Haemosporidian parasites and incubation period influence plumage coloration in tanagers (Passeriformes: Thraupidae).

Birds are highly visually oriented and use plumage coloration as an important signalling trait in social communication. Hence, males and females may have different patterns of plumage coloration, a phenomenon known as sexual dichromatism. Because males tend to have more complex plumages, sexual dichromatism is usually attributed to female choice. However, plumage coloration is partly condition-dependent; therefore, other selective pressures affecting individuals' success may also drive the evolution of this trait. Here, we used tanagers as model organisms to study the relationships between dichromatism and plumage coloration complexity in tanagers with parasitism by haemosporidians, investment in reproduction and life-history traits. We screened blood samples from 2849 individual birds belonging to 52 tanager species to detect haemosporidian parasites. We used publicly available data for plumage coloration, bird phylogeny and life-history traits to run phylogenetic generalized least-square models of plumage dichromatism and complexity in male and female tanagers. We found that plumage dichromatism was more pronounced in bird species with a higher prevalence of haemosporidian parasites. Lastly, high plumage coloration complexity in female tanagers was associated with a longer incubation period. Our results indicate an association between haemosporidian parasites and plumage coloration suggesting that parasites impact mechanisms of sexual selection, increasing differences between the sexes, and social (non-sexual) selection, driving females to develop more complex coloration.

Host life-history traits predict haemosporidian parasite prevalence in tanagers (Aves: Thraupidae).

Vector-borne parasites are important ecological drivers influencing life-history evolution in birds by increasing host mortality or susceptibility to new diseases. Therefore, understanding why vulnerability to infection varies within a host clade is a crucial task for conservation biology and for understanding macroecological life-history patterns. Here, we studied the relationship of avian life-history traits and climate on the prevalence of Plasmodium and Parahaemoproteus parasites. We sampled 3569 individual birds belonging to 53 species of the family Thraupidae. Individuals were captured from 2007 to 2018 at 92 locations. We created 2 phylogenetic generalized least-squares models with Plasmodium and Parahaemoproteus prevalence as our response variables, and with the following predictor variables: climate PC1, climate PC2, body size, mixed-species flock participation, incubation period, migration, nest height, foraging height, forest cover, and diet. We found that Parahaemoproteus and Plasmodium prevalence was higher in species inhabiting open habitats. Tanager species with longer incubation periods had higher Parahaemoproteus prevalence as well, and we hypothesize that these longer incubation periods overlap with maximum vector abundances, resulting in a higher probability of infection among adult hosts during their incubation period and among chicks. Lastly, we found that Plasmodium prevalence was higher in species without migratory behaviour, with mixed-species flock participation, and with an omnivorous or animal-derived diet. We discuss the consequences of higher infection prevalence in relation to life-history traits in tanagers.

Molecular cytogenetic analysis and the establishment of a cell culture in the fish species Hollandichthys multifasciatus (Eigenmann & Norris, 1900) (Characiformes, Characidae).

Hollandichthys is a fish genus of the family Characidae that was until recently considered to be monotypic, with cytogenetic, morphological, and molecular data being restricted to a few local populations. In the present study, the karyotype of a population of Hollandichthys multifasciatus was analyzed using classical and molecular cytogenetic approaches for the investigation of potential markers that could provide new perspectives on the cytotaxonomy. H. multifasciatus presented a diploid number of 2n=50 chromosomes and a karyotype formula of 8m+10sm+32st. A single pair of chromosomes presented Ag-NORs signals, which coincided with the 18S rDNA sites visualized by FISH, whilst the 5S rDNA sequences were mapped in two chromosome pairs. The distribution of the U snRNA genes was mapped on the Hollandichthys chromosomes for the first time, with the probes revealing the presence of the U1 snDNA on the chromosomes of pair 20, U2 on pairs 6 and 19, U4 on pair 16, and U6 on the chromosomes of pair 11. The results of the present study indicated karyotypic differences in comparison with the other populations of H. multifasciatus studied previously, reinforcing the need for further research to identify isolated populations or the potential existence of cryptic Hollandichthys species.

Dynamics of avian haemosporidian assemblages through millennial time scales inferred from insular biotas of the West Indies.

Although introduced hemosporidian (malaria) parasites (Apicomplexa: Haemosporida) have hastened the extinction of endemic bird species in the Hawaiian Islands and perhaps elsewhere, little is known about the temporal dynamics of endemic malaria parasite populations. Haemosporidian parasites do not leave informative fossils, and records of population change are lacking beyond a few decades. Here, we take advantage of the isolation of West Indian land-bridge islands by rising postglacial sea levels to estimate rates of change in hemosporidian parasite assemblages over a millennial time frame. Several pairs of West Indian islands have been connected and separated by falling and rising sea levels associated with the advance and retreat of Pleistocene continental glaciers. We use island isolation following postglacial sea-level rise, ca. 2.5 ka, to characterize long-term change in insular assemblages of hemosporidian parasites. We find that assemblages on formerly connected islands are as differentiated as assemblages on islands that have never been connected, and both are more differentiated than local assemblages sampled up to two decades apart. Differentiation of parasite assemblages between formerly connected islands reflects variation in the prevalence of shared hemosporidian lineages, whereas differentiation between islands isolated by millions of years reflects replacement of hemosporidian lineages infecting similar assemblages of avian host species.

Haemosporidian parasites of resident and wintering migratory birds in The Bahamas.

In temperate regions, some avian haemosporidian parasites have evolved seasonal transmission strategies, with chronic infections relapsing during spring and transmission peaking during the hosts' breeding season. Because lineages with seasonal transmission strategies are unlikely to produce gametocytes in winter, we predicted that (1) resident birds living within wintering areas of Neotropical migrants would unlikely be infected with North American parasite lineages; and (2) if infected, wintering migratory birds would be more likely to harbor Plasmodium spp. rather than Parahaemoproteus spp. or Haemoproteus spp. parasites in their bloodstreams, as only Plasmodium produces life stages, other than gametocytes, that infect red blood cells. To test these predictions, we used molecular detection and microscopy to compare the diversity and prevalence of haemosporidian parasites among year-round residents and wintering migratory birds during February 2016, on three islands of The Bahamas archipelago, i.e., Andros, Grand Bahama, and Great Abaco. Infection prevalence was low and comparable between migratory (15/111) and resident (15/129) individuals, and it did not differ significantly among islands. Out of the 12 lineages detected infecting migratory birds, five were transmitted in North America; four lineages could have been transmitted during breeding, wintering, or migration; and three lineages were likely transmitted in The Bahamas. Resident birds mostly carried lineages endemic to the Caribbean region. All North American-transmitted parasite lineages detected among migratory birds were Plasmodium spp. Our findings suggest that haemosporidian parasites of migrants shift resource allocation seasonally, minimizing the production of gametocytes during winter, with low risk of infection spillover to resident birds.

More than just nestlings: incidence of subcutaneous Philornis (Diptera: Muscidae) nest flies in adult birds.

Philornis flies Meinert (Diptera: Muscidae) have been documented parasitizing over 250 bird species, some of which are endemic species threatened with extinction. Philornis parasitism is hypothesized to affect nestlings disproportionately more than adult birds because limited mobility and exposed skin of nestlings increase their vulnerability to parasitism. We used a comprehensive literature review and our recent fieldwork in the Dominican Republic, Puerto Rico, and Grenada to challenge the idea that parasitism by subcutaneous Philornis species is a phenomenon primarily found in nestlings, a fact that has not been quantified to date. Of the 265 reviewed publications, 125 (49%) reported incidences of parasitism by subcutaneous Philornis, but only 12 included the sampling of adult breeding birds. Nine of these publications (75%) reported Philornis parasitism in adults of ten bird species. During fieldwork in the Dominican Republic, Puerto Rico, and Grenada, we documented 14 instances of parasitism of adult birds of seven avian species. From literature review and fieldwork, adults of at least fifteen bird species across 12 families and four orders of birds were parasitized by at least five Philornis species. In both the published literature and fieldwork, incidences of parasitism of adult birds occurred predominantly in females and was frequently associated with incubation. Although our findings indicate that Philornis parasitism of adult birds is more common than widely presumed, parasite prevalence is still greater in nestlings. In the future, we recommend surveys of adult birds to better understand host-Philornis relationships across life stages. This information may be essential for the development of effective control measures of Philornis to ensure the long-term protection of bird species of conservation concern.

Nitrogen maintenance requirements and potential for nitrogen retention of pullets in growth phase.

Experiments were conducted to estimate daily N maintenance requirements (NMRs) and the genetic potential for daily N retention (NRmax T) of pullets in growth phase. Three nitrogen balance trials were conducted, and a total of 48 Hy-line W-36 pullets were used in each trial in age periods (starter: 14-28, grower: 56-70 and developer: 98-112 days). The treatments consisted of six graded levels of nitrogen in the diets (L1 = 8, L2 = 16, L3 = 24, L4 = 32, L5 = 40 and L6 = 48 g N/kg of feed), formulated using the dilution technique. The regression analyses between nitrogen intake and nitrogen excretion were performed to fit the exponential function and to determine the NMR. The daily NMRs that were estimated at 294, 331 and 355 mg/BWkg 0.67 for the initial, grower and developer periods, respectively, were applied for further calculation of NRmax T as the threshold value of the function between N intake and daily N balance. The NRmax T was estimated by a statistical procedure following several iteration steps by the Levenberg-Marquardt algorithm until the sum of the squares of the residual was minimized. The NRmax T was estimated at 3,200, 2,633 and 1,826 mg/BWkg 0.67 for starter, grower and developer periods respectively. The determined model parameters were the precondition for modelling of the amino acid requirement based on an exponential N-utilization model and depended on performance and dietary amino acid efficiency. This procedure will be further developed and applied in the subsequent study.

Optimal in-feed amino acid ratio for laying hens based on deletion method.

A total of 56 Hy-line W-36 hens from 28 to 30 weeks were used on nitrogen balance (NB) trial to estimate daily N maintenance requirements (NMR) and the genetic potential for daily N retention (NRmax T). The treatments consisted of six graded levels of nitrogen in the diets (N1 = 8; N2 = 16; N3 = 24; N4 = 32; N5 = 40; and N6 = 48 g N/kg of feed), formulated using the dilution technique. The regression analyses between nitrogen intake and excretion were performed to fit the exponential function and to determine the NMR = 292 mg/BWkg 0.67 , which was applied for further calculation of NRmax T = 1,883 mg/BWkg 0.67 . A second NB trial was conducted, and a total of 96 Hy-line W-36 hens were used in the same period to estimate the ideal amino acid ratio (IAAR). Twelve treatments with eight replicates and one bird per cage were used. A balanced diet (BD) was formulated to meet the IAAR and the requirement of other nutrients for pullets. The limiting diets were formulated diluting BD with cornstarch and refilled with synthetic AAs and other feed ingredients, except for the AA under study. In each trial, the data of nitrogen intake, excretion, deposition and retention were obtained in a NB trial. The IAAR determined by Goettingen approach was Lys 100, Met+Cys 88, Trp 21, Thr 69, Arg 109, Val 90, Ile 75, Leu 127, Phe+Tir 110, Gly+Ser 73 and His 29%. The IAAR determined by Louvain approach was Lys 100, Met+Cys 88, Trp 21, Thr 69, Arg 104, Val 91, Ile 78, Leu 121, Phe+Tir 119, Gly+Ser 77 and His 29%.

The malaria parasite Plasmodium relictum in the endemic avifauna of eastern Cuba.

Island populations are vulnerable to introduced pathogens, as evidenced by extinction or population decline of several endemic Hawaiian birds caused by the malaria parasite, Plasmodium relictum (order Haemosporida). We analyzed blood samples from 363 birds caught near Guantánamo Bay, Cuba, for the presence of haemosporidian infections. We characterized parasite lineages by determining nucleotide variation of the parasite's mitochondrial cyt b gene. Fifty-nine individuals were infected, and we identified 7 lineages of haemosporidian parasites. Fifty individuals were infected by 6 Haemoproteus sp. lineages, including a newly characterized lineage of Haem. (Parahaemoproteus) sp. CUH01. Nine individuals carried the P. relictum lineage GRW4, including 5 endemic Cuban Grassquits (Tiaris canorus) and 1 migratory Cape May Warbler (Setophaga tigrina). A sequence of the merozoite surface protein gene from one Cuban Grassquit infected with GRW4 matched that of the Hawaiian haplotype Pr9. Our results indicate that resident and migratory Cuban birds are infected with a malaria lineage that has severely affected populations of several endemic Hawaiian birds. We suggest GRW4 may be associated with the lack of several bird species on Cuba that are ubiquitous elsewhere in the West Indies. From the standpoint of avian conservation in the Caribbean Basin, it will be important to determine the distribution of haemosporidian parasites, especially P. relictum GRW4, in Cuba as well as the pathogenicity of this lineage in species that occur and are absent from Cuba.

Co-infections of haemosporidian and trypanosome parasites in a North American songbird.

Hosts frequently harbour multiple parasite infections, yet patterns of parasite co-occurrence are poorly documented in nature. In this study, we asked whether two common avian blood parasites, one haemosporidian and one trypanosome, affect each other's occurrence in individuals of a single host species. We used molecular genotyping to survey protozoan parasites in the peripheral blood of yellow-breasted chats (Aves: Passeriformes [Parulidae]: Icteria virens) from the Ozarks of Southern Missouri. We also determined whether single and co-infections differently influence white blood cell and polychromatic erythrocyte counts, the latter being a measure of regenerative anaemia. We found a positive association between the haemosporidian and trypanosome parasites, such that infection by one increases the probability that an individual host is infected by the other. Adult individuals were more likely than juveniles to exhibit haemosporidian infection, but co-infections and single trypanosome infections were not age-related. We found evidence of pathogenicity of trypanosomes in that infected individuals exhibited similar levels of regenerative anaemia as birds infected with haemosporidian parasites of the genus Plasmodium. Counts of white blood cells did not differ with respect to infection status.

Epidemiology of cutaneous leishmaniasis in central Amazonia: a comparison of sex-biased incidence among rural settlers and field biologists.

OBJECTIVE: Cutaneous leishmaniasis (CL) is more frequently reported in men than in women; this may be due to male-biased exposure to CL vectors, female-biased resistance against the disease or both. We sought to determine whether gender-specific exposure to vector habitats explains male-biased CL incidence in two human populations of central Amazonia. METHODS: We compared the CL incidence in one population of field researchers (N = 166), with similar exposure for males and females, and one population of rural settlers (N = 646), where exposure is overall male-biased. We used a combination of questionnaires and clinical data to quantify CL cases, and modelled disease incidence in a Bayesian framework. RESULTS: There was a moderately higher incidence of CL among men than among women in both populations, but male bias decreased as exposure time increased. Disease incidence was overall higher among field researchers, suggesting that they are an important but understudied CL risk group. CONCLUSION: Our comparison of two contrasting populations provided epidemiological evidence that CL incidence can be male-biased even when exposure is comparable in both sexes.

Overview of global healthcare policies for patients with chronic kidney disease: an integrative literature review.

INTRODUCTION: Chronic kidney disease is a progressive and irreversible loss of kidney function and considerably affects the lives of patients and their families. Its high incidence necessitates efficient public policies for prevention and treatment. However, policies for chronic kidney disease education and awareness are scarce. OBJECTIVE: To evaluate global public policies for the prevention and treatment of chronic kidney disease adopted in various regions, aiming to comprehend the differences between various models. METHODS: This integrative review followed PRISMA recommendations and included papers published between 2016 and 2021 across several databases. RESULTS: The 44 selected articles were categorized into three themes: structural and financial aspects of the organization of renal healthcare, access to renal healthcare or management of chronic kidney disease, and coping strategies for chronic kidney disease or kidney health. Critical analysis of the papers revealed global neglect of kidney disease in political agendas. Considerable policy variations exist between different countries and regions of the same country. Our research highlighted that free and universal health coverage, especially for the most vulnerable patients, is crucial for accessing treatment owing to the prohibitively high treatment costs. CONCLUSION: Social, economic, and ethnic inequalities strongly correlate with disease occurrence, primarily affecting minority groups who lack health support, especially for the prevention and treatment of chronic kidney disease.

Promoting equity, diversity, and inclusion in surveys: insights from a patient-engaged study to assess long COVID health-care needs in Brazil.

BACKGROUND AND OBJECTIVE: Long COVID (LC) refers to persistent symptoms after acute COVID-19 infection, which may persist for months or years. LC affects millions of people globally, with substantial impacts on quality of life, employment, and social participation. Ensuring access to effective, patient-centered care for LC demands evidence, grounded in inclusive representation of those affected by the condition. Yet survey studies frequently under-represent people with the most disabling disease presentations and racially and socioeconomically marginalized groups. We aimed to describe a patient-engaged approach to developing a survey to inform public LC health care and to assess its implementation in terms of enabling participation by diverse LC patients in Brazil. METHODS: Survey development was iterative, achieved through an interdisciplinary collaboration among researchers including people living with LC, and grounded in 3 guiding principles: (1) evidence-based; (2) inclusive, intersectional, and patient-centered understanding of chronic illness and research participation; and (3) sensitivity to the context of health-care access. RESULTS: The product of our collaboration was a longitudinal survey using a questionnaire assessing: LC symptoms; their clinical and functional evolution; and impacts on quality of life, household income, health service access, utilization, and out-of-pocket expenses. We illustrate how we operationalized our 3 principles through survey content, instrument design, and administration. Six hundred fifty-one participants with diverse LC symptoms, demography, and socioeconomic status completed the survey. We successfully included participants experiencing disabling symptoms, Black and mixed race participants, and those with lower education and income. CONCLUSION: By centering patient experience, our novel, principles-based approach succeeded in promoting equity, diversity, and inclusion in LC survey research. These principles guiding patient-engaged collaboration have broad transferability. We encourage survey researchers working on chronic illness and in other contexts of marginalization and inequality to adopt them.

Female reproductive health impacts of Long COVID and associated illnesses including ME/CFS, POTS, and connective tissue disorders: a literature review.

Long COVID disproportionately affects premenopausal women, but relatively few studies have examined Long COVID's impact on female reproductive health. We conduct a review of the literature documenting the female reproductive health impacts of Long COVID which may include disruptions to the menstrual cycle, gonadal function, ovarian sufficiency, menopause, and fertility, as well as symptom exacerbation around menstruation. Given limited research, we also review the reproductive health impacts of overlapping and associated illnesses including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), postural orthostatic tachycardia syndrome (POTS), connective tissue disorders like Ehlers-Danlos syndrome (EDS), and endometriosis, as these illnesses may help to elucidate reproductive health conditions in Long COVID. These associated illnesses, whose patients are 70%-80% women, have increased rates of dysmenorrhea, amenorrhea, oligomenorrhea, dyspareunia, endometriosis, infertility, vulvodynia, intermenstrual bleeding, ovarian cysts, uterine fibroids and bleeding, pelvic congestion syndrome, gynecological surgeries, and adverse pregnancy complications such as preeclampsia, maternal mortality, and premature birth. Additionally, in Long COVID and associated illnesses, symptoms can be impacted by the menstrual cycle, pregnancy, and menopause. We propose priorities for future research and reproductive healthcare in Long COVID based on a review of the literature. These include screening Long COVID patients for comorbid and associated conditions; studying the impacts of the menstrual cycle, pregnancy, and menopause on symptoms and illness progression; uncovering the role of sex differences and sex hormones in Long COVID and associated illnesses; and addressing historical research and healthcare inequities that have contributed to detrimental knowledge gaps for this patient population.

Occurrence of Sex Chromosomes in Fish of the Genus Ancistrus with a New Description of Multiple Sex Chromosomes in the Ecuadorian Endemic Ancistrus clementinae (Loricariidae).

Ancistrus Kner, 1854, is the most diverse genus among the Ancistrini (Loricariidae) with 70 valid species showing a wide geographic distribution and great taxonomic and systematic complexity. To date, about 40 Ancistrus taxa have been karyotyped, all from Brazil and Argentina, but the statistic is uncertain because 30 of these reports deal with samples that have not yet been identified at the species level. This study provides the first cytogenetic description of the bristlenose catfish, Ancistrus clementinae Rendahl, 1937, a species endemic to Ecuador, aiming to verify whether a sex chromosome system is identifiable in the species and, if so, which, and if its differentiation is associated with the presence of repetitive sequences reported for other species of the family. We associated the karyotype analysis with the COI molecular identification of the specimens. Karyotype analysis suggested the presence of a ♂ZZ/♀ZW1W2 sex chromosome system, never detected before in Ancistrus, with both W1W2 chromosomes enriched with heterochromatic blocks and 18S rDNA, in addition to GC-rich repeats (W2). No differences were observed between males and females in the distribution of 5S rDNA or telomeric repeats. Cytogenetic data here obtained confirm the huge karyotype diversity of Ancistrus, both in chromosome number and sex-determination systems.

Different combinations of monensin and narasin on growth performance, carcass traits, and ruminal fermentation characteristics of finishing beef cattle.

The objective of this study was to evaluate the effects of different combinations of monensin and narasin on finishing cattle. In Exp. 1, 40 rumen-cannulated Nellore steers [initial body weight (BW) = 231 ± 3.64 kg] were blocked by initial BW and assigned to one of the five treatments as follows: Control (CON): no feed additive in the basal diet during the entire feeding period; Sodium monensin (MM) at 25 mg/kg dry matter (DM) during the entire feeding period [adaptation (days 1-21) and finishing (days 22-42) periods]; Narasin (NN) at 13 mg/kg DM during the entire feeding period (adaptation and finishing periods); Sodium monensin at 25 mg/kg DM during the adaptation period and narasin at 13 mg/kg DM during the finishing period (MN); and narasin at 13 mg/kg DM during the adaptation period and sodium monensin at 25 mg/kg DM during the finishing period (NM). Steers fed MM had lower dry matter intake (DMI) during the adaptation period compared to NM (P = 0.02) but not compared to CON, MM, MN, or NN (P ≥ 0.12). No differences in DMI were observed among the treatments during the finishing (P = 0.45) or the total feeding period (P = 0.15). Treatments did not affect the nutrient intake (P ≥ 0.51) or the total apparent digestibility of nutrients (P ≥ 0.22). In Exp. 2, 120 Nellore bulls (initial BW = 425 ± 5.4 kg) were used to evaluate the effects of the same treatments of Exp. 1 on growth performance and carcass characteristics of finishing feedlot cattle. Steers fed NM had greater DMI during the adaptation period compared to CON, MM, and MN (P ≤ 0.03), but no differences were observed between NM and NN (P = 0.66) or between CON, MM, and NN (P ≥ 0.11). No other differences between treatments were observed (P ≥ 12). Feeding narasin at 13 mg/kg DM during the adaptation period increases the DMI compared to monensin at 25 mg/kg DM, but the feed additives evaluated herein did not affect the total tract apparent digestibility of nutrients, growth performance, or carcass characteristics of finishing cattle.

Residual effect of narasin on feed intake and rumen fermentation characteristics in Nellore steers fed forage-based diet.

This study aimed to evaluate the residual effect of narasin on intake and ruminal fermentation parameters in Nellore cattle fed a forage-based diet. Thirty rumen-cannulated Nellore steers [initial body weight (BW) = 281 ± 21 kg] were allocated to individual pens in a randomized complete block design, with 10 blocks and 3 treatments, defined according to the fasting BW at the beginning of the experiment. The animals were fed a forage-based diet containing 99% Tifton-85 haylage and 1% concentrate. Within blocks, animals were randomly assigned to one of three treatments: (1) forage-based diet without addition of narasin (CON; n = 10), (2) CON diet plus 13 mg of narasin/kg DM (N13; n = 10), or (3) CON diet plus 20 mg of narasin/kg DM (N20; n =10). The experiment lasted 156 d and was divided into two periods. The first period lasted 140 d and consisted of the daily supply of narasin. In the second period (last 16 d), the animals were not supplemented with narasin when the residual effect of the additive was evaluated. The treatments were evaluated by linear and quadratic orthogonal contrasts. The results were reported as least square means and the effect was considered significant when P ≤ 0.05. No treatment × day interaction was identified for dry matter intake (P = 0.27). There was a treatment × day (P ≤ 0.03) interaction after narasin removal for the molar proportion of acetate, propionate, ac:prop ratio, and ammonia nitrogen. The inclusion of narasin decreased linearly (P < 0.01) the molar proportion of acetate (P < 0.01), and this effect persisted until day 5 after narasin withdrawal (P < 0.01). Narasin inclusion linearly increased the molar proportion of propionate (P < 0.04), and linearly decreased (P < 0.01) ac:prop ratio up to 5 d after removing narasin from the diets. No treatment effects were observed (P > 0.45) on days 8 and 16 after the withdrawal. Narasin linearly decreased ammonia nitrogen up to 1 day after withdrawal (P < 0.01). In conclusion, the use of narasin for a prolonged period (140 d) resulted in a residual effect on rumen fermentation parameters after the removal of the additive from the diets.

[Longitudinal care: factors associated with adherence to postpartum follow-up according to data from PMAQ-AB]. / Longitudinalidade do cuidado: fatores associados à adesão à consulta puerperal segundo dados do PMAQ-AB.

The aim was to identify factors of longitudinal care associated with women´s adherence to postpartum consultation in Brazil. This was a cross-sectional study of data from 19,177 postpartum women who participated in the external assessment of the third cycle of the Brazilian National Program for Improvement of Access and Quality of Basic Care (PMAQ-AB), 2017. The dependent variable was postpartum consultation, and the independent variables, grouped hierarchically, were sociodemographic and economic at the distal level and issues analogous to longitudinal care at the proximal level. Multiple logistic regression analysis was performed with hierarchical entry of variables, where sociodemographic and economic variables were used to adjust the model. The results showed that 53% of women had undergone postpartum follow-up. The odds of adherence to postpartum follow-up were higher in women who received a home visit by a community health agents in the first week after childbirth (OR = 4.81), those with seven or more prenatal consultations (OR = 2.74), those who had sought care at the health unit in question (OR = 1.21), and those who had been seen by the same physician (OR = 1.14). In conclusion, the proportion of postpartum consultations was low (53%), and adherence to postpartum follow-up was higher when women received visits by community health agents, were accompanied by the same physician, had regular prenatal care, and had a specific healthcare unit as their regular source of care. Consistent longitudinal care was identified as an attribute of primary care that should be strengthened to improve postpartum care.

Objetivou-se identificar os fatores de longitudinalidade do cuidado associados à adesão das mulheres à consulta puerperal no Brasil. Trata-se de um estudo transversal com dados secundários de 19.177 puérperas que participaram da avaliação externa do terceiro ciclo do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB), de 2017. A variável dependente foi a realização de consulta puerperal e as variáveis independentes, agrupadas em níveis de maneira hierarquizada, foram as sociodemográficas e econômicas, como nível distal; e questões análogas à longitudinalidade do cuidado, como o nível proximal. Realizou-se análise de regressão logística múltipla, com entrada hierarquizada das variáveis, sendo as variáveis sociodemográficas e econômicas utilizadas para ajuste do modelo. Os resultados mostraram que a proporção de mulheres que realizaram consulta puerperal foi de 53%. Mulheres que receberam visita domiciliar do agente comunitário de saúde (ACS) na primeira semana após o parto (OR = 4,81), com sete ou mais consultas de pré-natal (OR = 2,74), que procuraram atendimento na unidade de saúde em questão (OR = 1,21) e atendidas pelo mesmo(a) médico(a) (OR = 1,14) têm mais chance de aderir à consulta puerperal. Conclui-se que a proporção de realização da consulta puerperal é baixa (53%), e que a adesão das mulheres à consulta puerperal é maior quando recebem visita do ACS, são acompanhadas pelo(a) mesmo(a) médico(a), têm acompanhamento pré-natal e têm uma unidade de saúde como fonte regular de cuidado. A longitudinalidade do cuidado foi identificada como um atributo da atenção primária que deve ser fortalecido para aprimorar a atenção pós-parto.

El objetivo fue identificar factores de longitudinalidad del cuidado asociados a la adhesión de las mujeres a la consulta posparto en Brasil. Se trata de un estudio transversal con datos secundarios de 19.177 puérperas que participaron en la evaluación externa del tercer ciclo del Programa Nacional de Mejoría de Acceso y Calidad de la Atención Básica (PMAQ-AB), 2017. La variable dependiente fue la realización de la consulta posparto y las variables independientes, agrupadas en niveles de manera jerarquizada, fueron las sociodemográficas y económicas, como nivel distal; cuestiones análogas a la longitudinalidad del cuidado, como nivel proximal. Se realizó un análisis de regresión logística múltiple, con entrada jerarquizada de las variables, siendo las variables sociodemográficas y económicas utilizadas para el ajuste del modelo. Los resultados mostraron que la proporción de mujeres que realizaron la consulta posparto fue de un 53%. Las mujeres que recibieron visita domiciliaria del agentes comunitarios de salud durante la primera semana tras el parto (OR = 4,81), con siete o más consultas prenatales (OR = 2,74), buscaron atención en la unidad de salud en cuestión (OR = 1,21) y fueron atendidas por el mismo(a) médico(a) (OR = 1,14) tienen más oportunidades de adherirse a la consulta posparto. Se concluye que la proporción de realización de la consulta posparto es baja (53%), y que la adhesión de las mujeres a la consulta puerperal es mayor cuando reciben visita del agentes comunitarios de salud, están acompañadas por el(a) mismo(a) médico(a), hay seguimiento prenatal y hay una unidad de salud como fuente de cuidado regular. La longitudinalidad del cuidado se identificó como un atributo de la atención primaria que debe ser fortalecido para perfeccionar la atención posparto.

[Hematopoietic stem-cell transplants in Brazil: inequities in the distribution in Brazilian territory, 2001 to 2020]. / Transplante de células-tronco hematopoiéticas: iniquidades na distribuição em território brasileiro, 2001 a 2020.

The scope of this article is to describe the distribution of Transplant Centers (TCs) and hematopoietic stem-cell transplants (HSCTs) in the Brazilian territory. It is a descriptive study, which brings together information on the distribution of TCs and the number of procedures performed between 2001 and 2020, based on the following data sources: the Brazilian Cell Therapy and Bone Marrow Transplant Society of (SBTMO); the Brazilian Organ Transplant Association (ABTO); the Hospital Information System of the Unified Health System (SIH/SUS); and the Ministry of Health (MS). A total of 86 TCs were identified, predominantly in the Southeastern region of the country (64%). There are no TCs in the Northern region. Throughout the period, there were more than 30,000 procedures, concentrated in the Southeastern and Southern regions. The allogeneic type of HSCT was prevalent. Differences were found between the numbers of transplants performed depending on the source consulted. Despite the increase in the number of procedures during the period studied, both the distribution of TCs and the number of HSCTs were concentrated in more developed regions. This heterogeneity may have led to inequities in the access of the population to treatment.

O objetivo deste artigo é descrever a distribuição de Centros Transplantadores (CTs) e transplantes de células-tronco hematopoiéticas (TCTH) no território brasileiro. Estudo descritivo, que reúne informações sobre a distribuição CTs e o número de procedimentos realizados entre 2001 e 2020, a partir das fontes dos dados: Sociedade Brasileira de Terapia celular e Transplantes de Medula Óssea (SBTMO); Associação Brasileira de Transplante de Órgãos (ABTO); Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS); e Ministério da Saúde (MS). Foram identificados 86 CTs, com predominância na região Sudeste do país (64%). A região Norte não possui CTs. No período contabilizaram-se mais de 30 mil procedimentos, concentrados nas regiões Sudeste e Sul. O TCTH do tipo alogênico foi prevalente. Constataram-se divergências entre os números de transplantes realizados a depender da fonte consultada. Apesar do crescimento do número de procedimentos no período do estudo, tanto a distribuição de CTs quanto o número de TCTHs se concentrou em regiões mais desenvolvidas. Essa heterogeneidade pode ter propiciado iniquidades no acesso ao tratamento pela população.

Epitope identification of SARS-CoV-2 structural proteins using in silico approaches to obtain a conserved rational immunogenic peptide.

The short time between the first cases of COVID-19 and the declaration of a pandemic initiated the search for ways to stop the spread of SARS-CoV-2. There are great expectations regarding the development of effective vaccines that protect against all variants, and in the search for it, we hypothesized the obtention of a predicted rational immunogenic peptide from structural components of SARS-CoV-2 might help the vaccine research direction. In the search for a candidate of an immunogenic peptide of the SARS-CoV-2 envelope (E), membrane (M), nucleocapsid (N), or spike (S) proteins, we access the predicted sequences of each protein after the genome sequenced worldwide. We obtained the consensus amino acid sequences of about 14,441 sequences of each protein of each continent and the worldwide consensus sequence. For epitope identification and characterization from each consensus structural protein related to MHC-I or MHC-II interaction and B-cell receptor recognition, we used the IEDB reaching 68 epitopes to E, 174 to M, 245 to N, and 833 to S proteins. To select an epitope with the highest probability of binding to the MHC or BCR, all epitopes of each consensus sequence were aligned. The curation indicated 1, 4, 8, and 21 selected epitopes for E, M, N, and S proteins, respectively. Those epitopes were tested in silico for antigenicity obtaining 16 antigenic epitopes. Physicochemical properties and allergenicity evaluation of the obtained epitopes were done. Ranking the results, we obtained one epitope of each protein except for the S protein that presented two epitopes after the selection. To check the 3D position of each selected epitope in the protein structure, we used molecular homology modeling. Afterward, each selected epitope was evaluated by molecular docking to reference MHC-I or MHC-II allelic protein sequences. Taken together, the results obtained in this study showed a rational search for a putative immunogenic peptide of SARS-CoV-2 structural proteins that can improve vaccine development using in silico approaches. The epitopes selected represent the most conserved sequence of new coronavirus and may be used in a variety of vaccine development strategies since they are also presented in the described variants of SARS-CoV-2.