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Abstract Background Human immunodeficiency virus (HIV) infection is a health problem in Brazil and worldwide. Without treatment, the infection can progress to Acquired Immunodeficiency Syndrome (AIDS), with a high mortality potential. The objective of this study was to analyze the time trend of AIDS mortality in Brazil, macro-regions, federal units and their respective capitals, from 2012 to 2022. Methods This is a time-series study of all AIDS deaths in Brazil from 2012 to 2022. The study included the annual number of deaths and the crude and standardized mortality rates. The Joinpoint regression model was used for the time analysis of the standardized rates. Annual percentage change (APC) and average annual percentage change (AAPC) were calculated. A 95% confidence interval (CI) and a 5% significance level were used. Results During the period analyzed, 128,678 AIDS deaths were recorded in Brazil, with a crude mortality rate of 6.3/100,000 and a standardized mortality rate of 5.3/100,000. From 2012 to 2020, three regions showed a declining trend in AIDS mortality: Central-West (AAPC − 2.3%; 95%CI -4.3 to -0.21; p = 0.03), Southeast (AAPC − 5.6%; 95%CI -6.8 to -4.0; p

Abstract Background Dengue is a vector-borne viral infection caused by the dengue virus transmitted to humans primarily by Aedes aegypti. The year 2024 has been a historic year for dengue in Brazil, with the highest number of probable cases ever registered. Herein, we analyze the temporal trend and spatio-temporal dynamics of dengue cases in Brazil during the first nine epidemiological weeks (EW) of 2024. Methods This is an ecological study, including all probable cases of dengue in Brazil during the period, carried out in two steps: time series analysis to assess the temporal trend and spatial analysis to identify high-risk clusters. Results 1,345,801 probable cases of dengue were reported. The regions with the highest increasing trend were the Northeast with an average epidemiologic week percent change (AEPC) of 52.4 (95% CI: 45.5–59.7; p

BackgroundCutaneous Leishmaniasis (CL) is a neglected tropical disease endemic in Brazil. Morbidity and disabilities caused by CL lesions require an analysis of a Global Burden of Disease (GBD), which would help discern the impact on the Brazilian population. Herein, we assess the burden of CL and its spatial and temporal patterns in Brazil between 2001 and 2021.Methodology/principal findingsWe estimated rates per 100,000 population for years lived with disabilities (YLD), years of life lost prematurely (YLL) and disability-adjusted life years (DALY) for each year of the study, sex assigned at birth, age group, and for each municipality in Brazil. In addition, the relative changes in these metrics over time for each region and sex were determined, as well as temporal trends using segmented joinpoint regression models. Using spatiotemporal analysis tools, we created choropleth maps representing DALY, YLD and YLL for three distinct periods (P1 = 2001 to 2007; P2 = 2008 to 2014; P3 = 2015 to 2021). These maps were constructed to visualize the inferences from Bayesian spatial statistics and Moran's autocorrelation using the Poisson model. The data were obtained from the DATASUS database. Although the global burden of CL has reduced over two decades, with the continual high impact among adults aged 20 to 39 years. In turn, YLL increased over time in 40-year-old populations, while among the elderly (>60 years old) this rate almost doubled from 2010 to 2021. Regarding the region of residence, we observed an average increase of 28% in YLL in Southeast, South and Central-West. Furthermore, the global burden of CL does not have a random spatial distribution, since there was a high-risk clustering of YLD in the north of the country. Interestingly, the YLL showed a vast geographic expansion through Brazilian territory.ConclusionsThis study provides a comprehensive analysis of the burden of CL in Brazil, pointing out areas of highest disease burden, where control and surveillance efforts should be undertaken.

Background and Objectives: Suicide is a pressing public health issue globally, including in Brazil, where it ranks among the leading causes of mortality. This study aimed to analyze the spatial, temporal, and spatiotemporal distribution of suicide mortality in Brazil from 2000 to 2022. Materials and Methods: Using secondary data from the Mortality Information System of Brazil’s 5570 municipalities, an ecological study of time series was conducted. Segmented linear regression (Joinpoint 4.6 version) was used to calculate temporal trends, while Moran’s indices were employed to analyze spatial autocorrelations. Retrospective scanning was utilized to investigate spatiotemporal clusters, and choropleth maps were developed to visualize high-risk areas. Results: The analysis revealed the occurrence of 240,843 suicides in Brazil, with higher percentages in the southeast, south, and northeast regions. The south, central–west, and southeast regions exhibited the highest mortality rates, predominantly among white, single men, aged 20 to 59, with 1 to 11 years of schooling. Intentional self-harm by hanging, strangulation, and suffocation was the main cause. The general trend of mortality due to suicide in Brazil was increasing (AAPC: 2.9; CI 95%: 2.6 to 3.0), with emphasis on the age groups from 10 to 19 years (AAPC: 3.7; CI 95%: 2.9 to 4.5) and 20–39 years old (AAPC: 2.9; CI 95%: 2.3 to 3.5). The brutal and smoothed rates revealed areas of high mortality in the south, north, and central–west regions. Conclusions: The findings of this study highlight the need to direct resources and efforts to the south and midwest regions of Brazil, where suicide rates are the highest. Additionally, implementing targeted prevention programs for young men, who are the most affected, is essential to reduce suicide mortality in these areas.

Abstract The COVID-19 pandemic has severely affected global health, leading to the suspension of numerous routine healthcare services and posing challenges in efforts to control other diseases, such as HIV/AIDS. This study aimed to assess the impact of the COVID-19 pandemic on HIV/AIDS diagnoses and mortality rates in Brazil during 2020 and 2021. The percentage change was calculated to determine whether there was an increase or decrease in HIV/AIDS diagnoses and mortality, considering the average numbers from the last 5 years. Additionally, a Joinpoint regression model and an interrupted time series analysis were applied to assess time trends before and after the onset of the pandemic. Lastly, choropleth maps were prepared. We observed a reduction of 22.4% (2020) and 9.8% (2021) in the diagnosis of HIV/AIDS in Brazil. Conversely, there was a significant increase in the percentage change of late diagnosis of AIDS deaths in 2020 (6.9%) and 2021 (13.9%), with some states showing an increase of over 87%. Decreasing time trends in the diagnosis of HIV/AIDS were identified before the pandemic in Brazil, especially in the Southeast and South regions, and then time trends stabilized after including the pandemic years. Along with the dissemination of COVID-19, there was a reduction in the diagnosis of HIV/AIDS and an increase in late diagnosis AIDS deaths, signaling a serious impact of the pandemic on HIV/AIDS control strategies in Brazil. Therefore, we highlight the need for continuous efforts to control both diseases, that is, maintaining regular health services even in crisis situations.

Background: Mpox is a viral zoonosis that has gained increased attention due to a global outbreak in 2022, significantly impacting men who have sex with men (MSM). Vaccination for this disease poses a public health challenge; because it carries a strong stigma, there may be greater hesitancy in vulnerable groups. Objectives: This study aimed to determine the prevalence and factors associated with Mpox vaccine hesitancy among Brazilian MSM. Methods: A cross-sectional study was conducted between September and December 2022 using an online survey targeted at MSM. Recruitment was carried out through social media and dating apps. The sample consisted of 1449 participants and the analysis involved bivariate logistic regression. Results: The prevalence of Mpox vaccine hesitancy was 7.57%. The significant factors associated with hesitancy were primarily related to sexual practices and attitudes towards Mpox exposure and diagnosis, such as not using “glory holes” (aOR: 19.82; 95% CI: 1.60–245.69), reluctance to undergo pre- and post-exposure testing for Mpox (aOR: 9.54; 95% CI: 5.52–16.48), and not knowing close contacts diagnosed with Mpox (aOR: 4.09; 95% CI: 1.72–9.73). Participants who would not take precautions after diagnosis (aOR: 3.00; 95% CI: 1.27–7.07) and those who would not disclose their serological status (aOR: 1.93; 95% CI: 1.13–3.30) also showed a higher likelihood of vaccine hesitancy. Conclusion: Public health strategies should address these factors to expand knowledge about vaccination barriers, plan educational campaigns with targeted messaging for the MSM population, and provide inclusive healthcare environments to increase vaccine acceptance and reduce Mpox transmission in vulnerable groups.

Abstract Objectives To perform a systematic review of the literature on the anatomy of the medial meniscotibial ligaments (MTLs), and to present the most accepted findings, as well as the evolution of the anatomical knowledge on this structure. Materials and Methods An electronic search was conducted in the MEDLINE/PubMed, Google Scholar, EMBASE and Cochrane library databases with no date restrictions. The following index terms were used in the search: anatomy AND meniscotibial AND ligament AND medial. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We included anatomical studies of the knee were included, such as cadaver dissections, histological and/or biological investigations, and/or imaging of the medial MTL anatomy. Results Eight articles that met the inclusion criteria were selected. The first article was published in 1984 and the last, in 2020. The total sample in the 8 articles was of 96 patients. Most studies are purely descriptive in terms of the macroscopic morphological and microscopic histological findings. Two studies evaluated the biomechanical aspects of the MTL, and one, the anatomical correlation with the magnetic resonance imaging examination. Conclusion The main function of the medial MTL, a ligament that originates in the tibia and is inserted in the lower meniscus, is to stabilize and maintain the meniscus in its position on the tibial plateau. However, there is a limited amount of information regarding medial MTLs, primarily in terms of anatomy, especially vascularization and innervation.

Abstract Objectives To describe a series of cases of tibial fractures surgically treated using the posterior approach as described by Carlson, focusing on evaluating its functional results and complication rate. Methods Eleven patients with tibial plateau fractures, who underwent surgical treatment using the Carlson approach from July to December 2019, were followed-up. The minimum follow-up period was defined as 6 months. The American Knee Society Score (AKSS), American Knee Society Score/Function (AKSS/Function) and the Lysholm score were used to check treatment results at 6 months after the fracture. The patients underwent standard anteroposterior and lateral radiographs to assess fracture healing, and clinical healing was determined by the absence of pain during full weight-bearing. Results The mean follow-up period was 12 months (9-16 months). The primary mechanism of trauma was motorcycle accident, and the most prevalent side of fracture was the right side. Eight participants were male. The mean age of the patients was 28 years. All fractures healed, and none of the patients presented complications. The AKSS was excellent in 11 patients, with a mean AKSS/Function of 99.1±3, and Lysholm scores with a median of 95.0±5.6. Conclusions The Carlson approach for posterior fractures of the tibial plateau can be considered safe, presenting a low complication rate and satisfactory functional results.

Background: Pre-exposure prophylaxis (PrEP) is a valuable tool in the response to the HIV epidemic, recommended for groups with a higher risk of HIV infection, such as men who have sex with men (MSM), particularly in the context of high-risk sexual behavior such as chemsex. Purpose: This study aimed to analyze the prevalence and factors associated with the intention to use PrEP among MSM who engage in chemsex in Brazil and Portugal. Methods: This was a cross-sectional study of a secondary dataset from a larger study conducted between January 2020 and May 2021 throughout Brazil and Portugal involving 1852 MSM who engage in chemsex. An initial descriptive analysis was performed to calculate the absolute and relative frequencies of independent variables related to the intention to use PrEP among MSM. A multivariate regression model was developed to identify factors independently associated with the intention to use PrEP. Results: Although a high level of PrEP knowledge (85.75%) was observed among MSM who engage in chemsex, the prevalence of intention to use PrEP was only 59.07%. Five variables were associated with a higher prevalence of intention to use PrEP [engaging in double penetration – adjusted prevalence ratio (aPR): 1.56, 95% CI: 1.44–1.69; being assigned female sex at birth – aPR: 1.34, 95% CI: 1.12–1.61; cruising – aPR: 1.21, 95% CI: 1.06–1.38; not using condoms – aPR: 1.20, 95% CI: 1.05–1.36; and being an immigrant – aPR: 1.16; 95% CI: 1.07–1.25], while having knowledge of postexposure prophylaxis (aPR: 0.91; 95% CI: 0.84–0.98), having a casual sexual partner (aPR: 0.86 and 0.85; 95% CI: 0.74–0.99 and 0.74–0.98), and engaging in group sex (aPR: 0.81; 95% CI: 0.73–0.90) were associated with a lower intention to use PrEP. Conclusion: The intention to use PrEP among MSM who engage in chemsex was high, and several factors were associated with this intention. Understanding the factors associated with the intention to use PrEP among MSM practicing chemsex is crucial for developing targeted interventions to increase PrEP uptake in this population. The results of this study suggest that tailored approaches are necessary to promote PrEP use in this population.

Introdução/objetivo: A hanseníase é uma doença infecciosa de caráter crônico causada pelo bacilo Mycobacterium leprae que pode causar graves deficiências físicas, psicológicas e sociais. É problema sanitário mundial e, no Brasil e em Sergipe, é endêmica. O objetivo do trabalho foi analisar os dados de laudos anatomopatológicos com a classificação clínica e operacional dos casos de hanseníase no estado de Sergipe em laboratórios de referência no período de 2007 a 2016. Métodos: Trata-se de um estudo observacional descritivo e retrospectivo realizado a partir de laudos anatomopatológicos de pacientes com diagnóstico de hanseníase. Esses laudos foram coletados no Hospital Universitário da Universidade Federal de Sergipe (laboratório público) e em três laboratórios particulares. Foram tabuladas as variáveis idade, sexo, baciloscopia e forma clínica. Utilizou-se o Teste de Mann Whitney e o Teste de Qui-Quadrado de Igualdade para comparação das variáveis entre os diferentes laboratórios. Os resultados foram considerados estatisticamente significativos quando p

Introdução/objetivo: A hanseníase é uma doença infectocontagiosa, crônica e granulomatosa, cujo agente etiológico é o bacilo Mycobacterium leprae. Os idosos estão suscetíveis à infecção devido a senescência e o longo período de incubação do bacilo. O objetivo do trabalho foi analisar o perfil clínico e epidemiológico dos casos de hanseníase na população idosa no Estado de Sergipe, no período de 2007 a 2016. Métodos: Estudo observacional descritivo e retrospectivo dos casos de hanseníase com laudos anatomopatológicos positivos na população idosa do Estado de Sergipe. Os laudos foram coletados na Unidade de anatomia patológica do Hospital Universitário da Universidade Federal de Sergipe, centro de referência para o diagnóstico anatomopatológico da hanseníase, e em três laboratórios privados, que possuem convênios com a rede municipal e estadual de saúde e recebem uma grande demanda de exames. Os dados coletados foram sexo, idade, forma clínica e baciloscopia. Para avaliação da associação entre as formas clínicas e sexo, foi utilizado o teste do qui-quadrado. O estudo foi aprovado pelo comitê de ética em Pesquisa do Hospital Universitário da Universidade Federal de Sergipe (CAAE 87953018.3.0000.5546). Resultados: Foram observados 261 laudos positivos em Sergipe na população idosa, sendo 50,57% do sexo feminino e predominância de casos na faixa etária de 60 a 69 anos (51,34%). Em relação a classificação operacional a forma paucibacilar predominou com 81,60%. As formas clínicas mais prevalentes foram a hanseníase tuberculóide e indeterminada com 49,81% e 25,29%, respectivamente, e a baciloscopia apresentou resultado positivo em 17,05% dos casos. Na comparação das formas polares da hanseníase entre os sexos, a forma clínica tuberculoide foi significativamente mais prevalente no sexo feminino, enquanto a virchowiana, forma mais grave da doença, predominou no masculino (0,0031). Por fim, na análise da razão de chance entre os sexos, observou-se que homens idosos apresentaram uma chance 3,96 vezes maior de desenvolver a forma grave da hanseníase. Conclusão: As ações de políticas públicas direcionadas para o controle e tratamento da hanseníase em áreas endêmicas precisam ser realizadas, principalmente para homens idosos, já que estes possuem um risco mais elevado de desenvolver a forma grave e contagiosa da doença.

Sistematiza as características que definem os repositórios digitais em uma perspectiva científico-literária, adotando mapas conceituais para apresentá-las. Confecciona protótipos em papel, posteriormente transpostos para o software livre CmapTools, admitindo figuras geométricas especificas para representar categorias, conceitos e relações, o que permitiu descrever e qualificar o objeto de estudo. Assume-se como uma pesquisa bibliográfica que resultou na atribuição de um conjunto de características como autoarquivamento, padrões abertos e interoperabilidade, devidamente classificadas em 10 categorias: natureza, essenciais, funcionais, funcionamento, tipos de serviços, tipos de materiais, tipos de usuários, confiabilidade, gerenciais e técnicas. Conclui que os repositórios digitais constituem sistemas interoperáveis e bem estruturados, assentados em padrões abertos e consoantes aos incentivos de implementação a partir de softwares livres e de código aberto, os quais devem permitir gerenciamento, autoarquivamento e representação, a fim de fomentar a recuperação da informação e o acesso em longo prazo ao repositório em si, aos objetos digitais armazenados e à memória institucional.

Leprosy reaction (LR) and physical disability (PD) are the most significant clinical complications of leprosy. Herein, we assessed the circulating serum-sTREM-1 and TNF-α levels and their genetic polymorphisms in leprosy. Serum-sTREM-1 and TNF-α levels were measured in leprosy patients (LP) before treatment (n = 51) and from their household contacts (HHCs; n = 25). DNA samples were genotyped using TREM-1 rs2234246 and TNF-α rs1800629-SNP in 210 LPs and 168 endemic controls. The circulating sTREM-1 and TNF-α levels are higher in the multibacillary form. The ROC curve of the serum-sTREM-1 levels was able to differentiate LR from non-LR and PD from non-PD. Similarly, LPs with serum-sTREM-1 levels >210 pg/ml have 3-fold and 6-fold higher chances of presenting with LR and PD, respectively. Genotypes CC+CT of the TREM-1 were associated with leprosy. Taken together, our analyses indicated that sTREM-1 and TNF-α play an important role in the pathogenesis of leprosy and provide promising biomarkers to assist in the diagnosis of leprosy complications.

Resumo Fundamento: A pandemia da COVID-19 tem causado um impacto sobre a mortalidade por várias doenças em todo o mundo, especialmente por doenças cardiovasculares (DCVs). O Brasil é um país de dimensões continentais com diferenças significativas na estrutura de saúde entre seus estados. Objetivo: Analisar a mortalidade hospitalar por DCV no sistema público de saúde durante o primeiro ano da pandemia por COVID-19 (2020) no Brasil. Métodos: Este é um estudo ecológico analisando o número absoluto de mortes hospitalares e a taxa de mortalidade hospitalar no Brasil, suas macrorregiões, e unidades federativas. Os dados foram obtidos do Sistema de Informações Hospitalares (SIH) do Ministério da Saúde. O P-escore foi usado para analisar o excesso de mortalidade. O escore compara os eventos observados com os eventos esperados para um dado local e período. O escore-P foi corrigido por um modelo de regressão joinpoint, com um intervalo de confiança de 95% e nível de significância de 5%. Resultados: Houve 93.104 óbitos hospitalares por DCV no Brasil em 2020, o que representa 1495 menos óbitos (escore-P: -1,58) que o esperado. A região centro-oeste apresentou um escore-P positivo, com um aumento de 15,1% no número de mortes. Dez estados apresentaram um maior número de óbitos em 2020. Ainda, observou-se um excesso de 13,3% de mortalidade hospitalar no país como um todo, e um excesso de mortalidade hospitalar em todas as macrorregiões. Conclusões: Houve uma diminuição no número absoluto de óbitos hospitalares, bem como um aumento na taxa de mortalidade por DCV no Brasil em 2020, após o início da pandemia por COVID-19.

Abstract Background The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate hepatitis C virus (HCV) infection by 2030. In Brazil, efforts have been undertaken to achieve this goal; there are, however, great challenges. It is important to understand the disease profile in different regions of the country in order to design strategies to fight the disease nationwide. The objective of this study was to analyse the time trend of the incidence and mortality of hepatitis C in Brazil during the period from 2008 to 2018 according to sociodemographic and clinical characteristics. Methods All newly diagnosed cases of hepatitis C reported between 2008 and 2018, in all regions of Brazil, were included. The indicators were obtained from the databases of the Brazilian Ministry of Health. For the time series analysis, a joinpoint regression model was used. Results Between 2008 and 2018, 136,759 newly diagnosed cases of hepatitis C were reported considering anti-HCV and HCV RNA positivity, and 271,624 newly diagnosed cases were reported considering one or another positive test. The majority of the records were concentrated in the Southeast (61%) and South (26.2%) Regions. The joinpoint regression model indicated an increasing trend in the detection rate of hepatitis C in Brazil, but there was a decreasing trend in the mortality rate during the period analysed. Conclusions Differences were observed in the time trend of hepatitis C and in the sociodemographic and clinical characteristics in different regions of Brazil. These data can provide support to design strategies for the elimination of hepatitis C in Brazil, according to regional particularities.

Background: This study aimed to analyze the temporal evolution, spatial distribution, and impact of the COVID-19 pandemic on tuberculosis records in a northeastern state of Brazil. Methods: This is an ecological study involving all diagnoses of Tuberculosis (TB) in residents of the state of Pernambuco/Brazil. Data were extracted from the National System of Notifiable Diseases. A pre-pandemic COVID-19 temporal analysis (2001–2019), a spatial analysis before (2015–2019) and during the first two pandemic years (2020–2021), and the impact of the COVID-19 pandemic on cases of TB diagnoses in Pernambuco in the years 2020 and 2021 were performed. Inflection point regression models, Global and Local Moran’s statistics, and spatial scan statistics were used. Results: In the period from 2001 to 2019, 91,225 cases of TB were registered in Pernambuco (48.40/100,000 inhabitants), with a tendency of growth starting in 2007 (0.7% per year; p = 0.005). In the pre-pandemic period (2015–2019), 10.8% (n = 20) of Pernambuco municipalities had TB incidence rates below 10/100,000. In 2020, this percentage reached 27.0% (n = 50) and in 2021 it was 17.8% (n = 33). Risk clusters were identified in the eastern region of the state, with five clusters in the pre-pandemic period and in 2021 and six in 2020. In the first year of the pandemic, an 8.5% reduction in the number of new TB cases was observed. In 2021, the state showed a slight increase (1.1%) in the number of new TB cases. Conclusions: The data indicate that the COVID-19 pandemic may have caused a reduction in the number of new TB case reports in the state of Pernambuco, Brazil.

Abstract Objective To evaluate the interobserver agreement of two classifications for floating knee: Fraser and Blake & McBryde. Method Thirty-two observers, subdivided according to the degree of titration (26 resident physicians and 6 orthopedic physicians specialized in orthopedic trauma), classified 15 fractures of the ipsilateral femur and tibia. Interobserver agreement was evaluated by using the Kappa coefficient. Result When evaluating the agreement between the 9 R1, a Kappa index of 0.58 was obtained for the Fraser classification and of 0.46 for the Blake & McBryde classification. Among the 7 R2, a rate of 0.59 was obtained for the Fraser rating and 0.51 for the Blake & McBryderating. Among the 10 R3, theagreement index was higher for both classifications: 0.72 for the Fraser and 0.71 for the Blake & McBryde classification. Considering the 3 groups (R1, R2, R3) as one large group, the general Kappa index was calculated, which resulted in 0.63for the Fraser classification and 0.56 for the Blake & McBryde classification. In the group of traumaand orthopedic knee specialists, in turn, an agreement of 0.597 was obtained for the Blake and McBryde classification and of 0.843 for the Fraser classification. Conclusion Comparatively, the two classifications presented a weak to moderate degree of agreement. Fraser classification had better agreement in both groups. The agreement was higher when evaluating orthopedic trauma physicians.

Objective. Research that aims to identify useful metadata standards for the preservation and digital availability of open data according to current literature.. Method. Is characterized as an exploratory research, in the identification of metadata and bibliographic standards, for the necessary literary foundation on descriptive representation of information, digital preservation and metadata, with the purpose of digitally treating, conserving and making available the open data, from the qualitative approach of data collection. Results. Based on literary research, results on the list of environments such as government websites, research institutes, digital repositories, electronic catalogs and digital libraries that adopt metadata standards that can be used to preserve and make available open data, specifically, Dublin Core, used in environments such as the Brazilian Open Data Portal; Preservation Metadata Implementation Strategies, present in repositories such as the Carolina Digital Repository; Metadata Object Description Schema, adopted by systems such as Copac: UK and Irish Research Library Catalog; and Metadata Encoding and Transmission Standard, accessed to manage digital objects in libraries and repositories such as the National Digital Library of Portugal. Conclusions. Was concluded that the only metadata standard thought specifically of digital preservation, and that if considered as the recommended for the digital safeguard and availability of open data, is the Preservation Metadata Implementation, from fields like rights, agents and events, while that the other schemas identified, even if created for other purposes, also allow the preservation of data, such as the Dublin Core, in the use of the source, relation, coverage and rigths elements, of the Metadata Object Description Schema, when adopting the location and recordInfo attributes, and the Metadata Encoding and Transmission Standard, in adopting the structural link section and behavior section components.

Neglected tropical diseases encompass a group of chronic and debilitating infectious diseases that primarily affect marginalized populations. Among these diseases, leprosy and leishmaniasis are endemic in numerous countries and can result in severe and disfiguring manifestations. Although there have been reports indicating a higher incidence of leprosy and leishmaniasis in males, the underlying factors contributing to this observation remain unclear. Therefore, the objective of this study was to examine both clinical and experimental evidence regarding the role of testosterone in leprosy and leishmaniasis. A prospective clinical study was conducted to compare the clinical forms of leprosy and assess circulating testosterone levels. Additionally, the impact of testosterone on Leishmania amazonensis-infected macrophages was evaluated in vitro. The findings demonstrated that serum testosterone levels were higher in women with leprosy than in the control group, irrespective of the multi- or pauci-bacillary form of the disease. However, no differences in testosterone levels were observed in men when comparing leprosy patients and controls. Interestingly, increasing doses of testosterone in macrophages infected with L. amazonensis resulted in a higher proportion of infected cells, decreased CD40 expression on the cell surface, elevated expression of SOCS1, and decreased expression of IRF5. These findings provide biological evidence to support the influence of testosterone on intracellular infections, though the interpretation of clinical evidence remains limited.

O presente artigo é resultado de pesquisa sobre a obra do artista Hélio Melo, em que se realiza uma leitura densa sobre a obra visual, de caráter social e antropológico, conversando com questões mais amplas que surgiram no processo de análise da realidade social e leitura de imagem; funcionando como elo entre as muitas observações, aqui, se discute o binômio “arte e identidade”, atravessado por temas oriundos das possibilidades de leituras da obra. Nesse sentido, objetivou-se passar em revista alguns aspectos das análises, destacando pontos insurgentes das leituras. Em paralelo, tão importante quanto, procurou-se analisar a condição social do artista que viveu e produziu na Amazônia, especialmente no Acre, sob a direção dos estudos de Roberto Conduru (2009) e Márcio de Souza (1977). As abordagens geraram múltiplas impressões, como é múltipla a Amazônia, requerendo do leitor-intérprete, uma densidade e atenção de leitura deste tema que permanece inesgotável e universal.

Background: In 2014, the World Health Organization (WHO) launched the “post-2015 End TB strategy”, that aims to end the global tuberculosis (TB) epidemic by 2030. However, the COVID-19 pandemic has severely impacted global public health and the strict measures to control the coronavirus spread can affect the management of other diseases, such as TB. Herein, we aimed to assess the impact of the COVID-19 pandemic on the diagnosis of TB in Brazil, during 2020.Methods: We carried out an ecological and population-based study, using spatial analysis techniques. The variables used were the new cases of TB, pulmonary tuberculosis (PTB), and also baciloscopy-positive (BP) cases in Brazil between 2015 and 2020. The percentage of changes (% change) was calculated to verify if there was an increase or decrease of TB cases in 2020, along with time trend analyses given by Joinpoint regression model. Also, interrupted time series analyses were used to assess the trend of TB diagnosis before and after the onset of the COVID-19 in Brazil. Spatial distribution maps were elaborated, considering the % change of each Brazilian state.Findings: Data analyses showed a reduction in the diagnosis of TB (−8.3%) and PTB (−8.1%) in Brazil after the irruption of the COVID-19 pandemic. Likewise, 22 states depicted a reduction in TB diagnosis. An expressive reduction of BP cases (−17.1%) was also observed. Interestingly, interrupted time series analysis showed decline in TB and PTB diagnoses from March 2020. Spatial analyses revealed that all states had a progressive reduction of TB, PTB and PB cases, from March on, with the highest percentages of reduction in December (−100% to −75%).Interpretation: Taken together, our analyses demonstrated a reduction in TB diagnosis after the irruption of the COVID-19 pandemic in Brazil and its regions, signaling a serious impact on the WHO “End TB Strategy” global plan.

Summary: Background: The pandemic caused by COVID-19 has seriously affected global health, resulting in the suspension of many regular health services, making the diagnosis of other infections difficult. Therefore, this study aimed to assess the impact of the COVID-19 pandemic on the diagnosis of leprosy in Brazil during the year 2020. Methods: We evaluated the monthly incidence of leprosy and calculated the percentage change to verify whether there was an increase or decrease in the number of leprosy cases in 2020, considering the monthly average of cases over the previous 5 years. We used interrupted time series analysis to assess the trend in the diagnosis of leprosy before and after the start of COVID-19 in Brazil and prepared spatial distribution maps, considering the percentage variation in each state. Findings: We verified a reduction of 41.4% of leprosy cases in Brazil in 2020. Likewise, there was a reduction of leprosy notifications in children under 15 years-old (-56.82%). Conversely, the diagnosis of multibacillary leprosy increased (8.1%). There was a decreasing trend in the leprosy incidence in the general population between 2015 and 2020 in Brazil. Spatial distribution maps depicted a reduction of up to 100% in new cases of leprosy in some states. Interpretation: Along with COVID-19 spread there was a reduction in leprosy diagnosis in the general population and children under 15 years-old, and also an increase in multibacillary cases diagnosed, signalling a serious impact of the pandemic on leprosy control strategies in Brazil. Funding: This research received no specific grants.

ABSTRACT Objective: To verify inter- and intra-observer agreement of three classification systems for tibial plateau fractures - Schatzker, AO/ASIF, and Luo’s - among orthopedic surgery residents. Methods: This cross-sectional study was conducted with 29 observers. Radiographic and tomographic imaging of the knee of 15 patients presenting with fractures were evaluated. After six weeks, the test was reapplied. The level of agreement was calculated by the Kappa index. Results: In test 1, inter-observer agreement of all residents, according to the Kappa index, for Schatzker classification was 0.226, for AO 0.431, and Luo’s 0.319. In test 2, values were 0.316, 0.333, and 0.347, respectively (p < 0.001). Regarding intra-observer analysis, the mean Kappa indexes of 1st-year residents were: Schatzker, 0.20; AO, 0.32; and Luo’s, 0.3. For 2nd-year residents, means were: 0.51, 0.58, and 0.38, respectively. As for 3rd-year, results were 0.42, 0.42, and 0.41, respectively (p < 0.001). Conclusion: AO/ASIF showed a better reproducibility than other classifications, with substantial inter- and intra-observer agreement. We also found a stronger agreement among 2nd- and 3rd-year residents. Level of Evidence III, Diagnostic Studies - Investigating a Diagnostic Test.

Pesquisa que apresenta características que formalizem o pacote de software Dspace a partir de três pontos: elenco de predicados que definem os repositórios institucionais, exemplos de ambientes acadêmico-institucionais que fazem uso do DSpace e identificação de características presentes no DSpace à luz dos repositórios institucionais. Aborda temas básicos para a pesquisa, sendo: comunicação científica, movimento de acesso aberto, iniciativa de arquivos abertos e repositório institucional. Destaca o DSpace enquanto um tipo de recurso de software livre e de código aberto. Resulta, segundo uma pesquisa exploratória e bibliográfica, e de abordagem qualitativa de coleta de dados, que o DSpace provê a construção de repositórios institucionais ao redor do mundo, inclusive em todo o território nacional, que a divulgação de eventos e programas da Instituição, enquanto um dos predicados inerentes ao conceito de repositório institucional, não é contemplado pelo software, ao passo que o DSpace abrange os demais predicados identificados, tais como: gerenciar dados e atividades de pesquisa; apoiar e veicular objetos digitais, no uso do padrão de metadados Dublin Core; gerir o conhecimento do corpus de conteúdos que constitui o repositório institucional; expor as produções virtualmente, na íntegra e de forma aberta; intecionar a preservação digital; e administrar perfis e depósitos de obras com fins de qualidade. Conclui-se que o DSpace caracteriza-se como um pacote de software livre e de código aberto que facilita o acesso aos materiais armazenados, promove o autoarquivamento e a publicação das produções científicas, na íntegra e de forma livre, adota metadados para a curadoria e veiculação de produções, promove a gestão do conhecimento, expõe virtualmente as produções, inteciona a preservação digital, realiza cópias de segurança e migrações, controla os direitos de acesso e supervisiona o autoarquivamento a partir do DSpaceDirect, e, finalmente, atribui funções de uso específicas aos usuários.

ABSTRACT Objective To assess the temporal trends of hospitalizations for pulmonary embolism (PE) in Brazil, its regions, and states between 2008 and 2019. Methods An ecological and time series study was conducted. Data were obtained from the Hospital Information System (SIH) of the Brazilian Ministry of Health. The inflection point regression model was applied for temporal trend analyses. Trends were classified as increasing, decreasing, or stationary according to the slope of the regression line. The Annual Percent Charge (APC) and the Average Annual Percent Change (AAPC) were calculated considering a confidence interval of 95% and p-value

This is a case series study to evaluate immunological markers associated with schistosomiasis advanced fibrosis, including 69 patients from an endemic area from the State of Sergipe and from the Hepatology Service of the University Hospital in Sergipe, Brazil. Hepatic fibrosis was classified based on Niamey protocol for ultrasonography (US). Immune response to Schistosoma mansoni antigens was evaluated by stimulating peripheral blood mononuclear cells (PBMCs) from these patients with either adult worm (SWAP—10 μg/ml) or egg (SEA—10 μg/ml) antigens or purified protein derivative of turberculin (PPD—10 μg/ml) or phytohemagglutinin (PHA—1 μg/ml) for 72 h. The levels of IFN-γ, TNF-α, IL-5, IL-10, and IL-17 were measured in these supernatants by ELISA and IL-9 by Luminex. Single nucleotide polymorphisms in IL-17, IL10, and CD209 genes were genotyped using TaqMan probe by qPCR. Higher levels of IL-9, IL-10, and IL-17 were found in PBMC supernatants of patients with advanced hepatic fibrosis. Direct correlations were detected between IL-9 and IL-17 levels with US spleen sizes, portal vein diameters, and periportal thickening. The CD209 rs2287886 AG polymorphism patients produce higher IL-17 levels. Together, these data suggest a role of these cytokines in the immunopathogenesis of advanced fibrosis in human schistosomiasis.

Abstract INTRODUCTION Chagas disease can be transmitted by blood transfusion. Herein, we assessed the seropositivity for Chagas disease in blood donors from Alagoas, during 2010-2020. METHODS Data were requested from the Alagoas blood center. Time trend analysis was performed using a joinpoint regression model. RESULTS Seropositivity rate during the study period was 0.35%, which decreased from 2014 to 2020, (annual percentage change, APC = -29.38; p-value

During the COVID-19 pandemic, a reduction in vaccination coverage of children and adolescents was observed in several countries. The aim of this study was to assess the impact of the pandemic, in the first two years, on human rotavirus vaccine (HRV) coverage in Brazil compared with previous years. The number of doses of HRV administered in the period from January 2015 to December 2021 and its annual vaccination coverage were analyzed. The vaccination coverage decreased to 77.3% in 2020 and to 70.4% in 2021, substantially lower than the minimum that would be expected (89.2%); the decline was more pronounced in the second year of the pandemic despite the fact that in this period, the circulation restrictions were already less tight. Of the five Brazilian macro-regions, the northeast had the largest decline, and the south had the smallest impact on coverage. At the municipal level, less than half of the Brazilian municipalities managed to achieve vaccination coverage above 90% in either pandemic year. Although there was already a downward trend in coverage in the pre-pandemic years, the present study shows that the values recorded in 2020 and 2021 were significantly lower. Monitoring of vaccination coverage in the coming years should be carried out continuously in order to avoid a possible resurgence of rotavirus-induced diarrhea.

We analyzed the knowledge, attitudes and practices (KAP) of schistosomiasis mansoni prevention in an endemic area of Brazil. This cross-sectional study was conducted between March and May 2021, with 412 participants living in the municipality of Feira Grande, Alagoas, Brazil. Data collection occurred through visits to the Health Center Urbano II and Massapê, through an interview with a structured questionnaire to identify the levels of KAP regarding schistosomiasis prevention. Of all respondents, 70.87% lived in rural areas, 22.66% reported a history of past schistosomiasis and 52.71% never participated in schistosomiasis control program actions. Factors associated with better KAP scores were being part of an older age group, not using rainwater and having no history of past schistosomiasis. Specifically, among the domains, attitude was the highest score and knowledge was the lowest. Participation in a health intervention program, knowing someone who had schistosomiasis and having been informed through a public health program seemed to have an important impact on the population’s KAP. Our results contributed to broadening perceptions about schistosomiasis prevention, highlighting the positive impacts that health programs and interventions have on disease control.

Objetivo: Analisar as tendências temporais e o perfil epidemiológico das principais causas de mortalidade em residentes do município de Lagarto, Sergipe, entre 2006 a 2015. Métodos: Estudo epidemiológico, descritivo e de série histórica, através de dados secundários dos óbitos notificados no Sistema de Informação de Mortalidade (SIM). A análise das tendências temporais foi realizada pelo Programa Joinpoint Regression obtendo-se a variação percentual anual (APC) das taxas de mortalidade por meio da regressão Possion. Resultados: Foram notificados 5.586 óbitos, com predomínio do sexo masculino e idosos, 58% e 59,61% respectivamente. Observou-se um aumento da taxa de mortalidade geral de 1,58% ao ano (IC95%: 0,5 a 2,6; p=0,01). Somente as taxas de mortalidade infantil (TMI) e de seus componentes apresentaram tendências decrescentes. Conclusão: Apesar da tendência decrescente das TMI, as mesmas requerem ações especializada, bem como para a redução da mortalidade por doenças crônicas. Descritores: Epidemiologia; Mortalidade; Estudo de Séries Temporais.

Abstract Background Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. It is a disease known worldwide for its vulnerability factors, magnitude and mortality. The objective of the study was to analyze the spatial and temporal dynamics of TB in the area of social inequality in northeast Brazil between the years 2001 and 2016. Methods An ecological time series study with the use of spatial analysis techniques was carried out from 2001 to 2016. The units of analysis were the 75 municipalities in the state of Sergipe. Data from the Notification of Injury Information System were used. For the construction of the maps, the cartographic base of the state of Sergipe, obtained at the Instituto Brasileiro de Geografia e Estatística, was used. Georeferenced data were analysed using TerraView 4.2.2 software (Instituto Nacional de Pesquisas Espaciais) and QGis 2.18.2 (Open Source Geospatial Foundation). Spatial analyses included the empirical Bayesian model and the global and local Moran indices. The time trend analyses were performed by the software Joinpoint Regression, Version 4.5.0.1, with the variables of sex, age, cure and abandonment. Results There was an increasing trend of tuberculosis cases in patients under 20 years old and 20–39 years old, especially in males. Cured cases showed a decreasing trend, and cases of treatment withdrawal were stationary. A spatial dependence was observed in almost all analysed territories but with different concentrations. Significant spatial correlations with the formation of clusters in the southeast and northeast of the state were observed. The probability of illness among municipalities was determined not to occur in a random way. Conclusion The identification of risk areas and priority groups can help health planning by refining the focus of attention to tuberculosis control. Understanding the epidemiological, spatial and temporal dynamics of tuberculosis can allow for improved targeting of strategies for disease prevention and control.

Investigação que apresenta sistemas de automação de bibliotecas de acordo com um levantamento de conceitos, paradigmas e exemplos de recursos de software. Utiliza-se de uma metodologia ocorrida pela adoção da pesquisa bibliográfica e das abordagens de coleta de dados quanti-qualitativa, especificamente em periódicos de qualis A1, A2 e B1. Resulta em 13 expressões de busca sobre sistemas de automação de bibliotecas, sendo que apenas uma não foi contemplada pelo periódico de qualis B1; nove sistemas foram identificados, sendo cinco de paradigma proprietário e quatro de paradigma livre, fragmentando este último entre sistemas do tipo freeware e open source; e que os sistemas proprietários possuem como características o pagamento de licença de uso e ter o código fonte como privado etc.; enquanto que os sistemas freeware permitem o uso sem pagamento de licença, mas de código fonte também privado etc., ao passo que os sistemas open source podem, ou não, exigir o pagamento de licença, mas ofertam o código fonte de maneira editável etc. Concluiu-se que os sistemas de automação de bibliotecas podem ser apresentados entre proprietários e livres, variando entre o pagamento ou não de licença para uso e distribuição, a disponibilidade na edição do código fonte, a melhoria/atualização do sistema, a interoperabilidade entre sistemas que fazem parte da rede e o tributo donativo para a distribuição do sistema.

Acute diarrhea is the second leading cause of death among children in developing countries and is strongly related with the socioeconomic conditions of the population. In Brazil, data show a drop in the diarrhea mortality rate. Nevertheless, the northeastern region still has the most deaths. Considering this, we analyze high-risk areas for diarrhea- and gastroenteritis-related deaths, and their association with social determinants of health (SDH) in the state with one of the worst human development indicators in Brazil (Alagoas) between 2000 and 2019. We applied temporal, spatial, and space–time risk modelling. We used a log-linear regression model to assess temporal trends and the local empirical Bayesian estimator, the global and local Moran indices for spatial analysis. Spearman’s correlation was used to correlate mortality rates with SDH. A total of 3472 diarrhea-related deaths were reported during this period in Alagoas. We observed a decreasing time trend of deaths in the state (9.41/100,000 in 2000 to 2.21 in 2019; APC = −6.7; p-value < 0.001), especially in children under one year of age. However, there was stability among adults and the elderly. We identified two high-risk spatiotemporal clusters of mortality in inland municipalities. Lastly, mortality rates correlated significantly with 90% of SDH. Taken together, these findings indicate that diarrhea diseases remain a serious public health concern in Alagoas, mainly in the poorest and inland municipalities. Thereby, it is urgently necessary to invest in measures to control and prevent cases, and improve the living conditions of the poorest populations and those with the highest social vulnerability index.

Abstract INTRODUCTION: Considering that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been detected in feces, this study aimed to verify a possible relationship between basic sanitation indices and coronavirus disease (COVID-19) numbers/rates. METHODS: Data of COVID-19 cases registered in Brazil until May 28, 2020, and independent variables associated with basic sanitation were analyzed. RESULTS: A significant correlation between the number of cases and sewage treatment index/population density was observed. In addition, COVID-19 incidence and mortality rates were significantly associated with the total water service index and lethality rate was significantly associated with the sewage treatment index. CONCLUSIONS: Precarious basic sanitation infrastructure may potentially increase the SARS-CoV-2 transmission in Brazil.

Abstract Background The World Health Organization defines suicide as the act of deliberately killing oneself. It is the second leading cause of death among 15-29 year olds globally. Objective To analyze the epidemiological profile and the spatial distribution of suicide deaths in the state of Sergipe. Methods We performed an ecological time-series study with data from the Brazilian Mortality Information System (Sistema de Informações sobre Mortalidade – SIM) about deaths by suicide occurring between 2000 and 2015. We considered as suicide deaths cases recorded as voluntary self-inflicted injuries. Suicide rates were estimated and age-adjusted in the population above 9 years. We analyzed temporal trends by sex and age groups using the simple linear regression model. For the spatial analysis, we performed Kernel density estimation with the software TerraView version 4.2.2. Results We identified 1,560 suicide cases in the state of Sergipe between 2000 and 2015, with a mean of 97.5 cases per year. We also observed that suicide rates in the state increased 102.3% (from 2.69/100,000 population in 2000 to 5.44 in 2015). Suicides occurred predominantly among males (1,160 cases; 74.35%), single people (1,010 cases; 64.7%), and brown-skinned people (1,039 cases; 66.6%). We observed significantly growing temporal trends in the general population, especially among male adults. Spatial analysis allowed us to draw a map that showed the regions with the highest occurrence of suicide. Conclusion We observed growing suicide trends in the state of Sergipe and the spatial analysis was an important tool that showed the areas with higher incidences of suicide.

Fibular head avulsion fractures are rare and are so-called the arcuate signal. Avulsion fracture of the iliotibial band and anterolateral ligament is known as a Segond fracture, and it is another rare entity. We describe the case of a 27-year-old woman who was hit by a car and suffered polytrauma, mainly suffering injuries to both knees. Radiographs of the knees showed a Segond fracture associated with the arched signal bilaterally. The aim of this study is to present a rare case report and literature review of a bilateral fibular head avulsion fracture associated with an anterolateral tibial avulsion fracture.

Objective This study aimed to analyse the clinical and epidemiological indicators, temporal trends and the spatial distribution of leprosy in patients under 15 years old in an endemic area of Northeast Brazil.Design Regional surveillance study of all reported cases.Setting State of Sergipe, endemic area of Northeast Brazil.Methods An ecological and time series study was conducted, based on secondary data reported by the Brazilian Information System on Notifiable Diseases for leprosy cases diagnosed in Sergipe state (2002–2015). The analysis of temporal trends was performed using the Joinpoint Regression Programme through Poisson regression. We performed spatial analysis by Kernel estimator and Moran index.Results The incidence rate was reduced from 6.29 to 3.78 cases per 100 000 inhabitants in 2002 and 2015, respectively. However, Sergipe was still classified as highly endemicity in 2015. The mean number of household contacts (HHC) examined was significantly lower than those registered. Clinical data indicated that 21.4% of the patients developed leprosy reactions, and 31.3% presented with some physical disability in the multibacillary groups. Patients diagnosed by examination within the HHC presented better indicators, such as lower percentage of leprosy reaction and physical disability. Spatial analysis showed the most risk areas distributed on the northeast and cities around the capital, Aracaju.Conclusion The data indicate that there is a persistence of active Myobacterium leprae transmission and a delay in disease detection, following a pattern of high endemicity in many municipalities. The early detection by HHC examination is important to stop transmission and also to detect the cases in a less severe state.

ABSTRACT OBJECTIVE: The Hip Function Recovery Score questionnaire is an instrument that was developed for evaluating the functional recovery of patients over 60 years of age who undergo surgical treatment due to hip fractures. The objective of this study was to make a thorough transcultural translation of this questionnaire, with adaptation to the individual and cultural traits of the Brazilian population. METHOD: This translation method consisted of initial translation, back translation, drafting of a consensual version and pretesting with comments invited. Subsequently, a final version was drawn up after making the necessary adjustments, without altering the semantics of the questions in the original text. RESULTS: The consensual version was applied to thirty patients over the age of 60 years who had undergone surgical treatment due to hip fractures. However, some difficulties in understanding some words and expressions were observed, and these were then replaced with terms that were more easily understood. After the final version had been drawn up, this was applied to the same patients and full understanding was achieved among some of them, without altering the semantics of the questions of the original text. CONCLUSION: The transcultural translation of the Hip Function Recovery Score will have an immediate impact on functional evaluations on patients over 60 years of age who underwent surgery due to hip fracture. It will subsequently be possible for other Brazilian scientific studies to use this questionnaire, which has been standardized and adapted to Brazilian culture, in order to make comparisons between results, thereby enriching Brazilian scientific production.

Mensura o desejo de uso da folksonomia pelos funcionários que usam o Ortodocs, sistema de automação de biblioteca (SAB) adotado pela Biblioteca Central (BC) da Universidade Federal da Paraíba (UFPB). Discute biblioteca, representação da informação e Web 2.0, com enfoque na folksonomia. Adota, como percurso metodológico, as técnicas de pesquisa exploratória e bibliográfica, com a abordagem de coleta de dados quanti-qualitativa junto a 20 pesquisados da BC/UFPB. Encontra, como resultados da pesquisa, que a maioria dos pesquisados usa a Internet mais de 12 vezes na semana, sabe o significado do termo folksonomia, aprova o uso da folksonomia no SAB e acredita que a biblioteca pode ser considerada atualizada ao adotar a folksonomia, indo ao encontro dos preceitos da Web 2.0. Concluiu-se que o uso da folksonomia é desejado pela maioria dos funcionários pesquisados, pois os usuários poderiam colaborar uns com os outros, como também com os bibliotecários, apresentando sugestões de termos a serem inseridos na taxonomia padrão do sistema enquanto uma coexistência entre taxonomia e folksonomia. Almeja novos estudos, inclusive a realização de investigações sobre o Ortodocs após a atualização e/ou aquisição de novo sistema na BC/UFPB, pois o hibridismo de sistemas talvez seja o meio termo desse debate, ao qual um modelo potencializará e influenciará o outro com vistas à colaboração social.

Apresenta a inserção da Teoria da Classificação Facetada (TCF) na prototipagem de Banco de Dados (BD) a partir da modelagem de dados, mais especificamente nas etapas de programação: lógica e física. Discute modelagem de dados em BD como técnica que deverá representar a realidade do ambiente que o sistema será inserido. Objetiva-se, de forma maior, a partir de um percurso metodológico formado pela pesquisa aplicada, exploratória e bibliográfica, de abordagem qualitativa, apresentar a aplicação da classificação facetada para organização do conhecimento, visando à recuperação da informação em BD; e de forma específica, investigar a possibilidade de aplicabilidade da classificação facetada com a modelagem de dados em ambientes digitais e expor um panorama de uso do protótipo de BD. Alcança, como resultados da pesquisa, as contribuições da TCF na modelagem lógica e física, especificamente nos métodos de formação de assunto de Ranganathan, dissecação e desnudação, feito na modelagem conceitual (outro trabalho); e na modelagem física, ou seja, na escolha de recursos de software que, em seguida, a confeccionou os módulos do sistema em Cadastro (catalogação), Classificação e Pesquisa (busca); além de contribuições da TCF na facetação ilimitada e filtragem nas ocorrências de buscas, tornando as pesquisas mais precisas. Conclui-se que os subsídios para o desenvolvimento do Sistema Facetado foi a TCF na modelagem de dados em BD, e mesmo com os resultados satisfatórios, a grande questão encontra-se na ausência de modelos e/ou estudos empíricos que apresentem metodologias e testes, nos oferecendo como ponto de partida a imaginação e conhecimento profissional em BD. Finaliza almejando o desejo de outros estudos, outros modelos, os quais poderão nos ajudar a ampliar esta discussão para ambientes mais gerais, abrangentes, como é o caso da Web.

Leprosy is a chronic disease caused by M. leprae infection that can cause severe neurological complications and physical disabilities. A leprosy-specific vaccine would be an important component within control programs but is still lacking. Given that multifunctional CD4 T cells [i.e., those capable of simultaneously secreting combinations of interferon (IFN)-γ, interleukin (IL)-2, and tumor necrosis factor (TNF)] have now been implicated in the protective response to several infections, we tested the hypothesis if a recombinant M. leprae antigen-specific multifunctional T cells differed between leprosy patients and their healthy contacts. We used whole blood assays and peripheral blood mononuclear cells to characterize the antigen-specific T cell responses of 39 paucibacillary (PB) and 17 multibacillary (MB) leprosy patients and 31 healthy household contacts (HHC). Cells were incubated with either crude mycobacterial extracts (M. leprae cell sonicate–MLCS) and purified protein derivative (PPD) or recombinant ML2028 protein, the homolog of M. tuberculosis Ag85B. Multiplex assay revealed antigen-specific production of IFN-γ and IL-2 from cells of HHC and PB, confirming a Th1 bias within these individuals. Multiparameter flow cytometry then revealed that the population of multifunctional ML2028-specific T cells observed in HHC was larger than that observed in PB patients. Taken together, our data suggest that these multifunctional antigen-specific T cells provide a more effective response against M. leprae infection that prevents the development of leprosy. These data further our understanding of M. leprae infection/leprosy and are instructive for vaccine development.

Apresenta as compreensões de inclusão digital nas políticas de informação à luz dos Livros Verde e Branco. Discute políticas de informação a partir do regime de informação, baseado em noções conceituais oferecidas por González de Gómez (1999) e na tentativa de aproximação ao conceito de inclusão digital, na perspectiva de que seja um elemento primordial no processo de inclusão social. Objetiva-se, segundo um percurso metodológico constituído pelas pesquisas documental e bibliográfica, verificar a compreensão de inclusão digital nas políticas dos Livros Verde e Branco. Resulta, à luz da quarta definição apresentada sobre regime de informação (contexto), que no Livro Verde existe a concepção de que os recursos tecnológicos, com destaque à Internet, serão vitais ao alcance da inclusão digital – alfabetização digital – inclusão social,enquanto no Livro Branco reflete-se a preocupação com o contexto territorializado, historicizado, físico/virtual e coletivo, de modo a compor as ações de informação, não se preocupando apenas com equipamentos tecnológicos, mas em oferecer formas de capacitação aos usuários. Conclui-se que não existe apenas uma definição para inclusão digital e que esta ação não garante a inclusão social, mas que esteja presente nas políticas de informação de uma comunidade, assim como subsidiar a compreensão de que uso das recentes tecnologias digitais de informação e de comunicação (TDICs) seja encarado como meio e não como fim. Entende-se, neste sentido, que talvez tal inferência seja a chave para interpretar o significado de inclusão digital na efetivação da inclusão social.

Objective. Research that objective to analyze the scientific production in information technology by professors of biblioteconomy, Faculty of Information Science, University of Brasilia (Brazil), through the Curriculum Lattes Platform of teachers cited. Method. Adopts inductive method, bibliographical research and technical, quantitative research and data collection approach and document analysis from Lattes (Lattes Platform) of the selected teachers. Results. Presents that the areas databases, libraries and digital repositories as that have the greatest production, metadata and library automation system areas as those with lack of jobs published, the most used types of records are the proceedings of congress, course conclusion papers and journal articles, as well the thesis and extended abstracts are little used, besides identifying other areas not listed in the original scope of work such as electronic document management, digital preservation, information security, information architecture, hypertext and applied technologies. Conclusions. The analysis of scientific production helps in decision-making, idealizes an overview of professors' research, and helps understand how certain area behaves and its main composition of subjects.

Ecto-nucleotidase activity is involved in the infection process of Leishmania and various other parasites that enables modulation of host immune responses to promote disease progression. One of the enzymes responsible for this activity is the ecto-nucleoside triphosphate diphosphohydrolase (E-NTPDase). The enzyme hydrolyzes nucleotides tri- and/or di-phosphate into monophosphate products, which are subsequently hydrolyzed into adenosine. These nucleotides can serve as purinergic signaling molecules involved in diverse cellular processes that govern immune responses. Given the importance of the extracellular metabolism of these nucleotides during intracellular pathogen infections, this study evaluates the role of ecto-nucleotidase activity during Leishmania infantum (L. infantum) infection in human macrophages. E-NTPDase protein expression and activity was evaluated in L. infantum during purine starvation, adenosine-enriched medium, or in the presence of an inhibitor of ecto-nucleotidases. Results show that E-NTPDase is expressed in L. infantum parasites, including on the cell membrane. Furthermore, functional activity of the enzyme was modulated according to the availability of adenosine in the medium. Purine starvation increased the hydrolytic capacity of nucleotides leading to higher infectivity, while growth in adenosine-enriched medium led to lower infectivity. Moreover, inhibiting E-NTPDase function decreased L. infantum infection in macrophages, suggesting the enzyme may serve as a ligand. Taken together, the ability of L. infantum to hydrolyze nucleotides is directly associated with increased infectivity in macrophages.

Este artigo relata as conclusões da reunião de consenso com médicos especialistas sobre diagnóstico de narcolepsia baseada na revisão dos artigos sobre narcolepsia listados no Medline entre 1980 e 2010. A narcolepsia é uma doença crônica de início entre a primeira e segunda décadas de vida do indivíduo. Os sintomas essenciais são cataplexia e sonolência excessiva. A cataplexia é definida como episódios súbitos, recorrentes e reversíveis de fraqueza da musculatura esquelética desencadeados por situações de conteúdo emocional. Os sintomas acessórios são alucinações hipnagógicas, paralisia do sono e sono fragmentado. Critérios de diagnóstico clínico de acordo com a Classificação Internacional dos Transtornos do Sono são de sonolência excessiva e cataplexia. Recomenda-se a realização de polissonografia seguida do teste de latência múltipla do sono em um laboratório de sono para confirmação e diagnóstico de comorbidades. Quando não houver cataplexia, deve haver duas ou mais sonecas com sono REM no teste de latência múltipla do sono. Tipagem HLA-DQB1*0602 positiva com níveis de hipocretina-1 abaixo de 110pg/mL devem estar presentes para o diagnóstico de narcolepsia sem cataplexia e sem sonecas com sono REM.This manuscript contains the conclusion of the consensus meeting on the diagnosis of narcolepsy based on the review of Medline publications between 1980-2010. Narcolepsy is a chronic disorder with age at onset between the first and second decade of life. Essential narcolepsy symptoms are cataplexy and excessive sleepiness. Cataplexy is defined as sudden, recurrent and reversible attacks of muscle weakness triggered by emotions. Accessory narcolepsy symptoms are hypnagogic hallucinations, sleep paralysis and nocturnal fragmented sleep. The clinical diagnosis according to the International Classification of Sleep Disorders is the presence of excessive sleepiness and cataplexy. A full in-lab polysomnography followed by a multiple sleep latency test is recommended for the confirmation of the diagnosis and co-morbidities. The presence of two sleep-onset REM period naps in the multiple sleep latency test is diagnostic for cataplexy-free narcolepsy. A positive HLA-DQB1*0602 with lower than 110pg/mL level of hypocretin-1 in the cerebrospinal fluid is required for the final diagnosis of cataplexy- and sleep-onset REM period -free narcolepsy.

Este artigo relata as conclusões da reunião de consenso da Associação Brasileira de Sono com médicos especialistas brasileiros sobre o tratamento da narcolepsia, baseado na revisão dos artigos sobre narcolepsia publicados entre 1980 e 2010. Os objetivos do consenso são valorizar o uso de agentes avaliados em estudos randomizados placebo-controlados, emitir recomendações de consenso para o uso de outras medicações e informar pontos importantes a respeito da segurança e efeitos adversos das medicações. O tratamento da narcolepsia é baseado em diversas classes de agentes, estimulantes para sonolência excessiva, agentes antidepressivos para cataplexia e hipnóticos para sono noturno fragmentado. Medidas comportamentais são igualmente importantes e recomendadas universalmente. Todos os ensaios clínicos terapêuticos foram classificados de acordo com o nível de qualidade da evidência. Recomendações terapêuticas individualizadas para cada tipo de sintoma e recomendações gerais foram formuladas pelos autores. Modafinila é indicada como a primeira escolha para o tratamento da sonolência diurna. Agentes de segunda escolha para o tratamento da sonolência excessiva são metilfenidato de liberação lenta seguido pelo mazindol. Reboxetina, clomipramina, venlafaxina, desvenlafaxina e os inibidores seletivos de recaptação de serotonina em doses altas são a primeira escolha para o tratamento da cataplexia. Hipnóticos são utilizados para o tratamento do sono noturno fragmentado. Antidepressivos e hipnóticos são igualmente utilizados para o tratamento das alucinações hipnagógicas e paralisia do sono.This manuscript contains the conclusion of the consensus meeting of the Brazilian Sleep Association with Brazilian sleep specialists on the treatment of narcolepsy based on the review of medical literature from 1980 to 2010. The manuscript objectives were to reinforce the use of agents evaluated in randomized placebo-controlled trials and to issue consensus opinions on the use of other available medications as well as to inform about safety and adverse effects of these medications. Management of narcolepsy relies on several classes of drugs, namely, stimulants for excessive sleepiness, antidepressants for cataplexy and hypnotics for disturbed nocturnal sleep. Behavioral measures are likewise valuable and universally recommended. All therapeutic trials were analyzed according to their class of evidence. Recommendations concerning the treatment of each single symptom of narcolepsy as well as general recommendations were made. Modafinil is the first-line pharmacological treatment of excessive sleepiness. Second-line choices for the treatment of excessive sleepiness are slow-release metylphenidate followed by mazindol. The first-line treatments of cataplexy are the antidepressants, reboxetine, clomipramine, venlafaxine, desvenlafaxine or high doses of selective serotonin reuptake inibitors antidepressants. As for disturbed nocturnal sleep the best option is still hypnotics. Antidepressants and hypnotics are used to treat hypnagogic hallucinations and sleep paralysis.

Objetiva, a partir das pesquisas aplicada (prototipagem), explicativa e bibliográfica, e de abordagem qualitativa, apresentar uma proposta de catálogo bibliográfico 2.0 na perspectiva dos sistemas gerenciadores de conteúdo (CMS), em consonância com os preceitos da Web 2.0 e com as ações de representação da informação da biblioteconomia (catalogação e indexação). Resulta em um catálogo bibliográfico 2.0 desenvolvido no CMS WordPress mediante o uso do template Fashionista, e dos plug-ins Book Review Library, que possibilita a realização de ações de representação da informação; e Rating-Widget: Star Rating, que permite avaliar os itens do catálogo. Conclui-se que a proposta apresenta um ambiente dinâmico e intuitivo que permite e incentiva a participação ativa dos usuários mediante avaliação dos registros, sugestão de livros cujos gêneros sejam similares e rotulação livre, diferentemente das propostas dos tradicionais catálogos públicos de acesso em linha, sem participação do usuário, dificuldades na navegação e insatisfação nos processos de busca.