Beginning in 2018, a quality improvement collaborative initiative in Brazil successfully reduced the baseline incidence density of healthcare-associated infections in intensive care settings after 2 years. We describe the adaptations of the quality improvement interventions as the COVID-19 pandemic emerged and how the pandemic affected the project outcomes.

The intrinsic complexity, variety of concepts and numerous ways to quantify landscape heterogeneity (LH) may hamper a better understanding of how its components relate to ecological phenomena. Our study is the first to synthesize understanding of this concept and to provide the state of the art on the subject based on a comprehensive systematic literature review of 661 articles published between 1982 and 2019. Definitions, terminologies and measurements of LH were diverse and conflicting. Most articles (534 out of 661) did not provide any definition for LH, and we found great variation among the studies that did. According to our review, only 10 studies measured the effects of different land-cover types on biotic or abiotic processes (functional LH). The remaining 651 studies measured physical attributes of the landscape without mentioning that different land-cover types may impact biotic and abiotic processes differently (structural LH). The metrics most frequently used to represent LH were the Shannon diversity index and proportion of land-cover type. Most metrics used as proxies of LH also coincided with those used to represent non-heterogeneity metrics, such as fragmentation and connectivity. We identify knowledge gaps, indicate future perspectives and propose guidelines that should be addressed when researching LH.

Teachers can contribute to preventing and solving cyberbullying situations. Therefore, it is relevant to investigate what may influence their involvement and actions concerning this phenomenon. A first study analyze teachers’ definitions of cyberbullying, how they would intervene and feel morally implicated with the phenomenon. A second study aimed to investigate the association between teachers’ being aware of cyberbullying and their perceived severity, moral disengagement with the phenomenon, perceived performance to solve such situations and their acquired knowledge about cyberbullying. Twenty semi-structured interviews were conducted in the first study with 25 to 65-year-old teachers. An online inventory was answered in study two by 541 middle and high school teachers (Mage = 50, SD = 7). A thematic analysis from the first study revealed that most teachers did not report repetition of behavior, power imbalance, intentionality to harm, and occurrence among peers as defining features of cyberbullying. Also, strategies they would use to intervene mainly focused on reporting the incident. Moreover, moral disengagement mechanisms were found in teachers’ discourse, which contribute to displacing responsibility for intervening and perceiving cyberbullying as less severe. In the second study, path analysis revealed that teachers’ awareness of cyberbullying among their students was positively associated with moral disengagement and acquired knowledge of the phenomenon. The mediating role of acquired knowledge of cyberbullying was significant between being aware of cyberbullying and teachers’ perceived severity of the situation, moral disengagement, and perceived performance to solve these situations. These findings highlight the relevance of developing cyberbullying training actions involving teachers.

This study aimed to evaluate the longitudinal association of vitamin D status with glycaemia, insulin, homoeostatic model assessment of insulin resistance, adiponectin and leptin. A prospective cohort with 181 healthy, pregnant Brazilian women was followed at the 5th–13th, 20th–26th and 30th–36th gestational weeks. In this cohort, 25-hydroxyvitamin D (25(OH)D) plasma concentrations were analysed using liquid chromatography–tandem MS. Vitamin D status was categorised as sufficient or insufficient using the Endocrine Society Practice Guidelines (≥75/<75 nmol/l) and the Institute of Medicine (≥50/<50 nmol/l) thresholds. Linear mixed-effect regression models were employed to evaluate the association between vitamin D status and each outcome, considering interaction terms between vitamin D status and gestational age (P<0·1). At baseline, 70·7 % of pregnant women had 25(OH)D levels <75 nmol/l and 16 % had levels <50 nmol/l. Women with sufficient vitamin D status at baseline, using both thresholds, presented lower glycaemia than those with insufficient 25(OH)D. Pregnant women with 25(OH)D concentrations <75 nmol/l showed lower insulin (β=−0·12; 95 % CI −0·251, 0·009; P=0·069) and adiponectin (β=−0·070; 95 % CI −0·150, 0·010; P=0·085) concentrations throughout pregnancy than those with 25(OH)D levels ≥75 nmol/l. Pregnant women with 25(OH)D <50 nmol/l at baseline presented significantly higher leptin concentrations than those with 25(OH)D levels ≥50 nmol/l (β=−0·253; 95 % CI −0·044, 0·550; P=0·095). The baseline status of vitamin D influences the biomarkers involved in glucose metabolism. Vitamin D-sufficient women at baseline had higher increases in insulin and adiponectin changes throughout gestation than those who were insufficient.

The aim of the study was to evaluate the food intake of pregnant women with gestational diabetes mellitus (GDM) according to two methods of dietary guidance. A randomised controlled clinical trial was conducted by appointment with a nutritionist and by using data from hospital records (2011–2014). The study population comprised adult women diagnosed with GDM treated in a public maternity hospital in Rio de Janeiro, Brazil. The control group (CG) received nutritional advice by the traditional method and the intervention group (IG) were instructed on carbohydrate counting. The analysis of food intake and the consumption of processed foods (PF) and ultra-processed foods (UPF) were evaluated in the second and third trimester. A total of 286 pregnant women were initially assessed (145 in the CG and 141 in the IG). It was observed that 89/120 (74·2 %) and 183/229 (79·9 %) consumed PF daily in the second and third trimesters, respectively, whereas 117/120 (97·5 %) and 225/231 (97·4 %) consumed UPF daily in the second and third trimesters, respectively. When analysing the intake of macronutrients (%) by quartiles, women who had fat intake in the third quartile had the highest average postprandial blood glucose compared with those who consumed fat in the second quartile (P=0·02). The consumption of PF and UPF was high and dietary intake was similar in both groups, regardless of dietary guidance method deployed, suggesting that both methods tested in the study can be used for monitoring the nutritional status of pregnant women with GDM.

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.

Bioactive molecules isolated from plants are promising sources for the development of new therapies against leishmaniasis. We investigated the leishmanicidal activity of cariphenone A (1), isouliginosin B (2) and uliginosin B (3) isolated from Hypericum species. Promastigotes and amastigotes of Leishmania amazonensis were incubated with compounds 1–3 at concentrations 1–100 µm for 48 h. The anti-promastigote effect of compounds was also tested in combinations. The cytotoxicity against macrophages and human erythrocytes were determined using the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) method and hemolysis assay, respectively. The compounds 1–3 showed high leishmanicidal activity against promastigotes, IC50 values of 10.5, 17.5 and 11.3 µm, respectively. Synergistic interactions were found to the associations of compounds 1 and 2 [Σ fractional inhibitory concentration (FIC) = 0.41], and 2 and 3 (ΣFIC = 0.28) on promastigotes. All Hypericum compounds induced mitochondrial hyperpolarization and reactive oxygen species production in promastigotes. The compounds showed low cytotoxicity toward mammalian cells, high selectivity index and killed intracellular amastigotes probably mediated by oxidative stress. These results indicate that these compounds are promising candidates for the development of drugs against leishmaniasis.

The aim of this study was to evaluate the association of dietary patterns (DP) with maternal adiposity indicators, leptin, adiponectin and insulin concentrations during pregnancy. A prospective cohort of pregnant women followed up at the 5th–13th, 20th –26th and 30th–36th gestational weeks and 30–40 d postpartum was conducted in Rio de Janeiro. A FFQ was administered in the third trimester (30th–36th gestational weeks). The reduced rank regression procedure was used to identify DP that explain response variables (dietary fibre and total fat) related to indicators of maternal adiposity (postpartum weight retention and gestational weight gain (GWG) adequacy), and plasma leptin, adiponectin and insulin concentrations. The associations between tertiles of DP and the outcomes were determined using logistic regression or longitudinal linear mixed-effect regression models. The mean daily energy intake during pregnancy was 10 104 (sd 3234) kJ (2415 (sd 773) kcal), and GWG was 11·9 (sd 4·2) kg. In all, 40 % of women presented pre-gestational overweight/obesity. Excessive GWG occurred in 34·7 % of pregnant women and 56·6 % were overweight/obese at postpartum. The ‘common-Brazilian’ DP (characterised by higher intake of beans, rice and lower intake of fast food/snacks, candies/table sugar and processed meats/bacon) was positively associated with adiponectin (β=1·07; 95 % CI 0·17, 1·98). The ‘Western’ DP (characterised by higher intake of fast food/snacks and processed meat/bacon and lower intake of noodles/pasta/roots/tubers and sodas) was negatively associated with adiponectin (β=−1·11; 95 % CI −2·00, −0·22) and positively associated with leptin concentrations (β=64·9; 95 % CI 22·8, 107·0) throughout pregnancy. It may be suggested that the ‘common-Brazilian’ is a healthy DP and beneficial for serum concentrations of adiponectin and leptin.

Pristine multiwalled carbon nanotubes (P-MWCNTs) were functionalized with carboxylic groups (MWCNT-COOH) through oxidation reactions and then reduced to produce hydroxyl groups (MWCNT-OH). Pristine and functionalized MWCNTs were used to produce poly(hydroxybutyrate-co-hydroxyvalerate) (PHBV) nanocomposites with 0.5 wt% of MWCNTs. MWCNT functionalization was verified by visual stability in water, infrared and Raman spectroscopy, and zeta potential measurements. Pristine and functionalized MWCNTs acted as the nucleating agent in a PHBV matrix, as verified by differential scanning calorimetry (DSC). However, the dispersion of filler into the matrix, thermal stability, and direct current (DC) conductivity were affected by MWCNT functionalization. Scanning electron microscopy (SEM) showed that filler dispersion into the PHBV matrix was improved with MWCNT functionalization. The surface roughness was reduced with the addition and functionalization of MWCNT. The thermal stability of PHBV/MWCNT-COOH, PHBV/P-MWCNT, and PHBV/MWCNT-OH nanocomposites were 20, 30, and 30 °C higher than neat PHBV, respectively, as verified by thermogravimetry analysis (TGA). Addition of pristine and functionalized MWCNTs provided electrical conductivity in nanocomposite, which was higher for PHBV/P-MWCNTs (1.2 × 10−5 S cm−1).

The aim of this work was to evaluate the effect of cryopreservation protocols on subsequent development of in vitro produced bovine embryos under different culture conditions. Expanded in vitro produced blastocysts (n = 600) harvested on days 7–9 were submitted to controlled freezing [slow freezing group: 10% ethylene glycol (EG) for 10 min and 1.2°C/min cryopreservation]; quick-freezing [rapid freezing group: 10% EG for 10 min, 20% EG + 20% glycerol (Gly) for 30 s]; or vitrification [vitrification group: 10% EG for 10 min, 25% EG + 25% Gly for 30 s] protocols. Control group embryos were not exposed to cryoprotectant or cryopreservation protocols and the hatching rate was evaluated on day 12 post-insemination. In order to evaluate development, frozen–thawed embryos were subjected to granulosa cell co-culture in TCM199 or SOFaa for 4 days. Data were analyzed by PROC MIXED model using SAS Systems for Windows®. Values were significant at p < 0.05. The hatching rate of the control group was 46.09%. In embryos cultured in TCM199, slow freezing and vitrification group hatching rates were 44.65 ± 5.94% and 9.43 ± 6.77%, respectively. In embryos cultured in SOFaa, slow freezing and vitrification groups showed hatching rates of 11.65 ± 3.37 and 8.67 ± 4.47%, respectively. In contrast, the rapid freezing group embryos did not hatch, regardless of culture medium. The slow freezing group showed higher hatching rates than other cryopreservation groups. Under such conditions, controlled freezing (1.2°C/min) can be an alternative to cryopreservation of in vitro produced bovine embryos.

The domestic dog's involvement with different members of the Trypanosomatidae family has been the focus of several studies due to this animal's close proximity to man. Recently this animal has been infected by a new Trypanosoma species (T. caninum), described in Rio de Janeiro and 19 similar isolates were later obtained. The objective of this study was to identify these isolates. All samples were isolated from intact skin cultures and analysed morphologically, by biochemical isoenzyme electrophoresis assays and by several molecular PCR assays. Additionally, anti-Leishmania sp. antibodies were assessed using the indirect Immunofluorescence Antibody Test (IFAT) in all animals. The methodologies employed to identify the isolates, including partial nucleotide sequences of 18S rRNA gene, indicated patterns identical to T. caninum and patterns different from the other species, including T. cruzi and T. rangeli samples. A phylogenetic tree constructed with the partial 18S ribosomal sequence shows that T. caninum is clustered with T. pestanai. Ten (52·6%) animals presented anti-Leishmania sp. antibodies with titres varying from 1:40 to 1:320. Thus, the hypothesis that this protozoan has disseminated among the dogs in Rio de Janeiro must be considered. The importance of a correct diagnosis in those animals and the possible consequences in the areas where visceral leishmaniasis is found are discussed here.

An unknown Trypanosoma species was isolated from an axenic culture of intact skin from a domestic dog captured in Rio de Janeiro, Brazil, which was co-infected with Leishmania (Viannia) braziliensis. Giemsa-stained smears of cultures grown in different media revealed the presence of epimastigotes, trypomastigotes, spheromastigotes, transitional stages, and dividing forms (epimastigotes or spheromastigotes). The highest frequency of trypomastigotes was observed in RPMI (15·2%) and DMEM (9·2%) media containing 5% FCS, with a mean length of these forms of 43·0 and 36·0 μm, respectively. Molecular analysis by sequential application of PCR assays indicated that this trypanosome differs from Trypanosoma cruzi and T. rangeli when specific primers were applied. On the other hand, a PCR strategy targeted to the D7 domain of 24sα rDNA, using primers D75/D76, amplified products of about 250 bp in that isolate (stock A-27), different from the amplification products obtained with T. cruzi and T. rangeli. This organism differs from T. cruzi mainly by the size of its trypomastigote forms and kinetoplasts and the absence of infectivity for macrophages and triatomine bugs. It is also morphologically distinct from salivarian trypanosomes reported in Brazil. Isoenzyme analysis at 8 loci demonstrated a very peculiar banding pattern clearly distinct from those of T. rangeli and T. cruzi. We conclude that this isolate is a new Trypanosoma species. The name T. caninum is suggested.

Microhabitat use by tadpole species was investigated in streams of montane meadows of the Serra do Cipó, south-eastern Brazil. Microhabitats were classified into 24 types based on water depth, current, aquatic vegetation and substrate type, and quantified in 16 streams. A total of 844 tadpoles from 19 species was recorded, as well as microhabitat types used. Tadpoles, from all species pooled, used microhabitat types in the proportions available in the set of sampled streams. Diversity of microhabitats used was considered as a measure of niche breadth for tadpoles, and microhabitat diversity in streams was interpreted as available niche space. For the most part, species used microhabitats in different proportions, and conspecifics differed in microhabitat use among different streams. Neither niche breadths nor niche overlaps of tadpoles could be related to the number of species occupying streams. Thus not all available niche space may be occupied by tadpole species. More generalist species (those with broader niches) did not generally occupy more streams. Behavioural flexibility of tadpoles in microhabitat use may be a response to the unpredictability of the montane-meadow stream habitat. The role of adult anurans in choosing oviposition sites may also influence the distribution of tadpole species among streams.