Carlos Eduardo

End-of-life delirium affects a vast majority of patients before death. It is highly distressing and often associated with restlessness or agitation. Unlike delirium in other settings, it is considered irreversible, and non-pharmacologic measures may be less feasible. The objective of this review is to provide an in-depth discussion of the clinical trials on delirium in the palliative care setting, with a particular focus on studies investigating pharmacologic interventions for end-of-life delirium. To date, only six randomized trials have examined pharmacologic options in palliative care populations, and only two have focused on end-of-life delirium. These studies suggest that neuroleptics and benzodiazepines may be beneficial for the control of the terminal restlessness or agitation associated with end-of-life delirium. However, existing studies have significant methodologic limitations. Further studies are needed to confirm these findings and examine novel therapeutic options to manage this distressing syndrome.

Graduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90010-150, Rio Grande do Sul, Brazil

Abstract The carbon capture and storage (CCS) process has become one of the main technologies used for mitigating greenhouse gas emissions.

In the pursuit of developing expressive music performance models using artificial intelligence, this paper introduces DExter, a new approach leveraging diffusion probabilistic models to render Western classical piano performances. The main challenge faced in performance rendering tasks is the continuous and sequential modeling of expressive timing and dynamics over time, which is critical for capturing the evolving nuances that characterize live musical performances. In this approach, performance parameters are represented in a continuous expression space, and a diffusion model is trained to predict these continuous parameters while being conditioned on a musical score. Furthermore, DExter also enables the generation of interpretations (expressive variations of a performance) guided by perceptually meaningful features by being jointly conditioned on score and perceptual-feature representations. Consequently, we find that our model is useful for learning expressive performance, generating perceptually steered performances, and transferring performance styles. We assess the model through quantitative and qualitative analyses, focusing on specific performance metrics regarding dimensions like asynchrony and articulation, as well as through listening tests that compare generated performances with different human interpretations. The results show that DExter is able to capture the time-varying correlation of the expressive parameters, and it compares well to existing rendering models in subjectively evaluated ratings. The perceptual-feature-conditioned generation and transferring capabilities of DExter are verified via a proxy model predicting perceptual characteristics of differently steered performances.

Technology Center, Federal University of Alagoas, Maceió 57072-900, Brazil

AQPs contribute to breast cancer progression and metastasis. We previously found that genetic inhibition of Aqp7 reduces primary tumor burden and metastasis in breast cancer. In this study, we utilized two AQP inhibitors, Auphen and Z433927330, to evaluate the efficacy of therapeutic inhibition of AQPs in breast cancer treatment. The inhibitors were evaluated in breast cancer for both cytotoxicity and metabolic stability assays across both murine and human breast cancer cell lines. Both AQP inhibitors also affected the expression of other AQP transcripts and proteins, which demonstrates compensatory regulation between AQP family members. As a single agent, Auphen treatment in vivo extended overall survival but did not impact primary or metastatic tumor burden. However, Auphen treatment made cells more responsive to chemotherapy (doxorubicin) or endocrine treatment (tamoxifen, fulvestrant). In fact, treatment with Tamoxifen reduced overall AQP7 protein expression. RNA-seq of breast cancer cells treated with Auphen identified mitochondrial metabolism genes as impacted by Auphen and may contribute to reducing mammary tumor progression, lung metastasis, and increased therapeutic efficacy of endocrine therapy in breast cancer. Interestingly, we found that Auphen and tamoxifen cooperate to reduce breast cancer cell viability, which suggests that Auphen treatment makes the cells more susceptible to Tamoxifen. Together, this study highlights AQPs as therapeutic vulnerabilities of breast cancer metastasis that are promising and should be exploited. However, the pharmacologic results suggest additional chemical refinements and optimization of AQP inhibition are needed to make these AQP inhibitors appropriate to use for therapeutic benefit in overcoming endocrine therapy resistance.

Food Research Laboratory, Technological Institute of Tepic, National Technological Institute of Mexico, Instituto Tecnológico Avenue No 2595, Lagos del Country, Tepic 63175, Nayarit, Mexico

Brazilian nuts are native to the Amazon rainforest and are considered a non-timber forest-product of extreme economic importance to local populations. This study evaluated the lipid profile, bioactive compounds, and oxidative stability of semi-defatted Brazilian nut flour oil (BNSDFO) obtained using pressurized fluids (n-propane at 40 °C and 2, 4, and 8 MPa or a CO2/n-propane mixture at 40 °C and 12 MPa). A Brazilian nut kernel oil (BNKO) processed by conventional cold pressing was also obtained. The BNKO showed a higher concentration of total phenolic compounds and saturated fatty acids, higher antioxidant activity, and the presence of gallic acid derivatives. The oils extracted using pressurized fluids showed a higher concentration of linoleic acid, β-sitosterol, and polyunsaturated fatty acids. The utilization of pressurized n-propane resulted in higher yields (13.7 wt%), and at intermediate pressures (4 MPa), the product showed myricetin 3-O-rhamnoside and higher oxidative stability (OSI, 12 h) than at lower pressures (2 MPa). The CO2/n-propane mixture of pressurized solvents resulted in higher concentrations of squalene (4.5 times), the presence of different phenolic compounds, and a high OSI (12 h) but lower yield (2.2 wt%). In conclusion, oils with better fatty acid profiles (oleic e linoleic acids), phytosterol composition, and suitable radical scavenging activity may be obtained using pressurized fluids and Brazilian nut flour, a byproduct of oil extraction. The mixture of solvents may improve the concentration of squalene, whereas using only n-propane may increase oil yield.

Department of Breeding and Animal Nutrition, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu 18618-681, Brazil

Unidad de Medicina Familiar No. 92, Instituto Mexicano del Seguro Social, Guadalajara 44990, Jalisco, Mexico