Change in Age profile of Respiratory Syncytial Virus disease over the course of annual epidemics: a multi-national study.

OBJECTIVES: We aimed to study whether the percentwise age distribution of RSV cases changes over time during annual epidemics. METHODS: We used surveillance data (2008-2019) from the Netherlands, Lyon (France), Portugal, Singapore, Ecuador, South Africa, and New Zealand. In each country, every season was divided into "epidemic quarters", i.e. periods corresponding to each quartile of RSV cases. Multinomial logistic regression models were fitted to evaluate whether the likelihood of RSV cases being aged <1 or ≥5 years (vs. 1 to <5) changed over time within a season. RESULTS: In all countries, RSV cases were significantly more likely to be aged <1 year in the 4th vs. 1st epidemic quarter; the relative risk ratio [RRR] ranged between 1.35 and 2.56. Likewise, RSV cases were significantly more likely to be aged ≥5 years in the 4th vs. 1st epidemic quarter (except in Singapore); the RRR ranged from 1.75 to 6.70. The results did not change when stratifying by level of care or moving the lower cut-off to 6 months. CONCLUSIONS: The age profile of RSV cases shifts within a season, with infants and adolescents, adults, and the elderly constituting a higher proportion of cases in the later phases of annual epidemics. These findings may have implications for RSV prevention policies with newly approved vaccines.

Description of an intramonocytic haemoparasite, Hepatozoon lainsoni sp. nov. (Apicomplexa: Adeleorina: Hepatozoidae), infecting Ameiva ameiva lizard (Reptilia: Squamata: Teiidae) in northern Brazil.

Haemogregarine (Apicomplexa: Adeleorina) parasites are considered to be the most common and widespread haemoparasites in reptiles. The genus Hepatozoon (Apicomplexa: Adeleorina: Hepatozoidae) can be found parasitizing a broad range of species and, in reptiles, they infect mainly peripheral blood erythrocytes. The present study detected and characterized a haemogregarine isolated from the lizard species, Ameiva ameiva, collected from the municipality of Capanema, Pará state, north Brazil. Blood smears and imprints from lungs, brain, heart, kidney, liver, bone marrow and spleen were observed using light microscopy and the parasite was genetically identified by molecular analysis. Morphological, morphometric and molecular data were obtained. Parasite gamonts were found in 49.5% (55/111) of the blood smears from A. ameiva, and were characterized as oval, averaging 12.0 ± 0.8 × 5.9 ± 0.6 µm2 in size, which displaced the nuclei of parasitized monocytes laterally. Parasite forms resembling immature gamonts were observed in the spleen and bone marrow of the lizards. Furthermore, phylogenetic analyses of 18S rRNA sequences did not reveal gene similarity with other Hepatozoon spp. sequences from reptiles. Thus, morphological and molecular analyses have identified a new species of Hepatozoon parasite, Hepatozoon lainsoni sp. nov., which infects monocytes of the A. ameiva lizard.

Excess mortality in Europe coincides with peaks of COVID-19, influenza and respiratory syncytial virus (RSV), November 2023 to February 2024.

Since the end of November 2023, the European Mortality Monitoring Network (EuroMOMO) has observed excess mortality in Europe. During weeks 48 2023-6 2024, preliminary results show a substantially increased rate of 95.3 (95% CI:  91.7-98.9) excess all-cause deaths per 100,000 person-years for all ages. This excess mortality is seen in adults aged 45 years and older, and coincides with widespread presence of COVID-19, influenza and respiratory syncytial virus (RSV) observed in many European countries during the 2023/24 winter season.

COVID-19 vaccine effectiveness against symptomatic infection with SARS-CoV-2 BA.1/BA.2 lineages among adults and adolescents in a multicentre primary care study, Europe, December 2021 to June 2022.

BackgroundScarce European data in early 2021 suggested lower vaccine effectiveness (VE) against SARS-CoV-2 Omicron lineages than previous variants.AimWe aimed to estimate primary series (PS) and first booster VE against symptomatic BA.1/BA.2 infection and investigate potential biases.MethodsThis European test-negative multicentre study tested primary care patients with acute respiratory symptoms for SARS-CoV-2 in the BA.1/BA.2-dominant period. We estimated PS and booster VE among adults and adolescents (PS only) for all products combined and for Comirnaty alone, by time since vaccination, age and chronic condition. We investigated potential bias due to correlation between COVID-19 and influenza vaccination and explored effect modification and confounding by prior SARS-CoV-2 infection.ResultsAmong adults, PS VE was 37% (95% CI: 24-47%) overall and 60% (95% CI: 44-72%), 43% (95% CI: 26-55%) and 29% (95% CI: 13-43%) < 90, 90-179 and ≥ 180 days post vaccination, respectively. Booster VE was 42% (95% CI: 32-51%) overall and 56% (95% CI: 47-64%), 22% (95% CI: 2-38%) and 3% (95% CI: -78% to 48%), respectively. Primary series VE was similar among adolescents. Restricting analyses to Comirnaty had little impact. Vaccine effectiveness was higher among older adults. There was no signal of bias due to correlation between COVID-19 and influenza vaccination. Confounding by previous infection was low, but sample size precluded definite assessment of effect modification.ConclusionPrimary series and booster VE against symptomatic infection with BA.1/BA.2 ranged from 37% to 42%, with similar waning post vaccination. Comprehensive data on previous SARS-CoV-2 infection would help disentangle vaccine- and infection-induced immunity.

On activism and knowledge: the experience of cannabis associations in Brazil. / Sobre ativismos e conhecimentos: a experiência de associações canábicas no Brasil.

The emergence of civil associations in favor of cannabis began in the 2010s. Faced with the inertia of the State, these organizations have acted in the reception, support, information, training, and facilitation of access for patients and their families to the medicine produced from marijuana, a prohibited substance in Brazil. This study aims to analyze how cannabis activism promoted by Brazilian associations is based on scientific knowledge or knowledge acquired through the experience of members. The methodology included interviews with participants from the ACuCa, Ama+me, and Apepi associations, as well as the Content Analysis of the profiles of these institutions on Instagram. It was found that cannabis activism on Instagram is similar to that practiced in person; however, activism on social media prioritizes the dissemination of knowledge through information and training of its followers, being careful to treat the content in order to suit the guidelines of the platform. In addition, the main lines of action of cannabis associations (reception and distribution of medicinal oils) appear in a veiled way in the publications, most of which occur through private conversations in the media with the associations.

O surgimento de associações civis em prol da cannabis se iniciou na década de 2010. Diante da inércia do Estado, essas organizações têm atuado no acolhimento, apoio, informação, capacitação e facilitação do acesso de pacientes e familiares a medicamento produzido à base de maconha, substância proibida no Brasil. Este estudo visa analisar como o ativismo canábico promovido pelas associações brasileiras se fundamenta em conhecimentos científicos ou adquiridos pela vivência dos associados. A metodologia englobou entrevistas com participantes das associações ACuCa, Ama+me e Apepi e análise de conteúdo dos perfis dessas instituições no Instagram. Verificou-se que o ativismo canábico no Instagram apresenta semelhanças com aquele praticado presencialmente, no entanto, o ativismo nas mídias sociais prioriza a divulgação do conhecimento pela informação e capacitação de seus seguidores, tendo o cuidado de tratar o conteúdo para se adequar às diretrizes da plataforma. Além disso, as principais linhas de atuação do associativismo canábico (acolhimento e distribuição de óleos medicinais) aparecem de forma velada nas publicações, sendo que em sua maioria ocorrem em conversas privadas nos meios de comunicação com as associações.

Polymeric nanoparticles containing kojic acid induce structural alterations and apoptosis-like death in Leishmania (Leishmania) amazonensis.

Leishmaniasis encompasses a cluster of neglected tropical diseases triggered by kinetoplastid phatogens belonging to the genus Leishmania. Current therapeutic approaches are toxic, expensive, and require long-term treatment. Nanoparticles are emerging as a new alternative for the treatment of neglected tropical diseases. Silk Fibroin is a biocompatible and amphiphilic protein that can be used for formulating nanoemulsions, while kojic acid is a secondary metabolite with antileishmanial actions. Thus, this study evaluated the efficacy of a nanoemulsion, formulated with silk fibroin as the surfactant and containing kojic acid (NanoFKA), against promastigote and amastigote forms of Leishmania (Leishmania) amazonensis. The NanoFKA had an average particle size of 176 nm, Polydispersity Index (PDI) of 0.370, and a Zeta Potential of -32.3 mV. It presented inhibitory concentration (IC50) values of >56 µg/mL and >7 µg/mL for the promastigote and amastigote forms, respectively. Ultrastructural analysis, cell cycle distribution and phosphatidylserine exposure showed that NanoFKA treatment induces apoptosis-like cell death and cell cycle arrest in L. (L.) amazonensis. In addition, NanoFKA exhibited no cytotoxicity against macrophages. Given these results, NanoFKA present leishmanicidal activity against L. (L.) amazonensis.

Do spirituality and emotional intelligence improve the perception of the ability to provide care at the end of life? The role of knowledge and self-efficacy.

OBJECTIVES: Spirituality, emotional intelligence, and palliative care (PC) knowledge have a positive and direct influence on self-efficacy and on perception of preparation and ability to provide end-of-life (EOL) care. The aim of this work is to propose a conceptual model that relates spirituality, emotional intelligence, PC knowledge, self-efficacy, and the preparation and ability to provide EOL care by doctors and nurses. METHODS: Quantitative, exploratory, descriptive, and inferential study applied to doctors and nurses in a hospital in the north of Portugal, between May and July 2022. The data collection instrument includes a questionnaire. The relationships between latent variables were evaluated using structural equation models by the partial least squares method using the Smart PLS 3.0 software. It was obtained the previous authorization of the ethics committee. RESULTS: The results (n = 380) indicate that self-efficacy, spirituality, and PC knowledge have a positive influence on the ability to provide EOL care. Emotional intelligence and spirituality have a direct and positive effect on self-efficacy. There is no direct influence of emotional intelligence on the ability to provide EOL care, but emotional intelligence has an indirect effect mediated by self-efficacy. SIGNIFICANCE OF RESULTS: Spirituality, self-efficacy, and emotional intelligence are very important for the ability of doctors and nurses to provide EOL care. The identification of predictive factors of the ability to provide EOL care and the determination of the relationship between them can improve the provision of EOL care, reduction of health costs, timely and early referral of people to PC, and increase life quality.

Interim 2023/24 influenza A vaccine effectiveness: VEBIS European primary care and hospital multicentre studies, September 2023 to January 2024.

Influenza A viruses circulated in Europe from September 2023 to January 2024, with influenza A(H1N1)pdm09 predominance. We provide interim 2023/24 influenza vaccine effectiveness (IVE) estimates from two European studies, covering 10 countries across primary care (EU-PC) and hospital (EU-H) settings. Interim IVE was higher against A(H1N1)pdm09 than A(H3N2): EU-PC influenza A(H1N1)pdm09 IVE was 53% (95% CI: 41 to 63) and 30% (95% CI: -3 to 54) against influenza A(H3N2). For EU-H, these were 44% (95% CI: 30 to 55) and 14% (95% CI: -32 to 43), respectively.

Influenza vaccine effectiveness in Europe: Results from the 2022-2023 VEBIS (Vaccine Effectiveness, Burden and Impact Studies) primary care multicentre study.

Background: Influenza A(H3N2) viruses dominated early in the 2022-2023 influenza season in Europe, followed by higher circulation of influenza A(H1N1)pdm09 and B viruses. The VEBIS primary care network estimated the influenza vaccine effectiveness (VE) using a multicentre test-negative study. Materials and Methods: Primary care practitioners collected information and specimens from patients consulting with acute respiratory infection. We measured VE against any influenza, influenza (sub)type and clade, by age group, by influenza vaccine target group and by time since vaccination, using logistic regression. Results: We included 38 058 patients, of which 3786 were influenza A(H3N2), 1548 influenza A(H1N1)pdm09 and 3275 influenza B cases. Against influenza A(H3N2), VE was 36% (95% CI: 25-45) among all ages and ranged between 30% and 52% by age group and target group. VE against influenza A(H3N2) clade 2b was 38% (95% CI: 25-49). Overall, VE against influenza A(H1N1)pdm09 was 46% (95% CI: 35-56) and ranged between 29% and 59% by age group and target group. VE against influenza A(H1N1)pdm09 clade 5a.2a was 56% (95% CI: 46-65) and 79% (95% CI: 64-88) against clade 5a.2a.1. VE against influenza B was 76% (95% CI: 70-81); overall, 84%, 72% and 71% were among 0-14-year-olds, 15-64-year-olds and those in the influenza vaccination target group, respectively. VE against influenza B with a position 197 mutation of the hemagglutinin (HA) gene was 79% (95% CI: 73-85) and 90% (95% CI: 85-94) without this mutation. Conclusion: The 2022-2023 end-of-season results from the VEBIS network at primary care level showed high VE among children and against influenza B, with lower VE against influenza A(H1N1)pdm09 and A(H3N2).

Cobertura vacinal e fatores associados ao esquema incompleto de vacinação em crianças aos 12 e 24 meses de idade em cidade de médio porte na região nordeste do Brasil / Vaccination coverage and factors associated with incomplete vaccination schedule in children at 12 and 24 months of age in a medium-sized city in the northeastern region of Brazil

Introdução: A expressiva queda nas coberturas vacinais, no Brasil, a partir de 2016, que persistem até os dias atuais, constitui relevante problema de saúde pública, tornando prioridade estudos sobre seus determinantes em diferentes contextos. Objetivo: Estimar a cobertura vacinal atualizada e oportuna aos 12 e 24 meses para cada vacina e para o esquema completo e analisar os fatores associados aos esquemas incompletos, atualizado e oportuno, de vacinação em coorte de nascidos em 2018, em Arapiraca. Métodos: Estudo transversal, descritivo e analítico, em amostra representativa da coorte de nascidos vivos, em Arapiraca (AL), em 2018. As fontes de informação foram: Sistema de Informação de Nascidos Vivos; Sistema de Informação sobre Mortalidade; Prontuário Eletrônico do Cidadão; Registros de vacinação e Prontuários das Unidades Sanitárias. Foram estimadas as coberturas vacinais atualizadas e oportunas por vacina e do esquema completo em porcentagem e com intervalo de confiança de 95%, por zona rural e urbana. A associação entre o esquema incompleto de vacinação e as variáveis independentes foi investigada por meio da estimativa das razões de prevalência bruta e ajustada e os respectivos intervalos de 95% confiança, aplicando-se a regressão de Poisson. Resultados: Foram estudadas 318 crianças. A cobertura média do esquema vacinal completo e atualizado aos 12 meses foi 91,8%, respectivamente, 93,6% e 88,8%, nas áreas urbanas e rurais; aos 24 meses declinou para 75,2%, respectivamente, 76,2% e 73,3%, em zonas urbanas e rurais. A cobertura oportuna aos 12 meses, foi de 47,8%, sendo mais elevada na zona rural, 50,9% versus 46,0% (p>0,05), enquanto que aos 24 meses declina para 9,1%, sendo mais elevada em áreas rurais, 14,7% versus 5,9% (p<0,05). As vacinas com menores coberturas foram: i) esquema atualizado aos 12 meses, a segunda dose da Rotavírus Humano com 96,2% e aos 24 meses, a primeira dose de Varicela e a dose única de Hepatite A com 92,1%; ii) esquema oportuno aos 12 meses, temos a terceira dose de VIP/VOP, com 66,7%, e aos 24 meses, foi o primeiro Reforço da DTP, com 24,5%. As exposições que se mostraram independentemente associadas ao esquema incompleto atualizado e oportuno aos 12 e 24 meses foram: escolaridade da mãe inferior a oito anos ou igual/superior a 12 anos de estudo; mãe com menos de sete consultas de pré-natal; mãe residente em área rural; nascer com menos de 2.800 gramas. Contudo, mostrou-se inversamente associado ao desfecho: nascer com menos de 2.800 gramas no esquema incompleto atualizado aos 12 meses; nascer com peso entre 2.800 e 3199 gramas no esquema incompleto oportuno aos 12 meses; residir em área rural no incompleto oportuno aos 24 meses. Conclusões: Os resultados sugerem, entre as estratégias para aumentar as coberturas vacinais: políticas educativas com foco específico em segmentos mais pobres e mais ricos da população; o fortalecimento do vínculo dos serviços com a comunidade, com medidas voltadas a melhor estruturação das salas de vacinação e diminuição da rotatividade dos funcionários e o fortalecimento dos programas de saúde materno-infantil, elevando a cobertura dos programas de pré-natal e assistência à saúde dos lactentes.

Introduction: The significant decline in vaccination coverage in Brazil since 2016, persisting to the present day, constitutes a relevant public health problem, making studies on its determinants in different contexts a priority. Objective: To estimate the updated and timely vaccination coverage at 12 and 24 months for each vaccine and for the complete schedule, and to analyze the factors associated with incomplete, updated, and timely vaccination schedules in a cohort of infants born in 2018 in Arapiraca. Methods: A cross-sectional, descriptive, and analytical study was conducted on a representative sample of the cohort of live births in Arapiraca (AL), in 2018. The sources of information included: Live Birth Information System; Mortality Information System; Electronic Citizen Records; Vaccination Records; and Sanitary Unit Records. Updated and timely vaccination coverage rates were estimated for each vaccine and for the complete schedule, presented as percentages with a 95% confidence interval, stratified by rural and urban areas. The association between incomplete vaccination schedule and independent variables was investigated through estimation of crude and adjusted prevalence ratios and their respective 95% confidence intervals, using Poisson regression. Results: A total of 318 children were studied. The average coverage of the complete and updated vaccination schedule at 12 months was 91.8%, with rates of 93.6% and 88.8% in urban and rural areas, respectively. By 24 months, coverage declined to 75.2%, with rates of 76.2% and 73.3% in urban and rural areas, respectively. Timely coverage at 12 months was 47.8%, higher in rural areas at 50.9% versus 46.0% in urban areas (p>0.05). By 24 months, timely coverage decreased to 9.1%, higher in rural areas at 14.7% versus 5.9% in urban areas (p<0.05). Vaccines with lower coverage rates included: i) at 12 months, the second dose of Human Rotavirus with 96.2%, and at 24 months, the first dose of Varicella and the single dose of Hepatitis A with 92.1%; ii) for timely coverage at 12 months, the third dose of IPV/OPV had 66.7% coverage, and at 24 months, the first DTP booster had 24.5% coverage. Factors independently associated with incomplete updated and timely schedules at 12 and 24 months included: maternal education less than eight years or equal/superior to 12 years of schooling; mother with fewer than seven prenatal visits; mother residing in rural areas; and birth weight less than 2,800 grams. However, being born with less than 2,800 grams was inversely associated with incomplete updated schedules at 12 months; being born with weight between 2,800 and 3,199 grams was associated with incomplete timely schedules at 12 months; and residing in rural areas was associated with incomplete timely schedules at 24 months. Conclusions: The results suggest, among strategies to increase vaccination coverage: educational policies with specific focus on both the poorer and wealthier segments of the population; strengthening the bond between services and the community through measures aimed at better structuring vaccination rooms and reducing staff turnover; and enhancing maternal and child health programs by increasing coverage of prenatal programs and infant healthcare assistance.

Sobre ativismos e conhecimentos: a experiência de associações canábicas no Brasil / On activism and knowledge: the experience of cannabis associations in Brazil

Resumo O surgimento de associações civis em prol da cannabis se iniciou na década de 2010. Diante da inércia do Estado, essas organizações têm atuado no acolhimento, apoio, informação, capacitação e facilitação do acesso de pacientes e familiares a medicamento produzido à base de maconha, substância proibida no Brasil. Este estudo visa analisar como o ativismo canábico promovido pelas associações brasileiras se fundamenta em conhecimentos científicos ou adquiridos pela vivência dos associados. A metodologia englobou entrevistas com participantes das associações ACuCa, Ama+me e Apepi e análise de conteúdo dos perfis dessas instituições no Instagram. Verificou-se que o ativismo canábico no Instagram apresenta semelhanças com aquele praticado presencialmente, no entanto, o ativismo nas mídias sociais prioriza a divulgação do conhecimento pela informação e capacitação de seus seguidores, tendo o cuidado de tratar o conteúdo para se adequar às diretrizes da plataforma. Além disso, as principais linhas de atuação do associativismo canábico (acolhimento e distribuição de óleos medicinais) aparecem de forma velada nas publicações, sendo que em sua maioria ocorrem em conversas privadas nos meios de comunicação com as associações.

Abstract The emergence of civil associations in favor of cannabis began in the 2010s. Faced with the inertia of the State, these organizations have acted in the reception, support, information, training, and facilitation of access for patients and their families to the medicine produced from marijuana, a prohibited substance in Brazil. This study aims to analyze how cannabis activism promoted by Brazilian associations is based on scientific knowledge or knowledge acquired through the experience of members. The methodology included interviews with participants from the ACuCa, Ama+me, and Apepi associations, as well as the Content Analysis of the profiles of these institutions on Instagram. It was found that cannabis activism on Instagram is similar to that practiced in person; however, activism on social media prioritizes the dissemination of knowledge through information and training of its followers, being careful to treat the content in order to suit the guidelines of the platform. In addition, the main lines of action of cannabis associations (reception and distribution of medicinal oils) appear in a veiled way in the publications, most of which occur through private conversations in the media with the associations.

In Vitro Leishmanicidal Activity of Copaiba Oil and Kojic Acid Combination on the Protozoan Leishmania (Leishmania) amazonensis and Host Cell.

(1) Background: Leishmaniasis refers to a group of anthropozoonotic diseases caused by Leishmania. The major chemotherapeutic agent used for its treatment is Glucantime®®, but the search continues for new compounds that are economically viable and act on the protozoan without causing damage to the host cell. As an alternative approach, this study used a combination of copaiba oil (CO) and kojic acid (KA) to determine their in vitro action on host cells, on the Leishmania (Leishmania) amazonensis protozoan and its interaction with macrophages. (2) Methods: In vitro culture, analysis of cytokine release and microscopy assays were performed. Statistical analysis was performed with ANOVA (GraphPad Prism). (3) Results: The combination did not induce cytotoxic effects on macrophages after treatment but promoted morphological changes in the protozoan, such as nuclear alterations (apoptotic characteristics), alterations in the cellular body and an increase in the number of electrodense structures and acidocalcisomes, observed mainly at the concentrations of CO20KA50 and CO30KA50 µg/mL. We observed reductions in the intracellular amastigote number and in the production of proinflammatory cytokines, such as IL-6 and TNF-α, after treatment with CO30KA at 50 µg/mL. (4) Conclusions: We report here, for the first time, that the combination of CO and KA may be a promising approach against Leishmania (Leishmania) amazonensis.

End of season 2022/2023 quadrivalent influenza vaccine effectiveness in preventing influenza in primary care in Portugal.

Using a test-negative case-control design, we aim to estimate influenza vaccine effectiveness (VE) against medically attended laboratory-confirmed influenza in Portugal in 2022/2023 season. Between week 41/2022 and week 14/2023, data on 592 patients with influenza-like illness aged 18 or more years old were collected by the national sentinel influenza surveillance system in primary care settings. Of those, 218 were positive for influenza and 374 were negative controls. We estimated seasonal influenza VE as (1-odds ratio)*100% of being vaccinated in laboratory-confirmed influenza cases vs. negative controls using logistic regression model adjusted for age group, sex, presence of chronic conditions, and month of symptoms onset. The seasonal VE was 59.3% (95% confidence interval (CI): 27.3 to 77.3) against any laboratory-confirmed influenza and not statistically significant 44.5% (95% CI: -5.6 to 70.8) against influenza A (H3N2). In the 2022/2023 season, characterized by early and low influenza activity and predominant A (H3N2) circulation, vaccination provided a moderate protection against medically attended laboratory-confirmed influenza in primary care.

Poly (ε-caprolactone)-Based Scaffolds with Multizonal Architecture: Synthesis, Characterization, and In Vitro Tests.

Tissue engineering is vital in treating injuries and restoring damaged tissues, aiming to accelerate regeneration and optimize the complex healing process. In this study, multizonal scaffolds, designed to mimic tissues with bilayer architecture, were prepared using the rotary jet spinning technique (RJS scaffolds). Polycaprolactone and different concentrations of alginate hydrogel (2, 4, and 6% m/v) were used. The materials were swollen in pracaxi vegetable oil (PO) (Pentaclethra macroloba) and evaluated in terms of surface morphology, wettability, functional groups, thermal behavior, crystallinity, and cytotoxicity. X-ray diffraction (XRD) showed the disappearance of the diffraction peak 2θ = 31.5° for samples from the polycaprolactone/pracaxi/alginate (PCLOA) group, suggesting a reduction of crystallinity according to the presence of PO and semi-crystalline structure. Wettability gradients (0 to 80.91°) were observed according to the deposition layer and hydrogel content. Pore diameters varied between 9.27 µm and 37.57 µm. Molecular interactions with the constituents of the formulation were observed via infrared spectra with Fourier transform (FTIR), and their influence was detected in the reduction of the maximum degradation temperature within the groups of scaffolds (polycaprolactone/alginate (PCLA) and PCLOA) about the control. In vitro tests indicated reduced cell viability in the presence of alginate hydrogel and PO, respectively.

Additive manufacturing of poly (lactic acid)/hydroxyapatite/carbon nanotubes biocomposites for fibroblast cell proliferation.

Bone tissue is one of the most important in the human body. In this study, scaffolds of poly (lactic acid) PLA reinforced with hydroxyapatite (HA) and carbon nanotubes (CNT) were manufactured, evaluating their mechanical and biological properties. HA was synthesized by wet method and characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and scanning electron microscopy (SEM). The scaffolds were produced using additive manufacturing and characterized by optical microscopy, SEM, thermogravimetric analysis (TGA), Raman spectroscopy and biological tests. The SEM results showed that the PLA surface was affected by the incorporation of CNT. TG showed that the incorporation of HA into the polymer matrix compromised the thermal stability of PLA. On the other hand, the incorporation of CNT to the polymer and the impregnation with HA on the surface by thermal effect increased the stability of PLA/CNT scaffolds. Raman spectra indicated that HA impregnation on the surface did not modify the polymer or the ceramic. In the compression tests, PLA and PLA/CNT scaffolds displayed the best compressive strength. In the biological tests, more than 85% of the cells remained viable after 48 h of incubation with all tested scaffolds and groups with CNT in the composition disclosing the best results.

Systematic review and meta-analysis on patented and non-patented vitrification processes to ovarian tissue reported between 2000 and 2021.

Due to the great interest in ovarian cryopreservation and, consequently conservation and restoration of female fertility in the last decades, different vitrification procedures (vitrification devices or solutions) have been developed, patented, and used both for academic research purposes and for clinical use. Therefore, the present study aimed to provide a systematic review and meta-analysis of data obtained from the application of different patented and non-patented vitrification devices and solutions in different countries. For this purpose, relevant observational studies published between the years 2000 to 2021 were selected to verify the efficiency of ovarian vitrification processes on parameters such as morphology, viability, and apoptosis in preantral ovarian follicles after transplantation or in vitro culture. Our research revealed that, although several countries were considered in the study, the United States and Japan were the countries that registered the most processes, and 22 and 16 vitrification devices and solutions out of a total of 51, respectively were patented. Sixty-two non-patented processes were also considered in the study in all countries. We also observed that transplantation and in vitro ovarian culture were the techniques predominantly used to evaluate the efficiency of the devices and vitrification solutions, respectively. In conclusion, this review showed that patented or non-patented protocols available in the literature are able to successfully preserve preantral follicles present in ovarian tissue. Despite the satisfactory results reported so far, adjustments in ovarian vitrification protocols in order to minimize cryoinjuries to the follicles remain one of the goals of cryopreservation and preservation of the female reproductive function. We found that vitrification alters the morphology and viability, and offers risks leading in some cases to follicular apoptosis. However, adjustments to current protocols to develop an optimal procedure can minimize damage by not compromising follicular development after vitrification/warming.

Red sacaca essential oil-loaded nanostructured lipid carriers optimized by factorial design: cytotoxicity and cellular reactive oxygen species levels.

Amazonian flora includes several species with the potential to develop pharmaceutical and biotechnological products. The essential oils from Amazonian species possess some biological properties, such as antioxidant, antibacterial, and cytotoxic activities. The essential oil of red sacaca (RSO), Croton cajucara Benth., contains metabolites characterized by antioxidant and anti-inflammatory activities. Nanostructured lipid carriers (NLC) are an advantageous alternative for the effective delivery of drugs because they can solubilize lipophilic actives and reduce their cytotoxicity. This study aimed to optimize the synthesis of RSO-loaded nanostructured lipid carriers (NLC-RSO) using a 23 factorial design and investigate their antioxidant and cytotoxic effects. The red sacaca essential oil (RSO) metabolite profile was characterized using gas chromatography coupled with a mass spectrometer (GC-MS), identifying 33 metabolites, with linalool and 7-hydroxy-calamenene as the major ones, as reported in the literature. The optimized NLC-RSO formulation had a particle size less than 100 nm and a polydispersity index lower than 0.25. After characterizing NLC-RSO using Fourier-transform infrared spectroscopy, powder X-ray diffraction, zeta potential, moisture content, and wettability, in vitro cytotoxicity were performed in A549 and BEAS-2B cell lines using the resazurin metabolism assay. The data indicated a lower IC50 for RSO than for NLC-RSOs in both cell lines. Furthermore, low cytotoxicity of blank nanoparticles (blank NP) and medium chain triglycerides-loaded nanostructured lipid carriers (NLC-MCT) towards both pulmonary cell lines was noted. At a concentration of 50-100 µg/mL, free RSO exhibited higher cytotoxicity than NLC-RSO, demonstrating the protective effect of this lipid carrier in reducing cytotoxicity during metabolite delivery. Similarly, free RSO showed higher 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging than NLC-RSO, also indicating this protective effect. The 2',7'-dichlorofluorescein diacetate (DCFH-DA) intracellular reactive oxygen species (ROS) level assay did not show differences between the treatments at higher but non-cytotoxic dosages. Taken together, our results suggest that NLC-RSOs are potential RSO delivery systems for applications related to cancer treatment.

Multimorbidity and complex multimorbidity in Brazilians with severe obesity.

To investigate the prevalence of multimorbidity and complex multimorbidity and their association with sociodemographic and health variables in individuals with severe obesity. This is a baseline data analysis of 150 individuals with severe obesity (body mass index ≥ 35.0 kg/m2) aged 18-65 years. The outcomes were multimorbidity and complex multimorbidity. Sociodemographic, lifestyle, anthropometric and self-perceived health data were collected. Poisson multiple regression was conducted to identify multimorbidity risk factors. The frequency of two or more morbidities was 90.7%, three or more morbidities was 76.7%, and complex multimorbidity was 72.0%. Living with four or more household residents was associated with ≥ 3 morbidities and complex multimorbidity. Fair and very poor self-perceived health was associated with ≥ 2 morbidities, ≥ 3 morbidities and complex multimorbidity. A higher BMI range (45.0-65.0 kg/m2) was associated with ≥ 2 morbidities and ≥ 3 morbidities. Anxiety (82.7%), varicose veins of lower limbs (58.7%), hypertension (56.0%) were the most frequent morbidities, as well as the pairs and triads including them. The prevalence of multimorbidity and complex multimorbidity in individuals with severe obesity was higher and the risk for multimorbidity and complex multimorbidity increased in individuals living in households of four or more residents, with fair or poor/very poor self-perceived health and with a higher BMI.

Research for Cytomegalovirus Mutations Associated With Resistance to Antivirals in Kidney Transplant Receptors.

Cytomegalovirus (CMV) mutations associated with antiviral resistance have become a major problem related to high mortality in kidney transplant patients. The aim of the study was to investigate mutations in the CMV genes UL97 and UL54 associated with antiviral resistance. A retrospective observational cohort study was carried out at Hospital Ophir Loyola (HOL), a reference in Kidney Transplantation. A total of 81 patients who underwent kidney transplantation were followed up between 2016 and 2018 were monitored for CMV viral load by performing qPCR. Sanger sequencing was performed on 66 patients. All CMV-positive kidney transplant recipients were included. Mutations were observed in 15 samples (22.72%) from patients. Most cases involved UL97 mutations. Mutation in UL54 without mutation in UL97 was detected in only 2 cases. Resistance mutations in UL97 were identified, such as M460V, L595S, H520Q, two co-mutations D465R + Del524 and A594P + D413A and a 3 codon deletion (del598-601). The search for mutations in the CMV genes identified mutations that confer resistance to conventional antivirals, such as ganciclovir and cidofovir, used in the treatment of these patients. Confirmation of the association with increased CMV viral load in transplanted patients, due to mutation in resistance genes, requires phenotypic analysis for confirmation purposes. These were the first findings in patients in northern Brazil that we know of.

Ter alguém com quem contar: A percepção de adolescentes acerca do amor e do suporte do(a) parceiro(a) amoroso(a) / Have somebody to count on: Adolescents' perception about love and support from a romantic partner

Embora interações com amigos e parceiros amorosos ganhem importância na adolescência, ainda há controvérsias acerca da profundidade e da qualidade da vinculação amorosa. Buscou-se avaliar a percepção de setenta adolescentes gaúchos (12 a 18 anos), de escolas públicas e privadas de Porto Alegre e Canoas/RS, acerca do amor e do suporte do(a) parceiro(a) amoroso(a), e verificar suas associações com características sociodemográficas. Aplicou-se individualmente, em sala de aula, um questionário de dados sociodemográficos, o Inventário de Qualidade dos Relacionamentos Interpessoais e a Escala Triangular do Amor ­ Versão Reduzida. Os dados obtidos foram digitados em planilha no SPSS e analisados por meio de estatística descritiva e correlacional (Correlação de Spearman e comparação entre grupos via teste de Mann-Whitney, considerando as variáveis gênero, faixa etária, renda familiar, religião, escolaridade e presença ou não de relação sexual). Os adolescentes perceberam seus relacionamentos como importantes, considerando-os boa fonte de suporte, apresentando altos índices de intimidade, paixão e comprometimento e baixo nível de conflito. Encontrou-se associação positiva entre comprometimento e profundidade e intimidade e suporte, assim como entre maior idade e maior comprometimento. Ter relacionamento sexual associou-se a maior percepção de conflito e paixão. Os relacionamentos amorosos mostraram ser fonte de suporte para o desenvolvimento saudável desses adolescentes.

Although interactions with friends and romantic relationships become important during adolescence, there is still controversy about the depth and quality of adolescents' attachment to their romantic partners. The present study aimed to evaluate the adolescents' perception of love and their romantic partner's support, as well as to verify its possible associations with sociodemographic characteristics. Seventy adolescents (12 to 18 years old) from South Brazil, enrolled in public and private schools of Porto Alegre and Canoas/RS, fulfilled individually, at school, a sociodemographic data questionnaire, the Quality of Relationships Inventory and the Triangular Love Scale ­ Reduced Version. The collected data were entered into a spreadsheet in SPSS. Descriptive and correlational statistics analysis were performed (Spearman correlation and comparison between groups via Mann-Whitney test, considering the variables gender, age group, family income, religion, education level, and the presence or absence of sexual intercourse). The adolescents perceived their romantic relationships as important, as a good source of support, showing high levels of intimacy, passion and commitment, and low levels of conflict. A positive association was found between commitment and depth, and intimacy and support, as well as higher age and more advanced levels of commitment. Having a sexual relationship was associated with a higher perception of conflict and passion. Romantic relationships proved to be a source of support for the healthy development of these adolescents.