Immunogenicity of PvCyRPA, PvCelTOS and Pvs25 chimeric recombinant protein of Plasmodium vivax in murine model.

In the Americas, P. vivax is the predominant causative species of malaria, a debilitating and economically significant disease. Due to the complexity of the malaria parasite life cycle, a vaccine formulation with multiple antigens expressed in various parasite stages may represent an effective approach. Based on this, we previously designed and constructed a chimeric recombinant protein, PvRMC-1, composed by PvCyRPA, PvCelTOS, and Pvs25 epitopes. This chimeric protein was strongly recognized by naturally acquired antibodies from exposed population in the Brazilian Amazon. However, there was no investigation about the induced immune response of PvRMC-1. Therefore, in this work, we evaluated the immunogenicity of this chimeric antigen formulated in three distinct adjuvants: Stimune, AddaVax or Aluminum hydroxide (Al(OH)3) in BALB/c mice. Our results suggested that the chimeric protein PvRMC-1 were capable to generate humoral and cellular responses across all three formulations. Antibodies recognized full-length PvRMC-1 and linear B-cell epitopes from PvCyRPA, PvCelTOS, and Pvs25 individually. Moreover, mice's splenocytes were activated, producing IFN-γ in response to PvCelTOS and PvCyRPA peptide epitopes, affirming T-cell epitopes in the antigen. While aluminum hydroxide showed notable cellular response, Stimune and Addavax induced a more comprehensive immune response, encompassing both cellular and humoral components. Thus, our findings indicate that PvRMC-1 would be a promising multistage vaccine candidate that could advance to further preclinical studies.

Three-dimensional Simulation on Patient-reported Outcomes Following Oncoplastic and Reconstructive Surgery of the Breast: A Randomized Trial.

Background: Three-dimensional (3D) imaging using computer simulations is an evolving technology. There is a lack of strong data on the use of this technology for oncoplastic (OP) and reconstructive surgery. Methods: A prospective, randomized, single-center trial including breast cancer patients undergoing OP or mastectomy with immediate breast reconstruction with implant (IBR) enrolled from November 2019 to October 2021 at the Hospital Nossa Senhora das Graças, Breast Unit in Curitiba, Brazil. Both patients undergoing OP and those in the IBR group were randomized to undergo 3D imaging and simulation of postoperative results (intervention group) or 3D imaging without simulation (control group). All patients were invited to complete a patient-reported outcome (BREAST-Q) expectations module and breast reconstruction or reduction/mastopexy module before and 6 months after surgery. Results: A total of 96 patients were enrolled. Sixty-nine patients (45 OP and 24 IBR) completed the pre- and postoperative questionnaires and were randomized for the simulation. Women in the OP group had higher expectations for breast appearance when clothed than those in the IBR implant group (93.4 ± 16.3 versus 82.9 ± 26.5; P = 0.03). The intervention group was more satisfied with information than the control group (P = 0.021). Both patients who underwent OP and IBR believed that the 3D simulation helped them understand the surgical process (86.6% and 75%, respectively). Conclusions: Preoperative 3D simulation significantly improved patient's satisfaction with information and did not decrease postoperative satisfaction with the outcomes. The incorporation of preoperative 3D simulation may be a valuable tool in breast reconstruction.

Multipurpose arrowroot starch films with anthocyanin-rich grape pomace extract: Color migration for food simulants and monitoring the freshness of fish meat.

Extraction of anthocyanins from grape pomace, is a way of valuing these abundant by-products with low added value. Its integration into films may allow it to be used in bioactive packaging, which creates new color and solubility properties for food and smart food packaging which tracks the freshness of fish. Films of arrowroot starch added with different concentrations of grape pomace extract (GPE) were flexible to handle, reddish and presented a high content of anthocyanins. The water vapor permeability increased by 17 %, while the tensile strength of arrowroot starch film decreased by 79 % with the addition of 40 % GPE. The addition of GPE increased the solubility of the starch film in aqueous and lipid food simulants by 121 and 119 %. The GPE pigment preferentially migrated to the aqueous simulant due to the hydrophilic nature of anthocyanins and starch. The GPE film showed distinguishable color changes in different pH buffer solutions from pink at pH 2 to light blue at pH 7 and slightly yellowish green at pH 10. When the composite films were monitored for fish meat freshness, the change in color of the film from reddish pink to slightly green after 96 h of storage at 25 °C was evident.

Trunk muscles influence lower limb performance in crossfit athletes: A cross-sectional study.

INTRODUCTION: Crossfit is a sport that combines cardio-respiratory and muscle endurance, strength, flexibility, muscle power, speed, coordination, agility and balance. However, there is no information in the literature regarding functional performance of the lower limbs and the endurance of core muscles in this population. The objective of this study was to evaluate the correlation between trunk strength/endurance and lower limb function through lower limb symmetry and balance tests. METHODS: Forty-one young adults aged 19-41 years (26.3 ± 5.4) participated, 15 sedentary and 26 cross fit practitioners for at least one year. The tests were as follows: Biering-Sørensen Test of trunk extensor endurance, Trunk Flexors Endurance Test at 60°, Side Plank Endurance Test, Lumbar Dynamometry, Single-Leg Hop Test and Star Excursion Balance Test. RESULTS AND DISCUSSION: Although there were higher values, there was no significant difference (p > 0.05) between the groups for lower limb symmetry and strength of trunk flexor muscles. For balance, strength and resistance variables of trunk extensor muscles, the values found were higher in crossfit practitioners than in sedentary subjects. CONCLUSION: There is a relationship between trunk muscle strength and endurance and lower limb balance. Moreover, cross fit athletes showed higher values of trunk muscle strength/endurance and lower limb balance compared to sedentary adults.

Edadismo contra las personas mayores en servicios de salud: revisión de alcance* / Ageism directed to older adults in health services: A scoping review / Ageísmo direcionado às pessoas idosas em serviços de saúde: uma revisão de escopo

Objetivo: mapear las expresiones y medidas para combatir el edadismo contra las personas mayores en los servicios de salud. Método: revisión de alcance de estudios primarios en inglés, español y portugués, sin delimitación temporal, recopilados de 14 bases de datos. Dos revisores independientes realizaron de forma ciega la selección de títulos, resúmenes y texto completo, el corpus estuvo compuesto por 41 artículos. La extracción de datos se realizó por pares. Los datos se presentaron en resúmenes narrativos y cuadros. Resultados: las expresiones de edadismo se manifiestan a nivel interpersonal, mediante imágenes y actitudes que deprecian, infravaloran la vida y deslegitiman las necesidades de las personas mayores, y a nivel institucional, por medio de barreras para acceder a los servicios de salud, que provocan falta de atención y descuido. Las medidas para combatirlo consisten en intervenciones educativas y ampliación de los canales de comunicación entre las personas mayores, los profesionales de la salud y gestores. Conclusión: los resultados pueden hacer que los profesionales de la salud estén atentos a la (falta de) atención debido al sesgo etario y sensibilizarlos para que enfrenten el edadismo mediante la adquisición del conocimiento científico. Hay lagunas de conocimiento tanto en el análisis del fenómeno en el contexto del Sistema Único de Salud como sobre las expresiones implícitas de edadismo.

Objective: to map the expressions of ageism directed to older adults in health services and the respective coping measures. Method: a scoping review of primary studies in English, Spanish and Portuguese, without time delimitation and collected from 14 databases. Selection of the titles, abstracts and full text was in charge of two independent and blinded reviewers, totaling a corpus comprised by 41 articles. Data extraction was performed by pairs. The data were presented in narrative summaries and charts. Results: the ageism expressions are understood at the interpersonal level through images and attitudes that depreciate, devalue life and delegitimize older adults' needs, as well as at the institutional level, which confers barriers to accessing health services, generating non-assistance and neglect. The coping measures consist of educational interventions and expansion of communication channels between aged people, health professionals and managers. Conclusion: the results may make health professionals vigilant for care/neglect guided by age bias and sensitive for coping with ageism by obtaining diverse scientific knowledge. The analysis of the phenomenon in the Unified Health System context constitutes a knowledge gap, as well as the implicit ageism expressions.

Objetivo: mapear as expressões e medidas de enfrentamento do ageísmo direcionado às pessoas idosas em serviços de saúde. Método: revisão de escopo de estudos primários em inglês, espanhol e português, sem delimitação temporal, coletados em 14 bases de dados. A seleção dos títulos, resumos e texto completo foi realizada por dois revisores independentes e às cegas, totalizando corpus de 41 artigos. A extração dos dados foi realizada por pares. Os dados foram apresentados em resumos narrativos e quadros. Resultados: expressões de ageísmo estão compreendidas no nível interpessoal, por meio de imagens e atitudes que depreciam, desvalorizam a vida e deslegitimam as necessidades das pessoas idosas, e o nível institucional, que confere barreiras ao acesso dos serviços de saúde, gerando desassistência e descuidado. As medidas de enfrentamento consistem em intervenções educativas e ampliação dos canais de comunicação entre pessoas idosas, profissionais da saúde e gestores. Conclusão: os resultados poderão tornar os profissionais da saúde vigilantes para o (des)cuidado guiado pelo viés de idade e sensíveis para o enfrentamento do ageísmo pela obtenção de conhecimentos científicos. A análise do fenômeno no contexto do Sistema Único da Saúde constitui lacuna do conhecimento, bem como as expressões implícitas do ageísmo.

Ageism directed to older adults in health services: A scoping review. / Edadismo contra las personas mayores en servicios de salud: revisión de alcance.

OBJECTIVE: to map the expressions of ageism directed to older adults in health services and the respective coping measures. METHOD: a scoping review of primary studies in English, Spanish and Portuguese, without time delimitation and collected from 14 databases. Selection of the titles, abstracts and full text was in charge of two independent and blinded reviewers, totaling a corpus comprised by 41 articles. Data extraction was performed by pairs. The data were presented in narrative summaries and charts. RESULTS: the ageism expressions are understood at the interpersonal level through images and attitudes that depreciate, devalue life and delegitimize older adults' needs, as well as at the institutional level, which confers barriers to accessing health services, generating non-assistance and neglect. The coping measures consist of educational interventions and expansion of communication channels between aged people, health professionals and managers. CONCLUSION: the results may make health professionals vigilant for care/neglect guided by age bias and sensitive for coping with ageism by obtaining diverse scientific knowledge. The analysis of the phenomenon in the Unified Health System context constitutes a knowledge gap, as well as the implicit ageism expressions. (1) Ageism expressions involve interpersonal and institutional relationships. (2) Ageism directed to older adults permeates from diagnosis to treatment. (3) The coping measures comprise educational actions and also scientific research studies. (4) It is necessary to recognize the presence of ageism in health services. (5) It is necessary to recognize care/neglect practices guided by age bias.

Oncological safety of nipple-sparing mastectomy after neoadjuvant chemotherapy: a systematic review.

BACKGROUND: the use of nipple-sparing mastectomy (NSM) in local advanced breast cancer after neoadjuvant chemotherapy (NQT) is increasing, despite few studies on the subject. The aim of this systematic review was to determine the safety of NSM after neoadjuvant chemotherapy. METHODS: for this systematic review we searched MEDLINE; Cochrane; Scientific Electronic Library Online (SciELO); Embase and Scopus. A literature search of all original studies including randomized controlled trials, cohort studies and case-control studies comparing women undergoing NSM after neoadjuvant chemotherapy for breast cancer was undertaken. Outcomes were locoregional recurrence (LRR), nipple recurrence and distant recurrence (DR). Data analysis was undertaken to explore the safety of NSM after NQT. The quality of the evidence was assessed with the Cochrane risk of bias tool. This study is registered on PROSPERO, number CRD42021276778. FINDINGS: a total of 437 articles were identified. Four articles were included with 1466 patients all of which had a high to serious risk of overall bias. Local recurrence in the NSM after the NQT group ranged from zero to 9.8%. Nippleareolar complex (NAC) recurrence ranged from zero to 2.1%. The distant recurrence rate ranged from 6.5% to 16%. Due to the lack of pattern among the control groups, it was not possible to perform a meta-analysis. INTERPRETATION: this review provides information for decision making in performing NSM after NQT. Despite the low rates of local recurrence and patients should be counseled about limited oncological information.

Construction, Expression, and Evaluation of the Naturally Acquired Humoral Immune Response against Plasmodium vivax RMC-1, a Multistage Chimeric Protein.

The PvCelTOS, PvCyRPA, and Pvs25 proteins play important roles during the three stages of the P. vivax lifecycle. In this study, we designed and expressed a P. vivax recombinant modular chimeric protein (PvRMC-1) composed of the main antigenic regions of these vaccine candidates. After structure modelling by prediction, the chimeric protein was expressed, and the antigenicity was assessed by IgM and IgG (total and subclass) ELISA in 301 naturally exposed individuals from the Brazilian Amazon. The recombinant protein was recognized by IgG (54%) and IgM (40%) antibodies in the studied individuals, confirming the natural immunogenicity of the epitopes that composed PvRMC-1 as its maintenance in the chimeric structure. Among responders, a predominant cytophilic response mediated by IgG1 (70%) and IgG3 (69%) was observed. IgM levels were inversely correlated with age and time of residence in endemic areas (p < 0.01). By contrast, the IgG and IgM reactivity indexes were positively correlated with each other, and both were inversely correlated with the time of the last malaria episode. Conclusions: The study demonstrates that PvRMC-1 was successfully expressed and targeted by natural antibodies, providing important insights into the construction of a multistage chimeric recombinant protein and the use of naturally acquired antibodies to validate the construction.

Evaluation of the total phenolic content, antioxidative capacity, and chemical fingerprint of Annona crassiflora Mart. Bioaccessible molecules.

Annona crassiflora Mart. (araticum) is an exotic fruit native to the Brazilian Cerrado that stands out for its phytochemical profile, especially for the presence of bioactive compounds. The health-related benefits promoted by these metabolites are widely explored. It is known that the biological activity of bioactive compounds is directly dependent on the availability of the molecules, and their bioaccessibility after the digestion process is one of the main limiting factors. The present study aimed to evaluate the bioaccessibility of bioactive compounds in some parts of araticum (peel, pulp and seeds) fruits obtained from different regions through the in vitro digestion process simulating the gastrointestinal tract. The total phenolic content ranged from 480.81 to 1007.62 for pulp; 837.53 to 1926.56 for peel; and 358.28 to 1186.07 for seeds (mg GAE.100 g-1 of sample). The highest antioxidant activity was observed for the seeds by the DPPH method, the peel by the ABTS method, and most of the peel, except for the Cordisburgo sample, by the FRAP method. Through the research of the chemical profile, it was possible to list up to 35 compounds, including the nutrients, in this identification attempt. It was observed that some compounds were listed only in natura samples (epicatechin and procyanidin) and others only for the bioaccessible fraction (quercetin-3-O-dipentoside), which is justified by the different gastrointestinal tract conditions. Thus, the present study elucidates that the food matrix will directly influence the bioaccessibility of bioactive compounds. In addition, it highlights the potential of unconventionally used or consumed parts that can be used as sources of substances with biological activities, increasing the sustainability by reducing waste.

A New Strategy for Mapping Epitopes of LACK and PEPCK Proteins of Leishmania amazonensis Specific for Major Histocompatibility Complex Class I.

Leishmaniasis represents a complex of diseases with a broad clinical spectrum and epidemiological diversity, considered a major public health problem. Although there is treatment, there are still no vaccines for cutaneous leishmaniasis. Because Leishmania spp. is an intracellular protozoan with several escape mechanisms, a vaccine must provoke cellular and humoral immune responses. Previously, we identified the Leishmania homolog of receptors for activated C kinase (LACK) and phosphoenolpyruvate carboxykinase (PEPCK) proteins as strong immunogens and candidates for the development of a vaccine strategy. The present work focuses on the in silico prediction and characterization of antigenic epitopes that might interact with mice or human major histocompatibility complex class I. After immunogenicity prediction on the Immune Epitope Database (IEDB) and the Database of MHC Ligands and Peptide Motifs (SYFPEITHI), 26 peptides were selected for interaction assays with infected mouse lymphocytes by flow cytometry and ELISpot. This strategy identified nine antigenic peptides (pL1-H2, pPL3-H2, pL10-HLA, pP13-H2, pP14-H2, pP15-H2, pP16-H2, pP17-H2, pP18-H2, pP26-HLA), which are strong candidates for developing a peptide vaccine against leishmaniasis.

Production and physicochemical properties of fungal chitosans with efficacy to inhibit mycelial growth activity of pathogenic fungi.

In order to enable the applicability of chitosan as an antifungal, soil fungi were isolated and identified, then used in its production. Fungal chitosan has several advantages, including lower toxicity, low cost, and high degree of deacetylation. These characteristics are essential for therapeutic applications. The results indicate high viability of the isolated strains to produce chitosan, obtaining a maximum yield of 40.59 mg chitosan/g of dry biomass. M. pseudolusitanicus L. was reported for the first time for production by chitosan. The chitosan signals were observed by ATR-FTIR and 13C SSNMR. Chitosans showed high degrees of deacetylation (DD), ranging from 68.8% to 88.5%. In comparison with the crustacean chitosan, Rhizopus stolonifer and Cunninghamella elegans presented lower viscometric molar masses (26.23 and 22.18 kDa). At the same time, the molar mass of chitosan Mucor pseudolusitanicus L. showed a value coincident with that assumed as low molar mass (50,000-150,000 g mol-1). Concerning the in vitro antifungal potential against the dermatophyte fungus Microsporum canis (CFP 00098), the fungal chitosans showed satisfactory antifungal activities, inhibiting mycelial growth by up to 62.81%. This study points to the potential of chitosans extracted from fungal cell walls for applications in the inhibition of the growth of (Microsporum canis) human pathogenic dermatophyte.

Application of highly ozonated sunflower oil does not improve palatal wound healing: A randomized controlled clinical trial.

BACKGROUND: Ozone is a molecule that plays an important role in dentistry, specially for wound healing. The aim of the present study was to clinically and immunologically evaluate the effect of ozonated oil on the healing of palatal wounds. METHODS: This is a prospective, longitudinal, triple-blind, randomized, placebo-controlled clinical trial. The groups were divided as follows: Test group (n = 14): after removal of the free gingival graft (FGG), the palatal wound was treated with ozonized seed sunflower oil with a peroxide index between 510 and 625 meq O2 /kg; Control group (n = 14): after removal of the FGG, the palatal wound was treated with non-ozonated sunflower oil (placebo). The treatments were applied three times a day, for 7 days. RESULTS: There were no significant differences in the measurements of wound area (mm2 ) between the test and control groups in the different periods evaluated (0, 3, 7, and 14 days; p > 0.05). The intra-group analysis showed a significant decrease in wound size over the course of days (0, 3, 7, and 14 days; p < 0.05). Vascular endothelial growth factor (VEGF; pg/mL) presented a significant reduction at 7 days (p < 0.05) compared to day 3 in the test group (p < 0.05). There was a statistical difference for malondialdehyde (MDA; pg/mL) in the test group between 3 and 7 days post-treatment (p < 0.05) and between test and control groups on the 7th day (p < 0.05). CONCLUSIONS: The application of highly ozonated sunflower oil did not improve the remaining scar area of the palate, decreasing the VEGF and increasing the oxidative stress marker MDA.

Oncological safety of nipple-sparing mastectomy after neoadjuvant chemotherapy: a systematic review / Segurança oncológica da mastectomia conservadora do mamilo após quimioterapia neoadjuvante: revisão sistemática

ABSTRACT Background: the use of nipple-sparing mastectomy (NSM) in local advanced breast cancer after neoadjuvant chemotherapy (NQT) is increasing, despite few studies on the subject. The aim of this systematic review was to determine the safety of NSM after neoadjuvant chemotherapy. Methods: for this systematic review we searched MEDLINE; Cochrane; Scientific Electronic Library Online (SciELO); Embase and Scopus. A literature search of all original studies including randomized controlled trials, cohort studies and case-control studies comparing women undergoing NSM after neoadjuvant chemotherapy for breast cancer was undertaken. Outcomes were locoregional recurrence (LRR), nipple recurrence and distant recurrence (DR). Data analysis was undertaken to explore the safety of NSM after NQT. The quality of the evidence was assessed with the Cochrane risk of bias tool. This study is registered on PROSPERO, number CRD42021276778. Findings: a total of 437 articles were identified. Four articles were included with 1466 patients all of which had a high to serious risk of overall bias. Local recurrence in the NSM after the NQT group ranged from zero to 9.8%. Nippleareolar complex (NAC) recurrence ranged from zero to 2.1%. The distant recurrence rate ranged from 6.5% to 16%. Due to the lack of pattern among the control groups, it was not possible to perform a meta-analysis. Interpretation: this review provides information for decision making in performing NSM after NQT. Despite the low rates of local recurrence and patients should be counseled about limited oncological information.

RESUMO Introdução: O uso de mastectomia preservadora de complexo aréolo-papilar (MPCAP) no câncer de mama localmente avançado após quimioterapia neoadjuvante (QTN) é crescente, apesar de ainda haver poucos estudos abordando o assunto. O objetivo desta revisão sistemática foi determinar a segurança da MPCAP após a quimioterapia neoadjuvante. Métodos: para esta revisão sistemática, pesquisamos no MEDLINE; Cochrane; Scientific Electronic Library Online (SciELO); Embase e Scopus. Foi realizada uma busca na literatura de todos os estudos originais, incluindo ensaios clínicos randomizados, estudos de coorte e estudos de caso-controle comparando mulheres submetidas a MPCAP após quimioterapia neoadjuvante para câncer de mama. Os desfechos foram recorrência locorregional, recidiva em papila e recorrência à distância. A análise dos dados foi realizada para avaliar a segurança da mastectomia preservadora de complexo aréolo-papilar após o QTN. A qualidade da evidência foi avaliada com a ferramenta de avaliação de risco de viés da Cochrane - ROBINS-I. Este estudo está registrado no PROSPERO, número CRD42021276778. Resultados: Um total de 437 artigos foram identificados. Quatro artigos foram incluídos na análise, totalizando 1466 pacientes, todos com risco de viés geral moderado a alto. A recorrência local no grupo MPCAP após QTN variou de zero a 9,8%. A recorrência no complexo aréolo-papilar (CAP) variou de zero a 2,1%. A taxa de recorrência à distância variou de 6,5% a 16%. Devido à falta de padrão entre os grupos de controle, não foi possível realizar uma meta-análise. Interpretação: esta revisão fornece informações para a tomada de decisão na realização de NSM após QTN. Apesar das baixas taxas de recorrência local, os pacientes devem ser orientados sobre as informações oncológicas limitadas.

"Vá para casa, seu idoso!" Ageísmo na pandemia da covid-19: netnografia na plataforma Youtube™ / "Go home, old man!" Ageism in the covid-19 pandemic: netnography on the Youtube™ platform

Resumo Objetivo Analisar as repercussões do ageísmo direcionado a pessoas idosas durante a covid-19, por meio dos conteúdos disponíveis na plataforma Youtube™. Método Estudo netnográfico, exploratório e qualitativo, cujos dados foram coletados em vídeos na plataforma Youtube™; foi realizada análise temática de conteúdo de Bardin e os elementos foram discutidos à luz da Teoria do Estigma. Resultados Três categorias explicam as repercussões do fenômeno investigado: expressões do ageísmo pré-existentes à pandemia, com expressões de exclusão, desconsideração e desrespeito; expressões de ageísmo durante a pandemia a partir do rótulo de grupo de risco que fortalece os estereótipos de doentes e incapazes; e sentimentos e atitudes da pessoa idosa frente às repercussões do ageísmo, que levaram a repercussões nas interações sociais, no estilo de vida e na saúde das pessoas idosas. Conclusões As repercussões podem ocasionar sequelas de ordem física, cognitiva, social e psíquica, e o combate aos seus impactos parte da esfera educativa para um pacto social que permita uma convivência respeitosa e empática entre as gerações.

Abstract Objective To analyze the repercussions of ageism directed at older people during covid-19, through the content available on the Youtube™ platform. Method Netnographic, exploratory and qualitative study, whose data were collected in videos on the Youtube™ platform; a thematic analysis of Bardin's content was performed and the elements were discussed in the light of the Theory of Stigma. Results Three categories explain the repercussions of the investigated phenomenon: expressions of ageism pre-existing to the pandemic, with expressions of exclusion, disregard and disrespect; expressions of ageism during the pandemic from the risk group label that strengthens stereotypes of sick and incapable people; and feelings and attitudes of the older people towards the repercussions of ageism, which led to repercussions on social interactions, lifestyle and health of older people. Conclusions The repercussions can cause physical, cognitive, social and psychic sequelae, and the fight against its impacts starts from the educational sphere towards a social pact that allows a respectful and empathetic coexistence between generations.

Time to achieve steady state for an accurate assessment of resting energy expenditure in adolescents with healthy weight and obesity: A cross-sectional study

ABSTRACT Objective: The present study investigated the time needed to achieve a steady state for an accurate assessment of resting energy expenditure (REE) in adolescents with healthy weight and obesity. Materials and methods: Thirty adolescents aged 12-17 years were assigned to a group with healthy weight (GHW; n = 12, body mass index [BMI] 22.5 ± 3.6 kg/m2) and another group with obesity (GO; n = 18, BMI 34.1 ± 5.2 kg/m2). Participants underwent test-retest reliability of REE assessment as follows: a) 24 h of abstention from physical exercise, soft drinks, or caffeine; b) fasting for ~12 h; c) acclimation period of 10 min; d) 30-min assessment in a supine position. Results and discussion: A significant change occurred during the 30 min in REE. Significant differences existed between consecutive means until the 20th and 25th min for the GHW and GO, respectively. Although significant differences between trials 1 and 2 were detected during the first 5-10 min of assessment, the REE for each 5-min time point exhibited high test-retest reliability across trials in both groups (intraclass correlation coefficients range 0.79-0.99). Conclusion: The following recommendations are provided to promote accurate assessment of REE among adolescents: a) initiate the REE assessment with 10 min of acclimation to decrease restlessness; b) determine REE for a minimum of 20 min if healthy weight and 25 min if obesity; c) determine REE for a further 5 min, with the average of this last 5 min of REE data being regarded as the REE.

Time to achieve steady state for an accurate assessment of resting energy expenditure in adolescents with healthy weight and obesity: A cross-sectional study.

Objective: The present study investigated the time needed to achieve a steady state for an accurate assessment of resting energy expenditure (REE) in adolescents with healthy weight and obesity. Methods: Thirty adolescents aged 12-17 years were assigned to a group with healthy weight (GHW; n = 12, body mass index [BMI] 22.5 ± 3.6 kg/m2) and another group with obesity (GO; n = 18, BMI 34.1 ± 5.2 kg/m2). Participants underwent test-retest reliability of REE assessment as follows: a) 24 h of abstention from physical exercise, soft drinks, or caffeine; b) fasting for ~12 h; c) acclimation period of 10 min; d) 30-min assessment in a supine position. Results: A significant change occurred during the 30 min in REE. Significant differences existed between consecutive means until the 20th and 25th min for the GHW and GO, respectively. Although significant differences between trials 1 and 2 were detected during the first 5-10 min of assessment, the REE for each 5-min time point exhibited high test-retest reliability across trials in both groups (intraclass correlation coefficients range 0.79-0.99). Conclusion: The following recommendations are provided to promote accurate assessment of REE among adolescents: a) initiate the REE assessment with 10 min of acclimation to decrease restlessness; b) determine REE for a minimum of 20 min if healthy weight and 25 min if obesity; c) determine REE for a further 5 min, with the average of this last 5 min of REE data being regarded as the REE.

Caracterização da resposta imune celular e humoral frente ao antígeno protetor rico em cisteína de p. Vivax (pvcyrpa) em indivíduos da Amazônia brasileira / Characterization of the cellular and humoral immune response to the protective cysteine-rich antigen of p. Vivax (pvcyrpa) in individuals from the Brazilian Amazon

As infecções causadas por Plasmodium vivax representam um grave problema de saúde pública, sendo esta espécie plasmodial considerada uma das mais difíceis de se eliminar. Por esta razão a pesquisa de antígenos candidatos vacinais específicos para P. vivax necessita de impulso, uma vez que atualmente existe uma única candidata vacinal em ensaios clínicos na iniciativa global de desenvolvimento de vacinas anti-maláricas. Neste cenário, a proteína PvCyRPA, presente em merozoítas de P. vivax surgiu como uma promissora candidata vacinal. Ensaios em P. falciparum demonstraram que anticorpos contra esta proteína são capazes de impedir a invasão de eritrócitos tanto in vitro como in vivo, além disso, essa proteína foi indicada em uma ampla biblioteca de antígenos de P. vivax como uma das proteínas com maior potencial protetor, mesmo com baixos níveis de anticorpos. Nesse aspecto, o objetivo deste trabalho foi caracterizar as respostas imune humoral e celular frente à proteína PvCyRPA em uma população da Amazônia brasileira naturalmente exposta à malária e correlacionar as respostas encontradas com parâmetros de exposição/proteção. Nos resultados obtidos verificou-se que a PvCyRPA é naturalmente imunogênica na população de estudo, e que a presença de anticorpos IgM contra esta proteína parece ser um indicativo de infecções recentes. Os anticorpos citofílicos IgG3 produzidos nessa população estão correlacionados com o número de infecções anteriores. A proteína apresenta uma sobreposição importante de epítopos de células B e T e as sequências correspondentes aos epítopos de células T foram capazes de induzir a produção de INF-γ em ensaios de ELISPOT. Estes dados representam a primeira caracterização da resposta imune frente à PvCyRPA em populações brasileiras e reforçam o potencial deste antígeno como um candidato vacinal para P. vivax. (AU)

Infections caused by Plasmodium vivax represent a serious public health problem, and this plasmodial species is considered one of the most difficult to eliminate. For this reason, the search for specific vaccine candidate antigens for P. vivax needs to be boosted, since there is currently a single vaccine candidate in clinical trials in the global anti-malarial vaccine development initiative. In this scenario, the protein PvCyRPA, present in P. vivax merozoites has emerged as a promising vaccine candidate. Tests on P. falciparum have shown that antibodies against this protein are able to prevent erythrocyte invasion both in vitro and in vivo. In addition, this protein has been indicated in a wide library of P. vivax antigens as one of the proteins with the greatest protective potential, even with low levels of antibodies. In this regard, the objective of this work was to characterize the humoral and cellular immune responses against PvCyRPA protein in a population of Brazilian Amazon naturally exposed to malaria and to correlate the responses found with exposure / protection parameters. The results obtained showed that PvCyRPA is naturally immunogenic in the study population, and that the presence of IgM antibodies against this protein seems to be an indicative of recent infections. The cytophilic IgG3 antibodies produced in this population seems to be correlated with the number of previous infections. The protein has an important overlap of B and T cell epitopes and the sequences corresponding to the T cell epitopes were able to induce the production of INF-γ in ELISPOT assays. These data represent the first characterization of the immune response to PvCyRPA in Brazilian populations and reinforce the potential of this antigen as a vaccine candidate for P. vivax. (AU)

Recombinant Plasmodium vivax circumsporozoite surface protein allelic variants: antibody recognition by individuals from three communities in the Brazilian Amazon.

Circumsporozoite protein (CSP) variants of P. vivax, besides having variations in the protein repetitive portion, can differ from each other in aspects such as geographical distribution, intensity of transmission, vectorial competence and immune response. Such aspects must be considered to P. vivax vaccine development. Therefore, we evaluated the immunogenicity of novel recombinant proteins corresponding to each of the three P. vivax allelic variants (VK210, VK247 and P. vivax-like) and of the C-terminal region (shared by all PvCSP variants) in naturally malaria-exposed populations of Brazilian Amazon. Our results demonstrated that PvCSP-VK210 was the major target of humoral immune response in studied population, presenting higher frequency and magnitude of IgG response. The IgG subclass profile showed a prevalence of cytophilic antibodies (IgG1 and IgG3), that seem to have an essential role in protective immune response. Differently of PvCSP allelic variants, antibodies elicited against C-terminal region of protein did not correlate with epidemiological parameters, bringing additional evidence that humoral response against this protein region is not essential to protective immunity. Taken together, these findings increase the knowledge on serological response to distinct PvCSP allelic variants and may contribute to the development of a global and effective P. vivax vaccine.

Estratégias de ensino à distância para a educação interprofissional em Saúde frente à pandemia COVID-19 / Distance learning strategies for interprofessional health education in the face of the COVID-19 pandemic / Estrategias de aprendizaje a distancia para la educación sanitaria interprofesional ante la pandemia de COVID-19

Objetivo: Relatar as experiências de trabalho remoto e EaD de um grupo do PET-Saúde Interprofissionalidade na pandemia. Método: Trata-se de um relato de experiência das atividades realizadas por um grupo do PET-Saúde, vinculado a Universidade Estadual de Feira de Santana (UEFS) e ao Centro de Atendimento ao Diabético e Hipertenso (CADH), de março a junho de 2020. As atividades presenciais na UEFS e no CADH foram substituídas por atividades remotas e EaD. A metodologia utilizada envolveu a incorporação de ferramentas virtuais em: 1) Seminários e cursos EaD; 2) Estabelecimento de estratégias de inovação para atuação em saúde; 3) Construção de materiais de Educação em Saúde. Resultados: As ferramentas educacionais virtuais permitiram a realização de um trabalho inovador, focado na formação inicial e continuada de alunos, professores e profissionais de saúde. Mudanças no fluxo dos pacientes, produção de cartilha e artigos também foram atividades desenvolvidas. Conclusão: O uso de plataformas virtuais e EaD favoreceram o planejamento de ações, proporcionando ganho de conhecimento individual e coletivo, permitindo alterações no serviço, orientação dos pacientes e produção científica.

Objective: To report the experiences of remote work and distance education of a group from PET-Saúde Interprofessionality in the pandemic. Method: This is an experience report of the activities developed by a group from PET-Saúde, linked to the State University of Feira de Santana (UEFS) and the Diabetic and Hypertensive Care Center (CADH), from March to June of 2020. Face-to-face activities at UEFS and CADH have been replaced by remote and distance learning activities. The methodology used involved the incorporation of virtual tools in: 1) Seminars and distance education courses; 2) Establishment of innovation strategies for health activities; 3) Construction of Health Education materials. Results: The virtual educational tools allowed the realization of an innovative work, focused on the initial and continuous training of students, teachers and health professionals. Changes in the flow of patients, production of booklets and articles were also developed. Conclusion: The use of virtual platforms and distance education favored the planning of actions, providing gain of individual and collective knowledge, allowing changes in the service, guidance of patients and scientific production..

Objetivo: Describir las experiencias de trabajo remoto y AD de un grupo del Programa PETSalud Interprofesional en la pandemia de Covid-19. Método: Este es un reporte de experiencia de las actividades realizadas por un grupo del Program PET-Salud, vinculado a la Universidad Estatal de Feira de Santana (UEFS) y Centro de Servicio a los Diabéticos e Hipertensos (CADH), de marzo a junio de 2020. Las actividades presenciales en UEFS y en el CADH han sido reemplazadas por actividades remotas y AD. La metodología utilizada implicó la incorporación de herramientas virtuales en: 1) seminarios y cursos de AD; 2) Establecimiento de estrategias de innovación para actividades de salud; y 3) Construcción de materiales de educación sanitaria. Resultados: Las herramientas educativas virtuales permitieron la realización de un trabajo innovador, enfocado en la formación inicial y continua de estudiantes, docentes y profesionales de la salud. Además, se desarrollaron cambios en el flujo de pacientes, producción de folletos y artículos. Conclusión: El uso de plataformas virtuales y el AD favorecieran la planificación de acciones, aportando conocimiento individual y colectivo, además de permitir cambios en el servicio, orientación de pacientes y producción científica

Implantação do Escore de Framingham na Atenção Primária para manejo de pacientes hipertensos e diabéticos / Implementation of the Framingham Score in Primary Care for the management of hypertensive and diabetic patients / Implementación de la puntuación de riesgo de Framingham en la atención primaria de salud para el manejo de pacientes hipertensos y diabéticos

RESUMO Objetivo: Descrever a experiência de implantação do escore de risco de Framingham, na Atenção Primária, para manejo de pacientes hipertensos e diabéticos. Método: Trata-se de um relato de experiência, sobre a implantação do escore de Framingham, nas unidades da Atenção Primária à Saúde do município de Feira de Santana, Bahia, visando estimar o risco do desenvolvimento de doenças coronarianas. A amostra foi composta de profissionais de 89 Unidades de Saúde da Família, incluindo médicos, enfermeiros e apoiadores institucionais. Os profissionais foram divididos em grupos de 14 participantes por encontro. A ação foi realizada na Secretaria Municipal de Saúde, de janeiro a junho de 2018. Os materiais didáticos foram confeccionados, incluindo um folder informativo sobre o escore de Framingham e um formato de instrumento a ser aplicado nas unidades. Resultados: Participaram 06 apoiadoras e 187 profissionais, sendo 109 enfermeiros e 78 médicos. As oficinas aconteceram em 14 encontros, com duração de 4h, sendo a atividade dividida em teórica e prática, com discussão de casos clínicos e aplicação do escore apresentado. Conclusão: A implantação dessa ferramenta permite a identificação de estratégias mais adequadas para o manejo de pacientes hipertensos e diabéticos, de acordo com o risco, auxiliando na definição de condutas multidisciplinares

Objective: To describe the experience of implementing the Framingham risk score in Primary Care for the management of hypertensive and diabetic patients. Method: This is an experience report on the implementation of the Framingham score in Primary Health Care units in Feira de Santana-Bahia city, order to estimate the risk of developing coronary heart disease. The sample consisted of professionals from 89 Family Health Units, including doctors, nurses and institutional supporters. The professionals were divided into groups of 14 participants per meeting. The action was carried out at the Municipal Health Department, from January to June 2018. The teaching materials were made, including an information folder on the Framingham score and an instrument format to be applied in the units. Results: 06 supporters and 187 professionals participated, being 109 nurses and 78 doctors. The workshops took place in 14 meetings, lasting 4 hours, the activity being divided into theoretical and practical, with discussion of clinical cases and application of the score presented. Conclusion: The implementation of this tool allows the identification of more appropriate strategies for the management of hypertensive and diabetic patients, according to the risk, helping to define multidisciplinary approaches..

Objetivo: Describir la experiencia de implementación de la puntuación de riesgo de Framingham en la atención primaria de salud para el manejo de pacientes hipertensos y diabéticos. Método: Este es un reporte de experiencia sobre la implementación de la puntuación de Framingham en unidades de atención primaria de salud en el municipio de Feira de Santana, Bahia, Brasil, para estimar el riesgo de desarrollar enfermedades coronarias. La muestra fue compuesta por profesionales de 89 Unidades de Salud de la Familia, incluidos médicos, enfermeras y colaboradores institucionales. Los profesionales fueron alocados en grupos de 14 participantes por reunión. La acción tuvo lugar en el Departamento de Salud Municipal de enero a junio de 2018. Se prepararon materiales didácticos, incluida una carpeta informativa sobre la puntuación de riesgo de Framingham y un formato de instrumento para aplicar en las unidades de salud. Resultados: Un total de 6 asistentes y 187 profesionales participaron en el estudio, de los cuales 109 eran enfermeras y 78 eran médicos. Los talleres fueron divididos en 14 reuniones, de 4 horas de duración cada una, con actividades teóricas y prácticas, discusión de casos clínicos y aplicación de la puntuación de Framingham. Conclusión: La implementación de esta herramienta permitió la identificación de estrategias más apropiadas para el manejo de pacientes hipertensos y diabéticos, según la clasificación de riesgo, contribuyendo a un enfoque multidisciplinario