Endoscopic Ventricular Lavage in Pediatric Pyogenic Cerebral Ventriculitis Associated with Shunt: Outcomes and Technical Notes.

OBJECTIVE: Pyogenic cerebral ventriculitis (PCV) is a rare infectious entity characterized by a potent inflammatory reaction of the ventricular ependyma, which in most cases leads to death. We aim to present the technical note and protocol, based on our center's 10-year experience of the use of endoscopic ventricular lavage (EVL) in pediatric patients with PCV and ventricular peritoneal shunt. METHODS: For this study, all pediatric patients (<16 years) with VP shunts and PCV who were treated with EVL between January 2012 and January 2022 were included. RESULTS: Thirty-four pediatric patients with ventriculitis were analyzed. The median age was 6 years, with 61.7% being male. Most consultations occurred on Day 2 of symptoms. Fever (38.2%) and altered consciousness (26.5%) were the most common initial symptoms. Early ventriculitis was observed in 67.7% of patients. Pathogen identification in the initial cerebrospinal fluid sample was 70.6%, while samples from ventricular peritoneal shunt yielded 23.53% and catheter culture 79.4%. Gram-positive bacteria, mainly S.epidermidis (44.1%), was the most commonly isolated agent. EVL was performed in 73.5% on the second or third day. Reinfection occurred in 23.5%, and 26.5% of patients died. Concordance analysis showed 85.3% agreement between LP and catheter tip samples. Functionality improved, with 55.88% achieving a Lansky score of 90. Early ventriculitis was associated with better Lansky scores. CONCLUSION: EVL can be a useful tool in the management of PCV in cases with VP shunts. Our study suggests a higher chance of isolating an infection-causing germ in the catheter tip culture specimen compared to the cerebrospinal fluid culture. However, future studies with a larger number of patients, or multicentric studies are required for further analysis.

Hemoperitoneum after a Bothrops snakebite: Case report.

Snakebites are frequent in tropical countries. Brazil has an average of 27,000 cases per year, with a fatality rate of 0.5%, and the Bothrops genus is the most common causative agent, accounting for about 70-90% of the accidents. This report describes a case of human envenomation by a juvenile Bothrops jararaca snake in São Paulo, Brazil, in a 71 years-old man, previously healthy. He presented a life-threatening envenomation, which developed to severe hypotension, acute kidney injury and extensive peritoneal hemorrhage. The hemoperitoneum was diagnosed due to persistent hypotension associated with anemia, pain and gastrointestinal complaints. Abdominal Computed Tomography scans showed a moderate to large amount of presumable hematic material inside the abdominal cavity, predominantly in the perihepatic and perisplenic spaces. The intra-abdominal hemorrhage was not surgically addressed, and the patient was discharged 5 days after hospitalization, with the progressive absorption of the hemoperitoneum. Systemic bleeding is one of the complications and main causes of death in Bothrops envenomations. Acute peritoneal hemorrhage is one of these serious complications that must be carefully addressed since its management must take into account the risk of bleeding caused by toxins that affect hemostasis. The case described highlights the importance of early diagnosis and adequate management of this potentially fatal complication in snakebites.

Study of the pollen type in Neotropical hawkmoths (Lepidoptera: Sphingidae: Macroglossinae) collected in the Brazilian Atlantic Forest.

We recorded 14 pollen types belonging to 12 families of angiosperms. Pera (Peraceae) pollen type was found in all genera and was the most abundant. Our results suggest low specificity in the choice of flowers; thus, Sphingids with either short or long proboscises visited flowers of the same species.

Transcultural adaptation, content, and internal structure validity evidence of the perceived efficacy and goal setting system - 2 edition for Brazilian children.

Aim: The aim was to investigate the validity of evidence of the Perceived Efficacy and Goal Setting System second edition for Brazilian children. Methods: 258 children participated, both sexes (n = 133 girls; 51.6%), 5 to 9 years old (total sample Mage = 7.1, SD = 1.4), from four regions of Brazil. The Perceived Efficacy and Goal Setting System ­ second edition, was used. Results: Experts showed agreement about the high clarity and practical pertinence of the items (content validity coefficient from 98.4 to 100%; Gwet's agreement coefficient from 0.85 to 1.00, p < 0.001). Confirmatory factorial analysis showed adequate adjustment indexes (RMSEA [0.048, 90% C.I. = 0.043 to 0.053], SRMR [0.243], CFI [0.91], RNI [0.91], TLI [0.91], ꭓ2/df [1.962]). The multigroup analysis showed configural, metric and scalar invariance of two models for gender (CFI = 0.97; RMSEA, [90%C.I.] = 0.05 [0.03 to 0.07]; metric: ΔRMSEA = 0.001; scalar: ΔRMSEA = −0.004) and age band (5­7 years-old and 8­9 years-old; CFI = 0.94; RMSEA, [90%C.I.] = 0.05 [0.03 to 0.07]; metric: ΔRMSEA = 0.002; scalar: ΔRMSEA = 0.010). The Heterotrait-Monotrait ratio test showed adequate discriminant validity among three dimensions (self-care and productivity [value = 0.76]; self-care and leisure [value = 0.57], productivity and leisure [value = 0.76]). Alpha for polychoric correlations showed an adequate internal consistency for all items and total scale (all α values >0.70). Composite reliability (Self-care = 0.8; Productivity = 0.81; Leisure = 0.8) reinforce evidence about reliability. Percentage agreement showed adequate item-level test-retest reliability (values between 76 and 92%). Conclusion: This scale showed adequate content and internal structure validity evidence to assess the perceived self-efficacy for Brazilian children.

Antinociceptive Effect of a p-Cymene/ß-Cyclodextrin Inclusion Complex in a Murine Cancer Pain Model: Characterization Aided through a Docking Study.

Pain is one of the most prevalent and difficult to manage symptoms in cancer patients, and conventional drugs present a range of adverse reactions. The development of ß-cyclodextrins (ß-CD) complexes has been used to avoid physicochemical and pharmacological limitations due to the lipophilicity of compounds such as p-Cymene (PC), a monoterpene with antinociceptive effects. Our aim was to obtain, characterize, and measure the effect of the complex of p-cymene and ß-cyclodextrin (PC/ß-CD) in a cancer pain model. Initially, molecular docking was performed to predict the viability of complex formation. Afterward, PC/ß-CD was obtained by slurry complexation, characterized by HPLC and NMR. Finally, PC/ß-CD was tested in a Sarcoma 180 (S180)-induced pain model. Molecular docking indicated that the occurrence of interaction between PC and ß-CD is favorable. PC/ß-CD showed complexation efficiency of 82.61%, and NMR demonstrated PC complexation in the ß-CD cavity. In the S180 cancer pain model, PC/ß-CD significantly reduced the mechanical hyperalgesia, spontaneous nociception, and nociception induced by non-noxious palpation at the doses tested (p < 0.05) when compared to vehicle differently from free PC (p > 0.05). Therefore, the complexation of PC in ß-CD was shown to improve the pharmacological effect of the drug as well as reducing the required dose.

Occurrence and distribution of Panstrongylus megistus (Burmeister, 1835) (Hemiptera, Reduviidae) in a metropolitan area of Southern Brazil.

Two triatomine genera (Panstrongylus and Triatoma) have essentially been recorded in Rio Grande do Sul State, Brazil. Panstrongylus megistus should be highlighted since this species is one of the main vectors of Trypanosoma cruzi in Brazil, due to its wide geographical distribution and the high susceptibility to this protozoan. This study aimed to present not only the occurrence and distribution of P. megistus in the Porto Alegre city's metropolitan area (PAMA), Rio Grande do Sul State, Brazil, but also the rates of T. cruzi infection, from 2009 to 2020. The PAMA, which comprises 34 cities and 4.4 million habitants, extends across the transition area in two biomes - Pampa and Mata Atlantica - found in the state. Results showed that P. megistus was recorded in 76.5% of cities (i.e., 26 out of 34), mainly in Porto Alegre city, where the vector was found in 11 out of the 12 years that were monitored. Three hundred and nineteen specimens were captured. Two hundred and sixty-seven specimens (83.7%) were located intradomicile (p < 0.0001), while 52.3% positivity for T. cruzi was found. Thus, P. megistus is important in the PAMA, because it invades and colonizes the households. Moreover, the high rates of T. cruzi infection have drawn attention.

Lyotropic liquid crystal mesophases as transdermal delivery systems for lipophilic drugs: A comparative study.

The present work aimed to evaluate different Liquid Crystal Mesophases (LCM) as transdermal drug delivery systems (TDDS) for nifedipine (NFD), a lipophilic drug model. The formulations composed of water, Citrus sinensis essential oil (CSEO), PPG-5-CETETH-20, and Olive oil ester PEG-7 were obtained and characterized by polarized light microscopy (PLM), rheology, small-angle x-ray scattering (SAXS), Fourier transform infrared coupled with an attenuated total reflection accessory (FTIR-ATR) and in vitro assays: bioadhesion, drug release, skin permeation, and retention tests. As a result, changes in component proportions led to several transparent viscous systems with an anisotropic profile. PLM and SAXS proved the presence of lamellar (S1), hexagonal (S3), and lamellar + hexagonal (S2) LCM, and rheology showed a high viscoelasticity profile. LCMs were able to adhere to the skin, and S2 achieved higher adhesion strength. NFD (5 mg/mL) has not modified the organization of LCMs. Results also showed that S3 promoted higher permeation and retention and higher disorganization of stratum corneum lipids, which is the main permeation-enhancing mechanism. Thus, the formulations obtained can carry and improve drug delivery through the skin and are promising TDDS for lipophilic drug administration, such as NFD.

A comparative study of COVID-19 transcriptional signatures between clinical samples and preclinical cell models in the search for disease master regulators and drug repositioning candidates.

Coronavirus disease 2019 (COVID-19) is an acute viral disease with millions of cases worldwide. Although the number of daily new cases and deaths has been dropping, there is still a need for therapeutic alternatives to deal with severe cases. A promising strategy to prospect new therapeutic candidates is to investigate the regulatory mechanisms involved in COVID-19 progression using integrated transcriptomics approaches. In this work, we aimed to identify COVID-19 Master Regulators (MRs) using a series of publicly available gene expression datasets of lung tissue from patients which developed the severe form of the disease. We were able to identify a set of six potential COVID-19 MRs related to its severe form, namely TAL1, TEAD4, EPAS1, ATOH8, ERG, and ARNTL2. In addition, using the Connectivity Map drug repositioning approach, we identified 52 different drugs which could be used to revert the disease signature, thus being candidates for the design of novel clinical treatments. Furthermore, we compared the identified signature and drugs with the ones obtained from the analysis of nasopharyngeal swab samples from infected patients and preclinical cell models. This comparison showed significant similarities between them, although also revealing some limitations on the overlap between clinical and preclinical data in COVID-19, highlighting the need for careful selection of the best model for each disease stage.

Occurrence and distribution of Panstrongylus megistus (Burmeister, 1835) (Hemiptera, Reduviidae) in a metropolitan area of Southern Brazil

ABSTRACT Two triatomine genera (Panstrongylus and Triatoma) have essentially been recorded in Rio Grande do Sul State, Brazil. Panstrongylus megistus should be highlighted since this species is one of the main vectors of Trypanosoma cruzi in Brazil, due to its wide geographical distribution and the high susceptibility to this protozoan. This study aimed to present not only the occurrence and distribution of P. megistus in the Porto Alegre city's metropolitan area (PAMA), Rio Grande do Sul State, Brazil, but also the rates of T. cruzi infection, from 2009 to 2020. The PAMA, which comprises 34 cities and 4.4 million habitants, extends across the transition area in two biomes - Pampa and Mata Atlantica - found in the state. Results showed that P. megistus was recorded in 76.5% of cities (i.e., 26 out of 34), mainly in Porto Alegre city, where the vector was found in 11 out of the 12 years that were monitored. Three hundred and nineteen specimens were captured. Two hundred and sixty-seven specimens (83.7%) were located intradomicile (p < 0.0001), while 52.3% positivity for T. cruzi was found. Thus, P. megistus is important in the PAMA, because it invades and colonizes the households. Moreover, the high rates of T. cruzi infection have drawn attention.

Test of Gross Motor Development-3: Item Difficulty and Item Differential Functioning by Gender and Age with Rasch Analysis.

The assessment of motor proficiency is essential across childhood to identify children's strengths and difficulties and to provide adequate instruction and opportunities; assessment is a powerful tool to promote children's development. This study aimed to investigate the hierarchal order of the Test of Gross Motor Development-Third Edition (TGMD-3) items regarding difficulty levels and the differential item functioning across gender and age group (3 to 5, 6 to 8, and 9 to 10 years old). Participants are 989 children (3 to 10.9 years; girls n = 491) who were assessed using TGMD-3. For locomotor skills, appropriate results reliability (alpha = 1.0), infit (M = 0.99; SD = 0.17), outfit (M = 1.18; SD = 0.64), and point-biserial correlations (rpb values from 0.14 to 0.58) were found; the trend was similar for ball skills: reliability (alpha = 1.0), infit (M = 0.99; SD = 0.13), outfit (M = 1.08; SD = 0.52); point-biserial correlations (rpb values from 0.06 to 0.59) were obtained. Two motor criteria: gallop, item-1, and one-hand forehand strike, item-4, were the most difficult items; in contrast, run, item-2, and two-hand catch, item-2, were the easiest items. Differential item functioning for age was observed in nine locomotor and ten ball skills items. These items were easier for older children compared to younger ones. The TGMD-3 has items with different difficulty levels capable of differential functioning across age groups.

Genomics-based higher classification of the species-rich Hairstreaks (Lepidoptera: Lycaenidae: Eumaeini).

We propose a higher classification of the lycaenid hairstreak tribe Eumaeini - one of the youngest and most species-rich butterfly tribes - based on autosome, Lepidopteran Z sex chromosome, and mitochondrial protein-coding genes. The subtribe Neolycaenina Korb is a synonym of Callophryidina Tutt, and subtribe Tmolusina Bálint is a synonym of Strephonotina K. Johnson, Austin, Le Crom, & Salazar. Proposed names are Rhammina Prieto & Busby, new subtribe; Timaetina Busby & Prieto, new subtribe; Atlidina Martins & Duarte, new subtribe; Evenina Faynel & Grishin, new subtribe; Jantheclina Robbins & Faynel, new subtribe; Paiwarriina Lamas & Robbins, new subtribe; Cupatheclina Lamas & Grishin, new subtribe; Parrhasiina Busby & Robbins, new subtribe; Ipideclina Martins & Grishin, new subtribe; and Trichonidina Duarte & Faynel, new subtribe. Phylogenetic results from the autosome and Z sex chromosome analyses are similar. Future analyses of datasets with hundreds of terminal taxa may be more practical time-wise by focussing on the smaller number of sex chromosome sequences (2.6% of nuclear protein-coding sequences). The phylogenetic classification and biological summaries for each subtribe suggest that a variety of factors affected Eumaeini diversification. About a dozen kinds of male secondary sexual organs with frequent evolutionary gains and losses occur in Atlidina, Evenina, and Jantheclina (141 species combined). Females have been shown to use these organs to discriminate between conspecific and non-conspecific males, facilitating sympatry among close relatives. Eumaeina, Rhammina, and Timaetina (140 species combined) are overwhelmingly montane with some evidence for a higher incidence of sympatric diversification. Seven Neotropical lineages in five subtribes invaded the temperate parts of the Nearctic Region with a diversification increase in the Callophryidina (262 species). North American Satyrium and Callophrys then invaded the Palearctic at least once each, with a major species-richness increase in Satyrium. The evolution of litter feeding detritivores within Calycopidina (172 species) resulted in an increase in diversification rate compared with its flower-feeding sister lineage. Atlidina, Strephonotina, Parrhasiina, and Strymonina (562 species combined) each contain a mixture of genera that specialize on one or two caterpillar food plant families and genera that are polyphagous. These would be appropriate subtribes to assess how the breadth of caterpillar food plants and the frequency of host shifts affected diversification.

Contextual Factors and Motor Skills in Indigenous Amazon Forest and Urban Indigenous Children.

This study investigated the contextual factors, motor performance, and body mass index across indigenous land children, indigenous urban children, and non-indigenous urban children. A number of 153 children, both sexes (71 girls, 46.4%), from 8 to 10 years were assessed. The Test of Motor Gross Development-3 was utilized. Indigenous land children showed higher motor performance ( η2ρ = 0.37 and η2ρ = 0.19 locomotor and object control, respectively) than indigenous urban children (p < 0.03) and non-indigenous urban children (p < 0.01); Indigenous urban children showed higher motor performance than non-indigenous urban children (p < 0.01). Body mass index was similar across groups ( η2ρ = 0,02; p = 0.15). Motor performance of indigenous land children was explained by the contextual factors that lead to a more active lifestyle, unsupervised free time, and play outside. In urban areas, behavior was similar, and although indigenous urban children kept some play tradition, it was not strong enough to be a protective factor for the motor performance.

Gross motor skills trajectory variation between WEIRD and LMIC countries: A cross-cultural study.

AIM: This study aimed to examine the prevalence of delays and borderline impaired performance for Brazilian girls and boys and the differences in the motor trajectories (locomotor and ball skills) of girls and boys (3- to 10-years-old) across WEIRD (Western, Educated, Industrial, Rich, and Democratic) countries and Brazil-a low- and middle-income country (LMIC). METHODS: We assessed 1000 children (524 girls; 476 boys), 3- to 10.9-year-old (M = 6.9, SD = 2.1; Girls M = 6.9, SD = 2.0; Boys M = 6.9, SD = 2.1), using the Test of Gross Motor Development-3. Using systematic search, original studies investigating FMS in children using the TGMD-3 were eligible; 5 studies were eligible to have the results compared to the Brazilian sample. One sample t-test to run the secondary data from Irish, American, Finnish, and German children (i.e., mean, standard deviation). RESULTS: The prevalence of delays and borderline impaired performance was high among Brazilian girls (28.3% and 27.5%) and boys (10.6% and 22.7%). The cross-countries comparisons showed significant (p values from .048 and < .001) overall lower locomotor and ball skills scores for Brazilian children; the only exceptions were skipping, catching, and kicking. We observed stability in performance, across countries, after 8-years-old, and no ceiling effects were found in the samples. CONCLUSIONS: The Brazilian sample emphasized the need for national strategies to foster children's motor proficiency. Differences in motor opportunities may explain the differences in motor trajectories between children in WEIRD and LMIC countries.

Microemulsions formed by PPG-5-CETETH-20 at low concentrations for transdermal delivery of nifedipine: Structural and in vitro study.

Nifedipine is a potent anti-hypertensive, which is poorly orally bioavailable on account of first-pass metabolism, short half-life, and low water solubility. This study aimed to develop a microemulsified system with low surfactant concentration and to evaluate the influence of microemulsion (ME) phase behavior on skin permeation of nifedipine, as drug model. Thereafter, MEs were obtained using PPG-5-CETETH-20, oleic acid, and phosphate buffer at pH 5.0. The selected MEs were isotropic, with droplet diameters less than 10 nm, polydispersity index < 0.25, and pH between 5.0 and 5.2. MEs presented low viscosity and Newtonian behavior. SAXS results confirmed bicontinuous and oil-in-water (o/w) MEs formation. The presence of the drug promoted only very slight modifications in the ME structure. The MEs presented ability to deliver nifedipine via the transdermal route when in comparison with the control. Nevertheless, the skin permeated and retained amounts from the o/w and bicontinuous formulations did not differ significantly. The ATR-FTIR demonstrated that both formulations promoted fluidization and disorganization of lipids and increased the drug diffusion and partition coefficients in the skin. In conclusion, PPG-5-CETETH-20 MEs obtained proved to be effective skin permeation enhancers, acting by rising the coefficients of partition and diffusion of the nifedipine in the skin.

Gastroprotective action of the ethanol extract of Leonurus sibiricus L. (Lamiaceae) in mice.

ETHNOPHARMACOLOGICAL RELEVANCE: Leonurus sibiricus L. (Lamiaceae) is a medicinal plant known in Brazil as "rubim" or "erva de macaé". It is used for various purposes, including stomach disorders. AIM OF THE STUDY: To evaluate the effect of the ethanol extract of the aerial parts of L. sibiricus (EELs) in models of gastric damage in mice. MATERIAL AND METHODS: The effect of EELs (50, 100 and 300 mg/kg, p.o., 1 h before induction) was tested on acidified ethanol (ACEt)-induced gastric ulcers. Additionally, we tested the effect of EELs (by intraduodenal administration) in the pylorus ligation (PL) model. RESULTS: Pretreatment with EELs, at 300 mg/kg, but not 50 and 100 mg/kg, reduced the relative area of gastric ulcers induced by ACEt (p < 0.01) and lipoperoxidation (p < 0.001), and increased the sulfhydryl content (p < 0.01) in the stomach in comparison with the vehicle group. Pretreatment with N-ethylmaleimide (a blocker of non-protein sulfhydryl groups, 10 mg/kg, i.p.) or glibenclamide (a KATP channel blocker, 10 mg/kg, i.p.) inhibited the gastroprotective response caused by EELs (300 mg/kg; p < 0.001), but there were no alterations due to pretreatments with inhibitors of the synthesis of prostaglandins (indomethacin, 10 mg/kg), nitric oxide (L-NAME, 70 mg/kg) or hydrogen sulfide (DL-propargylglycine, 10 mg/kg). Treatment with EELs (300 mg/kg) reduced mucus production (p < 0.001) and the volume of gastric secretion (p < 0.001) after PL without affecting gastric acidity or pH. CONCLUSIONS: These results provide evidence that EELs exerts gastroprotective action in mice, with the participation of oxidative stress and mediation of NP-SH, KATP channels and mucus production.

Phytochemical screening and cardiovascular effects of the ethanol extract of Erythroxylum passerinum mart.

Species of Erythroxylum genus are popularly used as anti-inflammatories and in the treatment of renal and respiratory disorders. Although it has been reported that species from the Erythroxylum genus induce cardiovascular effects, E. passerinum had not been studied specifically in this respect. However, previous phytochemical studies of E. passerinum demonstrated the presence of compounds which can have potential activity on the cardiovascular system. In this study, phytochemical screening of the ethanol extract of E. passerinum (EEEP) detected polyphenols, but not alkaloids. EEEP caused hypotension, bradycardia and vasorelaxation in rats. The vasorelaxation was attenuated by Nw-nitro-L-arginine methyl ester (L-NAME) or L-NAME + indomethacin (INDO), but not by INDO alone. Vasorelaxation was also significantly attenuated after endothelium removal or after incubation with high K+, 4-aminopyridine, glibenclamide or tetraethylammonium, but was not affected by pre-contraction with serotonin. Thus, EEEP induces hypotension and endothelium-dependent and independent vasorelaxation, which seems to involve the nitric oxide and K+-channels.

Segmental muscle twitching behaviour in the flanks of lancehead vipers Bothrops spp in response to human approach

Bothrops species are known to have a wide range of defensive behaviours against potential threats. Herein we show a frequently observed, but to date undocumented, behaviour in male and female Bothrops spp of varying sizes in newly arrived specimens from the wild, short-or long-term captives as well as in captive born individuals. The behaviour consists of irregular, synchronous or asynchronous muscular twitches in segments of the body flanks in otherwise motionless snakes. We named this ‘Segmental Muscle Twitching Behaviour’ (SMTB). We observed fifteen Bothrops spp from six species groups for incidence of this behaviour and made videos of snakes during the ‘alertness’ and ‘threatening’ phases of response to human approach. We found the behaviour in only five species, these belong to the monophyletic Bothrops jararacussu and Bothrops atrox species groups, suggesting a single evolutionary origin of this behaviour. Macroscopically, SMTB varied in the number of segments involved and the twitches had uneven intensities. Although recurrent and often replicable in similar situations during human approach, the behaviour was not displayed consistently. In addition, SMTB can be interrupted, stay inactive for quite some time and then restart. Hypotheses to explain this behaviour are suggested

Speciation process on brazilian continental islands, with the description of a new insular lancehead of the genus Bothrops (Serpentes, Viperidae)

Brazilian continental islands represent a natural laboratory to study speciation driven by recent phenotypic and genotypic divergence. The Bothrops jararaca species group is distributed in the Brazilian Atlantic Forest and on most of the Brazilian continental islands. The group is currently composed of the mainland common lancehead (B. jararaca) and four insular species (B. alcatraz, B. insularis, B. otavioi, and B. sazimai). Here, we evaluate mitochondrial DNA and morphological diversity of the B. jararaca species group and aim to provide additional evidence to understand insularization processes on the Brazilian coast. Our results, interpreted together with a comprehensive review of geomorphological data, provide a new conceptual framework for understanding the colonization process of the Brazilian continental islands. This framework suggests a history of multiple rounds of periodic isolation and reconnection between insular populations and their mainland relatives throughout the last 420,000 years. Furthermore, although some insular populations may have speciated prior to the last glacial maximum, other species likely diverged within the last 11,000 years. Additionally, the repeated evolution of size and dietary shift in the B. jararaca species group suggests a remarkable case of convergent adaptation. Our study provides evidence that the Bothrops from Ilha da Moela (Brazilian state of São Paulo) represents an undescribed species, presenting a distinct phenotype, and an exclusive history of isolation and adaptation. We describe this unique lancehead as a new species and we suggest it should be listed as critically endangered based on its endemicity to a small island that is severely impacted by constant and longstanding human presence.

Oportunidades de estimulação motora em ambientes domiciliares do Amazonas e fatores associados / Opportunities for motor stimulation in home environments of Amazonas and associated factors / Oportunidades de estimulación motora en ambientes domiciliarios de Amazonas y factores asociados

O objetivo do presente estudo foi analisar as oportunidades de estimulação motora em ambientes domiciliares e fatores associados em crianças de Parintins/Amazonas. Participaram 300 pais/responsáveis por crianças da cidade de Parintins/Amazonas. Affordances in the Home Environment for Motor Development foi utilizado para avaliar oportunidades de estimulação motora. A prevalência de baixa estimulação motora foi 78% maior nas casas em que moravam quatro ou mais adultos (RP: 1,78; IC95%: 1,07-2,87); mães com o ensino fundamental (RP: 15,93; IC95%:2,45-17,50) e ensino médio (RP: 10,07; IC95%: 1,46-54,01) fornecem baixa estimulação motora; e crianças do sexo masculino apresentaram maior probabilidade de baixa estimulação motora (RP: 1,56; IC95%: 1,09-1,94). Identificamos que lares nessa região não ofertam oportunidades de estimulação motora adequada para as crianças (AU)

The objective was to analyze the opportunities for motor stimulation of home environments and associated factors in children from Parintins/Amazonas. Participants included 300 parents/guardians of children from the city of Parintins/ Amazonas participated. Affordances in the Home Environment for Motor Development was used to assess opportunities for motor stimulation. The prevalence of low motor stimulation was 78% higher in the homes where four or more adults lived (PR: 1.78; 95% CI: 1.07-2.87); mothers with elementary school (PR: 15.93; 95% CI: 2.45-17.50) and high school (PR: 10.07; 95% CI: 1.46-54.01) provide low motor stimulation; and male children were more likely to have low motor stimulation (PR: 1.56; 95% CI: 1.09-1.94). We identified that homes in this region do not offer opportunities for adequate motor stimulation for children (AU).

El objetivo fue analizar las oportunidades de estimulación motora de los ambientes domésticos y factores asociados en niños de Parintins/Amazonas. Los participantes incluyeron a 300 padres/tutores de niños de la ciudad de Parintins/Amazonas. Se utilizó Affordances in the Home Environment for Motor Development para evaluar las oportunidades de estimulación motora. La prevalencia de estimulación motora baja fue 78% mayor en los hogares donde vivían cuatro o más adultos (RP: 1,78; IC 95%: 1,07-2,87); las madres con escuela primaria (RP: 15,93; IC del 95%: 2,45-17,50) y secundaria (RP: 10,07; IC del 95%: 1,46-54,01) proporcionan una estimulación motora baja; y los niños varones tenían más probabilidades de tener una estimulación motora baja (PR: 1,56; IC del 95%: 1,09-1,94). Identificamos que los hogares en esta región no ofrecen oportunidades para la estimulación motora adecuada para los niños (AU).