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The rupture of the Brumadinho mining tailings dam in Brazil is considered one of the largest mining disasters in the world, resulting in 244 deaths and 26 missing people, in addition to the environmental consequences. The present study aims to evaluate the concentrations of multiple elements and the biological effects on water and sediments of the Paraopeba River after the Brumadinho Dam rupture. The tailings are formed by fine particulate material with large amounts of Fe, Al, Mn, Ti, rare earth metals and toxic metals. In the water, the levels of Fe, Al, Mn, Zn, Cu, Pb, Cd and U were higher than those allowed by Brazilian legislation. In the sediments, Cr, Ni, Cu and Cd levels were higher than the established sediment quality guidelines (TEL-NOAA). The differences in metal concentrations in the water and sediments between the upstream and downstream sides of the dam illustrate the effect of the tailings in the Paraopeba River. Toxicological tests demonstrated that the water and sediments were toxic to different trophic levels, from algae to microcrustaceans and fish. The fish exposed to water and sediments containing mine ore also accumulated metals in muscle tissue. This evaluation emphasizes the necessity of long-term monitoring in the affected area.

The production ofpapaya seedlings is one of the main steps for establishing crops that present maximum quality performance. Nutritional availability is one of the factors limiting the formation process of quality seedlings, and fertilization is often done without technical criteria. Thus, the objective of this study was to evaluate the effect of different doses of sp., obtained from different sources, on the development and growth of 'Aliança' papaya seedlings. The study was developed at the Experimental Farm of the Capixaba Institute of Research, Technical Assistance, and Rural Extension, in the municipality of Linhares, north of the state of Espírito Santo. The experimental design used was randomized blocks in a factorial scheme, where the first factor was composed of three commercial sources of sp. (LT Supra®; Algen® and Primaz®). The second factor was composed of six different doses, namely: 0; 2; 4; 6; 8; and 10 kg m of sp. At 37 days after sowing, the seedlings were evaluated for the following characteristics: germination percentage; leaf area; stem length; stem mass fraction; root length; stem diameter; leaf dry mass; stem dry mass; root dry mass; and total dry mass. The content of nitrogen, phosphorus, potassium, calcium, magnesium, and sulfur in the leaves and roots was also evaluated. The use of sp. on 'Aliança' papaya seedlings promoted leaf and stem growth and development, dry matter accumulation, and improved germination percentage. sp. from the coast of Espírito Santo (LT supra®) promoted significant gains in germination percentage, leaf area, stem length, root collar diameter, leaf dry matter, stem dry matter, and total dry matter. sp. from the coast of Maranhão (Algen®) and Bahia (Prima®) increased leaf phosphorus and root sulfur levels. sp. promoted a biostimulant effect with improved growth and development in 'Aliança' papaya seedlings, with a dosage close to 4 kg m , with the LT supra® product being the most recommended.

Purpose Many regions worldwide report difficulties in recruiting applicants to surgery. One strategy proposed to reverse this trend consists of early exposure of medical students to the field. Against this backdrop, the present study presents an innovative approach for anatomy teaching, integrating a surgically relevant trend: 3D printing. Methods Whole-body computed tomography (CT) was made of two cadavers. Twelve students performed measurements and 3D reconstructions of selected anatomical structures (Osirix, Mimics). 3D printed (3DP) models were obtained (ZPrinter 310 Plus), and the students completed the analogous measurements on these replicas. Finally, classical anatomical dissection was performed and the same parameters were measured. The differences between the values obtained by the three modalities were submitted to standard statistical analysis (Wilcoxon two-tail paired test). Results Qualitative comparison of the digital 3D reconstructions based on the students’ manual CT segmentation and the anatomical reality showed excellent correlation. Quantitatively, the values measured on the CT images and the physical models created by 3D printing differed from those measured on the cadavers by less than 2 mm. Students were highly appreciative of the approach (CT, 3DP, cadaver). Their average satisfaction score was 5.8 on a 1–6 scale. Conclusions This study shows that the approach proposed can be achieved. The results obtained also show that CT-based 3D printed models are close to the authentic anatomic reality. The program allows early and interactive exposure of medical students to a surgically relevant trend—in this case 3D printing.

Abstract Aims Information about current use of finerenone in patients with heart failure (HF) finerenone in clinical practice is scarce, and its effectiveness in clinical practice in patients is scarce. We aim to assess both the baseline clinical profile and prognostic role of finerenone in patients with HF, irrespective of ejection fraction. Methods and results The study is a multicentre, observational registry, including regional and tertiary hospitals. The registry incorporates contributions from cardiology, internal medicine, and nephrology departments, ensuring comprehensive data collection. Patients with previous history of decompensated HF and elevated natriuretic peptides (NPs) will be included and classified into two groups: Those initiating finerenone will constitute the study cohort, with a 1:1 matched control cohort including those patients not receiving finerenone. Follow-up will occur at 6 and 12 months (and optional 3 and 5 years). Endpoints will include the incidence of HF exacerbations requiring intravenous therapy, hospitalizations, renal replacement therapy, and mortality due to cardiovascular or renal causes. Conclusions This study will provide valuable real-world evidence on the clinical effectiveness and safety of finerenone across a wide range of HF patients, including those with reduced, mildly reduced, and preserved ejection fraction. By leveraging a large, representative, and controlled cohort, the findings aim to enhance clinical decision-making and optimize the use of finerenone in routine practice, particularly in high-risk patients with complex co-morbidities.

Connective tissue growth factor (CTGF)/CCN family member 2 (CCN2) is a CCN family member of matricellular signaling modulators. It has been shown that CCN2/CTGF mediates cell adhesion, aggregation and migration in a large variety of cell types, including vascular endothelial cells, fibroblasts, epithelial cells, aortic smooth muscle and also pluripotent stem cells. Others matricellular proteins are capable of interacting with CCN2/CTGF to mediate its function. Cell migration is a key feature for tumor cell invasion and metastasis. CCN2/CTGF seems to be a prognostic marker for cancer. In addition, here we intend to discuss recent discoveries and a new strategy to develop therapies against CCN2/CTGF, in order to treat cancer metastasis.

Half of the Amazon Forest, which has a marked seasonality in rainfall, is susceptible to intense droughts caused by positive phases of the El Niño-Southern Oscillation (ENSO). Cedrela odorata L., sensitive to climate variations, emerges as a promising candidate for studies on how trees respond to climate change. Given the demand for its wood and the imperative for its protection in the Amazon Biome, applying the principles of environmental sustainability becomes crucial. This study characterizes local climatic variables near the Amazon River and assesses their impact, as well as the effect of ENSO, on the radial growth of Cedrela odorata using Pearson correlation analyses. Ring synchronization followed the standard methodology in dendrochronology, confirming common growth patterns and the formation of growth rings in C. odorata. Significant correlations with growth were noted concerning local climate, with negative associations for maximum and average temperatures and evapotranspiration, and a positive correlation with relative air humidity. ENSO exhibited a significant negative correlation with growth rings, indicating reduced growth during El Niño events. The species is notably sensitive to water availability, particularly at the onset of the growth period. The study concludes that the growth of C. odorata in the Óbidos-PA microregion responds to climate change.

Half of the Amazon Forest, which has a marked seasonality in rainfall, is susceptible to intense droughts caused by positive phases of the El Niño-Southern Oscillation (ENSO). Cedrela odorata L., sensitive to climate variations, emerges as a promising candidate for studies on how trees respond to climate change. Given the demand for its wood and the imperative for its protection in the Amazon Biome, applying the principles of environmental sustainability becomes crucial. This study characterizes local climatic variables near the Amazon River and assesses their impact, as well as the effect of ENSO, on the radial growth of Cedrela odorata using Pearson correlation analyses. Ring synchronization followed the standard methodology in dendrochronology, confirming common growth patterns and the formation of growth rings in C. odorata. Significant correlations with growth were noted concerning local climate, with negative associations for maximum and average temperatures and evapotranspiration, and a positive correlation with relative air humidity. ENSO exhibited a significant negative correlation with growth rings, indicating reduced growth during El Niño events. The species is notably sensitive to water availability, particularly at the onset of the growth period. The study concludes that the growth of C. odorata in the Óbidos-PA microregion responds to climate change.

 Reports on the prevalence of anemia in pituitary tumors are rare. This study aimed to establish the prevalence of anemia at the time of diagnosis in a cohort of patients with acromegaly, non-secretory pituitary adenomas (NFA), and prolactinomas. A secondary objective was to evaluate the coexistence of hypopituitarism and anemia. Clinical and hematological data were reviewed in the medical records of patients diagnosed with pituitary adenomas at a neuroendocrinology reference center. Of the 344 cases eligible for the study, 98 (28.5%) were patients with acromegaly (mean age 50.5 years old, 57.1% women), 166 (48.3%) patients had NFA (64.6 years old, 44% women), and 80 (23.2%) had prolactinomas (52.1 years old, 60% women).  Anemia was diagnosed in 68 (19.8%) patients: 22 (32.35%) with acromegaly (average hemoglobin (aHb): 11.8 g/dL), 29 (42.65%) with NFA (aHb: 11.6) and 17 (25%) with prolactinomas (aHb: 11.5). The prevalence was significantly higher in men, with 45 cases (27%), compared to 23 (13%) cases in women (p = 0.002). Most cases had mild anemia, 65 (96.6%). Regarding the classification according to mean corpuscular volume and mean corpuscular hemoglobin concentration values, 59 (87%) had normocytic normochromic anemia. Testosterone and thyroxine deficiency did not significantly affect the frequency of anemia. Anemia was associated with hypocortisolism (p= 0.027) and growth hormone deficiency (IGF-1) in the NFA group (p= 0.009).  This study shows a high prevalence of anemia, particularly in men, among patients with pituitary adenomas. The results improve knowledge of the comorbidities in patients with pituitary adenomas and suggest the importance of monitoring blood counts in patients' evolution, given the impact of anemia on general health.

Background Extrauterine leiomyomata is an uncommon lesion that can lead to several problems of differential diagnosis, especially when localized in the external genitalia. There are few reports in the English literature and a novel association with Alport’s syndrome has been investigated since the 1980s. Case presentation Here, we describe the case of a premenopausal woman who presented with an indolent swelling of the right interlabial fossa that resulted in a Bartholin cyst. In addition to this cyst, a benign leiomyoma of the right side of the clitoris was also found and removed. Our patient refused any further examination, although she was informed that genetic counselling could be organized to rule out an association with Alport’s syndrome. Conclusions Extrauterine leiomyomata localized in the external genitalia is an uncommon lesion arising from smooth muscle cells around vascular epithelium or erectile tissue. Since an association between extrauterine leiomyomata and Alport’s syndrome has been described, genetic testing can be proposed to these patients. Upper intestinal tract symptoms such as dysphagia should prompt a gastroenterological evaluation as an association with an esophageal leiomyomatosis has been described.

An amendment to this paper has been published and can be accessed via the original article.