Practices of Physical Therapists Who Assist People With Cerebral Palsy in Brazil: A National Survey.

PURPOSE: To describe the practices of pediatric physical therapists (PTs) working with children and adolescents with cerebral palsy (CP) in Brazil. METHODS: PTs working with children and adolescents with CP were invited to participate via social media and email campaigns to complete an online survey containing 46 questions. RESULTS: In total, 373 PTs participated. Most PTs reported searching in scientific databases (96.8%) and on social media (71%). The main barrier to information reported was limited access to full-text articles (44%). Among the PTs, 58.4% and 84% reported using the International Classification of Functioning, Disability and Health (ICF) and family centered practice models, respectively. Regarding tools and interventions, there was little focus on the domains of contextual factors and participation. CONCLUSIONS: This survey points to some important advances. However, strategies are still needed to promote knowledge translation and evidence-based practices among pediatric PTs in Brazil.

Prevalence of sarcopenia according to EWGSOP1 and EWGSOP2 in older adults and their associations with unfavorable health outcomes: a systematic review.

BACKGROUND: The European Working Group on Sarcopenia in Older People (EWGSOP) recently updated the definition and diagnostic criteria to assess sarcopenia, which can result in important changes in sarcopenia prevalence in older adults. AIM: To compare the prevalence of sarcopenia through the diagnostic criteria and definition proposed by the first (EWGSOP1) and recent (EWGSOP2) European consensus in older adults. We also aimed to evaluate which sarcopenia consensus is better associated with unfavorable health outcomes. METHODS: The review followed PRISMA guidelines. Embase, Medline (PubMed), Scopus and Web of Science were searched from 2018 to February 2021. The systematic review protocol was registered at PROSPERO (CRD42020213303). The search, selection, and evaluation processes were done in a duplicate and independent manner. RESULTS: Of the 298 potentially eligible articles, 9 were included in this review. The prevalence of sarcopenia was 17.7% by EWGSOP1 and 11% by EWGSOP2. Evaluating all the studies, the sarcopenia prevalence ranged from 6.2 to 35.3% for the EWGSOP1, and from 3.2 to 26.3% for the EWGSOP2. Five studies have evaluated the association between the prevalence of sarcopenia (EWGSOP1 versus EWGSOP2) and unfavorable health outcomes, in which three studies showed that EWGSOP1 was better associated with increased risk of hospitalization and/or mortality. CONCLUSION: In comparison with EWGSOP1, the prevalence of sarcopenia in older adults decreased when diagnosed according to EWGSOP2. Based on limited evidence, EWGSOP2 seems to be worse for predicting unfavorable outcomes compared with EWGSOP1.

Results of muscle strength and range of motion after total open knee synovectomy.

AIM OF THE STUDY: Scar tissue formation after synovectomy limits range of motion and causes muscle atrophy. The functional results for patients who underwent total open knee synovectomy often included questionnaires, and assessment of muscle strength was lacking in the literature. Therefore, we aimed to identify the strength and range of motion outcomes for patients who underwent total open synovectomy and to compare the results with the contralateral limb and healthy individuals. METHOD: Knee range of motion and muscle strength were assessed in fourteen patients that underwent total (anterior and posterior) open knee synovectomy and were compared with the contralateral limb and with 14 healthy individuals matched by sex, age, height, and weight. RESULTS: The range of motion of flexion decreased 8.4% compared with the contralateral limb (95% CI - 18.9 to - 4.7, p = 0.002) and 9.9% compared with the control group (95% CI 3.9-14.9, p < 0.01). Knee extension strength decreased by 35% compared with the contralateral limb (95% CI 11.1-77.2, p = 0.01) and 37% compared with the control group (95% CI - 112.4-12.1, p = 0.01). CONCLUSION: Despite the aggressiveness of the surgical procedure, the patients achieved satisfactory functional results.

Strengthening the perception-assessment tools for dengue prevention: a cross-sectional survey in a temperate region (Madeira, Portugal).

BACKGROUND: Community participation is mandatory in the prevention of Dengue outbreaks. Taking public views into account is crucial to guide more effective planning and quicker community participation in preventing campaigns. This study aims to assess community perceptions of Madeira population in order to explore their involvement in the A. aegypti's control and reinforce health-educational planning. Due to the lack of accurate methodologies for measuring perception, a new tool to assess the community's perceptions was built. METHODS: A cross-sectional survey was performed in the Island's aegypti-infested area, exploring residents' perceptions regarding most critical community behaviour: aegypti-source reduction and their domestic aegypti-breeding sites. A novel tool defining five essential topics which underlie the source reduction's awareness and accession was built, herein called Essential-Perception (EP) analysis. RESULTS: Of 1276 individuals, 1182 completed the questionnaire (92 · 6%). EP-Score analysis revealed that community's perceptions were scarce, inconsistent and possibly incorrect. Most of the population (99 · 6%) did not completely understood the five essential topics explored. An average of 54 · 2% of residents only partially understood each essential topic, revealing inconsistencies in their understanding. Each resident apparently believed in an average of four false assumptions/myths. Significant association (p<0.001) was found between both the EP-Score level and the domestic presence of breeding sites, supporting the validity of this EP-analysis. Aedes aegypti's breeding sites, consisting of décor/leisure containers, presented an atypical pattern of infestation comparing with dengue prone regions. CONCLUSIONS: The studied population was not prepared for being fully engaged in dengue prevention. Evidences suggest that EP-methodology was efficient and accurate in assessing the community perception and its compliance to practices. Moreover, it suggested a list of myths that could persist in the community. This is the first study reporting an aegypti-entomological pattern and community's perception in a developed dengue-prone region. Tailored messages considering findings of this study are recommended to be used in future campaigns in order to more effectively impact the community perception and behaviour.

Wastewater surveillance for viral pathogens: A tool for public health.

A focus on water quality has intensified globally, considering its critical role in sustaining life and ecosystems. Wastewater, reflecting societal development, profoundly impacts public health. Wastewater-based epidemiology (WBE) has emerged as a surveillance tool for detecting outbreaks early, monitoring infectious disease trends, and providing real-time insights, particularly in vulnerable communities. WBE aids in tracking pathogens, including viruses, in sewage, offering a comprehensive understanding of community health and lifestyle habits. With the rise in global COVID-19 cases, WBE has gained prominence, aiding in monitoring SARS-CoV-2 levels worldwide. Despite advancements in water treatment, poorly treated wastewater discharge remains a threat, amplifying the spread of water-, sanitation-, and hygiene (WaSH)-related diseases. WBE, serving as complementary surveillance, is pivotal for monitoring community-level viral infections. However, there is untapped potential for WBE to expand its role in public health surveillance. This review emphasizes the importance of WBE in understanding the link between viral surveillance in wastewater and public health, highlighting the need for its further integration into public health management.

Aedes aegypti on Madeira Island (Portugal): genetic variation of a recently introduced dengue vector.

The increasing population of Aedes aegypti mosquitoes on Madeira Island (Portugal) resulted in the first autochthonous dengue outbreak, which occurred in October 2012. Our study establishes the first genetic evaluation based on the mitochondrial DNA (mtDNA) genes [cytochrome oxidase subunit I (COI) and NADH dehydrogenase subunit 4 (ND4)] and knockdown resistance (kdr) mutations exploring the colonisation history and the genetic diversity of this insular vector population. We included mosquito populations from Brazil and Venezuela in the analysis as putative geographic sources. The Ae. aegypti population from Madeira showed extremely low mtDNA genetic variability, with a single haplotype for COI and ND4. We also detected the presence of two important kdr mutations and the quasi-fixation of one of these mutations (F1534C). These results are consistent with a unique recent founder event that occurred on the island of Ae. aegypti mosquitoes that carry kdr mutations associated with insecticide resistance. Finally, we also report the presence of the F1534C kdr mutation in the Brazil and Venezuela populations. To our knowledge, this is the first time this mutation has been found in South American Ae. aegypti mosquitoes. Given the present risk of Ae. aegypti re-invading continental Europe from Madeira and the recent dengue outbreaks on the island, this information is important to plan surveillance and control measures.

Development and Validation of a Transgender Health Care Humanization Scale.

Purpose: Stigma and discrimination against transgender people can lead to their segregation. Fighting stigma and discrimination is a crucial strategy to expand access to health services. The goals of the present study were to develop and validate a transgender health care humanization scale (THcH scale) to evaluate the perception of humanization in health care for transgender individuals. Methods: This cross-sectional study included 340 health care providers aged ≥18 years. Participants answered a structured questionnaire when attending HIV/AIDS scientific meetings or at their place of work. An exploratory factor analysis was conducted, using a polychoric matrix and robust diagonally weighted least squares extraction method. The number of retained factors was defined through the parallel analysis technique, with random permutation of the observed data and the use of Robust Promin rotation. Results: The interpretability of correlation matrix items was suggested by the Bartlett's sphericity tests (1633.7, df=91; p<0.001) and Kaiser-Meyer-Olkin Test (0.875). The factor structure showed adequate adjustment indices (χ2=44,200, df=52; root mean square error of approximation p<0.05; comparative fit index=0.968; Tucker-Lewis index=0.945; goodness-of-fit index = 0.995). Only one factor was retained by parallel analysis, explained by 54.17% of the variance of the construct and confirmed by the following indices: unidimensional congruence=0.902, explained common variance=0.828, and mean of item residual absolute loadings=0.279. Good reliability was confirmed by Cronbach's alpha test (0.899). Conclusion: The THcH scale showed good psychometric properties. This self-report questionnaire, which can be completed in 5 min, may be useful in scientific research and could guide health care providers in expansion of a Health Humanization Policy and in deconstructing prejudice against transgender people in health care settings.

Temporal and Spatiotemporal Arboviruses Forecasting by Machine Learning: A Systematic Review.

Arboviruses are a group of diseases that are transmitted by an arthropod vector. Since they are part of the Neglected Tropical Diseases that pose several public health challenges for countries around the world. The arboviruses' dynamics are governed by a combination of climatic, environmental, and human mobility factors. Arboviruses prediction models can be a support tool for decision-making by public health agents. In this study, we propose a systematic literature review to identify arboviruses prediction models, as well as models for their transmitter vector dynamics. To carry out this review, we searched reputable scientific bases such as IEE Xplore, PubMed, Science Direct, Springer Link, and Scopus. We search for studies published between the years 2015 and 2020, using a search string. A total of 429 articles were returned, however, after filtering by exclusion and inclusion criteria, 139 were included. Through this systematic review, it was possible to identify the challenges present in the construction of arboviruses prediction models, as well as the existing gap in the construction of spatiotemporal models.

Covid-19 Dynamic Monitoring and Real-Time Spatio-Temporal Forecasting.

Background: Periodically, humanity is often faced with new and emerging viruses that can be a significant global threat. It has already been over a century post-the Spanish Flu pandemic, and we are witnessing a new type of coronavirus, the SARS-CoV-2, which is responsible for Covid-19. It emerged from the city of Wuhan (China) in December 2019, and within a few months, the virus propagated itself globally now resulting more than 50 million cases with over 1 million deaths. The high infection rates coupled with dynamic population movement demands for tools, especially within a Brazilian context, that will support health managers to develop policies for controlling and combating the new virus. Methods: In this work, we propose a tool for real-time spatio-temporal analysis using a machine learning approach. The COVID-SGIS system brings together routinely collected health data on Covid-19 distributed across public health systems in Brazil, as well as taking to under consideration the geographic and time-dependent features of Covid-19 so as to make spatio-temporal predictions. The data are sub-divided by federative unit and municipality. In our case study, we made spatio-temporal predictions of the distribution of cases and deaths in Brazil and in each federative unit. Four regression methods were investigated: linear regression, support vector machines (polynomial kernels and RBF), multilayer perceptrons, and random forests. We use the percentage RMSE and the correlation coefficient as quality metrics. Results: For qualitative evaluation, we made spatio-temporal predictions for the period from 25 to 27 May 2020. Considering qualitatively and quantitatively the case of the State of Pernambuco and Brazil as a whole, linear regression presented the best prediction results (thematic maps with good data distribution, correlation coefficient >0.99 and RMSE (%) <4% for Pernambuco and around 5% for Brazil) with low training time: [0.00; 0.04 ms], CI 95%. Conclusion: Spatio-temporal analysis provided a broader assessment of those in the regions where the accumulated confirmed cases of Covid-19 were concentrated. It was possible to differentiate in the thematic maps the regions with the highest concentration of cases from the regions with low concentration and regions in the transition range. This approach is fundamental to support health managers and epidemiologists to elaborate policies and plans to control the Covid-19 pandemics.

A review exploring the overarching burden of Zika virus with emphasis on epidemiological case studies from Brazil.

This paper explores the main factors for mosquito-borne transmission of the Zika virus by focusing on environmental, anthropogenic, and social risks. A literature review was conducted bringing together related information from this genre of research from peer-reviewed publications. It was observed that environmental conditions, especially precipitation, humidity, and temperature, played a role in the transmission. Furthermore, anthropogenic factors including sanitation, urbanization, and environmental pollution promote the transmission by affecting the mosquito density. In addition, socioeconomic factors such as poverty as well as social inequality and low-quality housing have also an impact since these are social factors that limit access to certain facilities or infrastructure which, in turn, promote transmission when absent (e.g., piped water and screened windows). Finally, the paper presents short-, mid-, and long-term preventative solutions together with future perspectives. This is the first review exploring the effects of anthropogenic aspects on Zika transmission with a special emphasis in Brazil.

COVID-SGIS: A Smart Tool for Dynamic Monitoring and Temporal Forecasting of Covid-19.

Background: The global burden of the new coronavirus SARS-CoV-2 is increasing at an unprecedented rate. The current spread of Covid-19 in Brazil is problematic causing a huge public health burden to its population and national health-care service. To evaluate strategies for alleviating such problems, it is necessary to forecast the number of cases and deaths in order to aid the stakeholders in the process of making decisions against the disease. We propose a novel system for real-time forecast of the cumulative cases of Covid-19 in Brazil. Methods: We developed the novel COVID-SGIS application for the real-time surveillance, forecast and spatial visualization of Covid-19 for Brazil. This system captures routinely reported Covid-19 information from 27 federative units from the Brazil.io database. It utilizes all Covid-19 confirmed case data that have been notified through the National Notification System, from March to May 2020. Time series ARIMA models were integrated for the forecast of cumulative number of Covid-19 cases and deaths. These include 6-days forecasts as graphical outputs for each federative unit in Brazil, separately, with its corresponding 95% CI for statistical significance. In addition, a worst and best scenarios are presented. Results: The following federative units (out of 27) were flagged by our ARIMA models showing statistically significant increasing temporal patterns of Covid-19 cases during the specified day-to-day period: Bahia, Maranhão, Piauí, Rio Grande do Norte, Amapá, Rondônia, where their day-to-day forecasts were within the 95% CI limits. Equally, the same findings were observed for Espírito Santo, Minas Gerais, Paraná, and Santa Catarina. The overall percentage error between the forecasted values and the actual values varied between 2.56 and 6.50%. For the days when the forecasts fell outside the forecast interval, the percentage errors in relation to the worst case scenario were below 5%. Conclusion: The proposed method for dynamic forecasting may be used to guide social policies and plan direct interventions in a cost-effective, concise, and robust manner. This novel tools can play an important role for guiding the course of action against the Covid-19 pandemic for Brazil and country neighbors in South America.

First dengue virus seroprevalence study on Madeira Island after the 2012 outbreak indicates unreported dengue circulation.

BACKGROUND: In 2012, the first dengue virus outbreak was reported on the Portuguese island of Madeira with 1080 confirmed cases. Dengue virus of serotype 1 (DENV-1), probably imported from Venezuela, caused this outbreak with autochthonous transmission by invasive Aedes aegypti mosquitoes. RESULTS: We investigated the seroprevalence among the population on Madeira Island four years after the outbreak. Study participants (n = 358), representative of the island population regarding their age and gender, were enrolled in 2012 in a cross-sectional study. Dengue antibodies were detected with an in-house enzyme-linked immunosorbent assay (ELISA) using the dimer of domain III (ED3) of the DENV-1 envelope protein as well as commercial Panbio indirect and capture IgG ELISAs. Positive ELISA results were validated with a neutralization test. The overall seroprevalence was found to be 7.8% (28/358) with the in-house ELISA, whereas the commercial DENV indirect ELISA detected IgG antibodies in 8.9% of the individuals (32/358). The results of the foci reduction neutralization test confirmed DENV-1 imported from South America as the causative agent of the 2012 epidemic. Additionally, we found a higher seroprevalence in study participants with an age above 60 years old and probable secondary DENV infected individuals indicating unreported dengue circulation before or after 2012 on Madeira Island. CONCLUSIONS: This study revealed that the number of infections might have been much higher than estimated from only confirmed cases in 2012/2013. These mainly DENV-1 immune individuals are not protected from a secondary DENV infection and the majority of the population of Madeira Island is still naïve for DENV. Surveillance of mosquitoes and arboviruses should be continued on Madeira Island as well as in other European areas where invasive vector mosquitoes are present.

Origin and expansion of the mosquito Aedes aegypti in Madeira Island (Portugal).

Historically known as the yellow fever mosquito, Aedes aegypti invaded Madeira Island in 2005 and was the vector of the island's first dengue outbreak in 2012. We have studied genetic variation at 16 microsatellites and two mitochondrial DNA genes in temporal samples of Madeira Island, in order to assess the origin of the invasion and the population structure of this mosquito vector. Our results indicated at least two independent colonization events occurred on the island, both having a South American source population. In both scenarios, Venezuela was the most probable origin of these introductions, a result that is in accordance with the socioeconomic relations between this country and Madeira Island. Once introduced, Ae. aegypti has rapidly expanded along the southern coast of the island and reached a maximum effective population size (Ne) in 2012, coincident with the dengue epidemic. After the outbreak, there was a 10-fold reduction in Ne estimates, possibly reflecting the impact of community-based vector control measures implemented during the outbreak. These findings have implications for mosquito surveillance not only for Madeira Island, but also for other European regions where Aedes mosquitoes are expanding.

An evaluation of efficacy of the auto-dissemination technique as a tool for Aedes aegypti control in Madeira, Portugal.

BACKGROUND: The frequency and intensity of arboviral epidemics is steadily increasing and posing an intractable public health burden. Current vector control methods are proving ineffectual and despite progress in the development of high technology approaches, there is an urgent need for the development of tools for immediate implementation. Several studies suggest that the auto-dissemination of pyriproxyfen (PPF) is a promising new approach to larviciding although there is little detail on the conditions under which it is optimally effective. Here, we evaluate the efficacy of the approach in urban and rural sites in Madeira, Portugal. RESULTS: Auto-dissemination of PPF through adapted Biogents Sentinel traps (BGSTs) resulted in a modest but consistent impact on both juvenile and adult mosquito populations, but with considerable spatial heterogeneity. This heterogeneity was related to the distance from the BGST dissemination station as well as the local density of adult mosquitoes. There was evidence that the impact of PPF was cumulative over time both locally and with gradual spatial expansion. CONCLUSIONS: The density of adult mosquitoes and the spatial distribution of dissemination devices are key factors in mediating efficacy. In addition, urban topography may affect the efficiency of auto-dissemination by impeding adult mosquito dispersal. Further studies in a range of urban landscapes are necessary to guide optimal strategies for the implementation of this potentially efficacious and cost-effective approach to larviciding.

Sociodemographic disparities in hypertension prevalence: Results from the first Portuguese National Health Examination Survey.

INTRODUCTION: Cardiovascular disease is an important cause of death and disability worldwide, and hypertension is responsible for at least 45% of all deaths due to heart disease and 51% of deaths due to stroke. This study aimed to estimate and describe the distribution of prevalence, awareness, treatment and control of hypertension in the Portuguese population in 2015. METHODS: A national survey using a representative sample of 4911 individuals residing in Portugal and aged between 25 and 74 years was implemented. Trained nurses performed a health interview and a physical examination, including blood pressure measurement (right arm, three measurements at 1-min intervals). The prevalence of hypertension was stratified by gender, age group, marital status, education, occupation and type of residential area. Associations between hypertension prevalence and sociodemographic factors were assessed using bivariate and multivariate Poisson regression. RESULTS: The overall hypertension prevalence was 36.0%. The highest rates were observed in males (39.6%), in individuals aged between 65 and 74 years (71.3%), and in those with low levels of education (62.6%) and with no formal occupation (64.5%). Among hypertensive individuals, 69.8% were aware of their condition and 69.4% were under treatment, of whom 71.3% were controlled. Rates of awareness and medical treatment were significantly higher among women and older individuals. CONCLUSIONS: A large majority of the adult Portuguese population are likely to reach blood pressure levels defined as hypertension in adulthood. Significant differences in hypertension prevalence were found according to gender, age and socioeconomic status, which highlights the importance of population strategies in public health policies.

Knowledge about Stroke in Belo Horizonte, Brazil: A Community-Based Study Using an Innovative Video Approach.

BACKGROUND AND PURPOSE: Stroke is a leading cause of death in Brazil. Knowledge about the clinical manifestations of stroke as well as its risk factors and its management is still poor in the country. We intended to assess the stroke knowledge of an urban population in Belo Ho-rizonte, Brazil. METHODS: Individuals assisted by a basic health unit were interviewed between February and August 2014. After demographic data collection, the participants were asked to watch a video that consisted of a person presenting stroke signals and they were asked to answer questions about the condition shown on the video. Afterwards, they answered a semi-structured questionnaire to evaluate their stroke knowledge. RESULTS: A total of 703 people were interviewed (62.1% female, mean age 46.7 years). Recognition of a person having a stroke on the presented video was achieved by 56.1% of the subjects. Female sex (p = 0.029) and contact with someone who had had a stroke (family member [p < 0.01], neighbor [p < 0.05]) increased the odds of correctly identifying the condition showed on the video. The most commonly mentioned clinical manifestations of stroke were weakness (34.7%) and speech disturbance (31.6%). Stroke risk factors that were most named were "unbalanced diet" (42.3%) and hypertension (33.7%). Most participants (66.8%) said they would call the emergency medical services, while 17.8% would go directly to a hospital. Only 17 subjects knew thrombolytic therapy for acute stroke. CONCLUSION: Female sex and a family history of stroke increased the odds of recognizing the signs of stroke. Knowledge about the clinical manifestations, risk factors, and management of stroke was low in the studied population.

Platelet-Rich Plasma, Hydroxyapatite, and Chitosan in the Bone and Cartilaginous Regeneration of Femoral Trochlea in Rabbits: Clinical, Radiographic, and Histomorphometric Evaluations.

The aim of this study was to evaluate the trochlear bone and cartilaginous regeneration of rabbits using the association of PRP, chitosan, and hydroxyapatite. Hole was made in rabbit troches, one hole in each animal remained empty (group C), and one was filled by a combination of PRP, chitosan, and hydroxyapatite (group T). Clinical-orthopedic, radiographic, and histomorphometric evaluations were performed. Clinical-orthopedic evaluation showed lameness of two members of the T group and one member of group C. The radiographic evaluation showed that the T group showed absence of subchondral bone reaction (33%). The presence of moderate subchondral bone reaction was more frequently reported in group C with 67%. Microscopic evaluation revealed a presence of tissue neoformation, composed of connective tissue. Microscopic findings were similar in both groups, with a difference in the amount of neoformed tissue being perceptible, which was confirmed after the morphometric analysis, which revealed a significant difference in the quantity of newly formed tissue at the bone/cartilage/implant interface. The composite base of the association of chitosan, hydroxyapatite, and platelet-rich plasma favored bone and cartilage healing.

Prevalence, awareness, treatment and control of diabetes in Portugal: Results from the first National Health examination Survey (INSEF 2015).

AIMS: Diabetes Mellitus is a major public health threat worldwide and continues to increase in numbers and significance. Estimates of diabetes prevalence, awareness, treatment and control are essential to effectively monitor its trends, plan and evaluate interventions. METHODS: We conducted a nationwide health examination survey in the population residing in Portugal aged between 25 and 74 years old in 2015. It consisted in a cross sectional prevalence study which included the measurement of HbA1c, a physical examination and a general health interview of a probabilistic sample of 4911 individuals (Authorization n°9348/2010 of the National Committee for Data Protection). RESULTS: The overall prevalence of diabetes was 9.9% (95%CI: 8.4; 11.5). It was higher in males than in females (12.1% vs 7.8%). Diabetes was more prevalent among individuals of lower education and without any professional activity. The majority of persons with diabetes was aware of their condition (87.1%) and was taking antidiabetic medication (79.7%). Of these, 63.2% had glycated hemoglobin levels lower than 7.0% (53 mmol/mol), but the majority failed to comply with the LDL and blood pressure recommended clinical targets (71.9% and 59.0%). Similarly, the prevalence of prediabetes was 16%, higher among women than men (17.5% vs 14.4%). CONCLUSION: The prevalence of diabetes and prediabetes remains higher than the global and European estimates, although there is increasing awareness of this disorder.

Development and characterization of photoprotective nanoemulsions containing Babassu (Orbignya phalerata Mart. ) lipophilic extract

Abstract Oil-in-water photoprotective nanoemulsions (NEs) were developed using Babassu (BBS) lipophilic extract, nonionic surfactants, and low concentrations of organic sunscreens by ultrasonic processing. BBS extract was chosen due to its suitable physicochemical properties (acidity index, peroxide index, refraction index, and relative density) and predominance of saturated fatty acids, identified by gas chromatography-mass spectrometry (GC-MS), which promote biological activities and high oxidative stability. NEs were characterized by mean droplet size, morphology, polydispersity index (PdI), pH, and organoleptic properties, and the physical stability of the NEs was evaluated for 120 days at room temperature. The sun protection factor (SPF) was determined, and the photostability and in vitro cytotoxicity assays were performed for NEs. All NEs remained stable for 120 days, with a droplet size <150 nm and a monomodal distribution profile. The pH values were compatible with the skin's pH. NE3 showed a spherical morphology, with a mean droplet size of 125.15 ± 0.16 nm and PdI of 0.145 ± 0.032. NE3 containing BBS extract and sunscreens presented an SPF of 35.5 ± 3.0, was photostable after 6 h of radiation and was non-cytotoxic to fibroblast cells. Thus, NE3 could be considered a promising formulation for developing synergic plant-extract sunscreen photoprotective products for the market