Identification of established and novel extracellular matrix components in glioblastoma as targets for angiogenesis and prognosis.

Glioblastomas (GBM) are aggressive tumors known for their heterogeneity, rapid proliferation, treatment resistance, and extensive vasculature. Angiogenesis, the formation of new vessels, involves endothelial cell (EC) migration and proliferation. Various extracellular matrix (ECM) molecules regulate EC survival, migration, and proliferation. Culturing human brain EC (HBMEC) on GBM-derived ECM revealed a decrease in EC numbers compared to controls. Through in silico analysis, we explored ECM gene expression differences between GBM and brain normal glia cells and the impact of GBM microenvironment on EC ECM transcripts. ECM molecules such as collagen alpha chains (COL4A1, COL4A2, p < 0.0001); laminin alpha (LAMA4), beta (LAMB2), and gamma (LAMC1) chains (p < 0.0005); neurocan (NCAN), brevican (BCAN) and versican (VCAN) (p < 0.0005); hyaluronan synthase (HAS) 2 and metalloprotease (MMP) 2 (p < 0.005); MMP inhibitors (TIMP1-4, p < 0.0005), transforming growth factor beta-1 (TGFB1) and integrin alpha (ITGA3/5) (p < 0.05) and beta (ITGB1, p < 0.0005) chains showed increased expression in GBM. Additionally, GBM-influenced EC exhibited elevated expression of COL5A3, COL6A1, COL22A1 and COL27A1 (p < 0.01); LAMA1, LAMB1 (p < 0.001); fibulins (FBLN1/2, p < 0.01); MMP9, HAS1, ITGA3, TGFB1, and wingless-related integration site 9B (WNT9B) (p < 0.01) compared to normal EC. Some of these molecules: COL5A1/3, COL6A1, COL22/27A1, FBLN1/2, ITGA3/5, ITGB1 and LAMA1/B1 (p < 0.01); NCAN, HAS1, MMP2/9, TIMP1/2 and TGFB1 (p < 0.05) correlated with GBM patient survival. In conclusion, this study identified both established and novel ECM molecules regulating GBM angiogenesis, suggesting NCAN and COL27A1 are new potential prognostic biomarkers for GBM.

Revisiting the utility of identifying nuclear grooves as unique nuclear changes by an object detector model.

BACKGROUND: Among other structures, nuclear grooves are vastly found in papillary thyroid carcinoma (PTC). Considering that the application of artificial intelligence in thyroid cytology has potential for diagnostic routine, our goal was to develop a new supervised convolutional neural network capable of identifying nuclear grooves in Diff-Quik stained whole-slide images (WSI) obtained from thyroid fineneedle aspiration. METHODS: We selected 22 Diff-Quik stained cytological slides with cytological diagnosis of PTC and concordant histological diagnosis. Each of the slides was scanned, forming a WSI. Images that contained the region of interest were obtained, followed by pre-formatting, annotation of the nuclear grooves and data augmentation techniques. The final dataset was divided into training and validation groups in a 7:3 ratio. RESULTS: This is the first artificial intelligence model based on object detection applied to nuclear structures in thyroid cytopathology. A total of 7,255 images were obtained from 22 WSI, totaling 7,242 annotated nuclear grooves. The best model was obtained after it was submitted 15 times with the train dataset (14th epoch), with 67% true positives, 49.8% for sensitivity and 43.1% for predictive positive value. CONCLUSIONS: The model was able to develop a structure predictor rule, indicating that the application of an artificial intelligence model based on object detection in the identification of nuclear grooves is feasible. Associated with a reduction in interobserver variability and in time per slide, this demonstrates that nuclear evaluation constitutes one of the possibilities for refining the diagnosis through computational models.

Human exposure to elements through consumption of raw and cooked fish in an urban region of the central Brazilian Amazon biome: Health risks.

Fish is an important source of animal protein for local communities in the Amazon basin, whose food safety must be assured. However, certain potential toxicants elements, can bioaccumulate in fish species, which inhabit anthropogenically polluted waters, ultimately posing a risk to human health. In the present study, the concentrations of nine elements (Al, As, Cd, Cr, Cu, Hg, Ni, Pb and Zn) were determined in raw and cooked samples of eight fish species consumed in Santarém (northern Brazil, Amazon biome). The potential for non- carcinogenic human health risks linked to the consumption of cooked fish were evaluated for adults and children in two different scenarios. Four carnivores, three omnivores and one detritivore, all of them regularly marketed and consumed by the Santarém population, were the target species. The safety reference values set by national and international guidelines for humans, in both raw and cooked preparations, were used. In most cases, the cooking process showed a trend to increase elements concentrations compared to raw samples, however the differences were not significant. Moreover, the risk assessment showed danger for children in relation to Hg from the consumption of fish, in both scenarios evaluated. For adults, in one of the scenarios, there was a health risk associated to Hg as a result of carnivorous fish consumption. In a context of combined exposure to all elements, children were at risk when consuming fish, especially carnivorous and omnivorous species. For adults, the mixture of elements posed a risk to health human only for carnivorous fish consumption. The results reveal an environmental scenario of Hg contamination, which requires monitoring actions to preserve the aquatic biodiversity and human health in the Brazilian Amazon biome.

MUC17 mutations and methylation are associated with poor prognosis in adult-type diffuse glioma patients.

Diffuse gliomas are tumors that arise from glial or glial progenitor cells. They are currently classified as astrocytoma isocitrate dehydrogenase (IDH)-mutant or oligodendroglioma IDH-mutant, and 1p/19q-codeleted, both slower-growing tumors, or glioblastoma (GBM), a more aggressive tumor. Despite advances in the diagnosis and treatment of gliomas, the median survival time after diagnosis of GBM remains low, approximately 15 months, with a 5-year overall survival rate of only 6.8%. Therefore, new biomarkers that could support the earlier diagnosis and prognosis of these tumors would be of great value. MUC17, a membrane-bound mucin, has been identified as a potential biomarker for several tumors. However, the role of this mucin in adult gliomas has not yet been explored. Here, we show for the first time, in a retrospective study and by in silico analysis that MUC17 is one of the relevant mutant genes in adult gliomas. Moreover, that an increase in MUC17 methylation correlates with an increase in glioma malignancy grade. Patients with MUC17 mutations had a poorer prognosis than their wild-type counterparts in both GBM and non-GBM glioma cohorts. We also analyzed mutational profiles that correlated strongly with poor survival. Therefore, in this study, we present a new potential biomarker for further investigation, especially for the prognosis of adult diffuse gliomas.

CAREGIVERS OF PATIENTS WITH CANCER AT THE END OF LIFE: PSYCHOLOGICAL SUFFERING AND REDUCED WELFARE / CUIDADORES DE PACIENTES COM CÂNCER NO FINAL DA VIDA: SOFRIMENTO PSÍQUICO E REDUÇÃO DE BEM-ESTAR

Introduction: Caregivers of end-of-life patients are exposed to great emotional overload and suffering. This study aims to investigate signs of psychological distress (depression, anxiety and anguish) and the presence of well-being in caregivers of patients at the end of life hospitalized in an oncology palliative care ward. Methods: This is a cross-sectional descriptive study, which included a non-probabilistic sample of 90 main caregivers of individuals hospitalized in the palliative care sector of a cancer reference hospital. The subjects were assessed for the presence of well-being using the Well-Being Assessment Questionnaire (GCQ); the presence of anguish (distress) through the Distress Thermometer; and anxiety and depression by the Anxiety and Depression Scale. Statistical correlations were made between the variables. Results: Female caregivers who lived with the patient had lower levels of well-being. Anxious symptoms were present in 76%, with higher scores in caregivers with less education, who lived with the patient and who cared for other people. Depressive symptoms were present in 55%, with a higher rate in caregivers who lived with the patient. Women and caregivers who performed rotation had a higher distress score. Well-being was inversely proportional to depression, distress and anxiety. Conclusion: This analysis showed higher rates of depression, anxiety and anguish among caregivers, as well as lower well-being. The improvement in well-being can alleviate anxiety, depressive and anguish symptoms. Strategies to improve communication and welcoming in the hospital environment can promote well-being and reduce the symptoms of psychic illness in caregivers of patients at the end of life.

Introdução: Cuidadores de pacientes em fim de vida estão expostos a grande sobrecarga emocional e sofrimento. Esse estudo objetiva investigar sinais de sofrimento psíquico (depressão, ansiedade e angústia) e presença de bem-estar em cuidadores de pacientes no fim da vida hospitalizados em enfermaria de cuidados paliativos oncológicos. Métodos: Trata-se de estudo descritivo transversal, o qual contou com uma amostra não probabilística de 90 cuidadores principais de indivíduos hospitalizados no setor de cuidados paliativos de um hospital referência em câncer. Os sujeitos foram avaliados quanto à presença de bem-estar por meio do Questionário de Avaliação do Bem-Estar (GCQ); a presença de angústia (distress) através do Termômetro de Distress; e ansiedade e depressão pela Escala de Depressão e Ansiedade. Foram feitas correlações estatísticas entre as variáveis. Resultados: Cuidadores do gênero feminino e que residiam com o paciente apresentaram menores índices de bem-estar. Sintomas ansiosos estiveram presentes em 76%, com maiores escores em cuidadores com menor escolaridade, que residiam com o paciente e que cuidavam de outras pessoas. Sintomas depressivos apresentaram-se em 55%, com maior índice em cuidadores que residiam com o paciente. Mulheres e cuidadores que realizavam rodízio apresentaram maior escore de angústia. Bem-estar foi inversamente proporcional a depressão, angústia e ansiedade. Conclusão: A partir desta análise demonstrou-se maiores índices de depressão, ansiedade e angústia entre cuidadores, assim como menor bem-estar. A melhora no bem-estar pode aliviar sintomas ansiosos, depressivos e angústia. Estratégias para a melhoria da comunicação e acolhimento no ambiente hospitalar podem promover bem-estar e redução dos sintomas de adoecimento psíquico de cuidadores de pacientes no final da vida.

Potential of an anti-bevacizumab idiotype scFv DNA-based immunization to elicit VEGF-binding antibody response.

Anti-idiotype antibodies have been considered for vaccination approaches against different diseases, including cancers. Based on that, we previously described an anti-bevacizumab idiotype monoclonal antibody, 10.D7, that revealed detectable antitumor effects on a vascular endothelial growth factor (VEGF)-dependent tumor model. Herein, we evaluated the possible applicability of a single-chain variable fragment (scFv) for the 10.D7 antibody in a gene immunization strategy. After checking that mammalian cells transfected to express the 10.D7 scFv are recognized by bevacizumab, it was explored the ability of our scFv construction, in a gene-based scheme, to elicit an immune response containing VEGF-binding antibodies. The results provide evidence that the designed 10.D7 scFv construct maintains the anti-bevacizumab idiotype features and has potential to activate an immune response recognizing VEGF.

A set of antibiotic-resistance mechanisms and virulence factors in GES-16-producing Klebsiella quasipneumoniae subsp. similipneumoniae from hospital wastewater revealed by whole-genome sequencing.

Klebsiella quasipneumoniae subsp. similipneumoniae has emerged as a human pathogen and sporadic isolates from non-clinical sources were reported. Here, we described the phenotypic- and genomic-characteristics of a multidrug-resistant (MDR) and potentially hypervirulent (MDR-hv) Klebsiella quasipneumoniae subsp. similipneumoniae (KqA1) isolated from hospital wastewater. The antibiotic susceptibility profile of KqA1 was investigated using disk-diffusion method, broth microdilution method, and agar dilution method, and the genetic characteristics of antimicrobial resistance, mobile genetics elements, and virulence were evaluated by genomic DNA sequencing on the Illumina® NovaSeq6000 platform as well as by bioinformatic analysis. Resistome analyses revealed the presence of genes related to resistance to ß-lactams, aminoglycosides, quinolones, tetracyclines, sulfonamides, trimethoprim, chloramphenicol, macrolides, and fosfomycin. New genetic contexts to blaGES-16 (carbapenemase gene) and to fosA (fosfomycin resistance gene) were described. A set of mechanisms that can contribute to antibiotic resistance, commonly detected in Klebsiella spp., was also found including chromosomal mutations, efflux systems, proteins, and regulators. Moreover, KqA1 presented genes related to tolerance to metals (arsenic, copper, nickel, cobalt, magnesium, cadmium, zinc, tellurium, selenium) and to biocides (quaternary-ammonium compounds). The isolate was classified as potentially hypervirulent due to a wide range of virulence factors found associated to regulation, motility, biofilm, effector delivery systems, immune modulation, nutritional/metabolic factors, adherence, invasion, and competitive advantage. The occurrence of MDR-hv KqA1 in hospital wastewater points out how this environment matrix plays a crucial role in the maintenance and selection of critical bacterial pathogens. Regarding One Health perspective, it is evident the need for multidisciplinary implementation of control measures for antibiotic-resistant bacteria, not only in hospital settings but also in a general environmental context to mitigate the dissemination of MDR and hv bacteria.

Agenda governamental brasileira: prioridades e mudanças na dinâmica da atenção sobre a distribuição orçamentária da União (2000-2021) / Agenda del gobierno brasileño: prioridades y cambios en la dinámica de atención a la distribución del presupuesto federal (2000-2021) / Brazilian policy agenda: priorities and changes in the dynamics of attention on the federal budget distribution (2000-2021)

Resumo Os estudos sobre agenda governamental têm adotado diversos indicadores para mensurar a atenção e as prioridades dos governos, a fim de analisar os processos de formulação e mudança de políticas públicas. Com base nas prerrogativas da teoria do equilíbrio pontuado sobre os padrões de mudanças na dinâmica das políticas, a distribuição do orçamento público tem se destacado como um dos instrumentos que melhor expressam os níveis de atenção e as prioridades dos governos em diferentes setores. Nesse contexto, alinhado a uma agenda internacional, este estudo busca investigar o padrão da atenção governamental acerca da distribuição orçamentária no Brasil. Assim, o objetivo deste trabalho é mapear a dinâmica da atenção governamental sobre a disposição do orçamento aprovado da União ao longo das últimas duas décadas (2000-2021), identificando os níveis percentuais de atenção aos diferentes setores de políticas públicas ao longo do tempo e os fatores conjunturais e institucionais que balizam os níveis de atenção governamental na classificação orçamentária. Para isso, foi formulado um banco de dados do orçamento aprovado de 2000 a 2021, no qual as 814 combinações de funções e subfunções de gastos foram codificadas em 21 setores, conforme metodologia do comparative agenda project (CAP). Os resultados indicam que a atenção governamental sobre essa distribuição opera sob um padrão majoritariamente incremental no decorrer do tempo, mas permeado por pontuações no equilíbrio em políticas setoriais específicas, comprovando a teoria do equilíbrio pontuado (punctuated equilibrium theory [PET]) no cenário nacional. De igual modo, apontam para a necessidade de mais estudos setoriais que expliquem as causas e os efeitos das pontuações na atenção governamental, suas relações com mudanças na agenda legislativa e os impactos de momentos de crises institucionais na definição de prioridades na distribuição orçamentária, apontados como agendas futuras a partir deste trabalho.

Resumen Los estudios sobre la agenda gubernamental adoptaron varios indicadores para medir la atención y las prioridades de los gobiernos a los efectos de analizar los procesos de formulación y cambio de políticas públicas. Desde las prerrogativas de la teoría del equilibrio puntuado sobre los patrones de cambios en la dinámica de las políticas, la distribución del presupuesto público se ha destacado como uno de los instrumentos que mejor expresan los niveles de atención y las prioridades de los gobiernos de los diferentes sectores. En ese contexto, de acuerdo con una agenda internacional, este estudio busca investigar cuál es el patrón de atención gubernamental respecto a la distribución presupuestaria en Brasil. Así, el objetivo de este trabajo es mapear la dinámica de atención gubernamental sobre la distribución del presupuesto federal aprobado en las últimas dos décadas (2000-2021), identificando (i) cuáles son los niveles porcentuales de atención a los diferentes sectores de las políticas públicas a lo largo del tiempo y (ii) los factores coyunturales e institucionales que orientan los niveles de atención del gobierno en la clasificación presupuestaria federal. Para ello, se creó una base de datos del presupuesto aprobado de 2000 a 2021, en la que se codificaron las 814 combinaciones de funciones y subfunciones del gasto en 21 sectores, según la metodología del Proyecto de Agenda Comparada (CAP). Los resultados indican que la atención del gobierno sobre la distribución del presupuesto opera en un patrón mayoritariamente incremental en el tiempo, pero permeado por puntajes de equilibrio en políticas sectoriales específicas, demostrando así la teoría del equilibrio puntuado a nivel nacional. Asimismo, señalan la necesidad de mayores estudios sectoriales que expliquen las causas y efectos de los puntajes en la atención del gobierno, sus relaciones con los cambios en la agenda legislativa y los impactos de los momentos de crisis institucional en la definición de prioridades en la distribución presupuestaria, identificadas como futuras agendas a partir de este trabajo.

Abstract Studies on policy agenda have adopted several indicators to measure the attention and priorities of governments to analyze the processes of policy change and policy dynamics. Based on the Punctuated Equilibrium Theory (PET) applied on the patterns of policy change, the distribution of the public budget has stood out as one of the instruments that best express the levels of attention and priority for governments in different sectors. This study seeks to investigate the pattern of government attention on the federal budget distribution in Brazil. Thus, this work maps the dynamics of government attention on the distribution of the federal approved budget over the last two decades (2000-2021), identifying (i) what are the percentage levels of attention to the different sectors of public policies over time and (ii) the conjunctural and institutional factors that guide the levels of government attention in the budget distribution of the federal government in Brazil. A database of the federal approved budget from 2000 to 2021 was created, in which the 814 combinations of expenditure functions and subfunctions were coded into 21 sectors according to the methodology of the Comparative Agenda Project (CAP). The results indicate that government attention on the distribution of the Brazilian federal budget operates in a mostly incremental pattern over time, permeated by punctuations in specific sectoral policies, thus proving the Punctuated Equilibrium Theory at the national level. As for future research agenda, the study shows the need for further sectoral studies that explain the causes and effects of changes on government attention, their relationships with the legislative agenda, and the impacts of moments of institutional crisis in defining priorities in budget distribution.

Evolution of Bacterial Cellulose in Cosmetic Applications: An Updated Systematic Review.

In recent decades, there has been an increase in environmental problems caused by cosmetic products derived from toxic substances. Based on this issue, researchers and developers of new beauty cosmetics are looking for new natural alternatives that work well for the consumer and have biodegradable characteristics. This systematic review highlights the major publications of bacterial cellulose used strictly for cosmetics in the last 10 years. Bacterial cellulose is a natural product with great cosmetic properties and low cost that has shown excellent results. This study aimed at collecting rigorous information on bacterial cellulose in the cosmetic field in the last decade to produce a systematized review. A comprehensive search was conducted with selected descriptors involving the topic of "bacterial cellulose", "cosmetics", "clean beauty", and "skin mask". Seventy studies were found, which went through exclusion criteria that selected only those related to the topic that was searched. In the 12 remaining studies that met the criteria, bacterial cellulose showed conditions for use as a mask-forming product for facial care. The increase in the number of publications concerning bacterial cellulose in cosmetics in the last ten years is a strong indicator that this is a growing area for both research and the industry.

Frequency independent, remotely reconfigurable passive coherent perfect absorber using conventional inkjet-printing technology.

This work presents a systematic theoretical analysis and experimental validation of a novel coherent absorber which is printed through conventional inkjet-printing technology. The new absorber consists of a single resistively loaded sheet printed on a conventional plastic sheet, resulting a low complexity and passive design. The low-cost and easily fabricated absorber is frequency independent, polarization insensitive, wide-angle and we demonstrate its absorbance reconfigurability using a remote illumination as a control signal. Theoretical, numerical and experimental results are in good agreement. Specifically, experimental results shown that near perfect absorption (i.e., [Formula: see text]) can be achieved using a printed sheet of thickness [Formula: see text].

Heterozygote Advantage of the Type II Deiodinase Thr92Ala Polymorphism on Intrahospital Mortality of COVID-19.

CONTEXT: The type 2 deiodinase and its Thr92Ala-DIO2 polymorphism have been linked to clinical outcomes in acute lung injury and pulmonary fibrosis. OBJECTIVE: Our objectives were to evaluate were cumulative mortality during admission according to Thr92Ala-DIO2 polymorphism. METHODS: Here we conducted an observational, longitudinal, and prospective cohort study to investigate a possible association between the Thr92Ala-DIO2 polymorphism and intrahospital mortality from COVID-19 in adult patients admitted between June and August 2020. Blood biochemistry, thyroid function tests, length of stay, comorbidities, complications, and severity scores were also studied according to Thr92Ala-DIO2 polymorphism. RESULTS: In total, 220 consecutive patients (median age 62; 48-74 years) were stratified into 3 subgroups: Thr/Thr (n = 79), Thr/Ala (n = 119), and Ala/Ala (n = 23). While the overall mortality was 17.3%, the lethality was lower in Ala/Thr patients (12.6%) than in Thr/Thr patients (21.7%) or Ala/Ala patients (23%). The heterozygous genotype (Thr/Ala) was associated with a 47% reduced risk of intrahospital mortality whereas univariate and multivariate logistic regression adjusted for multiple covariates revealed a reduction that ranged from 51% to 66%. The association of the Thr/Ala genotype with better clinical outcomes was confirmed in a metanalysis of 5 studies, including the present one. CONCLUSION: Here we provide evidence for a protective role played by Thr92Ala-DIO2 heterozygosity in patients with COVID-19. This protective effect follows an inheritance model known as overdominance, in which the phenotype of the heterozygote lies outside the phenotypical range of both homozygous.

Reservatórios de água para uso doméstico no Brasil: qualidade microbiológica e química e manutenção de condições sanitárias

Introdução: Os reservatórios domésticos de água garantem comodidade e segurança para os consumidores em relação à intermitência de água. Negligenciar os cuidados mínimos para os reservatórios pode transformá-los em uma fonte de água imprópria para consumo. Objetivo: Avaliar a qualidade físico-química e microbiológica da água dos reservatórios domiciliares, destacando a necessidade de ações individuais para garantir a qualidade da água consumida em casa. Métodos: Foram selecionadas 217 residências, onde os moradores responderam um questionário para o levantamento das condições de armazenamento e manutenção dos reservatórios de água e para coleta de amostras. As dosagens de cloro, pH e temperatura foram realizadas in situ e as de metais por espectrometria de massa com plasma indutivamente acoplado. A presença de parasitos foi avaliada pela técnica de sedimentação espontânea e a de bactérias dos grupos coliformes (totais e fecais) pela técnica de tubos múltiplos com substrato cromogênico. Resultados: Os resultados mostraram que 115 (53%) participantes conheciam o período correto de manutenção dos reservatórios e 109 (50%) indivíduos relataram que não executam a manutenção na frequência recomendada. Os valores médios de cloro, pH e temperatura foram de 1,34 mg/L, 6,5 e 25,4 ºC, respectivamente. As concentrações médias de metais apresentaram-se abaixo dos valores máximos permitidos e não foram detectados parasitos e bactérias. Os testes indicaram que as amostras de água se encontram de acordo com os padrões de potabilidade recomendados pela legislação nacional. Conclusão: Embora os resultados não mostrem contaminação microbiológica nas amostras estudadas, a população precisa ser regularmente informada sobre a importância da higienização do reservatório. Atualmente, existe uma preocupação crescente com o desenvolvimento de ações individuais direcionadas à saúde humana e prevenção de doenças relacionadas ao acesso e uso da água. Portanto, são necessários programas de educação em saúde para orientar a participação da comunidade, com fins de promover melhor qualidade de vida.

Carcinoma papilífero de tireoide pediátrico associado à fusão gênica RET-PTC6: relato de caso / Pediatric papillary thyroid carcinoma associated with RET-PTC6 gene fusion: a case report

Introdução: o carcinoma papilífero de tireoide é a neoplasia maligna que mais acomete o sistema endócrino, correspondendo a cerca de 90% dos casos. Diante de sua frequência, nas últimas décadas, foi registrado um aumento do número de casos na população pediátrica e, devido a isso, o número de crianças e adolescentes submetidos à tireoidectomia se tornou cada vez maior. Enquanto as alterações gênicas mais encontradas em adultos com carcinoma papilífero concentram-se em mutações pontuais, na população pediátrica as fusões gênicas são mais frequentes, com destaque para os rearranjos RET/PTC. Objetivo: relatar aspectos clínico-patológicos do carcinoma papilífero de tireoide, associado à fusão do gene RET, em criança submetida à tireoidectomia e radioiodoterapia adjuvante. Em seguida, discute-se a importância do diagnóstico molecular na escolha de terapias relevantes no tratamento do CPT. Caso Clínico: trata-se de uma paciente do sexo feminino, 11 anos de idade, submetida a tireoidectomia total e esvaziamento cervical após diagnóstico do referido carcinoma. O estudo anatomopatológico revelou um carcinoma metastático em linfonodos regionais. Utilizou-se uma amostra de tecido em bloco de parafina para a realização de um sequenciamento de nova geração, que apontou a existência da fusão gênica TRIM24-RET. Conclusão: os dados deste relato de caso evidenciam que a mutação RET/PTC6 está muito associada à população pediátrica e que testes moleculares, como o NGS, são de extremo valor na identificação dessas alterações gênicas e, consequentemente, na terapia a ser adotada para cada paciente.

Introduction: thyroid papillary carcinoma is the malignant neoplasm that most affects the endocrine system, corresponding to about 90% of cases. Given its frequency, in recent decades, there has been an increase in the number of cases in the pediatric population and, as a result, the number of children and adolescents undergoing thyroidectomy has become increasingly larger. While the most common gene alterations found in adults with papillary carcinoma are concentrated in point mutations, in the pediatric population gene fusions are more frequent, with emphasis on the RET/PTC rearrangements. Objective: to report clinical and pathological aspects of papillary thyroid carcinoma associated with RET gene fusion in a child undergoing thyroidectomy and adjuvant radioiodine therapy. Then, the importance of molecular diagnosis in choosing relevant therapies in the treatment of PTC is discussed. Clinical Case: this is an 11-year-old female patient who underwent total thyroidectomy and neck dissection after diagnosis of the aforementioned carcinoma. The anatomopathological study revealed a metastatic carcinoma in regional lymph nodes. A tissue sample in paraffin block was used to perform a new generation sequencing, which showed the existence of the TRIM24-RET gene fusion. Conclusion: the data in this case report show that the RET/PTC6 mutation is closely associated with the pediatric population and that molecular tests, such as the NGS, are extremely valuable in identifying these genetic alterations and, consequently, in the therapy to be adopted for each patient.

Design and analysis of Maxwell fisheye lens based beamformer.

Antenna arrays and multi-antenna systems are essential in beyond 5G wireless networks for providing wireless connectivity, especially in the context of Internet-of-Everything. To facilitate this requirement, beamforming technology is emerging as a key enabling solution for adaptive on-demand wireless coverage. Despite digital beamforming being the primary choice for adaptive wireless coverage, a set of applications rely on pure analogue beamforming approaches, e.g., in point-to-multi point and physical-layer secure communication links. In this work, we present a novel scalable analogue beamforming hardware architecture that is capable of adaptive 2.5-dimensional beam steering and beam shaping to fulfil the coverage requirements. Beamformer hardware comprises of a finite size Maxwell fisheye lens used as a scalable feed network solution for a semi-circular array of monopole antennas. This unique hardware architecture enables a flexibility of using 2 to 8 antenna elements. Beamformer development stages are presented while experimental beam steering and beam shaping results show good agreement with the estimated performance.

Percepções e práticas sobre o enfrentamento em rede da violência entre parceiros íntimos adolescentes / Perceptions and practices on coping in a network of violence between adolescent intimate partners

Objective: to identify the perceptions and practices about violence between adolescent intimate partners of the professionals who comprise the different coordination levels of the Network for the Protection of Children and Adolescents at Risk for Violence. Method:a qualitative study anchored in the Theory of Praxis Intervention in Collective Health Nursing. Data collection took place through interviews conducted between December2020 and July2021. Thematic content analysis was performed. Results:The participants were seven professionals from the Protection network of Curitiba, Paraná. Three empirical categories emerged that deal with the following: perceptions about violence between adolescent intimate partners; difficulties and practicalities of the network to face it; and the potential of the Protection Network for devising interventions. Conclusion: The network proved to be a powerful strategy to intervene in this form of violence. However,network coping is still scarce, which denotes the need for its inclusion in the public policy agenda.

Fadiga e uso de álcool por graduandos do curso de Enfermagem / Fatigue and alcohol use by undergraduate nursing students / Fatiga y consumo de alcohol por estudiantes de pregrado de enfermería

OBJETIVO: analisar o uso de álcool no padrão binge drinking e os níveis de fadiga em graduandos do curso em Enfermagem na Universidade Federal de Uberlândia. MÉTODO: a pesquisa é de abordagem quantitativa, utilizando estatísticas descritivas e bivariadas, com o valor de p>0,05, e realizada conforme a Resolução nº 466/12 do CNS. Assim, foram aplicados questionários em uma amostra com 202 universitários da graduação em Enfermagem da Universidade Federal de Uberlândia. RESULTADOS: o estudo mostrou a maior predominância do álcool no sexo feminino, com idade média de 22,6 anos de idade. CONCLUSÃO: a análise e a discussão dos dados possibilitaram afirmar que o uso abusivo de álcool está presente, principalmente na forma de binge drinking, e encontra-se associado à presença da fadiga e ao desempenho acadêmico nos universitários da graduação em Enfermagem, em diferentes períodos letivos.

OBJECTIVE: to analyze the use of alcohol in the binge drinking pattern and the levels of fatigue in graduates of the Nursing course at the Federal University of Uberlândia. METHOD: the research is of quantitative approach, using descriptive and bivariate statistics, with the value of p>0.05, and carried out according to Resolution 466/12 of the NHC. Thus, questionnaires were applied to a sample of 202 university students from the Nursing undergraduate program of the Federal University of Uberlândia. RESULTS: the study showed the highest predominance of alcohol in females, with a mean age of 22.6 years. CONCLUSION: the analysis and discussion of the data made it possible to affirm that the abusive use of alcohol is present, mainly in the form of binge drinking, and is associated with the presence of fatigue and academic performance in undergraduate students of Nursing, in different school periods.

OBJETIVO: analizar el uso de alcohol en el patrón de consumo excesivo de alcohol y los niveles de fatiga en estudiantes universitarios de enfermería de la Universidad Federal de Uberlândia. MÉTODO: la investigación tiene un enfoque cuantitativo, utilizando estadísticas descriptivas y bivariadas, con un valor de p> 0.05, y realizada de acuerdo con la Resolución 466/12 del CNS, por lo tanto, se aplicaron cuestionarios a una muestra de 202 estudiantes universitarios en enfermería en la Universidad Federal de Uberlândia. RESULTADOS: el estudio mostró un mayor predominio del alcohol en mujeres, con una edad promedio de 22.6 años. CONCLUSIÓN: el análisis y discusión de los datos permitió afirmar que el abuso de alcohol está presente, principalmente en la forma de binge drinking, que se asocia con la presencia de fatiga y rendimiento académico en estudiantes de licenciatura en enfermería, en diferentes periodos académicos.

Conhecimento e atitude sobre diabetes mellitus em pacientes hospitalizados / Knowledge and attitude about diabetes mellitus in hospitalized patients

Introdução: a educação em diabetes mellitus tem como objetivo orientar as pessoas e ajudar a enfrentar e atuar ativamente na prevenção de complicações que podem surgir com a doença. Objetivo: caracterizar os pacientes com diagnóstico de diabetes mellitus (DM) internados em um hospital terciário do Sul do Brasil por meio da análise dos seus escores de conhecimento e atitudes em relação à doença. Métodos: realizou-se um estudo transversal com 69 pacientes entre os meses de setembro de 2019 e janeiro de 2020. Para coleta de dados, foram utilizados três questionários: um sobre conhecimento do DM (DKN-A), outro acerca das atitudes psicológicas sobre a doença (ATT-19) e um último constituído por perguntas objetivas aplicadas por meio de entrevista, o qual avalia as características clínicas e sociodemográficas de cada paciente. Para a análise estatística, foram utilizados os testes qui-quadrado ou Exato de Fisher. Resultados: em relação ao questionário DKN-A, 49 pacientes avaliados (71%) obtiveram boa pontuação (escore superior a 8 pontos), a qual está associada a um bom conhecimento do DM. Verificou-se que esses pacientes realizavam acompanhamento médico do DM de forma mais regular, consultando, no mínimo, três vezes ao ano (p=0,036). 66 participantes (95,7%) apresentaram baixa pontuação no questionário ATT-19. Discussão: grande parte dos pacientes avaliados têm bom conhecimento sobre o DM, entretanto, a baixa pontuação no questionário ATT-19 apresentada pela maioria dos pacientes indica dificuldade de enfrentamento da doença. O acompanhamento médico mais regular do diabetes mellitus pode estar associado a maior envolvimento do paciente no tratamento da doença, assim como maior e mais frequente fluxo de informações entre médico e paciente.

Introduction: diabetes education aims to guide people and help to face and act actively in preventing complications that may arise with the disease. Aims: to characterize patients diagnosed with Diabetes Mellitus (DM) admitted to a tertiary hospital in southern Brazil through the analysis of their knowledge and attitudes towards the disease. Methods: a cross-sectional study with 69 patients was carried out between September 2019 and January 2020. For data collection, three questionnaires were used: one on knowledge of DM (DKN-A), another on psychological attitudes about the disease (ATT-19) and a last one consisting of objective questions applied through an interview, which assesses the clinical and sociodemographic characteristics of each patient. For statistical analysis, Chi-square or Fisher's exact tests were used. Results: regarding the DKN-A questionnaire, 49 patients evaluated (71%) obtained a good score (score greater than 8 points), which is associated with a good knowledge of DM. It was found that these patients underwent medical monitoring of Diabetes on a more regular basis, consulting at least three times a year (p = 0.036). Sixty-six participants (95.7%) had low scores on the ATT-19 questionnaire. Discussion: most of the patients evaluated have good knowledge about DM, however, the low score on the ATT-19 questionnaire presented by most patients indicates difficulty in coping with the disease. More regular medical monitoring of Diabetes may be associated with greater patient involvement in the treatment of the disease, as well as a greater and more frequent flow of information between doctor and patient.

Impacto financeiro no tratamento cirúrgico do glaucoma / Financial impact on glaucoma surgical treatment

Resumo Objetivo: Segunda maior causa de cegueira mundial, o glaucoma, ocasionalmente necessita de procedimento cirúrgico para controle. Tendo o Brasil um Sistema Único de Saúde (SUS), e crise político-econômica em 2016, objetiva-se avaliar o impacto financeiro na decisão terapêutica do glaucoma nos últimos 6 anos no Brasil, e considerar atual discussão sobre indicação de procedimentos intervencionistas precocemente no seu algoritmo terapêutico. Métodos: Estudo ecológico da população brasileira, com base no Sistema de Informações Hospitalares do SUS, avaliando comportamento temporal dos procedimentos cirúrgicos do SUS para tratamento do glaucoma, e variação do dólar como influenciador da tendência temporal sobre os procedimentos. Realizada a análise de Regressão Linear Simples, com significância estatística de P<0.05. Resultados: Entre 2013 e 2018 foram internados 24888 indivíduos por glaucoma, prevalência do sexo masculino (51.68%), brancos (32,57%) e idosos (57.84%). Regiões Sudeste (45.61%) e Nordeste (26.36%) com maior número de internações, sendo a Trabeculectomia (84,18%) principal procedimento realizado. Houve associação da Trabeculectomia e Implante de Válvula, individualmente e atrelados, com os valores do dólar nas regiões Centro-Oeste (β= 1,103 com P= 0,007 para Trabeculectomias e β= 1,105 com P=0,012 para ambos os procedimentos) e Sul (β= 16,727 e P= 0,006 para os Implantes), e associação entre aumento de Implantes na região Sul e maior cobertura na atenção básica (β= 0.64 e P= 0.009). Conclusão: Observou-se não interferência do dólar, e aumento dos procedimentos na região Sul e Centro-Oeste. Os resultados corroboram tendência intervencionista, podendo ser representada pelo possível uso dos procedimentos disponibilizados pelo SUS de forma precoce.

Abstract Objective: The second leading cause of blindness worldwide, glaucoma, occasionally requires surgical procedure for control. Given that Brazil has an Unified Health System (SUS) and a political-economic crisis in 2016, we aim to evaluate the financial impact on the therapeutic decision of glaucoma in the last 6 years in Brazil, and to consider the current discussion about early interventionist indication in its therapeutic algorithm. Methods: Ecological study of the Brazilian population, based on the SUS Hospital Information System, evaluating the temporal behavior of SUS surgical procedures on glaucoma treatment, and dollar variation as influencing the temporal trend on the procedures. Simple Linear Regression analysis was performed, with statistical significance of P <0.05. Results: Between 2013 and 2018, 24888 individuals were hospitalized for glaucoma, male prevalence (51.68%), whites (32.57%) and elderly (57.84%). Southeast (45.61%) and Northeast (26.36%) Regions with the largest number of hospitalizations, and Trabeculectomy (84.18%) being the main procedure performed. There was an association of trabeculectomy and valve implantation, individually and linked, with dollar values in the Midwest (β = 1.103 with P = 0.007 for Trabeculectomies and β = 1.105 with P = 0.012 for both procedures) and South (β). = 16,727 and P = 0,006 for Implants), and association between increased Implants in the South region and greater coverage in primary care (β = 0.64 and P = 0.009). Conclusion: Non-dollar interference was observed, and increased procedures in the South and Midwest. The results corroborate an interventionist tendency and may be represented, possible, by the use of procedures provided by the SUS in an early manner.

Gram-negative bacteria carrying ß-lactamase encoding genes in hospital and urban wastewater in Brazil.

Multidrug resistance mediated by ß-lactamase in Gram-negative bacilli is a serious public health problem. Sewers are considered reservoirs of multiresistant bacteria due to presence of antibiotics that select them and favor their dissemination. The present study evaluated the antibiotic resistance profile and ß-lactamases production in Gram-negative bacilli isolates from hospital sewage and urban wastewater treatment plants (UWWTP) in Brazil. Bacteria were isolated and identified with biochemical tests. Antibiotic susceptibility testing was performed by the disk-diffusion method and detection of extended-spectrum ß-lactamase and carbapenemases by enzymatic inhibitor and conventional PCR. Differences in resistance to amoxicillin clavulanic, aztreonam, cefepime, and cefotaxime were observed in hospital sewage compared with urban sewage (p < 0.05). The multidrug-resistant phenotype was observed in 33.3% of hospital sewage isolates (p = 0.0025). ß-lactamases genes were found in 35.6% of isolates, with the most frequent being blaKPC and blaTEM (17.8%), and blaSHV and blaCTX-M (13.3% and 8.9%, respectively). The data obtained are relevant, since the bacteria detected are on the priority pathogens list from the World Health Organization and hospital sewage could be released untreated into the municipal collection system, which may favor the spread of resistance. Changes in hospital sewage discharge practices, as well as additional technologies regarding effluent disinfection in the UWWTP, can prevent the spread of these bacteria into the environment and negative impact on water resources.

Neutrophil elastase inhibitor purification strategy from cowpea seeds.

Serine proteases and its inhibitors are involved in physiological process and its deregulation lead to various diseases like Chronic Obstructive Pulmonary Disease (COPD), pulmonary emphysema, skin diseases, atherosclerosis, coagulation diseases, cancer, inflammatory diseases, neuronal disorders and other diseases. Serine protease inhibitors have been described in many species, as well as in plants, including cowpea beans (Vigna unguiculata (L.) Walp). Here, we purified and characterized a protease inhibitor, named VuEI (Vigna unguiculata elastase inhibitor), from Vigna unguiculata, with inhibitory activity against HNE (human neutrophil elastase) and chymotrypsin but has no inhibitory activity against trypsin and thrombin. VuEI was obtained by alkaline protein extraction followed by three different chromatographic steps in sequence. First, an ion exchange chromatography using Hitrap Q column was employed, followed by two reversed-phase chromatography using Source15RPC and ACE18 columns. The molecular mass of VuEI was estimated in 10.99 kDa by MALDI-TOF mass spectrometry. The dissociation constant (Ki) to HNE was 9 pM. These data indicate that VuEI is a potent inhibitor of human neutrophil elastase, besides to inhibit chymotrypsin.