Access to dental services in an elder population of African descent in Brazil.

OBJECTIVES: We investigated access to dental services and associated factors in a community of Quilombola older people. BACKGROUND: Quilombola populations are groups of individuals descended from black Africans subjected to slavery during part of Brazilian history. As marginalised and neglected individuals, they have high rates of negative indicators and require further attention to the social determinants that affect their health reality. MATERIALS AND METHODS: A cross-sectional quantitative study was conducted in the Quilombola community of Castainho, in the Northeast region of Brazil. In this community, 34 older people aged between 65 and 74 resided. We collected self-report data on sociodemographic and economic characteristics, along with oral examinations by the researchers. The primary dependent variable was regular access to dental services. Statistical analysis used Fisher's exact test (P = .05). RESULTS: Among the 32 participants in the final sample, 18.8% (n = 6) reported accessing dental services in the previous 6 months. Self-declared individuals of mixed race, with positive self-assessment of oral health, and those who did not self-perceive the need for treatment had lower rates of regular access to dental services (P < .05). CONCLUSION: Use of dental services by older Quilombola people is low, and there are differences by ethnicity and individual perception of oral health.

Might Zika virus-associated microcephaly's severity impact deciduous tooth eruption and orofacial structures?

OBJECTIVE: to investigate the impact of the severity of microcephaly caused by the Zika virus (MCZ) on tooth eruption and orofacial structures of children. DESIGN: This case series study developed the research at the Mens Sana Rehabilitation Center, Arcoverde, Brazil. The study included 27 children diagnosed with MCZ. We performed the data collection in June 2018 through a questionnaire answered by the legal guardians, followed by a clinical examination of the children. The data were analyzed by the Mann-Whitney and Fisher's exact tests (p = 0.05). RESULTS: The final sample was composed of 20 children. Of these, 13 (35.0%) had severe microcephaly, 5 (30.0%) had altered sequence of tooth eruption, 10 (50.0%) had delayed eruption, and the mean number of decayed teeth was 2.3. The most identified orofacial changes were teeth grinding habit (65.0%), difficult chewing (50.0%), and non-nutritive sucking (50.0%). The Mann-Whitney test showed that the severity of microcephaly did not affect tooth eruption (p = 0.581). The Fisher's exact test showed that the severity of microcephaly was not associated with orofacial changes (p > 0.05). CONCLUSIONS: The severity of MCZ does not seem to influence changes in deciduous tooth eruption and the presence of orofacial anomalies.

Orofacial features in children with microcephaly associated with Zika virus: A scoping review.

OBJECTIVE: To analyze published scientific evidence about the most common orofacial disorders in children with microcephaly associated with ZIKV infection. METHODS: Through a scoping review, we respond to the search question was formulated: "What are the orofacial alterations in children with microcephaly associated with ZIKV?" It was performed a search in PubMed, EMBASE, Scopus, and Health Virtual Library. It was selected papers wrote in English, Portuguese, or Spanish. An evidence quality analysis was performed using the Agency for Healthcare Research and Quality classification. RESULTS: It was included 11 studies performed in the Brazilian Northeast region. The studies were carried out between 2018 and 2020. The main related alterations were delay in the tooth-eruption and deformation in the oral structures. CONCLUSION: The results observed in our work show moderate scientific evidence regarding the association of ZIKV with orofacial alterations in children with microcephaly due to the classifications of the quality of evidence of each one of the included studies. The main changes reported were in the chronology of tooth eruption, alteration in teeth, and oral structures.

Access to information on oral hygiene and mothers' practices of children with microcephaly caused by Zika virus.

OBJECTIVE: To verify whether access to information about oral hygiene influenced the practices of caregivers of children with microcephaly caused by Zika virus (ZIKV). METHODS: A case series study was developed at the Mens Sana Rehabilitation Center, in the municipality of Arcoverde, Pernambuco, Brazil. The study universe included the mothers of 32 children with microcephaly caused by Zika virus. Data collection took place in June 2018 and was carried out through a structured questionnaire. The variables studied comprised socioeconomic issues, habits, diet, and knowledge about oral hygiene. Fisher's Exact and Pearson's Chi-square tests were used with a significance level of 5%. RESULTS: Out of 32 individuals eligible to participate in the study, only 27 were selected. Most mothers reported receiving information about oral hygiene from their infants (63.0%). Fisher's Exact and Pearson's Chi-square tests showed that access to oral hygiene information was associated with mother's education, family income, regular visits to the dentist, frequency of tooth brushing, age at which the infant started brushing, and brushing time (p < 0.05). CONCLUSION: Access to information about oral hygiene positively influenced the oral health care of mothers with their children with microcephaly caused by ZIKV.

Identification of docosahexaenoic and eicosapentaenoic acids multiple targets facing periodontopathogens.

The eicosapentaenoic (EPA) and docosahexaenoic acid (DHA) play a substantial role in Periodontal Disease (PD) due to their antimicrobial and immunomodulatory actions. However, their antimicrobial mechanism of action against bacteria involved in PD remains unclear. We aimed to estimate the probable targets of EPA and DHA against the seven periodontopathogens. Through in silico analyses, the protein-acids interactions, protein characterization, and molecular docking were performed. We identified 165 proteins from periodontopathogens that may interact with EPA and DHA. Fusobacterium nucleatum has the highest number of predicted proteins among analyzed bacteria (n = 43, 26.06%). The EPA shows more interactions than DHA. The EPA and DHA interact mainly with proteins involved in the metabolism (n = 69, 41.81%). Also, the EPA and DHA interact with proteins located in any subcellular location. The affinities between acids and pathogenic proteins were moderate (binding energy was lower than -4.0 kcal/mol). The interactions between EPA and DHA and periodontopathogens occur in multiples proteins. There is not a predilection about the functional class of pathogenic proteins targeting EPA and DHA. However, there are moderate binding affinities between EPA or DHA and essential pathogenic proteins (TolC, CRISPR, FusA).

On the genetic architecture in a public tropical maize panel of the symbiosis between corn and plant growth-promoting bacteria aiming to improve plant resilience.

Exploring the symbiosis between plants and plant growth-promoting bacteria (PGPB) is a new challenge for sustainable agriculture. Even though many works have reported the beneficial effects of PGPB in increasing plant resilience for several stresses, its potential is not yet widely explored. One of the many reasons is the differential symbiosis performance depending on the host genotype. This opens doors to plant breeding programs to explore the genetic variability and develop new cultivars with higher responses to PGPB interaction and, therefore, have higher resilience to stress. Hence, we aimed to study the genetic architecture of the symbiosis between PGPB and tropical maize germplasm, using a public association panel and its impact on plant resilience. Our findings reveal that the synthetic PGPB population can modulate and impact root architecture traits and improve resilience to nitrogen stress, and 37 regions were significant for controlling the symbiosis between PGPB and tropical maize. In addition, we found two overlapping SNPs in the GWAS analysis indicating strong candidates for further investigations. Furthermore, genomic prediction analysis with genomic relationship matrix computed using only significant SNPs obtained from GWAS analysis substantially increased the predictive ability for several traits endorsing the importance of these genomic regions for the response of PGPB. Finally, the public tropical panel reveals a significant genetic variability to the symbiosis with the PGPB and can be a source of alleles to improve plant resilience. Supplementary Information: The online version contains supplementary material available at 10.1007/s11032-021-01257-6.

Two phytocompounds from Schinopsis brasiliensis show promising antiviral activity with multiples targets in Influenza A virus.

Influenza A virus, the main flu agent, affects billions of people worldwide. Conventional treatments still present limitations related to drug-resistance and severe side effects. As a result, natural product-derived molecules have been increasingly investigated as prospect drug candidates. Therefore, the aim of this study was to investigate the possible anti-flu activity and to evaluate the toxicity and pharmacokinetic parameters, by in silico approaches, of the Schinopsis brasiliensis Engl. phytochemical compounds. Nine phytocompounds and six antiviral drugs (Amantadine, Umifenovir, Favipiravir, Nitazoxanide, Oseltamivir, Zanamivir) were selected for the analyses against four Influenza A proteins: neuraminidase, polymerase basic protein 2, hemagglutinin and M2 ion channel protein. The molecular docking, the predicted antiviral activity, the predicted toxicity and the pharmacokinetics investigations were conducted. The obtained results demonstrated that Syringaresinol and Cycloartenone display promising in silico antiviral activity (binding energy < 5.0 and ≥ 9.0 kcal/mol) and safety (low toxicity than commercial anti-flu drugs). Overall, this study corroborated the hypothesis that S. brasiliensis barks extract has a biological activity against Influenza A virus. Additionally, Syringaresinol and Cycloartenone have multiple targets in Influenza A virus and showed themselves as the most promising phytocompounds to be isolated and considered for the therapeutic arsenal against the flu.

Schinopsis brasiliensis Engl. to combat the biofilm-dependents diseases in vitro.

Dental caries and periodontal disease are the most prevalent of the biofilm-dependent diseases. With numerous side effects on the use of chlorhexidine, the search for new safe therapeutic alternatives for microorganisms involved with these diseases increases every day. This study aimed to evaluate the antimicrobial activity and cytotoxicity of extracts made from the bark of Schinopsis brasiliensis Engl. against five oral microorganisms and analyze their phytochemical and thermal degradation profile. The liquid-liquid partition was performed with hexane, chloroform and ethyl acetate. The identification and quantification of the chemical marker was done. Antimicrobial activity was evaluated based on the minimum inhibitory concentration. The cytotoxicity was analyzed based on the hemolysing potential of the samples. The thermal degradation profile was performed by two different methods. Gallic acid was identified as the main compound of the samples and showed the highest amount in the chloroform fraction. All samples were able to inhibit the growth of the microorganisms tested and showed no cytotoxicity. The ethanol extract absorbs less heat than the fractions. All samples exhibited exothermic peak consistent with degradation of gallic acid. Based on the results, the samples used are potential candidates for use in dental formulations for biofilm control.

Antimicrobial Activity of Schinopsis brasiliensis Engler Extract-Loaded Chitosan Microparticles in Oral Infectious Disease.

Enterococcus faecalis infections represent a health concern, mainly in oral diseases, in which treatments with chlorhexidine solution (0.2%) are often used; however, it presents high toxicity degree and several side effects. Based on this, the use of natural products as an alternative to treatment has been explored. Nonetheless, plant extracts have poor organoleptic characteristics that impair theirs in natura use. Therefore, this work aimed to evaluate the analytical profile, biological activity, and cytotoxicity in vitro of S. brasiliensis-loaded chitosan microparticles (CMSb) produced using different aspersion flow rates. The analytical fingerprint was obtained by FTIR and NIR spectra. Principal components analysis (PCA) was used to verify the similarity between the samples. The crystallinity degree was evaluated by X-ray diffraction (XRD). Phytochemical screening (PS) was performed to quantify phytocompounds. Antimicrobial activity was evaluated by minimum inhibitory concentration (MIC). Antibiofilm activity and bactericidal kinetics against E. faecalis (ATCC 29212 and MB 146-clinical isolated) were also assessed. The hemolytic potential was performed to evaluate the cytotoxicity. Data provided by FTIR, NIR, and PCA analyses revealed chemical similarity between all CMSb. Furthermore, the results from XRD analysis showed that the obtained CMSb present amorphous characteristic. Tannins and polyphenols were accurately quantified by the PS, but methodology limitations did not allow the flavonoid quantification. The low hemolytic potential assay indicates that all samples are safe. Antimicrobial assays revealed that CMSb were able to inhibit not only the E. faecalis ATCC growth but also the biofilm formation. Only one CMSb sample was able to inhibit the clinical strain. These results highlighted the CMSb antimicrobial potential and revealed this system as a promising product to treat infections caused by E. faecalis.

Antibiotic Resistance Profile of Clinical Strains of Enterococci from Secondary/Persistent Endodontic Infections: What do We Know? A Systematic Review of Clinical Studies.

INTRODUCTION: Enterococcus faecalis is the most common enterococcal species associated with infective endocarditis and 1 of the most commonly detected bacteria in cases of secondary/persistent endodontic infection (SPEI). Antimicrobial resistance is a global public health concern. This review aimed to answer the following research question: "Is there a change in the antibiotic resistance profile in clinical strains of E. faecalis over the years?". P (population) - patients with SPEI, I (intervention) -endodontic retreatment, C (comparison) -not included, O (outcome) - profile of Enterococci resistance and susceptibility to systemic antibiotics used. METHODS: Two authors independently performed study selection, data extraction, and risk of bias assessment. The literature search was conducted using the following electronic databases: PubMed, Scopus, EMBASE, Web of Science, and Medline. Clinical studies in which Enterococci strains were isolated to assess their antimicrobial resistance were included. RESULTS: Eleven clinical trials were included. Overall, E. faecalis isolated from teeth with SPEI presented an intermediate resistance to 16 antibiotics. In recent years, E. faecalis showed a little resistance to amoxicillin (without clavulanate) and benzylpenicillin. Erythromycin and rifampicin presented an increase in the intermediate-resistance status between the first and the last studies. E. faecium presented intermediate-resistance results. CONCLUSION: The most effective drugs remain the combination of amoxicillin and clavulanate, followed by amoxicillin and benzylpenicillin. In patients allergic to penicillin derivatives, moxifloxacin and azithromycin may be indicated with caution. The antibiotics with the highest pattern of resistance against E. faecalis are clindamycin, gentamicin, metronidazole, and rifampicin and are therefore, contraindicated in cases of SPEI. Very few clinical studies using a microbiological approach in teeth with endodontic failure have been carried out to improve the efficacy of prophylactic regimens. However, as bacteria periodically develop resistance to the main drugs used, regular studies should be carried out on the action of these drugs in infection control.

Unlocking the complete blood count as a risk stratification tool for breast cancer using machine learning: a large scale retrospective study.

Optimizing early breast cancer (BC) detection requires effective risk assessment tools. This retrospective study from Brazil showcases the efficacy of machine learning in discerning complex patterns within routine blood tests, presenting a globally accessible and cost-effective approach for risk evaluation. We analyzed complete blood count (CBC) tests from 396,848 women aged 40-70, who underwent breast imaging or biopsies within six months after their CBC test. Of these, 2861 (0.72%) were identified as cases: 1882 with BC confirmed by anatomopathological tests, and 979 with highly suspicious imaging (BI-RADS 5). The remaining 393,987 participants (99.28%), with BI-RADS 1 or 2 results, were classified as controls. The database was divided into modeling (including training and validation) and testing sets based on diagnostic certainty. The testing set comprised cases confirmed by anatomopathology and controls cancer-free for 4.5-6.5 years post-CBC. Our ridge regression model, incorporating neutrophil-lymphocyte ratio, red blood cells, and age, achieved an AUC of 0.64 (95% CI 0.64-0.65). We also demonstrate that these results are slightly better than those from a boosting machine learning model, LightGBM, plus having the benefit of being fully interpretable. Using the probabilistic output from this model, we divided the study population into four risk groups: high, moderate, average, and low risk, which obtained relative ratios of BC of 1.99, 1.32, 1.02, and 0.42, respectively. The aim of this stratification was to streamline prioritization, potentially improving the early detection of breast cancer, particularly in resource-limited environments. As a risk stratification tool, this model offers the potential for personalized breast cancer screening by prioritizing women based on their individual risk, thereby indicating a shift from a broad population strategy.

Preemptive use of ibuprofen and desensitizer decreases immediate tooth sensitivity after in-office bleaching: A triple-blind, randomized, placebo-controlled clinical trial.

BACKGROUND: The authors evaluated the synergistic analgesic effect of preemptive administration of 400 mg of ibuprofen (IBU) and potassium fluoride 2% (KF2), both in isolation or combination, on the painful perception of tooth sensitivity after tooth bleaching. METHODS: Fifteen patients participated in this triple-blind, randomized, placebo-controlled clinical trial. The study used a crossover design for drug administration and a split-mouth design for desensitizer agent. Four paired groups were formed: IBU plus KF2 (IBU + KF2); IBU (IBU + placebo KF); KF2 (placebo IBU + KF2), and placebo (placebo IBU + placebo KF). The outcome measure was the perception of tooth sensitivity, assessed using a visual analog scale. Data were collected at 4 different times: immediately after tooth bleaching (baseline) and after 6, 30, and 54 hours. Statistical analysis was performed using the Friedman test and relative risk. RESULTS: IBU plus KF2 was found to be more effective in reducing tooth sensitivity immediately after bleaching (baseline) compared with the placebo group (P < .05). The risk of experiencing moderate or severe tooth sensitivity was approximately 4 times higher in the placebo group than in the IBU plus KF2 group (relative risk, 4.00; 95% CI, 1.01 to 15.81; P = .025). CONCLUSIONS: The combined use of 400 mg of IBU and KF2 appears to be beneficial in managing postbleaching tooth sensitivity. It provides a superior analgesic effect compared with placebo. PRACTICAL IMPLICATIONS: The preemptive administration of IBU plus KF2 reduces tooth sensitivity after tooth whitening when compared with placebo. This clinical trial was registered in the Brazilian Clinical Trials Registry Platform. The registration number is U1111-1249-8191.

Effect of Endo-Z bur or Bladesonic ultrasonic tip on the adaptation of filling material. A micro-CT study.

This study aimed to evaluate the effect of apicoectomy performed with a bur or an ultrasonic tip on the adaptation of the filling material to root canal dentin. Twenty human mandibular incisors were selected and prepared with a ProDesign Logic system up to diameter 40/.05. The root canals were filled with Bio-C Sealer (Angelus, PR, Brazil) using the single cone technique and were stored at 37ºC and 95% relative humidity for 7 days. After this period, the apicoectomy of the 3 millimeters of the root apex was performed using Endo-Z bur (Dentsply Sirona) or Bladesonic ultrasonic tip (Helse Ultrasonic, Santa Rosa de Viterbo, Brazil) (n=10). The specimens were scanned by micro-computed tomography (micro-CT; SkyScan 1176) with a voxel size of 8.74 µm after obturation and after apicoectomy. The percentage of voids at the interface between the filling material and the root canal wall was evaluated in the apical 4 mm of the root after apicoectomy, besides the time cutting to both devices. The data obtained were submitted to paired and unpaired t-tests (α = 0.05). Endo-Z and Bladesonic increased the percentage of voids between the filling material and the dentin after apicectomy (p<0.05), and they were similar (p>0.05). Endo-Z has a shorter time to perform apicoectomy compared to Bladesonic (p<0.05). Apicectomies with Endo-Z or Bladesonic could harm the material/dentin interface, while the Endo-Z bur was faster than the Bladesonic ultrasonic tip.

Analysis of professional training in Multiprofessional Health Residency Programs in Brazil from the perspective of residents. / Análise da formação em Programas de Residência Multiprofissional em Saúde no Brasil: perspectiva dos egressos.

The aim of this study was to analyze professional training in multiprofessional health residency programs (MHRPs) in primary care from the perspective of residents from 20 programs who had completed residency in the period 2015-2019. We undertook a cross-sectional study analyzing criteria in the dimensions Pedagogical Approach and In-Service Education Settings responded using a 10-point Likert scale. The study sample consisted of 365 graduates from MHRPs in 12 Brazilian states. The highest-scoring criteria in the dimension Pedagogical Approach (Cronbach's α=0.94) were broad concept of care and professional training oriented towards comprehensive care (P50=10). The lowest scoring criteria were those involving preceptorship (P50=7). With regard to the In-Service Education Settings dimension (Cronbach's α=0.90), the main strength was group educational activities (P50=9) and the main weaknesses were adequacy of the physical structure of health facilities (P50=6), participation of residents in local health committees (P50=6), and coordination with medical residency programs (P50=5). The findings show that professional training in MHRPs is aligned with the principles and guidelines underpinning Brazil's public health system, with emphasis on comprehensiveness and prevention. However, efforts are needed to improve preceptor training and address weaknesses in practice settings.

Objetivou-se analisar a formação em Programas de Residência Multiprofissional em Atenção Básica (PRMAB) no Brasil a partir dos egressos de 20 Programas no período de 2015 a 2019. Trata-se de um estudo transversal que analisou as dimensões Abordagem Pedagógica (AP) e Cenários de Educação em Serviço (CES) com escala do tipo Likert. Participaram do estudo 365 egressos de programas instalados em 12 estados da federação. Na dimensão AP (α de Cronbach=0,94) destacaram-se os critérios sobre a concepção ampliada do cuidado e formação pautada em cuidado integral (P50=10), enquanto os com pior desempenho se relacionavam à preceptoria (P50=7). Quanto aos CES (α de Cronbach=0,90), foram reveladas potencialidades para as atividades educativas em grupo (P50=9) e fragilidades para critérios relativos à suficiência de espaço físico nas unidades de saúde (P50=6), participação dos residentes em Conselhos (P50=6) e articulação com Programas de Residência Médica (P50=5). A formação nos PRMAB mostra-se sintonizada com os atuais paradigmas da atenção à saúde, com ênfase na integralidade e prevenção. Contudo, os Programas carecem de investimento na formação de preceptores e melhoria de fragilidades no âmbito dos cenários de prática.

Use of WhatsApp in Dental Education: a Scoping Review.

Purpose/Objective: This study aimed to perform a critical appraisal of WhatsApp use by undergraduate students in dental education. Methods: A PRISMA-Scoping Review was carried out to explain (i) how has WhatsApp been used as a learning tool in dental education? and (ii) how has WhatsApp been evaluated as a learning tool in dental education? Inclusion criteria are specified as the population (dental students), concept (use of WhatsApp), context (institutions/universities of dental education), and types of sources of evidence (peer-reviewed publication). Results: Nine studies published between 2016 and 2020 were included in this scoping review. Mostly had a cross-sectional design. Conclusion: WhatsApp is used in dental education to facilitate communication and improve learning through discussions via the app.

[Training in Multi-Professional Primary Health Care Residency Programs: a systematic review of the literature]. / Formação na Residência Multiprofissional em Atenção Básica: revisão sistemática da literatura.

The scope of this study is to investigate how the training of health professionals has been provided in Multi-professional Primary Health Care Residency Programs in Brazil. A systematic review was conducted on Scielo, BVS and PubMed databases in 2019, under registration number CRD42019134350. The search was carried out using key words related to Multi-Professional Residency Programs and Primary Health Care, including empirical research on the theme with a low-level risk of bias. Of the 700 studies identified, 13 articles were included in this review. All the studies adopted a qualitative approach predominantly performed in São Paulo with a low risk of bias (69%). The main results were categorized as: Contribution of measures for occupational training; Definition of professional training strategies; Potential of Multi-Professional Primary Health Care Residency Programs for health professional training and difficulties experienced during the training process. Professional training on programs studied has provided a new profile of health providers, despite limitations in the training process. Investments in the qualification of the personnel involved in training were perceived as being necessary, since it was one of the main weaknesses reported.

Este estudo tem como objetivo investigar a formação de profissionais de saúde em programas de Residência Multiprofissional em Saúde (RMS) direcionados à atenção básica no Brasil. Trata-se de uma revisão sistemática da literatura conduzida nas bases de dados SciELO, BVS e PubMed no ano de 2019, registrada sob número CRD42019134350. A busca ocorreu utilizando descritores relacionados à RMS e à atenção básica, sendo incluídas pesquisas empíricas sobre o tema sem alto risco de viés. Dos 700 registros recuperados no processo de busca, 13 artigos foram incluídos na revisão. Todos os estudos apresentaram abordagem qualitativa, predominando estudos realizados no estado de São Paulo e com baixo risco de viés (69%). Os principais resultados foram categorizados em: contribuição de dispositivos para a formação pelo trabalho; estratégias balizadoras da formação; potencialidades da residência para a formação em saúde; e dificuldades experienciadas no processo de formação. A formação nos programas estudados tem proporcionado um novo perfil de profissional de saúde, apesar das limitações vivenciadas no processo. Torna-se necessário investimento na qualificação dos atores envolvidos na formação, uma vez que essa foi uma das principais dificuldades relatadas.

Validation study of the use of the HRVCAM software for the evaluation of heart rate and heart rate variability at rest.

Aims: The existing instruments for assessing heart rate (HR) and heart rate variability (HRV) require contact area. This is difficult to obtain from specific groups of patients and from those moving. The aim of this study was to validate the use of the HRVCam software for measuring HR and HRV in healthy adults. Methods and results: The HR and HRV variables were evaluated in terms of time and frequency using a webcam and Polar® S810i. The Shapiro-Wilk test was used to test the normality of the data, and the Pearson's correlation coefficient (r) was used to identify the possible correlation between the two instruments. The size of the effect was calculated based on a generalized linear model, and the Bland-Altman plots were used to analyse the agreement between the methods. The level of significance for all analyses was set at P < 0.05. We evaluated 102 participants, of whom 52% were men; 83.3% were aged between 18 and 29.9 years; and 84.3% were single. Conclusion: There was a good agreement and moderate to strong correlations among all analysed variables. The biases were low, except for the low frequency/high frequency measures. Moreover, the difference between the samples was small to moderate. The results of this study corroborate the use of HRVCam for measuring HR and HRV.

Schinopsis brasiliensis Engler-Phytochemical Properties, Biological Activities, and Ethnomedicinal Use: A Scoping Review.

Brazil has the most incredible biodiversity globally and has a vast storehouse of molecules to be discovered. However, there are no pharmacological and phytochemical studies on most native plants. Parts of Schinopsis brasiliensis Engler, a tree from the Anacardiaceae family, are used by several traditional communities to treat injuries and health problems. The objective of this scoping review was to summarize the pharmacological information about S. brasiliensis, from ethnobotanical to phytochemical and biological studies. Data collection concerning the geographical distribution of S. brasiliensis specimens was achieved through the Reflora Virtual Herbarium. The study's protocol was drafted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The search strategy used the keyword "Schinopsis brasiliensis" in the databases: PUBMED, EMBASE, SCOPUS, Science Direct, Web of Science, SciFinder, and SciELO. Rayyan was used for the selection of eligible studies. In total, 35 studies were included in the paper. The most recurrent therapeutic indications were for general pain, flu and inflammation. The bark was the most studied part of the plant. The most used preparation method was decoction and infusion, followed by syrup. Phytochemical investigations indicate the presence of tannins, flavonoids, phenols, and polyphenols. Most of the substances were found in the plant's leaf and bark. Important biological activities were reported, such as antimicrobial, antioxidant, and anti-inflammatory. S. brasiliensis is used mainly by communities in the semi-arid region of northeastern Brazil to treat several diseases. Pharmacological and phytochemical studies together provide scientific support for the popular knowledge of the medicinal use of S. brasiliensis. In vitro and in vivo analyses reported antimicrobial, antioxidant, anti-inflammatory, antinociceptive, cytotoxic, photoprotective, preservative, molluscicidal, larvicidal, and pupicidal effects. It is essential to highlight the need for future studies that elucidate the mechanisms of action of these phytocompounds.

Admission of alumni from Multiprofessional Residency Programs into the SUS.

INTRODUCTION: The Multiprofessional Health Residency Programs (PRMS) were set up as a strategy for training workforce for the Brazilian Unified Health System (SUS). OBJECTIVE: To investigate the proportion of alumni from Primary Health Care Multiprofessional Residency Programs admitted into the SUS and associated factors. METHODS: This is a sectional study developed with alumni from Primary Health Care Multiprofessional Residency Programs from all over Brazil, encompassing the period from 2015 to 2019. Participants answered an online questionnaire with general personal information, admission into stricto sensu graduate school, the labor market and, specifically, the SUS. We applied Pearson's chi-square test for bivariate analyses and Poisson's regression for multiple analysis. RESULTS: A total of 365 alumni from Programs from all Brazilian regions participated in the study. Of those, 80.2% reported entry into the labor market and 47.9% reported being employed in the SUS. Admission into the SUS has been associated with the professions that make up the Reference Team for Primary Health Care (PHC) (PR = 1.87; 95% CI 1.54-2.28) and non-admission into stricto sensu graduate programs (PR = 0.77; 95% CI 0.61-0.97). Regarding admission characteristics, the PHC scenario (47.4%) and work focused on health care (84.9%) were prevalent. Almost 40% of alumni who entered the SUS are working with unstable contracts. Besides, being a residency alumnus is often undervalued in recruitment (56.9%). Among those admitted into the SUS, 8.7% reported being selected to work in the Covid-19 pandemic effort. CONCLUSIONS: The results of this study reinforce the need for a policy to encourage the maintenance, creation and valorization of the PRMS. They also warn about the possibility that admission into the SUS for workers is increasingly difficult due to the current underfunding of the health system.