the ecophysiolo...The family farmer’s knowledge about floodplains agroecosystems dynamics is part of agrobiodiversity conservation cognitive strategies. This is because the conservation in floodplains is conditioned by the ecophysiological adaptation to the period and flood gradient of the agricultural lands and by the transformations promoted in the environment by the waters pulse. The aim of this study was to understand the cognitive strategies expressed in the organized meaning of agroecosystems by local knowledge, related to the geomorphological dynamics of the Aramaçá Island, Amazonas, Brazil. In this research, the Case Study and Ethnoecology were adopted as approach, taking the systemic complexity paradigm as a theoretical framework. To do so, it was necessary to establish a dialogue with the local knowledge through multitemporal analyses of satellite images, historical series of hydrological data, as well as cartographic documents of the locality. The floodplains amphibian mark, as a living organism in permanent autopoietic process, seems to be imprinted in the family farmer’s knowledge. In order to live in the floodplains and of floodplains, it is necessary, above all, to develop a cognitive ability capable of understanding not only the rivers action on the lands, but also that of the lands on the rivers as well. Therefore, the geomorphological dynamics in the spaces managed by the family farmers impose on them, risks and uncertainties, demanding from them strategies that allow knowing and dealing with this complexity.展开更多
Scientists regularly lament that development and habitat destruction in once isolated and distant areas are promoting species extinction before species can even be known by science. In the Brazilian Amazon, the govern...Scientists regularly lament that development and habitat destruction in once isolated and distant areas are promoting species extinction before species can even be known by science. In the Brazilian Amazon, the government’s Plan for Growth Acceleration in part involves major improvements and expansion of highways. Such infrastructure has long been linked to the main causes of deforestation in this region. It is essential for scientists to assess where to target bio-diversity collections in relation to the location of road development and existing protected areas. The objective of this study was to amass all of the records of occurrence of orchid bees in digital form, in order to obtain a spatial picture of our knowledge thus far and to make recommendations about priority areas for future collections and the role of protected areas in species conservation. The collection data used for this study come from various collection efforts, and were also gathered from the literature. The collection data were then imported into a Geographic Information System, making it possible to integrate other spatial data layers such as highways, conservation units, indigenous lands and forest cover. Results show a major need for collections along the BR 163 and BR 230 highways, heavily deforested areas with few conservation units. We suggest the creation of conservation units and recommend that abandoned areas be allowed to remain fallow as a way to help save additional biodiversity in the area of influence of these two main highways.展开更多
基金supported by a NERC grant to C.A.P.(NE/J01401X/1)a Science Without Borders postdoctoral fellowship awarded to D.S.(CNPq grant 246975/2012-1)+1 种基金M.B.received a productivity grant from CNPq(304189/2022-7)supported by the inaugural Frontiers Planet Prize。
文摘Hydropower development has become an important driver of habitat loss and fragmentation across lowland tropical forests.Despite ample evidence on the detrimental effects of insular habitat fragmentation on biodiversity,invertebrate taxa,that may be critical to ecosystem functioning,have been overlooked.We assessed the assemblage-level responses of social wasps to forest insularization induced by the Balbina Hydroelectric Dam in Central Brazilian Amazonia.Employing Malaise trapping,we captured wasps on 27 forest islands and three continuous forests.We constructed Generalized Linear Models and employed a model selection approach to examine the impact of local variables(fire severity(FIRE)and basal area of pioneer tree species(PIONEER))and landscape-scale variables(amount of habitat(COVER))on patterns of species richness,composition,and body size of wasps.A total of 374 individuals(29 species)were collected across all sampling sites.COVER was the main predictor of species richness,while PIONEER was the only variable that explained variation in community composition,with a negative effect on body size.Our results add evidence to the pervasive impacts of large hydroelectric dams on tropical forest biodiversity,and suggest that social wasps,among other invertebrates,can be used as bioindicators in infrastructure development projects.
基金supported by Research Program for Sistema único de Saúde (SUS)/Brazilian Ministry of Healthy/Funda??o de AmparoàPesquisa do Estado de Goiás (FAPEG) grant No. 201.710.267.001.235。
文摘Rationale: Co-infection of human immunodeficiency virus(HIV) and Leishmania spp. has impact on clinical and therapeutic outcomes of leishmaniases. Most studies do not present the identification of Leishmania species causing American tegumentary leishmaniasis in co-infections. In the Americas, Leishmania(L.) Viannia(V.) braziliensis and L.(V.) guyanensis have been identified. Patient concerns: In this study, two cases of American tegumentary leishmaniasis in patients infected with HIV are described. Patients presented several lesions with rapid dissemination and mucosal involvement. Diagnosis: Disseminated cutaneous leishmaniasis caused by L. amazonensis was identified by molecular test. Interventions: The patients were treated with conventional therapies for HIV infection and American tegumentary leishmaniasis. Outcomes: In co-infection, the clinical manifestations are atypical and the treatment response can be impaired. Lessons: These cases show that HIV infection impacts L. amazonensis infection and point to the relevance of identifying Leishmania species, which can lead to a better patient management.
文摘Background: Cutaneous squamous cell carcinoma is a common malignant neoplasm that affects areas that are exposed to the sun in fair-skinned people. It occurs less frequently on the lower limbs where other etiological factors are involved. Objective: To determine the epidemiological aspects of cutaneous squamous cell carcinoma of the lower limbs in Goinia. Methodology: Forty-three cases of cutaneous squamous cell carcinoma of the lower limbs from the Cancer Registry of the Population Base of Gois, for the period between 1995 and 1999, were included in the study. Results: Among the cases of cutaneous squamous cell carcinoma registered in this 5-year interval, 43 (4.6%) represented cases affecting the lower limbs. Of these individuals, seven (16.3%)were male and 36 (83.7%)-female (P < 0.001). Those in the age group of 60 years and above represented 90.7%of the cases (P < 0.001). None of the patients had metastasis. Conclusion: Cutaneous squamous cell carcinomas on the lower limbs are more frequently seen in women older than 60 years of age, and they rarely metastasize.
文摘Amazonian fruits are outstanding in quality. They are consumed as true delicacies of nature by the Brazilian population. Besides their attractive attributes, i.e. appearance, different textures and distinctive flavors, their nutritional value is diversified in the type of calories and the functional food ingredients. In addition to being very palatable, Amazonian fruits provide energy-rich macronutrients (lipids, proteins and carbohydrates), micronutrients (minerals, water-soluble vitamins and fat-soluble vitamins), prebiotics (dietary fibers, especially pectin), bioactive substances (carotenoids and polyphenols), variety in the diet and improvement in the organoleptic properties and digestibility of (mixed) foods. This study first aimed to review concepts applicable to nutritional constituents and caloric contents of Amazonian fruits. It also attempted to clarify the potential use of these fruits in metabolic disorders (i.e. diabetes mellitus and/or obesity). To fulfill these purposes, 12 fruits were chosen for their dietetic significance in the Brazilian Amazonia.
文摘The upland rice productivity in the state of Rond?nia is still low, in view of the potential of culture. The use of cultivars adapted to different regions and more responsive to fertilizer employed is an essential practice which can change that. The aim of this study was to evaluate the agronomic characteristics and productivity of two upland rice cultivars with nitrogen, phosphorus and potassium (N-P-K) doses in two municipalities in the southern state of Rondonia region. The experimental design was a randomized block design with four replications in a factorial 2 × 2 × 5, with the first factor composed of two cultivars (hybrid Ecco and conventional farming AN Cambará), the second factor, the environment of the two municipalities, Cerejeiras and Vilhena and the third factor of five doses of N-P-K (0-0-0, 30-40-30, 60-60-60, 90-90-90 and 120-100-120 kg·ha-1). The characteristics evaluated were: tillering, number of integers and sterile grains per panicle, weight of 1000 grains, grain yield (kg·ha-1) and whole grain yield. There was no triple interaction between the three factors for any of the traits. The hybrid Ecco has higher tillering ability than AN Cambara and presents fewer sterile grains per panicle, heavier 1000 grains and hence greater productivity. For both cultivars, the highest yields are obtained with a dose of 120-100-120 kg·ha-1 N-P-K. For the Ecco, the productivity is achieved with this dose and the dose of 90-90-90 kg·ha-1 is statistically similar. There is no difference in productivity between the municipalities when the dose of N-P-K is less than 60-60-60 kg·ha-1. The highest yield of whole grains in function of N-P-K fertilization is obtained in Cerejeiras.
基金supported by FAPDF(Call03/2018Process n°23568.93.50253.24052018)Serrapilheira Institute(Serra-1709-18152)。
文摘Here we present new data on the major and trace element compositions of silicate and oxide minerals from mantle xenoliths brought to the surface by the Carolina kimberlite,Pimenta Bueno Kimberlitic Field,which is located on the southwestern border of the Amazonian Craton.We also present Sr-Nd isotopic data of garnet xenocrysts and whole-rocks from the Carolina kimberlite.Mantle xenoliths are mainly clinopyroxenites and garnetites.Some of the clinopyroxenites were classified as GPP–PP–PKP(garnet-phlogopite peridotite,phlogopite-peridotite,phlogopite-K-richterite peridotite)suites,and two clinopyroxenites(eclogites)and two garnetites are relicts of an ancient subducted slab.Temperature and pressure estimates yield 855–1102℃ and 3.6–7.0 GPa,respectively.Clinopyroxenes are enriched in light rare earth elements(LREE)(La_(N)/Yb_(N)=5–62;Ce_(N)/Sm_(N)=1–3;where N=primitive mantle normalized values),they have high Ca/Al ratios(10–410),low to medium Ti/Eu ratios(742–2840),and low Zr/Hf ratios(13–26),which suggest they were formed by metasomatic reactions with CO_(2)-rich silicate melts.Phlogopite with high TiO_(2)(>2.0 wt.%),Al_(2)O_(3)(>12.0 wt.%),and FeOt(5.0–13.0 wt.%)resemble those found in the groundmass of kimberlites,lamproites and lamprophyres.Conversely,phlogopite with low TiO_(2)(<1.0 wt.%)and lower Al_(2)O_(3)(<12.0 wt.%)are similar to those present in GPP-PP-PKP,and in MARID(mica-amphibole-rutile-ilmenite-diopside)and PIC(phlogopite-ilmenite-clinopyorxene)xenoliths.The GPP-PP-PKP suite of xenoliths,together with the clinopyroxene and phlogopite major and trace element signatures suggests that an intense proto-kimberlite melt metasomatism occurred in the deep cratonic lithosphere beneath the Amazonian Craton.The Sr-Nd isotopic ratios of pyrope xenocrysts(G3,G9 and G11)from the Carolina kimberlite are characterized by high ^(143)Nd/^(144)Nd(0.51287–0.51371)and eNd(+4.55 to+20.85)accompanied with enriched ^(87)Sr/^(86)Sr(0.70405–0.71098).These results suggest interaction with a proto-kimberlite melt compositionally similar with worldwide kimberlites.Based on Sr-Nd whole-rock compositions,the Carolina kimberlite has affinity with Group 1 kimberlites.The Sm-Nd isochron age calculated with selected eclogitic garnets yielded an age of 291.9±5.4 Ma(2σ),which represents the cooling age after the proto-kimberlite melt metasomatism.Therefore,we propose that the lithospheric mantle beneath the Amazonian Craton records the Paleozoic subduction with the attachment of an eclogitic slab into the cratonic mantle(garnetites and eclogites);with a later metasomatic event caused by proto-kimberlite melts shortly before the Carolina kimberlite erupted.
文摘We identified that oncological treatments in general (chemotherapies, immunotherapies and radiotherapies) frequently cause peripheral neuropathy, including cramps, characterized by excess protons due to metabolic and neuronal factors, such as sudden changes in pH, uremia and aspects that affect neuromotor functions. Such situations and others like them are often neglected in treatment, which naturally concerns itself with the main problem: Cancer. Sometimes toxic solutions are implemented that have comorbid side effects, such as duloxetine (standard treatment). Based on monitoring of cancer patients who used the non-toxic product, called “Magicramp® Electrostatic Charge Reduction Cushion” (MECRC), approved in Europe more than 10 years ago, we carried out a controlled test in Brazil. In this clinical trial, we hypothesized that reducing excessive ionic charges (electrostatic charge), which is one of the side effects often described in the literature as “Chemotherapy-Induced Peripheral Neuropathy” (CIPN), would decrease or eliminate cramping, under the hypothesis that such elimination would prevent or attenuate muscular vulnerability to action impulses, and increase the power of relaxation through the same mechanism. In this double-blind and randomized clinical trial, 40 (forty) adult patients with muscle cramps caused by oncological treatments were tested, evaluating the degree of efficiency of the product that aims to reduce muscle cramps, by eliminating and/or reducing excess loads electrostatic ionic. Data from the clinical research conducted in this study are available online at https://doi.org/10.7910/DVN/QUS94U.
文摘Landslides are highly dangerous phenomena that occur in different parts of the world and pose significant threats to human populations. Intense rainfall events are the main triggering process for landslides in urbanized slope regions, especially those considered high-risk areas. Various other factors contribute to the process;thus, it is essential to analyze the causes of such incidents in all possible ways. Soil moisture plays a critical role in the Earth’s surface-atmosphere interaction systems;hence, measurements and their estimations are crucial for understanding all processes involved in the water balance, especially those related to landslides. Soil moisture can be estimated from in-situ measurements using different sensors and techniques, satellite remote sensing, hydrological modeling, and indicators to index moisture conditions. Antecedent soil moisture can significantly impact runoff for the same rainfall event in a watershed. The Antecedent Precipitation Index (API) or “retained rainfall,” along with the antecedent moisture condition from the Natural Resources Conservation Service, is generally applied to estimate runoff in watersheds where data is limited or unavailable. This work aims to explore API in estimating soil moisture and establish thresholds based on landslide occurrences. The estimated soil moisture will be compared and calibrated using measurements obtained through multisensor capacitance probes installed in a high-risk area located in the mountainous region of Campos do Jordão municipality, São Paulo, Brazil. The API used in the calculation has been modified, where the recession coefficient depends on air temperature variability as well as the climatological mean temperature, which can be considered as losses in the water balance due to evapotranspiration. Once the API is calibrated, it will be used to extrapolate to the entire watershed and consequently estimate soil moisture. By utilizing recorded mass movements and comparing them with API and soil moisture, it will be possible to determine thresholds, thus enabling anticipation of landslide occurrences.
文摘Objective: This case report aimed to demonstrate a possible neuromuscular effect of Latarjet nerves transection or truncal vagotomy, in association with sleeve gastrectomy plus antrojejunostomy, in order to reproduce a Roux-en-Y gastric bypass (RYGB) mechanistic principles, in patients with previous Sleeve Gastrectomy (SG) who had had weight regain, with or without concomitant gastroesophageal reflux disease (GERD). Background: Sleeve gastrectomy (SG) is one of the most frequently performed bariatric operations worldwide. Nevertheless, weight regain and gastroesophageal reflux disease (GERD) have been consistently demonstrated, in association with this technique, which may require a revisional procedure. RYGB is an option in such a situation but, implies in gastrointestinal exclusions, which represents a shortcoming of this revision. Surpassing this inconvenient would be of great value for the patients. Methods: We describe herein two cases of SG revision for weight regain and GERD, with a follow-up of one year. Gastroesophageal reflux disease was evaluated by validated questionnaire, upper endoscopy, seriography, high resolution manometry (HRM) and impedance pHmetry (I-pHmetry), in the pre and postoperative periods. A re-Sleeve Gastrectomy with antrojejunal anastomosis was done in both cases, after informed consents. The Latarjet nerves were transected in one case, due to a bleeding in the left gastric vessels and a truncal vagotomy was required in the other, to appropriately treat an associated hiatal hernia. Results: In the postoperative evaluation it was observed a pyloric spasm in both cases, during seriography and endoscopy, kept until the one-year follow-up. There was unidirectional contrast flow to the gastrointestinal anastomosis, filling the jejunal limb, in radiologic contrast study. No contrast passed through the pylorus. Nonetheless, the duodenum was kept endoscopically accessible. In the one-year evaluation, weight loss was adequate and GERD resolution was obtained in both cases, confirmed by endoscopic and functional esophageal assessment, together with symptoms questionnaire. Conclusion: The association of Latarjet nerves sectioning or truncal vagotomy with re-sleeve gastrectomy plus gastrointestinal anastomosis (antrojejunal), in a revision for a failed sleeve, can represent a technical approach, to reproduce RYGB results, without exclusions and with duodenum endoscopic accessibility maintenance. It maybe could be applied for primary surgeries. Additional studies are necessary to confirm this hypothesis.
基金supported by scholarships provided by Fundação de ApoioàPesquisa eàInovação Tecnológica do Estado de Sergipe(FAPITEC)and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior(CAPES,PDPG-postdoc,nº88887.691645/2022-00)SFG was supported by a FAPITEC PRONEM grant(Prof.432/2023)+1 种基金a Conselho Nacional de Desenvolvimento Científico e Tecnológico(CNPq)Universal grant(Proc.405967/2023-3)supported by CNPq productivity grants(Proc.302552/2022-7).
文摘Tropical regions have provided new insights into how ecological communities are assembled.In dry coastal communities,water stress has been hypothesized to determine plant assembly structure by favoring preadapted lineages from neighboring ecosystems,consistent with functional clustering.However,it is unclear whether this hypothesis is sufficient to explain how coastal communities in tropical ecosystems are assembled.Here,we test whether water stress or other factors drive community assembly in woody plant communities across the coastal zone of Brazil,a tropical ecosystem.We characterized functional and phylogenetic structures of these communities and determined the underlying environmental factors(e.g.,water stress,historical climate stability,edaphic constraints,and habitat heterogeneity)that drive their community assembly.Assemblages of coastal woody species show geographically varied patterns,including stochastic arrangements,clustering,and overdispersion of species relative to their traits and phylogenetic relatedness.Topographic complexity,water vapor pressure,and soil nutrient availability best explained the gradient in the functional structure.Water deficit,water vapor pressure,and soil organic carbon were the best predictors of variation in phylogenetic structure.Our results support the water-stress conservatism hypothesis on functional and phylogenetic structure,as well as the effect of habitat heterogeneity on functional structure and edaphic constraints on functional and phylogenetic structure.These effects are associated with increased phenotypic and phylogenetic divergence of woody plant assemblages,which is likely mediated by abiotic filtering and niche opportunities,suggesting a complex pattern of ecological assembly.
基金This research was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico(CNPq)the Instituto Tecnológico Vale(ITV),Fundação de Desenvolvimento da Pesquisa(FUNDEP)Fundação de Amparo e Desenvolvimento da Pesquisa(FADESP).
文摘Despite its enormous benefits,mining is respon-sible for intense changes to vegetation and soil properties.Thus,after extraction,it is necessary to rehabilitate the mined areas,creating better conditions for the establishment of plant species which is challenging.This study evaluated mineral and organic fertilization on the growth,and carbon and nitrogen(N)metabolism of two Crotalaria species[Cro-talaria spectabilis(exotic species)and Crotalaria maypu-rensis(native species from Carajás Mineral Province(CMP)]established on a waste pile from an iron mine in CMP.A control(without fertilizer application)and six fertilization mixtures were tested(i=NPK;ii=NPK+micronutrients;iii=NPK+micronutrients+organic compost;iv=PK;v=PK+micronutrients;vi=PK+micronutrients+organic compost).Fertilization contributed to increased growth of both species,and treatments with NPK and micronutrients had the best results(up to 257%cf.controls),while organic fertilization did not show differences.Exotic Crotalaria had a greater number of nodules,higher nodule dry mass,chlorophyll a and b contents and showed free ammonium as the predominant N form,reflecting greater increments in biomass compared to native species.Although having lower growth,the use of this native species in the rehabilitation of mining areas should be considered,mainly because it has good development and meets current government legislation as an opportunity to restore local biodiversity.
文摘Liver cancer is the sixth most commonly diagnosed cancer worldwide,with hepatocellular carcinoma(HCC)comprising most cases.Besides hepatitis B and C viral infections,heavy alcohol use,and nonalcoholic steatohepatitis(NASH)-associated advanced fibrosis/cirrhosis,several other risk factors for HCC have been identified(i.e.old age,obesity,insulin resistance,type 2 diabetes).These might in fact partially explain the occurrence of HCC in non-cirrhotic patients without viral infection.HCC surveillance through effective screening programs is still an unmet need for many nonalcoholic fatty liver disease(NAFLD)patients,and identification of pre-cirrhotic individuals who progress to HCC represents a substantial challenge in clinical practice at the moment.Patients with NASHcirrhosis should undergo systematic HCC surveillance,while this might be considered in patients with advanced fibrosis based on individual risk assessment.In this context,interventions that potentially prevent NAFLD/NASH-associated HCC are needed.This paper provided an overview of evidence related to lifestyle changes(i.e.weight loss,physical exercise,adherence to healthy dietary patterns,intake of certain dietary components,etc.)and pharmacological interventions that might play a protective role by targeting the underlying causative factors and pathogenetic mechanisms.However,well-designed prospective studies specifically dedicated to NAFLD/NASH patients are still needed to clarify the relationship with HCC risk.
文摘Background: HPV infection represents an important etiologic factor for Oropharyngeal Squamous Cell Carcinoma (OPSCC). The different ethnic backgrounds could be related to different susceptibility to Human Papillomavirus (HPV). The aim of our study was to assess the whole of genetic ancestry in HPV status in OPSCC patients. Methods: We conducted a cross-sectional study on patients with OPSCC admitted to the Barretos Cancer Hospital, Brazil from 2014 to 2019. Of these, DNA extraction was performed on 40 patients and genetic ancestry was assessed using a specific panel of 46 informative ancestry markers. Results: We observed a predominance of European ancestry (63%), followed by African (18%), Amerindian (9%) and Asian (8%) both in the OPSCC HPV-positive and HPV-negative group. We did not find any statistically significant differences between the HPV-positive and HPV-negative OPSCC groups in relation to European (p = 0.499), African (p = 0.448), Asian (p = 0.275) or Amerindian (p = 0.836) ancestry. Conclusions: We found a predominance of European ancestry, both in the HPV-positive and HPV-negative groups. In our study, we did not find statistically significant differences between HPV-positive or HPV-negative groups in relation to ancestry.
文摘Obesity has been growing in Brazil and in the world. It is reaching epidemic proportions, and bariatric surgery is the most effective treatment for patients with this disease. Among the procedures described in the literature, ileal surgeries such as biliopancreatic diversion with duodenal switch (BPD-DS) and single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) present better long-term results in terms of weight loss and comorbidities control. However, there are concerns regarding long term nutritional problems with these procedures. In this case report the aim is to demonstrate the technical feasibility of preserving an extended duodenal bulb segment, in the SADIS-S procedure, when there are difficulties in dissecting the retrobulbar region, as occurred here, due to fibrosis in this area. This assures the maintenance of the proposed surgical technique, in such a situation. The dissection and transection of the duodenum was done 7 cm distally to the pylorus, under endoscopic view, proximally to the papillae, where the tissue was normal. Additionally, due the importance of the duodenal mucosa on minerals and trace elements absorption and the release of important hormones in this region, this case report elicits the evaluation of the impact of this technical modification, which occurred casually, in the nutritional, hormonal and metabolic results, long term. In this case report, the extended duodenal length has demonstrated reasonable weight loss, adequate comorbidities control and good nutritional status, so far. These aspects must be evaluated in the long term, by clinical trials.
文摘Obesity has been growing worldwide, reaching epidemic proportions. Bariatric surgery is the most effective and durable treatment for severe obesity and related diseases. Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG) are the most frequently performed bariatric operations, with long-term good results, in terms of weight loss and comorbidities control. Gastroesophageal Reflux Disease (GERD) is commonly associated with obesity. In general, it precludes the indication of sleeve gastrectomy, since this technique has a refluxogenic potential, as shown in many studies. In such cases, RYGB is considered the best surgery, reaching good weight loss and gastroesophageal reflux disease control. The drawback of this technique is that it leaves the remnant stomach, the duodenum, and the proximal part of the jejunum inaccessible. Besides, RYGB makes transoral endoscopic access to the biliary tree impossible. For all these reasons, this bariatric technique is not indicated in cases of gastric polyposis, gastric dysplasia, or strong family history of cancer, among others. We report a case of a morbidly obese patient with intense GERD, for whom a RYGB was precluded due to her strong family history of cancer, even knowing that it would be the best choice for reflux disease control. Instead, SG was chosen, even knowing it could worsen the gastroesophageal reflux disease. The patient signed an informed consent, after being fully enlightened about the risks. During the surgery, a small subserosal whitish lesion was detected, near the pylorus, on the anterior wall of the antrum. Thinking in a Gastrointestinal Stromal Tumor (GIST), it was resected, with a 2 cm safety margin, leaving a 4 to 5 cm hole on the gastric wall. The decision to maintain the proposed sleeve gastrectomy was made, to avoid leaving a remnant stomach, in a patient with such a strong family history of cancer. In the area of the resected lesion, an intraoperative decision was made not to just close the big gastric hole, being afraid of causing some anatomic or functional disturbance in gastric emptying. Instead, we decided to use the gastric opening to construct a Roux-en-Y antrotrojejunal anastomosis, with a 50 cm alimentary limb and a 200 cm biliopancreatic limb. Accordingly, it was performed a sleeve gastrectomy, associated with an antrojejunostomy in a Roux-en-Y fashion. The patient had an uneventful postoperative course. In the second year, she achieved normal weight and good nutritional status, without gastroesophageal reflux symptoms complaints. Seriography study shows that most of the contrast material passes through the antrojejunal anastomosis, instead of the pylorus, while the duodenum is endoscopically patent. This case report shows an unexpected surgical finding that led to a tactic of adding a Roux-en-Y gastric bypass in the antrum, associated with a sleeve gastrectomy, a strategy that may be adopted in cases of morbidly obese patients with important GERD, for whom gastrointestinal exclusions are contraindicated. To confirm this hypothesis, controlled studies are needed.
文摘N-11-azaartemisinins potentially active against Plasmodium falciparum are designed by combining molecular electrostatic potential (MEP), ligand-receptor interaction, and models built with supervised machine learning methods (PCA, HCA, KNN, SIMCA, and SDA). The optimization of molecular structures was performed using the B3LYP/6-31G* approach. MEP maps and ligand-receptor interactions were used to investigate key structural features required for biological activities and likely interactions between N-11-azaartemisinins and heme, respectively. The supervised machine learning methods allowed the separation of the investigated compounds into two classes: cha and cla, with the properties ε<sub>LUMO+1</sub> (one level above lowest unoccupied molecular orbital energy), d(C<sub>6</sub>-C<sub>5</sub>) (distance between C<sub>6</sub> and C<sub>5</sub> atoms in ligands), and TSA (total surface area) responsible for the classification. The insights extracted from the investigation developed and the chemical intuition enabled the design of sixteen new N-11-azaartemisinins (prediction set), moreover, models built with supervised machine learning methods were applied to this prediction set. The result of this application showed twelve new promising N-11-azaartemisinins for synthesis and biological evaluation.
文摘During the SARS-Cov-2 or COVID-19 clinical course pandemic of the coronavirus family, we observed symptoms of the respiratory tract, fever, cough, sore throat, and fatigue. The most common symptoms were loss of smell and taste and, when aggravated, it could develop into pneumonia and even death. We selected 40 former COVID-19 patients, who answered a questionnaire with questions about the symptoms and complications after they were cured and which symptoms remained or appeared after the total isolation quarantine for a specific time. Among the answers, the most cited was about “forgetting”. Another observation noted was the number of cases in children, which surprised us, considering that, at the beginning of the pandemic, the danger was more related to the elderly population and those with comorbidities.
文摘The family farmer’s knowledge about floodplains agroecosystems dynamics is part of agrobiodiversity conservation cognitive strategies. This is because the conservation in floodplains is conditioned by the ecophysiological adaptation to the period and flood gradient of the agricultural lands and by the transformations promoted in the environment by the waters pulse. The aim of this study was to understand the cognitive strategies expressed in the organized meaning of agroecosystems by local knowledge, related to the geomorphological dynamics of the Aramaçá Island, Amazonas, Brazil. In this research, the Case Study and Ethnoecology were adopted as approach, taking the systemic complexity paradigm as a theoretical framework. To do so, it was necessary to establish a dialogue with the local knowledge through multitemporal analyses of satellite images, historical series of hydrological data, as well as cartographic documents of the locality. The floodplains amphibian mark, as a living organism in permanent autopoietic process, seems to be imprinted in the family farmer’s knowledge. In order to live in the floodplains and of floodplains, it is necessary, above all, to develop a cognitive ability capable of understanding not only the rivers action on the lands, but also that of the lands on the rivers as well. Therefore, the geomorphological dynamics in the spaces managed by the family farmers impose on them, risks and uncertainties, demanding from them strategies that allow knowing and dealing with this complexity.
文摘Scientists regularly lament that development and habitat destruction in once isolated and distant areas are promoting species extinction before species can even be known by science. In the Brazilian Amazon, the government’s Plan for Growth Acceleration in part involves major improvements and expansion of highways. Such infrastructure has long been linked to the main causes of deforestation in this region. It is essential for scientists to assess where to target bio-diversity collections in relation to the location of road development and existing protected areas. The objective of this study was to amass all of the records of occurrence of orchid bees in digital form, in order to obtain a spatial picture of our knowledge thus far and to make recommendations about priority areas for future collections and the role of protected areas in species conservation. The collection data used for this study come from various collection efforts, and were also gathered from the literature. The collection data were then imported into a Geographic Information System, making it possible to integrate other spatial data layers such as highways, conservation units, indigenous lands and forest cover. Results show a major need for collections along the BR 163 and BR 230 highways, heavily deforested areas with few conservation units. We suggest the creation of conservation units and recommend that abandoned areas be allowed to remain fallow as a way to help save additional biodiversity in the area of influence of these two main highways.