Raising patient voices in medical education: an assessment of patient perceived effect of social determinants of health conversations and the patient-physician relationship on quality of obstetric care, to inform the development of patient driven medical education curricula.

Background: Conventional medical education lacks the lived experiences of patients which may authentically convey the social determinants of health (SDOH) and resulting health disparities. Videos of first-person patient narratives may prove a valuable education tool in this regard. The objective of this study is to investigate how patient demographics, satisfaction with care, and patient-physician relationships influence obstetric patient interest and willingness to contribute to a SDOH video curriculum by sharing their lived experiences through first-person narratives. Methods: Study design included an anonymous, cross-sectional survey and an optional semi-structured telephone interview. Participants were 18 years old with a live-birth delivery <8 weeks prior to recruitment and received care during their pregnancy at Los Angeles General Medical Center (LAGMC). Variables surveyed included demographics, satisfaction with care, aspects of the patient-physician relationship, perceived utility, and personal interest in contributing to an educational SDOH video. A bivariate analysis was conducted to compare participants' characteristics and responses on interest in contributing and perceived helpfulness of first-person patient SDOH videos. Results: 72.43% of participants (N = 70) believed a patient's first-person video on SDOH would be "Helpful" in preparing physicians to provide competent medical care; however, 71.43% responded "No" to "Interest" in sharing with physicians their experiences with SDOH. English preference and being U.S. born were factors significantly associated with viewing first-person SDOH video as "Helpful" (P > 0.001). Major themes from telephone interviews reflected enthusiasm for first-person patient narratives and perceived benefits of using patient experiences to educate physicians on SDOH. However, participants cited barriers to disclosing SDOH including brief and strictly clinical interactions with physicians, lack of continuity of care, and fear of being judged by physicians. Conclusion: While most participants recognized the utility of addressing social needs in medical education and reported satisfaction with their obstetricians and care, these factors did not uniformly translate into willingness to contribute first-person patient narratives. To improve the representation of patients from racial, ethnic, gender, linguistic, and sexual minorities into medical curricula, further research and strategies are needed to overcome the barriers discouraging patient disclosure of social needs to physicians.

Pattern of anuran infection by acanthocephalans from the Cerrado, Northeastern Brazil with a summary for South America.

In Brazil, acanthocephalans parasitise anurans in several biomes. In the present study, we performed an analysis of acanthocephalan infections across 175 anuran individuals from the Cerrado biome, belonging to ten species: Boana raniceps, Pithecopus hypochondrialis, Scinax fuscomarginatus, Scinax x-signatus, Leptodactylus pustulatus, Leptodactylus macrosternum, Leptodactylus vastus, Physalaemus cuvieri, Adenomera hylaedactyla, and Elachistocleis piauiensis. We also verified the specificity of the parasites using the STD* index. Additionally, we conducted a survey of acanthocephalan infection in anurans in South America. The studied assemblage in the Brazilian Cerrado presented 57 parasitised hosts of 175 specimens (overall prevalence: 32.6%). In total, 437 acanthocephalans cystacanths were recorded, among which 286 presented the same morphotype but could not be identified, 148 belonged to the genus Centrorhynchus, and three belonged to Oncicola. Unidentified acanthocephalans had a higher prevalence in L. vastus (53.85%) and the highest intensity was in L. pustulatus (17±16). The highest prevalence of Centrorhynchus sp. was in the species S. fuscomarginatus (28.57%), while the highest intensity was observed in L. vastus (111). The taxon Oncicola sp. it had a prevalence of 3.23% and an intensity of 3 only in S. x-signatus. The highest specificity was recorded for Oncicola sp. (STD*= 1), whereas the lowest was found in Centrorhynchus sp. (STD*= 2.21). Finally, according to the survey for South America, we found ten records of acanthocephalan taxa parasitizing 58 species of anurans distributed in seven countries (Brazil with the most records).

Environmental and bioclimatic factors influencing yeasts and molds distribution along European shores.

The present study employed data collected during the Mycosands survey to investigate the environmental factors influencing yeasts and molds distribution along European shores applying a species distribution modelling approach. Occurrence data were compared to climatic datasets (temperature, precipitation, and solar radiation), soil datasets (chemical and physical properties), and water datasets (temperature, salinity, and chlorophyll-a concentration) downloaded from web databases. Analyses were performed by MaxEnt software. Results suggested a different probability of distribution of yeasts and molds along European shores. Yeasts seem to tolerate low temperatures better during winter than molds and this reflects a higher suitability for the Northern European coasts. This difference is more evident considering suitability in waters. Both distributions of molds and yeasts are influenced by basic soil pH, probably because acidic soils are more favorable to bacterial growth. Soils with high nitrogen concentrations are not suitable for fungal growth, which, in contrast, are optimal for plant growth, favored by this environment. Finally, molds show affinity with soil rich in nickel and yeasts with soils rich in cadmium resulting in a distribution mainly at the mouths of European rivers or lagoons, where these metals accumulate in river sediments.

Endoparasite community structure of an anuran assemblage in the Caatinga, Northeastern Neotropical Region.

Amphibians are a widespread Chordata taxon and are important for maintaining the balance of both terrestrial and aquatic ecosystems. Brazil has a rich amphibian fauna; however, little is known about the role of their ecology and phylogenetic relationships during the assembly processes of associated endoparasite communities. Herein, we describe an endoparasite community in an anuran assemblage in the Caatinga, a unique biome of dry forests in north-eastern Brazil. We studied endoparasite diversity, as well as the effects of body length, body mass, body volume and sex on parasite abundance. We also investigated the influence of ecological and historical factors and anuran microhabitat use on endoparasite composition. We analysed individuals from 13 anuran species distributed across five families: Odontophrynidae (Proceratophrys cristiceps); Leptodactylidae (Leptodactylus fuscus, Leptodactylus vastus, Leptodactylus macrosternum, Leptodactylus troglodytes and Physalaemus cuvieri); Hylidae (Pithecopus gonzagai, Scinax x-signatus, Boana raniceps and Dendropsophus nanus); Bufonidae (Rhinella diptycha and Rhinella granulosa); and Microhylidae (Dermatonotus muelleri). We found nine species of endoparasites, including seven nematodes (Aplectana membranosa, Cosmocerca sp., Oswaldocruzia mazzai, Raillietnema spectans, Rhabdias fuelleborni, Schrankiana sp. and Physaloptera sp.), one species of Trematoda (Glypthelmins pseudium) and one non-identified cestode. There was no significant relationship between endoparasite abundance and host body length, body mass, body volume and sex. A phylogenetic principal component analysis showed that ecological factors had a greater influence on endoparasite assemblage than historical factors. Similarly, our results showed that ecological factors had a greater influence on anuran microhabitat use compared to historical factors, which contributed to the generalist characteristics presented by most of the sampled endoparasite species.

Mean glandular dose in the mammary gland and dose of radiation in the thyroid gland and lens in women with and without breast implants during different modalities of mammography.

There have always been concerns about the secondary effects of diagnostic methods that use ionizing radiation. During mammography, the parameters to be concerned about are the mean glandular dose and the scatter dose. We evaluated the dose of radiation to the breast, thyroid gland, and lens in digital mammography in women with and without implants, in tomosynthesis in women with and without implants, and in contrast-enhanced mammography. MATERIALS AND METHODS: The study included 212 women with and without disease who were attended at the Centro Clínico de Estereotaxia, CECLINES, in Caracas, Venezuela, between June 2017 and August 2017; the women were classified into five groups according to the mammographic modality used to evaluate them and whether or not they had implants. The statistical analysis included descriptive statistics for the study population. We used the Mann-Whitney U to compare the mean glandular dose and dose in the thyroid gland and lens between groups. RESULTS: The mean glandular dose and the dose of radiation received in the thyroid and lens were within the acceptable range. In a few exceptions, the mean glandular dose per view was slightly higher than 3 mGy. The scatter dose to the thyroid gland and the lens during mammography has a very small contribution to the annual dose equivalent. CONCLUSION: The mean glandular dose and the scatter dose to the thyroid gland and lens delivered during tomosynthesis and 2D mammography in women with implants were higher than those delivered during other mammographic techniques in women without implants.

Helminth fauna of Norops fuscoauratus (D'Orbigny, 1837) (Squamata: Dactyloidae) in the Atlantic Forest, northeastern Brazil / Helmintofauna de Norops fuscoauratus (D'Orbigny, 1837) (Squamata: Dactyloidae) na Mata Atlântica, Nordeste, Brasil

The composition of macro endoparasites associated with the lizard Norops fuscoauratus (Squamata) was analysed in two localities in the Atlantic Forest on the northeast of Brazil between December 2012 and July 2015. 74 specimens of N. fuscoauratus were examined and five species of helminths were reported, being: (a) for the population of Pernambuco: Cystacanth (Prevalence=37.5%), Physaloptera retusa Rudolphi, 1819 (Prevalence=4.16%), larva of flatworm (Prevalence=2.08%), Rhabdias sp. (Prevalence=2.08%) and Strongyluris oscari Travassos, 1923 (Prevalence=2.08%), and (b) of Alagoas: S. oscari (Prevalence=17.85%) and Rhabdias sp. (Prevalence=3.57%). The differences in the composition of endoparasites in the two populations are attributed to individualities of environments occupied by the lizards. The collection period does not influence the abundance of parasites, but when associated with sex, there was a positive correlation with the abundance of helminths, with more females than males being infected with parasites in the rainy season.

A composição de macro endoparasitas associada com o lagarto Norops fuscoauratus (Squamata) foi analisada em duas localidades da Mata Atlântica no nordeste do Brasil, entre dezembro de 2012 e julho de 2015. 74 espécimes foram examinados e cinco espécies de helmintos foram encontradas, sendo: (a) para a população de Pernambuco: Cistacanto (Prevalência=37.5%), Physaloptera retusa Rudolphi, 1819 (Prevalência=4.16%), larva de platelminto (Prevalência=2.08%), Rhabdias sp. (Prevalência =2.08%) e Strongyluris oscari Travassos, 1923 (Prevalência =2.08%) e (b) Alagoas: S. oscari (Prevalência=17.85%) e Rhabdias sp. (Prevalência =3.57%). As diferenças na composição dos endoparasitas nas duas populações pode ser atribuída as individualidades dos ambientes ocupados por esses lagartos. O período de coleta não influenciou na abundância de parasitas, mas quando associado com o sexo, houve uma correlação positiva com a abundância de helmintos, com mais fêmeas do que machos, infectadas na estação chuvosa.

Helminth fauna of Norops fuscoauratus (DOrbigny, 1837) (Squamata: Dactyloidae) in the Atlantic Forest, northeastern Brazil

Abstract The composition of macro endoparasites associated with the lizard Norops fuscoauratus (Squamata) was analysed in two localities in the Atlantic Forest on the northeast of Brazil between December 2012 and July 2015. 74 specimens of N. fuscoauratus were examined and five species of helminths were reported, being: (a) for the population of Pernambuco: Cystacanth (Prevalence=37.5%), Physaloptera retusa Rudolphi, 1819 (Prevalence=4.16%), larva of flatworm (Prevalence=2.08%), Rhabdias sp. (Prevalence=2.08%) and Strongyluris oscari Travassos, 1923 (Prevalence=2.08%), and (b) of Alagoas: S. oscari (Prevalence=17.85%) and Rhabdias sp. (Prevalence=3.57%). The differences in the composition of endoparasites in the two populations are attributed to individualities of environments occupied by the lizards. The collection period does not influence the abundance of parasites, but when associated with sex, there was a positive correlation with the abundance of helminths, with more females than males being infected with parasites in the rainy season.

Resumo A composição de macro endoparasitas associada com o lagarto Norops fuscoauratus (Squamata) foi analisada em duas localidades da Mata Atlântica no nordeste do Brasil, entre dezembro de 2012 e julho de 2015. 74 espécimes foram examinados e cinco espécies de helmintos foram encontradas, sendo: (a) para a população de Pernambuco: Cistacanto (Prevalência=37.5%), Physaloptera retusa Rudolphi, 1819 (Prevalência=4.16%), larva de platelminto (Prevalência=2.08%), Rhabdias sp. (Prevalência =2.08%) e Strongyluris oscari Travassos, 1923 (Prevalência =2.08%) e (b) Alagoas: S. oscari (Prevalência=17.85%) e Rhabdias sp. (Prevalência =3.57%). As diferenças na composição dos endoparasitas nas duas populações pode ser atribuída as individualidades dos ambientes ocupados por esses lagartos. O período de coleta não influenciou na abundância de parasitas, mas quando associado com o sexo, houve uma correlação positiva com a abundância de helmintos, com mais fêmeas do que machos, infectadas na estação chuvosa.

Helminth fauna of Norops fuscoauratus (D'Orbigny, 1837) (Squamata: Dactyloidae) in the Atlantic Forest, northeastern Brazil / Helmintofauna de Norops fuscoauratus (D'Orbigny, 1837) (Squamata: Dactyloidae) na Mata Atlântica, Nordeste, Brasil

The composition of macro endoparasites associated with the lizard Norops fuscoauratus (Squamata) was analysed in two localities in the Atlantic Forest on the northeast of Brazil between December 2012 and July 2015. 74 specimens of N. fuscoauratus were examined and five species of helminths were reported, being: (a) for the population of Pernambuco: Cystacanth (Prevalence=37.5%), Physaloptera retusa Rudolphi, 1819 (Prevalence=4.16%), larva of flatworm (Prevalence=2.08%), Rhabdias sp. (Prevalence=2.08%) and Strongyluris oscari Travassos, 1923 (Prevalence=2.08%), and (b) of Alagoas: S. oscari (Prevalence=17.85%) and Rhabdias sp. (Prevalence=3.57%). The differences in the composition of endoparasites in the two populations are attributed to individualities of environments occupied by the lizards. The collection period does not influence the abundance of parasites, but when associated with sex, there was a positive correlation with the abundance of helminths, with more females than males being infected with parasites in the rainy season.

A composição de macro endoparasitas associada com o lagarto Norops fuscoauratus (Squamata) foi analisada em duas localidades da Mata Atlântica no nordeste do Brasil, entre dezembro de 2012 e julho de 2015. 74 espécimes foram examinados e cinco espécies de helmintos foram encontradas, sendo: (a) para a população de Pernambuco: Cistacanto (Prevalência=37.5%), Physaloptera retusa Rudolphi, 1819 (Prevalência=4.16%), larva de platelminto (Prevalência=2.08%), Rhabdias sp. (Prevalência =2.08%) e Strongyluris oscari Travassos, 1923 (Prevalência =2.08%) e (b) Alagoas: S. oscari (Prevalência=17.85%) e Rhabdias sp. (Prevalência =3.57%). As diferenças na composição dos endoparasitas nas duas populações pode ser atribuída as individualidades dos ambientes ocupados por esses lagartos. O período de coleta não influenciou na abundância de parasitas, mas quando associado com o sexo, houve uma correlação positiva com a abundância de helmintos, com mais fêmeas do que machos, infectadas na estação chuvosa.

Helminth fauna of Norops fuscoauratus (D'Orbigny, 1837) (Squamata: Dactyloidae) in the Atlantic Forest, northeastern Brazil.

The composition of macro endoparasites associated with the lizard Norops fuscoauratus (Squamata) was analysed in two localities in the Atlantic Forest on the northeast of Brazil between December 2012 and July 2015. 74 specimens of N. fuscoauratus were examined and five species of helminths were reported, being: (a) for the population of Pernambuco: Cystacanth (Prevalence=37.5%), Physaloptera retusa Rudolphi, 1819 (Prevalence=4.16%), larva of flatworm (Prevalence=2.08%), Rhabdias sp. (Prevalence=2.08%) and Strongyluris oscari Travassos, 1923 (Prevalence=2.08%), and (b) of Alagoas: S. oscari (Prevalence=17.85%) and Rhabdias sp. (Prevalence=3.57%). The differences in the composition of endoparasites in the two populations are attributed to individualities of environments occupied by the lizards. The collection period does not influence the abundance of parasites, but when associated with sex, there was a positive correlation with the abundance of helminths, with more females than males being infected with parasites in the rainy season.

Mycosands: Fungal diversity and abundance in beach sand and recreational waters - Relevance to human health.

The goal of most studies published on sand contaminants is to gather and discuss knowledge to avoid faecal contamination of water by run-offs and tide-retractions. Other life forms in the sand, however, are seldom studied but always pointed out as relevant. The Mycosands initiative was created to generate data on fungi in beach sands and waters, of both coastal and freshwater inland bathing sites. A team of medical mycologists and water quality specialists explored the sand culturable mycobiota of 91 bathing sites, and water of 67 of these, spanning from the Atlantic to the Eastern Mediterranean coasts, including the Italian lakes and the Adriatic, Baltic, and Black Seas. Sydney (Australia) was also included in the study. Thirteen countries took part in the initiative. The present study considered several fungal parameters (all fungi, several species of the genus Aspergillus and Candida and the genera themselves, plus other yeasts, allergenic fungi, dematiaceous fungi and dermatophytes). The study considered four variables that the team expected would influence the results of the analytical parameters, such as coast or inland location, urban and non-urban sites, period of the year, geographical proximity and type of sediment. The genera most frequently found were Aspergillus spp., Candida spp., Fusarium spp. and Cryptococcus spp. both in sand and in water. A site-blind median was found to be 89 Colony-Forming Units (CFU) of fungi per gram of sand in coastal and inland freshwaters, with variability between 0 and 6400 CFU/g. For freshwater sites, that number was 201.7 CFU/g (0, 6400 CFU/g (p = 0.01)) and for coastal sites was 76.7 CFU/g (0, 3497.5 CFU/g). For coastal waters and all waters, the median was 0 CFU/ml (0, 1592 CFU/ml) and for freshwaters 6.7 (0, 310.0) CFU/ml (p < 0.001). The results advocate that beaches should be monitored for fungi for safer use and better management.

Mean glandular dose in the mammary gland and dose of radiation in the thyroid gland and lens in women with and without breast implants during different modalities of mammography. / Dosis glandular promedio en glándula mamaria y dosis de radiación en glándula tiroides y cristalino en mujeres con y sin implantes mamarios durante diferentes modalidades mamográficas.

There have always been concerns about the secondary effects of diagnostic methods that use ionizing radiation. During mammography, the parameters to be concerned about are the mean glandular dose and the scatter dose. We evaluated the dose of radiation to the breast, thyroid gland, and lens in digital mammography in women with and without implants, in tomosynthesis in women with and without implants, and in contrast-enhanced mammography. MATERIALS AND METHODS: The study included 212 women with and without disease who were attended at the Centro Clínico de Estereotaxia, CECLINES, in Caracas, Venezuela, between June 2017 and August 2017; the women were classified into five groups according to the mammographic modality used to evaluate them and whether or not they had implants. The statistical analysis included descriptive statistics for the study population. We used the Mann-Whitney U to compare the mean glandular dose and dose in the thyroid gland and lens between groups. RESULTS: The mean glandular dose and the dose of radiation received in the thyroid and lens were within the acceptable range. In a few exceptions, the mean glandular dose per view was slightly higher than 3mGy. The scatter dose to the thyroid gland and the lens during mammography has a very small contribution to the annual dose equivalent. CONCLUSION: The mean glandular dose and the scatter dose to the thyroid gland and lens delivered during tomosynthesis and 2D mammography in women with implants were higher than those delivered during other mammographic techniques in women without implants.

Parasitic Infection Patterns in Coleodactylus Meridionalis (Squamata: Sphaerodactylidae) from Atlantic Forest Fragments, Northeast of The Neotropical Region.

Studies that seek to understand which factors influence the patterns of infection in the lizard Coleodactylus meridionalis are non-existent. In this way, we recorded the infection rates for these lizards from three different sized fragments of the Atlantic rainforest and investigated if there is influence of the size, mass and sex of the host regarding the endoparasite abundance. In addition, we investigated if there were possible associations between the host's diet and parasitism, by calculating the diet niche breadth (based on the prey number of pooled stomachs) for each host population and comparing the diet between fragments and sexes (from the three sampled fragments). We collected 38 lizards across the three sampled forest fragments. We only found parasites in the lizards sampled from the smallest of the three forest fragments which included: Physaloptera lutzi, Haplometroides odhneri and Oligacanthorhynchus sp. For this population, lizards with greater length and body mass have a greater endoparasite abundance. In addition, based on the results obtained in our study, the diet of the lizards varies in food composition between sampled populations. Finally, knowing that among the infected lizards there is no sexual dimorphism in relation to size and body mass and that the stomach sampling for this population is insufficient to calculate the indexes related to the food niche; we used the number of prey lizards from all populations, thus we were able to associate the fact that female lizards have a greater endoparasite abundance due to variations in food composition between sexes.

Gastroprotective and cicatrizing activity of the Ziziphus joazeiro Mart. leaf hydroalcoholic extract.

Ziziphus joazeiro Mart., popularly known as 'juazeiro', is a species used in popular medicine for the treatment of bronchitis, gastric ulcers, skin wounds, and in the manufacture of cosmetic and food products. The objective of this study is to evaluate the gastroprotective and cicatrizing activity of the Z. joazeiro Mart. leaf hydroalcoholic extract (EHFZJ). The acute pre-clinical toxicity was determined by the single administration of the EHFZJ (2000 mg/kg/p.o.) and by assessing clinical signs of toxicity, according to established criteria by Malone, or mortality. Gastroprotective activity was identified through classical models of acute gastric lesions induced by indomethacin, absolute and acidified ethanol (100, 200 and 400 mg/kg/per os) and the physical barrier mechanism (400 mg/kg/per os or intraperitoneally). The cicatrizing activity of the EHFZJ was investigated by measuring the speed of wound closure and the percentage of contraction. The acute pre-clinical toxicity of EHFZJ showed no signs of toxicity and mortality. The EHFZJ demonstrated a gastroprotective effect at the 400 mg/kg dose in the classical models of acute gastric injury induced by indomethacin, absolute and acidified ethanol. The EHFZJ administration (orally) demonstrated significant inhibition, suggesting a possible physical barrier mechanism exists. The EHFZJ showed no significant differences in terms of percentage of contraction or the speed of wound closure during the observation times (0, 3, 7, 11 and 14 days). The results obtained in this study provide evidence of a potential gastroprotective activity for the Ziziphus joazeiro Mart. Leaf hydroalcoholic extract.

Description of the Egg and Larva of Raillietiella Mottae (Pentastomida: Raillietiellidae).

In the current study, the structural characteristics of the egg and larva of the pentastomid Raillietiella mottae (Almeida, Freire, & Lopes 2008), are described and compared with those of other pentastomids. The eggs and larvae were obtained from lizards Phyllopezus periosus (Rodrigues 1986) and Phyllopezus pollicaris (Spix 1825) which were collected in the environmental protection area of Cachoeira de Missão Velha, Ceará state, northeastern Brazil (7° 13' S; 39° 08' W). Following collection, the specimens were transported to the Laboratorio de Zoologia (LZ-URCA) and deposited in terrariums to obtain the feces, which were collected and analyzed for the presence of pentastomid eggs. The eggs found were typical of the genus Raillietiella, differing from those of other genera due to the lack of an outer fl exible membrane. The larva had two pairs of limbs, each with a pair of terminal hooks. The limbs were unsegmented, ventrally curved, and supported by conical muscle structures with visible segmentation. The tail was bifurcate, and each section had a terminal bristle. Information on egg and larval morphology can be useful in the identification of genera and species. The current study provides a description of the eggs and embryos of a Pentastomida species from the Neotropical Region.

Raillietiella mottae (Pentastomida: Raillietiellidae) infecting Ameiva ameiva (Squamata: Teiidae) in Araripe Plateau, Northeast Brazil / Raillietiella mottae (Pentastomida: Raillietiellidae) infectando Ameiva ameiva (Squamata: Teiidae) na Chapada do Araripe, Nordeste, Brasil

Abstract We investigated the infection by pulmonary parasites in the lizard Ameiva ameiva (Teiidae) inhabiting the Environmental Protection Area of Araripe (APA-Araripe). A total of 45 specimens were collected in three areas between the cities of Várzea Alegre and Barbalha. A Pentastomid species (Raillietiella mottae) was parasitizing (nine specimens) a male of A. ameiva with a prevalence of 2.22% considering all lizards collected in the region and prevalence of 50% considering only rainforest environment. The Pentastomids infection rates shown in this study are similar to data found for infections of other insectivorous lizards. Raillietiella mottae is considered a generalist parasite, which uses insects as intermediate hosts. The results of this study represent the first record of a Pentastomid infecting this species of lizard in South America.

Resumo Neste estudo investigamos a infecção por parasitas pulmonares no lagarto teiídeo Ameiva ameiva (Teiidae) habitando a Área de Proteção Ambiental do Araripe - APA Araripe. Um total de 45 espécimes foram coletados em três áreas entre os municípios de Várzea Alegre e Barbalha. Uma espécie de pentastomida (Raillietiella mottae) estava parasitando (nove espécimes) um macho de A. ameiva com uma prevalência de 2,22%, considerando todos os lagartos da região, e uma prevalência de 50% considerando apenas a floresta úmida. A taxa de infecção por pentastomídeos demonstrado no presente estudo é semelhante aos dados de infecção encontrados para outros lagartos insetívoros. Raillietiella mottae é considerado um parasita generalista, que usa insetos como hospedeiros intermediários. O resultado do presente estudo representa o primeiro registro de um pentastomídeo infectando lagartos do gênero Ameiva na América do Sul.

Raillietiella mottae (Pentastomida: Raillietiellidae) infecting Ameiva ameiva (Squamata: Teiidae) in Araripe Plateau, Northeast Brazil.

We investigated the infection by pulmonary parasites in the lizard Ameiva ameiva (Teiidae) inhabiting the Environmental Protection Area of Araripe (APA-Araripe). A total of 45 specimens were collected in three areas between the cities of Várzea Alegre and Barbalha. A Pentastomid species (Raillietiella mottae) was parasitizing (nine specimens) a male of A. ameiva with a prevalence of 2.22% considering all lizards collected in the region and prevalence of 50% considering only rainforest environment. The Pentastomids infection rates shown in this study are similar to data found for infections of other insectivorous lizards. Raillietiella mottae is considered a generalist parasite, which uses insects as intermediate hosts. The results of this study represent the first record of a Pentastomid infecting this species of lizard in South America.

Machine learning for medical decision support in a first attendance ambulatory of a tertiary care cardiologic hospital

INTRODUCTION: Cardiovascular disease is an expensive public health problem. Establish the right level of healthcare attention for each patient in a highdemand system is a complex task, and in this scenario, the development of computational methods to support medical decisions has shown to be quite promising. Purpose: Define Machine Learning (ML) algorithms to support medical decisions in a first attendance ambulatory of a tertiary cardiology hospital. METHODS: A prospective observational study was performed in 336 patients (58±13 years and 49.4% male), obtaining clinical and ECG/VCG data. A follow up of 15 months was performed in order to access MACE, PCI, Cardiac Surgery and evidence of Severe Cardiac Disease. From twentyfive initial features, running the ML Kmeans Clustering algorithm, we identify which ones to use and the optimal number of Clusters. Once defined the Clusters the data were labeled, and then the clusters compared with field data (outcomes) and by Kaplan Meyer curves. The labeled data were also run by a Gradient Boosting algorithm in order to define a Predictor for future use in medical decision support. RESULTS: The best result, with welldefined Clusters, was obtained with the combination 5 Clusters and 8 specific Features, and the follow-up data has matched the Cluster classification as shown in the Table. Kaplan Meyer curves corroborated these finding with statistically significant differences between the Clusters: Logrank test (p<0.001). Predictor algorithm, trained by the labeled data, presented an average precision of 95% (CI 95%; 91100%). CONCLUSION: The defined Predictor, using eight simple, quick and easy to get Features (clinical and ECG/VCG), shows excellent performance to classify patients who require tertiary cardiovascular healthcare attention. (AU)

Can Bradyrhizobium strains inoculation reduce water deficit effects on peanuts?

Drought is one of the environmental factors that most affects peanut cultivation in semi-arid regions, resulting in economic losses to growers. However, growth promoting bacteria are able to reduce water deficit damage in some plant species. In this context, this study aimed to evaluate the interaction of Bradyrhizobium strains reducing water stress effects on peanut genotypes by antioxidant enzymes activities, leaf gas exchanges and vegetative growth, as well as to determine the taxonomic positioning of strain ESA 123. The 16S rRNA gene of ESA 123 was amplified by PCR and sequenced by dideoxy Sanger sequencing method. An experiment was performed in greenhouse with three peanut genotypes (BRS Havana, CNPA 76 AM and 2012-4), two Bradyrhizobium strains (SEMIA 6144 and ESA 123), a mineral source of N and an absolute control (without N) under two water regimes (with and without irrigation). Seeds of peanut were sown and the plants were grown until 30 days after emergence. On the 20th day, the water deficit plants group had their irrigation suspended for 10 days. At in silico analyzes, ESA 123 presented 98.97% similarity with the type strain of B. kavangense. Leaf gas exchange was affected by water deficit; as well as alteration of antioxidant activities and reduction of vegetative growth variables. However, some plants inoculated with SEMIA 6144 and ESA 123 strains presented lower reductions and increment of some evaluated variables, mainly the ones inoculated with the ESA 123 strain, Bradyrhizobium sp. from the semi-arid region of Northeast Brazil. This data suggests beneficial effects of the peanut-Bradyrhizobium interaction in a water stress condition, specially with the ESA 123 strain.

Vertebrates as a Bactericidal Agent.

In Brazil, although a large number of animals are used in traditional medicine (at least 354 species), information about their biological activities is scarce. In this context, the objective of this study was to evaluate the bactericidal potential of zootherapeutic by-products from animals used in Brazilian traditional medicine and discuss the ecological and cultural consequences of such practices. The species analyzed were: Tupinambis merianae (skin), Iguana iguana (skin and body fat), Crotalus durissus (skin and body fat), Boa constrictor (skin), Euphractus sexcinctus (body fat) and Coendou prehensilis (quills). Experiments were performed with standard clinical strains of Escherichia coli (EC-ATCC10536) and Staphylococcus aureus (SA-ATCC 25923). For the microbiological assay, the zootherapeutics were evaluated using serial microdilutions. The results indicate that none of the samples possess inhibitory activity against standard bacterial strains. The in vitro ineffectiveness of the analyzed products demonstrate a necessity for new pharmacological research that encompass a large number of species of medicinal animals as well as highlight the importance of zootherapy in the context of plans for animal conservation.

Raillietiella Mottae (Pentastomida: Raillietiellidae) Parasitizing Four Species of Gekkota Lizards (Gekkonidae and Phyllodactylidae) in the Brazilian Caatinga.

We tested the role of sex, size, and mass of the lizards Phyllopezus pollicaris, Gymnodactylus geckoides, Hemidactylus agrius, Lygodactylus klugei, and Hemidactylus brasilianus on the rates of pentastomid infection in the Brazilian Caatinga. We collected 355 individuals of these five species, of which four (prevalence of infection: P. pollicaris 15.9 %, G. geckoides 1.4 %, H. agrius 28.57 %, and H. brasilianus 4.16 %) were infected by Raillietiella mottae. Parasite abundance was influenced by host body size and mass only in P. pollicaris. Host sex did not infl uence the abundance of parasites in any species. Hemidactylus agrius, G. geckoides, and H. brasilianus are three new host records for pentastomids.