Thiamine Deficiency Increases Intrinsic Excitability of Mouse Cerebellar Purkinje Cells.

Thiamine deficiency is associated with cerebellar dysfunction; however, the consequences of thiamine deficiency on the electrophysiological properties of cerebellar Purkinje cells are poorly understood. Here, we evaluated these parameters in brain slices containing cerebellar vermis. Adult mice were maintained for 12-13 days on a thiamine-free diet coupled with daily injections of pyrithiamine, an inhibitor of thiamine phosphorylation. Morphological analysis revealed a 20% reduction in Purkinje cell and nuclear volume in thiamine-deficient animals compared to feeding-matched controls, with no reduction in cell count. Under whole-cell current clamp, thiamine-deficient Purkinje cells required significantly less current injection to fire an action potential. This reduction in rheobase was not due to a change in voltage threshold. Rather, thiamine-deficient neurons presented significantly higher input resistance specifically in the voltage range just below threshold, which increases their sensitivity to current at these critical membrane potentials. In addition, thiamine deficiency caused a significant decrease in the amplitude of the action potential afterhyperpolarization, broadened the action potential, and decreased the current threshold for depolarization block. When thiamine-deficient animals were allowed to recover for 1 week on a normal diet, rheobase, threshold, action potential half-width, and depolarization block threshold were no longer different from controls. We conclude that thiamine deficiency causes significant but reversible changes to the electrophysiology properties of Purkinje cells prior to pathological morphological alterations or cell loss. Thus, the data obtained in the present study indicate that increased excitability of Purkinje cells may represent a leading indicator of cerebellar dysfunction caused by lack of thiamine.

Mechanisms and functional impact of Group I metabotropic glutamate receptor modulation of excitability in mouse MNTB neurons.

We examined effects of Group I metabotropic glutamate receptors on the excitability of mouse medial nucleus of the trapezoid body (MNTB) neurons. The selective agonist, S-3,5-dihydroxyphenylglycine (DHPG), evoked a dose-dependent depolarization of the resting potential, increased membrane resistance, increased sag depolarization, and promoted rebound action potential firing. Under voltage-clamp, DHPG evoked an inward current, referred to as IDHPG , which was developmentally stable through postnatal day P56. IDHPG had low temperature dependence in the range 25-34°C, consistent with a channel mechanism. However, the I-V relationship took the form of an inverted U that did not reverse at the calculated Nernst potential for K+ or Cl- . Thus, it is likely that more than one ion type contributes to IDHPG and the mix may be voltage dependent. IDHPG was resistant to the Na+ channel blockers tetrodotoxin and amiloride, and to inhibitors of iGluR (CNQX and MK801). IDHPG was inhibited 21% by Ba2+ (500 µM), 60% by ZD7288 (100 µM) and 73% when the two antagonists were applied together, suggesting that KIR channels and HCN channels contribute to the current. Voltage clamp measurements of IH indicated a small (6%) increase in Gmax by DHPG with no change in the voltage dependence. DHPG reduced action potential rheobase and reduced the number of post-synaptic AP failures during high frequency stimulation of the calyx of Held. Thus, activation of post-synaptic Group I mGlu receptors modifies the excitability of MNTB neurons and contributes to the reliability of high frequency firing in this auditory relay nucleus.

Understanding the double burden of malnutrition in food insecure households in Brazil.

Household food insecurity (HFI) has been associated with both obesity among mothers and undernutrition among children. However, this association has not been well investigated in mother/child pairs living in the same household. The objective of this study was to examine the relationship of coexistence of maternal overweight and child stunting with HFI in Brazil. We conducted secondary data analyses of the 2006 Brazilian National Demographic and Health Survey. We analyzed the nutritional status of 4299 pairs of 15-49-year-olds mothers and their children under 5 years of age. The double burden of malnutrition (DBM) was defined as the presence of an overweight mother and a stunted child in the same household. HFI was measured with the Brazilian HFI Measurement Scale. The association between DBM and HFI was examined with hierarchical multivariable logistic regression analyses. Severe HFI was associated with DBM after adjusting for macroeconomic and household level socio-economic and demographic variables (Adjusted OR: 2.65 - CI: 1.17-8.53). Findings suggest that policies and programmes targeting HFI are needed to prevent the coexistence of child chronic undernutrition and maternal overweight/obesity in the same household. These investments are likely to be highly cost-effective as stunting has been identified as one of the major risk factors for poor child development and adult overweight/obesity and a strong risk factor for the development of costly chronic diseases including type 2 diabetes and cardiovascular disease.

Poverty-Food Insecurity Nexus in the Post-Construction Context of a Large Hydropower Dam in the Brazilian Amazon.

Within the 2030 Sustainable Development Agenda, large hydropower dams are positioned as a sustainable energy source, notwithstanding their adverse impacts on societies and ecosystems. This study contributed to ongoing discussions about the persistence of critical social issues, even after the investments of large amounts of resources in areas impacted by the construction of large hydropower dams. Our study focused on food insecurity and evaluated this issue in the city of Altamira in the Brazilian Amazon, which has been profoundly socially and economically impacted by the construction, between 2011 and 2015, of Brazil's second-largest dam, namely, Belo Monte. A survey in Altamira city featured a 500-household random sample. Structural equation modeling showed conditioning factors of 60% of the population experiencing varying food insecurity degrees. Poverty, female-led households, lower education, youth, and unemployment were strongly linked to higher food insecurity. Crowded, officially impacted, and resettled households also faced heightened food insecurity. Our findings underscore the food insecurity conditions in the region impacted by the Belo Monte dam, emphasizing the need to take into account this crucial issue while planning and implementing hydropower dams.

The EU-funded I3LUNG Project: Integrative Science, Intelligent Data Platform for Individualized LUNG Cancer Care With Immunotherapy.

Although immunotherapy (IO) has changed the paradigm for the treatment of patients with advanced non-small cell lung cancers (aNSCLC), only around 30% to 50% of treated patients experience a long-term benefit from IO. Furthermore, the identification of the 30 to 50% of patients who respond remains a major challenge, as programmed Death-Ligand 1 (PD-L1) is currently the only biomarker used to predict the outcome of IO in NSCLC patients despite its limited efficacy. Considering the dynamic complexity of the immune system-tumor microenvironment (TME) and its interaction with the host's and patient's behavior, it is unlikely that a single biomarker will accurately predict a patient's outcomes. In this scenario, Artificial Intelligence (AI) and Machine Learning (ML) are becoming essential to the development of powerful decision-making tools that are able to deal with this high-complexity and provide individualized predictions to better match treatments to individual patients and thus improve patient outcomes and reduce the economic burden of aNSCLC on healthcare systems. I3LUNG is an international, multicenter, retrospective and prospective, observational study of patients with aNSCLC treated with IO, entirely funded by European Union (EU) under the Horizon 2020 (H2020) program. Using AI-based tools, the aim of this study is to promote individualized treatment in aNSCLC, with the goals of improving survival and quality of life, minimizing or preventing undue toxicity and promoting efficient resource allocation. The final objective of the project is the construction of a novel, integrated, AI-assisted data storage and elaboration platform to guide IO administration in aNSCLC, ensuring easy access and cost-effective use by healthcare providers and patients.

Severe food insecurity is associated with obesity among Brazilian adolescent females.

OBJECTIVE: To determine whether household food insecurity (HFI) is associated with a higher prevalence of excessive weight (EW) in a large random sample of Brazilian female adolescents. DESIGN: Nationally representative cross-sectional study. EW was the outcome variable (BMI ≥ 85th percentile of WHO reference for adolescents aged 15-18 years and BMI ≥ 25 kg/m(2) for those aged 19 years). HFI was measured with the Brazilian Food Insecurity Scale. Associations were measured using crude and adjusted prevalence ratios (PR) with 95 % confidence intervals through Poisson regression models taking into account the complex sampling design. SETTING: Data were derived from the third wave of the Demographic and Health Survey conducted in 2006-2007, in Brazil. SUBJECTS: The sample included 1529 female adolescents aged 15-19 years. RESULTS: The prevalence of any level of HFI was 40.8 %, with 26.6 % of households experiencing mild, 9.4 % moderate and 4.8 % severe food insecurity. The overall prevalence of EW was 21.9 % (12.9 % were overweight and 9.0 % obese). EW prevalence among those living in severely, moderately and mildly food-insecure households was 36.8 %, 14.9 % and 16.5 %, respectively (P for the overall association = 0.036). Women living in severely food-insecure households had an increased prevalence of EW compared with their food-secure counterparts (PR = 1.96; 95 % CI 1.18, 3.27; P = 0.007), after adjusting for important confounders. CONCLUSIONS: The study suggests that severe but not mild or moderate HFI is independently associated with EW among adolescents residing in Brazil, a middle-income country undergoing the nutrition transition.

National Trends and Disparities in Severe Food Insecurity in Brazil between 2004 and 2018.

Background: The Brazilian Household Food Insecurity Measurement Scale (EBIA) is the main tool for assessing household food insecurity (FI) in Brazil and facilitates the monitoring and improvement of national public policies to promote food security. Since 2004, the Brazilian government has conducted National Household Sample Surveys, and in 2018, the government carried out the last national evaluation of FI. Objectives: To describe trends in severe FI in Brazil from 2004 to 2018. Methods: Data from 3 cross-sectional Brazilian National Household Sample Surveys (sample sizes: 2004 = 112,530; 2009 = 120,910; 2013 = 116,196) and from the last Household Budget Survey (sample size = 57,920) that assessed the status of FI using the EBIA were analyzed. Changes in severe FI during 2 periods (2004-2013; 2013-2018) were estimated while considering sociodemographic factors. Results: The period between 2004 and 2013 was marked by a significant decrease in severe FI (-53.6%), but this trend reversed in 2013-2018 (+43.8%). The greatest decrease in severe FI occurred in the Northeast (-57.6%) among households where the reference person was a man (-57.6%) and self-identified as white (-58.1%) (2004-2013). In 2013-2018, households with children aged ≤4 y (+6.3%) and members aged ≥65 y (+12.5%) experienced the lowest increases in severe FI. Conclusions: After a significant reduction from 2004 to 2013, severe FI increased sharply from 2013 to 2018, likely due to disruptions in public policies aimed at reducing hunger and unemployment rates.

[Validity of an instrument for screening households at risk of food insecurity in different strata of the Brazilian population]. / Validade do instrumento para triagem de domicílios em risco de insegurança alimentar em diversos estratos da população brasileira.

The absence of risk screening tools for food insecurity compromises the ability to assess, monitor, and provide immediate assistance to those in hunger, especially during emergencies such as the COVID-19 crisis. Hence, this study sought to test the validity of an instrument for Screening Households at Risk of Food Insecurity (TRIA) in different strata of the Brazilian population TRIA uses questions 2 and 4 of the Brazilian Food Insecurity Scale (EBIA), originally validated using data from the Brazilian National Survey of Demography and Health of Children and Women (PNDS 2006). In this study, using data from the Brazilian National Household Sample Survey (PNAD 2013), its reproducibility was tested by repeating the original combinatorial procedures, examining whether the parameters of sensitivity, specificity, accuracy, and positive predictive values (PPV) and negative values (NPV) would result in the same arrangement of questions. Moreover, convergent validity was analyzed by comparing the strength of association between food insecurity and dietary variables using two binomial regression models (TRIA x EBIA). Results indicated that the combination of questions 2 and 4 performed best among the population strata studied, and presented optimal convergent validity. PPV and NPV adjusted for food insecurity prevalence in states ranged from 42.8% (Santa Catarina) to 87.6% (Amazonas) and 95.8% (Amazonas) to 99.5% (Santa Catarina), respectively. In conclusion, besides being reproducible, TRIA presented excellent validity parameters, especially among vulnerable groups. It can thus be used in care practice and as an instrument of food and nutritional surveillance in Brazil.

A ausência de instrumentos de triagem de risco para insegurança alimentar compromete a capacidade de avaliar, monitorar e ofertar assistência imediata a pessoas em situação de fome, especialmente durante emergências, como a crise da COVID-19. Assim, o objetivo deste estudo foi testar a validade do instrumento de Triagem para Risco de Insegurança Alimentar (TRIA), em diversos estratos da população brasileira. A TRIA é composta pelas questões 2 e 4 da Escala Brasileira de Insegurança Alimentar (EBIA), validada, originalmente, a partir de dados da Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS 2006). Neste estudo, utilizando dados da Pesquisa Nacional por Amostra de Domicílios (PNAD 2013), testou-se sua reprodutibilidade por meio da repetição dos procedimentos combinatórios originais, examinando se os parâmetros de sensibilidade, especificidade, acurácia e valores preditivos positivo (VPP) e negativo (VPN) resultariam no mesmo arranjo de questões. Ainda, analisou-se a validade convergente comparando a força de associação entre insegurança alimentar e variáveis alimentares por meio de dois modelos de regressão binomial (TRIA x EBIA). Os resultados indicaram que a combinação das questões 2 e 4 apresentou melhor desempenho entre os estratos populacionais estudados, além de ótima validade convergente. O VPP e VPN ajustado pela prevalência de insegurança alimentar nos estados variou de 42,8% (Santa Catarina) a 87,6% (Amazonas) e 95,8% (Amazonas) a 99,5% (Santa Catarina), respectivamente. Em conclusão, além de ser reprodutível, a TRIA apresentou excelentes parâmetros de validade, sobretudo em grupos vulnerabilizados. Assim, seu uso pode ser recomendado na prática assistencial e como instrumento de vigilância alimentar e nutricional no Brasil.

La ausencia de instrumentos de triaje de riesgo para la inseguridad alimentaria compromete la capacidad de evaluar, monitorear y brindar asistencia inmediata a las personas en situación de hambre, especialmente durante emergencias como la crisis de la COVID-19. Por lo tanto, el objetivo de este estudio fue probar la validez del instrumento de Triaje para Riesgo de Inseguridad Alimentaria (TRIA) en diferentes estratos de la población brasileña. El TRIA consta de las preguntas 2 y 4 de la Escala Brasileña de Inseguridad Alimentaria (EBIA), originalmente validada con base en datos de la Encuesta Nacional de Demografía y Salud de la Mujer y el Niño (PNDS 2006). En este estudio, utilizando datos de la Encuesta Nacional por Muestra de Domicilios (PNAD 2013), se probó su reproducibilidad repitiendo los procedimientos combinatorios originales, examinando si los parámetros de sensibilidad, especificidad, exactitud y valores predictivos positivos (VPP) y negativo (VPN) resultarían en el mismo arreglo de preguntas. Además, se analizó la validez convergente comparando la fuerza de asociación entre la inseguridad alimentaria y las variables alimentarias por medio de dos modelos de regresión binomial (TRIA x EBIA). Los resultados indicaron que la combinación de las preguntas 2 y 4 presentó el mejor desempeño entre los estratos poblacionales estudiados, además de excelente validez convergente. El VPP y el VPN ajustado por la prevalencia de inseguridad alimentaria en los estados osciló entre el 42,8% (Santa Catarina) y el 87,6% (Amazonas) y entre el 95,8% (Amazonas) y el 99,5% (Santa Catarina), respectivamente. En conclusión, además de ser reproducible, el TRIA presentó excelentes parámetros de validez, especialmente en grupos en situación de vulnerabilidad. Por lo tanto, se puede recomendar su uso en la práctica asistencial y como instrumento para la vigilancia alimentaria y nutricional en Brasil.

Validity of a 2-item screening tool to identify families at risk for food insecurity in Brazil.

This manuscript aimed to develop a brief 2-item screening tool to identify Brazilian households that include families with children at risk for food insecurity. Psychometric analyses including sensitivity, specificity, positive and negative predictive value, accuracy, and ROC curves were used to test combinations of questions to determine the most effective screener to assess households at risk for food insecurity when compared to a gold standard scale. Participants included Brazilian National Survey of Demography and Health on Women and Children (PNDS) surveyed households with a valid Brazilian Food Insecurity Scale (EBIA) response. The sample included 3,920 households representing 11,779,686 households when expanded using PNDS sample weights. With overall prevalence of food insecurity at 21%, a Brazilian 2-item food-insecurity screen showed sensitivity of 79.31%, specificity of 92.95%, positive predictive value of 74.62%, negative predictive value of 94.5% and ROC area 86.13%. This screen also presented high convergent validity for children's nutrition and health variables when compared with the gold standard, the EBIA full scale. Based on its ability to detect households at risk for food insecurity, a 2-item screening tool is recommended for widespread adoption as a screening measure throughout Brazil, especially when rapid decision-making has been made fundamental, as under the COVID-19 pandemic. This screener can enable providers to accurately identify families at risk for food insecurity and promptly intervene to prevent or ameliorate adverse health and developmental consequences associated with food insecurity and swiftly respond to crises.

Food and nutritional security of semi-arid farm families benefiting from rainwater collection equipment in Brazil.

The objective of this study was to identify and describe the experience of family farmers and their respective families after using the Boardwalk Cistern rainwater collection system and consequent impacts on nutrition profile and food security. This is a qualitative-quantitative study conducted in two municipalities in the semi-arid region of the state of Alagoas, northeastern Brazil. A structured questionnaire was applied to collect information on demographic and socioeconomic status and household access to food, based on the Brazilian Food Insecurity Scale of 29 family farmers' households. Food intake was assessed by food intake markers of the Ministry of Health, while nutritional status was determined by measuring the weight and height of all family members and waist circumference of adults. Nutrition diagnosis was performed using the cutoff points of body mass index for age. Three focus groups were conducted, and the information collected was analyzed through Content Analysis with the aim of knowing the participants' perception of the effects of the received water equipment. The study showed a high prevalence of excess weight (52.7%) and high risk for cardiovascular diseases (35.9%) marked by a high salt and sugar in the food intake. Food Insecurity Scale showed that food insecurity is a problem occurring in 75% of these families. However, focus groups showed that families have a positive perception of Boardwalk Cisterns for their food security. They believe that agricultural production has improved, thereby offering a wider range of foods and, consequently, improving food security. In conclusion, this study highlights the importance of water access programs for food production within public policies to guarantee FNS.

Angiotensin-converting enzyme 2 activator, DIZE in the basolateral amygdala attenuates the tachycardic response to acute stress by modulating glutamatergic tone.

The basolateral amygdala (BLA) is critical in the control of the sympathetic output during stress. Studies demonstrated the involvement of the renin-angiotensin system components in the BLA. Angiotensin-(1-7) [Ang-(1-7)], acting through Mas receptors, reduces stress effects. Considering that angiotensin-converting enzyme 2 (ACE2) is the principal enzyme for the production of Ang-(1-7), here we evaluate the cardiovascular reactivity to acute stress after administration of the ACE2 activator, diminazene aceturate (DIZE) into the BLA. We also tested whether systemic treatment with DIZE could modify synaptic activity in the BLA and its effect directly on the expression of the N-methyl-d-aspartate receptors (NMDARs) in NG108 neurons in-vitro. Administration of DIZE into the BLA (200 pmol/100 nL) attenuated the tachycardia to stress (ΔHR, bpm: vehicle = 103 ± 17 vs DIZE = 49 ± 7 p = 0.018); this effect was inhibited by Ang-(1-7) antagonist, A-779 (ΔHR, bpm: DIZE = 49 ± 7 vs A-779 + DIZE = 100 ± 15 p = 0.04). Systemic treatment with DIZE attenuated the excitatory synaptic activity in the BLA (Frequency (Hz): vehicle = 2.9 ± 0.4 vs. DIZE =1.8 ± 0.3 p < 0.04). NG108 cells treated with DIZE demonstrated decreased expression of l subunit NMDAR-NR1 (NR1 expression (a.u): control = 0.534 ± 0.0593 vs. DIZE = 0.254 ± 0.0260) of NMDAR and increases of Mas receptors expression. These data demonstrate that DIZE attenuates the tachycardia evoked by acute stress. This effect results from a central action in the BLA involving activation of Mas receptors. The ACE2 activation via DIZE treatment attenuated the frequency of excitatory synaptic activity in the basolateral amygdala and this effect can be related with the decreases of the NMDAR-NR1 receptor expression.

Sexual and Reproductive Health in Patients with Schizophrenia and Bipolar Disorder. / Salud sexual y reproductiva de los pacientes con esquizofrenia y trastorno afectivo bipolar.

INTRODUCTION: People with schizophrenia and bipolar disorder (BD) have a high risk of unwanted pregnancies and abortions, due to their condition of vulnerability or hypersexuality (common in BD). This is associated with difficulty in planning their actions and lack of sex education and counselling by medical personnel, and can lead to adverse obstetric outcomes and inability to care adequately for their children. OBJECTIVE: To describe the characteristics in terms of sexual and reproductive health, and the use of contraception and counselling in psychiatric consultations, in a sample of patients with BD and schizophrenia in Medellin, Colombia. METHODS: Observational cross-sectional study. We included the 160 participants from the clinical trial, "The effects of a multimodal intervention programme in patients with bipolar disorder and schizophrenia", who were recruited from the mood and psychosis disorders group clinic at Hospital Universitario de San Vicente Fundación in Medellin. They were contacted by phone by a third-year psychiatry resident, who applied a survey about the characteristics of their sex life, contraception and reproduction. RESULTS: Almost all of the patients with schizophrenia were single, had no undergraduate studies and were unemployed. No significant differences were found regarding the age of starting sexual relations when comparing by diagnosis and gender. Almost all patients with schizophrenia and almost half of the patients with BD reported not having an active sexual life. Almost all of those who admitted to having an active sexual life claimed to always use contraception; in the BD group, only 48.8% of single women admitted to using contraception and a little over half of men stated that they used a condom when having sex. A quarter of the pregnancies were unplanned. Although the majority of the patients stated that they had never received information about family planning in the consultations with their psychiatrist, 57.4% of the patients with BD and 78.8% of those who had schizophrenia, considered themselves to be well informed on the subject. CONCLUSIONS: Patients with mental illness have cognitive and behavioural alterations that affect their sexual and reproductive lives. Psychiatrists should therefore address this issue, to ensure education in areas such as contraception, family planning and sexually transmitted diseases and help safeguard the safety and quality of life of their patients.

Food security status in times of financial and political crisis in Brazil.

This study sought to describe the changes in the food security status in Brazil before and during its most recent financial and political crisis, as well as to explore associations between food security and socioeconomic factors during the crisis. This cross-sectional study analyzed data from two different sources: the Brazilian National Household Sample Survey for 2004 (n = 112,479), 2009 (n = 120,910), and 2013 (n = 116,192); and the Gallup World Poll for 2015 (n = 1,004), 2016 (n = 1,002), and 2017 (n = 1,001). Household food security status was measured by a shorter version of the Brazilian Food Insecurity Scale, consisting of the first 8 questions of the original 14-item scale. Descriptive and logistic regression analyses were performed to assess the changes in food security and their association with socioeconomic factors. Results suggest that during the crisis the percentage of households classified as food secure declined by one third (76% in 2013 to 49% in 2017) while severe food insecurity tripled (4% in 2013 to 12% in 2017). Whereas before the crisis (2013) 44% of the poorest households were food secure, by 2017 this decreased to 26%. Household income per capita was strongly associated with food security, increasing by six times the chances of being food insecure among the poorest strata. Those who reported a low job climate, social support or level of education were twice as likely to be food insecure. Despite significant improvements between 2004 and 2013, findings indicate that during the crisis Brazil suffered from a great deterioration of food security, highlighting the need for emergency policies to protect and guarantee access to food for the most vulnerable.

Comparing food environment and food purchase in areas with low and high prevalence of obesity: data from a mapping, in-store audit, and population-based survey.

Our study aimed to compare key aspects of the food environment in two low-income areas in the city of Campinas, São Paulo State, Brazil: one with low and the other with high prevalence of obesity. We compared the availability of retail food establishments, the types of food sold, and the residents' eating habits. Demographic and socioeconomic data and eating habits were obtained from a population-based health survey. We also analyzed local food environment data collected from remote mapping of the retail food establishments and audit of the foods sold. For comparison purposes, the areas were selected according to obesity prevalence (body mass index - BMI ≥ 30kg/m²), defined as low prevalence (< 25%) and high prevalence (> 45%). Only 18 out of the 150 points of sale for food products sold fruits and vegetables across the areas. Areas with high obesity prevalence had more grocery stores and shops specialized in fruits and vegetables, as well as more supermarkets that sold fruits and vegetables. With less schooling, residents in the areas with high obesity prevalence reported purchasing food more often in supermarket chains and specialized shops with fruits and vegetables, although they consumed more sodas when compared with residents of areas with low obesity prevalence. Our results suggest interventions in low-income areas should consider the diverse environmental contexts and the interaction between schooling and food purchase behaviors in settings less prone to healthy eating.

[Food security in Teréna indigenous families, Mato Grosso do Sul, Brazil]. / Segurança alimentar em famílias indígenas Teréna, Mato Grosso do Sul, Brasil.

This study aims to describe the food security situation among Teréna families in the villages of Agua Azul, Olho D'Agua, and Oliveiras in Mato Grosso do Sul State, Brazil. The Brazilian Food Insecurity Scale was adapted to 15 questions that reflect food insecurity at different levels of intensity. A survey was conducted in the villages with 49 families that had under-five children. Information was obtained on income, family size, maternal education, and children's food intake. 75.5% of families showed some level of food insecurity (22.4% low, 32.7% moderate, and 20.4% high). A large percentage (67.3%) of the families live with fear of lack of food. One-fourth of women had experienced hunger during the month prior to the survey, and 14.3% (7) reported the same condition for children in the household. More serious food insecurity was observed in families with lower per capita income and lower maternal education, more family members, and more children per family group in which the children's diet was insufficient, especially in protein and iron.

Manifestaciones mucocutáneas en pacientes hospitalizados por COVID 19 en un hospital de alta complejidad / Mucocutaneous manifestations in patients hospitalized with covid-19 in a high complexity hospital

Resumen Introducción: el SARS-CoV-2 es un virus ARN de cadena simple que compromete diferentes órganos, incluyendo la piel. Los pacientes que cursan con este virus pueden presentar diferentes manifestaciones mucocutáneas. Objetivo: determinar la prevalencia de las lesiones mucocutáneas en pacientes hospitalizados por infección SARS-CoV-2/COVID 19 en el Hospital San Vicente Fundación Rionegro entre abril y junio del 2021. Materiales y métodos: estudio descriptivo transversal en pacientes hospitalizados con diagnóstico de infección por COVID-19 confirmado por pruebas serológicas y con lesiones mucocutáneas. Resultados: de 600 pacientes hospitalizados por COVID-19, 16 presentaron lesiones mucocutáneas para una prevalencia del 2,6%, y entre estos, 13 requirieron manejo en unidad de cuidados intensivos por síndrome de dificultad respiratoria aguda severa o enfermedad severa (81,25%) asociado a marcadores de mal pronóstico elevados. Los más elevados fueron la PCR, LDH o la presencia de linfopenia. Las lesiones vasculares fueron las más frecuentes (42,9%), que se manifestaron como púrpuras, vasculitis, livedo racemosa, perniosis y pseudoperniosis. Las erupciones o exantemas fueron de tipo maculopapulares (28,6%), eritematosas (19%) y urticariales (9,5%); además de úlceras en cavidad oral (8,8%) y vesículas (2,9%). El 75% de estos pacientes presentaron lesiones cutáneas en la fase activa de la enfermedad y el 25% en la fase resolutiva. Las morbilidades más frecuentes fueron hipertensión arterial (30%) y diabetes (20%). Seis pacientes fallecieron (37,5%). Conclusiones: las manifestaciones mucocutáneas asociadas al COVID-19, especialmente las de tipo vascular como las púrpuras, vasculitis y livedo racemosa, se asocian a formas graves de la enfermedad, especialmente en pacientes con ventilación mecánica asistida con un alto índice de mortalidad.

Abstract Introduction: SARS-CoV-2 is a single-stranded RNA virus that affects different organs, including the skin. Patients with this virus can present different mucocutaneous manifestations. Objective: to determine the prevalence of skin lesions in patients hospitalized for SARS-CoV-2 / COVID 19 infection at the Hospital San Vicente Fundación Rionegro between April and June 2021. Materials and methods: descriptive cross-sectional study in hospitalized patients with a diagnosis of infection by COVID-19 confirmed by serological tests and with mucocutaneous lesions. Results: of 600 patients hospitalized for COVID-19, 16 presented mucocutaneous lesions for a prevalence of 2,6 %, and among these, 13 required management in the intensive care unit due to severe acute respiratory distress syndrome or severe illness (81,25%) associated with elevated markers of poor prognosis. The most increased were PCR, LDH and/or lymphopenia. Vascular lesions were the most frequent (42,9%), manifested as purples, vasculitis, livedo racemosa, perniosis and pseudoperniosis. The eruptions or rashes were maculopapular (28.6%), erythematous (19%) and urticarial (9,5%), and ulcers in the oral cavity (8,8%) and vesicles (2,9%). 75% of these patients had skin lesions in the active phase of the disease and 25% in the resolution phase. The most frequent morbidity was arterial hypertension (30%) and diabetes (20%). six patients (37,5%) died. Conclusions: the mucocutaneous manifestations associated with COVID-19, especially those of a vascular type such as purples, vasculitis and livedo racemosa, are associated with severe forms of the disease, especially in patients with assisted mechanical ventilation with a high mortality rate.

Control of neuronal excitability by Group I metabotropic glutamate receptors.

Metabotropic glutamate (mGlu) receptors couple through G proteins to regulate a large number of cell functions. Eight mGlu receptor isoforms have been cloned and classified into three Groups based on sequence, signal transduction mechanisms and pharmacology. This review will focus on Group I mGlu receptors, comprising the isoforms mGlu1 and mGlu5. Activation of these receptors initiates both G protein-dependent and -independent signal transduction pathways. The G-protein-dependent pathway involves mainly Gαq, which can activate PLCß, leading initially to the formation of IP3 and diacylglycerol. IP3 can release Ca2+ from cellular stores resulting in activation of Ca2+-dependent ion channels. Intracellular Ca2+, together with diacylglycerol, activates PKC, which has many protein targets, including ion channels. Thus, activation of the G-protein-dependent pathway affects cellular excitability though several different effectors. In parallel, G protein-independent pathways lead to activation of non-selective cationic currents and metabotropic synaptic currents and potentials. Here, we provide a survey of the membrane transport proteins responsible for these electrical effects of Group I metabotropic glutamate receptors.

Validade do instrumento para triagem de domicílios em risco de insegurança alimentar em diversos estratos da população brasileira / Validity of an instrument for screening households at risk of food insecurity in different strata of the Brazilian population / Validez del instrumento de triaje de hogares en riesgo de inseguridad alimentaria en diferentes estratos de la población brasileña

A ausência de instrumentos de triagem de risco para insegurança alimentar compromete a capacidade de avaliar, monitorar e ofertar assistência imediata a pessoas em situação de fome, especialmente durante emergências, como a crise da COVID-19. Assim, o objetivo deste estudo foi testar a validade do instrumento de Triagem para Risco de Insegurança Alimentar (TRIA), em diversos estratos da população brasileira. A TRIA é composta pelas questões 2 e 4 da Escala Brasileira de Insegurança Alimentar (EBIA), validada, originalmente, a partir de dados da Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS 2006). Neste estudo, utilizando dados da Pesquisa Nacional por Amostra de Domicílios (PNAD 2013), testou-se sua reprodutibilidade por meio da repetição dos procedimentos combinatórios originais, examinando se os parâmetros de sensibilidade, especificidade, acurácia e valores preditivos positivo (VPP) e negativo (VPN) resultariam no mesmo arranjo de questões. Ainda, analisou-se a validade convergente comparando a força de associação entre insegurança alimentar e variáveis alimentares por meio de dois modelos de regressão binomial (TRIA x EBIA). Os resultados indicaram que a combinação das questões 2 e 4 apresentou melhor desempenho entre os estratos populacionais estudados, além de ótima validade convergente. O VPP e VPN ajustado pela prevalência de insegurança alimentar nos estados variou de 42,8% (Santa Catarina) a 87,6% (Amazonas) e 95,8% (Amazonas) a 99,5% (Santa Catarina), respectivamente. Em conclusão, além de ser reprodutível, a TRIA apresentou excelentes parâmetros de validade, sobretudo em grupos vulnerabilizados. Assim, seu uso pode ser recomendado na prática assistencial e como instrumento de vigilância alimentar e nutricional no Brasil.

The absence of risk screening tools for food insecurity compromises the ability to assess, monitor, and provide immediate assistance to those in hunger, especially during emergencies such as the COVID-19 crisis. Hence, this study sought to test the validity of an instrument for Screening Households at Risk of Food Insecurity (TRIA) in different strata of the Brazilian population TRIA uses questions 2 and 4 of the Brazilian Food Insecurity Scale (EBIA), originally validated using data from the Brazilian National Survey of Demography and Health of Children and Women (PNDS 2006). In this study, using data from the Brazilian National Household Sample Survey (PNAD 2013), its reproducibility was tested by repeating the original combinatorial procedures, examining whether the parameters of sensitivity, specificity, accuracy, and positive predictive values (PPV) and negative values (NPV) would result in the same arrangement of questions. Moreover, convergent validity was analyzed by comparing the strength of association between food insecurity and dietary variables using two binomial regression models (TRIA x EBIA). Results indicated that the combination of questions 2 and 4 performed best among the population strata studied, and presented optimal convergent validity. PPV and NPV adjusted for food insecurity prevalence in states ranged from 42.8% (Santa Catarina) to 87.6% (Amazonas) and 95.8% (Amazonas) to 99.5% (Santa Catarina), respectively. In conclusion, besides being reproducible, TRIA presented excellent validity parameters, especially among vulnerable groups. It can thus be used in care practice and as an instrument of food and nutritional surveillance in Brazil.

La ausencia de instrumentos de triaje de riesgo para la inseguridad alimentaria compromete la capacidad de evaluar, monitorear y brindar asistencia inmediata a las personas en situación de hambre, especialmente durante emergencias como la crisis de la COVID-19. Por lo tanto, el objetivo de este estudio fue probar la validez del instrumento de Triaje para Riesgo de Inseguridad Alimentaria (TRIA) en diferentes estratos de la población brasileña. El TRIA consta de las preguntas 2 y 4 de la Escala Brasileña de Inseguridad Alimentaria (EBIA), originalmente validada con base en datos de la Encuesta Nacional de Demografía y Salud de la Mujer y el Niño (PNDS 2006). En este estudio, utilizando datos de la Encuesta Nacional por Muestra de Domicilios (PNAD 2013), se probó su reproducibilidad repitiendo los procedimientos combinatorios originales, examinando si los parámetros de sensibilidad, especificidad, exactitud y valores predictivos positivos (VPP) y negativo (VPN) resultarían en el mismo arreglo de preguntas. Además, se analizó la validez convergente comparando la fuerza de asociación entre la inseguridad alimentaria y las variables alimentarias por medio de dos modelos de regresión binomial (TRIA x EBIA). Los resultados indicaron que la combinación de las preguntas 2 y 4 presentó el mejor desempeño entre los estratos poblacionales estudiados, además de excelente validez convergente. El VPP y el VPN ajustado por la prevalencia de inseguridad alimentaria en los estados osciló entre el 42,8% (Santa Catarina) y el 87,6% (Amazonas) y entre el 95,8% (Amazonas) y el 99,5% (Santa Catarina), respectivamente. En conclusión, además de ser reproducible, el TRIA presentó excelentes parámetros de validez, especialmente en grupos en situación de vulnerabilidad. Por lo tanto, se puede recomendar su uso en la práctica asistencial y como instrumento para la vigilancia alimentaria y nutricional en Brasil.

Validity of a 2-item screening tool to identify families at risk for food insecurity in Brazil / Validade de um instrumento de triagem com dois itens para identificar famílias em risco de insegurança alimentar no Brasil / Validez de un instrumento de 2-ítems para identificar a familias en riesgo de inseguridad alimentaria en Brasil

This manuscript aimed to develop a brief 2-item screening tool to identify Brazilian households that include families with children at risk for food insecurity. Psychometric analyses including sensitivity, specificity, positive and negative predictive value, accuracy, and ROC curves were used to test combinations of questions to determine the most effective screener to assess households at risk for food insecurity when compared to a gold standard scale. Participants included Brazilian National Survey of Demography and Health on Women and Children (PNDS) surveyed households with a valid Brazilian Food Insecurity Scale (EBIA) response. The sample included 3,920 households representing 11,779,686 households when expanded using PNDS sample weights. With overall prevalence of food insecurity at 21%, a Brazilian 2-item food-insecurity screen showed sensitivity of 79.31%, specificity of 92.95%, positive predictive value of 74.62%, negative predictive value of 94.5% and ROC area 86.13%. This screen also presented high convergent validity for children's nutrition and health variables when compared with the gold standard, the EBIA full scale. Based on its ability to detect households at risk for food insecurity, a 2-item screening tool is recommended for widespread adoption as a screening measure throughout Brazil, especially when rapid decision-making has been made fundamental, as under the COVID-19 pandemic. This screener can enable providers to accurately identify families at risk for food insecurity and promptly intervene to prevent or ameliorate adverse health and developmental consequences associated with food insecurity and swiftly respond to crises.

O estudo teve como objetivo desenvolver um instrumento de triagem breve com dois itens para identificar famílias brasileiras com filhos em risco de insegurança alimentar. Foram utilizadas análises psicométricas, inclusive sensibilidade, especificidade, valor preditivo positivo e negativo, acurácia e curvas ROC, para testar as combinações de perguntas e determinar o instrumento mais eficaz para avaliar as famílias com risco de insegurança alimentar, comparado a uma escala padrão-ouro. Os participantes pertenciam aos domicílios da Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS), usando a resposta à Escala Brasileira de Insegurança Alimentar (EBIA). A amostra incluiu 3.920 domicílios, representando 11.779.686 domicílios quando expandida com os pesos amostrais da PNDS. Com uma prevalência geral de insegurança alimentar de 21%, o instrumento brasileiro de dois itens para avaliação de insegurança alimentar mostrou sensibilidade 79,31%, especificidade 92,95%, valor preditivo positivo 74,62%, valor preditivo negativo 94,5% e área ROC 86,13%. O instrumento também apresentou validade convergente alta para as variáveis de nutrição e saúde das crianças, comparado ao padrão-ouro, a EBIA completa. Com base na capacidade de detectar domicílios com risco de insegurança alimentar, esse instrumento de triagem com dois itens é recomendado para adoção geral, enquanto medida de triagem em todo o Brasil, sobretudo durante a pandemia da COVID-19, quando as decisões rápidas são fundamentais. O instrumento pode permitir que os profissionais identifiquem com precisão as famílias em risco de insegurança alimentar e intervenham prontamente para prevenir ou mitigar as consequências adversas para a saúde e o desenvolvimento, associadas à insegurança alimentar, respondendo rapidamente às crises.

Este trabajo tuvo el objetivo de desarrollar un instrumento breve de 2 ítems para identificar a los hogares brasileños que incluyen a familias con niños en riesgo de inseguridad alimentaria. Los análisis psicométricos incluyendo sensibilidad, especificidad, valor predictivo positivo y negativo, precisión, y curvas ROC fueron usados para probar combinaciones de preguntas, con el fin de determinar el instrumento más efectivo para evaluar hogares en riesgo de inseguridad alimentaria, cuando se compararon con una escala de estándar de oro. Los participantes incluyeron a los hogares encuestados de la Encuesta Nacional Demográfica sobre la Salud de Mujeres y Niños (PNDS) con una respuesta válida en la Escala de Brasileña de Inseguridad Alimentaria (EBIA). La muestra incluyó 3.920 hogares, representando 11.779.686 hogares, cuando se amplió usando las ponderaciones de la muestra del PNDS. Con la prevalencia general de la inseguridad alimentaria a un 21%, el instrumento de 2 ítems brasileño sobre inseguridad alimentaria mostró una sensibilidad de un 79,31%, especificidad de un 92,95%, un valor predictivo positivo de 74,62%, un valor negativo predictivo de un 94,50% y un área ROC de 86,13%. Este instrumento también presentó una validez convergente alta para la nutrición de los niños y variables de salud, cuando se comparó la escala completa EBIA, el estándar de oro. Basada en su habilidad para detectar hogares en riesgo por inseguridad alimentaria, la herramienta de instrumento de 2 ítems está recomendada para su amplia adopción, como medida de cribado en todo Brasil, especialmente cuando la toma de decisiones rápidas se ha hecho fundamental, como ante la pandemia de COVID-19. Este método de cribado puede permitir a los proveedores de cuidados identificar con precisión a las familias en riesgo de inseguridad alimentaria e intervenir prontamente para prevenir o mejorar salud adversa y las consecuencias en el desarrollo, relacionadas con la inseguridad alimentaria, así como responder con prontitud a las crisis.