Costs of hospital admissions due to COVID-19 in the federal capital of Brazil: a study based on hospital admission authorizations.

This is a cost analysis study based on hospital admissions, conducted from the perspective of the Brazilian Unified Health System (SUS), carried out in a cohort of patients hospitalized at the University Hospital of Brasília (UHB) due to Severe Acute Respiratory Infections (SARI) caused by COVID-19, from April 1, 2020, to March 31, 2022. An approach based on macro-costing was used, considering the costs per patient identified in the Hospital Admission Authorizations (HAA). Were identified 1,015 HAA from 622 patients. The total cost of hospitalizations was R$ 2,875,867.18 for 2020 and 2021. Of this total, 86.41 % referred to hospital services and 13.59 % to professional services. The highest median cost per patient identified was for May 2020 (R$ 19,677.81 IQR [3,334.81-33,041.43]), while the lowest was in January 2021 (R$ 1,698.50 IQR [1,602.70-2,224.11]). The high cost of treating patients with COVID-19 resulted in a high economic burden of SARI due to COVID-19 for UHB and, consequently, for SUS.

Oocyte Competence of Prepubertal Sheep and Goat Oocytes: An Assessment of Large-Scale Chromatin Configuration and Epidermal Growth Factor Receptor Expression in Oocytes and Cumulus Cells.

The oocyte competence of prepubertal females is lower compared to that of adults, mainly because they originate from small follicles. In adult females, the germinal vesicle (GV) and epidermal growth factor receptor (EGFR) have been associated with oocyte competence. This study aimed to analyze GV chromatin configuration and EGFR expression in prepubertal goat and sheep oocytes obtained from small (<3 mm) and large (≥3 mm) follicles and compare them with those from adults. GV chromatin was classified from diffuse to condensed as GV1, GVn, and GVc for goats and NSN, SN, and SNE for sheep. EGFR was quantified in cumulus cells (CCs) by Western blotting and in oocytes by immunofluorescence. Oocytes from prepubertal large follicles and adults exhibited highly condensed chromatin in goats (71% and 69% in GVc, respectively) and sheep (59% and 75% in SNE, respectively). In both species, EGFR expression in CCs and oocytes was higher in prepubertal large follicles than in small ones. In adult females, EGFR expression in oocytes was higher than in prepubertal large follicles. In conclusion, GV configuration and EGFR expression in CCs and oocytes were higher in the large than small follicles of prepubertal females.

Análise econômica dos gastos diretos com internações hospitalares por vítimas de trauma do Sistema Único de Saúde em um município de Minas Gerais, 2011-2021 / Economic analysis of direct expenses with hospital admissions for victims of trauma in the United Health System in a municipality of Minas Gerais, 2011-2021

Objetivo: Determinar o perfil epidemiológico de pacientes atendidos pelo Sistema Único de Saúde (SUS), em determinado município do interior de Minas Gerais, bem como os gastos financeiros e o repasse financeiro para os centros de atendimento de traumas. Material e métodos: Trata-se de um estudo ecológico, descritivo, realizado a partir da coleta de dados pelo SIH-SUS, no período de janeiro de 2011 a dezembro de 2021, em um município do interior de Minas Gerais. Resultados: Foi identificado um total de 14.138 pacientes, com maior acometimento de pessoas do sexo masculino, com idade entre 15 e 44 anos. Como causas mais frequentes, destacaram-se os traumatismos de quadril e coxa, seguidos de traumatismos de membros superiores (ombro, antebraço, braço, punho e mão) e cabeça. Como tempo médio de permanência hospitalar, houve 4.693 diárias entre 2011 e 2021 secundárias a complicações em enfermarias e unidade de terapia intensiva, elevando cerca de 2,37% os valores repassados pelo SUS no período estudado. Em resumo, a análise da incidência de traumas nas emergências de um município do interior de Minas Gerais revela uma preocupante tendência em que homens na faixa etária de 15 a 44 anos emergem como as principais vítimas. Esse padrão pode ser influenciado por fatores como ocupação, comportamentos de risco e mobilidade. Conclusão: A compreensão dessa demografia específica é crucial para direcionar estratégias de prevenção e resposta adequadas. A implementação de medidas educativas, segurança no trânsito e promoção da saúde mental pode contribuir para mitigar os impactos dos traumas nesse grupo demográfico, melhorando sua qualidade de vida e a saúde geral da comunidade.

Objective: To determine the epidemiological profile of patients assisted by the unified health system, in a certain municipality in the interior of Minas Gerais, as well as the financial expenses and the financial transfer to trauma care centers. Material and methods: This is an ecological, descriptive study, carried out from data collection by SIH-SUS, from January 2011 to December 2021 in a municipality in the interior of Minas Gerais. Results: a total of 14,138 patients were identified, with greater involvement of male people aged between 15 and 44 years. As the most frequent causes, trauma to the hip and thigh stood out, followed by trauma to the upper limbs (shoulder, forearm, arm, wrist and hand) and head. As for the average length of hospital stay, there were 4,693 daily stays between 2011 and 2021 secondary to complications in wards and the intensive care unit. Increasing about 2.37% in the values transferred by the unified health system between the studied decade. In summary, the analysis of the incidence of trauma in emergencies in a municipality in the interior of Minas Gerais reveals a worrying trend in which men aged 15 to 44 years emerge as the main victims. This pattern can be influenced by factors such as occupation, risky behavior and mobility. Conclusion: Understanding this specific demographic is crucial to targeting appropriate prevention and response strategies. The implementation of educational measures, road safety and mental health promotion can help to mitigate the impacts of trauma in this demographic group, improving their quality of life and the general health of the community.

Nonordinary Experiences, Well-being and Mental Health: A Systematic Review of the Evidence and Recommendations for Future Research.

Throughout history, people have reported nonordinary experiences (NOEs) such as feelings of oneness with the universe and hearing voices. Although these experiences form the basis of several spiritual and religious traditions, experiencing NOEs may create stress and uncertainty among those who experience such events. To provide a more systematic overview of the research linking NOEs with mental health, we present a systematic review of studies focusing on NOEs, well-being and mental health indicators. In a search of ProQuest and PsycInfo, we identified 725 references, of which 157 reported empirical data and were included in our review. Overall, the studies reviewed suggest that the relationship between NOEs and mental health is complex, varying according to a series of psychological and social factors. In particular, they suggest that appraisal processes play a fundamental role in the mental health outcomes of these experiences. However, we also highlight important methodological challenges such as the conceptual overlap between NOEs and well-being or psychopathological constructs, the conflation between experiences and appraisal processes in the assessment procedure, and the need for clearer assessment of the duration, controllability, impact on daily functioning and general context of the experiences. We provide a qualitative summary of empirical evidence and main themes of research and make recommendations for future investigation.

Nonchromosomal birth defects and risk of childhood acute leukemia: An assessment in 15 000 leukemia cases and 46 000 controls from the Childhood Cancer and Leukemia International Consortium.

Although recent studies have demonstrated associations between nonchromosomal birth defects and several pediatric cancers, less is known about their role on childhood leukemia susceptibility. Using data from the Childhood Cancer and Leukemia International Consortium, we evaluated associations between nonchromosomal birth defects and childhood leukemia. Pooling consortium data from 18 questionnaire-based and three registry-based case-control studies across 13 countries, we used multivariable logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between a spectrum of birth defects and leukemia. Our analyses included acute lymphoblastic leukemia (ALL, n = 13 115) and acute myeloid leukemia (AML, n = 2120) cases, along with 46 172 controls. We used the false discovery rate to account for multiple comparisons. In the questionnaire-based studies, the prevalence of birth defects was 5% among cases vs 4% in controls, whereas, in the registry-based studies, the prevalence was 11% among cases vs 7% in controls. In pooled adjusted analyses, there were several notable associations, including (1) digestive system defects and ALL (OR = 2.70, 95% CI: 1.46-4.98); (2) congenital anomalies of the heart and circulatory system and AML (OR = 2.86, 95% CI: 1.81-4.52) and (3) nervous system defects and AML (OR = 4.23, 95% CI: 1.50-11.89). Effect sizes were generally larger in registry-based studies. Overall, our results could point to novel genetic and environmental factors associated with birth defects that could also increase leukemia susceptibility. Additionally, differences between questionnaire- and registry-based studies point to the importance of complementary sources of birth defect phenotype data when exploring these associations.

Internação hospitalar de idosos por Doença de Alzheimer no Brasil, e custo associado: estudo ecológico / Hospitalization of the elderly for Alzheimer's Disease in Brazil, and associated costs: an ecological study

A alta prevalência de demências, onde a população goza de uma maior longevidade, torna-se importante a necessidade de realizar pesquisas relacionadas à doença de alzheimer, assim objetivou-se analisar a tendência temporal de internação hospitalar de idosos por doença de alzheimer no brasil, e custo associado, entre 2008-2020. Estudo ecológico de séries temporais, utilizando registros do sistema de informação hospitalar. Identificou-se que a taxa geral (ß= 0,203; p= 0,009), em ambos os sexos (p≤0,05), na faixa etária de 80 anos ou mais (ß= 1,081; p= 0,002) e em todas as regiões do brasil (p≤ 0,05) apresentou tendência crescente. O custo total de internação foi de r$ 27.617.699,74 e o custo médio de r$ 2.124.438,44. Conclui-se que a tendência temporal de internação hospitalar de idosos por doença de alzheimer está crescente no brasil entre 2008-2020, e os custos associados são consideráveis.

The high prevalence of dementias, where the population enjoys greater longevity, makes the need to conduct research related to alzheimer's disease important, thus we aimed to analyze the temporal trend of hospital admissions of the elderly for alzheimer's disease in brazil, and associated cost, between 2008-2020. Ecological study of analysis of time series, using records from the hospital information system. It was identified that the overall rate (ß= 0.203; p= 0.009), in both sexes (p≤ 0.05), in the age group 80 years and older (ß= 1.081; p= 0.002) and in all regions of brazil (p≤ 0.05) showed an increasing trend. The total cost of hospitalization was r$ 27,617,699.74 and the average cost was r$ 2,124,438.44. it is concluded that the time trend of hospitalization of the elderly for alzheimer's disease is increasing in brazil between 2008-2020, and the associated costs are considerable.

Elimination of cervical cancer in Latin America (Project ECHO-ELA): lessons from phase one of implementation

[ABSTRACT]. We describe the outcomes of The Extension for Community Healthcare Outcomes-Elimination of Cervical Cancer in The Americas (ECHO-ELA) program, which was developed as a tri-lateral cooperation between Pan American Health Organization (PAHO), the U.S. National Cancer Institute (NCI) and The University of Texas MD Anderson Cancer Center (MD Anderson). The program’s purpose is to disseminate strategies for cervical cancer prevention and is structured around the three pillars of the World Health Organization’s (WHO) Cervical Cancer Elimination Strategy and the associated 90-70-90 target goals. The target audience includes health authorities from Latin American and Caribbean countries, as well as PAHO’s non-communicable disease Focal Points in country offices as well as clinical and public health collaborators. The virtual sessions are held in Spanish for 1.5 hours every month using the ECHO® format. From May 2020 to June 2021, 14 ECHO sessions were held with an average of 74 participants per session (range: 46 – 142). We conducted two anonymous surveys (baseline and follow up) and two focus groups. Respondents stated that the topics they learned the most about included the state of HPV vaccination in the region and strategies for implementing HPV vaccina- tion. Identified needs included support between ECHO sessions and country-specific technical assistance. The ECHO-ELA program provides a forum for increased collaboration between countries in Latin America/ Caribbean and the dissemination of best-practice strategies to reach the WHO Cervical Cancer Elimination target goals.

[RESUMEN]. Se describen los resultados del programa ECHO® (Extension for Community Healthcare Outcomes) para la eliminación del cáncer cervicouterino en las Américas (ECHO-ELA), que se concibió como una coop- eración trilateral entre la Organización Panamericana de la Salud (OPS), el Instituto Nacional del Cáncer de los Estados Unidos (NCI) y el centro contra el cáncer MD Anderson (MD Anderson) de la Universidad de Texas. La finalidad del programa es difundir las estrategias para la prevención del cáncer cervicouterino, y está estructurado en torno a los tres pilares de la estrategia para la eliminación del cáncer cervicouterino de la Organización Mundial de la Salud (OMS) y los objetivos 90-70-90 conexos. El público destinatario com- prende autoridades de salud de países de América Latina y el Caribe, así como los puntos focales de la OPS para las enfermedades no transmisibles en las Representaciones en los países, además de colaboradores en el ámbito clínico y de la salud pública. Las sesiones virtuales se llevan a cabo en español, durante 1,5 horas cada mes, utilizando el formato ECHO®. De mayo del 2020 a junio del 2021 se celebraron 14 sesiones de ECHO, con un promedio de 74 participantes por sesión (límites: 46-142). Se realizaron dos encuestas anónimas (al inicio y de seguimiento) y dos grupos de opinión. Los encuestados declararon que los temas sobre los que más aprendieron fueron la situación de la vacunación contra el VPH en la región y las estrate- gias para poner en marcha la vacunación contra el VPH. Entre las necesidades mencionadas figuraban el apoyo entre las sesiones de ECHO y la asistencia técnica específica para cada país. El programa ECHO-ELA brinda un foro para una mayor colaboración entre los países de América Latina y el Caribe y para difundir las estrategias sobre las mejores prácticas, a fin de alcanzar los objetivos de la OMS de eliminación del cáncer cervicouterino.

[RESUMO]. Este trabalho descreve os resultados do programa Extension for Community Healthcare Outcomes para elimi- nação do câncer do colo do útero nas Américas (ECHO ELA), desenvolvido na forma de cooperação trilateral entre a Organização Pan-Americana da Saúde (OPAS), o Instituto Nacional do Câncer dos Estados Unidos (NCI) e o MD Anderson Cancer Center da Universidade do Texas (MD Anderson). O programa visa a dissem- inar estratégias para a prevenção do câncer do colo do útero e está estruturado em torno dos três pilares da estratégia de eliminação do câncer do colo do útero da Organização Mundial da Saúde (OMS) e das Metas 90-70-90 associadas. O público-alvo inclui autoridades sanitárias de países da América Latina e do Caribe, bem como os pontos focais de doenças não transmissíveis nas representações da OPAS nos países, além de colaboradores clínicos e de saúde pública. Todos os meses, são realizadas sessões virtuais de uma hora e meia em espanhol usando o formato ECHO®. No período de maio de 2020 a junho de 2021, foram realizadas 14 sessões do ECHO, com uma média de 74 participantes por sessão (variação: 46 a 142). Foram realizadas duas enquetes anônimas (linha de base e acompanhamento) e dois grupos focais. Os entrevistados afirma- ram que os tópicos sobre os quais mais aprenderam foram a situação da vacinação contra o HPV na região e as estratégias para implementar a vacinação contra o HPV. As necessidades identificadas incluíam apoio entre as sessões do ECHO e assistência técnica específica para o país. O programa ECHO ELA oferece um fórum para aumentar a colaboração entre os países da América Latina e do Caribe e difundir melhores práti- cas para atingir as metas de eliminação do câncer do colo do útero da OMS.

Assessment of Aptamer as a Potential Drug Targeted Delivery for Retinal Angiogenesis Inhibition.

AT11-L0 is an aptamer derivative of AS1411 composed of G-rich sequences that can adopt a G-quadruplex (G4) structure and target nucleolin (NCL), a protein that acts as a co-receptor for several growth factors. Hence, this study aimed to characterize the AT11-L0 G4 structure and its interaction with several ligands for NCL targeting and to evaluate their capacity to inhibit angiogenesis using an in vitro model. The AT11-L0 aptamer was then used to functionalize drug-associated liposomes to increase the bioavailability of the aptamer-based drug in the formulation. Biophysical studies, such as nuclear magnetic resonance, circular dichroism, and fluorescence titrations, were performed to characterize the liposomes functionalized with the AT11-L0 aptamer. Finally, these liposome formulations with the encapsulated drugs were tested on the human umbilical vein endothelial cell (HUVEC) model to assess their antiangiogenic capacity. The results showed that the AT11-L0 aptamer-ligand complexes are highly stable, presenting melting temperatures from 45 °C to 60 °C, allowing for efficient targeting of NCL with a KD in the order of nM. The aptamer-functionalized liposomes loaded with ligands C8 and dexamethasone did not show cytotoxic effects in HUVEC cells compared with the free ligands and AT11-L0, as assessed by cell viability assays. AT11-L0 aptamer-functionalized liposomes encapsulating C8 and dexamethasone did not present a significant reduction in the angiogenic process when compared with the free ligands. In addition, AT11-L0 did not show anti-angiogenic effects at the concentrations tested. However, C8 shows potential as an angiogenesis inhibitor, which should be further developed and optimized in future experiments.

Co-developing a health promotion programme for indigenous youths in Brazil: A concept mapping report.

BACKGROUND: Latin America and the Caribbean Region are home to about 42 million Indigenous people, with about 900,000 living in Brazil. The little routinely collected population-level data from Indigenous communities in the region available shows stark inequities in health and well-being. There are 305 Indigenous ethnic groups, speaking 274 languages, spread across the remote national territory, who have endured long-lasting inequities related to poverty, poor health, and limited access to health care. Malnutrition and mental health are key concerns for young people. Building on our Indigenous communities-academic partnerships over the last two decades, we collaborated with young people from the Terena Indigenous ethnic group, village leaders, teachers, parents, and local health practitioners from the Polo Base (community health centres) to obtain their perspectives on important and feasible actions for a youth health promotion programme. METHODS: The report was conducted in the Tereré Village in Mato Grosso do Sul. Concept mapping, a participatory mixed method approach, was conducted in 7 workshops, 15 adults and 40 youths aged 9-17 years. Art-based concept mapping was used with 9 to 11 years old children (N = 20). Concept systems software was used to create concept maps, which were finalised during the workshops. Focused prompts related to factors that may influence the health and happiness of youths. The participatory method gave Terena youths a significant voice in shaping an agenda that can improve their health. RESULTS: Terena youths identified priority actions that clustered under 'Family', 'School', 'Education', 'Socio-economic circumstances', 'Respect' and 'Sport' in response to protecting happiness; and 'Nutrition pattern', 'Physical activity', 'Local environment', and 'Well-being' in response to having a healthy body. Through the participatory lens of concept mapping, youths articulated the interconnectedness of priority actions across these clusters such that behaviours (e.g. Nutrition pattern, drinking water, physical activity) and aspirations (being able to read, to have a good job) were recognised to be dependent on a wider ecology of factors (e.g. loss of eco-systems, parent-child relationships, student- teacher relationships, parental unemployment). In response to developing youth health, Terena adults suggested priority actions that clustered under 'Relationships', 'Health issues', 'Prevention at Polo Base', 'Access to health care', 'Communication with young people', 'Community life', 'Raising awareness' and 'School support'. Their priorities reflected the need for structural transformative actions (e.g. Polo Base and school staff working together) and for embedding actions to protect Indigenous culture (e.g. integrating their cultural knowledge into training programmes). CONCLUSIONS: Concept maps of Indigenous youths emphasised the need for a health promotion programme that engages with the structural and social determinants of health to protect their happiness and health, whilst those of adults emphasised the need to address specific health issues through preventative care via a school-Polo Base collaboration. Investment in a co-developed school-Polo-Base health promotion programme, with intersectoral engagement, has potential for making Indigenous health systems responsive to the inequalities of youth health, to yield dividends for healthy ageing trajectories as well as for the health of the next generation.

Construção de ferramentas para padronização da classificação de risco em Unidade de Urgência de Sergipe / Construction of tools to standardize risk classification in the Emergency Unit of Sergipe

Introdução:as Unidades de Urgência 24 horas utilizam o acolhimento com classificação de risco para atender efetivamente os quadros clínicos ou agudizados. Contudo, alta demanda e falta de sistematização para a realização desse processo dificultam a identificação dos pacientes graves e agilidade no fluxo de atendimento ao aumentar o tempo de espera no atendimento dos usuários. descrever a construção e implementação do Objetivo:protocolo operacional padrão (POP) melhorar o fluxo de atendimento na Unidade de Urgência 24 horas em um município sergipano. Métodos:trata-se de um estudo descritivo, do tipo relato de experiência sobre o processo de construção de um POPpara a classificação de risco e de ferramentas para implementação na unidade, realizado entre novembro de 2022 e fevereiro de 2023. As fundamentações teóricas para construção do protocolo seguiram as diretrizes do Ministério da Saúde sobre acolhimento com classificação de risco e instrumentos adotados em outras unidades de urgência. Conclusões:o uso de ferramentas assistenciais padronizadas é essencial para a resolutividade da superlotação e fluxo de comunicação nas unidades de urgência. Assim, o estudo identificou a necessidade da padronização da classificação de risco, bem como a sua importância para a sensibilização da população.

Fatores associados ao estado nutricional de crianças menores de 5 anos na região Nordeste do Brasil / Factors associated with the nutritional status of children under 5 years of age in the Northeast region of Brazil

Resumo Introdução: A dupla carga de má nutrição apresenta na atualidade novos e complexos desafios para a saúde pública, afetando de modo crescente populações vulneráveis, com consequências sociais negativas. Objetivo: Avaliar inter-relações de fatores biológicos e sociais com indicadores antropométricos do estado nutricional de crianças menores de cinco anos de idade. Método: Estudo transversal realizado em dois municípios do Estado da Paraíba, com crianças atendidas na Estratégia Saúde da Família. Analisaram-se fatores representativos das causas imediatas, intermediárias e básicas do estado nutricional das crianças, por meio de análise de correlação canônica. Resultados: Das 413 crianças que participaram do estudo, 9,4% foram diagnosticadas com déficit de estatura e 16,5% com sobrepeso/obesidade. O crescimento linear da criança associou-se ao peso ao nascer, à idade gestacional, à estatura materna e ao nível socioeconômico da família. O sobrepeso/obesidade revelou-se relacionado à idade da criança, ao índice de massa corporal materno, ao benefício do Bolsa Família e ao suporte social. Conclusões: A associação de características da criança ao nascimento, do estado nutricional materno e do entorno social com as proporções importantes de déficit de estatura e sobrepeso/obesidade observadas fundamentam a melhoria do estado nutricional da criança com foco na prevenção desde os estágios iniciais da vida.

Abstract Background: The double burden of malnutrition currently presents new and complex public health challenges, increasingly affecting vulnerable populations, with negative social consequences. Objective: To evaluate the interrelationships of biological and social factors with anthropometric indicators of the nutritional status of children under 5 years of age. Method: It is a cross-sectional study carried out in two municipalities in the state of Paraíba, with children assisted by the Family Health Strategy. Factors representative of the immediate, intermediate and basic causes of children's nutritional status were analyzed, through canonical correlation analysis. Results: Of the 413 children who participated in the study, 9.4% were diagnosed stunting and 16.5% were overweight/obese. The linear growth of child was associated with birth weight, gestational age, maternal height, and socioeconomic level of the family. Overweight/obesity was related to the child's age, maternal body mass index, the benefit of the Bolsa Família and social support. Conclusions: The association of child characteristics at birth, maternal nutritional status, and social environment with the important proportions of stunting and overweight/obesity observed support the improvement of the child's nutritional status with a focus on prevention from the early stages of life.

Analysis of scientific production aligned with the Food and Nutrition Security Strategy of Portuguese-Speaking African Institutions: a systematic scoping review / Análise da produção científica alinhada com a Estratégia de Segurança Alimentar e Nutricional das Instituições Africanas de Língua Portuguesa: uma revisão sistemática de escopo

ABSTRACT This systematic scoping review aimed to map and characterize the scientific production of researchers from Portuguese-speaking African institutions that align with the Food and Nutrition Security Strategy of the Community of Portuguese-Speaking Countries. The literature search was conducted using six electronic databases (PubMed, EMBASE, Virtual Health Library, Scientific Electronic Library Online, Scopus, and Web of Science), with no restrictions on the year of publication nor language. Through the search strategy, 10,061 records were identified, of which 502 documents and 654 researchers were selected by Food and Nutrition Security specialists along three axes: 1) Policy governance; 2) Access to food; 3) Availability of food. Institutional researchers from Mozambique (66.9%), Guinea-Bissau (15.9%), and Angola (11.4%) presented the most publications and international collaborations. Researchers from Cape Verde, Sao Tome and Principe, and Equatorial Guinea institutions added only 5.8% of the total production. A greater number of publications (61%) was related to axis two of the Food and Nutrition Security Strategy of the Community of Portuguese-Speaking Countries. The most studied themes were sustainable development, child malnutrition, and agricultural production for the first, second, and third axis, respectively. In general, scientific publications have shown limitations in their approaches due to the challenge imposed by the complexity of the food system. However, there has been a quantitative evolution in publications in the last decade, with a greater participation of researchers from Portuguese-speaking African institutions.

RESUMO Esta revisão sistemática de escopo teve como objetivo mapear e caracterizar a produção científica de pesquisadores de instituições africanas de língua portuguesa que se alinham com a Estratégia de Segurança Alimentar e Nutricional da Comunidade dos Países de Língua Portuguesa. A busca das literaturas foi realizada em seis bases de dados eletrônicas (PubMed, EMBASE, Biblioteca Virtual em Saúde, Scientific Electronic Library Online, Scopus e Web of Science), sem restrição quanto ao ano de publicação e ao idioma. Por meio da estratégia de busca, foram identificados 10.061 registros, dos quais 502 documentos e 654 pesquisadores foram selecionados por especialistas em Segurança Alimentar e Nutricional em três eixos: 1) Governança de políticas; 2) Acesso à alimentação; 3) Disponibilidade de alimentos. Pesquisadores de intuições de Moçambique (66,9%), Guiné-Bissau (15,9%) e Angola (11,4%) foram os que apresentaram o maior número de publicações e colaborações internacionais. No entanto, os pesquisadores das instituições de Cabo Verde, São Tomé e Príncipe e Guiné Equatorial somaram apenas 5,8% da produção total. Foi observado maior número de publicações (61%) relacionadas com o eixo dois da Estratégia de Segurança Alimentar e Nutricional da Comunidade dos Países de Língua Portuguesa. As temáticas mais estudadas foram desenvolvimento sustentável, desnutrição infantil e produção agrícola para o primeiro, segundo e terceiro eixo, respectivamente. De forma geral, as publicações científicas mostraram limitações em suas abordagens frente ao desafio imposto pela complexidade do sistema alimentar. Todavia, foi houve uma evolução quantitativa nas publicações na última década; além disso, maior participação de pesquisadores de instituições africanas de língua portuguesa pode ser vislumbrada.

Vulnerability of Venezuelan immigrants living in Boa Vista, Roraima / Vulnerabilidad de inmigrantes venezolanos residentes en Boa vista, Roraima / Vulnerabilidade de imigrantes venezuelanos residentes em Boa vista, Roraima

ABSTRACT Objective: To identify the social and health vulnerabilities of Venezuelan immigrants living in Boa Vista, Roraima. Method: Mixed methods research, with concomitant transformative strategy. In the quantitative phase, analysis of management documents for the state of Roraima and the capital Boa Vista were carried out. In the qualitative, open interviews with 16 Venezuelan immigrants, 14 nursing professionals and 8 public managers and a focus group with 12 nursing professionals. The webQDA software was used to organize the data and the content and discourse analyzes were based on Bardin and on dialectic-hermeneutics, according to Minayo. Results: The main vulnerabilities identified were the absence of public policies for immigrants, the fragility of links with health services and language differences. Conclusion: The vulnerabilities of Venezuelan immigrants are linked to their ways of living and working. Health institutions and organizations are not fully qualified to serve them. Specific policies are needed for this social group and to qualify institutions and health professionals to implement these policies.

RESUMEN Objetivo: Identificar las vulnerabilidades sociales y sanitarias de inmigrantes venezolanos residentes en Boa Vista, Roraima. Método: Es una investigación de métodos mixtos, con estrategia transformativa concomitante. En la fase cuantitativa se llevó a cabo el análisis de documentos de gestión del estado de Roraima y de su capital, Boa Vista. En la fase cualitativa, se realizaron entrevistas abiertas con 16 inmigrantes venezolanos, 14 enfermeros y 8 gestores públicos y un grupo focal con 12 profesionales de enfermería. Se utilizó el software webQDA para organizar los datos y el análisis de contenido y discurso estuvo basado en Bardin y en la hermenéutica-dialéctica, según Minayo. Resultados: Las principales vulnerabilidades fueron la falta de políticas públicas hacia los inmigrantes, la fragilidad de los vínculos con los servicios sanitarios y las diferencias lingüísticas. Conclusión: Las vulnerabilidades de los inmigrantes venezolanos están relacionadas con su forma de vida y trabajo. Las instituciones y organizaciones sanitarias no tienen suficiente capacidad para atenderlos. Se necesitan políticas específicas para este grupo social y preparación de las instituciones y profesionales de la salud para implementar dichas políticas.

RESUMO Objetivo: Identificar as vulnerabilidades sociais e de saúde de imigrantes venezuelanos residentes em Boa Vista, Roraima. Método: Pesquisa de métodos mistos, com estratégia transformativa concomitante. Na fase quantitativa, foram realizadas análises de documentos de gestão do estado de Roraima e da capital Boa Vista. Na qualitativa, entrevistas abertas com 16 imigrantes venezuelanos, 14 profissionais de enfermagem e 8 gestores públicos e um grupo focal com 12 profissionais de enfermagem. Utilizou-se o software webQDA para organização dos dados, e as análises de conteúdo e de discurso foram baseadas em Bardin e na hermenêutica-dialética, segundo Minayo. Resultados: As principais vulnerabilidades identificadas foram a ausência de políticas públicas para imigrantes, a fragilidade dos vínculos com os serviços de saúde e as diferenças de idioma. Conclusão: As vulnerabilidades dos imigrantes venezuelanos encontram-se vinculadas aos seus modos de viver e de trabalhar. As instituições e organizações de saúde não se encontram plenamente qualificadas para atendê-los. São necessárias políticas específicas para esse grupo social e qualificar instituições e profissionais de saúde para execução dessas políticas.

The Free Radical Scavenging Property of the Leaves, Branches, and Roots of Mansoa hirsuta DC: In Vitro Assessment, 3D Pharmacophore, and Molecular Docking Study.

In this work, a metabolic profile of Mansoa hirsuta was investigated, and in vitro assays and theoretical approaches were carried out to evaluate its antioxidant potential. The phytochemical screening detected saponins, organic acids, phenols, tannins, flavonoids, and alkaloids in extracts of leaves, branches, and roots. Through LC-MS analysis, the triterpenes oleanolic acid (m/z 455 [M-H]-) and ursolic acid (m/z 455 [M-H]-) were identified as the main bioactive components. The extracts of the leaves, branches, and roots revealed moderate antioxidant potential in the DPPH test and all extracts were more active in the ABTS test. The leaf extracts showed better antioxidant capacity, displaying IC50 values of 43.5 ± 0.14, 63.6 ± 0.54, and 56.1 ± 0.05 µg mL-1 for DPPH, ABTS, and kinetics assays, respectively. The leaf extract showed higher total flavonoid content (TFC) (5.12 ± 1.02 mg QR/g), followed by branches (3.16 ± 0.88 QR/g) and roots (2.04 ± 0.52 QR/g/g). The extract of the branches exhibited higher total phenolic content (TPC) (1.07 ± 0.77 GAE/g), followed by leaves (0.58 ± 0.30 GAE/g) and roots (0.19 ± 0.47 GAE/g). Pharmacophore and molecular docking analysis were performed in order to better understand the potential mechanism of the antioxidant activity of its major metabolites.

Wideband absorbance for the assessment of pressure equalizing tubes patency in children.

OBJECTIVES: To analyze the feasibility of using wideband absorbance to verify the patency of pressure equalizing tubes (PETs) in clinical practice and to present the response pattern of this measure for ears with patent PET. METHODS: This observational case-control type study evaluated 48 ears of 30 children with severe or profound hearing loss, aged 10-44 months, of both sexes. The subjects were subdivided into two groups: 24 ears with Sheppard type PET (experimental group - EG) and 24 ears with normal middle ear (control group - CG), paired with the EG, according to age, sex, and ear evaluated. To obtain the wideband absorbance, a Middle-Ear Power Analyzer, version 5.0 (Mimosa Acoustics), was used, and absorbance values for pure tone and chirp stimuli were analyzed. RESULTS: There was no influence of ear (right or left) on the measurements obtained. The EG showed higher absorbance values at low frequencies. Although the two stimuli made it possible to identify the difference in acoustic transfer function between the groups studied, compared to pure tone, the chirp stimulus allowed identification of differences in a higher number of frequencies. CONCLUSIONS: Ears with a patent PET present an acoustic transfer pattern that differs from that obtained for normal middle ears, with a higher absorbance at low frequencies. Both pure tone and chirp stimuli can be used to identify such differences, nevertheless, the use of chirp stimulus is recommended, since it allows differentiation over a wider frequency range.

Lack of validity of free-living physical activity energy expenditure estimated from ActiGraph equations in severely obese women: A doubly labelled water study.

The current study aimed to investigate the validity of three ActiGraph predictive equations that are available to estimate free-living physical activity energy expenditure (PAEE) in women with severe obesity. The study included 20 women with class III obesity (age: 22-38 years). During 14 days of free-living conditions, total energy expenditure was measured using the doubly labelled water method; in addition, participants wore a triaxial accelerometer (model GT3X+) on the hip. The resting metabolic rate was measured by indirect calorimetry. At group level, the Freedson VM3 Combination was found to be more precise (bias = -61 kcal/day) than the Williams Work-Energy (bias = -283 kcal/day) and the Freedson Combination equations (bias = -186 kcal/day) for estimating PAEE. However, the three predictive equations had a wider limit of agreement (Williams Work-Energy [258, -824 kcal/day], Freedson Combination equations [324, -697 kcal/day] and Freedson VM3 Combination [424, -546 kcal/day]), indicating great uncertainty of the estimate. In conclusion, a wide variation was observed in the performance of different ActiGraph equations in estimating free-living PAEE among women with class III obesity. Therefore, our data do not support the use of these equations, and more studies are needed to improve predictive performance in free-living conditions.

Assessment of screening programs as a strategy for early detection of oral cancer: a systematic review.

The present study is a systematic review of the evaluation of screening programs as a strategy for early detection of oral cancer. The aim of this study was to assess whether screening through visual inspection is able to identify injuries in early stages, to increase survival, and to decrease the incidence and mortality of oral cancer. Studies using visual inspection to screen for oral cancer and potentially malignant lesions in apparently healthy individuals over 18 years without previous diagnosis of the disease were included. The MEDLINE/PubMed, Cochrane databases Library, EMBASE, and LILACS, including manual search and gray literature, were searched through January 2021 with no language or date restrictions. The risk of bias and the methodological quality were evaluated according to the appropriate tool for each study design. The analysis of the results was narrative. Seventeen studies were reviewed that included cohort, accuracy, and randomized clinical trial studies. The tracking type performed was opportunistic and organized in a variety of environments. The age of participants ranged between 18 and 60 years old and, in some programs, only people with risk habits for oral cancer were included. The screeners were healthcare professionals, physicians, and dentists. Two studies reported data on the incidence rate of severe cases and mortality and showed a reduction when patients were at risk for the disease and participated in the program more than once. A limitation of this review was the great variability observed in the estimates of the screening effectiveness among the studies, which made comparisons difficult. If a screening program is continuous and able to ensure the inclusion of high-risk individuals, it can contribute to improvement in survival rates with a change of stage and can have a significant impact on incidence and mortality due to the disease. Registration in the Open Science Framebook (OSF) with the osf.io/zg8nr link.

Assessment of microcystins in surface water and irrigated vegetables in Kwaru stream, Hayin Danmani, Kaduna-Nigeria.

Microcystins (MCs) are hepatotoxic secondary metabolites produced by several genera of cyanobacteria. Human exposure routes include drinking contaminated water and consuming contaminated fish, vegetables, crops, and even food supplements that contain cyanotoxin. This study investigated the presence of MCs in a stream with a long history of use as a source of water for irrigation farming. To establish the risk of a lack of monitoring programs, we studied MCs contamination of irrigated vegetables. Toxin levels in the water were generally <0.05 µg L-1 in all the investigated stations. Total microcystin concentrations in spinach (0.306 µg Kg-1 upstream and 0.217 µg Kg-1 downstream), lettuce (0.085 µg Kg-1 upstream and 0.462 µg Kg-1 downstream), carrot (0.050 µg Kg-1 downstream and 0.116 µg Kg-1 downstream), cabbage (0.014 µg Kg-1 upstream and 0.031 µg Kg-1 downstream), tomatoes (0.233 µg Kg-1 upstream), and bitter leaf (0.460 µg Kg-1 upstream and 0.050 µg Kg-1 downstream) collected in March were higher than the levels detected in samples of the same vegetables collected in April. These results highlight Nigeria's severe public health problem, especially in regions with long dry season spells. The level of MCs contamination of irrigated vegetables implies a potential for chronic exposure and associated health challenges.

Marine macroalgae in a circular economy context: A comprehensive analysis focused on residual biomass.

The accumulation of Marine Macroalgal Waste (MMW) - drifted marine macroalgae - is a growing phenomenon. The lack of appropriate management protocols for this residual biomass leaves it mostly unmanaged or disposed of in landfills. Such inappropriate solutions lead to negative environmental impacts, health concerns and coastal degradation, representing an opportunity to develop the bioeconomy. Although a relevant number of studies exists on the use of edible marine macroalgae for several purposes, there is generally a lack of information concerning MMW valorisation, at both local and global scales. This review thus explores the ecological and biotechnological potential for the establishment of a new approach for MMW valorisation based in the circular and blue economies. It is supported in literature on the use of residual biomass whenever possible and also includes studies with fresh biomass to extrapolate, considering known characteristics of MMW; consequently, a roadmap for its utilisation is provided. The review includes characteristics of various seaweeds, MMW accumulation worldwide and traditional uses, together with the development of alternative and integrated valorisation strategies. By analysing a large number of studies, it was possible to perceive a clear potential to explore MMW to obtain renewable fuels, especially biogas and bioethanol and for use in agricultural activities. Allied to this, the extraction of value-added compounds, such as lipids, pigments, phenolic compounds and specific polysaccharides is highlighted, aiming to contribute to the development of an economically feasible zero-waste biorefinery approach.

Malignancy risk of thyroid nodules: quality assessment of the thyroid ultrasound report.

BACKGROUND: Thyroid nodules are a challenge in clinical practice and thyroid ultrasonography is essential for assessing the risk of malignancy. The use of ultrasound-based malignancy risk classification systems has been recommended by several scientific societies but radiologist's adherence to these guidelines may vary. The authors aimed to analyze the quality of the information provided by the thyroid ultrasound report, to assess the malignancy risk of thyroid nodules, in Portugal. METHODS: Multicenter and retrospective study, conducted in three of the five Portuguese NUTS2 corresponding to about 88.3% of the mainland population. We included 344 consecutive unselected participants aged ≥ 18 years who underwent thyroid ultrasonography in 2019. The description of six features of the dominant thyroid nodule was analyzed: maximum size, shape, margins, composition, echogenicity and echogenic foci. A utility score, including these six features, was used as an indicator of the report's quality. A score of 4 was considered as a minimum value. RESULTS: Maximum diameter was reported for all nodules. Shape, margins, composition, echogenicity and echogenic foci were reported in 8.1%, 25.0%, 76.5%, 53.2% and 20.9%, respectively. Only 21.8% of the nodules had a score ≥ 4. At least one of four suspicious features, including marked hypoechogenicity, microcalcifications, irregular margins and non-oval shape, was identified in 8.7% of the nodules. Cervical lymph nodes' status was reported in 93% of the exams. The risk category was only reported in 7.8% of the participants. CONCLUSION: The adherence of Portuguese radiologists to a standardized reporting model and to an ultrasound-based malignancy risk stratification system is still low and has implications for the correct characterization of the malignancy risk of nodules and the decision to perform fine-needle aspiration biopsy.