Influence of Citrus sunki and Poncirus trifoliata Root Extracts on Metabolome of Phytophthora parasitica.

Phytophthora parasitica is an oomycete pathogen that infects a broad range of crops of worldwide economic interest; among them are citrus species. In general, some Citrus and the rootstocks of related genera offer considerable resistance against P. parasitica; therefore, understanding the mechanisms involved in the virulence of this pathogen is crucial. In this work, P. parasitica secondary metabolite production was studied using matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI) and ultrahigh-performance liquid chromatography coupled with electrospray ionization quadrupole time-of-flight tandem mass spectrometry (UHPLC/ESI-Q-TOF-MS) combined with chemometric tools, and its metabolic profile was evaluated under the influence of Citrus sunki (a highly susceptible host) and Poncirus trifoliata (a resistant genotype) extracts. The root extracts of Citrus sunki had an influence on the growth and hyphae morphology, and the root extracts of P. trifoliata had an influence on the zoospore behavior. In parallel, the spatial distribution of several metabolites was revealed in P. parasitica colonies using MALDI-MSI, and the metabolite ion of m/z 246 was identified as the protonated molecule of Arg-Ala. The MALDI-MSI showed variations in the surface metabolite profile of P. parasitica under the influence of the P. trifoliata extract. The P. parasitica metabolome analysis using UHPLC-ESI-Q-TOF-MS resulted in the detection of Arg-Gln (m/z 303.1775), as well as L-arginine (m/z 175.1191) and other unidentified metabolites. Significant variations in this metabolome were detected under the influence of the plant extracts when evaluated using UHPLC-ESI-Q-TOF-MS. Both techniques proved to be complementary, offering valuable insights at the molecular level when used to assess the impact of the plant extracts on microbial physiology in vitro. The metabolites identified in this study may play significant roles in the interaction or virulence of P. parasitica, but their functional characterization remains to be analyzed. Overall, these data confirm our initial hypotheses, demonstrating that P. parasitica has the capabilities of (i) recognizing host signals and altering its reproductive programing and (ii) distinguishing between hosts with varying responses in terms of reproduction and the production of secondary metabolites.

Third-Generation Solid Dispersion Through Lyophilization Enhanced Oral Bioavailability of Resveratrol.

Resveratrol (RES) is a biopharmaceutical classification system (BCS) class II compound with low solubility and high permeability. Several strategies have been explored to overcome the low bioavailability of RES, making the formation of solid dispersions (SDs) one of the most promising. This study aimed at the development of a RES third-generation SD prepared by lyophilization as a strategy to improve RES solubility, dissolution, and oral bioavailability. Eudragit E PO was selected as the hydrophilic carrier in a 1:2 (RES:carrier) ratio, and Gelucire 44/14 as the surfactant, at 16% (w/w) of RES. Differential scanning calorimetry (DSC), scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), polarized light microscopy (PLM), X-ray powder diffraction (XRPD), and particle size distribution (Morphologi 4 Malvern) were used for solid-state characterization and to confirm the conversion of RES to the amorphous state in the SD. Third-generation SD presented an 8-, 12-, and 8-fold increase of RES solubilized compared to pure RES at pH 1.2, 4.5, and 6.8, respectively, and a 10-fold increase compared to the physical mixture (PM), at pH 6.8, after 24 h. In the gastric environment, the dissolution rate of third-generation SD and PM was similar, and 2-fold higher than pure RES after 30 min, while at pH 6.8, third-generation SD presented approximately a 5-fold increase in comparison to pure RES and PM. Third-generation SD presented higher in vitro intestinal permeability compared to its PM and second-generation SD (without Gelucire 44/14). A 2.4 and 1.7-fold increase of RES permeated, respectively in Caco-2 and Caco-2/HT2-MTX models, was obtained with third-generation SD compared to PM, after 3 h. Third-generation SD allowed a 3-fold increase of RES bioavailability compared to second-generation SD, after oral administration of 200 mg/kg of RES to Wistar rats. Enhanced RES oral bioavailability was obtained not only by solubility and dissolution improvement, but also by the interference of Gelucire 44/14, with RES metabolism, and inhibition of P-gp-mediated efflux. The presence of excipients like Gelucire 44/14 in the SD allows for greater bioavailability of orally administered RES, making it easier to obtain some of the physiological benefits demonstrated by this molecule.

Green Synthesis of Er-Doped ZnO Nanoparticles: An Investigation on the Methylene Blue, Eosin, and Ibuprofen Removal by Photodegradation.

We present a study on the green synthesis of undoped and Er-doped ZnO compounds using Mangifera indica gum (MI). A set of tests were conducted to assess the structure of the material. The tests included X-ray diffraction, Raman, and Fourier-transform infrared spectroscopy. Optical properties were studied using diffuse reflectance and photoluminescence. Morphological and textural investigations were done using SEM images and N2 adsorption/desorption. Furthermore, photocatalytic tests were performed with methylene blue (MB), yellow eosin (EY), and the pharmaceutical drug ibuprofen (IBU) under UV irradiation. The study demonstrated that replacing the stabilizing agent with Mangifera indica gum is an effective method for obtaining ZnO nanoparticles. Additionally, the energy gap of the nanoparticles exhibits a slight reduction in value. Photoluminescence studies showed the presence of zinc vacancies and other defects in both samples. In the photocatalytic test, the sample containing Er3+ exhibited a degradation of 99.7% for methylene blue, 81.2% for yellow eosin, and 52.3% for ibuprofen over 120 min. In the presence of methyl alcohol, the degradation of MB and EY dyes is 16.7% and 55.7%, respectively. This suggests that hydroxyl radicals are responsible for the direct degradation of both dyes. In addition, after the second reuse, the degradation rate for MB was 94.08%, and for EY, it was 82.35%. For the third reuse, the degradation rate for MB was 97.15%, and for EY, it was 17%. These results indicate the significant potential of the new semiconductor in environmental remediation applications from an ecological synthesis.

Landsat data respond to variations in the structure of Caatinga plant communities along a successional gradient.

Plant community succession is generally approached with phytosociological methods, but field surveys are time-consuming, expensive, and limited to several of sites. Remote sensing offers an efficient and economical way to analyze vegetation on large extensions and in inaccessible areas. Most studies addressing remote sensing and tree community succession refer to forest physiognomies. We investigated whether structural changes that occur in non-forest physiognomies are identified by multispectral sensor images (OLI-Landsat). Thirteen 0.1-ha plots were set up in Caatinga fragments aging 10-15, 20-25, 30-35, 40-45 and >50 years to calculate the total density of individuals (TD), mean canopy height (H), total basal area (G) and total aboveground biomass (AGB). We performed correlation analyses between these structural descriptors and eight remote sensing variables (reflectance data and spectral indices) obtained from Landsat images at the end of the rainy season and during the dry season. Blue and short-wave infrared reflectances were negatively correlated with mean height, basal area and biomass, regardless of the analyzed scene (coefficients between -0.58 and -0.79). The litter layer (a non-photosynthetic vegetation component) and the soil exposure are important factors influencing the spectral data.

Photoresponsive Activity of the Zn0.94Er0.02Cr0.04O Compound with Hemisphere-like Structure Obtained by Co-Precipitation.

In this work, a ZnO hemisphere-like structure co-doped with Er and Cr was obtained by the co-precipitation method for photocatalytic applications. The dopant's effect on the ZnO lattice was investigated using X-ray diffraction, Raman, photoluminescence, UV-Vis and scanning electron microscopy/energy dispersive spectroscopy techniques. The photocatalytic response of the material was analyzed using methylene blue (MB) as the model pollutant under UV irradiation. The wurtzite structure of the Zn0.94Er0.02Cr0.04O compound presented distortions in the lattice due to the difference between the ionic radii of the Cr3+, Er3+ and Zn2+ cations. Oxygen vacancy defects were predominant, and the energy competition of the dopants interfered in the band gap energy of the material. In the photocatalytic test, the MB degradation rate was 42.3%. However, using optimized H2O2 concentration, the dye removal capacity reached 90.1%. Inhibitor tests showed that •OH radicals were the main species involved in MB degradation that occurred without the formation of toxic intermediates, as demonstrated in the ecotoxicity assays in Artemia salina. In short, the co-doping with Er and Cr proved to be an efficient strategy to obtain new materials for environmental remediation.

DESI-MSI-based technique to unravel spatial distribution of COMT inhibitor Tolcapone.

Ascertaining compound exposure and its spatial distribution are essential steps in the drug development process. Desorption electrospray ionization mass spectrometry (DESI-MSI) is a label-free imaging technique capable of simultaneously identify and visualize the distribution of a diverse range of biomolecules. In this study, DESI-MSI was employed to investigate spatial distribution of tolcapone in rat liver and brain coronal - frontal and striatal -sections after a single oral administration of 100 mg/Kg of tolcapone, brain-penetrant compound. Tolcapone was evenly distributed in liver tissue sections whereas in the brain it showed differential distribution across brain regions analyzed, being mainly located in the olfactory bulb, basal forebrain region, striatum, and pre-frontal cortex (PFC; cingulate, prelimbic and infralimbic area). Tolcapone concentration in tissues was compared using DESI-MSI and liquid-chromatography mass spectrometry (LC-MS/MS). DESI-MSI technique showed a higher specificity on detecting tolcapone in liver sections while in the brain samples DESI-MSI did not allow a feasible quantification. Indeed, DESI-MSI is a qualitative technique that allows to observe heterogeneity on distribution but more challenging regarding accurate measurements. Overall, tolcapone was successfully localized in liver and brain tissue sections using DESI-MSI, highlighting the added value that this technique could provide in assisting tissue-specific drug distribution studies.

Análise da evolução espacial e fatores associados à morbimortalidade por Covid-19 nas regiões geográficas do Brasil: um estudo ecológico / Analysis of spatial evolution and factors associated with Covid-19 morbidity and mortality in the geographic regions of Brazil: an ecological study

Resumo Objetivo Este estudo analisou a evolução do padrão de distribuição espacial dos coeficientes de morbimortalidade por Covid-19 e fatores associados nas Regiões Intermediárias de Articulação Urbana do Brasil. Métodos Estudo ecológico com variáveis de bancos secundários, com dados de incidência e mortalidade por Covid-19 acumulados no intervalo de três meses, o que corresponde ao aumento das medidas de flexibilização do isolamento social. As variáveis independentes representaram fatores socioeconômicos. Foram realizadas análise de dependência espacial, regressão clássica e espacial. Resultados Houve um aumento da morbimortalidade por Covid-19 entre os dois períodos analisados. Foi encontrada uma autocorrelação positiva com formação de cluster em áreas de maior incidência de Covid-19 e com maior significância em Regiões Intermediárias de Articulação Urbana na região Norte do Brasil, com agrupamentos maiores em relação à mortalidade após a flexibilização das medidas de isolamento. A ocorrência da morbimortalidade apresentou associação significativa com variáveis étnicas com maiores coeficientes de determinação na região Norte. Conclusão Determinantes sociais demonstraram um comportamento preditivo no aumento da autocorrelação positiva para a mortalidade por Covid-19 durante os períodos observados, com aumento da morbimortalidade na região Norte após a flexibilização do isolamento social.

Abstract Background This study analyzed the evolution of the spatial distribution pattern of Covid-19 morbidity and mortality coefficients and associated factors in the Intermediate Regions of Urban Articulation in Brazil. Method Ecological study with secondary bank variables with Covid-19 incidence and mortality data accumulated over the three-month interval, which corresponds to an increase in the measures for easing social isolation. The independent variables represented socioeconomic factors. Spatial dependence analysis, classical regression and spatial regression were performed. Results There was an increase in Covid-19 morbidity and mortality between the two periods analyzed. A positive autocorrelation with cluster formation was found in areas with a higher incidence of Covid-19 and with greater significance in the Intermediate Regions of Urban Articulation in the North of Brazil, with larger clusters in relation to mortality after the relaxation of isolation measures. The occurrence of morbidity and mortality was significantly associated with ethnic variables, with higher coefficients of determination in the North. Conclusion Social determinants demonstrated a predictive behavior in the increase of positive autocorrelation for mortality due to Covid-19 during the observed periods, with an increase in morbidity and mortality in the North region after the relaxation of social isolation.

Mudança no perfil do aleitamento materno exclusivo em um território vulnerável do município de Fortaleza ­ Ce durante a pandemia do novo coronavírus / Change in the profile of exclusive breastfeeding in a vulnerable territory in the city of Fortaleza - Ce during the pandemic of the new coronavirus / Cambio en el perfil de lactancia materna exclusiva en un territorio vulnerable de la ciudad de Fortaleza - Ce durante la pandemia del nuevo coronavirus

Introdução: A prevalência do aleitamento materno exclusivo (AME) no Brasil permanece aquém do recomendado pela Organização Mundial da Saúde, principalmente no Nordeste. Destaca-se o papel da Atenção Primária à Saúde (APS), imprescindível para a manutenção do AME. Em 2020, entretanto, a APS de Fortaleza deixou de realizar parte de suas funções devido à pandemia do novo coronavírus (COVID-19), o que pode ter causado prejuízos ainda não identificados para o AME. Objetivo: Avaliar se houve mudanças na duração do AME durante a pandemia de COVID-19 em um território adscrito a uma Equipe de Saúde da Família (ESF) em Fortaleza. Métodos: Estudo observacional, transversal e quantitativo, pela revisão de prontuários das crianças assistidas pela equipe da ESF Lagamar 1, nascidas de setembro de 2018 a junho de 2019 (grupo pré-pandêmico) e de setembro de 2019 a junho de 2020 (grupo pandêmico). Os prontuários permitiram estabelecer a mediana das variáveis: duração do AME, número de consultas de puericultura até os seis meses de idade e de pré-natal durante a gestação, idade e paridade maternas e realizar a comparação entre os grupos. Resultados: Foram analisados 39 prontuários, sendo dois retirados do estudo por critérios de exclusão. Dos remanescentes, 15 (40,54%) pertenciam ao grupo pré- pandêmico e 22 (59,46%) ao pandêmico. A mediana do tempo de duração do AME foi de 2 meses e 1,5 mês, respectivamente. Houve redução ainda da mediana da idade materna (de 25 para 21 anos) e da paridade da nutriz (de dois para 1,5) entre os grupos. Além disso, durante o período pandêmico, 12 crianças já não estavam em AME no primeiro contato com a ESF. Conclusões: Houve redução na duração mediana do AME na ESF do Lagamar durante a pandemia de COVID-19. Contudo, o presente estudo teve limitações, como o pequeno tamanho da amostra. É necessária, portanto, a realização de outros estudos para fornecer evidências robustas e explicações acerca dos resultados encontrados para as variáveis.

Introduction: The prevalence of exclusive breastfeeding (EBF) in Brazil remains below that recommended by the World Health Organization, especially in the Northeast. The role of Primary Health Care (PHC) is highlighted, essential for maintaining EBF. In 2020, however, the PHC in Fortaleza ceased to carry out its functions due to the new coronavirus (COVID-19) pandemic, which may have caused unidentified damage to the EBF. Objective: Assess whether there were changes in the duration of EBF during the COVID-19 pandemic in a territory assigned to a Family Health Team (FHT) in Fortaleza. Methods: Observational, cross-sectional and quantitative study, by reviewing the medical records of children assisted by the FHT Lagamar 1 team, born from September 2018 to June 2019 (pre-pandemic group) and from September 2019 to June 2020 (pandemic group). The medical records allowed establishing the median of the variables: duration of EBF, number of childcare consultations up to six months of age and prenatal care during pregnancy, maternal age and parity, and comparison between groups. Results: A total of 39 medical records were analyzed, two of which were removed from the study due to exclusion criteria. Of the remainder, 15 (40.54%) belonged to the pre- pandemic group and 22 (59.46%) to the pandemic. The median duration of EBF was 2 months and 1.5 months, respectively. There was also a reduction in the median maternal age (from 25 to 21 years) and the mother's parity (from two to 1.5) between groups. In addition, during the pandemic period, 12 children were no longer on EBF at the first contact with the FHT. Conclusions: There was a reduction in the median duration of EBF at the Lagamar FHT during the COVID-19 pandemic. However, the present study had limitations, such as the small sample size. It is therefore necessary to carry out other studies to provide robust evidence and explanations about the results found for the variables.

Introducción: La prevalencia de lactancia materna exclusiva (LME) en Brasil se mantiene por debajo de lo recomendado por la Organización Mundial de la Salud, especialmente en el Nordeste. Se destaca el papel de la Atención Primaria de Salud (APS), esencial para el mantenimiento de la LME. Sin embargo, en 2020, la APS de Fortaleza dejó de ejercer sus funciones debido a la nueva pandemia de coronavirus (COVID-19), que puede haber causado daños no identificados a la LME. Objetivo: Evaluar si hubo cambios en la duración de la FEB durante la pandemia de COVID-19 en un territorio asignado a un Equipo de Salud de la Familia (ESF) en Fortaleza. Método: Estudio observacional, transversal y cuantitativo, mediante la revisión de las historias clínicas de los niños atendidos por el equipo FHT Lagamar 1, nacidos de septiembre de 2018 a junio de 2019 (grupo prepandémico) y de septiembre de 2019 a junio de 2020 (grupo pandémico). Las historias clínicas permitieron establecer la mediana de las variables: duración de la FEB, número de consultas de puericultura hasta los seis meses de edad y cuidados prenatales durante el embarazo, edad materna y paridad, y comparación entre grupos. Resultados: Se analizaron 39 historias clínicas, dos de las cuales fueron eliminadas del estudio por criterios de exclusión. Del resto, 15 (40,54%) pertenecían al grupo prepandémico y 22 (59,46%) al pandémico. La duración media de la FEB fue de 2 meses y 1,5 meses, respectivamente. También hubo una reducción de la mediana de la edad materna (de 25 a 21 años) y de la paridad de la madre (de 2 a 1,5) entre los grupos. Además, durante el periodo pandémico, 12 niños dejaron de recibir LME en el primer contacto con el FHT. Conclusiones: Durante la pandemia de COVID-19 se produjo una reducción de la mediana de duración de la LME en el FHT de Lagamar. Sin embargo, el presente estudio tuvo limitaciones, como el pequeño tamaño de la muestra. Por lo tanto, es necesario llevar a cabo otros estudios para proporcionar pruebas sólidas y explicaciones sobre los resultados encontrados para las variables.

Bioherbicidal potential of plant species with allelopathic effects on the weed Bidens bipinnata L.

Plant species with allelopathic effects against weeds have emerged as a potential strategy for the development of ecologically friendly bioherbicides. In this study, the allelopathic effects of the plant species Dipteryx lacunifera Ducke, Ricinus communis L., Piper tuberculatum Jacq., and Jatropha gossypiifolia L. on the weed Bidens bipinnata L. were investigated. In vitro bioassays revealed that aqueous extracts of selected plant species were able to inhibit seed germination and seedling growth of B. bipinnata, highlighting the strongest allelopathic effect evidenced by R. communis. The phytotoxicity of the aqueous extracts was evaluated in pot experiments, which indicated that the foliar application of R. communis and P. tuberculatum extracts on B. bipinnata plants caused yellowing of leaves, affecting the chlorophyll content and reducing growth. The discrimination of the plant extracts by attenuated total reflectance Fourier transform mid-infrared (ATR FT-MIR) spectroscopy combined with principal component analysis (PCA) indicated the presence of allelochemical compounds, such as phenolics and terpenoids, which may be associated with allelopathic activity. Overall, this study provides valuable information about the substantial allelopathic inhibitory effects of the plant species R. communis and P. tuberculatum on the weed B. bipinnata, which may be used for the development of eco-friendly bioherbicides.

TiO2/Karaya Composite for Photoinactivation of Bacteria.

TiO2/Karaya composite was synthesized by the sol-gel method for the photoinactivation of pathogens. This is the first time that we have reported this composite for an antimicrobial approach. The structure, morphology, and optical properties were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive X-rays (EDS), Fourier transform infrared spectroscopy (FTIR), and diffuse reflectance, and the surface area was characterized by the BET method. The XRD and EDS results showed that the TiO2/Karaya composite was successfully stabilized by the crystal structure and pore diameter distribution, indicating a composite of mesoporous nature. Furthermore, antibacterial experiments showed that the TiO2/Karaya composite under light was able to photoinactivate bacteria. Therefore, the composite is a promising candidate for inhibiting the growth of bacteria.

Endophytic Trichoderma strains isolated from forest species of the Cerrado-Caatinga ecotone are potential biocontrol agents against crop pathogenic fungi.

The indiscriminate use of chemical pesticides increasingly harms the health of living beings and the environment. Thus, biological control carried out by microorganisms has gained prominence, since it consists of an environmentally friendly alternative to the use of pesticides for controlling plant diseases. Herein, we evaluated the potential role of endophytic Trichoderma strains isolated from forest species of the Cerrado-Caatinga ecotone as biological control agents of crop pathogenic fungi. Nineteen Trichoderma strains were used to assess the antagonistic activity by in vitro bioassays against the plant pathogens Colletotrichum truncatum, Lasiodiplodia theobromae, Macrophomina phaseolina, and Sclerotium delphinii isolated from soybean, cacao, fava bean, and black pepper crops, respectively. All Trichoderma strains demonstrated inhibitory activity on pathogen mycelial growth, with maximum percent inhibition of 70% against C. truncatum, 78% against L. theobromae, 78% against M. phaseolina, and 69% against S. delphinii. Crude methanol extracts (0.5 to 2.0 mg mL-1) of Trichoderma strains were able to inhibit the growth of C. truncatum, except Trichoderma sp. T3 (UFPIT06) and T. orientale (UFPIT09 and UFPIT17) at 0.5 mg mL-1, indicating that the endophytes employ a biocontrol mechanism related to antibiosis, together with multiple mechanisms. Discriminant metabolites of Trichoderma extracts were unveiled by liquid chromatography-tandem mass spectrometry-based metabolomics combined with principal component analysis (PCA), which included antifungal metabolites and molecules with other bioactivities. These results highlight the biocontrol potential of Trichoderma strains isolated from the Cerrado-Caatinga ecotone against crop pathogenic fungi, providing support for ongoing research on disease control in agriculture.

16ª Conferência Nacional de Saúde: relatório final / 16th National Health Conference: Final Report

A 16ª Conferência Nacional de Saúde (8ª+8), conhecida pela marca da 8ª+8, em referência à relevância da 8ª Conferência Nacional de Saúde, realizada em 1986 e que deu origem às bases políticas e operacionais que permitiram a criação do Sistema Único de Saúde (SUS), percorreu um longo processo até a etapa nacional, realizada no período de 4 a 7 de agosto de 2019, em Brasília. A Comissão de Organização, instituiu amplo debate com conselheiros profissionais de saúde, gestores e prestadores, usuários, movimentos sociais e sindicais, que elaborou um documento orientador, o qual foi disponibilizado aos municípios e estados, para subsidiar os debates locais. Além dessa atribuição, acreditamos que seria necessário organizar um documento que permitisse o registro da 16ª Conferência para a memória da história da saúde no Brasil. A estruturação do presente relatório procurou dar conta dessa condição e foi feita de forma que se materialize a singularidade de cada momento e ações ofertadas e experienciadas por cada um(a) e, no seu todo, que representasse a relevância para a história do nosso sistema de saúde e para o contexto em que vivemos.

Quando a conferência de saúde ensina para o trabalho e para a vida: narrativas dos estudantes sobre a 16ª Conferência Nacional de Saúde / When the health conference teaches for work and for life: student narratives about the 16th National Health Conference

Em um contexto de retrocessos políticos, sociais, sanitários e civilizatórios, deparamo-nos com a 16ª Conferência Nacional de Saúde, carinhosamente apelidada de 8ª + 8, para tornar visível o encontro com a conferência-marco da reforma sanitária brasileira. Durante a conferência foi realizada a pesquisa "Saúde e democracia: estudos integrados sobre participação social na 16ª Conferência Nacional de Saúde", cujo objetivo foi analisar a participação social no processo da 16ª Conferência Nacional de Saúde em dimensões que permitissem sistematizar evidências da relevância e da abrangência do processo participativo nas etapas e atividades que a compuseram. A partir das experiências vivenciadas pelos estudantes pesquisadores, afetivamente reconhecidos como "verdinhos e verdinhas", em alusão à camiseta de cor verde que os identificava entre os participantes da 16ª CNS, elaborou-se a chamada de manuscritos que culminou neste livro. Encontram-se aqui reunidos aproximadamente 30 narrativas, somadas a alguns manuscritos feitos sob demanda dos organizadores. Agradecemos a cada uma das pessoas que ofereceu sua narrativa, a cada esforço necessário para compor uma estética capaz de dizer do lugar de aprendizagem que cada um e cada uma das pessoas que estiveram conosco nesse grande laboratório de democracia e cidadania que foi a 16ª Conferência Nacional de Saúde. E a cada leitor e leitora que, sensivelmente, compreender que cada um dos textos é um convite para a defesa do SUS, do ensino da saúde pautado pelo compromisso ético com todas as saúdes dos territórios e com o SUS como política pública.

Nanocellulose/palygorskite biocomposite membranes for controlled release of metronidazole.

The incorporation of drugs in nanocomposites can be considered a potential strategy for controlled drug release. In this study, a nanocomposite based on bacterial cellulose and the palygorskite clay (BC/PLG) was produced and loaded with metronidazole (MTZ). The samples were characterized using X-ray diffraction (XRD) Spectroscopy, thermal analysis (TG/DTG) and Scanning Electron Microscopy (SEM). The barrier properties were determined to water vapor permeability (WVP). Adsorption tests with PLG were performed using MTZ and drug release profile of the membranes was investigated. The results indicated that PLG increased the crystallinity of the nanocomposites, and greater thermal stability when PLG concentration was 15.0% (BC/PLG15) was observed. WVP of the samples also varied, according to the clay content. Adsorption equilibrium was achieved from 400 mg/L of the PLG and a plateau in the MTZ release rates from BC/PLG was observed after 30 min. Therefore, the results of this study show the potential of these nanocomposite membranes as a platform for controlled drug release.

Superabsorbent Hydrogels Based to Polyacrylamide/Cashew Tree Gum for the Controlled Release of Water and Plant Nutrients.

Agricultural production is influenced by the water content in the soil and availability of fertilizers. Thus, superabsorbent hydrogels, based on polyacrylamide, natural cashew tree gum (CG) and potassium hydrogen phosphate (PHP), as fertilizer and water releaser were developed. The structure, morphology, thermal stability and chemical composition of samples of polyacrylamide and cashew tree gum hydrogels with the presence of fertilizer (HCGP) and without fertilizer (HCG) were investigated, using X-ray diffractometry (XRD), Fourier Transformed Infrared Spectroscopy (FTIR), Scanning Electron Microscopy (SEM), Thermogravimetric Analysis (TGA/DTG) and Energy Dispersive Spectroscopy (EDS). Swelling/reswelling tests, textural analysis, effect of pH, release of nutrients and kinetics were determined; the ecotoxicity of the hydrogels was investigated by the Artemia salina test. The results showed that PHP incorporation in the hydrogel favored the crosslinking of chains. This increased the thermal stability in HCGP but decreased the hardness and adhesion properties. The HCGP demonstrated good swelling capacity (~15,000 times) and an excellent potential for reuse after fifty-five consecutive cycles. The swelling was favored in an alkaline pH due to the ionization of hydrophilic groups. The sustained release of phosphorus in HCGP was described by the Korsmeyer-Peppas model, and Fickian diffusion is the main fertilizer release mechanism. Finally, the hydrogels do not demonstrate toxicity, and HCGP has potential for application in agriculture.

A Digital Filter-Based Method for Diagnosing Speech Comprehension Deficits.

OBJECTIVE: To improve the diagnostic efficiency of current tests for auditory processing disorders (APDs) by creating new test signals using digital filtering methods. METHODS: We conducted a prospective study from August 1, 2014, to August 31, 2019, using 3 low speech redundancy tests with novel test signals that we created with specially designed digital filters: the binaural resynthesis test and the low pass and high pass filtered speech tests. We validated and optimized these new tests, then applied them to healthy individuals across different age groups to examine how age affected performance and to children with APD before and after acoustically controlled auditory training (ACAT) to assess clinical improvement after treatment. RESULTS: We found a progressive increase in performance accuracy with less restrictive filters (P<.001) and with increasing age for all tests (P<.001). Our results suggest that binaural resynthesis and auditory closure mature at similar rates. We also demonstrate that the new tests can be used for the diagnosis of APD and for the monitoring of ACAT effects. Interestingly, we found that patients having the most severe deficits also benefited the most from ACAT (P<.001). CONCLUSION: We introduce a method that substantially improves current diagnostic tools for APD. In addition, we provide information on auditory processing maturation in normal development and validate that our method can detect APD-related deficits and ACAT-induced improvements in auditory processing.

Conhecimento e autoconfiança de Agentes Comunitários de Saúde sobre Primeiros Socorros e Parada cardiopulmonar / Knowledge and Confidence among Community Health Workers on First Aid and Cardiopulmonary Resuscitation / Conocimiento y grado de confianza de los agentes comunitarios de salud sobre primeros auxilios y reanimación cardiopulmonar

Resumo Introdução Os Agentes Comunitários de Saúde são uma categoria profissional no Brasil que se encontram contato direto e diário com os usuários na comunidade e possuem maior probabilidade de se deparar com situações de emergência ou primeiros socorros. Objetivo Avaliar o conhecimento e autoconfiança de Agentes Comunitários de Saúde sobre Primeiros Socorros e Parada cardiopulmonar. Materiais e Método Estudo descritivo e quantitativo, realizado de junho a outubro de 2018, em 22 Centros de Saúde da Família de município do Ceará, Brasil, com 186 Agentes Comunitários de Saúde, divididos em dois grupos: aqueles já tinham treinamento sobre a temática e os que não possuíam treinamento. Na coleta de dados foi aplicado questionário com: 1) caracterização da amostra; 2) Questões sobre Parada Cardiopulmonar; 3) Questões sobre primeiros socorros; 4) Escala de autoconfiança. Resultados Houve diferença significante entre os grupos nas questões de conhecimento em quatro itens, nas questões sobre definição de PCR, verificação da responsividade de uma vítima desacordada, sequência para o posicionamento das mãos e braços na ressuscitação cardiopulmonar (RCP) e momento de troca dos socorristas. Nos primeiros socorros, houve diferença estatisticamente significante em quatro itens, nas questões de primeira conduta no caso de precisar atender uma vítima em situação de urgência, cuidados durante uma crise de convulsão, condutas com vítimas de afogamento e cuidados com bebê engasgado. Ambos os grupos apresentaram autoconfiança baixa para intervir em situações de emergências cardíacas, neurológicas e respiratórias. Conclusão Os achados da pesquisa apontam déficit de conhecimento dos agentes comunitários de saúde para atuar frente a parada Cardiopulmonar e em situações de primeiros socorros, associado à baixa autoconfiança para intervir em situações de emergências.

Abscratc Introduction Community health workers are considered a professional health category in Brazil who are in direct daily contact with community users and, therefore, more likely to face emergency or first aid situations. Objective To assess the level of knowledge and confidence of community health workers on first aid and cardiopulmonary resuscitation. Materials and Methods A descriptive quantitative study was conducted between June and October 2018 in 22 Family Health Centers in a city in Ceará, Brazil with 186 community agents grouped as follows: a group that has already received training on these matters and another group that has not had such training. For data collection, a questionnaire containing the following items was administered: 1) sample characterization; 2) questions on cardiopulmonary resuscitation; 4) questions on first aid; 4) confidence scale. Results A significant difference among both groups was found in questions related to the knowledge of the four items, especially for explaining CPR, checking for responsiveness of an unconscious person, the sequence for placing hands and arms in cardiopulmonary resuscitation (CPR) and rotating resuscitators. Regarding first aid, a statistically significant difference was also found in four items related to first aid questions when attending a victim in an emergency such as convulsions, drowning and choking in children. Both groups showed low confidence to intervene in cardiac, neurological and respiratory emergencies. Conclusions Research results indicate that there is a lack of knowledge among community health workers to respond effectively to situations involving cardiopulmonary resuscitation and first aid, which is also associated with low confidence to perform interventions in emergencies.

Resumen Introducción Los agentes comunitarios de salud constituyen una categoría sanitaria profesional en Brasil que está en contacto directo a diario con los usuarios de la comunidad, por lo que tiene más probabilidades de enfrentarse a situaciones de emergencia o primeros auxilios. Objetivo Evaluar los conocimientos y el grado de confianza de los agentes comunitarios de salud en materia de primeros auxilios y reanimación cardiopulmonar. Materiales y Métodos Se realizó un estudio cuantitativo descriptivo entre junio y octubre de 2018 en 22 Centros de Salud Familiar de una ciudad del estado de Ceará, Brasil con 186 agentes comunitarios, que luego fueron agrupados así: un grupo que ya contaba con formación sobre estos temas y otro grupo que no contaba con dicha formación. Para la recolección de datos, se administró un cuestionario que contenía los siguientes ítems: 1) caracterización de la muestra; 2) preguntas sobre reanimación cardiopulmonar; 3) preguntas sobre primeros auxilios; 4) escala del grado de confianza. Resultados Se presentó una diferencia significativa entre los grupos en cuanto a las preguntas relacionadas con los conocimientos de los cuatro ítems, especialmente en cuanto a la definición de RCP, la comprobación de la capacidad de respuesta de una víctima en estado de inconciencia, la secuencia para la colocación de manos y brazos en la reanimación cardiopulmonar (RCP) y los turnos para cambiar los reanimadores. En cuanto a primeros auxilios, también se presentó una diferencia estadísticamente significativa en cuatro ítems relacionados con preguntas de primeros auxilios en caso de necesitar atender una víctima en una situación de emergencia, durante una crisis convulsiva o víctimas de ahogamiento y atragantamiento en bebés. Ambos grupos presentaron un bajo grado de confianza para realizar intervenciones en situaciones de emergencias cardíacas, neurológicas y respiratorias. Conclusiones Los resultados de la investigación apuntan a un déficit de conocimiento por parte de los agentes comunitarios de salud para actuar frente situaciones que requieren reanimación cardiopulmonar y primeros auxilios, lo cual está también asociado a un bajo grado de confianza para realizar intervenciones en situaciones de emergencia.

Conhecimento e autoconfiança de Agentes Comunitários de Saúde sobre Primeiros Socorros e Parada cardiopulmonar / Knowledge and Confidence among Community Health Workers on First Aid and Cardiopulmonary Resuscitation

Introdução: Os Agentes Comunitários de Saúde são uma categoria profissional no Brasil que se encontram contato direto e diário com os usuários na comunidade e possuem maior probabilidade de se deparar com situações de emergência ou primeiros socorros. Objetivo: Avaliar o conhecimento e autoconfiança de Agentes Comunitários de Saúde so-bre Primeiros Socorros e Parada cardiopulmonar. Materiais e Método:Estudo descritivo e quantitativo, realizado de junho a outubro de 2018, em 22 Centros de Saúde da Família de município do Ceará, Brasil, com 186 Agentes Comunitários de Saúde, divididos em dois grupos: aqueles já tinham treinamento sobre a temática e os que não possuíam treina-mento. Na coleta de dados foi aplicado questionário com: 1) caracteri-zação da amostra; 2) Questões sobre Parada Cardiopulmonar; 3) Ques-tões sobre primeiros socorros; 4) Escala de autoconfiança. Resultados:Houve diferença significante entre os grupos nas questões de conhe-cimento em quatro itens, nas questões sobre definição de PCR, verifi-cação da responsividade de uma vítima desacordada, sequência para o posicionamento das mãos e braços na ressuscitação cardiopulmonar (RCP) e momento de troca dos socorristas. Nos primeiros socorros, hou-ve diferença estatisticamente significante em quatro itens, nas questões de primeira conduta no caso de precisar atender uma vítima em situa-ção de urgência, cuidados durante uma crise de convulsão, condutas com vítimas de afogamento e cuidados com bebê engasgado. Ambos os grupos apresentaram autoconfiança baixa para intervir em situações de emergências cardíacas, neurológicas e respiratórias. Conclusão: Os achados da pesquisa apontam déficit de conhecimento dos agentes co-munitários de saúde para atuar frente a parada Cardiopulmonar e em situações de primeiros socorros, associado à baixa autoconfiança para intervir em situações de emergências.

Introduction: Community health workers are considered a professional health category in Brazil who are in direct daily contact with community users and, therefore, more likely to face emergency or first aid situations. Objective: To assess the level of knowledge and confidence of community health workers on first aid and cardiopulmonary resuscitation. Materials and Methods: A descriptive quantitative study was conducted between June and October 2018 in 22 Family Health Centers in a city in Ceará, Brazil with 186 community agents grouped as follows: a group that has already received training on these matters and another group that has not had such training. For data collection, a questionnaire containing the following items was administered: 1) sample characterization; 2) questions on cardiopulmonary resuscitation; 4) questions on first aid; 4) confidence scale. Results: A significant difference among both groups was found in questions related to the knowledge of the four items, especially for explaining CPR, checking for responsiveness of an unconscious person, the sequence for placing hands and arms in cardiopulmonary resuscitation (CPR) and rotating resuscitators. Regarding first aid, a statistically significant difference was also found in four items related to first aid questions when attending a victim in an emergency such as convulsions, drowning and choking in children. Both groups showed low confidence to intervene in cardiac, neurological and respiratory emergencies. Conclusions: Research results indicate that there is a lack of knowledge among community health workers to respond effectively to situations involving cardiopulmonary resuscitation and first aid, which is also associated with low confidence to perform interventions in emergencies.

Introducción: Los agentes comunitarios de salud constituyen una categoría sanitaria profesional en Brasil que está en contacto directo a diario con los usuarios de la comunidad, por lo que tiene más probabilidades de enfrentarse a situaciones de emergencia o primeros auxilios. Objetivo: Evaluar los conocimientos y el grado de confianza de los agentes comunitarios de salud en materia de primeros auxilios y reanimación cardiopulmonar. Materiales y Métodos: Se realizó un estudio cuantitativo descriptivo entre junio y octubre de 2018 en 22 Centros de Salud Familiar de una ciudad del estado de Ceará, Brasil con 186 agentes comunitarios, que luego fueron agrupados así: un grupo que ya contaba con formación sobre estos temas y otro grupo que no contaba con dicha formación. Para la recolección de datos, se administró un cuestionario que contenía los siguientes ítems: 1) caracterización de la muestra; 2) preguntas sobre reanimación cardiopulmonar; 3) preguntas sobre primeros auxilios; 4) escala del grado de confianza. Resultados: Se presentó una diferencia significativa entre los grupos en cuanto a las preguntas relacionadas con los conocimientos de los cuatro ítems, especialmente en cuanto a la definición de RCP, la comprobación de la capacidad de respuesta de una víctima en estado de inconciencia, la secuencia para la colocación de manos y brazos en la reanimación cardiopulmonar (RCP) y los turnos para cambiar los reanimadores. En cuanto a primeros auxilios, también se presentó una diferencia estadísticamente significativa en cuatro ítems relacionados con preguntas de primeros auxilios en caso de necesitar atender una víctima en una situación de emergencia, durante una crisis convulsiva o víctimas de ahogamiento y atragantamiento en bebés. Ambos grupos presentaron un bajo grado de confianza para realizar intervenciones en situaciones de emergencias cardíacas, neurológicas y respiratorias. Conclusiones: Los resultados de la investigación apuntan a un déficit de conocimiento por parte de los agentes comunitarios de salud para actuar frente situaciones que requieren reanimación cardiopulmonar y primeros auxilios, lo cual está también asociado a un bajo grado de confianza para realizar intervenciones en situaciones de emergencia

A nanoemulsion/micelles mixed nanosystem for the oral administration of hydrophobically modified insulin.

The potential of nanoemulsions for the oral administration of peptides is still in its early stage. The aim of the present work was to rationally design, develop, and fully characterize a new nanoemulsion (NE) intended for the oral administration of hydrophobically modified insulin (HM-insulin). Specific components of the NE were selected based on their enhancing permeation properties as well as their ability to improve insulin association efficiency (Miglyol 812, sodium taurocholate), stability in the intestinal fluids, and mucodiffusion (PEGylated phospholipids and poloxamer 407). The results showed that the NE co-existed with a population of micelles, forming a mixed system that exhibited a 100% of HM-insulin association efficiency. The nanosystem showed good stability and miscibility in different bio-relevant media and displayed an acceptable mucodiffusive behavior in porcine mucus. In addition, it exhibited a high interaction with cell mono-cultures (Caco -2 and C2BBe1 human colon carcinoma Caco-2 clone cells) and co-cultures (C2BBe1 human colon carcinoma Caco-2 clone/HT29-MTX cells). The internalization in Caco-2 monolayers was also confirmed by confocal microscopy. Finally, the promising in vitro behavior of the nanosystem in terms of overcoming the biological barriers of the intestinal tract was translated into a moderate, although significant, hypoglycemic response (≈ 20-30%), following intestinal administration to both healthy and diabetic rat models. Overall, this information underlines the crucial steps to address when designing peptide-based nanoformulations to successfully overcome the intestinal barriers associated to the oral modality of administration.