Nanotechnology has played a prominent role in biomedical engineering, offering innovative approaches to numerous treatments. Notable advances have been observed in the development of medical devices, ...contributing to the advancement of modern medicine. This article briefly discusses key applications of nanotechnology in tissue engineering, controlled drug release systems, biosensors and monitoring, and imaging and diagnosis. The particular emphasis on this theme will result in a better understanding, selection, and technical approach to nanomaterials for biomedical purposes, including biological risks, security, and biocompatibility criteria.
Abnormal activation of toll-like receptors (TLRs) is observed in obese rodents and is correlated with local dysbiosis and increased gut permeability. These purported changes trigger systemic ...inflammation associated with obesity-related comorbidities, including type 2 diabetes (T2D). Roux-en-Y gastric bypass (RYGB) surgery is an effective treatment for severe obesity and known to induce changes in the gut microbiota and decrease systemic inflammation in humans. This study examined the intestinal expression of TLR-encoding genes in obese women (n = 20) treated with RYGB surgery and the relationship of these genes with T2D remission (T2Dr
Intestinal biopsies were performed before and 3 months after RYGB surgery. Partial and complete T2Dr after 1 year was assessed using the American Diabetes Association criteria. Affymetrix Human GeneChip 1.0 ST array (microarray) and TaqMan assay (real-time quantitative polymerase chain reaction) were used to analyze intestinal gene expression, and associations with systemic markers of energy homeostasis were examined.
Patients experienced significant weight loss (P < 0.001) and altered gut TLR gene expression 3 months after surgery. The main effects were a reduction in jejunal TLR4 expression in patients with complete and partial T2Dr (P < 0.05). There was a postoperative decrease in jejunal TLR7 expression in patients with complete T2Dr that correlated inversely with high-density lipoprotein cholesterol and positively with triglyceride concentrations, but not with weight loss.
RYGB-induced weight loss–independent changes in the expression of intestinal TLR-encoding genes in obese women and complete T2Dr that was correlated with systemic markers of energy homeostasis. The modulation of intestinal TLRs may mediate inflammatory mechanisms linked to T2Dr after RYGB surgery.
•In obesity models, abnormal toll-like receptor (TLR) activation by dysbiosis increases gut permeability•Gut dysbiosis and permeability have been associated with chronic inflammation in type 2 diabetes•Roux-en-Y gastric bypass (RYGB) surgery influences gut microbiota and can lead to the remission of obesity-related type 2 diabetes•Decreases in gut TLR-4 and TLR-7 expression were observed after RYGB surgery•Decreased gut TLR expression may be enrolled in post-RYGB surgery glycemic homeostasis
New ultrasound techniques may complement current diagnostic tools, and combined techniques may help to overcome the limitations of individual techniques for the diagnosis of anorectal dysfunction. A ...high degree of agreement has been demonstrated between echodefecography (dynamic 3-dimensional anorectal ultrasonography) and conventional defecography.
Our aim was to evaluate the ability of a combined approach consisting of dynamic 3-dimensional transvaginal and transrectal ultrasonography by using a 3-dimensional biplane endoprobe to assess posterior pelvic floor dysfunctions related to obstructed defecation syndrome in comparison with echodefecography.
This was a prospective, observational cohort study conducted at a tertiary-care hospital.
Consecutive female patients with symptoms of obstructed defecation were eligible.
Each patient underwent assessment of posterior pelvic floor dysfunctions with a combination of dynamic 3-dimensional transvaginal and transrectal ultrasonography by using a biplane transducer and with echodefecography.
Kappa (κ) was calculated as an index of agreement between the techniques. Diagnostic accuracy (sensitivity, specificity, and positive and negative predictive values) of the combined technique in detection of posterior dysfunctions was assessed with echodefecography as the standard for comparison.
A total of 33 women were evaluated. Substantial agreement was observed regarding normal relaxation and anismus. In detecting the absence or presence of rectocele, the 2 methods agreed in all cases. Near-perfect agreement was found for rectocele grade I, grade II, and grade III. Perfect agreement was found for entero/sigmoidocele, with near-perfect agreement for rectal intussusception. Using echodefecography as the standard for comparison, we found high diagnostic accuracy of transvaginal and transrectal ultrasonography in the detection of posterior dysfunctions.
This combined technique should be compared with other dynamic techniques and validated with conventional defecography.
Dynamic 3-dimensional transvaginal and transrectal ultrasonography is a simple and fast ultrasound technique that shows strong agreement with echodefecography and may be used as an alternative method to assess patients with obstructed defecation syndrome.
The outbreak of COVID-19 pandemics highlighted the need of sensitive, selective, and easy-to-handle biosensing devices. In the contemporary scenario, point-of-care devices for mass testing and ...infection mapping within a population have proven themselves as of primordial importance. Here, we introduce a graphene-based Electrical-Electrochemical Vertical Device (EEVD) point-of-care biosensor, strategically engineered for serologic COVID-19 diagnosis. EEVD uses serologic IgG quantifications on SARS-CoV-2 Receptor Binding Domain (RBD) bioconjugate immobilized onto device surface. EEVD combines graphene basal plane with high charge carrier mobility, high conductivity, low intrinsic resistance, and interfacial sensitivity to capacitance alterations. EEVD application was carried out in real human serum samples. Since EEVD is a miniaturized device, it requires just 40 μL of sample for a point-of-care COVID-19 infections detection. When compared to serologic assays such ELISA and other immunochromatographic methods, EEVD presents some advantages such as time of analyses (15 min), sample preparation, and a LOD of 1.0 pg mL-1. We glimpse that EEVD meets the principles of robustness and accuracy, desirable analytic parameters for assays destined to pandemics control strategies.
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•We present a miniaturized graphene 2D device for COVID-19 diagnosis.•OCP potential of each interface used as detection signal.•Use of AuNP bioconjugates for IgG immobilization at the interface.•Achievement of a LOD of 1.0 pg mL-1 for IgG antibodies.
New prevention strategies are needed to detect cervical intraepithelial neoplasia (CIN). The microRNA expression analysis has already been reported as molecular biomarkers in the early detection of ...cervical cancer (CC) through minimally invasive samples, such as liquid biopsy, obtained through collection using liquid-based cytology (LBC). In this study, we aimed to identify molecular signatures of microRNAs in cervical precursor lesions from LBC cervical and the molecular pathways potentially associated with the CC progression. We analyzed 31 LBC cervical samples from women who underwent colposcopy. These samples were divided into two groups: the first group was composed of samples without precursor lesions of CC, considering the control group, referred to as healthy female subjects (HFS; n=11). The second group corresponded to women diagnosed with cervical interepithelial neoplasia grade 3 (CIN 3; n=20). We performed microRNA and gene expression profiling using the nCounter® miRNA Expression Assays (NanoString Technology) and PanCancer Pathways (NanoString Technology), respectively. A microRNA target prediction was performed by mirDIP, and molecular pathway interaction was constructed using Cytoscape. Bidirectional in silico analyses and Pearson’s correlation were performed for associated the relation between genes, and miRNAs differentially expressed related cervical cancer progression were performed. We found that the expression of nine microRNAs was significantly higher, two were downregulated (miR-381-3p and miR-4531), and seven miRNAs were upregulated (miR-205-5p, miR-130a-3p, miR-3136-3p, miR-128-2-5p, let-7f-5p, miR-202-3p, and miR-323a-5p) in CIN 3 (fold change≥2 and p≤0.05). The miRNA expression patterns were independent of hr-HPV infection. We identified four miRNAs (miR-205-5p, miR-130a-3p, miR-4531, and miR-381-3p) that could be used as biomarkers for CIN 3 in LBC samples through multiple logistic regression analyses. We found 16 genes differentially expressed between CIN 3 and HSF samples (fold change≥2 and p≤0.05). We found the correlation between miR-130a-3p and CCND1(R=−0.52; p=0.0029), miR-205-5p and EGFR (R=0.53; p=0.0021), and miR-4531 and SMAD2 (R=−0.54; p=0.0016). In addition, we demonstrated the most significant pathways of the targets associated with cervical cancer progression (FDR-corrected p<0.001). This study demonstrated that miRNA biomarkers may distinguish healthy cervix and CIN 3 and regulate important molecular pathways of carcinogenesis.
To synthesize available evidence about factors associated with patients' satisfaction after orthodontic treatment combined with orthognathic surgery.
Studies that evaluated any factor associated with ...patients' satisfaction after the conclusion of an orthodontic treatment combined with an orthognathic surgery were identified. Orthognathic surgical procedures should have been undertaken after completion of craniofacial growth. Any satisfaction psychometric tool was considered. No language limitation was set. A detailed individual search strategy for each of the following bibliographic databases was crafted: MEDLINE, PubMed, EBM Reviews, Web of Science, EMBASE, LILACS, and Scopus. The references cited in the identified articles were also cross-checked, and a partial gray-literature search was undertaken using Google Scholar.
Eight articles satisfied the inclusion criteria of this systematic review and accounted for 998 patients. The included studies showed large variation in sample size (range = 44 to 505 patients), age (range = 15 to 72 years old), distinct psychological evaluation tools, and time elapsed between the assessment and the completion of surgery and postorthodontic treatment. Most of the studies (five of eight) were classified as having high risk of bias.
Factors associated with satisfaction were final esthetic outcome, perceived social benefits from the outcome, type of orthognathic surgery, sex, and changes in patient self-concept during treatment. Factors associated with dissatisfaction were treatment length; sensation of functional impairment and/or dysfunction after surgery, and perceived omitted information about surgical risks.
The ability to integrate echocardiographic for rheumatic heart disease (RHD) into RHD prevention programs is limited because of lack of financial and expert human resources in endemic areas. Task ...shifting to nonexperts is promising; but investigations into workforce composition and training schemes are needed. The objective of this study was to test nonexperts' ability to interpret RHD screening echocardiograms after a brief, standardized, computer-based training course. Six nonexperts completed a 3-week curriculum on image interpretation. Participant performance was tested in a school-screening environment in comparison to the reference approach (cardiologists, standard portable echocardiography machines, and 2012 World Heart Federation criteria). All participants successfully completed the curriculum, and feedback was universally positive. Screening was performed in 1,381 children (5 to 18 years, 60% female), with 397 (47 borderline RHD, 6 definite RHD, 336 normal, and 8 other) referred for handheld echo. Overall sensitivity of the simplified approach was 83% (95% CI 76% to 89%), with an overall specificity of 85% (95% CI 82% to 87%). The most common reasons for false-negative screens (n = 16) were missed mitral regurgitation (MR; 44%) and MR ≤1.5 cm (29%). The most common reasons for false-positive screens (n = 179) included identification of erroneous color jets (25%), incorrect MR measurement (24%), and appropriate application of simplified guidelines (39.4%). In conclusion, a short, independent computer-based curriculum can be successfully used to train a heterogeneous group of nonexperts to interpret RHD screening echocardiograms. This approach helps address prohibitive financial and workforce barriers to widespread RHD screening.
The emergence of multidrug-resistant Klebsiella pneumoniae is a major public health concern. Many K. pneumoniae infections can only be treated when resorting to last-line drugs such as polymyxin B ...(PB). However, resistance to this antibiotic is also observed, although insufficient information is described on its mode of action as well as the mechanisms used by resistant bacteria to evade its effects. We aimed to study PB resistance and the influence of abiotic stresses in a clinical K. pneumoniae strain using whole transcriptome profiling.
We sequenced 12 cDNA libraries of K. pneumoniae Kp13 bacteria, from two biological replicates of the original strain Kp13 (Kp13) and five derivative strains: induced high-level PB resistance in acidic pH (Kp13
), magnesium deprivation (Kp13
), high concentrations of calcium (Kp13
) and iron (Kp13
), and a control condition with PB (Kp13
). Our results show the involvement of multiple regulatory loci that differentially respond to each condition as well as a shared gene expression response elicited by PB treatment, and indicate the participation of two-regulatory components such as ArcA-ArcB, which could be involved in re-routing the K. pneumoniae metabolism following PB treatment. Modules of co-expressed genes could be determined, which correlated to growth in acid stress and PB exposure. We hypothesize that polymyxin B induces metabolic shifts in K. pneumoniae that could relate to surviving against the action of this antibiotic.
We obtained whole transcriptome data for K. pneumoniae under different environmental conditions and PB treatment. Our results supports the notion that the K. pneumoniae response to PB exposure goes beyond damaged membrane reconstruction and involves recruitment of multiple gene modules and intracellular targets.
Silva, R.; Martínez, M.L.; Hesp, P.; Catalan, P.; Osorio, A. F.; Martell, R.; Fossati, M.; Miot da Silva, G.; Mariño-Tapia, I.; Pereira, P.; Cienfuegos, R.; Klein, A., and Govaere, G., 2014. Present ...and future challenges of coastal erosion in Latin America. The coastal zones of Latin America have many landforms and environments, including sedimentary cliffs, deeply incised estuaries, headlands, barrier coasts and low lying, muddy coastal plains. These forms will respond differently to the expected changes in climate and associated sea level rise, which may produce coastal erosion in the future. Considering the coasts of Latin America overall, erosion is not yet a serious threat, although it is widespread and it is severe in some parts. Major erosion problems are frequently associated with human intervention in sediment supply, with poor planning or with the morphodynamic nature of the coast. Permanent erosional processes, locally or regionally, are caused by tectonic subsidence, deforestation and the fragmentation of coastal ecosystems, land use changes and sediment deficits because of infrastructure built along the coast. In this article we analyse coastal erosion in Latin America and the challenges it presents to the region. We first highlight the relevance of Latin America in terms of its biodiversity; then we describe the population at risk, demographic trends and economic growth throughout the low lying coastal zones. We also examine the vulnerability of the region by analyzing the resilience of key coastal ecosystems after exposure to the most frequent hazards that affect coastal zones in Latin America, namely tropical cyclones, sea level rise, ocean acidification, earthquakes and tsunamis. Finally, we discuss seven case studies of coastal erosion across Latin America. We close the study by pinpointing the main areas of concern in Latin America and explore possible strategies to overcome erosion and thus sustain economic growth, minimize population risk and maintain biodiversity.
Summary Background & aims We evaluated the ability of Nutritional Risk Screening 2002 (NRS 2002) and Subjective Global Assessment (SGA) to predict malnutrition related to poor clinical outcomes. ...Methods We assessed 705 patients at a public university hospital within 48 h of admission. Logistic regression and number needed to screen (NNS) were calculated to test the complementarity between the tools and their ability to predict very long length of hospital stay (VLLOS), complications, and death. Results Of the patients screened, 27.9% were at nutritional risk (NRS+) and 38.9% were malnourished (SGA B or C). Compared to those patients not at nutritional risk, NRS+, SGA B or C patients were at increased risk for complications ( p = 0.03, 0.02, and 0.003, respectively). NRS+ patients had an increased risk of death ( p = 0.03), and SGA B and C patients had an increased likelihood of VLLOS ( p = 0.008 and p < 0.0001, respectively). Patients who were both NRS+ and SGA C had lower estimates of NNS than patients who were NRS+ or SGA C only, though their confidence intervals did overlap. Conclusions The concurrent application of SGA in NRS+ patients might enhance the ability to predict poor clinical outcomes in hospitalized patients in Brazil.
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