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The main factors related to the lack of coverage in Health Information Systems are concentrated in the scarce and incipient training of health professionals regarding the collection and typing of data, as well as the importance of using information. The aim of this study was to analyze the perceptions of primary health care professionals from Brazil about the functioning of the Food and Nutritional Monitoring System (SISVAN). Multicentric qualitative study, carried out with 38 health professionals in Basic Health Units (BHU) in five regions around the country. Data collection took place through interviews, which were submitted to content analysis, using the thematic modality. The treatment of the results and interpretation of the themes were carried out using the theoretical framework of the philosopher Michel Foucault. Four themes emerged: (Lack of) knowledge of SISVAN; SISVAN and the conditional income transfer program; Difficulties in the execution and use of SISVAN information; and Strengths. Some of the interviewees recognized the purpose of SISVAN's functioning. The collection of anthropometric data was related to the conditions of the Bolsa Família Program. Ignorance of the system and/or limited perception emerged as obstacles in the operability, use and quality of the data. The participants recognize that professional training is necessary to optimize the strengths of the system., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Barbosa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Malaria is an infectious disease caused by the Plasmodium species and is a global burden. When not treated correctly, it can reemerge as a relapse or recrudescence. Malaria relapse cases can contribute to maintaining active transmission chains and can influence the patient to develop severe malaria, potentially leading to hospitalization or death. The objective of this study is to estimate the number of malaria relapse cases in the extra-Amazon region of Brazil and to investigate the associated factors., Methods: This is a case-control study that analyses malaria infections caused by Plasmodium vivax, as reported in Notifiable Diseases Information System (Sinan) for the Brazilian extra-Amazon region (an area not endemic for the disease) from 2008 to 2019. For the identification of relapse cases, deduplication record linkage processes in R software were used. Malaria relapses were defined as the case group, and new malaria infections were defined as the control group. Logistic regression models were used to assess associated factors., Results: Of the 711 malaria relapses, 589 (82.8%) were first relapses. Most relapses (71.6%) occurred between 30 and 120 days after the previous infection. Malaria relapses are spread throughout the extra-Amazon region, with a higher concentration near big cities. Driver occupation was found to be a common risk factor compared to other occupations, along with asymptomatic individuals. Other associated factors were: being infected in the Brazilian Amazon region, having follow-ups for malaria relapses, and having parasite density of the previous infection higher than 10,000 parasites per mm 3 ., Conclusions: This study provides evidence that allows malaria health surveillance services to direct their efforts to monitor cases of malaria in the highest risk segments identified in this study, particularly in the period between 30 and 120 days after being infected and treated. Relapses were associated to driver occupation, absence of symptoms, infection in endemic areas of Brazil, being detected through active surveillance or routine follow-up actions, and with parasitaemia greater than 10,000 parasites per mm 3 in the previous infection. Improving cases follow-up is essential for preventing relapses., (© 2024. The Author(s).)

Coral microbiomes play crucial roles in holobiont homeostasis and adaptation. The host's ability to populate broad ecological niches and to cope with environmental changes seems to be related to the flexibility of the coral microbiome. By means of high-throughput DNA sequencing we characterized simultaneously both bacterial (16S rRNA) and Symbiodiniaceae (ITS2) communities of four reef-building coral species (Mussismilia braziliensis, Mussismilia harttii, Montastraea cavernosa, and Favia gravida) that differ in geographic distribution and niche specificity. Samples were collected in a marginal reef system (Abrolhos, Brazil) in four sites of contrasting irradiance and turbidity. Biological filters governed by the host are important in shaping corals' microbiome structure. More structured associated microbial communities by reef site tend to occur in coral species with broader geographic and depth ranges, especially for Symbiodiniaceae, whereas the endemic and habitat-specialist host, M. braziliensis, has relatively more homogenous bacterial communities with more exclusive members. Our findings lend credence to the hypothesis that higher microbiome flexibility renders corals more adaptable to diverse environments, a trend that should be investigated in more hosts and reef areas., (© 2024. The Author(s).)

The Sepetiba Bay (SB, SE Brazil) is a highly anthropized and industrialized area that has experienced severe environmental degradation in recent decades. This study applies a multiproxy approach to document the response of living benthic foraminifera to environmental stress and to infer the Ecological Quality Status (EcoQS) in SB. Our methodology involved a comprehensive comparison of the density and percentage of benthic foraminiferal species with physicochemical, textural, and geochemical data, specifically the concentrations of potentially toxic elements (PTEs). We also statistically compared two geochemical indices, the pollution load index (PLI) and the potential ecological risk index (PERI), with two ecological indices, the Tolerant Species Index (TSI) and the Exp(H'bc). The TSI and the Exp(H'bc) indices are significantly correlated with the environmental stressors in Sepetiba Bay, namely the PTEs concentrations (As, Cd, Pb, and Zn). The most tolerant species to the enrichment of PTEs and organic matter are Ammonia tepida (Cushman, 1926), Elphidium excavatum (Terquem, 1875), Ammonia buzasi Hayward and Holzmann, 2021 and Ammonia rolshauseni (Cushman and Bermúdez, 1946). The Exp(H'bc) and TSI reveal that most stations located in the inner zone and near the margins of the bay have poor and bad EcoQS, which agrees with the distribution of the environmental stressors. Thus, the current environmental conditions of the inner area of Sepetiba Bay are of great concern. This work also shows that using the TSI and the Exp(H'bc) indices, it is possible to classify EcoQS in transitional coastal environments in the North and South Atlantic transitional waters. This work has relevant scientific and social implications due to its importance in biomonitoring and the management of the coastal regions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Soil contamination by hydrocarbons is a problem that causes severe damage to the environment and public health. Technologies such as bioremediation using native microbial species represent a promising and environmentally friendly alternative for decontamination. This study aimed to isolate indigenous fungi species from the State of Rio de Janeiro, Brazil and evaluate their diesel degrading capacity in soils contaminated with crude oil. Seven filamentous fungi were isolated after enrichment cultivation from soils collected from contaminated sites and subjected to growth analysis on diesel nutrient media. Two fungal species were pre-selected and identified by morphological genus analysis and molecular techniques as Trichoderma asperellum and Penicillium pedernalense. The microdilution test showed that T. asperellum presented better fungal growth in high diesel concentrations than P. pedernalense. In addition, T. asperellum was able to degrade 41 and 54% of the total petroleum hydrocarbon (TPH) content present in soil artificially contaminated with diesel (10 g/kg of soil) in 7 and 14 days of incubation, respectively. In higher diesel concentration (1000 g of diesel/kg of soil) the TPH degradation reached 26%, 45%, and 48%, in 9, 16, and 30 d, respectively. The results demonstrated that the selected species was suitable for diesel degradation. We can also conclude that the isolation and selection process proposed in this work was successful and represents a simple alternative for obtaining native species with hydrocarbon degradation capacity, for use in the bioremediation process in the recovery of contaminated areas in an ecologically acceptable way., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

We developed a protein to rapidly and accurately diagnose Chagas disease, a life-threatening illness identified by the WHO as a critical worldwide public health risk. Limitations in present day serological tests are complicating the current health situation and contributing to most infected persons being unaware of their condition and therefore untreated. To improve diagnostic testing, we developed an immunological mimic of the etiological agent, Trypanosoma cruzi , by combining ten pathogen-specific epitopes within the beta-barrel protein structure of Thermal Green Protein. The resulting multi-epitope protein, DxCruziV3, displayed high specificity and sensitivity as the antibody capture reagent in an ELISA platform with an analytical sensitivity that exceeds WHO recommendations. Within an immunochromatographic platform, DxCruziV3 showed excellent performance for the point of application diagnosis in a region endemic for multiple diseases, the municipality of Barcelos in the state of Amazonas, Brazil. In total, 167 individuals were rapidly tested using whole blood from a finger stick. As recommended by the Brazilian Ministry of Health, venous blood samples were laboratory tested by conventional assays for comparison. Test results suggest utilizing DxCruziV3 in different assay platforms can confidently diagnose chronic infections by T. cruzi . Rapid and more accurate results will benefit everyone but will have the most noticeable impact in resource-limited rural areas where the disease is endemic.

Purpose of Review: The Amazon region has a high biodiversity of flora, with an elevated variety of fruits, such as Camu-Camu (Myrciaria dúbia), Açaí (Euterpe oleracea Mart.), Tucumã (Astrocaryum aculeatum and Astrocaryum vulgare), Fruta-do-conde (Annona squamosa L.), Cupuaçu (Theobroma grandiflorum), Graviola (Annona muricata L.), Guarana (Paullinia cupana Kunth var. sorbilis), and Pitanga (Eugenia uniflora), among many others, that are rich in phytochemicals, minerals and vitamins with prominent antioxidant and anti-inflammatory potential., Recent Findings: Studies evaluating the chemical composition of these fruits have observed a high content of nutrients and bioactive compounds. Such components are associated with significant biological effects in treating various non-communicable diseases (NCDs) and related complications. Regular intake of these fruits from Amazonas emerges as a potential therapeutic approach to preventing and treating NCDs as a nutritional strategy to reduce the incidence or mitigate common complications in these patients, which are the leading global causes of death. As studies remain largely unexplored, this narrative review discusses the possible health-beneficial effects for patients with NCDs., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Health care challenges in remote rural municipalities (RRMs) emphasize the importance of primary health care (PHC) and require an expanded scope of practice. Doctors are key actors in this context. The aim of this study was to explore the level of integration of doctors in RRMs and working practices. We conducted a qualitative study involving semi-structured interviews with 46 PHC doctors working in 27 RRMs in Brazil. Content analysis was performed, resulting in the identification of categories of analysis grouped under three core dimensions: doctor training and experience; comprehensive care and timely access; and the community-based approach. Doctors working in RRMs were mainly recent graduates with limited experience who had undertaken their degree outside Brazil, and care was focused on the individual. The findings also revealed weak sociocultural adaptation and a harsh working environment and issues related to social status that reinforced prejudice against rurality and poverty. Practice was limited in scope and care tended to be oriented towards acute problems, disease-centered and focused on the biomedical model of medicine. Barriers to the delivery of comprehensive care include both structural constraints, such as poor facilities and centralization of services in administrative centers, and the lack of professional competencies necessary for PHC in these areas. The findings point to the need to promote an expanded scope of practice in PHC delivery in RRMs, with major public investment in the promotion of training and strengthening career pathways in these areas., (© 2024. The Author(s).)

The Pantanal region, the largest floodplain in the world, has a huge biodiversity and is an important livestock center. Bovine brucellosis has been reported in the region over the last three decades, posing implications for cattle industry as well as for the maintenance of biodiversity. We aimed to investigate the presence of B. abortus S19 vaccine strain DNA in unvaccinated domestic and wild ungulates from the Brazilian Pantanal. Fifty-two heifers, 63 ovine, 24 domestic pigs, 28 feral pigs, and three Pampas deer were sampled. Brucella spp. was detected through bcsp31 PCR of blood samples in 45.3% (77/170) of the sampled animals, of which 36.4% (28/77) showed positivity in ery PCR corresponding to B. abortus S19 strain. Feral pigs presented the highest occurrence of positive samples in bcsp31 PCR (75%), followed by ovine (47.6%), domestic pigs (41.7%), and unvaccinated heifers (30.8%). We did not observe positivity in Pampas deer. Our results strongly suggest that vaccination against bovine brucellosis may promote spill-over of B. abortus S19 strain in the Pantanal region. Moreover, our data indicate that wild strains of Brucella circulates in the Pantanal Biome., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Hybrid methods are a suitable option for extracting dietary patterns associated with health outcomes. This study aimed to identify the dietary patterns of Brazilian adults (20-59 years old; n = 28,153) related to dietary components associated with the risk of obesity. Data from the 2017-2018 Brazilian National Dietary Survey were analyzed. Food consumption was obtained through 24 h recall. Dietary patterns were extracted using partial least squares regression, using energy density (ED), percentage of total fat (%TF), and fiber density (FD) as response variables. In addition, 32 food groups were established as predictor variables in the model. The first dietary pattern, named as energy-dense and low-fiber (ED-LF), included with the positive factor loadings solid fats, breads, added-sugar beverages, fast foods, sauces, pasta, and cheeses, and negative factor loadings rice, beans, vegetables, water, and fruits (≥|0.15|). Higher adherence to the ED-LF dietary pattern was observed for individuals >40 years old from urban areas, in the highest income level, who were not on a diet, reported away-from-home food consumption, and having ≥1 snack/day. The dietary pattern characterized by a low intake of fruits, vegetables, and staple foods and a high intake of fast foods and sugar-sweetened beverages may contribute to the obesity scenario in Brazil.

Identification of Aedes aegypti breeding hotspots is essential for the implementation of targeted vector control strategies and thus the prevention of several mosquito-borne diseases worldwide. Training computer vision models on satellite and street view imagery in the municipality of Rio de Janeiro, we analyzed the correlation between the density of common breeding grounds and Aedes aegypti infestation measured by ovitraps on a monthly basis between 2019 and 2022. Our findings emphasized the significance (p ≤ 0.05) of micro-habitat proxies generated through object detection, allowing to explain high spatial variance in urban abundance of Aedes aegypti immatures. Water tanks, non-mounted car tires, plastic bags, potted plants, and storm drains positively correlated with Aedes aegypti egg and larva counts considering a 1000 m mosquito flight range buffer around 2700 ovitrap locations, while dumpsters, small trash bins, and large trash bins exhibited a negative association. This complementary application of satellite and street view imagery opens the pathway for high-resolution interpolation of entomological surveillance data and has the potential to optimize vector control strategies. Consequently it supports the mitigation of emerging infectious diseases transmitted by Aedes aegypti, such as dengue, chikungunya, and Zika, which cause thousands of deaths each year., (© 2024. The Author(s).)

This study aimed to evaluate the Free Drawing method to assess food consumption information compared to the Free Listing method. Furthermore, the citation frequencies of dairy products consumed by adolescents were compared in Brazilian regions. Adolescents (14-17 years old, n = 265, n = 53 for each region, North, South, Northeast, Midwest, and Southeast regions) listed or drew the dairy products they consumed using Free Listing or Free Drawing. The contingency tables were constructed, and the cognitive saliency indexes (CSI) were calculated. Multiple Factor Analysis (MFA) was performed, and the RV indices were determined. The adolescents listed/drew 55 dairy products, grouped into 10 categories. The Free Listing method resulted in greater citation frequencies of dairy products. The Free Drawing method resulted in richer and more detailed information, with specifications of the type of product consumed within the category, flavor, type of packaging, and brand. The dairy products with the highest citation frequencies/CSI by adolescents were milk, cheese, and fermented milk. The South and Southeast regions observed greater citation frequencies and diversity of dairy products (prevalence in 6 categories). The CSI did not depend on the method, but it was affected by the region (p < 0.05). The sensory methods showed high similarity considering the categories of dairy products (RV = 0.80) and regions (RV = 0.79). It is concluded that the Free Drawing method proved to be an alternative to Free Listing for evaluating adolescents' consumption information of dairy products in an intracultural study in Brazil., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background/objectives: Chronic pancreatitis (CP) is a progressive inflammatory disorder associated with marked morbidity and mortality and frequently requires hospitalization. This study aimed to investigate the time trends and geographical distribution of hospital admissions, the lethality rate of CP across Brazil, and the potential relationship with social indicators and associated risk factors., Methods: Data were retrospectively obtained from the Brazilian Public Health System Registry between January 2009 and December 2019. The prevalence and lethality rates of CP per 100,000 inhabitants in each municipality were estimated from hospitalizations to in-hospital deaths and classified by age, sex, and demographic features., Results: During the study period, 64,609 admissions were retrieved, and most of the patients were males (63.54%). Hospitalization decreased by nearly half (-54.68%) in both sexes. CP rates in males were higher in all age groups. The greatest reduction in admissions (- 64%) was also noted in patients ≥ 70y. CP In-hospital lethality remained stable (5-6%) and similar for males and females. Patients ≥ 70y showed the highest lethality. The greatest increase in CP lethality rates (+ 10%) was observed in municipalities integrated into metropolises, which was mainly driven by small-sized municipalities (+ 124%)., Conclusions: CP hospitalizations decrease in both urban and rural areas, particularly in the North, Northeast, and Central-West regions, and in those above 70 years of age, but are not correlated with lethality rates in the South. This suggests ongoing changes in the environmental and socioeconomic factors in Brazil., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The Amazon rivers constitute the largest river basin in the world, with a high level of biodiversity. The Tocantins River is one of the most important rivers in this region, which has been impacted by different land uses. The objective of this study was to carry out a multi-evidence analysis focusing on the water quality of the Tocantins River, close to the municipality of Marabá-PA. We analyzed forest cover and water quality and, using the model organism Danio rerio, performed toxicity tests for histopathological effects, as well as the habitat selection approach by exposing fish to different river water samples in a multi-compartment device. The results showed that the studied area has already lost almost 30% of its forests in recent decades. Regarding water quality, the upstream (C1) and downstream (C5) points are the least impacted. On the other hand, the other points (C2-C4), closer to the city, greater input of pollutants was detected. Fish exposed to water samples from the most impacted sites showed several oedemas and hyperplastic cells in the gills. Regarding habitat selection behavior, there was a marked avoidance by samples with the highest contamination load. The results of this study lead to the understanding of the potential negative effects of human activities on local Amazonian biodiversity, since the potential toxicity of the environment, in conjunction with changes in the habitat selection process, could lead to a decline in populations of aquatic organisms, altering the environmental balance., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Urban tropical lagoons are commonly impacted by silting, domestic sewage and industrial wastes and the dredging of their sediments is often required to minimize environmental impacts. However, the ecological implications of land disposal of dredged sediments are still poorly investigated in the tropics. Aiming to contribute to filling this gap, an ecotoxicological evaluation was conducted with dredged sediments from Tijuca Lagoon (Rio de Janeiro, Brazil) using different lines of evidence, including soil and sediment characterization, metal determination, and acute and avoidance bioassays with Eisenia andrei. Two different dredged sediment samples, a sandy sediment and another muddy one, were obtained in two distinct and spatially representative sectors of the Tijuca Lagoon. The sediments were mixed with an artificial soil, Ferralsol and Spodosol to obtain doses between 0 (pure soil) and 12%. The sediment dose that caused mortality (LC 50 ) or avoidance responses (EC 50 ) to 50% of the organisms was estimated through PriProbit analysis. Metal concentrations and toxicity levels were higher in the muddy sediment (artificial soil LC 50  = 3.84%; Ferralsol LC 50  = 4.58%; Spodosol LC 50  = 2.85%) compared to the sandy one (artificial soil LC 50  = 10.94%; Ferralsol LC 50  = 14.36%; Spodosol LC 50  = 10.38%), since fine grains tend to adsorb more organic matter and contaminants. Mortality and avoidance responses were the highest in Spodosol due to its extremely sandy texture (98% of sand). Metal concentrations in surviving earthworms were generally low, except sodium whose bioaccumulation was high. Finally, the toxicity is probably linked to marine salts, and the earthworms seem to accumulate water in excess to maintain osmotic equilibrium, increasing their biomass., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

We aimed to analyze the seasonal acclimatization process of Nelore and Canchim cattle raised on two production systems (non-shaded, NS, and integrated crop-livestock-forest, ICLF), based on the dynamics of the morphological and functional attributes of the hair coat and skin during winter and summer. The study was conducted in Brazil, in a low-altitude tropical climate region. A completely randomized 2 × 2 factorial design was adopted as follows: two production systems (NS and ICLF), two breeds (Nelore and Canchim) in a longitudinal structure, with measurements repeated over time through two stations (winter and summer). The experimental animals consisted of 32 Nelore (Bos indicus) and 32 Canchim (5/8 Bos taurus × 3/8 Bos indicus) bulls. The animals were equally distributed between two intensive rotational grazing systems. In both breeds, the hair coat was significantly thicker in winter but longer in summer, which increased epidermal protection. The Nelore bulls had shorter, wider, and thicker hairs, which are attributes that promote heat loss via conduction. The Canchim bulls showed significantly lower hair density and higher epithelium distance to sweat glands, which resulted in higher core temperature and respiratory rate. In turn, Nelore bulls had higher serum concentrations of triiodothyronine and lower serum concentrations of cortisol. However, Canchim bulls more frequently and intensely activated their thermoregulatory system and markedly adjusted their hair coat and hair features to reduce heat gain, especially in summer. Therefore, the anatomical plasticity and functional integumentary characteristics of Nelore and Canchim bulls reflect their acclimatization to tropical conditions., (© 2024. The Author(s).)

This study examined the association between media and Instagram interaction patterns with weight bias among undergraduate nutrition students in the Brazilian Nutritionists' Health Study. We also explored the potential mediating role of students' own body image perception in these relationships. A total of 406 students (78% women) participated in this cross-sectional analysis. Sociodemographic data, media influence, Instagram interaction patterns, body image perception, and weight bias were assessed using semi-structured questionnaires. Findings indicated that exposure to fitness content on Instagram ( β = 0.17, p < 0.001) and the pursuit of an ideal athletic body ( β = 0.12, p = 0.034) were associated with increased weight bias. In contrast, engagement with body diversity content ( β = -0.23, p < 0.001) and perceived pressure from media to conform to appearance ideals ( β = -0.24, p < 0.001) had a mitigating effect on weight bias. Notably, body image perception did not mediate these relationships ( p > 0.05). In conclusion, this study revealed a link between media exposure and weight bias among undergraduate nutrition students, independent of their body image perception. Developing social media literacy programs that encourage students to critically evaluate media content is imperative to reduce weight bias. Additionally, a deeper examination of the media content that contributes to weight bias and the potential need for targeted regulatory measures is warranted.

University students are vulnerable to mental health issues during their academic lives. During the COVID-19 pandemic, university students faced mental distress due to lockdowns and the transition to e-learning. However, it is not known whether these students were also affected specifically by COVID-19-related traumatic events. This study examined the impact of COVID-19-related traumatic events on 2277 university students from two federal institutions of higher education in Brazil. The university students completed an online questionnaire covering demographics, lifestyle habits, health characteristics, COVID-19-related traumatic events, and depression, anxiety, and stress symptoms. The results showed that an increased intensity of COVID-19-related traumatic events was positively associated with stress, anxiety, and depressive symptoms, and each specific type of event was associated with these symptoms. In addition, we found a negative association between these symptoms and male sex and age and a positive association with having or having had a history of cardiovascular, respiratory, neurological, or mental disorders or another disease diagnosed by a physician. In conclusion, this study emphasizes the heightened risk of mental health issues in university students in the face of COVID-19-related traumatic events. Women, young people and people who have or have had a history of disease were the most vulnerable to mental health issues during the COVID-19 pandemic., Competing Interests: Declaration of competing interest The Authors declare that there is no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Objectives: To evaluate the feasibility of using the pulp volume (Pv) to total volume (Tv) ratio (Pv:Tv), obtained from cone beam computed tomography (CBCT) scans of single-rooted teeth, for age estimation in a Brazilian population sample., Methods: After obtaining approval from the ethics committee, the study commenced by applying inclusion criteria to screen CBCT scans, resulting in a probability-based sample of participants aged 18 years and older (ranging from 18 to 82 years, with a mean age of 46.44 years). A total of 517 single-rooted teeth, including maxillary central incisors (CI), mandibular canines (C), and mandibular first premolars (FP), were chosen based on excellent agreement values (> 0.9). Pv and Tv measurements were conducted using semi-automatic segmentation with ITK-SNAP 3.8 software. Statistical analysis was performed using Jamovi software, with a significance level set at 5% (α = 0.05)., Results: A strong negative correlation (r > -0.7) was observed between chronological age and the Pv:Tv ratio across all examined teeth. However, when conducting regression analysis with Pv:Tv data and chronological age as the independent variable, only the mandibular FP teeth exhibited a normal distribution. The resulting linear model demonstrated moderate predictive value (approximately 64%) in explaining the variance in chronological age, but caution should be exercised when interpreting these findings., Conclusions: The method of measuring individual tooth volume using CBCT to estimate chronological age via Pv:Tv has been demonstrated as effective and reproducible within the Brazilian population sample., (© 2024. The Author(s) under exclusive licence to Japanese Society for Oral and Maxillofacial Radiology.)

Purpose: The aim of the present study was to analyze the frequency of the piroplasmids in blood from dogs and ticks recovered from these animals in Teresópolis city, located in the mountain region of Rio de Janeiro state, Brazil. In addition to the clinical and hematological profile., Methods: A total of 400 dogs attended in a veterinary clinic in this city between 2020 and 2021 were included. The blood was collected from the dogs, along with ticks and information on these dogs was obtained through a questionnaire applied to the owners. Thin-smear analyses and complete blood counts were performed. All forms characteristic of piroplasmids were measured and classified morphologically. The blood was also subjected to PCR assays based on the genes 18S rRNA and hsp70. In addition, the ixodid ticks were classified morphologically and subjected to PCR for piroplasmids research. The amplified products were sent for gene sequencing., Results: Piroplasmids were detected in 2.3% of the dogs. The variables statistically associated with infections in these animals were hemorrhage/bleeding, jaundice, anisocytosis, activated monocytes and macroplatelets (p ≤ 0.05). Piriform, ring-shaped, oval and aberrant structures were viewed in erythrocytes, neutrophils and monocytes, with lengths greater than and less than 2.5 µm. The nine positive samples from these dogs were characterized as due to Rangelia vitalii. However, one sequence from B. vogeli was detected in a single adult specimen of R. sanguineus., Conclusion: Although circulation of two species of piroplasmids potentially infective for domestic dogs has been observed in the mountain city of Rio de Janeiro, infection due to R. vitalii was mostly seen in the dogs of the present study., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Mastitis is the most common disease of dairy cattle and can be manifested in clinical and subclinical forms. The overuse of antimicrobials in the treatment and prevention of mastitis favours antimicrobial resistance and milk can be a potential route of dissemination. This study aimed to evaluate the biological quality of bulk tank milk (BTM) and the microbiological quality and signs of mastitis of freshly milked raw milk. In addition, to evaluate antimicrobial resistance in Enterobacteriaceae and Staphylococcus spp. isolated from freshly milked raw milk. None of the farms were within the official Brazilian biological quality limits for BTM. Freshly milked raw milk with signs of clinical (CMM), subclinical (SCMM) and no signs (MFM) of mastitis were detected in 6.67%, 27.62% and 65.71% samples, respectively. Most samples of freshly milked raw milk showed acceptable microbiological quality, when evaluating the indicators total coliforms (78.10%), Escherichia coli (88.57%) and Staphylococcus aureus (100%). Klebsiella oxytoca and S. aureus were the most prevalent microorganisms in SCMM and MFM samples. Antimicrobial resistance and multidrug resistance (MDR) were observed in 65.12% and 13.95% of Enterobacteriaceae and 84.31% and 5.88% of Staphylococcus spp., respectively, isolated from both SCMM and MFM samples. Enterobacteriaceae resistant to third-generation cephalosporin (3GCR) (6.98%) and carbapenems (CRE) (6.98%) and methicillin-resistant S. aureus (MRSA) (4.88%) were observed. Antimicrobial-resistant bacteria can spread resistance genes to previously susceptible bacteria. This is a problem that affects animal, human and environmental health and should be evaluated within the one-health concept., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: The sphenoid bone is an irregular, unpaired, symmetrical bone located in the middle of the anterior skull and is involved in craniofacial growth and development. Since the morphology of Sella turcica (ST) is associated with different craniofacial patterns, this study aimed to investigate if there is a correlation between ST morphology on the one hand and sagittal craniofacial patterns on the other hand., Methods: This study was conducted with a convenience sample that included Brazilian individuals undergoing orthodontic treatment. Lateral cephalograms were used to evaluate the calcification pattern and morphology of ST, as well as skeletal class by analyzing the ANB angle. Pearson's chi-square test with Bonferroni post-hoc test was performed to evaluate the association between ST calcification pattern and morphology, and anteroposterior skeletal malocclusion. The established significance level was 0.05., Results: The study collective was comprised of 305 orthodontic patients (178 (58.4 %) female, 127 (41.6 %) male), who had a mean age of 23.2 (±10.6) years. 131 participants (42.9 %) presented skeletal class I, 142 (46.6%) skeletal Class II, and 32 (10.5%) had a skeletal class III. The degree of prognathism of the mandible showed a homogenous distribution within the study collective (91 (29.9 %) orthognathic, 100 (32.9 %) retrognathic, 113 (37.2 %) prognathic mandible). Concerning the maxilla, 92 (30.2%) individuals presented an orthognathic upper jaw, whereas 60 (19.7%) showed maxillary retrognathism and 153 (50.2%) maxillary prognathism. Compared to patients with skeletal class I, skeletal class III individuals presented significantly more hypertrophic posterior clinoid process (p<0.007) and pyramidal shape of the dorsum of the ST (p<0.038)., Conclusions: Our results suggest that the hypertrophic posterior clinoid process and pyramidal shape of the ST dorsum are more prevalent in individuals with skeletal class III malocclusion., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier GmbH.. All rights reserved.)

Mercury (Hg) contamination on the Brazilian southeast coast has been highlighted, especially in relation to species of commercial importance. This study aimed to quantify the Hg concentration in species of mussels, fish, and crabs obtained from fishing colonies on the beaches of the west and south of the city of Rio de Janeiro, investigate the possible effect of seasonality, sex, and location sampling, and finally, the risk to consumer health in four different age groups. The difference between cooked and raw commercially available mussel samples was also verified. The main results highlight that the fish presented higher levels of Hg and that the mussel samples sold cooked presented lower levels of Hg when compared to the raw ones. For Micropogonias furnieri, Sardinella brasiliensis, and Callinectes spp., the season variable influenced Hg concentrations, while only for Merluccius merluccius was a difference between the sexes identified, with males having the highest values. Although Hg concentrations in animals were below the permitted limit, consumption of all species exceeded the monthly intake limit for this metal. For the hazard quotient (HQ) calculation, most species presented HQ > 1, especially when ingested by the child population. These results are fundamental for designing consumption strategies for these animals, in order to prioritize the acquisition of some species over others, depending on the location and/or season, for each age group, with the aim of maintaining seafood consumption with minimal risk to the population's health., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

In this initial study, the impact of thermosonication as an alternative to the traditional fusion in Brazilian cheese spread (Requeijão Cremoso) manufacture was investigated. The effect of ultrasound (US) power was evaluated considering various aspects such as gross composition, microstructure, texture, rheology, color, fatty acid composition, and volatile compounds. A 13 mm US probe operating at 20 kHz was used. The experiment involved different US power levels (200, 400, and 600 W) at 85 °C for 1 min, and results were compared to the conventional process in the same conditions (85 °C for 1 min, control treatment). The texture became softer as ultrasound power increased from 200 to 600 W, which was attributed to structural changes within the protein and lipid matrix. The color of the cheese spread also underwent noticeable changes for all US treatments, and treatment at 600 W resulted in increased lightness but reduced color intensity. Moreover, the fatty acid composition of the cheese spread showed variations with different US power, with samples treated at 600 W showing lower concentrations of saturated and unsaturated fatty acids, as well as lower atherogenicity and thrombogenicity indexes, indicating a potentially healthier product. Volatile compounds were also influenced by US, with less compounds being identified at higher powers, especially at 600 W. This could indicate possible degradation, which should be evaluated in further studies regarding US treatment effects on consumer perception. Hence, this initial work demonstrated that thermosonication might be interesting in the manufacture of Brazilian cheese spread, since it can be used to manipulate the texture, color and aroma of the product in order to improve its quality parameters., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Daily violations of air quality have an impact on urban populations and cause damage to the environment. Thus, the study evaluated the violations of the daily concentrations of SO 2 , NO 2 , and PM 10 , in regions of the State of São Paulo (SSP), based on the National Environment Council (CONAMA) resolution no 491/2018 and the World Health Organization (WHO - World Health Organization. (2016). Ambient air pollution: a global assessment of exposure and burden of disease.) criteria. Daily SO 2 , NO 2 , and PM 10 data from 6 air quality stations operated by Environmental Company of the State of São Paulo CETESB (1996-2011) were organized and submitted to quality control, with data faults (gaps) being identified. The imputation of data via spline proved satisfactory in filling in the gaps (r > 0.7 and low values of Standard Error of the Estimate (SEE) and Root Mean Square Error (RMSE). The cluster analysis (CA) applied to SO 2 formed only one homogeneous group (G 1 ). Contrariwise, NO 2 and PM 10 formed two homogeneous groups (G 1 and G 2 ) each. The stations that showed the greatest similarity according to the CA were Cerqueira Cesar and Osasco. The cophenetic matrix generated for SO 2 (0.83), NO 2 (0.79), and PM 10 (0.77) indicate a satisfactory adjustment of the dendrograms. The exploratory statistics applied to groups G 1 and G 2 point to the high variability of outliers. The WHO criteria are more restrictive than CONAMA regarding daily violations, with a reduction in SO 2 and an increase in specific years for NO 2 and PM 10 . Such variability is due to the adoption of public policies by the SSP and the influence of meteorological systems, being confirmed by the Run test that indicated oscillations in the time series, mainly in PM 10 , and also recognized well-defined biannual cycles., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Accurate estimates of the COVID-19 pandemic's indirect impacts are crucial, especially in low- and middle-income countries. This study aims to update estimates of excess maternal deaths in Brazil during the first two years of the COVID-19 pandemic., Methods: This was an exploratory mixed ecological study using the counterfactual approach. The observed maternal deaths were gathered from the Mortality Information System (SIM) for the period between March 2015 and February 2022. Expected deaths from March 2020 to February 2022 were estimated using quasipoisson generalized additive models, considering quadrimester, age group, and their interaction as predictor variables. Analyses were performed in R version 4.1.2, RStudio, version 2023.03.1+446 and carried out with support from the "mgcv" and "plot&#95;model" libraries., Results: A total of 5,040 maternal deaths were reported, with varying excess mortality across regions and age groups, resulting in 69% excess maternal mortality throughout Brazil during the first two years of the pandemic. The Southeast region had 50% excess mortality throughout the first two years and 76% excess in the second year. The North region had 69% excess mortality, increasing in the second year, particularly among women aged 20-34. The Northeast region showed 80% excess mortality, with a significant increase in the second year, especially among women aged 35-49. The Central-West region had 75% excess mortality, higher in the second year and statistically significant among women aged 35-49. The South region showed 117% excess mortality, reaching 203% in the second year among women aged 20-34, but no excess mortality in the 10-19 age category., Conclusions: Over two years, Brazil saw a significant impact on maternal excess deaths, regardless of region and pandemic year. The highest peak occurred between March and June 2021, emphasizing the importance of timely and effective epidemic responses to prevent avoidable deaths and prepare for new crises., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Orellana et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Uranium mining can cause environmental impacts on non-human biota around mine sites. Because of this, the reduction in non-human biota exposure becomes an important issue. Environmental radioprotection results from the evolution of human radioprotection; it is based on dose rate to non-human biota and uses, as a biological target, and has harmful effects on populations. In the present study, a flooded impoundment created following dam construction in a uranium mine plant undergoing decommissioning was investigated. Internal dose rates due to activity concentration of natural uranium (U nat ) and 232 Th in omnivorous, phytophagous, and carnivorous fish species were estimated. Radionuclide activity concentrations were obtained by spectrophotometry with arsenazo III in the visible range. The dose rate contribution of 232 Th was lower than that of U nat . There were no differences between the internal dose rates to studied fish species due to 232 Th, but there were differences for U nat . A dose rate of 2.30·10 -2  µGy∙d -1 was found due to the two studied radionuclides. Although this value falls below the benchmark for harmful effects, it is important to acknowledge that the assessment did not account for other critical radionuclides from uranium mining, which also contribute to the internal dose. Moreover, the study did not assess external doses. As a result, the possibility cannot be excluded that dose rates at the study area overcome the established benchmarks for harmful effects., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The dam failure of the Córrego do Feijão Mine (CFM) located in Minas Gerais State, Brazil, killed at least 278 people. In addition, large extensions of aquatic and terrestrial ecosystems were destroyed, directly compromising the environmental and socioeconomic quality of the region. This study assessed the pollution and human health risks of soils impacted by the tailing spill of the CFM dam, along a sample perimeter of approximately 200 km. Based on potential ecological risk and pollution load indices, the enrichments of Cd, As, Hg, Cu, Pb and Ni in soils indicated that the Brumadinho, Mário Campos, Betim and São Joaquim de Bicas municipalities were the most affected areas by the broken dam. Restorative and reparative actions must be urgently carried out in these areas. For all contaminated areas, the children's group indicated an exacerbated propensity to the development of carcinogenic and non-carcinogenic diseases, mainly through the ingestion pathway. Toxicological risk assessments, including acute, chronic and genotoxic effects, on people living and working in mining areas should be a priority for public management and mining companies to ensure effective environmental measures that do not harm human health and well-being over time., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Ocular toxoplasmosis (OT) is caused by protozoan T. gondii. Ophthalmological examination is considered the gold standard for OT diagnosis, and laboratory tests are used for diagnostic confirmation. However, these tests can present different results, which change depending on their basis, on sample type and on patients' clinical alteration. Thus, the aim of the present study is to assess immunodiagnostic and molecular techniques applied in blood, serum and tear fluid to diagnose T. gondii infection in patients seen at an Ophthalmology Clinic. In total, 160 patients were included in the study, 40 of them had OT with active lesions (G1); 40 had OT with healed lesions (G2), 40 had non-toxoplasmic uveitis (G3) and 40 had no ocular alterations (G4). Serum samples were subjected to Immunoenzymatic Assay (ELISA) and to Indirect Immunofluorescence Reaction (IFAT) to search for anti-T. gondii IgM and IgG. Tear fluid samples were analyzed through ELISA for IgA research. All blood and tear fluid samples were subjected to conventional polymerase chain reaction (cPCR) and in a Nested PCR model for T. gondii DNA amplification with targets B1, GRA7 and REP 529. IgG and IgM anti-T. gondii was detected in serum samples from 106 and 15 patients, respectively, when combining ELISA and IFAT results. Anti-T.gondii IgA antibodies were detected in 9.2% of the tear material. Nested PCR with GRA7 target showed higher positivity in blood samples (24.4%); Nested PCR with B1 target showed a higher frequency of positivity in tears (15%). Biological samples of patients with active lesions showed the highest positivity frequencies in all immunodiagnostic assays, as well as in most PCR models. The present results highlighted the need of associating techniques with different fundamentals to confirm OT diagnosis. Furthermore, further tear fluid analyses should be performed to validate this biological material as lesser invasive alternative for the more accurate OT diagnosis., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ramos et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The occurrence of adverse drug events (ADEs) during dapsone (DDS) treatment in patients with leprosy can constitute a significant barrier to the successful completion of the standardized therapeutic regimen for this disease. Well-known DDS-ADEs are hemolytic anemia, methemoglobinemia, hepatotoxicity, agranulocytosis, and hypersensitivity reactions. Identifying risk factors for ADEs before starting World Health Organization recommended standard multidrug therapy (WHO/MDT) can guide therapeutic planning for the patient. The objective of this study was to develop a predictive model for DDS-ADEs in patients with leprosy receiving standard WHO/MDT., Methodology: This is a case-control study that involved the review of medical records of adult (≥18 years) patients registered at a Leprosy Reference Center in Rio de Janeiro, Brazil. The cohort included individuals that received standard WHO/MDT between January 2000 to December 2021. A prediction nomogram was developed by means of multivariable logistic regression (LR) using variables. The Hosmer-Lemeshow test was used to determine the model fit. Odds ratios (ORs) and their respective 95% confidence intervals (CIs) were estimated. The predictive ability of the LRM was assessed by the area under the receiver operating characteristic curve (AUC)., Results: A total of 329 medical records were assessed, comprising 120 cases and 209 controls. Based on the final LRM analysis, female sex (OR = 3.61; 95% CI: 2.03-6.59), multibacillary classification (OR = 2.5; 95% CI: 1.39-4.66), and higher education level (completed primary education) (OR = 1.97; 95% CI: 1.14-3.47) were considered factors to predict ADEs that caused standard WHO/MDT discontinuation. The prediction model developed had an AUC of 0.7208, that is 72% capable of predicting DDS-ADEs., Conclusion: We propose a clinical model that could become a helpful tool for physicians in predicting ADEs in DDS-treated leprosy patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 de Araujo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This study aimed to analyse intersectoral arrangements among the health, education and social assistance sectors in the operationalization of the Bolsa Família Program (BFP). A qualitative approach was carried out, in a peripheral region of a large urban centre of Southeast Brazil. Data content analysis was performed on the basis of reference in the Actor-Network Theory (ANT) using statements by the actors and considering ideas in dispute and work processes in the geopolitical territorial context. Seventeen managers of Municipal Secretariats of Health, Education and Social Assistance were interviewed, as were basic education, primary health care and social assistance professionals. One-off, episodic and discontinuous intersectoral actions were identified, with limited integration among sectors. Convergences and conflicts were found with respect to the institutional processes of BFP. The convergences referred to the conceptions shared among the actors about the role of intersectoral collaboration, as they recognize themselves as providing care to the same vulnerable population. Considering the multiple vulnerabilities of these families, the convergence of actions from different sectors can impact factors that condition inequalities. The conflicts were related to institutional conditions, to sectorized work processes and to a lack of understanding by professionals about the duties of their respective sectors.

In the last few years, the number of studies on feline hepatozoonosis has increased, but our knowledge on the actual species of Hepatozoon and/or different genotypes affecting felines is still incipient. At least three species, namely Hepatozoon felis, H. canis, and H. silvestris, have been isolated from domestic cats in various countries. Additionally, there are indications that other species and genotypes may affect felines in given geographic areas. This study was carried out to investigate the occurrence of Hepatozoon spp. in cats from Niterói, a municipality within the metropolitan area of Rio de Janeiro, Brazil. Individual blood samples were collected from 28 cats enrolled in a spaying/castration program. DNA was extracted from all samples and subjected to sequencing specific for Hepatozoon spp. DNA of H. felis was found in 21/28 cats (75%), and four genetic polymorphisms never described thus far were detected. This is the first report of H. felis in cats living in the State of Rio de Janeiro, and the present data confirm that H. felis is a species complex encompassing different genotypes circulating within cat populations. Further studies are warranted to investigate whether different genotypes have different biology or pathogenicity for felids., (© D. Traversa et al., published by EDP Sciences, 2024.)

The Brazilian National Network of Alternative Methods (RENAMA), which is linked to the Ministry of Science, Technology and Innovation, is currently comprised of 51 laboratories from CROs, academia, industry and government. RENAMA's aim is to develop and validate new approach methodologies (NAMs), as well as train researchers and disseminate information on their use - thus reducing Brazilian, and consequently Latin American, dependence on external technology. Moreover, it promotes the adoption of NAMs by educators and trained researchers, as well as the implementation of good laboratory practice (GLP) and the use of certified products. The RENAMA network started its activities in 2012, and was originally comprised of three central laboratories - the National Institute of Metrology, Quality and Technology (INMETRO); the National Institute of Quality Control in Health (INCQS); and the National Brazilian Biosciences Laboratory (LNBio) - and ten associated laboratories. In 2022, RENAMA celebrated its 10th anniversary, a milestone commemorated by the organisation of a meeting attended by different stakeholders, including the RENAMA-associated laboratories, academia, non-governmental organisations and industry. Ninety-six participants attended the meeting, held on 26 May 2022 in Balneário Camboriú, SC, Brazil, as part of the programme of the XXIII Brazilian Congress of Toxicology 2022. Significant moments of the RENAMA were remembered, and new goals and discussion themes were established. The lectures highlighted recent innovations in the toxicological sciences that have translated into the assessment of consumer product safety through the use of human-relevant NAMs instead of the use of existing animal-based approaches. The challenges and opportunities in accepting such practices for regulatory purposes were also presented and discussed., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study investigates the chronology of copper (Cu) contamination and its stable isotopes within an emblematic Brazilian mangrove impacted by multiple urban and industrial Cu sources, deforestation, and eutrophication. In particular, it tests Cu isotopes as tracers of anthropogenic inputs into an anthropized watershed impacted by multiple sources. To do so, we used multi-isotopic approaches (δ 65 Cu, δ 13 C, and δ 15 N), elemental analyses (Al, Ca, Fe, P, Cu, C, and N), and selective and sequential extractions in a 210 Pb-dated sediment core. This geochemical "toolbox" allowed identifying two main stages of Cu evolution in the sediment core. In the first stage, before 1965, Cu isotope fingerprints responded to landscape changes, indicating a shift from marine to geogenic dominance due to the remobilization and erosion of terrestrial materials. In the second stage, after 1965, the sediment geochemical profile showed increased Cu total concentrations with a higher bioavailability (as reflected by sequential extraction data) accompanying changes in Cu isotope signatures towards anthropogenic values. The findings evidence that local industrial sources, possibly combined with diffuse urban sources, export Cu into downstream mangroves with a distinguishable isotope signature compared to natural values. This study demonstrates the applicability of Cu isotopes as new environmental forensic tools to trace anthropogenic sources in mangrove sediments. Incorporated into a robust geochemical toolbox that combines inorganic and organic proxies for sedimentary materials, this new tool provides a comprehensive understanding of Cu dynamics in mangrove ecosystems, shedding light on the historical and current sources of Cu., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

This study aimed to estimate the risk of listeriosis from the consumption of pasteurized milk in Brazil, comparing conventional treatment with the technology of thermosonication. The Quantitative Microbiological Risk Assessment (QMRA) model was developed, covering the entire milk production chain, from milking to the moment of consumption. In general, higher risks were observed in association with higher initial concentrations of the pathogen and the vulnerable population. The highest risk predicted (3.67 × 10 -5 ) was related to the scenario considering the initial concentration range of L. monocytogenes between 4 and 6 log CFU/mL, with conventional treatment and considering the vulnerable population, resulting in one case of listeriosis every 27,248 servings. When considering thermosonication treatment, lower risks have been predicted. The scenario analysis indicated that the steps related to storage conditions in retail and at the consumer's home (post-processing steps) are the most influential in the associated risk, in all scenarios. The predictive parameters of inactivation related to the applied treatment also have a considerable influence on the risk. The results point to the influence of the stages of the dairy production chain and the thermosonication treatment applied in the food safety of milk, subsidizing information for industrial application and for regulatory agencies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Artepillin C is the most studied compound in Brazilian Green Propolis and, along with its acetylated derivative, displays neurotrophic activity on PC12 cells. Specific inhibitors of the trkA receptor (K252a), PI3K/Akt (LY294002), and MAPK/ERK (U0126) signaling pathways were used to investigate the neurotrophic mechanism. The expression of proteins involved in axonal and synaptic plasticity (GAP-43 and Synapsin I) was assessed by western blotting. Additionally, physicochemical properties, pharmacokinetics, and drug-likeness were evaluated by the SwissADME web tool. Both compounds induced neurite outgrowth by activating the NGF-signaling pathways but through different neuronal proteins. Furthermore, in silico analyses showed interesting physicochemical and pharmacokinetic properties of these compounds. Therefore, these compounds could play an important role in axonal and synaptic plasticity and should be further investigated., (© 2023 Wiley-VHCA AG, Zurich, Switzerland.)

Brazilian Amazon contains over 30,000 plant species and foods rich in bioactive compounds such as terpenes, phenolic acids, alkaloids, and flavonoids, of potential health benefits (antioxidant, antimicrobial, antiparasitic, anticancer, gastroprotection, prebiotic effects, among others). The existence of residues from non-edible parts of plants (leaves, roots, stems, branches, barks) or fruit wastes (peel, bagasse, seeds) in the agri-food industry and its supply chain is an important challenge in food loss and waste management. In this critical review several Amazon species, focusing on extracts/essential oils from nonedible parts or wastes, were analyzed in terms of phytochemicals, biological activity, and underlying mechanisms. We hope this review emphasizes the importance of Amazon's sustainability initiatives on population health due to the potential shown against cancer, infectious diseases, and prevention of oral diseases. It is urgent to think about the conversion of amazon food wastes and co-products into high-added-value raw materials to develop novel drugs, food packaging systems, or nutraceutical foods.

Mercury is an element with potential risk to fish and those who consume it. Thus, this study aimed to determine the levels of total mercury (THg), carry out a health risk assessment related to the consumption of the freshwater stingrays Potamotrygon motoro , and determine the physical and chemical properties of the water where stingrays occur. Stingrays of the species P. motoro were obtained from the Amazon River, and samples of the animals' musculature were collected to determine THg levels. Risk assessment was conducted using pre-established formulas of estimated monthly intake (EMI), maximum monthly intake rate (IRmm), and hazard quotient (HQ). Three population scenarios were evaluated, considering both sexes and differences between rural and urban areas. There was no relationship between weight and THg concentration nor between total length and THg concentration. Higher EMI values were observed in rural children; for the IRmm, male children had the lowest consumption levels. For the hazard quotient, there was a similarity between the three age groups when comparing the male and female sexes. In addition, the representatives of the rural area always had lower values than the urban area. Freshwater stingrays, like other elasmobranchs, can be crucial animal species because they act as sentinels in studies that assess harmful chemicals like mercury.

Submarine outfalls have been employed to convey urban effluents to their fate in the open ocean due to their dilution capacity and organic matter decay. This work analysed Escherichia coli concentrations in the Barra da Tijuca (Rio de Janeiro, Brazil) submarine outfall plume, considering an hourly variable bacterial die-off due to environmental parameters associated with dynamic changes, vertical plume position, and thickness in response to hydrodynamic conditions. The adopted modelling procedure included coupling a near-field mixing zone model, NRFIELD, with the far-field Lagrangian transport and water quality model of the SisBaHiA® ( http://www.sisbahia.coppe.ufrj.br ). The coupling methodology simulated E. coli concentrations considering simultaneous variations in temperature, salinity, solar radiation, and hydrodynamic conditions. The results showed substantial variability in E. coli concentrations in the marine environment due to variable environmental conditions, regulating solar radiation levels over the submerged plume., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Dictyotaceae algae have gained recognition as prolific producers of diterpenes, which are molecules with significant biotechnological potential. These diterpenes hold immense promise as potential active drug components, making the algae a compelling area of study. The present review aims to present the latest advancements in understanding the biopotential of Brazilian Dictyota and Canistrocarpus brown algae, shedding light on the remarkable diversity and the biological and pharmacological potential of the secondary metabolites they produce. A total of 78 articles featuring 26 distinct diterpenes are reported in this review, with their antiviral potential being the mosthighlighted biological activity. Despite considerable research on these algae and their diterpenes, significant knowledge gaps persist. Consequently, the present review is poised to serve as a pivotal resource for researchers who are actively engaged in the pursuit of active diterpenes beyond the immediate purview. Furthermore, it holds the potential to catalyze an increase in research endeavors centered around these algal species within the geographical confines of the Brazilian coastline. Also, it assumes a critical role in directing future scientific explorations toward a better comprehension of these compounds and their ecological implications.

Objective: To relate the distance traveled from the patient's residence to the gestational trophoblastic neoplasia (GTN) reference center (RC) and the occurrence of unfavorable clinical outcomes, as well as to estimate the possible association between this distance and the risk of metastatic disease at presentation, the need for multiagent chemotherapy to achieve remission and loss to follow-up before remission., Study Design: Retrospective historical cohort study of patients with GTN followed at 8 Brazilian GTN-RC, from January 1st, 2000 - December 31st, 2017., Results: Evaluating 1055 cases of GTN, and using a receiver operating characteristic curve, we found a distance of 56 km (km) from the residence to the GTN-RC (sensitivity = 0.57, specificity = 0.61) best predicted the occurrence of at least one of the following outcomes: occurrence of metastatic disease, need for multiagent chemotherapy to achieve remission, or loss to follow-up during chemotherapy. Multivariate logistic regression adjusted by age, ethnicity, marital status and the reference center location showed that when the distance between residence and GTN-RC was ≥56 km, there was an increase in the occurrence of metastatic disease (relative risk - RR:3.27; 95%CI:2.20-4.85), need for multiagent chemotherapy (RR:1.36; 95%CI:1.05-1.76), loss to follow-up during chemotherapy (RR:4.52; 95CI:1.93-10.63), occurrence of chemoresistance (RR:4.61; 95%CI:3.07-6.93), relapse (RR:10.27; 95%CI:3.08-34.28) and death due to GTN (RR:3.62; 95%CI:1.51-8.67)., Conclusions: The distance between the patient's residence and the GTN-RC is a risk factor for unfavorable outcomes, including death from this disease. It is crucial to guarantee these patients get prompt access to the GTN-RC and receive follow-up support., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: The innate immune response plays an important role during malaria. Toll-like receptors (TLR) are capable of recognizing pathogen molecules. We aimed to evaluate five polymorphisms in TLR-4, TLR-6, and TLR-9 genes and their association with cytokine levels and clinical parameters in malaria from the Brazil-French Guiana border., Methods: A case-control study was conducted in Amapá, Brazil. P. vivax patients and individuals not infected were evaluated. Genotyping of five SNPs was carried out by qPCR. Circulating cytokines were measured by CBA. The MSP-1 19 IgG antibodies were performed by ELISA., Results: An association between TLR4 A299G with parasitemia was observed. There was an increase for IFN-ɤ, TNF-ɑ, IL-6, and IL-10 in the TLR-4 A299G and T3911, TLR-6 S249P, and TLR-9 1486C/T, SNPs for the studied malarial groups. There were significant findings for the TLR-4 variants A299G and T3911, TLR-9 1237C/T, and 1486C/T. For the reactivity of MSP-1 19 antibodies levels, no significant results were found in malaria, and control groups., Conclusions: The profile of the immune response observed by polymorphisms in TLRs genes does not seem to be standard for all types of malaria infection around the world. This can depend on the human population and the species of Plasmodium., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: The immunopathology during malaria depends on the level of inflammatory response generated. In this scenario, the TREM-1 has been associated with the severity of infectious diseases and could play an important role in the inflammatory course of malaria. We aimed to describe the allelic and genotypic frequency of four polymorphisms in the trem-1 gene in Plasmodium vivax-infected patients and to verify the association of these polymorphisms with clinical and immunological factors in a frontier area of the Brazilian Amazon., Methods: We included 76 individuals infected with P. vivax and 144 healthy controls living in the municipality of Oiapoque, Amapá, Brazil. The levels of TNF-α, IL-10, IL-2, IL-4, IL-5, and IFN-γ were measured by flow cytometry, while IL-6, sTREM-1, and antibodies against PvMSP-1 19 were evaluated by ELISA. The SNPs were genotyped by qPCR technique. Polymorphisms analysis, allelic and genotype, frequencies, and HWE calculation were determined by x 2 test in R Software. The association between the parasitemia, gametocytes, antibodies, cytokines, and sTREM-1 with the genotypes of malaria and control groups was performed using the Kruskal-Wallis test, these analyzes were conducted in SPSS Software, at 5% significance level., Results: All SNPs were successfully genotyped. Allelic and genotypic distribution was in Hardy-Weinberg Equilibrium. Furthermore, several associations were identified between malaria and control groups, with increased levels of IL-5, IL-6, IL-10, TNF-α, and IFN-γ in the infected individuals with rs6910730A, rs2234237T, rs2234246T, rs4711668C alleles compared to the homozygous wild-type and heterozygous genotypes of the controls (p-value < 0.05). No association was found for these SNPs and the levels of IL-2, and sTREM-1., Conclusions: The SNPs on the trem-1 gene are associated with the effector molecules of the innate immunity and may contribute to the identification and effective participation of trem-1 in the modulation of the immune response. This association may be essential for the establishment of immunization strategies against malaria., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: To analyze the experiences of maternal health workers in three Brazilian cities, located in the Northeast (São Luís), Southeast (Niterói), and South (Pelotas) regions during the first year of the COVID-19 pandemic., Methods: Qualitative research carried out between December 2020 and February 2021. Interviews were conducted, in person or remotely, with 30 health workers, doctors and nurses, working in maternity hospitals of different degrees of complexity., Results: Sociodemographic characteristics, employment relationships and professional qualification of the interviewees were described. Two thematic axes were identified: 1) changes in hospital organization and dynamics in the pandemic; 2) Illness and suffering of health workers. The majority of respondents were women. Most physicians had work relationships in the public and private sectors. In Niterói, health workers had better professional qualifications and more precarious work relationships (as temporary hires), compared to São Luís and Pelotas. In the context of the uncertainties resulting from the pandemic, this situation generated even more insecurity for those workers. The statements at the beginning of the pandemic covered topics such as changes in the organizational dynamics of services, healthcare, telemedicine, and interaction between health workers and users. In the health workers' perception, the initial period of the health emergency, which resulted in intense changes in the provision of services, was marked by an increase in preterm births, perinatal mortality, and fetal losses. Work overload, fear of contamination, concern for family members and uncertainties regarding the new disease caused intense suffering in health workers who had little institutional support in the cities studied. The suffering experienced by health workers went beyond the work dimension, reaching their private life., Conclusion: Changes caused by the pandemic required immediate adjustments in professional practices, generating insecurities in healthcare regardless of the location studied. The method of hiring health workers remained the same as the previously practiced one in each city. Due to the risk of disease transmission, measures contrary to humanization practices, and more restrictive in São Luís, were reported as harmful to obstetric care. The Covid-19 pandemic was a huge challenge for the Brazilian health system, aggravating the working conditions experienced by health workers. In addition to the work environment, it was possible to briefly glimpse its effects on private life., Competing Interests: The authors declare that they have no conflict of interest, (Copyright: © 2023 Carvalho et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Undergraduate students present high rates of psychological distress, including suicide risk. Due to the coronavirus disease 2019 (COVID-19) pandemic, this scenario may have been aggravated. Thus, the objective of the current study was to evaluate changes in the suicide risk rate from the period before to during the COVID-19 pandemic, as well as the factors associated with this outcome among Brazilian undergraduate students., Methods: This was a nationwide survey carried out in Brazil with a cross-sectional design, including two data collection periods: a single-center in-person collection in 2019 and another multicenter online collection in 2020/2021. Data were collected using self-administered instruments. The outcome was a high risk of suicide, measured through the Mini International Neuropsychiatric Interview. Analyses were carried out on data from two periods, i.e. before and during the pandemic (bivariate analysis and interaction tests), and a model of associated factors (multivariate analysis using Poisson regression) was developed including all participating universities distributed in the five regions of Brazil., Results: In total, 6716 Brazilian undergraduate students participated (996 in 2019 and 5720 in 2020/2021). The prevalence of a high suicide risk rose from 11.3% to 17.0%, especially among women and poorer individuals. The prevalence of a high risk of suicide among Brazilian undergraduates was 19.6% and was associated with several socioeconomic, academic, pandemic, and mental health factors., Conclusions: The prevalence of a high suicide risk increased from prepandemic to during the pandemic, appearing to be largely influenced by social determinants, in conjunction with the implications of the COVID-19 pandemic.

Background: The control of the COVID-19 pandemic has been a great challenge. Understanding the thoughts and beliefs underlying vaccine hesitancy can help in the formulation of public policies. The present study aimed to analyze the social representations of hesitant Brazilians about vaccination against COVID-19., Methods: Qualitative research guided by the Theory of Social Representations, carried out through an online survey among Brazilian adults living in Brazil. The data were analyzed using the IRaMuTeQ software., Results: Of the 173,178 respondents, 10,928 were hesitant and declared reasons for vaccination hesitation. The analysis generated three classes: mistrust of the vaccine and underestimation of the severity of the pandemic; (dis)information and distrust of political involvement; and fear of adverse reactions to COVID-19 vaccines., Conclusions: Social knowledge, presented by the representations apprehended in this study, demonstrates difficulty in discerning the reliability of information and a social imagination full of doubts and uncertainties. Understanding the internal dynamics of these groups, with their representations of the world, is important to propose policies and actions that echo and cause changes in the understanding of the role of immunization. It is essential to shed light on the sociological imagination so that gaps filled with false information can be dismantled and confronted with scientific knowledge accessible to the population.

Student assistance (SA), regulated through the National Student Assistance Program (PNAES), seeks to meet the basic social needs of university students and is inserted in the field of public policies for higher education in federal institutions in Brazil. The program allocates financial resources in order to provide scholarships, housing, food, transport, physical and mental health, and accessibility for disabled students. The present study aims to identify the senses attributed by students of a federal public university to AE and the relationship between SA and their eating practices during the COVID-19 pandemic. A qualitative approach was used. Online questionnaire and focus groups were employed for data collection. The study public consisted of undergraduate students. Descriptive statistics and content analysis were used, opting for thematic analysis, with the support of the MAXQDA software. The core meanings were organized into two categories: (i) food during pandemic and (ii) role of student assistance. A total of 55 responses were obtained, and three focus groups were carried out. About 45% reported that the pecuniary aid offered by the university was the family's only source of income during the pandemic and 65% used it to buy food. More than half described worsening in food quality, related to food prices. Although no specific evaluation instrument was used, it is plausible to admit that the students experienced a situation of food insecurity, given the uncertainty in regular access to food, the compromised quality of food, and the strategies mobilized to guarantee a minimum amount of food for all members of the family. Among the reported strategies were changing the location and mode of acquisition (receiving donations, buying in groups or in wholesalers) and choosing cheaper genres. Although students consider SA essential for access and maintenance at the university, a sense assigned to SA was the role of "help." In general, students did not link SA to social rights, as part of public educational policy and as a mechanism for food and nutrition security. SA actions developed during the pandemic were essential for keeping students at the university, also functioning, albeit unintentionally, as a food and nutritional security mechanism., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Mota, Santos and Campos.)

Background: Chronic kidney disease (CKD) patients on dialysis display a low-grade systemic inflammatory burden. Nutritional interventions designed to activate the cytoprotective nuclear factor erythroid-2-related factor 2 (Nrf2) and inhibit nuclear factor-kB (NF-κB) have been proposed to mitigate this burden. Several bioactive compounds have been investigated to achieve this, including propolis, a resin produced by Apis mellifera bees. Considering the safety and efficacy of propolis, it could be a strategy to benefit these patients. Still, there are no studies using propolis in patients with CKD on peritoneal dialysis (DP), and clinical studies to support this application are lacking., Hypothesis/purpose: The objective and novelty of the present study are to evaluate the effects of propolis supplementation on inflammatory markers in patients with CKD on PD., Study Design: A longitudinal, double-blind, placebo-controlled trial with CKD patients on PD., Methods: The patients were randomised into two groups: propolis that received four capsules of 100 mg (400 mg/day), containing concentrated and standardised dry EPP-AF® Brazilian green propolis extract) or placebo, four capsules of 100 mg (400 mg/day), of magnesium stearate, silicon dioxide, and microcrystalline cellulose, for two months. Plasma levels of inflammatory cytokines, including tumour necrosis factor (TNF-α) and interleukin-6 (IL-6), were evaluated by ELISA. Quantitative real-time PCR analyses were performed to evaluate the transcriptional expression levels of Nrf2 and NF-κB in peripheral blood mononuclear cells (PBMCs). Plasma malondialdehyde (MDA) levels, a lipid peroxidation marker, was measured as thiobarbituric acid reactive substances (TBARS). Routine biochemical markers, including C-reactive protein (CRP), were analysed using commercial kits. Carotid Intima-Media Thickness (CIMT) was measured with a doppler ultrasonography device. The study was registered on ClinicalTrials.gov under the number NCT04411758., Results: A total of 19 patients completed the study, ten patients in the propolis group (54 ± 1.0 years, five men, 7.2  (5.1) months on PD) and 9 in the placebo group (47.5 ± 15.2 years, three men, 10.8  (24.3) months on PD). The plasma levels of TNF-α reduced significantly (p = 0.02), and expression of Nrf2 showed a trend to increase (p = 0.07) after propolis supplementation., Conclusion: EPP-AF® Green Propolis extract (400 mg/day) supplementation for two months appears as a potential strategy to mitigate inflammation, reducing TNF-α plasma levels in CKD patients on PD., Competing Interests: Declaration of Competing Interest AAB works at Research, Development, and Innovation Department, Apis Flora Indl. Coml. Ltda. All authors declare that they have no conflicts of interest., (Copyright © 2023 Elsevier GmbH. All rights reserved.)

The present study determined the presence of heavy metals in green sea turtles with and without fibropapillomatosis in Itapirubá and Cassino beaches, southern Brazil. The weight, curved length of the carapace and body index were determined and blood was collected to quantify the concentrations of cadmium, lead and mercury. A total of 51 blood samples were analyzed, being 46 positives for at least one of the metals. There was a greater number of juvenile turtles in Itapirubá, larger in size and weight than those in Cassino. No statistical differences were found between metal concentrations between regions or between turtles with and without fibropapillomatosis. There was no significant correlation between metal concentrations, biometric variables and the presence of fibropapilomatose. Metal concentrations were low in both regions, with the highest concentrations being Cd and the lowest Hg., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Non-conventional edible plants (NCEP) are plants or parts of plants that are not usually consumed by the population and have limited geographic distribution. This study investigated the consumption of NCEP, the influence of Food Neophobia and risk perception on Brazilian consumers attitudes as well as purchase preferences to determinate the best sale promotional strategy. Participants (n = 271) answered the online questionnaire that consisted of socio-demographic questions, items about consumption (open questions), Food Neophobia Scale, risk perception (to assign the level risk) and attitudes towards NCEP (using 5-point Likert scale). Fisher's exact test was used to investigate possible associations. Task purchase choice was evaluated using the Best-Worst Scale. The most consumed conventional leafy vegetables were collard greens (Brassica oleracea L. var. acephala D.C) (95.6%) and lettuce (Lactuca sativa) (88.5%). As for NCEP, taioba (Xanthosoma taioba E.G) (26.7%), bertalha (Basela alba L.) (23.3%) and beldroega (Portulaca oleracea L.) (14.1%) were the most cited leafy vegetables. High food neophobia individuals demonstrated to try NCEP if its nutritional value and safety are proven, showing a demand for such strategy, this would increase the consumption of these vegetables. The perception of a high risk was also associated with the inclusion of NCEP in the diet. The inclusion of NCEP at the moment of purchase, even at a higher price, presented higher scores when compared to the purchase of only conventional vegetables, at lower prices. Despite this, the price can still be a limiting factor and the search for promotional strategies should be reinforced to increase the commercialization of NCEP at street markets., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)