Abstract We investigated the Biogran on bone repair and metabolism at several time-intervals upon grafting into rat tibia artificial defects. The biomaterial was thoroughly characterized in vitro, and its dissolution behavior upon immersion was assessed in simulated body fluid (SBF) solution for 1, 3, 7, 14, and 30 days. Biogran was also assessed by in vitro hydroxyapatite formation in SBF solution, which is a marker for bioactive behavior. In vivo, distal and proximal bone defects were performed in the Wistar rat's right tibia and filled according to the experimental groups: I) negative control, no filling; II) positive control, 10 mg of autogenous bone; and III) 10 mg of Biogran. Animals were euthanized at 1, 2, 3, 4, 7, and 10 weeks. Bone neoformation was analyzed using histomorphometry (proximal defect), and local levels of bone morphogenetic protein 2 (BMP-2) were measured using the ELISA assay (distal defect). In vitro, the Biogran sample showed a fast dissolution rate within the first 7 days, parallel to the formation of the hydroxyapatite layer. In vivo, the sample was progressively resorbed at a higher rate within the first month until it became almost absent at week 10th. The sample presented similar or higher bone neoformation concerning the autogenous bone. BMP-2 levels were sustained in the Biogran group (around 200 pg/mg) and detected until the last experimental time with a significant difference compared with the controls. Results suggest Biogran is a candidate for hard tissue engineering even in highly active bone remodeling sites.

ABSTRACT: Protocols to artificially induce cows and heifers into lactation are effective and commercially available in Brazil. However, these protocols demand long hormonal treatments, which is debatable since little research has been done in the subject. To further understand artificial induction to lactation (AIL) protocols, we conducted two experiments. In experiment 1, our objective was to better characterize steroidal profile during an AIL protocol and assess the estradiol (E2) and progesterone (P4) serum profiles of Jersey cows (n=6) subjected to a conventional protocol. In experiment 2, we aimed to compare milk production and serum E2 concentrations of Holstein heifers induced into lactation by the standard AIL protocol (15 injections of E2 and 8 P4 injections) and by a short protocol in which the number of E2 injections and, consequently, the overall dosage of E2, were reduced (8 injections of E2 and 8 P4 injections). We hypothesized that a short AIL protocol (8 days) would be as efficient as the long standard protocol of 15 days. Our hypothesis was confirmed, since we demonstrated that a shorter protocol was able to induce lactation in Holstein heifers without hindering milk production.

RESUMO: Protocolos que induzem à lactação artificial em vacas e novilhas são eficazes e estão comercialmente disponíveis no Brasil. No entanto, esses protocolos demandam longos tratamentos hormonais, o que é discutível visto que poucas pesquisas foram feitas sobre o assunto. Para entender melhor os protocolos de indução artificial à lactação (IAL), realizamos dois experimentos. Foi testada a hipótese de que um protocolo curto (oito dias) de IAL é tão eficiente quanto o protocolo padrão de 15 dias. No experimento 1 objetivou-se caracterizar o perfil esteroidal durante um protocolo de IAL e avaliou-se os perfis séricos de estradiol (E2) e progesterona (P4) de vacas Jersey (n=6) submetidas a um protocolo convencional. No experimento 2 foram comparadas a produção de leite e as concentrações séricas de E2 de novilhas holandesas induzidas à lactação pelo protocolo padrão de IAL (15 injeções de E2 e 8 injeções de P4) e por um protocolo curto, no qual o número de injeções de E2 e, consequentemente, a dosagem geral de E2 foram reduzidas (oito injeções de E2 e oito injeções de P4). A hipótese foi confirmada, demonstrado que um protocolo mais curto induziu a lactação em novilhas holandesas sem prejudicar a produção de leite.

Fresh coconut (Cocos nucifera) water, a popular beverage in tropical countries, is often exposed to pesticide contamination due to agricultural practices. Thus, this work proposed the simultaneous determination of 36 pesticides in fresh coconut water samples using liquid-liquid extraction, drying assisted by a household microwave oven, and gas chromatography-mass spectrometry (GC-MS) analysis. Limits of detection varied from 5.4 (disulfoton) to 9.6 ng L-1 (parathion-methyl). Nine pesticide residues were detected (dimethoate, γ-HCH, β-HCH, 4,4’-dichlorodiphenyldichloroethylene, endosulfan II, 4,4’-dichlorodiphenyldichloroethane, 4,4’-dichlorodiphenyltrichloroethane, endrin ketone, and methoxychlor) with concentrations from < limit of quantification to 5,768.34 ± 1.64 ng L-1. Dimethoate was quantified in all samples, indicating its recent use. The proposed methodology offers several advantages, including the use of small sample volumes and solvent extraction, which eliminates the need for costly cartridges and reduces waste production. Additionally, the obtained results can be valuable for regulatory agencies, aiding in the mitigation of environmental damage and the protection of human health.

ABSTRACT Objectives: This review discusses deep infiltrating endometriosis (DIE) diagnosis and surgery using current urological knowledge and technologies. Materials and Methods: Narrative review of deep infiltrating endometriosis that result in urological issues. We examined manuscripts from Pubmed, Embase, and Scielo’s database using the following MeSH terms: (‘endometriosis’) AND (‘urology’ OR ‘urological’ OR ‘urologist’) AND (‘bladder’ OR’vesical’) AND (‘ureteral’ OR ‘ureter’). Selection followed PRISMA guidelines. Sample images from our records were brought to endorse the findings. Results: Thirty four related articles were chosen from 105. DIE may affect the urinary system in 52.6% of patients. Lower urinary tract symptoms may require urodynamic examination. Ultrasonography offers strong statistical yields for detecting urinary tract lesions or distortions, but magnetic resonance will confirm the diagnosis. Cystoscopy can detect active lesions, although any macroscopic visual appeal is pathognomonic. Endourology is utilized intraoperatively for bladder and ureteral assessment, however transurethral endoscopic excision of bladder lesions had higher recurrence rates. Laparoscopy is the route of choice for treatment; partial cystectomy, and bladder shaving were the most prevalent surgical treatments for bladder endometriosis. Regarding the ureteral treatment, the simple ureterolysis and complex reconstructive techniques were described in most papers. Using anatomical landmarks or neuronavigation, pelvic surgical systematization allows intraoperative neural structure identification. Conclusions: DIE in the urinary system is common, however the number of publications with high level of evidence is limited. The initial tools for diagnosis are ultrasonography and cystoscopy, but magnetic resonance is the most reliable tool. When the patient has voiding symptoms, the urodynamic examination is crucial. Laparoscopy improves lesion detection and anatomical understanding. This approach must be carried out by professionals with high expertise, since the surgery goes beyond the resection of lesions and includes the preservation of nerve structures and urinary tract reconstruction techniques.

Abstract Background The distinction between sensory neuronopathies (SN), which is by definition purely sensory, and sensory polyneuropathies (SP) and sensory multineuropathies (SM) is important for etiologic investigation and prognosis estimation. However, this task is often challenging in clinical practice. We hypothesize that F-wave assessment might be helpful, since it is able to detect subtle signs of motor involvement, which are found in SP and SM, but not in SN. Objective The aim of the present study was to determine whether F-waves are useful to distinguish SN from SP and SM. Methods We selected 21 patients with SP (12 diabetes mellitus, 4 transthyretin familial amyloid polyneuropathy, 4 others), 22 with SM (22 leprosy), and 26 with SN (13 immune-mediated, 10 idiopathic, 3 others) according to clinical-electrophysiological-etiological criteria. For every subject, we collected data on height and performed 20 supramaximal distal stimuli in median, ulnar, peroneal, and tibial nerves, bilaterally, to record F-waves. Latencies (minimum and mean) and persistences were compared across groups using the Kruskal-Wallis and Bonferroni tests. P-values < 0.05 were considered significant. Results All groups were age, gender, and height-matched. Overall, there were no significant between-group differences regarding F-wave latencies. In contrast, F-wave persistence was able to stratify the groups. Peroneal F-wave persistence was higher, bilaterally, in the SN group compared to SM and SP (p < 0.05). In addition, F-waves persistence of the ulnar and tibial nerves was also helpful to separate SN from SP (p < 0.05). Conclusion F-wave persistence of the peroneal nerves might be an additional and useful diagnostic tool to differentiate peripheral sensory syndromes.

Resumo Antecedentes A distinção entre neuronopatias sensitivas (SN) e polineuropatias sensitivas (SP) e multineuropatias sensitivas (SM) é importante para a investigação etiológica e para o prognóstico. Contudo, esta tarefa é desafiadora na prática clínica. Hipotetizou-se que a avaliação das ondas-F pode ser útil, por ser capaz de detectar envolvimento motor nas SP e SM, mas não nas SN. Objetivo Determinar se as ondas-F podem ajudar a distinguir entre SN, SP e SM. Métodos Selecionou-se 21 pacientes com SP (12 diabetes mellitus, 4 ATTR-FAP e 4 com outras neuropatias), 22 com SM (22 hanseníases) e 26 com SN (13 imunomediadas, 10 idiopáticas e 3 com outras neuronopatias), de acordo com critérios clínicos, etiológicos e eletrofisiológicos. Para cada indivíduo, foi aferida a altura e foram aplicados 20 estímulos distais supramáximos nos nervos mediano, ulnar, fibular e tibial, bilateralmente, para registrar as ondas-F. Uma comparação foi feita, por grupo, das latências (mínimas e médias) e persistências pelos testes Kruskal-Wallis e Bonferroni. Valores de p < 0.05 foram considerados estatisticamente significativos. Resultados Todos os grupos foram pareados por idade, sexo e altura. Não houve diferença estatística significativa entre os grupos quanto às latências das ondas-F. A persistência da onda-F foi capaz de estratificar os grupos, sendo as dos nervos fibulares bilateralmente maiores no grupo SN que nos grupos SM e SP (p < 0.05). Adicionalmente, a persistência das ondas-F dos nervos ulnares e tibiais também foi útil para distinguir SN de SP (p < 0.05). Conclusão A persistência das ondas-F dos nervos fibulares pode ser uma ferramenta adicional e útil para diferenciar síndromes sensitivas periféricas.

Resumo Antecedentes A percussão é uma parte importante do exame neurológico e os martelos de reflexo são necessários para obtê-la adequadamente. Objetivo Nós visamos revisar os aspectos históricos dos principais martelos de reflexo neurológico e definir qual é o preferido dos neurologistas brasileiros. Métodos Procuramos artigos originais e artigos de revisão sobre os aspectos históricos dos martelos de reflexo na Scielo e no Pubmed, e conduzimos um questionário online para investigar qual é o preferido dos neurologistas brasileiros. Resultados Na primeira parte, descrevemos os principais marcos na criação dos martelos de reflexo. Na sequência, expomos os resultados do questionário online: Babinski-Rabiner foi o martelo mais votado. Conclusões A origem dos martelos de reflexos vem muito antes de sua criação, a partir de um método de exame clínico básico: a percussão. Desde a descrição dos reflexos tendinosos profundos e da criação de martelos de percussão, muito se aperfeiçoou sobre essa técnica. Dentre todos os martelos pesquisados, o de Babinski-Rabiner foi o escolhido por uma parcela significativa dos neurologistas brasileiros. obtêla obtê la adequadamente brasileiros Pubmed sequência BabinskiRabiner Babinski Rabiner votado básico técnica pesquisados

Abstract Background Percussion is an important part of the neurological examination and reflex hammers are necessary to obtain it properly. Objective We aimed to review the historical aspects of the main reflex hammers and to define the favorite one of Brazilian neurologists. Methods We searched original and review articles about historical aspects of the reflex hammers in Scielo and Pubmed and conducted an online survey to investigate the favorite reflex hammer of Brazilian neurologists. Results In the first part, we describe the major milestones in the creation of the reflex hammers. Following, we exhibit the results of the online survey: Babinski-Rabiner was the most voted. Conclusions The origins of the reflex hammers goes back long before their creation, from a basic clinical examination method: percussion. Since the description of deep tendon reflexes and the creation of percussion hammers, much has been improved in this technique. Among all the hammers surveyed, the Babinski-Rabiner was the chosen one by a significant portion of Brazilian neurologists. properly neurologists Following BabinskiRabiner Babinski Rabiner voted method technique surveyed

Resumen Introducción: la ingesta elevada de sodio es un factor de riesgo para enfermedades como la hipertensión arterial sistémica, el accidente cerebrovascular, la hipertrofia ventricular izquierda y la enfermedad renal crónica (ERC). Objetivo: evaluar la correlación entre la ingesta estimada de sodio y la excreción urinaria de 24 horas en pacientes con ERC sin diálisis. Métodos: estudio transversal con 151 individuos. Se evaluaron datos demográficos, socioeconómicos, clínicos y de estilo de vida. El sodio se cuantificó en orina de 24 horas y se estimó en Food Recall (R24h) de 24 horas. Para evaluar la asociación entre variables demográficas, antropométricas, nutricionales y de laboratorio con la excreción de sodio en orina de 24 horas, se utilizó el análisis de varianza (ANOVA) o la prueba de Kruskal-Wallis. La correlación entre la excreción urinaria de sodio de 24 horas y la ingesta de sodio en la dieta se realizó mediante el coeficiente de correlación de Spearman. Resultados: la edad media fue de 60,8 ± 11,8 años, el 51,7 % eran mujeres. Los pacientes hipertensos eran el 88,9 %; los diabéticos, el 45,0 %, y el 39,1 % se encontraban en estadio 3B de ERC. La mediana de excreción de sodio en orina de 24 horas fue de 112,2 mmol/L y la ingesta de R24h fue de 833,8 mg/día. Los individuos pertenecientes al tercil más alto de excreción de sodio (T3) presentaron valores de PTH más bajos y aquellos con niveles más bajos de tercil (T1), mayores niveles séricos de HDL-c (p < 0,05). No hubo correlación estadística entre la ingesta de sodio en la dieta y la excreción de orina durante 24 horas (valor p = 0,241). Conclusión: la ausencia de correlación entre el sodio obtenido por excreción urinaria de 24 horas y la ingesta dietética demuestra la fragilidad de la estimación de la excreción de sodio a través de la encuesta dietética.

Abstract Introduction: high sodium intake is a risk factor for diseases such as systemic arterial hypertension, stroke, left ventricular hypertrophy, and chronic kidney disease (CKD). Objective: to evaluate the correlation between estimated sodium intake by dietary intake and 24-hour urinary excretion in patients with non-dialysis CKD. Material and methods: a cross-sectional study with 151 individuals. Demographic, socioeconomic, clinical and lifestyle data were evaluated. Sodium was dosed in 24-hour urine and estimated by 24-hour Food Recall (R24h). To evaluate the association between demographic, anthropometric, nutritional and laboratory variables with sodium excretion in 24-hour urine, variance analysis (ANOVA) or Kruskal-Wallis test were used. The correlation between 24-hour urinary sodium excretion and dietary sodium intake was performed by Spearman's correlation coefficient. Results: mean age was 60.8 ± 11.8 years, 51.7 % were women. Hypertensive patients, 88.9 %; diabetics, 45.0 %; and 39.1 % were in stage 3B of CKD. Median sodium excretion in 24-hour urine was 112.2 mmol/L and R24h intake was 833.8 mg/day. Individuals belonging to the highest tertile of sodium excretion (T3) presented lower PTH values, and those with lower tertile (T1), higher serum HDL-c levels (p < 0.05). There was no statistical correlation between dietary sodium intake and 24-hour urine excretion (p-value = 0.241). Conclusion: the non-correlation between sodium obtained by 24-hour urinary excretion and dietary intake demonstrates the fragility of the estimation of sodium excretion through the dietary survey.

RESUMO O uso da irrigação desempenha papel fundamental no avanço das fronteiras agrícolas e no aumento da produtividade nas áreas de cultivo, principalmente em ambientes semiáridos que apresentam alta variação espaço-temporal de chuvas. Essa prática é sugerida até mesmo para cultivos adaptados como palma forrageira (Opuntia sp.) e sorgo (Sorghum bicolor). Assim, objetivou-se avaliar a rentabilidade do uso da irrigação no sistema solteiro e sistema consorciado palma-sorgo no semiárido. O delineamento experimental foi em blocos casualizados em esquema fatorial 5 × 3: cinco lâminas de irrigação por gotejamento (0, 25, 50, 75 e 100% da evapotranspiração de referência - ET0) e três sistemas de cultivo (palma forrageira solteira, sorgo solteiro e consórcio palma-sorgo), com quatro repetições. O tratamento 0% ET0 correspondeu à condição de sequeiro com uma lâmina de 355 mm. Foi conduzido um ciclo de palma e dois de sorgo (planta e rebrota) compreendidos de novembro 2014 a novembro de 2015. Verificou-se que os maiores custos para implantação dos sistemas de cultivo em condições irrigadas se devem à aquisição do sistema de irrigação e insumos, representando 85,3% do custo operacional efetivo. O sistema sorgo solteiro e o sistema palma forrageira-sorgo proporcionaram as maiores produtividades de matéria fresca (62.013,05 e 60.075,36 kg ha-1), respectivamente. Com base em indicadores econômicos, a adoção de lâminas de irrigação (25, 50, 75 e 100% ET0) promoveu lucros para os sistemas (solteiro e consorciado) a partir do segundo ano de implantação.

ABSTRACT Irrigation plays a fundamental role in advancing agricultural frontiers and increasing crop productivity, especially in semi-arid environments, because they exhibit high spatiotemporal rainfall variation. This practice is suggested even for adapted crops, such as forage cactus (Opuntia sp.), sorghum (Sorghum bicolor), and single or intercropping systems. In this study, aimed to evaluate the profitability of using irrigation in a single and intercropping forage cactus-sorghum system in a semi-arid region. The experimental design was in randomized blocks in a 5 × 3 factorial arrangement: five drip irrigation depths (0, 25, 50, 75, and 100% of the reference evapotranspiration - ET0) and three cropping systems (single forage cactus, single sorghum, and intercropping forage cactus-sorghum), with four replicates. The 0% ET0 treatment corresponded to rainfed conditions at a depth of 355 mm. A cycle of forage cactus and two sorghum cultivars (plant and regrowth) was conducted between November 2014 and November 2015. It was verified that the highest costs for implantation of the crop systems in irrigated conditions are due to the acquisition of irrigation and input systems, representing 85.3% of the effective operational cost. The single sorghum and forage cactus-sorghum systems provided the highest fresh matter productivity (62,013.05 and 60,075.36 kg ha-1, respectively). Based on economic indicators, the adoption of irrigation depths (25, 50, 75, and 100% ET0) promoted profits for the systems (single and intercropping) from the second year of implementation.

Abstract Objective: To assess the predictive value of selected growth phenotypes for neonatal morbidity and mortality in preterm infants < 30 weeks and to compare them with INTERGROWTH-21st (IG21). Methods: Retrospective analysis of data from the Brazilian Neonatal Research Network (BNRN) database for very low birth weight (VLBW) at 20 public tertiary-care university hospitals. Outcome: the composite neonatal morbidity and mortality (CNMM) consisted of in-hospital death, oxygen use at 36 weeks, intraventricular hemorrhage grade 3 or 4, and Bell stage 2 or 3 necrotizing enterocolitis. Selected growth phenotypes: small-for-gestational-age (SGA) defined as being < 3rd (SGA3) or 10th (SGA10) percentiles of BW, and large-for-gestational-age (LGA) as being > 97th percentile of BW. Stunting as being < 3rd percentile of the length and wasting as being < 3rd percentile of BMI. Single and multiple log-binomial regression models were fitted to estimate the relative risks of CNMM, comparing them to IG21. Results: 4,072 infants were included. The adjusted relative risks of CNMM associated with selected growth phenotypes were (BNRN/IG21): 1.45 (0.92–2.31)/1.60 (1.27–2.02) for SGA; 0.90 (0.55–1.47)/1.05 (0.55–1.99) for LGA; 1.65 (1.08–2.51)/1.58 (1.28–1.96) for stunting; and 1.48 (1.02–2.17) for wasting. Agreement between the two references was variable. The growth phenotypes had good specificity (>95%) and positive predictive value (70-90%), with poor sensitivity and low negative predictive value. Conclusion: The BNRN phenotypes at birth differed markedly from the IG21 standard and showed poor accuracy in predicting adverse neonatal outcomes.

ABSTRACT Introduction: Congenital heart diseases (CHDs) constitute the most prevalent congenital pathology, and they are a consequence of structural and functional abnormalities during fetal development. The etiology of CHD involves the interaction of genetic and environmental factors. Fetal cardiac surgery aims at preventing natural pathways of CHD in utero, mitigating progression to more complex abnormalities. The goal of this review was to demonstrate the benefits and risks of fetal interventions in the two most prevalent CHDs, pulmonary stenosis and pulmonary atresia with an intact ventricular septum, but also critical aortic stenosis and hypoplastic left heart syndrome. Methods: Original and relevant articles were selected by meta-aggregation to perform a qualitative analysis of fetal cardiac interventions for pulmonary stenosis and critical aortic stenosis. The Joanna Briggs Institute’s Qualitative Assessment and Review Instrument (or JBI-QARI) was used for data quality appraisal. Results: Of 61 potential articles, 13 were selected, and nine were finally included. Discussion: The present review demonstrated that fetal cardiac surgery increases right ventricular growth and hemodynamic flow in pulmonary stenosis, whereas in critical aortic stenosis it enables growth of the left ventricle and increases left ventricular pressure. However, it has a high complication rate, along with considerable morbidity and mortality. Conclusion: The benefits of fetal cardiac surgery for pulmonary stenosis and critical aortic stenosis are well-described in the literature; however, there is a significant risk of complications which can be reduced by the surgeon’s technical expertise and well-structured hospital facilities.

Abstract Objective Gastroschisis (GS) is a congenital anomaly in the abdominal wall with the intestinal loops exiting laterally to the umbilicus. The contact of the loops with Amniotic Fluid (AF) causes an inflammatory process in the exposed part, leading to an extended hospital stay and an increased risk of morbidity due to alterations related to intestinal motility. The authors aimed to evaluate the time of exposure to the AF in the experimental GS and to search for potential biomarkers of intestinal inflammation by measuring microRNAs. Methods Rat fetuses were divided into three groups: a) CONTROL, b) GS reared on day 18 (GS = 18), and c) GS reared on day 19.5 (GS = 19) (term = 22 days). On day 21.5, the fetuses were removed for biometric parameters and biochemical analyses: 1) Biometrics: Body and Intestinal Weight (BW, IW), and intestinal-body weight ratio (IW/BW); 2) Descriptive histopathology and 3) miR-143 quantification by real-time Polymerase Chain Reaction (PCR). Results BW was higher in CONTROL than GS 18 and G19 (p < 0.05). IW, IW/BW, intestinal water, and mRNA-143 were higher in GS 18 and GS 19 than in CONTROL, and GS 18 was higher than GS 19 (p < 0.05). The average of the inflammation score from the intestinal wall with mucosal inflammation and intra-epithelial lymphocytes shows worst in GS 18 and GS 19 vs. CONTROL (p < 0.05). Conclusions The tissue expression of mRNA-143 and the morphological changes in the intestine of GS worsened according to the time of exposure to AF, which could be a possible marker of fetal intestinal damage.

Abstract A Penicillium sp. strain was isolated from corroded parts in the Coaracy Nunes hydroelectric power plant in Amapá State, Brazil. Morphological and molecular techniques identified this strain as Penicillium citreosulfuratum Biourge, whose 5.8S-ITS rDNA sequence grouped well in a phylogenetic tree with other Exilicaulis section species of the Penicillium genus. The obtained strain of P. citreosulfuratum ability to form biofilm on the surface of aluminum wires was confirmed by optical and scanning electron microscopy. In plates containing PDA or T&K media, the P. citreosulfuratum strain growth was inhibited around a paper disk containing a highly concentrated solution of copper, iron, or nickel. However, there was no inhibition halo around the paper disk containing aluminum and there was a faint halo around the paper disk containing zinc. This fungus was able to grow in a modified T&K liquid medium containing 50 mM of Al3+ and less efficiently in the same medium but containing 50 mM Zn2+. The essential oils of melaleuca, mint, thyme, and oregano at 100% inhibited the fungus growth. Oregano essential oil inhibited the P. citreosulfuratum strain growth in concentrations as low as 10%. In conclusion, the results show that the obtained strain of P. citreosulfurarum can form a biofilm on aluminum wires, it grows in the presence of a high concentrations of aluminum and zinc, and essential oils can control its growth.

Abstract Several factors influence the citation impact. This paper constructed paths from funding to citation impact on a country basis. Country data came from Incites® (2011-2020). The (2013 to 2018) UNESCO database was used to define investments in Research and Development (R&D). An overall analysis and analyses by clusters formed by investments in R&D were carried out. Countries that invest relatively less in R&D tend to have less investment by businesses and publish fewer documents. Some differences exist in this pattern. For example, countries in the lowest investment group show higher international collaboration and publications in Open Access Journals. This leads to a higher impact but below countries with the highest investments in R&D. The paths from funding to high impact differed by cluster. While international collaboration appeared in several clusters, the % of papers in Q1 (Top) journal quartile, based on citations, was in almost all clusters. More investments in R&D and open access publishing do not necessarily lead to high impact.

ABSTRACT Background: This study aimed to describe the kinetics of Leishmania parasite load determined using kinetoplast DNA (kDNA)-based quantitative polymerase chain reaction (qPCR) in visceral leishmaniasis (VL) patients. Methods: Parasite load in blood was assessed by qPCR at five time points, up to 12 months post-diagnosis. Sixteen patients were followed up. Results: A significant reduction in the parasite load was observed after treatment (P < 0.0001). One patient had an increased parasite load 3 months post-treatment and relapsed clinically at month six. Conclusions: We have described the use of kDNA-based qPCR in the post-treatment follow-up of VL cases.