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RMSF, a tickborne infection caused by Rickettsia rickettsii, produces severe and fatal disease in humans and dogs. Since the beginning of the 21st century, cases have risen dramatically, most notably in Mexico and Brazil, where outbreaks occur in urban centers including cities with populations of > 1,000,000 persons. Reported case fatality rates can exceed 50%. Factors consistent with high case fatality include lack of awareness of disease ecology, limited capacity for diagnosis, and delay in appropriate antimicrobial treatment. The emergence of urban hyperendemic foci has been leveraged by 2 distinct but similar anthropogenic events that create disproportionately high numbers of vertebrate amplifiers of R rickettsii, as well as the tick species that transmit this pathogen in proximity with dense human populations. This often occurs in neighborhoods with a highly marginalized at-risk population that includes persons in poverty and particularly children, and health management systems that are under-resourced. We discuss strategies to reduce host dog populations, particularly in Mexico, and capybaras in Brazil. We review challenges to the control of tick populations in these settings. Robust systems are required to enhance awareness of RMSF among medical practitioners and people at risk of RMSF. Public health campaigns should incorporate innovative behavioral science (eg, diverse learning models, motivational interviews, and gamification) to increase prevention and understanding within communities. While anti-Rickettsia or anti-tick vaccines will be necessary to resolve this One Health crisis, impactful implementation will require data-driven and multiple-target innovations to address challenges with hosts, ticks, medical systems, and public welfare. The companion Currents in One Health by Foley, Backus, and López-Pérez, JAVMA, March 2025, addresses helpful information for the practicing veterinarian.

Aim: This study aimed to evaluate if dental atraumatic restorative treatment (ART) impacts salivary total protein and redox biomarkers in children with caries., Methods: The study included 30 children (aged 4 to 6 years) with caries on posterior deciduous teeth, classified by ICCMS, attending a basic education school. Participants were divided into enamel (n = 15) and dentin (n = 15) lesion groups. Unstimulated saliva samples were collected before (B), immediately after (A), and seven days after (A7) ART. Analyses included total protein concentration, lipid peroxidation (TBARS), total antioxidant capacity (TAC), and uric acid (UA). The results obtained at different time points (B, A, A7) were compared between children with caries and between those with enamel or dentin lesions using a paired repeated-measures ANOVA, followed by Tukey's post-hoc test (p < 0.05)., Results: ART caused significant decreases in total protein concentration (p = 0.0146), which rebounded by the 7th day. TBARS levels increased (p = 0.0215) immediately after ART and remained unchanged until the 7th day. TAC (p = 0.0032) and UA (p = 0.0006) levels decreased in the saliva of children 7 days after ART. These changes were significant only in children with dentin lesions, not enamel lesions., Conclusion: ART temporarily alters salivary protein levels and redox biomarkers in children with caries, returning to baseline after 7 days. These findings highlight the importance of complementing restorative treatments with dietary advice and oral hygiene to ensure comprehensive caries management., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Cristina Antoniali reports financial support was provided by São Paulo State University. Adrielle Ouchi Lopes reports financial support was provided by Coordination of Higher Education Personnel Improvement. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Phosphorus (P) movement in soils is influenced by flow velocities, diffusion rates, and several soil characteristics and properties. In acidic soils, P is tightly bound to soil particles, reducing its availability to plants. Organomineral fertilizers combine organic matter with mineral nutrients, enhancing P fertilization efficiency, and reducing environmental impacts. In this study, we aimed to investigate the P miscible displacement and availability in sandy loam and clayey Oxisols, focusing on the influence of soil pH and phosphorus sources (organomineral and triple superphosphate). An experimental column setup was employed to investigate P transport and sorption in both soils at their natural pH of 4.8 and an adjusted pH of 6.0. Breakthrough curves (BTCs) were used to provide insights into P transport mechanisms. Soil pH adjustment from 4.8 to 6.0 resulted in decreases in sorption coefficients and maximum P sorption capacity, highlighting the critical role of pH in P dynamics. The soil bulk density increased at the higher pH level indicated changes in soil particle arrangement, which are probably due to changes in structural stability promoted by liming and organic matter addition. Conversely, clayey soil had remarkable stability across the pH range due to the buffering properties of clay particles. The data from the BTCs were fitted by the two-site kinetic model at a pH of 4.8 and the linear model at pH of 6.0. These findings underscore the complex interactions among soil pH, texture, and mineralogical composition in regulating P dynamics. Furthermore, the study also highlights the necessity for differentiated soil management practices that incorporate these factors in order to achieve sustainable agricultural productivity and environmental protection., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier B.V. All rights reserved.)

Introduction: Healthcare workers (HCWs) are at higher risk of SARS-CoV-2 infection. Viral surveillance for early detection of COVID-19 is a critical strategy to understand this population's infection dynamics and prevent transmission. The study examines SARS-CoV-2 infection and reinfection among HCWs vaccinated against COVID-19 working at a primary healthcare unit serving a disenfranchised community in Brazil., Methods: The study was conducted in Cidade Estrutural, Federal District, Brazil, between February and October 2021. Participants were interviewed and provided samples. A prospective open cohort study was used to analyze the frequency of SARS-CoV-2 infection and reinfection, and the vaccine-induced seroconversion. Nasopharyngeal swab specimen was collected from workers presenting with flu-like symptoms and subjected to RT-qPCR. Peripheral blood samples were also collected every 30 ± 2 days for eight months, starting from the day participants received their first dose of COVID-19 vaccine, and submitted to serological testing (IgM and IgG chemiluminescence). The frequencies of infection and reinfection (RT-qPCR positive results 90 days after the infection) were calculated along with their respective confidence intervals (95% CI)., Results: Of the 128 workers, 61 (47.65%; CI: 39.19-56.25) reported probable SARS-CoV-2 infection before vaccination and 50 (39.06%; CI: 31.04-47.71) had SARS-CoV-2 infection after vaccination, confirmed by molecular test. Reinfection was identified in seven workers (7/50, 14%; CI: 6.95-26.18) based on the 90-day interval between results. The serological data from the 128 workers during the cohort indicated that 68 (53.12%; CI: 44.5-61.5) had IgG antibodies and 46 had IgM antibodies (35.93%; CI: 28.14-44.54) against SARS-CoV-2. SARS-CoV-2 infection was common in 56% of the community health workers (CHWs), 50% of registered nurses, and licensed vocational nurses (33%). Following the COVID-19 vaccination, the percentage of infections among HCWs decreased from 47.83% to 4.35%., Conclusion: These results demonstrate that (i) approximately 40% of the workers were infected with SARS-CoV-2 in 2021 and (ii) reinfections confirmed by RT-qPCR occurred in 14% of the HCWs after vaccination. The results provide valuable insights into the circulation of SARS-CoV-2 among HCWs in a primary care unit serving a minoritized community.

Aging is associated with an increased risk of cardiovascular disease and vascular dysfunction. Reduced nitric oxide bioavailability is considered one of the key mechanisms underlying vascular dysfunction in large arteries of older adults. However, the relationship between cardiovascular disease risk factors, nitric oxide bioavailability, and skeletal muscle microvascular reactivity, an early hallmark in cardiovascular disease progression, is unclear in older individuals. Also uncertain is whether this relationship is influenced by sex. Therefore, this study assessed the association between cardiovascular disease risk factors, circulating markers of nitric oxide availability (plasma nitrate and nitrite), and skeletal muscle microvascular reactivity in older individuals. First, we confirmed in a cohort of young and older individuals that aging is associated with skeletal muscle microvascular dysfunction. Next, we observed that skeletal muscle microvascular reactivity (P = 0.653; η 2  = 0.016) and circulating nitric oxide metabolites (Nitrate: P = 0.641, η 2  = 0.011; Nitrite: P = 0.560, η 2  = 0.017; NOx: P = 0.639, η 2  = 0.011) did not differ between older males and females. Finally, using multivariate regression models, we found that: (i) the number of cardiovascular risk factors was negatively associated with skeletal muscle microvascular reactivity in older males and females (B = -0.132, P = 0.044); (ii) the relationship between plasma nitrite and skeletal muscle microvascular reactivity was influenced by sex (F = 6.837, P = 0.016); and (iii) skeletal muscle microvascular reactivity in older females displayed a strong positive association with plasma nitrite (R 2  = 0.720, P < 0.001). While the impact of cardiovascular disease risk factors on skeletal muscle microvascular reactivity was not influenced by sex, sex-related discrepancies were found in the relationship between nitric oxide bioavailability and skeletal muscle microvascular reactivity in older individuals., Competing Interests: Declaration of competing interest The authors declare that they have no competing interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Invasive infections caused by non-albicans Candida are increasing worldwide. However, there is still a lack of information on invasive candidiasis (IC) in the pediatric setting, including susceptibility profiles and clonal studies. We investigated the clinical, epidemiologic, and laboratory characteristics of IC, possible changes in antifungal susceptibility profiles over time, and the occurrence of clonality in our tertiary children's hospital. We analyzed 123 non-duplicate Candida isolates from sterile sites of pediatric patients in a tertiary hospital in southern Brazil, between 2016 and 2021. Data on demographics, comorbidities, and clinical outcomes were collected. Candida species distribution, antifungal susceptibility profiles, biofilm production, and molecular epidemiology of isolates were assessed using reference methods. The range of IC incidence was 0.88-1.55 cases/1000 hospitalized patients/year, and the IC-related mortality rate was 20.3%. Of the total IC cases, 42.3% were in patients aged < 13 months. Mechanical ventilation, parenteral nutrition, and intensive care unit (ICU) admission were common in this group. In addition, ICU admission was identified as a risk factor for IC-related mortality. The main site of Candida spp. isolation was blood, and non-albicans Candida species were predominant (70.8%). No significant clonal spread was observed among isolates of the three most commonly isolated species, and 99.1% of all isolates were biofilm producers. Non-albicans Candida species were predominant in this study. Notably, clonal expansion and emergence of antifungal drug resistance were not observed in our pediatric setting., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology.)

Summary Statement: An integrative review following Whittemore and Knafl's 5-stage approach (problem identification, literature search, data evaluation, data analysis, and presentation) was conducted to synthesize the evidence on the theoretical, conceptual, and operational aspects of simulation training with rapid cycle deliberate practice (RCDP). After the literature search, 2 reviewers independently read and critically evaluated primary studies using the eligibility criteria. A third more experienced reviewer solved disagreements between the reviewers.This review included 31 articles. Eight themes were identified and grouped into 2 pre-established categories: theoretical/conceptual and operational aspects. The first category had the following 3 themes: definition of RCDP, concepts related to the principles of RCDP, and theories underpinning RCDP. The second category had the following 5 themes: total training time, number of participants in the training, training system, first scenario without intervention, and progressive difficulty. This review showed that knowledge about RCDP is still under construction. As a new simulation strategy, there are some theoretical, conceptual, and operational differences in the studies applying RCDP interventions as simulation training., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 Society for Simulation in Healthcare.)

The abusive use of anabolic androgenic steroids has become a serious health problem worldwide, but its effects on oral health are still poorly understood. Therefore, the objective of this study was to evaluate the effects of a supraphysiological dose of testosterone cypionate (TC) on salivary biochemical, histomorphology, immunohistochemistry, and redox state parameters of parotid and submandibular glands. Twenty male Wistar rats, 12 weeks old, were divided into two groups (n=10/group): a control group and TC group, which received a dose of 20 mg/kg, once a week, for 6 weeks. Post treatment, the saliva and glands were collected. A supraphysiological dose of TC increased plasma and salivary testosterone concentrations. Although TC did not alter salivary flow, pH, and buffering capacity, the treatment increased the salivary secretion of total protein and reduced amylase, calcium, phosphate, and potassium. TC reduced the connective tissue area in the parotid gland and acinar area of the submandibular gland, while increasing the granular convoluted tubule area in the submandibular gland. Proliferating cell nuclear antigen was higher in the acinar cells of the submandibular glands from the TC group. Moreover, TC increased concentrations of total oxidant capacity and damaged lipids in both salivary glands, while total antioxidant activity and uric acid were lower in the submandibular gland, and reduced glutathione was higher in both glands. Superoxide dismutase, catalase, and glutathione peroxidase activities were higher in the parotid gland, while only glutathione peroxidase activity was lower in the submandibular gland of the TC group. In conclusion, TC abuse may be a potential factor for dysfunction of the parotid and submandibular glands, becoming a risk factor for the oral and systemic health of users., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Near-infrared spectroscopy combined with vascular occlusion test (NIRS-VOT) is a reactive hyperemia technique for in vivo evaluation of skeletal muscle microvascular reactivity. Previous studies using NIRS-VOT have been shown to be able to detect impairments in microvascular function in high-risk cardiovascular disease populations, such as older individuals. It has been demonstrated that older individuals have slower reactive hyperemia compared with young individuals. Importantly, older individuals also show less desaturation during ischemia compared with young individuals. Based on these findings, it has been suggested that the slower reactive hyperemia observed in older individuals is explained by the lower desaturation during blood flow occlusion (reduced ischemic stimulus). This retrospective analysis compared reactive hyperemia in 36 young and 47 older tissue desaturation-matched individuals that underwent 5-min blood flow occlusion. Overall, we showed that older individuals have impaired reactive hyperemia compared with young when matching for the degree of desaturation and blood flow occlusion time. These findings provide evidence that lower tissue desaturation during ischemia is not a major determinant of impaired reactive hyperemia in older individuals. NEW & NOTEWORTHY Previous findings have suggested that aging-related impairment in skeletal muscle reactive hyperemia is majorly influenced by a lower degree of tissue desaturation during ischemia in older individuals compared with young individuals. In a retrospective analysis including 83 tissue desaturation-matched individuals, we show that the degree of tissue desaturation is not a major determinant of aging-related impairments in reactive hyperemia.

Introduction: Low cardiorespiratory fitness (CRF) increases the risk of cardiovascular disease by up to eightfold and is one of the strongest predictors of mortality. Some studies demonstrate impaired CRF in people living with type 1 and type 2 diabetes compared with those without diabetes, whereas others demonstrate no diabetes-associated impairment in CRF., Purpose: We aimed to determine whether diabetes can influence CRF and, if so, identify clinical associations underlying diabetes-associated exercise impairments., Methods: Sixty-eight studies were included in the quantitative analysis. Standardized mean difference (SMD) was calculated and meta-analyses and meta-regressions were performed by using a random-effects model., Results: Diabetes is associated with a large negative effect on CRF (SMD = -0.80, P < 0.001)-an effect that is partially mitigated, but still significant, in those with high physical activity levels (SMD = -0.50, P = 0.007). A sedentary lifestyle (SMD = -0.83, P = 0.007) and the presence of clinical complications related to diabetes (SMD = -1.66, P < 0.001) predict a greater magnitude of CRF reduction in people with diabetes compared with controls without diabetes. Both type 1 diabetes and type 2 diabetes are independently associated with impaired CRF compared with controls without diabetes; however, the effect is significantly greater in those type 2 diabetes (SMD = -0.97, P < 0.001). Meta-regression analysis demonstrates the effects of diabetes on CRF are primarily associated with HbA1c levels for type 1 diabetes ( B = -0.07, P < 0.001) and body mass index for type 2 diabetes ( B = -0.17, P = 0.005)., Conclusions: These data demonstrate a negative influence of diabetes on the key risk factor of low CRF and provide critical insight into specific clinical markers of low CRF associated with diabetes., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Sports Medicine.)

Aging, especially in female, is complex, involving various factors such as reproductive sensitivity, cognitive and functional decline, and an imbalance in the redox system. This study aims to assess the effectiveness of long-term resistance training as a non-pharmacological strategy to mitigate the impairment of recognition memory, hippocampal redox state, and ambulation in aging female Wistar rats during the periestropause period. Thirty Wistar rats aged 17 months, in periestropause, were distributed into non-trained (NT) and resistance training (RT; stair climbing 3 times per week for 4 months) groups. Before (17 months) and after (21 months) of the RT period, the rats underwent tests for ambulation, elevated plus maze (EPM), open field, and object recognition. Biochemical and histological analyses were conducted on the hippocampus of these animals. Analysis of the results revealed that at 21 months, females in the NT group (21Mo/NT) exhibited a decreased in length (p=0.0458) and an increased in past width (p<0.0479) compared to their measurements at 17 months. However, after 4 months of RT, the female rats aged 21 months (21Mo/RT group) experienced changes in gait components, showing an increase in length (p<0.0008) and a decrease in stride width. Regarding memory, the object recognition test indicated potential cognitive improvement in 21Mo/RT animals, with significant interaction between intervention and age across all three stages of the test (total exploration time, p=0.0001; Test 1, p=0.0003; Test 2, p=0.0014). This response was notable compared to animals in the 21Mo/NT group, which showed a decline in memory capacity (p<0.01). The data showed a significant difference in relation to the age of the animals (p<0.01). The hippocampal redox state markers showed reduced lipid oxidative (p=0.028), catalase (p=0.022), and superoxide dismutase (p=0.0067) in the RT group compared to the NT group. Hippocampal cells from the 21Mo/RT group showed increased citrate synthase enzyme activity (p<0.05) and Nissl body staining (p<0.05). The results of this study demonstrate that RT performed during the periestropause phase leads to significant improvements in functional abilities, cognitive performance, and neuroplasticity in aging female rats., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Purpose: Assessing health care providers' knowledge, clinical skills, and prejudice toward lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other sexual and gender minority populations (LGBTQIA+) can help identify areas for improvement in health care provider training. The aim of this study was to map the range of studies that report measures of health care providers' knowledge, clinical skills, or prejudice toward LGBTQIA+ populations. Methods: A scoping review adopting the Joanna Briggs Institute methodology was conducted. Electronic database searches were conducted in CINAHL via EBSCO Host, Epistemonikos, LILACS via Virtual Health Library Regional Portal, PubMed, Scopus, and Web of Sciences. The samples of other reviews were screened. Studies that validated, translated, and/or cross-culturally adapted measures of the knowledge, clinical skills, and prejudice of health care providers and students toward LGBTQIA+ individuals were selected. Scholars were consulted to ensure that no relevant studies were missing. Data were extracted by two independent reviewers and presented in tabular form along with narrative summaries. Results: This scoping review identified 27 measures that have been validated, translated, and/or adapted with health care providers or students as the target population, distributed across 33 studies. Conclusions: Psychometric studies involving LGBTQIA+ patients and health care professionals have increased in recent years, with North American countries being the most frequent location. However, a growing number of studies are being conducted in Latin American countries such as Brazil and Colombia.

Background: We evaluated the predictive factors for case confirmation and death from Brazilian spotted fever in an endemic area of Southeastern Brazil., Methods: A cross-sectional study was conducted. All suspected cases reported between 2007 and 2021 were analyzed using two logistic regression models., Results: 60 cases were confirmed. Male sex, age group of 40-59 years, tick parasitism, presence of capybaras or horses, exanthema and hospitalization were positively associated with confirmation. Death was associated with a longer period between first symptom-hospitalization and shorter treatment., Conclusions: Complete clinical evaluation and information on risk exposure are key to early suspicion, diagnosis, treatment and prevention of deaths.

Mental disorders are leading causes of disability and premature death worldwide, partly due to high comorbidity with cardiometabolic disorders. Reasons for this comorbidity are still poorly understood. We leverage nation-wide health records and near-complete genealogies of Denmark and Sweden (n = 17 million) to reveal the genetic and environmental contributions underlying the observed comorbidity between six mental disorders and 15 cardiometabolic disorders. Genetic factors contributed about 50% to the comorbidity of schizophrenia, affective disorders, and autism spectrum disorder with cardiometabolic disorders, whereas the comorbidity of attention-deficit/hyperactivity disorder and anorexia with cardiometabolic disorders was mainly or fully driven by environmental factors. In this work we provide causal insight to guide clinical and scientific initiatives directed at achieving mechanistic understanding as well as preventing and alleviating the consequences of these disorders., (© 2024. The Author(s).)

Carbapenem-resistant Klebsiella pneumoniae (CRKP) exhibit high mortality rates in pediatric patients and usually belong to international high-risk clones. This study aimed to investigate the molecular epidemiology and carbapenem resistance mechanisms of K. pneumoniae isolates recovered from pediatric patients, and correlate them with phenotypical data. Twenty-five CRKP isolates were identified, and antimicrobial susceptibility was assessed using broth microdilution. Carbapenemase production and β-lactamase genes were detected by phenotypic and genotypic tests. Multilocus sequence typing was performed to differentiate the strains and whole-genome sequencing was assessed to characterize a new sequence type. Admission to the intensive care unit and the use of catheters were significantly positive correlates of CRKP infection, and the mortality rate was 36%. Almost all isolates showed multidrug-resistant phenotype, and most frequent resistant gene was bla KPC . We observed the dissemination of ST307 and clones belonging to CG258, which are considered high risk. In pediatric patients, these clones present with high genomic plasticity, favoring adaptation of the KPC and NDM enzymes to healthcare environments., (© 2024. The Author(s) under exclusive licence to Sociedade Brasileira de Microbiologia.)

The objective was to evaluate the effect of detoxified castor bean replacing soybean meal in the concentrate diet or as nitrogen organic fertilizer replacing urea on intake and nutrient digestibility, blood parameters and productive performance of sheep finished on irrigated Tamani grass pasture under continuous stocking and variable stocking rate. The treatments were two concentrate diets: standard (ground corn and soybean meal) and alternative diet (ground corn and detoxified castor bean cake), and two nitrogen fertilizers: chemical (urea) and organic (fresh castor bean cake). The randomized complete block design was used in a 2 × 2 factorial arrangement with four replications (500 m² paddocks). Four sheep (2 castrated males and 2 females) were distributed in each experimental unit, totaling 64 animals with an average initial weight of 19.42 ± 3.6 kg. No effects (P > 0.05) were observed on the variables inherent to the evaluation of the pasture. The average stocking rate (SR) among treatments was 85.50 sheep/ha, equivalent to 9.87 Animal Units (AU)/ha. The alternative diet presented lower dry matter digestibility (62.71%), with no negative effects on nutrient intake and kidney parameters. Animals fed the standard and alternative diet showed average daily gain of 103.75 and 86.76 g/day, respectively. A finishing period of up to 100 days is recommended for sheep selected for production systems in semi-arid regions managed intensively on pasture. Detoxified castor bean cake did not alter nutrient intake, liver and kidney parameters of the sheep and can be used in pasture-based sheep farming., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Aerobic exercise is established to increase cardiorespiratory fitness (CRF), which is linked to reduced morbidity and mortality. However, people with metabolic diseases such as type 1 and type 2 diabetes may be more likely to display blunted improvements in CRF with training. Here, we present evidence supporting the hypothesis that altered skeletal muscle signaling and remodeling may contribute to low CRF with metabolic disease., (Copyright © 2023 by the American College of Sports Medicine.)

Background: Labelling is a strategy that contributes to the correct and faster identification of drugs, minimizing misidentification. There is a gap in knowledge on optimal labelling standards for intravenous (IV) devices applied to the care of critically ill patients., Aim: The goal of this article was to map existing knowledge on the labelling of IV drug delivery devices in critically ill patients for the prevention of medication errors., Study Design: This was a scoping review conducted according to the JBI methodology in the LILACS, MEDLINE, CINAHL, IBECS, Scopus, Embase and Web of Science databases, and on the websites of specialized institutions. Searches were conducted up to December 2022 for scientific articles and grey literature that addressed the labelling of IV devices in intensive care units, emergency departments, and anaesthesia units. The data were collected using a structured form and were later classified, summarized, and aggregated to map the knowledge related to the review question., Results: Twenty-one documents were included, which demonstrated variability in label use with IV drug delivery devices. The following features of structure and design stood out: printed format, colour coding, letter size differentiation, and the use of sturdy material. In terms of information, the name of the drug, dose, date and time of preparation, identification of the patient, and who prepared it were found., Conclusions: The identified patterns contributed to the reduction of drug misidentification and the development of timelier drug labelling and administration., Relevance to Clinical Practice: The evidence supports the development of standardized labels for the prevention of medication errors., (© 2023 British Association of Critical Care Nurses.)

Objectives: The objective was to evaluate the effects of experimental apical periodontitis on the inflammatory, functional, biochemical, and redox parameters of the parotid and submandibular glands in rats., Materials and Methods: Twenty 12-week-old male Wistar rats were randomly divided into two groups (n = 10): a control group and apical periodontitis group. After 28 days, the saliva was collected for salivary flow rate and biochemistry composition. Both glands were sampled for quantification of the tumor necrosis factor-alpha (TNF-α) and biochemical analyses of redox state., Results: TNF-α concentrations were higher in both salivary glands adjacent to the periapical lesions in animals with apical periodontitis and also compared to the control group. The apical periodontitis group increased the salivary amylase, chloride, potassium, calcium, and phosphate. The total oxidant capacity increased in the parotid gland adjacent to the periapical lesions in the same rat and compared to the control group. Conversely, the total antioxidant capacity of the parotid glands on both sides in the apical periodontitis group was lower than that in the control group. Furthermore, glutathione peroxidase activity increased in the submandibular gland adjacent to the apical periodontitis group compared to the control group., Conclusions: Experimental apical periodontitis alters salivary biochemical composition, in addition to increasing inflammatory marker and inducing local disturbances in the redox state in the parotid and submandibular glands of male rats., Clinical Relevance: Apical periodontitis could exacerbate the decline in oral health by triggering dysfunction in the salivary glands., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Food-related procedures are a part of rehabilitation interventions for dysphagia. However, studies show that professional-caregiver communication is often lacking in dysphagia, risking caregivers' knowledge, understanding, and practice of those procedures, with negative consequences for patient safety and rehabilitation. The aim of this study was to evaluate caregivers' perspectives about the utility of a poster designed to communicate dysphagia-related risks and food procedures for caregivers of patients in inpatient care. The impact of caregivers' exposure to the poster on patients' dysphagia-related health was additionally explored. The poster was placed by the beds of a randomly assigned group of patients ( n = 21). Their caregivers responded to a questionnaire about the poster's utility. In addition, to explore whether the caregiver exposure to the poster could already have some effect on patient dysphagia-related health, patient risk of aspiration, food swallowing capacity, nutritional status, and oral cavity health were assessed before and one month after placement of the poster, and the poster-exposed group was compared with a (randomly-assigned) non-exposed group ( n = 21). Data were analyzed with descriptive statistics and generalized linear models based on analyses of covariance. All caregivers across various education levels reported noticing, reading, and understanding the poster (100%). Nearly all reported that the poster added new information to their knowledge (17 out of 21). In the additional analysis, the patients in the poster-exposed group showed greater improvements in the health outcomes, compared with the non-exposed group, although the effects were statistically non-significant within this study's one-month period. A poster with pictorial information was effective in increasing awareness about dysphagia-specific information among caregivers of patients in inpatient care and can be used as an augmentative means of information, with potential benefits for patient safety and rehabilitation.

This manuscript presents a wavelength-division multiplexing (WDM)-based photonic beamformer for an RF phased array antenna transmitter, capable of simultaneously generating multiple beams using the same optical spectrum. In the proposed architecture, for each RF beam, a WDM signal comprising the modulated RF sidebands undergoes complex-valued filtering, while another WDM signal with the same channels, but carrying only optical carriers, goes through an optical frequency-shifting stage. The proposed architecture allows the same WDM channels to be reused for multiple RF beams. The detection of the frequency-shifted optical carrier and the filtered RF sideband of each WDM channel at the photodetector produces a frequency-converted, correctly weighted signal to be fed to each antenna element. The features described herein are analytically derived, numerically simulated, and experimentally demonstrated. Results showcase two independent beams being transmitted in different directions.

Aim: This study aims to investigate the possible association between digit ratio (2D:4D) and match-play success (MPS) in junior tennis players. In addition, we consider the possible explanatory pathways of these associations in relation to psychological, strength, power, and hormonal parameters., Methods: We performed a cross-sectional study, with a sample comprised of 64 male junior tennis players (11-18 years old). Digit ratio was calculated from direct finger measurements. In addition, we measured the ratio of wins by number of matches played in 5 years of official competition (MPS), handgrip strength (HGS), standing long jump (SLJ), training (in weekly hours), and expertise (number of years in official competition). Salivary testosterone and cortisol levels were measured before and after physical "challenge" tests., Results: The 2D:4D correlated negatively with HGS and SLJ. MPS was also negatively associated with 2D:4D, but was positively correlated to HGS, expertise, training, and self-confidence (SC). Multiple linear regression showed 2D:4D and expertise were associated with MPS (43%-54%). None of the physical, or hormonal variables tested explained the links between 2D:4D and MPS., Conclusion: Therefore, the specific fitness components influenced by prenatal androgenization that moderate sports success remain unknown. Future studies should explore the interaction of 2D:4D, with tennis exercises as a challenge to induce hormonal change, the effect of pubertal stage, and the influence of aerobic endurance in determining MPS., (© 2023 Wiley Periodicals LLC.)

Although many positive psychology interventions like mindfulness-based treatments (MBTs) for youth have been used with a wide array of risk exposed populations (children living in poverty, victims of violence, displaced persons, children with disabilities, etc.), the efficacy of MBTs with regard to the level and domain of risk exposure has been largely overlooked. This oversight contributes to a perception of positive psychology as being decontextualized. The purpose of this meta-analysis is to better understand how a young person's level and domain of risk exposure influences the efficacy of MBTs. Published studies were included if participants were children or adolescents, were RCTs or cluster RCTs, and focused on the effect of an MBT or an MBT component. Specifically, 58 studies were qualitatively analyzed and 42 were quantitatively analyzed. The qualitative analysis evidenced a lack of objectivity in the assessment of risk exposure, with many papers providing very little or no detail on participants' level or domain of risk exposure (whether threats to psychological wellbeing originate with the individual's biology or cognitions, or the social, built or natural environment). Our quantitative analysis showed that MBTs significantly improved main outcomes relative to the control conditions, with a small-to-moderate effect size. Where it was possible to identify the level of risk exposure, we found that MBTs positively moderated treatment response, with better response among those participants with a higher level of risk. We conclude that future Positive Psychology research will need to better account for risk exposure if the discipline is to improve our understanding of which populations benefit most from interventions that promote mindfulness., Supplementary Information: The online version contains supplementary material available at 10.1007/s41042-023-00145-y., Competing Interests: Conflicts of InterestThe authors have no conflicts of interest to declare., (© The Author(s) 2024.)

Planted forest soils can have great potential for CO 2 -C sequestration, mainly due to belowground C inputs, which impact deep soil C (DSC) accumulation. However, there are still gaps in understanding the CO 2 emission dynamics in eucalypt plantations. Therefore, we used isotopic techniques to investigate the dynamics of the soil surface CO 2 -C flux and CO 2 -C concentration with depth for a eucalypt plantation influenced by different C inputs (above- and belowground). The gas evaluations were carried in depth the root to valuation of root priming effect (RPE) was calculated. In addition, measurements of the plant (C-fine root and C-litterfall) and soil (total organic carbon - TOC, total nitrogen - TN, soil moisture - SM, and soil temperature - ST) were performed. After planting the eucalypt trees, there was an increase in the soil surface CO 2 -C flux with plant growth. Root growth contributed greatly to the soil surface CO 2 -C flux, promoting greater surface RPE over time. In comparison to the other factors, SM had a greater influence on litterfall decomposition and root respiration. It was not possible to detect losses in TOC and TN in the different soil layers for the 31-month-old eucalypt. However, the 40-month-old eucalypt showed a positive RPE with depth, indicating possible replacement of DSC ("old C") by rhizodeposition-C ("new C") in the soil. Thus, in eucalyptus plantations, aboveground plant growth influences CO 2 emissions on the soil surface, while root growth and activity influence C in deeper soil layers. This information indicates the need for future changes in forest management, with a view to reducing CO 2 emissions., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Purpose: Kidney stones are one of the most common urological diseases worldwide. The size and location of the stone are the most important factors in determining the most suitable treatment options. The aim of this review was to evaluate the displacement of lower pole stones., Methods: Three studies assessing the efficacy of translocating kidney stones from the lower pole of the kidney to other locations during retrograde intrarenal surgery published in the last 20 years were included. A systematic search was conducted in the PubMed, Embase, Latin American and Caribbean Health Sciences Literature (LILACS), and Web of Science databases using the following search terms: "Lower pole," "Lithotripsy." Meta-analysis was performed using Review Manager version 5.4., Results: Stone-free rates were improved through displacement (odds ratio - OR = -0.15; 95% confidence interval-95%CI -0.24--0.05; p = 0.002; I2 = 21%), but at the cost of increased surgical duration (mean difference = -12.50; 95%CI -24.06--0.95; p = 0.03; I2 = 94%). Although this represents a potentially negative outcome, the improvement in clearance rates justifies the additional investment of time and effort., Conclusions: Displacement of lower pole kidney stones for subsequent lithotripsy brings significant benefits in terms of stone-free rate, with no difference in laser energy usage. However, it results in increased surgical time. Despite these factors, the benefits to patients undergoing the procedure are substantial.

Objective: To investigate the effects of the anticonvulsant valproic acid (VPA) on salivary glands in male rat using biochemical, functional, histomorphometric, and redox state parameters., Materials and Methods: Twenty-four male Wistar rats were randomly distributed into three groups (n = 8 per group): Control (0.9% saline solution), VPA100 (100 mg/kg), and VPA400 (400 mg/kg). After 21 consecutive days of treatment with by intragastric gavage. Pilocarpine-induced saliva was collected to determine salivary flow rate, pH, buffering capacity, and biochemical composition. Analyses of histomorphometric parameters and redox balance markers were performed on the parotid and submandibular glands., Results: Salivary flow rate, pH, buffering capacity, total protein, potassium, sodium, and chloride were similar between groups. However, phosphate and calcium were reduced in VPA400, while amylase was increased in both VPA100 and VPA400. We did not detect significant differences in the areas of acini, ducts, and connective tissue in the salivary glands between the groups. There were no significant changes in the redox status of the submandibular glands. In turn, in the parotid glands we detected reduced total oxidizing capacity and lipid peroxidation, measured as thiobarbituric acid reactive substances (TBARs) and higher uric acid concentration in both the VPA100 and VPA400 groups, and increased superoxide dismutase (SOD) in the VPA400 group., Conclusion: Chronic treatment with VPA modified the salivary biochemical composition and caused disruption in the redox state of the parotid gland in rats., Competing Interests: Declaration of Competing Interest The author(s) declare no potential conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Levetiracetam (LEV) is an anticonvulsant for epilepsy. The toxic effects of this medication in tissues have been associated with redox state imbalance, which can lead to salivary gland dysfunction. Therefore, the current work investigated the effects of LEV on the biochemical, functional, and redox parameters of the parotid and submandibular glands in rats. For this, male Wistar rats (Rattus norvegicus albinus) were randomly divided into 3 groups (n = 10/group): Control (0.9% saline solution), LEV100 (100 mg/kg), and LEV300 (300 mg/kg). After 21 consecutive days of intragastric gavage treatments, pilocarpine stimulated saliva secretion was collected for salivary biochemical analysis. The extracted salivary glands were utilized for histomorphometry and redox state analyses. Our results showed that LEV300 increased plasma hepatotoxicity markers and reduced salivary amylase activity and the acinar surface area of the parotid gland. Total oxidant capacity and oxidative damage to lipids and proteins were higher in the parotid gland, while total antioxidant capacity and uric acid levels were reduced in the submandibular gland of the LEV100 group compared to Control. On the other hand, total oxidant capacity, oxidative damage to lipids and proteins, total antioxidant capacity, and uric acid levels were lower in both salivary glands of the LEV300 group compared to Control. Superoxide dismutase and glutathione peroxidase activities were lower in the salivary glands of treated animals compared to Control. In conclusion our data suggest that treatment with LEV represents a potentially toxic agent, that contributes to drug-induced salivary gland dysfunction., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objective: Romantic relationship dysfunction is a risk for subsequent alcohol use, with some research suggesting gender differences in this link. We evaluated how different aspects of relationship dysfunction are related to different drinking behaviors and whether these associations vary by gender. We further examined the role of age as a potential moderator of this gender difference., Method: Qualtrics Panelists ( N = 1,470; 50% women) who were in a romantic relationship and regularly consumed alcohol completed an online survey. The sample was wide-ranging in age (range: 18-85 years old; M = 46.64, SD = 11.95). Participants reported drinking about 10 drinks per week, on average ( SD = 11.01)., Results: Five factor scores were constructed from relationship predictors (relationship distress, intrusion/jealousy, and disagreements) and drinking outcomes (consumption and coping motives). Moderation analyses indicated several significant two-way interactions between relationship dysfunction, gender, and age when predicting alcohol outcomes. Of note, the positive associations between relationship distress and both consumption and coping motives were stronger among younger than older individuals and among men than women (consistent with an externalizing stress perspective). A significant three-way interaction suggested that, for women, associations between intrusion/jealousy and coping motives were strongest at younger ages, consistent with an interpersonal sensitivity perspective. Conversely, for men, these associations were stronger at older ages, consistent with an externalizing stress perspective., Conclusions: Men and younger individuals should be of particular focus when designing and testing interventions for drinking in response to relationship distress and disagreements. Younger women and older men may benefit from interventions focused on drinking to cope with relationship jealousy and electronic intrusions.

Purpose: There is evidence that humans can transmit SARS-CoV-2 to cats and dogs. However, there is no evidence that they can transmit it back to humans or play any role in SARS-CoV-2 transmission. Here, we present an exploratory analysis on that matter., Methods: We conducted a case-control study with participants with flu-like symptoms seeking care at a primary healthcare unit to be tested for COVID-19. They were asked if they owned pet cats and/or dogs in their residences, and this variable was evaluated as exposure., Results: The odds ratio of "having dogs and/or cats in the residence" was 1.29 (95% CI 1.08-1.54) of "having only dogs and no cats" was 1.26 (1.05-1.52), and "no dogs and only cats" was 1.29 (0.95-1.75)., Conclusion: Having a cat/dog in the house can affect the risk of infection by SARS-CoV-2., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

The study evaluated the feeding behaviour of Phractocephalus hemioliopterus through the animals' ability to adapt to the self-feeding system, their preferred feeding times and locomotor activity, as well as the blood biochemistry of juveniles fed in a light/dark cycle. The study was carried out through two experiments, the first of which contained two phases. In experiment 1 - phase I, 24 juveniles (35.28 ± 0.62 g) were distributed in eight 48 l tanks. The tanks were equipped with a self-feeding system and the experiment consisted of evaluating whether the animals were able to adapt to the self-feeding system, as well as evaluating the preferred feeding times and locomotor activity of these animals. A feeding challenge to the animals was introduced in phase II, based on the results of phase I. The results of the first phase evidenced a nocturnal feeding preference. Thus, the feeding challenge consisted of measuring whether the animal would feed during the day and how long it would take to adapt. When the animals consumed 100% of the amount of feed provided daily, phase II was ended. In experiment 2, 24 juveniles of P. hemioliopterus (182.00 ± 14.03 g) were distributed in eight 96 l tanks. This experiment consisted of two treatments with four repetitions, one with exclusive feeding during the middle of the light cycle and another with exclusive feeding in the middle of the dark cycle. At the end, blood samples were collected from the animals for blood biochemistry evaluations. In experiment 1 - phase I, the results showed that the fish adapted very well to the self-feeding system and had a strictly nocturnal feeding behaviour and locomotor rhythm. When they were submitted to the feeding challenge in phase II, the feed intake was stabilized from the 17th day onwards, proportionally to the nocturnal consumption observed in the first phase, thus demonstrating feeding plasticity. In experiment 2, the feeding times influenced the animals' biochemical parameters. Animals fed during the night had higher values of cholesterol and triglycerides than animals fed during the day. It is concluded that P. hemioliopterus has fast adaptability to a self-feeding system, with strictly nocturnal feeding and locomotor behaviours. However, it has feeding plasticity, adapting its behaviour according to food availability. Blood biochemical parameters are influenced by the light/dark feeding cycle., (© 2023 Fisheries Society of the British Isles.)

Background: β-lapachone (β-lap) is a naphthoquinone widely found in species of vegetables. However, its poor aqueous solubility limits its systemic administration and clinical applications in vivo. To overcome this limitation, several studies have been carried out in order to investigate techniques that can enhance the solubility and dissolution rate of β-lap, such as the use of inclusion complexes with cyclodextrin., Purpose: To evaluate the in vivo effect of β-lap complexed in methyl-β-cyclodextrin (MβCD) on the evolutionary stages of Schistosoma mansoni in a murine model., Methods: The development and characterization of the physicochemical properties of the inclusion complex of β-lap in β-lap:MβCD was prepared by solubility and dissolution tests, FTIR, DSC, X-RD and SEM. The mice were infected and subsequently treated with β-lap:MβCD orally with 50 mg/kg/day and 100 mg/kg/day for 5 consecutive days, starting therapy on the 1 st (skin schistosomula), 14 th (pulmonary schistosomula), 28 th (young worms) and 45 th (adult worms) days after infection. Control groups were also formed; one infected untreated, treated with MβCD, and the other treated with PZQ., Results: The loss of the crystalline form of β-lap in the β-lap:MβCD complex obtained by spray drying was proven through physical-chemical characterization analyses. β-lap:MβCD caused reduction in the number of worms of the 33.56%, 35.7%, 35.45% and 36.45%, when the dose was at 50 mg/kg, and 65.00%, 60.34%, 52.72% and 65.01%, in the dose 100 mg/kg; when treatment was started in the 1 st , 14 th , 28 th and 45 th days after infection, respectively. It was also possible to observe a significant reduction in the number of immature eggs and an increase in the number of ripe and dead eggs and, consequently, a reduction in the damage caused by the egg antigens to the host tissue, where we attributed the reduction in the average diameter of the granulomas to the β-lap., Conclusion: The dissolved content of β-lap:MβCD by spray drying reached almost 100%, serving for future formulations and delineation of the mechanisms of action of β-lap against S. mansoni., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Heart rate biologging has been successfully used to study wildlife responses to natural and human-caused stressors (e.g., hunting, landscape of fear). Although rarely deployed to inform conservation, heart rate biologging may be particularly valuable for assessing success in wildlife reintroductions. We conducted a case study for testing and validating the use of subcutaneous heart rate monitors in eight captive scimitar-horned oryx ( Oryx dammah ), a once-extinct species that is currently being restored to the wild. We evaluated biologger safety and accuracy while collecting long-term baseline data and assessing factors explaining variation in heart rate. None of the biologgers were rejected after implantation, with successful data capture for 16-21 months. Heart rate detection accuracy was high (83%-99%) for six of the individuals with left lateral placement of the biologgers. We excluded data from two individuals with a right lateral placement because accuracies were below 60%. Average heart rate for the six scimitar-horned oryx was 60.3 ± 12.7 bpm, and varied by about 12 bpm between individuals, with a minimum of 31 bpm and a maximum of 188 bpm across individuals. Scimitar-horned oryx displayed distinct circadian rhythms in heart rate and activity. Heart rate and activity were low early in the morning and peaked near dusk. Circadian rhythm in heart rate and activity were relatively unchanged across season, but hourly averages for heart rate and activity were higher in spring and summer, respectively. Variation in hourly heart rate averages was best explained by a combination of activity, hour, astronomical season, ambient temperature, and an interaction term for hour and season. Increases in activity appeared to result in the largest changes in heart rate. We concluded that biologgers are safe and accurate and can be deployed in free-ranging and reintroduced scimitar-horned oryx. In addition to current monitoring practices of reintroduced scimitar-horned oryx, the resulting biologging data could significantly aid in 1) evaluating care and management action prior to release, 2) characterizing different animal personalities and how these might affect reintroduction outcomes for individual animals, and 3) identifying stressors after release to determine their timing, duration, and impact on released animals. Heart rate monitoring in released scimitar-horned oryx may also aid in advancing our knowledge about how desert ungulates adapt to extreme environmental variation in their habitats (e.g., heat, drought)., Competing Interests: Author TL was employed by the company Medtronic Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Leimgruber, Songsasen, Stabach, Horning, Reed, Buk, Harwood, Layman, Mathews, Vance, Marinari, Helmick, Delaski, Ware, Jones, Silva, Laske and Moraes.)

The aim of this study was to evaluate the feeding activity and the rhythm of daily locomotor activity of the convict cichlid (Amatitlania sp.) kept in different social groups under a self-feeding system. A total of 120 animals was distributed among six repetitions of four social groups, as follows: group 1 with one male and one female per tank; group 2 with three males and three females per tank; group 3 with six males per tank; and group 4 with six females per tank. Feeding activity (FA) and locomotor activity (LA) were evaluated using photoelectric presence-sensors connected to automatic feeders. The fish were fed a commercial extruded diet (46% crude protein and 3600 kcal kg -1 of digestible energy). Animal growth was evaluated for all groups. After 30 days of experimentation, the fish stabilized their demands by adjusting their consumption. Amatitlania sp. showed predominantly diurnal FA and LA. All groups showed a peak of activity when the light was turned on and when it was turned off. In summary, FA and LA of Amatitlania sp. are predominantly diurnal and independent of social group. Pairs and groups of males and females together consume less food in relation to groups of one sex or the other due to reproductive behaviour. On the other hand, groups of only males or females consume more food because they lack reproductive stimuli and thus prioritize growth. These results may support good feeding management practices for this ornamental cichlid. Studies relating feeding behaviour with different social groups are of great importance for determining effective feeding strategies for this species in captivity. Thus, such a study assists in a more efficient production of Amatitlania sp., (© 2022 Fisheries Society of the British Isles.)

Objective: The study aimed to assess the effects of mate tea [Ilex paraguariensis] on the redox state and biochemical parameters of salivary glands in diabetic male rats., Design: Twenty-four male Wistar rats (3 months old) were randomly divided into groups (n = 8 per group): control rats that received water (C); diabetic rats that received water (D); diabetic rats treated with mate tea (DMT). The treated streptozotocin-induced diabetic rats were given mate tea powder by intragastric gavage at a dose of 20 mg/kg daily for 28 days. Content of total protein, amylase, oxidative lipid damage, measured as thiobarbituric acid reactive substances (TBARs), oxidative protein damage, measured as protein carbonyl, total antioxidant capacity, uric acid, reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) were examined by the spectrophotometric method in the parotid and submandibular glands., Results: The D group showed lower total protein, amylase, TBARs, protein carbonyl, total antioxidant capacity, GSH, uric acid, and GPx than the C group in both salivary glands, as well as higher SOD and CAT activities. The DMT group showed higher total protein, amylase, total antioxidant capacity, GSH, uric acid, and GPx than the D group in both salivary glands. Moreover, mate tea increased SOD in the parotid gland and CAT in the submandibular gland of diabetic rats but did not influence TBARs and protein carbonyl in either salivary gland compared to D group., Conclusion: Mate tea increased tissue protein synthesis and improved antioxidant defenses in the salivary glands of streptozotocin-induced diabetic male rats., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: to identify spatial clusters corresponding to abandonment of routine vaccines in children., Method: an ecological study, according to data from the 853 municipalities of a Brazilian state. The records analyzed were those of the multidose pentavalent, pneumococcal 10-valent, inactivated poliomyelitis and oral human rotavirus vaccines of 781,489 children aged less than one year old. The spatial scan statistics was used to identify spatial clusters and assess the relative risk based on the vaccination abandonment indicator., Results: the spatial scan statistics detected the presence of statistically significant clusters for abandonment regarding the four vaccines in all the years analyzed. However, the highest number of clusters with high relative risk estimates was identified in 2020. The Vale do Aço and West, North and West, and Southwest regions stand out for the pentavalent, poliomyelitis and rotavirus vaccines, respectively., Conclusion: in an attempt to mitigate the devastating impact of the COVID-19 pandemic, the immunization program experienced setbacks. The presence of clusters points to the need to implement integrated strategies that may involve different sectors for an active search for children and prevent outbreaks of vaccine-preventable diseases in the near future.

Background: Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is known that host microRNAs (miRNAs) can be modulated to favor viral infection or to protect the host. Herein, we report preliminary results of a study aiming at identifying differentially expressed plasmatic miRNAs in Brazilian patients with COVID-19., Methods and Results: miRNAs were extracted from the plasma of eight patients with COVID-19 (four patients with mild COVID-19 and four patients with severe/critical COVID-19) and four healthy controls. Patients and controls were matched for sex and age. miRNA expression levels were detected using high-throughput sequencing. Differential miRNA expression and enrichment analyses were further evaluated. A total of 18 miRNAs were differentially expressed between patients with COVID-19 and controls. miR-4433b-5p, miR-6780b-3p, miR-6883-3p, miR-320b, miR-7111-3p, miR-4755-3p, miR-320c, and miR-6511a-3p were the most important miRNAs significantly involved in the PI3K/AKT, Wnt/β-catenin, and STAT3 signaling pathways. Moreover, 42 miRNAs were differentially expressed between severe/critical and mild patients with COVID-19. miR-451a, miR-101-3p, miR-185-5p, miR-30d-5p, miR-25-3p, miR-342-3p, miR-30e-5p, miR-150-5p, miR-15b-5p, and miR-29c-3p were the most important miRNAs significantly involved in the Wnt/β-catenin, NF-κβ, and STAT3 signaling pathways., Conclusions: If validated by quantitative real-time reverse transcriptase-polymerase chain reaction (RT-PCR) in a larger number of participants, the miRNAs identified in this study might be used as possible biomarkers for the diagnosis and severity of COVID-19., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Competing Interests: Competing interests: None declared.

The nasopharyngeal swab is a gold standard for detecting SARS-CoV-2. However, the inconvenience of this method compelled us to compare its efficiency with saliva and gargle samples, which we collected sequentially from 229 individuals. Saliva outperformed gargle samples, constituting a reliable RNA viral source with similar performance to nasopharyngeal samples., Competing Interests: Declaration of competing interest The authors have no relevant financial or non-financial interests to disclose., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Objective: To analyze the temporal trend of vaccination coverage for hepatitis A, measles, mumps and rubella, and varicella in a Brazilian state from 2014 to 2020., Methods: An ecological, time-series study that considered data from 853 municipalities in the state of Minas Gerais that compose the 14 regions of the state, these being the territorial units of analysis. Records of applied doses of hepatitis A, measles, mumps and rubella, and varicella vaccines registered in the Brazilian Immunization Information System were analyzed. Trends were estimated by Prais-Winsten regression and 95% confidence intervals of measures of variation were calculated., Results: Low vaccine coverage of hepatitis A, measles, mumps and rubella, and varicella was identified. Coverages above 95% were observed only in 2015 for the vaccine against hepatitis A (98.8%) and, in 2016, for varicella (98.4%). The measles, mumps and rubella vaccine showed coverage of less than 95% in all analyzed years. Decreases of 13.6 and 4.3% between the years 2019 and 2020 were identified for the measles, mumps and rubella, and hepatitis A vaccines, respectively. There was a decreasing trend in hepatitis A vaccination coverage in the South (p=0.041), East (p=0.030), and North (p=0.045) regions; and for the measles, mumps and rubella in Jequitinhonha Valley (p=0.002), East (p=0.004), and North (p=0.024) regions. Increasing coverage was observed only for varicella in eight regions of the state., Conclusions: The data point to heterogeneity in the temporal behavior of vaccination coverage in Minas Gerais. The downward trend in some regions causes concern about the possibility of resurgence of diseases, such as measles, which until then had been controlled.