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to investigate the shifts and factors associated with different scenarios resulting from the prevalence of child stunting and overweight in Brazilian municipalities.
This is an ecological study using municipality-level panel data of stunting and overweight prevalence and socioeconomic characteristics from 2008 to 2014. The municipalities were classified according to the WHO-UNICEF prevalence thresholds for stunting and overweight, and were categorized into four nutritional scenarios: no burden (prevalence of stunting <20% and overweight <10%), stunting burden (prevalence of stunting ≥20% and overweight <10%), overweight burden (prevalence of stunting <20% and overweight ≥10%), and double burden (prevalence of stunting ≥20% and overweight ≥10%).
4,443 Brazilian municipalities.
Aggregated data of children under 5 years old enrolled in the Brazil’s conditional cash transfer program (Bolsa Família).
A mean reduction from 14.2% to 12.7% in the prevalence of stunting and an increase from 17.2% to 18.4% in the prevalence of overweight were observed. The predominant scenarios were overweight burden and double burden. The odds of both scenarios increased with higher GDP per capita and decreased with higher unemployment rates. Stunting and double burden decreased with higher expected years of schooling, and stunting burden increased with household crowding.
Our findings indicate an advanced nutrition transition stage in Brazil, associated mainly with municipal GDP per capita growth, which has contributed to increasing the burden of overweight alone or coexisting with stunting (double burden) among children in the most socioeconomically vulnerable strata of the population.
Background:Stenotrophomonas maltophilia is an emerging pathogen responsible for high morbidity and mortality rates. Hospital infections caused by this bacteria, especially in intensive care centers, are concerning for the health system, given that the microorganism is multidrug resistant to most antimicrobials available. Objective: Therefore, the present study is built from an analysis of the variables related to nosocomial infections caused by S. maltophilia in hospitals in Brazil, to display points of major concern. Methods: We used the data collected by the Infection Prevention and Control Service to clarify the incidence rate of Stenotrophomonas maltophilia in Brazilian hospitals as well as the gross lethality of these infections and the profiles of infected patients. We collected and analyzed epidemiological data from 10 hospitals in Brazil for the period July 2014 to June 2019 according to the CDC NHSN protocol. Results: In 5 years, 93 Stenotrophomonas maltophilia infections were diagnosed in the hospitals analyzed. Overall, 61 occurred in men (66%) and 32 occurred in women (34%). Furthermore, 47 cases (51%) occurred in adult ICUs; 19 cases (20%) followed zascular surgery; 9 (10%) cases occurred in the neonatal ICU; 7 (8%) cases were from the medical clinic; and 11 (12%) were from other clinics. The incidence rate was 1.2 cases for 10,000 hospitalizations, ranging from 0.0 to 2.8 (Fig. 1). Patients’ ages ranged from 0 to 90 years, with a mean of 55 years (SD, 26 years) and a median of 64 years. Time between admission and diagnosis of infection was 1 to 102 days, with a mean of 24 days (SD, 21 days) and a median of 17 days. The gross lethality for S. maltophilia infection was 43 of 93 (46%) (95% CI, 35.8%–56.9%). The frequencies of specific infections were as follows (Fig. 2): pneumonia, 26 (28%); tracheobronchitism, 22 (24%); primary bloodstream infection, 18 (19%); skin and soft-tissue infection, 13 (14%); local infection, 7 (8%); vascular access infection, 3 (3%); urinary tract infection, 2 (2%); gastrointestinal infection, 1 (1%); and eye, nose, throat, and mouth infections, 1 (1%). Conclusions:Stenotrophomonas maltophilia infection is a rare and highly lethal event that usually occurs after 2 weeks of hospitalization. The most affected region is the respiratory tract, with a higher incidence in patients aged >60 years or in the ICU. Early and accurate investigations of multiresistant microorganisms in a hospital setting are needed to reduce patient morbidity and mortality.
Motor abnormalities (MAs) are the primary manifestations of schizophrenia. However, the extent to which MAs are related to alterations of subcortical structures remains understudied.
We aimed to investigate the associations of MAs and basal ganglia abnormalities in first-episode psychosis (FEP) and healthy controls. Magnetic resonance imaging was performed on 48 right-handed FEP and 23 age-, gender-, handedness-, and educational attainment-matched controls, to obtain basal ganglia shape analysis, diffusion tensor imaging techniques (fractional anisotropy and mean diffusivity), and relaxometry (R2*) to estimate iron load. A comprehensive motor battery was applied including the assessment of parkinsonism, catatonic signs, and neurological soft signs (NSS). A fully automated model-based segmentation algorithm on 1.5T MRI anatomical images and accurate corregistration of diffusion and T2* volumes and R2* was used.
FEP patients showed significant local atrophic changes in left globus pallidus nucleus regarding controls. Hypertrophic changes in left-side caudate were associated with higher scores in sensory integration, and in right accumbens with tremor subscale. FEP patients showed lower fractional anisotropy measures than controls but no significant differences regarding mean diffusivity and iron load of basal ganglia. However, iron load in left basal ganglia and right accumbens correlated significantly with higher extrapyramidal and motor coordination signs in FEP patients.
Taken together, iron load in left basal ganglia may have a role in the emergence of extrapyramidal signs and NSS of FEP patients and in consequence in the pathophysiology of psychosis.
In the present study, the morphological development of the Brycon amazonicus digestive tract is described to provide basic knowledge for nutritional studies and, therefore, increase the survival of this species during larviculture. Samples were collected from hatching up to 25 days of age, measured, processed and observed under a stereomicroscope and light microscopy. Newly hatched larvae presented their digestive tract as a straight tube, dorsal to the yolk sac, lined with a single layer of undifferentiated cells. At 24 h post-hatching (hPH), the buccopharyngeal cavity was open, but the posterior region of the digestive tube remained closed. At 25 hPH, the digestive tube was completely open and could be divided into buccopharyngeal cavity, oesophagus and intestine. At 35 hPH, the intestine presented a dilatation in the proximal region, which had the function of storing food. Differentiation of the stomach started at 83 hPH, and mucous cells were observed in the epithelium. These cells are important in the production of mucus, whose function is to protect the organ against acidity, although the gastric glands began developing only from 171 hPH, when three stomach regions were observed: cardiac, fundic and pyloric. The gastric glands were observed in the cardiac region, indicating that this organ already had digestive functionality. From 243 hPH, the absorption and assimilation of nutrients were already possible but, only from 412 hPH, the digestive tract was completely developed and functional.
Definitive diagnosis of hookworm infection is usually based on the microscopic detection of eggs in a stool sample; however, several cases display a low or irregular egg output. Serodiagnosis can be a useful tool to identify these cases, but conventional tests do not differentiate past from active infections. The aim of this study was to obtain and apply egg yolk polyclonal immunoglobulin (IgY) antibodies to detect immune complexes (ICs) in serum samples from patients infected with hookworm. Hens were immunized with Ancylostoma ceylanicum saline extract, their eggs were collected and then IgY antibodies were extracted and purified. Antibody purity was tested by 12% sodium dodecyl sulphate polyacrylamide gel electrophoresis and specificity was assessed by immunoblotting and immunofluorescence. IgY production was evaluated by kinetics enzyme-linked immunosorbent assay (ELISA). Sandwich ELISA tested the ability of IgY to detect ICs in serum samples, from which diagnostic parameters were calculated. Antibody responses increased steadily from day 7 to 42. In the immunoblotting assay, IgY recognized two protein complexes. The immunofluorescence assay showed no staining in control samples. The sandwich ELISA presented a very high diagnostic value, with a sensitivity of 90% and a specificity of 86.7%. Our pioneer strategy highlights the potential use of egg yolk IgY as a diagnostic test to detect active hookworm infection.
Portable haemoglobinometers have been used in order to estimate the prevalence of anaemia in diverse settings. However, few studies have been conducted to evaluate their performance in children of different age groups in distinct epidemiological contexts. To evaluate the reproducibility and reliability of a portable haemoglobinometer for the diagnosis of anaemia in children <5 years Hb was measured in the venous blood of 351 children <5 years by an automated system (standard method) and in three capillary blood samples, using a portable haemoglobinometer (HemoCue®; test method). The reproducibility of the device and of the test method was evaluated using the intraclass correlation coefficient (ICC) (Hb in its continuous form), κ and prevalence-adjusted bias-adjusted κ (PABAK) (categorised variable: anaemia: yes/no). For test method validation, Bland–Altman analyses were performed and sensitivity, specificity, accuracy rate, positive predictive value (PPV) and negative predictive values (NPV) were calculated. The haemoglobinometer presented good device reproducibility (ICC = 0·79) and reasonable method reproducibility (puncture, collection and reading) (ICC = 0·71). Superficial and fair agreement (κ) and good agreement (PABAK) were observed among the diagnoses obtained through the test method. The prevalence of anaemia was 19·1 and 19·7 % using the standard and the test method, respectively, with no statistically significant differences. The test method presented higher specificity (87·7 %) and NPV (88·3 %) than sensitivity (50·7 %) and PPV (49·3 %), and intermediary accuracy rate (57·8 %). HemoCue® showed good device reproducibility and reasonable method reproducibility, as well as good performance in estimating the prevalence of anaemia. Nevertheless, it showed a fair reliability and low individual diagnostic accuracy.
The demographic transition is a global event intensified during the last decades that represents population aging. Thus, the studies directed to the elderly 80 years of age or more with preserved cognitive functions (named SuperAgers) emerges as a possible path to full comprehension of the health of those aging with acceptable levels of functionality and independency.
To evaluate the cognitive performance of the elderly over 80 years old, associating the results to their educational level.
We evaluated 144 healthy elders with 80 years or more through the following cognitive tests Mini-Mental State Examination (MMSE), Cambridge Cognitive Examination (CAMCOG), Clock Drawing Test (CDT), and Verbal Fluency Test (VF) and compared the tests’ scores with their educational level segmented in years of formal education, being the groups ILLITR (<1 year of schooling), 1TO4 (from 1 to 4 years of schooling), and 5MORE (>5 years of schooling).
There was positive influence of educational level on the cognitive tests’ score, which indicates higher cognitive reserve of the elderly with higher educational levels.
The functionality and independence of the so-called SuperAgers is determined by the cognitive reserve acquired throughout life, mainly developed by the years of formal education.
Femoral vein access is the first choice for percutaneous atrial septal defect closure, and when it cannot be used due to anatomic reasons, the alternative sites should be considered, frequently increasing the complexity of the procedure. Here we report the case of a 3-year-old boy, with situs inversus and dextrocardia, electively referred for percutaneous closure of an ostium secundum atrial septal defect. During the procedure, agenesis of the infra-hepatic segment of the inferior caval vein was diagnosed, and no double inferior caval vein or right superior caval vein were identified by ultrasound or angiography. Therefore, we opted to perform the procedure through the left internal jugular vein, with fluoroscopy and transesophageal echocardiographic guidance. Catheters were navigated through a hydrophilic guidewire, and a Stiff guidewire was positioned in the left ventricle for better support. An Amplatzer septa occluder 19 was successfully deployed without major difficulties and the patient was discharged after 24 hours in good clinical condition. Percutaneous atrial septal defect closure through alternative access sites, especially in the presence of situs inversus, may pose significant challenges to the interventional team. In this case, the left internal jugular vein has shown to be a feasible option, allowing the navigation and manipulation of devices without complications. Provided the expertise of the interventional team, and awareness of the risks involved, alternative access sites can be successfully used for paediatric structural interventions.
The University of São Paulo Twin Panel (Painel USP de Gêmeos), based at the Institute of Psychology of the University of São Paulo, started formally in 2017. Our registry is new, but in only two years of formal existence, it comprises a volunteer sample of 4826 registered individuals (98% twins and 2% higher-order multiples), recruited at the University of São Paulo and by social media campaigns. Our main aim is to conduct and promote research with twins on psychological processes and behavior. The University of São Paulo is the largest higher education and research institution in South America, and the Painel USP de Gêmeos has great potential for fostering research on twin-related issues from a psychological perspective in Brazil and South America.
Studies have shown that daily exposure to different products, whether chemical or natural, can cause irreversible damage to women’s reproductive health. Therefore it is necessary to use tests that evaluate the safety and efficacy of these products. Most reproductive toxicology tests are performed in vivo. However, in recent years, various cell culture methods, including embryonic stem cells and tissues have been developed with the aim of reducing the use of animals in toxicological tests. This is a major advance in the area of toxicology, as these systems have the potential to become a widely used tool compared with in vivo tests routinely used in reproductive biology and toxicology. The present review describes and highlights data on in vitro culture processes used to evaluate reproductive toxicity as an alternative to traditional methods using in vivo tests.
The objectives were to develop an effective protocol for transfection of ovine secondary follicles and to assess the effect of attenuating aquaporin 3 (AQP3) using a small interfering RNA (siRNA-AQP3) on antrum formation and follicular growth in vitro. Various combinations of Lipofectamine® volumes (0.5, 0.75 or 1.0 µl), fluorescent oligonucleotide (BLOCK-iT ™) concentrations (3.18, 27.12 or 36.16 nM) and exposure times (12, 14, 16, 18 or 20 h) were tested. The BLOCK-iT™ was replaced by siRNA-AQP3 in the transfection complex. Ovine secondary follicles were isolated and cultured in vitro for 6 days using standard protocols. Follicles were transfected on day 0 or 3 or on both days (0 and 3) and then cultured for an additional 3 or 6 days. As revealed by the fluorescence signal, the Lipofectamine®/BLOCK-iT™ complex (0.75 µl + 27.12 nM by 12 h of incubation) crossed the basement membrane and granulosa cell and reached the oocytes. In general, the rate of intact follicles was higher and the rate of antrum formation was lower in transfected follicles compared with control follicles. In conclusion, ovine secondary follicles can be successfully transfected during in vitro culture, and siRNA-mediated attenuation of AQP3 gene reduced antrum formation of secondary follicles.
Phenological models for predicting the grapevine flowering were tested using phenological data of 15 grape varieties collected between 1990 and 2014 in Vinhos Verdes and Lisbon Portuguese wine regions. Three models were tested: Spring Warming (Growing Degree Days – GDD model), Spring Warming modified using a triangular function – GDD triangular and UniFORC model, which considers an exponential response curve to temperature. Model estimation was performed using data on two grape varieties (Loureiro and Fernão Pires), present in both regions. Three dates were tested for the beginning of heat unit accumulation (t0 date): budburst, 1 January and 1 September. The best overall date was budburst. Furthermore, for each model parameter, an intermediate range of values common for the studied regions was estimated and further optimized to obtain one model that could be used for a diverse range of grape varieties in both wine regions. External validation was performed using an independent data set from 13 grape varieties (seven red and six white), different from the two used in the estimation step. The results showed a high coefficient of determination (R2: 0.59–0.89), low Root Mean Square Error (RMSE: 3–7 days) and Mean Absolute Deviation (MAD: 2–6 days) between predicted and observed values. The UniFORC model overall performed slightly better than the two GDD models, presenting higher R2 (0.75) and lower RMSE (4.55) and MAD (3.60). The developed phenological models presented good accuracy when applied to several varieties in different regions and can be used as a predictor tool of flowering date in Portugal.
Selenium (Se) is an essential micronutrient for humans, yet its dietary intake is low, mostly due to the low bioavailability in soils and therefore in edible plant tissues. To overcome Se deficiency, the breeding approach (i.e., genetic biofortification), namely in rice, is largely dependent on available Se pools. To ensure the success of genetic biofortification with Se, agronomic biofortification can be accomplished through foliar Se application. Considering this background, the main hypothesis of this work was centered in the foliar application of Se to attain agronomic biofortification of rice crops. This study also aimed to assess the full potential for increasing grain Se concentrations during rice filling, as well as the types of nutrients deposition. An experimental design applying two foliar fertilizers (sodium selenite and sodium selenate) was developed. As test systems, four rice genotypes (Ariete, Albatros, OP1105 and OP1109) were used and the kinetics of micro- and macro-nutrients accumulation and deposition were assessed. Biofortification was performed in field trials for two years with foliar fertilization ranging between 0 and 300 g Se ha−1. At the end of the plant cycle, selenite applications triggered 427- to 884-fold increases in grain Se concentrations among rice genotypes (Albatros > OP1105 > OP1109 > Ariete). The application of selenate also prompted 128- to 347-fold increases in grain Se concentrations in rice crops (Albatros > OP1105 > Ariete > OP1109). Regardless of the foliar fertilizer applied, Se deposition among genotypes occurred throughout the grain without relevant inhibitory effects on yields. In each genotype, micro and macronutrients varied among crop tissues.
The aim of this study was to describe the effect of temperature on the fertilization, early developmental stages, and survival rate of two Neotropical catfishes Pimelodus maculatus and Pseudopimelodus mangurus. After fertilization, the eggs were incubated at 22°C, 26°C, and 30°C, which resulted in fertilization rates of 96.95 ± 1.79%, 98.74 ± 0.76%, and 98.44 ± 0.19% for P. maculatus and 96.10 ± 1.58%, 98.00 ± 0.63%, and 94.60 ± 2.09% for P. mangurus, respectively. For P. maculatus, hatching occurred after 22 h 30 min post-fertilization at 22°C, 16 h 30 min at 26°C, and 11 h 20 min at 30°C, and the hatching rates were 43.87 ± 7,46%, 57.57 ± 17.49%, and 53.63 ± 16.27%, respectively. For P. mangurus, hatching occurred after 28 h 30 min post-fertilization at 22°C and 17 h 30 min at 26°C with respective hatching rates of 45.4 ± 21.02% and 68.1 ± 12.67%. For this species, all embryos incubated at 30°C died before hatching. Additionally, for P. maculatus, the larvae from the lower (22°C) and higher temperatures (30°C) presented increased abnormality rates, as observed in the head, tail and yolk regions. The lowest abnormality rate was detected at 26°C, which was considered the optimal incubation temperature for both species. The developed protocol enables the manipulation of embryonic development, which is important for the application of reproductive biotechniques, including chimerism and chromosome-set manipulation. The data obtained here are also important for the surrogate propagation of this species as P. mangurus was recently categorized as an endangered fish species.
Several methods can be used to obtain, from powder diffraction patterns, crystallite size and lattice strain of polycrystalline samples. Some examples are the Scherrer equation, Williamson–Hall plots, Warren/Averbach Fourier decomposition, Whole Powder Pattern Modeling, and Debye function analysis. To apply some of these methods, it is necessary to remove the contribution of the instrument to the widths of the diffraction peaks. Nowadays, one of the main samples used for this purpose is the LaB6 SRM660b commercialized by the National Institute of Standard Technology; the width of the diffraction peak of this sample is caused only by the instrumental apparatus. However, this sample can be expensive for researchers in developing countries. In this work, the authors present a simple route to obtain micron-sized polycrystalline CeO2 that have a full width at half maximum comparable with the SRM660b and therefore it can be used to remove instrumental broadening.
With obesity being a major public health epidemic, dietitians are charged with the difficult task to assist clients in modifying their behaviours. Since there are inconsistent data about dietitians’ beliefs, attitudes and practices concerning obesity and little is known concerning differences in public and private practice, we conducted the present study to address those gaps.
Semi-structured interviews analysed according to thematic analysis procedures.
Public primary-care and private settings.
Seventeen Portuguese registered dietitians working in public primary-care (n 10) and private settings (n 7).
Regardless of work context, ‘persistence of efforts’ emerged as the main characteristic of dietitians’ action. Besides holding negative attitudes towards obese patients, their practices are not negatively influenced. They perceive themselves as active agents in promoting lifestyle changes, offering as many management strategies as possible to empower patients, feeling positive about the accomplishment of a successful weight loss, believing in their own efficacy and competency in helping patients. However, differences in reimbursement, work environment, perceived barriers, patient characteristics and availability of resources seem to contribute to differences in persistence according to the setting in which dietitians are working, evidenced by an increase of efforts and engagement in private practice and a decrease in public primary-care practice.
Portuguese dietitians present a positive mindset and actions about obesity treatment outcomes; however, education in behaviour change strategies should be improved. The public health system requires reorganization to enhance effective obesity management delivery. Motivation driving dietitians’ work in private settings should be addressed.
Anthropogenic disturbance often results in the proliferation of native species of particular groups that leads to biotic homogenization. Leaf-cutting ants are an example of such winner organisms in tropical rain forests, but their response to disturbance in dry forests is poorly known. We investigated Atta colony density in areas of tropical dry forest in Brazil with different distance to roads and vegetation cover. Atta colonies were surveyed in 59 belt transects of 300 × 20 m, covering a total area of 35.4 ha. We found 224 Atta colonies, 131 of which were active and belonged to Atta opaciceps (87 colonies, 2.45 ha−1), A. sexdens (35 colonies, 0.98 ha−1) and A. laevigata (9 colonies, 0.25 ha−1). The density of active colonies sharply decreased from 15 ± 2.92 ha−1 in the 50-m zone along roads to only 2.55 ± 1.65 ha−1 at distances up to 300 m. The reverse pattern was observed for inactive colonies. Active Atta colonies preferentially occur in areas with low vegetation cover, while inactive colonies prefer areas with high vegetation cover. We demonstrate for the first time that anthropogenic disturbances promote the proliferation of leaf-cutting ants in dry forest in Brazil, which may affect plant regeneration via herbivory and ecosystem engineering as demonstrated for rain forests.
This study aims to investigate the effect 5-azacytidine (5-Aza) during induction of pluripotency in bovine fibroblasts and to evaluate the effects of BMP2, BMP4 or follicular fluid in the differentiation of reprogrammed fibroblasts in primordial germ cells and oocytes. It also analysis the mRNA levels for OCT4, NANOG, REX, SOX2, VASA, DAZL, cKIT, SCP3, ZPA and GDF9 after culturing 5-Aza treated fibroblasts in the different tested medium. Dermal fibroblasts were cultured and exposed to 0.5, 1.0 or 2.0 μM of 5-Aza for 18 h, 36 h or 72 h. Then, the cells were cultured in DMEM/F12 supplemented with 10 ng/ml BMP2, 10 ng/ml BMP4 or 5% follicular fluid. After culture, morphological characteristics, viability and gene expression were evaluated by qPCR. Treatment of skin fibroblasts with 2.0 μM 5-Aza for 72 h significantly increased expression of mRNAs for SOX2, OCT4, NANOG and REX. The culture in medium supplemented with BMP2, BMP4 or follicular fluid for 7 or 14 days induced formation of oocyte-like cells, as well as the expression of markers for germ cells and oocyte. In conclusion, treatment of bovine skin-derived fibroblasts with 2.0 μM 5-Aza for 72 h induces the expression of pluripotency factors. Culturing these cells in differentiation medium supplemented with BMP2, BMP4 or follicular fluid induces morphological changes and promotes expression of markers for germ cells, meiosis and oocyte.
In the frame of the COST ACTION ‘EMBOS’ (Development and implementation of a pan-European Marine Biodiversity Observatory System), coverage of intertidal macroalgae was estimated at a range of marine stations along the European coastline (Subarctic, Baltic, Atlantic, Mediterranean). Based on these data, we tested whether patterns in macroalgal diversity and distribution along European intertidal rocky shores could be explained by a set of meteo-oceanographic variables. The variables considered were salinity, sea surface temperature, photosynthetically active radiation, significant wave height and tidal range and were compiled from three different sources: remote sensing, reanalysis technique and in situ measurement. These variables were parameterized to represent average conditions (mean values), variability (standard deviation) and extreme events (minimum and maximum values). The results obtained in this study contribute to reinforce the EMBOS network approach and highlight the necessity of considering meteo-oceanographic variables in long-term assessments. The broad spatial distribution of pilot sites has allowed identification of latitudinal and longitudinal gradients manifested through species composition, diversity and dominance structure of intertidal macroalgae. These patterns follow a latitudinal gradient mainly explained by sea surface temperature, but also by photosynthetically active radiation, salinity and tidal range. Additionally, a longitudinal gradient was also detected and could be linked to wave height.