Bisphenol A [2,2-bis(4hydroxyphenyl) propane, BPA], one of the endocrine disruptors, is of great concern due to its widespread use throughout the world. Several studies have shown that BPA has toxic effects when ingested, making contact with this substance a risk factor for the development of diseases in various organs, including the intestine and associated lymphoid tissue. Therefore, the objective of this work was to study the morphology of Peyer’s patches in young rats supplemented with selenium and exposed to BPA. The study was approved by the UFPI Animal Use Ethics Committee, with protocol number 583/19. 28 male Wistar rats ( Rattus novergicus albinus) were randomly divided into 4 groups: Control (CT), BPA, Se and BPA+Se. The pups were weaned on the 21st day and, from the 22nd postnatal day, the animals in the BPA group received daily doses of 5 mg/kg of BPA diluted in 0.3 ml of corn oil, administered orally. The Se group received 10 μg/kg of Se, the BPA+Se group received 5 mg/kg of BPA and 10 μg/kg of Se and the CT group did not receive any substance but was subjected to the oral gavage process. After 4 weeks of exposure, the puppies were anesthetized and euthanized for intestinal collection and subsequent histological, immunohistochemical and morphometric analysis. Our results showed that BPA caused damage to the epithelial layer of Peyer’s patches, there was a structural disarray in the architecture of the follicular region of the BPA and BPA+Se groups, zones of inflammation with the presence of vacuoles in the tissue. A reduction in Ki-67 expression in Peyer’s patches was also observed in the BPA group, as well as a significant reduction in the number of defense cells in the group. Animals exposed to BPA, but supplemented with Se, showed no damage to the epithelial layer and there was no reduction in Ki-67 expression. BPA, when ingested above the safe level, altered Peyer’s patches tissue, and reduced cell proliferation. Additionally, BPA reduced the immune cell population in Peyer’s patches. Se was able to reverse the observed damage, suggesting antioxidant potential.

Recent advances in computing power triggered the use of Artificial Intelligence in image analysis in life sciences. To train these algorithms, a large enough set of certified labelled data is required. The trained neural network is then capable of producing accurate instance segmentation results, that will then need to be re-assembled into the original dataset: the entire process requires substantial expertise and time to achieve quantifiable results. To speed-up the process, from cell organelle detection to quantification across modalities, we propose a deep learning based approach for Fast AutoMatic Outline Segmentation (FAMOUS), that involves organelle detection combined with image morphology, and 3D meshing to automatically segment, visualize and quantify cell organelles within volume electron microscopy datasets. From start to finish, FAMOUS provides full segmentation results within a week on previously unseen datasets. FAMOUS was showcased on a dataset acquired using a focused ion beam scanning electron microscope (FIBSEM), and on yeast cells acquired by transmission electron microscopy.

Aim: Inhibitors of dopamine-β-hydroxylase (DβH), such as zamicastat, emerged as promising drugs for pulmonary arterial hypertension (PAH). This study intended to validate the mechanism of action of zamicastat by studying its effect on the overdrive of sympathetic nervous system (SNS). Methods: This was a single-centre, prospective, double-blind, randomised, placebo-controlled, crossover study, with 400 mg zamicastat, in 22 healthy male subjects. Cold pressor test (CPT) was performed at screening and each treatment period at day 1 and day 10. The concentration of dopamine (DA), epinephrine (EPI), norepinephrine (NE) in plasma and 24h-urine, and DβH activity in plasma were measured. Results: For zamicastat compared to placebo, the difference between cold stimulus and rest phases on the change from baseline to day 10 of CPT showed an estimated decrease of -4.62 mmHg for systolic blood pressure (SBP; p=0.020). Zamicastat caused a decrease of -2.62 mmHg in mean arterial pressure (MAP) response to cold stimulus during CPT (p=0.025). At day 10, zamicastat elicited a statistically significant increase of 12.63 ng/L (p=0.040) and 19.22 ng/L (p=0.001) in plasma DA, before CPT and after CPT, and a significant estimated increase in plasma EPI change from baseline after CPT (p=0.040). Inhibition of plasma DβH activity ranged from 19.8% to 25.0%. At day 10, statistically significant reductions in 24-hour urinary excretion of EPI (p=0.002) and NE (p=0.001) were observed. Conclusions: Zamicastat decreased SBP and MAP response to cold stimulus during CPT, evidencing its effect on the overdrive sympathetic response to cold stimulus.

Adeeb Oweidat MD, DESAIC, EDRA

Treatment for childhood solid tumors may lead to an increased risk for gonadal dysfunction/infertility. Discussion of risk should occur at diagnosis, any changes in therapy, and during survivorship. Gonadotoxic therapies were abstracted from 32 Children’s Oncology Group (COG) phase III, frontline solid tumor protocols, in use from 2000-2022. Risk for gonadal dysfunction/infertility was assessed based on gonadotoxic therapies, sex, and pubertal status and assigned as minimal, significant, and high following the Oncofertility Consortium Pediatric Initiative Network (PIN) risk stratification. Most protocols (65.6%, 21/32) contained at least one therapeutic arm with a high level of increased risk. Solid tumor therapies present challenges in risk stratification due to response-adjusted therapy and the need to account for radiation field in the risk assessment. This guide hopes to serve as a tool to assist in standardizing gonadotoxic risk assessments across disciplines and improve referral for fertility services and reproductive health counseling for patients receiving COG based solid tumor therapy.

Background: The COVID‐19 pandemic have impacts on the prevalence of other [pathogen](javascript:;)s and people’s social lifestyle. This study aimed to compare the [pathogen](javascript:;), allergen and micronutrient characteristics of pediatric inpatients with pneumonia prior to and during the COVID-19 pandemic in a large tertiary hospital in Shanghai, China. Methods: Patients with pneumonia admitted to the Department of Pediatric Pulmonology of Xinhua Hospital between March-August 2019 and March-August 2020 were recruited. And clinical characteristics of the patients in 2019 were compared with those in 2020. Results: Hospitalizations for pneumonia decreased by 74% after the COVID-19 pandemic. For [pathogen](javascript:;)s, virus, mycoplasma pneumoniae (MP) and mixed infection rates were all much lower in 2020 than those in 2019 ( P < 0.01). Regarding allergens, compared with 2019, the positive rates of house dust mite, shrimp and crab were significantly higher in 2020 ( P < 0.01). And for micronutrients, the levels of vitamin B2, B6, C and 25-hydroxyvitamin D (25(OH)D) in 2020 were observed to be significantly lower than those in 2019 ( P < 0.05). For all the study participants, longer hospital stay (OR = 1.521, P = 0.000), milk allergy (OR = 6.552, P = 0.033) and [calcium](javascript:;) (Ca) insufficiency (OR = 12.048, P = 0.019) were identified as high-risk factors for severe pneumonia by multivariate analysis. Conclusions: The number of children hospitalized with pneumonia and incidence of common pathogen infections were both reduced, and that allergy and micronutrient status in children were also changed after the outbreak of the COVID-19 pandemic.

ChromaCard represents an automated apparatus designed for the authentication of access to a given location based on the coloration of an individual’s ID card tag. In contrast to conventional systems reliant upon ID card readers, which necessitate manual interaction to present the tag to the device, our innovative robotic solution excels in seamlessly detecting tag colours even when in motion. Employing a sophisticated camera equipped with object detection capabilities, the robotic entity rigorously scrutinizes the hues of the ID tag. Subsequently, it cross-references this data with a comprehensive repository of validated ID cards authorized for entry to the specified location at the given moment. The determination of an individual’s entitlement to access is thereby made, leading to one of two outcomes: should authorization be affirmed, the robotic system proceeds to assess the subsequent ID card; conversely, if access is denied, it promptly dispatches a notification to the student care administrator, who is near the facility.

Popcorn is a special kind of maize that can easily become popcorn flake when heated under a given condition. However, its popping mechanism remains unclear at present. Opaque2 (O2) was a central transcriptional factor that play important roles during maize endosperm development. In this study, an o2 introgression into N04 inbred line was constructed, and the mutation of o2 reduced the popping rate of N04. In order to reveal the underlying mechanism of O2 involved in popping characteristics, the o2 introgression and popcorn inbred line N04 were performed proteomic analysis at three development stage of their kernels using the 8-plex iTRAQ reagents with three repetitions followed by 2D-LC-MS/MS spectra. A total of 5184 proteins were found, and 1073 proteins of which showed dynamics change. KEGG enrichment analysis found that these dynamic changed proteins were significantly enriched in carbon metabolism, pyruvate metabolism, citrate cycle, fructose and mannose metabolism, starch and sucrose metabolism, and pentose phosphate pathway. A total of 16 differentially expressed protein regulated by O2 were identified. These results preliminary uncover the molecular mechanism of popping characteristics in popcorn.

A document by Richard Finlay Fletcher. Click on the document to view its contents.

Extreme hydroclimate events affect the thermal regimes of freshwater systems. In a four-year period spanning periods of flooding and severe drought in Southeastern South America (2019-2023), we monitored temperature variability in streams and floodplain lakes in an undammed tributary of the Lower Uruguay River, using Onset HOBO dataloggers and modeled daily streamflow (Q). We compare the performance of linear and nonlinear regression and generalized additive models (GAM) to evaluate how air temperature (T air) variability affects water temperature (T water) at daily, weekly and monthly time scales and under different Q percentile ranges. Mean daily temperatures ranged from 6.4ºC to 30.2ºC with daily maxima coinciding with record highs >40 ºC in T air and record low streamflow in summer months. Daily and weekly air-water relationships for rivers, streams and lakes were best fit by nonlinear sinusoidal models (Nash Sutcliffe Error - NSE ≥ 0.68). Extremely low-flow periods (<10% Q) showed a linear relationship to T air, while high-flow periods (>90%) showed a nonlinear sinusoidal air-water relationship. Moreover, high-flow events showed weaker T air-T water model perforamce than moderate to low flow periods. Preliminary comparisons between basin land-cover and T water suggest that forest cover favors lower T min. This study fills a geographical gap in thermal regime data in freshwater ecosystems in South America and suggests that extreme hydroclimate events have important implications for the thermal behavior of freshwater systems.

Intraspecific hybridization between distinct populations could increase fitness and adaptive potential of biological control agents that often have low genetic diversity and can be inbred due to long-term laboratory rearing often at small population sizes. Hybridization can also alter host preference and performance when the parental insect populations are adapted to different host plants. We investigated the effects of hybridization between two populations (Northern and Southern) of the psyllid, Aphalara itadori, that have different fitness on three invasive knotweed species (Japanese, giant, and Bohemian). Fecundity, host choice, and developmental success of second-generation reciprocal hybrids and the parental psyllid populations were compared on the three knotweed species in multiple choice tests. Hybridization did not increase fecundity. All three knotweed species were accepted for oviposition without preference by the Southern and the two hybrid psyllid populations. The northern psyllid population laid the most eggs on Bohemian knotweeds but those were maladaptive choices since almost all eggs failed to develop. Developmental success of the parental psyllid populations was highest on the knotweed species they were originally collected from, on Japanese knotweed of the Southern psyllids and on giant knotweed of the Northern psyllids. Hybrids had intermediate or higher survival on given knotweed hosts compared to their parents. These results can inform release tactics of A. itadori in different regions especially where there appears to be climatic and/or host mismatches such as in Michigan. In southern Michigan, based on climate the Northern psyllid population should be released. However, the most common knotweed species in the region are Bohemian and Japanese knotweeds that do not support development of the Northern psyllids. In this case, hybrids that may carry cold adaptations of the Northern psyllids but have better developmental success on the prevailing knotweed species may be considered for release to increase establishment success.

A document by Bellot Twig. Click on the document to view its contents.

The growing demand for global food production is likely to be a defining issue facing humanity over the next 50 years. In order to tackle this challenge, there is a desire to bioengineer crops with higher photosynthetic efficiencies, to increase yields. Recently, there has been a growing interest in engineering leaves with higher mesophyll conductance (gm), which would allow CO2 to move more efficiently from the substomatal cavities to the chloroplast stroma. However, if crop yield gains are to be realised through this approach, it is essential that the methodological limitations associated with estimating gm are fully appreciated. In this review, we summarise these limitations, and outline the uncertainties and assumptions that can affect the final estimation of gm. Furthermore, we critically assess the predicted quantitative effect that elevating gm will have on assimilation rates in crop species. We highlight the need for more theoretical modelling to determine whether altering gm is truly a viable route to improve crop performance. Finally, we offer suggestions to guide future research on gm, which will help mitigate the uncertainty inherently associated with estimating this parameter.

Low cholesterol levels are good markers for central hypothyroidism in case with dialysis using roxadustatSerina Kita1，Hiroshi Okuyama2，Takaya Kondo1，Mizuki Hayashi1，Shinichiro Nakao1，Toshitaka Sawamura2，Keiji Fujimoto1，Atsushi Nakagawa3，Hitoshi Yokoyama1，Kengo Furuichi1Department of Nephrology, Kanazawa Medical University1，Asanogawa General Hospital2，Department of Diabetology and endocrinology, Kanazawa Medical University3Corresponding author　Kengo FuruichiKanazawa Medical University　Department of Nephrology1-1 Daigaku, Uchinada, Kahoku, Ishikawa 920-0293, Japantel +81-76-286-2211 (ext 33401)fax +81-76-286-2786　 E-mail: furuichi@kanazawa-med.ac.jpKeywords： hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitors, low cholesterol levels, roxadustat, central hypothyroidismPatient consent statement: Written informed consent was obtained from the patient to publish this report in accordance with the journal’spatient consent policy.

A Rare Case Report of Marjolin Ulcer of the Lower Limb Managed with AmputationDr Suraj KC1*, Dr Rakesh Kumar Gupta1, Dr Abhijeet Kumar1, Dr Bhawani Khanal1, Dr Samiksha Lamichhane2 ,Dr Sanjok Bartaulla1 , Dr Raghav jindal1, Dr Injmamul Haque Raki1* Corresponding Author: Dr Suraj KCDepartment of General Surgery, BPKIHS, Dharankcsuraj1122@gmail.comDr Rakesh Kumar Gupta:Department of General Surgery, BPKIHS, Dharanrakesh154@yahoo.co.inDr Abhijet Kumar:Department of General Surgery, BPKIHS, Dharanabhijeetkr639@gmail.comDr Bhawani Khanal:Department of General Surgery, BPKIHS, Dharanitsmebhawanikhanal@gmail.comDr Samiksha Lamichhane:Department of Radiodiagnosis and imaging, BPKIHS, Dharanslamichhane215@gmail.comDr. Rahul Shrestha:Department of General Surgery, BPKIHS, DharanShrestharahul1522@gmail.comDr. Sanjok Bartaulla:Department of General Surgery, BPKIHS, Dharansanjok.bartaula.sb@gmail.comDr Injmamul Haque Raki:Department of General Surgery, BPKIHS, DharanInjmamulhaqueraki@gmail.comDr Raghav JindalDepartment of General Surgery, BPKIHS, Dharandrraghavjindal@gmail.comAbstract:Marjolin ulcers are known to develop on chronic wounds and ulcers. Biopsy is indicated for chronically suspicious ulcers with no signs of healing. Metastatic workup is necessary before considering any type of surgery. Amputation, as in our case, is indicated when wide local excision or Mohs surgery cannot be performed. Chemotherapy and radiotherapy are reserved for advanced disease and patients who are not fit for surgery. Introduction: Post-burn wounds or scars have the potential to become chronic and may progress into Marjolin ulcers. While rare, it is important to be vigilant with suspicious wounds that do not show signs of healing. We present a case of a 55-year-old woman who developed a non-healing ulcer on the back of her right foot, covering the Achilles tendon, which ultimately required below knee amputation.Case Report:A 55-year-old woman with a history of hypertension and a flame burn on her right foot two years ago presented to the General Surgery Outpatient Department with a non-healing ulcer and foul-smelling discharge. The ulcer had grown from the size of a coin to 5cm x 5cm, located on the posterior aspect of her right ankle. The ulcer was painless with minimal bleeding, and she had intact distal neurovascular function. She denied any respiratory symptoms, chest pain, cough, or similar ulcers elsewhere on her body. Physical examination and vitals were stable. Upon local examination there was 5 x 5cm ulcer over the lateral malleolus and mass on the posterior aspect of the right Achilles tendon ( figure 1). Routine tests were normal, and a biopsy revealed squamous cell carcinoma. Imaging showed no signs of metastasis. The patient underwent a right below knee amputation, and the postoperative period was uneventful (figure2). She was discharged on the 4th post-operative day. The margins were negative for squamous cell carcinoma. On a follow up, stump was healthy, and she was referred for a prosthesis and rehabilitation. Regular follow-ups were advised under the General Surgery Department.\sout

Nitrogen (N) and phosphorus (P) are important factors controlling biogeochemical cycling in terrestrial ecosystems and significantly affect the decomposition process of litter. However, N and P addition effects on litter decomposition, especially biological pathways in alpine grassland in northwest Sichuan, remain unclear. Therefore, this study explored the response mechanism of Salix cupularis litter decomposition and soil enzyme activity to different exogenous nitrogen and phosphorus additions and the inner relationship, combined with field in situ experiments and laboratory analysis methods. The results showed that: (1) In general, N, P and NP treatments significantly promoted the decomposition of litter, lignin and cellulose, and the addition of NP had a stronger effect in the same concentration level. P addition could alleviate the inhibitory effect of litter decomposition by high N concentration. (2) Litter C, N and P basically showed a sustained release pattern, and NP treatment had the strongest promoting effect. (3) Each treatment significantly increased the activities of soil invertase, cellulase, polyphenol oxidase, urease and phosphatase, and the NP treatment had the best effect. The rate of litter decomposition was significantly influenced by nutrient content as well as soil enzyme activity, where cellulose content and invertase activity may be a key factor controlling the rate of litter decomposition.

Type V Gastric Ulcer: An Unusual Etiology of Gastrosplenic Fistula Associated with Upper Gastrointestinal BleedingMuhammad Nadeem Yousaf MD1, Riyasha Dahal MBBS2, Subeena Phull MD3, Vinayak Aryal MD4, Karun Neupane MD5, Hamza Ertugrul MD6, Ebubekir Daglilar MD71Department of Medicine, Division of Gastroenterology and HepatologyUniversity of Missouri, Columbia, MO, United States2Department of Medicine, Universal College of Medical Sciences, Bhairahawa, Nepal3Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States4Department of Pathology and Laboratory Medicine, MetroHealth System, Case Western Reserve University, Cleveland, OH, United States5Department of Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, NY, United States6Department of Medicine, Saint Mary’s Hospital, Waterbury, CT, United States7Department of Medicine, Division of Gastroenterology and HepatologyCharleston Area Medical Center, Charleston, WV, United StatesKeywords: Gastric Ulcers, Gastrosplenic fistula, Gastrointestinal bleeding, NSAIDs, Embolization, Endoscopy.Consent statement: Written informed consent was obtained from the patient to publish this report in accordance with the journal’s patient consent policy.

Disseminated Bacillus Calmette-Guérin (BCG) infection presenting with fever and pancytopeniaMarina Henriques Mendes1, Andreia Pereira Branco1, Sofia Rodrigues Carvalho1, Marta Dalila Martins1, Ana Silva Rocha1, Sofia Garcês Soares1, Diana Pereira Anjos1Corresponding author email:marina_hmendes@hotmail.com1Centro Hospitalar Tâmega e Sousa

Saline-alkali land is an important component of terrestrial ecosystems and may serve as a carbon sink but its net contribution to the overall terrestrial carbon sink is unknown. Using methods recommended by the IPCC, this study evaluates the impacts of interconverting saline-alkali and non-saline-alkali land on terrestrial carbon stocks by measuring two major carbon pools (soil organic carbon and vegetation biocarbon) in the saline-alkali land of China’s Songnen Plain. Distinct phases in the evolution of the region’s terrestrial carbon stock were delineated, factors contributing to transitions between phases were identified, and effects of changes in the saline-alkali land carbon stock on the overall terrestrial carbon sink were estimated. Between 2005 and 2020, the region’s saline-alkali land carbon stock initially increased, then declined, and finally increased again. However, the overall terrestrial carbon stock decreased by 0.5 Tg (1 Tg=10 9 g), indicating that the increase in the saline-alkali land carbon stock was due primarily to expansion of the saline-alkali land area. The conversion of non-saline-alkali land to saline-alkali land was a carbon-emitting process; consequently, in areas undergoing saline-alkali land change, the lower carbon density bound was equal to the carbon density of unconverted saline-alkali land and the upper bound was equal to the carbon density of unconverted non-saline-alkali land. In general, changes in the carbon stock of saline-alkali land correlated negatively with changes in the overall terrestrial carbon stock. These findings may guide the development of policies for remediating and reclaiming saline-alkali land, especially those relating to land development and carbon sequestration.

Aging brain undergoes multiple structural and functional changes. These may contribute to an increased risk of neurodegenerative disease (NDD) and other age-related diseases, highlighting the importance of assessing deviations from healthy brain aging trajectory. In this human brain study, 50 healthy adults were investigated by functional near-infrared spectroscopy (fNIRS). A resting state single channel multiwavelength fNIRS was measured from the forehead in a supine position. The subjects were divided into four age groups. A machine learning approach was utilized for age group classification by using support vector machine and random forest learners with nested cross-validation. The results suggest brain aging effects being more distinct in the oldest age group and a difference in the brain aging for the subjects of the in-between groups. Our study shows high potential for the use of fNIRS in the analysis of brain aging.

Biologists increasingly rely on computer code to collect and analyze their data, reinforcing the importance of published code for transparency, reproducibility, training, and a basis for further work. Here we conduct a literature review examining temporal trends in code sharing in ecology and evolution publications since 2010, and test for an influence of code sharing on citation rate. We find that there is wide room for improvement in sharing code, as scientists are overwhelmingly (95%) failing to publish their code and that there has been no significant improvement over time. We also determined that there is a significant incentive to share, as we additionally find that code sharing can considerably improve citations, particularly when combined with open-access publication.

Composite nanoparticles with a gold core enveloped by cobalt ferrite nanoparticles show potential for enhanced photothermal therapy. Determining the optimal gold-to-cobalt ferrite nanoparticle ratio, dependent on size, is vital for improving treatment efficiency. We address the urgent need for advancing photothermal therapy through utilising combined plasmon-magnetic composites with potential of controlled directional delivery. Our computational modeling and experimental absorption spectra analysis reveal that adjusting the cobalt ferrite nanoparticle content redshifts the plasmon resonance frequency in gold nanoparticles, which is accompanied by increase in the extinction cross-section. As a result, cobalt ferrite nanoparticle absorption dominates. Our experiments on photothermal response in aqueous solutions of composite nanoparticles of various concentrations demonstrate that 100 μg/ml solution yields a significant temperature increase of ~8.2 K and a photothermal conversion efficiency of ~51%. At this concentration, the composite nanoparticles effectively heat the cell culture medium under photothermal conditions, leading to 22% reduction in cell viability.

Background: Pacemakers are an essential tool in managing bradyarrhythmias. Using the large Nationwide Inpatient Sample (NIS) database, we evaluated complications, trends and mortality rates of pacemakers over 2016 2020. Methods: We utilized International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding for our study. We evaluated clinical predictors, complications and mortality of pacemakers using the NIS database. Results: Significant independent Clinical predicators for pacer insertion are: NSTEMI: OR, 1.85; 95% CI, 1.80–1.91; p<0.001, hypertension: OR, 4.26; 95% CI, 4.19–4.34; p<0.001, hyperlipidemia: OR, 3.01; 95% CI, 2.97–3.05; p<0.001, atrial fibrillation/flutter: OR, 4.68 95% CI, 4.62–4.74; p<0.001, diabetes: OR, 1.49; 95% CI, 1.47–1.51; p<0.001, chronic kidney disease: OR, 1.99; 95% CI, 1.97–2.02; p<0.001, smoking: OR, 1.41; 95% CI, 1.31–1.43; p<0.001, COPD: OR, 1.11; 95% CI, 1.09–1.13; p<0.001, valvular heart disease: OR, 5.31; 95% CI, 5.21–5.41; p<0.001, systolic heart failure: OR, 1.98; 95% CI, 1.94–2.02; p<0.001, prior PCI: OR, 2.30; 95% CI, 2.26–2.34; p<0.001, obesity 1.19; 95% CI, 1.17–1.22; p<0.001), history of CABG{:OR, 2.48; 95% CI, 2.43–2.52; p<0.001, STEMI: OR, 1.86; 95% CI, 1.79–1.93; p<0.001, history of cardiomyopathy: OR, 1.90; 95% CI, 1.78–2.03; p<0.001, and endocarditis: OR, 1.77; 95% CI, 1.53–2.04; p<0.001. Pacemaker complication rates is around 2% Mortality around 1.44% Conclusion: We found many predictors for the need of pacemaker insertion. Mortality and complications have remained low over recent years.

Fluoxetine is a widespread antidepressant medication, with side effects, including xerostomia. In search of treatments to reduce discomfort, PBM is one of the alternatives that has proven to be effective. This article aims to demonstrate the clinical evolution of a female patient, L.R.O., 55 years old, who reported severe oral discomfort due to lack of saliva. The selected treatment was the Low Power Laser - EccoFibras with vascular photobiomodulation, in radial artery for 30 minutes, wavelength 660nm and power of 100mW, with 180J energy delivery. After the first treatment session, the patient reported improvement and satisfaction and, due to the unpredictability of psychiatric discharge, she tried to perform weekly applications. With each session, she reported a decrease in symptoms, which encouraged her attendance. With the prevention of xerostomia, the pacient achieved a clear increase in her quality of life, demonstrating that vascular photobiomodulation can be an interesting low-cost non-invasive treatment.