Adipose Tissue-Derived Mesenchymal Stromal Cells from Ex-Morbidly Obese Individuals Instruct Macrophages towards a M2-Like Profile In Vitro.

Obesity, which continues to increase worldwide, was shown to irreversibly impair the differentiation potential and angiogenic properties of adipose tissue mesenchymal stromal cells (ADSCs). Because these cells are intended for regenerative medicine, especially for the treatment of inflammatory conditions, and the effects of obesity on the immunomodulatory properties of ADSCs are not yet clear, here we investigated how ADSCs isolated from former obese subjects (Ex-Ob) would influence macrophage differentiation and polarization, since these cells are the main instructors of inflammatory responses. Analysis of the subcutaneous adipose tissue (SAT) of overweight (OW) and Ex-Ob subjects showed the maintenance of approximately twice as many macrophages in Ex-Ob SAT, contained within the CD68＋/FXIII-A- inflammatory pool. Despite it, in vitro, coculture experiments revealed that Ex-Ob ADSCs instructed monocyte differentiation into a M2-like profile, and under inflammatory conditions induced by LPS treatment, inhibited HLA-DR upregulation by resting M0 macrophages, originated a similar percentage of TNF-α＋ cells, and inhibited IL-10 secretion, similar to OW-ADSCs and BMSCs, which were used for comparison, as these are the main alternative cell types available for therapeutic purposes. Our results showed that Ex-Ob ADSCs mirrored OW-ADSCs in macrophage education, favoring the M2 immunophenotype and a mixed (M1/M2) secretory response. These results have translational potential, since they provide evidence that ADSCs from both Ex-Ob and OW subjects can be used in regenerative medicine in eligible therapies. Further in vivo studies will be fundamental to validate these observations.

Legacies of Indigenous land use and cultural burning in the Bolivian Amazon rainforest ecotone.

The southwestern Amazon Rainforest Ecotone (ARE) is the transitional landscape between the tropical forest and seasonally flooded savannahs of the Bolivian Llanos de Moxos. These heterogeneous landscapes harbour high levels of biodiversity and some of the earliest records of human occupation and plant domestication in Amazonia. While persistent Indigenous legacies have been demonstrated elsewhere in the Amazon, it is unclear how past human-environment interactions may have shaped vegetation composition and structure in the ARE. Here, we examine 6000 years of archaeological and palaeoecological data from Laguna Versalles (LV), Bolivia. LV was dominated by stable rainforest vegetation throughout the Holocene. Maize cultivation and cultural burning are present after ca 5700 cal yr BP. Polyculture cultivation of maize, manioc and leren after ca 3400 cal yr BP predates the formation of Amazonian Dark/Brown Earth (ADE/ABE) soils (approx. 2400 cal yr BP). ADE/ABE formation is associated with agroforestry indicated by increased edible palms, including Mauritia flexuosa and Attalea sp., and record levels of burning, suggesting that fire played an important role in agroforestry practices. The frequent use of fire altered ADE/ABD forest composition and structure by controlling ignitions, decreasing fuel loads and increasing the abundance of plants preferred by humans. Cultural burning and polyculture agroforestry provided a stable subsistence strategy that persisted despite pronounced climate change and cultural transformations and has an enduring legacy in ADE/ABE forests in the ARE. This article is part of the theme issue 'Tropical forests in the deep human past'.

Immunophenotypic shifts during minimal residual evaluation in a case of leukemic form of anaplastic large cell lymphoma ALK.

BACKGROUND: This study aims to describe immunophenotypic explorations at diagnosis and follow up of a pediatric patient with leukemic phase of ALK+ anaplastic large cell lymphoma (ALCL) by multiparametric flow cytometry (MFC). CASE: An 8-color MFC combination of antibodies allowed to identify neoplastic cells in concentrations until 0.02% during minimal residual disease (MRD) monitoring. Immunophenotypic shifts occurred in key markers as CD30, CD7, CD2, and CD5, however neoplastic cells were clearly discriminated from normal populations. CONCLUSION: MFC can be a useful tool for ALCL diagnosis and MRD monitoring and may support therapeutic decisions.

Estratégias da gestão estadual da atenção básica diante da pandemia de covid-19, Bahia, 2020/2021 / Primary care state management strategies for the covid-19 pandemic, Bahia, 2020/2021 / Estrategias de gestión estadual de atención primaria ante la pandemia del covid-19, Bahía, 2020/2021

A pandemia de Covid-19, maior acontecimento sanitário e com diversas implicações no cenário sociopolítico mundial nos últimos cem anos, trouxe consigo a necessidade de ir além das recomendações iniciais voltadas ao distanciamento físico, imposto como medida sanitária para passar a articular diferentes ações. Nesse sentido, este texto tem como objetivo apresentar a experiência da Diretoria de Atenção Básica (DAB), relativa ao desenvolvimento de estratégias com os municípios baianos para o enfrentamento da Covid-19. Algumas estratégias foram definidas, entre elas: ações de telessaúde; de apoio institucional; e de avaliação e monitoramento. O advento da pandemia tem exigido respostas rápidas e inovadoras da DAB diante do desafio de reestruturação desse nível de atenção, como o uso das tecnologias de informação e comunicação, que possibilitaram uma aproximação ainda maior entre a gestão estadual e municípios, assim como permitiram um melhor monitoramento e apoio às ações no nível local. As três estratégias têm se mostrado de grande relevância para o fortalecimento das ações da Atenção Básica.

The COVID ­ 19 pandemic, the biggest sanitary event and with several implications in the world  socio-political scenario in the last century, brought with in the need to go beyond the premise of social distancing imposed as a sanitary measure to start articulating different actions. In this context, the experience reported here had the general objective of describing the strategies  developed by the State Primary Care Directorate (DAB) with Bahian municipalities to face the COVID ­ 19 pandemic. Some strategies were defined, among them, the redefinition of the space of the Collegiate of Primary Care Coordinators (COCAB),which started to happen on virtual platforms for meetings and with greater frequency; the implementation of Telehealth/BA, with more web lectures focused on topics related to the pandemic and teleinterconsultation for higher education professionals in Primary Care om post ­ COVID-19 care and rehabilitation, and the third strategy comprised the implementation of thecnology for active search of cases of Flu Syndrome, COVID-19 and SRAG, for early identification and better monitoring of the epidemiological situation. This thecnology was developed through Sheet B ­ Flu Syndrome (SG) and the Indicator Base System. The onset of the pandemic has required and innovative responses from DAB to the challenge of restructuring at this level of care, such as the use of information and communication technologies, which allowed for an even greater approximation of state management and municipalities, as well as allowing for better monitoring and support for actions at the local level. The three strategies have been shown to be of great relevance to support actions at the local level, from the perspective of strengthening actions aimed at primary care.

La pandemia COVID ­ 19, el mayor evento sanitario y con varias implicaciones em el escenario sociopolítico mundial en el último siglo, trajo consigo la necesidad de ir más allá de la premisa del distanciamiento social impuesto como medida sanitaria para comenzar a articular diferentes acciones. En este contexto, la experiencia aquí reportada tuvo el objetivo general de describir las estrategias desarrolladas por la Dirección Estatal de Atención Primaria (DAB) con los municipios bahianos para enfrentar la pandemia COVID-19. Se definieron algunas estrategias, entre ellas, la redefinición del espacio del Colegiado de Coordinadores de Atención Primaria (COCAB), que comenzó a ocurrir en plataformas virtuales para reuniones y con mayor frecuencia; la implementación de Telesalud / BA, con más conferencias web enfocadas en temas relacionados con la pandemia y la teleinterconsulta para profesionales de educación superior en Atención Primaria en la atención y rehabilitación post-COVID-19, y la tercera estrategia comprendió la implementación de tecnología para la búsqueda activa de casos de Síndrome Gripal, COVID-19 y SRAG,  para una identificación temprana y un mejor seguimiento de la situación epidemiológica. Esta tecnología se desarrolló a través de la Hoja B - Síndrome de la gripe (SG) y el Sistema de base de indicadores. El inicio de la pandemia ha requerido respuestas rápidas e innovadoras por parte de la DAB al desafío de reestructurar en este nivel de atención, como el uso de tecnologías de la información y la comunicación, que permitieron una aproximación aún mayor de la gestión estatal y los municipios, así como permitiendo un mejor seguimiento y apoyo a las acciones a nivel local. Las tres estrategias se han mostrado de gran relevancia para apoyar acciones a nivel local, desde la perspectiva de fortalecer las acciones dirigidas a la atención primaria.

Human mesenchymal stromal/stem cells recruit resident pericytes and induce blood vessels maturation to repair experimental spinal cord injury in rats.

Angiogenesis is considered to mediate the beneficial effects of mesenchymal cell therapy in spinal cord injury. After a moderate balloon-compression injury in rats, injections of either human adipose tissue-derived stromal/stem cells (hADSCs) or their conditioned culture media (CM-hADSC) elicited angiogenesis around the lesion site. Both therapies increased vascular density, but the presence of hADSCs in the tissue was required for the full maturation of new blood vessels. Only animals that received hADSC significantly improved their open field locomotion, assessed by the BBB score. Animals that received CM-hADSC only, presented haemorrhagic areas and lack pericytes. Proteomic analyses of human angiogenesis-related factors produced by hADSCs showed that both pro- and anti-angiogenic factors were produced by hADSCs in vitro, but only those related to vessel maturation were detectable in vivo. hADSCs produced PDGF-AA only after insertion into the injured spinal cord. hADSCs attracted resident pericytes expressing NG2, α-SMA, PDGF-Rß and nestin to the lesion, potentially contributing to blood vessel maturation. We conclude that the presence of hADSCs in the injured spinal cord is essential for tissue repair.

Climate change and cultural resilience in late pre-Columbian Amazonia.

The long-term response of ancient societies to climate change has been a matter of global debate. Until recently, the lack of integrative studies using archaeological, palaeoecological and palaeoclimatological data prevented an evaluation of the relationship between climate change, distinct subsistence strategies and cultural transformations across the largest rainforest of the world, Amazonia. Here we review the most relevant cultural changes seen in the archaeological record of six different regions within Greater Amazonia during late pre-Columbian times. We compare the chronology of those cultural transitions with high-resolution regional palaeoclimate proxies, showing that, while some societies faced major reorganization during periods of climate change, others were unaffected and even flourished. We propose that societies with intensive, specialized land-use systems were vulnerable to transient climate change. In contrast, land-use systems that relied primarily on polyculture agroforestry, resulting in the formation of enriched forests and fertile Amazonian dark earth in the long term, were more resilient to climate change.

The legacy of 4,500 years of polyculture agroforestry in the eastern Amazon.

The legacy of pre-Columbian land use in the Amazonian rainforest is one of the most controversial topics in the social1-10 and natural sciences11,12. Until now, the debate has been limited to discipline-specific studies, based purely on archaeological data8, modern vegetation13, modern ethnographic data3 or a limited integration of archaeological and palaeoecological data12. The lack of integrated studies to connect past land use with modern vegetation has left questions about the legacy of pre-Columbian land use on the modern vegetation composition in the Amazon, unanswered11. Here, we show that persistent anthropogenic landscapes for the past 4,500 years have had an enduring legacy on the hyperdominance of edible plants in modern forests in the eastern Amazon. We found an abrupt enrichment of edible plant species in fossil lake and terrestrial records associated with pre-Columbian occupation. Our results demonstrate that, through closed-canopy forest enrichment, limited clearing for crop cultivation and low-severity fire management, long-term food security was attained despite climate and social changes. Our results suggest that, in the eastern Amazon, the subsistence basis for the development of complex societies began ~4,500 years ago with the adoption of polyculture agroforestry, combining the cultivation of multiple annual crops with the progressive enrichment of edible forest species and the exploitation of aquatic resources. This subsistence strategy intensified with the later development of Amazonian dark earths, enabling the expansion of maize cultivation to the Belterra Plateau, providing a food production system that sustained growing human populations in the eastern Amazon. Furthermore, these millennial-scale polyculture agroforestry systems have an enduring legacy on the hyperdominance of edible plants in modern forests in the eastern Amazon. Together, our data provide a long-term example of past anthropogenic land use that can inform management and conservation efforts in modern Amazonian ecosystems.

Pré-conferências de saúde: uma proposta de democratização da saúde no município de Camaçari / Pre-conferences as of to your health: a proposal as of democratization from the to your health at athe county as of Camaçari

A legalização do direito à participação e ao controle das políticas de saúde no Brasil, conquistada principalmente pelos movimentos sociais organizados, foi estabelecida na Constituição de 1988 e nas Leis 8.080/90 e 8.142/90. Este artigo aponta o potencial das pré-conferências como espaços de mobilização social e de empoderamento das comunidades locais. As pré-conferências de saúde realizadas em Camaçari tiveram como objetivos divulgar a conferência municipal de saúde, eleger os delegados de usuários e construir propostas para os problemas de saúde enfrentados pela população. as 35 pré-conferências realizadas, distribuídas nas zonas urbana e rural, contribuíram para a realização da maior conferência de saúde do município, com 102 delegados de usuários provenientes das pré-conferências. Os resultados reforçam a importância das pré-conferências de saúde como espaços de democratização da saúde e, consequentemente, de fortalecimento do SUS.