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Background: Digital therapeutics, an emerging type of medical approach, is defined as evidence-based therapeutic interventions through qualified software programs that help prevent, manage, or treat chronic diseases such as type 2 diabetes mellitus (T2DM), which has high social and economic burden. Klivo, a startup certified by the Brazilian Society of Diabetes, developed the first digital therapeutic product for managing T2DM in Brazil, reaching 21 of 24 states. Klivo has continuously been improving its model of behavior change on the basis of an intensive lifestyle intervention method that addresses individuals' needs–the Klivo Intervention Program for T2DM (KIPDM). To test the most recent version of the KIPDM, we will evaluate the ongoing management of daily life habits in patients with T2DM by measuring clinically significant outcomes. To improve the transparency of further results, here we will present the study protocol and detail the plan for the research project, including the study design and the analysis strategies. Methods: The KIPDM will be sponsored by health plans and healthcare provider organizations and will be free for patients (adults aged ≥ 18 years and <65 years; and glycated hemoglobin ≥ 7%). The program will be based on a 6-month management process that will supervise patients remotely. The program will include educational classes via the Klivo app, text messages, or e-mails. Evaluation will include objectively assessing clinical, laboratory, and behavioral outcomes such as health-related quality of life, mental health, medication adherence, and healthcare utilization. For this, validated electronic questionnaires will be available through the Klivo app. The primary outcome will be glycated hemoglobin (HbA1c) values. The secondary outcome will be time in target blood glucose range (TIR) estimated by capillary glycemia. Other outcomes of interest will be evaluated at baseline and stipulated time points (3 and 6 months after the start of the program). Expected outcomes: KIPDM patients should present improved HbA1c and TIR along the intervention as compared to baseline values. Findings from this study will provide insights into the health improvement of T2DM and other cardiometabolic conditions such as hypertension, dyslipidemia, and obesity by using a digital therapeutic strategy. By analyzing the patient's health over time, this study will also contribute to understanding comorbidities associated with this chronic condition in the Brazilian population. [ABSTRACT FROM AUTHOR]

Copyright of Rodriguésia is the property of Revista Rodriguesia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Brasilioporus olivaceoflavidus, gen. et sp. nov., Brasilioporus simoniarum, sp. nov., Neotropicomus australis, gen. et sp. nov., and Nevesoporus nigrostipitatus, gen. et sp. nov. (Boletaceae, Boletales, Basidiomycota), are described from the endangered Atlantic Forest biome of eastern Brazil. New combinations into these new genera are proposed for the Guyanese taxa Xerocomus parvogracilis, Tylopilus rufonigricans, and Tylopilus exiguus. Boletaceae subfamily Chalciporoideae was recircumscribed to include the new genus Nevesoporus. Molecular phylogenetic analyses using a multilocus data set (ITS+28S+TEF1+RPB1+RPB2) from a large taxon set across the Boletaceae justify recognition of the new genera. Morphological, ecological, and DNA sequence data are provided for the new species. A key to known native and introduced bolete species from the Brazilian Atlantic Forest is provided. [ABSTRACT FROM AUTHOR]

Background: This review aimed to estimate the time-trend prevalence of excess weight, overweight and obesity in the Brazilian adult population, from the 1970s–2020, through systematic review and meta-analysis (Protocol: CRD42018091002). Methods: A search for articles was conducted in the databases MEDLINE, EMBASE, Scopus, and LILACS up to June 2021. Studies that assessed excess weight, overweight and obesity in the adult population were eligible. Two authors selected studies, collected data and assessed the methodological quality of the studies. The primary outcomes were the prevalence of excess weight, overweight, and obesity by sex and period of years. Pooled prevalence and 95% confidence intervals (CIs) were calculated in the meta-analysis of the random effects model. Heterogeneity (I2) was investigated by meta-regression and publication bias was investigated by Egger's test. Results: A total of 7,938 references were identified in the search strategies, of which eighty-nine studies and nine national surveys, conducted from 1974–2020, were included in the meta-analysis. The pooled prevalence of excess weight in Brazilian adults increased from 33.5% (95% CI: 25.0; 42.6%) in 1974–1990 to 52.5% (95% CI: 47.6; 57.3%) in 2011–2020. The pooled prevalence of overweight in Brazilian adults was 24.6% (95% CI: 18.8; 31.0%) from 1974–1990 and 40.5% (95% CI: 37.0; 43.9%) from 2011–2020. The pooled prevalence of obesity in Brazilian adults increased by 15.0% from 1974–1990 to 2011–2020. The increases were observed for both men and women in almost all periods. The prevalence of excess weight and obesity remained higher among women in all periods. Conclusions: A continuous increase in the prevalence of excess weight, overweight and obesity were observed over the years. The prevalence of excess weight affected half of Brazilian adults in the period from 2011–2020 and both sexes. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization recognizes exclusive breastfeeding a safe source of nutrition available for children in most humanitarian emergencies, as in the current pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Despite the Brazilian national guideline protecting breastfeeding practices, there are many concerns about protecting infants from their infected mothers. This study aimed to analyze how the Brazilian hospitals and maternity services promote and support mothers suspected or diagnosed with coronavirus disease (COVID-19). Methods: This is a descriptive cross-sectional and multicenter study which collected data from 24 Brazilian hospitals and maternity services between March and July 2020. Representatives of the institutions completed a questionnaire based on acts to promote and support breastfeeding, the Baby-Friendly Hospital Initiative, and Brazil's federal law recommendations. Results: The results showed that in delivery rooms, 98.5% of the services prohibited immediate and uninterrupted skin-to-skin contact between mothers and their infants and did not support mothers to initiate breastfeeding in the first hour. On the postnatal ward, 98.5% of the services allowed breastfeeding while implementing respiratory hygiene practices to prevent transmission of COVID-19. Companions for mothers were forbidden in 83.3% of the hospitals. Hospital discharge was mostly between 24 and 28 h (79.1%); discharge guidelines were not individualized. Additionally, a lack of support was noticed from the home environment's health community network (83.3%). Hospital and home breast pumping were allowed (87.5%), but breast milk donation was not accepted (95.8%). There was a lack of guidance regarding the use of infant comforting strategies. Guidelines specific for vulnerable populations were not covered in the material evaluated. Conclusions: In Brazil, hospitals have not followed recommendations to protect, promote, and support breastfeeding during the COVID-19 outbreak. The disagreement between international guidelines has been a major issue. The absence of recommendations on breastfeeding support during the pandemic led to difficulties in developing standards among hospitals in different regions of Brazil and other countries worldwide. The scientific community needs to discuss how to improve maternal and infant care services to protect breastfeeding in the current pandemic. [ABSTRACT FROM AUTHOR]

The Brazilian Cerrado is a highly diverse ecosystem, harboring a great variety of organisms; however, the mycodiversity is still poorly documented. In this study, we record for the first time the bolete Phlebopus beniensis from the Cerrado biome in the state of Goiás, located in Brazil’s Central-West Region. Description, macroscopic images, line drawings and comments, as well as the geographic distribution of the genus for Brazil are presented herein. [ABSTRACT FROM AUTHOR]

Fistulinella is a small genus of boletoid fungi in the subfamily Austroboletoideae in the order Boletales. In this paper, F. ruschii from the Atlantic Forest is proposed as new to science and F. campinaranae var. scrobiculata, known from the Brazilian Amazon forest, is recorded for the first time in the Atlantic Forest. Macro- and microscopic descriptions, molecular data (nuc rDNA ITS1- 5.8S-ITS2 and nuc 28S rDNA), photographs of the basidiomata, and scanning electron microscopy images of basidiospores are provided for both species. Based on sampling of six taxa, New World Fistulinella is found to be a strongly supported monophyletic group, but the genus at large is nonmonophyletic. [ABSTRACT FROM AUTHOR]

The objective was to evaluate the quality of important brands of ultra-heat-treated (UHT) milk marketed in the northern of Parana State, Brazil, during the shelf life of the product. Five brands were analysed at 30, 60, 90 and 120 days after UHT milk production. The physicochemical quality of the milk was assessed in terms of fat content, titratable acidity, density, freezing point depression, total solids, solids-not-fat, proteolysis and alcohol stability. Microbiological quality was assessed by the enumeration of aerobic mesophilic micro-organisms. None of the brands complied with all the physicochemical standards. Two brands met all applicable microbiological requirements. Gelation was observed from 90 days of storage onwards in all brands. [ABSTRACT FROM AUTHOR]

Copyright of Revista Eletrônica de Enfermagem is the property of Revista Eletronica de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study was the first conducted in Brazil to evaluate the presence of Enterobacter sakazakii in milk-based powdered infant formula manufactured for infants 0 to 6 months of age and to examine the conditions of formula preparation and service in three hospitals in São Paulo State Brazil. Samples of dried and rehydrated infant formula, environments of milk kitchens, water, bottles and nipples, utensils, and hands of personnel were analyzed, and E. sakazakii and Enterobacteriaceae populations were determined. All samples of powdered infant formula purchased at retail contained E. sakazakii at <0.03 most probable number (MPN)/100 g. In hospital samples, E. sakazakii was found in one unopened formula can (0.3 MPN/100 g) and in the residue from one nursing bottle from hospital A. All other cans of formula from the same lot bought at a retail store contained E. sakazakii at <0.03 MPN/100 g. The pathogen also was found in one cleaning sponge from hospital B. Enterobacteriaceae populations ranged from 10¹ to 105 CFU/g in cleaning aids and <5 CFU/g in all formula types (dry or rehydrated), except for the sample that contained E. sakazakii, which also was contaminated with Enterobacteriaceae at 5 CFU/g. E. sakazakii isolates were not genetically related. In an experiment in which rehydrated formula was used as the growth medium, the temperature was that of the neonatal intensive care unit (25°C), and the incubation time was the average time that formula is left at room temperature while feeding the babies (up to 4 h), a 2-log increase in levels of E. sakazakii was found in the formula. Visual inspection of the facilities revealed that the hygienic conditions in the milk kitchens needed improvement. The length of time that formula is left at room temperature in the different hospitals while the babies in the neonatal intensive care unit are being fed (up to 4 h) may allow for the multiplication of E. sakazakii and thus may lead to an increased health risk for infants. [ABSTRACT FROM AUTHOR]

[Display omitted] • Lime is recommended to Eucalyptus aimed to supply Ca and Mg contents to plant growth. • Lime increased pH of the topsoil in the first months after application. • In Eucalyptus plantation, high soil Cu and Zn contents were bound to organic matter fraction. • Lime increased Ca and Mg, while reduced Cu and Zn levels in Ferralsol and Eucalyptus grandis. • Copper plus zinc fertilization can improve plant growth when associated with liming. Brazil is a global reference in forest management for wood production (e.g., pulp and solid wood products), and large areas are planted mainly in acidic and poorly fertile soils, with a predominance of Eucalyptus species. Liming is widely adopted in acidic soils in humid tropical regions planted with Eucalyptus to increase the availability of some nutrients and supply Ca and Mg. However, liming decreases the availability of some micronutrients, such as Cu and Zn, depending on the lime content. Copper and Zn fertilization for Eucalyptus is usually intended to replace the amount of micronutrients extracted after wood harvesting. However, few studies have been carried out to investigate the combined effects of lime and Cu plus Zn application on forest plantations in tropical soils. Here, the effects of these factors on soil chemical-attributes, as well as nutrition, and growth performance of Eucalyptus grandis plantations were evaluated on a medium-textured Ferralsol. The stem volume yield improved after liming, regardless of the rate of application, and after Cu plus Zn fertilization. Liming increased soil pH and Ca and Mg availability and reduced Cu and Zn availability. Overall, liming reduced soil Cu and Zn contents in the residual-fraction, while increasing the fraction bound to organic-matter. High contents of Cu and Zn were linked to the organic-matter fraction in the soil under the Eucalyptus plantation. Eucalyptus trees grown in soils amended with lime had higher values for leaf area index and leaf Ca and Mg concentrations but showed reduced Cu and Zn concentrations. The combined application of lime and Cu plus Zn improved Eucalyptus growth, with the higher contribution of lime compared to Cu and Zn. In conclusion, the combined application of lime and Cu plus Zn is a useful strategy to provide balanced nutrition and optimize stem volume yields. [ABSTRACT FROM AUTHOR]

In Brazil, the incidence of Bacillus cereus outbreaks is unknown, and there is little information about B. cereus occurrence in food. In addition, data on toxin production and genetic characterization of the B. cereus isolates cannot be found. This pathogen causes two distinct types of toxin-mediated foodborne illnesses known as diarrheal and emetic syndromes. Diarrheal syndrome has been linked to three different enterotoxins: two protein complexes, hemolysin BL (HBL) and nonhemolytic enterotoxin (NHE); and an enterotoxic protein, cytotoxin K (cytK). Emetic syndrome is related to cereulide, a toxin encoded by the ces gene. In this study, NHE and HBL production capacities of 155 strains of B. cereus isolated from Brazilian food products were evaluated with an immunoassay. Strains were also tested for the presence of the genes of the HBL and NHE complexes, cytK, cytK-1, cytK-2, and ces, using PCR. HBL was detected in 105 (67.7%) strains and NHE in 154 (99.4%) strains. All the strains harbored at least one gene of the NHE complex, while 96.1% of them were positive for at least one of those of the HBL complex. Genes cytK1 and ces were not detected. All strains showed toxigenic capacity and could represent a risk for consumers if good practices are not followed. This is the first report on toxigenic and genetic profiles of B. cereus strains isolated in Brazil. [ABSTRACT FROM AUTHOR]

Abstract: This study aimed at evaluating the acceptance of MP watermelon and pineapple exposed to 1.0 and 2.5kGy compared to non-irradiated samples. No significant differences were observed in liking between irradiated and non-irradiated samples, and also between doses of 1.0 and 2.5kGy. Significant differences in sourness (pineapple) or sweetness (watermelon) and between intention of purchase of irradiated and non-irradiated fruits were not observed as well. Results showed that MP watermelon and pineapple could be irradiated with doses up to 2.5kGy without significant changes in acceptability. [Copyright &y& Elsevier]

Objective: to determine the profile of pregnancies and prevalence of adherence to puerperal consultation among adolescent puerperal women compared to non-adolescent puerperal women served in an outpatient clinic of a teaching hospital in the rural area of Minas Gerais. Method: cross-sectional study nested in a cohort of puerperal women; non-probabilistic sample, by convenience; adolescent pregnancy -- dependent variable; sociodemographic, clinical and obstetric -- independent variables. It employed its own instrument, tested by means of a pilot test. Prevalence ratios and confidence intervals were calculated; chi-square and Fisher's exact tests were applied, considering a significance level of 5%, and Poisson regression with robust variance. Results: we interviewed 121 puerperal women, of which 18.2% (22) were adolescents, and observed among them low educational level (p<0.001); fewer pregnancies with pathologies (p=0.016); predominance of primiparous women (p<0.001), and higher rates of normal delivery (p=0.032). The prevalence of adherence to puerperal consultation was 34.7% and 31.8% for adolescents. There were no differences regarding adherence and age of puerperal women. Conclusion: adolescents did not present negative obstetric and neonatal outcomes, although a lower educational level was observed. Association was found between early age and absence of diseases during pregnancy and higher rates of normal vaginal deliveries. Adherence to puerperal return visit was slightly lower, but without statistical significance. [ABSTRACT FROM AUTHOR]