Amylovis-201 enhances physiological memory formation and rescues memory and hippocampal cell loss in a streptozotocin-induced Alzheimer's disease animal model.

Alzheimer's disease is the most common neurodegenerative disease, and its treatment is lacking. In this work, we tested Amylovis-201, a naphthalene-derived compound, as a possible therapeutic candidate for the treatment of AD. For this purpose, we performed three experiments. In the first and third experiment, animals received a bilateral administration of streptozotocin and, starting 24 h after injection, a daily dose of Amylovis-201 (orally), for 17 days or for the whole time of the experiment respectively (28 days), after which learning and memory, as well as the number of hippocampal dentate gyrus cells, were assessed. In the second experiment, healthy animals received a single dose of Amylovis-201, 10 min or 5 h after the learning section to assess whether this substance could promote specific mechanisms involved in memory trace formation. Our data show that, administration of a single dose of Amylovis-201, 10 min after the end of training, but not at 5 h, produces a prolongation in memory duration, probably because it modulates specific mechanisms involved in memory trace consolidation. Furthermore, daily administration of Amylovis-201 to animals with bilateral intracerebroventricular injection of STZ produces a reduction in the loss of the hippocampus dentate gyrus cells and an improvement in spatial memory, probably because Amylovis-201 can interact with some of the protein kinases of the insulin signaling cascade, also involved in neural plasticity, and thereby halt or reverse some of the effects of STZ. Taking to account these results, Amylovis-201 is a good candidate for the therapeutic treatment of AD.

Ultrasonography use for tongue cancer management: A scoping review.

BACKGROUND: Tongue cancer is associated with debilitating diseases and poor prognostic outcomes. The use of imaging techniques like ultrasonography to assist in the clinical management of affected patients is desirable, but its reliability remains debatable. Therefore, the aim of this study is to investigate the importance of ultrasound use for the clinicopathological management of tongue cancer. METHODS: A scoping review was carried out using specific search strategies in the following electronic databases: PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar. Collected data included bibliographical information, study design, ultrasound equipment, the aim of the ultrasonography use, the timing of ultrasound use during oncological treatment (pre-, trans-, and/or post-operatively), and the advantages and disadvantages of the use of the ultrasound. RESULTS: A total of 47 studies were included in this review after following the selection process. The majority of the studies investigated the use of ultrasound pre-operatively for the investigation of lymph node metastases or to determine the tumor thickness and depth of invasion. The sensitivity, specificity, and accuracy of ultrasound to determine clinical lymph node metastases ranged from 47% to 87.2%, from 84.3% to 95.8%, and from 70% to 86.2%, respectively. The sensitivity and specificity to determine the microscopic depth of invasion were 92.3% and from 70.6% to 82.1%, respectively. CONCLUSION: Ultrasonography seems to be a reliable imaging technique for the investigation of important prognostic parameters for tongue cancer, including depth of invasion and lymph node metastases.

Acolhimento da mulher migrante venezuelana na atenção básica: um ensaio teórico-reflexivo / Embracement of venezuelan migrant women in primary care: a theoretical-reflective essay / Acogida a la mujer migrante venezolana en la atención primaria: un ensayo teórico-reflexivo

Este ensaio emerge a partir de uma aposta científica que se propõe a produzir reflexões teorizadas sobre as práticas assistenciais de acolhimento produzidas pelos profissionais da saúde com mulheres migrantes venezuelanas na Atenção Básica. É um ensaio teórico-reflexivo. Salienta-se que, neste tipo de estudo, a produção de reflexões corre pela compreensão de um dado objeto sem que nele haja um sistema de compreensão rígido. As reflexões foram agrupadas em um núcleo teórico-reflexivo, intitulado: fundamentos para pensar o acolhimento à mulher migrante venezuelana na Atenção Básica. Nele, são encontrados conceitos e reflexões a respeito da Atenção Básica, migração, processos migratórios envolvendo mulheres venezuelanas e estratégias de acolhimento às suas necessidades em Unidades Básicas de Saúde. As (in)conclusões reflexivas para intensificar investigações perpassam por leituras do cotidiano no trabalho em saúde. Nesse sentido, é fundamental observar três rotas conceituais e reflexivas que fundamentalmente são necessárias para cuidar das migrantes venezuelanas de forma acolhedora na Atenção Básica ­ a saber: escuta qualificada, vínculo e clínica ampliada do sujeito ­ como forma de promover uma assistência alinhada aos princípios e diretrizes da política nacional de humanização.

This essay emerges from a scientific proposal to reflect on embracement care practices aimed at Venezuelan immigrant women in primary care. As a theoretical-reflective essay, the reflections produced on a given object disregard any rigid understanding system. Concepts and reflections on primary care, migration, migratory processes involving Venezuelan women, and embracement strategies were grouped into a theoretical-reflective nucleus entitled "foundations for discussing the embracement of Venezuelan immigrant women in primary care." Reflective (in)conclusions used to intensify investigations involve readings of everyday healthcare work. In this regard, three conceptual and reflective routes are essential to embrace Venezuelan immigrant women in in primary care­qualified listening, bond, and expanded clinical approach­to promote care aligned with the principles and guidelines of the national humanization policy.

Este ensayo propone producir reflexiones teorizadas sobre las prácticas asistenciales de acogida de los profesionales de la salud a las mujeres migrantes venezolanas en la atención primaria. Se trata de un ensayo teórico-reflexivo. En este tipo de estudio se destaca que la producción de reflexiones parte de la comprensión de un objeto dado sin que haya un sistema de comprensión rígido. Las reflexiones se agruparon en un núcleo teórico-reflexivo, titulado fundamentos para pensar en la acogida a la mujer migrante venezolana en la atención primaria. Se encuentran conceptos y reflexiones en torno a la atención primaria, migración, procesos migratorios que involucran a mujeres venezolanas y estrategias para acoger sus necesidades en unidades básicas de salud. Las (in)conclusiones reflexivas para intensificar las investigaciones pasan por lecturas de lo cotidiano en el trabajo en salud. En este sentido, es fundamental observar tres rutas conceptuales y reflexivas que fundamentalmente son necesarias para cuidar a la mujer migrante venezolana de forma acogedora en la atención primaria: escucha calificada, vínculo y clínica ampliada del sujeto; como forma de promover una asistencia alineada con los principios y directrices de la política nacional de humanización.

Dificuldades com amamentação e sua relação com a prática alimentar na alta hospitalar / Breastfeeding difficulties and their relationship with eating habits at hospital discharge / Dificultades con la lactancia y su relación con la práctica alimentaria en el alta hospitalaria

Objetivo: descrever as frequências das dificuldades com aleitamento materno durante a internação em alojamento conjunto e sua relação com a prática alimentar na alta hospitalar. Método: estudo transversal conduzido a partir de dados de uma coorte, realizada entre março de 2017 e abril de 2018, mediante entrevistas face a face e coleta de dados de prontuários hospitalares de um hospital de referência nacional para alto risco fetal e infantil. Utilizou-se a estatística descritiva por meio de frequências absolutas, relativas e teste qui-quadrado em todas as análises. Resultados: de 686 mães e seus recém-nascidos, 50,6% das mulheres apresentaram dificuldades com aleitamento materno, com destaque para: pega, sucção, tipo de mamilo, trauma mamilar. Dentre os recém-nascidos que receberam aleitamento materno exclusivo na alta hospitalar, 51,3% não apresentaram dificuldades com amamentação durante a internação. Conclusão: apesar da dificuldade apresentada em metade da amostra estudada, ressalta-se a necessidade do suporte precoce ao aleitamento materno exclusivo ainda no ambiente hospitalar.

Objective: to describe the frequencies of breastfeeding difficulties during hospitalization in rooming-in and their relationship with eating habits at hospital discharge. Method: cross-sectional study conducted from data from a cohort, carried out between March 2017 and April 2018, through face-to-face interviews and data collection from hospital records of a national reference hospital for high fetal and infant risk. Descriptive statistics were used through absolute and relative frequencies and the chi-square test in all analyses. Results: of 686 mothers and their newborns, 50.6% of the women had difficulties with breastfeeding, with emphasis on: attachment, suction, type of nipple, nipple trauma. Among newborns who were exclusively breastfed at hospital discharge, 51.3% had no breastfeeding difficulties during hospitalization. Conclusion: despite the difficulty presented by half of the studied sample, the need for early support for exclusive breastfeeding is highlighted, even in the hospital environment.

Objetivo: describir las frecuencias de dificultades para amamantar durante la hospitalización en alojamiento conjunto y su relación con los hábitos alimentarios al alta hospitalaria. Método: estudio transversal realizado a partir de datos de una cohorte, realizada entre marzo de 2017 y abril de 2018, a través de entrevistas cara a cara y recolección de datos de registros hospitalarios de un hospital de referencia nacional de alto riesgo fetal e infantil. Se utilizó estadística descriptiva a través de frecuencias absolutas y relativas y la prueba de chi-cuadrado en todos los análisis. Resultados: de 686 madres y sus recién nacidos, el 50,6% de las mujeres presentaron dificultades para amamantar, con énfasis en: agarre, succión, tipo de pezón, traumatismo en el pezón. Entre los recién nacidos que recibieron lactancia materna exclusiva al alta hospitalaria, el 51,3% no tuvo dificultades para amamantar durante la hospitalización. Conclusión: a pesar de la dificultad presentada por la mitad de la muestra estudiada, se destaca la necesidad de apoyo temprano para la lactancia materna exclusiva, incluso en el ámbito hospitalario.

Design and application of a paper-based optoelectronic nose for the on-site discrimination of essential oils using a chemometric web app.

Essential oils are appreciated worldwide for their pleasant aroma, in addition to their therapeutic, pharmacological, and cosmetic functions. For these reasons, adulteration is a common practice that decreases product quality causing economic and health issues. In this study, we present for the first time the application of a simple, inexpensive and disposable paper-based optoelectronic nose (i.e. colorimetric sensor array) to (i) discriminate sixteen different types of essential oils and (ii) detect adulterated samples. The colorimetric array was prepared by adding 1.5 µL of 9 chemo-responsive dyes with different chemical properties to each circular spot of the paper-based device. 1 mL of each essential oil was transferred to a flask and bubbled with synthetic air at an airflow of 200 mL min-1. Then, the optoelectronic nose was exposed to the airstream containing the volatiles from the sample for 5 minutes. Digital images from before and after exposure were obtained using a smartphone and the RGB values were extracted using appropriate software. The color changes provided a unique color map fingerprint for each essential oil. Hierarchical clustering analysis (HCA) and principal component analysis (PCA) were successfully employed using a customized smartphone app, showing suitable discrimination of all studied essential oils as well as among adulterated and non-adulterated samples. The proof-of-concept showed the potential of the optoelectronic nose approach for the discrimination of different essential oils and the identification of adulterated samples, providing a valuable tool for quality control procedures.

Risk factors related to preventable infant mortality in Espirito Santo, Brazil.

Objective: To analyse the factors associated with preventable of infant mortality, in Espirito Santo, Brazil. Methods: Data were collected from records of notifiable of infant death of the Mortality Information System. A total of 5,089 infant deaths were classified as preventable and non-preventable according to the International Collaborative Effort on Infant Mortality (ICE) and the State System of Data Analysis Foundation (SEADE) methods. To investigate the factors associated with preventable of deaths, it was applied the logistic regression. Results: Approximately, 73% of the deaths were preventable according to the ICE, while 76% were preventable according to the SEADE method. Using to both methods, it was observed that preterm birth, postneonatal death and birth weight between 3000 and above 4,000 g represented higher chances for preventable infant deaths. Furthermore, the medical care was more likely to preventable infant death only for ICE method. Conclusions: The factors related to the quality of care offered in the prenatal, prepartum and childbirth periods were more relevant for the occurrence of preventable infant death. Accordingly, it is recommended to strengthen mother-child care to detect risk pregnancies during prenatal care, as well as a hierarchical, regionalized and integrated perinatal network.

Digital transformation towards sustainability in higher education: state-of-the-art and future research insights.

The technological revolution has contributed to environmental and social issues around the world. However, in the context of higher education institutions (HEIs) - key stakeholders for sustainable development - there is a theoretical gap regarding systematic reviews on the topic. In order to address this need, this study explores how digital transformation (DT) can contribute to sustainability in HEIs by identifying the general state of the art, the theoretical perspectives in the field, and future research insights. A multi-methods approach was adopted, which consisted of a quantitative bibliometric review and a qualitative content analysis. Consistent with this approach, the Scopus database was used for the bibliometric analysis of 672 publications, which was conducted with the support of VOSviewer software. Subsequently, a content analysis of 72 publications was carried out using the software ATLAS.ti and Zotero. The findings suggest three areas of current research: ensuring sustainability competencies through DT, smart and sustainable campus approaches, and theorisation of sustainability in higher education through DT. The theoretical perspectives of the field were divided and discussed into seven main clusters. Lastly, five research lines for further studies on DT towards sustainability were identified. This study has both theoretical and practical implications since it may be the first literature review on this subject, providing theoretical insights to the academic community, guiding sustainability and digital practices in HEIs - through the identification of tools, approaches, and strategies - and then supporting the implementation of the United Nations Sustainable Development Goals.

Malária: A crise silenciosa em Alto Alegre, Roraima e o fantasma do garimpo na Terra Indígena Yanomami / Malaria: The Silent Crisis in Alto Alegre, Roraima and the Specter of Mining in the Yanomami Indigenous Land / Malaria: La crisissilenciosa en Alto Alegre, Roraima y el fantasma de la minería en la Tierra Indígena Yanomami

Objetivo:analisar a evolução dos casos de malária em Roraima, principalmente no município de Alto Alegre, estratificado por aglomerações por área geográfica habitada -rural, urbana e área indígena no período de 2013 a 2022. Método:Estudo ecológico do tipo série temporal baseado em dados secundários dos casos confirmados de malária em Roraima, no período de 2013 a 2022. Resultados:nesse período foram confirmados 72.828 casos de malária em Roraima, dos quais 78,0% foram por Plasmodium vivax. Além disso, a maior parte dos casos se concentrou no município de Alto Alegre, correspondendo a 41,1%. Portanto, este foi o município que mais produziu malária procedente de garimpo, apesar de existirem outros que registraram aumento da doença nesse período. Conclusão:assim, osmunicípios de Alto Alegre, Amajari, Caracaraí, Iracema e Mucajaí, juntos respondem por 77.8% de toda malária produzida em Roraima. Estes municípios fazem parte da rota do garimpo ilegal na terra indígena Yanomami.

Objective: analyze the evolution of malaria cases in Roraima, especially in the municipality of Alto Alegre, stratified by geographical areas of habitation -rural, urban, and indigenous areas, from 2013 to 2022. Method: A time series ecological study based on secondary data of confirmed malaria cases in Roraima from 2013 to 2022. Results:During this period, 72,828 cases of malaria were confirmed in Roraima, of which 78.0% were due to Plasmodium vivax. Furthermore, the majority of cases were concentrated in the municipality of Alto Alegre, accounting for 41.1%. Therefore, this was the municipality that produced the most malariafrom mining activities, despite others experiencing an increase in the disease during this period. Conclusion: Thus, the municipalities of Alto Alegre, Amajari, Caracaraí, Iracema, and Mucajaí together accounted for 77.8% of all malaria cases produced in Roraima. These municipalities are part of the illegal mining route within the Yanomami indigenous land.

Objetivo: analizar la evolución de los casos de malaria en Roraima, principalmente en el municipio de Alto Alegre, marcado por aglomeraciones por área geográfica habitada -rural, urbana, en el área indígena en el período comprendido desde 2013 hasta 2022. Método: Estudio ecológico de tipo serie temporal basado en datos secundarios de los casos confirmados de malaria en Roraima, en el periodo de 2013 hasta 2022. Resultados: Durante este periodo fueron confirmados 72.828 casos de malaria en Roraima, de los cuales 78,0% correspondieron a Plasmodium Vivax. Además, la mayor parte de los casos estaban concentrados en el municipio de Alto Alegre, correspondiendo a 41,1%. Por lo tanto, este fue el condado que más produjo malaria proveniente de la minería, a pesar de existir otros que registraron aumentos de la enfermedad durante este periodo. Conclusión: Siendo así, los condados de Alto Alegre, Amajari, Caracaraí, Iracema y Mucajaí, juntos representan el 77.8% de toda la malaria existente en Roraima. Estos condados hacen parte de la ruta de minería ilegal en tierras indígenas Yanomam.

Novel time-domain NMR-based traits for rapid, label-free Olive oils profiling.

Olive oil is one of the oldest and essential edible oils in the market. The classification of olive oils (e.g. extra virgin, virgin, refined) is often influenced by factors ranging from its complex inherent physiochemical properties (e.g. fatty acid profiles) to the undisclosed manufacturing processes. Therefore, olive oils have been the target of adulteration due to its profitable margin. In this work, we demonstrate that multi-parametric time-domain NMR relaxometry can be used to rapidly (in minutes) identify and classify olive oils in label-free and non-destructive manner. The subtle differences in molecular microenvironment of the olive oils induce substantial changes in the relaxation mechanism in the time-domain NMR regime. We demonstrated that the proposed NMR-relaxation based detection (AUC = 0.95) is far more sensitive and specific than the current gold-standards in the field i.e. near-infrared spectroscopy (AUC = 0.84) and Ultraviolet-visible spectroscopy (AUC = 0.73), respectively. We further show that, albeit the inherent complexity of olive plant natural phenotypic variations, the proposed NMR-relaxation based traits may be a viable mean (AUC = 0.71) in tracing the regions of origin for olive trees, in agreement with their geographical orientation.

Variations in cesarean and repeated cesarean section rates in Brazil according to gestational age at birth and type of hospital. / Variações das taxas de cesariana e cesariana recorrente no Brasil segundo idade gestacional ao nascer e tipo de hospital.

This study aimed to describe cesarean and repeated cesarean section rates in Brazil according to gestational age (GA) at birth and type of hospital. This is an ecologic study using data from the Brazilian Information System on Live Births and the 2017 National Registry of Health Facilities. Overall and repeated cesarean section rates were calculated and analyzed according to GA, region of residence, and type of hospital. Spearman correlations were performed between cesarean and repeated cesarean section rates by GA subgroups at birth (≤ 33, 34-36, 37-38, 39-41, and ≥ 42 weeks) and analyzed according to the type of hospital. Overall and repeated cesarean section rates were 55.1% and 85.3%, respectively. More than 60% of newborns between 37-38 weeks were delivered via cesarean section. Private hospitals in all regions showed the highest cesarean section rates, especially those in the Central-West Region, with more than 80% at all GAs. The overall cesarean section rate was highly correlated with all cesarean section rates of GA subgroups (r > 0.7, p < 0.01). Regarding repeated cesarean sections, the overall rate was strongly correlated with the rates of 37-38 and 39-41 weeks in public/mixed hospitals, differing from private hospitals, which showed moderate correlations. This finding indicates the decision for cesarean section is not based on clinical factors, which can cause unnecessary damage to the health of both the mother and the baby. Then, changes in the delivery care model, strengthening public policies, and encouragement of vaginal delivery after a cesarean section in subsequent pregnancies are important strategies to reduce cesarean section rates in Brazil.

O objetivo deste estudo foi descrever as taxas de cesariana e cesariana recorrente no Brasil segundo a idade gestacional (IG) ao nascer e o tipo de hospital. Trata-se de um estudo ecológico, utilizando dados do Sistema de Informação sobre Nascidos Vivos e do Cadastro Nacional de Estabelecimentos de Saúde de 2017. As taxas de cesariana geral e recorrente foram calculadas e analisadas de acordo com a IG, região de residência e tipo de hospital. Foram realizadas correlações de Spearman entre as taxas de cesariana e cesariana recorrente por subgrupos de IG ao nascer (≤ 33, 34-36, 37-38, 39-41 e ≥ 42 semanas), analisadas segundo o tipo de hospital. Verificaram-se taxas de cesariana geral e recorrente de 55,1% e 85,3%, respectivamente. Mais de 60% dos recém-nascidos entre 37-38 semanas ocorreram via cesariana. Os hospitais privados de todas as regiões concentraram as maiores taxas de cesariana, sobretudo os do Centro-oeste, com mais de 80% em todas as IG. A taxa geral de cesariana foi altamente correlacionada com todas as taxas de cesariana dos subgrupos de IG (r > 0,7, p < 0,01). Quanto à cesariana recorrente, verificou-se forte correlação com as taxas de 37-38 e 39-41 semanas no hospital público/misto, diferindo do hospital privado, que apresentou correlações moderadas. Isso indica que a decisão pela cesariana não é pautada em fatores clínicos, o que pode causar danos desnecessários à saúde da mulher e do bebê. Conclui-se que mudanças no modelo de atenção ao parto, fortalecimento de políticas públicas e maior incentivo do parto vaginal após cesárea em gestações subsequentes são estratégias importantes para a redução das cesarianas no Brasil.

El objetivo de este estudio fue describir las tasas de cesárea y de cesárea recurrente en Brasil según la edad gestacional (EG) al nacer y el tipo de hospital. Estudio ecológico a partir de los datos del Sistema de Información de Nacidos Vivos y del Registro Nacional de Establecimientos de Salud 2017. Se calcularon y analizaron las tasas de cesárea general y recurrente según EG, región de residencia y tipo de hospital. Se aplicaron las correlaciones de Spearman entre las tasas de cesárea y de cesárea recurrente por subgrupos de EG al nacer (≤ 33, 34-36, 37-38, 39-41 y ≥ 42 semanas) y se analizaron según el tipo de hospital. Las tasas de cesárea general y recurrente fueron del 55,1% y 85,3%, respectivamente. Más del 60% de los recién nacidos entre 37-38 semanas nacieron por cesárea. Los hospitales privados de todas las regiones concentraron las tasas más altas de cesáreas, especialmente los del Centro-Oeste, con más del 80% en todas las EG. En general, la tasa general de cesáreas estuvo altamente correlacionada con todas las tasas de cesáreas de los subgrupos de EG (r > 0,7, p < 0,01). En cuanto a la cesárea recurrente, se encontró que la tasa general se correlacionó fuertemente con las tasas de 37-38 y 39-41 semanas en el hospital público/mixto, a diferencia del hospital privado que mostró correlaciones moderadas. Esto indica que la decisión de hacer la cesárea no se basa en factores clínicos, lo que puede causar daños innecesarios a la salud de la mujer y del bebé. Por lo tanto, los cambios en el modelo de asistencia al parto, el fortalecimiento de las políticas públicas y una mayor promoción del parto vaginal en los embarazos posteriores de la cesárea se encuentran entre las estrategias importantes para reducir esta práctica en Brasil.

Decoding the Role of Melatonin Structure on Plasmodium falciparum Human Malaria Parasites Synchronization Using 2-Sulfenylindoles Derivatives.

Melatonin acts to synchronize the parasite's intraerythrocytic cycle by triggering the phospholipase C-inositol 1,4,5-trisphosphate (PLC-IP3) signaling cascade. Compounds with an indole scaffold impair in vitro proliferation of blood-stage malaria parasites, indicating that this class of compounds is potentially emerging antiplasmodial drugs. Therefore, we aimed to study the role of the alkyl and aryl thiol moieties of 14 synthetic indole compounds against chloroquine-sensitive (3D7) and chloroquine-resistant (Dd2) strains of Plasmodium falciparum. Four compounds (3, 26, 18, 21) inhibited the growth of P. falciparum (3D7) by 50% at concentrations below 20 µM. A set of 2-sulfenylindoles also showed activity against Dd2 parasites. Our data suggest that Dd2 parasites are more susceptible to compounds 20 and 28 than 3D7 parasites. These data show that 2-sulfenylindoles are promising antimalarials against chloroquine-resistant parasite strains. We also evaluated the effects of the 14 compounds on the parasitemia of the 3D7 strain and their ability to interfere with the effect of 100 nM melatonin on the parasitemia of the 3D7 strain. Our results showed that compounds 3, 7, 8, 10, 14, 16, 17, and 20 slightly increased the effect of melatonin by increasing parasitemia by 8-20% compared with that of melatonin-only-treated 3D7 parasites. Moreover, we found that melatonin modulates the expression of kinase-related signaling components giving additional evidence to investigate inhibitors that can block melatonin signaling.

Recurrent preterm birth: data from the study "Birth in Brazil".

OBJECTIVE: Describe and estimate the rate of recurrent preterm birth in Brazil according to the type of delivery, weighted by associated factors. METHODS: We obtained data from the national hospital-based study "Birth in Brazil", conducted in 2011 and 2012, from interviews with 23,894 women. Initially, we used the chi-square test to verify the differences between newborns according to previous prematurity and type of recurrent prematurity. Sequentially, we applied the propensity score method to balance the groups according to the following covariates: maternal age, socio-economic status, smoking during pregnancy, parity, previous cesarean section, previous stillbirth or neonatal death, chronic hypertension and chronic diabetes. Finally, we performed multiple logistic regression to estimate the recorrence. RESULTS: We analyzed 6,701 newborns. The rate of recurrence was 42.0%, considering all women with previous prematurity. Among the recurrent premature births, 62.2% were spontaneous and 37.8% were provider-initiated. After weighting by propensity score, we found that women with prematurity have 3.89 times the chance of having spontaneous recurrent preterm birth (ORaj = 3.89; 95%CI 3.01-5.03) and 3.47 times the chance of having provider-initiated recurrent preterm birth (ORaj = 3.47; 95%CI 2.59-4.66), compared to women who had full-term newborns. CONCLUSIONS: Previous prematurity showed to be a strong predictor for its recurrence. Thus, expanding and improving the monitoring and management of pregnant women who had occurrence of prematurity strongly influence the reduction of rates and, consequently, the reduction of infant morbidity and mortality risks in the country.

A population-based study of the relationship between advanced maternal age and premature/early-term birth in Brazil.

OBJECTIVE: To verify whether advanced maternal age (AMA), defined as women of ≥35 years, is associated with premature and early-term birth in Brazil, according to the onset of labor (spontaneous or provider-initiated). METHODS: Cross-sectional population-based study. The "Birth in Brazil" study interviewed 23 894 puerperal women between 2011 and 2012, in all regions of Brazil. The current analysis included 17 994 adult mothers and their newborns (15 448 aged between 20-34 years, and 2536 ≥ 35 years). A propensity score was used to assess the likelihood of AMA women giving birth to premature or early-term infants (spontaneous or provider-initiated) compared to women aged 20-34 years. To balance the groups, we used maternal, prenatal, and childbirth characteristics. RESULTS: The general prematurity rate was 10.24%, of which the majority of births were spontaneous (55.73%). Conversely, early-term births were more often provider-initiated (54.81%). AMA did not increase the chance of premature births, whether spontaneous or provider-initiated. However, AMA was associated with a higher rate of provider-initiated early-term birth (OR = 1.48; 95% CI: 1.23-1.77). CONCLUSION: AMA alone does not contribute to premature birth; AMA's independent association with provider-initiated early-term birth may not be based solely on clinical indications.

Variações das taxas de cesariana e cesariana recorrente no Brasil segundo idade gestacional ao nascer e tipo de hospital / Variaciones en las tasas de cesárea y de cesárea recurrente en Brasil según la edad gestacional al nacer y el tipo de hospital / Variations in cesarean and repeated cesarean section rates in Brazil according to gestational age at birth and type of hospital

O objetivo deste estudo foi descrever as taxas de cesariana e cesariana recorrente no Brasil segundo a idade gestacional (IG) ao nascer e o tipo de hospital. Trata-se de um estudo ecológico, utilizando dados do Sistema de Informação sobre Nascidos Vivos e do Cadastro Nacional de Estabelecimentos de Saúde de 2017. As taxas de cesariana geral e recorrente foram calculadas e analisadas de acordo com a IG, região de residência e tipo de hospital. Foram realizadas correlações de Spearman entre as taxas de cesariana e cesariana recorrente por subgrupos de IG ao nascer (≤ 33, 34-36, 37-38, 39-41 e ≥ 42 semanas), analisadas segundo o tipo de hospital. Verificaram-se taxas de cesariana geral e recorrente de 55,1% e 85,3%, respectivamente. Mais de 60% dos recém-nascidos entre 37-38 semanas ocorreram via cesariana. Os hospitais privados de todas as regiões concentraram as maiores taxas de cesariana, sobretudo os do Centro-oeste, com mais de 80% em todas as IG. A taxa geral de cesariana foi altamente correlacionada com todas as taxas de cesariana dos subgrupos de IG (r > 0,7, p < 0,01). Quanto à cesariana recorrente, verificou-se forte correlação com as taxas de 37-38 e 39-41 semanas no hospital público/misto, diferindo do hospital privado, que apresentou correlações moderadas. Isso indica que a decisão pela cesariana não é pautada em fatores clínicos, o que pode causar danos desnecessários à saúde da mulher e do bebê. Conclui-se que mudanças no modelo de atenção ao parto, fortalecimento de políticas públicas e maior incentivo do parto vaginal após cesárea em gestações subsequentes são estratégias importantes para a redução das cesarianas no Brasil.

El objetivo de este estudio fue describir las tasas de cesárea y de cesárea recurrente en Brasil según la edad gestacional (EG) al nacer y el tipo de hospital. Estudio ecológico a partir de los datos del Sistema de Información de Nacidos Vivos y del Registro Nacional de Establecimientos de Salud 2017. Se calcularon y analizaron las tasas de cesárea general y recurrente según EG, región de residencia y tipo de hospital. Se aplicaron las correlaciones de Spearman entre las tasas de cesárea y de cesárea recurrente por subgrupos de EG al nacer (≤ 33, 34-36, 37-38, 39-41 y ≥ 42 semanas) y se analizaron según el tipo de hospital. Las tasas de cesárea general y recurrente fueron del 55,1% y 85,3%, respectivamente. Más del 60% de los recién nacidos entre 37-38 semanas nacieron por cesárea. Los hospitales privados de todas las regiones concentraron las tasas más altas de cesáreas, especialmente los del Centro-Oeste, con más del 80% en todas las EG. En general, la tasa general de cesáreas estuvo altamente correlacionada con todas las tasas de cesáreas de los subgrupos de EG (r > 0,7, p < 0,01). En cuanto a la cesárea recurrente, se encontró que la tasa general se correlacionó fuertemente con las tasas de 37-38 y 39-41 semanas en el hospital público/mixto, a diferencia del hospital privado que mostró correlaciones moderadas. Esto indica que la decisión de hacer la cesárea no se basa en factores clínicos, lo que puede causar daños innecesarios a la salud de la mujer y del bebé. Por lo tanto, los cambios en el modelo de asistencia al parto, el fortalecimiento de las políticas públicas y una mayor promoción del parto vaginal en los embarazos posteriores de la cesárea se encuentran entre las estrategias importantes para reducir esta práctica en Brasil.

This study aimed to describe cesarean and repeated cesarean section rates in Brazil according to gestational age (GA) at birth and type of hospital. This is an ecologic study using data from the Brazilian Information System on Live Births and the 2017 National Registry of Health Facilities. Overall and repeated cesarean section rates were calculated and analyzed according to GA, region of residence, and type of hospital. Spearman correlations were performed between cesarean and repeated cesarean section rates by GA subgroups at birth (≤ 33, 34-36, 37-38, 39-41, and ≥ 42 weeks) and analyzed according to the type of hospital. Overall and repeated cesarean section rates were 55.1% and 85.3%, respectively. More than 60% of newborns between 37-38 weeks were delivered via cesarean section. Private hospitals in all regions showed the highest cesarean section rates, especially those in the Central-West Region, with more than 80% at all GAs. The overall cesarean section rate was highly correlated with all cesarean section rates of GA subgroups (r > 0.7, p < 0.01). Regarding repeated cesarean sections, the overall rate was strongly correlated with the rates of 37-38 and 39-41 weeks in public/mixed hospitals, differing from private hospitals, which showed moderate correlations. This finding indicates the decision for cesarean section is not based on clinical factors, which can cause unnecessary damage to the health of both the mother and the baby. Then, changes in the delivery care model, strengthening public policies, and encouragement of vaginal delivery after a cesarean section in subsequent pregnancies are important strategies to reduce cesarean section rates in Brazil.

Recurrent preterm birth: data from the study "Birth in Brazil" / Prematuridade recorrente: dados do estudo "Nascer no Brasil"

ABSTRACT OBJECTIVE Describe and estimate the rate of recurrent preterm birth in Brazil according to the type of delivery, weighted by associated factors. METHODS We obtained data from the national hospital-based study "Birth in Brazil", conducted in 2011 and 2012, from interviews with 23,894 women. Initially, we used the chi-square test to verify the differences between newborns according to previous prematurity and type of recurrent prematurity. Sequentially, we applied the propensity score method to balance the groups according to the following covariates: maternal age, socio-economic status, smoking during pregnancy, parity, previous cesarean section, previous stillbirth or neonatal death, chronic hypertension and chronic diabetes. Finally, we performed multiple logistic regression to estimate the recorrence. RESULTS We analyzed 6,701 newborns. The rate of recurrence was 42.0%, considering all women with previous prematurity. Among the recurrent premature births, 62.2% were spontaneous and 37.8% were provider-initiated. After weighting by propensity score, we found that women with prematurity have 3.89 times the chance of having spontaneous recurrent preterm birth (ORaj = 3.89; 95%CI 3.01-5.03) and 3.47 times the chance of having provider-initiated recurrent preterm birth (ORaj = 3.47; 95%CI 2.59-4.66), compared to women who had full-term newborns. CONCLUSIONS Previous prematurity showed to be a strong predictor for its recurrence. Thus, expanding and improving the monitoring and management of pregnant women who had occurrence of prematurity strongly influence the reduction of rates and, consequently, the reduction of infant morbidity and mortality risks in the country.

RESUMO OBJETIVO Descrever e estimar a taxa de prematuridade recorrente no Brasil segundo o tipo de parto, ponderado pelos fatores associados. MÉTODOS Os dados foram obtidos do estudo nacional de base hospitalar "Nascer no Brasil", realizado em 2011 e 2012, a partir de entrevistas com 23.894 mulheres. Inicialmente foi utilizado o teste qui-quadrado para verificar as diferenças entre os recém-nascidos, segundo a prematuridade prévia e o tipo de prematuridade recorrente. Sequencialmente, aplicou-se o método de ponderação pelo escore de propensão para equilibrar os grupos de acordo com as seguintes covariáveis: idade materna, classificação socioeconômica, tabagismo durante a gravidez, paridade, cesárea anterior, natimorto ou óbito neonatal anterior, hipertensão crônica e diabetes crônica. Por último, foi realizada regressão logística múltipla para estimar a prematuridade recorrente. RESULTADOS Foram analisados 6.701 recém-nascidos. A taxa de prematuridade recorrente foi de 42,0%, considerando todas as mulheres com prematuridade prévia. Dentre os prematuros recorrentes, 62,2% foram espontâneos e 37,8% ocorreram por intervenção-obstétrica. Após a ponderação pelo escore de propensão, verificou-se que mulheres com prematuridade prévia têm 3,89 vezes a chance de terem prematuridade recorrente espontânea (ORaj = 3,89; IC95% 3,01-5,03) e 3,47 vezes a chance de terem prematuridade recorrente por intervenção obstétrica (ORaj = 3,47; IC95% 2,59-4,66), em comparação às mulheres que tiveram recém-nascidos termo completo. CONCLUSÕES A prematuridade prévia revelou-se um forte preditor para sua recorrência. Assim, ampliar e melhorar o monitoramento e manejo de gestantes com história de prematuridade impacta fortemente na redução das taxas e, consequentemente, na redução dos riscos de morbimortalidade infantil no país.

Malaria parasites and circadian rhythm: New insights into an old puzzle.

•Discuss molecular components for the coordination of circadian rhythm of malaria parasites inside the vertebrate host.•Synthetic indole compounds show antimalarial activity in vitro against P.falciparum 3D7.•Plasmodium falciparum synchronizes in cell culture upon melatonin treatment.

µOPTO: A microfluidic paper-based optoelectronic tongue as presumptive tests for the discrimination of alkaloid drugs for forensic purposes.

Natural and synthetic alkaloids are widely used for several applications, ranging from clinical purposes to criminal activities. Presumptive color tests are considered a leading tool to reveal on-scene substance identification via rapid chemical reactions that result in visual color changes. Colorimetric tests are popular due to their inherent simplicity, low cost, promptitude and portability; however, in many cases the results of such tests may not be predictable, partly because of the interference from similar species. In this proof-of-concept study, we present a paper-based microfluidic optoelectronic tongue - the so-called µOPTO - comprised of 6 indicators in lieu of one specific test and capable of discriminating 8 different alkaloid drugs (i.e. scopolamine, atropine, cocaine, morphine, ephedrine, caffeine, dipyrone and alprazolam) used for recreational, criminal and medical purposes. The wax printing method was employed to fabricate the microfluidic analytical device with six circular spots for reagent accommodation connected to a centered spot to enable simultaneous reactions with one sample injection. Digital images were obtained using an ordinary flatbed scanner, and the RGB information from before and after sample exposure was extracted using appropriate software. The color changes related to each spot were used to build differential maps with a unique fingerprint for each drug. The chemometric tools (i.e. PCA and HCA) showed suitable discrimination of all studied alkaloids in different quantities. To demonstrate a practical application, different alcoholic beverages spiked with scopolamine - a famous substance that causes drug abuse - were analyzed using the optoelectronic tongue. The results showed that small quantities of the drug were identified in different beverages, demonstrating that our device has the potential to be used in situ to prevent ingestion of contaminated samples.

Extracellular vesicles cargo from head and neck cancer cell lines disrupt dendritic cells function and match plasma microRNAs.

Extracellular vesicles (EVs) are mediators of the immune system response. Encapsulated in EVs, microRNAs can be transferred between cancer and immune cells. To define the potential effects of EVs originated from squamous cell carcinoma cells on immune system response, we performed microRNA profiling of EVs released from two distinct cell lines and treated dendritic cells derived from circulating monocytes (mono-DCs) with these EVs. We confirmed the internalization of EVs by mono-DCs and the down-regulation of microRNA mRNA targets in treated mono-DCs. Differences in surface markers of dendritic cells cultivated in the presence of EVs indicated that their content disrupts the maturation process. Additionally, microRNAs known to interfere with dendritic cell function, and detected in EVs, matched microRNAs from squamous cell carcinoma patients' plasma: miR-17-5p in oropharyngeal squamous cell carcinoma, miR-21 in oral squamous cell carcinoma, miR-16, miR-24, and miR-181a circulating in both oral and oropharyngeal squamous cell carcinoma, and miR-23b, which has not been previously described in plasma of head and neck squamous cell carcinoma, was found in plasma from patients with these cancer subtypes. This study contributes with insights on EVs in signaling between cancer and immune cells in squamous cell carcinoma of the head and neck.

Alterações eletrocardiográficas em pacientes com Leishmaniose Tegumentar Americana tratados com antimoniato de meglumina: revisão integrativa / Electrocardiographic changes in patients with American tegumentary leishmaniasis treated with meglumine antimoniate: integrative review

Introdução: a Leishmaniose Tegumentar Americana (LTA) é uma infecção zoonótica cujo tratamento é realizado com a droga antimoniato de meglumina (AM). Objetivo: Relatar as alterações eletrocardiográficas decorrentes do uso de AM em pacientes com LTA. Metodologia: foi realizada uma revisão integrativa da literatura por meio das bases de dados BIREME, PUBMED, COCHRANE, SCIELO e literatura cinzenta, usando como estratégia de busca o cruzamento dos seguintes descritores, nos idiomas português e inglês: leishmaniose cutânea, eletrocardiografia, meglumina e toxicidade. Não foi estipulado um intervalo temporal para que um maior número de publicações fosse obtido. Resultados: foram encontrados 134 artigos, desses apenas 09 atenderam aos critérios de inclusão. As principais alterações eletrocardiográficas encontradas durante a terapêutica foram as alterações de repolarização ventricular, com destaque para o prolongamento do intervalo QT corrigido pela frequência cardíaca. Já entre as alterações mais graves em termos de morbimortalidade, destacam-se as arritmias ventriculares complexas, principalmente a Torsade de pointes. Discussão: em todos os artigos selecionados foram encontradas alterações ao eletrocardiograma (ECG) durante o tratamento com AM, sendo recomendado em todos os pacientes, o acompanhamento eletrocardiográfico. Apenas um estudo excluiu as alterações do ECG basal, presença de comorbidades e uso de drogas cardiotóxicas sendo esses possíveis vieses para avaliação da toxicidade cardíaca diretamente provocada pelo antimonial. Conclusão: considerando as alterações na repolarização ventricular e as possíveis arritmias ventriculares em pacientes em tratamento para LTA em uso de AM, o acompanhamento eletrocardiográfico é recomendado durante a terapêutica de todos esses pacientes, sendo útil para prevenção de complicações cardiovasculares importantes.

Introduction: American Tegumentary Leishmaniasis (ATL) is a zoonotic infection whose treatment is carried out with the meglumine antimoniate drug (AM). Objective: To report the electrocardiographic changes resulting from the use of AM in patients with ATL. Methodology: an integrative literature review was carried out using the BIREME, PUBMED, COCHRANE, SCIELO and gray literature databases, using as a search strategy the crossing of the following descriptors, in Portuguese and English: cutaneous leishmaniasis, electrocardiography, meglumine and toxicity. A time interval was not stipulated in order to obtain a greater number of publications. Results: we found 134 articles, of which only 9 met the inclusion criteria. The main electrocardiographic changes found during therapy were changes in ventricular repolarization, with emphasis on the prolongation of the QT interval corrected by heart rate. Already the most serious changes in terms of morbidity and mortality, complex ventricular arrhythmias, especially Torsade de pointes, stand out. Discussion: changes in the electrocardiogram (ECG) were found in all selected articles during treatment with AM, with electrocardiographic monitoring being recommended in all patients. Only one study excluded: changes in the baseline ECG, the presence of comorbidities and / or use of cardiotoxic drugs, these being possible biases to assess cardiac toxicity directly caused by the antimonial. Conclusion: considering the changes in ventricular repolarization and possible ventricular arrhythmias in patients undergoing treatment for ATL using AM, electrocardiographic monitoring is recommended during the therapy of all these patients, being useful for the prevention of important cardiovascular complications.

The Knockout for G Protein-Coupled Receptor-Like PfSR25 Increases the Susceptibility of Malaria Parasites to the Antimalarials Lumefantrine and Piperaquine but Not to Medicine for Malaria Venture Compounds.

Previously we have reported that the G protein-coupled receptor (GPCR)-like PfSR25 in Plasmodium falciparum is a potassium (K+) sensor linked to intracellular calcium signaling and that knockout parasites (PfSR25-) are more susceptible to oxidative stress and antimalarial compounds. Here, we explore the potential role of PfSR25 in susceptibility to the antimalarial compounds atovaquone, chloroquine, dihydroartemisinin, lumefantrine, mefloquine, piperaquine, primaquine, and pyrimethamine and the Medicine for Malaria Venture (MMV) compounds previously described to act on egress/invasion (MMV006429, MMV396715, MMV019127, MMV665874, MMV665878, MMV665785, and MMV66583) through comparative assays with PfSR25- and 3D7 parasite strains, using flow cytometry assays. The IC50 and IC90 results show that lumefantrine and piperaquine have greater activity on the PfSR25- parasite strain when compared to 3D7. For MMV compounds, we found no differences between the strains except for the compound MMV665831, which we used to investigate the store-operated calcium entry (SOCE) mechanism. The results suggest that PfSR25 may be involved in the mechanism of action of the antimalarials lumefantrine and piperaquine. Our data clearly show that MMV665831 does not affect calcium entry in parasites after we depleted their internal calcium pools with thapsigargin. The results demonstrated here shed light on new possibilities on the antimalarial mechanism, bringing evidence of the involvement of the GPCR-like PfSR25.