Characteristics of Skeletal Muscle Strength in Subjects With Interstitial Lung Disease.

OBJECTIVES: To investigate muscle strength and the prevalence of muscle weakness in adults with interstitial lung diseases (ILDs) compared to healthy subjects. DESIGN: Cross-sectional (description of clinical features). SETTING: Public referral center (University Hospital). PARTICIPANTS: One hundred and twelve adults with ILD (n=48, 60±10yr, 68% female) and healthy counterparts (control group, n=64, 57±10yr, 58% female) (N=112). INTERVENTION: Not applicable. MAIN OUTCOME MEASURE(S): Muscle strength and prevalence of muscle weakness in adults with ILD. Muscle strength was assessed via maximal isometric voluntary contraction of dominant upper and lower limb muscle groups. Data from the control group were used to generate reference equations. Muscle weakness was defined as a muscle strength value below the lower limit of normal calculated using data from the control group. Data were expressed as mean ± SD or median [interquartile range] according to the data distribution. RESULTS: Compared to the control group, adults with ILD had lower muscle strength for all muscle groups assessed (values presented as %predicted: pectoralis major 75[57-86]%; quadriceps 72[58-87]%; latissimus dorsi 76[57-103]%; deltoid 74[64-98]%; biceps brachii 78[64-91]%; triceps brachii 84[62-101]%; P≤.001 for all). Prevalence of muscle weakness in people with ILD was 40% for pectoralis major, 25% for latissimus dorsi, 16% for triceps brachii, 20% for biceps brachii, 27% for deltoid and 46% for quadriceps. CONCLUSIONS: Adults with ILD present a generalised reduction in peripheral Muscle strength, ranging between 20% to 46% of people depending on the muscle group assessed. and it was more prevalent in lower limb muscles.

An uncertainty approach for Electric Submersible Pump modeling through Deep Neural Network.

This work proposes a new methodology to identify and validate deep learning models for artificial oil lift systems that use submersible electric pumps. The proposed methodology allows for obtaining the models and evaluating the prediction's uncertainty jointly and systematically. The methodology employs a nonlinear model to generate training and validation data and the Markov Chain Monte Carlo algorithm to assess the neural network's epistemic uncertainty. The nonlinear model was used to overcome the limitations of the need for big datasets for training deep learning models. However, the developed models are validated against experimental data after training and validation with synthetic data. The validation is also performed through the models' uncertainty assessment and experimental data. From the implementation point of view, the method was coded in Python with Tensorflow and Keras libraries used to build the neural Networks and find the hyperparameters. The results show that the proposed methodology obtained models representing both the nonlinear model's dynamic behavior and the experimental data. It provides a most probable value close to the experimental data, and the uncertainty of the generated deep learning models has the same order of magnitude as that of the nonlinear model. This uncertainty assessment shows that the built models were adequately validated. The proposed deep learning models can be applied in several applications requiring a reliable and computationally lighter model. Hence, the obtained AI dynamic models can be employed for digital twin construction, control, and optimization.

The impact of sleep duration on physical activity in daily life in patients with idiopathic pulmonary fibrosis.

BACKGROUND: Despite the high prevalence of sleep disturbances in idiopathic pulmonary fibrosis (IPF), the relationship between physical activity in daily life (PADL) and sleep in this population remains unclear. OBJECTIVES: Investigate the impact of sleep on different domains of PADL in IPF and characterize their PADL profile. METHODS: Sixty-seven participants (thirty-three with IPF and thirty-four healthy subjects [control group]) were included. The subjects underwent assessments of pulmonary function, exercise capacity, respiratory and peripheral muscle strength, PADL, sleep, dyspnea, and health-related quality of life. PADL and sleep measures were assessed using an activity monitor (Actigraph®, wGT3x-BT). Associations between sleep and PADL were done using correlation and regression models. RESULTS: In the IPF, sleep duration at night associated significantly with step counts, sedentary, light, and moderate-to-vigorous physical activity (MVPA) (-0.82 ≤ R ≤ 0.43; p < .05 for all). Lung function and sleep partially explained PADL variables (0.19 ≤ R2 ≤ 0.65, p < .05 for all). Compared to controls, the IPF subjects presented lower step counts, less time spent in MVPA, standing position, and more time spent in lying position (p < .05, for all). CONCLUSIONS: Sleep duration is associated with PADL in IPF. The PADL profile of patients is worse than in control subjects.

The Prevalence of Oropharyngeal Dysphagia in Adults: A Systematic Review and Meta-analysis.

To determine the global prevalence of oropharyngeal dysphagia (OD) in adults. Six electronic databases (Embase, LILACS, LIVIVO, PubMed/Medline, Scopus, and Web of Science) were searched, in addition to gray literature (ASHA, Google Scholar, ProQuest Dissertation, and Theses). A random-effects model for meta-analysis of proportions was conducted, and heterogeneity was evaluated according to the moderator variable through subgroup analysis and meta-regression. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist and the certainty of the evidence was assessed using the GRADE tool. Thirty papers were included for qualitative and quantitative synthesis. The combined prevalence estimate was 60% [CI 95% = 50%-70%; I2 = 95%], accounting for different baseline conditions. However, the wide variation that exists between the different baseline conditions (underlying disease or risk factor) tended to overestimate this prevalence when considering the general population. Only one study evaluated healthy individuals, which showed a prevalence of 31% [CI95% = 27%-36%]. The risk of bias was considered low for all studies. None of the variables were considered predictors for the observed variance between the effect sizes of the included studies. For the prevalence of OD, the GRADE rating was considered very low. Despite the high prevalence observed, with over half of the individuals affected, the evidence regarding this outcome remains uncertain due to an overestimation of the generated estimates caused by the baseline condition of the sample.

Profissão e vocação: a enfermagem em questão / Profession and vocation: nursing in question / Profesión y vocación: la enfermería en cuestión

Objetivo: Identificar os motivos pelos quais levaram os estudantes a escolherem a formação universitário em Enfermagem. Metodologia: Estudo exploratório- descritivo, sob abordagem qualitativa, desenvolvido com 276 acadêmicos de Enfermagem de uma universidade pública do Noroeste do estado do Ceará, Brasil. As informações foram coletadas por meio de um questionário eletrônico, aplicado por meio da plataforma Google Forms®. Essas por sua vez, foram analisadas a partir de análise de conteúdo proposto por Minayo, com o suporte do software N VIVO 11®. Resultados: As palavras mais referidas pelos estudantes ao serem questionados acerca dos motivos na escolha do curso de Enfermagem, foram: "Área", "Saúde", "Curso" e "Profissão", as quais suscitam que em algumas situações a escolha do curso aconteceu pela área da Saúde e não pelo curso em específico. Entretanto, outras palavras com maior quantitativo de repetição foram identificadas: "Sempre", "Gosto" e "Enfermagem", que por sua vez, demonstram a identificação com o curso de Enfermagem em específico e com o fazer da profissão. A partir de então, foram definidas seis categorias de análise, a saber "Identificar-se com a profissão", "Determinação Social e Mercado de Trabalho", "Enfermagem como segunda ou única opção", "Influências externas", "Permanência na área da Saúde" e "Vocação e visão solidária-romântica". Considerações finais: A partir dos discursos dos participantes em estudo, evidenciou-se que os motivos pelos quais levaram esses a ingressarem no curso universitário em Enfermagem estão associados ao imaginário da vocação, da concepção da Enfermagem enquanto profissão voltada para o cuidar/cuidado, bem como pelo o interesse de atuação na área da saúde.

Objective: To identify the reasons why students chose a university degree in Nursing. Methodology: Exploratory-descriptive study, under a qualitative approach, developed with 276 Nursing students from a public university in the Northwest of the state of Ceará, Brazil. Information was collected through an electronic questionnaire, applied through the Google Forms® platform. These, in turn, were analyzed based on the content analysis proposed by Minayo, with the support of the N VIVO 11® software. Results: The words most mentioned by students when asked about the reasons for choosing the Nursing course were: "Area", "Health", "Course" and "Profession", which suggest that in some situations the choice of course happened by the Health area and not by the specific course. However, other words with a higher number of repetitions were identified: "Always", "I like" and "Nursing", which, in turn, demonstrate identification with the Nursing course in particular and with the profession. From then on, six categories of analysis were defined, namely "Identifying with the profession", "Social Determination and the Labor Market", "Nursing as a second or only option", "External influences", "Permanence in the area of Health" and "Vocation and solidarity-romantic vision". Final considerations: From the speeches of the participants in the study, it was evident that the reasons why they entered the university course in Nursing are associated with the imaginary of the vocation, of the conception of Nursing as a profession focused on care/care, as well as as well as the interest in acting in the health area.

Objetivo: Identificar las razones por las cuales los estudiantes eligieron la carrera universitaria de Enfermería. Metodología: Estudio exploratorio-descriptivo, con abordaje cualitativo, desarrollado con 276 estudiantes de Enfermería de una universidad pública del Noroeste del estado de Ceará, Brasil. La información se recolectó a través de un cuestionario electrónico, aplicado a través de la plataforma Google Forms®. Estos, a su vez, fueron analizados con base en el análisis de contenido propuesto por Minayo, con el apoyo del software N VIVO 11®. Resultados: Las palabras más mencionadas por los estudiantes cuando se les preguntó acerca de los motivos de la elección de la carrera de Enfermería fueron: "Área", "Salud", "Curso" y "Profesión", lo que sugiere que en algunas situaciones la elección de la carrera pasó por la carrera de Enfermería. área y no por el curso específico. Sin embargo, fueron identificadas otras palabras con mayor número de repeticiones: "Siempre", "Me gusta" y "Enfermería", que, a su vez, demuestran identificación con la carrera de Enfermería en particular y con la profesión. A partir de ahí, se definieron seis categorías de análisis, a saber, "Identificación con la profesión", "Determinación social y mercado de trabajo", "Enfermería como segunda o única opción", "Influencias externas", "Permanencia en el área de la Salud". " y "Vocación y visión solidaria-romántica". Consideraciones finales: A partir de los discursos de los participantes en el estudio, se evidenció que las razones por las cuales ingresaron a la carrera universitaria en Enfermería están asociadas al imaginario de la vocación, de la concepción de la Enfermería como profesión enfocada en el cuidado, así como el interés por actuar en el área de la salud.

The Impact of Family Stress and Resilience on Child Development: a scope review.

INTRODUCTION: Children grow up spending most of their time within the family social environment, where they can experience stressful situations such as marital conflict, a non-cohesive environment, parental alcohol use disorder, parental depression, and other parental mental health issues. All these factors are associated with children's developmental delays. OBJECTIVE: We aimed to conduct a scoping review on family stress and family resilience associated with child development delays to examine familial conditions associated with child development. METHODS: We conducted a scoping review of observational studies published between January 2000 to July 2023, indexed in MEDLINE and LILACS databases. We included observational studies that evaluated the history of exposure to violence, and behavioral or emotional symptoms, or mental health problems among children aged 4-12. Data were independently extracted using a structured form. RESULTS: Database searches identified 12,990 different records. A total of 43 articles were included in the review. Three main findings emerged: (1) parental mental health problems, especially depressive symptoms in mothers, were associated with child developmental delays and mental health problems; (2) better parenting practices and cohesive home environment were positively associated with child development, and (3) Vulnerable social environments (e.g., poverty and housing insecurity) may be linked to child mental health problems. CONCLUSIONS: Studies reviewed show that promoting better family dynamics and increasing family cohesion, as well as parenting abilities, are beneficial to a child's socio-emotional development and prevention of child mental health problems. Moreover, increasing family and children's resilience improves the quality of life within family units.

Determining reference ranges for immunological cells of healthy indigenous individuals from a region in Brazil.

Morais et al. conducted a pioneering study with Brazilian indigenous populations to determine reference values for immunologic cells from healthy adult individuals. The main findings included a higher relative median for T lymphocyte subsets in females than males, and T CD3+, T CD4+, and T CD8+ relative values were statistically different when compared with Brazilian populations from other Brazilian regions. The relative medians of CD3+, CD4+, and CD8+ T cells were significantly higher in women than in men in a healthy indigenous population. Demographic and ethnic diversity of the Brazilian population can be associated with quantitative modifications in the immunologic cells of healthy individuals. OBJECTIVE: The establishment of reference values for a subset of leukocytes is common in clinical practice, and ethnic variations are strongly associated with disease development. In Brazil, indigenous people are vulnerable to infections, and few studies have described the health and disease conditions of this population. This study aimed to provide reference values for immunological cell subsets in indigenous Brazilians living in the state of Mato Grosso do Sul. METHODS: Flow cytometry and 4-color combinations of monoclonal antibodies were used to characterize cells. A total of 115 healthy adults, mostly females (72%), were included in the study. The results are presented as mean and median (2.5%-97.5% percentiles) for T and B lymphocytes, CD4+ T cells, CD8+ T cells, Natural Killer cells, monocytes, and dendritic cells, providing an average immunological profile for the population in question. RESULTS: The relative medians of CD3+, CD4+, and CD8+ T cells were significantly higher in women than in men in a healthy indigenous population. CONCLUSION: To our knowledge, cell reference data from indigenous Brazilians are unknown in the literature. The immune cell results presented in this pioneering study will contribute to the clinical and laboratory evaluation of the Brazilian indigenous population, especially given the important differences when compared with other Brazilian ethnic groups.

Synthesis, characterization, and reusability of novel nanobiocomposite of endophytic fungus Aspergillus flavus and magnetic nanoparticles (Fe3O4) with dye bioremediation potential.

The incorrect disposal of textile dyes, such as Reactive Black 5 (RB5), causes several problems for living beings and the quality of the environment. Nanobiocomposites (NBC) produced from endophytic fungi (potentially remediation dyes-agents) and magnetic nanoparticles have high biotechnological potential due to their superparamagnetic behavior, which would allow their recovery through the magnetic field after the bioremediation process. This work aimed to obtain a new nanobiocomposite from the interaction of magnetite nanoparticles (Fe3O4) with the endophyte Aspergillus flavus (Af-CL-7) to evaluate its bioremediation capacity and to reduce the toxicity of RB5 and its reuse. Before obtaining the NBC, Af-CL-7 showed discoloration of RB5 and it was tolerant to all tested concentrations of this dye. The discovery of the nanobiocomposite textile dye bioremediator product presents a significant environmental advantage by addressing the issue of water pollution caused by textile dyes. The NBC called Af-Fe3O4 was successfully obtained with the magnetized endophyte, and their magnetic properties were verified by VSM analysis and by action of magnetic fields generated by Nd-Fe-B magnets SEM analyzes showed that the nanoparticles did not cause any damage to the hypha morphology, and TEM analyzes confirmed the presence of nanoparticles in the fungus wall and also inside the cell. The NBC Af-Fe3O4 and Af-CL-7 showed, respectively, 96.1% and 92.2% of RB5 discoloration in the first use, 91.1% e 86.2% of discoloration in the validation test, and 89.0% in NBC reuse. In the toxicological bioassay with Lactuca sativa seeds, NBC showed a positive reduction in the toxicity of RB5 after treatment, allowing the hypocotyl growth to be statistically similar to the control with water. Thus, we highlight the promising obtaining process of NBC that could be applied in bioremediation of contaminated waters, wherein the industrial economic cost will depend on the fermentation efficiency, biomass production and nanoparticle synthesis.

Antitumor and antibacterial activity of metabolites of endophytic Colletotrichum siamense isolated from coffee (Coffea arabica L. cv IAPAR-59).

Endophytic fungi produce a range of known metabolites and several others, not yet explored, which present important biological activities from the pharmaceutical and industrial perspective. Several studies have reported the diversity of endophytes in Coffea arabica plants, although few have been described in organic cultures. In the current paper, we describe the chemical profile of specialized metabolites in the ethyl acetate phase in a strain of the endophytic fungus Colletotrichum siamense associated with coffee (Coffea arabica L.) (Rubiaceae) and its potential against tumor cells and bacteria of medical and food importance. Cytotoxicity assays in tumor cells MCF-7 and HepG2/C3A were performed by MTT and microdilution in broth to evaluate the antibacterial action of metabolic extract. The antiproliferative assay showed promising results after 24 h of treatment, with 50% injunction concentrations for the two cell types. UHPLC-MS/MS analyses with an electrospray ionization source were used to analyze the extracts and identify compounds of species Colletotrichum siamense, which is still little explored as a source of active metabolites. Many of these compounds observed in the endophytic need to be chemically synthesized in industry, at high costs, while production by the fungus becomes a chemically and economically more viable alternative. Pyrocatechol, gentisyl alcohol, and alpha-linolenic acid, associated with different mechanisms of action against tumor cells, were detected among the main compounds. The extract of the endophytic fungus Colletotrichum siamense presented several compounds with pharmacological potential and antibacterial activity, corroborating its potential in biotechnological applications.

Application of two- and multiway chemometric strategies for describing elementomic changes in pepper plants exposed to cadmium stress by multielement determination.

The objective of this work was to evaluate elemental changes in pepper exposed to Cd stress through different chemometric tools. For this purpose, pepper plants were grown under five different treatments with different Cd concentrations in the nutrient solution. Considering the hypothesis that pepper plants exposed to Cd stress during growth undergo changes in the macro- and microelemental distribution in leaves, stems, and roots, principal component analysis (PCA) and parallel factor (PARAFAC) analysis were applied to compare bidirectional and multivariate chemometric strategies to assess elemental changes in pepper plants. Since the number of variables and the data generated were large and complex, the application of chemometric tools was justified to facilitate the visualization and interpretation of results. The mineral composition, namely the Ca, Cd, Cu, Fe, K, Mg, Mn, N, and P contents, was assessed in 180 samples of leaves, stems, and roots of the cultivated peppers. Then, PCA and PARAFAC analysis were applied to compare bidirectional and multivariate chemometric strategies to assess elemental changes throughout pepper plants. The visualization of the trend on each sample and their intrinsic relationship with the variables were possible with the application of PCA. The use of PARAFAC analysis permitted the simultaneous study of all samples in a straightforward representation of the information that facilitated a quick and comprehensive understanding of the spatial distribution of elements in plants. Thus, macroelements (Ca, K, Mg, N, and P) that were found in higher concentrations in leaves did not present significant differences in the distribution along the plants under different treatment conditions. In contrast, a significant impact on the microelement (Cu, Fe, and Mn) distribution was produced between uncontaminated and contaminated samples. This analysis revealed a significant accumulation of Cd in roots and adverse effects on normal plant growth, demonstrating their level of phytotoxicity to pepper.

Evaluation of SARS-CoV-2 ORF7a Deletions from COVID-19-Positive Individuals and Its Impact on Virus Spread in Cell Culture.

The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing the COVID-19 outbreak, posed a primary concern of public health worldwide. The most common changes in SARS-CoV-2 are single nucleotide substitutions, also reported insertions and deletions. This work investigates the presence of SARS-CoV-2 ORF7a deletions identified in COVID-19-positive individuals. Sequencing of SARS-CoV-2 complete genomes showed three different ORF7a size deletions (190-nt, 339-nt and 365-nt). Deletions were confirmed through Sanger sequencing. The ORF7a∆190 was detected in a group of five relatives with mild symptoms of COVID-19, and the ORF7a∆339 and ORF7a∆365 in a couple of co-workers. These deletions did not affect subgenomic RNAs (sgRNA) production downstream of ORF7a. Still, fragments associated with sgRNA of genes upstream of ORF7a showed a decrease in size when corresponding to samples with deletions. In silico analysis suggests that the deletions impair protein proper function; however, isolated viruses with partial deletion of ORF7a can replicate in culture cells similarly to wild-type viruses at 24 hpi, but with less infectious particles after 48 hpi. These findings on deleted ORF7a accessory protein gene, contribute to understanding SARS-CoV-2 phenotypes such as replication, immune evasion and evolutionary fitness as well insights into the role of SARS-CoV-2_ORF7a in the mechanism of virus-host interactions.

Produção de informações para tomada de decisão durante a pandemia de covid-19 / Information production for decision making during the covid-19 pandemic / Producción de información para la toma de decisiones durante la pandemia de covid-19

Objetivo: Narrar a experiência de um grupo de pesquisadores e gestores construindo materiais informativos a partir dos dados epidemiológicos dos casos de covid-19 em Sobral - CE. Métodos: Trata-se de um estudo do tipo relato de experiência. Contempla uma experiência vivenciada de maio a agosto de 2020. Resultados: Em reunião via internet, alguns integrantes do grupo de pesquisas Observatório de Pesquisas para o SUS com a participação da secretária da saúde de Sobral, do prefeito de Sobral, de um professor especialista em inteligência artificial para tratar do avanço da pandemia em Sobral e na colaboração dos pesquisadores locais diante desse cenário. As ações firmadas foram: analisar semanalmente os dados epidemiológicos do município, desenvolver semanalmente um boletim epidemiológico com um condensado das informações criadas a partir dos dados, expor projeções da curva da pandemia no município, dispor as redes sociais do grupo de pesquisa para as informações, manter o diálogo entre os profissionais e gestores para ajudar na tomada de decisão. Conclusão: Foi possível estabelecer um fluxo semanal de divulgação do boletim epidemiológico local. A experiência serve como base para decisões de outros locais que buscam alternativas na gestão do cuidado. (AU)

Objective: To narrate the experience of a group of researchers and managers building information materials from the epidemiological data of cases of covid-19 in Sobral - CE. Methods: This is an experience report study. Contemplates an experience lived from May to August 2020. Results: In a meeting via internet, some members of the research group Research Observatory for SUS with the participation of the health secretary of Sobral, the mayor of Sobral, a professor specializing in artificial intelligence to address the pandemic progress in Sobral and the collaboration of local researchers facing this scenario. The actions agreed upon were: analyze weekly the epidemiological data of the city, develop weekly an epidemiological bulletin with a condensed information created from the data, expose projections of the pandemic curve in the city, make available the social networks of the research group for information, maintain dialogue between professionals and managers to help in decision making. Conclusion: It was possible to establish a weekly flow of dissemination of the local epidemiological bulletin. The experience serves as a basis for decisions from other places that seek alternatives in the management of care. (AU)

Objetivo: Narrar la experiencia de un grupo de investigadores y gestores construyendo material informativo a partir de los datos epidemiológicos de los casos de covid-19 en Sobral/CE. Métodos: Se trata de un estudio de informe de experiencia. Contempla una experiencia vivida de mayo a agosto de 2020. Resultados: En una reunión vía internet, algunos miembros del grupo de investigación Observatorio para el SUS con la participación del secretario de salud de Sobral, el alcalde de Sobral, un profesor experto en inteligencia artificial para abordar el avance de la pandemia en Sobral y en la colaboración de los investigadores locales frente a este escenario. Las acciones acordadas fueron: analizar semanalmente los datos epidemiológicos del municipio, elaborar semanalmente un boletín epidemiológico con una información condensada creada a partir de los datos, exponer proyecciones de la curva pandémica en el municipio, poner a disposición las redes sociales del grupo de investigación para su información, mantener el diálogo entre profesionales y gestores para ayudar en la toma de decisiones. ]Conclusión: Fue posible establecer un flujo semanal de divulgación del boletín epidemiológico local. La experiencia sirve de base para las decisiones de otros lugares que buscan alternativas en la gestión del cuidado. (AU)

Caregiver Social Capital and Supportive Relationships are Associated with Better Child Social-Emotional Development.

This study examined how different domains of social capital and of social support among caregivers are associated with social-emotional development in children ages 4-6 and how caregiver depressive symptoms modify these associations. Using a stratified random sample of preschools, data included a cross-sectional study of 1147 child-caregiver pairs (543 girls) in a low-income municipality in Brazil. Crude and adjusted linear regression models revealed that all domains of social support and two domains of social capital were associated with less social-emotional development delay in children. Given a significant proportion of children in low- and middle-income countries do not meet developmental milestones, strengthening caregiver social capital and support in these settings may have the potential to improve child social-emotional development.

Are Social Vulnerability and Family Social Support Associated with Children's Psychiatric Symptoms?

Social influence can shape early childhood at different levels. We explored the association between social vulnerability and lifetime caregiver alcohol use with children's psychiatric symptoms. Multivariable logistic regression assessed the association between child psychiatric symptoms and social vulnerability among 1275 preschool child-caregiver pairs with lifetime caregiver alcohol used as a control variable. Of the children, 15.78% (95% CI 15.17-16.42) had internalizing symptoms, 2.49% (95% CI 2.19-2.83) had externalizing symptoms, and 9.36% (95% CI 8.88-9.86) had internalizing/externalizing symptoms. High social vulnerability was positively correlated with internalizing (aRRR 1.54; 95% CI 1.41-1.68) and internalizing/externalizing symptoms (aRRR 1.77; 95% CI 1.58-2.00). Low family support was strongly associated with internalizing/externalizing symptoms (aRRR 2.60; 95% CI 2.20-3.10). Lifetime caregiver alcohol use was positively correlated with all three psychiatric symptoms (aRRR 1.33; 95% CI 1.18-1.51; aRRR 1.13; 95% CI 1.06-1.59; and aRRR 1.26; 95% CI 1.12-1.42). Their association with children's mental health outcomes calls for social policy changes at the macrosystem level.

Determining reference ranges for immunological cells of healthy indigenous individuals from a region in Brazil

ABSTRACT Objective The establishment of reference values for a subset of leukocytes is common in clinical practice, and ethnic variations are strongly associated with disease development. In Brazil, indigenous people are vulnerable to infections, and few studies have described the health and disease conditions of this population. This study aimed to provide reference values for immunological cell subsets in indigenous Brazilians living in the state of Mato Grosso do Sul. Methods Flow cytometry and 4-color combinations of monoclonal antibodies were used to characterize cells. A total of 115 healthy adults, mostly females (72%), were included in the study. The results are presented as mean and median (2.5%-97.5% percentiles) for T and B lymphocytes, CD4+ T cells, CD8+ T cells, Natural Killer cells, monocytes, and dendritic cells, providing an average immunological profile for the population in question. Results The relative medians of CD3+, CD4+, and CD8+ T cells were significantly higher in women than in men in a healthy indigenous population. Conclusion To our knowledge, cell reference data from indigenous Brazilians are unknown in the literature. The immune cell results presented in this pioneering study will contribute to the clinical and laboratory evaluation of the Brazilian indigenous population, especially given the important differences when compared with other Brazilian ethnic groups.

Gerenciamento na Estratégia Saúde da Família: processo de validação para avaliação de competências / Gestión de la Estrategia Salud de la Familia: proceso de validación para la evaluación de competencias / Management in Family Health Strategy: validity process for assessing competences

Resumo Objetivo Validar um instrumento de competências para o gerenciamento de equipes de Estratégia Saúde da Família (ESF) Métodos Trata-se de uma pesquisa descritiva e metodológica de abordagem quantitativa realizada entre os anos de 2019 e 2020 com enfoque na validação de âmbito nacional do Instrumento: Avaliação das competências gerenciais na ESF. A validação das competências ocorreu por meio da técnica Delphi e a consistência interna foi examinada por meio do Alpha de Cronbach. Resultados Por meio da técnica Delphi, realizada com experts de áreas relacionadas ao constructo, foram validadas 47 competências, subdivididas em três dimensões: conhecimentos, habilidades e atitudes. A partir de então, as 47 competências foram decompostas em 25 itens do instrumento de avaliação. Este instrumento foi aplicado com gerentes de unidades básicas de saúde, com a finalidade de proceder a avaliação da consistência interna entre os itens. A matriz de correlação entre os itens do instrumento demonstrou forte correlação, o que representa que o instrumento possui níveis altos de confiabilidade. Conclusão O processo de validação demonstrou consistência interna entre os itens, de modo que o instrumento de avaliação das competências gerenciais mostrou-se apto para aplicação em pesquisas no âmbito da ESF.

Resumen Objetivo Validar un instrumento de competencias para la gestión de equipos de Estrategia Salud de la Familia (ESF). Métodos Se trata de una investigación descriptiva y metodológica de enfoque cuantitativo realizada entre los años 2019 y 2020 centrada en la validación de ámbito nacional del Instrumento: Evaluación de las competencias de gestión en la ESF. La validación de las competencias se realizó por medio del método Delphi y la consistencia interna se examinó por medio del alfa de Cronbach. Resultados Mediante el método Delphi, realizado con especialistas de áreas relacionadas con el constructo, se validaron 47 competencias, subdivididas en tres dimensiones: conocimientos, habilidades y actitudes. A partir de ahí, se desglosaron las 47 competencias en 25 ítems del instrumento de evaluación. Este instrumento se aplicó con gerentes de unidades básicas de salud, con la finalidad de proceder a la evaluación de la consistencia interna entre los ítems. La matriz de correlación entre los ítems del instrumento evidenció una fuerte correlación, lo que representa que el instrumento tiene altos niveles de fiabilidad. Conclusión El proceso de validación demostró consistencia interna entre los ítems, de modo que el instrumento de evaluación de las competencias de gestión demostró ser apto para uso en investigaciones en el ámbito de la ESF.

Abstract Objective To validate an instrument on competence for managing Family Health Strategy (FHS) teams. Methods This is a descriptive and methodological research with a quantitative approach carried out between 2019 and 2020 with a focus on the nationwide validity of FHS management competence assessment instrument. The validity of competences was performed using the Delphi technique and internal consistency was examined using Cronbach's alpha. Results Using the Delphi technique, performed with experts from areas related to the construct, 47 competences were validated, subdivided into three dimensions: knowledge, skills and attitudes. From then on, the 47 competences were broken down into 25 items of an assessment instrument. This instrument was applied with managers of Basic Health Units, in order to proceed with internal consistency assessment between items. The correlation matrix between the instrument items showed a strong correlation, which means that the instrument has high levels of reliability. Conclusion The validity process demonstrated internal consistency between items so that the instrument for assessing management competences proved to be suitable for application in research within the scope of FHS.

The Association of Bacterin and Recombinant Proteins Induces a Humoral Response in Sheep against Caseous Lymphadenitis.

In this study, we investigated the capacity of the recombinant proteins SpaC, NanH, SodC, and PLD of C. pseudotuberculosis to trigger protective humoral and cellular immune responses against experimentally induced C. pseudotuberculosis infection in sheep. The antigens were produced in a heterologous system and were purified by affinity chromatography. Nine sheep were randomly divided into three groups, which were immunized as follows: Group 1 (control)-a mix of adjuvants composed of the inactivated T1 strain of C. pseudotuberculosis and commercial Montanide™ISA 61 VG (T1M); Group 2-rSpaC, rSodC, rPLD, and T1M; Group 3-rNanH, rSodC, rPLD, and T1M. All groups were immunized twice (on days 0 and 30) and challenged on day 90 of the experiment. Humoral and cellular immune responses were evaluated by Enzyme-Linked Immunosorbent Assay (ELISA) to quantify the IgG antibodies and interferon-gamma (IFN-y). Both vaccine formulations with recombinant proteins (groups 2 and 3) could induce a significant humoral IgG immune response in sheep. The proteins rSodC, rPLD, and rNanH were more immunogenic, inducing significant levels of IgG antibodies after the first dose of the vaccine or after the challenge, maintaining constant levels until the end of the experiment. However, it was not possible to differentiate between the cellular responses induced by the vaccines. This lack of effectiveness points toward the need for further studies to improve the efficacy of this subunit-based vaccine approach.

Assessment of rSodC, rPknG, rNanH, and rSpaC as Antigens for Diagnostic Tools Against Caseous Lymphadenitis.

Corynebacterium pseudotuberculosis is a bacillus that causes caseous lymphadenitis in small ruminants, leading to great losses to rural producers; thus, an efficient diagnosis is necessary for using disease control measures. This study aimed to evaluate the antigenic potential of four C. pseudotuberculosis recombinant proteins (rSodC, rPknG, rNanH, and rSpaC) against sera of goat and sheep experimentally infected with one of three different C. pseudotuberculosis strains. Goats were infected with CAP76 or CAP21 strain (n = 10), sheep with VD57 strain (n = 6), and a group of not-infected animals (goats and sheep) were kept as a healthy control (healthy n = 12). Sera were collected at 0, 14, 60, 90, 180, or 190 days after inoculation for antigenicity testing using Western blotting and enzyme-linked immunosorbent assay (ELISA) techniques. Cross-reactivity tests with recombinant proteins were performed in goat serum experimentally vaccinated with Nocardia sp. or Rhodococcus equi bacterin. The rSodC protein showed discriminatory antigenic reactivity with a statistically significant difference against three different C. pseudotuberculosis strains evaluated in goats and sheep samples, while rPknG showed statistical significance only against two C. pseudotuberculosis strains evaluated in goats. rSodC was proved to be a strong candidate as a tool for diagnosis of C. pseudotuberculosis infection, once it was able to recognize antibodies against all strains evaluated in goats and sheep.

Differential Chemical Profile of Metabolite Extracts Produced by the Diaporthe citri (G-01) Endophyte Mediated by Varying the Fermented Broth pH.

Endophytic microorganisms show great potential for biotechnological exploitation because they are able to produce a wide range of secondary compounds involved in endophyte−plant adaptation, and their interactions with other living organisms that share the same microhabitat. Techniques used to chemically extract these compounds often neglect the intrinsic chemical characteristics of the molecules involved, such as the ability to form conjugate acids or bases and how they influence the solubilities of these molecules in organic solvents. Therefore, in this study, we aimed to evaluate how the pH of the fermented broth affects the process used to extract the secondary metabolites of the Diaporthe citri strain G-01 endophyte with ethyl acetate as the organic solvent. The analyzed samples, conducted by direct-infusion electrospray-ionization mass spectrometry, were grouped according to the pH of the fermented broth (i.e., <7 and ≥7). A more extreme pH (i.e., 2 or 12) was found to affect the chemical profile of the sample. Moreover, statistical analysis enabled us to determine the presence or absence of ions of high importance; for example, ions at 390.7 and 456.5 m/z were observed mainly at acidic pH, while 226.5, 298.3, and 430.1 m/z ions were observed at pH ≥ 7. Extraction at a pH between 4 and 9 may be of interest for exploring the differential secondary metabolites produced by endophytes. Furthermore, pH influences the chemical phenotype of the fungal metabolic extract.