Integrative nursing in the Brazilian northeast: introduction, potential, and challenges.

OBJECTIVE: to describe the introduction, potential, and challenges experienced by nurses in the provision of Integrative and Complementary Health Practices in the northeast f Brazil. METHOD: A qualitative study conducted from June to December 2022 with 15 northeastern nurses qualified in Integrative and Complementary Practices. The data were produced through individual online interviews and submitted to content analysis. RESULTS: 15 nurses participated, and 23 integrative practices were cited, with a predominance of auriculotherapy, greater introduction in primary care and private nursing offices, highlighting labor and personal benefits. Their potential includes technical qualification for the practice and interest in continuing education. The hospital-centric view of professionals, the low diffusion on the theme in teaching, as well as the difficulty in pricing procedures and in developing clinical reasoning in other medical rationalities were cited as the main challenges. CONCLUSION: Despite the challenges still faced, northeastern nurses are offering integrative practices to complement user care.

External breast prostheses after mastectomy: production and selection of a low-cost functional model to be performed in developing countries.

Introduction: Breast cancer is one of the most common types of cancer affecting women. Despite advancements in early diagnosis, neoadjuvant therapy, and various treatment modalities, mastectomy remains a common procedure for many women. Although some women opt for reconstructive surgery (BR), many do not have the indication, desire, or opportunity to undergo this procedure. Methods: An easily manufactured, washable, lightweight, and inexpensive external breast prosthesis (EBP) model was developed specifically for the study. Participants were presented with five EBP models-one commercially available, three manufactured options, and one created for the study-and were asked to choose a prosthesis. We also evaluated the factors associated with non-adherence to EBP among women who had undergone mastectomy without BR. The chi-square test was used to assess adherence or non-adherence to EBP, while logistic regression was used to identify factors associated with non-adherence. Results: We introduced a low-cost, lightweight, washable EBP model. When participants were asked to choose between two prostheses, the silicone prosthesis was the first choice for 33.9% of the participants, while the prosthesis created for the study emerged as the second choice for 70.5%. Out of the 72 women assessed, 45.8% (33) opted not to use any of the EBP models. Our analysis revealed that age and BMI were significantly associated with non-use of EBP. Conclusion: Multiple barriers contribute to non-adherence to EBP, underscoring the need for interventions aimed at improving patient knowledge and adherence. This study introduces a lightweight, easily reproducible, and low-cost EBP model.

Unusual presentation of pancreatitis: Inguinoscrotal edema mimicking an incarcerated hernia - a case report.

INTRODUCTION: In rare instances, pancreatitis can manifest as inguinal edema without typical abdominal symptoms, posing diagnostic challenges. CASE PRESENTATION: We report a case of a man in his 40s, with alcohol addiction, who presented with left inguinal pain and swelling but no other abdominal complaints. Physical examination revealed inguinal tenderness and edema, with no hernia signs. Laboratory results showed leukocytosis and elevated C-reactive protein, inconsistent with the patient's symptoms. Abdominopelvic CT scan revealed peripancreatic fat densification and retroperitoneal fluid extending into the inguinal area. No hernia was evident. Extended analysis revealed elevated amylase and lipase levels, sustaining the diagnosis of pancreatitis. The patient responded well to supportive care and was discharged symptom-free. DISCUSSION: Acute pancreatitis emerging as an inguinoscrotal swelling, in the absence of any abdominal symptoms or signs, is extremely rare and can mimic more common causes of inguinoscrotal swellings, such as incarcerated hernias. This case highlights the ability of leaking pancreatic juice to track widely in the retroperitoneal tissues, particularly on the left side. A high level of suspicion, in combination with a CT scan, is essential for achieving an accurate diagnosis and determining the disease's extent. Failure to diagnose correctly could lead to unnecessary surgical procedures and inappropriate/delayed medical care. CONCLUSION: Inguinal edema as the sole presentation of acute pancreatitis is extremely rare. Therefore, it is essential to maintain a high index of suspicion, especially in patients with a history of alcohol consumption, in order to proceed with prompt treatment and avoid unnecessary surgery.

Overexpression of miR-22-3p and miR-29c-3p in CFU-Hill colonies is related to senescence process among children with low birth weight.

BACKGROUND: The current study mainly focused on provide further insights into the association of the miR-22-3p and miR-29c-3p expression in CFU-Hill colonies with birth weight and senescence process in children. METHODS: This cross-sectional study evaluated 61 children (32 boys, 29 girls). The CFU-Hill colonies number was evaluated in vitro by cell culture technique and senescence was detected by ß-galactosidase (SA-ß-Gal) assay. Expression of miR-22-3p and miR-29c-3p isolated from CFU-Hill colonies were detected using quantitative real-time polymerase chain reaction. RESULTS: Birth weight was correlated with both CFU-Hill colonies and %SA-ß-Gal positive staining. Multivariate linear regression analysis revealed that the senescence was a predictor of the lower CFU-Hill colonies number, while only the birth weight was a predictor of senescence of CFU-Hill colonies. Overexpression of miR-22-3p and miR-29c-3p was observed in CFU-Hill colonies isolated from children with low birth weight (LBW). Interestingly, we found a significant correlation between %SA-ß-Gal cells staining positive for both miR-22-3p and miR-29c-3p. CONCLUSION: The LBW is associated with decreased CFU-Hill colonies number and high senescence of these cells. The overexpression of miR-22-3p and miR-29c-3p may be partially responsible for this alteration due to regulation of several pathways related to the senescence process. IMPACT: The study establishes a significant correlation between birth weight and the number of CFU-Hill colonies, suggesting that birth weight could be a predictive biomarker for vascular health in children. Data indicates that cellular senescence is a predictor of reduced CFU-Hill colony numbers. This suggests that the aging process of these cells could be an important factor in understanding the vascular health issues in children with low birth weight. The overexpression of miR-22-3p and miR-29c-3p in children with low birth weight and their correlation with increased cellular senescence highlight these microRNAs as possible molecular mechanisms influencing the aging of CFU-Hill colonies.

Práticas de enfermagem: contexto ambiental e a relação com o materialismo histórico dialético / Nursing practices: environmental context and the relationship with dialectical historical materialism / Prácticas de enfermería: contexto ambiental y la relación con el materialismo histórico dialéctico

Objetivo: Descrever as práticas dos enfermeiros em nossa sociedade e sob as circunstâncias que podem contribuir para a inclusão das práticas avançadas. Métodos: Estudo descritivo, de abordagem qualitativa e delineamento transversal, sob a perspectiva da teoria do materialismo histórico-dialético de Karl Marx, estruturada pela utilização do instrumento COREQ. Resultados: O campo de atuação do enfermeiro na atenção primária à saúde é diversificado, extrapola os muros do consultório. Muitas vezes o dinamismo das atividades traduz o empenho de obter os melhores resultados por meio de sua assistência. E o materialismo histórico-dialético reflete justamente a busca por uma assistência de qualidade e as mudanças no ambiente laboral, onde a interação de diversos fatores contribuem de forma direta no ambiente laboral e social. Conclusão: Os enfermeiros da atenção primária à saúde brasileira atuam nos mais diversos territórios, desse modo, precisam dinamizar os seus atendimentos para contemplar as necessidades sociais. Perante esses aspectos, as diversidades sociodemográficas brasileiras demonstraram que a escassez de recursos em regiões remotas é um dos fatores que fortalece a inclusão das práticas avançadas de enfermagem na atenção primária à saúde no Brasil. (AU)

Objective: To describe the practices of nurses in our society and under circumstances that may contribute to the inclusion of advanced practices. Methods: Descriptive study, with a qualitative approach and cross-sectional design, from the perspective of Karl Marx's dialectical historical materialism theory, structured by using the COREQ instrument. Results: The nurse's field of action in primary health care is diverse, it goes beyond the walls of the office. Often the dynamism of activities translates the effort to obtain the best results through their assistance. And dialectical historical materialism precisely reflects the search for quality care and changes in the work environment, where the interaction of several factors directly contribute to the work and social environment. Conclusion: Brazilian primary health care nurses work in the most diverse territories, therefore, they need to streamline their care to address social needs. In view of these aspects, Brazilian sociodemographic diversity has shown that the scarcity of resources in remote regions is one of the factors that strengthens the inclusion of advanced nursing practices in primary health care in Brazil. (AU)

Objetivo: Describir las prácticas de los enfermeros en nuestra sociedad y en circunstancias que puedan contribuir a la inclusión de prácticas avanzadas. Métodos: Estudio descriptivo, con enfoque cualitativo y diseño transversal, desde la perspectiva de la teoría del materialismo histórico dialéctico de Karl Marx, estructurado mediante el uso del instrumento COREQ. Resultados: El campo de actuación del enfermero en la atención primaria de salud es diverso, va más allá de las paredes del consultorio. Muchas veces el dinamismo de las actividades se traduce en el esfuerzo por obtener los mejores resultados a través de su asistencia. Y el materialismo histórico dialéctico refleja precisamente la búsqueda de cuidados de calidad y cambios en el ambiente laboral, donde la interacción de varios factores contribuyen directamente al ambiente laboral y social. Conclusión: Las enfermeras brasileñas de atención primaria de salud actúan en los más diversos territorios, por lo tanto, necesitan optimizar su atención para atender las necesidades sociales. Frente a estos aspectos, la diversidad sociodemográfica brasileña ha demostrado que la escasez de recursos en regiones remotas es uno de los factores que fortalece la inclusión de prácticas avanzadas de enfermería en la atención primaria de salud en Brasil. (AU)

Assistência de enfermagem à saúde da mulher na atenção primária à saúde / Nursing assistance to women's health in primary health care / Asistencia de enfermería a la salud de la mujer en la atención primaria de salud

Objetivo: Conhecer as práticas de cuidado de enfermeiros voltadas à saúde da mulher na APS. Métodos: Trata-se de uma pesquisa transversal de abordagem quanti-qualitativa, realizada com 24 enfermeiros da Atenção Primária a Saúde do estado de Sergipe. As entrevistas foram realizadas durante o período de dezembro de 2020 a abril de 2021, utilizando um roteiro semiestruturado. A análise dos dados quantitativos ocorreu de forma descritiva, a qualitativa ocorreu através da análise de conteúdo conforme Bardin. Resultados: As práticas mais citadas pelos entrevistados foram: consulta de enfermagem no pré-natal; exame Papanicolau e abordagem sindrômica das infecções sexualmente transmissíveis, exame clínico das mamas e solicitação da mamografia; no planejamento familiar, evidenciou-se a educação em saúde; no puerpério, comentaram sobre a avaliação clínica e obstétrica da mulher e as orientações. Conclusão: Os enfermeiros atuam, principalmente, como agentes fundamentais na promoção e prevenção da saúde da mulher, atuando em diversas fases da vida destas e auxiliando na manutenção da saúde e na prevenção de riscos e agravos. (AU)

Objective: to understand the care practices of nurses focused on women's health in PHC. Methods: This is cross-sectional research with a quantitative-qualitative approach, carried out with 24 nurses from Primary Health Care in the state of Sergipe. The interviews were conducted from December 2020 to April 2021, using a semistructured script. The analysis of the quantitative data occurred in a descriptive way, the qualitative one occurred through content analysis according to Bardin. Results: The practices most frequently mentioned by the interviewees were: prenatal nursing consultation; Pap smear and syndromic approach to sexually transmitted infections, clinical examination of the breasts and request for mammography; In family planning, health education was highlighted; In the postpartum period, they commented on the clinical and obstetric evaluation of the woman and the orientations. Conclusion: Nurses act mainly as fundamental agents in the promotion and prevention of women's health, acting in various phases of women's lives and assisting in the maintenance of health and in the prevention of risks and diseases. (AU)

Objetivo: comprender las prácticas asistenciales de los enfermeros enfocados en la salud de la mujer en la APS. Métodos: Se trata de una investigación transversal con abordaje cuantitativo-cualitativo, realizada con 24 enfermeros de la Atención Básica de Salud del estado de Sergipe. Las entrevistas se realizaron entre diciembre de 2020 y abril de 2021, utilizando un guión semiestructurado. El análisis de los datos cuantitativos ocurrió de forma descriptiva, el cualitativo ocurrió a través del análisis de contenido según Bardin. Resultados: Las prácticas más frecuentemente mencionadas por los entrevistados fueron: consulta de enfermería prenatal; Papanicolaou y abordaje sindrómico de las infecciones de transmisión sexual, examen clínico de las mamas y solicitud de mamografía; En cuanto a la planificación familiar, se destacó la educación para la salud; En el puerperio, comentaron sobre la evaluación clínica y obstétrica de la mujer y las orientaciones. Conclusión: Las enfermeras actúan principalmente como agentes fundamentales en la promoción y prevención de la salud de la mujer, actuando en diversas fases de la vida de la mujer y ayudando en el mantenimiento de la salud y en la prevención de riesgos y enfermedades. (AU)

Ideação suicida e fatores associados em estudantes de ciências da saúde nos tempos de pandemia / Suicidal ideation and associated factors among health sciences students in the pandemic times / Ideación suicida y factores asociados en estudiantes de ciencias de la salud durante la pandemia

RESUMO Objetivo: verificar a existência de associação entre a ideação suicida, o suporte social e os sintomas ansiosos-depressivos entre os estudantes de Ciências da Saúde. Método: estudo quantitativo e transversal. A coleta de dados ocorreu de novembro de 2020 a julho de 2021, em Sergipe - Brasil, utilizando-se o Questionário Sociodemográfico, Questionário de Ideação Suicida, Escala de Satisfação com o Suporte Social e Escala de Ansiedade, Depressão e Estresse. Foram estimados coeficientes de regressão linear simples e múltipla e razões de chance. Resultados: dos 190 entrevistados, 57 (30%) apresentaram baixa satisfação com o suporte social, 66 (34,8%) relataram sintomas de depressão grave ou muito grave, 32 (16,8%) possuíam potencial risco de suicídio, podendo ser aumentada em 18% em pessoas com depressão. Conclusão: estresse, ansiedade e depressão, são os fatores de risco para a ideação suicida em estudantes da saúde. O suporte social torna-se um aliado no controle emocional, na diminuição do sofrimento psíquico e a precipitação de transtornos mentais de estudantes.

ABSTRACT Objective: To verify the existence of an association between suicidal ideation, social support, and anxious-depressive symptoms among Health Sciences students. Method: Quantitative, cross-sectional study. Data collection took place from November 2020 to July 2021 in Sergipe - Brazil, using the Sociodemographic Questionnaire, Suicidal Ideation Questionnaire, Satisfaction with Social Support Scale, and Anxiety, Depression, and Stress Scale. Simple and multiple linear regression coefficients and odds ratios were estimated. Results: Of the 190 interviewees, 57 (30%) had low satisfaction with social support, 66 (34.8%) reported symptoms of severe or very severe depression, 32 (16.8%) had a potential risk of suicide, which can be increased by 18% in people with depression. Conclusion: Stress, anxiety, and depression are risk factors for suicidal ideation in health students. Social support becomes an ally in emotional control, in the reduction of psychological suffering, and in the precipitation of mental disorders in students.

RESUMEN Objetivo: Comprobar la existencia de una asociación entre la ideación suicida, el apoyo social y los síntomas ansioso-depresivos entre los estudiantes de Ciencias de la Salud. Método: cuantitativo, estudio transversal. La recogida de datos tuvo lugar de noviembre de 2020 a julio de 2021, en Sergipe - Brasil, utilizando el Cuestionario Sociodemográfico, el Cuestionario de Ideación Suicida, la Escala de Satisfacción con el Apoyo Social y la Escala de Ansiedad, Depresión y Estrés. Se estimaron los coeficientes de regresión lineal simple y múltiple y las odds ratio. Resultados: de los 190 entrevistados, 57 (30%) estaban poco satisfechos con el apoyo social, 66 (34,8%) presentaban síntomas de depresión grave o muy grave, 32 (16,8%) tenían un riesgo potencial de suicidio, que puede aumentar en un 18% en las personas con depresión. Conclusión: El estrés, la ansiedad y la depresión son factores de riesgo de ideación suicida en los estudiantes de sanidad. El apoyo social se convierte en un aliado en el control emocional, en la reducción del sufrimiento psicológico y en la precipitación de los trastornos mentales en los estudiantes.

Epidemiology of breast cancer in a tertiary oncology hospital in the countryside of Minas Gerais

Objective: In Brazil, the characteristics of breast cancer patients who arrive at cancer treatment services are influenced by conditions related to the tumor, to the diagnostic system and navigation in the phase prior to care, with regional differences being little known as well as their seasonal variation. Methods: This is a retrospective study of epidemiological data of patients with breast cancer treated at the Hospital do Câncer de Muriaé (HCM), an exclusively oncology hospital (CACON II), with primarily public care, a reference for cancer treatment in the east of Zona da Mata region, Minas Gerais. Clinical and care-related characteristics were evaluated from 2010 to 2021. Results: During this period, 4,573 new patients were treated. The care was primarily public (80.5%) and most patients were undiagnosed (45.7%) or untreated (71.8%) at the first visit. The patients were between 40 and 69 years old (70.2%) and a significant portion were between 70 and 74 years old (7.4%). The rate of early stage (clinical stage ­ CS 0 + I) represented only 33.9 and 25.8% of all patients and those treated exclusively in the hospital, respectively. There was no change in clinical stage and age group over the years. Conclusion: When evaluating epidemiological data, the characteristics of the service and the pre-institutional diagnostic care network should be analyzed, facts that influence the results. Throughout the period, there was no great variation in relation to age group and staging. In this region, the early stage of breast cancer has unsatisfactory rates, and the 70 to 74 age group should be considered in mammographic screening. Epidemiological studies are essential to improve health strategies. (AU)

Integrative nursing in the Brazilian northeast: introduction, potential, and challenges / Enfermería integradora en el nordeste Brasileño: inserción, potencialidades y desafíos / Enfermagem integrativa no nordeste Brasileiro: inserção, potencialidades e desafios

ABSTRACT Objective: to describe the introduction, potential, and challenges experienced by nurses in the provision of Integrative and Complementary Health Practices in the northeast f Brazil. Method: A qualitative study conducted from June to December 2022 with 15 northeastern nurses qualified in Integrative and Complementary Practices. The data were produced through individual online interviews and submitted to content analysis. Results: 15 nurses participated, and 23 integrative practices were cited, with a predominance of auriculotherapy, greater introduction in primary care and private nursing offices, highlighting labor and personal benefits. Their potential includes technical qualification for the practice and interest in continuing education. The hospital-centric view of professionals, the low diffusion on the theme in teaching, as well as the difficulty in pricing procedures and in developing clinical reasoning in other medical rationalities were cited as the main challenges. Conclusion: Despite the challenges still faced, northeastern nurses are offering integrative practices to complement user care.

RESUMEN Objetivo: describir la inserción, las potencialidades y los desafíos experimentados por los enfermeros en la oferta de Prácticas Integrativas y Complementarias en Salud en la región noreste de Brasil. Método: estudio cualitativo, realizado de junio a diciembre de 2022 con 15 enfermeros del noreste calificados en Prácticas Integrativas y complementarias. Los datos se produjeron por medio de entrevistas individuales en línea y se sometieron a análisis de contenido. Resultados: Participaron 15 enfermeros y se citaron 23 prácticas integrativas, con predominio de la auriculoterapia, con mayor inserción en la atención primaria y en consultorios privados de enfermería, destacando beneficios laborales y personales. Algunas de las potencialidades incluyen la calificación técnica para la práctica y el interés en la educación continua. La visión hospitalocéntrica de los profesionales, la baja difusión del tema en la enseñanza, la dificultad en la fijación de precios de los procedimientos y en el desarrollo del razonamiento clínico en otras racionalidades médicas se citaron como los principales desafíos. Conclusión: A pesar de los desafíos enfrentados, enfermeros del noreste ofrecen prácticas integradoras, con el objetivo de complementar la atención a los usuarios.

RESUMO Objetivo: descrever a inserção, as potencialidades e os desafios vivenciados pelos enfermeiros na oferta das Práticas Integrativas e Complementares em Saúde na região Nordeste do Brasil. Método: estudo qualitativo, realizado de junho a dezembro de 2022 com 15 enfermeiros nordestinos habilitados em Práticas Integrativas e Complementares. Os dados foram produzidos por meio de entrevistas individuais online e submetidos à análise de conteúdo. Resultados: Participaram 15 enfermeiros e 23 práticas integrativas foram citadas, com predomínio da auriculoterapia, com maior inserção na atenção primária e nos consultórios privados de enfermagem, ressaltando benefícios laborais e pessoais. Algumas das potencialidades incluem a habilitação técnica para a prática e o interesse na realização da educação continuada. A visão hospitalocêntrica dos profissionais, a baixa difusão sobre a temática no ensino, a dificuldade em precificar os procedimentos e em desenvolver raciocínio clínico em outras racionalidades médicas foram citados como os principais desafios. Conclusão: Apesar dos desafios ainda enfrentados, os enfermeiros nordestinos estão ofertando as práticas integrativas, visando complementar os cuidados aos usuários.

O financiamento da Atenção Básica no Brasil: um balanço de duas décadas (2000-2020) / The financing primary care in Brazil: a balance of two decades (2000-2020)

Este artigo analisa o financiamento da Atenção Básica do Brasil entre 2000 e 2020 a partir de uma revisão integrativa das produções científicas disponíveis nas bases científicas eletrônicas BVS, SciELO e MEDLINE. Foram elegíveis artigos com acesso gratuito e situados no Brasil, excluindo duplicados e textos não científicos. Após aplicados os critérios de inclusão e exclusão, foram selecionados dez artigos, os quais foram submetidos à análise de conteúdo temática e organizados em duas categorias: (1) "Diferenças municipais no financiamento da Atenção Básica" e (2) "Financiamento tripartite da Atenção Básica". Os resultados apontam para diversas desigualdades no financiamento desse nível de atenção. Apesar do crescimento da participação federal, as transferências ocorreram por incentivos à adoção de programas federais que não alcançaram os municípios homogeneamente. Houve maior dependência das transferências federais em municípios pequenos e nas regiões Norte e Nordeste, além de baixa participação estadual no financiamento. Um dos limites do estudo foi não alcançar, pelo recorte temporal, estudos analisando os impactos das atuais políticas que agravaram o desfinanciamento da Atenção Básica, que provavelmente tem piorado o contexto apresentado e colocado ainda mais em risco a qualidade e preservação dela.

This article analyzes the primary healthcare financing in Brazil between 2000 and 2020. We conducted an integrative review of the scientific productions available in the electronic scientific databases BVS, Scielo, and MEDLINE in December 2020. After including articles undertaken in Brazil, with free access, and excluding duplicates and non-scientific texts, ten articles were selected. Those articles were submitted to Thematic Content Analysis and organized into two categories (1) "Municipal differences in the financing of Primary Care" and (2) "Tripartite Financing of Primary Care". The results of this review pointed out several inequalities in the financing of primary healthcare. Although federal participation in the budget has grown during the analyzed period, the transfers occurred due to incentives for the adoption of federal programs that did not reach the municipalities homogeneously. Compared to the South and Southeast, small municipalities in the North and Northeast regions had greater dependence on federal transfers. In addition, there was lower state participation in the overall financing in the North and Northeast regions. The main limitation of our review was not including studies published since 2021 analyzing the impacts of recent policies that aggravated the underfunding of primary healthcare in Brazil, which could have potentially worsened the results presented in this study and put primary healthcare quality and preservation even more at risk.

Atlantic cod individual spatial behaviour and stable isotope associations in a no-take marine reserve.

Foraging is a behavioural process and, therefore, individual behaviour and diet are theorized to covary. However, few comparisons of individual behaviour type and diet exist in the wild. We tested whether behaviour type and diet covary in a protected population of Atlantic cod, Gadus morhua. Working in a no-take marine reserve, we could collect data on natural behavioural variation and diet choice with minimal anthropogenic disturbance. We inferred behaviour using acoustic telemetry and diet from stable isotope compositions (expressed as δ13 C and δ15 N values). We further investigated whether behaviour and diet could have survival costs. We found cod with shorter diel vertical migration distances fed at higher trophic levels. Cod δ13 C and δ15 N values scaled positively with body size. Neither behaviour nor diet predicted survival, indicating phenotypic diversity is maintained without survival costs for cod in a protected ecosystem. The links between diet and diel vertical migration highlight that future work is needed to understand whether the shifts in this behaviour during environmental change (e.g. fishing or climate), could lead to trophic cascades.

Genomic epidemiology unveils the dynamics and spatial corridor behind the Yellow Fever virus outbreak in Southern Brazil.

Despite the considerable morbidity and mortality of yellow fever virus (YFV) infections in Brazil, our understanding of disease outbreaks is hampered by limited viral genomic data. Here, through a combination of phylogenetic and epidemiological models, we reconstructed the recent transmission history of YFV within different epidemic seasons in Brazil. A suitability index based on the highly domesticated Aedes aegypti was able to capture the seasonality of reported human infections. Spatial modeling revealed spatial hotspots with both past reporting and low vaccination coverage, which coincided with many of the largest urban centers in the Southeast. Phylodynamic analysis unraveled the circulation of three distinct lineages and provided proof of the directionality of a known spatial corridor that connects the endemic North with the extra-Amazonian basin. This study illustrates that genomics linked with eco-epidemiology can provide new insights into the landscape of YFV transmission, augmenting traditional approaches to infectious disease surveillance and control.

Technology transfer during the COVID-19 pandemic: report on the first face-to-face practical training course in Brazil.

MAIN RESULTS: Technology transfer can take place at large events, as long as safety protocols are strictly enforced. It is important to disseminate, at these events, the concepts of the Responsible Research and Innovation (RRI). Implications for services: Face-to-face training course is fundamental for training public health professionals. Technology transfer between research institutions and health services results in updating and improving health system performance. PERSPECTIVES: Based on the success of the reported technology transfer, a new module will be incorporated into the next edition of VEME (Panama 2022), entitled Virus Evolution to Public Health Policy Makers. The objective of this report was to describe the first face-to-face course aimed at training public health professionals in performing real-time genomic surveillance during the pandemic period. Experience report on a theoretical-practical course focusing on genomic research and surveillance, including mobile sequencing technologies, bioinformatics, phylogenetics and epidemiological modeling. There were 162 participants in the event and it was the first major face-to-face training course conducted during the COVID-19 epidemic in Brazil. No cases of SARS-CoV-2 infection was detected among the participants at the end of the event, suggesting the safety and effectiveness of all safety measures adopted. The results of this experience suggest that it is possible to conduct professional training safely during pandemics, as long as all safety protocols are followed.

Antilisterial activity of cinnamon essential oil, pomegranate extract, or strawberry tree extract against Listeria monocytogenes in slices of dry-cured ham and pork loin.

Owing to concerns about the antimicrobial resistance of agents that can prevent the growth of Listeria monocytogenes in meat, researchers have investigated natural preservatives with antilisterial effects. However, in vivo application of essential oils and plant extracts usually results in reduced antimicrobial activity in meat products when compared to in vitro studies. This study aimed to evaluate the in vivo antimicrobial activity of cinnamon essential oil, pomegranate, and strawberry tree extracts in slices of dry-cured ham and pork loin against L. monocytogenes. Fragments of sterile dry-cured ham were inoculated with 100 µL cinnamon oil 0.5%, pomegranate, or strawberry crude extract. After 10 min, 100 µL of L. monocytogenes serotype 4b (104 colony-forming unit [CFU]/mL) was inoculated, and samples were incubated at 7 °C for 7 d to simulate the processing and storage temperature conditions of dry-cured meat products. L. monocytogenes was detected and quantified. Only strawberry extract presented significant differences (P < 0.05) from the control; thus, it was selected for the assay with 2% and 4% salt-treated pork loin. The strawberry tree extract significantly (P < 0.05) reduced the growth of L. monocytogenes in dry-cured ham. However, it could not reduce L. monocytogenes growth in pork loin, regardless of the salt concentration. This is the first report on the antimicrobial effect of strawberry tree leaf extract against L. monocytogenes in dry-cured ham.

Increased interregional virus exchange and nucleotide diversity outline the expansion of chikungunya virus in Brazil.

The emergence and reemergence of mosquito-borne diseases in Brazil such as yellow fever, zika, chikungunya, and dengue have had serious impacts on public health. Concerns have been raised due to the rapid dissemination of the chikungunya virus across the country since its first detection in 2014 in Northeast Brazil. In this work, we carried out on-site training activities in genomic surveillance in partnership with the National Network of Public Health Laboratories that have led to the generation of 422 chikungunya virus genomes from 12 Brazilian states over the past two years (2021-2022), a period that has seen more than 312 thousand chikungunya fever cases reported in the country. These genomes increased the amount of available data and allowed a more comprehensive characterization of the dispersal dynamics of the chikungunya virus East-Central-South-African lineage in Brazil. Tree branching patterns revealed the emergence and expansion of two distinct subclades. Phylogeographic analysis indicated that the northeast region has been the leading hub of virus spread towards other regions. Increased frequency of C > T transitions among the new genomes suggested that host restriction factors from the immune system such as ADAR and AID/APOBEC deaminases might be driving the genetic diversity of the chikungunya virus in Brazil.

Increased interregional virus exchange and nucleotide diversity outline the expansion of the chikungunya virus ECSA lineage in Brazil.

The emergence and reemergence of mosquito-borne diseases in Brazil such as Yellow Fever, Zika, Chikungunya, and Dengue have had serious impacts on public health. Concerns have been raised due to the rapid dissemination of the chikungunya virus (CHIKV) across the country since its first detection in 2014 in Northeast Brazil. Faced with this scenario, on-site training activities in genomic surveillance carried out in partnership with the National Network of Public Health Laboratories have led to the generation of 422 CHIKV genomes from 12 Brazilian states over the past two years (2021-2022), a period that has seen more than 312 thousand chikungunya fever cases reported in the country. These new genomes increased the amount of available data and allowed a more comprehensive characterization of the dispersion dynamics of the CHIKV East-Central-South-African (ECSA) lineage in Brazil. Tree branching patterns revealed the emergence and expansion of two distinct subclades. Phylogeographic analysis indicated that the northeast region has been the leading hub of virus spread towards other regions. Increased frequency of C>T transitions among the new genomes suggested that host restriction factors from the immune system such as ADAR and AID/APOBEC deaminases might be driving CHIKV ECSA lineage genetic diversity in Brazil.

Molecular dynamics simulations of the SARS-CoV-2 Spike protein and variants of concern: structural evidence for convergent adaptive evolution.

The Spike protein's structure of the SARS-CoV-2 provides a unique opportunity to consider perturbations at the atomic level. We used the cryo-electron microscopy structure of the open conformation of the Spike protein to assess the impact of the mutations observed in the variants of concern at the molecular level. Molecular dynamics were subsequently performed with both the wt and the mutated forms to compare the flexibility and variation data for each residue of the three-dimensional fluctuations in the region associated with each alpha carbon. Additionally, protein-protein docking was used to investigate the interaction of each mutated profile with the ACE-2 receptor. After the molecular dynamics, the results show that the mutations increased the stability of the trimeric protein, with greater stability observed in the Gamma variant harboring the 10 characteristic mutations. The results of molecular dynamics, as shown by RMSF demonstrated for the residues that comprise the binding domain receptor (RBD), exhibited a reduction in flexibility, which was more pronounced in the Gamma variant. Finally, protein-protein docking experiments revealed an increase in the number of hydrophobic interactions and hydrogen bonds in the Gamma variant against the ACE-2 receptor, as opposed to the other variants. Taken together, these in silico experiments suggest that the evolution of the mutations favored the increased stability of Spike protein while potentially improving its interaction with the ACE-2 receptor, which in turn may indicate putative structural outcomes of the selection of these mutations in the convergent adaptive evolution as it has been observed for SARS-CoV-2.Communicated by Ramaswamy H. Sarma.

Transferência tecnológica durante a pandemia de covid-19: relato do primeiro treinamento prático presencial no Brasil / Technology transfer during the COVID-19 pandemic: report on the first face-to-face practical training course in Brazil / Transferencia de tecnología durante la epidemia de COVID-19 en Brasil: informe de la primera formación práctica presencial

O relato descreveu o primeiro curso presencial visando capacitar profissionais de saúde pública na realização de vigilância genômica em tempo real, durante períodos pandêmicos. Relato de experiência sobre um curso teórico-prático com foco em pesquisa e vigilância genômica, incluindo tecnologias de sequenciamento móvel, bioinformática, filogenética e modelagem epidemiológica. O evento contou com 162 participantes e foi o primeiro grande treinamento presencial realizado durante a epidemia de covid-19 no Brasil. Não foi detectada infecção pelo SARS-CoV-2 ao final do evento em nenhum participante, sugerindo a segurança e efetividade de todas as medidas de segurança adotadas. Os resultados do evento sugerem que é possível executar capacitação profissional com segurança durante pandemias, desde que seguidos todos os protocolos de segurança.

The objective of this report was to describe the first face-to-face course aimed at training public health professionals in performing real-time genomic surveillance during the pandemic period. Experience report on a theoretical-practical course focusing on genomic research and surveillance, including mobile sequencing technologies, bioinformatics, phylogenetics and epidemiological modeling. There were 162 participants in the event and it was the first major face-to-face training course conducted during the COVID-19 epidemic in Brazil. No cases of SARS-CoV-2 infection was detected among the participants at the end of the event, suggesting the safety and effectiveness of all safety measures adopted. The results of this experience suggest that it is possible to conduct professional training safely during pandemics, as long as all safety protocols are followed.

Este estudio tuvo como objetivo describir el primer curso presencial para capacitar a los profesionales de la salud pública para llevar a cabo la vigilancia genómica en tiempo real durante los períodos de pandemia. Este es un informe de experiencia en un curso teórico-práctico centrado en la investigación y vigilancia genómica, que incluye secuenciación móvil, bioinformática, filogenética y tecnologías de modelado epidemiológico. Este evento contó con la asistencia de 162 participantes y fue la primera gran capacitación presencial realizada durante la epidemia de COVID-19 en Brasil. No se detectó infección por SARS-CoV-2 al final del evento en ningún participante, lo que sugiere la seguridad y efectividad de todas las medidas de seguridad adoptadas. Por lo tanto, los resultados del evento sugieren que es posible realizar entrenamientos profesionales de manera segura durante pandemias, siempre y cuando se sigan todos los protocolos de seguridad.

Eco-evolutionary dynamics of Atlantic cod spatial behavior maintained after the implementation of a marine reserve.

The effects of marine reserves on the life history and demography of the protected populations are well-established, typically increasing population density and body size. However, little is known about how marine reserves may alter the behavior of the populations that are the target of protection. In theory, marine reserves can relax selection on spatial behavioral phenotypes that were previously targeted by the fishery and also drive selection in favor of less mobile individuals. In this study, we used acoustic telemetry to monitor the individual spatial behavior of 566 Atlantic cod (Gadus morhua Linnaeus, 1758) moving within a marine reserve and a control site in southern Norway, starting 1 year before the implementation of the marine reserve and lasting up to 9 years after. Following a before-after-control-impact approach, we investigated changes in (1) survival, (2) selection acting on behavioral traits, and (3) mean behavioral phenotypes, after the implementation of the marine reserve. We focused on three behavioral traits commonly used to describe the mobility of aquatic animals: home range size, depth position, and diel vertical migration range. Survival increased after reserve implementation, but contrary to our expectations, it subsequently decreased to preprotection levels after just 3 years. Further, we found no significance in selection patterns acting on any of the three behavioral traits after reserve implementation. Although some changes related to water column use (the tendency to occupy deeper waters) were observed in the marine reserve after 9 years, they cannot unequivocally be attributed to protection. Our results show that survival and behavioral responses to marine reserves in some cases may be more complex than previously anticipated and highlight the need for appropriately scaled management experiments and more integrated approaches to understand the effects of marine protected areas on harvested aquatic species.

Abdominal esophagocardiectomy with esophagogastric anastomosis, with vagal preservation and construction of a spiral anti reflux valve in the treatment of advanced megaesophagus.

OBJECTIVE: present a new operative technique characterized by abdominal esophagocardiectomy, with esophagogastrus anastomosis, vagal preservation and spiral anti-reflux valve construction in the treatment of advanced megaesophagus in patients with severe systemic diseases, as well as its result in an initial group of 17 patients. METHOD: We selected 17 patients with advanced megaesophagus and comorbidities submitted to new technique. The following parameters were analyzed: age, sex, length of hospital stay, early and late complications, mortality, radiological/endoscopic aspects. RESULTS: twelve male patients (70%) and five (30%) were operated on, with mean age of 51.5 years and mean hospital stay of 14.8 days. There was no mortality in the immediate intraoperative or postoperative period and there were no cases of postoperative fistula. During hospitalization there was one case of pulmonary atelectasis (5.8%), one of pleural effusion (5.8%), two of wall infection (11.7%) and one of urinary retention (5.8%). Discussion: We believe it to be an easy technique, made exclusively by the abdominal route, that is, without violating the thoracic cavity. Such a procedure would be beneficial in patients with advanced megaesophagus and important comorbidities, as well as in those with a history of previous surgeries. CONCLUSION: the technique described was easy to perform and safe, when performed by an experienced team, with low morbidity and mortality in patients with advanced megaesophagus and important comorbidities, which could increase your complications with more invasive and complex surgeries.