Analysis of the fight against the COVID-19 pandemic in long-term care facilities in the pre-vaccination period.

INTRODUCTION: The COVID-19 pandemic has disproportionately affected individuals residing in Long-Term Care Facilities (LTCFs), necessitating tailored strategies to manage outbreaks. This study examines the outcomes of the ILPI BH project, a collaborative effort between the Municipal Health Department and the Hospital das Clínicas of the Federal University of Minas Gerais, designed to mitigate COVID-19 spread within LTCFs. METHODS: Prospective cohort of secondary data: 1,794 old residents in 99 long-term care facilities of Belo Horizonte, Brazil, were followed from May 2020 to January 2021. The study analyzed the prevention strategies, residents' clinical data, and the characteristics of the long-term care facilities, correlating these variables with the number of infections, hospitalizations, and deaths from COVID-19. It checked absolute numbers and rates of incidence, hospitalization, mortality, and lethality. RESULTS: There have been 58 COVID-19 outbreaks in long-term care facilities. There were 399 cases among residents, 96 hospitalizations for COVID-19 and 48 deaths from COVID-19 (2.7 % of the cohort), with a case fatality rate of 12 %. After multivariate analysis, the intrinsic variables to residents associated with higher mortality risk were higher degree of frailty (OR=1.08; p = 0.004) and the fact of living in a long-term care facility with a considerable proportion of residents' coverage by health plans (OR = 1.01; p = 0.028). Early geriatric follow-up showed an association with a reduction in the number of hospitalizations due to COVID-19. CONCLUSION: The correct classification of the degree of frailty of institutionalized older people seems to have been relevant for predicting mortality from COVID-19. The extensive assistance by private health plans, contrary to what is supposed, did not result in better health protection. Early geriatric follow-up was beneficial and may be an attractive strategy in the face of health emergencies that affect long-term care facilities to reduce hospital admissions.

N6-methyltubercidin gives sterile cure in a cutaneous Leishmania amazonensis mouse model.

Leishmania is a trypanosomatid parasite that causes skin lesions in its cutaneous form. Current therapies rely on old and expensive drugs, against which the parasites have acquired considerable resistance. Trypanosomatids are unable to synthesize purines relying on salvaging from the host, and nucleoside analogues have emerged as attractive antiparasitic drug candidates. 4-Methyl-7-ß-D-ribofuranosyl-7H-pyrrolo[2,3-d]pyrimidine (CL5564), an analogue of tubercidin in which the amine has been replaced by a methyl group, demonstrates activity against Trypanosoma cruzi and Leishmania infantum. Herein, we investigated its in vitro and in vivo activity against L. amazonensis. CL5564 was 6.5-fold (P = 0.0002) more potent than milteforan™ (ML) against intracellular forms in peritoneal mouse macrophages, and highly selective, while combination with ML gave an additive effect. These results stimulated us to study the activity of CL5564 in mouse model of cutaneous Leishmania infection. BALB/c female and male mice infected by L. amazonensis treated with CL5564 (10 mg kg−1, intralesional route for five days) presented a >93% reduction of paw lesion size likely ML given orally at 40 mg kg−1, while the combination (10 + 40 mg kg−1 of CL5564 and ML, respectively) caused >96% reduction. The qPCR confirmed the suppression of parasite load, but only the combination approach reached 66% of parasitological cure. These results support additional studies with nucleoside derivatives.

Block Copolymer Micelles Encapsulating Au(III) Bis(Dithiolene) Complexes as Promising Nanostructures with Antiplasmodial Activity.

Block copolymer micelles (BCMs) can be used to improve the solubility of lipophilic drugs and increase their circulation half-life. Hence, BCMs assembled from MePEG-b-PCL were evaluated as drug delivery systems of gold(III) bis(dithiolene) complexes (herein AuS and AuSe) to be employed as antiplasmodial drugs. These complexes exhibited remarkable antiplasmodial activity against liver stages of the Plasmodiumberghei parasite, and low toxicity in a model of zebrafish embryos. To improve the complexes' solubility, BCMs were loaded with AuS, AuSe, and the reference drug primaquine (PQ). PQ-BCMs (Dh = 50.9 ± 2.8 nm), AuSe-BCMs (Dh = 87.1 ± 9.7 nm), and AuS-BCMs (Dh = 72.8 ± 3.1 nm) were obtained with a loading efficiency of 82.5%, 55.5%, and 77.4%, respectively. HPLC analysis and UV-Vis spectrophotometry showed that the compounds did not suffer degradation after encapsulation in BCMs. In vitro release studies suggest that AuS/AuSe-BCMs present a more controlled release compared with PQ-loaded BCMs. The antiplasmodial hepatic activity of the drugs was assessed in vitro and results indicate that both complexes present higher inhibitory activity than PQ, although encapsulated AuS and AuSe presented lower activity than their non-encapsulated counterparts. Nevertheless, these results suggest that the use of BCMs as delivery vehicles for lipophilic metallodrugs, particularly AuS and AuSe, could enable the controlled release of complexes and improve their biocompatibility, constituting a promising alternative to conventional antimalarial treatments.

In Situ Co-Amorphization of Olanzapine in the Matrix and on the Coat of Pellets.

In situ amorphization is a promising approach, considered in the present work, to enhance the solubility and dissolution rate of olanzapine, while minimizing the exposure of the amorphous material to the stress conditions applied during conventional processing. The production of pellets by extrusion/spheronization and the coating of inert beads were investigated as novel methods to promote the co-amorphization of olanzapine, a poorly water-soluble drug, and saccharin. Samples were characterized using differential scanning calorimetry, X-ray powder diffraction, Fourier-transform infrared spectroscopy and scanning electron microscopy, and dissolution and stability testing. The co-amorphous produced were compared with crystalline olanzapine, or physical mixture of olanzapine and saccharin. Results suggested that the addition of water to mixtures containing olanzapine and saccharin during the production of pellets, and the coating of inert beads, induced the in situ co-amorphization of these substances. The coating of inert beads enhanced the solubility and dissolution rate of olanzapine, especially when compared to pellets coated with the crystalline drug, but also with pellets containing the co-amorphous entity in the matrix of beads. Nine months stability tests (23 °C/60% RH) confirmed the preservation of the solid-state properties of the co-amorphous form on/in pellets. Overall, results highlighted the feasibility and benefits of in situ co-amorphization, either when the drug was entrapped in the pellets matrix, or preferentially applied directly on the surface of pellets.

"COVID-19 in Trials and Tribulations" Project: A Self-Regulation-Based Support Response for Confined Families through Social Networks.

The COVID-19 pandemic has placed today's society in an unprecedented scenario. During Portugal's first home confinement period (March-July 2020), the online-based "COVID-19 in Trials and Tribulations" project was implemented to support families with school-aged children. The project was grounded on the self-regulation framework and delivered through Facebook® and Instagram® pages. Being responsive to ongoing developments of the pandemic, activities were conveyed in two phases. Phase 1 occurred during lockdown (school was suspended). Phase 2 occurred while students were enrolled in at-distance (online) school. The present study aimed to examine the reach of the project, while examining the content and format of delivery that generated the most engagement among the users (4500 Facebook® effective followers; 1200 Instagram® effective followers) during the confinement period. Results showed that, at the individual page level, Facebook® had higher reach indicators compared to Instagram®, except for video. At the Facebook® post level, followers and users showed more engagement with the page prior to the at-distance schooling phase; however, videos still generated engagement (p = 0.002). Both the post type (p < 0.01) and frequency (p < 0.001) of publication were suggested to be good predictors of engagement. The information gathered will help design and inform future interventions that may be implemented as new lockdowns are set in place.

Studies of Potency and Efficacy of an Optimized Artemisinin-Quinoline Hybrid against Multiple Stages of the Plasmodium Life Cycle.

A recently developed artemisinin-quinoline hybrid, named 163A, has been shown to display potent activity against the asexual blood stage of Plasmodium, the malaria parasite. In this study, we determined its in vitro cytotoxicity to mammalian cells, its potency to suppress P. berghei hepatic infection and to decrease the viability of P. falciparum gametocytes, in addition to determining whether the drug exhibits efficacy of a P. berghei infection in mice. This hybrid compound has a low level of cytotoxicity to mammalian cells and, conversely, a high level of selectivity. It is potent in the prevention of hepatic stage development as well as in killing gametocytes, denoting a potential blockage of malaria transmission. The hybrid presents a potent inhibitory activity for beta-hematin crystal formation, in which subsequent assays revealed that its endoperoxide component undergoes bioactivation by reductive reaction with ferrous heme towards the formation of heme-drug adducts; in parallel, the 7-chloroquinoline component has binding affinity for ferric hemin. Both structural components of the hybrid co-operate to enhance the inhibition of beta-hematin, and this bitopic ligand property is essential for arresting the growth of asexual blood parasites. We demonstrated the in vivo efficacy of the hybrid as an erythrocytic schizonticide agent in comparison to a chloroquine/artemisinin combination therapy. Collectively, the findings suggest that the bitopic property of the hybrid is highly operative on heme detoxification suppression, and this provides compelling evidence for explaining the action of the hybrid on the asexual blood stage. For sporozoite and gametocyte stages, the hybrid conserves the potency typically observed for endoperoxide drugs, and this is possibly achieved due to the redox chemistry of endoperoxide components with ferrous heme.

3D-Hepatocyte Culture Applied to Parasitology: Immune Activation of Canine Hepatic Spheroids Exposed to Leishmania infantum.

The application of innovative three-dimensional (3D) spheroids cell culture strategy to Parasitology offers the opportunity to closely explore host-parasite interactions. Here we present a first report on the application of 3D hepatic spheroids to unravel the immune response of canine hepatocytes exposed to Leishmania infantum. The liver, usually considered a major metabolic organ, also performs several important immunological functions and constitutes a target organ for L. infantum infection, the etiological agent of canine leishmaniasis (CanL), and a parasitic disease of major veterinary and public health concern. 3D hepatic spheroids were able to sense and immunologically react to L. infantum parasites, generating an innate immune response by increasing nitric oxide (NO) production and enhancing toll-like receptor (TLR) 2 and interleukin-10 gene expression. The immune response orchestrated by canine hepatocytes also lead to the impairment of several cytochrome P450 (CYP450) with possible implications for liver natural xenobiotic metabolization capacity. The application of meglumine antimoniate (MgA) increased the inflammatory response of 3D hepatic spheroids by inducing the expression of Nucleotide oligomerization domain (NOD) -like receptors 1 and NOD2 and TLR2, TLR4, and TLR9 and enhancing gene expression of tumour necrosis factor α. It is therefore suggested that hepatocytes are key effector cells and can activate and orchestrate the immune response to L. infantum parasites.

From the Hospital Bed to the Laptop at Home: Effects of a Blended Self-Regulated Learning Intervention.

Hospitalization poses diverse challenges to school-aged youth well-being and their educational path. Some inpatients, due to the hospitalization duration, frequency or the needed recovery period at home, may struggle when returning to school. To help youth cope with this challenge, several hospitals have been implementing educational interventions tailored to the school-aged children and adolescents needs. Nevertheless, pediatric inpatients with short stays and/or with a recovery period at home usually do not benefit from these interventions. Therefore, the present study implemented a blended intervention (i.e., face-to-face and online) with the aim of training self-regulated learning competences with hospitalized school-aged adolescents with short hospital stays. The intervention was delivered on a weekly basis for eight individual sessions using a story-tool. Results showed the efficacy of the intervention in promoting adolescent's use of, perceived instrumentality of, and self-efficacy for self-regulated learning strategies. Overall, there was a differentiated impact according to the participants' age, grade level, grade retention, and engagement in the intervention. These findings support previous research indicating that hospitals can play an important role as educational contexts even for inpatients with short stays. The blended format used to deliver the self-regulation learning (SRL) training also may be an opportunity to extend these interventions from the hospital to the home context.

Inhibition of Plasmodium sporogonic stages by ivermectin and other avermectins.

BACKGROUND: The transmissible forms of Plasmodium parasites result from a process of sporogony that takes place inside their obligatory mosquito vector and culminates in the formation of mammalian-infective parasite forms. Ivermectin is a member of the avermectin family of endectocides, which has been proposed to inhibit malaria transmission due its insecticidal effect. However, it remains unclear whether ivermectin also exerts a direct action on the parasite's blood and transmission stages. METHODS: We employed a rodent model of infection to assess the impact of ivermectin treatment on P. berghei asexual and sexual blood forms in vivo. We then made use of a newly established luminescence-based methodology to evaluate the activity of ivermectin and other avermectins against the sporogonic stages of P. berghei parasites in vitro independent of their role on mosquito physiology. RESULTS: Our results show that whereas ivermectin does not affect the parasite's parasitemia, gametocytemia or exflagellation in the mammalian host, several members of the avermectin family of compounds exert a strong inhibitory effect on the generation and development of P. berghei oocysts. CONCLUSIONS: Our results shed light on the action of avermectins against Plasmodium transmission stages and highlight the potential of these compounds to help prevent the spread of malaria.

Genotoxic endpoints in a Pb-accumulating pea cultivar: insights into Pb2+ contamination limits.

Lead (Pb) persists among the most hazardous contaminant metals. Pb-induced genotoxic effects remain a matter of debate as they are a major cause of plant growth impairment, but assessing Pb genotoxicity requires the selection of Pb-sensitive genotoxic biomarkers. Seedlings of the ecotoxicological model species Pisum sativum L. were exposed to Pb2+ (≤ 2000 mg L-1). Flow cytometry (FCM) revealed that 28 days after, Pb2+ arrested root cell cycle at G2 but no eu/aneuploidies were found. Comet assay and FCM-clastogenicity assays showed that Pb2+ increased DNA breaks in roots at concentrations as low as 20 mg L-1. Leaves showed no variation in DNA-ploidy or cell cycle progression but had increased DNA breaks at the highest Pb2+ dose. We conclude that both Comet assay and the full-peak coefficient of variation (FPCV) were the most relevant endpoints of Pb-phytogenotoxicity. Also, the Pb-induced DNA breaks may be related with the arrest at the G2-checkpoint. Data will be relevant to better define Pb2+ ecogenotoxicological effects and their measuring tools and may contribute to a regulatory debate of this pollutant limits.

INSIG2 gene polymorphism is associated with higher blood pressure and triglyceride levels in Brazilian obese subjects.

INTRODUCTION: Objective: this study aimed to evaluate the association between polymorphisms of INSIG, PCSK9 and FTO genes with anthropometric, biochemical characteristics and presence of metabolic syndrome in patients with severe obesity. Material and methods: the present study enrolled 150 patients with grade II or III obesity, who were submitted to nutritional assessment, blood pressure measurement and peripheral blood collection. INSIG2 (rs75666605), PCSK9 (rs505151), and FTO (rs9939609) polymorphisms were genotyped using TaqMan Pre-Designed SNP Genotyping Assays probes in real time polymerase chain reaction (PCR). The experimental data are processed in SPSS Statistics 22.0 (p < 0.05). Results: in this study, 72.2% of obese subjects had metabolic syndrome (MS). There was a higher prevalence of AA (86.9%), CG (51.1%) and AT (46.2%) genotypes for the PCSK9, INSIG2 and FTO polymorphisms, respectively. There was no association of these polymorphisms with the prevalence of MS (p > 0.05). On the other hand, individuals with at least one variant allele (G) for the INSIG2 gene had higher triglycerides levels, systolic and diastolic blood pressure (p < 0.05). Conclusions: the polymorphism rs7566605 of the INSIG2 gene is associated with higher triglycerides levels and blood pressure values, which are also considered as risk factors for the development of MS.

INTRODUCCIÓN: Objetivo: este estudio tuvo como objetivo evaluar la asociación entre polimorfismos de los genes INSIG, PCSK9 y FTO con las características antropométricas, bioquímicas y la presencia de síndrome metabólico (SM) en pacientes con obesidad grave. Material y métodos: el presente estudio incluyó 150 pacientes con obesidad de grado II o III, que fueron sometidos a evaluación nutricional, medición de la presión arterial y extracción de sangre periférica. Los polimorfismos INSIG2 (rs75666605), PCSK9 (rs505151) y FTO (rs9939609) fueron genotipados utilizando sondas TaqMan Pre-Designed SNP Genotyping Assays en la reacción en cadena de la polimerasa en tiempo real (PCR). Los datos experimentales se procesan en SPSS Statistics 22.0 (p < 0,05). Resultados: en este estudio, el 72,2% de los sujetos obesos tenían síndrome metabólico (EM). Hubo una mayor prevalencia de genotipos AA (86,9%), CG (51,1%) y AT (46,2%) para los polimorfismos PCSK9, INSIG2 y FTO, respectivamente. No hubo asociación de estos polimorfismos con la prevalencia de SM (p > 0,05). Por otro lado, los individuos con al menos una variante de alelo (G) para el gen INSIG2 tenían niveles más altos de triglicéridos, presión arterial sistólica y diastólica (p < 0,05). Conclusiones: el polimorfismo rs7566605 del gen INSIG2 se asocia con niveles más altos de triglicéridos y valores de presión arterial, que también se consideran factores de riesgo para el desarrollo del síndrome metabólico.

The Impact of Antiretroviral Therapy on Malaria Parasite Transmission.

Coendemicity between the human immunodeficiency virus (HIV) and Plasmodium parasites, the causative agents of acquired immunodeficiency syndrome (AIDS) and malaria, respectively, occurs in several regions around the world. Although the impact of the interaction between these two organisms is not well understood, it is thought that the outcome of either disease may be negatively influenced by coinfection. Therefore, it is important to understand how current first-line antiretroviral therapies (ART) might impact Plasmodium infection in these regions. Here, we describe the effect of 18 antiretroviral compounds and of first-line ART on the blood and sporogonic stages of Plasmodium berghei in vitro and in vivo. We show that the combination zidovudine + lamivudine + lopinavir/ritonavir (LPV/r), employed as first-line HIV treatment in the field, has a strong inhibitory activity on the sporogonic stages of P. berghei and that several non-nucleoside reverse transcriptase inhibitors (NNRTI) have a moderate effect on this stage of the parasite's life cycle. Our results expose the effect of current first-line ART on Plasmodium infection and identify potential alternative therapies for HIV/AIDS that might impact malaria transmission.

Building knowledge of healthy eating in hospitalized youth: a self-regulated campaign.

BACKGROUND: Data from the World Health Organization shows obesity has more than doubled worldwide since 1980. Childhood obesity is mainly associated with external and modifiable factors, as eating habits, existing room for promoting healthy lifestyles. Additionally, learning can take place in contexts other than schools, as the hospital, potentiating the time of hospitalization. Self-regulated learning framework is suited to train the skills necessary for self-management processes and behavioral changes. The aim was to describe and evaluate a campaign designed to increase knowledge about healthy eating by hospitalized school-aged youth. METHOD: A quasi-experimental design was used. Participants were randomly distributed between the experimental and control groups, each one with 15 participants aged between six and 16 years-old. Information about healthy eating was not provided directly; participants had to reflect and work to build knowledge through activities inspired in the self-regulated learning framework. RESULTS: Results showed that the experimental group when compared with their counterparts significantly improved their knowledge on healthy eating after taking part in the campaign. CONCLUSIONS: Campaigns that increase knowledge on healthy eating based on the promotion of self-regulated learning strategies could be incorporated in health promotion programs not only in pediatric units but also in other educational contexts.

Experiences During a Psychoeducational Intervention Program Run in a Pediatric Ward: A Qualitative Study.

Hospitalization, despite its duration, is likely to result in emotional, social, and academic costs to school-age children and adolescents. Developing adequate psychoeducational activities and assuring inpatients' own class teachers' collaboration, allows for the enhancement of their personal and emotional competences and the maintenance of a connection with school and academic life. These educational programs have been mainly designed for patients with long stays and/or chronic conditions, in the format of Hospital Schools, and typically in pediatric Hospitals. However, the negative effects of hospitalization can be felt in internments of any duration, and children hospitalized in smaller regional hospitals should have access to actions to maintain the connection with their daily life. Thus, this investigation aims to present a psychoeducational intervention program theoretically grounded within the self-regulated learning (SRL) framework, implemented along 1 year in a pediatric ward of a regional hospital to all its school-aged inpatients, regardless of the duration of their stay. The program counts with two facets: the psychoeducational accompaniment and the linkage to school. All the 798 school-aged inpatients (Mage = 11.7; SDage = 3.71; Mhospital stay = 4 days) participated in pedagogical, leisure nature, and SRL activities designed to train transversal skills (e.g., goal-setting). Moreover, inpatients completed assigned study tasks resulting from the linkage between the students' own class teachers and the hospital teacher. The experiences reported by parents/caregivers and class teachers of the inpatients enrolling in the intervention allowed the researchers to reflect on the potential advantages of implementing a psychoeducational intervention to hospitalized children and adolescents that is: individually tailored, focused on leisure playful theoretically grounded activities that allow learning to naturally occur, and designed to facilitate school re-entry after hospital discharge. Parents/caregivers highlighted that the program helped in the preparation for surgery and facilitated the hospitalization process, aided in the distraction from the health condition, promoted SRL competences, and facilitated the communication and linkage with school life. Class teachers emphasized the relevance of the program, particularly in the liaison between hospital and school, in the academic and psycho-emotional and leisure-educational support provided, and in smoothing the school re-entry.

Self-perceived health and clinical-functional vulnerability of the elderly in Belo Horizonte/Minas Gerais.

OBJECTIVE: To determine the self-perceived health status and clinical-functional vulnerability of the elderly attended at a Reference Center of Minas Gerais, Brazil and to evaluate the association between these variables through the Clinical-Functional Vulnerability Index (IVCF-20) instrument. METHOD: This is an epidemiological, retrospective study of 311 medical records. Statistical analyses were performed using the Stata program; the evaluations were by Pearson's Chi-square test and Poisson regression models. RESULTS: The majority of the elderly presented negative self-perceived health status(70.10%); there was statistical significance between negative self-perceived health and the variables of mood and recent hospitalization. CONCLUSION: Perceived health status influences the morbidity and mortality of the elderly. Mood disorders and recent hospitalizations directly interfere with active aging.

Inorganic Hg toxicity in plants: A comparison of different genotoxic parameters.

Inorganic Mercury (Hg) contamination persists an environmental problem, but its cyto- and genotoxicity in plants remains yet unquantified. To determine the extent of Hg-induced cyto- and genotoxicity, and assess most sensitive endpoints in plants, Pisum sativum L. seedlings were exposed for 14 days to different HgCl2 concentrations up to 100 µM. Shoots and roots from hydroponic exposure presented growth impairment and/or morphological disorders for doses >1 µM, being the roots more sensitive. Plant growth, ploidy changes, clastogenicity (HPCV), cell cycle dynamics (G1-S-G2), Comet-tail moment (TM), Comet-TD, Mitotic-index (MI) and cell proliferation index (CPI) were used to evaluate Hg-induced cyto/genotoxicity. Both leaf and root DNA-ploidy levels, assessed by flow cytometry (FCM), remained unaltered after exposure. Root cell cycle impairment occurred at lower doses (≥1 µM) than structural DNA damages (≥10 µM). Cytostatic effects depended on the Hg concentration, with delays during S-phase at lower doses, and arrests at G1 at higher ones. This arrest was paralleled with decreases of both mitotic index (MI) and cell proliferation index (CPI). DNA fragmentation, assessed by the Comet assay parameters of TD and TM, could be visualized for conditions ≥10 µM, while FCM-clastogenic parameter (FPCV) and micronuclei (MNC) were only altered in roots exposed to 100 µM. We demonstrate that inorganic-Hg induced cytostaticity is detectable even at 1 µM (a value found in contaminated sites), while structural DNA breaks/damage are only visualized in plants at concentrations ≥10 µM. We also demonstrate that among the different techniques tested for cyto- and genotoxicity, TD and TM Comet endpoints were more sensitive than FPCV or MNC. Regarding cytostatic effects, cell cycle analysis by FCM, including the difference in % cell cycle phases and CPI were more sensitive than MI or MNC frequency. Our data contribute to better understand Hg cyto- and genotoxicity in plants and to understand the information and sensitivity provided by each of the genotoxic techniques used.

Self-perceived health and clinical-functional vulnerability of the elderly in Belo Horizonte/Minas Gerais / La percepción de salud y vulnerabilidad clínico-funcional de mayores de Belo Horizonte/Minas Gerais / Autopercepção de saúde e vulnerabilidade clínico-funcional de idosos de Belo Horizonte/Minas Gerais

ABSTRACT Objective: To determine the self-perceived health status and clinical-functional vulnerability of the elderly attended at a Reference Center of Minas Gerais, Brazil and to evaluate the association between these variables through the Clinical-Functional Vulnerability Index (IVCF-20) instrument. Method: This is an epidemiological, retrospective study of 311 medical records. Statistical analyses were performed using the Stata program; the evaluations were by Pearson's Chi-square test and Poisson regression models. Results: The majority of the elderly presented negative self-perceived health status(70.10%); there was statistical significance between negative self-perceived health and the variables of mood and recent hospitalization. Conclusion: Perceived health status influences the morbidity and mortality of the elderly. Mood disorders and recent hospitalizations directly interfere with active aging.

RESUMEN Objetivo: Conocer la percepción de salud y la vulnerabilidad clínico-funcional de mayores atendidos en un Centro de Referencia de Minas Gerais y evaluar la asociación entre esas variables a través del instrumento Índice de Vulnerabilidad Clínico Funcional (IVCF-20). Método: Se trata de un estudio epidemiológico, retrospectivo de análisis de 311 prontuarios. Los análisis estadísticos fueron realizados con auxilio del programa Stata; las evaluaciones fueron hechas a través del test Qui-quadrado de Pearson y modelos de regresión de Poisson. Resultados: La mayoría de los mayores presentó su percepción negativa de salud (70,10%); hubo significancia estadística entre la percepción de uno mismo negativa en salud y la variable humor y hospitalización reciente. Conclusión: Las percepciones del estado de salud influencian en la mortalidad de los mayores. Los trastornos de humor e internaciones recientes interfieren directamente en el envejecimiento activo.

RESUMO Objetivo: Conhecer a autopercepção de saúde e a vulnerabilidade clínico-funcional de idosos atendidos em um Centro de Referência de Minas Gerais e avaliar a associação entre essas variáveis através do instrumento Índice de Vulnerabilidade Clínico Funcional (IVCF-20). Método: Trata-se de um estudo epidemiológico, retrospectivo de análise de 311 prontuários. As análises estatísticas foram realizadas com auxílio do programa Stata; as avaliações foram feitas através do teste Qui-quadrado de Pearson e modelos de regressão de Poisson. Resultados: A maioria dos idosos apresentou autopercepção negativa de saúde (70,10%); houve significância estatística entre a autopercepção negativa em saúde e a variável humor e hospitalização recente. Conclusão: As percepções do estado de saúde influenciam na morbimortalidade dos idosos. Os transtornos de humor e internações recentes interferem diretamente no envelhecimento ativo.

Bioluminescence Method for In Vitro Screening of Plasmodium Transmission-Blocking Compounds.

The sporogonic stage of the life cycle of Plasmodium spp., the causative agents of malaria, occurs inside the parasite's mosquito vector, where a process of fertilization, meiosis, and mitotic divisions culminates in the generation of large numbers of mammalian-infective sporozoites. Efforts to cultivate Plasmodium mosquito stages in vitro have proved challenging and yielded only moderate success. Here, we describe a methodology that simplifies the in vitro screening of much-needed transmission-blocking (TB) compounds employing a bioluminescence-based method to monitor the in vitro development of sporogonic stages of the rodent malaria parasite Plasmodium berghei Our proof-of-principle assessment of the in vitro TB activity of several commonly used antimalarial compounds identified cycloheximide, thiostrepton, and atovaquone as the most active compounds against the parasite's sporogonic stages. The TB activity of these compounds was further confirmed by in vivo studies that validated our newly developed in vitro approach to TB compound screening.

An Innate Immunity Pathway in the Moss Physcomitrella patens.

MAP kinase (MPK) cascades in Arabidopsis thaliana and other vascular plants are activated by developmental cues, abiotic stress, and pathogen infection. Much less is known of MPK functions in nonvascular land plants such as the moss Physcomitrella patens Here, we provide evidence for a signaling pathway in P. patens required for immunity triggered by pathogen associated molecular patterns (PAMPs). This pathway induces rapid growth inhibition, a novel fluorescence burst, cell wall depositions, and accumulation of defense-related transcripts. Two P. patens MPKs (MPK4a and MPK4b) are phosphorylated and activated in response to PAMPs. This activation in response to the fungal PAMP chitin requires a chitin receptor and one or more MAP kinase kinase kinases and MAP kinase kinases. Knockout lines of MPK4a appear wild type but have increased susceptibility to the pathogenic fungi Botrytis cinerea and Alternaria brassisicola Both PAMPs and osmotic stress activate some of the same MPKs in Arabidopsis. In contrast, abscisic acid treatment or osmotic stress of P. patens does not activate MPK4a or any other MPK, but activates at least one SnRK2 kinase. Signaling via MPK4a may therefore be specific to immunity, and the moss relies on other pathways to respond to osmotic stress.

Clinical-Functional Vulnerability Index-20 (IVCF-20): rapid recognition of frail older adults.

OBJECTIVE: To evaluate the adequacy of the Clinical-Functional Vulnerability Index-20, a rapid triage instrument to test vulnerability in Brazilian older adults, for the use in primary health care. METHODS: The study included convenience sample of 397 patients aged older than or equal to 60 years attended at Centro de Referência para o Idoso (Reference Center for Older Adults) and of 52 older adults the same age attended at the community. The results of the questionnaire, consisting of 20 questions, were compared with those of the Comprehensive Geriatric Assessment, considered a reference for identifying frail older adults. Spearman's correlation was evaluated in the Clinical-Functional Vulnerability Index-20 with the Comprehensive Geriatric Assessment; the validity was verified by the area under the ROC curve; reliability was estimated by the percentage of agreement among evaluators and by the kappa coefficient, both with quadratic weighted. The cut-off point was obtained based on the higher accuracy criterion. Cronbach's alpha, a measure of internal consistency, was estimated. RESULTS: The Spearman's correlation coefficient was high and positive for both groups (0.792 for older adults attended at the Reference Center and 0.305 for older adults from the community [p < 0.001]). The area under the ROC curve for older adults attended at the Reference Center was substantial (0.903). The cut-off point obtained was six, and older adults with scores in Clinical-Functional Vulnerability Index-20 above that value had strong possibility of being frail. For older adults from the community, the quadratic weighted agreement among evaluators was 99.5%, and the global quadratic weighted kappa coefficient was 0.94. Cronbach's alpha was high for older adults attended at the Reference Center (0.861) and those attended at the community (0.740). CONCLUSIONS: The Clinical-Functional Vulnerability Index-20 questionnaire, in the sample examined, turned out to be positively correlated with the Comprehensive Geriatric Assessment, in addition to the results indicating a high degree of validity and reliability. Thus, the Clinical-Functional Vulnerability Index-20 proves to be viable as a triage instrument in the primary health care that identifies frail older adults (older adults at risk of weakening and frail older adults). OBJETIVO: Avaliar a adequação do Índice de Vulnerabilidade Clínico-Funcional-20 , instrumento de triagem rápida de vulnerabilidade em idosos brasileiros, para utilização pela atenção básica. O estudo incluiu amostra de conveniência de 397 pacientes com idade maior ou igual a 60 anos atendidos em um Centro de Referência para o Idoso e de 52 idosos da mesma idade atendidos na comunidade. Os resultados do questionário, constituído por 20 perguntas, foram comparados com aqueles da Avaliação Geriátrica Ampla, considerada referência para identificação do idoso frágil. Foi avaliada a correlação de Spearman do Índice de Vulnerabilidade Clínico-Funcional-20 com a Avaliação Geriátrica Ampla; a validade foi verificada pela área sob a curva ROC; a confiabilidade foi estimada pelo percentual de concordância entre avaliadores e coeficiente kappa, ambos com ponderação quadrática. Obteve-se ponto de corte com base no critério de maior acurácia. O alfa de Cronbach, medida de consistência interna, foi calculado. O coeficiente de correlação de Spearman foi elevado e positivo em ambos os grupos (0,792 para idosos atendidos no Centro de Referência para o Idoso e 0,305 para idosos da comunidade [p < 0,001]). A área sob a curva ROC para idosos atendidos no Centro de Referência para o Idoso foi substancial (0,903). O ponto de corte obtido foi seis e idosos com pontuação no Índice de Vulnerabilidade Clínico-Funcional-20 acima desse valor tinham forte possibilidade de serem frágeis. Para idosos da comunidade, a concordância ponderada quadrática entre avaliadores foi 99,5% e o coeficiente kappa ponderado quadrático global, 0,94. O alfa de Cronbach foi elevado para idosos atendidos no Centro de Referência para o Idoso (0,861) e da comunidade (0,740). CONCLUSÕES: O questionário do Índice de Vulnerabilidade Clínico-Funcional-20, na amostra analisada, mostrou ser positivamente correlacionado com a Avaliação Geriátrica Ampla, além de os resultados indicarem alto grau de validade e confiabilidade. Assim, o Índice de Vulnerabilidade Clínico-Funcional-20 se mostra viável como instrumento de rastreio na atenção básica que identifica o idoso com fragilidade (idoso em risco de fragilização e idoso frágil).