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The role of uropathogenic Escherichia coli (UPEC) in colonization and infection of female patients with anatomical and functional abnormalities of the urinary system is elusive. In this study, the phenotype, genotype and the phylogeny of UPEC strains isolated from the urine of pediatric female patients with cystitis of normal and abnormal urinary tract were determined. Multiplex PCR results demonstrated that 86% of the strains isolated from female patients with normal urinary tract (NUT), belonged to the phylo-groups B2 and D. Their prevalence decreased to 23% in strains isolated from patients with abnormal urinary tract (AUT). More of the isolates from AUT patients produced a biofilm on polystyrene and polyvinyl chloride (PVC), adhered to epithelial cells, and encoded pap and sfa genes than strains isolated from female patients with NUT. In contrast, a higher number of hemolysin-producing strains with serogroups associated with UPEC were isolated from patients with NUT. In summary, the results suggest that cystitis in female patients with NUT is associated with ExPEC, whereas cystitis in female patients with AUT is associated with pathogenic intestinal E. coli strains that have acquired the ability to colonize the bladder.

ABSTRACT Background The combined efficacy and durability of botulinum toxin A (BTX) and hyaluronic acid fillers (HA) for canthal wrinkles have not been thoroughly evaluated in randomized clinical trials. Aims This study evaluated the efficacy, safety, and durability of the combined treatment protocol of onabotulinumtoxinA and Juvederm Volite VYC‐12 (Skinvive) for moderate and severe canthal lines. Methods This randomized double‐blinded split‐face trial included 25 women with periorbital dynamic wrinkles at severity levels II–IV according to the Merz 5‐point scale. After bilateral onabotulinummtoxinA injections, the sides of the participants' faces were randomized to receive HA injections or a simulated injection. Assessed variables included electromyography activity (EMG), Merz 5‐point crow's feet scale, and FACE‐Q appraisal on crow's feet lines. Assessments were performed at baseline, 1, 2, 3, and 6 months. 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 Mann–Whitney U test. Results Inter‐treatment comparisons revealed no significant differences between treatment protocols in all assessed periods for EMG (p = 0.86). For severity of canthal wrinkles, onabotulinumtoxinA + VYC‐12 exhibited lower canthal wrinkle severity in rest and contracted positions after 3 (p = 0.04), and 3 (p = 0.007) and 6 (p = 0.001) months, respectively. Additionally, satisfaction with BTX‐HA treatment was significantly higher after 3‐month (p = 0.001) and 6‐month (p = 0.001) follow‐ups compared to BTX treatment. Conclusions Higher improvements in canthal wrinkles could be enhanced by using onabotulinumtoxinA and VYC‐12 in association as a treatment protocol.

ABSTRACT 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.

Over the last several decades, extensive changes in land use and land cover (LULC) have caused substantial environmental impacts in the watersheds of southeastern Amazonia, such as the Verde River Watershed (VRW). The effects of anthropogenic activities on soil cover loss rates in the VRW were evaluated to estimate soil loss over time by applying the revised Universal Soil Loss Equation (RUSLE) in a geographic information system (GIS) environment via rainfall erosivity (R), soil erodibility (K), topography (LS), and LULC (CP) data. The VRW experiences strong seasonality, with the most significant R concentrated from January to April, which coincides with a relatively high rainfall index reaching approximately 42% of the annual total. Most of the VRW has gently undulating to flat relief (88.9%) and low LS values (0.02–0.025), but its upper course has a sandy soil texture with high K values (0.02–0.073). Pastureland has replaced forested areas during the past 40 years, dramatically changing the landscape with more significant changes in LULC rates in the upper VRW. Estimates of annual and average soil losses and areas at high and very high risk of erosion increased by more than 200% from 1984 to 2021. In conclusion, deforestation is the main factor influencing erosion patterns and volume in the VRW and has accelerated soil degradation, increasing the risks to human health and the maintenance of tropical rainforests. Additionally, simply stopping deforestation is insufficient to prevent the expansion of areas with high and very high erosion risk. It is crucial to implement reforestation projects to recover forested areas.

Craniosynostosis, a developmental craniofacial anomaly, can impair brain development and cause abnormal skull shape due to premature closure of one or more cranial sutures. Traditional surgical treatments have evolved from open operations to minimally invasive endoscopic techniques. This systematic review and meta-analysis aim to evaluate the effectiveness and safety of the endoscopic approach in craniosynostosis correction. Adhering to Cochrane Group standards and the PRISMA framework, this review utilized databases like PubMed, Embase, and Web of Science, focusing on clinical and surgical outcomes of endoscopic craniosynostosis operations up to December 2023. Inclusion criteria emphasized studies with at least five patients undergoing endoscopic procedures, while exclusion criteria involved non-English papers, incomplete texts, and overlapping data. Statistical analysis used R software with various packages, and methodological bias was assessed using the ROBINS-I framework. The review included 30 studies (4 prospective, 26 retrospective) with 2561 patients. The median age at operation was 3.20 months. Findings showed a mean operative time of 68.06 min, median hospital stay of 1.28 days, and mean blood loss of 29.89 ml. Blood transfusion was required in 9.97% of cases. Helmet therapy post-operation was common, with a median duration of 9 months. The rate of postoperative complications was 1.86%, and the reoperation rate was 3.07%. No procedure-related mortality was observed. The study noted substantial variations in the handling of craniosynostosis and a lack of consensus on the optimal timing and surgical approach. Endoscopic techniques for craniosynostosis repair demonstrate safety and effectiveness, characterized by low complication risks and favorable surgical outcomes. However, due to the limitations of observational studies and inherent heterogeneity, further comprehensive and controlled trials are needed to validate these findings and understand the long-term outcomes of the endoscopic approach. •The median average age at operation was found to be 3.20 months.•A time of 68 min was found to be the overall time of endoscopic surgery.•The mean blood loss estimation is 29.89 ml, and the rate of transfusion is 9.97%.•The mean length of helmet therapy was found to be 9 months•Postoperative complication risk estimation was 1.86%.

Primary brainstem hemorrhage (PBSH) is a fatal condition related to hypertension. PBSH definitive treatment remains controversial, mainly when surgical options are discussed. To aid decision-making in PBSH scenarios, we aimed to perform a meta-analysis and evaluate the literature on stereotactic aspiration (SA) for PBSH in comparison to conservative management (CM). The outcomes assessed were: 30-day mortality, mortality, 90-day good outcome (mRs ≤ 3), good outcome (mRs ≤ 3), good outcome (mRs ≤ 3 or GOS 4–5), 90-day poor outcome (mRs ≥ 4), poor outcome (mRs ≥ 4). We included 1189 patients from 9 studies. 433 (36,41 %) patients were treated with SA. The risk of 30-Day Mortality (RR 0.57; 95 % CI 0.41–0.81; p=0.002; I²=58 %), Mortality (RR 0.56; 95 % CI 0.41–0.75; p<0.001; I²=54 %), 90-Day Poor Outcome (mRS ≥ 4) (RR 0.83; 95 % CI 0.73–0.93; p=0.001; I²=25 %), Poor Outcome (mRS ≥ 4) (RR 0.83; 95 % CI 0.75–0.93; p=0.001; I²=0 %) and Poor Outcome (mRS ≥ 4 or GOS ≤ 3) (RR 0.82; 95 % CI 0.74–0.91; p<0.001; I²=12 %) were significantly lower in patients receiving SA treatment. Also, the risk of 90-Day Good Outcome (mRS ≤ 3) (RR 1.60; 95 % CI 1.06–2.39; p=0.024; I²=21 %), Good Outcome (mRS ≤ 3) (RR 1.48; 95 % CI 1.13–1.94; p=0.005; I²=0) and Good Outcome (mRS ≤ 3 or GOS 4–5) (RR 1.72; 95 % CI 1.17–2.53; p=0.006; I²=25 %) were significant higher in the SA group. SA demonstrated favorable outcomes, including reduced mortality rates and improved functional recovery. Further clinical trials are needed to validate these findings.

Borneol is a bicyclic monoterpenoid alcohol commonly used in traditional Chinese and Indian medicine. It is extracted from the essential oil of various medicinal plants. It has antibacterial, analgesic, and anti-inflammatory action proven in studies that used oral and intraperitoneal applications of this monoterpene in mice. The current study was designed to develop a topical gel formulation containing the monoterpene borneol using carbopol as gel base and to evaluate its stability. The prepared formulation was subjected to physical characterization and physical-chemistry assessment. The gel was prepared from carbopol and 5% of borneol. The prepared gel was subjected to pharmacotechnical tests such as its pH, viscosity, conductivity, spreadability, centrifugation, and accelerated stability with freezing-thaw cycle. The borneol was successfully incorporated into the carbopol formulation. Borneol gel (BG5) showed good stability after eight months of its development and after 12 days in the freeze-thaw cycle, not showing statistical difference in pH value, conductivity, and viscosity before and after test. Furthermore, the formulation showed a good spreadability. Therefore, it was concluded that the formulation could be very promising alternative for the topical or transdermal treatment of skin diseases.

Objectives: This study aimed to analyze the critical and reflective self-assessment capacity of dentistry students based on two clinical courses that employ self-assessment processes as a strategy to foster autonomy in health care. Materials and Methods: Reflections from third- and fifth-year students were evaluated over a three-year period. The methodology sought to identify the presence of critical reflections, perceptions of strengths and weaknesses, and the formulation of improvement plans. Results: The results revealed low levels of continuous reflection, with only 20.0% of third-year students and 24.1% of fifth-year students engaging in reflection in at least half of their clinical activities. However, 78.7% of third-year students and 90.8% of fifth-year students completed at least one reflection during the academic year. The ability to sustain continuous critical reflection was observed in only 22.1% of the 453 students evaluated. These findings present a concerning scenario, as critical reflection is directly linked to competence in health care and informed decision-making. Conclusions: The study concludes that formative assessment processes requiring critical and reflective self-assessment must be broadly integrated into the curriculum to foster significant gains in the development of professional competencies.

Staphylococcus aureus is one of the most relevant mastitis pathogens in dairy cattle, and the acquisition of antimicrobial resistance genes presents a significant health issue in both veterinary and human fields. Among the different strategies to tackle S. aureus infection in livestock, bacteriophages have been thoroughly investigated in the last decades; however, few specimens of the so-called jumbo phages capable of infecting S. aureus have been described. Herein, we report the biological, genomic, and structural proteomic features of the jumbo phage vB_SauM-UFV_DC4 (DC4). DC4 exhibited a remarkable killing activity against S. aureus isolated from the veterinary environment and stability at alkaline conditions (pH 4 to 12). The complete genome of DC4 is 263,185 bp (GC content: 25%), encodes 263 predicted CDSs (80% without an assigned function), 1 tRNA (Phe-tRNA), multisubunit RNA polymerase, and an RNA-dependent DNA polymerase. Moreover, comparative analysis revealed that DC4 can be considered a new viral species belonging to a new genus DC4 and showed a similar set of lytic proteins and depolymerase activity with closely related jumbo phages. The characterization of a new S. aureus jumbo phage increases our understanding of the diversity of this group and provides insights into the biotechnological potential of these viruses.Key points• vB_SauM-UFV_DC4 is a new viral species belonging to a new genus within the class Caudoviricetes.• vB_SauM-UFV_DC4 carries a set of RNA polymerase subunits and an RNA-directed DNA polymerase.• vB_SauM-UFV_DC4 and closely related jumbo phages showed a similar set of lytic proteins.

Rehabilitation is the key factor for improving soil quality and soil carbon stock after mining operations. Monitoring is necessary to evaluate the progress of rehabilitation and its success, but the use of repeated field surveys is costly and time-consuming at a large scale. This study aimed to monitor the environmental/soil rehabilitation process of an Amazonian sandstone mine by applying spectral indices for predicting soil organic carbon (SOC) stock and comparing them to soil quality index. The studied area has different chronological rehabilitation stages: initial, intermediate, and advanced with 2, 10, and 12 years of onset rehabilitation activities, respectively. Non-rehabilitated (NR) and two native forest areas (RA) were used as controls. Soil samples were analyzed for physical, chemical, and biological attributes. After determination of Normalized Difference Vegetation Index and Bare Soil Index, simple regression analysis comparing these indices with SOC stock showed a good fit (R2 = 0.82). Rehabilitated areas presented higher soil quality index (~1.50-fold) and SOC stock (~10.6-fold) than NR; however, they did not differ of RA. The use of spectral indices was effective for monitoring the soil quality in this study, with a positive correlation between the predicted SOC stock and the calculated soil quality index.