O trabalho das equipes de saúde bucal na pandemia da covid-19 segundo gestores de saúde / The work of oral health teams in the COVID-19 pandemic according to health managers

RESUMO Este estudo objetivou caracterizar o trabalho dos profissionais das equipes de saúde bucal da rede pública na pandemia da covid-19 do ponto de vista dos gestores. Trata-se de um estudo quantitativo-qualitativo, com 163 gestores municipais de saúde da Bahia, que responderam a um questionário virtual, de junho a outubro de 2020. Foi realizada análise descritiva dos dados quantitativos utilizando o Statistical Package for the Social Science, e Análise Temática das respostas subjetivas, com auxílio do IRaMuTeQ. Um escopo de atuação das equipes de saúde bucal, que atuam em todos os níveis de atenção à saúde, foi reconhecido como mais abrangente que o tradicional nesse período. A pandemia deu ênfase às fragilidades crônicas nas condições de trabalho dos cirurgiões-dentistas, técnicos e auxiliares de saúde bucal da rede pública, como a insuficiência de instrumentais odontológicos e de insumos, a precária manutenção dos equipamentos odontológicos, a fragilidade dos vínculos empregatícios e a estrutura física inadequada nas unidades de saúde, comprometendo a biossegurança. Assim, abre-se uma oportunidade para identificar e implementar mudanças necessárias não apenas no contexto de crise sanitária, mas também no período pós-pandemia.

ABSTRACT This study aimed to characterize the work of professionals from oral health teams in the public service, in the COVID-19 pandemic, from the point of view of managers. This is a cross-sectional, quantitative-qualitative study, with 163 municipal health managers in Bahia, who answered a virtual questionnaire, from June to October 2020. The descriptive analysis of the quantitative data was performed using the Statistical Package for the Social Science, and Thematic Analysis was applied to the subjective responses, using IRaMuTeQ. The scope of action of oral health teams, which operate at all levels of health care, was recognized as broader than the traditional in this period. The pandemic emphasized the chronic problems in the working conditions of dentists, technicians, and oral health assistants in the public service, such as the lack of dental instruments and supplies, the precarious maintenance of dental equipment, the fragility of employment relationships, and the inadequate physical structure in the health units, compromising biosecurity. Thus, there is an opportunity to identify and implement necessary changes not only in the context of a health crisis, but in the post-pandemic period.

Health-Related quality of life of oral health workers in primary health care in Salvador, Brazil / Qualidade de vida relacionada à saúde de trabalhadores de saúde bucal da atenção primária à saúde em Salvador, Brasil / Calidad de vida relacionada con la salud de trabajadores de salud bucal de la atención primaria de salud en Salvador, Brasil

This study aimed to identify and determine the level of factors associated with the health-related quality of life (HRQoL) of oral health professionals working in Primary Health Care (PHC) in Brazil. A cross-sectional survey was carried out among 96 dentists and 65 dental assistants working in the Family Health Strategy (FHS) in six municipalities in the metropolitan area of Salvador (BA), Brazil. The HRQoL was evaluated using the 36-item Short Form Health Survey Questionnaire (SF-36). Higher mean scores in the SF-36 physical component summary were associated with younger age, post-graduate education in public health, and frequent leisure time. The mental component summary was associated with frequent leisure time, > 40 weekly working hours, suitable dental offices, satisfaction with colleagues, and satisfaction with working in PHC. The HRQoL level of oral health professionals working in primary health care in PHC in Brazil was comparable to those found in the available literature and associated with several modifiable factors. Incidentally, a literature search found few studies using the SF-36 to assess the HRQoL of oral health workers, and those found were produced outside the main scientific centers.

O objetivo deste estudo foi identificar e determinar o nível de fatores associados à qualidade de vida relacionada à saúde (QVRS) de profissionais de saúde bucal que atuam na Atenção Primária à Saúde (APS) no Brasil. Foi realizado um estudo de corte transversal com 96 cirurgiões-dentistas e 65 auxiliares em saúde bucal que atuam na Estratégia Saúde da Família (ESF) em seis municípios da região metropolitana de Salvador (BA), Brasil. A QVRS foi avaliada usando o 36-item Short Form Health Survey Questionnaire (SF-36). Escores médios mais altos no resumo do componente físico do SF-36 foram associadas a idade mais jovem, pós-graduação em saúde pública e tempo de lazer frequente. O resumo do componente mental foi associado a tempo de lazer frequente, > 40 horas semanais de trabalho, consultórios odontológicos adequados, satisfação com os colegas e satisfação em trabalhar na APS. O nível de QVRS dos profissionais de saúde bucal que atuam na APS no Brasil foi comparável aos encontrados na literatura disponível e associado a vários fatores modificáveis. Incidentalmente, uma pesquisa bibliográfica encontrou poucos estudos que utilizam o SF-36 para avaliar a QVRS de trabalhadores da saúde bucal; e os encontrados foram produzidos fora dos principais centros científicos.

El objetivo de este estudio fue identificar y determinar el nivel de los factores asociados a la calidad de vida relacionada con la salud (CVRS) de los profesionales de salud bucal que actúan en la Atención Primaria de Salud en Brasil. Se realizó un estudio transversal con 96 cirujano dentista y 65 auxiliares de salud bucal que actúan en la Estrategia Salud de la Familia en seis municipios de la región metropolitana de Salvador, Brasil. La CVRS se evaluó mediante el 36-item Short Form Health Survey Questionnaire (SF-36). Las puntuaciones medias más altas en el resumen del componente físico del SF-36 se asociaron con una edad más joven, títulos de posgrado en salud pública y tiempo libre frecuente. El resumen del componente mental se asoció con tiempo libre frecuente, > 40 horas de trabajo por semana, consultorios dentales adecuados, satisfacción con los colegas y satisfacción con el trabajo en la Atención Primaria de Salud. El nivel de CVRS de los profesionales de la salud bucal que actúan en la Atención Primaria de Salud en Brasil fue comparable a los encontrados en la literatura disponible y se asoció a varios factores modificables. Una búsqueda bibliográfica encontró pocos estudios que utilizan el SF-36 para evaluar la CVRS de los trabajadores de la salud bucal; y los encontrados estaban fuera de los principales centros científicos.

Meta-analysis contrasting freshwater biodiversity in forests and oil palm plantations with and without riparian buffers.

The expansion of oil palm plantations has led to land-use change and deforestation in the tropics, which has affected biodiversity. Although the impacts of the crop on terrestrial biodiversity have been extensively reviewed, its effects on freshwater biodiversity remain relatively unexplored. We reviewed the research assessing the impacts of forest-to-oil palm conversion on freshwater biota and the mitigating effect of riparian buffers on these impacts. We searched for studies comparing taxa richness, species abundance, and community composition of macroinvertebrates, amphibians, and fish in streams in forests (primary and disturbed) and oil palm plantations with and without riparian buffers. Then, we conducted a meta-analysis to quantify the overall effect of the land-use change on the 3 taxonomic groups. Twenty-nine studies fulfilled the inclusion criteria. On average, plantations lacking buffers hosted 44% and 19% fewer stream taxa than primary and disturbed forests, respectively. Stream taxa on plantations with buffers were 24% lower than in primary forest and did not differ significantly from disturbed forest. In contrast, stream community composition differed between forests and plantations regardless of the presence of riparian buffers. These differences were attributed to agrochemical use and altered environmental conditions in the plantations, including temperature changes, worsened water conditions, microhabitat loss, and food and shelter depletion. On aggregate, abundance did not differ significantly among land uses because increases in generalist species offset the population decline of vulnerable forest specialists in the plantation. Our results reveal significant impacts of forest-to-oil palm conversion on freshwater biota, particularly taxa richness and composition (but not aggregate abundance). Although preserving riparian buffers in the plantations can mitigate the loss of various aquatic species, it cannot conserve primary forest communities. Therefore, safeguarding primary forests from the oil palm expansion is crucial, and further research is needed to address riparian buffers as a promising mitigation strategy in agricultural areas.

Metaanálisis contrastando la biodiversidad de agua dulce en los bosques y las plantaciones de palma de aceite con o sin bosques ribereños Resumen La expansión de las plantaciones de palma de aceite ha derivado en cambios en el uso de suelo y deforestación en los trópicos, afectando a la biodiversidad. Existe una revisión extensa del impacto de este cultivo sobre la biodiversidad terrestre, pero sus efectos sobre la biodiversidad de agua dulce todavía no están muy documentados. Revisamos las investigaciones que han evaluado el impacto de la conversión de bosque a plantación de palma de aceite sobre la biota de agua dulce y el efecto mitigante que tienen los bosques ribereños sobre este impacto. Buscamos estudios que compararan la riqueza de taxones, abundancia de especies y composición comunitaria de los macroinvertebrados, anfibios y peces en los riachuelos de los bosques (primarios y perturbados) y los sembradíos de palma de aceite con y sin bosques ribereños. Después realizamos un metaanálisis para cuantificar el efecto del cambio de uso de suelo en los tres grupos taxonómicos. Veintinueve estudios cumplieron con el criterio de inclusión. En promedio, las plantaciones carentes de bosques ribereños albergaron 44% y 19% menos taxones que los bosques primarios y perturbados. Los taxones en los sembradíos con bosques ribereños fueron 24% menos que en el bosque primario y no difirieron significativamente del bosque perturbado. Como contraste, la composición comunitaria del riachuelo difirió entre los bosques y los sembradíos sin importar la presencia de los bosques ribereños. Atribuimos estas diferencias al uso de agroquímicos y las condiciones ambientales alteradas en las plantaciones, incluidas los cambios térmicos, condiciones hidrológicas alteradas, pérdida de microhábitats y reducción de alimentos y refugios. En general, la abundancia no difirió significativamente entre los usos de suelo porque el incremento de especies generalistas en las plantaciones contrarresta la declinación poblacional de los especialistas de bosque vulnerables. Nuestros resultados revelan un impacto significativo de la conversión de bosque a plantación sobre la biota de agua dulce, particularmente la riqueza de taxones y la composición (pero no la abundancia agregada). Aunque mantener los bosques ribereños en las plantaciones puede mitigar la pérdida de varias especies acuáticas, no puede conservar las comunidades del bosque primario. Por lo tanto, es crucial salvaguardar los bosques primarios de la expansión del aceite de palma, además de que se necesitan más investigaciones para abordar los bosques ribereños como una estrategia prometedora de mitigación en las áreas agrícolas.

Microgramma vacciniifolia Frond Lectin: In Vitro Anti-leishmanial Activity and Immunomodulatory Effects Against Internalized Amastigote Forms of Leishmania amazonensis.

PURPOSE: The treatment of leishmaniasis, an anthropozoonosis caused by Leishmania protozoa, is limited by factors, such as adverse effects, toxicity, and excessive cost, which has highlighted the importance of novel drugs. In this context, natural products have been considered as sources of antileishmanial agents. This study investigated the leishmanicidal activity of Microgramma vacciniifolia frond lectin (MvFL) on promastigotes and amastigotes of Leishmania amazonensis. METHODS: The effects of MvFL on promastigote proliferation and macrophage infection by amastigotes were evaluated and mean inhibitory concentrations (IC50) were calculated. As a safety assessment, the hemolytic capacity of MvFL (6.25-200 µg/mL) against mouse and human erythrocytes was determined. Additionally, the ability of MvFL (6.25-100 µg/mL) to modulate lysosomal and phagocytic activities and the nitric oxide (NO) production by murine peritoneal macrophages was also investigated. RESULTS: After 24 h, MvFL inhibited the proliferation of L. amazonensis promastigotes, with an IC50 of 88 µg/mL; however, hemolytic activity was not observed. MvFL also reduced macrophage infection by amastigotes with an IC50 of 52 µg/mL. Furthermore, treatment with MvFL reduced the number of amastigotes internalized by infected murine peritoneal macrophages by up to 68.9% within 48 h. At a concentration of 25 µg/mL, MvFL stimulated lysosomal activity of macrophages within 72 h, but did not alter phagocytic activity or induce NO production at any of the tested concentrations. CONCLUSION: MvFL exerts antileishmanial activity and further studies are needed to assess its therapeutic potential in in vivo experimental models of leishmaniasis.

Desfechos clínicos e gravidade da infecção pelo Clostridioides (Clostridium) difficile em um hospital terciário de referência no Brasil / Clinical outcome and severity of clostridioides (clostridium) difficile infection at a tertiary referral hospital in brazil

ABSTRACT Background: Clostridioides difficile infection (CDI) is a potentially severe disease that can present with refractoriness, recurrence, and evolution to death. In Brazil, the epidemiology of CDI seems to differ from that of the United States and most European countries, with only one ribotype (RT) 027-related case and a high prevalence of RT106. Objective: The aim of this study was to evaluate the outcomes of CDI and its possible association with ribotypes at a university hospital in Brazil. Methods: A total of 65 patients with CDI were included and stool samples were submitted to A/B toxin detection and toxigenic culture, and toxigenic isolates (n=44) were also PCR ribotyped. Results: Patients' median age was 59 (20-87) years and there were 16 (24.6%) deaths. The median Charlson comorbidity index (CCI) was 4 (0-15) and 16.9% of the patients had CCI ≥8. The ATLAS score and non-improvement of diarrhea were related to higher mortality. A longer length of hospitalization was related to the enteral nutrition and use of multiple antibiotics. The period between CDI diagnosis and hospital discharge was longer in those who received new antibiotics after diagnosis, multiple antibiotics, and required intensive care treatment. Recurrence was associated with CCI >7. Twenty ribotypes were identified and RT106 was the most frequently detected strain (43.2%). No relationship was observed between the ribotypes and outcomes. CDI was present in patients with more comorbidities. Conclusion: Risk factors for higher mortality, longer hospital stay and recurrence were identified. A diversity of ribotypes was observed and C. difficile strains were not related to the outcomes.

RESUMO Contexto: A infecção pelo Clostridioides difficile (ICD) é uma doença potencialmente grave que pode se apresentar com refratariedade, recidiva e evoluir para óbito. No Brasil, a epidemiologia da ICD parece diferir da dos Estados Unidos e da maioria dos países europeus, com apenas um caso relacionado ao ribotipo (RT) 027 e alta prevalência do RT106. Objetivo: Avaliar os desfechos da ICD e sua possível associação com ribotipos em um hospital universitário do Brasil. Métodos: Um total de 65 pacientes com ICD foram incluídos e amostras de fezes foram submetidas à detecção de toxina A/B e cultura toxigênica e as cepas toxigênicas isoladas (n=44) também foram ribotipadas por PCR. Resultados: A idade mediana dos pacientes foi de 59 (20-87) anos e houve 16 (24,6%) óbitos. A mediana do índice de comorbidade de Charlson (ICC) foi de 4 (0-15) e 16,9% dos pacientes apresentaram ICC ≥8. O escore ATLAS e a não melhora da diarreia foram relacionados a maior mortalidade. Maior tempo de internação esteve relacionado à nutrição enteral e ao uso de múltiplos antibióticos. O período entre o diagnóstico de ICD e a alta hospitalar foi maior naqueles que receberam novos antibióticos após o diagnóstico, múltiplos antibióticos e necessitaram de tratamento intensivo. A recorrência foi associada com ICC >7. Vinte ribotipos foram identificados e o RT106 foi a cepa mais frequentemente detectada (43,2%). Não foi observada relação entre os ribotipos e os desfechos. ICD esteve presente em pacientes com mais comorbidades. Conclusão: Foram identificados fatores de risco para maior mortalidade, maior tempo de internação e recorrência. Uma diversidade de ribotipos foi observada e cepas de C. difficile não foram relacionadas aos desfechos.

Immune sensing of food allergens promotes avoidance behaviour.

In addition to its canonical function of protection from pathogens, the immune system can also alter behaviour1,2. The scope and mechanisms of behavioural modifications by the immune system are not yet well understood. Here, using mouse models of food allergy, we show that allergic sensitization drives antigen-specific avoidance behaviour. Allergen ingestion activates brain areas involved in the response to aversive stimuli, including the nucleus of tractus solitarius, parabrachial nucleus and central amygdala. Allergen avoidance requires immunoglobulin E (IgE) antibodies and mast cells but precedes the development of gut allergic inflammation. The ability of allergen-specific IgE and mast cells to promote avoidance requires cysteinyl leukotrienes and growth and differentiation factor 15. Finally, a comparison of C57BL/6 and BALB/c mouse strains revealed a strong effect of the genetic background on the avoidance behaviour. These findings thus point to antigen-specific behavioural modifications that probably evolved to promote niche selection to avoid unfavourable environments.

Influence of phosphate fertilizers on the radioactivity of agricultural soils and tobacco plants in Kenya, Tanzania, and Uganda.

Three brands of NPK fertilizers that contain variable concentrations of natural radioactivity are commonly used in tobacco plantations in Kenya, Tanzania, and Uganda. Tobacco plants are known for hyper-accumulation of natural radionuclides, particularly 238U. This study investigated if the elevated radioactivity in phosphate fertilizers could enhance radioactivity in soils and tobacco plant leaves. The 232Th, 238U, and 40K radionuclide levels in NPK-fertilized soils and tobacco leaves were measured using gamma-ray spectroscopy. The research included a one-year reference experiment with tobacco growing in plots, a ten-year semi-controlled experiment in well-managed tobacco farms, and a field survey of radioactivity in soils and tobacco leaves at three traditional tobacco fields in Migori (Kenya), Urambo (Tanzania), and Kanungu (Uganda). The findings demonstrated that soils and tobacco leaves exposed to NPK fertilizers with increased radioactivity had activity concentrations of 232Th, 238U, and 40K that were considerably higher (at all sites) than in the control samples (with no use of NPK fertilizers). As the continued application of NPK fertilizers raises concentrations of 232Th, 238U, and 40K in agricultural soils, the study assessed radiological risks for humans from exposure to agricultural soils enriched with phosphate fertilizers, and it was found to be below the exposure limit of 1 mSvy-1 suggested by the International Commission on Radiological Protection (ICRP). However, tobacco consumers, both by snuffing and smoking, may face significant radiological risks, as the snuffing and smoking resulted in effective doses that were 2.41 to 6.53 and 1.14 to 2.45 times greater than the average yearly dose that the general public receives from inhalation of natural radionuclides (United Nations Scientific Committee on Atomic Radiations estimates). Furthermore, the results indicate that the lifetime excess cancer risk for tobacco snuffers and smokers ranged from 5 × 10-5 to 24.48 × 10-3 and 2.0 × 10-5 to 9.18 × 10-3, respectively. The influence of phosphorus-derived fertilizer containing relatively high natural radioactivity, potential human radiation exposure, and radiological risk due to gamma radionuclides is estimated and discussed. The results reveal that applying phosphate fertilizers enhances natural radioactivity in soil and is subsequently influenced by soil to tobacco plant uptake. Therefore, the study recommends that countries use fertilizers with lower radionuclide content to conserve soil quality and reduce gamma-emitting radionuclides in tobacco plants.

Synthetic hydrazones: In silico studies and in vitro evaluation of the antileishmania potential.

Bioprospecting and synthesis of strategically designed molecules have been used in the search for drugs that can be in leishmaniasis. Hydrazones (HDZ) are promising compounds with extensive biological activities. The objective of this work was to perform in silico studies of hydrazones 1-5 and to evaluate their antileishmanial, cytotoxic and macrophage immunomodulatory potential in vitro. Hydrazones were subjected to prediction and molecular docking studies. Antileishmanial protocols on promastigotes and amastigotes of Leishmania amazonensis, cytotoxicity and macrophage immunomodulatory activity were performed. Hydrazones showed a good pharmacokinetic profile and hydrazone 3 and hydrazone 5 were classified as non-carcinogenic. Hydrazone 5 obtained the best conformation with trypanothione reductase. Hydrazone 1 and hydrazone 3 obtained the best mean inhibitory concentration (IC50) values for promastigotes, 4.4-61.96 µM and 8.0-58.75 µM, respectively. It also showed good activity on intramacrophagic amastigotes, with hydrazone 1 being the most active (IC50 = 6.79 µM) with selectivity index of 56. In cytotoxicity to macrophages hydrazone 3 was the most cytotoxic (CC50 = 256.3 ± 0,04 µM), while hydrazone 4 the least (CC50 = 1055.9 ± 0.03 µM). It can be concluded that the hydrazones revealed important pharmacokinetic and toxicological properties, in addition to antileishmania potential in reducing infection and infectivity in parasitized macrophages.

Antileishmania and immunomodulatory potential of cashew nut shell liquid and cardanol.

Conventional treatments for leishmaniasis have caused serious adverse effects, poor tolerance, development of resistant strains. Natural products have been investigated as potential therapeutic alternatives. The cashew nut shell liquid (CNSL) is a natural source of phenolic compounds with several biological activities, where cardanol (CN) is considered one of the most important and promising compounds. This study aimed to evaluate antileishmanial, cytotoxic and immunomodulatory activities of CNSL and CN. Both showed antileishmanial potential, with IC50 for CNSL and CN against Leishmania infantum: 148.12 and 56.74 µg/mL; against Leishmania braziliensis: 85.71 and 64.28 µg/mL; against Leishmania major: 153.56 and 122.31 µg/mL, respectively. The mean cytotoxic concentrations (CC50) of CNSL and CN were 37.51 and 31.44 µg/mL, respectively. CNSL and CN significantly reduced the percentage of infected macrophages, with a selectivity index (SI) >20 for CN. CNSL and cardanol caused an increase in phagocytic capacity and lysosomal volume. Survival rates of Zophobas morio larvae at doses of 3; 30 and 300 mg/kg were: 85%, 75% and 60% in contact with CNSL and 85%, 60% and 40% in contact with CN, respectively. There was a significant difference between the survival curves of larvae when treated with CN, demonstrating a significant acute toxicity for this substance. Additional investigations are needed to evaluate these substances in the in vivo experimental infection model.

Isopropyl Gallate, a Gallic Acid Derivative: In Silico and In Vitro Investigation of Its Effects on Leishmania major.

Isopropyl gallate (IPG) is a polyphenol obtained from alterations in the gallic acid molecule via acid catalysis with previously reported leishmanicidal and trypanocidal activities. The present study aims to evaluate in silico binding activity towards some targets for antileishmanial chemotherapy against Leishmania major species, and ADMET parameters for IPG, as well as in vitro antileishmanial and cytotoxic effects. Molecular docking was performed using AutoDockVina and BIOVIA Discovery Studio software, whereas in silico analysis used SwissADME, PreADMET and admetSAR software. In vitro antileishmanial activity on promastigotes and amastigotes of Leishmania major, cytotoxicity and macrophages activation were assessed. IPG exhibited affinity for pteridine reductase (PTR1; -8.2 kcal/mol) and oligopeptidase B (OPB; -8.0 kcal/mol) enzymes. ADMET assays demonstrated good lipophilicity, oral bioavailability, and skin permeability, as well as non-mutagenic, non-carcinogenic properties and low risk of cardiac toxicity for IPG. Moreover, IPG inhibited the in vitro growth of promastigotes (IC50 = 90.813 µM), presented significant activity against amastigotes (IC50 = 13.45 µM), promoted low cytotoxicity in macrophages (CC50 = 1260 µM), and increased phagocytic capacity. These results suggest IPG is more selectively toxic to the parasite than to mammalian cells. IPG demonstrated acceptable in silico pharmacokinetics parameters, and reduced infection and infectivity in parasitized macrophages, possibly involving macrophage activation pathways and inhibition of leishmania enzymes.

Work ability and associated factors in people living with human T-cell leukemia virus type 1.

BACKGROUND: Infection with the human T-lymphotropic virus type 1 (HTLV-1) affects an estimated 10-15 million people worldwide. However, knowledge of the impact of HTLV-1 infection on work ability is lacking. This study aimed to measure the frequency and identify factors associated with poor work ability in patients living with HTLV-1. METHODS: This cross-sectional study included 207 individuals infected with HTLV-1 who attended the University Hospital in Salvador, Bahia, Brazil. HTLV-1 antibodies were detected in the participants' blood by enzyme-linked immunosorbent assay (ELISA) and confirmed by western blotting. Participants answered a questionnaire on sociodemographic data, personal habits, clinical data, health-related quality of life, and work ability, evaluated using the work ability index questionnaire. A Poisson regression model with a robust variance estimate was used to identify the factors associated with the prevalence of poor work ability. RESULTS: Patients mean age was 55.2, ranging from 19 to 84 years, 73.0% were females, 100% had monthly family income less than US$ 394, and 33.8% presented HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). No individual was classified as having excellent work ability. Poor work ability prevalence was strongly associated (prevalence ratio; 95% confidence interval [CI]) with sedentarism (1.30; 1.03-1.65), neurological symptoms (1.25; 1.02-1.52), and low physical (0.95; 0.94-0.96) and mental (0.98; 0.97-0.99) component summaries of health-related quality of life. CONCLUSIONS: Poor work ability among people living with HTLV-1 is associated with sedentarism, neurologic symptoms, and low health-related quality of life.

Impact of Environmental Radiation on the Incidence of Cancer and Birth Defects in Regions with High Natural Radioactivity.

Four regions of high natural radioactivity were selected to assess radionuclide levels in rocks and soils, ambient radiation doses, radon exhalation from the ground, and radon concentrations in the air. The regions have different geochemical characteristics and radioactivity levels, which modulate the radiation exposure of local populations. Combining radiometric data with data from regional health statistics on non-infectious diseases, a statistically significant positive correlation was found between radiation exposure and the incidence of cancer and birth defects. Although this is a preliminary and prospective study, the empirical evidence gathered in this paper indicated increased the incidence of some diseases in relationship with the natural radiation background. It is suggested that further research, including epidemiological studies and direct determination of radiation exposures in regions with a high natural radiation background, is needed and justified.

Antileishmanial activity of Riparin structural analogs of Aniba riparia: Biological evaluation, in silico Adme-Tox, and molecular docking.

We performed a biological evaluation of antileishmanial activity, in silico ADME-Tox profile, and molecular docking of riparins A-F. The antileishmanial activity was evaluated in Leishmania major promastigotes, whereas the cytotoxic activity was tested on murine macrophages. Computational parameters were predicted by in silico analysis. Molecular docking was performed with 18 L. major molecular targets. Riparins, especially RipC and RipE, showed cytotoxic activity in vitro toward L. major promastigotes and a high selectivity index. Riparins showed small differences in their physicochemical properties, such as polarity and aqueous solubility. LogP was an important parameter for the differences in the antileishmanial activity between the molecules. In molecular docking, the ligands displayed Ki < 1 µM for LmNMT and LmLEI. Significant molecular interactions were observed with residues from the active site and adjacent regions of such enzymes. Thus, riparins have the potential for application in antileishmanial therapy.

Radiation exposure in a region with natural high background radiation originated from rare earth element deposits at Bat Xat district, Vietnam.

Surface deposits of rare earth element (REE) were identified in the Bat Xat district, Northern Vietnam. As the area is inhabited, an in-depth investigation was carried out to assess the radioactivity levels and to evaluate the radiation exposure and radiological risks for the population. Samples of REE ore, soils, water and several foods locally produced were collected and analyzed by gamma spectrometry for determination of 232Th, 226Ra, and 40 K. Radon (222Rn and 220Rn) measurements were carried out in dwellings at the villages located near by the REE deposit area, and in Hanoi for comparison. Based on the measured radionuclide concentrations, several radiological parameters were calculated to evaluate the radiological risks for the population and to compare with worldwide values. Results indicate that the representative person of the most exposed group living near the REE deposits may receive a total annual effective dose as high as 37.9 ± 10.6 mSv, i.e., approximately 16 times the world average dose of 2.4 mSv y-1. Consequently, this area should be considered a high background radiation area. Exposure to external radiation and internal radiation from ingestion and inhalation of radionuclides were assessed separately. Radon inhalation contributed to approximately 70% of the total annual effective dose, with both radon isotopes contributing significantly, while the ingestion of local foods and water gave minor contributions to the total effective dose. Several measures were considered to improve the radiation safety and recommendations are given to relocate the most exposed members of the population.

Four new cycloartane-type triterpenoids from the leaves of Combretum mellifluum Eichler: assessment of their antioxidant and antileishmanial activities.

The beneficial pharmacological actions including antioxidant effects as an antileishmanial, antibacterial, antifungal, antidiabetic, anti-inflammatory, antitumor, antiviral, and analgesic of compounds isolated from Combretum mellifluum Eichler (Combretaceae) are well established. The aim of the present study was to determine the phytochemistry as well as assess the antioxidant and antileishmanial activities of the leaves from Combretum mellifluum Eichler (Combretaceae). Analysis of ethanolic extract resulted in isolation and identification of two epimeric mixtures of four previously unknown cycloartane-type triterpenoids, methyl quadrangularate M and methyl 24-epiquadrangularate M, and 2α,3ß,24ß-trihydroxy-cycloart-25-ene and 2α, 3ß, 24α-trihydroxy-cycloart-25-ene, and eight known compounds. Their structures were using one-dimensional nuclear magnetic resonance (1D NMR), 2D NMR and high-resolution electrospray ionization mass spectroscopy (HRESIMS) analysis. Further, the extract and fractions were tested for antioxidant potential. The ethyl acetate and aqueous fractions demonstrated the highest antioxidant activity against 2,2-dipheny-1-picrylhydrazl (DPPH) free radicals, which correlated directly with total flavonoid content. All extracts and fractions from C. mellifluum Eichler were assessed for antileishmanial activity. The supernatant fraction exhibited highest potential, inhibiting the growth of Leishmania amazonensis with IC50 value 31.29 µg/ml. Our findings provide information on the chemical composition of C. mellifluum and the potential beneficial therapeutic usefulness as an antioxidant agent in various diseases.

Performance of High Mobility Protein Group 1 and Interleukin-6 as Predictors of Outcomes Resulting from Variceal Bleeding in Patients with Advanced Chronic Liver Disease.

Variceal bleeding is a serious complication in cirrhotic patients and is related to increased expression of inflammatory mediators that accentuate circulatory dysfunction. The study aims to evaluate the performance of high mobility protein group 1 (HMG1) and interleukin-6 (IL-6) as predictors of acute kidney injury (AKI), infection and death in these patients. Fifty patients who were diagnosed with advanced chronic liver disease with variceal bleeding were included. The mean age was 52.8 ± 10.8 years, and 33 (66%) were male. Twenty-one (42%) patients were classified as Child-Pugh C, 21 (42%) Child-Pugh B and 8 (16%) Child-Pugh A. The mean HMG1 serum level was 2872.36 pg/mL ± 2491.94, and the median IL-6 serum level was 47.26 pg/mL (0-1102.4). In AKI, the serum level of HMG1 that performed best on the ROC curve was 3317.9 pg/mL. The IL-6 serum level was not associated with AKI. HMG1 and IL-6 cut-off values that better predicted infection were 3317.9 pg/mL and 72.9 pg/mL, and for mortality, the values were 2668 pg/mL and 84.5 pg/mL, respectively. In multivariate analysis, the variables that were associated with AKI and infection outcomes were model for end-stage liver disease and HMG1. Infections were related to the risk of death. Clinical and laboratory variables related to the outcomes were identified. Serum levels of HMG1 were associated with AKI and infection and had good performance in the ROC curve. IL-6 levels were not maintained in logistic regression outcomes but had good performance in infection and death outcomes. Such data will be useful for comparisons and possible future validations.

Work ability and associated factors in people living with human T-cell leukemia virus type 1

ABSTRACT Background: Infection with the human T-lymphotropic virus type 1 (HTLV-1) affects an estimated 10-15 million people worldwide. However, knowledge of the impact of HTLV-1 infection on work ability is lacking. This study aimed to measure the frequency and identify factors associated with poor work ability in patients living with HTLV-1. Methods: This cross-sectional study included 207 individuals infected with HTLV-1 who attended the University Hospital in Salvador, Bahia, Brazil. HTLV-1 antibodies were detected in the participants' blood by enzyme-linked immunosorbent assay (ELISA) and confirmed by western blotting. Participants answered a questionnaire on sociodemographic data, personal habits, clinical data, health-related quality of life, and work ability, evaluated using the work ability index questionnaire. A Poisson regression model with a robust variance estimate was used to identify the factors associated with the prevalence of poor work ability. Results: Patients mean age was 55.2, ranging from 19 to 84 years, 73.0% were females, 100% had monthly family income less than US$ 394, and 33.8% presented HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). No individual was classified as having excellent work ability. Poor work ability prevalence was strongly associated (prevalence ratio; 95% confidence interval [CI]) with sedentarism (1.30; 1.03-1.65), neurological symptoms (1.25; 1.02-1.52), and low physical (0.95; 0.94-0.96) and mental (0.98; 0.97-0.99) component summaries of health-related quality of life. Conclusions: Poor work ability among people living with HTLV-1 is associated with sedentarism, neurologic symptoms, and low health-related quality of life.

Qualidade de vida relacionada à saúde de profissionais de enfermagem na Bahia na pandemia da COVID-19 / Health-related quality of life of nursing professionals in Bahia, Brazil, in the COVID-19 pandemic / Calidad de vida de los profesionales de enfermería en Bahía, Brasil, en la pandemia COVID-19

Objetivo: Identificar fatores associados à qualidade de vida relacionada à saúde de profissionais de enfermagem da Bahia durante a pandemia da COVID-19. Método: Estudo transversal, amostragem tipo snowball com 113 enfermeiras(os) e técnicas(os) de enfermagem. De setembro/2020 a maio/2021, num formulário eletrônico, coletaram-se informações sociodemográficas, ocupacionais, epidemiológicas e de qualidade de vida, avaliada pelo questionário WHOQOL-BREF nos seus domínios Físico, Psicológico, Relações sociais e Meio ambiente. Utilizou-se regressão linear múltipla para identificar fatores associados à variação dos domínios do WHOQOL-BREF. Resultados: Baixos escores de qualidade de vida associaram-se significantemente a várias características dos profissionais: ser caso suspeito de COVID-19, no domínio Físico; ficar sem exercer a profissão por causa da COVID-19, nos domínios Físico e Psicológico; trabalhar exclusivamente em instituições privadas, no domínio Relações sociais; ter mais idade, no domínio Relações sociais; e não receber apoio social de outras pessoas, nos domínios Físico, Psicológico, Relações sociais e Meio Ambiente. Conclusão e implicações para a prática: Ter mais idade, vínculo exclusivo com instituição privada, ser caso suspeito de COVID-19, ficar sem exercer a profissão por causa da COVID-19 e não receber apoio social associaram-se à baixa qualidade de vida de profissionais de enfermagem durante a pandemia

Objective: To identify factors associated with the health-related quality of life of nursing professionals in Bahia, Brazil, during the COVID-19 pandemic. Method: Cross-sectional study with snowball sampling including 113 nurses and nursing technicians. From September 2020 to May 2021, sociodemographic, occupational, epidemiological, and quality of life information was collected in an electronic form and evaluated with the WHOQOL-BREF questionnaire, according to its Physical, Psychological, Social relations, and Environmental domains. Multiple linear regression was used to identify factors associated with variation in the four quality of life domains of the WHOQOL-BREF. Results: Low quality of life mean scores were significantly associated with being a suspected case of COVID-19 (in the Physical domain), withdrawing from professional practice due to COVID-19 (Physical and Psychological domains), working exclusively in private institutions (Social relations), older age (Social relations), and lack of social support (in the Physical, Psychological, Social Relations, and Environmental domains). Conclusion and implications for the practice: Older age, exclusive work in private institutions, being a suspected case of COVID-19, withdrawing from professional practice due to COVID-19, and lack of social support were associated with lower quality of life of nursing professionals during the pandemic

Objetivo: Identificar factores asociados a la calidad de vida relacionada con la salud de los profesionales de enfermería de Bahía, Brasil, durante la pandemia de COVID-19. Método: Estudio transversal, muestreo bola de nieve, con 113 enfermeros y técnicos de enfermería. De septiembre 2020 a mayo 2021, en formulario electrónico, fueron recolectadas informaciones sociodemográficas, ocupacionales, epidemiológicas y de calidad de vida, evaluadas por el cuestionario WHOQOL-BREF en sus dominios Físico, Psicológico, Relaciones Sociales y Medio Ambiente. Se utilizó la regresión lineal múltiple para identificar factores asociados con los dominios del WHOQOL-BREF. Resultados: Los puntajes bajos de calidad de vida se asociaron significativamente con ser un caso sospechoso de COVID-19 (en el dominio Físico); no ejercer la profesión a causa del COVID-19 (dominios Físico y Psicológico); trabajar exclusivamente en instituciones privadas (Relaciones Sociales); mayor edad (Relaciones Sociales); y no recibir apoyo social (en los dominios Físico, Psicológico, Relaciones Sociales y Medio Ambiente). Conclusión e implicaciones para la práctica: Mayor edad, tener vinculación exclusiva con una institución privada, ser caso sospechoso de COVID-19, no ejercer la profesión a causa del COVID-19 y no recibir apoyo social se asociaron con la baja calidad de vida de los profesionales de enfermería durante la pandemia

Enhanced Polonium Concentrations in Aerosols from the Gulf Oil Producing Region and the Role of Microorganisms.

This study provides the first data set of 210Po and 210Pb activity concentrations in the organic and inorganic components of several particle size classes of aerosols collected at two sampling stations in Kuwait. The 210Po concentrations in the aerosols (Bq/g) were similar in all of the particle size classes, but as most (91%) of the aerosol load was made of fine fraction particles of PM0.39-2.5 µm, most of the 210Po activity was carried by this aerosol fraction. At the two sampling stations, the 210Po/210Pb activity concentration ratios in the aerosols were similar, stable around the year, and averaged 1.5 (range 1.2-1.9), much higher than the typical activity concentration ratios of these radionuclides in unmodified (background) aerosols, with Po/Pb < 0.1. The aerosol enrichment in 210Po was likely originated from the oil industry, specifically by gas flaring and oil refining in the Gulf region. Radionuclide analysis in the organic and inorganic components of aerosols showed that the 210Po concentration in the organic component was one order of magnitude higher than the 210Po concentration in the inorganic component, in contrast with 210Pb, which displayed similar concentrations in both organic and inorganic aerosol components. The 210Po carrying organic component of aerosols was investigated and it was found to be largely composed of microorganisms with high microbial and fungi diversity, with the phyla Proteobacteria, Ascomycota, and Basidiomycota being dominant among the bacteria and with Zygomycota being dominant among the fungi. Therefore, we are facing an active concentration process of the atmospheric 210Po carried out by microorganisms, which underlies the 210Po enrichment process in the organic component of aerosols. This bioconcentration of polonium in bioaerosols was unknown.

Synthesis and antileishmanial activity of naphthoquinone-based hybrids / Síntesis y actividad antileishmania de híbridos naftoquinónicos / Síntese e atividade antileishmania de híbridos naftoquinónicos

SUMMARY Introduction: Leishmaniasis is a disease caused by protozoa of the genus Leishmania and is considered endemic in 98 countries. Treatment with pentavalent antimonials has a high toxicity, which motivates the search for effective and less toxic drugs. α- and β-lapachones have shown different biological activities, including antiprotozoa. In recent studies, the isonicotinoylhydrazone and phthalazinylhydrazone groups were considered innovative in the development of antileishmania drugs. Molecular hybridization is a strategy for the rational development of new prototypes, where the main compound is produced through the appropriate binding of pharmacophoric subunits. Aims: To synthesize four hybrids of α- and β-lapachones, together with the isonicotinoylhydrazone and phthalazinylhydrazone groups and to determine the antileishmania activity against the promastigotic forms of L. amazonensis, L. infantum and L. major. Results: β-lapachone derivatives were more active against all tested leishmania species. βACIL (IC50 0.044μM) and βHDZ (IC50 0.023μM) showed 15-fold higher activity than amphotericin B. The high selectivity index exhibited by the compounds indicates greater safety for vertebrate host cells. Conclusion: The results of this work show that the hybrids βACIL and (3HDZ are promising molecules for the development of new antileishmania drugs.

RESUMEN Introducción: Leishmaniasis es una enfermedad causada por protozoos del género Leishmania y se considera endémica en 98 países. El tratamiento con antimoniales pentavalentes tiene una alta toxicidad, lo que motiva la búsqueda de fármacos eficaces y menos tóxico. α- y β-lapachones han mostrado diferentes actividades biológicas, incluido los antiprotozoarios. En estudios recientes, los grupos isonicotinoilhidra-zona y ftalazinilhidrazona se consideraron innovadores en el desarrollo de fármacos antileishmania. La hibridación molecular es una estrategia para el desarrollo racional de nuevos prototipos, donde el compuesto principal se produce a través de la unión apropiada de subunidades farmacofóricas. Objetivos: Sintetizar cuatro híbridos de α- y β-lapachones, junto con los grupos isonicotinoilhidrazona y ftalazinilhidrazona y determinar la actividad antileishmania frente a las formas promastigotas de L. amazonensis, L. infantum y L. major. Resultados: Los derivados de β-lapachone fueron más activos contra todas las especies de leishmania probadas. La βACIL (CI50 0,044μM) y βHDZ (CI50 0,023μM) mostraron actividad 15 veces mayor que la anfotericina B. El alto índice de selectividad que presentan los compuestos indica una mayor seguridad para las células huésped del vertebrado. Conclusión: Los resultados de este trabajo demuestran que los híbridos (ACIL y (HDZ son moléculas prometodoras para el desarrollo de nuevos fármacos antileishmania.

RESUMO Introdução: A leishmaniose é uma doença causada por protozoários do género Leishmania e é considerada endémica em 98 países. O tratamento com antimoniais pentavalentes apresenta alta toxicidade, o que motiva a pesquisa por medicamentos eficazes e menos tóxicos. α- e β-lapachones tém mostrado diferentes atividades biológicas, incluindo antiprotozoários. Em estudos recentes, os grupos isonicotinoilhi-drazona e ftalazinilhidrazona foram considerados inovadores no desenvolvimento de drogas antileishmania. A hibridização molecular é uma estratégia para o desenvolvimento racional de novos protótipos, onde o composto principal é produzido através da ligação apropriada de subunidades farmacofóricas. Objetivos: Sintetizar quatro híbridos de α- e β-lapachones, juntamente com os grupos isonicotinoil-hidra-zona e ftalazinilhidrazona e determinar a atividade antileishmania contra as formas promastigóticas de L. amazonensis, L. infantum e L. major. Resultados: Os derivados de β-lapachona foram mais ativos contra todas as espécies de leishmania testadas. BACIL (IC50 0,044 μM) e βHDZ (IC50 0,023 μM) apresentaram atividade 15 vezes maior do que a anfotericina B. O alto índice de seletividade dos compostos indica maior segurança para células hospedeiras de vertebrados. Conclusaõ: Os resultados deste trabalho mostram que os híbridos βACIL e βHDZ são moléculas promissoras para o desenvolvimento de novos fármacos antileishmania.