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Matheus Aparecido dos Santos Ramos,1 Giovana Calixto,2 Luciani Gaspar de Toledo,3 Bruna Vidal Bonifácio,1 Lourdes Campaner dos Santos,4 Margarete Teresa Gottardo de Almeida,3 Marlus Chorilli,2 Taís Maria Bauab1 1Department of Biological Sciences, School of Pharmaceutical Sciences, 2Department of Drugs and Medicine, School of Pharmaceutical Sciences, São Paulo State University, Araraquara, 3Department of Infectious Diseases, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto, 4Department of Organic Chemistry, Chemistry Institute, São Paulo State University, Araraquara, São Paulo, Brazil Abstract: Vaginal infections caused by Candida krusei are a problem of extreme complexity due to the intrinsic resistance to azole drugs. The species Syngonanthus nitens (Bong.) Ruhland is a plant of the Eriocaulaceae family that has demonstrated promising antifungal activity. In phyto-formulation research, liquid crystal precursor mucoadhesive systems (LCPM) stand out as drug delivery systems for vaginal administration because they increase the activity and overcome the problems associated with plant-based medicines. Therefore, the objective of this study was to evaluate the potential of the methanolic extract of scapes of S. nitens (S. nitens extract [SNE]) and an SNE-loaded LCPM against C. krusei as prophylaxis for vulvovaginal candidiasis. LCPM formulation developed consisted of oleic acid as the oil phase (50% w/w), polyoxypropylene (5) polyoxyethylene (20) cetyl alcohol (40% w/w) as the surfactant and a polymeric dispersion containing 2.5% Carbopol® 974P and 2.5% polycarbophil (10% w/w) as the aqueous phase. LCPM formulation developed was characterized using polarized light microscopy, rheological analysis, and in vitro mucoadhesive studies. Different strains of C. krusei, including one standard strain (American Type Culture Collection 6258) and three clinically isolated strains from the vaginal region (CKV1, 2, and 3), were used to determine the minimum inhibitory concentration, inhibition of biofilms, and time kill. The in vivo prophylaxis assay was performed using the standard strain (American Type Culture Collection 6258). The analyses of F by polarized light microscopy and rheology showed isotropy; however, the addition of 100% artificial vaginal mucus (F100) made it more viscous and anisotropic. Moreover, the mucoadhesive strength was modified, which makes F an excellent formulation for vaginal applications. SNE was active against all strains studied, with minimum inhibitory concentration values ranging from 125 to 62.5 µg/mL; after incorporating SNE into F (FE), these values decreased to 62.5 to 31.2 µg/mL, demonstrating that incorporation into the formulation potentiated the action of SNE. Additionally, the time kill assays showed that both forms of SNE were capable of controlling growth, thereby suggesting a possible fungistatic mechanism. Unloaded SNE was not active against C. krusei biofilms, but FE was active against a clinical strain (CKV2). In vivo analysis showed that FE was able to prevent the development of infection following 10 days of administration. We concluded that the formulation developed in this study was an important vehicle for the delivery of SNE based on the improved antifungal activity in all in vitro and in vivo analyses. Furthermore, the extract incorporated into the system may serve as an important prophylactic agent against vaginal infections caused by C. krusei. Keywords: precursor system of mucoadhesive liquid crystal, nanostructured system, ­prophylaxis, Candida krusei

BACKGROUND: Dietary calcium intake has been described as being a negative contributor to adiposity. In adolescents, this relationship is not well established. The objectives of the present study were to compare the calcium intake of normal-weight and obese adolescents and to evaluate its relationship with adiposity and insulin resistance. METHODS: A cross-sectional analysis of 96 post-pubertal adolescents; 47 normal weight and 49 obese, mean age 16.6 (SD +/- 1.3) years. Body composition was assessed by dual-energy X-ray absorptiometry. Dietary intake was evaluated using a 3-day dietary record. The biochemical evaluation comprised the measurements of serum lipids, lipoproteins, glucose and insulin. Insulin resistance was calculated using the Homeostasis Model Assessment of Insulin resistance (HOMA-IR). RESULTS: The mean calcium intake, adjusted for energy, was lower in obese adolescents, 585.2 (+/-249.9) mg, than in normal weight adolescents, 692.1 (+/-199.5) mg. Only 4% of adolescents had an adequate intake of calcium. Calcium intake was inversely associated with body trunk fat, insulin and HOMA-IR in the obese group. The quartile analysis of calcium intake provided evidence that girls in the highest quartile had decreased adiposity and insulin resistance. CONCLUSIONS: This study showed a negative relationship between calcium intake and body fat and insulin resistance, mainly in obese girls, and demonstrates the importance of an increased dietary calcium intake. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to demonstrate the superiority of benfluorex over placebo as an add-on therapy in type 2 diabetic patients in whom diabetes is insufficiently controlled by sulfonylurea monotherapy and who have a limitation for the use of metformin.Research Design and Methods: Type 2 diabetic patients with HbA(1c) (A1C) (7-10%) who were receiving the maximum tolerated sulfonylurea dose and had a contraindication to or poor tolerance of metformin were randomly assigned (double blind) to receive benfluorex 450 mg/day (n = 165) or placebo (n = 160) for 18 weeks. The main efficacy criterion was A1C, analyzed as the change from baseline to the end of treatment using ANCOVA with baseline and country as covariates. Secondary criteria were fasting plasma glucose (FPG), insulin resistance, and plasma lipid level.Results: Both groups were similar at baseline in the intention-to-treat population. A1C significantly decreased with benfluorex from 8.34 +/- 0.83 to 7.52 +/- 1.04% (P < 0.001) and tended to increase with placebo from 8.33 +/- 0.87 to 8.52 +/- 1.36% (NS), resulting in a mean adjusted difference between groups of -1.01% (95% CI -1.26 to -0.76; P < 0.001). The target A1C (< or =7%) was achieved in 34% of patients receiving benfluorex versus 12% of patients receiving placebo. Significant between-group differences in favor of benfluorex were observed for mean FPG (-1.65 mmol/l) (P < 0.001) and for homeostasis model assessment of insulin resistance. Overall tolerance was similar in both groups. Serious adverse events were more frequent in the benfluorex group, without evidence of causality relationship.Conclusions: Benfluorex as an add-on therapy was superior to placebo in lowering A1C with a between-group difference of 1% in type 2 diabetic patients whose disease was insufficiently controlled with sulfonylurea alone and in whom metformin was contraindicated or not tolerated. [ABSTRACT FROM AUTHOR]

To assess the prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic on the American continent. A systematic review and meta-analysis of observational studies that estimated the prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic was performed through bibliographic database searches. A three-level meta-analysis model was used with the inverse variance method, tau was estimated via restricted maximum likelihood and logistic transformation, and heterogeneity was presented as tau 2 and I 2 . Of the 7467 studies obtained, 62 were included in the meta-analysis, which involved 52 270 nursing professionals. The overall prevalence for at least one mental health symptom was 56.3% (50.4%, 62.1%; I 2  = 98.6%, p < 0.001). Eight mental health symptoms were found; among them, the most prevalent were burnout (52.1%, 37.1%, 88.8%; I 2  = 98.5%, p < 0.001) and fear (52.1%, 30.1%, 73.3%; I 2  = 98.1%, p < 0.001). The prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic on the American continent was high, and strategies should be developed and implemented by managers and government agencies to promote the well-being, physical and mental health of nursing professionals. Studies like this one are necessary to highlight the need for efforts in the implementation of promotion and prevention actions to be developed by health organisations, managers and leaders with a view to improving the quality of life of nursing workers., (© 2023 John Wiley & Sons Australia, Ltd.)

In pregnant women, the Energy-adjusted Dietary Inflammatory Index (E-DII) is adopted to measure the inflammatory potential of the diet, but it does not predict the quality of the diet. Our hypothesis is that a more pro-inflammatory diet during pregnancy is also a poorer quality diet. Thus, the objective of this study is to verify the association of the E-DII with the Diet Quality Index Adapted for Pregnancy (DQI-P) and the nutrient intake from the diet in terms of the second and third gestational trimesters. This is a cross-sectional study that took place in Brazil (2018-2019), with eligible adult women up to 72 hours' postpartum and in good health. Socioeconomic, gestational, anthropometric, and food consumption data were collected, enabling the calculation of E-DII, DQI-P, and nutrient intake. The sample (n = 260) had a median E-DII of 0.04 (-1.30 to 1.90) and DQI-P of 68.82 (18.82-98.22). There was no relevant difference between E-DII tertiles by sociodemographic, gestational, and anthropometric characteristics. The E-DII and the DQI-P showed agreement (55.7%) and inverse correlation (r = -0.53; P < .001). Each 1-unit increase in DQI-P, iron, iodine, magnesium, pyridoxine, and vitamin E decreased the E-DII score (P < .05). An increase of 1 unit in protein, saturated fatty acids, and vitamin C increased the E-DII score (P < .05). Thus, the results suggest that the E-DII can predict diet quality during pregnancy, with the added benefit of measuring the inflammatory potential of the diet., Competing Interests: Declaration of competing interest The authors have no relevant interests to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Organic pollutants are widely distributed in the environment. Due to their physical and chemical characteristics, they tend to be biomagnified in food chains, mainly in aquatic organisms. Therefore, food consumption is a significant route of lifelong exposure. Although the Amazon River basin contains the highest freshwater biodiversity on Earth, there is scarce literature focusing on the levels of organic pollutants in the local population. The present study was aimed at assessing the levels of several environmental pollutants (polycyclic aromatic hydrocarbons, bisphenols, parabens, and benzophenones) in urine samples from riverside communities along the Tapajós and Amazon Rivers in the Brazilian Amazon region. The results show a 100 % detection of naphthalene metabolites (namely, 1-hydroxy-naphthalene (1OH-NAP), 2-hydroxy-naphthalene (2OH-NAP)), with the highest levels belonging to benzylparaben (BzP) (17.3 ng/mL). Gender-specific analysis revealed that women had significantly higher levels of certain PAH metabolites (i.e., 1OH-NAP and 2-hydroxy-fluorene (2OH-FLU)) than men. In turn, most of the evaluated compounds were higher in urine samples from people living near the Amazon River, which presents increased traffic of boats and ships than the Tapajós River. On the other hand, the human health risk assessment suggested that all communities are at risk of suffering non-carcinogenic effects from exposure to PAHs. At the same time, they are also at risk of carcinogenic effects from exposure to benzo[a]pyrene metabolites. Thus, further studies are needed in order to evaluate the potential health effects of exposure to a mixture of these organic pollutants and other contaminants present in the area, such as mercury., 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.)

The present work reports the effects of chemical elicitors and epigenetic modifiers on the production and diversification of secondary metabolites produced by Anthostomella brabeji - an endophytic fungus isolated from Paepalanthus planifolius (Eriocaulaceae). The fungus was cultivated under four different small-scale culture conditions in potato dextrose broth (PDB): PDB (control), PDB + Mg +2 , PDB + Cu +2 and PDB + 5-AZA (5-azacytidine). The incorporation of Cu +2 into PDB medium yielded the most promising results as the most significant differences in the metabolic profile of A. brabeji were observed under this condition. The chemical analysis of the PDB + Cu +2 extract resulted in the isolation of seven metabolites, including three new benzofuran derivatives (2, 4 and 6) and four known compounds (1, 3, 5 and 7). The metabolites were tested using the Gram-positive bacterium Staphylococcus aureus, Gram-negative bacteria Salmonella sp. and Escherichia coli, and six yeasts of Candida albicans and non-albicans. The EtOAc extract (PDB + Cu +2 ), and compounds 1, 2 and 7 exhibited relevant antifungal activity against Candida spp., with minimum inhibitory concentration ranging from 62.5 to 500.0 μg/mL., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023. Published by Elsevier B.V.)

Introduction: Migraine is a common and disabling primary headache, and its pathophysiology is not fully understood. Previous studies have suggested that pain can increase humans' Resting Energy Expenditure (REE). However, no previous study has investigated whether the REE of individuals with migraine differs from the general population. Therefore, this study aims to assess whether the REE of women with migraine differs from that of women without headaches. We also tested the accuracy of REE predictive formulas in the migraine patients., Methods: This cross-sectional study involves 131 adult women aged between 18 and 65 years, 83 with migraine and 48 without (controls). We collected clinical, demographic, and anthropometric data. Migraine severity was measured using the Migraine Disability Test and Headache Impact Test, version 6. The REE was measured by indirect calorimetry, and it was compared with the predicted REE calculated by formulas., Results: Patients with migraine had higher REE when compared to controls ( p  < 0.01). There was a positive correlation between REE and the patient-reported number of migraine attacks per month (Rho = 0.226; p  = 0.044). Mifflin-St Jeor and Henry and Rees were the predictive formulas that have more accuracy in predicting REE in women with migraine., Discussion: Considering the benefits of nutritional interventions on treating migraines, accurately measuring REE can positively impact migraine patient care. This study enhances our understanding of the relationship between pain and energy expenditure. Our results also provide valuable insights for healthcare professionals in selecting the most effective predictive formula to calculate energy expenditure in patients with migraine., Competing Interests: The 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. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2023 Martins, Ribeiro, Rodrigues, Santos, Teixeira and Ferreira.)

Many studies have been conducted to focused on developing an optimal alkali/surfactant/polymer (ASP) composition to increase the recovered fraction of oil in reservoirs that have already undergone water injection. To analyze the effect of alkali (Na 2 CO 3 ), surfactant (lauryl sodium sulfate), and polymer (commercial xanthan gum) concentration on oil recovery, a complete factorial experimental design was performed with combinations of three variables (alkali, surfactant, and polymer) and three central point replications (2³ + 3). The experiments were carried out on a core holder using rock samples from the Botucatu formation. The simulated oil reservoirs have an average permeability of 348 mD and a temperature of 60 °C. The crude oil was acquired from the Carmópolis field, with 25.72 °API. Synthetic production water containing 40,000 mg L -1 of NaCl and 13,000 mg L -1 of Na 2 SO 4 was injected through an HPLC pump to saturate the rock samples and to recover the oil in the secondary step. From the experimental results, it was verified that the surfactant and polymer concentrations are the most statistically significant independent variables and that first-order interactions are not statistically significant for the process. The oil recovery factors in the secondary stage ranged between 30 and 36 % of the OOIP, which are within the range reported in the literature. The optimal composition of the ASP fluid obtained a recovered fraction of oil of 62 % in the advanced step. Other combinations reported in the literature used higher concentrations of alkali, surfactant, and polymer with lower recoveries and higher cost in the injection design. Thus, the present study highlights the necessity to investigate the performance of each component of the ASP solution. In addition, the results obtained in this study are very attractive for possible full-scale applications., Competing Interests: 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., (© 2023 The Authors.)

The debate about the negative impacts that production and consumption cause on the environment is in vogue. Strategies that point to a sustainable, healthy, and resilient path are being sought. One of these paths is the Circular Economy, which emerges as an alternative to reduce the socio-environmental impacts caused by the linear model of production-use-disposal, presenting opportunities to generate revenue, income, and wealth with circular processes. However, despite the circular economy being considered an essential strategy to improve overall performance toward sustainability in its three dimensions, recent research has shown that the predominant focus of circular approaches is on the economic and environmental dimensions. At the same time, the social aspects still need to be explored. This article addresses this problem, aiming to explore circular economy environmental, economic, and social elements in three economic blocs from 2000 to 2020 using the Five Sector Sustainability Model, establishing a baseline to co-create an equitable and regenerative future. The results showed that ASEAN in 2000 occupied the first position in the general ranking. The European Union had the best classification in the economic sector, and Mercosur was the best regarding social benefits. In 2020, while the European bloc was better positioned in the general ranking, the South American bloc occupied the last post in almost all sectors. Comparatively, the highest-ranked bloc in 2020 in overall sustainability is more in line with the UN SDG due to circular actions oriented towards the three fundamental pillars of sustainability., 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 Ltd. All rights reserved.)

It has been suggested that an imbalance in mineral levels is involved in the pathophysiology of migraine. However, only a few studies have investigated the circulating levels of mineral in patients with migraine during the pain-free period (i.e. interictal). This study aimed to investigate whether the interictal plasma levels of minerals of women with migraine differ from those of women without migraine (controls). This is a cross-sectional study involving 67 women, of which 38 were diagnosed with migraine and 29 were controls. The groups were similar in age and body mass index. Plasma levels of magnesium (Mg), copper (Cu), calcium (Ca), zinc (Zn), iron (Fe), and selenium (Se) were measured. Dietary intake was assessed using a 24-hour food recall, and migraine impact was evaluated using the Headache Impact Test, version 6 (HIT-6). The association between migraine disability, and plasma levels and dietary intake of minerals was assessed through correlation and logistic regression analyses. Women with migraine had significantly lower plasma levels of Mg, Ca, Cu, and Zn than controls. In parallel, dietary intake of Mg, Cu, and Fe was significantly lower in patients with migraine. Migraine impact was not associated with plasma levels or dietary intake of minerals. The results suggest that patients with migraine have lower plasma levels of minerals, and dietary intervention to ensure adequate mineral intake should be considered as a therapeutic strategy for migraine.

Objectives: Evaluate the protective factors associated with early initiation of breastfeeding., Methods: Cross-sectional study conducted with Brazilian nursing mothers. Breastfeeding in the first hour of life and difficulty initiating breastfeeding in the birth room were adopted as outcome variables and associated with other maternal and child information. Poisson regression was conducted to synthesize the data., Results: Among 104 nursing mothers evaluated, 56.7% reported breastfeeding in the first hour of life and 43% had difficulty initiating breastfeeding in the birth room. There was a higher prevalence of breastfeeding in the first hour of life among mothers with previous breastfeeding experience (PR = 1.47, 95% CI 1.04-2.07). Difficulty initiating breastfeeding in the birth room was more prevalent among mothers who did not receive breastfeeding guidance during antenatal care (PR = 2.83, 95% CI 1.43-4.32) and those without previous breastfeeding experience (PR = 2.49, 95% CI 1.24-6.45)., Conclusion: These findings highlight the importance of adequate professional guidance, especially for primiparous mothers., Competing Interests: The 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., (© 2023 Lemos, Sousa, Souza, Ferreira, Miranda and Santos.)

Based on previous studies, we hypothesized that the dietary inflammatory potential in pregnant women might influence maternal and child health. The objective of this work is to review the literature on the association of Dietary Inflammatory Index (DII) during pregnancy with early and late maternal and child health outcomes. We searched Cochrane, Embase, PubMed, Scopus, Web of Science, and the Virtual Health Library. Observational studies on DII in the gestational period that met the objective of this review were selected. There was a double-blind evaluation of 185 studies, of which 16 were included in narrative synthesis and 9 in meta-analysis. High methodological quality, longitudinal studies (87.5%) and the Food Frequency Questionnaire for DII evaluation (68.8%) prevailed. Outcomes studied were gestational diabetes mellitus (n = 5), gestational age at delivery (n = 7), type of delivery (n = 3), gestational weight gain or pregestational body mass index (n = 11), and anthropometry at birth (n = 8) and of the child up to age 10 years (n = 4). Higher maternal DII was associated with increased risk of small-for-gestational-age babies (odds radio, 1.15; 95% confidence interval, 1.08-1.21; I 2 , 29%; P = .24) and low birth weight (<2.500 g) (odds ratio, 1.16; 95% confidence interval, 1.06-1.26; I 2 , 56%; P = .10). The association between higher maternal DII and higher risk of obesity in late childhood is also suggestive. Thus, maternal diet may be a modifiable factor of inflammation in pregnancy associated with health outcomes of the offspring., Competing Interests: Author Declarations The authors have no relevant interests to declare., (Copyright © 2023 Elsevier Inc. All rights reserved.)

The evaluation of food consumption in childhood is essential to help understand the effect of food choices on health. The objective of this study was to conduct a systematic review of studies that identified the dietary patterns in schoolchildren (7-10 years old) and their associated factors. Observational studies published in the last ten years were searched in the databases BVS (Virtual Health Library), Embase, PubMed, Scopus, and Web of Science. The Newcastle Ottawa Scale was adopted to evaluate the articles' quality. The studies covered schoolchildren, children, and adolescents as part of the sample. We selected 16 studies, 75% of which were considered good/very good and seven mentioned three food patterns. A dietary pattern considered unhealthy was identified in 93.75% of the studies, having as associated factors to its consumption: higher screen time, low bone mass, gain of weight and fat in children, and meal skipping. The children who usually had breakfast showed greater adherence to the dietary pattern consisting of healthier foods. The children's dietary patterns were related to their behavior, nutritional status, and family environment habits. Food and nutrition education's effective actions, as well as the regularization of the marketing of ultra-processed foods, must be stimulated and inserted in public policies as a way to promote and protect children's health.

Objective: To evaluate the association of the dietary inflammatory index adjusted for energy (E-DII ® ) with the evolution of maternal body mass index and human milk lipid (HM) profile in the first 6 months postpartum. Methods: This is a cohort study with 260 Brazilian women (19-43 years old) in the postpartum period. Sociodemographic, gestational, and anthropometric data of the mother were obtained in the immediate postpartum period and in the six monthly meetings. A food frequency questionnaire was applied at baseline and used to calculate the E-DII score. Mature HM was collected, analyzed by gas chromatography coupled with mass spectrometry and the Rose Gottlib method. Generalized estimation equation models were built. Results: Women with >E-DII showed lower adherence to physical activity during pregnancy ( p  = 0.027), higher frequency of cesarean delivery ( p  = 0.024), and higher body mass index over time ( p  < 0.001). At the end of the 6th month, 35 women remained in the study. As for HM, 151 analyses were performed, detecting in the 3rd collection greater fat (%) among those with >E-DII (4.27 ± 1.98 vs. 3.75 ± 2.48; p  = 0.003). Conclusion: Diets with >E-DII can impact the type of delivery, change the evolution of maternal nutritional status, and the stability of the lipid profile of HM.

The quantitative assessment of the carbonate system represents one of the biggest challenges toward the "Sustainable Development Goals" defined by the United Nations in 2015. In this sense, the present study investigated the Spatio-temporal dynamics of the carbonate system and the effects of the El Niño and La Niña phenomena over the Cabo Frio upwelling area. The physical characterization of the site was carried out through data on wind speed and sea surface temperature. Water samples were also collected during the oceanographic cruise onboard the Diadorim R/V (Research Vessel). From these samples, the parameters of absolute and practical salinity, density, pH, total alkalinity, carbonate, calcite, aragonite, bicarbonate dissolved inorganic carbon, carbon dioxide, partial pressure of carbon, calcium, and total boron were obtained. The highest average concentration of bicarbonate in S1 (2018 µmol/kg) seems to contribute to the dissolved inorganic carbon values (2203 µmol/kg). The values of calcite saturation state, aragonite saturation state, and carbonate were higher on the surface of each station (calcite saturation state = 4.80-5.48; aragonite saturation state = 3.10-3.63, and carbonate = 189-216 µmol/kg). The mean values of pH were similar in the day/night samples (7.96/7.97). The whole carbonate system was calculated through thermodynamic modeling with the Marine Chemical Analysis (AQM) program loaded with the results of the following parameters: temperature, salinity, total alkalinity, and pH parameters. This manuscript presents original data on the carbonate system and the "acidification" process influenced by the Cabo Frio upwelling, which directly depends on the El Niño and La Niña phenomena oscillations in the sea surface temperature., (© 2023. The Author(s).)

Background: It has been hypothesized that the coronavirus disease 2019 (COVID-19) pandemic may have changed the conduct of obstetric practices at the time of labor, delivery, and birth. In Brazil, many practices lacking scientific evidence are implemented in this care, which is charcaterized by excessive use of unnecessary interventions. This scenario may have been worsened by the pandemic. Thus, we analyzed the effects of the pandemic on care during prenatal care and delivery by comparing the results of two surveys (one was administered before the pandemic and the other during the pandemic) in public hospitals in Belo Horizonte - Minas Gerais (MG), Brazil., Methods: This cross-sectional and comparative study analyzed preliminary data from the study "Childbirth and breastfeeding in children of mothers infected with SARS-CoV-2", which was conducted in three referral maternity hospitals in Belo Horizonte - MG during the pandemic in the first half of 2020 in Brazil. The final sample consisted of 1532 eligible women. These results were compared with data from 390 puerperae who gave birth in the three public hospitals in the study "Birth in Belo Horizonte: labor and birth survey", conducted before the pandemic to investigate the changes in practices of labor and delivery care for the mother and her newborn, with or without COVID-19 infection, before and during the pandemic. In this research, "Birth in Belo Horizonte: labor and birth survey", data collection was performed between November 2011 and March 2013 by previously trained nurses. Between study comparisons were performed using Pearson's chi-square test, with a confidence level of 95%, and using Stata statistical program., Results: We found a significant increase in practices recommended by the World Health Organization during the pandemic including the following: diet offering (48.90 to 98.65%), non-pharmacological pain relief (43.84 to 67.57%), and breastfeeding in the newborn´s first hour of life (60.31 to 77.98%) (p < 0.001). We found a significant reduction of non-recommended interventions, such as routine use of episiotomy (15.73 to 2.09%), the Kristeller maneuver (16.55 to 0.94%), oxytocin infusion misused (45.55 to 28.07%), amniotomy (30.81 to 15.08%), and lithotomy position during labor (71.23 to 6.54%) (p < 0.001)., Conclusion: Our study revealed a statistically significant increase in the proportion of use of recommended practices and a reduction in non-recommended practices during labor and delivery. However, despite advances in the establishment of World Health Organization recommended practices in labor, delivery, and birth, the predominance of interventionist and medicalized practices persists, which is worsened by events, such as the pandemic., (© 2023. The Author(s).)

Objective: To evaluate the association between the consumption of NOVA food groups (classification based on the nature, extent and purpose of food processing) and the intake of energy, macro and micronutrients among school children., Design: Cross-sectional study. Food consumption was assessed by two 24-h dietary recalls on non-consecutive days. Energy from each NOVA food groups - ultra-processed foods, unprocessed or minimally processed foods, processed culinary ingredients and processed foods - was estimated. For analysis, the percentage of energy from ultra-processed foods and unprocessed or minimally processed foods were categorised into tertiles and associated with intake of energy, macro and micronutrients using analysis of covariance and linear regression., Setting: Public schools in Belo Horizonte, Minas Gerais, Brazil., Participants: School children aged 8-12 years ( n 797; 406 girls; 391 boys)., Results: Mean energy intake was 2050·18 ± 966·83 kcal/d, 25·8 % was from ultra-processed foods, 56·7 % from unprocessed or minimally processed foods, 8·9 % from processed culinary ingredients and 8·6 % from processed foods. A higher energy contribution from ultra-processed foods was negatively associated with the intake of protein, fibre, vitamin A, Fe and Zn ( P < 0·001) and positively associated with total energy, lipid and Na intake ( P < 0·001). Concurrently, a higher energy contribution from unprocessed or minimally processed foods was positively associated with the consumption of protein, fibre, Fe and Zn ( P < 0·001) and negatively associated with total energy ( P = 0·002), lipid and Na intake ( P < 0·001)., Conclusions: In conclusion, higher ultra-processed food consumption presented a negative association with the nutrient intake profile of school children.

Objective: This study aimed to assess the association between ultra-processed foods (UPF) consumption and some lifestyle factors during pregnancy and the baby's anthropometric measurements at birth., Methods: Cross-sectional study conducted with immediate postpartum women and their babies. Food consumption during pregnancy was assessed retrospectively by a semi-quantitative food frequency questionnaire, and the baby's anthropometric measurements were obtained from the medical records. The percentual of energy from UPF was estimated, categorized in tertiles, and associated with the baby's anthropometric measurements using multinomial logistic regression, adjusting by maternal characteristics (per capita income, maternal age, gestational weight gain, parity, physical activity, and number of prenatal consultations)., Results: A total of 626 immediate postpartum women and their babies were evaluated. The mean percentual of energy from UPF consumption during pregnancy was 30.56%. Before adjustment, there was a greater chance of insufficient birth weight among babies of immediate postpartum women in the highest tertile of UPF consumption (OR 1.72; 95% CI 1.09-2.70; p = 0.020); however, such an association was not significant in the adjusted analyses., Conclusions: No association between UPF consumption during pregnancy and baby's anthropometric measurements at birth was observed, probably due to the multifactorial nature of anthropometry and the interference of sociodemographic, gestational, and environmental factors in the baby's health outcomes.

Objective: This study aimed at reviewing food-based dietary guidelines (FBDGs) with content targeted at children and adolescents to present their main characteristics, thus enabling comparisons among countries., Design: We conducted a search of the FBDGs available on the Food and Agriculture Organization (FAO) website, followed by a scoping review with a gray literature search to find FBDGs for children or adolescents non-listed on the FAO's website. Data extraction included the year of publication, language, and guidelines for the target group., Results: From FAO website searches, 109 documents were found, and 17 of them could not be translated. The Scoping review search conducted in 5,190 articles, and none led to new guidelines, nor from the gray literature. Regarding the 92 FBDGs explored, 41 were specific for infants under 24 months old, children, and/or adolescents, and 51 were for the general population with information for the studied group. Twelve percent of the general FBDG and 35% of the specific ones have food icons. All of the guidelines were published after 2001. Latin America and the Caribbean were the regions that presented more specific FBDGs and the majority of countries with guidelines for fruits and vegetables. The information about fat (15 countries) and sugar (26 countries) consumption reduction is frequent. Reduction of sodium intake appears to be in the majority of guidelines after 2015. Food hygiene guidelines are recurrent in Latin American documents. NOVA classification was adopted in five countries and 21 countries approach recommendations for mealtimes. Both exclusive and continued breastfeeding guidance and healthy complementary feeding orientation are present in over 50% of the specific FBDG for infants and children under 24 months old., Conclusion: Food-based dietary guidelines are diverse due to both the nutritional and political aspects of each region. Latin America stands out for its orientations for the studied group. Further studies should measure the possible impacts and comprehension of FBDGs., Competing Interests: The 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 © 2022 Corrêa Rezende, de Medeiros Frazão Duarte, Melo, Santos and Toral.)

Sjogren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs, associated with sicca syndrome but also with systemic involvement with varying degrees of severity. Despite their importance, some systemic manifestations, mainly liver, gastrointestinal, and pancreatic are not routinely evaluated. To address these manifestations, the Sjögren's Syndrome Committee of the Brazilian Society of Rheumatology conducted a broad systematic review of the literature on studies investigating prevalence and diagnosis of these symptoms in Sjogren´s patients and made recommendations based on the findings. Agreement between the experts was achieved using the Delphi method. This is the second part of this guideline, providing 6 recommendations for liver, gastrointestinal, and pancreatic care of SS patients., (© 2022. The Author(s).)

As part of our continuing efforts to discover new bioactive compounds from endophytic fungal sources, we have investigated the extract of the Paraphaeosphaeria sporulosa F03 strain. The study led to the isolation of four new 3-methyl-isoquinoline alkaloids (1:  - 4: ) and four known polyketides (5:  - 8: ). The structures of compounds 1:  - 4: were elucidated by 1D and 2D NMR experiments and HRMS analysis. The absolute configuration of 4: was determined by comparison of its experimental electronic circular dichroism spectrum with calculated data. Compounds 1:  - 4: exhibited antifungal activity with minimal inhibitory concentration values ranging from 6.25 - 50 µg/mL against six Candida species but they did not present any cytotoxic activity against the human tumor cell lines A549 (lung), MCF-7 (breast), and HepG2 (hepatocellular). In addition, compound 4: exhibited antiplasmodial activity in the low micromolar range (IC 50  = 4 µM)., Competing Interests: The authors declare they have no conflict of interest., (Thieme. All rights reserved.)

Background: The simultaneous administration of drugs with food can compromise the bioaccessibility and absorption of nutrients. The objective of this study was to evaluate the influence of the use of losartan potassium (LP), metformin hydrochloride (MH), and simvastatin (S) on the in vitro bioaccessibility of micronutrients (Cu, Fe, Mn, and Zn) in oat flour from Bahia, Brazil., Methods: The experimental procedure consisted of the in vitro extraction of the bioaccessible fraction of Cu, Fe, Mn, and Zn in oat flour-with and without LP (50 mg), MH (500 mg), and S (20 mg)-using the unified bioaccessibility method (UBM), simulating the conditions of the gastrointestinal tract. For decomposition of the samples (oat flour and residue), a digester block with a closed system was used. To determine the total content (flour and residual fraction) and bioaccessible micronutrients, inductively coupled plasma optical emission spectrometry (ICP OES) was used., Results: The bioaccessible contents (µg g -1 ) without the addition of drugs were: Cu 5.86 ± 0.21, Fe 32.80 ± 1.32, Mn 87.90 ± 1.90, and Zn 30.33 ± 2.05, with bioaccessibility ranging from 31.5 % for Fe to 99 % for Mn. The in vitro extraction method was validated by mass balance with recovery values from 89.78 % for Cu to 101.94 % for Mn. The range of bioaccessible contents (µg g -1 ) were: Cu (<4.14), Fe (32.10 ± 0.20-54.10 ± 2.03), Mn (81.40 ± 0.93-93.22 ± 0.80), and Zn (<10.80-29.11 ± 2.20). The estimation of the bioaccessibility of Cu, Mn, and Zn in oat flour were compromised in the presence of LP, MH, and S (p < 0.05)., Conclusion: Chemical interactions can occur between drugs and micronutrients. Taken together, our results highlight that LP, MH, and S can interfere with the bioaccessibility of Cu, Fe, Mn, and Zn in oat flour in patients who use these drugs, suggesting its rational use in further investigations., (Copyright © 2022 Elsevier GmbH. All rights reserved.)

Yellow fever (YF) is an infectious disease considered a public health problem in tropical and subtropical areas. YF has many pathophysiological events that are correlated with the host immune response. In this study, the in situ Th22 cytokine profile was evaluated. Liver tissue samples were collected from 21 YFV-positive patients who died of the disease and five flavivirus-negative controls who died of other causes and whose hepatic parenchyma architecture was preserved. Immunohistochemical (IHC) analysis of tissues in the hepatic parenchyma of YF cases showed significantly higher expression of interleukin (IL)-22, IL-13, tumour necrosis factor-alpha, and FGF basic (FGF b) in YFV-positive cases than that in flavivirus-negative controls. These results indicate that the response of Th22 cytokines emerges as an alternative for a better understanding of adaptive immunity in the hepatic parenchyma, highlighting the role of cytokines in the repair and suppressive responses in the immunopathogenesis of YFV infection., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Microbiological diagnosis of equine respiratory infections is essential for disease management. However, reliable diagnosis can be a challenge due to colonization of the upper respiratory tract (URT) by a diverse microbial population, and because there is a lack of studies with samples from healthy animals. Aiming to guide adequate URT culture, this work reports culturable microbial population from the URT of 1,010 apparently healthy horses from 341 farms in Southern Brazil and identifies the putative presence of pathogenic microorganisms. Nasal swabs were cultured in 5% blood agar, and the isolates were phenotypically identified to genus level. A diverse respiratory microbial population was found, mostly composed of Gram-positive bacteria, including Staphylococcus spp., Bacillus spp., Streptococcus spp. and Corynebacterium spp. The microbiological profile from the nasal cavity of 911 horses was described, with the five most common profiles being: (1) Staphylococcus sp. + Gram-negative bacilli (12.67%), (2) Staphylococcus sp. in pure culture (12.47%), (3) Staphylococcus sp. + Bacillus sp. (10.10%), (4) Gram-negative bacilli in pure culture (6.93%), and (5) Staphylococcus sp. + Bacillus sp. + Gram-negative bacilli (6.73%). Streptococcus equi equi and Rhodococcus equi were detected in 34 horses (3.37%), demonstrating the presence of pathogenic bacteria along with commensal microorganisms in apparently healthy animals. The disclosed data may guide and facilitate microbiological diagnosis of URT infection in horses. The significant presence of Gram-negative bacilli was evidenced, as well as the occurrence of relevant pathogens, such as S. equi equi and R. equi, thus helping to improve diagnosis and antimicrobial therapy., (Copyright © 2022. Published by Elsevier Inc.)

Background: Dietary patterns can influence maternal and child health outcomes. The study aims to characterize dietary patterns during pregnancy as well as to identify their associations with gestational weight gain (GWG) and anthropometric measurements at birth., Methods: A minimum sample size of 95 nursing mothers was estimated for this work. Socioeconomic, anthropometric, physical activity, obstetric and food consumption (food frequency questionnaire) data was collected from mothers and their newborns in immediate postpartum (n = 260) at the maternity hospital. Maternal pregestational weight and GWG were self-reported and the neonatal data was obtained from their records. The patterns were derived posteriori by Principal Component Analysis (PCA). Multinomial Logistic Regression and Poisson Regression with Robust Variance were applied., Findings: Four dietary patterns were derived: "pattern 1", characterized by the consumption of meat and eggs, processed meat, vegetables and olive oil; "pattern 2", consisting of sweets, snacks and cookies; "pattern 3", which includes cereals and breads, coffee and tea, and processed fats; and "pattern 4", characterized by soft drinks, tubers and instant noodles. Together, the dietary patterns account for 49.16% of the total variance for food intake. Higher adherence to "pattern 3" was associated with inadequate birth weight (low and excessive birth weight); while greater adherence to "pattern 2" was associated with lower chances of inadequate GWG., Conclusion: The dietary patterns presented mixed composition and predominance of ultra-processed foods. They were associated with the investigated outcomes, denoting the importance of strategies to promote healthy eating habits during pregnancy in order to avoid possible complications., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Sjogren's Syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs, associated with sicca syndrome but also with systemic involvement with varying degrees of severity. Despite their importance, these systemic manifestations are not routinely evaluated and there is no homogenous approach to their diagnosis or evaluation. To close this gap, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of epidemiologic and clinical features of these manifestations and made recommendations based on the findings. Agreement between the experts was achieved using the Delphi method. The first part of this guideline summarizes the most important topics, and 11 recommendations are provided for the articular, pulmonary, and renal care of SS patients., (© 2022. The Author(s).)

Oral potentially malignant disorders (OPMD) represent a group of lesions with increased risk for malignant transformation. The management of such injuries is based on surgical treatment or detailed follow-up throughout the patient's lifetime. This systematic review and meta-analysis investigated and critically evaluated the use of autofluorescence and fluorescent probes as potential techniques for the early detection of OPMD. A comprehensive search was performed on Pubmed, Scopus, Web of Science and LIVIVO databases. The gray literature was also consulted and included Google Scholar, Proquest and Open gray databases. 2715 articles were retrieved, and after the different stages of critical evaluation, were reduced to 25 articles that fully met the inclusion criteria. VELscope® was the most used equipment for autofluorescence, while aminolevulinic acid (5-ALA) was the main representative of the probes. The meta-analysis performed included 10 articles that used VELscope® as a method to detect oral disorders. A 95% confidence interval (CI) with a p value significance <0.05 was considered as a criterion for the statistical analysis. The combined sensitivity was 74% (CI95 60-76%, p = 0.0001) and the specificity was 57% (CI95 52-60%, p = 0.0000). The inclusion of these adjunct methods in clinical practice is very promising, since they are able to help both the clinician and the specialist in the early detection of potentially malignant oral disorders, favoring a better prognosis. However, it is still necessary to carry out further studies, with the aim of establishing a protocol for use and qualification of results., (Copyright © 2022. Published by Elsevier B.V.)

Objectives: Investigating waist circumference (WC) and abdominal circumference (AC) evolution in lactating women, based on macronutrient intake adequacy up to 6 months after childbirth. Materials and Methods: Prospective cohort comprising lactating women recruited at a maternity hospital in Minas Gerais State, Brazil, from June 2018 to June 2019. Selected individuals were healthy adult women who had given birth 72 hours before data collection. Sociodemographic, breastfeeding, and anthropometric data were collected. Food intake was determined through 24 hours dietary recalls. Adequate carbohydrate, protein, and lipid intake was herein defined as 45-65%, 10-35%, and 20-35% of the caloric value consumed by participants, respectively. Wilcoxon test and generalized estimating equations were carried out. This research was approved by the Research Ethics Committee, as well as by the National Research Ethics Committee. Results: There was decrease in weight (-4.45 kg), body mass index (-4.43 kg/m 2 ), WC (-4.70 cm), and AC (-4.70 cm) values from the baseline ( n  = 260) up to 6 months after childbirth ( p  < 0.001). The evolution of these measurements has indicated that high carbohydrate and low protein intake were associated with the highest AC values. Low protein and high lipid intake have led to lower WC values ( p  < 0.05). Conclusions: Macronutrient intake adequacy by the investigated lactating women has influenced their WC and AC evolution. This outcome has evidenced the important role played by nutritional monitoring in puerperium to prevent abdominal fat retention after pregnancy.

Yellow fever (YF), a non-contagious infectious disease, is endemic or enzootic to the tropical regions of the Americas and Africa. Periodic outbreaks or epidemics have a significant impact on public health. Programmed cell death, or apoptosis, is generally characterised by distinct morphological changes and energy-dependent biochemical pathways. In this study, we performed immunohistochemistry analysis to identify and quantify proteases and protein targets involved in the cascade that triggers apoptosis in YF virus (YFV)-infected human hepatocytes. Liver tissue samples were collected from 26 individuals, among whom 21 were diagnosed as YF-positive, and five were flavivirus-negative and died due to other causes. The histopathological alterations in YFV-positive cases were characterised by the presence of apoptotic bodies, steatosis, cellular swelling, and extensive necrosis and haemorrhage in the hepatic lobules. Additionally, we observed an abundance of inflammatory infiltrates in the portal tract. The expression of various apoptotic markers in the hepatic parenchyma, including CASPASE 3, CASPASE 8, BAX, FAS, FASL, GRANZYME B, and SURVIVIN, differed between YFV-positive cases and controls. Collectively, this study confirmed the complexity of YFV infection-induced apoptosis in situ. However, our data suggest that apoptosis in liver parenchyma lesions may significantly contribute to the pathogenesis of fatal YF in humans.

Objective: to identify the cumulative prevalence of biological and social risk factors at birth., Method: a cross-sectional study, with retrospective data collection, carried out with live births in a medium-sized city, from January 2018 to July 2020. A database was used with information aimed at identifying social and biological risks after birth, assessed descriptively., Results: the sample consisted of 4,480 newborns, of which 78.9% were classified as at usual risk, and 21.1% as at risk. The cumulative prevalence showed that most newborns had more than one risk factor, with biological risks being the most prominent: need for admission to Intensive Care Unit, birth with less than 37 weeks of gestation and weight less than 2,500 g. Among the social risks, the following stand out: newborns who had a dead sibling aged less than 5 years old; head of family without income; mothers under 16 years old and who did not undergo prenatal care. The biological risk rate was 7.39 times higher than the social risk rate., Conclusion: the cumulative prevalence of the risks found was significant, with a considerable part of the sample presenting some biological risk.

According to the World Health Organization (WHO), about 80% of people rely on medicinal plants for their primary health needs. Traditional medicine's principal benefits are their vast population knowledge, low severe adverse effects rate, low cost, and the lack of a medical prescription to use them. While obesity has become a global health issue, an increase in finding cheap and fast ways to lose weight escalates medicinal herbs' use for this purpose, both in dietary supplements or in teas. At the same time that Brazil aims to expand traditional medicine, reports regarding toxicology and poisoning put natural products' safety in check. Plants can accumulate heavy metals and metalloids leading to health risks; however, there is a lack of information on that matter, possibly due to a lack of international standardization regarding elemental contamination - this study aimed to determine metal and metalloid concentrations in slimming medicinal plants and their respective teas and evaluate their safety consumption. Metal and metalloid content were determined by inductively coupled plasma optical emission spectrometry (ICP OES). All plants and teas were within the set limits for tolerable upper intake level (UL), provisional tolerable daily maximum intake (PTDMI), and provisional tolerable weekly intake (PTWI). The hazard quotient index (HQ) was above 1 for almost all plants, and the Hibiscus sabdariffa tea regarding aluminum content. The arsenic level was above the Brazilian Pharmacopeia limit in natura plants demonstrating risk in their consumption. Some herbs also presented detection for elements with no safety limits set, such as lead, cadmium, and arsenic, which could mark as a red flag for consumption once their security intake is not precise yet., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Carnauba wax nano and micro-sized emulsions and hydroxypropyl methylcellulose coatings, alone or combined with ginger essential oils (GEO) were applied on papayas and evaluated under several storage conditions. In a first experiment, storage parameters were: 6 days at 22 °C, and 9 days at 13 °C followed by 5 days at 22 °C. In a second experiment, storage was: 5 days at 22 °C, and 10 days at 16 °C followed by 3 days at 22 °C. Coating effects were dependent on storage conditions. While fruits were in cold storage, there were few changes; however, at 22 °C, the differences between coatings became more evident. Nanoemulsions maintained papaya quality during storage by retarding firmness loss, color changes, and reducing respiration rates, resulting in delayed ripening. GEO exhibited some positive effect on fungal disease control. Nanoemulsion-based coatings improved shelf life by reducing weight loss, color development, and slowing ripening of papaya fruit., Competing Interests: 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. Disclaimer: Mention of a trademark or proprietary product is for identification only and does not imply a guarantee or warranty of the product by the U.S. Department of Agriculture. The U.S. Department of Agriculture prohibits discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation, and marital or family status., (© 2022 The Author(s).)

Purpose: Orthorexia nervosa has been receiving considerable attention and several tools have been developed to assess it, for instance, the "Düsseldorf Orthorexie Scale" (DOS). Such scale is a validated test to measure orthorexic eating behavior and it has shown good psychometric properties. Therefore, this study aimed to transculturally adapt and validate the Brazilian version of the DOS (DOS-BR)., Methods: DOS-BR was obtained using the back-translation process after two reviews done by a focus group and after running a pilot-test (n = 64). A self-report questionnaire was administered to a sample of Brazilian dietitians and Nutrition college students (n = 486). To examine the factor structure of the DOS-BR, exploratory factor analysis and confirmatory factor analysis were conducted. The ordinal alpha was examined. Test-retest reliability was evaluated in a sub-sample (n = 159). Convergent validity was assessed by conducting correlation analyses between the DOS-BR and other theoretically related tools (EAT-26 and OCI-R) within the sub-sample., Results: A three-factor structure was revealed for the DOS-BR properly fitted (KMO = 0.787). The test showed good internal consistency with an ordinal alpha of 0.795, and it also had excellent test-retest reliability of 0.776. DOS-BR median score was 17 (14-22) in Measurement 1 and 19 (17-22) in Measurement 2. The total score had a positive and moderate correlation with eating disorders symptoms (0.488) and a positive and weak correlation with obsessive-compulsive symptoms (0.224)., Conclusion: The DOS-BR was culturally and psychometrically adequate for the samples of Brazilian Nutrition-related subjects. The tool is indicated as a reliable alternative to evaluate orthorexia nervosa in Brazilian scenery., Level of Evidence: Descriptive (cross-sectional) study, Level V., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG part of Springer Nature.)

Objective: Developing health promotion activities, aimed at healthy food intake, is essential for improving quality of life and reducing the prevalence of chronic diseases. Thus, the objective of this study is to describe both dietary and nutrient intake, according to length of participation in a health promotion service (Programa Academia da Saúde - PAS)., Design: A cross-sectional study was carried out with a representative sample of PAS units in vulnerable areas of the city. Dietary and nutrient intake were assessed, using the average of two 24-h recalls. Food was categorised according to the NOVA (a systematic grouping of all foods according to the nature, extent and purpose of the industrial processes they undergo) classification. The length of participation in PAS is presented in months and is then examined in tertiles for analysis., Setting: Belo Horizonte - Brazil., Participants: 3372 adults (≥20 years)., Results: Users in the third tertile of PAS (24·4-61·6 months) experienced less energy intake, lipids and ultra-processed foods, and more culinary preparations, compared to others. Users in the second (10·1-24·3 months) and third tertiles of PAS had higher carbohydrate intake, Ca and vitamin C v those in the first tertile (0-10 months)., Conclusions: Results suggest that greater participation in PAS can improve dietary and nutrient intake, showing its potential to promote healthy lifestyles, prevent chronic diseases and offer longitudinal health care.

Objectives: To evaluate the direct and indirect effects of family characteristics and the perceived neighborhood environment on obesity risks among schoolchildren., Methods: Through phone contact with the child's mothers/guardians, the perceptions about the aspects of the neighborhood that could limit or promote health. Physical activity, socioeconomic data, self-reported weight and height, and ultra-processed consumption of the respondents were evaluated, in addition to the screen time of both mothers and children. A hybrid model of structural equations was used to test the direct and indirect effects of family and environmental variables on childhood obesity., Setting: Belo Horizonte, Minas Gerais, Brazil., Subjects: A total of 322 children from 9 to 10 years old from municipal schools and their respective mothers/guardians., Results: Childhood obesity was positively associated with obesity among mothers/guardians and with the latent variable "socioeconomic status (SES)." It was observed that the child's guardians positively influenced childhood obesity through their own habits, such as screen time and consumption of ultra-processed products, with obesity of mothers/guardians as mediators of both associations. There were no direct and indirect effects of the latent variables of the perceived environment in childhood obesity., Conclusion: Family characteristics are important determinants of childhood obesity and should be considered when designing prevention strategies. Parental perceptions of neighborhood characteristics did not have an influence on childhood obesity., (© 2020 Wiley Periodicals LLC.)

Objectives: The objective of this study was to examine the influence of maternal nutrient intake during pregnancy on the baby's birth weight at term., Methods: A cross-sectional study design was used to evaluate a sample of women aged 18 to 44 y in the postpartum period in a public maternity department (2018-2019), with dietary intake collected by a validated food frequency questionnaire (n = 626 mother-offspring pairs). A multivariable linear regression model was used to identify the influence of nutrient intake during pregnancy on the baby's birth weight at term. The model was adjusted for maternal energy intake, education level, gestational age, physical activity, and supplementation during pregnancy., Results: Maternal intake of vitamins B 3 and C was associated with an increase in birth weight (respectively, β = 0.01; 95% confidence interval [CI], 0.01-0.02; P = 0.01; and β = 0.01; 95% CI, 0.01-0.02; P = 0.02). Prepregnancy body mass index (β = 0.01; 95% CI, 0.01-0.02; P = 0.001), gestational weight gain (β = 0.02; 95% CI, 0.01-0.02; P < 0.001), parity (β = 0.05; 95% CI, 0.02-0.09; P = 0.001), and male babies (β = 0.08; 95% CI, 0.01-0.02; P = 0.02) also contributed to increase birth weight. These variables explained about 27% of the variation of this outcome (adjusted R 2  = 0.27, P < 0.001)., Conclusions: Our findings provide evidence that maternal intake of vitamins B 3 and C influences increased birth weight. In addition, prepregnancy body mass index, gestational weight gain, parity, and male babies contribute to the same outcome., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Pacová ( Renealmia petasites Gagnep.) is a Brazilian native plant, usually cultivated in south regions of the country. Pacová was previously reported concerning their possible health benefits, mostly from folk medicine. However, only few works relates the health benefits with the composition of the fruit parts. In this context, this work aimed to bring, for the first time in literature, the chemical characterization in respect to lipid and terpene composition of R. petasites oilseed, performed by three different extraction methods (supercritical fluid extraction (SFE) with CO 2 , Soxhlet with petroleum ether (SOX), and maceration with hexane (MAC)). SFE was most selective for MUFAs, PUFAs, sesqui- and diterpenes. The main terpene identified in all extracts was 2-carene. The extracts presented poor AChE inhibition, and SOX presented potential inhibitory effect against lipoxygenase activity. Overall, R. petasites oilseed is a natural source of terpenes and their potential health benefits are highly encouraged to be investigated., Competing Interests: 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., (© 2021 The Authors.)

Objective: Describing the consumption of ultra-processed foods (UPF) and their association with the nutritional profiles among users of a health promotion service in a Brazilian city., Design: Cross-sectional study., Setting: Public health promotion service of Primary Health Care in Belo Horizonte, Minas Gerais, Brazil., Participants: Totally, 3372 participants., Results: UPF were found to contribute to 27·7 % of the diet's total energy. The highest consumption was associated with higher values for energy intake (1561·8 v. 1331·8 kcal/d; P < 0·01), energy density (1·7 v. 1·4 kcal/g; P < 0·01), total (32·5 v. 27·3 %; P < 0·01) and trans-fats (2·1 v. 1·2 %; P < 0·01) and Na (1001·6 v. 758·9 mg/1000 kcal; P < 0·01) and with lower values for proteins (14·9 v. 19·6 %; P < 0·01), mono-unsaturated fats (16·1 v. 20·1 %; P = 0·02), n-3 (0·9 v. 1·1 %; P < 0·01) and some vitamins and minerals when comparing individuals in the last quintile of energy contribution from UPF in relation to the first one. The prevalence rate of nutrient inadequacy aimed at preventing non-communicable diseases increased between 30 % and 100 % when compared with the values of the fifth to the first quintile of UPF consumption (P < 0·001). However, the participants had lower energy intake, energy density and Na and higher fibre consumption when compared to Brazilian population., Conclusions: Participants showed a high consumption of UPF, but also positive diet characteristics when compared with the national data. The results suggest the importance of health promotion services to promote healthy food and the need to include approaches to reduce UPF consumption.

Background: The Food Frequency Questionnaire (FFQ) is usually used in epidemiological studies to assess food consumption. However, the FFQ must have good accuracy, requiring its validation and reproducibility for the target population. Thus, this study aimed to describe the construction of the online Food Frequency Questionnaire (oFFQ) used at the Cohort of Universities of Minas Gerais (CUME project, Brazil) and evaluate its validity and reproducibility. Methods: The oFFQ was answered two times in 1 year (March/August 2018-March/April 2019; n = 108 participants-reproducibility), and four 24-h dietary recalls (24hRs) were applied in two seasons of the southern hemisphere [two 24hRs in autumn (March/June 2018) and two 24hRs in winter (August/September 2018); n = 146 participants-validity]. To assess the validity and reproducibility, the intraclass correlation coefficients (ICCs) were estimated. Results: The oFFQ had 144 food items separated into eight groups (dairy products; meat and fish; cereals and legumes; fruits; vegetables; fats and oils; drinks; other foods). In assessing the validity, ICCs for energy and macronutrients were considered moderate, ranging from 0.41 (energy) to 0.59 (protein), while the ICCs for micronutrients were considered low to moderate, ranging from 0.25 (fibers) to 0.65 (vitamin B6). Regarding reproducibility assessment, ICCs for energy and all the assessed items were considered moderate to excellent, ranging from 0.60 (vegetables) to 0.91 (vitamin E and retinol). Conclusions: The self-reported oFFQ had satisfactory validity and reproducibility. So, it can be used to analyze the association between food consumption and chronic diseases in the participants of the Cohort of Universities of Minas Gerais (CUME project-Brazil)., Competing Interests: The 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 © 2021 Azarias, Marques-Rocha, Miranda, dos Santos, Gomes Domingos, Hermsdorff, Bressan, Oliveira, Leal and Pimenta.)

Sjogren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs. Women with SS often experience gynecological symptoms due to the disease and need extra care regarding their sexual activity, reproductive health and during pregnancy, conditions that are not properly conducted in the clinical practice. To cover this gap, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of symptoms, diagnosis, monitoring, prognosis, and treatment of these manifestations. A Focus Group meeting was held and included experts in the field and methodologists, based on a previously developed script, with themes related to the objective of the study. The most important topics were summarized and 11 recommendations were provided., (© 2021. The Author(s).)

Oculo-auriculo-vertebral spectrum (OAVS) is a developmental disorder characterized by anomalies mainly involving the structures derived from the first and second pharyngeal arches. The spectrum presents with heterogeneous clinical features and complex etiology with genetic factors not yet completely understood. To date, MYT1 is the most important gene unambiguously associated with the spectrum and with functional data confirmation. In this work, we aimed to identify new single nucleotide variants (SNVs) affecting MYT1 in a cohort of 73 Brazilian patients diagnosed with OAVS. In addition, we investigated copy number variations (CNVs) encompassing this gene or its cis-regulatory elements and compared the frequency of these events in patients versus a cohort of 455 Brazilian control individuals. A new SNV, predicted as likely deleterious, was identified in five unrelated patients with OAVS. All five patients presented hearing impairment and orbital asymmetry suggesting an association with the variant. CNVs near MYT1, located in its neighboring topologically associating domain (TAD), were found to be enriched in patients when compared to controls, indicating a possible involvement of this region with OAVS pathogenicity. Our findings highlight the genetic complexity of the spectrum that seems to involve more than one variant type and inheritance patterns., (© 2021 Wiley Periodicals LLC.)

This paper presents a low-cost architecture that allows for beamforming with antenna arrays installed onto unmanned aerial vehicles (UAVs). Beam switching is proposed to improve the antenna gain towards the ground station with two three-element arrays installed below the wings of the UAV. The electromagnetic modeling of the complete structure (UAV and integrated antennas) was performed with commercial electromagnetic simulator Ansys HFSS. The radiation patterns were synthesized with particle swarm optimization (PSO). By employing lumped surface-mount device (SMD) components and switches, the design of the feeder to deliver proper excitation coefficients to the antennas is presented, and its performance was assessed by simulations. The proposed approach is demonstrated to be very effective with low-cost production.