Catholic University of Brasília

Chronic suppurative otitis media (CSOM), often due to multidrug-resistant (MDR) bacteria, is a serious therapeutic challenge with increasing antibiotic resistance. The current study investigates the antibacterial potential of silver nanoparticles (AgNPs) biosynthesized by Lactobacillus acidophilus (LA-AgNPs) and mixed Lactobacillus culture (ML-AgNPs) against MDR CSOM isolates, i.e., Pseudomonas aeruginosa, Staphylococcus aureus, Proteus mirabilis, Klebsiella pneumoniae, and Enterobacter aerogenes. Nanoparticles were characterized by UV–Vis, XRD, AFM, FE-SEM, and FTIR, revealing their spherical, crystalline shapes with sizes of 6.4 ± 1.2 nm (LA-AgNPs) and 82.89 ± 12.5 nm (ML-AgNPs), stabilized by microbial metabolites. Agar well diffusion assays demonstrated inhibitory zones of 22.5–30 mm (ML-AgNPs) and 20–25 mm (LA-AgNPs) against Gram-negative pathogens, with MIC₉₀ values ranging from 4.8–77.5 µg/mL (ML-AgNPs) to 9.7–38.7 µg/mL (LA-AgNPs). LA-AgNPs reduced bacterial viability to 7.68–73.50% at concentrations up to 38.7 µg/mL, showing dose-dependent efficacy. These results affirm the potential of probiotic-derived AgNPs as biocompatible alternatives to traditional antibiotics for treating multidrug-resistant CSOM infections. Graphical Abstract

Introduction Blood blister-like aneurysms (BBLAs) are rare, typically found in the anteromedial supraclinoid segment of the internal carotid artery, and are related to high morbidity and mortality rates. Although microsurgery has been traditionally used to manage BBLAs, the Endovascular treatment (EVT) is gaining importance. We aim to compare these two methods using a systematic review and meta-analysis. Methods A systematic search of PubMed, Embase, and Web of Science databases following PRISMA guidelines was conducted. We pooled odds ratios (OR) with 95% confidence intervals using a random-effects model, and I ² to assess heterogeneity. Eligible studies compared microsurgery and EVT for BBLAs. Outcome measures included Good and Poor clinical outcomes by Modified Rankin Scale (mRS), Epilepsy, Infection, Intracranial Hemorrhage, Vasospasm, Ischemic Events, Mortality, Operative Rupture, Rebleeding, Recurrence, and Retreatment. Results Fifteen studies with 770 patients were included (401 microsurgery; 369 EVT). EVT appeared to be protective against Poor Clinical Outcomes (mRS >2), with an OR of 0.43 (95% CI 0.21 to 0.87), and Ischemic Events, having an OR of 0.33 (95% CI 0.18 to 0.61). Microsurgery was related to higher Mortality, with an OR of 2.72 (95% CI 1.46 to 5.06), and Operative Rupture, with 7.72 (95% CI 3.50 to 17.07). EVT also statistically favored the Good Clinical Outcomes analysis, with an OR of 3.13 (95% CI 1.40 to 6.98). Epilepsy, Infection, Intracranial Hemorrhage, and Vasospasm occurrence showed no significant statistical difference. Conclusion Despite microsurgery being traditionally used in BBLAs management, EVT has been shown to be a safer and lower-morbidity option.

Purpose To investigate the interrelationships between 24‐h movement behaviors, health‐related physical fitness, and inhibitory control performance in adolescents. Methods This cross‐sectional study included 216 Brazilian adolescents (aged 16.7 ± 1.2 years) from a federal public school. Movement behaviors—moderate‐to‐vigorous physical activity (MVPA), smartphone screen time, sleep duration, and excessive daytime sleepiness—were assessed using the Global School‐based Student Health Survey, digital well‐being tools, and the Pediatric Daytime Sleepiness Scale. Aerobic capacity was measured using the PACER test, muscular strength by the FitnessGram push‐up test, and body composition through body mass index. Inhibitory control was assessed using the Flanker task (E‐Prime v3.0). Separate network analyses were performed for congruent and incongruent reaction times (RT). Results Physically active adolescents had faster RTs than their insufficiently active peers, with physical activity negatively associated with RT in both the congruent (−0.116) and incongruent (−0.125) networks. Aerobic capacity (e.g., expected influence: 0.879–0.902) and muscular strength (expected influence: 1.360–1.384) appeared as central components in both network structures. However, no associations were found between sleep duration, screen time, or excessive daytime sleepiness and inhibitory control. Conclusions Adherence to MVPA guidelines was directly associated with improved inhibitory control performance among adolescents. Health‐related physical fitness, particularly aerobic capacity and muscular strength, was indirectly associated with inhibitory control. Other movement behaviors were not associated with cognitive performance in this sample.

Background Chronic subdural hematomas (cSDHs) are potentially life-threatening neurological conditions with an increasing incidence worldwide. However, comparative data on the different cSDH managements remain limited. Herein, we aimed to conduct a network meta-analysis comparing standalone embolization (EMB), surgery, EMB plus surgery (EMBSurgery), and observation, to provide further clarity. Method We systematically searched PubMed, Embase, Web of Science, and Cochrane Library for studies comparing at least two cSDH approaches between EMB, surgery, EMBSurgery, and observation. Primary endpoints included the need for reintervention, length of hospital stay, procedure-related complications, and mortality. Random-effects model was used to calculate mean difference (MD) and odds ratio (OR) under a 95% confidence interval (CI). Cost-effective analysis and subanalyses for the randomized studies were conducted. Results A total of 19 studies involving 23,996 patients were included. A significant reduction in reintervention was observed with EMBSurgery (OR 0.21, CI 0.04–0.79), while EMB showed a non-significant reduction (OR 0.41, CI 0.12–1.32), compared to surgery. EMBSurgery neither significantly increased hospital stay (MD 4.80, CI −0.435–11.4) nor yielded higher complications (OR 1.11, CI 0.49–2.36) compared to surgery. Indeed, lower mortality was observed in both groups (EMB: OR 0.61, CI 0.03–5.08; EMBSurgery: OR 0.41, CI 0.03–3.05) and procedural costs were not significantly higher for EMB and EMBSurgery compared to surgery (EMB: MD 32,000, CI –13,500–70,300; EMBSurgery: MD 16,200, CI –40,100–72,600). Subanalyses revealed significantly lower reintervention rates in the EMBSurgery group versus the surgery group (OR 0.34, CI 0.16–0.74; I2 0%). Conclusion EMB combined with surgery seems to reduce reinterventions in cSDH compared to surgery alone with non significant complications that need further analysis through randomized trials with longer follow-ups.

Introduction Intracranial atherosclerotic disease (ICAD) is a major cause of ischemic stroke, particularly in high-risk populations. Endovascular treatment options, including drug-coated balloon (DCB) angioplasty and stent angioplasty (SA), have been explored as alternatives for patients with severe stenosis or refractory symptoms. However, the comparative efficacy and safety of these interventions remain a topic of debate. Methods A systematic search was conducted across PubMed, Embase, Cochrane, Scopus, and Web of Science up to December 2024. Studies comparing DCB to SA were included. Outcomes analyzed were symptomatic restenosis, overall restenosis rates, and recurrent ischemic events. Results Three studies with 213 patients met the inclusion criteria. DCB was associated with significantly lower rates of overall restenosis (OR: 0.22, 95% CI: 0.10–0.50, I2 = 0%,p < 0.001) and recurrent ischemic events (OR: 0.20, 95% CI: 0.07–0.63, I2 = 0%,p = 0.006). There was no statistically significant disparity between both methods concerning symptomatic restenosis (OR: 0.34, 95% CI: 0.09–1.24, I2 = 0%, p = 0.101). Conclusion This meta-analysis suggests that DCB angioplasty may be safer and more effective than SA for ICAD, with lower rates of restenosis and ischemic complications. However, the evidence is primarily based on observational studies, highlighting the need for multicenter randomized controlled trials with standardized protocols to establish further the comparative efficacy and long-term outcomes between DCB and SA in patients with ICAD.

This paper estimates own- and cross-price elasticities of cigarette consumption in licit and illicit markets. Using propensity score matching (PSM), we pair comparable licit- and illicit-cigarette consumers to assign hypothetical prices and address the challenge of exclusive consumption of just one type. The analysis focuses on Brazil, a developing country with a significant illicit cigarette market, using individual data from the 2013 and 2019 National Health Surveys (PNS). Illicit market identification relies on declared brands and official minimum prices. Results show that cross-price elasticities indicate a switching demand effect following illicit cigarette price changes in 2013, but not in 2019. However, changes in licit cigarette prices do not significantly influence switching demand in either year or in the combined sample. Across all models, illicit cigarette consumers exhibit lower price sensitivity than their licit counterparts, highlighting distinct behaviors in response to market dynamics.

The increase in freshwater contamination due to global population growth, industrialization, emerging anthropogenic pollutants, heavy metals, increased growth of pathogenic microbes and consumption of contaminated drinking water represents a critical problem. Because of these problems, significant emphasis should be placed on the recycling of wastewater. Conventional wastewater management methods require high economic input, provide poor treatment efficiency and cause environmental disbalances by emitting different toxic pollutants. To highlight and alter these types of issues, it is necessary to continuously evaluate the economically feasible technologies and environment-friendly biological methods that complement and improvise the conventional methods. This chapter represents the classifications, sources, characteristics of wastewater, and best-known green technologies available for the treatment of wastewater, as knowing more about the content and sources that discharge the hazardous wastewater may aid in developing more efficient and sustainable wastewater treatment technologies. This chapter also highlighted the different conventional wastewater treatment technologies and different green technologies, including physical, chemical, and biological treatment methods and these methods have been critically reviewed. The state-of-the-art discussed the advantages and limitations of different conventional and modern wastewater treatment techniques. Finally, it overviewed the advantages of the various green technologies used for wastewater treatment and discussed the upcoming, advanced and more promising environment-friendly technologies used for wastewater treatment.

Background Flow diverters (FDs) are increasingly used off-label for distal cerebral aneurysms (DCAs), those located at or beyond the anterior cerebral artery (ACA) A2, middle cerebral artery M2, and posterior cerebral artery P2 segments. However, data on their safety and efficacy remain limited. This systematic review and meta-analysis synthesizes current evidence on FD treatment for DCAs. Methods A comprehensive search was performed across PubMed, Scopus, and Web of Science, including studies with ≥5 patients reporting FD treatment of DCAs. Efficacy outcomes included adequate and complete aneurysm occlusion and retreatment rates. Safety outcomes included good functional outcome (modified Rankin Scale (mRS) score 0–2), procedure-related morbidity, mortality, complications, in-stent stenosis, and covered branch occlusion at follow-up. Pooled analyses with 95% confidence intervals (CI) were conducted using a random-effects model. Results Eighteen studies (441 patients, 70% women; mean age: 57.2±13.6 years) with 445 DCAs were included. Most aneurysms were unruptured (93.7%) and located in the ACA territory (78.4%). Adequate and complete occlusion at last follow-up were 90% (95% CI, 86 to 95) and 79% (95% CI, 74 to 85), respectively. The retreatment rate was 1.6% (95% CI, 0.2 to 3). Good functional outcome was achieved in 97% (95% CI, 95 to 99). Procedure-related complications occurred in 9% (95% CI, 5 to 13), with morbidity and mortality of 1.5% and 0.6%, respectively. In-stent stenosis and covered branch occlusion rates were 3% (95% CI, 0 to 8) and 5.5% (95% CI, 2 to 9), respectively. Conclusion FDs appear to be safe and effective for DCAs, with high occlusion rates and low retreatment and complication rates.

This study aimed to compare the effects of passive and active warm-up protocols combined with static or neurodynamic stretching on hamstring muscle function. Sixteen individuals (7 men and 9 women) performed three experimental sessions in a randomized order: 1) passive warm-up and static stretching, 2) passive warm-up and neurodynamic stretching, 3) active warm-up and static stretching (control condition). Passive warm- up consisted of 20 minutes in a 45°C hot-room. Active warm-up included 10 minutes of cycling and 10 minutes of sub-maximal contractions. Following warm-up, the participants were engaged in six sets of 30-second stretches, either performed using static or neurodynamic modalities. Testing involved two maximal voluntary contractions (MVC), a passive knee extension test (to evaluate range of motion and hamstring stiffness), and a stand-and-reach test (used for flexibility assessment) conducted before, after warm-up, and after stretching. Electromyography from the biceps femoris and semitendinosus were recorded during MVC. Results revealed a significant time effect for flexibility (p < 0.001). Flexibility enhancements were obtained following active and passive warm-ups and further increased after the stretch, independently of the stretch intervention. The electromyographic activity of the semitendinosus muscle was affected by the time (p = 0.004). It revealed a decrease after stretching as compared to a post-warm-up measurement. No other differences were observed between conditions and time for maximal torque and stiffness indexes. It is concluded that both the active and passive warm-up methods are efficient to increase flexibility. Irrespective of the modality, stretching further improved flexibility without any alteration in muscle viscoelastic properties.

Genome editing technologies have revolutionized the production of microorganisms, plants, and animals with phenotypes of interest to agriculture. Editing previously sequenced genomes allows for the punctual, discreet, precise, and accurate alteration of DNA for genetic analysis, genotyping, and phenotyping, as well as the production of edited organisms for academic and industrial purposes, among many other objectives. In this context, genome editing technologies have been causing a revolution in Brazilian agriculture. Thanks to the publication of Normative Resolution No. 16 (in Portuguese Resolução Normativa No. 16-RN16) in 2018, Brazilian regulatory authorities have adapted to the new genetic manipulation technologies available to the scientific community. This review aims to describe the effects of updates to the regulatory framework for edited organisms in Brazil and to point out their impacts on research and development of emerging technologies in the Brazilian agricultural sector. The implementation of RN16 rationalized the regulatory aspects regarding the production, manipulation, exploration and commercial release of edited organisms and led to the faster, cheaper and safer obtaining of edited technologies, which are more productive and better adapted to different environmental conditions in Brazil.

Extrachromosomal circular DNAs (eccDNAs) are heterogeneous circular DNA molecules derived from genomic DNA, and believed to be involved in intercellular communication and in natural biological processes. Extracellular vesicles (EVs) are membrane-bound particles released from all cells, and have been shown to contain various classes of nucleic acids. EVs can play a role in intercellular communication and may be used as biomarkers. This constitutes the first study to demonstrate that EVs derived from healthy human dermal fibroblasts carry eccDNA. eccDNA from EVs and their corresponding donor cells were isolated and sequenced on the Oxford Nanopore MinIon platform, followed by the identification of potential eccDNAs through four different bioinformatic pipelines, namely ecc_Finder, cyrcular-calling, CReSIL, and Flec. Our main findings demonstrate that EVs derived from human dermal fibroblasts carry eccDNA; there is variability in the number of eccDNAs identified in the same sample through different pipelines; and there is variability in the identified eccDNAs across biological replicates. Additionally, eccDNAs characterized in this research had (a) sequences as small as 306 base pairs and as large as 28,958 base pairs across all samples, (b) uneven chromosomal distribution, and (c) an average of 49.7% of the identified eccDNAs harboring gene fragments. Future implications for this novel research include using this framework method to elucidate factors and conditions that may influence the skin aging process and related biogenesis in human dermal cells.

Thoracic discectomy is performed via anterior or posterior approaches through different techniques. An updated comparison incorporating recent research is needed to inform clinical decision-making and guide future studies. A comprehensive search identified relevant studies, and meta-analyses evaluated neurological outcomes, complications, reoperations, and surgical efficiency metrics, including estimated blood loss (EBL) and length of stay (LOS). We pooled 37 studies (34 retrospective, 1 trial and 2 prospective) amounting to 27,450 patients. No significant differences were observed between anterior and posterior approaches for neurological improvement (OR 1.47, 95% CI 0.8-2.72), neurological worsening (OR 0.57, 95% CI 0.07-4.4), transient deterioration (OR 1.6, 95% CI 0.16-15.51), reoperations (OR 1.95, 95% CI 0.54-7.09), surgical site infections (OR 0.24, 95% CI 0.03-2.02), CSF leakage (OR 1.54, 95% CI 0.24-9.99), or postoperative neuropathic pain (OR 0.67, 95% CI 0.10-4.35). Operative time was similar (SMD 5.42, 95% CI-0.46 to 11.29). Mean EBL was lower for anterior approaches (600.1 mL, 95% CI 246.99-953.23) compared to posterior approaches (1925.1 mL, 95% CI 837.32-3012.88). The posterior approach had fewer overall complications (OR 0.32, 95% CI 0.24-0.42) and shorter LOS (SMD 0.48, 95% CI 0.25-0.71). Subgroup analysis confirmed that open approaches in both groups resulted in fewer complications and higher rates of neurological improvement. The choice of anterior vs. posterior approach for thoracic discectomy depends on patient factors and surgeon preference. Anterior approaches may provide better neurological outcomes but with potentially higher complication rates. Further research is needed to identify the optimal approach for each patient.

Background This study compared the long-term efficacy and safety of dual mobility (DM) prostheses versus conventional total hip arthroplasty (c-THA) in femoral neck fracture (FNF) patients. FNFs have a high rate of post-surgical complications, with no consensus on the optimal prosthetic design. This analysis synthesizes the available evidence to address this gap. Methods We systematically searched Cochrane, PubMed, and Embase databases for studies comparing DM and c-THA in FNF patients. Outcomes included dislocation, revision, heterotopic ossification, infection, mortality, peri-prosthetic fracture, quality of life, and functional scores. Relative risk (RR) was used for binary endpoints, while mean differences (MD) or standardized mean differences (SMD) were calculated for continuous endpoints. A random-effects model with a 95% confidence interval (CI) was applied. Statistical analyses were conducted using R version 4.4.0. Results We included three randomized controlled trials and ten cohort studies, amounting to 21,585 patients, of which 4887 received and 16,698 received c-THA. Compared to c-THA, DM showed lower dislocation (RR 0.47; 95% CI: 0.34–0.65; p < 0.001) and revision rates (RR 0.77; 95% CI: 0.67–0.89; p < 0.001) but higher heterotopic ossification (RR 1.98; 95% CI: 1.22–3.20; p < 0.05) and worse functional scores at six to nine months (SMD 1.65; 95% CI: 0.75–2.55; p < 0.001). Meta-regression analysis showed no impact of the posterior approach on dislocation outcomes (p = 0.76). Conclusion DM reduces dislocation and revision risks but increases heterotopic ossification and shows worse short-term functional outcomes. Larger randomized trials are needed to validate long-term efficacy and safety.

Objective This study systematically reviewed and meta-analyzed randomized and quasi-randomized controlled trials investigating the impact of exercise therapy on muscle strength, redox balance, and inflammatory profile in individuals with Down Syndrome. Design Systematic review and meta-analysis. Data Sources Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, SPORTDiscus, EMBASE, and PEDro. Eligibility Criteria for Selecting Studies Randomized and quasi-randomized controlled trials exploring exercise therapy effects on muscle strength and redox balance in individuals with Down Syndrome. While no initial restrictions on age, gender, or health condition were applied during the search process, all included studies focused on adult participants (>18 years old). No language restrictions were applied, and the search covered the period from 1970 to 2021. Results We assessed the abstract of 1964 studies. Of the 46 studies meeting the inclusion criteria for the period 2004-2021, 32 focused on muscle strength, and 14 examined redox balance and inflammation. A total of 1611 participants with a mean age of 27 years were included. This review confirmed that different exercise modalities are prone to improve muscle strength (random effect [95%CI]: 0.66, 0.54 – 0.78), redox balance and inflammatory profile (random effect [95%CI]: -1.04, -1.31 – -0.76) in this population. The multi-model inference suggested that the frequency of training (times per week) might play a significant role in the main effect. Unsupervised machine learning algorithms displayed a pattern-based graphic representation to assess heterogeneity. Conclusions Exercise training demonstrated a positive impact on muscle strength in adults with Down Syndrome. The review provides valuable insights into the effects of exercise therapy on individuals with Down Syndrome, emphasizing the need for tailored training prescriptions.

The adoption by the International Labour Organization (ILO) of a special convention dedicated to the struggle against violence and harassment in the workplace, namely the Violence and Harassment Convention, 2019 (C190), is a special opportunity to research the level of protection against these phenomena granted by national legislations and to better understand the ways to improve it. The main objective of this article is to analyze the national approaches of the BRICS countries to the issue of harassment in the world of work in order to identify the current problems and the possible ways of solving them, including through the implementation of the norms of the C190 or following Violence and Harassment Recommendation, 2019 (No. 206) (R206). In the five sections of this article, each of which is dedicated to a separate member state of BRICS, the authors examine the national labor legislation and other laws that are relevant to the topic, the gaps in these norms as compared to the requirements of the C190, and the case law in this field. The research demonstrates that certain BRICS nations, such as South Africa, have implemented a legal framework to address and prevent harassment, having ratified C190. In Brazil, violence and harassment in the workplace are not regulated by a special law; instead, the country’s norms are rather fragmented and tend to protect mostly women, in particular against sexual harassment. On the other hand, countries such as China and India, despite their focus on prohibiting sexual harassment against women, often overlook the aspect of moral harassment. Russia tends to neglect both issues, altogether disregarding the inclusion of specific norms in the labor law.

Teaching Computer Science concepts, such as graph theory, is often challenging. This study proposes an approach for teaching graph theory using an unplugged game (GraphGame) developed through a participatory design process that includes usage observation, clarifying meaning, prototyping, and implementation. This process was carried out with a group of Brazilian middle school students and involved collecting observations, interviews, ideation activities, and iterative prototyping with quantitative and qualitative tests. The game offers an interactive way to explore graph algorithms, improving abstraction capacity, a skill related to Computational Thinking. The effectiveness of the game in facilitating the learning of fundamental graphs concepts among high school students was evaluated with an independent sample of students. The results pointed out the proposal as a promising alternative for teaching graph theory, a complex computing topic, in an engaging way. By enhancing playful learning, this work offers an alternative to make teaching Computer Science more enjoyable and effective.

This chapter explores the issue of statelessness through the lens of Hannah Arendt’s political theories, mainly focusing on her concept of the “right to have rights”. By linking Arendt’s critique to the CSR practices of MNEs, the chapter highlights the potential of these entities to mitigate some of the adverse effects of statelessness. Through a critical analysis of Arendt’s work and its relevance to today’s globalised world, the chapter advocates for rethinking human rights frameworks and the role of corporate entities in promoting social justice and equity.

As freshwater resources become increasingly scarce, safe drinking water is critical to public health. However, emergent pollutants and pathogenic microorganisms threaten this goal, posing direct and indirect water quality risks. Photocatalysis offers a promising alternative disinfection strategy, overcoming many limitations of conventional methods by generating reactive oxygen species (ROS) capable of effectively deactivating microbial contaminants through targeted redox reactions. This review explores the photocatalytic disinfection process, detailing microbial inactivation mechanisms, and provides a comparative analysis of commonly used photocatalysts and their composites. Sources of microbial contamination, including bacteria, viruses, algae, fungi, and protozoa, are discussed to contextualize the challenges faced in water treatment. Key operational parameters influencing photocatalytic efficiency and an overview of practical bioreactor types optimized for varied disinfection needs are also addressed. This comprehensive review highlights the advancements and potential of photocatalytic bioreactors in safeguarding water quality and expanding accessible, efficient, and eco-friendly disinfection technologies.