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The present study aimed to assess the effectiveness and functional adverse effects of a single and multiple injections of botulinum toxin A (BoNT-A) for masseter hypertrophy (MH). Twenty-six women complaining about lower third facial enlargement due to MH, received 75 U of BoNT-A (abobotulinum toxin) in each masseter muscles. After 3 months, patients were randomly assigned to receive a second treatment session of Saline Solution: (G1; n = 11) or BoNT-A: (G2; n = 12). Muscle thickness (ultrasound), electrical activity (electromyography; EMG), masticatory performance, and subjective perception of MH were evaluated. Follow-up was performed at 1, 3 and 6 months. Muscle thickness, EMG activity, and masticatory performance were analyzed using ANOVA two-way and Sidak test as post-hoc. Masticatory performance was analyzed by the Friedman’s test and Mann–Whitney test. Regarding inter-groups comparisons, there was a significant decrease in the left masseter muscle thickness in the G2 group at the 6 month follow-up (p < 0.02). For EMG, significant differences were evident at the 6 month assessment, with higher masseter activity for G1 (p < 0.05). For masticatory performance, no significant differences were observed throughout the study (p > 0.05) and a higher improvement in subjective perception of MH was observed in the 1 month follow-up for G2 (p < 0.05). In conclusion, BoNT-A is effective for MH, however multiple injections cause functional adverse effects in masseter muscle.

The present study aimed to evaluate the influence of physical activity on the durability of the esthetic effect of botulinum toxin type A (BoNT-A). Sixty female patients were allocated to three groups (n = 20) according to their physical activity level (PA): Low PA, Moderate PA, and High PA. All groups received a single injection of onabotulinumtoxinA, considering standardized doses in the frontalis (12U), corrugator supercilia (7U, each), and procerus muscles (4U). Outcomes were measured using electromyography (EMG), Merz 5-point scales, and Face-Q scales (perceived age and lines between eyebrows). A follow-up occurred after 30, 60, and 90 days. EMG results showed a significant decrease in muscle activity in the Low-PA group at all follow-ups compared with the other groups (p < 0.001). The Merz scale scores showed that the severity of forehead and glabellar lines significantly improved in the Low-PA group throughout this study compared with the other groups (p < 0.001). No significant differences between groups were found in the Face-Q scale for perceived age, while the Face-Q scale for lines between eyebrows showed better results for Low-PA (p < 0.01) and Moderate-PA (p < 0.01) groups compared to the High-PA group at the 30- and 90-day follow-ups. The durability of the esthetic effect of BoNT-A seems to be negatively influenced by the level of physical activity.

The primary objective of this systematic review study was to investigate the effectiveness, durability, and adverse events of PLLA treatment for aesthetic indications. The search strategy was performed in MEDLINE (Ovid). The electronic literature search of five databases was performed, from the inception of the databases until the 12th of February 2024. This was to identify randomized clinical trials that assessed PLLA treatment in adult individuals exhibiting facial aging and/or facial lipoatrophy. Risk of bias was assessed using the Cochrane Risk-of-Bias Tool for Randomized Trials (RoB 2). Eleven RCTs out of 1467 identified citations were included. Four studies showed increased dermal thickness, significant improvement in facial lipoatrophy severity and aesthetic clinical scores, after PLLA treatment with its effects sustained for at least 25 months. Two studies demonstrated the superiority of PLLA over injectable human collagen. Also, three studies showed positive results favoring PLLA when compared with PH gel in lipoatrophy severity, transepidermal water loss, skin quality, elasticity, and patient satisfaction. All adverse events were mild-to-moderate in intensity, and the main ones worth noting were bruising, hematoma, tenderness, nodules, and edema. Five out of eleven studies were considered having high risk of bias. The evidence on the effectiveness and safety of PLLA for facial rejuvenation is of low quality; thus, the reported high effectiveness, safety, and long-lasting effects for this purpose should be further investigated.

BackgroundThis study aimed to elucidate the effects of botulinum toxin A (BoNT-A) treatment for patients diagnosed with masseter hypertrophy on the temporalis muscle, with a particular focus on assessing alterations in muscle thickness, electromyographic (EMG) activity, and the development of muscle pain.MethodsThe present randomized triple-blinded clinical trial enrolled 26 female participants aged between 25 and 50 years complaining about masseter hypertrophy. Participants received 75U of BoNT-A (abobotulinumtoxinA) in both masseter muscles and after three months were randomized to receive a second treatment session of saline solution (S-BoNT-A) or BoNT-A (M-BoNT-A). Longitudinal assessments included temporalis muscle thickness through ultrasound, EMG activity, subjective pain, and masseter prominence severity after one, three, and six months of the first injection session. Muscle thickness, EMG, and subjective pain were analysed using two-way ANOVA with repeated measures and post hoc Sidak test, and for masseter prominence severity, Friedman and Mann–Whitney tests were used.ResultsRegarding inter-group comparisons, a higher muscle thickness (p < 0.02) and a higher EMG activity (p < 0.01) were found in the M-BoNT-A group at the 6-month follow-up. For subjective pain assessments, inter-group comparisons showed a higher prevalence of painful regions in M-BoNT-A group at the 6-month follow-up (p < 0.02). No significant differences were found in masseter prominence severity at the 6 months assessment between groups.ConclusionBoNT-A treatment for masseter hypertrophy lead to structural and functional changes in the temporalis muscle, presenting higher changes after multiple injections of this treatment.Level of Evidence IThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Background Botulinum toxin A (BoNT‐A) is the most used procedure to treat glabellar lines; however, limited data exist about the effectiveness of ready‐to‐use BoNT‐A (RTUaboBoNT‐A) for this indication. Aims This study compared the efficacy, durability, and safety of RTUaboBoNT‐A for moderate and severe glabellar wrinkles. Methods This randomized triple‐blinded trial included 38 male volunteers aged between 25 and 50 years. Participants were randomly divided into two groups: abobotulinumtoxinA (aboBoNT‐A, n = 18) and RTUaboBoNT‐A (n = 20). Groups received 10 U for procerus muscle and 20 U for the corrugator muscle. Assessed variables included, electromyography activity (EMG), Merz 5‐point glabellar lines scale, FACE‐Q appraisal for lines between the eyebrows and Visual Analogue Scale for pain intensity. Assessments were performed before and 1, 2, 3, and 4 months after injections. For differences in EMG and satisfaction scores, the two‐way repeated‐measures ANOVA and Bonferroni's post hoc analyses were conducted. Wrinkle severity scores were analyzed with the chi‐squared test. Results Inter‐group comparisons revealed no significant differences in EMG scores in all assessed periods for the corrugator supercili (p = 0.11) and the procerus muscles (p = 0.93); for severity of glabellar lines, no significant differences were also found in all follow‐ups for rest (p = 0.737) and contracted position (p = 0.390), as well as for satisfaction with the treatments. However, the RTUaboBoNT‐A group presented higher levels of pain intensity during the injection procedure (p = 0.01). Conclusion The RTUaboBoNT‐A and aboBoNT‐A are comparable in efficacy, durability, and safety.

Citriculture has worldwide importance, and monitoring the nutritional status of plants through leaf analysis is essential. Recently, proximal sensing has supported this process, although there is a lack of studies conducted specifically for citrus. The objective of this study was to evaluate the application of portable X-ray fluorescence spectrometry (pXRF) combined with machine learning algorithms to predict the nutrient content (B, Ca, Cu, Fe, K, Mg, Mn, P, S, and Zn) of citrus leaves, using inductively coupled plasma optical emission spectrometry (ICP-OES) results as a reference. Additionally, the study aimed to differentiate 15 citrus scion/rootstock combinations via pXRF results and investigate the effect of the sample condition (fresh or dried leaves) on the accuracy of pXRF predictions. The samples were analyzed with pXRF both fresh and after drying and grinding. Subsequently, the samples underwent acid digestion and analysis via ICP-OES. Predictions using dried leaves yielded better results (R2 from 0.71 to 0.96) than those using fresh leaves (R2 from 0.35 to 0.87) for all analyzed elements. Predictions of scion/rootstock combinations were also more accurate with dry leaves (Overall accuracy = 0.64, kappa index = 0.62). The pXRF accurately predicted nutrient contents in citrus leaves and differentiated leaves from 15 scion/rootstock combinations. This can significantly reduce costs and time in the nutritional assessment of citrus crops.

Purpose This paper aim to propose a methodological mapping approach for the evaluation of dissertations and theses of graduate programs in the area of environmental sciences in Brazil in relation to the UN sustainable development goals (SDGs). Design/methodology/approach The research is characterized as exploratory with qualitative/quantitative approach. The proposed model was developed as a computational algorithm with a pilot being adopted as a professional master in national network for teaching in environmental sciences (ProfCiAmb) comprising associated courses from nine Brazilian public universities. 230 dissertations completed between 2018 and 2020 were analyzed. Findings A total of 266 correlations were identified between the texts and descriptors of each SDG. Correlation values between 0.100 (minimum value – Vmin) and 0.464 (maximum value – Vmax) were observed. SDG 4 – Quality Education (Vmax = 0.399) and SDG 6 – Drinking Water and Sanitation (Vmax = 0.464) were those with the highest correlation values, followed by SDG 3 – Health and Well-Being (Vmax = 0.299) and SDG 17 – Partnerships and Means of Implementation (Vmax = 0.249). Practical implications The construction of the computational algorithm provided consistent quantitative analyses with potential to contribute to the improvement of the multidimensional evaluation of graduate studies, as well as to support public policies related to teaching and research and strategic planning of the programs. Originality/value The relevance of this study lies in the creation of a model that involves the creation of metrics and tools regarding the impact of graduate studies on society.

Background: During March 2009 a novel Influenza A virus emerged in Mexico. We describe the clinical picture of the pandemic Influenza A (H1N1) Influenza in cancer patients during the 2009 influenza season. Methods: Twelve centers participated in a multicenter retrospective observational study of cancer patients with confirmed infection with the 2009 H1N1 Influenza A virus (influenza-like illness or pneumonia plus positive PCR for the 2009 H1N1 Influenza A virus  in respiratory secretions). Clinical data were obtained by retrospective chart review and analyzed.  Results: From May to August 2009, data of 65 patients were collected. Median age was 51 years, 57 % of the patients were female. Most patients (47) had onco-hematological cancers and 18 had solid tumors. Cancer treatment mainly consisted of chemotherapy (46), or stem cell transplantation (SCT) (16). Only 19 of 64 patients had received the 2009 seasonal Influenza vaccine. Clinical presentation included pneumonia (43) and upper respiratory tract infection (22). Forty five of 58 ambulatory patients were admitted. Mechanical ventilation was required in 12 patients (18%). Treatment included oseltamivir monotherapy or in combination with amantadine for a median of 7 days. The global 30-day mortality rate was 18%. All 12 deaths were among the non-vaccinated patients. No deaths were observed among the 19 vaccinated patients. Oxygen saturation <96% at presentation was a predictor of mortality (OR 19.5; 95%CI: 2.28 to 165.9). Conclusions: In our cancer patient population, the pandemic 2009 Influenza A (H1N1) virus was associated with high incidence of pneumonia (66%), and 30-day mortality (18.5%). Saturation <96% was significantly associated with death. No deaths were observed among vaccinated patients.

Background: During March 2009 a novel Influenza A virus emerged in Mexico. We describe the clinical picture of the pandemic Influenza A (H1N1) Influenza in cancer patients during the 2009 influenza season. Methods: Twelve centers participated in a multicenter retrospective observational study of cancer patients with confirmed infection with the 2009 H1N1 Influenza A virus (influenza-like illness or pneumonia plus positive PCR for the 2009 H1N1 Influenza A virus  in respiratory secretions). Clinical data were obtained by retrospective chart review and analyzed.  Results: From May to August 2009, data of 65 patients were collected. Median age was 51 years, 57 % of the patients were female. Most patients (47) had onco-hematological cancers and 18 had solid tumors. Cancer treatment mainly consisted of chemotherapy (46), or stem cell transplantation (SCT) (16). Only 19 of 64 patients had received the 2009 seasonal Influenza vaccine. Clinical presentation included pneumonia (43) and upper respiratory tract infection (22). Forty five of 58 ambulatory patients were admitted. Mechanical ventilation was required in 12 patients (18%). Treatment included oseltamivir monotherapy or in combination with amantadine for a median of 7 days. The global 30-day mortality rate was 18%. All 12 deaths were among the non-vaccinated patients. No deaths were observed among the 19 vaccinated patients. Oxygen saturation <96% at presentation was a predictor of mortality (OR 19.5; 95%CI: 2.28 to 165.9). Conclusions: In our cancer patient population, the pandemic 2009 Influenza A (H1N1) virus was associated with high incidence of pneumonia (66%), and 30-day mortality (18.5%). Saturation <96% was significantly associated with death. No deaths were observed among vaccinated patients.