Properties and kinetic behavior of free and immobilized laccase from Oudemansiella canarii: Emphasis on the effects of NaCl and Na2SO4 on catalytic activities.

Studies have highlighted the great potential of Oudemansiella canarii laccase in degrading synthetic dyes for reducing their toxicity. Immobilization of enzymes improves usability in degradation processes and the present work succeeded in immobilizing this laccase onto MANAE-agarose. Immobilization improved pH, thermal, and storage stabilities. Both, free and immobilized enzymes presented Michaelis-Menten kinetics with the substrate 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) with Km values of 0.056 ±â€¯0.003 and 0.195 ±â€¯0.022 mM, respectively. Immobilization increased Vmax 1.27-fold. NaCl caused incomplete (hyperbolic) inhibition, which was satisfactorily described by the one-substrate one-modifier mechanism. Immobilization reduced the maximal inhibition by NaCl from 80.2 to 55.7 %. The effect of Na2SO4 was predominantly stimulation, but inhibition of the free enzyme occurred at high substrate concentrations. Stimulation of the immobilized enzyme by Na2SO4 was much more pronounced. It strongly depended on the substrate concentration and was much stronger (up to 300 %) at low substrate concentrations. The combined effects of substrate and sulfate on the immobilized laccase could be satisfactorily described by the one-substrate one-modifier mechanism. The modified response of the immobilized O. canarii laccase to NaCl and Na2SO4 considerably favors its use as a tool in bioremediation processes because environmental contamination by salts frequently represents a strong operational challenge.

Biotechnological, Nutritional, and Therapeutic Applications of Quinoa (Chenopodium quinoa Willd.) and Its By-Products: A Review of the Past Five-Year Findings.

This study aimed to provide an updated critical review of the nutritional, therapeutic, biotechnological, and environmental aspects involved in the exploitation of Chenopodium quinoa Willd and its biowastes. Special attention was devoted to investigations of the therapeutic and nutritional properties of different parts and varieties of quinoa as well as of the use of the biowaste resulting from the processing of grain. Studies published from 2018 onward were prioritized. Extracts and fractions obtained from several Chenopodium quinoa matrices showed antioxidant, antidiabetic, immunoregulatory, neuroprotective, and antimicrobial effects in in vitro and in vivo models and some clinical studies. The activities were attributed to the presence of phytochemicals such as polyphenols, saponins, peptides, polysaccharides, and dietary fibers. Quinoa wastes are abundant and low-cost sources of bioactive molecules for the development of new drugs, natural antioxidants, preservatives, dyes, emulsifiers, and carriers for food and cosmetics applications. Among the demands to be fulfilled in the coming years are the following: (1) isolation of new bioactive phytochemicals from quinoa varieties that are still underexploited; (2) optimization of green approaches to the sustainable recovery of compounds of industrial interest from quinoa by-products; and (3) well-conducted clinical trials to attest safety and efficacy of extracts and compounds.

A Critical Appraisal of the Most Recent Investigations on Ora-Pro-Nobis (Pereskia sp.): Economical, Botanical, Phytochemical, Nutritional, and Ethnopharmacological Aspects.

Pereskia aculeata Miller and Pereskia grandfolia Haw, known as 'ora-pro-nobis', are unconventional vegetables belonging to the Cactaceae family, native to the Americas and common in the northeast and southeast regions of Brazil. This review attempts to present a balanced account of both the methods used for obtaining extracts from the diverse parts of the plants and the results that were obtained in terms of their applicability to foods and other products with biological activities. Attention will also be devoted to the properties of their bioactives and their applications to real food products. Methods for obtaining extracts from the diverse parts of the plants will be analyzed, as well as the chemical nature of the bioactives that were hitherto identified. Next, the applicability of ora-pro-nobis in either its integral form or in the form of extracts or other products (mucilages) to the production of food and dietary supplements will be analyzed. The species have been extensively investigated during the last few decades. But, the determination of chemical structures is frequently incomplete and there is a need for new studies on texture determination and color evaluation. Further studies exploring the fruit and flowers of P. aculeata are also required.

Teaching and learning pharmacology in Brazil before COVID-19 pandemic: a case study in Rio de Janeiro.

BACKGROUND: Knowledge of pharmacology is crucial for physicians to perform rational and safe medicine. Medical professionals are responsible for prescribing drugs and a weak performace of those can result in medication errors leading to disability, hospitalization, and death, among other situations. It occurs worldwide, including in Brazil, so that learning pharmacology impacts on public health service. We aim to investigate the current pharmacology educational practices in medical schools in the state of Rio de Janeiro, Brazil. METHODS: We surveyed 14 of 22 medical schools in Rio de Janeiro. Pharmacology teachers (n=16) and medical students (n=89) answered a semi-structured questionnaire that included questions about the staff characteristics, pharmacology content, teacher's concepts, and common practices and resources that were used in pharmacology classes. RESULTS: Our results revealed that the medical schools had similar overall curriculums. Pharmacology teachers work more than 30hs a week (75%) and conducted both research and teaching (62.5%). We also found that the multimedia projector was the most common resource (71.9%), and passive pedagogical methodologies (e.g., expository classes) remain a current strategy in pharmacology classes (89.9%). In general, medical students are poorly motivated (55%), which may be related to their performance in assessments. In addition, students believe that pharmacology is a complex (52%) or very complex subject (46%) since for its full understanding the student needs concepts from other disciplines, which can have an impact on the performance and motivation of students. As a result, these medical students do not fully understand the integration between pharmacology's basic concepts and their clinical applications. CONCLUSION: These data seem to demonstrate that the adopted teaching and learning pharmacology strategies and methodologies can be improved in Rio de Janeiro.

Pleurotus pulmonarius: a protease-producing white rot fungus in lignocellulosic residues.

The production of proteases by white rot fungi, such as those of the genus Pleurotus, is related to the degradation of wood proteins, the substrate on which these fungi grow in the environment. From the point of view of production, they are still little explored for this purpose. A selection of agro-industrial residues highlighted corn bagasse as the best substrate for solid-state protease production using the basidiomycete Pleurotus pulmonarius. The enzyme production was maximized through a factorial design, where the enzyme activity increased from 137.8 ± 1.9 to 234.1 ± 2.7 U/mL. Factors such as temperature stability, pH, and chemical reagents were evaluated. The optimum temperature was 45 °C, showing low thermal stability at higher temperatures. The enzyme inhibition occurred by Mn2+ (50.3%) and Ba2+ (76.4%); SDS strongly inhibited the activity (82.4%), while pepstatin A partially inhibited (56%), suggesting an aspartic protease character. Regarding pH, the highest protease activity was obtained at pH 5.5. Partial characterization resulted in apparent values of the KM and Vmax constants of 0.61 mg/mL and 1.79 mM/min, respectively.

Effects of dams on As and Hg concentrations in three southeastern Brazil fluvial systems: Ocean inputs, sources and seasonal dynamics among environmental compartments.

Damming rivers for hydropower generation interferes in the flow of water bodies and, consequently, in trace element biogeochemistry and transport. This study focused on the effects of dams on the seasonal dynamics of arsenic (As) and mercury (Hg) in three fluvial systems (Itabapoana River, Flechas Channel and Paraíba do Sul River) and on the input of these elements to the ocean. The elements were evaluated in suspended particulate matter (SPM), surface sediments, and the roots of the aquatic macrophyte Eichhornia crassipes. Our results showed that the proximity of the dams in the Flechas Channel and Rio Itabapoana in relation to their mouth (distances of 4 km and 58 km, respectively) changed As and Hg seasonal dynamics in the environmental compartments analyzed, with the Flechas Channel being the most impacted area. In contrast, the lower part of the Paraíba do Sul River that has more distant dams to its mouth (distance of 184 km) did not show such marked changes, suggesting that most of the inputs are coming from the long river reach. The isotopic and elemental composition of organic matter indicated the soils of native forests as the main source of trace elements to the water bodies. Flow rate was the main driver controlling As and Hg ocean inputs, with higher inputs observed in the Paraíba do Sul River (9.69 and 0.59 t∙year-1, respectively) compared to the other assessed fluvial systems. Also, this study demonstrated that, if a dam is closer to the mouth of a river, less contaminants will be input.

Biological Characterization and Antimicrobial Bioactives of Mycelium Extracts from Medicinal Mushrooms Phellinus linteus and Pleurotus albidus (Agaricomycetes).

Bioactivity is defined as the intrinsic property of compounds that enables their participation in specific biological reactions. This study aimed to evaluate the antimicrobial capacity and to separate and characterize bioactives from aqueous and hydroalcoholic extracts obtained from the mycelium of medicinal mushrooms Pleurotus albidus and Phellinus linteus. Antimicrobial activity, through the disc diffusion method, was found against strains of Bacillus cereus, B. subtilis, Pseudomonas aeruginosa, and Staphylococcus aureus. P. albidus extracts showed better activity against Bacillus strains, whereas Ph. linteus extracts had greater effectiveness against S. aureus and P. aeruginosa. Aqueous extraction was best for obtaining bioactive compounds of P. albidus, whereas 30% hydralcoholic extraction performed best for obtaining Ph. linteus. Mass spectrometry analyses allowed the identification of the main chemical compounds extracted from the fungal biomasses, including glutathione oxidase, leucovorin, and riboflavin. Taking these findings into consideration, P. albidus and Ph. linteus might be used as sources of bioactive molecules for the development of novel drugs or nutraceuticals, contributing to the improvement of public health.

Spatial-temporal dynamics of Cr in fish from Puruzinho Lake (Western Amazon) and dietary risk assessment.

Cr contamination is a growing concern in the Amazon. Along with the rise of cattle farming in the region, tanneries are becoming more common and threatening environmental quality, since the effluents from this activity are rich in Cr. The objective of this study was to evaluate the seasonal and spatial dynamics of Cr in fish with different feeding habits from Puruzinho Lake, located in the Madeira River basin, also determining the daily intake of Cr associated with the consumption of these fish by the population that lives around the lake. Seasonality and feeding habits directly affected Cr dynamics in fish (p < 0.0001), with medians of Cr concentration ranging between 0.07 mg kg-1 in the species Cichla pleiozona, a carnivorous fish, and 0.62 mg kg-1 in Mylossoma duriventre, a herbivorous fish. The high Cr concentrations in M. duriventre were related to the biodilution effect of Cr in the trophic chain (R2 = 0.14, p < 0.0001). The consumption of M. duriventre by the population was associated with the highest daily intake of Cr (55.5 µg∙day-1), exceeding the recommended limits of Cr intake (35 µg∙day-1). However, no harmful effects on health are expected due to the ingestion of Cr through the consumption of fish from Puruzinho Lake. Spatial analysis showed an increasing trend in Cr concentrations along the Madeira River, suggesting that contaminants present in the river are being carried over long distances and are reaching preserved areas of the Amazon.

The Role of COVID-19 Vaccinal Status in Admitted Children during OMICRON Variant Circulation in Rio de Janeiro, City-Preliminary Report.

Objective: To evaluate COVID-19 vaccination status in admitted children in 2020−2021 and during the OMICRON variant circulation (2022), a period when children older than 12 years of age had received two doses of COVID-19 vaccines. Design: An observational retrospective study. Patients with confirmed COVID-19 were compared in two different periods: 2020−2021 when adolescents aged 12−18 years had not received the complete COVID-19 vaccine, and 2022 when children older than 12 years had received the complete Pfizer-BioNTech vaccine scheme. Setting: Two pediatric hospitals in Rio de Janeiro city. Patients: Children aged < 18 years with confirmed COVID-19. Intervention: None. Main outcome: Vaccination status for COVID-19 on admission. Results: In total, 300 patients were admitted with confirmed COVID-19 (240 in 2020−2021 and 60 in 2022). The distribution of patients according to the age-groups was: 0−2 years (33.3% in 2020−2021 and 53.4% in 2022), 2−5 years (21.7% in 2020−2021 and 10% in 2022), 5−11 years (29.2% in 2020−2021 and 28.3% in 2022), and 12−18 years (15.8% in 2020−2021 and 8.3% in 2022) (p = 0.076). The median length of stay was six days in 2020−2021 and six days in 2022 (p = 0.423). We verified six deaths in the first analysis period and one death in the second one (p = 0.894). Of the 60 children admitted in 2022, 58 (96.7%) did not receive the complete COVID-19 vaccine scheme available. Conclusions: We verified in a "real-world condition" the ability of the Pfizer-BioNTech vaccine to prevent hospitalization in children over 12 years of age.

Efeito de um programa de acompanhamento farmacoterapêutico em pacientes com hipertensão arterial sistêmica / Effect of a pharmacotherapeutic follow-up program in patients with systemic arterial hypertension

A Hipertensão Arterial Sistêmica (HAS) é uma condição clínica multifatorial, com tratamento não-farmacológico e/ou farmacológico, que necessita de acompanhamento farmacoterapêutico para gestão da condição de saúde. O objetivo foi avaliar o impacto de um programa de acompanhamento farmacoterapêutico em pacientes com HAS, através do estudo quase-experimental, longitudinal e prospectivo. Foram avaliados 28 pacientes, 50% estavam com pressão arterial descompensada, os PRM (Problemas Relacionados à Medicamentos) identificados foram interações medicamentosas (57,1%), duplicidade farmacoterapêutica (28,8%), medicamentos potencialmente inapropriados para idosos (38,5 %) e não adesão ao tratamento (89,3%). Dos RNM (Resultado Negativos associados à Medicação) 56,2% relacionavam-se à segurança e 37,5% à efetividade. Após o acompanhamento, 56,3% dos RNM foram resolvidos, 57,1% dos pacientes aderiram ao tratamento e houve redução da Pressão Arterial Sistólica (p=0,010) e Pressão Arterial Diastólica (p=0,020). O programa mostrou-se favorável na redução da pressão arterial sistêmica e resolução dos PRM e RNM.

Systemic Arterial Hypertension (SAH) is a multifactorial clinical condition with non-pharmacological and/or pharmacological treatment that requires pharmacotherapeutic monitoring in order to manage the health condition. The objective was to evaluate the impact of a pharmacotherapeutic follow-up program of patients with SAH through a quasi-experimental, longitudinal, and prospective study. Twenty-eight patients were evaluated, 50% of which had decompensated blood pressure; the DRPs identified were drug interactions (57.1%), pharmacotherapeutic duplication (28.8%), potentially inappropriate medication use in older adults (38.5%), and non-adherence to treatment (89.3%). Of the NOM identified (Negative Outcomes associated with Medication), 56.2% were related to safety, and 37.5% to effectiveness. After the follow-up, 56.3% of the NOM were resolved, 57.1% of patients adhered to treatment, and there was a reduction in the Systolic Blood Pressure (p = 0.010) and Diastolic Blood Pressure (p = 0.020). The program proved to be efficient in reducing systemic blood pressure and resolving DRPs and NOM.

Evaluation of the Antioxidant and Antimicrobial Activity of the Culinary-Medicinal Mushroom Lentinula boryana (Agaricomycetes) from Brazil.

Mushrooms can be used in culinary applications, as a source of antioxidants, and for many therapeutic purposes. Foods are a natural source of antioxidant compounds, molecules that can inhibit oxidation of other molecules through the removal of free radicals, and thus play an important role in the protection of an organism's health. Phenolic compounds are secondary metabolites widely present in vegetables and mushrooms. Some studies highlight the capacity of mushrooms to produce antioxidant, antimicrobial, and antitumoral substances. This study aimed to evaluate the antioxidant capacity (with the ABTS, Trolox equivalent antioxidant capacity, and ferric reducing antioxidant power methods) and antimicrobial activity (disc diffusion method) of an Lentinula boryana isolate, using its mycelium as the primary material of study. The results showed that L. boryana has benefits such as antioxidant activity in medicinal and culinary uses.

Use of an evidence-based health portal to improve teaching and learning in primary care: a mixed methods evaluation.

BACKGROUND: Worldwide, primary care is for most people the gateway into many health systems. Offering solutions to the demands of the communities served requires the constant preparation of professionals, especially doctors and medical undergraduate students. We analyze and propose ways to improve the teaching and learning processes facilitated by the Basic Family Health Units (BFHUs) based on the use of electronic portals with evidence-based medicine criteria. METHOD: First phase: The authors conducted a qualitative-quantitative study on students and instructors of primary care (PC) medicine by administering a survey of open- and closed-ended questions at medical schools. The closed-ended questions were studied with descriptive statistics, and open-ended questions were analyzed via the creation of categories. Perceptions of major teaching and learning problems were then identified. Second phase: Meetings were held with students and their instructors for 6 months and involved the use of electronic portals and the application of new questionnaires using a Likert scale for pre- and postevaluation. RESULTS: In the first phase, 40% of the students considered local instructor training levels a problem. A similar result was found regarding teachers' lectures, revealing a lack of adequate PC training and performance. Building on our results, we focused on BFHUs to apply new strategies for teaching and learning, such as the use of the Evidence-Based Health (SBE) Portal, which includes several databases with clinical evidence criteria. In the second phase, the authors identified an improvement in the quality of learning among instructors and students. This outcome improved safety in daily clinical practice in PC, possibly with better results for its users. CONCLUSIONS: The use of electronic portals can facilitate BFHU teaching and learning and promote the health of users.

Influence of Iron on Physiological Parameters and Intracellular Microcystin in Microcystis Panniformis Strain Isolated from a Reservoir in the Amazon.

In the Amazon, the leaching from soil left unprotected by deforestation increases the entry of iron, among other elements, in aquatic ecosystems, which can cause cyanobacterial blooms. This study aimed to investigate the physiological response of a strain of Microcystis panniformis to iron variation. The strain was isolated from a reservoir located in the Western Amazon and produces microcystin-LR. After a period of iron deprivation, the cultures were submitted to three conditions: control (223 µgFe.L-1), treatment with 23 µgFe.L-1, and absence of iron. At regular intervals for eight days, the cell density, levels of chlorophyll a and microcystins were determined. On the second and fourth day, transcription of genes responsive to iron limitation was quantified. Starting on the fourth day of the experiment, the different iron concentrations affected growth, and on the eighth day in the iron-free condition cell density was 90% lower than in control. Chlorophyll cell quota in 23 µgFe.L-1 and control presented similar values, while without iron the cells became chlorotic as of the fourth day Toxin concentration in cells grow in 0 µgFe.L-1 in relation to the control. Higher transcription levels of the feo and fut genes were observed in the 0 µgFe.L-1 and 23 µgFe.L-1 treatments, indicating that the cells were activating high-affinity capture systems to reestablish an adequate concentration of intracellular iron. The increasing deforestation in the Jamari River Basin (Amazon region), can contribute to the occurrence of toxic cyanobacterial blooms due to the greater entrance of iron in water bodies.

Lessons from a Surgical Center Satellite Warehouse in a Large Brazilian Public Hospital.

Brazilian public hospitals face several operational problems not only related to poor public management practices and their complex nature, but also the economic, and social contexts. Considering this scenario and the fact that efforts in supply management might affect a hospital organization's excellence, this research aims to identify improvements in the logistic operations at the surgical center satellite warehouse of a Public Hospital located in Brazil. A case study based on an exploratory and qualitative approach was conducted by employing document analysis, semi-structured interviews, and on-site observations. Seven major problems concerning lack of surgical material, the non-definition of crucial logistic parameters, low information flow, surgical supply control, and management problems were pointed and addressed by seven independent but complementary actions that considered the Brazilian healthcare system's particularities. Given the nature of exploratory research, the results are not exhaustive and cannot be generalized to different contexts. However, they help understand that reducing the waste of the logistics processes makes it possible to improve the attention to the local population that uses public health services.

Impacto das intervenções dirigidas às grávidas com VIH/SIDA: Uma revisão integrativa / Impact of interventions directed to pregnant women with HIV/AIDS: An integrative review

A expansão do vírus da imunodeficiência humana/síndrome de imunodeficiência adquirida na população feminina, fez com que as políticas de saúde se voltassem para as mulheres com uma atenção especial, devido a possibilidade de transmissão vertical. Neste contexto, destaca-se o papel fundamental dos profissionais de sáude, como os enfermeiros, que prestam assistência direta e contínua às mães portadoras do vírus da imunodeficiência humana e crianças expostas ao vírus, sendo peças fundamentais na promoção da saúde do binômio. Desta forma, este estudo teve como objetivo analisar na literatura científica as evidências relacionadas com as intervenções dirigidas às grávidas com diagnóstico positivo para o vírus da imunodeficiência humana/síndrome de imunodeficiência adquirida, que já tenham iniciado o tratamento como forma de reduzir a transmissão vertical. Optamos por uma revisão integrativa, de acordo com as cinco etapas propostas por Whittemore e Knafl (2005): formulação do problema, pesquisa da literatura, avaliação dos dados, análise e interpretação dos dados, e apresentação dos resultados. Os bancos de dados selecionados para a pesquisa foram: Medline (via PubMed), EBSCOH, Portal de Periódicos CAPES/MEC, e Biblioteca Virtual em Saúde. Foram encontrados 10.799 artigos e os critérios para seleção foram: período de publicação compreendido entre janeiro de 2010 e janeiro de 2020; programas voltados para grávidas maiores de 18 anos, artigos em inglês e português e que abordassem diretamente o tema. Dessa forma, foram selecionados e incluídos 24 artigos nesta revisão. A análise foi baseada em leituras reiterativas para direcionar o agrupamento de dados e temas, de onde emergiram 9 focos temáticos: Aconselhamento, Participação Masculina, TARV, Comunicação, Capacitação profissional, Apoio Psicossocial, Incentivo monetário, Teste CD4 e Notificação e Vigilância. Observou-se grande variedade de intervenções dirigidas às grávidas com vírus da imunodeficiência humana / síndrome de imunodeficiência adquirida envolvendo os profissionais de saúde, a comunidade, família, marido e fornecimento precoce de antiretrovirrais, para evitar a transmissão vertical e a importância de estratégias eficazes para reduzir as demandas provenientes desse contexto. A aplicação da estratégia mais adequada na implementação da prevenção da transmissão vertical é altamente eficaz para reduzir o número de transmissão do vírus da imunodeficiência humana/síndrome de imunodeficiência adquirida da mãe para o filho. Com esta revisão não podemos precisar qual a estratégia mais eficiente, no entanto, podemos explanar quais as intervenções mais utilizadas e como tem sido sua aplicação, conduzindo assim, a uma linha de intervenções que devem ser refletidas e utilizadas conforme as particularidades de cada contexto.

The expansion of the human immunodeficiency virus/acquired immunodeficiency syndrome in the female population, made health policies to focus on women with special attention, due to the possibility of vertical transmission. In this context, the fundamental role of health professionals, such as nurses, who provide direct and continuous assistance to mothers with the human immunodeficiency virus and children exposed to the virus is highlighted, being fundamental parts in promoting the health of the binomial. Thus, this study aimed to analyze in the scientific literature the evidence related to measures aimed at pregnant women with a positive diagnosis for the human immunodeficiency virus/acquired immunodeficiency syndrome, which has already started treatment as a way to reduce vertical transmission. We opted for an integrative review, according to the five steps proposed by Whittemore and Knafl (2005): problem transportation, literature search, data evaluation, data analysis and interpretation, and presentation of results. The databases selected for a research were: Medline (via PubMed), EBSCOH, CAPES/MEC Journals Portal, and Virtual Health Library. 10,799 articles were found, and the selection criteria were: comprehension period between January 2010 and January 2020; programs for pregnant women over 18, articles in English and Portuguese, and that directly addressed the topic. Thus, 24 articles were selected and included in this review. The analysis was based on repeated readings to guide the grouping of data and themes, from which 9 thematic focuses emerged: Counseling, Male Participation, ART, Communication, Professional Training, Psychosocial Support, Monetary Incentive, CD4 Test and Notification and Surveillance. There was a wide variety of interventions aimed at pregnant women with human immunodeficiency virus /acquired immunodeficiency syndrome involving health professionals, the community, family, husband, and early antiretroviral drugs, to avoid vertical transmission and the importance of motivating to reduce the demands arising from that context. The application of the most appropriate strategy in the implementation of prevention of vertical transmission is highly effective in reducing the number of transmission of human immunodeficiency virus / acquired immunodeficiency syndrome from mother to child. With this review, we cannot need a more efficient strategy, however, we can explain which measures are most used, and how they have been applied, thus leading to a line of actions that must be reflected and used according to the particularities of each context.

Arsenic in the lower drainage basin of the Paraíba do Sul River (Southeast Brazil): dynamics between the water column and sediment.

The presence of arsenic (As) in the sediment and the particulate and dissolved fractions of the water column determines its behavior and bioavailability. The main geochemical parameters responsible for As mobility are organic matter and oxide-forming metals such as Fe. The As distribution and its concentration were evaluated in the dissolved fraction, suspended particulate matter (SPM) and sediment of the lower Paraíba do Sul River (PSR), its main tributaries (Muriaé, Pomba, and Dois Rios rivers), and flooded and estuarine areas. As was not detected in the dissolved fraction. The river flow influenced the As concentration in the SPM, which was higher in the dry season than in the rainy season (2.6 ± 0.69 and 1.98 ± 0.29 mg kg-1, respectively). The Fe oxyhydroxides, organic carbon, and surface area measured in the sediment were positively related with As concentration (R2 = 0.11, 0.34, and 0.30; p < 0.05). The highest As concentrations in the sediment occurred in the secondary estuary and flooded areas (5.16 ± 4.78 and 1.23 ± 0.44 mg kg-1, respectively), in which finer granulometric fractions (silt and clay) predominated (64% and 71%, respectively), in addition to greater surface area. The measurement of stable carbon and nitrogen isotopes (δ13C and δ15N) and atomic ratio (C:N)a indicated the existence of a combination of autochthonous and allochthonous sources of organic matter composing the SPM. In general, the As concentrations in the sediment and SPM were low, with values below that permitted by Brazilian regulations (5.9 mg kg-1), which suggests that the As sources in the lower basin of the PSR are diffuse and natural.

Mercury biomagnification in an ichthyic food chain of an amazon floodplain lake (Puruzinho Lake): Influence of seasonality and food chain modeling.

Mercury (Hg) biomagnification in fish food chains is a relevant subject due to the high fish consumption of the Amazonian population and the high toxicity of this metal. In the Amazon, floodplain lake hydrodynamics change considerably along the four seasons of the hydrological cycle (rising water, high water, falling water and low water), which can influence Hg bioaccumulation in fish. The main aim of this study was to evaluate if Hg biomagnification is influenced by seasonality in a floodplain lake (Puruzinho Lake) in the Brazilian Amazon. Additionally, the influence of food chain modeling on measurement of Hg biomagnification was tested. Hg concentrations and stable isotope signatures (carbon and nitrogen) were estimated in four species, Mylossoma duriventre (herbivorous), Prochilodus nigricans (detritivorous), Cichla pleiozona (piscivorous) and Serrasalmus rhombeus (piscivorous). The "trophic magnification slope" (TMS) of the food chain composed by the four species was calculated and compared among the four seasons. There was no significant seasonal variation in TMS among rising water, high water, falling water and low water seasons (p = 0.08), suggesting that Hg biomagnification does not change seasonally. However, there was significant variation in TMS among different food chain models. Lower TMS was observed in a food chain composed of detritivorous and piscivorous fish (0.20) in comparison with a food chain composed of the four species (0.26). The results indicate food chain modeling influences TMS results.

The first evidence about conceptual vs analytical lean healthcare research studies.

PURPOSE: Several authors have examined the lean healthcare literature, but besides all efforts made, articles comparing conceptual and analytical studies were not found. Thus, a systematic review is conducted aiming to understand the state of the art of lean healthcare by investigating and comparing how conceptual and analytical articles address tools/methods, application fields, implementation barriers and facilitators and positive and negative impacts. DESIGN/METHODOLOGY/APPROACH: Articles in English about lean healthcare, published in journals in the last ten years (2009-2018) and indexed in Web of Science (WoS) or Scopus were examined and assessed by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) protocol. A qualitative content analysis on the eligible articles was conducted, and results from the conceptual and analytical studies were compared. FINDINGS: There is a literature gap regarding tools/methods in both conceptual and analytical approaches once they prioritize for different items. Barriers, facilitators and negative impacts are perceived differently within both categories and might require more extensive analysis. The same items prevail in both conceptual and analytical categories when analyzing healthcare fields and positive impacts. ORIGINALITY/VALUE: There is a lack of articles comparing conceptual and analytical studies concerning lean healthcare. So, this study's relevance is in identifying theoretical and applied research gaps to strengthen the lean healthcare state of the art and to integrate theoretical-applied knowledge. For healthcare professionals, it might provide an overview of the key factors that can promote lean implementation.

Gestational outcomes in women infected by Zika virus during pregnancy in Mato Grosso do Sul, Brazil: A cross-sectional study.

OBJECTIVES: This study aimed to describe the demographic and clinical parameters of women infected by Zika virus who had infants with stigmata of Congenital Zika Syndrome (CZS) versus those who had normal-appearing infants at birth, thereby providing further details on the clinical caveats of neonatal ZIKV infection. METHODOLOGY: This cross-sectional study was performed in the state of Mato Grosso do Sul, Central-West region of Brazil, and included 117 mother-infant pairs who were interviewed and 120 gestational outcomes. All mothers had laboratory confirmation by qRT-PCR of ZIKV infection during pregnancy. RESULTS: The prevalence of congenital abnormalities related to ZIKV was 2.69 cases per 10,000 live births during this period. Exanthem was the main clinical finding, observed in 92.5% of the mothers in this study. Regarding the timing of ZIKV infection, the first trimester was the most frequent time of infection among mothers of infants with CZS (54.55%) (p=0.0007). The case fatality rate was 5% (n=6). Among the 23 children who were classified as having CZS, 13 (56.52%) of them presented with microcephaly. Only 13 (56.52%) children with CZS were tested by qRT-PCR for ZIKV infection at birth, five (38%) were positive. CONCLUSIONS: This study highlights the congenital alterations of ZIKV infection during pregnancy in an epidemic burst, demonstrating that the alterations found in other studies are similar to the present research.

Biochemical Properties and Effects on Mitochondrial Respiration of Aqueous Extracts of Basidiomycete Mushrooms.

There are different varieties of mushrooms not yet studied spread all over the planet. The objective of this study was to evaluate biochemical properties and effects on mitochondrial respiration of eight Basidiomycete mushrooms: Flaviporus venustus EF30, Hydnopolyporus fimbriatus EF41 and EF44, Inonotus splitgerberi EF46, Oudemansiella canarii EF72, Perenniporia sp. EF79, Phellinus linteus EF81, and Pleurotus albidus EF84. Total phenols, ABTS, TEAC, FRAP, and ORAC were measured in order to determine the antioxidant capacity. Antimicrobial potential was studied by disc-diffusion and microdilution method. Cytotoxicity was determined in murine peritoneal macrophages. The bioenergetic aspects were evaluated by the uncoupling of the oxidative phosphorylation in mitochondrias. The H. fimbriatus mushroom was the one that presented the most significant results for the antioxidant assays. Three mushrooms presented antimicrobial activity, indicating a potential for formulation of drugs. The results suggest that I. spligerberi has an uncoupling activity, even at the lowest concentration tested, dissipating the mitochondrial electrochemical gradient. On the other hand, P. albidus has effect only on succinate-oxidase activity without influencing mitochondrial respiratory efficiency. Therefore, both interfere negatively in mitochondrial respiration. In relation with the cytotoxicity in peritoneal macrophages, O. canarii and F. venustus were cytotoxic in this type of cells.