Evolution of SARS-CoV-2 in the Rhine-Neckar/Heidelberg Region 01/2021 - 07/2023.

In January 2021, the monitoring of circulating variants of SARS-CoV-2 was initiated in Germany under the Corona Surveillance Act, which was discontinued after July 2023. This initiative aimed to enhance pandemic containment, as specific amino acid changes, particularly in the spike protein, were associated with increased transmission and reduced vaccine efficacy. Our group conducted whole genome sequencing using the ARTIC protocol (currently V4) on Illumina's NextSeq 500 platform (and, starting in May 2023, on the MiSeq DX platform) for SARS-CoV-2 positive specimen from patients at Heidelberg University Hospital, associated hospitals, and the public health office in the Rhine-Neckar/Heidelberg region. In total, we sequenced 26,795 SARS-CoV-2-positive samples between January 2021 and July 2023. Valid sequences, meeting the requirements for upload to the German electronic sequencing data hub (DESH) operated by the Robert Koch Institute (RKI), were determined for 24,852 samples, and the lineage/clade could be identified for 25,912 samples. The year 2021 witnessed significant dynamics in the circulating variants in the Rhine-Neckar/Heidelberg region, including A.27.RN, followed by the emergence of B.1.1.7 (Alpha), subsequently displaced by B.1.617.2 (Delta), and the initial occurrences of B.1.1.529 (Omicron). By January 2022, B.1.1.529 had superseded B.1.617.2, dominating with over 90%. The years 2022 and 2023 were then characterized by the dominance of B.1.1.529 and its sublineages, particularly BA.5 and BA.2, and more recently, the emergence of recombinant variants like XBB.1.5. Since the global dominance of B.1.617.2, the identified variant distribution in our local study, apart from a time delay in the spread of new variants, can be considered largely representative of the global distribution. om a time delay in the spread of new variants, can be considered largely representative of the global distribution.

Prevalence and risk factors for intimate partner violence and indigenous women: A scoping review.

AIM: This study aims to map intimate partner violence evidence among indigenous women and explore the prevalence, social and systemic factors contributing to this occurrence. METHODS: This is a scoping review following the steps recommended by the JBI. We searched the MEDLINE/PubMed®, Web of Science™, Embase, CINAHL and LILACS databases on March 2023. Studies that addressed the intimate partner violence topic among indigenous women and risk factors, without time and language limitations, were included. Detailed information was extracted, standardized by JBI. RESULTS: Twenty studies of different designs were included, all published in English, between 2004 and 2022. A high intimate partner violence prevalence among indigenous women was identified, associated with a great diversity of risk factors. CONCLUSION: The great diversity of identified factors associated with its occurrence shows the complexity of this problem and the vulnerability of indigenous women.

Bundle para quantificação de perda sanguínea pós-parto vaginal / Bundle para la cuantificación de pérdida sanguínea posparto vaginal / Bundle for quantifying vaginal blood loss after childbirth

Resumo Objetivo Construir e validar o conteúdo de um bundle para quantificação da perda sanguínea pós-parto vaginal. Métodos Estudo metodológico desenvolvido de fevereiro a agosto de 2022, em três etapas: levantamento bibliográfico, construção do instrumento e validação de conteúdo por 14 experts. O instrumento para validação foi composto por 11 itens selecionados a partir de revisão sistemática. Para cada item do bundle aplicou-se escala Likert e para verificar a concordância entre experts, calculou-se o Índice de Concordância. Consideraram-se válidos os itens com concordância acima de 80%. A validação de conteúdo foi realizada em uma única rodada de avaliação. Resultados A versão final do bundle foi composta por nove itens. Os cuidados propostos estão relacionados à quantificação direta do sangramento pós-parto e seu registro, observação da puérpera, a utilização de protocolos institucionais em casos de hemorragia pós-parto, assim como a capacitação da equipe. Conclusão O estudo permitiu construir e validar bundle para quantificação da perda sanguínea pós-parto vaginal, com vistas à melhora do diagnóstico de hemorragia pós-parto.

Resumen Objetivo Elaborar y validar el contenido de un bundle para la cuantificación de pérdida sanguínea posparto vaginal. Métodos Estudio metodológico, llevado a cabo de febrero a agosto de 2022, en tres etapas: análisis bibliográfico, construcción del instrumento y validación de contenido por 14 expertos. El instrumento para validación consistió en 11 ítems seleccionados a partir de revisión sistemática. Se aplicó la escala Likert para cada ítem del bundle; y para verificar la concordancia entre expertos, se calculó el Índice de Concordancia. Se consideraron válidos los ítems con concordancia superior a 80 %. La validación de contenido se realizó en una única ronda de evaluación. Resultados La versión final del bundle consistió en nueve ítems. Los cuidados propuestos están relacionados con la cuantificación directa del sangrado posparto y su registro, la observación de la puérpera, la utilización de protocolos institucionales en casos de hemorragia posparto, así como también la capacitación del equipo. Conclusión El estudio permitió elaborar y validar un bundle para la cuantificación de pérdida sanguínea posparto vaginal, con el fin de mejorar el diagnóstico de hemorragia posparto.

Abstract Objective To construct and validate the content of a bundle to quantify vaginal blood loss after childbirth. Methods This is a methodological study developed from February to August 2022, divided into bibliographic survey, instrument construction and content validity, by 14 experts. The instrument for validity consisted of 11 items selected from a systematic review. For each item in the bundle, a Likert scale was applied, and to check agreement among experts, the Concordance Index was calculated. Items with agreement above 80% were considered valid. Content validity was carried out in a single round of assessment. Results The final version of the bundle consisted of nine items. The proposed care is related to direct quantification of postpartum bleeding and its recording, observation of postpartum women, use of institutional protocols in cases of postpartum hemorrhage as well as team training. Conclusion The study allowed constructing and validating a bundle for quantifying vaginal blood loss after childbirth, with a view to improving postpartum hemorrhage diagnosis.

Quantification of blood loss for the diagnosis of postpartum hemorrhage: a systematic review and meta-analysis.

OBJECTIVE: to compare the effectiveness of different diagnostic methods to estimate postpartum blood volume loss. METHODS: a systematic review of effectiveness according to PRISMA and JBI Protocol. Searches in PubMed/MEDLINE, LILACS, Scopus, Embase, Web of Science and CINAHL, with descriptor "Postpartum Hemorrhage" associated with keyword "Quantification of Blood Loss". Tabulated extracted data, presented in metasynthesis and meta-analysis was applied to quantitative data. To assess risk of bias, JBI Appraisal Tools were applied. RESULTS: fourteen studies were included, published between 2006 and 2021. Quantification of loss by any method was superior to visual estimation and is highly recommended, however the studies' high heterogeneity did not allow estimating this association. CONCLUSION: the studies' high heterogeneity, with a probable margin of error given the uncontrolled factors, indicates the need for further studies, however quantification proved to be effective in relation to visual estimate. PROSPERO registration CRD 42021234486.

Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review.

OBJECTIVES: to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19. METHODS: a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation. RESULTS: fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90-72.88), and artificial breastfeeding, 43.23% (CI = 30.99 - 55.88), without statistically significant differences. CONCLUSIONS: despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.

Co-translational binding of importins to nascent proteins.

Various cellular quality control mechanisms support proteostasis. While, ribosome-associated chaperones prevent the misfolding of nascent chains during translation, importins were shown to prevent the aggregation of specific cargoes in a post-translational mechanism prior the import into the nucleoplasm. Here, we hypothesize that importins may already bind ribosome-associated cargo in a co-translational manner. We systematically measure the nascent chain association of all importins in Saccharomyces cerevisiae by selective ribosome profiling. We identify a subset of importins that bind to a wide range of nascent, often uncharacterized cargoes. This includes ribosomal proteins, chromatin remodelers and RNA binding proteins that are aggregation prone in the cytosol. We show that importins act consecutively with other ribosome-associated chaperones. Thus, the nuclear import system is directly intertwined with nascent chain folding and chaperoning.

Skin-to-Skin Contact in the Third Stage of Labor and Postpartum Hemorrhage Prevention: A Scoping Review.

INTRODUCTION: Literature supports numerous benefits of skin-to-skin contact for neonatal adaptation to extrauterine life and bonding/attachment, but few studies explore the effects of skin-to-skin contact on maternal outcomes. This review aims to map the evidence on skin-to-skin contact in the third stage of labor for postpartum hemorrhage prevention. METHODS: Scoping review, which covered stages recommended by the Institute Joanna Briggs, including studies from the PubMed, EMBASE, CINAHL, LILACS, Web of Science, and Scopus databases, using the descriptors "Postpartum hemorrhage", "Labor stages, third", "Prevention" and "Kangaroo care/Skin-to-skin". RESULTS: 100 publications on the subject found, 13 articles met the inclusion criteria, with 10,169 dyads were assessed in all studies. Publications from 2008 to 2021 were mostly written in English and designed as a randomized controlled trial. Skin-to-skin contact was effective and significant in: reducing the duration of the third stage of labor; placenta delivery; uterine contractility and physiological involution; absence of atony, decreasing blood loss with lower rates of erythrocyte and hemoglobin drop; reducing the need for synthetic oxytocin and/or ergometrine to control bleeding; and reducing changing pads per period and length of stay. DISCUSSION: Skin-to-skin contact was considered an effective, low-cost, and safe strategy, with positive effects already established in the literature for infants and extremely favorable results in postpartum hemorrhage prevention cases, being highly recommended in assistance for the dyad. Open Science Framework Registry ( https://osf.io/n3685 ).

Quantification of blood loss for the diagnosis of postpartum hemorrhage: a systematic review and meta-analysis / Cuantificación de la pérdida de sangre para el diagnóstico de hemorragia posparto: revisión sistemática y metanálisis / Quantificação da perda sanguínea para o diagnóstico de hemorragia pós-parto: revisão sistemática e metanálise

ABSTRACT Objective: to compare the effectiveness of different diagnostic methods to estimate postpartum blood volume loss. Methods: a systematic review of effectiveness according to PRISMA and JBI Protocol. Searches in PubMed/MEDLINE, LILACS, Scopus, Embase, Web of Science and CINAHL, with descriptor "Postpartum Hemorrhage" associated with keyword "Quantification of Blood Loss". Tabulated extracted data, presented in metasynthesis and meta-analysis was applied to quantitative data. To assess risk of bias, JBI Appraisal Tools were applied. Results: fourteen studies were included, published between 2006 and 2021. Quantification of loss by any method was superior to visual estimation and is highly recommended, however the studies' high heterogeneity did not allow estimating this association. Conclusion: the studies' high heterogeneity, with a probable margin of error given the uncontrolled factors, indicates the need for further studies, however quantification proved to be effective in relation to visual estimate. PROSPERO registration CRD 42021234486.

RESUMEN Objetivo: comparar la efectividad de diferentes métodos diagnósticos para estimar la pérdida de volumen sanguíneo posparto. Métodos: revisión sistemática de efectividad según PRISMA y Protocolo JBI. Búsquedas en bases de datos: PubMed/MEDLINE, LILACS, Scopus, Embase, Web of Science y CINAHL, con el descriptor "Postpartum Hemorrhage" asociado a la palabra clave "Quantification of Blood Loss". Los datos extraídos tabulados fueron presentados en metasíntesis y metanálisis se aplicaron a los datos cuantitativos. Para evaluar el riesgo de sesgo, se aplicaron las herramientas de evaluación de JBI. Resultados: se incluyeron 14 estudios, publicados entre 2006 y 2021. La cuantificación de pérdida por cualquier método fue superior a la estimación visual y es muy recomendable, sin embargo, la alta heterogeneidad de los estudios no permitió estimar esta asociación. Conclusión: la alta heterogeneidad de los estudios, con probable margen de error dado el descontrol de los factores, indica la necesidad de más estudios, sin embargo la cuantificación demostró ser efectiva en relación a la estimación visual. Registro PRÓSPERO CRD 42021234486.

RESUMO Objetivo: comparar a efetividade de diferentes métodos diagnósticos para estimar a perda volêmica sanguínea pós-parto. Métodos: revisão sistemática de efetividade, de acordo com protocolo PRISMA e JBI. Buscas nas bases PubMed/MEDLINE, LILACS, Scopus, Embase, Web of Science e CINAHL, com o descritor "Postpartum Hemorrhage" associado à palavra-chave "Quantification of Blood Loss". Dados extraídos tabulados, apresentados em metassíntese, e aplicou-se metanálise para dados quantitativos. Para avaliar o risco de viés, aplicou-se o JBI Appraisal Tools. Resultados: incluídos 14 estudos, publicados entre 2006 e 2021. A quantificação da perda por qualquer método apresentou superioridade em relação à estimativa visual, sendo altamente recomendada, porém a alta heterogeneidade dos estudos não permitiu estimar essa associação. Conclusão: a alta heterogeneidade dos estudos, com provável margem de erro dado aos fatores não controlados, indica a necessidade de realização de novos estudos, contudo a quantificação se mostrou efetiva em relação à estimativa visual. Registro PROSPERO CRD 42021234486.

Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review / Prevalencia de lactancia materna en recién nacidos de madres con COVID-19: una revisión sistemática / Prevalência de aleitamento materno em recém-nascidos de mães com COVID-19: uma revisão sistemática

ABSTRACT Objectives: to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19. Methods: a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation. Results: fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90-72.88), and artificial breastfeeding, 43.23% (CI = 30.99 - 55.88), without statistically significant differences. Conclusions: despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.

RESUMEN Objetivos: comparar la prevalencia de lactancia materna exclusiva versus alimentación artificial en recién nacidos de madres con COVID-19. Métodos: revisión sistemática de prevalencia, según JBI. Búsquedas en las bases de datos PubMed®, Embase, CINAHL, LILACS y Web of Science™ en agosto de 2021. Se seleccionaron estudios transversales, longitudinales o de cohortes, sin limitaciones de idioma y tiempo que mostraran prevalencia de lactancia materna o que permitieran calcular. Resultados: se analizaron 15 artículos publicados en 2020 y 2021, de cohorte (60%) o transversal (40%). El promedio de lactancia materna exclusiva en madres con COVID-19 fue 56,76% (IC=39,90-72,88), y lactancia artificial, 43,23% (IC = 30,99 - 55,88), sin diferencias estadísticamente significativas. Conclusiones: a pesar de las recomendaciones de mantener la lactancia materna, hubo una reducción a nivel mundial, en comparación con períodos previos a la pandemia. Con los avances de la ciencia, estas tasas han mejorado, mostrando el impacto de la evidencia en las prácticas. Como limitaciones se citan las fuentes del estudio. Se recomienda realizar nuevos estudios. Registro PROSPERO CRD42021234486.

RESUMO Objetivos: comparar as prevalências de aleitamento materno exclusivo versus aleitamento artificial em recém-nascidos de mães com COVID-19. Métodos: revisão sistemática de prevalência, segundo JBI. Buscas nas bases PubMed®, Embase, CINAHL, LILACS e Web of Science™ em agosto de 2021. Selecionados estudos transversais, longitudinais ou coortes, sem limitação de idioma e tempo que apresentavam prevalência de aleitamento materno ou que permitissem o cálculo. Resultados: 15 artigos publicados em 2020 e 2021, coortes (60%) ou transversais (40%) foram analisados. A média de aleitamento materno exclusivo em mães com COVID-19 foi 56,76% (IC=39,90-72,88), e artificial, de 43,23% (IC = 30,99 - 55,88), sem diferenças estatisticamente significantes. Conclusões: apesar das recomendações para a manutenção do aleitamento materno, houve redução mundialmente, quando comparados à períodos anteriores à pandemia. Com avanços da ciência, esses índices têm melhorado, mostrando o impacto das evidências nas práticas. Como limitações, citam-se fontes dos estudos. Recomenda-se realização de novos estudos. Registro PROSPERO CRD42021234486.

MicroRNAs and other small RNAs in Aedes aegypti saliva and salivary glands following chikungunya virus infection.

Mosquito saliva facilitates blood feeding through the anti-haemostatic, anti-inflammatory and immunomodulatory properties of its proteins. However, the potential contribution of non-coding RNAs to host manipulation is still poorly understood. We analysed small RNAs from Aedes aegypti saliva and salivary glands and show here that chikungunya virus-infection triggers both the siRNA and piRNA antiviral pathways with limited effects on miRNA expression profiles. Saliva appears enriched in specific miRNA subsets and its miRNA content is well conserved among mosquitoes and ticks, clearly pointing to a non-random sorting and occurrence. Finally, we provide evidence that miRNAs from Ae. aegypti saliva may target human immune and inflammatory pathways, as indicated by prediction analysis and searching for experimentally validated targets of identical human miRNAs. Overall, we believe these observations convincingly support a scenario where both proteins and miRNAs from mosquito saliva are injected into vertebrates during blood feeding and contribute to the complex vector-host-pathogen interactions.

Co-translational assembly orchestrates competing biogenesis pathways.

During the co-translational assembly of protein complexes, a fully synthesized subunit engages with the nascent chain of a newly synthesized interaction partner. Such events are thought to contribute to productive assembly, but their exact physiological relevance remains underexplored. Here, we examine structural motifs contained in nucleoporins for their potential to facilitate co-translational assembly. We experimentally test candidate structural motifs and identify several previously unknown co-translational interactions. We demonstrate by selective ribosome profiling that domain invasion motifs of beta-propellers, coiled-coils, and short linear motifs may act as co-translational assembly domains. Such motifs are often contained in proteins that are members of multiple complexes (moonlighters) and engage with closely related paralogs. Surprisingly, moonlighters and paralogs assemble co-translationally in only some but not all of the relevant biogenesis pathways. Our results highlight the regulatory complexity of assembly pathways.

gga-miRNOME, a microRNA-sequencing dataset from chick embryonic tissues.

MicroRNAs (miRNAs) are small non-coding RNA molecules, with sizes ranging from 18 to 25 nucleotides, which are key players in gene expression regulation. These molecules play an important role in fine-tuning early vertebrate embryo development. However, there are scarce publicly available miRNA datasets from non-mammal embryos, such as the chicken (Gallus gallus), which is a classical model system to study vertebrate embryogenesis. Here, we performed microRNA-sequencing to characterize the early stages of trunk and limb development in the chick embryo. For this, we profiled three chick embryonic tissues, namely, Undetermined Presomitic Mesoderm (PSM_U), Determined Presomitic Mesoderm (PSM_D) and Forelimb Distal Cyclic Domain (DCD). We identified 926 known miRNAs, and 1,141 novel candidate miRNAs, which nearly duplicates the number of Gallus gallus entries in the miRBase database. These data will greatly benefit the avian research community, particularly by highlighting new miRNAs potentially involved in the regulation of early vertebrate embryo development, that can be prioritized for further experimental testing.

Structural snapshots of La Crosse virus polymerase reveal the mechanisms underlying Peribunyaviridae replication and transcription.

Segmented negative-strand RNA bunyaviruses encode a multi-functional polymerase that performs genome replication and transcription. Here, we establish conditions for in vitro activity of La Crosse virus polymerase and visualize its conformational dynamics by cryo-electron microscopy, unveiling the precise molecular mechanics underlying its essential activities. We find that replication initiation is coupled to distal duplex promoter formation, endonuclease movement, prime-and-realign loop extension and closure of the polymerase core that direct the template towards the active site. Transcription initiation depends on C-terminal region closure and endonuclease movements that prompt primer cleavage prior to primer entry in the active site. Product realignment after priming, observed in replication and transcription, is triggered by the prime-and-realign loop. Switch to elongation results in polymerase reorganization and core region opening to facilitate template-product duplex formation in the active site cavity. The uncovered detailed mechanics should be helpful for the future design of antivirals counteracting bunyaviral life threatening pathogens.

Lack of Conserved miRNA Deregulation in HPV-Induced Squamous Cell Carcinomas.

Squamous cell carcinomas (SCCs) in the anogenital and head and neck regions are associated with high-risk types of human papillomaviruses (HR-HPV). Deregulation of miRNA expression is an important contributor to carcinogenesis. This study aimed to pinpoint commonly and uniquely deregulated miRNAs in cervical, anal, vulvar, and tonsillar tumors of viral or non-viral etiology, searching for a common set of deregulated miRNAs linked to HPV-induced carcinogenesis. RNA was extracted from tumors and nonmalignant tissues from the same locations. The miRNA expression level was determined by next-generation sequencing. Differential expression of miRNAs was calculated, and the patterns of miRNA deregulation were compared between tumors. The total of deregulated miRNAs varied between tumors of different locations by two orders of magnitude, ranging from 1 to 282. The deregulated miRNA pool was largely tumor-specific. In tumors of the same location, a low proportion of miRNAs were exclusively deregulated and no deregulated miRNA was shared by all four types of HPV-positive tumors. The most significant overlap of deregulated miRNAs was found between tumors which differed in location and HPV status (HPV-positive cervical tumors vs. HPV-negative vulvar tumors). Our results imply that HPV infection does not elicit a conserved miRNA deregulation in SCCs.

A Mutation Upstream of the rplN-rpsD Ribosomal Operon Downregulates Bordetella pertussis Virulence Factor Production without Compromising Bacterial Survival within Human Macrophages.

The BvgS/BvgA two-component system controls expression of ∼550 genes of Bordetella pertussis, of which, ∼245 virulence-related genes are positively regulated by the BvgS-phosphorylated transcriptional regulator protein BvgA (BvgA∼P). We found that a single G-to-T nucleotide transversion in the 5'-untranslated region (5'-UTR) of the rplN gene enhanced transcription of the ribosomal protein operon and of the rpoA gene and provoked global dysregulation of B. pertussis genome expression. This comprised overproduction of the alpha subunit (RpoA) of the DNA-dependent RNA polymerase, downregulated BvgA and BvgS protein production, and impaired production and secretion of virulence factors by the mutant. Nonetheless, the mutant survived like the parental bacteria for >2 weeks inside infected primary human macrophages and persisted within infected mouse lungs for a longer period than wild-type B. pertussis These observations suggest that downregulation of virulence factor production by bacteria internalized into host cells may enable persistence of the whooping cough agent in the airways.IMPORTANCE We show that a spontaneous mutation that upregulates transcription of an operon encoding ribosomal proteins and causes overproduction of the downstream-encoded α subunit (RpoA) of RNA polymerase causes global effects on gene expression levels and proteome composition of Bordetella pertussis Nevertheless, the resulting important downregulation of the BvgAS-controlled expression of virulence factors of the whooping cough agent did not compromise its capacity to persist for prolonged periods inside primary human macrophage cells, and it even enhanced its capacity to persist in infected mouse lungs. These observations suggest that the modulation of BvgAS-controlled expression of virulence factors may occur also during natural infections of human airways by Bordetella pertussis and may possibly account for long-term persistence of the pathogen within infected cells of the airways.

In situ structural analysis of SARS-CoV-2 spike reveals flexibility mediated by three hinges.

The spike protein (S) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is required for cell entry and is the primary focus for vaccine development. In this study, we combined cryo-electron tomography, subtomogram averaging, and molecular dynamics simulations to structurally analyze S in situ. Compared with the recombinant S, the viral S was more heavily glycosylated and occurred mostly in the closed prefusion conformation. We show that the stalk domain of S contains three hinges, giving the head unexpected orientational freedom. We propose that the hinges allow S to scan the host cell surface, shielded from antibodies by an extensive glycan coat. The structure of native S contributes to our understanding of SARS-CoV-2 infection and potentially to the development of safe vaccines.

A Structure-Based Model for the Complete Transcription Cycle of Influenza Polymerase.

Influenza polymerase uses unique mechanisms to synthesize capped and polyadenylated mRNAs from the genomic viral RNA (vRNA) template, which is packaged inside ribonucleoprotein particles (vRNPs). Here, we visualize by cryoelectron microscopy the conformational dynamics of the polymerase during the complete transcription cycle from pre-initiation to termination, focusing on the template trajectory. After exiting the active site cavity, the template 3' extremity rebinds into a specific site on the polymerase surface. Here, it remains sequestered during all subsequent transcription steps, forcing the template to loop out as it further translocates. At termination, the strained connection between the bound template 5' end and the active site results in polyadenylation by stuttering at uridine 17. Upon product dissociation, further conformational changes release the trapped template, allowing recycling back into the pre-initiation state. Influenza polymerase thus performs transcription while tightly binding to and protecting both template ends, allowing efficient production of multiple mRNAs from a single vRNP.

Knowledge of the nursing team about the newborn's pain / Conhecimento da equipe de enfermagem sobre a dor do recém-nascido

ABSTRACT BACKGROUND AND OBJECTIVES: To describe the knowledge of the nursing team about the evaluation and treatment of pain in newborns hospitalized at the Neonatal Intermediate Care Unit of a university hospital in the state of Minas Gerais, due to the relevance of the issue regarding the quality of the neonatal care. METHODS: A descriptive and exploratory qualitative research with 13 professionals from a Neonatal Intermediate Care Unit. The data were collected through a semi-structured interview, and the data analysis was guided by the Content Thematic Analysis from January to June 2018. RESULTS: Four categories were elaborated: pain identification; methods for assessing pain; interventions of the nursing team to relieve pain, and nursing learnings in pain management. CONCLUSION: The knowledge of this team is based on the individual experience, showing the need for changes in the educational structures to reach better results and nursing practices based on scientific methods for quality assistance.

RESUMO JUSTIFICATIVA E OBJETIVOS: Descrever o conhecimento da equipe de enfermagem sobre a avaliação e o tratamento da dor em recém-nascidos internados na Unidade de Cuidado Intermediário Neonatal de um hospital universitário do estado de Minas Gerais, pela relevância da temática no que se refere à qualidade da assistência neonatal. MÉTODOS: Pesquisa de abordagem qualitativa do tipo descritiva e exploratória, com 13 profissionais de uma Unidade de Cuidados Intermediários Neonatal. Os dados foram coletados por meio de entrevista semiestruturada e a análise de dados foi orientada pela Análise Temática de Conteúdo nos meses de janeiro a junho de 2018. RESULTADOS: Foram elaboradas quatro categorias: identificação da dor; métodos para a avaliação da dor; intervenções da equipe de enfermagem para o alívio da dor; aprendizado da enfermagem no manuseio da dor. CONCLUSÃO: O conhecimento dessa equipe está baseado na experiência individual e registram necessidades de mudanças nas estruturas formativas para o alcance de melhores resultados e práticas de enfermagem, fundamentadas em métodos científicos para uma assistência de qualidade.

Knowledge about the human immunodeficiency syndrome among elders in a unit for the care of the elderly. / Conhecimento sobre síndrome da imunodeficiência humana de idosos de uma unidade de atenção ao idoso.

OBJECTIVE: To analyze the knowledge of elders regarding HIV/AIDS. METHODS: Descriptive, cross-sectional, quantitative study, with 457 elders from the Unit for the Care of Elders in Uberaba - Minas Gerais, lasting 3 months. The instruments used were the Mental State Mini-exam and a questionnaire on the human immunodeficiency virus for elders, together with frequency measures for their analysis. RESULTS: Most participants were female (74%), between 60 and 69 y/o (51%). The question with the most correct answers was about syringe/needle transmission (96.2%) and the ones with the least (45.3% and 49.6%, respectively) were regarding AIDS transmission through mosquito bites and whether a person with the human immunodeficiency virus always presents symptoms (49.6%). 88.2% of participants never use condoms. CONCLUSION: The general level of knowledge can be considered good, responding to our goal. However, gaps in knowledge were identified due to the lack of campaigns aimed exclusively at such public, as well as to the lack of awareness of professionals.

Sexuality and knowledge about hiv/aids in elders who participate in a social center for the elderly / Sexualidade e conhecimento sobre hiv/aids de idoso participantes de um centro de convivência para idosos

The objective of this study was to analyze the knowledge of elders regarding HIV/AIDS and the sexual quotient of both genders in a Social Center in a town in the countryside of Minas Gerais, Brazil. This is a descriptive, transversal and quantitative study, involving 457 elders who belong to social groups offered by the Facility for the Care of the Elderly (UAI, in the Portuguese acronym), in the town of Uberaba, MG. In this study, the following instruments were used: MEEM to select those with a minimum level of cognition, QHIV3I to evaluate their knowledge, and QS-F/QS-M to measure the sexual quotient. Data was analyzed with the "Statistical Package for Social Sciences" (SPSS), version 20.0. Females represented 74% of participants, 40.5% between 70 and 79 y/o. 51.8% stated not to have a partner. Questions regarding transmission by needles and syringes, had the greatest number of right answers 96.2%. Only 45.1%, however, answered correctly the question about transmission through mosquito bites. 90.2% of the elders know it is possible to detect the virus through laboratory exams. And 88.2% of them stated to have never used a condom in sexual intercourses. Regarding the sexual quotient, 57.7% of the female elders stated to have a bad or null sex life, while only 7.6% of the male stated to have inactive sex lives. Campaigns targeted at this population are necessary, as well as an increase in the awareness of the health professionals, since that would make it possible for them to recognize the sexuality of the elder, and the risks inherent to it.

O objetivo deste estudo foi analisar o conhecimento de idosos acerca do HIV/AIDS e o quociente sexual de ambos os sexos num Centro de Convivência de uma cidade do interior de Minas Gerais. Trata-se de um estudo descritivo, transversal e quantitativo envolvendo 457 idosos participantes de grupos de convivência da Unidade de Atenção ao Idoso (UAI) do Município de Uberaba ­MG. Neste estudo aplicou-se os instrumentos: MEEM para elegibilidade da cognição mínima, QHIV3I para avaliação do conhecimento e, QS-F/QS-M para mensuração do quociente sexual. Para análise dos dados utilizou-se "Statiscal Package for Social Sciences" (SPSS) versão 20.0. O sexo feminino representou 74%, com 40,5% na faixa etária entre 70 a 79 anos, 51,8% afirmaram não possuir parceiro. O maior índice de acertos foi encontrado no quesito transmissão, como por seringa e agulhas 96,2%. Já nos erros foi na resposta de transmissão através de mosquito com apenas 45,1% de acertos. Do total de idosos, 90,2% sabem que é possível detectar o vírus através de exames laboratorial. E, 88,2% deles relataram nunca terem usado camisinha durante as relações sexuais. Do quociente sexual 57,7% das idosas afirmaram ter vida sexual ativa nula ou ruim, enquanto os idosos com vida sexualmente inativa foram apenas 7,6%. São necessárias campanhas voltadas exclusivamente para tal público, bem como, a conscientização de profissionais da saúde, tornando possível o reconhecimento da sexualidade do envelhecido e os riscos inerentes a ela.