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To describe the first outbreak of Candida auris in Brazil, including epidemiological, clinical and microbiological data.

After the first Candida auris-colonised patient was diagnosed in a COVID-19 ICU at a hospital in Salvador, Brazil, a multidisciplinary team conducted a local C. auris prevalence investigation. Screening cultures for C. auris were collected from patients, healthcare workers and inanimate surfaces. Risk factors for C. auris colonisation were evaluated, and the fungemia episodes that occurred after the investigation were also analysed and described. Antifungal susceptibility of the C. auris isolates was determined, and they were genotyped with microsatellite analysis.

Among body swabs collected from 47 patients, eight (n=8/47, 17%) samples from the axillae were positive for C. learn more auris. Among samples collected from inanimate surfaces, digital thermometers had the highest rate of positive cultures (n=8/47, 17%). Antifungal susceptibility testing showed MICs of 0.5 to 1mg/L for AMB, 0.03 to 0dissemination of C. auris reinforcing the concept that these reusable devices should be carefully cleaned with an effective disinfectant or replaced by other temperature monitoring methods.

Occurrence of invasive fungal respiratory superinfections in patients with COVID-19 has gained increasing attention in the latest studies. Yet, description of acute invasive fungal sinusitis with its management in those patients is still scarce. This study aims to describe this recently increasing clinical entity in relation to COVID-19 patients.

Longitudinal prospective study.

Prospective longitudinal study included patients diagnosed with acute invasive fungal rhinosinusitis after a recent COVID-19 infection. Antifungal agents given included amphotericin B, voriconazole, and/or posaconazole. Surgical treatment was restricted to patients with PCR negative results for COVID-19. Endoscopic, open, and combined approaches were utilized to eradicate infection. Follow-up for survived patients was maintained regularly for the first postoperative month.

A total of 36 patients with a mean age of 52.92 ± 11.30 years old were included. Most common associated disease was diabetes mellitus (27.8%). Mycological analysis revealed infection with Mucor and Aspergillus species in 77.8% and 30.6% of patients, respectively. Sino-nasal, orbital, cerebral, and palatine involvement was found in 100%, 80.6%, 27.8%, and 33.3% of patients, respectively. The most common reported symptoms and signs are facial pain (75%), facial numbness (66.7%), ophthalmoplegia, and visual loss (63.9%). All patients were treated simultaneously by surgical debridement with antifungal medications except for two patients with PCR-positive swab for COVID-19. These two patients received antifungal therapy alone. Overall survival rate was 63.89% (23/36).

Clinical suspicion of acute invasive fungal sinusitis among COVID-19 patients and early management with antifungal therapy and surgical debridement is essential for better outcomes and higher survival.

IV Laryngoscope, 2021.

IV Laryngoscope, 2021.

This prospective study investigated the cross-sectional association between impaired oral health-related quality of life (OHRQoL) and the prevalence of depressive symptoms, and the longitudinal association between impaired OHRQoL and development of depressive symptoms among older adults.

Previous studies have shown a relationship between poor oral health and depression among older adults; however, findings are inconsistent.

Participants were 669 community-dwelling older Japanese individuals aged≥55years (mean 67.8±7.2years). Data of 296 participants were used for longitudinal analyses. OHRQoL was evaluated using the Oral Impacts on Daily Performances scale. Impaired OHRQoL was defined as the presence of at least one impact on the scale. Depressive symptoms were assessed using the Japanese version of the Zung self-rating depression scale with a cut-off score of 40.

The cross-sectional logistic regression model demonstrated that impaired OHRQoL was significantly associated with depressive symptoms (odds ratio [OR], 5.17; 95% confidence interval [CI], 2.99-8.95) independent of age, sex, body mass index, hypertension, cerebrovascular/cardiovascular disease, smoking, drinking alcohol, education, cognitive function, objective oral health (dentition status) and oral health behaviour (dental visit within 1year). Similarly, impaired OHRQoL predicted the development of depressive symptoms within 4years in a fully adjusted longitudinal model (OR, 6.00; 95% CI, 1.38-26.09).

Impaired OHRQoL was identified as a potential comorbidity of depressive symptoms and a predictor for depressive disorder later in life. OHRQoL may be a useful clinical outcome for elder patients with regard to their mental and oral health.

Impaired OHRQoL was identified as a potential comorbidity of depressive symptoms and a predictor for depressive disorder later in life. OHRQoL may be a useful clinical outcome for elder patients with regard to their mental and oral health.As a major carbon emitter, the electricity sector is crucial to the realization of China's emission reduction objectives. Existing studies focus mostly on the influencing factors, emission efficiency and low carbon development of carbon emissions in the electricity sector. Missing from the literature is an analysis of spatial characteristics of carbon emissions and the embodied carbon emission transfer caused by the separation of electricity production and consumption, which is the basis for assigning the responsibility for emission reduction. Thirty provinces in China were taken as research objects, and Moran's I index was adopted to analyze the spatial characteristics of the electricity sector's carbon emissions and carbon emission intensity. Based on multiregional input-output tables, we compared the transfer situation of China's provincial electricity carbon emissions in 2010 and 2015. The results demonstrate that, from 2010 to 2015, the electricity carbon emissions in 20 provinces increased, whereas the carbon emission intensity in 21 provinces decreased. Carbon emissions and carbon emission intensity of electricity in most provinces demonstrate positive spatial clustering characteristics. The total amount of carbon emission transfer in the electricity sector increased from 421.22 million tons in 2010 to 581.369 million tons in 2015, the number of net transfers out of areas increased from 13 to 15, and the number of net transfers into areas decreased from 16 to 15. The active degree of carbon emission transfer reveals the eastern region > the central region > the western region. Different emission reduction policies should be formulated based on the difference in resource endowment between the north and south. Provinces that transferred out large amounts of electricity carbon emissions should take greater responsibility for emission reduction. Integr Environ Assess Manag 2021;001-16. © 2021 SETAC.Aneuploidy is the leading cause of miscarriage and congenital birth defects, and a hallmark of cancer. Despite this strong association with human disease, the genetic causes of aneuploidy remain largely unknown. Through exome sequencing of patients with constitutional mosaic aneuploidy, we identified biallelic truncating mutations in CENATAC (CCDC84). We show that CENATAC is a novel component of the minor (U12-dependent) spliceosome that promotes splicing of a specific, rare minor intron subtype. This subtype is characterized by AT-AN splice sites and relatively high basal levels of intron retention. CENATAC depletion or expression of disease mutants resulted in excessive retention of AT-AN minor introns in ˜ 100 genes enriched for nucleocytoplasmic transport and cell cycle regulators, and caused chromosome segregation errors. Our findings reveal selectivity in minor intron splicing and suggest a link between minor spliceosome defects and constitutional aneuploidy in humans.

The association between the quantitative flow ratio (QFR) and adverse events after drug-coated balloon (DCB) angioplasty for in-stent restenosis (ISR) lesions has not been investigated.

Post-procedural QFR is related to adverse events in patients undergoing DCB angioplasty for ISR lesions.

This retrospective study included data from patients undergoing DCB angioplasty for drug-eluting stent (DES) ISR between January 2016 and February 2019. The QFR was measured at baseline and after DCB angioplasty. The endpoint was the vessel-oriented composite endpoint (VOCE), defined as a composite of cardiac death, vessel-related myocardial infarction, and ischemia-driven target vessel revascularization.

Overall, 177 patients with 185 DES-ISR lesions were included. link2 During 1-year follow-up, 27 VOCEs occurred in 26 patients. The area under curve (AUC) of the post-procedural QFR was statistically greater than that of the in-stent percent diameter stenosis (0.77, 95% confidence interval [CI] 0.67-0.87 vs. link3 0.64, 95% CI 0.53-0.75; p = .032). Final QFR cutoff of 0.94 has the best predictive accuracy for VOCE. A QFR > 0.94 was associated with a lower risk of VOCE compared to a QFR ≤ 0.94 (log-rank test, p < .0001). Survival analysis using the multivariable Cox model showed that a post-procedural QFR ≤ 0.94 was an independent predictor of 1-year VOCE (hazard ratio 6.53, 95% CI 2.70-15.8, p < .001).

A lower QFR value was associated with worse clinical outcomes at 1 year after DCB angioplasty for DES-ISR.

A lower QFR value was associated with worse clinical outcomes at 1 year after DCB angioplasty for DES-ISR.

Motivational interviewing (MI) is an evidence-based method of promoting oral healthcare behaviour. Conventional training of MI is a time-consuming and costly aspect in the dental curriculum. Therefore, the aim of this study was to evaluate the effectiveness and acceptance of a MI-blended learning programme for dental students.

Dental students had to perform an interdisciplinary created "ecourse Motivational Interviewing in medical settings" (eMI-med). After completion, patient-student interviews were recorded and evaluated using the Motivational Interviewing Treatment Integrity Code (MITI-d). Furthermore, the students' self-efficacy regarding smoking cessation and oral hygiene motivation was examined and the acceptance of the tool was enquired.

Forty interviews with 25 different students were analysed with the MITI-d. Students showed high levels of MI-adherent behaviour (15.45±6.98), open-ended questions (9.95±6.90) and reflections (10.43±8.85), which were comparable to previous classroom trainings. In addition, 90% of the students preferred e-learning over classroom teaching. Furthermore, the students' therapeutical self-efficacies were significantly increased by the programme.

Within the limitations of this study, the created e-learning programme was able to equip dental students with basic knowledge and MI skills. Furthermore, learning MI through e-learning may heighten the self-efficacy of dental students regarding smoking cessation and oral hygiene promotion. Students showed a high acceptance of e-learning, preferring it over traditional learning.

Within the limitations of this study, the created e-learning programme was able to equip dental students with basic knowledge and MI skills. Furthermore, learning MI through e-learning may heighten the self-efficacy of dental students regarding smoking cessation and oral hygiene promotion. Students showed a high acceptance of e-learning, preferring it over traditional learning.