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This study aims to evaluate the epidemiological and molecular features associated with HAV transmission in adults in Rio de Janeiro during a period of increased registered cases of HAV (2017–2018). Socio-epidemiological data and serum samples from anti-HAV IgM+ individuals were obtained. HAV RNA was RT-PCR amplified and sequenced for further phylogenetic and phylogeographic analyses. From fifty-two HAV IgM+ individuals, most were men (78.85%; p = 0.024), aged 20–30 years old (84.61%; p < 0.001), resided in the Rio de Janeiro north zone (31/52; 59.62%; p = 0.001), and are men who have sex with men (MSM) (57.69%; p = 0.002). Sexual practices were more frequent (96%) than others risk factors (food-borne (44%), water-borne (42.31%), and parenteral (34.62%)). Individuals who traveled to endemic regions had a 7.19-fold (1.93–36.04; p < 0.01) increased risk of HAV. Phylogenetic analysis revealed four distinct clades of subgenotype IA, three of them comprised sequences from European/Asian MSM outbreaks and one from Brazilian endemic strains. Bayesian Inference showed that the imported strains were introduced to Brazil during large mass sportive events. Sexual orientation and sexual practices may play a role in acquiring HAV infection. Public policies targeting key populations must be implemented to prevent further dissemination of HAV and other STIs.

Abstract Background Adoption of contraceptive implants and intrauterine devices has been less than might be expected given their superior efficacy and convenience. The purpose of this study was to assess knowledge and beliefs held by women, which may influence their contraceptive choices and theirongoing utilization of contraceptive methods. Methods English speaking, nonpregnant, reproductive-age women, who were not surgically sterilized, were individually interviewed to obtain limited demographic characteristics and to assess their knowledge about the efficacy of various contraceptive methods in typical use and about the relative safety of oral contraceptives. Results A convenience sample of 500 women aged 18–45 years, with education levels that ranged from middle school to postdoctoral level was interviewed. The efficacy in typical use of both combined oral contraceptives and male condoms was correctly estimated by 2.2%; over two-thirds of women significantly overestimated the efficacy of each of those methods in typical use. Oral contraceptives were thought to be at least as hazardous to a woman’s health as pregnancy by 56% of women. Conclusions The majority of reproductive aged women surveyed substantially overestimated the efficacy of the two most popular contraceptive methods, often saying that they were 99% effective. Women with higher education levels were most likely to overestimate efficacy of oral contraceptives. Women of all ages and education levels significantly overestimated the health hazards of oral contraceptives compared to pregnancy. Overestimation of effectiveness of these methods of contraception, may contribute to lower adoption of implants and intrauterine devices. When individualizing patient counselling, misperceptions must be identified and addressed with women of all educational backgrounds. Trial registration Not applicable.

Background. The relationship between 25-hydroxyvitamin D [25(OH)D] serum levels and response to antiviral therapy and laboratory data in HCV infection remains unclear. The aim of this study was to determine pre-treatment 25(OH)D serum level among HCV infected individuals and to evaluate the association between vitamin D status, virological response, and laboratory data.Material and methods. Baseline serum 25(OH)D levels were measured in 237 chronic HCV infected patients (139 female, age 53.7 ± 11.2 years) using chemiluminescence immunoassay. Correlations between serum 25(OH)D levels, virological and laboratory data regarding HCV infection as well as sustained virological response (SVR) to antiviral therapy were evaluated.Results. Mean serum values of 25(OH)D was 26.2 ± 12 ng/mL and prevalence of vitamin D deficiency (< 30 ng/mL) was 66.2%. Advanced age (> 55 years), high mean values of LDL, total cholesterol, HDL and low mean values of alkaline phosphatase and hemoglobin were statistically associated to vitamin D deficiency. Antiviral treatment was underwent by 133 HCV patients and 44.3% of them achieved SVR. Most of individuals that presented SVR also presented 25(OH)D level higher than 30ng/mL (55.9%). SVR was associated to low mean values of LDL, total cholesterol and platelets; high mean values of ALT, AST and low fibrosis grade. Conclusions: In conclusion, low vitamin D levels were observed among HCV infected patients and was associated to laboratory findings, however baseline 25(OH)D level is not independently associated with SVR.

Hepatitis B virus (HBV) subgenotypes may be related to clinical outcomes and response to antiviral therapy. Most Brazilian studies on HBV subgenotypes are restricted to some regions and to specific population groups. Here, we provide an insight about genetic diversity of HBV subgenotypes in 321 serum samples from all five geographical regions, providing a representative overview of their circulation among chronic carriers. Overall, HBV/A1 was the most prevalent subgenotype, being found as the major one in all regions except in South Brazil. Among HBV/D samples, subgenotype D3 was the most prevalent, found in 51.5%, followed by D2 (27.3%) and D4 (21.2%). D2 and D3 were the most prevalent subgenotypes in South region, with high similarity with European strains. D4 was found in North and Northeast region and clustered with strains from Cape Verde and India. For HBV/F, the most frequent subgenotype was F2 (84.1%), followed by F4 (10.1%) and F1 (5.8%), closely related with strains from Venezuela, Argentina and Chile, respectively. Phylogeographic analyses were performed using an HBV full-length genome obtained from samples infected with genotypes rarely found in Brazil (B, C, and E). According to Bayesian inference, HBV/B2 and HBV/C2 were probably introduced in Brazil through China, and HBV/E from Guinea, all of them mostly linked to recent events of human migration. In conclusion, this study provided a comprehensive overview of the current circulation of HBV subgenotypes in Brazil. Our findings might contribute to a better understand of the dynamics of viral variants, to establish a permanent molecular surveillance on the introduction and dispersion patterns of new strains and, thus, to support public policies to control HBV dissemination in Brazil.

Hepatitis A virus (HAV) outbreaks among men who have sex with men (MSM) have been reported worldwide and associated primarily with sexual transmission through oral-anal sex. Here, we provide the molecular and evolutionary description of a European strain, linked to HAV outbreaks among MSM, detected in a Brazilian homosexual couple. Bayesian analysis provided evidence that the viral isolates were introduced in Brazil from Spain between the end of 2016 and the beginning of 2017.

O objetivo do presente estudo foi realizar a comparação entre dois sítios de coleta sanguínea em 24 exemplares de tigre-d'água-americano (Trachemys scripta elegans) oriundos de um criadouro comercial, localizado no município de Antonina, litoral do Paraná, Brasil. Os animais foram submetidos a contenção física e as venopunções foram realizadas no seio supraocciptal e na veia coccígea dorsal. As amostras heparinizadas foram identificadas e refrigeradas para posterior análise laboratorial. A contagem total de eritrócitos e leucócitos foi realizada pela técnica de hemocitometria. O hematócrito (Ht) e a hemoglobina (Hb) foram determinados pelo método de microhematócrito e cianometahemoglobina, respectivamente. A proteína plasmática total (PPT) foi determinada por refratometria e a contagem diferencial de leucócitos foi realizada através da técnica de Shilling. Houve diferença significativa no número de leucócitos e no valor da proteína plasmática total, e em ambos os casos os valores encontrados nas amostras provenientes da veia coccígea dorsal foram inferiores. A diferença encontrada no número de leucócitos provavelmente foi devido à contaminação por linfa, que também justifica o menor valor na concentração da proteína plasmática total. Conclui-se que é mais indicada a venopunção no seio supraocciptal quando comparado a veia coccígea dorsal.The aim of the present study was to compare two different blood collection sites of 24 red-eared sliders (Trachemys scripta elegans) from a commercial breeder, situated in Antonina, Paraná, Brasil. The animals were physically restrained and paired blood samples were collected from the dorsal coccygeal vein and the occipital sinus. The samples were collected in syringes containing heparin. After collection the samples were identified and refrigerated to posterior hematological analysis. Red blood cell and white blood count were performed using a hemocytometer. The packed cell volume and hemoglobin were determined by the microhematocrit method and cyanmethemoglobin method, respectively. Total plasma protein was determined by refractometry and differential leukocyte count was performed by the Shilling technique. There was a significant difference in the total white blood cell count and on the total plasma protein value, and on both cases the results found on the samples from the dorsal coccygeal vein were lower. The difference found on the white blood cell count was probably due to the lymph contamination of the samples, which also justifies the lower values of total plasma protein. In conclusion, the occipital sinus is more recommended blood collection site than the dorsal coccygeal vein.

A durabilidade de compósito biomassa vegetal-cimento é um dos fatores mais importantes para a colocação desse material no mercado consumidor. A utilização de polímeros em concreto e argamassa, com o objetivo de melhorar sua durabilidade, é cada vez mais freqüente. Este estudo visou à caracterização de propriedades físicas e mecânicas de compósito biomassa vegetal-cimento modificado com polímeros e a análise da durabilidade desse compósito. Foi testado um polímero de base acrílica em compósitos produzidos com resíduo de Pinus caribaea. Foram realizados ensaios de envelhecimento acelerado, por meio de ciclos de molhamento e secagem, por imersão em água quente e ensaio de envelhecimento natural. As propriedades físicas do compósito avaliadas foram a massa específica aparente e a absorção total de água por imersão. As propriedades mecânicas foram determinadas por meio de ensaios de resistência à tração na flexão, analisando-se a tensão e a energia de ruptura. Os corpos-de-prova foram extraídos de placas executadas por simples prensagem. Ensaios de microscopia eletrônica de varredura foram utilizados para observar o estado da fibra e da matriz após os processos de envelhecimento. O uso de polímero melhorou o desempenho mecânico do compósito nas primeiras idades e também promoveu significativa redução da capacidade de absorção de água, demonstrando que o uso desse material pode vir a melhorar a durabilidade desses compósitos, uma vez que reduziu sensivelmente sua capacidade de absorção.The durability of the cellulose-cement composites is a decisive factor to introduce such material in the market. Polymers have been used in concrete and mortar production to increase its durability. The goal of this work was the physical and mechanical characterization of cellulose-cement composites modified by a polymer and the subsequent durability evaluation. The work also evaluated the dispersion of acrylic polymer in composites made of Pinus caribaea residues. The physical properties observed were water absorption by immersion and bulk density. Rupture modulus and toughness were determined by flexural test. The specimens were obtained from pads, produced by pressing and wet curing. Samples were subjected to accelerated aging tests by repeated wetting and drying cycles and hot-water bath and natural aging. The scanning electron microscopy (SEM) allowed verifying the fiber and composite characteristics along the time. For the composite range analyzed, it was observed the polymer improved the mechanical properties of composites besides a significant decreasing in water absorption. The use of polymer improved the performance of vegetable fiber-cement composites when compared to the conventional mortar, due to water absorption decreasing.

Serological evidence of hepatitis E virus infection (HEV) has been observed in both humans and different animal species living in non-endemic areas, suggesting that animals could be important reservoir for virus transmission to man. Antibodies to HEV have been detected in some Brazilian population groups. Nevertheless, sporadic cases of acute HEV infection have never been reported. We collected 271 serum samples from several domestic animals and also from pig handlers from Southeast of Brazil in order to investigate the seroprevalence of HEV infection. Anti-HEV IgG was detected in cows (1.42%), dogs (6.97%), chickens (20%), swines (24.3%), and rodents (50%), as well as in pig handlers (6.3%). The recognition of swine HEV infections in pigs in many countries of the world led us to investigate a larger sample of pigs (n = 357) from the same Brazilian region with ages ranging from 1 to > 25 weeks. IgG anti-HEV was detected in 100% of 7-day old pigs. Following a gradual decline between weeks 2 and 8 (probably due to loss of maternal IgG), the prevalence then steady increased until it reached 97.3% of animals older than 25 weeks. Besides the detection of anti-HEV antibodies in different animal species, the results showed that swine HEV infection seems to be almost universal within this Brazilian pig population. This is the first report that shows evidences of HEV circulation in Brazilian animal species and pig handlers.

The article presents the results of a comparative analysis of the composition of academic rights of students in Russia, the United States and the European Union countries, their legislative regulation and practice of implementation in universities. The following conclusions were made: (1) the wording of the rights, their thematic groups in Russia and abroad have significant differences, despite the fact that upon the entry into the Bologna process, the relevant changes were made to the Federal law and by-laws of RF; (2) there have not been created conditions in the higher education system of Russia for the implementation of students' academic rights in accordance with the principles and objectives of the Bologna process, in particular, the right to design and implement an individual learning trajectory, students' participation in creating of the content of education, usage of ECTS to transfer from one university to another, implementation of "short bachelor programs", recognition of the previous non-formal and informal level of education, involvement of students in the process of assessment of the quality of education at all stages, priority of the results of international accreditation of educational programs when making government decisions towards a university, etc.; (3) in the Russian educational system, many universities, despite the possibility established by the Federal Law, do not provide students with additional academic rights, while outside Russia it widespread to give students so-called "contract" rights, which are granted to a student in accordance with an educational contract and university code (eg Student Rights, Responsibilities and Code ...); (4) compared to foreign students, Russian students are less active in exercising and defending their academic rights. To improve the current situation, it is proposed to make changes to the current legislation of the Russian Federation regarding clarification, additions and expansion of the legal status of participants in the educational process, to deliver responsibilities through creation and compliance with regulatory, economic and organizational conditions and mechanisms for the implementation of academic rights of students in universities, to enter into academic regulations and regulatory documents of universities additional academic rights similar to those in the United States and the countries of the European Union; to bring into this process associations of higher educational institutions of the Russian Federation, including student associations to monitor, implement and lobby the students' academic rights; to encourage students to be active in exercising their academic rights during their study at the university.

Ultra-high-performance concrete (UHPC) has gained worldwide popularity due to its high mechanical performance. This research studied the influence of adding a mixture of two fibers (steel and PVA) on the compressive strength, modulus of elasticity, and flexural tensile strength of UHPC. The mixtures were prepared by adding steel fibers and PVA fibers using a standard procedure defined in the research, which is the time to mix the dry materials and the time to mix the admixture and water. The Central Composite Rotational Design (CCRD) methodology was used for the experimental design of the compressive strength and longitudinal deformation modulus tests. The results were analyzed using statistical software to investigate the influence of fibers on these two mechanical properties of UHPC. With this technique, an optimized design for the study of flexural tensile strength was arrived at. It was found that the standardized equations for the modulus of elasticity, directed to conventional concrete and high-strength concrete, are inadequate for estimating the modulus of UHPC in this research. Statistical analysis indicated that the range of fiber amounts analyzed did not significantly affect the compressive strength and modulus of elasticity. Regarding the optimized mixture, its flexural tensile strength indicated that the fiber content should be higher for UHPC to be suitable for structural use. [ABSTRACT FROM AUTHOR]

The main concern with concrete at high temperatures is loss of strength and explosive spalling, which are more pronounced in high-strength concretes, such as Ultra-High Performance Concrete (UHPC). The use of polymeric fibers in the mixture helps control chipping, increasing porosity and reducing internal water vapor pressure, but their addition can impact its mechanical properties and workability. This study evaluated the physical and mechanical properties of UHPC with metallic and PVA fibers under high temperatures using a 23 central composite factorial design. The consistency of fresh UHPC and the compressive strength and elasticity modulus of hardened UHPC were measured. Above 300 °C, both compressive strength and elasticity modulus decreased drastically. Although the addition of PVA fibers reduced fluidity, it decreased the loss of compressive strength after exposure to high temperatures. The response surface indicates that the ideal mixture—1.65% steel fiber and 0.50% PVA fiber—achieved the highest compressive strength, both at room temperature and at high temperatures. However, PVA fibers did not protect UHPC against explosive spalling at the levels used in this research. [ABSTRACT FROM AUTHOR]

Abstract Background There are significant discrepancies in the optic nerve sheath diameter (ONSD) reported in the literature. We aimed to determine the ultrasonographic imaging features of ONSD and ophthalmic vessels in a healthy population, using a standardized protocol, and to estimate the effect of demographics and positioning changes on imaging measurements. Methods We measured the mean values of the ONSD in supine and sitting position and the Doppler imaging parameters of the ophthalmic, central retinal and short posterior ciliary arteries. Inter-observer reliability was assessed using intraclass correlation coefficient (ICC). Linear regression models were fitted to predict the effect of demographic and clinical determinants on the imaging features. Results A total of 50 measurements were obtained for each observer. The mean ONSD was 5.9 mm and there was a mean reduction of 0.2 mm when assessed in sitting position (p

This pilot investigation evaluated the effectiveness of siblings as generalisation agents in an 8-week social skills training (SST) program designed for boys with Asperger syndrome (AS). Twenty-one boys aged 8-12 participated in a SST group alone, with a sibling, or remained in a wait-list control group. After training, participants' identification of non-verbal social cues significantly improved and was maintained at 3-month follow-up, irrespective of sibling involvement. Similar trends existed for participants' ability to accurately interpret emotions relative to controls. Improvements did not extend to parent and teacher ratings on standardised social skills measures, suggesting poor generalisation, or questionable sensitivity of measures to taught skills. Results suggest some promise in improving social skills training for children with AS. (Contains 1 table and 4 figures.)

Conflict of interest: No Introduction and Objectives: Long COVID syndrome affects millions of people and is characterized by the permanence of signs and symptoms after 90 days of SARS-CoV-2 infection. MicroRNAs (miRNAs) are small non-coding RNAs that are related to different conditions and can characterize profiles including liver disease. OBJECTIVES: Characterize the serum expression of miRNAs in relation to viral hepatitis B and C and Long COVID. Patients / Materials and Methods: Serums were obtained from 69 individuals from 4 groups: (i) only Long COVID (n=18); (ii) Viral Hepatitis/Long COVID (n=21); (iii) only Viral Hepatitis (n=10) and (iv) control individuals (n=20). MiRNAs were isolated using a commercial extraction kit and miR-122, miR-143 and miR-223 were evaluated using quantitative real-time PCR. The expression of the examined genes was calculated from the formula RQ = 2-ΔΔCT. Statistical analysis was carried out using GraphPad Prism 9.5.1 software. Results and Discussion: The upregulation of the miRNAs analyzed was observed in the groups with diseases compared to the control, all with statistical significance (p

Conflict of interest: No Introduction and Objectives: It is estimated that there are around 400 million people living with hepatitis B (HBV) and/or C virus (HCV) infections worldwide. This situation is relevant because both viruses can be transmitted vertically (VT). Despite efforts to prevent VT, many measures still need to be reinforced, especially regarding the spread of clinically relevant viral variants. Therefore, this study aimed to demonstrate the clinical/laboratory profile of pregnant women identified as positive for HBV and HCV during prenatal care, and referred to a specialized viral hepatitis unit in Rio de Janeiro between 2016-2022, and to identify those with clinically relevant mutations that can be transmitted vertically. Patients / Materials and Methods: To this end, all pregnant women with positive rapid tests were retested by eletrochemioluminescence using commercial tests for HBV antigens and antibodies against HBV and HCV. In addition, molecular tests were carried out to quantify HBV DNA and/or HCV RNA. Liver enzyme tests were also carried out in order to classify pregnant women according to HBV clinical phase. Results and Discussion: Two hundred and thirty-two pregnants women with HBV and HCV infection were analyzed. Among the 138 pregnant women with HBV, 95% had HBeAg-negative chronic infection and the mean viral load was 3.70 log IU/ml. Up to now, 6 samples were sequenced, Genotypes A1 (n=5/6,83%) and D3 (n=1/6,16%) were identified and the mutation Y100C was found. In 94 pregnant women with HCV, 75.7% had HCV RNA successfully amplified, with subtypes 1a (n=12/33; 36,4%), 1b (n=17/33; 51,5%) and 3a (n=3/33; 9,1%) detected. Clinically relevant mutations were found V321L, V321IV, C316N. Conclusions: Identifying mutations in HBV and HCV infections is crucial for epidemiological surveillance and postpartum treatment. Our findings highlight the importance of monitoring drug-resistant mutations in pregnant women with these infections.

The science teacher development program on STEM Learning using Arduino was conducted to enhance science teacher competencies in designing and implementing a 21st-century skills-based teaching approach. This study implemented research evaluation with Context, Input, Process, and Product (CIPP) to determine the drivers that supported and enhanced the program's effectiveness and address the barriers that obstruct teachers' competencies. The methodology employed in this study is both qualitative and quantitative methods. Qualitative methods gather data through observations, interviews, and document analysis. In addition, quantitative methods involve calculating the percentage of participants who complete the training program. Interviews and document studies in context evaluation help determine if program objectives are relevant to teachers' needs and aligned with the curriculum. Observation, interview, and document study were employed to evaluate input, process, and product and complement with quantitative data. The result shows that the science teacher development program is highly relevant today in enhancing teachers' competencies to design 21st-century skills-based teaching. However, some improvements are still needed to support the drivers and eliminate the barriers to make the program more effective. Some drivers, such as participants' motivation, well-organized content, competent facilitators, and sufficient resources, are assets to continue the program. However, the revision of the indicator objectives program, the selection process of participants, the time to conduct the workshop session, guidance, and content representation are essential to note.

Introdução: A febre Q é uma zoonose de distribuição mundial causada por Coxiella burnetii (Cb), uma bactéria Gram-negativa pleomórfica, estritamente intracelular. Aproximadamente 40% dos casos de infecção por Cb apresentam manifestações clínicas que variam desde uma doença febril aguda autolimitada até casos de pneumonia, síndrome da fadiga crônica e endocardite. Os quadros de hepatite por Cb são menos frequentes, podendo ser clinicamente silenciosa ou resultar em danos hepáticos na ausência de diagnóstico e tratamento oportuno. Embora a febre Q não seja de notificação compulsória e existam poucos estudos sobre sua presença no Brasil, na última década tem-se observado maior número de casos, alguns confundidos com dengue, além de endocardite e pneumonia. Diante da possibilidade de febre Q com acometimento hepático no estado do Rio de Janeiro, onde Cb tem sido identificada em pacientes, animais domésticos e silvestres, faz-se necessário investigar pacientes com hepatite sem etiologia definida. Objetivos: Realizar análise molecular e sorológica, em amostras de casos de hepatite sem etiologia definida, atendidos no serviço de referência para casos de hepatites agudos no estado do RJ. Metodologia: Dados secundários de prontuários de pacientes atendidos de 2012 a 2023, considerando os seguintes critérios de inclusão: 1) todas as faixas etárias, (2) ser residente nos municípios do RJ; (3) ter informações clínico-epidemiológicas; (4) ter amostras de soro pareadas. As amostras de biobanco, no contexto serviço de referência, foram submetidas ao teste de imunofluorescência indireta para detecção de anticorpos IgG anti- C. burnetii e à análise molecular para detecção do gene IS1111 de Cb. Resultados: A análise sorológica dos 59 pacientes selecionados identificou 2 (3,39%) pacientes sororreativos com titulação de 128. A análise molecular foi negativa. Os pacientes eram estudantes, um do sexo masculino 17 anos, e outro do sexo feminino 14 anos, ambos residentes no município do RJ. As manifestações clínicas foram inespecíficas, acompanhadas de febre com surgimento de icterícia. A adolescente relatou possuir um gato de estimação e presença de roedores peridomiciliares. Conclusão: Esta é a primeira investigação de febre Q em pacientes com hepatite realizada no Brasil. A presença de anticorpos anti-Cb no soro, corrobora a hipótese da possibilidade de hepatite causada por Cb e reforça a importância de se incluir febre Q na investigação de hepatites sem etiologia definida. Palavras-chave: Coxiella burnetii, Hepatite, Febre Q. Conflitos de interesse: Ética e financiamentos: Não houve conflitos de interesse.

Introdução: As espécies do Complexo Mycobacterium avium intracellulare (MAC) e o Mycobacterium kansasii (Mk) são patógenos de crescimento lento que causam pneumopatia. Objetivo: Contrastar a apresentação clínica e o desfecho clínico entre pacientes com Complexo Mycobacterium avium intracellulare ou Mycobacterium kansasii. Método: Coorte retrospectiva de pacientes adultos não infectados pelo HIV, com infecção por MAC ou Mk, de acordo com os critérios da ATS/MS, 2021, acompanhados em hospital de referência em Campinas-SP, de janeiro de 2016 a dezembro de 2023. Resultados: Foram incluídos 49 episódios de MAC (22 M. avium, 20 M. intracellulare, 3 M. chimaera, 4 MAC), correspondendo a 46 pacientes; enquanto que com Mk foram 37 episódios, relativos a 37 pacientes. Houve predomínio do sexo feminino entre os casos de MAC (61,2%) e do sexo masculino entre os pacientes com Mk (52%) (p < 0,01). A mediana de idade foi superior nos pacientes com MAC (62,5 anos) em relação aos com Mk (51 anos) (p < 0,01). Dentre os pacientes com MAC, todos apresentaram forma pulmonar, e naqueles com Mk, a forma pulmonar ocorreu em 35(95%) casos, disseminada em um caso e a óssea em outro. Cavitações pulmonares foram mais frequentes entre os pacientes com Mk, 27 (75%) quando comparado aqueles com MAC 22 (45%) (p < 0,01). O esquema terapêutico para MAC utilizado, mais frequentemente, foi claritromicina + rifampicina + etambutol em 29(59,2%), em 10 (20,4%) foi acrescentado um aminoglicosídeo, em cinco (10,2%) foi acrescentado uma quinolona e em cinco (10,2%) foram utilizados outros esquemas. Para Mk, o regime mais frequentemente utilizado consistiu em rifampicina + isoniazida + etambutol, em 18 (48,6%), acrescido de um aminoglicosídeo em 17 (45,9%), acrescido de uma quinolona em três (8,1%) e feito outro esquema em um (2,7%) episódio. Os casos de MAC evoluíram para tratamento completo em 26(53,1%) casos, para óbito em sete (14,3%) (um óbito por MAC e seis por outras causas), perda do seguimento em quatro (8,2%) e 10(20,4%) estão em tratamento. Para Mk, 26 (70,3%) completaram o tratamento, cinco (13,5%) morreram, dois (5,4%) abandonaram e quatro (10,8%) estão em tratamento. O desfecho clínico de MAC e de Mk foi favorável em 53% e 70% (p = 0.056), respectivamente, na coorte avaliada. Conclusão: Os pacientes com Mk foram mais jovens, com predomínio do sexo masculino, com maior frequência de cavitações ao exame de imagem e maior frequência de desfecho favorável, quando comparados aos pacientes com MAC.

Os serious games despontam como ferramentas de ensino que são jogos com um propósito para além do entretenimento, tendo como objetivo a melhoraria de algum aspecto do processo de ensino-aprendizagem. Frente a alta prevalência de doenças crônicas não transmissíveis na população brasileira, o objetivo do presente estudo foi avaliar, por meio de uma revisão sistemática da literatura, o potencial dos serious games como instrumento de Educação Alimentar e Nutricional. Para tanto, buscou-se nas bases de dados PubMed, Biblioteca Virtual de Saúde e SciELO, artigos publicados nos últimos cinco anos, nos idiomas inglês e português. Um total de 63 estudos foram identificados, dos quais apenas dez atenderam aos critérios de inclusão e exclusão estabelecidos para esta revisão. A maioria dos estudos reportaram desfechos positivos com a utilização dos serious games como ferramenta educativa, encontrando efeitos positivos na retenção dos conhecimentos aprendidos sobre alimentação e nutrição, e a sua utilização se mostrou promissora como uma alternativa às metodologias de ensino tradicionais. Apesar disso, os estudos apresentaram limitações quanto a duração das intervenções e a representatividade do tamanho de suas amostras, indicando a necessidade de futuros estudos com delineamento metodológico que supram tais lacunas. A partir desta revisão, demonstra-se que abordagens gamificadas de educação nutricional parecem promissoras no contexto do processo de ensino-aprendizagem, mas que ainda carecem de padronização metodológica para que intervenções baseadas em serious games sejam validadas como instrumento de Educação Alimentar e Nutricional.

IntroductionThe design of Pediatric Intensive Care Unit (PICU) rooms significantly impacts patient care and satisfaction. The aims were first, to describe the current physical space across PICUs in the USA, and second, to identify what proportion of PICUs are compliant with current guidelines.MethodsA descriptive cross-sectional survey was conducted, targeting division chiefs and medical directors of PICUs nationwide. The survey collected data on unit type, construction and renovation dates, room sizes, and available amenities. According to the Guidelines for Design and Construction of Hospitals, PICU rooms are recommended to be single rooms, at least 200 sq ft, have a window and a private bathroom. Data were anonymized and reported as median and interquartile ranges or frequencies and percentages.ResultsThirty units responded. Among the respondents, 26 had general PICUs, 9 had cardiac ICUs, and 3 had intermediate care units, with some units containing multiple types of ICUs. The median annual admissions were 1,125, with a median occupancy rate of 78%. Twenty-three percent of units had at least one double room, and 3% had triple or quadruple rooms. The median room size was 265 sq ft (IQR 230; 304), the smallest room size was 220 sq ft (IQR 179; 275), and the largest single room size was 312 sq ft (IQR 273; 330). Thirty-seven percent of units had bathrooms in every room, while 80% had windows in every room. Additionally, 46% of units had dialysis capabilities in every room, and 7% had negative pressure capabilities in every room. The median building year was 2008 (IQR 2001;2014), with 36% of units having undergone at least one renovation. Larger rooms were associated with more recent build dates (p = 0.01). Only 30% of the PICUs met the guidelines for physical space. These compliant units were built at a median of 4 years ago (IQR 1; 8).ConclusionThis study highlights the variability in PICU room design and amenities across healthcare facilities. Many units still fall short of meeting the guidelines for room size, windows, and private bathrooms. Future research should investigate the relationship between room characteristics and patient outcomes to inform better design practices, with a goal of improving patient experiences and clinical outcomes.

Abstract The selection pressure imposed by the host immune system impacts on hepatitis B virus (HBV) variability. This study evaluates HBV genetic diversity, nucleos(t)ide analogs resistance and HBsAg escape mutations in HBV patients under distinct selective pressures. One hundred and thirteen individuals in different phases of HBV infection were included: 13 HBeAg-positive chronic infection, 9 HBeAg-positive chronic hepatitis, 47 HBeAg-negative chronic infection (ENI), 29 HBeAg-negative chronic hepatitis (ENH) and 15 acute infected individuals. Samples were PCR amplified, sequenced and genetically analyzed for the overlapping POL/S genes. Most HBV carriers presented genotype A (84/113; 74.3%), subgenotype A1 (67/84; 79.7%), irrespective of group, followed by genotypes D (20/113; 17.7%), F (8/113; 7.1%) and E (1/113; 0.9%). Clinically relevant mutations in polymerase (tL180M/M204V) and in the Major Hydrophilic Region of HBsAg (sY100C, T118A/M, sM133T, sD144A and sG145R) were observed. Our findings, however, indicated that most polymorphic sites were located in the cytosolic loops (CYL1-2) and transmembrane domain 4 (TMD4) of HBsAg. Lower viral loads and higher HBV genetic diversity were observed in ENI and ENH groups (p

This research aims to explore the ethnoscience of the Terbang Gembrung percussion instrument of the indigenous community in Kampung Naga, Tasikmalaya, West Java, and its potential as a local context in physics education. The Terbang Gembrung percussion instrument of Kampung Naga employs an acoustic membrane of goat leather with an air column of albasia or manglid wood. The research methodology encompasses qualitative descriptive methods, including literature study and interviews, as well as observation methods involving the measurement of sound frequency generated using the Decibel X smartphone application under conditions where the instrument produces typical sound. The Terbang Gembrung tradition holds religious value and is commonly performed during significant celebrations such as Eid al-Fitr, Eid al-Adha, and other religious festivities. Based on the observation results, it was found that four types of percussion instruments produce sound frequencies at four harmonic levels according to the membrane size. The first harmonic has a frequency of approximately 199.0 Hz, the second harmonic around 211.5 Hz, the third harmonic approximately 231.5 Hz, and the fourth harmonic around 261.0 Hz. The design of the percussion instrument is in the form of a half-spherical cone, with the cross-sectional area decreasing from the membrane to the end of the air column. The potential application of science principles to the Terbang Gembrung percussion instrument makes it a cultural artifact that can serve as a local context in physics education at the high school level, focusing on the topics of sound waves, especially sound intensity and sound frequency.