Linking avian malaria parasitemia estimates from quantitative PCR and microscopy reveals new infection patterns in Hawai'i.

Plasmodium parasites infect thousands of species and provide an exceptional system for studying host-pathogen dynamics, especially for multi-host pathogens. However, understanding these interactions requires an accurate assay of infection. Assessing Plasmodium infections using microscopy on blood smears often misses infections with low parasitemias (the fractions of cells infected), and biases in malaria prevalence estimates will differ among hosts that differ in mean parasitemias. We examined Plasmodium relictum infection and parasitemia using both microscopy of blood smears and quantitative polymerase chain reaction (qPCR) on 299 samples from multiple bird species in Hawai'i and fit models to predict parasitemias from qPCR cycle threshold (Ct) values. We used these models to quantify the extent to which microscopy underestimated infection prevalence and to more accurately estimate infection patterns for each species for a large historical study done by microscopy. We found that most qPCR-positive wild-caught birds in Hawaii had low parasitemias (Ct scores ≥35), which were rarely detected by microscopy. The fraction of infections missed by microscopy differed substantially among eight species due to differences in species' parasitemia levels. Infection prevalence was likely 4-5-fold higher than previous microscopy estimates for three introduced species, including Zosterops japonicus, Hawaii's most abundant forest bird, which had low average parasitemias. In contrast, prevalence was likely only 1.5-2.3-fold higher than previous estimates for Himatione sanguinea and Chlorodrepanis virens, two native species with high average parasitemias. Our results indicate that relative patterns of infection among species differ substantially from those observed in previous microscopy studies, and that differences depend on variation in parasitemias among species. Although microscopy of blood smears is useful for estimating the frequency of different Plasmodium stages and host attributes, more sensitive quantitative methods, including qPCR, are needed to accurately estimate and compare infection prevalence among host species.

Molecular signatures of alternative reproductive strategies in a facultatively social hover wasp.

Social insect reproductives and non-reproductives represent ideal models with which to understand the expression and regulation of alternative phenotypes. Most research in this area has focused on the developmental regulation of reproductive phenotypes in obligately social taxa such as honey bees, while relatively few studies have addressed the molecular correlates of reproductive differentiation in species in which the division of reproductive labour is established only in plastic dominance hierarchies. To address this knowledge gap, we generate the first genome for any stenogastrine wasp and analyse brain transcriptomic data for non-reproductives and reproductives of the facultatively social species Liostenogaster flavolineata, a representative of one of the simplest forms of social living. By experimentally manipulating the reproductive 'queues' exhibited by social colonies of this species, we show that reproductive division of labour in this species is associated with transcriptomic signatures that are more subtle and variable than those observed in social taxa in which colony living has become obligate; that variation in gene expression among non-reproductives reflects their investment into foraging effort more than their social rank; and that genes associated with reproductive division of labour overlap to some extent with those underlying division of labour in the separate polistine origin of wasp sociality but only explain a small portion of overall variation in this trait. These results indicate that broad patterns of within-colony transcriptomic differentiation in this species are similar to those in Polistinae but offer little support for the existence of a strongly conserved 'toolkit' for sociality.

Tranexamic acid in bleeding reduction and operative time of nasal surgeries: systematic review and meta-analysis.

PURPOSE: Our study goal is to review the efficacy of tranexamic acid in reducing blood loss and operative time in nasal surgeries. METHODS: We included randomized clinical trials using oral or intravenous tranexamic acid, excluded non-randomized studies, topic administration, coagulopathy, and using other drugs interfering in the coagulation cascade. Online databases, National Library of Medicine (MEDLINE-PubMED), Latin American and Caribbean Literature on Health Sciences (Lilacs), Cochrane Library, Embase and Google Scholar were used to perform the search. The review was registered in PROSPERO by no CRD42022310977. Two authors, independently, selected the articles meeting the inclusion criteria. They extracted the data and used RevMan 5 software to perform the meta-analysis. RESULTS: Our search resulted in 16 RCTs that were included in the meta-analysis totalizing 1108 patients. Studies were evaluated resulting in a low risk of bias for the five domains. The use of tranexamic acid resulted in significant reduction in duration of surgery (DOS) and intraoperative blood loss (IBL) had significant reduction. The level of evidence according to GRADE System was high in all studies and variables. CONCLUSION: Tranexamic acid has an important role in reducing intraoperative blood loss and duration of surgery. Our study has some limitations due to the low number of RCTs available in the literature.

Diversity and host specificity of Borrelia burgdorferi's outer surface protein C (ospC) alleles in synanthropic mammals, with a notable ospC allele U absence from mixed infections.

Interactions among pathogen genotypes that vary in host specificity may affect overall transmission dynamics in multi-host systems. Borrelia burgdorferi, a bacterium that causes Lyme disease, is typically transmitted among wildlife by Ixodes ticks. Despite the existence of many alleles of B. burgdorferi's sensu stricto outer surface protein C (ospC) gene, most human infections are caused by a small number of ospC alleles ["human infectious alleles" (HIAs)], suggesting variation in host specificity associated with ospC. To characterize the wildlife host association of B. burgdorferi's ospC alleles, we used metagenomics to sequence ospC alleles from 68 infected individuals belonging to eight mammalian species trapped at three sites in suburban New Brunswick, New Jersey (USA). We found that multiple allele ("mixed") infections were common. HIAs were most common in mice (Peromyscus spp.) and only one HIA was detected at a site where mice were rarely captured. ospC allele U was exclusively found in chipmunks (Tamias striatus), and although a significant number of different alleles were observed in chipmunks, including HIAs, allele U never co-occurred with other alleles in mixed infections. Our results suggest that allele U may be excluding other alleles, thereby reducing the capacity of chipmunks to act as reservoirs for HIAs.

Multiple piroplasm parasites (Apicomplexa: Piroplasmida) in northeastern populations of the invasive Asian longhorned tick, Haemaphysalis longicornis Neumann (Ixodida: Ixodidae), in the United States.

Piroplasms, which include the agents of cattle fever and human and dog babesiosis, are a diverse group of blood parasites of significant veterinary and medical importance. The invasive Asian longhorned tick, Haemaphysalis longicornis, is a known vector of piroplasms in its native range in East Asia and invasive range in Australasia. In the USA, H. longicornis has been associated with Theileria orientalis Ikeda outbreaks that caused cattle mortality. To survey invasive populations of H. longicornis for a broad range of piroplasms, 667 questing H. longicornis collected in 2021 from 3 sites in New Jersey, USA, were tested with generalist piroplasm primers targeting the 18S small subunit rRNA (395­515 bp, depending on species) and the cytochrome b oxidase loci (1009 bp). Sequences matching Theileria cervi type F (1 adult, 5 nymphs), an unidentified Theileria species (in 1 nymph), an undescribed Babesia sensu stricto ('true' Babesia, 2 adults, 2 nymphs), a Babesia sp. Coco (also a 'true Babesia', 1 adult, 1 nymph), as well as Babesia microti S837 (1 adult, 4 nymphs) were recovered. Babesia microti S837 is closely related to the human pathogen B. microti US-type. Additionally, a 132 bp sequence matching the cytochrome b locus of deer, Odocoileus virginanus, was obtained from 2 partially engorged H. longicornis. The diverse assemblage of piroplasms now associated with H. longicornis in the USA spans 3 clades in the piroplasm phylogeny and raises concerns of transmission amplification of veterinary pathogens as well as spillover of pathogens from wildlife to humans.

Bioecological Aspects of Species of the Subgenus Mansonia (Mansonia) (Diptera: Culicidae) Prior to the Installation of Hydroelectric Dams on the Madeira River, Rondônia State, Brazil.

The objective of this study was to evaluate ecological aspects of Mansonia species before the construction of hydroelectric plants on the Madeira River, and thus enable the assessment of the impact of these projects on mosquitoes. A total of 199 samplings were carried out between November 2003 and August 2004, using the technique of attraction with protection. Temporal distribution was evaluated from monthly incidence values obtained from the bite index per man/hour. Relative abundance was subsequently calculated to evaluate the spatial distribution of species, according to land use and municipal districts; furthermore, the pattern of hematophagous activity was evaluated from 12-h and 4-h samplings. The data were analyzed according to the negative binomial distribution and generalized linear models to estimate the influence of environmental factors on the presence and abundance of Mansonia. A total of 1479 specimens were collected, distributed among four species-Mansonia titillans (87%), Mansonia humeralis (6.3%), Mansonia amazonensis (6%), and Mansonia indubitans (0.5%), and spatial distribution analysis showed Ma. titillans to be dominant. Hematophagous activity had peaks between 6:00 p.m. and 8:00 p.m. and species incidence was higher during the rainy season and in areas where domestic animals are raised. Therefore, the region studied presented characteristics favorable to the reproduction of Mansonia even before the construction of the hydroelectric plants and after construction, these conditions were enhanced, due to the increase in the availability of breeding sites for immatures and blood sources for females, as a consequence of changes in the environment.

Leucocytozoon cariamae n. sp. and Haemoproteus pulcher coinfection in Cariama cristata (Aves: Cariamiformes): first mitochondrial genome analysis and morphological description of a leucocytozoid in Brazil.

The distribution of avian haemosporidians of the genus Leucocytozoon in the Neotropics remains poorly understood. Recent studies confirmed their presence in the region using molecular techniques alone, but evidence for gametocytes and data on putative competent hosts for Leucocytozoon are still lacking outside highland areas. We combined morphological and molecular data to characterize a new Leucocytozoon species infecting a non-migratory red-legged seriema (Cariama cristata), the first report of a competent host for Leucocytozoon in Brazil. Leucocytozoon cariamae n. sp. is distinguished from the Leucocytozoon fringillinarum group by its microgametocytes that are not strongly appressed to the host cell nucleus. The bird studied was coinfected with Haemoproteus pulcher, and we present a Bayesian phylogenetic analysis based on nearly complete mitochondrial genomes of these 2 parasites. Leucocytozoon cariamae n. sp. morphology is consistent with our phylogenetic analysis indicating that it does not share a recent common ancestor with the L. fringillinarum group. Haemoproteus pulcher and Haemoproteus catharti form a monophyletic group with Haemocystidium parasites of Reptilia, supporting the polyphyly of the genus Haemoproteus. We also discussed the hypothesis that H. pulcher and H. catharti may be avian Haemocystidium, highlighting the need to study non-passerine parasites to untangle the systematics of Haemosporida.

Species Identification and Mycotoxigenic Potential of Aspergillus Section Flavi Isolated from Maize Marketed in the Metropolitan Region of Asunción, Paraguay.

Zea mays var. amylacea and Zea mays var. indurata are maize ecotypes from Paraguay. Aspergillus section Flavi is the main spoilage fungus of maize under storage conditions. Due to its large intraspecific genetic variability, the accurate identification of this fungal taxonomic group is difficult. In the present study, potential mycotoxigenic strains of Aspergillus section Flavi isolated from Z. mays var. indurata and Z. mays var. amylacea that are marketed in the metropolitan region of Asunción were identified by a polyphasic approach. Based on morphological characters, 211 isolates were confirmed to belong to Aspergillus section Flavi. A subset of 92 strains was identified as Aspergillus flavus by mass spectrometry MALDI-TOF and the strains were classified by MALDI-TOF MS into chemotypes based on their aflatoxins and cyclopiazonic acid production. According to the partial sequencing of ITS and CaM genes, a representative subset of 38 A. flavus strains was confirmed. Overall, 75 A. flavus strains (86%) were characterized as producers of aflatoxins. The co-occurrence of at least two mycotoxins (AF/ZEA, FUM/ZEA, and AF/ZEA/FUM) was detected for five of the Z. mays samples (63%). Considering the high mycological bioburden and mycotoxin contamination, maize marketed in the metropolitan region of Asunción constitutes a potential risk to food safety and public health and requires control measures.

Ticks (Acari: Ixodida) on synanthropic small and medium-sized mammals in areas of the northeastern United States infested with the Asian longhorned tick, Haemaphysalis longicornis.

The northeastern United States (US) is a hotspot for tick-borne diseases. Adding to an already complex vector landscape, in 2017 large populations of the invasive Haemaphysalis longicornis, the Asian longhorned tick, were detected in New Jersey (NJ) and later found to be widespread from Connecticut to Georgia. In its native range in northeastern Asia, H. longicornis is considered an important vector of deadly pathogens to humans, companion animals, and livestock. To identify the primary hosts of H. longicornis, we surveyed synanthropic small and medium-sized mammals in three different sites in suburban New Brunswick, NJ. Specifically, we collected approximately 9,000 tick specimens belonging to nine species from 11 different species of mammals sampled between May and September 2021. We found that H. longicornis feeds more frequently on rodents than previously thought, and that this invasive tick is likely exposed to important enzootic and zoonotic pathogens. Overall, we obtained detailed information about the seasonal dynamics and feeding patterns of six tick species common in the northeastern US, Haemaphysalis longicornis, Amblyomma americanum, Dermacentor variabilis, Ixodes scapularis, Ixodes texanus and Ixodes cookei. We found that unlike I. scapularis that feeds on mammals of all sizes, H. longicornis feeds on hosts following the general pattern of A. americanum, favoring larger species such as skunks, groundhogs, and raccoons. However, our survey revealed that unlike A. americanum, H. longicornis reaches high densities on Virginia opossum. Overall, the newly invasive H. longicornis was the most numerous tick species, both on multiple host species and in the environment, raising significant questions regarding its role in the epidemiology of tick-borne pathogens, especially those affecting livestock, companion animals and wildlife. In conclusion, our findings provide valuable insights into the tick species composition on mammalian hosts in NJ and the ongoing national expansion of H. longicornis.

Favolus rugulosus from the Neotropics: first bioprospecting for its evaluation in the food industry / Favolus rugulosus del Neotrópico: primera bioprospección para su valoración en la industria alimenticia

[Objective] Our main objective was to evaluate Favolus rugulosus indoor production in different substrates and to analyze the proximal composition of cultivated basidiomata. [Methodology] The studied species was identified by morphological and phylogenetic analyses based on ITS markers. Domestication capability was evaluated in different easy-access substrates. Total phenolic content and antioxidant activities were quantified, and proximal content was analyzed on cultivated basidiomata. [Results] Eucalypts sawdust-straw mixture produced basidiomata in higher yields in an intermediate amount of time (45 days). The highest concentration of phenolic compounds (35.6 ± 2.6 mg GAE g-1) and antioxidants (13.6 ± 1.3 mg AAE g-1) were obtained in the ethyl acetate fraction. Regarding proximal composition, F. rugulosus is composed of 20 % proteins, 15,4 % carbohydrates, 25,2 % dietary fiber and 5,7 % fat. [Conclusions] Nutritional composition analyses on cultivated basidiomata revealed F. rugulosus to be high in protein, carbohydrates, dietary fiber and essential fatty acids.

[Objetivo] El objetivo del trabajo fue evaluar la producción indoor de Favolus rugulosus en distintos sustratos y realizar los análisis de composición proximal de los basidiomas cultivados. [Metodología] La especie en estudio fue identificada por análisis morfológicos y filogenéticos basados en el marcador ITS. Se evaluó la capacidad de domesticación de la especie mediante el cultivo en distintos sustratos de fácil acceso, se cuantificó el contenido de compuestos fenólicos totales, antioxidantes y se realizó el análisis proximal de los basidiomas obtenidos. [Resultados] La mezcla eucalipto-paja resultó ser el mejor sustrato para la producción de basidiomas, por producir rindes más altos en un tiempo intermedio (45 días); la mayor concentración de compuestos fenólicos (35.6 ± 2.6 mg GAE g-1) y antioxidantes (13.6 ± 1.3 mg AAE g-1) se obtuvo en la fracción de acetato de etilo; en cuanto la composición proximal, F. rugulosus contiene 20 % proteínas, 15,4 % carbohidratos, 25,2 % fibra alimentaria y 5,7 % de grasas. [Conclusiones] Los análisis de composición química y nutricional del basidioma cultivado revelan que F. rugulosus es una fuente rica en  proteínas, carbohidratos, fibra alimentaria y ácidos grasos esenciales. 

Association between elite swimmers' force production and 100†m front crawl inter-lap pacing and kinematics.

The present study aimed to analyse the associations between force production and 100 m front crawl inter-lap pacing and kinematics. Eleven elite male swimmers performed a 100 m front crawl maximal effort to collect 50 m lap time (T50, s) and velocity (v, m·s-1) for pacing, stroke rate (SR), stroke length (SL) and stroke index (SI) as kinematic variables. A 30 s tethered effort allowed to determine the peak (Fpeak) and mean force (Fmean) as force production variables. The relative change (Δ) between 50 m laps was also calculated for all measures. A paired sample t-test was used to check differences between laps and Pearson correlation coefficients allowed to quantify the associations between force and remaining variables. The T50 increased from the first to the second lap (ΔT50 = 10.61%, p < 0.01, d = 2.68), while v (Δv = -5.92%, p < 0.01, d = 1.53), SR (ΔSR = -6.61%, p < 0.01, d = 0.45) and SI (ΔSI = -4.92%, p = 0.02, d = 0.45) decreased. SL remained unchanged between laps (ΔSL = 1.07%, p = 0.66, d = 0.08). No associations were found between force production and most of Δ, with the only exception being the reasonable good association between Fpeak and Δv (r = 0.62, p = 0.04). Although both pacing and kinematics fall from the first to the second sections of a 100 m front-crawl effort, the swimmers who exhibit higher Fpeak show a more stable front crawl v between both 50 m laps.

Host phylogeny and seasonality shapes avian haemosporidian prevalence in a Brazilian biodiverse and dry forest: the Caatinga.

The relationships between host phylogenetics, functional traits and parasites in wildlife remain poorly understood in the Neotropics, especially in habitats with marked seasonal variation. Here, we examined the effect of seasonality and host functional traits on the prevalence of avian haemosporidians (Plasmodium and Haemoproteus) in the Brazilian Caatinga, a seasonally dry tropical forest. 933 birds were evaluated for haemosporidian infections. We found a high parasitism prevalence (51.2%), which was correlated with phylogenetic relatedness among avian species. Prevalence varied drastically among the 20 well-sampled species, ranging from 0 to 70%. Seasonality was the main factor associated with infections, but how this abiotic condition influenced parasite prevalence varied according to the host-parasite system. Plasmodium prevalence increased during the rainy season and, after excluding the large sample size of Columbiformes (n = 462/933), Plasmodium infection rate was maintained high in the wet season and showed a negative association with host body mass. No association was found between non-Columbiform bird prevalence and seasonality or body mass when evaluating both Plasmodium and Haemoproteus or only Haemoproteus infections. Parasite community was composed of 32 lineages including 7 new lineages. We evidenced that even dry domains can harbour a high prevalence and diversity of vector-borne parasites and pointed out seasonality as a ruling factor.

Chemical Profile and Biological Potential of Hornodermoporus martius (Agaricomycetes) from Paraguay.

To further knowledge of the biological activity of native neotropical fungal species, this study aimed to determine the chemical composition and microbiological activity of Hornodermoporus martius. Ethanol, hexane, diethyl ether, and ethyl acetate fractions and the water residue were analyzed and resulted in a total phenolic compound content between 13 and 63 mg of gallic acid equivalents per gram of crude extract. The total antioxidants ranged between 3 and 19 mg of ascorbic acid equivalents per gram of crude extract, and the percentage of antioxidant activity was determined to be between 6 and 25%. A preliminary profile of compounds is provided for the first time for the species; the results from the nonpolar fraction showcased the presence of saturated and unsaturated acids, fatty alcohol, sterols, and cis-vaccenic acid. Our findings also revealed antimicrobial properties from compounds within the hexane and diethyl ether fractions at concentrations of 1 mg mL-1, which inhibited the growth of certain gram-positive and gram-negative bacteria. For the first time in academic literature, our work analyzed and documented the chemical characteristics and microbial properties of H. martius, suggesting potential for medicinal applications.

Putting hornets on the genomic map.

Hornets are the largest of the social wasps, and are important regulators of insect populations in their native ranges. Hornets are also very successful as invasive species, with often devastating economic, ecological and societal effects. Understanding why these wasps are such successful invaders is critical to managing future introductions and minimising impact on native biodiversity. Critical to the management toolkit is a comprehensive genomic resource for these insects. Here we provide the annotated genomes for two hornets, Vespa crabro and Vespa velutina. We compare their genomes with those of other social Hymenoptera, including the northern giant hornet Vespa mandarinia. The three hornet genomes show evidence of selection pressure on genes associated with reproduction, which might facilitate the transition into invasive ranges. Vespa crabro has experienced positive selection on the highest number of genes, including those putatively associated with molecular binding and olfactory systems. Caste-specific brain transcriptomic analysis also revealed 133 differentially expressed genes, some of which are associated with olfactory functions. This report provides a spring-board for advancing our understanding of the evolution and ecology of hornets, and opens up opportunities for using molecular methods in the future management of both native and invasive populations of these over-looked insects.

Análise dos indicadores de gestão do serviço de atendimento móvel de urgências do ceará / Analysis of the management indicators of the mobile emergency care service of ceará / Análisis de los indicadores de gestión del servicio móvil de atención de urgencias de ceará

RESUMO Objetivo: analisar os indicadores de gestão em saúde relacionados ao serviço de atendimento móvel de urgências do Ceará. Método: trata-se de um estudo documental, retrospectivo, de abordagem quantitativa, realizado no sítio eletrônico IntegraSUS do governo do estado do Ceará - Brasil, no período de julho de 2021, para análise dos indicadores "total de chamadas" e "tempo médio de resposta". Resultados: verificou-se um perfil de chamadas prevalentes para homens (52,66%), com idade avançada >70 anos (22,06%), ocorrências de atendimento Covid-19 para a Central Juazeiro (7,62%) e acidentes por motocicleta para a Central Eusébio (7,94%). O serviço obteve chamados para 177 municípios cearenses (96,19%) com tempo médio de resposta maior para Covid-19. Conclusão: a análise sinaliza a necessidade de ajuste das estratégias para melhorar o desempenho do tempo-resposta do serviço, com revisão do sistema organizacional, inclusive, da publicização dos dados pela plataforma digital.

ABSTRACT Objective: To analyze the health management indicators related to the mobile emergency care service in Ceará. Method: This is a documentary, retrospective, quantitative study, carried out on the IntegraSUS website of the Ceará state government - Brazil, during the period July 2021, to analyze the indicators "total calls" and "average response time". Results: It was verified a profile of prevalent calls for men (52.66%), with advanced age >70 years (22.06%), Covid-19 service occurrences for the Juazeiro central station (7.62%) and motorcycle accidents for the Eusébio central station (7.94%). The service got calls for 177 cities in Ceará (96.19%) with a longer average response time for Covid-19. Conclusion: The analysis signals the need to adjust strategies to improve the performance of the service response time, with a review of the organizational system, including the publication of data by the digital platform.

RESUMEN Objetivo: analizar los indicadores de gestión de salud relacionados con el servicio móvil de atención de urgencias en el Estado de Ceará. Método: se trata de un estudio documental, retrospectivo, de abordaje cuantitativo, realizado en el sitio IntegraSUS del gobierno del estado de Ceará - Brasil, en el período de julio de 2021, para el análisis de los indicadores "total de llamadas" y "tiempo medio de respuesta". Resultados: se verificó un perfil de prevalencia de llamadas para hombres (52,66%), con edad avanzada >70 años (22,06%), ocurrencias de asistencia del Covid-19 para la Central Juazeiro (7,62%) y accidentes de motocicleta para la Central Eusébio (7,94%). El servicio obtuvo llamadas para 177 municipios de Ceará (96,19%) con un tiempo medio de respuesta mayor para Covid-19. Conclusión: el análisis señala la necesidad de ajustar las estrategias para mejorar el rendimiento del tiempo de respuesta del servicio, con una revisión del sistema organizativo, incluida la publicación de datos por la plataforma digital.

Analysis of labeling infant's formulas to children allergic to the protein in cow's milk / Análise da rotulagem de fórmulas infantis para lactentes com alergia a proteína do leite de vaca

Introduction: breastfeeding is the most effective way to feed the child in the first six months of life exclusively and up to two years as a complementary form, as it provides a healthy development. However, in some situations it is impossible among them in children with food allergies such as Cow's Milk Protein Allergy (APLV). This condition can be defined as an adverse reaction of the immune system, caused by antigens present in the food that triggers the allergy.Objective: analyze the information on the labeling of infant formulas for infants with allergies to cow's milk protein (APLV), sold in pharmacies in Sobral/CE.Methods: cross-sectional, exploratory, quantitative and qualitative study. After data collection, the labels were analyzed based on a check list composed by the current legislation in accordance with RDC 45/2011, measuring the number of adjustments and inadequacies.Results: of the seven formulas analyzed, five were 100% adequate, when considering all the provisions that made up the check list. Of these were FAB-1 B, FAB-1 C, FAB-1 E, FAB-1 F, FAB-2 A, they were all in accordance with the dimensions established by RDC 45/2011, it is already in relation to formulas with inadequacy we observed that FAB-1 A was 2.22% in dimension two in which the micronutrient riboflavin was above the recommended range and FAB-1 D was 2.22% in dimension two, the carbohydrate macronutrient above the recommended range. In view of this, what we observed was that most of the formulas analyzed were within the labeling standards specified in Resolution RDC 45/2011, despite the many regulatory standards that govern the labeling and marketing of infant foods, it was realized that there is still a need for regulation stricter in this regard so that the legislation is fully complied with.Conclusion: according to what was evaluated about formulas for infants with APLV in relation to the labeling standards of the current legislation, some inadequacies were found. Therefore, this study showed a greater number of non-conformities in relation to the essential characteristics of composition and quality, despite the many regulatory standards that govern the labeling and marketing of infant foods, it is clear that they are still not fully complied with. It was found that we still need to evolve in the Elaboration, execution and inspection of the labels of formulas for infants with Allergy to Cow's Milk Protein (APLV), in order to minimize these non-conformities and offer the best food within the recommended standard, however these studies are necessary in order to better show and discuss the legislation referring to these products.

Introdução: a amamentação é a forma mais eficaz de alimentar a criança nos primeiros seis meses de vida exclusivamente e até os dois anos como forma complementar, pois proporciona um desenvolvimento saudável. No entanto, em algumas situações, é impossível entre eles em crianças com alergia alimentar, como a alergia à proteína do leite de vaca (APLV). Essa condição pode ser definida como uma reação adversa do sistema imunológico, causada por antígenos presentes nos alimentos que desencadeiam a alergia.Objetivo: analisar as informações sobre a rotulagem de fórmulas infantis para lactentes com alergia à proteína do leite de vaca (APLV), comercializadas em farmácias de Sobral/CE.Método: estudo transversal, exploratório, quantitativo e qualitativo. Após a coleta de dados, os rótulos foram analisados com base em um check list composto pela legislação vigente de acordo com a RDC 45/2011, mensurando o número de adequações e inadequações.Resultados: das sete fórmulas analisadas, cinco foram 100% adequadas, quando consideradas todas as disposições que compunham o check list. Destes eram FAB -1 B, FAB -1 C, FAB -1 E, FAB -1 F, FAB -2 A, todos estavam de acordo com as dimensões estabelecidas pela RDC 45/2011, já está em relação às fórmulas com inadequação observamos que FAB-1 A foi de 2,22% na dimensão dois em que a micronutriente riboflavina estava acima da faixa recomendada e FAB-1 D foi de 2,22% na dimensão dois, o macronutriente carboidrato acima da faixa recomendada. Diante disso, o que observamos foi que a maioria das fórmulas analisadas estava dentro dos padrões de rotulagem especificados na Resolução, apesar das inúmeras normas regulamentadoras que regem a rotulagem e comercialização de alimentos infantis, percebeu-se que ainda existe necessidade de regulamentação mais rigorosa nesse sentido, para que a legislação seja integralmente cumprida.Conclusão: de acordo com o que foi avaliado sobre as fórmulas para lactentes com APLV em relação aos padrões de rotulagem da legislação vigente foram encontradas algumas inadequações. Portanto esse estudo apresentou maior número de inconformidades em relação as características essênciais de composição e qualidade, apesar das muitas normas regulamentadoras que regem a rotulagem e comercialização de alimentos infantis, percebe-se que ainda não são totalmente cumpridas. Verificou-se que ainda precisamos evoluir na Elaboração, execussão e fiscalização dos rótulos das fórmulas para lactentes com Alergia a Proteína do Leite de Vaca (APLV), a fim de minimizar essas não conformidades e ofererer o melhor alimento dentro do padrão preconizado, no entanto faz-se necessários estes estudos a fim de mostrar e discutir melhor as legislações referentes a esses produtos.

[8] and [10]-Gingerol reduces urothelial damage in ifosfamide-induced hemorrhagic cystitis via JAK/STAT/FOXO signaling pathway via IL-10.

Acrolein is the main toxic metabolite of ifosfamide (IFO) that causes urothelial damage by oxidative stress and inflammation. Here, we investigate the molecular mechanism of action of gingerols, Zingiber officinale bioactive molecules, as an alternative treatment for ifosfamide-induced hemorrhagic cystitis. Female Swiss mice were randomly divided into 5 groups: control; IFO; IFO + Mesna; and IFO + [8]- or [10]-gingerol. Mesna (80 mg/kg, i.p.) was given 5 min before, 4 and 8 h after IFO (400mg/kg, i.p.). Gingerols (25 mg/kg, p.o.) were given 1 h before and 4 and 8 h after IFO. Animals were euthanized 12 h after IFO injection. Bladders were submitted to macroscopic and histological evaluation. Oxidative stress and inflammation were assessed by malondialdehyde (MDA) or myeloperoxidase assays, respectively. mRNA gene expression was performed to evaluate mesna and gingerols mechanisms of action. Mesna was able to protect bladder tissue by activating NF-κB and NrF2 pathways. However, we demonstrated that gingerols acted as an antioxidant and anti-inflammatory agent stimulating the expression of IL-10, which intracellularly activates JAK/STAT/FOXO signaling pathway.

Outra falha de bioprótese valvar cirúrgica: uma segunda solução transcateter valve-in-valve / Another failed surgical bioprosthetic valve: a second transcatheter valve-in-valve solution

A substituição transcateter valve-in-valve da valva mitral surgiu recentemente como uma alternativa cada vez mais utilizada nos pacientes de alto risco cirúrgico. O presente caso relata uma substituição de valva mitral transcateter valve-in-valve, por via transeptal, como tratamento da degeneração de uma bioprótese mitral cirúrgica e regurgitação grave, em paciente de 86 anos já submetido a uma substituição transcateter valve-in-valve aórtica, há 6 anos. Este caso enfatiza o papel crucial de uma avaliação pré-operatória cuidadosa, com uso de diferentes modalidades de exames de imagem, para planejamento do procedimento, em paciente com maior risco de obstrução da via de saída do ventrículo esquerdo, devido a um procedimento valve-in-valve aórtico prévio.

Transcatheter mitral valve-in-valve replacement has recently emerged as an increasingly common alternative for high surgical risk patients. We report a case of a successful transseptal transcatheter mitral valve-in-valve replacement for the treatment of a bioprosthetic mitral valve degeneration and severe regurgitation, in an 86-year-old patient who had undergone transcatheter aortic valve-in-valve procedure 6 years ago. This case emphasizes the crucial role of a careful preoperative assessment using multimodality imaging to plan the procedure, in a patient with higher risk of left ventricular outflow obstruction due to the previous transcatheter aortic valve-in- valve procedure.

The greatest air quality experiment ever: Policy suggestions from the COVID-19 lockdown in twelve European cities.

COVID-19 (Coronavirus disease 2019) hit Europe in January 2020. By March, Europe was the active centre of the pandemic. As a result, widespread "lockdown" measures were enforced across the various European countries, even if to a different extent. Such actions caused a dramatic reduction, especially in road traffic. This event can be considered the most significant experiment ever conducted in Europe to assess the impact of a massive switch-off of atmospheric pollutant sources. In this study, we focus on in situ concentration data of the main atmospheric pollutants measured in twelve European cities, characterized by different climatology, emission sources, and strengths. We propose a methodology for the fair comparison of the impact of lockdown measures considering the non-stationarity of meteorological conditions and emissions, which are progressively declining due to the adoption of stricter air quality measures. The analysis of these unmatched circumstances allowed us to estimate the impact of a nearly zero-emission urban transport scenario on air quality in 12 European cities. The clearest result, common to all the cities, is that a dramatic traffic reduction effectively reduces NO2 concentrations. In contrast, each city's PM and ozone concentrations can respond differently to the same type of emission reduction measure. From the policy point of view, these findings suggest that measures targeting urban traffic alone may not be the only effective option for improving air quality in cities.

Evolutionary consequences of vector-borne transmission: how using vectors shapes host, vector and pathogen evolution.

Transmission mode is a key factor that influences host­parasite coevolution. Vector-borne pathogens are among the most important disease agents for humans and wildlife due to their broad distribution, high diversity, prevalence and lethality. They comprise some of the most important and widespread human pathogens, such as yellow fever, leishmania and malaria. Vector-borne parasites (in this review, those transmitted by blood-feeding Diptera) follow unique transmission routes towards their vertebrate hosts. Consequently, each part of this tri-partite (i.e. parasite, vector and host) interaction can influence co- and counter-evolutionary pressures among antagonists. This mode of transmission may favour the evolution of greater virulence to the vertebrate host; however, pathogen­vector interactions can also have a broad spectrum of fitness costs to the insect vector. To complete their life cycle, vector-borne pathogens must overcome immune responses from 2 unrelated organisms, since they can activate responses in both vertebrate and invertebrate hosts, possibly creating a trade-off between investments against both types of immunity. Here, we assess how dipteran vector-borne transmission shapes the evolution of hosts, vectors and the pathogens themselves. Hosts, vectors and pathogens co-evolve together in a constant antagonistic arms race with each participant's primary goal being to maximize its performance and fitness.