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Background: Vectorial transmission through hematophagous triatomine insects remains the primary mode of Chagas Disease contagion. These insects have become increasingly common in urban environments. Therefore, this study aimed to report an encounter of triatomines with trypanosomatid infection in a vertical residential condominium in Rio Branco, the capital of the state of Acre, in the western Brazilian Amazon., Methods: Triatomines were collected from residents and sent to the municipality's Entomological Surveillance sector. Trypanosomatid positivity was evaluated using optical microscopy, followed by species and genotype identification using molecular biology techniques., Results: Twenty-five adult triatomine specimens were collected from two of three condominium buildings invading apartments from the 2nd to 13th floors. Six specimens were identified as Rhodnius sp. and 19 as R. montenegrensis. Among these, molecular tests were conducted on seven specimens, with five testing positive for Trypanosoma cruzi, all belonging to genotype TcI., Conclusions: These findings underscore the need for further studies to better understand the invasive capacity of these insects in these environments and the mechanisms involved in this process.

Competing Interests: None to declare.

This study assessed the feasibility of pulmonary telerehabilitation‧s (PTR) acceptability, implementation, practicality, and adaptation for people with Chronic Obstructive Pulmonary Disease (COPD) in Brazil. It also explored associations with clinical and socioeconomic features of Brazilians with COPD. This mixed-method study included thirty-one participants with COPD (age 62±10 years; FEV 1 = 72±14% predicted). Most participants (74.2%) reported good PTR session acceptability on the System Usability Scale and scores of 4.6±0.3 and 4.5±0.6 on a 1-5 Likert-type scale of implementation and practicality, respectively. Participants suggested adaptations for better comfort on the exercise bike and varying exercise modalities. PTR acceptability was associated with participants' younger age (r s =-0.57, p<0.01) and higher education (r s =0.51, p<0.01). PTR is feasible for people with COPD in Brazil regarding acceptability, implementation, practicality, and adaptation. Younger age and higher educational level are associated with greater PTR acceptability., Competing Interests: The authors declare no competing financial interests or personal relationships related to or influencing the work reported in this paper., (Copyright © 2023 Luis H. G. Neves, Carla Malaguti, Marissa R. Santos, Laura A. Cabral, Laura B. D. da Silva, Hugo H. de Oliveira, Alessa S. S. Brugiolo, Anderson José, Anne E. Holland, Cristino C. Oliveira.)

For the purpose of renewable materials applications, Curauá fiber treated with 5% sodium hydroxide was added to high-density biopolyethylene, using an entirely Brazilian raw material of sugarcane ethanol. Polyethylene grafted with maleic anhydride was used as a compatibilizer. With the addition of curauá fiber, the crystallinity was reduced, possibly due to interactions in the crystalline matrix. A positive thermal resistance effect was observed for the maximum degradation temperatures of the biocomposites. When curauá fiber was added (5% by weight), the morphology showed interfacial adhesion, greater energy storage and damping capacity. Although curauá fiber additions did not affect the yield strength of high-density bio polyethylene, its fracture toughness improved. With the addition of curauá fiber (5% by weight), the fracture strain was greatly reduced to about 52%, the impact strength was also reduced, suggesting a reinforcing effect. Concomitantly, the modulus and the maximum bending stress, as well as the Shore D hardness of the curauá fiber biocomposites (at 3 and 5% by weight), were improved. Two important aspects of product viability were achieved. First, there was no change in processability and, second, with the addition of small amounts of curauá fiber, there was a gain in the specific properties of the biopolymer. The resulting synergies can help ensure more sustainable and environmentally friendly manufacturing of automotive products.

Bacterial acquisition of metals from a host is an essential attribute to facilitate survival and colonization within an infected organism. Staphylococcus aureus , a bacterial pathogen of medical importance, has evolved its strategies to acquire multiple metals, including iron, manganese, and zinc. Other important strategies for the colonization and infection of the host have been reported for staphylococci and include the expression of adhesins on the bacterial surface, as well as the acquisition of host plasminogen and complement regulatory proteins. Here we assess the ability of the zinc transport protein AdcA from Staphylococcus aureus , first characterized elsewhere as a zinc-binding protein of the ABC (ATP-binding cassette) transporters, to bind to host molecules. Like other staphylococcus ion-scavenging proteins, such as MntC, a manganese-binding protein, AdcA interacts with human plasminogen. Once activated, plasmin bound to AdcA cleaves fibrinogen and vitronectin. In addition, AdcA interacts with the human negative complement regulator factor H (FH). Plasminogen and FH have been shown to bind to distinct sites on the AdcA C-terminal portion. In conclusion, our in vitro data pave the way for future studies addressing the relevance of AdcA interactions with host molecules in vivo.

Objective: To test the effect of interventions to chronic low back pain developed by nurses in the Program to Increase Self-efficacy and Reduce the Fear of Pain and Avoidance of Movement., Method: Clinical trial, with 81 patients, carried out in 2016, at the Pain Outpatient Clinic in São Luís, Maranhão, Brazil. The groups received: A (education and exposure), B (education) and C (control). Chi-square, Fisher's Exact, ANOVA and Kruskal Wallis tests were performed., Results: Patients in groups A and B improved self-efficacy, anxiety, depression, and disability, compared to group C. The reduction in fear of pain and avoidance of movement was greater in Group A, which also showed a decrease in current pain and overall scores compared to Group B and C., Conclusion: Education was effective in increasing the Self-Efficacy Belief. For the Belief of Fear of Pain and Avoidance of Movement and pain intensity, the association with exposure showed better results.

Competing Interests: None to declare.

Objectives: This observational, cross-sectional study based aimed to test whether heart failure (HF)-disease management program (DMP) components are influencing care and clinical decision-making in Brazil., Methods: The survey respondents were cardiologists recommended by experts in the field and invited to participate in the survey via printed form or email. The survey consisted of 29 questions addressing site demographics, public versus private infrastructure, HF baseline data of patients, clinical management of HF, performance indicators, and perceptions about HF treatment., Results: Data were obtained from 98 centers (58% public and 42% private practice) distributed across Brazil. Public HF-DMPs compared to private HF-DMP were associated with a higher percentage of HF-DMP-dedicated services (79% vs 24%; OR: 12, 95% CI: 94-34), multidisciplinary HF (MHF)-DMP [84% vs 65%; OR: 3; 95% CI: 1-8), HF educational programs (49% vs 18%; OR: 4; 95% CI: 1-2), written instructions before hospital discharge (83% vs 76%; OR: 1; 95% CI: 0-5), rehabilitation (69% vs 39%; OR: 3; 95% CI: 1-9), monitoring (44% vs 29%; OR: 2; 95% CI: 1-5), guideline-directed medical therapy-HF use (94% vs 85%; OR: 3; 95% CI: 0-15), and less B-type natriuretic peptide (BNP) dosage (73% vs 88%; OR: 3; 95% CI: 1-9), and key performance indicators (37% vs 60%; OR: 3; 95% CI: 1-7). In comparison to non- MHF-DMP, MHF-DMP was associated with more educational initiatives (42% vs 6%; OR: 12; 95% CI: 1-97), written instructions (83% vs 68%; OR: 2: 95% CI: 1-7), rehabilitation (69% vs 17%; OR: 11; 95% CI: 3-44), monitoring (47% vs 6%; OR: 14; 95% CI: 2-115), GDMT-HF (92% vs 83%; OR: 3; 95% CI: 0-15). In addition, there were less use of BNP as a biomarker (70% vs 84%; OR: 2; 95% CI: 1-8) and key performance indicators (35% vs 51%; OR: 2; 95% CI: 91,6) in the non-MHF group. Physicians considered changing or introducing new medications mostly when patients were hospitalized or when observing worsening disease and/or symptoms. Adherence to drug treatment and non-drug treatment factors were the greatest medical problems associated with HF treatment., Conclusion: HF-DMPs are highly heterogeneous. New strategies for HF care should consider the present study highlights and clinical decision-making processes to improve HF patient care.

Preoperative evaluation in elective surgeries has been associated with successful surgical treatment. However, there is no solid scientific evidence that screening for coronary artery disease (CAD) reduces surgical risk. The aims of this study were to describe the frequency of inappropriate investigation of obstructive CAD induced by pre-anesthetic assessment in individuals without cardiovascular symptoms (candidates for low- to intermediate-risk surgeries) and to evaluate predictors of this conduct. We performed a retrospective evaluation of medical records of anesthesiology services from patients undergoing pre-anesthesia assessment between May 2015 and May 2016, including those with functional capacity ≥4 metabolic equivalents without a diagnosis of heart disease. A total of 778 medical records (47±16 years of age, 62.6% female) were studied. A private hospital performed 50.1% of the surgeries and 60.4% were of intermediate risk. Only 2.7% (95%CI: 1.7-4.1%) were screened for CAD, and 91% of these requests were mediated by cardiology consultations performed during pre-anesthetic testing visits. Factors associated with screening for CAD were hypertension, diabetes, moderate systemic disease (ASA III), cardiac consultation, previous diagnosis of CAD, and admission to a private hospital. Independent predictors were private hospitals (OR: 3.9; 95%CI: 1.3-11.0), ASA III (OR: 5.3; 95%CI: 1.7-16.2), and hypertension (OR: 3.8; 95%CI: 1.5-9.8). The frequency of inappropriate requests for CAD screening in asymptomatic individuals without untreated systemic diseases was low in pre-anesthetic visits. Although infrequent, screening for CAD is more common in the private setting, in patients with poorer health status, and is usually prescribed during cardiology consultation.

Objectives: to analyze the knowledge of health professionals on the health policies for the riverside population; identify how health practices with this group are developed; and discuss facilitators and barriers for the implementation of these policies., Methods: qualitative and descriptive study with 24 professionals from the Riverside Family Health Strategy Teams in the city of Belém-Pará. Data were collected in individual interviews and analyzed by Content Analysis., Results: although professionals demonstrate knowledge about public health policies, there is a need to expand and strengthen knowledge about health policies for the riverside population. The activities directed to the communities took place in the Unit itself, and some did not occur due to insufficient material and human resources., Final Considerations: the greatest barrier for the organization of health care is the lack of material and human resources, and the most prominent facilitator was the union and cohesion of the health team.

Objective: to understand the perception of users of a Specialized Care Service (SAE- Serviço de Assistência Especializada) in HIV/AIDS about their oral health., Method: qualitative research that used the techniques of participant observation and focal group. For the analysis of the material produced, categories of analysis, construction of dialogical map and identification of linguistic repertoires were used., Results: impacts arising from oral health problems such as: inability to eat properly, feeling ashamed due to tooth loss, inability to perform physical exercises and, as the main barrier to access to dental treatment, fear of exposure to practices of discrimination and prejudice., Final Considerations: we need the implementation of policies of Permanent Education to all professionals involved in the care for this population, to ensure users' rights, ensure qualified care, and create security and trust relationships with individuals living with HIV/AIDS, in access to services.

Objective: to analyze the health professionals' perception about counseling in a Centro de Testagem e Aconselhamento em Infecções Sexualmente Transmissíveis (Center for Testing and Counseling in Sexually Transmitted Infections (STIs) and AIDS) in Maceió, Alagoas., Method: it is a qualitative research, with theoretical framework of the Discursive Practices and Production of Senses in the daily life carried out with the participation of 6 counselors. For research material production, the 'Conversation Round' technique and the semi-structured script were used. For material treatment the Discourse Analysis method was used, resulting in the production of analysis categories and Dialogic Maps., Results: in the current policies and actions of STI/AIDS, there is centralization in the procedures of anti-HIV testing and displacement of the professional counselor, undoing the testing and counseling., Final Considerations: the study indicates the need to overcome the instrumental and prescriptive models of counseling to produce a dialogical process of care and co-responsibility.