Extracellular vesicles in malaria: Pathogenesis, diagnosis and therapy.

Malaria is a life-threatening disease caused by parasites from the genus Plasmodium. Five species can cause malaria in humans, with Plasmodium vivax being the most common in many countries and Plasmodium falciparum having the highest lethality, which can lead to cerebral malaria. Extracellular vesicles (EVs) are in focus in malaria research to better understand pathogenesis, diagnosis, therapy, and prognosis. Malaria-causing parasites use EVs to transfer their molecules to host cells, a mechanism that significantly contributes to parasite survival and successful infection. EVs have thus emerged as an essential component of the immunopathological cascade of malaria, playing a pivotal role in disease progression and severity. This chapter discusses the epidemiology and pathogenesis of malaria and the role of EVs as new diagnostic and therapeutic tools, emphasizing their potential clinical significance.

Burnout syndrome among health care professionals in the context of the COVID-19 pandemic.

Introduction: Burnout syndrome, a mental illness caused by stressful work conditions, is prevalent among health professionals. In addition to existing risk factors, the COVID-19 pandemic introduced new ones, such as fear of infection and concern about the availability of personal protective equipment. Objectives: This study's purpose was to verify the prevalence and correlates of burnout syndrome among health professionals in the context of the pandemic. Methods: This quantitative study was conducted between April and June 2021 using the Google Forms platform. A semi-structured questionnaire and the Questionário para la Evaluación del Syndrome de Quemarse por el Trabajo were applied. Results: A total of 93 health professionals participated. Those who fought on the frontline against COVID-19 were younger and had less professional experience, longer work hours, daily contact with a greater number of patients, lower scores in the disillusionment dimension, and higher scores in the emotional exhaustion dimension. Significant correlations were found between age and disillusionment, emotional exhaustion, and indolence. Less professional experience was also correlated with psychological distress. Conclusions: Age and length of experience were significantly associated with burnout, given that younger and less experienced professionals generally worked on the frontline against COVID-19.

Introdução: A síndrome de burnout é uma doença psíquica ocasionada por situações desgastantes de trabalho, sendo prevalente entre os profissionais de saúde. Além dos fatores de risco já existentes para o seu desenvolvimento, a pandemia de covid-19 apresentou novos fatores de risco, como o medo de adquirir a doença e a preocupação com a disponibilidade de equipamentos de proteção individual. Objetivos: Verificar a prevalência da síndrome de burnout em profissionais de saúde no contexto da covid-19 e suas correlações. Métodos: Trata-se de um estudo quantitativo, realizado em 2021 por meio da plataforma Google Forms. Foram utilizados um questionário semiestruturado e o Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo. Resultados: Participaram da pesquisa 93 profissionais de saúde. Os profissionais que participaram do enfrentamento à covid-19 possuíam menor idade, menor tempo de atuação profissional, maior carga horária semanal de trabalho, contato com maior número de pacientes diariamente, menor pontuação na dimensão ilusão pelo trabalho e maior pontuação na dimensão desgaste psíquico. Correlações significantes foram encontradas entre idade e ilusão pelo trabalho, desgaste psíquico e indolência. Além disso, menor tempo de atuação profissional foi correlacionado com desgaste psíquico. Conclusões: A idade e o tempo de atuação foram as variáveis que apresentaram significância nos testes estatísticos realizados, em que profissionais mais jovens e com menor tempo de atuação estavam em maioria no enfrentamento à covid-19, além de estarem associados ao burnout, corroborando para que fossem os profissionais mais susceptíveis a desenvolver a síndrome de burnout.

Prevalence of depressive symptoms among young adults in Brazil: Results of the 2013 and 2019 editions of the National Health Survey.

OBJECTIVE: To estimate the prevalence of depressive symptoms in the population aged 18 to 24, according to socioeconomic and demographic aspects in Brazil, comparing its evolution between 2013 and 2019. METHODS: Cross-sectional study carried out with secondary data obtained from National Health Survey 2013 and 2019. It were included 7,823 young adulthood (aged 18 to 24) from 2013 and 8,047 from 2019. The instrument used to assess depression was the Patient Health Questionnaire-9 (PHQ-9). All estimates included population weights and complex sampling. RESULTS: The prevalence of depression almost doubled: 10.9% (95%CI 9.6-12.2) in 2019, compared to 5.6% (95%CI 4.8-6.4) in 2013, an absolute difference of 5.3% (4.5-6.0) greater. Women were the most affected in both surveys, with an increase between 2013 (8.3%; 95%CI 6.9-9.6) and 2019 (15.6%; 95%CI 13.5-17.6) higher than that of men (2013: 2.9%; 95%CI 2.0-3.8 and 2019: 6.2%; 95%CI 4.7-7.7). In both sexes, the pattern of increase was greater for the groups aged 18 to 20, not participating in religious activities, who were at the lowest levels of education and income, who lived with two or three or more people, who lived in the Northeast, Southeast, capitals and metropolitan areas of the country. CONCLUSION: There was a significant increase in the prevalence of depressive symptoms over the six years between the two surveys. However, this increase did not occur homogeneously among the characteristics analyzed, indicating population groups and locations in Brazil where the presence of these symptoms increased most in the period.

Temporal dominance of Sensations: Do different concepts of "dominance" affect the results?

The purpose of this study was to understand the role of "dominance" definitions in the results of TDS applied to consumers. This study compared two temporal dominance of sensations (TDS) approaches - TDS-I - that attracts the most attention and TDS-II - most intense/strongest sensation - in the context of evaluating artisanal Minas cheeses from the Serra da Canastra and chocolate with different cocoa concentrations samples. TDS curves were constructed and a trajectory-based principal component analysis (PCA) was performed dominance rates at ten equally spaced time points. Additionally, difference curves, multiple factor analysis (MFA) and regression vector coefficient (RV coefficient) were performed to compare the two approaches. The findings showed that the two approaches produced similar results, suggesting that consumers interpret the terms dominant and intense in a similar way during TDS evaluations, the results were even closer at the chocolate study than at the cheese study. However, in both approaches were observed low dominance rates and differences between the sensation perception time, mainly in the evaluation of cheese flavor. This variability may be attributed to the complexity of the cheese's flavor and the varied interpretations of dominance among evaluators. Despite these differences, the approaches showed similar characterizations across the same samples, demonstrating high reproducibility and a strong ability to differentiate between samples. This study demonstrates that the choice between the terms dominant (which captures more attention) or intense (stronger) to guide consumers in performing the sensory test does not significantly influence the results. Consequently, it is possible to adopt greater freedom and flexibility in the terminology used to instruct participants in conducting the test.

Consumption of food markers of a healthy diet according to racial groups of women in Brazil. / Consumo de alimentos marcadores de uma alimentação saudável, segundo os grupos raciais de mulheres no Brasil.

This article aims to analyze the consumption of healthy food consumption markers, according to racial groups of Brazilian women interviewed in the 2019 National Health Survey (NHS). This work was a cross-sectional study with data from 45,148 white and black women, aged ≥ 20 years. The variables used were the consumption of fruits, vegetables and legumes, beans, and fish. The association between color/race and the dietary intake indicators was tested using crude Poisson regression and adjusted to estimate prevalence ratios and 95% confidence intervals (95%CI). The prevalence of the consumption of fruits and vegetables was statistically higher among white women, while fish and beans was higher among black women. After adjusting for socioeconomic and demographic variables, it was found that black women remained only less likely to consume fruit (PR = 0.91; 95% CI: 0.88-0.95) and only more likely to consume beans (PR = 1.07; 95% CI: 1.04-1.10) than whites. There were racial inequalities for the consumption of healthy foods among Brazilian women, indicating that color/race defined a dietary pattern for black women that put them in vulnerable conditions in terms of fruit consumption.

O objetivo do artigo é analisar o consumo de alimentos marcadores de uma alimentação saudável, segundo os grupos raciais de mulheres brasileiras entrevistadas na Pesquisa Nacional de Saúde 2019. Estudo transversal com dados de 45.148 mulheres brancas e negras de ≥ 20 anos de idade. Os marcadores utilizados foram o consumo de frutas, verduras e legumes e feijão e peixe. A associação de cor/raça com os indicadores de consumo alimentar foi testada por regressão de Poisson bruta e ajustada para estimar razões de prevalência e intervalo de confiança de 95%. A prevalência do consumo de frutas, verduras e legumes foi estatisticamente maior nas brancas, e o de peixes e feijão foi maior nas negras. Após o ajuste pelas variáveis socioeconômicas e demográficas, verificou-se que mulheres negras permaneceram apresentando menores chances apenas de consumir frutas (RP = 0,91; IC95%: 0,88-0,95) e maior somente de consumir feijão (RP = 1,07; IC95%: 1,04-1,10) do que as brancas. Verificaram-se desigualdades raciais para o consumo de alimentos saudáveis entre mulheres brasileiras, indicando que a cor/raça definiu um padrão alimentar para as mulheres negras que as colocam em condições vulneráveis em grande parte do consumo de frutas.

Potential of extracellular vesicles in the pathogenesis, diagnosis and therapy for parasitic diseases.

Parasitic diseases have a significant impact on human and animal health, representing a major hazard to the public and causing economic and health damage worldwide. Extracellular vesicles (EVs) have long been recognized as diagnostic and therapeutic tools but are now also known to be implicated in the natural history of parasitic diseases and host immune response modulation. Studies have shown that EVs play a role in parasitic disease development by interacting with parasites and communicating with other types of cells. This review highlights the most recent research on EVs and their role in several aspects of parasite-host interactions in five key parasitic diseases: Chagas disease, malaria, toxoplasmosis, leishmaniasis and helminthiases. We also discuss the potential use of EVs as diagnostic tools or treatment options for these infectious diseases.

The angiotensin II/type 1 angiotensin II receptor pathway is implicated in the dysfunction of albumin endocytosis in renal proximal tubule epithelial cells induced by high glucose levels.

It is well-established that dysfunction of megalin-mediated albumin endocytosis by proximal tubule epithelial cells (PTECs) and the activation of the Renin-Angiotensin System (RAS) play significant roles in the development of Diabetic Kidney Disease (DKD). However, the precise correlation between these factors still requires further investigation. In this study, we aimed to elucidate the potential role of angiotensin II (Ang II), a known effector of RAS, as the mediator of albumin endocytosis dysfunction induced by high glucose (HG) in PTECs. To achieve this, we utilized LLC-PK1 and HK-2 cells, which are well-established in vitro models of PTECs. Using albumin-FITC or DQ-albumin as tracers, we observed that incubation of LLC-PK1 and HK-2 cells with HG (25 mM for 48 h) significantly reduced canonical receptor-mediated albumin endocytosis, primarily due to the decrease in megalin expression. HG increased the concentration of Ang II in the LLC-PK1 cell supernatant, a phenomenon associated with an increase in angiotensin-converting enzyme (ACE) expression and a decrease in prolyl carboxypeptidase (PRCP) expression. ACE type 2 (ACE2) expression remained unchanged. To investigate the potential impact of Ang II on HG effects, the cells were co-incubated with angiotensin receptor inhibitors. Only co-incubation with 10-7 M losartan (an antagonist for type 1 angiotensin receptor, AT1R) attenuated the inhibitory effect of HG on albumin endocytosis, as well as megalin expression. Our findings contribute to understanding the genesis of tubular albuminuria observed in the early stages of DKD, which involves the activation of the Ang II/AT1R axis by HG.

Technology for nursing care in a Maternal Intensive Care Unit: a methodological study.

OBJECTIVES: to develop and validate a nursing care plan in a Maternal Intensive Care Unit. METHODS: a methodological study, developed in stages: integrative review; Nursing History construction; care plan restructuring; appearance and content validity by judges. RESULTS: the history was organized into sections: Identification; Basic Human Needs; Physical Examination; and Assessment of Basic Human Needs. A care plan was restructured with 34 diagnoses, organized according to basic human needs. A satisfactory level of appearance validity of the history and care plan was obtained (Concordance Index varying between 86.3 and 100 for both instruments), and content validity with average indexes of 90.8 and 92.8, respectively. Thirty-four diagnoses, their interventions and nursing actions were consolidated. CONCLUSIONS: the instruments were considered relevant and pertinent in terms of appearance and content, and their use in the institution under study as well as in other similar services may be recommended.

Performance of ß-carotene-loaded nanostructured lipid carriers under dynamic in vitro digestion system: Influence of the emulsifier type.

A better understanding of how emulsifier type could differently influence the behavior of nanostructured lipid carriers (NLC) under the gastrointestinal digestion process, as well as at the cellular level, is of utmost importance for the NLC-based formulations' optimization and risk assessment in the food field. In this study, NLC composed by fully hydrogenated soybean and high-oleic sunflower oils were prepared using soy lecithin (NLC Lß) or Tween 80 (NLC Tß) as an emulsifier. ß-Carotene was entrapped within NLC developed as a promising strategy to overcome ß-carotene's low bioavailability and stability. The effect of emulsifier type on the digestibility of ß-carotene-loaded NLC was evaluated using an in vitro dynamic digestion model mimicking peristalsis motion. The influence of ß-carotene-loaded NLC on cell viability was assessed using Caco-2 cells in vitro. NLC Tß remained stable in the gastric compartment, presenting particle size (PS) similar to the initial NLC (PS: 245.68 and 218.18 nm, respectively), while NLC Lß showed lower stability (PS > 1000 nm) in stomach and duodenum phases. NLC Tß also provided high ß-carotene protection and delivery capacity (i.e., ß-carotene bioaccessibility increased 10-fold). Based on the results of digestion studies, NLC Tß has shown better physical stability during the passage through the in vitro dynamic gastrointestinal system than NLC Lß. Moreover, the developed NLC did not compromise cell viability up to 25 µg/mL of ß-carotene. Thus, the NLC developed proved to be a biocompatible structure and able to incorporate and protect ß-carotene for further food applications. PRACTICAL APPLICATION: The findings of this study hold significant implications for industrial applications in terms of developing nanostructured lipid carriers from natural raw materials widely available and used to produce other lipid-based products in the food industry, as an alternative to synthetic ones. In this respect, the ß-carotene-loaded NLC developed in this study would find a great industrial application in the food industry, which is in constant search to develop functional foods capable of increasing the bioavailability of bioactive compounds.

Toll like receptor 4 mediates the inhibitory effect of SARS-CoV-2 spike protein on proximal tubule albumin endocytosis.

Tubular proteinuria is a common feature in COVID-19 patients, even in the absence of established acute kidney injury. SARS-CoV-2 spike protein (S protein) was shown to inhibit megalin-mediated albumin endocytosis in proximal tubule epithelial cells (PTECs). Angiotensin-converting enzyme type 2 (ACE2) was not directly involved. Since Toll-like receptor 4 (TLR4) mediates S protein effects in various cell types, we hypothesized that TLR4 could be participating in the inhibition of PTECs albumin endocytosis elicited by S protein. Two different models of PTECs were used: porcine proximal tubule cells (LLC-PK1) and human embryonic kidney cells (HEK-293). S protein reduced Akt activity by specifically inhibiting of threonine 308 (Thr308) phosphorylation, a process mediated by phosphoinositide-dependent kinase 1 (PDK1). GSK2334470, a PDK1 inhibitor, decreased albumin endocytosis and megalin expression mimicking S protein effect. S protein did not change total TLR4 expression but decreased its surface expression. LPS-RS, a TLR4 antagonist, also counteracted the effects of the S protein on Akt phosphorylation at Thr308, albumin endocytosis, and megalin expression. Conversely, these effects of the S protein were replicated by LPS, an agonist of TLR4. Incubation of PTECs with a pseudovirus containing S protein inhibited albumin endocytosis. Null or VSV-G pseudovirus, used as control, had no effect. LPS-RS prevented the inhibitory impact of pseudovirus containing the S protein on albumin endocytosis but had no influence on virus internalization. Our findings demonstrate that the inhibitory effect of the S protein on albumin endocytosis in PTECs is mediated through TLR4, resulting from a reduction in megalin expression.

Mycobacterium tuberculosis latent infection in healthcare students: systematic review of prevalence.

OBJECTIVE: The aim of this study was to synthesize the evidence on the prevalence of latent Mycobacterium tuberculosis infection (LTBI) among undergraduate health care students. METHODS: A systematic review of prevalence with meta-analysis was conducted. Prospective and retrospective cohorts and cross-sectional studies involving probable exposure to M. tuberculosis during undergraduate education, along with the tuberculin skin test (TST) or interferon-γ release assay (IGRA) for investigation of latent tuberculosis were searched. Searches were conducted in MEDLINE, CINAHL, EMBASE, LILACS, Scopus, and Web of Science databases. Independent reviewers were responsible for the selection and inclusion of studies. Data were extracted, critically appraised, and synthesized using the JBI approach. PRISMA was used to report the study. RESULTS: Twenty-two studies were analyzed. The overall prevalence in healthcare undergraduate students was 12.53%. CONCLUSION: The prevalence of LTBI in undergraduate health students was high for such a highly educated population. Screening with TST and/or IGRA and chemoprophylaxis, when necessary, should be provided to undergraduate health students when in contact with respiratory symptomatic patients.

Synthetic angiotensin II peptide derivatives confer protection against cerebral and severe non-cerebral malaria in murine models.

Malaria can have severe long-term effects. Even after treatment with antimalarial drugs eliminates the parasite, survivors of cerebral malaria may suffer from irreversible brain damage, leading to cognitive deficits. Angiotensin II, a natural human peptide hormone that regulates blood pressure, has been shown to be active against Plasmodium spp., the etiologic agent of malaria. Here, we tested two Ang II derivatives that do not elicit vasoconstriction in mice: VIPF, a linear tetrapeptide, which constitutes part of the hydrophobic portion of Ang II; and Ang II-SS, a disulfide-bridged derivative. The antiplasmodial potential of both peptides was evaluated with two mouse models: an experimental cerebral malaria model and a mouse model of non-cerebral malaria. The latter consisted of BALB/c mice infected with Plasmodium berghei ANKA. The peptides had no effect on mean blood pressure and significantly reduced parasitemia in both mouse models. Both peptides reduced the SHIRPA score, an assay used to assess murine health and behavior. However, only the constrained derivative (Ang II-SS), which was also resistant to proteolytic degradation, significantly increased mouse survival. Here, we show that synthetic peptides derived from Ang II are capable of conferring protection against severe manifestations of malaria in mouse models while overcoming the vasoconstrictive side effects of the parent peptide.

Prenatal care associated with neonatal outcomes in maternity hospitals: a hospital-based cross-sectional study.

OBJECTIVE: To verify the association between prenatal care quality indicators and neonatal outcomes in maternity hospitals. METHOD: Hospital-based cross-sectional study in four high-risk referral maternity hospitals in the five health macro-regions enabled by the Stork Network in Ceará-Brazil. Between April 2017 and July 2018, 440 puerperal women were interviewed using simple probabilistic sampling and a formula with finite populations and stratification of each maternity hospital. The analysis involved Pearson's Chi-Square, Adjusted Residuals Analysis and Fisher's Exact. RESULTS: There was an association between fewer consultations with prematurity and low birth weight. Delivery in the maternity hospital where the woman lived was associated with low birth weight and the need for ventilatory support. CONCLUSION: Prenatal care quality indicators influenced neonatal outcomes, which underlines the importance of ensuring access and quality of care as ways of reducing infant morbidity and mortality.

Reflectance confocal microscopy - Consensus terminology glossary in Brazilian Portuguese for normal skin, melanocytic and non-melanocytic lesions

Abstract Background: Currently, there is no uniform and official terminology in Portuguese for reflectance confocal microscopy analysis, despite the increasing number of Brazilian dermatologists using this new tool. Objective: To present the terminology in Brazilian Portuguese for the description of reflectance confocal microscopy and establish the first Brazilian consensus on terms related to normal skin and cutaneous tumors. Methods: 10 Brazilian specialists from different institutions and states of Brazil were selected to evaluate the best corresponding terms in Portuguese for normal skin, melanocytic and non-melanocytic tumors. The terms used were translated from international consensuses in the English language. The modified Delphi method was used to create the consensus in 3 steps. Results: The terms considered the most appropriate in the Portuguese language to describe the findings of normal skin, melanocytic and non-melanocytic lesions in the reflectance confocal microscopy analysis were presented. Study limitations: The limitations of the present study include the number of participants and limited regional representation (only two of the five Brazilian regions were represented). Conclusion: This Brazilian consensus represents an opportunity for dermatologists and physicians specializing in cutaneous oncology to become familiar with reflectance confocal microscopy, propagating the technique in clinical and research environments to stimulate national and international publications on this subject.

Reflectance confocal microscopy - Consensus terminology glossary in Brazilian Portuguese for normal skin, melanocytic and non-melanocytic lesions.

BACKGROUND: Currently, there is no uniform and official terminology in Portuguese for reflectance confocal microscopy analysis, despite the increasing number of Brazilian dermatologists using this new tool. OBJECTIVE: To present the terminology in Brazilian Portuguese for the description of reflectance confocal microscopy and establish the first Brazilian consensus on terms related to normal skin and cutaneous tumors. METHODS: 10 Brazilian specialists from different institutions and states of Brazil were selected to evaluate the best corresponding terms in Portuguese for normal skin, melanocytic and non-melanocytic tumors. The terms used were translated from international consensuses in the English language. The modified Delphi method was used to create the consensus in 3 steps. RESULTS: The terms considered the most appropriate in the Portuguese language to describe the findings of normal skin, melanocytic and non-melanocytic lesions in the reflectance confocal microscopy analysis were presented. STUDY LIMITATIONS: The limitations of the present study include the number of participants and limited regional representation (only two of the five Brazilian regions were represented). CONCLUSION: This Brazilian consensus represents an opportunity for dermatologists and physicians specializing in cutaneous oncology to become familiar with reflectance confocal microscopy, propagating the technique in clinical and research environments to stimulate national and international publications on this subject.

Antiaging effects of a skin care formulation containing nanoencapsulated antioxidants: A clinical, in vitro, and ex vivo study.

BACKGROUND: The development of effective cosmetic products for the reduction of the signs of skin aging is a complex process which requires an optimized combination of ingredients and specialized systems to deliver the actives to the skin layers. AIM: To evaluate the tolerance and antiaging clinical efficacy of a cosmetic formulation containing a blend of nanoencapsulated antioxidants: ascorbyl palmitate, resveratrol, tocopherol, caffeine, carnosine, and niacinamide. METHODS: Clinical efficacy was determined by subjective and instrumental analyses of collagen synthesis by fluorescence spectroscopy, by three-dimensional imaging analysis of suborbital edema, and by analysis of skin hydration and sebum content by biophysical techniques-Corneometer® and Sebumeter®. RESULTS: The studied formulation was safe and effective for the improvement of skin appearance by increasing collagen synthesis and skin moisturizing and by reducing facial blemishes, swelling, and oiliness. A preclinical exploratory approach using an experimental model of human cell and skin cultures agreed with the observed antiaging effects, identifying mechanisms related to the containment of oxidative stress, reduction of melanin production, increased synthesis of type I procollagen, and regulation of the epidermal cohesion protein filaggrin. CONCLUSIONS: The skin benefits obtained resulted from the combination of the ingredients in the formulation and the nanoencapsulation-based delivery system, which favors the solubility, safety, efficacy, and bioavailability of the preparation to the skin.

Bradykinin produced during Plasmodium falciparum erythrocytic cycle drives monocyte adhesion to human brain microvascular endothelial cells.

Cerebral malaria (CM) pathogenesis is described as a multistep mechanism. In this context, monocytes have been implicated in CM pathogenesis by increasing the sequestration of infected red blood cells to the brain microvasculature. In disease, endothelial activation is followed by reduced monocyte rolling and increased adhesion. Nowadays, an important challenge is to identify potential pro-inflammatory stimuli that can modulate monocytes behavior. Our group have demonstrated that bradykinin (BK), a pro-inflammatory peptide involved in CM, is generated during the erythrocytic cycle of P. falciparum and is detected in culture supernatant (conditioned medium). Herein we investigated the role of BK in the adhesion of monocytes to endothelial cells of blood brain barrier (BBB). To address this issue human monocytic cell line (THP-1) and human brain microvascular endothelial cells (hBMECs) were used. It was observed that 20% conditioned medium from P. falciparum infected erythrocytes (Pf-iRBC sup) increased the adhesion of THP-1 cells to hBMECs. This effect was mediated by BK through the activation of B2 and B1 receptors and involves the increase in ICAM-1 expression in THP-1 cells. Additionally, it was observed that angiotensin-converting enzyme (ACE) inhibitor, captopril, enhanced the effect of both BK and Pf-iRBC sup on THP-1 adhesion. Together these data show that BK, generated during the erythrocytic cycle of P. falciparum, could play an important role in adhesion of monocytes in endothelial cells lining the BBB.

Starvation-induced autophagy modulates spermatogenesis and sperm quality in Nile tilapia.

Spermatogenesis is a finely regulated process that involves the interaction of several cellular mechanisms to ensure the proper development and maturation of germ cells. This study assessed autophagy contribution and its relation to apoptosis in fish spermatogenesis during starvation. To that end, Nile tilapia males were subjected to 0 (control), 7, 14, 21, and 28 days of starvation to induce autophagy. Testes samples were obtained for analyses of spermatogenesis by histology, electron microscopy, immunohistochemistry, and western blotting. Sperm quality was assessed using a computer-assisted sperm analysis (CASA) system. Data indicated a significant reduction in gonadosomatic index, seminiferous tubule area, and spermatozoa proportion in fish subject to starvation compared to the control group. Immunoblotting revealed a reduction of Bcl2 and Beclin 1 associated with increased Bax and Caspase-3, mainly after 21 and 28 days of starvation. LC3 and P62 indicated reduced autophagic flux in these starvation times. Immunolabeling for autophagic and apoptotic proteins occurred in all development stages of the germ cells, but protein expression varied throughout starvation. Beclin 1 and Cathepsin D decreased while Bax and Caspase-3 increased in spermatocytes, spermatids, and spermatozoa after 21 and 28 days. Autophagic and lysosomal proteins colocalization indicated the fusion of autophagosomes with lysosomes and lysosomal degradation in spermatogenic cells. The CASA system indicated reduced sperm motility and velocity in animals subjected to 21 and 28 days of starvation. Altogether, the data support autophagy acting at different spermatogenesis stages in Nile tilapia, with decreased autophagy and increased apoptosis after 21 and 28 days of starvation, which results in a decrease in the spermatozoa number and sperm quality.

Consumo de alimentos marcadores de uma alimentação saudável, segundo os grupos raciais de mulheres no Brasil / Consumption of food markers of a healthy diet according to racial groups of women in Brazil

Resumo O objetivo do artigo é analisar o consumo de alimentos marcadores de uma alimentação saudável, segundo os grupos raciais de mulheres brasileiras entrevistadas na Pesquisa Nacional de Saúde 2019. Estudo transversal com dados de 45.148 mulheres brancas e negras de ≥ 20 anos de idade. Os marcadores utilizados foram o consumo de frutas, verduras e legumes e feijão e peixe. A associação de cor/raça com os indicadores de consumo alimentar foi testada por regressão de Poisson bruta e ajustada para estimar razões de prevalência e intervalo de confiança de 95%. A prevalência do consumo de frutas, verduras e legumes foi estatisticamente maior nas brancas, e o de peixes e feijão foi maior nas negras. Após o ajuste pelas variáveis socioeconômicas e demográficas, verificou-se que mulheres negras permaneceram apresentando menores chances apenas de consumir frutas (RP = 0,91; IC95%: 0,88-0,95) e maior somente de consumir feijão (RP = 1,07; IC95%: 1,04-1,10) do que as brancas. Verificaram-se desigualdades raciais para o consumo de alimentos saudáveis entre mulheres brasileiras, indicando que a cor/raça definiu um padrão alimentar para as mulheres negras que as colocam em condições vulneráveis em grande parte do consumo de frutas.

Abstract This article aims to analyze the consumption of healthy food consumption markers, according to racial groups of Brazilian women interviewed in the 2019 National Health Survey (NHS). This work was a cross-sectional study with data from 45,148 white and black women, aged ≥ 20 years. The variables used were the consumption of fruits, vegetables and legumes, beans, and fish. The association between color/race and the dietary intake indicators was tested using crude Poisson regression and adjusted to estimate prevalence ratios and 95% confidence intervals (95%CI). The prevalence of the consumption of fruits and vegetables was statistically higher among white women, while fish and beans was higher among black women. After adjusting for socioeconomic and demographic variables, it was found that black women remained only less likely to consume fruit (PR = 0.91; 95% CI: 0.88-0.95) and only more likely to consume beans (PR = 1.07; 95% CI: 1.04-1.10) than whites. There were racial inequalities for the consumption of healthy foods among Brazilian women, indicating that color/race defined a dietary pattern for black women that put them in vulnerable conditions in terms of fruit consumption.

Prevalence of depressive symptoms among young adults in Brazil: Results of the 2013 and 2019 editions of the National Health Survey / Prevalência de sintomas depressivos entre adultos jovens no Brasil: resultados da Pesquisa Nacional de Saúde 2013 e 2019

ABSTRACT Objective: To estimate the prevalence of depressive symptoms in the population aged 18 to 24, according to socioeconomic and demographic aspects in Brazil, comparing its evolution between 2013 and 2019. Methods: Cross-sectional study carried out with secondary data obtained from National Health Survey 2013 and 2019. It were included 7,823 young adulthood (aged 18 to 24) from 2013 and 8,047 from 2019. The instrument used to assess depression was the Patient Health Questionnaire-9 (PHQ-9). All estimates included population weights and complex sampling. Results: The prevalence of depression almost doubled: 10.9% (95%CI 9.6-12.2) in 2019, compared to 5.6% (95%CI 4.8-6.4) in 2013, an absolute difference of 5.3% (4.5-6.0) greater. Women were the most affected in both surveys, with an increase between 2013 (8.3%; 95%CI 6.9-9.6) and 2019 (15.6%; 95%CI 13.5-17.6) higher than that of men (2013: 2.9%; 95%CI 2.0-3.8 and 2019: 6.2%; 95%CI 4.7-7.7). In both sexes, the pattern of increase was greater for the groups aged 18 to 20, not participating in religious activities, who were at the lowest levels of education and income, who lived with two or three or more people, who lived in the Northeast, Southeast, capitals and metropolitan areas of the country. Conclusion: There was a significant increase in the prevalence of depressive symptoms over the six years between the two surveys. However, this increase did not occur homogeneously among the characteristics analyzed, indicating population groups and locations in Brazil where the presence of these symptoms increased most in the period.

RESUMO Objetivo: Estimar a prevalência de sintomas depressivos na população de 18 a 24 anos, segundo aspectos socioeconômicos e demográficos no Brasil, comparando sua evolução entre os anos de 2013 e 2019. Métodos: Estudo transversal realizado com dados secundários da Pesquisa Nacional de Saúde 2013 e 2019. Foram incluídos 7.823 adultos jovens (18 a 24 anos) de 2013 e 8.047 de 2019. O instrumento utilizado para avaliar a depressão foi o Patient Health Questionnaire-9 (PHQ-9). Todas as estimativas incluíram os pesos da população e a amostragem complexa. Resultados: A prevalência de sintomas depressivos quase dobrou: 10,9% (IC95% 9,6-12,2) em 2019, ante os 5,6% (IC95% 4,8-6,4) em 2013; uma diferença absoluta de 5,3% (4,5-6,0) maior. As mulheres foram as mais afetadas em ambos os inquéritos, com aumento entre 2013 (8,3%; IC95% 6,9-9,6) e 2019 (15,6%; IC95% 13,5-17,6) superior aos dos homens (2013: 2,9%; IC95% 2,0-3,8 e 2019: 6,2%; IC95% 4,7-7,7). Em ambos os sexos, o padrão de aumento foi maior para os grupos de 18 a 20 anos; não participantes de atividades religiosas; que estavam nos mais baixos níveis de escolaridade e renda; que residiam com duas ou mais pessoas; e que residiam nas regiões Nordeste, Sudeste, capitais e áreas metropolitanas do país. Conclusão: Verificou-se aumento estatisticamente significante da prevalência de sintomas depressivos ao longo dos 6 anos dos inquéritos. Esse aumento não ocorreu de modo homogêneo entre as características analisadas, indicando os grupos populacionais e localidades do Brasil em que mais cresceu a presença desses sintomas no período.