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COVID-19 has affected more than half a billion people worldwide, with more than 6.3 million deaths, but the pathophysiological mechanisms involved in lethal cases and the host determinants that determine the different clinical outcomes are still unclear. In this study, we assessed lung autopsies of 47 COVID-19 patients and examined the inflammatory profiles, viral loads, and inflammasome activation. Additionally, we correlated these factors with the patient's clinical and histopathological conditions. Robust inflammasome activation was detected in the lungs of lethal cases of SARS-CoV-2. Experiments conducted on transgenic mice expressing hACE2 and infected with SARS-CoV-2 showed that Nlrp3-/- mice were protected from disease development and lethality compared to Nlrp3+/+ littermate mice, supporting the involvement of this inflammasome in disease exacerbation. An analysis of gene expression allowed for the classification of COVID-19 patients into two different clusters. Cluster 1 died with higher viral loads and exhibited a reduced inflammatory profile than Cluster 2. Illness time, mechanical ventilation time, pulmonary fibrosis, respiratory functions, histopathological status, thrombosis, viral loads, and inflammasome activation significantly differed between the two clusters. Our data demonstrated two distinct profiles in lethal cases of COVID-19, thus indicating that the balance of viral replication and inflammasome-mediated pulmonary inflammation led to different clinical outcomes. We provide important information to understand clinical variations in severe COVID-19, a process that is critical for decisions between immune-mediated or antiviral-mediated therapies for the treatment of critical cases of COVID-19.

Objetivo: verificar na produção científica quais as publicações existentes sobre a assistência de enfermagem não farmacológica à puérpera. Métodos: Trata-se de uma revisão integrativa, com coleta de dados no mês de outubro de 2021, nas bases de dados eletrônicos: LILACS, SciELO, Pubmed e BDENF. Como questão norteadora: Quais as publicações existentes sobre a assistência de enfermagem não farmacológica à puérpera? Empregaram-se os termos de busca combinados: ‘Cuidados de Enfermagem’, ‘Período Pós-Parto’, ‘Terapias Complementares’, ‘Enfermagem Obstétrica’ resultando em 29 artigos, sendo destes 11 elegíveis. Resultados: Os resultados expressam maioria dos estudos selecionados realizados em países asiáticos (54,55%) com destaque para Coréia do sul e Turquia, publicados em 2013 (18,50%) e os descritivos foram os mais prevalentes (36,4%). Duas categorias emergiram. I- Uso de terapias complementares na assistência de enfermagem puerperal; II- Avaliação do uso de terapias alternativas na assistência de enfermagem puerperal. Conclusões: Portanto, os achados deste estudo identificaram estudos sobre medidas e intervenções alternativas/complementares que se distanciam da assistência no modelo convencional, atuando de forma coadjuvante no âmbito da assistência de enfermagem no puerpério.

IntroductionDuring pneumoperitoneum (PNP), airway driving pressure (ΔPRS) increases due to the stiffness of the chest wall and cephalic shift of the diaphragm, which favors atelectasis. In addition, depending on the mechanical power (MP) formulas, they may lead to different interpretations.MethodsPatients >18 years of age with body mass index >35 kg/m2 were included in a single-center randomized controlled trial during their admission for bariatric surgery by abdominal laparoscopy. Intra-abdominal pressure was set at 15 mmHg at the pneumoperitoneum time point (PNP). After the recruitment maneuver, the lowest respiratory system elastance (ERS) was detected during the positive end-expiratory pressure (PEEP) step-wise decrement. Patients were randomized to the 1) CTRL group: ventilated with PEEP of 5 cmH2O and 2) PEEPIND group: ventilated with PEEP value associated with ERS that is 5% higher than its lowest level. Respiratory system mechanics and mean arterial pressure (MAP) were assessed at the PNP, 5 min after randomization (T1), and at the end of the ventilation protocol (T2); arterial blood gas was assessed at PNP and T2. ΔPRS was the primary outcome. Three MP formulas were used: MPA, which computes static PEEP × volume, elastic, and resistive components; MPB, which computes only the elastic component; and MPC, which computes static PEEP × volume, elastic, and resistive components without inspiratory holds.ResultsTwenty-eight patients were assessed for eligibility: eight were not included and 20 patients were randomized and allocated to CTRL and PEEPIND groups (n = 10/group). The PEEPIND ventilator strategy reduced ΔPRS when compared with the CTRL group (PEEPIND, 13 ± 2 cmH2O; CTRL, 22 ± 4 cmH2O; p < 0.001). Oxygenation improved in the PEEPIND group when compared with the CTRL group (p = 0.029), whereas MAP was comparable between the PEEPIND and CTRL groups. At the end of surgery, MPA and MPB were correlated in both the CTRL (rho = 0.71, p = 0.019) and PEEPIND (rho = 0.84, p = 0.020) groups but showed different bias (CTRL, −1.9 J/min; PEEPIND, +10.0 J/min). At the end of the surgery, MPA and MPC were correlated in both the CTRL (rho = 0.71, p = 0.019) and PEEPIND (rho = 0.84, p = 0.020) groups but showed different bias (CTRL, −1.9 J/min; PEEPIND, +10.0 J/min).ConclusionIndividualized PEEP was associated with a reduction in ΔPRS and an improvement in oxygenation with comparable MAP. The MP, which solely computes the elastic component, better reflected the improvement in ΔPRS observed in the individualized PEEP group.Clinical Trial Registration:The protocol was registered at the Brazilian Registry of Clinical Trials (U1111-1220-7296).

RESUMO Como produto das Reformas Psiquiátrica e Sanitária, surgiram os Centros de Atenção Psicossocial (Caps), dispositivos para pensar a reinserção de pacientes psiquiátricos na sociedade em 2001. A inserção do nutricionista nesse contexto ganhou espaço consonante a sua crescente atuação no Sistema Único de Saúde. Este artigo objetivou analisar os sentidos da cozinha em três Caps do Rio de Janeiro, a formação e a atuação dos nutricionistas. Optou-se pela modalidade de ensaio analítico, adotando como ponto de partida pressupostos teóricos da clínica ampliada, que entendem cuidado como uma experiência de troca entre sujeitos e responsabilização mútua, e do campo alimentar-nutricional como problema complexo. Nesse sentido, a discussão foi sistematizada em dois momentos: Entre panelas, tensões, saberes e sabores: a cozinha como espaço terapêutico; e Caps: desafios para formação e atuação do nutricionista. A análise toma a cozinha como espaço social e discute a permanência de uma atuação do nutricionista no cuidado em saúde mental moldada pelo modelo biomédico, construindo uma prática descontextualizada. Conclusivamente, o ensaio não buscou respostas ou afirmações verdadeiras, mas fez emergir a percepção de um problema que possibilita refletir sobre a prática dos nutricionistas nos Caps, contribuindo para a consolidação das propostas da Reforma Psiquiátrica brasileira.

COVID-19 is a disease of dysfunctional immune responses, but the mechanisms triggering immunopathogenesis are not established. The functional plasticity of macrophages allows this cell type to promote pathogen elimination and inflammation or suppress inflammation and promote tissue remodeling and injury repair. During an infection, the clearance of dead and dying cells, a process named efferocytosis, can modulate the interplay between these contrasting functions. Here, we show that engulfment of SARS-CoV-2-infected apoptotic cells exacerbates inflammatory cytokine production, inhibits the expression of efferocytic receptors, and impairs continual efferocytosis by macrophages. We also provide evidence supporting that lung monocytes and macrophages from severe COVID-19 patients have compromised efferocytic capacity. Our findings reveal that dysfunctional efferocytosis of SARS-CoV-2-infected cell corpses suppresses macrophage anti-inflammation and efficient tissue repair programs and provides mechanistic insights for the excessive production of pro-inflammatory cytokines and accumulation of tissue damage associated with COVID-19 immunopathogenesis.

Precision poultry farming is related to effective monitoring of production stages and product quality. This work evaluated the influence of temperature, air humidity, and luminosity variables on chicken egg production and quality (internal and external), under uncontrolled environment and natural lighting, using precision poultry techniques. One hundred and sixty birds of Embrapa 51 line, reared in cages, were assessed with 24, 30, 50, and 70 weeks of life. Values of temperature, relative humidity, luminosity, and the samples for productivity and egg quality determination were collected in predefined locations in a poultry house belonging to IFMS, Nova Andradina/MS Campus. Spatial maps were generated using the inverse distance weighted interpolation (IDW). Environmental variables show significant correlations with production and internal/external quality parameters of chicken egg raised in uncontrolled environments. The use of spatial maps for environmental characteristics of the poultry house, production, and internal/external chicken egg quality provides better visualization of the variations and correlations among the investigated variables, assisting the process of decision-making related to appropriate management and optimization of the poultry house.

Objective: to evaluate the knowledge and practice of women assisted in Basic Health Units in relation to the Pap smear. Method: this is a quantitative, descriptive study with a cross-sectional design. 320 women living in the area covered by three Basic Health Units in the city of Caxias-MA were interviewed. Results: although almost all of the women interviewed heard about the Pap smear exam 311 (97.2%), more than half of them had inadequate knowledge 233 (72.8%). It was also noticed that despite the fact that more than half were classified as having inadequate knowledge, most women had an adequate practice 187 (58.44%). Conclusion: thus, this study showed that there was no association between the level of knowledge and the practice of women. Therefore, there is a precarious knowledge of the majority of women about the cervical cancer preventive exam, resulting in an erroneous attribution about its purposes.

Background Previous data have reported that the growth of established tumors may be facilitated by postsepsis disorder through changes in the microenvironment and immune dysfunction. However, the influence of postsepsis disorder in initial carcinogenesis remains elusive.Methods In the present work, the effect of postsepsis on inflammation-induced early carcinogenesis was evaluated in an experimental model of colitis-associated colorectal cancer (CAC). We also analyzed the frequency and role of intestinal T regulatory cells (Treg) in CAC carcinogenesis.Results The colitis grade and the tumor development rate were evaluated postmortem or in vivo through serial colonoscopies. Sepsis-surviving mice (SSM) presented with a lower colonic DNA damage, polyp incidence, reduced tumor load, and milder colitis than their sham-operated counterparts. Ablating Treg led to restoration of the ability to develop colitis and tumor polyps in the SSM, in a similar fashion to that in the sham-operated mice. On the other hand, the growth of subcutaneously inoculated MC38luc colorectal cancer cells or previously established chemical CAC tumors was increased in SSM.Conclusion Our results provide evidence that postsepsis disorder has a dual effect in cancer development, inhibiting inflammation-induced early carcinogenesis in a Treg-dependent manner, while increasing the growth of previously established tumors.

With the objective to evaluate PCR-mediated detection of Mycobacterium tuberculosis DNA as a diagnostic procedure for diagnosis of tuberculosis in individuals attending ambulatory services in Primary Health Units of the City Tuberculosis Program in Rio de Janeiro, Brazil, their sputum samples were collected and treated with a DNA extraction procedure using silica-guanidiniumthiocyanate. This procedure has been described to be highly efficient for extraction of different kind of nucleic acids from bacteria and clinical samples. Upon comparing PCR results with the number of acid-fast bacilli, no direct relation was observed between the number of bacilli present in the sample and PCR positivity. Part of the processed samples was therefore spiked with pure DNA of M. tuberculosis and inhibition of the PCR reaction was verified in 22 out of 36 (61%) of the samples, demonstrating that the extraction procedure as originally described should not be used for PCR analysis of sputum samples.

The article examines the consequences of the forced displacement of the residents of São José Island, in Tocantins, due to the construction of the Estreito Hydroelectric Power Plant. Based on Saskia Sassen's theory of “expulsions”, the study analyzes how the process of relocating residents in the Mirindiba settlement intensified pre-existing vulnerabilities, dismantling essential social and economic networks for these communities. The qualitative, descriptive and exploratory research reveals that the displacement not only resulted in the loss of land, but also aggravated social marginalization and fragmented community relations. The study highlights the prioritization of corporate interests over the needs of local populations, perpetuating cycles of poverty and exclusion. The authors conclude that future public policies must protect the rights and integrity of populations affected by large developments in order to avoid perpetuating these vulnerabilities and social exclusion.

The protozoan parasite Leishmania spp. is a causative agent of leishmaniasis, a disease that affects millions of people in more than 80 countries worldwide. Apart from its medical relevance, this organism has a genetic organization that is unique among eukaryotes. Studies of the mechanisms regulating gene expression in Leishmania led us to investigate noncoding RNAs (ncRNAs) as regulatory elements. We previously identified differentially expressed (DE) ncRNAs in Leishmania braziliensis with potential roles in the parasite biology and development. Herein, we present a functional analysis of one such DE ncRNA, the 147-nucleotide-long transcript ncRNA97, which is preferentially expressed in amastigotes, the replicative form within mammalian phagocytes. By RT-qPCR the ncRNA97 was detected in greater quantities in the nucleus under physiological conditions and in the cytoplasm under nutritional stress. Interestingly, the transcript is protected at the 5’ end but is not processed by the canonical trypanosomatid trans-splicing mechanism, according to the RNA circularization assay. ncRNA97 knockout (KO) and addback (AB) transfectants were generated and subjected to phenotypic analysis, which revealed that the lack of ncRNA97 impairs the starvation response and differentiation to the infective form. Comparative transcriptomics of ncRNA97KO and parental cells revealed that transcripts encoding amastigote-specific proteins were affected. This pioneering work demonstrates that ncRNAs contribute to the developmental regulatory mechanisms of Leishmania.

Quando vivem no campo, geralmente, as mulheres não possuem o reconhecimento e valorização de seu trabalho, sendo que seus papéis socioespaciais ficam restritos à esfera reprodutiva do lar e acabam buscando, na cidade, uma situação diferente. A partir do caso das mulheres que viveram no campo e depois migraram para a cidade, no município de Muzambinho-MG, essa pesquisa buscou compreender se seus papéis socioespaciais e as relações de trabalho se alteraram a partir do momento que passaram a viver no espaço urbano. Partindo de entrevistas com mulheres do campo e migrantes da cidade, pode-se concluir que, no contexto da realidade de uma cidade pequena, permeada pela ruralidade, a busca por melhores condições de vida na cidade foi, de certa forma concretizada, embora ainda vivenciem papéis socioespaciais desiguais, especialmente, pelos postos ocupados com menor remuneração e pela responsabilidade integral do trabalho reprodutivo

The literature on bilingual language development often reports cases of cross-linguistic interaction of the two languages being acquired. In this paper, we investigate possible cross-linguistic interaction outputs in the development of branching onsets in the bilingual acquisition of French and Portuguese. Thirty French–Portuguese bilingual children, aged between 3;6 and 6;1, participated in our study. Their elicited productions were collected using two picture naming tasks containing 29 clusters in French and 57 clusters in Portuguese. Almost all the children acquire branching onsets earlier in French than in Portuguese, independently of the quality of cluster type (Consonant + Rhotic (Cr) clusters vs. Consonant + Lateral (Cl) clusters). Epenthesis is more present in Portuguese than in French. Shared structures in both languages are not acquired at the same time. These results show that bilingual children follow separate patterns of development, close to the ones reported for monolinguals, during the acquisition of their two languages. Moreover, the bilingual children show higher rates of development of clusters in Portuguese than the ones reported for monolinguals, suggesting an accelerated acquisition of clusters in Portuguese due to a positive influence of French.

Este texto configura-se em um relato de experiência que se deu no âmbito do Programa Residência Pedagógica (PRP), proporcionado pela Universidade Federal do Pampa, campus São Borja. O núcleo do campus é de Geografia em decorrência do curso de Licenciatura em Ciências Humanas. A interação com a educação básica de ensino ocorreu por meio de um instituto da rede pública periférico. O problema do presente relato se molda a partir do momento em que se busca refletir sobre a própria prática de ensino e, consequentemente, de aprendizagem, bem como seu desenrolar e sua continuidade no sentido de desenvolvimento docente. Dessa forma, justifica-se pela própria importância de se pensar sobre a atividade docente e o papel que programas como esse têm sobre ela. Portanto, o objetivo do presente relato é identificar quais foram os processos formativos ao longo do período de estágio do programa. Intentou-se fazer isso por meio do relato das vivências e experiências fundamentado por uma revisão de literatura. As considerações finais abrangem a importância de programas que possibilitam a prática como importante canal de aprendizagem da docência para professores em formação.

The Tocantins–Araguaia basin is one of South America’s largest river systems, across three Brazilian states (Maranhão, Tocantins, and Pará), within the Legal Amazon region. Despite draining extensive Cerrado savanna and rainforest ecosystems, it has suffered significant degradation, notably in the past 40 years. Human activities, including agricultural expansion, deforestation, and the introduction of non-native species, have worsened the environmental damage, which is alarming since many residents and villages along the middle Tocantins River rely on it for water supply, recreation, and fishing. This study assessed the concentration of potentially toxic and essential elements in water samples from four sampling sites distributed along the middle Tocantins River. The monitoring occurred throughout 2023, involving the measurement of parameters both on-site and in the laboratory. Water quality and its health implications were evaluated using the Weighted Arithmetic Water Quality Index (WAWQI), the Water Quality Index (WQI), and the health risk assessment index. The levels of aluminum, copper, iron, magnesium, and selenium exceeded legal standards. Seasonal fluctuations indicate a complex dynamic influenced by climatic or seasonal factors, with February showing the highest values. Site P1, located in urban areas, exhibited elevated mean concentrations for conductivity, total dissolved solids (TDS), and chlorophyll, indicating the need for continuous monitoring. The nitrogen concentrations at P1 raise concerns regarding drinking water quality, which is a concern for the region’s residents who use untreated river water. Despite seasonal variations in element concentrations, the overall WAWQI categorized all sections as “Excellent,” and the WQI rated as “Good.” Human health risk assessments detected no risks, but continuous monitoring and interventions are crucial for sustained water quality improvement.

A discussão acerca da profissão docente não é recente, porém é pertinente que se mantenha em pauta devido às mudanças que ocorrem na sociedade e, consequentemente, no cenário geral da docência. Assim, a pergunta norteadora do presente trabalho é quais são os desafios do início da carreira? O objetivo da pesquisa é compreender os desafios encontrados no início da carreira e reconhecer os movimentos da docência iniciais, tendo em vista que é nesta etapa que ocorre a mudança de papéis, onde o aluno se torna o professor. Metodologicamente, realizou- se uma pesquisa bibliográfica respaldada em autores basilares que versam sobre o tema, bem como produções recentes. Nossos estudos fazem entender que os desafios na iniciação à docência implicam em diversos outros, principalmente da vida pessoal e que se entrelaçam com a profissão. Assim como a preparação psicológica e emocional necessárias para tal fase, mas que não são características abordadas o suficiente nos cursos de formação de professores, que chegam despreparados para o que enfrentarão ao se inserir na profissão. Portanto, compreendemos que na fase da iniciação da carreira são vários os desafios que o professor iniciante terá de superar e isto torna necessário contínuos movimentos de aprendizagem docente.

ABSTRACT Congenital and gestational syphilis are increasingly prevalent multisystemic infections in Brazil. This study aimed to present a case series of three children diagnosed with congenital syphilis even though their mother had unreactive treponemal tests. The VDRL (Venereal Disease Research Laboratory) titers of a 22-year-old mother with three pregnancies decreased after treatment. The mother did not have a reactive treponemal test, but all the three children were diagnosed with early congenital syphilis. This case series highlights the difficulty in diagnosing gestational and congenital syphilis in Brazil.

Coronavirus disease 2019 (COVID-19) is an infection caused by SARS-CoV-2. Genome-wide association studies (GWASs) have suggested a strong association of genetic factors with the severity of the disease. However, many of these studies have been completed in European populations, and little is known about the genetic variability of indigenous peoples’ underlying infection by SARS-CoV-2. The objective of the study is to investigate genetic variants present in the genes AQP3, ARHGAP27, ELF5L, IFNAR2, LIMD1, OAS1 and UPK1A, selected due to their association with the severity of COVID-19, in a sample of indigenous people from the Brazilian Amazon in order to describe potential new and already studied variants. We performed the complete sequencing of the exome of 64 healthy indigenous people from the Brazilian Amazon. The allele frequency data of the population were compared with data from other continental populations. A total of 66 variants present in the seven genes studied were identified, including a variant with a high impact on the ARHGAP27 gene (rs201721078) and three new variants located in the Amazon Indigenous populations (INDG) present in the AQP3, IFNAR2 and LIMD1 genes, with low, moderate and modifier impact, respectively.

Abstract Bacterial wilt of the common bean caused by Curtobacterium flaccumfaciens pv. flaccumfaciens results in economic losses. The aim of this study was to analyze the colonization of C. flaccumfaciens pv. flaccumfaciens in resistant, moderately resistant, and susceptible genotypes of common bean plants. The genotypes Ouro Branco and IPA 9 (resistant), Diacol Calima (moderately resistant), and CNFRS 11997 and CNFP 10429 (susceptible) were inoculated in the epicotyl, with 100 µL of bacterial suspension of the BRM 14933(Cff25). Disease severity was evaluated 21 days after inoculation (DAI), on a scale from 1 to 9. The samples for SEM were dehydrated in an ethyl alcohol series, critical-point dried with liquid carbon dioxide (CO2), and coated with gold and analyzed using a scanning electron microscope. Ouro Branco and IPA 9 (resistant) plants exhibited low colonization, the formation of filaments surrounding bacterial cells and vestures more developed in the pit the xylem vessels. Diacol Calima (moderately resistant) plants presented lower levels of colonization and filament formation than that of resistant cultivars. CNFC 10429 and CNFRS 11997 (susceptible) showed high levels of colonization in the xylem and vessel obstruction, preventing water and nutrient flow, which explains the symptoms of wilt and plant death. Thus, resistance to C. flaccumfaciens pv. flaccumfaciens can be explained by plant’s capacity to limit pathogen propagation as a cell defense mechanism, suggesting that this is a factor in post-formed structural resistance that occurs in this pathosystem. Keywords: susceptibility; bacterial wilt; plant-pathogen interaction.