Evidences of differential methylation in the genome during development in the cactophilic Drosophila species.

DNA methylation with 5-methylcytosine (5mC) has been reported in the genome of several eukaryotes, with marked differences between vertebrates and invertebrates. DNA methylation is poorly understood as its role in evolution in insects. Drosophila gouveai (cluster Drosophila buzzatii) presents larvae that develop obligatorily in necrotic tissues of cacti in nature, with the distribution of populations in South America, and plasticity of phenotypes in insect-plant interaction. We characterize organisms at developmental stages and analyze variations at multiple methylation-sensitive loci in pupae, and adult flies using methylation sensitive amplification polymorphism. We obtained 326 loci with CCGG targets in the genome of D. gouveai. Genomic regions with molecular lengths from 100 to 700 pb were most informative about methylation states. Multiple loci show differences in methylation-sensitive sites (MSL) concerning developmental stages, such as in pupae (MSL = 40), female reproductive tissue (MSL = 76), and male reproductive tissues (MSL = 58). Our results are the first evidence of genome-wide methylation in D. gouveai organisms.

Designing Quantum Capacitive Peptide Interfaces for Electroanalytical Applications.

Redox-active moieties assembled on metallic interfaces have been shown to follow quantum mechanical rules, where the quantum capacitance of the interface (directly associated with the electronic structure of the redox-active moieties) plays a key role in the electron transfer dynamics of the interface. Modifying these interfaces with biological receptors has significant advantages (simplifying molecular diagnostics methods, reducing size, time, and cost while maintaining high sensitivity), enabling the fabrication of miniaturized electroanalytical devices that can compete with traditional ELISA and RT-PCR benchtop assay methods. Owing to their intrinsic characteristics, the use of peptide-based redox-active moieties is a promising chemical route for modifying metallic surfaces, resulting in a high quantum capacitive signal sensitivity. In the present work, different ferrocene-tagged peptides with a structure of Fc-Glu-XX-XX-Cys-NH2 (XX = serine, phenylalanine, glycine) were used to form self-assembled monolayers on gold. The feasibility of using these interfaces in an electroanalytical assay was verified by detecting the NS1 DENV (Dengue Virus) biomarker to compare the efficiency of peptide structures for biosensing purposes. Parameters such as the formal potential of the interface, normalized electronic density of states (DOS), quantum capacitance, and electron transfer rate constants were obtained for Ser-, Phe-, and Gly-peptides. The Gly-peptide structure presented the highest analytical performance for sensing NS1 with a sensitivity of 5.6% per decade and the lowest LOD (1.4 ng mL-1) and LOQ (2.6 ng mL-1), followed by Phe-peptide, whereas Ser-peptide had the lowest performance. This work demonstrates that the use of peptides to fabricate a self-assembled monolayer as a biosensor component has advantages for low-cost point-of-care diagnostics. It also shows that the performance of the sensing interface depends strongly on how the chemistry of the surface is designed as a whole, not only on the redox-active group.

Effects of Exercise Intensity on Cardiometabolic Parameters of Ovariectomized Obese Mice.

The aim of this study was to compare the effects of continuous-moderate vs. high-intensity interval aerobic training on cardiovascular and metabolic parameters in ovariectomized high-fat-fed mice. C57BL/6 female ovariectomized were divided into four groups (n=8): low-fat-fed sedentary (SLF); high-fat-fed sedentary (SHF); high-fat-fed moderate-intensity continuous trained (MICT-HF); and high-fat-fed high-intensity interval aerobic trained (HIIT-HF). The high-fat diet lasted 10 weeks. Ovariectomy was performed in the fourth week. The exercise training was carried out in the last four weeks of protocol. Fasting glycemia, oral glucose tolerance, arterial pressure, baroreflex sensitivity, and cardiovascular autonomic modulation were evaluated. Moderate-intensity continuous training prevented the increase in arterial pressure and promoted a reduction in HR at rest, associated with an improvement in the sympathovagal balance in MICT-HF vs. SHF. The high-intensity interval training reduced blood glucose and glucose intolerance in HIIT-HF vs. SHF and MICT-HF. In addition, it improved sympathovagal balance in HIIT-HF vs. SHF. Moderate-intensity continuous training was more effective in promoting cardiovascular benefits, while high-intensity interval training was more effective in promoting metabolic benefits.

Willingness of health care providers to offer HIV self-testing from specialized HIV care services in the northeast of Brazil.

BACKGROUND: The insufficient knowledge regarding the serological status of people affected with human immunodeficiency virus (HIV) is a concern in Brazil. HIV self-testing (HIVST) has been proved to have great potential for increasing testing, especially among vulnerable populations. The large-scale distribution of HIVST by the Brazilian public health system has increased in recent years. We aimed to investigate the awareness of HIVST among health care providers (HCP) from specialized HIV/AIDS care services in the state of Bahia, Northeast Brazil. Further we investigated HCP acceptability and willingness to offer its use. METHODS: A cross-sectional study on HCP from 29 specialized care services (SCS) located in 21 cities in the state of Bahia. HCP working in the service for at least 6 months were included. Sociodemographic, occupational, and behavioral data were collected using a questionnaire. Descriptive statistics were carried out. Bivariate, and multivariate analyses estimating adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) using logistic regression were conducted. RESULTS: The awareness and acceptability of HIVST and the willingness to provide it were 79.8, 55.2, and 47.1%, respectively. Few HCP reported that the SCS where they worked dispensed HIVST (3.6%), and 13.5% received some information or training on HIVST. Factors associated with willingness to offer HIVST were: HIVST acceptability (aOR = 9.45; 95% CI: 4.53-19.71), willingness to use HIVST on themselves (aOR = 4.45; 95% CI: 1.62-12.24), confidence in offering HIVST to clients (aOR = 5.73; 95% CI: 2.26-12.72), and considering everyone eligible for HIVST (aOR = 2.88; 95% CI: 1.25-6.59). CONCLUSIONS: Although most HCP were aware of HIVST, acceptability and willingness to provide it to the clients was moderate. The scale up of HIVST as a mean for the HIV prevention and control policy in Brazil, requires further training of HCP and better implementation of this program.

Challenges to the provision of specialized care in remote rural municipalities in Brazil.

This case study analyses the challenges to providing specialized care in Brazilian remote rural municipalities (RRM). Interviews were conducted with managers from two Brazilian states (Piauí and Bahia). We identified that the distance between municipalities is a limiting factor for access and that significant care gaps contribute to different organizational arrangements for providing and accessing specialized care. Physicians in all the RRMs offer specialized care by direct disbursement to users or sale of procedures to managers periodically, compromising municipal and household budgets. Health regions do not meet the demand for specialized care and exacerbate the need for extensive travel. RRM managers face additional challenges for the provision of specialized care regarding the financing, implementation of cooperative arrangements, and the provision of care articulated in networks to achieve comprehensive care, seeking solutions to the locoregional specificities.

[Control of cervical cancer in the primary care setting in South American countries: systematic reviewControl del cáncer cervicouterino en los servicios de atención primaria de salud en los países de América del Sur: revisión sistemática]. / Controle do câncer do colo do útero na atenção primária à saúde em países sul-americanos: revisão sistemática.

Objective: To describe cervical cancer (CC) prevention and control strategies in the primary care setting in South America. Method: Two review steps were performed: review of documents published in governmental websites in Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Uruguay, and Venezuela; and systematic review of the literature available in LILACS, MEDLINE, Scopus, SciELO, and Science Direct databases. Results: Twenty-one institutional documents (plans, practice guides, and national guidelines) and 25 journal articles were included. All countries had high CC morbidity and mortality rates. Screening in primary healthcare (PHC) was mostly opportunistic, although the institutional documents indicated an intention and strategies for early diagnosis and longitudinal follow-up of suspected and confirmed cases, preferably within the public healthcare system. All countries adopted a broad view of PHC, although the stage of PHC implementation was heterogeneous in different countries, with predominance of selective PHC. Access to screening was more difficult for women from rural or remote areas and for indigenous populations. The unavailability of PHC close to households/communities was an important barrier for CC screening. Conclusions: The fragmentation of healthcare systems and the selective provision of services are barriers for the prevention and control of CC in South America. Organized CC screening programs and active search for Papanicolaou testing in primary care are needed. Intercultural practices and intersectional public policies are essential to overcome the inequities in CC control in South American countries.

Objetivo: Describir las estrategias de prevención y control del cáncer cervicouterino (CCU) en los servicios de atención primaria de salud (APS) de América del Sur. Métodos: Revisión bibliográfica en dos etapas, a saber, revisión documental en sitios web gubernamentales de Argentina, Bolivia, Brasil, Chile, Colombia, Ecuador, Paraguay, Perú, Uruguay y Venezuela, y revisión sistemática en las bases de datos LILACS, MEDLINE, Scopus, SciELO y Science Direct. Resultados: Se incluyeron 21 documentos institucionales (planes, guías de práctica y directrices nacionales) y 25 artículos. Todos los países tenían altas tasas de morbilidad y mortalidad por CCU. En los servicios de APS predominó el tamizaje oportunista, aunque los documentos disponibles señalaran intenciones y estrategias de diagnóstico precoz y seguimiento longitudinal de los casos sospechosos y confirmados, particularmente en la red pública. Todos los países adoptaron un concepto integral de APS, aunque el proceso de aplicación se encontrara en fases heterogéneas y predominaran la focalización y la selectividad. Cabe destacar que las mujeres de las zonas rurales o remotas y de los pueblos indígenas registran el peor grado de acceso al tamizaje. La falta de servicios de APS cerca de las residencias o las comunidades fue una barrera importante para el tamizaje del CCU. Conclusiones: La fragmentación de los sistemas de salud y la segmentación en la oferta de servicios son obstáculos para la prevención y el control del CCU en América del Sur. Se necesitan programas organizados de tamizaje del CCU e incorporación de la búsqueda activa para realizar la prueba de Papanicolaou en los servicios de APS. La interculturalidad en las prácticas y la formulación de políticas desde una perspectiva intersectorial son esenciales para superar las inequidades en el control del CCU en los países suramericanos.

Biogas production in a tropical landfill: Long-term monitoring results and analysis of variables of influence.

The use of landfill gas for power production is a very attractive option in tropical sanitary landfills mainly in developing countries, where the waste composition, water content, and the climate conditions are favorable to a fast depletion of waste organic matter and a robust short term biogas production response. In this paper, the results of long-term monitoring and methane extraction activities in a tropical landfill are presented, and the obtained results are analyzed taking into account the structure of the prokaryotic communities and the fugitive emissions through the temporary covers. It is shown that waste depletion by aerobic processes and fugitive emissions are probable related to the drop in the efficiency of the extraction system verified in the field and that the performance of the temporary covers is of paramount importance when implementing good practices of waste management in sanitary landfills. The fugitive emissions through temporary covers was estimated at about 12% of the methane production in the field, and the distance from drains and sampling depth were confirmed as having an influence on the environmental conditions for waste depletion and on the relative abundance of the bacterial communities.

Provision of specialized care in remote rural municipalities of the Brazilian semi-arid region.

INTRODUCTION: Specialized care barriers are widespread and multifactorial, with consequences for timely access, health outcomes, and equity, especially in rural contexts. This article aims to identify and analyze arrangements for providing specialized care in the Brazilian remote rural municipalities (RRMs). METHODS: This is a multiple-case qualitative case study developed in seven RRMs located in the Brazilian semi-arid region. Twenty-two semi-structured interviews were conducted with the public health system managers, complemented by analysis of secondary data from national health information systems. Thematic content analysis was guided by the Integrated Health Service Network attributes related to the provision of specialized care. RESULTS: Socioeconomic indicators and indicators of availability and accessibility to health services express the context of greater vulnerability of RRM and their respective health regions when compared to states and the country. The analyzed cases do not come close to the RISS constitutive attributes. Various arrangements for the provision and financing of specialized care in the RRM were identified: public provision through an agreement between managers in the health region, health consortia, public provision in the municipality itself or neighboring municipalities, provision in private health services through direct purchase (out-of-pocket), and telehealth (very incipient). Such arrangements were unable to respond quantitatively and qualitatively to the demand for specialized care. Providing timely specialized care in an adequate place is not achieved, resulting in a fragmented, low-resolution model. The fragility of regionalized networks, aggravated by underfunding of the Brazilian Unified Health System, insufficient logistical support, and computerization of health services, contributes to care gaps and unacceptably long travel times for common specialized procedures, with more severe effects for people residing in the rural areas of the municipalities. CONCLUSION: Brazil's disorganization or lack of a systemic response based on regionalized health networks generates several care improvisations. The less structured the RISS, the more informal arrangements are made, with gains for the private sector to the detriment of public health system users.

Introducing mesoscopic charge transfer rates into molecular electronics.

It has been demonstrated that mesoscopic rates operate in nanoscale electrochemical systems and, from a fundamental point of view, are able to establish a bridge between electrochemical and molecular electronic concepts. In the present work we offer additional experimental evidence in support of this statement.

The nanoscopic principles of capacitive ion sensing interfaces.

Herein we discuss the operational principles of molecular interfaces that specifically recruit ions from an electrolyte solution and report this in a reagentless capacitive manner. At low ionic occupancy the response of the interface obeys a Debye-type phenomenon akin to classic "image charge" effects. At higher levels of occupancy, the response follows Thomas-Fermi screening and, significantly, is dependent on the electronic structure of the mesoscopic ion-receptor host-guest ensemble.

Incident analysis occurrence related to potentially dangerous medicines distributed in teaching hospital. / Análise das ocorrências de incidentes relacionados aos medicamentos potencialmente perigosos dispensados em hospital de ensino.

OBJECTIVE: To analyze the reports of incidents related to potentially hazardous medications distributed at a teaching hospital in the interior of São Paulo. METHODS: A descriptive, retrospective study with a quantitative approach of data from the analysis of pharmacovigilance notifications that occurred between January 2009 and December 2014, from tables and graphs, showing the absolute/relative frequencies. RESULTS: From 786 reports of pharmacovigilance, 188 were related to potentially hazardous medicines, 36.7% of which were ineffective, 32.44% were technical complaints, 15.95% were adverse reactions, 7.44% were phlebitis, 5.13% were extravasation , 1.06% dispensing error, 0.53% administration error and 0.53% medication error. The professionals who most notified were nurses. The most commonly reported pharmacological groups were drugs with action on the nervous system (35.63%). CONCLUSION: The analysis showed that there were a significant number of reports and the need to adopt strategies to ensure greater patient safety.

Maternal voluntary physical activity attenuates delayed neurodevelopment in malnourished rats.

NEW FINDINGS: What is the central question of this study? In the present study, a reproducible model of maternal voluntary physical activity was developed to evaluate the adaptive response of physical activity by attenuating the effects of maternal undernutrition on physical features, reflex ontogeny and growth trajectory of offspring during development. What is the main finding and its importance? Maternal physical activity may induce neuronal maturation of sensorimotor connections impacting on the patterns of locomotor activity in malnourished offspring. Thus, physical activity should be considered as a therapeutic means of countering the effects of maternal undernutrition, by providing a useful strategy for enhancing the neuronal activity of children born to mothers who experience a restricted diet during pregnancy. This study evaluated the effects of maternal voluntary physical activity during pregnancy and lactation on somatic growth (SG), reflex ontogeny (RO) and locomotor activity (LA) of rats whose mothers were protein restricted. Virgin female Wistar rats were divided into the following six groups: control, normal protein (C-NP, n = 4); control, low protein (C-LP, n = 4); inactive, normal protein (I-NP, n = 8); inactive, low protein (I-LP, n = 7); very active, normal protein (VA-NP, n = 8); and very active, low protein (VA-LP, n = 6). Voluntary physical activity was recorded daily in dams. The LP groups were fed an 8% casein diet, whereas control groups were fed a 17% casein diet during pregnancy and lactation. Offspring were evaluated in terms of SG (body weight and length, latero-lateral skull axis and anteroposterior head axis) and RO (palmar grasp, righting, free-fall righting, negative geotaxis, cliff avoidance, auditory startle response and vibrissa placing). The LA was evaluated at 23, 45 and 60 days old in the open field. Voluntary physical activity was reduced during pregnancy and lactation independent of the maternal diet. Pups from LP dams showed delayed SG, reflex maturation and patterns of LA when compared with control pups. The C-LP and I-LP pups showed a delayed SG, RO and LA. Pups from VA-LP mothers showed no delay in SG and RO and presented a faster development of patterns of LA. Maternal voluntary physical activity attenuated the effects of LP diet on indicators of neurodevelopment and patterns of LA of offspring.

Mapping the ionic fingerprints of molecular monolayers.

We have previously proposed, and experimentally resolved, an ionic charge relaxation model for redox inactive self-assembled monolayers (SAMs) on metallic electrodes in contact with a liquid electrolyte. Here we analyse, by capacitance spectroscopy, the resistance and capacitance terms presented by a range of thiolated molecular films. Molecular dynamics simulations support a SAM-specific energy barrier to solution-phase ions. Once surmounted, the entrapped ions support a film embedded ionic capacitance and non-faradaic relaxation, which can be assigned as a particular case of general electrochemical capacitance.

The self-assembly of redox active peptides: Synthesis and electrochemical capacitive behavior.

The present work reports on the synthesis of a redox-tagged peptide with self-assembling capability aiming applications in electrochemically active capacitive surfaces (associated with the presence of the redox centers) generally useful in electroanalytical applications. Peptide containing ferrocene (fc) molecular (redox) group (Ac-Cys-Ile-Ile-Lys(fc)-Ile-Ile-COOH) was thus synthesized by solid phase peptide synthesis (SPPS). To obtain the electrochemically active capacitive interface, the side chain of the cysteine was covalently bound to the gold electrode (sulfur group) and the side chain of Lys was used to attach the ferrocene in the peptide chain. After obtaining the purified redox-tagged peptide, the self-assembly and redox capability was characterized by cyclic voltammetry (CV) and electrochemical impedance-based capacitance spectroscopy techniques. The obtained results confirmed that the redox-tagged peptide was successfully attached by forming an electroactive self-assembled monolayer onto gold electrode. The design of redox active self-assembly ferrocene-tagged peptide is predictably useful in the development of biosensor devices precisely to detect, in a label-free platform, those biomarkers of clinical relevance. © 2016 Wiley Periodicals, Inc. Biopolymers (Pept Sci) 106: 357-367, 2016.

Evidence for Conformational Mechanism on the Binding of TgMIC4 with ß-Galactose-Containing Carbohydrate Ligand.

A deeper understanding of the role of sialic/desialylated groups during TgMIC4-glycoproteins interactions has importance to better clarify the odd process of host cell invasion by members of the apicomplexan phylum. Within this context, we evaluated the interaction established by recombinant TgMIC4 (the whole molecule) with sialylated (bovine fetuin) and desialylated (asialofetuin) glycoproteins by using functionalized quartz crystal microbalance with dissipation monitoring (QCM-D). A suitable receptive surface containing recombinant TgMIC4 for monitoring ß-galactose-containing carbohydrate ligand (limit of quantification ∼ 40 µM) was designed and used as biomolecular recognition platform to study the binding and conformational mechanisms of TgMIC4 during the interaction with glycoprotein containing (fetuin), or not, terminal sialic group (asialofetuin). It was inferred that the binding/interaction monitoring depends on the presence/absence of sialic groups in target protein and is possible to be differentiated through a slower binding kinetic step using QCM-D approach (which we are inferring to be thus associated with ß-galactose ligand). This slower binding/interaction step is likely supposed (from mechanical energetic analysis obtained in QCM-D measurements) to be involved with Toxoplasma gondii (the causative agent of toxoplasmosis) parasitic invasion accompanied by ligand (galactose) induced binding conformational change (i.e., cell internalization process can be additionally dependent on structural conformational changes, controlled by the absence of sialic groups and to the specific binding with galactose), in addition to TgMIC4-glycoprotein solely recognition binding process.

Recreational Anabolic-Androgenic Steroid Use Associated With Liver Injuries Among Brazilian Young Men.

BACKGROUND: The recreational use of anabolic-androgenic steroids (AAS) has reached alarming levels among healthy people. However, several complications have been related to consumption of these drugs, including liver disorders. OBJECTIVE: To evaluate the prevalence of liver injuries in young Brazilian recreational AAS users. METHODS: Between February/2007 and May/2012 asymptomatic bodybuilders who were ≥18 years old and reported AAS use for ≥6 months were enrolled. All had clinical evaluations, abdominal ultrasound (AUS), and blood tests. RESULTS: 182 individuals were included in the study. The median age (interquartile range) was 26.0 years (22.0-30.0) and all were male. Elevated liver enzyme levels were observed in 38.5% (n = 70) of AAS users, and creatine phosphokinase was normal in 27.1% (n = 19) of them. Hepatic steatosis was observed by AUS in 12.1% of the sample. One individual had focal nodular hyperplasia and another had hepatocellular adenoma. One case each of hepatitis B and C virus infection was found. A diagnosis of toxic liver injury was suggested in 23 (12.6%) AAS users without a history of alcohol or other medications/drugs consumption, or evidence of other liver diseases. CONCLUSIONS/IMPORTANCE: Young Brazilian recreational AAS users presented a wide spectrum of liver injuries that included hepatotoxicity, fatty liver, and liver neoplasm. They also presented risk factors for liver diseases such as alcohol consumption and hepatitis B and C virus infection. The results suggest that the risk of AAS use for the liver may be greater than the esthetic benefits, and demonstrate the importance of screening AAS users for liver injuries.

Photobiostimulation reduces edema formation induced in mice by Lys-49 phospholipases A2 isolated from Bothrops moojeni venom.

The prominent local myotoxic effects induced by Bothrops snake venom are due, in part, to myotoxins. This effect is not neutralized by antivenom, which is the main therapy for victims of snakebite. Two basic myotoxins named MjTX-I and MjTX-II were isolated from Bothrops moojeni venom. Both myotoxins have a Lys-49 phospholipase A2 structure devoid of enzymatic activity, but are highly myonecrotic and edema-inducing. In this study, we analyzed the effect of a low-level laser (LLL) at 685 nm, an energy density of 2.2 J cm(-2), and the irradiation time of 15 s, and a light emitting diode (LED) at 635 or 945 nm at energy densities of 4 and 3.8 J cm(-2), and irradiation times of 41 and 38 s, respectively, applied 30 min and 3 h after edema formation in mice caused by MjTX-I or MjTX-II. MjTX-I or MjTX-II caused a significant edema formation in envenomed paws. LLL and LED irradiation significantly reduced the edema formation by both myotoxins from 1 up to 6 hours after the injection. Both LLL and LEDs were similar in reducing the edema formation induced by myotoxins. The combined photobiostimulation with antivenom had the same effect in reducing edema as treatment with the LLL or LEDs alone. In conclusion, the results of this study indicate that photobiostimulation could be used in association with antivenom therapy for treatment of local effects of Bothrops species venom.

The Microbiota-Gut-Brain Axis in Metabolic Syndrome and Sleep Disorders: A Systematic Review.

BACKGROUND: Over recent decades, a growing body of evidence has emerged linking the composition of the gut microbiota to sleep regulation. Interestingly, the prevalence of sleep disorders is commonly related to cardiometabolic comorbidities such as diabetes, impaired lipid metabolism, and metabolic syndrome (MetS). In this complex scenario, the role of the gut-brain axis as the main communicating pathway between gut microbiota and sleep regulation pathways in the brain reveals some common host-microbial biomarkers in both sleep disturbances and MetS. As the biological mechanisms behind this complex interacting network of neuroendocrine, immune, and metabolic pathways are not fully understood yet, the present systematic review aims to describe common microbial features between these two unrelated chronic conditions. RESULTS: This systematic review highlights a total of 36 articles associating the gut microbial signature with MetS or sleep disorders. Specific emphasis is given to studies evaluating the effect of dietary patterns, dietary supplementation, and probiotics on MetS or sleep disturbances. CONCLUSIONS: Dietary choices promote microbial composition and metabolites, causing both the amelioration and impairment of MetS and sleep homeostasis.

Social movements and the genesis of LGBT health policy in Bahia, Brazil (1979-2014): initial disputes and possible alternatives. / Os movimentos sociais e a gênese de propostas para a saúde da população LGBT na Bahia, Brasil (1979-2014): disputas iniciais e alternativas possíveis.

We conducted a socio-historical study covering the period 1979-2014 to explore the genesis of LGBT health policy in Bahia, Brazil, drawing on Pinell's theoretical framework for the sociological analysis of public policy. To analyze the social space, we investigated the trajectories of the agents involved in policy formulation and the relations between these agents and the national social space and field of State power. The agents were predominantly from the scientific, human rights, sexual rights, feminism and AIDS fields, and had a high level of bureaucratic and militant capital, meaning they were well-versed in LGBT health issues. The historical conditions of possibility underlying the formulation of LGBT health policy included the formalization of the State Technical Committee on LGBT Health in 2014, in an effort to improve access to comprehensive health care for vulnerable groups; and the Bahia without Homophobia plan, which helped expand dialogue around with civil society and social movements and address the main criticisms of policy making.

Com o objetivo de descrever a gênese de propostas para a saúde da população de LGBT na Bahia, foi realizado um estudo sócio histórico entre 1979 e 2014. Adotou-se as proposições de Patrice Pinell para a análise sociológica de políticas públicas. A análise do espaço social compreendeu a identificação das trajetórias dos agentes envolvidos com as propostas no estado da Bahia e as relações entre esses agentes e o espaço social nacional, assim como, o campo do poder do Estado. Na Bahia, destacaram-se agentes com trajetórias vinculadas ao campo científico, dos direitos humanos, dos direitos sexuais, do feminismo e do espaço AIDS, com alto capital burocrático e militante, que propiciou aproximação às questões relacionadas a saúde LGBT local. As condições de possibilidade que permitiram a formulação de propostas políticas baseadas na integralidade e na universalidade da atenção à saúde foram a formalização do Comitê Técnico Estadual de Saúde Integral LGBT da Bahia, em 2014, onde buscou-se ampliar a Atenção Integral à Saúde voltada às populações de maior vulnerabilidade; e o Plano Bahia sem homofobia, que permitiu ampliar o diálogo com a sociedade civil e os movimentos sociais e abarcar as principais críticas para a formulação de propostas políticas.

Scorpion envenomation in Brazil and its relationship with the social determinants of health: A population-based ecological study.

This study comprehensively analyzed cases of scorpion envenomation in Brazil, exploring the temporal trends and geographic patterns of such incidents between January 1, 2012, and December 31, 2022. Simultaneously, we assessed the correlation between scorpion envenomation and social determinants of health and social vulnerability. We conducted a population-based ecological study, gathering information on the number of scorpion envenomation cases in Brazil, as well as socioeconomic data and social vulnerability indicators across the 5,570 Brazilian municipalities. The season-trend model, based on the classical additive decomposition method, informed estimations of scorpion envenomation variations over time. The spatial correlation of scorpion envenomation with socioeconomic and vulnerability indicators was assessed using the Bivariate Moran's I. A total of 1,343,224 cases of scorpion envenomation were recorded in Brazil from Jan 2012 to Dec 2022. A single increasing time trend was observed for the entire country for this period (APC 8.94, P < 0.001). The seasonal analysis was significant for Brazil as a whole and all regions (p < 0.001), with peaks evident between October and November. The spatial distribution of cases was heterogeneous, with spatial clusters concentrated in the high-risk Southeast and Northeast regions. There was a high incidence of scorpion envenomation in municipalities facing social vulnerability, and, paradoxically, in those with better sanitation and waste collection. Our study revealed a heterogeneous geographical distribution of scorpion accidents in Brazil. Municipalities with higher social vulnerability exhibited a high incidence of scorpion envenomation.