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O artigo estima a magnitude da coerção sexual entre jovens, moradores de três grandes centros urbanos brasileiros. Além de avaliar a prevalência, analisa as características de vítimas e perpetradores, identifica as principais estratégias de coerção utilizadas e explora os cenários sociais que favoreceram a ocorrência da violência sexual. Trata-se de parte dos resultados de um inquérito domiciliar realizado em Porto Alegre, Rio de Janeiro e Salvador, concluído em 2002 - Pesquisa GRAVAD. Foram realizadas entrevistas em uma amostra estratificada de homens e mulheres entre 18 e 24 anos, totalizando 4.634 respondentes (47,2% homens e 52,8% mulheres). A prevalência de coerção sexual ao longo da trajetória de vida foi estimada em 16,5% para as mulheres e 11,1% para os homens. A idade da vítima e do perpetrador no primeiro episódio, o tipo de relacionamento entre esses, e as formas de constrangimento utilizadas variaram entre rapazes e moças. A grande magnitude do evento, suas diferenças entre homens e mulheres e as maiores prevalências em certos subgrupos populacionais impõem a elaboração imediata de políticas e estratégias de ação específicas para a prevenção do problema.

O estudo enfoca as repercussões da paternidade ocorrida no período da adolescência, para a trajetória biográfica de rapazes de camadas populares. Realizou-se um trabalho de campo associado a entrevistas individuais com jovens pais, moradores de uma comunidade favelada da cidade do Rio de Janeiro. Advoga-se que a abordagem do ponto de vista masculino possibilita ter acesso a outros níveis de uma teia de significados e relações que remete à lógica contraceptiva, à formação de casal, à assunção da paternidade etc. Ressalta-se o entrelaçamento entre tipo de relacionamento e de parceria, usos e desusos de métodos contraceptivos e significados da paternidade para os jovens das camadas populares. Salienta-se que a assunção da paternidade ajuda o jovem na consolidação da imagem de homem "maduro", "responsável", "adulto".

Abstract Background Chronic low back pain is an expensive and difficult condition to treat. One of the interventions widely used by physiotherapists in the treatment of chronic non-specific low back pain is exercise therapy based upon the Pilates principles. Pilates exercises can be performed with or without specific equipment. These two types of Pilates exercises have never been compared on a high-quality randomised controlled trial. Methods/design This randomised controlled trial with a blinded assessor will evaluate eighty six patients of both genders with chronic low back pain, aged between 18 and 60 years, from one Brazilian private physiotherapy clinic. The patients will be randomly allocated into two groups: Mat Group will perform the exercises on the ground while the Equipment-based Group will perform the Pilates method exercises on the following equipment: Cadillac, Reformer, Ladder Barrel, and Step Chair. The general and specific disability of the patient, kinesiophobia, pain intensity and global perceived effect will be evaluated by a blinded assessor before randomisation and at six weeks and six months after randomisation. In addition, the expectation of the participants and their confidence with the treatment will be evaluated before randomisation and after the first treatment session, respectively. Discussion This will be the first study aiming to compare the effectiveness of Mat and Equipment-based Pilates exercises in patients with chronic non-specific low back pain. The results may help health-care professionals in clinical decision-making and could potentially reduce the treatment costs of this condition. Trial registration Brazilian Registry of Clinical Trials RBR-7tyg5j

Synthetic messenger RNA (mRNA)-based therapeutics are an increasingly popular approach to gene and cell therapies, genome engineering, enzyme replacement therapy, and now, during the global SARS-CoV-2 pandemic, vaccine development. mRNA for such purposes can be synthesized through an enzymatic in vitro transcription (IVT) reaction and formulated for in vivo delivery. Mature mRNA requires a 5'-cap for gene expression and mRNA stability. There are two methods to add a cap in vitro: via a two-step multi-enzymatic reaction or co-transcriptionally. Co-transcriptional methods minimize reaction steps and enzymes needed to make mRNA when compared to enzymatic capping. CleanCap ® AG co-transcriptional capping results in 5 mg/ml of IVT with 94% 5'-cap 1 structure. This is highly efficient compared to first-generation cap analogs, such as mCap and ARCA, that incorporate cap 0 structures at lower efficiency and reaction yield. This article describes co-transcriptional capping using TriLink Biotechnology's CleanCap ® AG in IVT. © 2021 Wiley Periodicals LLC. Basic Protocol 1: IVT with CleanCap Basic Protocol 2: mRNA purification and analysis., (© 2021 Wiley Periodicals LLC.)

Globally, conversion of pristine areas to anthropogenic landscapes is one of the main causes of ecosystem service losses. Land uses associated with urbanization and farming can be major sources of pollution to freshwaters promoting artificial inputs of several elements, leading to impaired water quality. However, how the effects of land use on freshwater quality are contingent on properties of the local landscape and climate is still poorly understood. The aim of this study was to evaluate the effects of landscape properties (morphometric measurements of lakes and their catchments), precipitation patterns, and land use properties (extent and proximity of the land use to freshwaters) on water quality of 98 natural lakes and reservoirs in northeast Brazil. Water quality impairment (WQI) was expressed as a composite variable incorporating parameters correlated with eutrophication including nitrogen (N), phosphorus (P) and Chlorophyll-a concentration. Regression tree analysis showed that WQI is mainly related to highly impacted "buffer areas". However, the effects of land use in these adjacent lands were contingent on precipitation variability for 13% of waterbodies and on surface area of the buffer in relation to the volume of waterbody (BA:Vol) for 87% of waterbodies. Overall, effects on WQI originating from the land use in the adjacent portion of the lake were amplified by high precipitation variability for ecosystems with highly impacted buffer areas and by high BA:Vol for ecosystems with less impacted buffer areas, indicating that ecosystems subjected to intense episodic rainfall events (e.g. storms) and higher buffer areas relative to aquatic ecosystem size (i.e. small waterbodies) are more susceptible to impacts of land use. Land use at the catchment scale was important for the largest ecosystems. Thus, our findings point toward the need for considering a holistic approach to managing water quality, which includes watershed management within the context of climate change., 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 © 2020 Elsevier B.V. All rights reserved.)

The role of tropical lakes and reservoirs in the global carbon cycle has received increasing attention in the past decade, but our understanding of its variability is still limited. The metabolism of tropical systems may differ profoundly from temperate systems due to the higher temperatures and wider variations in precipitation. Here, we investigated the spatial and temporal patterns of the variability in the partial pressure of carbon dioxide (pCO 2 ) and its drivers in a set of 102 low-latitude lakes and reservoirs that encompass wide gradients of precipitation, productivity and landscape properties (lake area, perimeter-to-area ratio, catchment size, catchment area-to-lake area ratio, and types of catchment land use). We used multiple regressions and structural equation modeling (SEM) to determine the direct and indirect effects of the main in-lake variables and landscape properties on the water pCO 2 variance. We found that these systems were mostly supersaturated with CO 2 (92% spatially and 72% seasonally) regardless of their trophic status and landscape properties. The pCO 2 values (9-40,020 μatm) were within the range found in tropical ecosystems, and higher (p < 0.005) than pCO 2 values recorded from high-latitude ecosystems. Water volume had a negative effect on the trophic state (r = -0.63), which mediated a positive indirect effect on pCO 2 (r = 0.4), representing an important negative feedback in the context of climate change-driven reduction in precipitation. Our results demonstrated that precipitation drives the pCO 2 seasonal variability, with significantly higher pCO 2 during the rainy season (F = 16.67; p < 0.001), due to two potential main mechanisms: (1) phytoplankton dilution and (2) increasing inputs of terrestrial CO 2 from the catchment. We conclude that at low latitudes, precipitation is a major climatic driver of pCO 2 variability by influencing volume variations and linking lentic ecosystems to their catchments., (Copyright © 2019 Elsevier B.V. All rights reserved.)

This study evaluated the effects of a ketogenic diet (KD) based on extra virgin coconut oil (Cocos nucifera L., VCO), on the treatment of epileptic rats. Two sets of experiments were conducted. First, male Wistar rats underwent induction of status epilepticus (SE) with the administration of pilocarpine intraperitoneally 21 animals reached spontaneous recurrent seizures (SRS) and were randomly allocated to the dietary regimens and video-monitored for 19 days. In the second experiment, 24 animals were randomized immediately after the induction of SE and followed for 67 days. Diets were as follows: Control (AIN-93G; 7% lipid), KetoTAGsoya (KD based on soybean oil; 69.79% lipid), and KetoTAGcoco (KD based on VCO; 69.79% lipid). There were no differences in the latency to the first crisis, total frequency, and duration of the SRS between groups in 2 experiments. The data suggest no effects of KD, with or without VCO, in rats with pilocarpine-induced epilepsy., (© 2018 AOCS.)

To understand the significance of the trail pheromone used in chemical communication of the leaf-cutting ants Atta opaciceps we investigated, under laboratory conditions, the trail-following behaviour of different castes. We observed a clear behavioural discrimination of conspecific venom gland extract of foraging ants from those of other species. Additionally, we determined the pheromone composition of A. opaciceps venom gland secretion using a two-dimensional gas chromatography coupled with mass spectrometry. Chemical analyses revealed the presence of three nitrogen-containing compounds, identified as 2,5-dimethylpyrazine, 3-ethyl-2,5-dimethylpyrazine and methyl 4-methylpyrrole-2-carboxylate (M4MPC). Four different bioassays performed with workers from different castes of A. opaciceps suggested that the trail pheromone elicits the trail-following behaviour in conspecifics of all castes, but the foragers respond more strongly to their own pheromone than to that of other castes (gardeners, generalists and soldiers). In addition, A. opaciceps foragers follow the trails made with the venom gland extracts of the unrelated Acromyrmex subterraneus subterraneus foragers as well as they follow the trails made with their own venom gland extract. M4MPC was identified to be the most abundant and the most behaviourally active component of the venom gland extract of A. opaciceps foragers., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Glomus tumors originate from modified perivascular muscle cells. The most common form is the solitary one. The multiple form may be associated with dominant genetic inheritance. We report a case of a patient with hemangiomatous lesions on the calcaneus and wrist since birth. In 6 years, there was progression of lesions throughout the body. Multiple glomangiomas are asymptomatic and more common in childhood. They can be confused with other vascular malformations. Histopathological diagnosis is essential. The case shows a type 2 segmental manifestation that can be explained by genetic mutation leading to the loss of heterozygosity. As the child grows, the lesions may disseminate due to mutation in distant parts of the skin. Literature shows few reports. The treatment is conservative.

The aim of this study was to investigate the prevalence of inherited neuromuscular disorders (NMDs) in eight communities in Northeast (NE) Brazil in which there was an elevated rate of inbreeding. A cross-sectional epidemiological study, using the key informant (KI) approach, was performed to estimate the prevalence of NMD among the 48,499 individuals living in these eight communities, located in the backlands of the Paraíba State. Twenty-seven individuals fulfilled the diagnostic criteria for inherited NMD, which means that 1 out of 1,796 inhabitants of this highly consanguineous population was affected by NMD. This is twofold higher than that observed in previous studies in general population and was probably due to a combination of genetic drift and inbreeding. Public policies should be implemented to offer genetics services in high-risk communities.

The population of the northeast of Brazil is characterized by high rates of endogamy and disabilities. An epidemiological cross-sectional study using the informant method was conducted in eight communities in the hinterlands of Paraiba to describe genetic and acquired diseases that cause disabilities and to estimate the costs of specialized services such as physiotherapy and the acquisition of technological assistential equipment. From a population of 48,499 inhabitants, 338 individuals were screened and 123 (0.34%) were clinically, genetically and functionally assessed by a multidisciplinary team of specialists. Genetic factors were responsible for 58.5% of the disabilities, with some clusters of prevalent diseases being found within the sampled communities, namely progressive spinal muscular atrophy, spinocerebellar ataxia, muscular dystrophy and Spoan syndrome. The socioeconomic profile and the demand for rehabilitation services and technological assistance highlight the need to introduce and implement specific public health policies in these communities.

Background: Studies suggest that in patients admitted to intensive care units (ICU), physical functional status (PFS) improves over time, but does not return to the same level as before ICU admission. The goal of this study was to assess physical functional status two years after discharge from an ICU and to determine factors influencing physical status in this population., Methods: The study reviewed all patients admitted to two non-trauma ICUs during a one-year period and included patients with age ≥ 18 yrs, ICU stay ≥ 24 h, and who were alive 24 months after ICU discharge. To assess PFS, Karnofsky Performance Status Scale scores and Lawton-Instrumental Activities of Daily Living (IADL) scores at ICU admission (K-ICU and L-ICU) were compared to the scores at the end of 24 months (K-24mo and L-24mo). Data at 24 months were obtained through telephone interviews., Results: A total of 1,216 patients were eligible for the study. Twenty-four months after ICU discharge, 499 (41.6%) were alive, agreed to answer the interview, and had all hospital data available. PFS (K-ICU: 86.6 ± 13.8 vs. K-24mo: 77.1 ± 19.6, p < 0.001) and IADL (L-ICU: 27.0 ± 11.7 vs. L-24mo: 22.5 ± 11.5, p < 0.001) declined in patients with medical and unplanned surgical admissions. Most strikingly, the level of dependency increased in neurological patients (K-ICU: 86 ± 12 vs. K-24mo: 64 ± 21, relative risk [RR] 2.6, 95% CI, 1.8-3.6, p < 0.001) and trauma patients (K-ICU: 99 ± 2 vs. K-24mo: 83 ± 21, RR 2.7, 95% CI, 1.6-4.6, p < 0.001). The largest reduction in the ability to perform ADL occurred in neurological patients (L-ICU: 27 ± 7 vs. L-24mo: 15 ± 12, RR 3.3, 95% CI, 2.3-4.6 p < 0.001), trauma patients (L-ICU: 32 ± 0 vs. L-24mo: 25 ± 11, RR 2.8, 95% CI, 1.5-5.1, p < 0.001), patients aged ≥ 65 years (RR 1.4, 95% CI, 1.07-1.86, p = 0.01) and those who received mechanical ventilation for ≥ 8 days (RR 1.48, 95% CI, 1.02-2.15, p = 0.03)., Conclusions: Twenty-four months after ICU discharge, PFS was significantly poorer in patients with neurological injury, trauma, age ≥ 65 tears, and mechanical ventilation ≥ 8 days. Future studies should focus on the relationship between PFS and health-related quality of life in this population.

Objective: To assess interobserver variability in the diagnosis of anal cancer precursor lesions in the usual scenario of a service consisting of pathologists without previous experience in the diagnosis of these lesions., Methods: Five hundred and two anal specimens taken from 372 HIV-positive and HIV-negative patients were analyzed at the Pathology Department of the Tropical Medicine Foundation of Amazonas by three pathologists with extensive experience in the diagnosis of infectious and tropical diseases, but without significant prior experience in the diagnosis of anal cancer precursor lesions. The individual readings of each pathologist were compared to the one following the consensus diagnosis in shared optical microscope by kappa statistics., Results: The absolute agreement between each individual diagnosis and corresponding consensus was poor (kappa = -0.002). Considering only the positive or negative results for anal squamous intraepithelial lesions, we obtained a fair agreement between observers (kappa = 0.35), while the agreement was moderate when the histopathological findings were considered positive or negative for high-grade squamous intraepithelial lesion or cancer (kappa = 0.52)., Conclusion: The interobserver variability in histopathologic diagnosis of anal cancer and its precursor lesions among pathologists with little experience in the area is such that the diagnoses in this field and this scenario should always be a consensus.

Purpose: To investigate the prevalence of anal squamous intraepithelial lesions (ASIL) or anal cancer in patients attended at the Tropical Medicine Foundation of Amazonas., Methods: 344 patients consecutively attended at the institution, in 2007/2008, were distributed in the following strata according to presence/abscense of at risk conditions for anal cancer: Group 1 - HIV-positive men-who-have-sex-with-men (101); Group 2 - HIV-positive females (49); Group 3 - patients without any at risk condition for anal cancer (53); Group 4 - HIV-positive heterosexual men (38); Group 5 - HIV-negative patients, without anoreceptive sexual habits, but with other at risk conditions for anal cancer (45); Group 6 - HIV-negative men-who-have-sex-with-men (26); and Group 7 - HIV-negative anoreceptive females (32). The histopathological results of biopsies guided by high-resolution anoscopy were analyzed by frequentist and bayesian statistics in order to calculate the point-prevalence of ASIL/cancer and observe any eventual preponderance of one group over the other., Results: The point-prevalence of ASIL for all the patients studied was 93/344 (27%), the difference between HIV-positive and negative patients being statistically significant (38.3% versus 13.5%; p < 0.0001). The prevalence of ASIL for each one of the groups studied was: Group 1 = 49.5%, Group 2 = 28.6%, Group 3 = 3.8%, Group 4 = 21.1%, Group 5 = 11.1%, Group 6 = 30.8% and Group 7 = 18.8%. Standard residual analysis demonstrated that ASIL was significantly prevalent in patients of Group 1 and high-grade ASIL in patients of Group 2. The odds for ASIL of Group 1 was significantly higher in comparison to Groups 2, 3, 4, 5 and 7 (p < 0.03). The odds for ASIL of Groups 2, 4 and 6 were significantly higher in comparison to Group 3 (p < 0.03)., Conclusions: In the patients studied, ASIL (low and/or high-grade) tended to be significantly more prevalent in HIV-positive patients. Nonetheless, HIV-negative anoreceptive patients also presented great probability to have anal cancer precursor lesions, mainly those of the male gender.

The effects of dietary supplementation with coconut oil on the biochemical and anthropometric profiles of women presenting waist circumferences (WC) >88 cm (abdominal obesity) were investigated. The randomised, double-blind, clinical trial involved 40 women aged 20-40 years. Groups received daily dietary supplements comprising 30 mL of either soy bean oil (group S; n = 20) or coconut oil (group C; n = 20) over a 12-week period, during which all subjects were instructed to follow a balanced hypocaloric diet and to walk for 50 min per day. Data were collected 1 week before (T1) and 1 week after (T2) dietary intervention. Energy intake and amount of carbohydrate ingested by both groups diminished over the trial, whereas the consumption of protein and fibre increased and lipid ingestion remained unchanged. At T1 there were no differences in biochemical or anthropometric characteristics between the groups, whereas at T2 group C presented a higher level of HDL (48.7 +/- 2.4 vs. 45.00 +/- 5.6; P = 0.01) and a lower LDL:HDL ratio (2.41 +/- 0.8 vs. 3.1 +/- 0.8; P = 0.04). Reductions in BMI were observed in both groups at T2 (P < 0.05), but only group C exhibited a reduction in WC (P = 0.005). Group S presented an increase (P < 0.05) in total cholesterol, LDL and LDL:HDL ratio, whilst HDL diminished (P = 0.03). Such alterations were not observed in group C. It appears that dietetic supplementation with coconut oil does not cause dyslipidemia and seems to promote a reduction in abdominal obesity.

The objectives of the study were to investigate whether the health conditions of mothers with short stature differed from those with normal stature, and to establish if these aspects were associated with the health of the offspring. Data relating to health and socio-economic, demographic and anthropometric conditions were collected from a probabilistic sample population consisting of 1180 mothers and 1511 children ( < 10 years) living in the semi-arid region of the State of Alagoas, Brazil. Mothers were categorised according to stature, with those in the 1st quartile being defined as of short stature and those in the 4th quartile being defined as of normal stature and serving as a reference for the comparison of variables of interest. Following verification that maternal stature fulfilled parametric assumptions, its associations with the other variables were determined by calculating Pearson correlation coefficients. After excluding strongly self-correlated variables (r >or= 0.70), the remaining variables were analysed by multiple linear regression. The results showed that low maternal stature was independently associated with obesity (percentage body fat >or= 30; P = 0.045), abdominal adiposity (waist:hip ratio >or= 0.85; P = 0.007) and high systolic blood pressure ( >or= 140 mmHg; P = 0.006). Short maternal stature was associated with low birth weight ( < 3000 g; P = 0.01) and stunting (height-for-age Z score < - 2; P = 0.019) in the offspring. Thus, in the semi-arid region of Alagoas, women of short stature presented a higher prevalence of chronic degenerative diseases and produced less healthy children than women of normal stature.

Purpose: To test the hypothesis that needlescopic cholecystectomies (NC) offer superior outcomes in comparison to common laparoscopic cholecystectomies (LC)., Methods: Sixty consecutive patients with gallbladder disease undergoing either LC or NC were evaluated with respect to differences in operative time, frequency of per-operative incidents, post-operative pain, late postoperative symptoms, length of scars and level of postoperative satisfaction., Results: Mean operative time was similar in both groups. Most of the patients, irrespective of the technique, informed mild postoperative pain. NC patients had lower levels of pain on the 7th postoperative day (PO7) (p<0.01) and decreased need for additional analgesia. Less frequency of epigastric wound pain was observed in NC patients until PO4 (p<0.01). Aesthetic result was far superior after NC (total length of scars less than half after LC). No differences regarding postoperative satisfaction with the operation were observed between the studied groups., Conclusions: Both techniques were safe and effective, presenting similar operative times and low levels of postoperative pain. Downsizing the ports to 2-3 mm was associated with significantly less frequency of postoperative pain only in the epigastric wound until PO4. Aesthetic outcome of NC was significantly superior to LC, although this advantage did not influence patient level of satisfaction.

Background: Renal graft recipients are one of the population groups known to be at high risk of developing anal cancer. This study investigated the presence of subclinical anal squamous intraepithelial lesions and the diagnostic ability of high-resolution anoscopy in detecting these lesions in renal graft recipients followed-up in Manaus., Methods: In a cross-sectional study, 50 renal graft recipients were interviewed and submitted to high-resolution anoscopy with biopsies of acetowhite lesions or of the anal transition zone mucosa when acetowhitening was absent. Considering the histopathological reports of the examined anal specimens as the gold standard, the diagnostic validation and precision measures of high-resolution anoscopy were calculated as well as the prevalence of anal squamous intraepithelial lesions in the studied population., Results: In 42 renal graft recipients with satisfactory histopathological readings, prevalence of anal squamous intraepithelial lesions or condyloma acuminatum (ASIL-ACU) was 23.81%. Sensitivity of high-resolution anoscopy was 100%; specificity, 65.63%; positive predictive value, 47.62%; negative predictive value, 100%; and kappa coefficient, 0.48., Conclusions: With a prevalence of 23.81% of subclinical ASIL-ACU lesions, the studied renal graft recipients had all these lesions detected by high-resolution anoscopy, notwithstanding most anal transition zone acetowhitened biopsied areas did not reveal histopathological aspects of anal cancer precursor lesions or condyloma acuminatum. Therefore, greater experience with the diagnostic tool was felt necessary to enhance its positive predictive value, specificity and diagnostic precision.

Purpose: To test the ability of analpaps performed with cotton swab smears to produce satisfactory cytologic readings as compared to traditional sampling materials., Methods: 318 consecutive patients were examined at the Ambulatório Araújo Lima of Hospital Universitario Getúlio Vargas in the Anal Cancer Prevention Week and were sampled for the performance of analpap. 180 of these patients were randomly sorted to be sampled by either one of the following materials: cytologic brush, dacron swab or cotton swab. The ability of cotton in producing satisfactory anal cytologic readings as compared to dacron and cytologic brush was analised., Results: There was no statistical difference among the materials employed in the ability to produce satisfactory citological readings in analpaps. (p > 0.05), Conclusion: Our results showed that cotton swabs were as efficient as dacron swabs or cytologic brushes in the ability to produce satisfactory analpap readings.

Study Objective: To evaluate the effect of diameter of the endoscope on the duration and quality of laparoscopic surgery., Design: Prospective, randomized trial (Canadian Task Force classification I)., Setting: Centre for Surgical Technologies., Subjects: Sixty adult, female, New Zealand, white rabbits., Intervention: Two series of laparoscopic nephrectomies, one each performed by an experienced and an inexperienced surgeon comparing 10-, 5-, 4-, and 2-mm endoscopes., Measurements and Main Results: Besides duration of surgery and occurrence of bleeding, the quality of dissection was scored by adding scores of dissection of renal vessels, ureters, and kidneys. During consecutive nephrectomies, the duration of surgery (p = 0. 001) and occurrence of bleeding (p = 0.02) decreased, whereas the quality of dissection increased (p = 0.002), demonstrating the learning curve, mainly for the less experienced surgeon. Duration of surgery (p = 0.04) decreased and quality of dissection increased (p = 0.05) when the larger endoscope was used. This was the case only for the less experienced surgeon, whereas for the experienced surgeon it had only a slight effect on learning curve., Conclusion: These results confirm a learning curve of nephrectomy consisting of some 20 animals. In addition, the endoscope diameter and thus quality of image affect both duration and quality of surgery, especially for less experienced surgeons.