Systematic review: the use of vaginal mold in current vaginoplasty surgeries - techniques and materials

This paper presents a study of the techniques and materials used in vaginoplasty surgeries performed around the world. It consists of a systematic review that covered the identification, selection and critique of primary studies of topics involving the use of vaginal molds in surgeries for different patients: women with Mayer-Rokitansky syndrome; and transgender patients who underwent sex reassignment surgery (CRS), that is, patients with gender dysphoria. The researches made in the chosen databases, after applying the criteria of inclusion and exclusion of articles, resulted in 19 publications, which represented the basis of the construction of this work. It also focuses on the description of the technologies, materials and methods used in the manufacture of vaginal molds used in surgery. In all studies, the molds have the function of maintaining the structure of the neovagina, thus avoiding vaginal stenosis, besides fixing the material used as a graft in the new cavity, covering it, favoring epithelization

Resistance exercise leading to failure versus not to failure : effects on cardiovascular control

Background: The aim of the present study was to evaluate the acute effects of resistance exercise (RE) leading to failure and RE that was not to failure on 24 h blood pressure (BP) and heart rate variability (HRV) in sedentary normotensive adult women. Methods: Ten women (33.2 ± 5.8 years; 159.3 ± 9.4 cm; 58.0 ±6.4 kg; body fat 28.4 ± 2.8%) randomly underwent three experimental sessions: control (40 minutes of seated rest), RE leading to failure with 3 sets of 10 repetitions maximum (10-RM), and RE not to failure at 60% of 10-RM with 3 sets of 10 repetitions. Immediately post session BP and HRV were measured for 24 h. Results: Ratings of perceived exertion and heart rate were higher during the 10-RM session when compared with 60% of 10-RM (6.4 ± 0.5 vs 3.5 ± 0.8 and 123.7 ± 13.9 vs 104.5 ± 7.3 bpm, respectively). The systolic, diastolic and mean BP decreased at 07:00 a.m. after the 10-RM session when compared with the control session (−9.0 ± 7.8 mmHg, -16.0 ± 12.9 mmHg and −14.3 ± 11.2 mmHg, respectively). The root mean square of the squared differences between R-R intervals decreased after both the 60% of 10-RM and 10-RM sessions compared with the control session. Conclusions: An acute RE session leading to failure induced a higher drop of BP upon awakening, while both RE sessions reduced cardiac parasympathetic modulation. RE may be an interesting training strategy to acutely decrease BP in adult women

Investigating the role of symptom valorisation in tuberculosis patient delay in urban areas in Portugal

URBANTB group: Patrícia Soares (Representative of the consortium), Mário Carreira, Sofia Pereira, Catarina Alves, Filipe Alves, Ana Rodrigues, Ana Moreira, Márcia Cardoso, Sandra Mota, Ana Gomes, Liliana Ferreira, Marta Lopes, Isabel Correia, Juan Rachadell, Maria Gameiro, Ângela Dias, Manuel Pereira, Jorge Gonçalves, Maria Gonçalves, Adriana Taveira, Celene Neves, Lucinda Silva, Maria Mendes, Maria Teixeira, Maria Pereira, Milena Piedade, Antónia Teixeira & Carlos Carvalho.Background: Diagnosis delay contributes to increased tuberculosis (TB) transmission and morbimortality. TB incidence has been decreasing in Portugal, but median patient delay (PD) has risen. Symptom valorisation may determine PD by influencing help-seeking behaviour. We aimed to analyse the association between symptom valorisation and PD, while characterising individuals who disregarded their symptoms. Methods: A cross-sectional study was conducted among TB patients in Lisbon and Oporto in 2019 - 2021. Subjects who delayed seeking care because they did not value their symptoms or thought these would go away on their own were considered to have disregarded their symptoms. PD was categorised using a 21-day cut-off, and a 30-day cut-off for sensitivity analysis. We estimated the effect of symptom valorisation on PD through a directed acyclic graph. Then, a multivariable regression analysis characterised patients that disregarded their symptoms, adjusting for relevant variables. We fitted Poisson regression models to estimate crude and adjusted prevalence ratios (PR). Results: The study included 75 patients. Median PD was 25 days (IQR 11.5-63.5), and 56.0% of participants had PD exceeding 21 days. Symptom disregard was reported by 38.7% of patients. Patients who did not value their symptoms had higher prevalence of PD exceeding 21 days compared to those who valued their symptoms [PR 1.59 (95% CI 1.05-2.42)]. The sensitivity analysis showed consistent point estimates but wider confidence intervals [PR 1.39 (95% CI 0.77-2.55)]. Being a smoker was a risk factor for symptom disregard [PR 2.35 (95% CI 1.14-4.82)], while living in Oporto [PR 0.35 (95% CI 0.16-0.75)] and having higher household incomes [PR 0.39 (95% CI 0.17-0.94)] were protective factors. Conclusions: These findings emphasise the importance of symptom valorisation in timely TB diagnosis. Patients who did not value their symptoms had longer PD, indicating a need for interventions to improve symptom recognition. Our findings also corroborate the importance of the socioeconomic determinants of health, highlighting tobacco as a risk factor both for TB and for PD.This work was supported by the Fundação para a Ciência e Tecnologia (FCT, Portugal) [Grant: PTDC/SAU-PUB/31346/2017]. The present publication was funded by Fundação para a Ciência e Tecnologia (FCT, Portugal) national support through Comprehensive Health Research Centre (CHRC) [UIDP/04923/2020].info:eu-repo/semantics/publishedVersio

Genomic history of coastal societies from eastern South America

Sambaqui (shellmound) societies are among the most intriguing archaeological phenomena in pre-colonial South America, extending from approximately 8,000 to 1,000 years before present (yr bp) across 3,000 km on the Atlantic coast. However, little is known about their connection to early Holocene hunter-gatherers, how this may have contributed to different historical pathways and the processes through which late Holocene ceramists came to rule the coast shortly before European contact. To contribute to our understanding of the population history of indigenous societies on the eastern coast of South America, we produced genome-wide data from 34 ancient individuals as early as 10,000 yr bp from four different regions in Brazil. Early Holocene hunter-gatherers were found to lack shared genetic drift among themselves and with later populations from eastern South America, suggesting that they derived from a common radiation and did not contribute substantially to later coastal groups. Our analyses show genetic heterogeneity among contemporaneous Sambaqui groups from the southeastern and southern Brazilian coast, contrary to the similarity expressed in the archaeological record. The complex history of intercultural contact between inland horticulturists and coastal populations becomes genetically evident during the final horizon of Sambaqui societies, from around 2,200 yr bp, corroborating evidence of cultural change

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

The coastal site Galheta IV: a zooarchaeological perspective

As pesquisas atuais sobre os sambaquis litorâneos no Brasil os consideram estruturas intencionalmente construídas a partir de unidades culturais complexas, de processo contínuo de sedentarização e adensamento demográfico, que se expandiram por toda a costa brasileira entre pelo menos sete mil e mil e quinhentos anos atrás. Após esse período de dominação sambaquieira em ecossistemas costeiros, ocorreu um processo de mudança na configuração dos sítios, marcado pela presença de cerâmica em camadas mais recentes dos sambaquis e pelo surgimento de novos assentamentos tardios. Tais transformações são interpretadas como o início do contato entre povos interioranos e as populações do litoral. Essa pesquisa de mestrado buscou aprofundar o conhecimento obtido a respeito do sítio cerâmico Galheta IV (datado entre 1256-1031 e 690-530 cal AP) durante o projeto Sambaquis e Paisagem, a partir de uma perspectiva zooarqueológica, e trazer novos dados que auxiliem na compreensão dos processos de descontinuidade da construção de sítios conchíferos no litoral sul catarinense. As análises contemplaram áreas intra-sítio na tentativa de compreender sua contextualização relacional e espacial. Os resultados identificaram vestígios zooarqueológicos atuando como acompanhamentos funerários. Uma concentração de vestígios de fauna em uma área específica do sítio arqueológico, associada à grande quantidade concreções, apontam para um alto processamento e consumo de vertebrados relacionados ao contexto funerário do sítio. A presença significativa de espécies marinhas de grande porte, como pinípedes, tubarões, e cetáceos, somados aos resultados de análises isotópicas previamente desenvolvidas, inaugura um panorama que difere dos demais estudos de fauna em sítios costeiros desenvolvidas até então, nos quais os peixes são fontes proteicas predominantes na dieta de populações pré ceramistas e ceramistas. Esses animais marinhos de elevado nível de cadeia trófica, somados aos peixes, aves e tartarugas marinhas, demonstram uma continuidade e intensificação das práticas pesqueiras desenvolvidas por grupos sambaquieiros, numa adaptação para a captura de recursos junto às áreas próximas ao costão rochoso e ao mar aberto.Current research on the coastal shellmounds (or sambaquis) in Brazil considers them structures intentionally constructed from complex cultural units, a continuous process of sedentarization and demographic densification, which have expanded throughout the Brazilian coast between at least seven thousand and fifteen hundred years ago. After this period of shellmounds domination in coastal ecosystems, a process of change in the configuration of the sites occurred, marked by the presence of pottery in more recent layers of the shellmounds and by the appearance of new late settlements. Such transformations are interpreted as the beginning of contact between the interior peoples and the coastal populations. This master\'s research sought to deepen the knowledge obtained about the Galheta IV ceramic site (dating from 1256-1031 and 690-530 cal BP) during the Sambaquis e Paisagem project, from a zooarchaeological perspective, and to bring new data that contribute to the understanding of the discontinuity processes of the construction of shellmounds sites in the south coast of Santa Catarina. Analyzes contemplated intra-site areas in an attempt to understand their relational and spatial contextualization. The results identified zooarchaeological vestiges acting as funerary accompaniments. A concentration of fauna remains in a specific area of the archaeological site, associated to a large number of concretions, point to a high processing and consumption of vertebrates related to the funerary context of the site. The significant presence of large marine species, such as pinnipeds, sharks, and cetaceans, added to the results of previously developed isotopic analyzes, inaugurates a panorama that differs from other studies of fauna in coastal sites developed until then, in which fish are protein sources predominant in the diet of pre-ceramic and ceramic populations. These marine animals of high trophic chain, in addition to fish, birds and sea turtles, demonstrate a continuity and intensification of the fishing practices developed by sambaquis people, in an adaptation for the capture of resources near the rocky coast and the open sea