Cyclin-Dependent Kinase 4/6 Inhibitors Plus Endocrine Therapy versus Endocrine Therapy Alone for HR-Positive, HER-2-Negative Early Breast Cancer: Meta-Analysis of Phase III Randomized Clinical Trials.

BACKGROUND: Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors are approved for advanced breast cancer combined with endocrine therapy (ET). The efficacy of CDK4/6 inhibitors plus ET in hormone estrogen-positive, human epidermal growth factor 2-negative (HR+/HER2-) early-stage breast cancer (esBC) is still to be confirmed. METHODS: We performed a systematic review and a meta-analysis to investigate the efficacy of CDK4/6i plus ET in esBC. Main outcomes included invasive disease-free survival (iDFS), distant relapse-free survival (DRFS), and overall survival (OS). We included only phase III randomized controlled trials. We used RStudio version 4.2.3, and we considered p < 0.05 to be statistically significant. RESULTS: Four studies were selected, including 14,168 patients, of which 7089 were treated with CDK4/6i plus ET and 7079 received ET monotherapy. Regarding patient characteristics, 6828 (48.2%) were premenopausal. Compared with ET alone, iDFS rates (HR 0.81; 95% CI: 0.67, 0.98; p = 0.034) were significantly in favor of CDK4/6 inhibitors plus ET. However, there were no significant differences in DRFS (HR 0.79; 95% CI: 0.58, 1.07; p = 0.132) nor OS (HR 0.96; 95% CI: 0.69, 1.35; p = 0.829). CONCLUSIONS: Our results show that the addition of CDK4/6 inhibitors is associated with a significant benefit for HR+/HER2- esBC patients in iDFS. More studies and longer follow-up are needed to assess overall survival benefits.

Roasted yerba mate (Ilex paraguariensis) infusions in bovine milk model before and after in vitro digestion: Bioaccessibility of phenolic compounds, antioxidant activity, protein-polyphenol interactions and bioactive peptides.

Yerba mate is increasingly acknowledged for its bioactive properties and is currently being incorporated into various food and pharmaceutical products. When roasted, yerba mate transforms into mate tea, consumed as a hot aqueous infusion, and has gained popularity. This study investigated the bioaccessibility of phenolic compounds, protein-polyphenol interactions, antioxidant activity, and bioactive peptides in roasted yerba mate infusions, utilizing whole, semi-skimmed, and skimmed bovine milk models. The phytochemical profile of roasted yerba mate was analyzed in infusions with water and milk (whole, semi-skimmed, and skimmed), before and after in vitro digestion, identifying 18 compounds that exhibited variations in composition and presence among the samples. Bioavailability varied across different milk matrices, with milk being four times more efficient as a solvent for extraction. Gastric digestion significantly impacted (p < 0.05) the release of phenolic compounds, such as chlorogenic acid and rutin, with only chlorogenic acid remaining 100 % bioavailable in the infusion prepared with skimmed milk. Protein-polyphenol interaction did not influence protein digestion in different infusions, as there was a similarity in the hydrolysis pattern during the digestive process. Changes in antioxidant activity during digestion phases, especially after intestinal digestion in milk infusions, were related to alterations in protein structures and digestive interactions. The evaluation of total phenolic compounds highlighted that skimmed milk infusion notably preserved these compounds during digestion. Peptidomic analysis identified 253, 221, and 191 potentially bioactive peptides for whole, semi-skimmed, and skimmed milk-digested infusions, respectively, with a focus on anti-inflammatory and anticancer activities, presenting a synergistic approach to promote health benefits. The selection of milk type is crucial for comprehending the effects of digestion and interactions in bioactive compound-rich foods, highlighting the advantages of consuming plant infusions prepared with milk.

Validation and optimization of the loop-mediated isothermal amplification (LAMP) technique for rapid detection of wheat stripe mosaic virus, a wheat-infecting pathogen.

BACKGROUND: Wheat stripe mosaic virus (WhSMV) is a significant wheat pathogen that causes substantial yield losses in Brazil and other countries. Although several detection methods are available, reliable and efficient tools for on-site WhSMV detection are currently lacking. In this study, a Loop-Mediated Isothermal Amplification (LAMP) method was developed for rapid and reliable field detection of WhSMV. We designed WhSMV-specific primers for the LAMP assay and optimized reaction conditions for increased sensitivity and specificity using infected plant samples. RESULTS: We have developed a diagnostic method utilizing the Loop-Mediated Isothermal Amplification (LAMP) technique capable of rapidly and reliably detecting WhSMV. The LAMP assay has been optimized to enhance sensitivity, specificity, and cost-effectiveness. CONCLUSION: The LAMP assay described here represents a valuable tool for early WhSMV detection, serving to mitigate the adverse economic and social impacts of this viral pathogen. By enabling swift and accurate identification, this assay can significantly improve the sustainability of cereal production systems, safeguarding crop yields against the detrimental effects of WhSMV.

The link between obesity and the gut microbiota and immune system in early-life.

In early-life, the gut microbiota is highly modifiable, being modulated by external factors such as maternal microbiota, mode of delivery, and feeding strategies. The composition of the child's gut microbiota will deeply impact the development and maturation of its immune system, with consequences for future health. As one of the main sources of microorganisms to the child, the mother represents a crucial factor in the establishment of early-life microbiota, impacting the infant's wellbeing. Recent studies have proposed that dysbiotic maternal gut microbiota could be transmitted to the offspring, influencing the development of its immunity, and leading to the development of diseases such as obesity. This paper aims to review recent findings in gut microbiota and immune system interaction in early-life, highlighting the benefits of a balanced gut microbiota in the regulation of the immune system.

Effect of the COVID-19 pandemic on cataract surgery by residents who had routine surgical simulator training during residency.

PURPOSE: To assess the effect of the Coronavirus disease 2019 (COVID-19) pandemic on cataract surgery by residents who had mandatory surgical simulator training during residency. METHODS: In this retrospective, observational analytical study, the total number of cataract surgeries and surgical complications by all senior residents of 2019 (2019 class; prepandemic) and 2020 (2020 class; affected by the reduced number of elective surgeries due to the COVID-19 pandemic) were collected and compared. All residents had routine mandatory cataract surgery training on a virtual surgical simulator during residency. The total score obtained by these residents on cataract challenges of the surgical simulator was also evaluated. RESULTS: The 2020 and 2019 classes performed 1275 and 2561 cataract surgeries, respectively. This revealed a reduction of 50.2% in the total number of procedures performed by the 2020 class because of the pandemic. The incidence of surgical complications was not statistically different between the two groups (4.2% in the 2019 class and 4.9% in the 2020 class; p=0.314). Both groups also did not differ in their mean scores on the simulator's cataract challenges (p<0.696). CONCLUSION: Despite the reduction of 50.2% in the total number of cataract surgeries performed by senior residents of 2020 during the COVID-19 pandemic, the incidence of surgical complications did not increase. This suggests that surgical simulator training during residency mitigated the negative effects of the reduced surgical volume during the pandemic.

Effect of the COVID-19 pandemic on cataract surgery by residents who had routine surgical simulator training during residency

ABSTRACT Purpose: To assess the effect of the coronavirus disease 2019 (COVID-19) pandemic on cataract surgery by residents who had mandatory surgical simulator training during residency. Methods: In this retrospective, observational analytical study, the total number of cataract surgeries and surgical complications by all senior residents of 2019 (2019 class; prepandemic) and 2020 (2020 class; affected by the reduced number of elective surgeries due to the COVID-19 pandemic) were collected and compared. All residents had routine mandatory cataract surgery training on a virtual surgical simulator during residency. The total score obtained by these residents on cataract challenges of the surgical simulator was also evaluated. Results: The 2020 and 2019 classes performed 1275 and 2561 cataract surgeries, respectively. This revealed a reduction of 50.2% in the total number of procedures performed by the 2020 class because of the pandemic. The incidence of surgical complications was not statistically different between the two groups (4.2% in the 2019 class and 4.9% in the 2020 class; p=0.314). Both groups also did not differ in their mean scores on the simulator's cataract challenges (p<0.696). Conclusion: Despite the reduction of 50.2% in the total number of cataract surgeries performed by senior residents of 2020 during the COVID-19 pandemic, the incidence of surgical complications did not increase. This suggests that surgical simulator training during residency mitigated the negative effects of the reduced surgical volume during the pandemic.

Espiritualidade e saúde mental em tempos de pandemia pelo COVID-19: um estudo teórico / Spirituality and mental health in times of pandemic by the COVID-19: a theoretical study

A Organização Mundial de Saúde (OMS) declarou em março de 2020 um estado de pandemia relacionada ao COVID-19. A partir desta declaração as autoridades sanitárias passaram a recomendar mudanças em hábitos para conter a disseminação deste agravo, dentre estes, o isolamento e distanciamento social. Neste sentido, medo, ansiedade e estresse como transtornos em saúde mental aumentaram de forma significativa em todo mundo. Sabe-se que uma das formas de combater ou ressignificar tais processos pode ser alcançada mediante o reconhecimento e prática da espiritualidade, enquanto parte importante da visão do ser integral. Tais práticas melhoram o enfrentamento, visto que proporcionam resiliência e transformação, permitindo aos envolvidos o aproveitamento destes desafios para crescer, aprender e transformar. Como estratégias para este processo, o indivíduo pode buscar apreciar a natureza e as pequenas coisas, realizar reflexões capazes de facilitar as construções ou reconstruções cognitivas, valorizar e praticar o apoio social e promover a compaixão, para enfim fomentar a resiliência. Neste sentido, dois anos após o início da pandemia da Covid-19 o debate de seu impacto permanece necessário, incluindo as relações com a saúde física, mental e espiritual.

The World Health Organization (WHO) declared a pandemic state in March 2020 regarding to COVID-19. Since that declaration the health authorities began to recommend changes in habits to contain the spread of this disease, including isolation, and social distancing. In this sense, fear, anxiety, and stress as mental health problems have increased significantly worldwide. It is known that one of the ways to combat or resignify such processes can be achieved through the recognition and practice of spirituality, as an important part of the vision of the integral being. Such practices improve coping, since they provide resilience and transformation, allowing those involved to take advantage of these challenges for growth, learning and transformation. As strategies for this process, the individual can seek to appreciate nature and trivial things, perform reflections capable of facilitating cognitive constructions or reconstructions, valuing, and practicing social support, and promoting compassion are able to foster resilience. In this sense, more than two years after the beginning of the Covid-19 pandemic, the debate on its impact remains necessary, including relations with physical, mental, and spiritual health.

Defining and supporting a professional role for pharmacists associated with traditional and complementary medicines: a cross-country survey of pharmacists.

Introduction: An estimated 80% of the world's population use traditional and complementary medicine (T&CM) products as part of their healthcare, with many accessed through pharmacy. This cross-cultural study posed a set of professional practice responsibilities and actions to pharmacists related to T&CM products, with a view toward developing consensus, safeguarding, and promoting the health of the public. Methods: Data were collected from 2,810 pharmacists across nine countries during 2022 via a cross-sectional online survey reported in accordance with the guidelines of STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) and the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results: Of the 2,810 participants from nine countries, 2,341 completed all sections of the survey. Of these, most agreed (69%) that T&CM product use was common in the community they served, but most did not have adequate training to support consumer needs. Over 75% acknowledged that there were known and unknown safety risks associated with T&CM use. Of 18 professional responsibilities posed, 92% agreed that pharmacists should be able to inform consumers about potential risks, including T&CM side effects and drug-herb interactions. The provision of accurate scientific information on the effectiveness of T&CM products, skills to guide consumers in making informed decisions, and communication with other healthcare professionals to support appropriate and safe T&CM product use were all ranked with high levels of agreement. In order to effectively fulfill these responsibilities, pharmacists agreed that regulatory reforms, development of T&CM education and training, and access to quality products supported by high-quality evidence were needed. Conclusion: General agreement from across nine countries on eighteen professional responsibilities and several stakeholder actions serve as a foundation for the discussion and development of international T&CM guidelines for pharmacists.

Generation and characterization of avian IgY antibodies for detecting beta-casein A1 in bovine milk.

Beta-casein is a primary milk protein that constitutes approximately 30% of the casein in bovine milk, with the two most common types in cattle being A1 and A2. The A2 protein differs from the A1 version due to a mutation in the codon at position 67, resulting in a histidine to proline substitution. However, the bioactive peptide, beta-casomorphine-7 (BCM7), which originates from partial proteolysis of the A1 variant, has been linked to several gastrointestinal disorders in humans. Production of A1 beta casein-free products is increasing demand in the milk market, worldwide. This study generated and characterized a polyclonal IgY antibody that specifically recognizes the A1 beta-casein protein present in cow's milk. A commercially available IgY anti-A1 antibody was used as a positive control, and the sensitivity and specificity of both the commercial and produced anti-A1 antibodies were evaluated. The results showed 100% sensitivity and specificity of 100% of the commercial IgY anti-A1. The in-house produced anti-A1 antibody demonstrated a sensitivity of 95.2% and a specificity of 100%, indicating its potential as a reliable and cost effective tool for detecting A1 beta-casein protein in milk samples.

Independência funcional de pacientes com síndrome de Guillain-Barré internados para reabilitação / Functional independence of patients with Guillain-Barré syndrome hospitalized for rehabilitation

Objetivo: Analisar a evolução da independência funcional de pacientes com Síndrome de Guillain-Barré (SGB) internados para reabilitação. Método: Estudo retrospectivo e longitudinal. Foram analisados prontuários de pacientes com diagnóstico de SGB internados para reabilitação, de janeiro de 2015 a março de 2020, que possuíam a Medida de Independência Funcional (MIF) na admissão e alta hospitalar devidamente preenchida, sem distinção de idade. A comparação da MIF antes e depois da internação para reabilitação foi feita por meio do teste t de Student e McNemar. Resultados: A amostra foi composta por 26 pacientes, com média de idade de 41,96 ± 19,67 anos. Os participantes tinham em média 66,07 ± 69,56 dias entre os primeiros sintomas e a admissão para internação para reabilitação. O tempo médio de internação foi de 38,96± 28,36 dias. Houve diferença significativa entre as médias das pontuações, na admissão e alta, nos domínios motor (37,58 - 59,62; p<0,001) e cognitivo (23,19 - 33,35; p<0,001) e escore total da MIF (60,77 - 92,96; p<0,001). Observou-se também aumento do número de pacientes com independência completa após internação para reabilitação (2 - 15; p<0,001). Conclusão: Pacientes com SGB internados para reabilitação apresentam melhora da independência funcional. É importante acesso a esta modalidade terapêutica multiprofissional aos pacientes com SGB.

Objective: To analyze the evolution of the functional independence of patients with Guillain-Barré Syndrome (GBS) hospitalized for rehabilitation. Method: Retrospective and longitudinal study. Medical records of patients with diagnosis of GBS hospitalized for rehabilitation were analyzed, from January 2015 to March 2020, who had the Functional Independence Measure (FIM) at admission and hospital discharge duly filled, regardless of age. The comparison of FIM before and after hospitalization for rehabilitation was performed using Student's t-test and McNemar's test. Results: The sample consisted of 26 patients, with a mean age of 41.96 ± 19.67 years. Participants had a mean of 66.07 ± 69.56 days between the first symptoms and hospital admission for rehabilitation. The mean length of stay was 38.96 ± 28.36 days. There was a significant difference between the mean scores, at admission and discharge, in the motor domain (37.58-59.62; p<0.001) and cognitive domain (23.19-33.35; p<0.001) and total FIM score (60.77-92.96; p<0.001). There was also an increase in the number of patients with complete independence after hospitalization for rehabilitation (2-15; p<0.001). Conclusion: Patients with GBS hospitalized for rehabilitation show improved functional independence. Access to this multiprofessional therapeutic modality is important for patients with GBS.

Bilateral Gonadal Dysgerminoma in a Phenotypic Female With 46,XY Disorder of Sexual Development: A Case Report.

The 46,XY disorder of sexual development (DSD) is a rare congenital condition characterized by a 46,XY karyotype associated with complete or disturbed female gonadal development and a non-virilized phenotype. The presence of Y chromosome material in these patients' karyotypes increases the risk of germ cell tumor development. The present study reports a unique case of a 16-year-old phenotypically female patient presenting with primary amenorrhea, who was later diagnosed with 46,XY DSD. After bilateral salpingo-oophorectomy, the patient was diagnosed with stage IIIC dysgerminoma. The patient received four cycles of chemotherapy and showed a good response. The patient is currently alive and well, with no evidence of disease after the residual lymph node resection.

Capacitação de docentes e não docentes do ensino básico em suporte básico de vida / Training teachers and non-teaching staff in basic life support

A maioria das situações de paragem cardiorrespiratória acontecem fora do hospital. Qualquer cidadão, capacitado para realizar manobras de suporte básico de vida (SBV), pode fazer a diferença na sobrevivência da vítima. A implementação de planos formativos, direcionados a classes profissionais específicas, poderá potenciar esta capacitação. Com o objetivo de avaliar a efetividade da implementação de um programa de formação em SBV, para docentes e não docentes do 2º e 3º ciclos do ensino básico, desenhou-se um estudo segundo uma metodologia quantitativa, quase-experimental, do tipo pré-teste pós-teste. A amostra,foi constituída por docentes e não docentes do 2º e 3º ciclos do ensino básico, de um Agrupamento de Escolas da zona centro, disponíveis para participar neste processo, criando assim uma amostra não probabilística acidental. A intervenção consistiu no desenvolvimento de sessões de formação em SBV. Através da aplicação dos instrumentos de colheita de dados pré e pós intervenção, alicerçados num questionário e numa grelha de avaliação prática, foram analisados fatores sociodemográficos e profissionais, conhecimentos e competências práticas em SBV, disponibilidade para realizar SBV e também as condicionantes à realização de SBV. Para a análise de dados utilizou-se estatística descritiva e estatística inferencial. Foram tidos em consideração todos os princípios éticos e formais inerentes. Constatou-se uma correlação estatisticamente significativa entre os conhecimentos prévios, com as competências práticas (?s=1,000) e com a disponibilidade para iniciar SBV (?s=0,441). De igual forma, verificou-se a relação entre a disponibilidade em iniciar SBV, e as competências práticas (?s=0,441). Por seu turno, observou-se uma correlação negativa estatisticamente significativa entre a disponibilidade em iniciar SBV e as condicionantes para a realização de SBV (?s=-0,437). Verificou-se ainda, que a implementação do programa de formação em SBV foi efetiva, não só quanto aos conhecimentos (p<0,001), mas também nas competências práticas em SBV (p<0,001), na disponibilidade para iniciar SBV (p<0,001) e nas condicionantes à realização de SBV (p=0,002). Concluiu-se que este estudo veio corroborar a efetividade de um programa de formação em SBV, através de mudanças na implementação de intervenções adequadas perante uma situação de Paragem Cardiorrespiratória.

Interrogation of TERT promoter hotspot mutations in ameloblastoma and ameloblastic carcinoma.

BACKGROUND: TERT promoter mutations increase telomerase activity, conferring cell immortality. The coexistence of TERT promoter mutations with BRAFV600E is associated with aggressiveness. Ameloblastoma and ameloblastic carcinoma are infiltrative neoplasms that harbor BRAFV600E; however, it remains unknown if these odontogenic tumors also show TERT promoter mutations. METHODS: Genomic DNA of paraffin-embedded ameloblastomas (n = 6) and ameloblastic carcinomas (n = 3) were Sanger-sequenced to assess the hotspot TERT promoter mutations C228T and C250T. BRAFV600E status was screened by TaqMan allele-specific quantitative polymerase chain reaction. RESULTS: None of the samples harbored TERT promoter mutations. The BRAFV600E mutation was positive in 3 of 6 of ameloblastomas and in 1 of 3 of ameloblastic carcinomas. CONCLUSION: The absence of TERT promoter mutation in the samples indicates that this molecular event is not relevant to the tumors' pathogenesis. Further studies are necessary to explore undefined genetic or epigenetic mechanisms related to TERT-upregulation in ameloblastoma, and the telomerase activity in ameloblastic carcinoma.

Perfil do egresso médico de uma instituição de ensino superior do Nordeste do Brasil / Profile of medical graduates from a higher education institution in Northeastern Brazil

Resumo Introdução: Nos últimos anos, ocorreu um aumento da quantidade de faculdades médicas no Brasil, e, concomitante a isso, houve a ampliação do interesse em melhorar a qualidade do ensino na Medicina. Um questionamento resultante dessa mudança é se esse aumento de faculdades de Medicina implicará a formação de profissionais capazes de atender às demandas da sociedade contemporânea. Uma forma de responder a esse questionamento é conhecer o perfil dos egressos das instituições. Objetivo: Este estudo teve como objetivo avaliar o perfil dos egressos médicos formados em uma instituição de ensino superior do Nordeste do Brasil. Método: Realizou-se um estudo transversal do tipo pesquisa de campo com abordagem quantitativa. Egressos do curso de Medicina de uma instituição de ensino superior, formados no período de 2012-2019, foram avaliados por meio de um questionário enviado via e-mail, com perguntas de múltipla escolha. O estudo foi aprovado pelo Comitê de Ética da instituição. Resultado: Analisaram-se 127 questionários, o que corresponde a uma taxa de resposta de 13,8%, e o sexo feminino predominou ao representar 67,7% da amostra. O conhecimento sobre as Diretrizes Curriculares Nacionais durante a graduação foi relatado por 24,2% dos participantes. A maioria dos egressos demonstrou satisfação com o curso realizado e sentimento de preparo para atuação profissional como generalista. Em relação à residência médica, 90,5% dos egressos realizaram esse tipo de programa de especialização. A atuação profissional dos egressos na Estratégia Saúde da Família e no Sistema Único de Saúde (SUS) foi identificada em 66,9% e 84,3%, respectivamente. Sentimento de aptidão e de habilidade para lidar com educação em saúde, gestão da saúde e atenção à saúde da população foi identificado na maioria dos egressos. Conclusão: Identificamos uma boa satisfação ao final do curso e um sentimento de confiança para atuação profissional na maioria dos egressos. Aperfeiçoamento por meio de residência médica é um objetivo frequente entre os egressos. O SUS é um campo de trabalho para a maioria destes. Além disso, aptidões recomendadas pelas Diretrizes Curriculares Nacionais foram percebidas pelos egressos ao final da graduação. Futuros trabalhos com amostras maiores e multicêntricos são necessários para a avaliação do perfil dos egressos no Brasil.

Abstract Introduction: In recent years, there has been an increase in the number of medical schools in Brazil and, concomitantly, the interest in improving the quality of teaching in medicine has increased. One question resulting from this change is whether this increase in medical schools will imply the training of professionals capable of meeting the demands of contemporary society. One way to answer this question is to know the profile of the institutions' graduates. Objective: To evaluate the profile of medical graduates trained at a higher education institution in northeast Brazil. Method: A cross-sectional field research study with a quantitative approach was carried out. Graduates of the medical course of a higher education institution, graduated from 2012 to 2019, were evaluated through a questionnaire sent via e-mail, with multiple choice questions. The study was approved by the institution's ethics committee. Results: A total of 127 questionnaires were analyzed, which corresponds to a response rate of 13.8%; females predominated, representing 67.7% of the sample. Knowledge about the National Curriculum Guidelines during undergraduate school was reported by 24.2% of the participants. Most graduates demonstrated satisfaction with the course taken and a feeling of being prepared for professional work as a generalist. Regarding medical residency, 90.5% of the graduates attended this type of specialization program. Professional performance of graduates in the Family Health Strategy and in the Brazilian Unified Health System (SUS) was identified in 66.9% and 84.3%, respectively. A feeling of aptitude and ability to deal with health education, health management and health care for the population was identified in most graduates. Conclusion: We identified good satisfaction at the end of the course and a feeling of confidence for professional performance in most graduates. Improvement through medical residency is a frequent goal among graduates. The SUS is a field of work for most of these professionals. In addition, skills recommended by the National Curriculum Guidelines were perceived by them at the end of undergraduate school. Future studies with larger and multicenter samples are needed to assess the profile of graduates in Brazil.

Dual visual impairment and contrast sensitivity among community-dwelling older adults: a cross-sectional study from the PrevQuedas Brazil trial / Duplo déficit visual e sensibilidade ao contraste em idosos da comunidade: estudo transversal do PrevQuedas Brasil

OBJECTIVE: To investigate the importance of improving visual assessment for community-dwelling older adult fallers. METHODS: Cross-sectional study with eligible older adults (> 60 years old) living in the community and who suffered at least one fall in the last 12 months from the PrevQuedas Brasil clinical trial. Sociodemographic data, information on previous falls, physical and functional assessment (BOMFAQ and FES-I) were collected. We evaluated impairments in visual acuity and contrast sensitivity using the Snellen E chart and low-contrast visual acuity tests, respectively. Dual visual impairment refers to the presence of both impairments. For statistical analysis we compared the participants in relation to the number of falls (single fallers or recurrent fallers) using Chi-square or Fisher's exact test and the significance level was <0.05 for all analyses. RESULTS: Visual acuity, low contrast sensitivity, and dual visual impairment were associated with recurrent falls (OR 1.85); visual impairment was more prevalent among the oldest old. Approximately 90% of the participants reported using glasses, and 63.80% used multifocal lenses. Dual impairment was identified in 143 (20.30%) participants. In multivariate logistic regression, the predictive variables for recurrent falls were low contrast sensitivity (95%CI 1.15­2.47), dual visual impairment (95%CI 1.16­2.83), and self-perceived fall risk (95%CI 1.16­2.46) which was measured using the Falls Efficacy Scale-International. CONCLUSION: Older adults with dual visual impairment are more likely to suffer recurrent falls. Low contrast sensitivity is crucial for fall risk assessment

OBJETIVO: Este estudo investiga a importância de avaliar a visão de idosos caidores na comunidade. METODOLOGIA: Estudo transversal com idosos elegíveis (> 60 anos) residentes na comunidade e que sofreram pelo menos uma queda nos últimos 12 meses do ensaio clínico PrevQuedas Brasil. Foram coletados dados sociodemográficos, informações sobre quedas pregressas, exames físicos e funcionais (BOMFAQ e FES-I). Avaliamos os comprometimentos da acuidade visual e da sensibilidade ao contraste por meio da Tabela E de Snellen e testes de acuidade visual de baixo contraste, respectivamente. O duplo déficit visual refere-se à presença de ambas as deficiências. Para análise estatística comparamos os idosos com relação ao número de quedas (caidores únicos ou caidores recorrentes) usando Qui-quadrado ou Teste exato de Fisher e o nível de significância foi <0.05 para todas as análises. RESULTADOS: Baixa acuidade visual, baixa sensibilidade ao contraste e duplo déficit visual foram associados a quedas recorrentes com odds ratio ­ OR 1,85, frequentemente mais prevalente entre os idosos longevos. Cerca de 90,00% dos idosos relataram usar óculos e 63,80% usavam lentes multifocais. O duplo déficit visual foi identificado em 143 (20,30%) participantes. Nos modelos de regressão logística multivariados, verificamos que as variáveis preditoras para queda recorrente foram a baixa sensibilidade ao contraste (intervalo de confiança ­ IC95% 1,15­2,47), duplo déficit (IC95% 1,16­2,83) e a autopercepção do risco de cair (IC95% 1,16­2,46) medido pela Falls Efficacy Scale-International. CONCLUSÃO: Idosos com baixa sensibilidade ao contraste e duplo déficit visual têm maiores chances de sofrerem múltiplas quedas quando comparados com idosos que possuem apenas baixa acuidade visual. Assim, a baixa sensibilidade ao contraste é essencial na avaliação do risco de quedas dos idosos

In Vitro Diagnostic Assay to Detect SARS-CoV-2-Neutralizing Antibody in Patient Sera Using Engineered ACE-2 Mini-Protein.

The recent development and mass administration of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccines allowed for disease control, reducing hospitalizations and mortality. Most of these vaccines target the SARS-CoV-2 Spike (S) protein antigens, culminating with the production of neutralizing antibodies (NAbs) that disrupt the attachment of the virus to ACE2 receptors on the host cells. However, several studies demonstrated that the NAbs typically rise within a few weeks after vaccination but quickly reduce months later. Thus, multiple booster administration is recommended, leading to vaccination hesitancy in many populations. Detecting serum anti-SARS-CoV-2 NAbs can instruct patients and healthcare providers on correct booster strategies. Several in vitro diagnostics kits are available; however, their high cost impairs the mass NAbs diagnostic testing. Recently, we engineered an ACE2 mimetic that interacts with the Receptor Binding Domain (RBD) of the SARS-2 S protein. Here we present the use of this engineered mini-protein (p-deface2 mut) to develop a detection assay to measure NAbs in patient sera using a competitive ELISA assay. Serum samples from twenty-one patients were tested. Nine samples (42.8%) tested positive, and twelve (57.1%) tested negative for neutralizing sera. The data correlated with the result from the standard commercial assay that uses human ACE2 protein. This confirmed that p-deface2 mut could replace human ACE2 in ELISA assays. Using bacterially expressed p-deface2 mut protein is cost-effective and may allow mass SARS-CoV-2 NAbs detection, especially in low-income countries where economical diagnostic testing is crucial. Such information will help providers decide when a booster is required, reducing risks of reinfection and preventing the administration before it is medically necessary.

Critical collaborative research: epistemic-ontological locus for the education of educators and researchers as agents of personal and collective transformation / Pesquisa crítica de colaboração: lócus epistemo-ontológico para a educação de educadores e pesquisadores como agentes de transformações pessoais e coletivas / Investigación crítica colaborativa: locus epistemo-ontológico para la formación de educadores y investigadores como agentes de transformaciones personales y colectivas

This text discusses the Critical Collaborative Research known in Brazil as PCCol ­ Pesquisa Crítica de Colaboração - which is a practical-theoretical approach used in the development of investigations that focus on understanding and often challenging knowledge production and actions so as to promote de organization of decolonial-and-inclusive schools. Standing on Marxian, Vygotskian and Freirean underpinnings, the text was written from the recordings of two classes delivered by the authors in a Graduate Course called Critical Research Methodologies, with participation of some guest professors, such as Maria Cecilia Camargo Magalhães, who also authors this paper. The text is organized from the speeches of the authors on two occasions in which they collaboratively delivered lessons about PCCol, as well as the questions and interventions from the other course participants. The writing procedure interweaves speeches, treated as data, and their analyses, treated as the actual discussion of some of the concepts that base the Research Methodology itself, and that include relational and transformational agency, the Freirean notion of data production from the South rather than the North, professional practice that is personal and collectively responsive, but more specifically, we will discuss the role played by language for the implementation of collaborative interactions, as well as how this type of language is organized. (AU)

Este texto discute a Pesquisa Crítica de Colaboração (PCCol), uma abordagem prático-teórica utilizada no desenvolvimento de trabalhos voltados à compreensão de conhecimentos e modos de agir, assim como ao questionamento destes, de modos a promover a formação de uma escola decolonial-e-inclusiva. De base marxiana, freiriana e vygotskiana, o texto foi escrito a partir de duas aulas ministradas no Curso "Critical Research Methodologies", com a presença de professores convidados como a segunda autora deste texto, Maria Cecília C. Magalhães. O presente artigo foi organizado a partir das falas e perguntas dos participantes das duas aulas ministradas por Fidalgo e Magalhães sobre a PCCol, que foram gravadas e transcritas. Em outras palavras, o artigo trará dados produzidos das exposições teórico-metodológicas das apresentadoras e das perguntas e intervenções dos demais participantes, intercaladas de discussão epistemo-metodológica dos conceitos que embasam a PCCol, tais como desenvolvimento da agência relacional e transformadora, a emergência de uma prática profissional pessoal e coletiva responsiva, mas mais fortemente sobre o papel da linguagem na colaboração e como esta se organiza. (AU)

Ese texto aborda la Investigación Colaborativa Crítica (PCCol), cuál enfoque teórico-práctico utilizado en el desarrollo de trabajos destinados a comprender saberes y modos de actuar, así como cuestionarlos, de manera que promuevan la formación de una escuela descolonial-e-inclusiva. Con base marxista, freireana y vygotskiana, el material ha sido escrito a partir de dos clases dictadas en el Curso "Metodologías de Investigación Crítica", además de profesores invitados como la segunda autora de este texto, Maria Cecília C. Magalhães. El presente artículo fue organizado a partir de las charlas, intervenciones y preguntas de los participantes de las dos clases impartidas por Fidalgo y Magalhães acerca de la PCCol, que han sido grabadas y transcritas. En otros términos, el artículo traerá datos producidos a partir de las exposiciones teórico-metodológicas de los expositores y de las preguntas e intervenciones de los demás participantes, interpuestos con una discusión epistemológica-metodológica de los conceptos que subyacen la PCCol, como el desarrollo de relaciones y agencia trasformadora, el surgimiento de una práctica profesional personal y colectiva comprometida, pero más fuertemente acerca del papel del lenguaje en la colaboración y cómo esa se organiza. (AU)

Humanização do cuidado ao paciente e familiares frente as doenças e complicações cardíacas / Humanization of care for patients and families in front of heart diseases and complications / Humanización de la atención a pacientes y familias ante enfermedades y complicaciones del corazón

Introdução: Pacientes com patologias cardiovasculares apresentam comprometimento nas dimensões física, emocional e sócio espiritual devido a alterações patológicas, podendo repercutir cotidianamente no processo saúde-doença. Diante das fragilidades e possíveis complicações, cabe à equipe de enfermagem o domínio de conhecimento técnico e científico, bem como de humanização. Assim, por meio da assistência humanizada a equipe de enfermagem buscará estratégias adequadas para tratar os aspectos emocionais, sociais, psicológicos e físicos, os quais deverão ser avaliados continuamente. Objetivo: Descrever as principais práticas da equipe de enfermagem relacionadas a humanização junto aos pacientes portadores de doenças cardiovasculares e seus familiares. Material e Método: Estudo de revisão bibliográfica, descritivo, qualitativo, cuja coleta de dados foi realizada no banco de dados LiLACS, acessado por meio do portal eletrônico da Biblioteca Virtual em Saúde. Resultados: Foram utilizados cinco artigos das 2843 publicações localizadas, guiados pelos descritores que contemplavam o tema abordado e criadas pelo cruzamento das palavras-chave estabelecidas. Duas categorias temáticas: Práticas humanizadas realizadas pela equipe de enfermagem ao paciente cardíaco e Percepção do familiar em relação as práticas humanizadas realizadas pela equipe de enfermagem ao paciente cardíaco. Conclusão: A assistência, bem como bons resultados no tratamento, decorrem e tem relevância nas práticas humanizadas oferecidas pela equipe de enfermagem no atendimento de pacientes com afecções cardíacas e seus familiares.

Introduction: Patients with cardiovascular pathologies present impairment in the physical, emotional and socio-spiritual dimensions due to pathological changes, which may have daily repercussions on the health-disease process. Faced with weaknesses and possible complications, it is up to the nursing team to master technical and scientific knowledge, as well as humanization. Thus, through humanized care, the nursing team will seek appropriate strategies to deal with emotional, social,psychological and physical aspects, which should be continuously evaluated. Objective: To describe the main practices of the nursing team related to humanization with patients with cardiovascular diseases and their families. Material and Method: Bibliographic review, descriptive, qualitative study, whose data collection was carried out in the LiLACS database, accessed through the electronic portal of the Virtual Health Library. Results: Five articles from the 2843 publications located were used, guided by the descriptors that contemplated the topic addressed and created by crossing the established keywords. Two thematic categories: Humanized practices performed by the nursing team to the cardiac patient and Perception of the family member in relation to the humanized practices carried out by the nursing team to the cardiac patient. Conclusion: Assistance, as well as good treatment results, derive from and are relevant to the humanized practices offered by the nursing team in the care of patients with cardiac conditions and their families.

Introducción: Los pacientes con patologías cardiovasculares presentan afectaciones en las dimensiones física, emocional y socioespiritual debido a cambios patológicos, que pueden repercutir en el día a día del proceso salud-enfermedad. Frente a las debilidades y posibles complicaciones, corresponde al equipo de enfermería dominar los conocimientos técnicos y científicos, así como la humanización. Así, a través del cuidado humanizado, el equipo de enfermería buscará estrategias adecuadas para el enfrentamiento de los aspectos emocionales, sociales, psicológicos y físicos, que deben ser evaluados continuamente. Objetivo: Describir las principales prácticas del equipo de enfermería relacionadas con la humanización con pacientes con enfermedades cardiovasculares y sus familias. Material y Método: Revisión bibliográfica, estudio descriptivo, cualitativo, cuya recolección de datos se realizó en la base de datos LiLACS, accedida a través del portal electrónico de la Biblioteca Virtual en Salud. Resultados: Se utilizaron cinco artículos de las 2843 publicaciones localizadas, guiados por los descriptores que contemplaban el tema abordado y creados a partir del cruce de las palabras clave establecidas. Dos categorías temáticas: Prácticas humanizadas realizadas por el equipo de enfermería al paciente cardíaco y Percepción del familiar en relación a las prácticas humanizadas realizadas por el equipo de enfermería al paciente cardíaco. Conclusión: La asistencia, así como los buenos resultados del tratamiento, se derivan y son relevantes para las prácticas humanizadas ofrecidas por el equipo de enfermería en el cuidado de los pacientes con condiciones cardíacas y sus familias.

Seasonal study of the nutritional composition of unexploited and low commercial value fish species from the Portuguese coast.

Target species diversification is essential for fisheries sustainability and fish market revitalization. Fish discards are a widely recognized problem resulting from fisheries worldwide, and are of major concern for all sector players, from administrations, to fishermen, and scientists. However, non-target species are seldom studied, and information on nutritional profiles and seasonal changes in nutritional properties is generally lacking. This study assessed the seasonal nutritional composition of two unexploited (Serranus cabrilla, Capros aper) and three low commercial value fish species (Trachurus picturatus, Spondyliosoma cantharus, and Trigla lyra), captured on the Portuguese coast over 1 year. Significant seasonal variations were observed in the nutritional composition of all the species studied. Moisture and ash contents varied from 70% to 81% and from 5% to 13%, respectively. The maximum fat contents were 5% for C. aper and 4% for T. picturatus, allowing to classify all studied fishes as lean. The highest protein contents were recorded for C. aper (25%) and S. cantharus (20%). The unexploited and low commercial value fish species studied were shown to be good fat and protein sources, comparable to commonly consumed species, such as cod and salmon, having a great potential to become commonly consumed fish in Portugal.

Autologous Anti-CD19 CAR T-Cells immunotherapy in relapsed/refractory acute lymphoblastic leukemia patients. A systematic review and meta-analysis / Imunoterapia de CAR T-Cells Anti-CD19 no tratamento de leucemia linfoblástica aguda refratária/recidivante. Revisão sistemática e metanálise

Introduction: Acute Lymphoblastic Leukemia (ALL) is the most prevalent malignancy in children; however, when the neoplasm becomes refractory/relapses (R/R) the cure possibilities are practically null. Objectives: To analyze the Anti-CD19 Chimeric Antigen Receptors (CAR) T-Cells immunotherapy efficacy in the treatment of R/R ALL, providing evidence about the efficacy and safety of the therapy for the analyzed group. Methods: The study consisted of a systematic review and meta-analysis based on the analysis of indexed articles. The searches were carried out with the terms: "acute lymphoblastic leukemia", "CAR T", and "CD19-specific chimeric antigen receptor". Results: Only 18 of the 94 articles obtained initially met the inclusion criteria and were selected for review, totaling 637 patients. Thus, it was observed in the responses that approximately 81% of the patients achieved a Complete Response; 7% did not respond; the neoplasm relapsed in 17% of the cases; and 6.1% of the patients died. The main side effects found were Cytokine Release Syndrome (CRS), Severe Cytokine Release Syndrome, and Neurotoxicity, present in 36.3%, 29%, and 24% of patients, respectively. Conclusion: Anti-CD19 CAR T-Cells immunotherapy is an effective therapy, capable of producing high rates of complete remission in R/R ALL treatment. [au]

Introdução: A Leucemia Linfoblástica Aguda (LLA) é a neoplasia maligna mais prevalente em crianças; entretanto, quando se torna refratária/recidivante (R/R) as possibilidades de cura são praticamente nulas. Objetivos: Analisar a eficácia da imunoterapia de Receptores de Antígenos Quiméricos anti-CD19 no tratamento da LLA R/R, fornecendo evidências sobre a efetividade e segurança da terapia para o grupo analisado. Métodos: O estudo consistiu em uma revisão sistemática e metanálise baseada em artigos indexados. As pesquisas foram realizadas com os termos: "acute lymphoblastic leukemia", "CAR T", and "CD19-specific chimeric antigen receptor". Resultados: Dos 94 artigos obtidos, apenas 18 atenderam inicialmente aos critérios de inclusão e foram selecionados para revisão, totalizando 637 pacientes. Assim, observou-se nas respostas que aproximadamente 81% dos pacientes obtiveram resposta completa; 7% não responderam; a neoplasia recidivou em 17% dos casos; e 6,1% dos pacientes morreram. Os principais efeitos colaterais encontrados foram síndrome de liberação de citocinas, síndrome de liberação grave de citocinas e neurotoxicidade, presentes em 36,3%, 29% e 24% dos pacientes, respectivamente. Conclusão: A imunoterapia com células CAR T anti-CD19 é uma terapia eficaz, sendo capaz de produzir altas taxas de remissão completa no tratamento de LLA R / R. [au]