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Abstract Background The 24-h urine protein (24-hUP) excretion is the gold standard for evaluating proteinuria. This study aimed to evaluate the diagnostic efficacy of protein/creatinine ratio (PCR) for estimating 24-hUP at various levels of renal function and proteinuria levels. Methods A cross-sectional study was conducted between December 2021 and December 2023 in Salvador, Bahia-Brazil, as an extension of previously published data from the TUNARI study. The study included 217 samples from 152 patients with various levels of renal function and proteinuria. PCR in isolated samples and 24-hUP were determined conventionally within a 24-h timeframe. Patients were classified into three groups according to the level of renal function (Group 1 = 10 to 60 mL/min) and level of proteinuria ( 3.5 g/day). The data were analyzed using the Spearman correlation (rs), coefficient of determination (r2), Bland–Altman plots and receiver operating characteristic (ROC) curve. Likelihood ratios, positive (LR +), and negative (LR-) were derived from the sensitivity and specificity of PCR. Results Mean age was 41.5 ± 15.7 years, 61.8% were women, 36.8% Black and 52% Mixed-race. Glomerulopathies constituted 80.3%; 46.1% with lupus nephritis. Of the total urine samples, we observed a high correlation between PCR in the total sample of 24-hUP sample (rs = 0.86, p 0.3–3.5 g/day, the sensitivity was 64.1%, the specificity was 84.6%, and the AUC was 0.76 (95% CI = 0.67; 0.84), PCR detected all cases > 3.5 g/day. Conclusions PCR is a suitable measure to be used as an indicator of 24-hUP at different levels of renal function, but may have limitations at higher levels of proteinuria. Analysis of PCR by proteinuria level found that agreement as well as sensitivity decreases at higher levels, but it maintains good specificity and is able to identify nephrotic range proteinuria.

Introdução: O cuidador principal é aquele responsável pelas tarefas, entre outras, de auxílio no dia-a-dia ao idoso dependente e que, em geral, é proveniente do próprio núcleo familiar. O papel do cuidador cai em suas mãos sem que para isso tenha sido preparado. Objetivo: Verificar a preparação dos cuidadores com relação aos cuidados básicos dos idosos internados sujeitos a alta hospitalar. Métodos: O estudo foi realizado na enfermaria de Geriatria do Hospital do Servidor Público Estadual Francisco Morato de Oliveira, durante os meses de outubro e novembro de 2007. É um estudo descritivo transversal, com abordagem quantitativa. Foram utilizados questionários de identificação aos cuidadores e aos idosos e um questionário semi-estruturado aos cuidadores. Resultados: A amostra do estudo foi de 17 cuidadores, sendo 94% do sexo feminino e 76% filhas. Com relação à preparação para realizar as atividades básicas da vida diária dos idosos, 65% dos cuidadores afirmaram que se sentiam preparados; 59% dos cuidadores não possuíam dúvidas antes da internação, e todos os participantes da pesquisa disseram que não precisavam receber mais orientações. Conclusão: Observou-se que, em concordância com a literatura, a maioria dos cuidadores era composta por mulheres e filhas, as quais referiram não apresentar dúvidas quanto aos cuidados básicos antes da internação e afirmaram estar preparadas para realizá-los após a alta hospitalar. Isso pode ser um indicador de impacto positivo do trabalho de orientação exercido por equipe interdisciplinar ao longo da hospitalização, objetivando um melhor cuidado do idoso no âmbito do domicílio.

The "Serra da Concórdia" is part of the Atlantic Forest phytogeographical domain in the Brazilian state of Rio de Janeiro and it has a predominant phytophysiognomy of Semideciduous Seasonal Forest. This region underwent intense habitat loss and fragmentation during the 19th century, due to coffee plantations and later pastures. With the decline of these activities, the areas were abandoned, triggering secondary succession. In 2002, the "Parque Estadual da Serra da Concórdia" was established in this region to preserve the remaining forest fragments. The updated list of vascular plants recorded in this protected area, published in the "Catálogo de Plantas das Unidades de Conservação do Brasil", is presented here, along with information on richness, endemism, and conservation status.The "Parque Estadual da Serra da Concórdia" houses 231 vascular plant species, of which 90% are angiosperms, 10% ferns and lycophytes, and 27% endemic to the Atlantic Forest. Ten species are threatened with extinction, three are categorized as Endangered, and seven as Vulnerable. Although there have been expeditions in the "Parque Estadual da Serra da Concórdia", they have been limited, resulting in a low number of records and the species richness for a protected area. This is notable considering the 2,130 Brazilian native vascular plant species recorded in the semideciduous seasonal forest of Rio de Janeiro. Our data indicates that floristic inventories of Brazilian protected areas could help highlight gaps in flora knowledge and support the proposal of effective conservation actions.

Abstract We describe the geographical variation in tree species composition across Amazonian forests and show how environmental conditions are associated with species turnover. Our analyses are based on 2023 forest inventory plots (1 ha) that provide abundance data for a total of 5188 tree species. Within-plot species composition reflected both local environmental conditions (especially soil nutrients and hydrology) and geographical regions. A broader-scale view of species turnover was obtained by interpolating the relative tree species abundances over Amazonia into 47,441 0.1-degree grid cells. Two main dimensions of spatial change in tree species composition were identified. The first was a gradient between western Amazonia at the Andean forelands (with young geology and relatively nutrient-rich soils) and central–eastern Amazonia associated with the Guiana and Brazilian Shields (with more ancient geology and poor soils). The second gradient was between the wet forests of the northwest and the drier forests in southern Amazonia. Isolines linking cells of similar composition crossed major Amazonian rivers, suggesting that tree species distributions are not limited by rivers. Even though some areas of relatively sharp species turnover were identified, mostly the tree species composition changed gradually over large extents, which does not support delimiting clear discrete biogeographic regions within Amazonia.

Abstract Background COVID-19 vaccines effectively prevent infection and hospitalization. However, few population-based studies have compared the clinical characteristics and outcomes of patients hospitalized for COVID-19 using advanced statistical methods. Our objective is to address this evidence gap by comparing vaccinated and unvaccinated patients hospitalized for COVID-19. Methods This retrospective cohort included adult COVID-19 patients admitted from March 2021 to August 2022 from 27 hospitals. Clinical characteristics, vaccination status, and outcomes were extracted from medical records. Vaccinated and unvaccinated patients were compared using propensity score analyses, calculated based on variables associated with vaccination status and/or outcomes, including waves. The vaccination effect was also assessed by covariate adjustment and feature importance by permutation. Results From the 3,188 patients, 1,963 (61.6%) were unvaccinated and 1,225 (38.4%) were fully vaccinated. Among these, 558 vaccinated individuals were matched with 558 unvaccinated ones. Vaccinated patients had lower rates of mortality (19.4% vs. 33.3%), invasive mechanical ventilation (IMV-18.3% vs. 34.6%), noninvasive mechanical ventilation (NIMV-10.6% vs. 22.0%), intensive care unit admission (ICU-32.0% vs. 44.1%) vasoactive drug use (21.1% vs. 32.6%), dialysis (8.2% vs. 14.7%) hospital length of stay (7.0 vs. 9.0 days), and thromboembolic events (3.9% vs.7.7%), p

Abstract Recent epidemiological studies have suggested a positive association between ultra-processed food consumption and breast cancer risk, although some studies also reported no association. Furthermore, the evidence regarding the associations between intake of food with lower degrees of processing and breast cancer risk is limited. Thus, we investigated the associations between dietary intake by degree of food processing and breast cancer risk, overall and by breast cancer subtypes in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Dietary intake of EPIC participants was assessed via questionnaires at baseline. More than 11,000 food ingredients were classified into four groups of food processing levels using the NOVA classification system: unprocessed/minimally processed (NOVA 1), culinary ingredients (NOVA 2), processed (NOVA 3) and ultra-processed (NOVA 4). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer per standard deviation increase in daily consumption (grams) of foods from each NOVA group. The current analysis included 14,933 breast cancer cases, diagnosed among the 318,686 EPIC female participants, (median follow-up of 14.9 years). No associations were found between breast cancer risk and the level of dietary intake from NOVA 1 [HR per 1 SD=0.99 (95% CI 0.97 – 1.01)], NOVA 2 [HR per 1 SD =1.01 (95% CI 0.98 – 1.03)] and NOVA 4 [HR per 1 SD =1.01 (95% CI 0.99 – 1.03)] foods. However, a positive association was found between NOVA 3 and breast cancer risk [HR per 1 SD =1.05 (95% CI 1.03 – 1.07)] which became non-significant after adjustment for alcohol intake [HR per 1 SD =1.01 (95% CI 0.98 – 1.05)] or when beer and wine were excluded from this group [HR per 1 SD =0.99 (95% CI 0.97 – 1.01)]. The associations did not differ by breast cancer subtype, menopausal status or body mass index. Findings from this large-scale prospective study suggest that the positive association between processed food intake and breast cancer risk was likely driven by alcoholic beverage consumption. Graphical Abstract

Investment migration programmes are used by over eighty states globally and pose serious security and criminal risks. Their existence is additionally complex in the EU, as EU citizenship opens up its internal market and grants a set of political rights. Relying predominantly on the normative-legal method, the authors analyse the compatibility of investment migration with international and EU law. The purpose of this analysis is twofold. First, it determines whether national autonomy in citizenship matters is subject to limitations by international and EU law since they impact the legality of investment migration. Second, implications of the Nottebohm case are analysed to determine the relevance of the genuine link criterion for the international recognition of nationality. It was concluded that the genuine link criterion does not affect the legality of investment migration in international and EU law. Instead, legality is achieved if investment migration programmes comply with rules on combating corruption, money laundering, and tax evasion. While authors give due regard to the autonomy of EU law, the need to avoid the danger of the “vertical aspect” of international law fragmentation, i.e., incoherence between EU and international law, and to avoid the creation of an imbalanced legal environment is considered a priority.

Abstract Amyotrophic lateral sclerosis (ALS) is a debilitating and fatal paralytic disorder associated with motor neuron death. Mutant superoxide dismutase 1 (SOD1) misfolding and aggregation have been linked to familial ALS, with the accumulation of abnormal wild-type SOD1 species being also observed in postmortem tissue of sporadic ALS cases. Both wild-type and mutated SOD1 are reported to contribute to motoneuron cell death. The autophagic pathway has been shown to be dysregulated in ALS. Recent evidence suggests a dual time-dependent role of autophagy in the progression of the disease. PACER, also called RUBCNL (Rubicon-like), is an enhancer of autophagy and has been found diminished in its levels during ALS pathology in mice and humans. Pacer loss of function disturbs the autophagy process and leads to the accumulation of SOD1 aggregates, as well as sensitizes neurons to death. Therefore, here we investigated if constitutive overexpression of PACER in neurons since early development is beneficial in an in vivo model of ALS. We generated a transgenic mouse model overexpressing human PACER in neurons, which then was crossbred with the mutant SOD1G93A ALS mouse model. Unexpectedly, PACER/SOD1G93A double transgenic mice exhibited an earlier disease onset and shorter lifespan than did littermate SOD1G93A mice. The overexpression of PACER in neurons in vivo and in vitro increased the accumulation of SOD1 aggregates, possibly due to impaired autophagy. These results suggest that similar to Pacer loss-of function, Pacer gain-of function is detrimental to autophagy, increases SOD1 aggregation and worsens ALS pathogenesis. In a wider context, our results indicate the requirement to maintain a fine balance of PACER protein levels to sustain proteostasis.

Objetivo: De acordo com idosos recrutados na comunidade, investigar significados de envelhecimento bemsucedido e identificar relações entre os significados e idade, gênero, escolaridade, saúde autorrelatada e suporte social percebido. Participantes: Foi utilizado o banco de dados do Estudo dos Processos de Envelhecimento Saudável (n = 716; 70,2% mulheres, média de idade = 72 ± 8,6). Instrumentos: Questionário sociodemográfico com um item escalar avaliando saúde percebida; cinco itens escalares avaliando suporte social percebido; e duas questões abertas investigando significados de velhice bem-sucedida. Resultados: Os temas derivados da análise de conteúdo dos significados associados à velhice saudável: saúde e independência física e mental, ajustamento psicológico, relações sociais positivas, engajamento ativo com a vida, orientação ao bem-estar dos outros, presença de recursos materiais e crença na impossibilidade de velhice bem-sucedida. Os idosos entre 60 e 69 anos apontaram mais engajamento ativo com a vida que os de 80 anos ou mais; os com menos de oito anos de escolaridade apontaram mais saúde e independência física e mental que os com mais anos de estudo. Com exceção de ajustamento psicológico, em que as mulheres pontuaram mais alto que os homens, não houve diferenças entre os gêneros. Relações sociais positivas foi o tema mais frequente entre os com suporte social baixo e moderado. Ajustamento psicológico e espiritualidade e religião relacionaram-se com melhores avaliações da saúde. Conclusões: O envelhecimento bem-sucedido é construto multidimensional e está relacionado com as avaliações subjetivas de saúde e suporte social. As especificidades da amostra podem ter afetado a homogeneidade dos resultados.

Objetivo: O alto número de idosos que sofrem quedas engloba, entre outras questões, a importância do uso adequado dos dispositivos auxiliares de marcha (DAM): bengalas, muletas e andadores. Apesar dos DAM visarem à melhoria da independência funcional, o equilíbrio e a redução dos efeitos de deficiências, a maioria dos portadores não é instruída sobre seu uso correto e muitas vezes utilizam modelos inadequados, danificados ou com altura inapropriada. Poucos estudos comprovam a eficácia da prescrição isolada dos DAM em reduzir o risco de quedas, e poucos apontam a forma adequada de indicar e ajustar de maneira individual. Assim, com o objetivo de descrever, informar e orientar sobre o uso adequado dos DAM, foi realizada uma revisão de literatura nas bases de dados Medline, Lilacs, Scielo e PubMed, e uma consulta a referências literárias e capítulos de livros que abordavam o tema. Foram selecionados nove artigos e três capítulos de livro. Os resultados encontrados apontam, para cada tipo de DAM, indicação, utilização, variações e características, orientações quanto à marcha e transferências e ajustes relacionados à altura. Além disso, foram descritos outros assuntos relevantes, como características e limitações do paciente, ambiente no qual está inserido, condições econômicas e sociais e principalmente a funcionalidade deste indivíduo. A prescrição, a orientação e o acompanhamento adequado dos DAM com um fisioterapeuta proporcionam ao paciente maior confiança, habilidade e aderência aos dispositivos. Possivelmente, tal ganho interferirá no desempenho das atividades diárias do paciente e atuará na prevenção de quedas.

Objetivos: Caracterizar idosos internados por fratura de fêmur proximal em um hospital escola e verificar o impacto das intervenções aplicadas no desfecho clínico final. Métodos: Analisados os prontuários de idosos maiores de 65 anos, admitidos no Hospital Universitário Risoleta Tolentino Neves com diagnóstico de fratura proximal do fêmur no período de 01/01/2009 a 28/02/2011. Foram coletados dados sócio-demográficos e de condições de saúde para caracterização da amostra. Considerou-se o tipo de fratura, tratamento médico recebido, tempo entre admissão e procedimento cirúrgico, e entre este e a alta hospitalar, verificando a existência de adiamentos no procedimento e seus motivos, e finalmente o recebimento de acompanhamento de outros profissionais da equipe de saúde. Resultados: No período avaliado foram admitidos 231 idosos com diagnóstico de fratura proximal de fêmur com média de idade de 80,8 anos. A média de dias entre admissão hospitalar e procedimento cirúrgico foi de 8,7 dias sendo que 40% da amostra tiveram pelo menos um adiamento da cirurgia. Dentre os que tiveram adiamento, 60% evoluíram com óbito intra-hospitalar contra 40% daqueles que não adiaram. A presença de adiamento configurou maior número de dias entre cirurgia e alta. Em análise de regressão, foram preditores de maior número de dias entre cirurgia e alta, a idade e os dias entre admissão e cirurgia. Apenas 48,4% da amostra receberam atendimento de fisioterapia durante a internação. Conclusões: A alta mortalidade intra-hospitalar de idosos com fratura proximal de fêmur foi associada à idade do paciente e ao risco cirúrgico. Atraso no procedimento cirúrgico configurou maior tempo de hospitalização.

Objetivo: Traçar o perfi l de idosos frágeis assistidos em ambulatório de referência quanto às comorbidades e o uso de medicamentos. Métodos: Utilizaram-se os critérios de Fried et al. (2001), relacionando-os aos diagnósticos de doenças crônicas confi rmadas, bem como aos medicamentos efetivamente utilizados em 151 idosos assistidos no Ambulatório de Geriatria do Hospital de Clínicas da Unicamp, ao longo do período de dois anos. Para estudar os fatores associados à presença de fragilidade foi utilizada a análise de regressão logística univariada e multivariada. Resultados: Verifi cou-se associação com fragilidade para diagnóstico de doenças do aparelho respiratório (p = 0,043) e uso de fármacos para o sistema cardiovascular (p = 0,036). Conclusão: Mesmo que esse estudo não permita uma associação do tipo causa-efeito, pode-se verifi car que as doenças do aparelho respiratório e os fármacos que atuam no aparelho cardiocirculatório podem se relacionar à condição de fragilidade, contribuindo para a manutenção ou acentuação dessa condição.

Abstract Seasonal snow in the extratropical Andes is a primary water source for major rivers supplying water for drinking, agriculture, and hydroelectric power in Central Chile. Here, we used estimates from the Moderate Resolution Imaging Spectroradiometer (MODIS) to analyze changes in snow cover extent over the period 2001–2022 in a total of 18 watersheds spanning approximately 1,100 km across the Chilean Andes (27–36°S). We found that the annual snow cover extent is receding in the watersheds analyzed at an average pace of approximately 19% per decade. These alarming trends have impacted meltwater runoff, resulting in historically low river streamflows during the dry season. We examined streamflow records dating back to the early 1980s for 10 major rivers within our study area. Further comparisons with large-scale climate modes suggest that the detected decreasing trends in snow cover extent are likely driven by the poleward migration of the westerly winds associated with a positive trend in the Southern Annular Mode (SAM).

Abstract Glioblastoma is an aggressive brain cancer with a poor prognosis. The O6-methylguanine-DNA methyltransferase (MGMT) gene methylation status is crucial for treatment stratification, yet economic constraints often limit access. This study aims to develop an artificial intelligence (AI) framework for predicting MGMT methylation. Diagnostic magnetic resonance (MR) images in public repositories were used for training. The algorithm created was validated in data from a single institution. All images were segmented according to widely used guidelines for radiotherapy planning and combined with clinical evaluations from neuroradiology experts. Radiomic features and clinical impressions were extracted, tabulated, and used for modeling. Feature selection methods were used to identify relevant phenotypes. A total of 100 patients were used for training and 46 for validation. A total of 343 features were extracted. Eight feature selection methods produced seven independent predictive frameworks. The top-performing ML model was a model post-Least Absolute Shrinkage and Selection Operator (LASSO) feature selection reaching accuracy (ACC) of 0.82, an area under the curve (AUC) of 0.81, a recall of 0.75, and a precision of 0.75. This study demonstrates that integrating clinical and radiotherapy-derived AI-driven phenotypes can predict MGMT methylation. The framework addresses constraints that limit molecular diagnosis access.

Abstract 3D skin models have been explored as an alternative method to the use of animals in research and development. Usually, human skin equivalents comprise only epidermis or epidermis/dermis layers. Herein, we leverage 3D bioprinting technology to fabricate a full-thickness human skin equivalent with hypodermis (HSEH). The collagen hydrogel-based structure provides a mimetic environment for skin cells to adhere, proliferate and differentiate. The effective incorporation of the hypodermis layer is evidenced by scanning electron microscopy, immunofluorescence, and hematoxylin and eosin staining. The transcriptome results underscore the pivotal role of the hypodermis in orchestrating the genetic expression of a multitude of genes vital for skin functionality, including hydration, development and differentiation. Accordingly, we evidence the paramount significance of full-thickness human skin equivalents with hypodermis layer to provide an accurate in vitro platform for disease modeling and toxicology studies.

Abstract Background The gut microbiota (GM) has proven to be essential for both physical health and mental wellbeing, yet the forces that ultimately shape its composition remain opaque. One critical force known to affect the GM is the social environment. Prior work in humans and free-ranging non-human primates has shown that cohabitation and frequent social interaction can lead to changes in GM composition. However, it is difficult to assess the direction of causation in these studies, and interpretations are complicated by the influence of uncontrolled but correlated factors, such as shared diet. Results We performed a 15-month longitudinal investigation wherein we disentangled the impacts of diet and social living conditions on GM composition in a captive cohort of 13 male cynomolgus macaques. The animals were in single housing for the first 3 months of the study initially with a variable diet. After baseline data collection they were placed on a controlled diet for the remainder of the study. Following this diet shift the animals were moved to paired housing for 6 months, enabling enhanced social interaction, and then subsequently returned to single housing at the end of our study. This structured sequencing of diet and housing changes allowed us to assess their distinct impacts on GM composition. We found that the early dietary adjustments led to GM changes in both alpha and beta diversity, whereas changes in social living conditions only altered beta diversity. With respect to the latter, we found that two particular bacterial families — Lactobacillaceae and Clostridiaceae — demonstrated significant shifts in abundance during the transition from single housing to paired housing, which was distinct from the shifts we observed based on a change in diet. Conversely, we found that other bacteria previously associated with sociality were not altered based on changes in social living conditions but rather only by changes in diet. Conclusions Together, these findings decouple the influences that diet and social living have on GM composition and reconcile previous observations in the human and animal literatures. Moreover, the results indicate biological alterations of the gut that may, in part, mediate the relationship between sociality and wellbeing.

Abstract Background Gestational weight gain (GWG) is a critical issue related to postpartum health in newborns and mothers. In Brazil, pregnant women’s public health recommends monitoring GWG. Therefore, the objective of this study is to evaluate gestational weight gain and associated health factors of pregnant women monitored at Unified Health System (SUS) in the city of São Paulo between 2012 and 2020. Methods This is a retrospective cohort study of pregnant women seen from 2012 to 2020 in São Paulo, Brazil. The database used was from the Integrated Health Care Management System related to the Live Birth Information System. Data distribution was assessed using the Kolmogorov-Smirnov test. Comparisons between groups according to weight gain (LWG vs. AWG vs. EWG) were performed using analysis of variance (ANOVA) with Tukey post hoc. Inclusion criteria considered that pregnant women had a recorded initial weight before 13 weeks and up to 15 days before delivery and a single pregnancy. The final database includes 276.220 pregnant women. Results The frequency of women according to initial body mass index (BMI) was 12.004 (4.4%) underweight, 132.049 (48.3%) normal weight, 78.856 (28.8%) overweight, and 50.660 (18.5%) living with obesity. The population consisted of 59.881 (21.9%), 37.217 (13.6%) and 176.471 (64.5%) women with LWG, AWG and EWG, respectively. Weight gain was associated with initial BMI, type of birth, color/ethnicity, marital status, women’s age and antenatal care visits. Conclusion The proportion of pregnant women with inadequate weight gain is high, relating initial BMI, type of birth, color/ethnicity, marital status, women’s age and antenatal care visits. Interventions such as nutritional education should be suggested to help achieve adequate GWG.

Objetivos: O principal objetivo deste estudo é identificar as alterações no processo de deglutição mais comumente encontradas em pacientes com doença de Alzheimer através do exame de videofluoroscopia. Métodos: A coleta de informações foi através de um banco de dados do setor de fonoaudiologia do Hospital da Cidade de Passo Fundo, no período de junho de 2007 a fevereiro de 2011. Foram selecionados 24 exames, com a patologia de base sendo somente a doença de Alzheimer. Os exames foram realizados com oferta de consistências líquidas e pastosas, analisando fases oral e faríngea na posição lateral. Resultados: Dos 24 exames com consistência pastosa, quatro (16,7%) não deglutiram e 2 pacientes (8,3%) apresentaram grande dificuldade nessa consistência; assim, 18 pacientes (75%) realizaram o exame com ambas as consistências. Na fase oral da deglutição, apresentaram movimentos ondulatórios reduzidos da língua, para líquidos, 17 pacientes (94,4%), e 23 pacientes (95,8%), para pastosos. Na deglutição faríngea com líquidos, a alteração mais predominante foi a dos resíduos em recessos faríngeos nos 18 pacientes (100,0%), sendo que na deglutição com pastosos as alterações mais frequentes foram a reação de deglutição e resíduos em recessos faríngeos, com 19 pacientes (95,0%). Conclusão: Os resultados obtidos permitem evidenciar que as alterações mais significativas na função de deglutição nesses pacientes com doença de Alzheimer apresentam-se na fase oral, quando a maioria dos pacientes retém alimentos na cavidade oral por longo período, possibilitando o escape prematuro posterior para a faringe, seguindo-se reação de deglutição atrasada e, consequentemente, resíduos em recessos faríngeos.

Objectives: To screen hospitalized older adults for sarcopenia and ascertain whether correlations exist between heart rate variability (HRV), peripheral muscle strength, functional ability, independence, and nutritional aspects in this population. Methods: Observational study of hospitalized adults aged > 60 years who were clinically stable and able to complete the study assessments. HRV, functionality, peripheral muscle strength, independence, level of physical activity, nutritional aspects, and risk of death were assessed. The Shapiro-Wilk, Kruskal-Wallis, and Mann-Whitney tests and Spearman correlations were used for statistical analysis; significance was accepted at p < 0.05. Results: The sample comprised 40 older adults, of whom only nine (22.50%) did not meet criteria for sarcopenia. HRV in participants with sarcopenia correlated positively with level of physical activity (rs 0.92, p = 0.001) and nutritional condition (rs 0.79, p = 0.001), and negatively with mortality (rs -0.59, p = 0.04) (rs 0.79, p = 0.001). In older adults without sarcopenia, HRV correlated positively with independence (rs 0.83, p = 0.001) and muscle strength (rs 0.67, p = 0.04). Conclusion: Most hospitalized older adults meet criteria for sarcopenia. In this population, better autonomic control of the heart is associated with greater independence, muscle strength, physical activity level, and better nutritional status, while worse HRV is associated with a higher risk of mortality.

Objetivo: Avaliar a prevalência do uso de medicamentos potencialmente inapropriados (MPIs) em pacientes idosos admitidos nas enfermarias de Clínica Médica, Infectologia, Neurologia e Cardiologia do Hospital de Clínicas da Universidade Federal do Paraná (HC-UFPR). Métodos: Estudo observacional, transversal, analítico e retrospectivo para identificação de medicamentos inapropriados utilizados entre idosos hospitalizados entre janeiro e dezembro de 2012. A amostra foi composta pelo total de internações de idosos nas enfermarias avaliadas. Os critérios de Beers (versão 2012) foram utilizados para identificação de MPI. Resultados: Foram avaliadas 605 internações de 512 pacientes. A média de idade dos pacientes da Clínica Médica foi de 71±7,4 anos, da Infectologia, 67±5,4 anos, da Neurologia, 70±6,5 anos, e da Cardiologia, 71±7,9 anos. Dos 8.715 medicamentos utilizados, 1.933 (~22%) eram inapropriados para idosos. Considerando a classificação ATC, os grupos com mais prescrições foram: A – aparelho digestivo e metabolismo (48,5%), B – sangue e órgão hematopoiéticos (17,4%), N – sistema nervoso (17%) e C – aparelho cardiovascular (12,5). Entre os MPIs, os princípios ativos mais prescritos foram metoclopramida (28,45%), glibenclamida (17,17%), diazepam (6,67%) e óleo mineral (6,31%). Conclusão: O presente estudo mostrou que a prescrição de MPI entre os idosos hospitalizados é prática comum e sua prevalência é semelhante à encontrada em outros estudos, mesmo quando são utilizados critérios anteriores ao de 2012. O grupo de medicamentos que atuam no aparelho digestivo e metabolismo foi o mais utilizado. Este estudo servirá como instrumento de educação terapêutica para o uso seguro e racional do medicamento e sensibilização dos prescritores, podendo ainda auxiliar na escolha de alternativas mais seguras para o paciente idoso e como ferramenta para possíveis intervenções multiprofissionais no manejo de MPI.

Objetivo: O objetivo do estudo foi avaliar a prevalência da incontinência urinária (IU) e seu impacto na qualidade de vida na população idosa de um bairro de Porto Alegre (Rio Grande do Sul). Metodologia: A amostra foi composta por 401 indivíduos, com idade superior a 65 anos, de ambos os sexos, residentes há pelo menos 12 meses no bairro. A coleta de dados foi realizada por meio da aplicação do International Consultation on Continence Questionnaire - Short Form (ICIQ-SF), durante uma visita domiciliar. Resultados: A prevalência de IU encontrada na população foi de 32,2%. Em relação ao gênero, 37,9% das mulheres apresentaram-se incontinentes; nos homens, o percentual foi de 15,5%. Os tipos de IU mais prevalentes foram de urgência (18%) e de esforço (16%). Existe uma associação significativa entre a presença de IU e o avanço da idade (r = 0,183; p < 0,001), idade e a interferência na vida diária (r = 0,101; p = 0,044) e idade e a piora na qualidade de vida (r = 0,117; p = 0,02). O ICIQ-SF demonstrou impacto negativo na qualidade de vida dos idosos com IU. Conclusão: Observou-se maior prevalência de IU entre mulheres em todas as faixas etárias. A IU de urgência e a de esforço foram as mais prevalentes. O ICIQ-SF indicou interferência negativa significativa da IU na qualidade de vida dos idosos, sobretudo na faixa etária dos 90 aos 99 anos. A prevalência de IU interferiu de maneira significativa na frequência das perdas, na realização das atividades de vida diária e na piora da qualidade de vida dos idosos estudados.

A new species, Leucheria peteroana sp. nov., endemic to a restricted area of the Andes of Central Chile, is here described. Using newly sequenced nDNA and cpDNA data, the phylogenetic affinities of Leucheria and closely related taxa within Nassauvieae are revisited. This new species shows a unique set of characters that clearly distinguish it from other species of Leucheria. Phylogenetic analyses place this perennial species close to annual species found in the pre-Andean environments of Central Chile. A detailed description, distribution map, insights about its habitat, conservation status, and photographs are provided.

Abstract This study aimed to evaluate the combined treatment system of domestic sewage and leachate by serial stabilization ponds in a Wastewater Treatment Plant (WWTP). The WWTP had two parallel pond modules, one receiving (module II—pond M10) and the other not receiving leachate (module I—pond M5). Physical, chemical, and biological monitoring parameters collected from January 2017 to December 2021 were evaluated. High reducing efficiency for ammonium nitrogen was found, with an average of 95.7 ± 2.5%. BOD5 and COD can be considered statistically different for a 95% confidence level in the two pond modules. The phytoplankton community was composed of 46 taxa distributed in four taxonomic classes: 6 belonging to the Cyanobacteria group (13%), 22 to the Green Algae group (48%), 4 to the Diatoms group (9%), and 14 to the Phytoflagellate group (30%). No ecotoxicity was detected for the evaluated pond effluent samples. Thus, although the insertion of leachate impacted the quality of the final effluent of the ponds and the organic matter, it may not have affected the effluents’ ecotoxicity. This research helps to understand the impacts of long-term leachate insertion in a real treatment system using stabilization ponds for combined treatment. In addition to the usual efficiency evaluation parameters, ecotoxicological tests and phytoplankton are also evaluated.

Abstract Background the independent association between parental obesity, sleep and lifestyle habits with cardiometabolic risk factors in children and adolescents has been widely explored in the literature. Our study represents a novel approach to comprehensively investigate a complex model encompassing various aspects associated with cardiometabolic risk in youth. Thus, the aim of the present study was to verify the relationship between parental obesity and cardiometabolic risk in children and adolescents, considering the mediator role of health indicators according to sleep time. Methods This cross-sectional study was conducted on 3,973 children and adolescents aged 6 to 17 years attending public and private schools in a city located in Southern Brazil. Sleep duration, lifestyle, physical activity, natural food consumption, and parental obesity were evaluated through self-reported questionnaires. Physical fitness was evaluated according to the protocols of Projeto Esporte Brasil. The body fat percentage was evaluated through the measures of tricipital and subscapular folds, and the body mass index was calculated. The clustered metabolic risk score (cMetS) considered the summing z-scores of waist circumference, systolic blood pressure, triglycerides, total cholesterol/high-density lipoprotein cholesterol ratio, and fasting glucose, divided by five. A structural equation model was applied for statistical analysis. Results: The relationship between parental obesity and cardiometabolic risk was observed in children and adolescents with adequate sleep, being significant (p

OBJECTIVE: There are few studies on intestinal parasitic infections in elderly populations. Therefore, this study aimed to determine the prevalence of intestinal parasites and identify the association between this prevalence and the sociodemographic, environmental, and health factors of the elderly attended by the Family Health Strategy (FHS). METHOD: This cross-sectional study involved the analysis of data collected from a random sample of elderly individuals. Community health workers drafted a general questionnaire to collect epidemiological data. The project team also collected blood and stool samples at the healthcare unit where each individual was enrolled. RESULTS: Among 581 elderly people, the prevalence of intestinal parasites was 10.8%. The parasites found were as follows: Endolimax nana (42.7%), Entamoeba coli (33.8%), Giardia lamblia (8.8%), Ascaris lumbricoides (5.9%), Strongyloides stercoralis (4.4%), Trichuris trichiura (2.9%), and Iodamoeba bütschlii (1.5%). CONCLUSION: The prevalence of intestinal parasites in elderly persons was lower than that reported in other studies, and the parasites identified were predominantly non-pathogenic. The findings suggest the possibility that interpersonal transmission, environmental contamination, or the ingestion of contaminated food or water is occurring in this population. These findings also highlight the importance of the ongoing implementation of sanitation and hygiene education programs in this community.

OBJETIVO: Investigar a percepção que um grupo de idosos residentes em uma Instituição de Longa Permanência (ILP) possui sobre a mudança alimentar decorrente da institucionalização. MÉTODO: Consiste em um estudo descritivo, englobando idosos lúcidos de uma ILP, de ambos os sexos, que não possuíam limitações para responder de forma fidedigna ao questionário. O projeto foi aprovado por um Comitê de Ética, e a análise dos dados deu-se por meio do Microsoft Excel 2010. RESULTADOS: A amostra consistiu de 27 idosos, com prevalência do sexo feminino. Foi constatado que a maioria das opiniões ligadas à alimentação pregressa, adaptação e à mudança alimentar foram positivas. CONCLUSÃO: Depreende-se então que as opiniões sobre a qualidade da alimentação a partir do ingresso na ILP, são heterogêneas, havendo, no entanto, fatores subjetivos que podem determinar melhor receptividade do novo modo de se alimentar.

Abstract The 4T1 model is extensively employed in murine studies to elucidate the mechanisms underlying the carcinogenesis of triple-negative breast cancer. Molecular biology serves as a cornerstone in these investigations. However, accurate gene expression analyses necessitate data normalization employing housekeeping genes (HKGs) to avert spurious results. Here, we initially delve into the characteristics of the tumor evolution induced by 4T1 in mice, underscoring the imperative for additional tools for tumor monitoring and assessment methods for tracking the animals, thereby facilitating prospective studies employing this methodology. Subsequently, leveraging various software platforms, we assessed ten distinct HKGs (GAPDH, 18 S, ACTB, HPRT1, B2M, GUSB, PGK1, CCSER2, SYMPK, ANKRD17) not hitherto evaluated in the 4T1 breast cancer model, across tumors and diverse tissues afflicted by metastasis. Our principal findings underscore GAPDH as the optimal HKG for gene expression analyses in tumors, while HPRT1 emerged as the most stable in the liver and CCSER2 in the lung. These genes demonstrated consistent expression and minimal variation among experimental groups. Furthermore, employing these HKGs for normalization, we assessed TNF-α and VEGF expression in tissues and discerned significant disparities among groups. We posit that this constitutes the inaugural delineation of an ideal HKG for experiments utilizing the 4T1 model, particularly in vivo settings.

Abstract Background The Universal Infant Free School Meal (UIFSM) policy was introduced in 2014/15 in England and Scotland for schoolchildren aged 4–7 years, leading to an increase in school meal uptake. UK school meals are known to be healthier and less industrially processed than food brought from home (packed lunches). However, the impact of the UIFSM policy on the quantity of ultra-processed food (UPF) consumed at school during lunchtime is unknown. This study aimed to evaluate the impact of the UIFSM policy on lunchtime intakes of UPF in English and Scottish schoolchildren. Methods Data from the UK National Diet and Nutrition Survey (2008–2019) were used to conduct a difference-in-difference (DID) natural experiment. Outcomes included school meal uptake and the average intake of UPF (% of total lunch in grams (%g) and % total lunch in Kcal (%Kcal)) during school lunchtime. The change in the outcomes before and after the introduction of UIFSM (September 2014 in England, January 2015 in Scotland) in the intervention group (4–7 years, n = 835) was compared to the change in an unexposed control group (8–11 years, n = 783), using linear regression. Inverse probability weights were used to balance characteristics between intervention and control groups. Results Before UIFSM, school meal uptake and consumption of UPFs were similar in the intervention and control groups. The DID model showed that after UIFSM, school meal uptake rose by 25%-points (pp) (95% CI 14.2, 35.9) and consumption of UPFs (%g) decreased by 6.8pp (95% CI -12.5,-1.0). Analyses indicated this was driven by increases in minimally processed dairy and eggs, and starchy foods, and decreases in ultra-processed salty snacks, bread and drinks. The differences were larger in the lowest-income children (-19.3 UPF(%g); 95% CI -30.4,-8.2) compared to middle- and high-income children. Analyses using UPF %Kcal had similar conclusions. Conclusions This study builds on previous evidence suggesting that UIFSM had a positive impact on dietary patterns, showing that it reduced consumption of UPFs at school lunchtime, with the greatest impact for children from the lowest-income households. Universal free school meals could be an important policy for long term equitable improvements in children’s diet.

Abstract Background Resilience is a crucial factor in students’ mental health, playing an important role in their successful adaptation to the academic environment. However, there is a lack of understanding about resilience and its associated factors in students from different undergraduate courses. This study aimed to describe the resilience profile of undergraduate students from various courses in Brazil and identify sociodemographic, economic, and academic factors associated with resilience. Methods This study has data from a cross-sectional multicenter study involving undergraduate students from eight Federal Institutions of Higher Education in Minas Gerais, Brazil. The dependent variable was resilience, measured using the Connor-Davidson Resilience Scale (CD-RISC) 10-item version, with sociodemographic, economic, and academic factors considered independent variables. Data was collected virtually via a self-administered questionnaire between October 2021 and February 2022 (during the covid-19 pandemic). Independent samples t-tests and ANOVAs were conducted to compare resilience scores between independent variables, and Tukey’s post-hoc test was performed when necessary. Multiple linear regression was performed to create three models. Results 8,650 undergraduate students were included in this study. The average score on the resilience scale was 19.86 ± 8.15, with a normal distribution. The respondents ranged from 18 to 71 years old, averaging 23.9 ± 6.33. Being female, not having a religious belief, having low per capita family income, having had a decrease in the family income, not being heterosexual, or having the head of the family with a low education level were the main factors associated, individually, with low resilience scores in the sociodemographic and economic multiple linear regression model constructed. Being from linguistics, letters and arts courses, being enrolled in fewer subjects, or being from UFMG were the main factors associated, individually, with low resilience scores in the academic multiple linear regression model constructed. Conclusions The study’s findings revealed that sociodemographic, economic, and academic variables were significantly associated with resilience scores in undergraduates from Minas Gerais during the covid-19 pandemic. These findings can help universities develop target strategies to promote students’ resilience and reduce the risk of poor mental health among this population.

Analysis of clinical and environmental Vibrio cholerae O1 strains obtained during 2008–2015 in Nigeria showed that lineages Afr9 and Afr12 carrying cholera toxin and Vibrio pathogenicity island 1 can be isolated from water. Our findings raise concerns about the role of the environment in maintenance and emergence of cholera outbreaks in Nigeria.

Banana breeding consists of obtaining diploid, triploid, and tetraploid intra- and interspecific hybrids by conventional breeding methods with the objective of aggregating characteristics of agronomic and commercial interest. Given the narrow genetic base of bananas, Embrapa’s Banana Genetic Breeding Program (BGBP) aims at crosses between improved diploids (ID) (ID × ID) and between improved diploids (ID) and commercial triploids (ID × CTP) and tetraploids (ID × CTT), in order to increase the genetic base and variability in bananas regarding agronomic traits of interest and resistance to main biotic and abiotic factors. These improved diploids are resistant to main fungal diseases such as yellow (YSD) and black Sigatoka (BSD) disease and Fusarium wilt (race 1 and subtropical race 4), the latter being one of the most devastating diseases in bananas. The genetic diversity between 22 improved diploids and seven commercial banana triploids was analyzed using DNA molecular markers. Five IRAP (Inter-Retrotransposon Amplified Polymorphism, 7 ISSR (Inter-Simple Sequence Repeats) and 12 SSR (Simple Sequence Repeat) markers were used. The genetic dissimilarity matrix was based on the Jaccard dissimilarity index; clusters were separated using the UPGMA (Unweighted Pair Group Method With Arithmetic Mean) method and cophenetic correlation of 0.8755. This study of the genetic diversity between improved diploids and commercial triploids, based on the genetic dissimilarity matrix, revealed that the most dissimilar diploids were DM23 and DM15 (74%) and DM16 and DM15 (74%). The smallest genetic distances between the improved diploids and commercial triploids were between TCGN25 and DM17 (50%) and TCN26 and DM17 (50%). The genetic distance matrix also revealed important genotypes to be used in crosses in order to maintain good characteristics in commercial triploids when crossed with improved diploids. The results of our study provide better breeding strategies for one of the largest banana-breeding programs worldwide focused on the development of banana varieties resistant to main biotic and abiotic factors.

The fresh fruits of ‘Grande Naine’ (Cavendish AAA—Musa spp.) dominate the world market, especially in countries with a population in a situation of social vulnerability. However, Fusarium wilt, caused by the fungus Fusarium oxysporum f.sp. cubense race 4 Subtropical (Foc ST4), emerges as a serious threat to banana production, requiring the development of resistant cultivars based on biotechnological strategies, such as the induction of mutation in tissue culture. This study aimed to identify and characterize genetic variation in somaclones resistant to Fusarium oxysporum f.sp. cubense subtropical race 4 (Foc ST4), derived from ‘Grand Naine’ bananas, by molecular markers based on retrotransposons IRAP (Inter-retrotransposon Amplified Polymorphism) and REMAP (Retrotransposon-Microsatellite Amplified Polymorphism). Nine combinations of IRAP and six combinations of REMAP primers were used. The low number of polymorphic bands did not allow for genetic diversity studies; however, ten polymorphic bands between the somaclones and control were sequenced. Of these, three presented good base calling and were aligned, namely, 1AF, 2AF, and 3AF bands. Only the 1AF band presented function related to stress response with homology to a calcium-binding protein. These proteins act early in plant infection as secondary messengers activated by pathogen-associated molecular patterns (PAMPs), initiating the cascade of plant defense signals. The fact that this band is present in all somaclones reinforces previous assessments of their resistance to Foc ST4. The use of markers IRAP and REMAP produced polymorphic bands that can, through future primer design and field validations, accelerate the identification of resistant banana genotypes for use in banana genetic breeding programs.

الملخص: أهداف البحث: يعد مرض الزهايمر تهديدا عالميا متزايدا، ولا يوجد علاج فعال له حاليا. ولذلك، تهدف هذه الدراسة إلى استكشاف المركبات النباتية في نبات الجرباء العمودية كمثبطات لإنزيم أسيتيل كولين إستيراز، وإنزيم شطر البروتين السلائف للأميلويد بيتا 1، وإنزيم محول عامل نخر الورم ألفا في مرض الزهايمر. يحتوي نبات الجرباء العمودية عادة على مركبات نشطة بيولوجيا مختلفة، مثل حمض الكلوروجينيك، واللينالول، والكاتيكين، المعروفة بخصائصها في إزالة السموم، والقدرة على التغلب على احتباس الرطوبة السامة، والآليات العلاجية في كوفيد-19. وقد أظهرت العديد من الدراسات أيضا أن المستخلص له نشاط مضاد للأكسدة قوي، مما قد يقلل من الالتهاب العصبي في مرض الزهايمر. في هذا السياق، توفر هذه الدراسة الحالية فرصا لتطوير المواد الكيميائية النباتية لنبات الجرباء العمودية كمرشحين علاجيين جدد لمرض الزهايمر من خلال دراسة التفاعلات مع الإنزيمات الرئيسية. طرق البحث: تم تقييم 27 مركبا نباتيا للنشاط التثبيطي ضد الإنزيمات المستهدفة باستخدام برنامج ''ياسارا ستركتشر''. تم تقييم الخصائص الدوائية والحركية والأيضية والسمية للمركبات. خضعت المركبات الأعلى تصنيفا لمحاكاة ديناميكية جزيئية لمدة 100 نانوثانية. النتائج: استوفت جميع المركبات معايير ''ليبينسكي'' مع انخفاض كبير في السمية. أظهرت الكاتيكينات نشاطا تثبيطيا أكبر وتفاعلات إضافية مع إنزيم أسيتيل كولين إستيراز مقارنة بدواء الجالانتامين. أظهر حمض الكلوروجينيك نشاطا تثبيطيا أقوى ضد إنزيم محول عامل نخر الورم ألفا مقارنة بدواء المراقبة. أظهرت المحاكاة الديناميكية الجزيئية استقرارا جيدا للمعقدات المتكونة، ولكنها تتطلب المزيد من الاستكشاف. الاستنتاجات: أظهرت المركبات المشتقة من نبات الجرباء العمودية إمكانات واعدة كمرشحات دوائية لمرض الزهايمر، خاصة حمض الكلوروجينيك في تفاعله مع إنزيم محول عامل نخر الورم ألفا. أكدت المحاكاة الديناميكية الجزيئية وحسابات الطاقة استقرار وقوة الروابط بين المركبات والبروتينات المستهدفة، مما يشير إلى إمكانية تطوير هذه المركبات كعلاجات محتملة لمرض الزهايمر. Abstract: Objectives: Alzheimer's disease (AD) is posing an increasing global threat and currently lacks effective treatments. Therefore, this study was aimed at exploring phytochemicals in Scabiosa columbaria (S. columbaria) as inhibitors of acetylcholinesterase (AChE), β-site APP cleavage enzyme 1 (BACE1), and TNF-α converting enzyme (TACE) in AD. S. columbaria contains various bioactive compounds, such as chlorogenic acid, linalool, and catechins, which are known for their detoxification properties, capacity to resist and manage harmful moisture buildup, and therapeutic roles in COVID-19. Several studies have also shown that S. columbaria extract has strong antioxidant activity, and may potentially decrease neuroinflammation in AD. Therefore, this study investigated the interactions between S. columbaria phytochemicals and key enzymes associated with AD, thus providing opportunities for the development of new therapeutic candidates. Methods: A total of 27 phytochemicals were evaluated for their inhibitory activity against AChE, BACE1, and TACE with YASARA Structure. ADMET profiles and toxicity were assessed. The top candidate compounds underwent 100 ns MD simulations. Results: All ligands met Lipinski's rule and showed low toxicity. Catechins, compared with the known drug galantamine, showed higher inhibitory activity and interacted with additional active sites on AChE, thus suggesting potentially higher efficacy. Moreover, chlorogenic acid showed stronger inhibitory activity against TACE than the control drug (aryl-sulfonamide), thereby suggesting a different mechanism of action. MD simulation revealed that the formed complexes had good stability. However, further exploration is necessary. Conclusion: S. columbaria derivative compounds are promising drug candidates because of their properties, including the affinity of chlorogenic acid toward TACE and hydrogen bond enhancing ligand–receptor interactions. MD simulation indicated stable ligand–protein complexes, and the radius of gyration and MM-PBSA calculations revealed favorable binding and interaction energies. Our findings demonstrate the identified compounds' potential for further drug development.

Objetivo: Descrever como os ambientes de informação podem favorecer a serendipidade por meio dos atributos de encontrabilidade da informação. Método: Pesquisa de natureza teórica, objetivo descritivo, utiliza abordagem qualitativa e pesquisa bibliográfica, realizada na Web of Science (WoS) e na Base de Dados em Ciência da Informação (BRAPCI). Resultado: Diferentes aspectos ambientais favorecem a serendipidade informacional, a saber, variedade de conteúdo; personalizar o acesso à informação; levar ao inesperado; estimular curiosidade e parabilidade; incentivar exploração e navegação; acesso desimpedido. Esses princípios gerais podem ser alcançados por meio dos atributos de encontrabilidade da informação e elementos do ambiente. Conclusões: Sugere-se que estudos futuros que abordem a serendipidade sob a perspectiva da descoberta de informação utilizem os termos “infoserendipidade” ou “serendipidade informacional” e que os princípios gerais apresentados podem ser utilizados como guia para avaliar a capacidade dos ambientes de informação em promover experiências de serendipidade.

Abstract Background Infliximab therapy is effective in controlling symptoms and attaining clinical remission of immune-mediated inflammatory diseases. However, treatment adherence is essential to achieve the therapeutic objective. This study aimed to determine the rate of adherence to infliximab treatment in patients treated at a referral center at a university hospital. Method This ambispective cohort study included patients treated at the Professor Edgard Santos University Hospital (HUPES) referral center of our university hospital between March 2022 and February 2023. Sociodemographic, clinical, and pharmacotherapeutic data were collected from 101 patients through interviews and medical record reviews using a structured form. The adherence rate was defined as the proportion of days covered in a year. Patients who achieved an adherence rate > 80% were considered adherent. Results The treatment adherence rate was 91.04%. Individuals with inflammatory bowel diseases had a 39.1% higher risk of non-adherence to treatment compared with other patients in our sample (p

Este artigo tem como objetivo analisar e discutir, a partir da carga global de doenças, as vulnerabilidades e violações de direitos humanos sob a perspectiva da saúde como um direito. Para alcançar esse objetivo, foi realizada uma revisão integrativa, visando responder como a carga global de doenças influencia os fatores de vulnerabilidade individual, social e programática, bem como as violações de direitos humanos no acesso à saúde da população brasileira. Dos 428 artigos encontrados, 119 foram incluídos nesta revisão. O texto acrescenta análises e reflexões sobre as camadas interconectadas entre os indivíduos, suas redes de participação social e as instituições que deveriam protegê-los, mas que, por vezes, acentuam as desigualdades de acesso e desamparo. Sob essa perspectiva, a bioética se apresenta como uma ponte possível para compreender as estruturas que expõem os indivíduos, os profissionais de saúde, a coletividade e as instituições às vulnerabilidades no acesso à saúde.

Type III effectors (T3Es) are major determinants of Xanthomonas virulence and targets for resistance breeding. XopJ2 (synonym AvrBsT) is a highly conserved YopJ-family T3E acquired by X. perforans, the pathogen responsible for bacterial spot disease of tomato. In this study, we characterized a new variant (XopJ2b) of XopJ2, which is predicted to have a similar three-dimensional (3D) structure as the canonical XopJ2 (XopJ2a) despite sharing only 70% sequence identity. XopJ2b carries an acetyltransferase domain and the critical residues required for its activity, and the positions of these residues are predicted to be conserved in the 3D structure of the proteins. We demonstrated that XopJ2b is a functional T3E and triggers a hypersensitive response (HR) when translocated into pepper cells. Like XopJ2a, XopJ2b triggers HR in Arabidopsis that is suppressed by the deacetylase, SOBER1. We found xopJ2b in genome sequences of X. euvesicatoria, X. citri, X. guizotiae, and X. vasicola strains, suggesting widespread horizontal transfer. In X. perforans, xopJ2b was present in strains collected in North America, Africa, Asia, Australia, and Europe, whereas xopJ2a had a narrower geographic distribution. This study expands the Xanthomonas T3E repertoire, demonstrates functional conservation in T3E evolution, and further supports the importance of XopJ2 in X. perforans fitness on tomato. [Figure: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

The emergence of plant pathogens is often associated with waves of unique evolutionary and epidemiological events. Xanthomonas hortorum pv. gardneri is one of the major pathogens causing bacterial spot disease of tomatoes. After its first report in the 1950s, there were no formal reports on this pathogen until the 1990s, despite active global research on the pathogens that cause tomato and pepper bacterial spot disease. Given the recently documented global distribution of X. hortorum pv. gardneri, our objective was to examine genomic diversification associated with its emergence. We sequenced the genomes of X. hortorum pv. gardneri strains collected in eight countries to examine global population structure and pathways of emergence using phylodynamic analysis. We found that strains isolated post-1990 group by region of collection and show minimal impact of recombination on genetic variation. A period of rapid geographic expansion in X. hortorum pv. gardneri is associated with acquisition of a large plasmid conferring copper tolerance by horizontal transfer and coincides with the burgeoning hybrid tomato seed industry through the 1980s. The ancestry of X. hortorum pv. gardneri is consistent with introduction to hybrid tomato seed production and dissemination during the rapid increase in trade of hybrid seeds. [Figure: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

Abstract Background Antibiotic resistance of Enterobacterales poses a major challenge in the treatment of urinary tract infections (UTIs). In low- and middle-income countries (LMICs), standard microbiological (i.e. urine culture and simple disk diffusion test) methods are considered the “gold standard” for bacterial identification and drug susceptibility testing, while PCR and DNA sequencing are less commonly used. In this study, we aimed to re-identifying Enterobacterales as the primary bacterial agents responsible for urinary tract infections (UTIs) by comparing the sensitivity and specificity of traditional microbiological methods with advanced molecular techniques for the detection of uropathogens in indigenous women from Otavalo, Ecuador. Methods A facility-based cross-sectional study was conducted from October 2021 to February 2022 among Kichwa-Otavalo women. Pathogens from urine samples were identified using culture and biochemical typing. Morphological identification was doble-checked through PCR and DNA sequencing of 16S, recA, and rpoB molecular barcodes. The isolates were subjected to antimicrobial susceptibility-testing using disk diffusion test. Results This study highlighted a 32% misidentification rate between biochemical and molecular identification. Using traditional methods, E. coli was 26.19% underrepresented meanwhile Klebsiella oxytoca was overrepresented by 92.86%. Furthermore, the genera Pseudomonas, Proteus, and Serratia were confirmed to be E. coli and Klebsiella spp. by molecular method, and one Klebsiella spp. was reidentified as Enterobacter spp. The susceptibility profile showed that 59% of the isolates were multidrug resistant strains and 31% produced extended spectrum beta-lactamases (ESBLs). Co-trimoxazole was the least effective antibiotic with 61% of the isolates resistant. Compared to previous reports, resistance to nitrofurantoin and fosfomycin showed an increase in resistance by 25% and 15%, respectively. Conclusions Community-acquired UTIs in indigenous women in Otavalo were primarily caused by E. coli and Klebsiella spp. Molecular identification (16S/rpoB/recA) revealed a high rate of misidentification by standard biochemical and microbiological techniques, which could lead to incorrect antibiotic prescriptions. UTI isolates in this population displayed higher levels of resistance to commonly used antibiotics compared with non-indigenous groups. Accurate identification of pathogens causing UTIs and their antibiotic susceptibility in local populations is important for local antibiotic prescribing guidelines.

The objective of this systematic review (SR) was to select studies on the use of gene editing by CRISPR technology related to plant resistance to biotic stresses. We sought to evaluate articles deposited in six electronic databases, using pre-defined inclusion and exclusion criteria. This SR demonstrates that countries such as China and the United States of America stand out in studies with CRISPR/Cas. Among the most studied crops are rice, tomatoes and the model plant Arabidopsis thaliana. The most cited biotic agents include the genera, Xanthomonas, Manaporthe, Pseudomonas and Phytophthora. This SR also identifies several CRISPR/Cas-edited genes and demonstrates that plant responses to stressors are mediated by many complex signaling pathways. The Cas9 enzyme is used in most articles and Cas12 and 13 are used as additional editing tools. Furthermore, the quality of the articles included in this SR was validated by a risk of bias analysis. The information collected in this SR helps to understand the state of the art of CRISPR/Cas aimed at improving resistance to diseases and pests to understand the mechanisms involved in most host–pathogen relationships. This SR shows that the CRISPR/Cas system provides a straightforward method for rapid gene targeting, providing useful information for plant breeding programs.

Abstract Background Streptococcus pneumoniae (S. pneumoniae), Haemophilus influenzae (H. influenzae), and Neisseria meningitidis (N. meningitidis) are leading causes of childhood bacterial meningitis and preventable by vaccines. The aim of this hospital-based sentinel surveillance is to describe the epidemiological characteristics of pneumococcal meningitis, including disease burden, and to provide baseline data on pneumococcal serotype distribution to support decision making for pneumococcal conjugate vaccine (PCV) introduction in Vietnam. Methods Surveillance for probable bacterial meningitis in children 1–59 months of age is conducted in three tertiary level pediatric hospitals: one in Hanoi and two in Ho Chi Minh City. Cerebrospinal fluid (CSF) specimens were collected via lumbar puncture from children with suspected meningitis. Specimens were transferred immediately to the laboratory department of the respective hospital for cytology, biochemistry, and microbiology testing, including culture. PCR testing was conducted on CSF specimens for bacterial detection (S. pneumoniae, H. influenzae, and N. meningitidis) and pneumococcal serotyping. Results During 2015–2018, a total of 1,803 children with probable bacterial meningitis were detected; 1,780 had CSF specimens available for testing. Of 245 laboratory-confirmed positive cases, the majority were caused by S. pneumoniae (229,93.5%). Of those with S. pneumoniae detected, over 70% were caused by serotypes included in currently available PCV products; serotypes 6 A/6B (27.1%), 14 (19.7%), and 23 F (16.2%) were the most common serotypes. Children with laboratory-confirmed pneumococcal meningitis were more likely to live in Hanoi (p

Abstract This data descriptor presents a curated dataset for pathogen detection and identification (Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans) directly from whole-blood samples. The dataset was created using differential cell lysis combined with rapid extraction, digestion, and mass spectrometry-based proteomics. Our method offers a rapid diagnostic alternative to traditional culture, enabling timely disease management, such as sepsis. Highlighting our dataset’s uniqueness, it features a three-tier structure: Spectral Libraries of Pathogens for identifying peptide peaks for putative biomarkers; Spiked pathogen in blood MS data for biomarker panel optimization through varied concentration samples; and Parallel Reaction Monitoring (PRM) data from sepsis patients for validating our biomarker panel, achieving 83.3% sensitivity within seven hours without microbial enrichment culture. This dataset serves as a comprehensive reference for bioinformatic tool development and biomarker panel proposals, advancing microbial detection, antimicrobial resistance, and epidemiological studies.

Abstract Background Drug resistance (DR) is one of the several challenges to global tuberculosis (TB) control. The implementation of bedaquiline (BED) for DR-TB after more than 40 years was expected to improve treatment outcomes as well as microbiologic conversion and adverse events (AE) occurrence. Methods Retrospective cohort study based on secondary data of patients with rifampicin-resistant (RR) or multidrug-resistant (MDR) TB reported to the Outpatient Clinic of Mycobacterial Diseases of the Thorax Diseases Institute – Federal University of Rio de Janeiro - Brazil, between 2016 and 2023. We aimed to evaluate microbiologic conversion, AE and TB treatment outcomes and compare them according to the treatment regimen used for RR/MDR-TB patients under routine conditions [Injectable Containing Regimens (ICR) versus BED Containing Regimens (BCR)]. Logistic regression and survival analysis using Cox regression and Kaplan Meier curve were used for statistical analysis. Results Of the 463 DR-TB patients notified during the study period, 297 (64.1%) were included for analysis (ICR = 197 and BCR = 100). Overall AEs were more frequent (83.7 vs. 16.3%, p

Abstract The mechanisms involved with the pathogenesis of carcinoma ex pleomorphic adenoma (CXPA) seem to be associated with the accumulation of molecular alterations in the pleomorphic adenoma (PA). In this sense, using array-based comparative genomic hybridization (aCGH) a rare series of 27 cases of CXPA and 14 residual PA (rPA) adjacent to the transformation area, we investigated the profile of the copy number alterations (CNAs) comparing benign residual and transformed areas. The main findings were correlated with the histopathological classification by histologic subtype and degree of invasion. The distribution of losses (p = 0.187) and amplifications (p = 0.172) was not statistically different between rPA and CXPA. The number of gains was increased in the transformed areas compared to the benign residual areas (p = 0.005). PLAG1 gain was maintained along the malignant transformation, as it was observed in both residual PA and CXPA samples, likely being an earlier event during transformation. The amplification of GRB7 and ERBB2 may also be an initial step in the malignant transformation of PA to CXPA (salivary duct carcinoma subtype). Furthermore, the amplification of HMGA2 and RPSAP52 were the most prevalent alterations among the studied samples. It was noteworthy that amplified genes in the transformed areas of the tumors were enriched for biological processes related to immune signaling. In conclusion, our results underscored for the first-time crucial CNAs in CXPA, some of them shared with the residual benign area adjacent to the transformation site. These CNAs included PLAG1 gain, as well as amplification of GRB7, ERBB2, HMGA2, and RPSAP52.

ABSTRACT: Adequate transfer of passive immunity (TPI) is a cornerstone for a proper health status of calves. In the literature, there is limited information on the prevalence of failure of TPI in dairy-beef crossbred calves and its effect on morbidity, mortality, and ADG during the preweaning period. Therefore, this study aimed to evaluate the association between TPI with morbidity, mortality, and ADG in preweaning dairy-beef crossbred calves. A total of 1,055 newborn dairy-beef crossbred calves were enrolled upon arrival at a calf-raising facility in California from January to August 2021. Farm of origin, genetic breed group, sex, and BW were recorded upon arrival. Blood was collected at 24 ± 1 h after arrival to evaluate serum IgG concentration, serum total protein (TP), and packed cell volume. Morbidity (diarrhea and respiratory treatment records) and mortality were recorded daily until 60 d of life. Calves were grouped into 2 genetic breed groups: Holstein × Beef (Ho × Be, 49.6%) and Jersey × Beef crossbred calves (Je × Be, 50.4%). Descriptive statistics and Cox proportional hazard models were created to evaluate the association of TPI categories for serum IgG (TPI-IgG: poor:

Este texto parte do seguinte problema: quais são os principais quadros de sentido construídos por jornais da mídia tradicional sobre os eventos do 8 de janeiro em Brasília? Para tanto, foram analisadas as edições impressas de 9 de janeiro de 2023, um dia após os eventos, veiculadas por quatro jornais brasileiros: Folha de S. Paulo, Estado de S. Paulo, O Globo e Correio Braziliense, por meio de Análise de Conteúdo e com base no conceito operador de enquadramento, para compreender como se deu o processo de construção das notícias e reportagens sobre os atentados ocorridos em Brasília. A partir das análises, é possível identificar que as capas em questão mostraram tanto em formas textuais quanto imagéticas a repulsa contra os ataques de 8 de janeiro à democracia com posicionamentos e quadros de sentido que evidenciam as ações de terrorismo e depredação de patrimônio público daquele acontecimento e a luta pelo direito à democracia no país.

The Atlantic Forest is one of the most diverse and threatened phytogeographical domains in the world. Despite that, it includes regions with poor floristic knowledge, even in protected areas. Although the importance of protected areas in conserving the Atlantic Forest hotspot is undisputed, it is necessary to recognise the floristic richness of these areas to propose effective conservation actions. In this sense, online databases have proved to be a promising tool for compiling species lists with relevant biodiversity information. This study is based on the list of vascular plants of the "Parque Estadual da Pedra Selada", published in the "Catálogo de Plantas das Unidades de Conservação do Brasil". It summarises the species richness, endemism and conservation status of this protected area.The published list of vascular plants was based on data obtained from herbarium collections available in online databases. A total of 303 species have been recorded for the "Parque Estadual da Pedra Selada," of which 297 are native to Brazil, 78 are endemic to the Brazilian Atlantic Forest, and seven are endemic to the State of Rio de Janeiro. More than 60% of the species are woody, and more than 40% are trees. Eight threatened species (Endangered – EN and Vulnerable – VU), of which five are endemic to the State of Rio de Janeiro, are housed in this protected area. One species was classified as Data Deficient (DD). Our results increase the knowledge of the Atlantic Forest flora in the State of Rio de Janeiro and support effective conservation planning for this protected area.