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We measured left atrial size and function from biplane MRI data in 62 adults with thalassemia major. Age-adjusted left atrial ejection fraction was depressed in 7 out of 20 subjects having T2* < 10 ms. Left atrial size, left ventricular size and cardiac output fell with cardiac iron loading, representing increased cardiac or peripheral vascular stiffness.

Bovine genital leptospirosis (BGL) is a silent and chronic reproductive syndrome associated with reproductive failures that result in animal suffering and substantial financial losses for farmers. Important aspects of the interactions between the host and the pathogen during chronic leptospirosis have been well described in the kidney, but little is known about the genital infection mechanisms. The present study sheds light on the pathophysiology of BGL based on comparative genomic analysis of renal versus genital isolates of Leptospira santarosai genomes, an endemic species on Latin America. A significant number of genes were exclusive of the genital strains, with emphasis on genes associated with cell wall/membrane/envelope biogenesis, mobilome: prophages and transposons, and signal transduction mechanisms. Overall, these gene clusters play crucial roles in bacterial colonization and evasion of the immune response, which can reflect leptospiral tissue tropism to the genital niche. We provide new insights into the pathophysiology of an important and neglected syndrome in bovine, helping to elucidate the evolution of adaptation of leptospires in the genital tract of cows.

Abstract Background Coronavirus disease 2019 originated in China and swiftly spread worldwide, posing a significant threat to public health. Caused by SARS-CoV-2, it manifests as a flu-like illness that can escalate to Acute Respiratory Distress Syndrome, potentially resulting in fatalities. In countries where HIV/Leishmania infantum is endemic, the occurrence of concurrent SARS-CoV-2/HIV/Leishmania infantum infections is a reality, prompting inquiries into appropriate clinical management. Case presentation We present the case of a 48-year-old woman who was hospitalized for 36 days across three different hospitals in the state of Pernambuco, Brazil. She was diagnosed with SARS-CoV-2/HIV/L. infantum coinfection. The patient exhibited severe COVID-19 symptoms, including fever, productive cough, and dyspnea. Throughout her hospitalization, she experienced oxygen saturation levels of ≤ 93%, along with fluctuations in blood pressure, respiratory rate, and heart rate. Her blood tests revealed lymphopenia, leukopenia, and neutropenia, while laboratory results indicated abnormal levels of d-dimer, AST, ALT, lactate dehydrogenase, ferritin, and C-reactive protein. A computed tomography scan revealed 75% involvement of the lung parenchyma with patchy ground-glass opacities. Conclusion Against all odds, the patient was discharged. The leukopenia associated with HIV/L. infantum may have played a decisive role. Further studies are necessary to better understand diagnostic strategies and clinical management measures for HIV/L. infantum coinfected patients who are susceptible to SARS-CoV-2 infection.

Introducción: En el presente trabajo se reflexiona críticamente sobre las relaciones entre el teletrabajo y la salud ocupacional en el contexto de la pandemia de COVID-19, con especial énfasis en la región de América Latina. Particularmente, se analizan las implicancias del teletrabajo sobre la salud ocupacional y el síndrome de desgaste profesional. Proposición: Para ello, se revisan conceptos clave, se examinan los resultados de varias investigaciones efectuadas antes y después de la pandemia, y se presentan los aspectos benéficos del teletrabajo, así como sus limitaciones asociadas a diversos factores organizacionales. Argumentos para la discusión: A partir de la pandemia de COVID-19, la modalidad del teletrabajo se ha logrado imponer como régimen laboral para muchas personas, por ende, se requiere profundizar en sus repercusiones sobre la salud de los trabajadores. Conclusiones: El teletrabajo es una herramienta que favorece la flexibilidad, la autonomía y la productividad del trabajador. Sin embargo, deben existir políticas de protección al trabajador que minimicen el riesgo psicosocial y promuevan su salud y bienestar. También resulta necesario seguir estudiando los efectos del teletrabajo sobre la salud ocupacional, principalmente en la región de América Latina.

ABSTRACT Visceral leishmaniasis (VL) is a neglected disease that is typical of tropical and subtropical parts of the world and is caused by the trypanosomatid Leishmania donovani complex. This disease is a multifactorial condition that involves parasitic, environmental, and immunogenetic characteristics. Genetic changes in genes encoding cytokines may be associated with changes in their expression and, consequently, with the development of clinical resistance or susceptibility to the disease. This systematic review and meta-analysis aimed to assess whether single nucleotide polymorphisms (SNPs) in interleukin genes influence the clinical consequences of visceral leishmaniasis infection. To this end, we carried out a systematic review and meta-analysis with structured searches in the EMBASE, PubMed, Scopus, SciELO, and Web of Science databases without time restrictions. Two independent reviewers examined the studies, performed data extraction, and assessed quality by assigning scores. If there were any discrepancies, a third reviewer with more experience was consulted. After the screening process, 28 articles were included in the systematic review and 9 in the final analysis of the meta-analysis. Statistical analyses were carried out using various genetic models. The odds ratio (OR) and corresponding 95% confidence intervals (CIs) were calculated to estimate the associations. Overall, the main clinical outcomes were classified as not associated or associated when they presented susceptibility, resistance, risk, or protective factors for the development of the disease. Associations between IFN-γ +874T/A polymorphisms in the dominant model (OR 1.64, 95% CI 1.13-2.38, I2 = 0%, p < 0.01) and heterozygous model (OR 1.72, 95% CI 1.15-2.57, I2 = 0%, p < 0.01) and IL-18 -137G/C in the recessive model (OR 1.33, 95% CI 1.02-1.71, I2 = 9%, p = 0.03) and VL were observed. For the IL-10 gene SNPs, there was no significant association. Our findings suggest that SNPs in the IFN-γ and IL-18 genes may be associated with the risk of developing VL.

ABSTRACT Objectives Individuals with congenital isolated growth hormone deficiency (IGHD) in Northeastern Brazil have a normal lifespan with a prolonged healthspan. We hypothesize that their increased healthspan is accompanied by a reduced cognitive decline during aging. We have recently shown that these individuals have a similar total cognitive function and better attention and executive function than controls. These data were obtained using a Portuguese version of the Literacy Independent Cognitive Assessment (LICA) instrument, whose translation to facilitate cognitive research in Portuguese-speaking countries is described here. Subjects and methods In the first stage, a psychologist and a psychiatrist translated the LICA instrument from English into Portuguese, and an English teacher proofread the translation. The second stage included its synthesis and cultural adaptation, carried out by Brazilian authors, and changes in some words and images. The third stage involved an evaluation round with two referees (independent psychologists). The fourth stage involved a back translation of the instrument, which demonstrated > 95% agreement with the original version. The fifth stage included a study to verify the understanding of the questionnaire by responders. In the sixth stage, an endocrinologist and a psychiatrist approved the final Portuguese version of the instrument, which was then administered to 15 individuals with IGHD and 15 controls older than 50 years. Results The LICA instrument was applied 59 times (5 times in the pilot study, 24 in the variability studies, and 30 in the experimental step). The interobserver and intraobserver variabilities were 99% and 96%, respectively. Cronbach’s alpha was 0.76, indicating good reliability. The mean (± standard deviation) duration of the application was 39 ± 8.6 and 48.5 ± 5.8 minutes in literate and illiterate individuals, respectively. Conclusion The Portuguese version of the LICA instrument was valuable for the cognitive assessment of individuals with Itabaianinha syndrome.

The multilevel psychosocial stressors associated with COVID-19 pandemic set the stage to investigate risk factors and groups susceptible for non-suicidal self-injury (NSSI). A national sample of 9,929 Brazilian adults aged 36.1 years on average participated in the study. Cross-sectional data were collected in 2020, 2021, 2022, and 2023. NSSI levels were considered high in the total sample (13.2%) when compared to other studies in this context. The variables with the highest explanatory power in the regression models were age, anxiety, and depression. The main risk factors were being younger, living in the South or Southeast regions of Brazil, having lower educational attainment, and having higher rates of anxiety and depression. Respondents had the highest probability of NSSI in 2022. The sustained higher rates of NSSI in 2023 compared to the beginning of the pandemic underscores the need for continuous monitoring and the development of preventive actions for self-injurious behaviors.

Individuals with untreated isolated GH deficiency (IGHD) due to a mutation in the GHRH receptor gene from Itabaianinha Brazil have increased insulin sensitivity, normal life expectancy, and an extended health span, i.e. the period of life free from disabilities. We hypothesize that their prolonged health span is accompanied by a delayed cognitive decline in senescence. To test this hypothesis, we have administered the Literacy-Independent Cognitive Assessment (LICA) to 15 IGHD individuals aged over 50 years and 15 controls matched by age, sex, years of education, and percentage of illiteracy. All individuals were negative for HIV and syphilis serology, and there were no differences in serum levels of folate, vitamin B12 and TSH between the two groups, while free T4 was higher in the IGHD group. IGHD subjects had a higher total LICA score than controls, 215 (22.7) vs 204.2 (18.1), without reaching statistical significance. Scores of memory, visuoconstruction, language and calculation were similar between the two groups, with better attention (9.5 (1.4) vs 8.3 (1.1), P = 0.01) and executive function (38.3 (4.8) vs 35.1 (2.5), P = 0.03) scores in IGHD. MANCOVA revealed that group (but no age) had a significant effect on the LICA variables (partial eta squared of 0.455, power of 0.812, P = 0.02). This effect is verified on attention (partial eta squared 0.216, power of 0.749, P = 0.01) and executive function (partial eta squared 0.154, power of 0.570, P = 0.03. In conclusion, IGHD in senescence is associated with similar total cognitive performance but better attention and executive function than controls.

Visceral leishmaniasis (VL) is a neglected tropical disease that is potentially fatal when untreated. Current diagnostic methods have limitations that contribute to ongoing transmission and poor prognosis. Thus, new tests are needed to provide quick, accurate diagnoses and evaluate clinical progression and treatment efficacy. The monokine induced by interferon-gamma (MIG) and interferon-gamma-inducible protein 10 (IP-10) has been associated with the host susceptibility to VL with potential diagnostic and prognostic purposes. We performed a systematic review using four search databases (Scopus, PubMed, Web of Science, and MEDLINE) to identify studies assessing MIG and IP-10 as potential biomarkers in patients with VL across various clinical conditions. A total of 13 studies were potentially eligible and included in this review. The articles, in general, reveal that the chemokines MIG and IP-10 are elevated in response to infection by Leishmania spp., acting on the host’s resistance to the development of the disease. They are associated with asymptomatic conditions and after VL treatment, and this relationship can be observed in both immunocompetent and immunocompromised individuals. Consequently, these chemokines hold relevance in the diagnoses and appropriate management of individuals with VL.

Resumo Diretivas antecipadas de vontade são instrumentos que buscam garantir antecipadamente o cumprimento dos desejos do paciente em circunstâncias em que ele não consiga se manifestar livremente. Neste trabalho investigou-se a percepção de profissionais de saúde sobre o uso dessa ferramenta em cuidados paliativos, além dos principais dilemas éticos e ganhos ou prejuízos decorrentes de seu uso. Foi realizada entrevista semidirigida com nove profissionais, e os dados foram submetidos à análise de conteúdo. Evidenciaram-se cinco categorias, que apontaram para uma boa receptividade do recurso, por assegurar o exercício da autonomia do paciente, fortalecendo a percepção do cuidado, facilitando as decisões e propiciando conforto psicológico. Por sua vez, as adversidades ou desafios envolveram necessidade de melhor preparo técnico e maior integração da equipe, sobrecarga profissional, insegurança jurídica com eventual uso do instrumento, finitude como tabu e desconhecimento da sociedade acerca do tema.

Abstract Bisphenol F (BPF) is replacing Bisphenol A (BPA) in the manufacture of products due to endocrine-disrupting effects. BPF monomers can also be released into the environment and enter the food chain, resulting in human exposure to low doses. Since bisphenols are primarily metabolized by the liver, this organ is more vulnerable to lower doses of bisphenols than others. Exposure during prenatal development may increase the risk of diseases in adulthood. The aim was to evaluate whether BPF administration could generate oxidative stress in liver of lactating rats, and whether these effects may be also observed in female and male postnatal day 6 (PND6) offspring. Long Evans rats received oral treatment: Control, BPF-low-dose (LBPF) 0.0365 mg/kg b.w./day, and BPF-high-dose (HBPF) 3.65 mg/kg b.w./day. The levels of antioxidant enzymes (CAT, SOD, GR, GPx and GST), glutathione system (GSH, GSSG) and lipid damage markers (MDA, LPO) were measured using colorimetric methods in liver of both lactating dams and in PND6 offspring. Mean values were analyzed using Prism-7. LBPF affected liver defense mechanisms (antioxidant enzymes and glutathione system), increasing ROS levels and producing lipid peroxidation in lactating dams. Similar effects were found in female and male PND6 offspring as a consequence of perinatal exposure.

Background:. Partial phalloplasty flap loss presents an evolving challenge, largely due to the complex demands required for both aesthetics and function. We describe our novel experience using the superficial circumflex iliac perforator (SCIP) propeller flap for neophallus salvage when skin grafting alone provides insufficient soft tissue bulk or coverage. Methods:. We retrospectively reviewed patients who underwent SCIP propeller flap reconstruction after phalloplasty partial flap loss. After suprafascial dissection, superficial circumflex iliac vessel perforator(s) were isolated toward the femoral origin. The flap was rotated 180 degrees and inset into the ventral or distal neophallus depending on the region of flap loss. If glans reconstruction was required, the flap was tubularized before inset. Division and inset were performed at a second stage, followed by subsequent glansplasty, urethral creation, and/or penile implant placement. Results:. SCIP propeller flap reconstruction was performed for four patients after one to six debridements at a mean of 6.5 (range 1.0-19.2) months following the initial phalloplasty. Three patients had lost the ventral phallus due to venous insufficiency, arterial insufficiency, and excessive postoperative swelling, respectively. The fourth patient experienced near-total loss of the glans following penile implant insertion. Division and inset was performed at an average of 7.5 (range 5.0-12.0) weeks after SCIP flap. There were no complications related to SCIP flap viability. Conclusion:. The SCIP propeller flap allows salvage of partial flap loss following phalloplasty by providing thin, pliable soft tissue bulk and skin coverage with minimal donor site morbidity, without the need for microsurgery, allowing progression with subsequent reconstructive stages.

Abstract Background Ocular manifestations of granulomatosis with polyangiitis (GPA) have been reported in a limited number of studies and with largely variable frequency. Here we report on the clinical, diagnostic, and therapeutic features of a cohort of 63 GPA patients, with particular regard to 22 of them with ophthalmic involvement (35%). Methods Clinical manifestations, results of immunological findings, histopathological pictures, imaging data, Birmingham Vasculitis Activity Score, therapeutic regimens, and outcomes were retrospectively analyzed. At diagnosis, in addition to a structured clinical assessment, all patients underwent a comprehensive ophthalmologic examination. Results The most frequently involved organs were kidneys, lungs, ear/nose/throat, and eyes. Ocular manifestations were bilateral in 32%. The three most commonly diagnosed ophthalmologic manifestations were scleritis (36%), retro-orbital pseudotumor or orbital mass (23%), and episcleritis (13%). Ocular and systemic involvement were simultaneously present at onset in 41% of the patients; systemic involvement was followed by ocular lesions in 36%; ocular inflammation was followed by systemic manifestations in 18%; and an orbital mass in the absence of systemic disease characterized 5%. Glucocorticoids plus cyclophosphamide and glucocorticoids plus rituximab were the combined therapies most frequently employed during remission induction and remission maintenance, respectively. Persistent ophthalmologic and extra-ocular remissions were achieved in 77 and 64% of the patients, respectively. One to three systemic relapses were diagnosed in 7 patients (31.8%). At the last follow-up, a visual outcome 20/40 or better in 31 (70%) of 44 eyes was determined. Conclusions The eye was involved in over one third of our patients with GPA. Increased awareness, early diagnosis, and multi-specialty collaboration are critical in achieving a favorable outcome of GPA.

ABSTRACT The Mini-Mental State Examination (MMSE) was created by Marshal Folstein et al. in 1975 as an instrument for brief (5–10 min) assessment of mental status in hospitalized patients. It is considered the most widely used test for standardized cognitive assessment in the clinical setting, especially with the elderly population. It has countless translations in different languages, and according to the different international (PubMed) and regional (SciELO, Redalyc, and Dialnet) scientific databases, it has been widely used by the scientific community. This article describes the historical evolution of the MMSE, highlights its evaluative properties, and provides bibliometric data on its impact on scientific publications, with a special focus on Ibero-America.

Abstract The strategies of academic medical centers arise from core values and missions that aim to provide unmatched clinical care, patient experience, research, education, and training. These missions drive nearly all activities. They should also drive digital health activities – and particularly now given the rapid adoption of digital health, marking one of the great transformations of healthcare; increasing pressures on health systems to provide more cost-effective care; the pandemic-accelerated funding and rise of well-funded new entrants and technology giants that provide more convenient forms of care; and a more favorable regulatory and reimbursement landscape to incorporate digital health approaches. As academic medical centers emerge from a pandemic-related reactionary digital health posture, where pressures to adopt more digital health technologies mount, a broad digital health realignment that leverages the strengths of such centers is required to accomplish their missions.

Bovine leptospirosis is an important disease that affects the reproductive sphere. Due to its high relevance for the bovine production chain in a worldwide scenario, a better understanding of the disease is crucial to reduce its negative impacts. The main agents are strains from the Sejroe serogroup, such as Hardjo and Guaricura, which lead to renal and genital infection. The genital colonization causes a chronic, silent, and subclinical reproductive syndrome, called Bovine Genital Leptospirosis (BGL). Embryonic death, estrus repetition, subfertility, and abortions are the main signs of BGL condition in females. However, although leptospires have been identified in semen, the manifestation of BGL in bulls remains to be clarified. The recommended diagnosis of BGL includes a serologic screening of the herds using the microscopic agglutination test followed by PCR of genital samples (cervicovaginal mucus, uterine fragment, or semen), especially from animals with reproductive failures. After the identification of carriers, control is carried out considering three steps: antimicrobial treatment of the carriers, environmental and reproductive management, and herd vaccination. Systematic testing, quarantine of newly arrived animals, and usage of antimicrobials in semen diluents or embryo culture media are other sanitary approaches that are encouraged to improve the control of the syndrome. Herein we discuss protocols for an efficient diagnosis and preventive procedures of BGL, which are fundamental to reducing the negative impact of the disease on cattle reproduction and its consequent economic hazards.

O objetivo desse artigo é uma autorreflexão. Trata-se de descrever e estabelecer um olhar crítico retrospectivo, sobre a minha própria formação teatral realizada entre os anos de 1982 e 1989, na Escola de Teatro da UNI-RIO no Rio de Janeiro. Parto da premissa que passados 30 anos do início desses estudos universitários, eu seja capaz de revisitar essa formação para diretores em artes cênicas, desde o lugar ocupado (ou não) pela tradução de textos teatrais estrangeiros trabalhados por nós. Trata-se da construção de uma autocritica acerca do padrão formativo que foi dispensado não somente a mim, mas a uma boa geração de formandos desse estabelecimento de ensino público e outros similares Brasil afora, concluindo com uma reflexão pessoal sobre a tradução de textos teatrais.

Rotary friction welding produces joints by inserting wood dowels, with a specific rotation and feed rate, into pre-drilled holes made in wood substrates. Studies on the welding of fast-growing eucalypts from Brazilian planted forests are recent. Therefore, this research aimed to evaluate the macro and microstructural and thermochemical changes at the dowel/substrate interface of eucalypts welded joints from Brazilian planted forests and to determine the mechanical strength of two-piece eucalypts welded joints. Specimens formed by eucalypts dowels and substrates were produced. Subsequently, visual evaluation and scanning electron microscopy, attenuated total reflectance-Fourier transform infrared spectroscopy, X-ray diffraction, thermogravimetric, differential scanning calorimetry and tensile tests were performed. The results reveal that the rotary friction welding parameters adopted contribute to the densification of the welded interface and the formation of a structure responsible for joining the dowel and the substrate, providing mechanical strength to the joint. The cellulose crystallinity index and the apparent crystallite size of the eucalypts welded sample increase due to thermal degradation of amorphous components. The rupture of the welded joints is ductile and their average strength is 2,1 MPa. Welded joints of fast-growing eucalypts, from Brazilian planted forests, are suitable when the rotary friction welding parameters are similar to those used for eucalypts woods from Australian forests.

Neste trabalho são apresentadas as características e a resistência ao cisalhamento das interfaces soldadas por fricção rotativa (SFR) de cavilhas de madeira de itaúba em substratos de madeira de pinus. Os corpos de prova são compostos por cavilhas de itaúba e substratos de pinus, nos quais foram usinados pré-furos usando duas relações de diâmetro cavilha/pré-furo: 1,25 e 1,11. Após a SFR, as uniões soldadas foram submetidas a ensaios mecânicos de extração das cavilhas, a fim de se determinar a tensão de cisalhamento na ruptura. A macro e a microestrutura da interface soldada foram avaliadas visualmente e por microscopia eletrônica de varredura (MEV). Os resultados mostram que: a tensão de cisalhamento média na ruptura, para as relações diâmetro cavilha/pré-furo de 1,25 e 1,11, são de 2,41 e 1,77 MPa, respectivamente, indicando que, para as madeiras estudadas, a relação diâmetro cavilha/pré-furo de 1,25 apresenta ligações soldadas mais resistentes; a SFR ocasiona o escurecimento da interface de soldagem; o pré-furo e a cavilha, originalmente cilíndricos, assumem um formato cônico, durante o processo de SFR; a interface entre as madeiras de pinus e de itaúba é homogênea e bem soldada.

The COVID-19 pandemic has significantly impacted food security for the people due to the imposition of stringent measures to halt the spread of COVID-19 transmission. This study aimed to measure the community’s perception of the level of COVID-19 impacts on their food security and to identify the community’s participation in forest management around the Forest Management Unit (FMU) in Sook, Keningau District of Sabah, to improve their livelihood. A mixed-method approach was conducted where a total of 122 respondents were sampled using a questionnaire survey, focus group discussion with communities, and expert interviews to gather more valuable data. The result showed that the communities were primarily involved in forest management through employment, empowerment, capacity building, and decision-making, which could indirectly contribute to their food security. Meanwhile, the impacts of the COVID-19 transmission were found to moderately affect the people who live inside or adjacent to the forest. The impacts could be explained based on eight themes as the outcome of Principal Component Analysis (PCA): market access, food storage and safety, resource availability, adequate nutrition, food aid, affordability, continuous food supply, and food adaptation to shock. Communities were mainly involved in agricultural practices and could obtain resources from the forest to supplement their daily need. The communities raise a prominent issue regarding land tenure that needs to be resolved; thus, it is suggested that imperative action be considered to create a balance between conservation, economy, and social responsibilities.

Introducción: Los sucesos estresantes extraordinarios se consideran eventos de gran relevancia en la vida de las personas por los cambios que acarrean y porque se asocian con diversas patologías físicas y mentales. Objetivo: Analizar las propiedades psicométricas de la Escala de Sucesos Estresantes Extraordinarios de JF Labrador en profesores de la provincia de Caylloma, ubicada en la región Arequipa, al sur de Perú. Métodos: Se realizó un estudio de tipo instrumental con 169 profesores de la provincia de Caylloma (37,3 % varones y 62,7 % mujeres), a quienes se les aplicó la ficha de datos sociodemográficos y la Escala de Sucesos Estresantes Extraordinarios mediante una aplicación de Google forms. Resultados: Se encontró que la prueba cuenta con validez de constructo obtenida mediante el análisis factorial exploratorio, con una estructura bifactorial. Estos factores se denominaron estresores debidos a cambios en el entorno y estresores provocados por problemas en las relaciones interpersonales, que obtuvieron óptimos índices de confiabilidad mediante la prueba Omega de McDonald y la prueba Alfa de Cronbach. Conclusión: Se concluye que la Escala de Sucesos Estresantes Extraordinarios posee adecuados índices de validez y confiabilidad en los profesores de Caylloma, por tanto, se recomienda su uso para evaluar el estrés. Introduction: Extraordinary stressful events are considered events of great relevance in people's lives because of the changes that they bring about and because they are associated with various physical and mental illnesses. Objective: To analyze the psychometric properties of the JF Labrador’s Extraordinary Stress Events scale in professors from the Caylloma Province, located in the Arequipa Region, southern Peru. Methods: An instrumental study was carried out with 169 professors from the Caylloma Province (37.3% were males and 62.7% were females), to whom the sociodemographic data sheet and the Extraordinary Stress Events scale were applied through a Google Forms application. Results: The test was found to have construct validity obtained through exploratory factor analysis, with a bifactor structure. These factors were called stressors due to changes in the environment and stressors caused by problems in interpersonal relationships, which obtained optimal reliability indexes by means of the McDonald's omega and the Cronbach's alpha tests. Conclusion: The Extraordinary Stress Events scale has been concluded to have adequate validity and reliability indexes in Caylloma teachers; therefore, its use is recommended to evaluate stress.

Rotary friction welding technique is a promising alternative of joining dowel-laminated timber (DLT) and dowelled cross-laminated timber (DCLT), without any adhesive. Studies on the welding of Brazilian woods are few and recent, mainly when determining the optimal welding parameters. Therefore, an exploratory study was carried out to evaluate the influence of pre-drilling hole and dowel feed rate on the welded surface strength of pine (Pinus taeda) and itauba (Mezilaurus itauba) joints, determining optimal welding parameters for these woods. The study was complemented with a macrostructural analysis of welded specimens and the determination of the taper rate of itauba dowels, to comprehend the mechanical performance of these welded joints. The specimens comprised itauba dowels, 10 mm in diameter, welded at a rotation of 1000 rpm and feed rates of 100, 300, 400 and 500 mm/min, into single-stage (8 mm in diameter) and two-stage (8 and 7 mm in diameter) pre-drilled holes, made in pine substrates. They were subjected to tensile tests and to macrostructure analysis. The results revealed that two-stage pre-drilled holes contributed to improving the mechanical strength of these welded joints. Feed rates higher than 100 mm/min avoid excessive wear and charring of the dowels, while feed rates lower than 500 mm/min prevent dowel splintering. The optimal welding parameters for pine joints welded with itauba dowels are two-stage pre-drilled holes and a feed rate of 400 mm/min.

Neste ensaio, procuramos introduzir uma tentativa de resposta à pergunta: Por que o teatro viaja, e para que o teatro viaja? Nossa hipótese é que o teatro viaja desde sempre. E o motivo da viagem está associado a uma busca de reconhecimento e gratificação. Sugerimos algumas pistas oriundas da mitologia do próprio teatro para tentar explicitar a condição deste nomadismo teatral que nos chega até os dias de hoje em condições diferentes.

A hospitalização, essencial para recuperação da saúde, costuma ampliar o sofrimento psíquico dos pacientes, na medida em que impõe uma rotina de cuidados, afasta o paciente da família e do meio social. O objetivo deste estudo é apresentar a compreensão psicodramática desse contexto e possibilidades de intervenção. Foi realizada uma articulação teórica com a experiência psicoterapêutica de enfoque psicodramático. Observou-se que a existência de conservas culturais hospitalares e limitações impostas pelo adoecimento gera perda da espontaneidade e cristalização no papel de doente, aumentando o sofrimento e prejudicando a recuperação do indivíduo. O estabelecimento de uma relação télica e o uso de técnicas psicodramáticas mostraram-se relevantes no resgate da espontaneidade e na promoção da saúde mental dos pacientes.

Asymptomatic Leishmania infantum, when associated with HIV, can become severe and potentially fatal. In this co-infection, the worst prognosis may be influenced by the host’s immunological aspects, which are crucial in determining susceptibility. Chemokines play an important role in this process by influencing the cellular composition at affected sites and impacting the disease’s outcome. Therefore, the aim of this study was to evaluate proinflammatory chemokines in HIV patients with the asymptomatic L. infantum infection. In this cross-sectional study, the levels of CCL2, CCL5, CXCL8, MIG, and IP-10 were measured in 160 serum samples from co-infected patients (n = 53), patients with HIV (n = 90), and negative controls (n = 17). Quantification was determined by flow cytometry. The obtained data were statistically analyzed using the Kruskal–Wallis test, followed by the Dunn’s post-test and the Spearman’s correlation coefficient. Significance was set at p < 0.05. The chemokines CCL2, CCL5, MIG, and IP-10 exhibited higher levels in the HIV group compared to co-infection. However, the elevated levels of all these chemokines and their increased connectivity in co-infected patients appear to be important in identifying proinflammatory immune responses associated with the asymptomatic condition. Furthermore, a weak negative correlation was observed between higher levels of CXCL8 and lower viral loads in co-infected patients.

Endoscopic submucosal dissection (ESD) was developed for the removal of benign and early malignant lesions in the gastrointestinal tract. We aimed to evaluate the performance and safety of a novel high-pressure waterjet-assisted ESD knife in colorectal applications. Six female German Landrace pigs with an average weight of 62 kg (range 60–65 kg) were used in this prospective, randomized, and controlled study. Twenty-four ESDs were performed by three endoscopists: Twelve each with the new Erbe HYBRIDknife® flex T-Type (HK-T) and the Olympus DualKnife® J (DK-J), including six rectal and six colonic ESDs per instrument. The order of performance was randomized regarding anatomic position and instrument. As the primary endpoint, ESD knife performance characteristics were combined and rated on a 5-point Likert scale, with 5 Likert points (LP) representing the best response (5 = very good). The HK-T was rated significantly better than the DK-J (4.7 LP versus 4.4 LP, p = 0.0295), mainly because of HK-T injection ability (5 LP versus 3 LP, p < 0.0001) and hemostasis (5 LP versus 4 LP, p = 0.0452). There was no difference in procedure time (HK-T: 35 min versus DK-J: 34 min, p = 0.8005), resection diameter (3.1 cm versus 2.8 cm, p = 0.3492), injection volume (41 mL versus 46 mL, p = 0.5633), and complication rates. HK-T is as effective as DK-J in colorectal ESD in terms of dissection quality but has better injection and hemostatic properties. The impact of these technical advantages on the ESD treatment of patients with large superficial colorectal lesions remains to be clinically verified.

Background: Bovine leptospirosis is an important reproductive disease and abortion is a major sign, leading to economic impacts. Due to its multifactorial etiology, the proper diagnosis of the cause of the abortion is crucial. Necropsy of the fetuses followed by molecular analysis is recommended for diagnosis, and the investigation mainly occurs in the kidneys and liver. This study aimed to analyze unconventional sites for the presence of leptospiral DNA in bovine anicteric aborted fetuses. Methods: Five fetuses of the same herd were received for necropsy and diagnosis. Conventional lipL32-PCR was performed in the fetuses’ kidneys, livers, lungs, hearts, spleens, subcapsular kidney content, abomasal fluid, and in the cavity’s hemorrhagic contents. To complete the investigation, the sera of 30 cows of the herd were collected to perform the serologic screening by Microscopic Agglutination Test. In addition, six subfertile non-pregnant cows from the same herd were selected due to their low reproductive performance, and genital samples (uterine fragment and cervicovaginal mucus) and urine were collected for lipL32-PCR. PCR-positive samples were submitted to a nested PCR of the secY gene and intended for sequencing. Results: The herd presented seroreactive animals (11/30, 36.6%), all against the Sejroe serogroup, with titers between 200 and 1600. In necropsy, four fetuses showed hemorrhagic and anicteric lesions, while one fetus had no macroscopic lesions. Regarding molecular analysis, all the fetuses were positive in lipL32-PCR and the positive sites were the heart, lungs, subcapsular kidney content, thymus, kidneys, liver, and abomasal fluid. Only one fetus presented positive results in the kidney and liver, while three fetuses were positive in the abomasal fluid. Five of six cows were positive for lipL32-PCR, all being positive only in genital samples. Of the fetuses and the cows, seven sequences were obtained and all were identified as Leptospira interrogans serogroup Sejroe serovar Hardjoprajitno. Conclusions: In order to improve the diagnosis of leptospirosis in cows, it is recommended to perform a comprehensive analysis of the samples, beyond the kidneys and liver. Thus, we highly encourage testing multiple organs by PCR to investigate abortions suspected of bovine leptospirosis, particularly in anicteric fetuses.

Canine leptospirosis is a bacterial disease caused by spirochetes of the genus Leptospira. Infections can vary from asymptomatic and chronic infections to clinical acute diseases. The disease is endemic in tropical areas, such as Latin American countries, but a broad understanding of the dynamics of circulation of strains, based on molecular data, has not yet been performed. Based on in silico analyses, the present study aims to analyze the genetic diversity and circulation patterns of haplotypes from pathogenic leptospires infecting dogs in Latin America. DNA sequences were obtained from GenBank platform, curated, and aligned. Genetic distances were calculated, and a maximum likelihood tree and haplotype network were constructed. According to the inclusion criteria adopted, a total of 148 sequences were identified. Most of the records were from Brazil, including sequences from L. interrogans serogroup Icterohaemorrhagiae. Phylogenetic analysis showed a genetically closely related cluster, consisting of a larger haplogroup that includes the reference strain Fiocruz L1-130, known to be the major circulating strain in humans. Moreover, no genetic variations were observed according to clinical history and/or geographical localization. We described the molecular epidemiology of leptospires circulating among dogs in Latin America and demonstrated a very genetically homogeneous group, elucidating its ubiquitous circulation pattern and drawing attention to the important role of dogs in the One Health transmission dynamics of leptospirosis.

Este estudio cualitativo (documental y empírico) se aboca a la enseñanza de la investigación educativa en las instituciones que forman maestros o profesores de educación básica en el Perú. Específicamente, y en el marco de los cursos de metodología de la investigación (CMI) se estudiaron: los sílabos (programas); los perfiles profesionales de los profesores (hojas de vida); y, los manuales o textos que se emplean. Asimismo, se analizaron las revistas de investigación educacional y, de manera complementaria se realizaron entrevistas a profesores de estas materias. Los resultados develan la existencia de prejuicios positivistas (que impiden la incorporación de métodos y técnicas cualitativas), la enseñanza guiada por manuales que transmiten una idea estereotipada e incompleta con respecto a la investigación y la escasa experiencia de los profesores de los CMI en despliegues investigativos en el campo de las ciencias de la educación. En este contexto, las entrevistas develaron un elevado interés por investigar y publicar artículos en revistas científicas por parte de los profesores de los CMI que no contaban con la experiencia suficiente. De todos modos, es probable que las dificultades (no presentes en dos universidades asociativas de elevado prestigio) nos remitan a factores más estructurales asociados a la escasa comprensión de lo que realmente implica la investigación formativa y el desarrollo de una adecuada cultura científica en los centros que forman a los maestros de educación básica.

BackgroundVisceral leishmaniasis (VL) remains an important infectious disease worldwide. VL-HIV coinfected individuals can present with atypical clinical forms of VL and have a high risk of VL relapse. Some cytokines have been described as potential markers to diagnose active VL and to predict the severity of the cases. However, few studies have included VL-HIV coinfected patients. We aimed to characterize the levels of several cytokines among VL-HIV coinfected individuals living in a VL-endemic area in Northeast Brazil.MethodsThis was a retrospective, cross-sectional study, aiming to estimate the levels of various cytokines in symptomatic and asymptomatic VL-HIV coinfected individuals. There were 134 study participants (35 symptomatic VL-HIV, 75 asymptomatic VL-HIV, and 24 healthy controls), all ≥ 18 years-old. Serum cytokine levels (interferon-γ, tumor necrosis factor, and interleukins 2, 4, 6, 10, and 17A) were quantified using the Becton Dickinson-BD's Cytometric Bead Array (CBA) system.ResultsThe population mainly consisted of men (64.9%), with a median age of 35 (27-41) years. Asymptomatic individuals were younger (p = 0.013), with more years of education (p < 0.001), and were more often on antiretroviral therapy (p < 0.001) than those in the symptomatic group. Hemoglobin levels (p < 0.001), lymphocytes (p < 0.001) and CD4 count (p < 0.001) were lower in symptomatic individuals, while HIV viral loads were higher (p < 0.001). In the symptomatic VL-HIV coinfected group, we observed increased serum levels of IL-17A, IL-6, and IL-10 compared to asymptomatic patients and the healthy controls. There were no differences in the levels of all cytokines between asymptomatic VL-HIV coinfected individuals and the healthy controls.ConclusionsHigher serum levels of IL-17A, IL-6, and IL-10 cytokines were observed in symptomatic coinfected individuals but not in asymptomatically infected individuals. More studies among HIV-positive persons are needed to better understand the role of serum cytokines for prognosis, to define cure and predict VL relapses in VL-HIV coinfected individuals.

Background and study aims Indeterminate biliary strictures represent a major challenge in clinical diagnostics. Diagnostic yield of radiological, endoscopic imaging and histopathological diagnosis is insufficient. The cryobiopsy technique is a new method for tissue extraction already used in different clinical settings. The aim of this ex vivo clinical study was to investigate feasibility and tissue quality of cryobiopsy in the bile duct. Patients and methods We included 14 patients who underwent pancreaticoduodenectomy. Bile duct samples were taken with either a new prototype cryoprobe or one of two forceps types. Results were analyzed for general feasibility, specimen size, histological assessability as well as representativity of retrieved tissue. Results Feasibility of cholangioscopic forceps was poor compared to gastric biopsy forceps or cryobiopsy. Significantly larger tissue samples were obtained with cryobiopsy (5.6 ± 4.5 mm2) compared to gastric biopsy forceps (3.3 ± 5.1 mm2, P = 0.006). Furthermore, cryobiopsy was superior in histological assessment quality (P = 0.02) and concerning representativity (P = 0.03). Conclusions Cryobiopsy in the bile duct is feasible and the quality of the obtained tissue is high. Further investigation of bile duct cryobiopsy in vivo is warranted.

A residência multiprofissional qualifica profissionais para o serviço na saúde pública, mas o tipo de atuação e os desafios podem gerar impacto à saúde mental, desde sintomas ansiosos e depressivos a transtornos mentais. O objetivo deste trabalho foi apresentar uma estratégia de intervenção sociodramática com residentes de um hospital universitário. Realizou-se uma reflexão a partir da interlocução entre um relato de experiência e da literatura. Durante a intervenção, os residentes mostraram-se receptivos à proposta sociodramática e relataram experiências de crescimento pessoal, acolhimento e fortalecimento do vínculo entre os colegas. Com isso, evidencia-se o potencial de promoção de saúde do sociodrama no contexto hospitalar, alinhado à Política Nacional de Humanização, ao propiciar acolhimento, crescimento pessoal e relações de trabalho mais harmônicas.

Dada sua importância na medicina veterinária e seu impacto na saúde humana, a tuberculose bovina exige atenção em programas de saúde animal em vários países. Novos protocolos de diagnóstico ante e post mortem estão disponíveis e facilitam a detecção e controle de doenças. No entanto, além das vantagens e desvantagens conhecidas de cada protocolo, há pouca menção sobre seus custos. Este estudo pretende fornecer uma visão geral sobre os aspectos econômicos dos testes de diagnóstico para controle e erradicação da tuberculose bovina.