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Difficulties Faced by Physicians in the Diagnosis of Endometriosis in the Brazilian Public Health System

Health 2023年第7期15卷 788-795页

作者： Carla Patrícia Alves Barbosa Tayná Maria Dantas Carozo Calumby Ana Paula Portela Andrade júlia de araújo gomes Maria Renata Suyane Silva de Farias Maria Eduarda Dantas Donald Gabrielly Pinheiro Marinho Antônia Iva Sampaio Bisneta Francisco Expedito Ramos Aguiar Sobrinho Elizabeth Bacha Centro Universitário Tiradentes (UNIT) Maceió Brasil Universidade de Pernambuco (UPE) Recife Brasil

Endometriosis is a clinical and recurrent condition characterized by the presence of functional endometrial tissue outside the uterine cavity and myometrium. It is estimated that 6% to 10% of women of reproductive age, 50% to 60% of adolescents and adults with pelvic pain, and up to 50% of women with infertility are pregnant from the condition. However, this proportion tends to be even greater due to the difficulty in diagnosing it: because it presents different symptoms, lack of information from health professionals, and a high-cost diagnostic test. Another aggravating factor is the average time from the onset of symptoms to the medical diagnosis, which even today ranges from five to ten years;this delay has consequences for disease progression, as it prevents early treatment, which is important for improving pain levels and physical and psychological well-being. Aware of these mishaps, it is therefore important to assess the difficulties faced by doctors in the diagnosis of endometriosis in the public health system, in Brazil, the Unified Health System (SUS). With this purpose, a cross sectional was carried out, developed in the virtual environment using traffic in Google forms, with the difficulties quantified in the Likert scale. Participating physicians pointed out a medium difficulty for patients with endometriosis to access the consultation (58%) and moderate difficulty (52%) to perform an ultrasound examination;also signaled great difficulty in performing magnetic resonance imaging (77%) and laparotomy (61%) in these patients. It is hoped that knowledge about the difficulties faced by physicians in the diagnosis of endometriosis in the SUS will give these physicians a voice and corroborate, even if minimally, so that there is more research that provokes the search for these difficulties, in order to improving the quality of life of these women.

关键词： Endometriosis Diagnosis Public Health System

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Emerging role of liquid biopsy in rat sarcoma virus mutated metastatic colorectal cancer:A case report

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World journal of Gastrointestinal Oncology 2024年第1期16卷 234-243页

作者： joão Gramaça Isabel gomes Fernandes Carolina Trabulo joana Gonçalves Rita Gameiro dos Santos Adriano Baptista Idília Pina Centro Hospitalar Barreiro Montijo Centro Hospitalar Barreiro MontijoSetúbalBarreiro 2830-003Portugal Medical Oncology Unit Centro Hospitalar Barreiro MontijoSetúbalBarreiro 2830-003Portugal

BACKGROUND In patients with metastatic colorectal cancer(mCRC),the treatment options are limited and have been proved to be affected by rat sarcoma virus(RAS)mutational status.In RAS wild-type(wt)patients,the combination of antiepidermal growth factor receptor(EGFR)monoclonal antibodies with chemotherapy(CT)is more effective than CT alone.On the other hand,RAS-mutated patients are not eligible for treatment with anti-EGFR antibodies.CASE SUMMARY Eleven patients with initially RAS-mutated mCRC were followed from diagnosis to May 2022.At the time of cell-free DNA determination,five patients had undergone one CT line,five patients had undergone two CT lines,and one patient had undergone three CT lines(all in combination with bevacizumab).At the second and third treatment lines[second line(2L),third line(3L)],patients with neo-RAS wt received a combination of CT and cetuximab.In neo-RAS wt patients treated with anti-EGFR,our findings indicated an increase in progression-free survival for both 2L and 3L(14.5 mo,P=0.119 and 3.9 mo,P=0.882,respectively).Regarding 2L overall survival,we registered a slight increase in neo-RAS wt patients treated with anti-EGFR(33.6 mo vs 32.4 mo,P=0.385).At data cut-off,two patients were still alive:A RAS-mutated patient undergoing 3L treatment and a neo-RAS wt patient who received 2L treatment with anti-EGFR(ongoing).CONCLUSION Our case series demonstrated that monitoring RAS mutations in mCRC by liquid biopsy may provide an additional treatment line for neo-RAS wt patients.

关键词： Metastatic colorectal cancer Rat sarcoma virus mutational status Liquid biopsy Rat sarcoma virus wild-type Neo-rat sarcoma virus wild-type Anti-epidermal growth factor receptor therapy Case report

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development of a Ready-to-Use PSMA-11 Kit Formulation and Biological Evaluation of Binding Affinity

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Advances in Molecular Imaging 2024年第2期13卷 7-22页

作者： Maria Renata Valente Brandão Freire Natália Marchesan Bexiga Marco Antonio Stephano joão Ezequiel Oliveira Carlos Roberto jorge Soares Ana Cláudia Camargo Miranda Anna Carolina de Alcântara Barbosa Marycel Figols de Barboza Laura Fernanda Garcia Luiz Felipe S. Teixeira Maria Helena Marumo Bellini Natanael gomes da Silva Luiza Mascarenhas Balieiro joel Mendes Elaine Bortoleti de araújo Centro de Radiofarmcia Instituto de Pesquisas Energticas e Nucleares (IPEN) Cidade Universitria So Paulo Brasil departamento de Tecnologia Farmacutica Faculdade de Cincias Farmacuticas (USP) Cidade Universitria So Paulo Brasil Centro de Biotecnologia Instituto de Pesquisas Energticas e Nucleares (IPEN) Cidade Universitria So Paulo Brasil departamento de Medicina Nuclear do Hospital Israelita Albert Einstein So Paulo/SP Brasil

Introduction: 68Ga-PSMA-11 is considered the gold standard in detection of micro and oligometastases in advanced prostate cancer, being used for therapeutic planning, as well as, potentially, for evaluating response to treatment. The development of ready-to-use lyophilized kit of PSMA-11 adds quality and safety to the routine use of this radiopharmaceutical and represents a pharmacotechnical challenge as it must preserve the integrity and specificity of the ligand. Methods: PSMA-11 kit formulation was proposed, considering radiolabeling parameters and the preservation of the peptide during the lyophilization process, using mannitol as an excipient. Critical temperature characterization studies were carried out using DSC equipment and the freeze-drying process was developed. The direct radiolabeling conditions were evaluated and standardized using 68Ge/68Ga generator eluate from two different manufacturers (ITG and Eckert & Ziegler). The radiochemical purity was evaluated by TLC and HPLC. Biological evaluation was carried out with lyophilized PSMA-11 to demonstrate the integrity of the peptide and preservation of biological activity after the lyophilization process. Results: Based on critical temperature characterization studies, the freeze-drying cycle was designed to reach a freezing temperature of around −40˚C and primary drying at 2˚C. Using 20 mg of mannitol, an intact and elegant lyophilized cake was obtained. PSMA-11 lyophilized kit was directly labeled with 68Ga eluate from 68Ge/68Ga GMP generators (ITG and Eckert & Ziegler) resulting in % RP > 95% at pH 4.0 to 4.5. The results obtained from in vitro and in vivo biological competition studies confirmed the preservation of PSMA-11 affinity for the receptor after lyophilization. Conclusion: A lyophilized formulation (Kit) of PSMA-11 was successfully obtained, which preserved the integrity and biological activity of the peptide and guaranteed radiolabeling efficiency.

关键词： 68Ga-PSMA-11 Prostate-Specific Membrane Antigen (PSMA) Ready-to-Use Kit GMP-Grade Generators Metastatic Prostate Cancer PET Imaging

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Is magnesium deficiency the major cause of needle chlorosis of Pinus taeda in Brazil?

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journal of Forestry Research 2024年第2期35卷 209-221页

作者： Antônio Carlos Vargas Motta Shizuo Maeda Valdécio dos Santos dos Santos Rodrigues Tamires Maiara Ercole Stephen Arthur Prior Ana Elisa Lyra Brumat Amanda Pacheco Cardoso Moura julierme Zimmer Barbosa joão Bosco Vasconcellos gomes department of Soil Sciences and Agriculture Engineering Federal University of ParanáR.dos Funcionários1540.CuritibaParanáCEP 80035‑050Brazil Brazilian Agricultural Research Company Embrapa FlorestasEstr.da Ribeira–Br‑476Km 111–Parque Monte Castelo.ColomboParanáCEP 83411‑000Brazil United States department of Agriculture‑Agricultural Research Service USDA-ARS National Soil Dynamics Laboratory411 South Donahue DriveAuburnAL 36832USA Reforestation Remasa Rodovia PR 170–Km 522.BiturunaParanáCEP 84640‑000Brazil Federal Institute of Southeast of Minas Gerais R.Luz Interior360.Juiz de ForaMinas Gerais CEP 36030‑713Brazil

Needle chlorosis(NC)in Pinus taeda L.systems in Brazil becomes more frequent after second and third harvest rotation cycles.In a study to identify factors contributing to yellowing needle chorosis(YNC),trees were grown in soils originating from contrasting parent materials,and soils and needles(whole,green and chlorotic portions)from 1-and 2-year-old branches and the first and second needle flush release at four sites with YNC on P.taeda were analyzed for various elements and properties.All soils had very low base levels(Ca^(2+),Mg^(2+)and K^(+))and P,suggesting a possible lack of multiple elements.YNC symptoms started at needle tips,then extended toward the needle base with time.First flush needles had longer portions with YNC than second flush needles did.Needles from the lower crown also had more symptoms along their length than those higher in the canopy.Symptoms were similar to those reported for Mg.In chlorotic portions,Mg and Ca concentrations were well below critical values;in particular,Mg levels were only one third of the critical value of 0.3 g kg^(-1).Collectively,results suggest that Mg deficiency is the primary reason for NC of P.taeda in various parent soils in Brazil.

关键词： Nutritional deficiency Forest management Soil depletion Pine foliar analysis Needle chlorosis

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Floristic composition and edaphic relationships in ferruginous campo rupestre reference ecosystems

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journal of Mountain Science 2024年第3期21卷 719-733页

作者： G.Wilson FERNANdeS Letícia RAMOS Dario C.PAIVA jéssica CUNHA-BLUM Vanessa Matos gomes Daniel NEGREIROS Ecologia Evolutiva&Biodiversidade Departamento de GenéticaEcologia e Evolução/ICBUniversidade Federal de Minas Gerais31270-901Belo HorizonteMGBrazil Knowledge Center for Biodiversity 31270-901Belo HorizonteMGBrazil department of Biological Sciences Institute of EnvironmentFlorida International UniversityMiamiFL 33199USA Programa de Pós Graduação em Biodiversidade e Uso dos Recursos Naturais Universidade Estadual de Montes ClarosMontes ClarosMGBrazil Laboratório de Estudo das Relações Solo-Planta Departamento de SolosUniversidade Federal Rural do Rio de JaneiroSeropédicaRGBrazil

Land use change and occupation have led to modifications in the environment causing loss of biodiversity and ecosystem services throughout the planet.Some environments with high economic relevance,such as the ferruginous campo rupestre(rupestrian grassland known as Canga in Brazil),are even more susceptible to severe impacts due to their extreme habitat conditions and low resilience.The determination of reference ecosystems based on the intrinsic characteristics of the ecosystem is essential for conservation as well as to the implementation of ecological restoration.We proposed the reference ecosystem of the three main types of habitats of the ferruginous campo rupestre based on their floristic composition.We described the floristic composition of each habitat and evaluated the physicochemical properties of the soils and the relationship between plants and soils.All three habitats showed high diversity of plant species and many endemic species,such as Chamaecrista choriophylla,Cuphea pseudovaccinium,Lychnophora pinaster,and Vellozia subalata.The distribution of vegetation was strongly related with the edaphic characteristics,with a set of species more adapted to high concentration of base saturation,fine sand,organic carbon,and iron,while another set of species succeeded in more acidic soils with higher S and silt concentration.We provide support for the contention that the ferruginous campo rupestre is a mosaic of different habitats shaped by intrinsic local conditions.Failure to recognize the floristic composition of each particular habitat can lead to inappropriate restoration,increased habitat homogenization and increased loss of biodiversity and ecosystem services.This study also advances the knowledge base for building the reference ecosystem for the different types of ferruginous campo rupestre habitats,as well as a key database for highlighting those species contribute most to community assembly in this diverse and threatened tropical mountain ecosystem.

关键词： Canga Ecological restoration Extreme ecosystem Non-forest ecosystems Rupestrian grassland Taxon environment relationships

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Embodying deeply Held Values in Education:Seeking a More Equitable World for Both Humans and Non-Humans

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ECNU Review of Education 2024年第2期7卷 241-251页

作者：林静 Shue-kei joanna Mok Virginia gomes department of Counseling Higher Education and Special EducationCollege of Education3214 Benjamin BuildingUniversity of MarylandCollege ParkMD20742USA

Highlights In this article,we contend that the bedrock of an equitable world lies in the profound recognition of love as the fundamental force permeating the cosmos.We believe that love is built into the essence of who we are.We posit that genuine progress toward an equitable world is elusive unless we place love,both for one another and for the natural world,at the core of our educational endeavors.

关键词： Embodied practices heart and spirit love and equity love as a cosmic force

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Dysregulated microRNAs in type 2 diabetes and breast cancer:Potential associated molecular mechanisms

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World journal of Diabetes 2024年第6期15卷 1187-1198页

作者： Alex Cleber Improta-Caria Filipe Ferrari joão Lucas Penteado gomes Paloma Brasilio Villalta Úrsula Paula RenóSoci Ricardo Stein Edilamar M Oliveira Laboratory of Biochemistry and Molecular Biology of the Exercise Physical Education and Sport SchoolUniversity of São PauloSão Paulo 05508-030Brazil Graduate Program in Cardiology and Cardiovascular Sciences Federal University of Rio Grande do SulHospital de Clínicas de Porto AlegrePorto Alegre 90035003Brazil Laboratory of Metabolic Disorders(Labdime) School of Applied SciencesUniversity of Campinas-UNICAMPCampinas 13484-350Brazil departments of Internal Medicine Molecular Pharmacology and PhysiologyCenter for Regenerative MedicineUSF Health Heart InstituteMorsani College of MedicineUniversity of South FloridaTampaFL 33602United States

Type 2 diabetes(T2D)is a multifaceted and heterogeneous syndrome associated with complications such as hypertension,coronary artery disease,and notably,breast cancer(BC).The connection between T2D and BC is established through processes that involve insulin resistance,inflammation and other factors.despite this comprehension the specific cellular and molecular mechanisms linking T2D to BC,especially through microRNAs(miRNAs),remain elusive.miRNAs are regulators of gene expression at the post-transcriptional level and have the function of regulating target genes by modulating various signaling pathways and biological processes.However,the signaling pathways and biological processes regulated by miRNAs that are associated with T2D and BC have not yet been elucidated.This review aims to identify dysregulated miRNAs in both T2D and BC,exploring potential signaling pathways and biological processes that collectively contribute to the development of BC.

关键词： Type 2 diabetes Breast cancer MicroRNAs Molecular mechanisms

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Solid pseudopapillary tumor of the pancreas:A systematic review of clinical,surgical and oncological characteristics of 1384 patients underwent pancreatic surgery

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 331-338页

作者： Gennaro Mazzarella Edoardo Maria Muttillo Diego Coletta Biagio Picardi Stefano Rossi Simone Rossi del Monte Vito gomes Irnerio Angelo Muttillo Division of General and Emergency Surgery San Filippo Neri Hospital00136 RomeItaly department of Surgery“Pietro Valdoni” Sapienza University of RomeViale del Policlinico 15500161 RomeItaly Surgical and Medical department of Translational Medicine Sant’Andrea HospitalSapienza University of Rome00185 RomeItaly department of Surgical Sciences Umberto I University HospitalSapienza University of Rome00136 RomeItaly department of General Surgery Ospedali Riuniti Marche Nord61121 PesaroItaly department of Pathology San Filippo Neri Hospital00136 RomeItaly

Background:Pancreatic solid pseudopapillary tumors(SPTs)are rare clinical entity,with low malignancy and still unclear pathogenesis.They account for less than 2%of exocrine pancreatic neoplasms.This study aimed to perform a systematic review of the main clinical,surgical and oncological characteristics of pancreatic SPTs.Data sources:MEDLINE/PubMed,Web of Science and Scopus databases were systematically searched for the main clinical,surgical and oncological characteristics of pancreatic SPTs up to April 2021,in accordance with the preferred reporting items for systematic reviews and meta-analyses(PRISMA)standards.Primary endpoints were to analyze treatments and oncological outcomes.Results:A total of 823 studies were recorded,86 studies underwent full-text reviews and 28 met inclusion criteria.Overall,1384 patients underwent pancreatic surgery.Mean age was 30 years and 1181 patients(85.3%)were female.The most common clinical presentation was non-specific abdominal pain(52.6%of cases).Mean overall survival was 98.1%.Mean recurrence rate was 2.8%.Mean follow-up was 4.2 years.Conclusions:Pancreatic SPTs are rare,and predominantly affect young women with unclear pathogenesis.Radical resection is the gold standard of treatment achieving good oncological impact and a favorable prognosis in a yearly life-long follow-up.

关键词： Frantz’s tumor Pancreas Pancreatic neoplasms Pancreatic surgery Solid pseudopapillary tumor

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Analysis on the Impact of Cattle Fattening Technology on Farmer Households in Atabae Timor-Leste

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Agricultural Sciences 2024年第4期15卷 399-407页

作者： Marcolino Estevão Fernandes E. Brito Vicente de Paulo Correia Carlos da Conceicão de deus Mateus de jesus gomes Agro-Socio Economic Faculty of Agriculture National University of Timor Lorosa&#8217e Dili Timor-Leste

Agriculture is one of the priority sectors in Timor-Leste. Introducing new agriculture technology is crucial to enhance agricultural production. Practicing cattle fattening can increase beef cattle body weight and generate income to the beef cattle farmers. As farmers face problems including agricultural production decline, lack of forages and information and weather unfavourable. The study’s purpose was to examine the impact of adoption of cattle fattening technology on farmer households in Atabae administrative post, Bobonaro municipality in Timor-Leste. There were 200 beef cattle farmers households where randomly selected in four villages in Atabae. It consisted of 65 farmers practicing cattle fattening and 135 farmers non-practicing cattle fattening. Face to face interviews used structured questionnaire. Statistical analysis such as t-test and descriptive analysis were used to examine impact adoption of cattle fattening technology by farmers and factor constraints of cattle production and the solutions of it. The results indicated the average value of cattle and profit were significant different from zero and it is associated with practicing of cattle fattening. The average of labour used on cattle activities, the average of cattle sold, and total cost spent on cattle were not significant different from zero. The percentage of farmers said that factors constraints cattle production were shortage of water and forage (53%) and spend time on culture ceremony and lack of capital (33%). The number of farmers said that they collected water from river, feed cattle with sago and forage (55.3%) and cultivated forage (23.4%). This finding contributes information to the farmers, traders, and Timorese government to continue implementing cattle fattening activities as it enhances farmers’ income and developing cattle production.

关键词： Cattle Production Adoption of Cattle Fattening Technology and Cattle Farmer Households

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digital micromirror device;flat-top beam;orbital angular momentum;perfect vortex beam;random fiber laser

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High Power Laser Science and Engineering 2024年第1期12卷 42-51页

作者： Rui Ma Ke Hai Luo jing Song He Wei Li Zhang Dian Yuan Fan Anderson S.L.gomes jun Liu International Collaborative Laboratory of 2D Materials for Optoelectronics Science and Technology of Ministry of Education Institute of Microscale OptoelectronicsShenzhen UniversityShenzhenChina Institute for Advanced Study Shenzhen UniversityShenzhenChina Fiber Optics Research Centre School of Information and Communication EngineeringUniversity of Electronic Science and Technology of ChinaChengduChina departamento de Física Universidade Federal de PernambucoRecife-PEBrazil

High-intensity vortex beams with tunable topological charges and low coherence are highly demanded in applications such as inertial confinement fusion(ICF) and optical communication. However, traditional optical vortices featuring nonuniform intensity distributions are dramatically restricted in application scenarios that require a high-intensity vortex beam owing to their ineffective amplification resulting from the intensity-dependent nonlinear effect. Here, a low-coherence perfect vortex beam(PVB) with a topological charge as high as 140 is realized based on the super-pixel wavefront-shaping technique. More importantly, a globally adaptive feedback algorithm(GAFA) is proposed to efficiently suppress the original intensity fluctuation and achieve a flat-top PVB with dramatically reduced beam speckle contrast. The GAFA-based flat-top PVB generation method can pave the way for high-intensity vortex beam generation,which is crucial for potential applications in ICF, laser processing, optical communication and optical trapping.

关键词： digital micromirror device flat-top beam orbital angular momentum perfect vortex beam random fiber laser

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