Assessing the Clinical Impact of the SARS-CoV-2 Gamma Variant on Intensive Care Unit Admissions: Insights from a Reference Hospital in Northeastern Brazil.

The global challenge posed by the prolonged COVID-19 pandemic underscores the critical need for ongoing genomic surveillance to identify emerging variants and formulate effective public health strategies. This retrospective observational study, conducted in a reference hospital in Northeast Brazil and comprising 2116 cases, employed PCR genotyping together with epidemiological data to elucidate the impact of the Gamma variant during its emergence, revealing distinct patterns in hospitalization rates, severity of illness, and outcomes. The study emphasizes the challenges posed by the variant, particularly an increased tendency for ICU admissions and respiratory support, especially among adults aged 18 to 59 without comorbidities. Laboratory analyses further demonstrate elevated inflammatory, coagulation, and hepatic markers in the Gamma variant cohort, suggesting a more severe systemic response. Despite limitations, including a retrospective approach and single-institution data, the study underscores the importance of ongoing genomic surveillance. Overall, this research contributes valuable insights into the impact of the Gamma variant on COVID-19 dynamics, advocating for continued research and surveillance to inform effective public health strategies regarding evolving viral variants.

Capacity of community health centers to treat snakebite envenoming in indigenous territories of the Brazilian Amazon.

INTRODUCTION: The deaths from and morbidities associated with snakebites - amputations, loss of function in the limb, visible scarring or tissue damage - have a vast economic, social, and psychological impact on indigenous communities in the Brazilian Amazon, especially children, and represent a real and pressing health crisis in this population. Snakebite clinical and research experts have therefore proposed expanding antivenom access from only hospitals to include the community health centers (CHC) located near and within indigenous communities. However, there are no studies examining the capacity of CHCs to store, administer, and manage antivenom treatment. In response to this gap, the research team calling for antivenom decentralization developed and validated an expert-based checklist outlining the minimum requirements for a CHC to provide antivenom. METHODS: The objective of this study was thus to survey a sample of CHCs in indigenous territories and evaluate their capacity to provide antivenom treatment according to this accredited checklist. The checklist was administered to nurses and doctors from 16 CHCs, two per indigenous district in Amazonas/Roraima states. RESULTS: Our results can be conceptualized into three central findings: 1) most CHCs have the capacity to provide antivenom treatment, 2) challenges to capacity are human resources and specialized items, and 3) antivenom decentralization is feasible and appropriate in indigenous communities. CONCLUSION: Decentralization would provide culturally and contextually appropriate care accessibility to a historically marginalized and underserved population of the Brazilian Amazon. Future studies should examine optimal resource allocation in indigenous territories and develop an implementation strategy in partnership with indigenous leaders. Beyond the indigenous population, the checklist utilized could be applied to community health centers treating the general population and/or adapted to other low-resource settings.

Development and validation of a minimum requirements checklist for snakebite envenoming treatment in the Brazilian Amazonia.

BACKGROUND: Currently, antivenoms are the only specific treatment available for snakebite envenoming. In Brazil, over 30% of patients cannot access antivenom within its critical care window. Researchers have therefore proposed decentralizing to community health centers to decrease time-to-care and improve morbidity and mortality. Currently, there is no evidence-based method to evaluate the capacity of health units for antivenom treatment, nor what the absolute minimum supplies and staff are necessary for safe and effective antivenom administration and clinical management. METHODS: This study utilized a modified-Delphi approach to develop and validate a checklist to evaluate the minimum requirements for health units to adequately treat snakebite envenoming in the Amazon region of Brazil. The modified-Delphi approach consisted of four rounds: 1) iterative development of preliminary checklist by expert steering committee; 2) controlled feedback on preliminary checklist via expert judge survey; 3) two-phase nominal group technique with new expert judges to resolve pending items; and 4) checklist finalization and closing criteria by expert steering committee. The measure of agreement selected for this study was percent agreement defined a priori as ≥75%. RESULTS: A valid, reliable, and feasible checklist was developed. The development process highlighted three key findings: (1) the definition of community health centers and its list of essential items by expert judges is consistent with the Brazilian Ministry of Health, WHO snakebite strategic plan, and a general snakebite capacity guideline in India (internal validity), (2) the list of essential items for antivenom administration and clinical management is feasible and aligns with the literature regarding clinical care (reliability), and (3) engagement of local experts is critical to developing and implementing an antivenom decentralization strategy (feasibility). CONCLUSION: This study joins an international set of evidence advocating for decentralization, adding value in its definition of essential care items; identification of training needs across the care continuum; and demonstration of the validity, reliability, and feasibility provided by engaging local experts. Specific to Brazil, further added value comes in the potential use of the checklist for health unit accreditation as well as its applications to logistics and resource distribution. Future research priorities should apply this checklist to health units in the Amazon region of Brazil to determine which community health centers are or could be capable of receiving antivenom and translate this expert-driven checklist and approach to snakebite care in other settings or other diseases in low-resource settings.

Development and validation of a minimum requirements checklist for snakebite envenoming treatment in the Brazilian Amazonia

Background Currently, antivenoms are the only specific treatment available for snakebite envenoming. In Brazil, over 30% of patients cannot access antivenom within its critical care window. Researchers have therefore proposed decentralizing to community health centers to decrease time-to-care and improve morbidity and mortality. Currently, there is no evidence-based method to evaluate the capacity of health units for antivenom treatment, nor what the absolute minimum supplies and staff are necessary for safe and effective antivenom administration and clinical management. Methods This study utilized a modified-Delphi approach to develop and validate a checklist to evaluate the minimum requirements for health units to adequately treat snakebite envenoming in the Amazon region of Brazil. The modified-Delphi approach consisted of four rounds: 1) iterative development of preliminary checklist by expert steering committee; 2) controlled feedback on preliminary checklist via expert judge survey; 3) two-phase nominal group technique with new expert judges to resolve pending items; and 4) checklist finalization and closing criteria by expert steering committee. The measure of agreement selected for this study was percent agreement defined a priori as ≥75%. Results A valid, reliable, and feasible checklist was developed. The development process highlighted three key findings: (1) the definition of community health centers and its list of essential items by expert judges is consistent with the Brazilian Ministry of Health, WHO snakebite strategic plan, and a general snakebite capacity guideline in India (internal validity), (2) the list of essential items for antivenom administration and clinical management is feasible and aligns with the literature regarding clinical care (reliability), and (3) engagement of local experts is critical to developing and implementing an antivenom decentralization strategy (feasibility). Conclusion This study joins an international set of evidence advocating for decentralization, adding value in its definition of essential care items; identification of training needs across the care continuum; and demonstration of the validity, reliability, and feasibility provided by engaging local experts. Specific to Brazil, further added value comes in the potential use of the checklist for health unit accreditation as well as its applications to logistics and resource distribution. Future research priorities should apply this checklist to health units in the Amazon region of Brazil to determine which community health centers are or could be capable of receiving antivenom and translate this expert-driven checklist and approach to snakebite care in other settings or other diseases in low-resource settings.

A relevância em abordar suporte básico de vida para estudantes em escolas públicas e privadas / The relevance of addressing basic life support for students in public and private schools / La relevancia de abordar el soportevital básico para estudiantes en escuelas públicas y privadas

Objetivo:Investigar a relevância da abordagem de suporte básico de vida aos estudantes nas escolas públicas e privadas. Método:Trata-se de um trabalho constituído através de um estudo descritivo, exploratório, por intermédio de uma revisão sistemática, utilizandoestratégias qualitativas de pesquisa. Ao todo, nove artigos foram escolhidos, cujos critérios foram inclusão, exclusão e éticos. Posteriormente houve a leitura dos textos completos e descarte de conteúdos que fugiam da temática. Utilizou-se como base de dados a Biblioteca Virtual em Saúde e a PUBMED (Serviço da U. S. National Library of Medicine). Resultados:Verificou-se que os estudantes que tiveram contato com a temática Suporte Básico de Vida, por meio de simulações e questionários, se mostraram mais preparados para salvar vidas, prevenir acidentes e reduzir danos. Visto que, as emoções e o desenvolvimento de habilidades foram diretamente ligadas, pois, as emoções positivas contribuíram para maior adesão das informações e desenvolvimento de habilidades. Considerações Finais: Assim sendo, os estudantes entendem a relevância de abordar esse assunto e com treinamento contínuo nas escolas a longo prazo irá manter a expertise dos alunos, garantindo chances altas para salvar uma vida.

Objective:To investigate the relevance of the basic life support approach to students in public and private schools. Method:This is a work constituted through a descriptive, exploratory study, through an integrative review, using qualitative research strategies. In all, nine articles were chosen, whose criteria were inclusion, exclusion and ethical. Subsequently, the complete texts were read and contents that deviated from the theme were discarded. The Virtual Health Library and PUBMED (Service of the U.S. National Library of Medicine) were used as a database. Results:It was found that students who had contact with the theme Basic Life Support, through simulations and questionnaires, were more prepared to save lives, prevent accidents and reduce harm. Since emotions and skill development were directly linked, as positive emotions contributed to greater adherence to information and skill development. Final considerations:Therefore, students understand the relevance of addressing this subject and with continuous training in schools in the long term, students' expertise will be maintained, guaranteeing high chances of saving a life.

Objetivo:Investigar la pertinencia del abordaje de soporte vital básico para estudiantes de escuelas públicas y privadas. Método: Este es un trabajo constituido a través de un estudio descriptivo, exploratorio, a través de una revisión integradora, utilizando estrategias de investigación cualitativa. En total, se eligieron nueve artículos, cuyos criterios fueron de inclusión, exclusión y éticos. Posteriormente, se leyeron los textos completos y se descartaron los contenidos que se desviaban del tema. Se utilizó como base de datos la Virtual Health Library y PUBMED (Service of the U.S. National Library of Medicine). Resultados: Se constató que los estudiantes que tuvieron contacto con el tema Soporte Básico de Vida, a través de simulacros y cuestionarios, estaban máspreparados para salvar vidas, prevenir accidentes y reducir daños. Dado que las emociones y el desarrollo de habilidades estaban directamente relacionados, las emociones positivas contribuyeron a una mayor adherencia a la información y al desarrollo de habilidades. Consideraciones Finales: Por lo tanto, los estudiantes entienden la relevancia de abordar este tema y con la formación continua en las escuelas a largo plazo, se mantendrá la experiencia de los estudiantes, garantizando altas posibilidades de salvar una vida

A green method for the determination of illicit drugs in wastewater and surface waters-based on a semi-automated liquid-liquid microextraction device.

Liquid-phase microextraction (LPME) is a simple, low-cost, and eco-friendly technique that enables the detection of trace concentrations of organic contaminants in water samples. In this work, a novel customized microextraction device was developed for the LPME extraction and preconcentration of nine illicit drugs in surface water and influent and effluent wastewater samples, followed by analysis by GC-MS without derivatization. The customized device was semi-automated by coupling it with a peristaltic pump to perform the collection of the upper layer of the organic phase. The extraction parameters affecting the LPME efficiency were optimized. The optimized conditions were: 100 µL of a toluene/DCM/EtAc mixture as extractor solvent; 30min of extraction time under vortex agitation (500rpm) and a solution pH of 11.6. The limits of detection and quantification ranged from 10.5ng L-1 (ethylone) to 22.0ng L-1 (methylone), and from 34.9ng L-1 to 73.3ng L-1 for these same compounds, respectively. The enrichment factors ranged from 39.7 (MDMA) to 117 (cocaethylene) and the relative recoveries ranged from 80.4% (N-ethylpentylone) to 120% (cocaine and cocaine-d3). The method was applied to real surface water, effluent, and influent wastewater samples collected in Salvador City, Bahia, Brazil. Cocaine was the main drug detected and quantified in wastewater samples, and its concentration ranged from 312ng L-1 to 1,847ng L-1. Finally, the AGREE metrics were applied to verify the greenness of the proposed method, and an overall score of 0.56 was achieved, which was considered environmentally friendly.

Multivariate optimization of a green procedure for determination of emerging polycyclic aromatic nitrogen heterocycles in PM2.5 from sites with different characteristics.

Emerging polycyclic aromatic nitrogen heterocycles (PANHs) contributes significantly to the health risk associated with inhaling polluted air. However, there is a lack of analytical methods with the needed performance to their determination. This study presents the optimization and validation for the first time of a green microscale extraction procedure for the determination of twenty-one PANHs, including carbazole, indole, and quinolone classes, in particulate matter (PM2.5) samples by gas chromatography-mass spectrometry. A simplex-centroid mixture design and full factorial design (23) were employed to optimize the following extraction parameters: type and volume of solvent, sample size, extraction time, and necessity of a cleanup step. Low limits of detection and quantification (LOD < 0.97 pg m-3 and LOQ < 3.24 pg m-3, respectively) were obtained in terms of matrix-matched calibration. The accuracy and precision of the method were adequate, with recoveries in three levels between 73 to 120% and intraday and interday relative standard deviations from 2.0 to 12.9% and 7.3 to 18.9%, respectively. The green character of the method was evaluated using the Analytical Greenness (AGREE) tool, where a score of 0.69 was obtained, indicating a great green procedure. The method was applied to PM2.5 samples collected from sites with different characteristics; the concentrations ranged from 69.3 pg m-3 (2-methylcarbazole) to 11,874 pg m-3 (carbazole) for individual PANHs and from 2306 to 24,530 pg m-3 for ∑21PANHs. Principal component analysis (PCA) and hierarchical clustering enabled discrimination of the sampling sites according to the PANHs concentrations. The score plots formed two distinct groups, one with samples containing higher concentrations of PANHs, corresponding to sites with a major influence from diesel emissions, and another group with minor PANH contents, corresponding to sites impacted by emissions from urban traffic and industrial activities.

Quantification of polycyclic aromatic sulfur heterocycles in fine airborne urban particles (PM2.5) after multivariate optimization of a green procedure.

Polycyclic aromatic sulfur heterocycles (PASHs), such as benzothiophenes (BT), dibenzothiophenes (DBT) and benzonapthothiophenes (BNT), can be emitted from vehicular traffic and deposited in fine particles matter (PM2.5). The presence of these compounds in PM2.5 is an environmental concern due to air pollution and its toxic properties. In this study, a green microscale solid-liquid extraction method was developed to determine twenty-three PASHs in PM2.5. A simplex-centroid mixture design was applied to optimize the extraction solvent. A full factorial design was used for preliminary evaluation of the factors that influence the extraction process (extraction time, sample size, and solvent volume) and then a Doehlert design for the significant parameters. The optimal extraction conditions based on the experimental design were: sample size, 4.15 cm2; 450 µL of toluene:dichloromethane (80:20,v/v); and extraction duration, 24 min. High sensitivity (LOD < 0.66pg m-3 and LOQ < 2.21 pg m-3) and acceptable recovery (82.8-120 %), and precision (RSD 3.6-14.0 %) were obtained. The greenness of the method was demonstrated using the Analytical GREEnness (AGREE) tool. The method was applied for analyzing PASHs in PM2.5 samples collected in three time intervals per day from years with different sulfur contents in the diesel: S-500 (≤500 ppm sulfur) and S-50 (≤50 ppm sulfur). Fourteen PASHs were quantified with the highest concentrations observed for 2,8-DMDBT and 4,6-DMDBT, which are recalcitrant compounds. The ANOVA test indicated significant differences between sampling periods during the day. The reduction of diesel S-500 to S-50 corresponded to a 28 % decrease in the total sum of PASHs (∑PASHs) evaluated. Spearman's rank correlations allowed for verifying that BTs and DBTs were highly correlated, suggesting that they were derived from similar sources. A weak correlation of 2,1-BNT and 2,3-BNT with BTs and DBTs indicates that these compounds are a chemical proxy for the emission of diesel engines during the combustion process.

Polycyclic aromatic hydrocarbons in coral reefs with a focus on Scleractinian corals: A systematic overview.

The impact of petroleum exploitation and oil spills in marine ecosystems has increased over time. Among the concerns regarding these events, the impact on coral reefs stand out because this ecosystem has ecological and economic importance and is globally threatened. We performed a systematic review and bibliometric analysis of studies that determine polycyclic aromatic hydrocarbons (PAHs) in coral reefs, attempting to answer how the studies were distributed around the globe, the main environmental matrices and species of coral studied, the main PAHs found and their mean concentrations, and the methodology used. A bibliographic search resulted in 42 studies with worldwide distribution. The bibliometric results presented more explored terms, such as sediments and toxicology, and newly investigated terms, which should encourage a new area of study, such as those related to zooxanthellae and mucus. The main matrices studied in coral reefs are sediments, corals, and water, whereas air and other invertebrates have rarely been studied. Approximately 45 species of corals with several morphotypes have been reported. PAHs recommended by the United States Environmental Protection Agency (US EPA) were analyzed in all studies, while additional compounds were analyzed in only five. The methods used to determine hydrocarbons are predominantly the most traditional; however, for corals, studies have tended to separate tissue, zooxanthellae, skeleton, and mucus. In the future, we recommend investment in improving the capacity to detect non-conventional PAHs, more studies in regions that are rarely explored in developing countries, and the creation of databases to facilitate management planning on marine coasts.

"Two Cultures in Favor of a Dying Patient": Experiences of Health Care Professionals Providing Snakebite Care to Indigenous Peoples in the Brazilian Amazon.

In the Brazilian Amazon, deaths and disabilities from snakebite envenomations (SBEs) are a major and neglected problem for the indigenous population. However, minimal research has been conducted on how indigenous peoples access and utilize the health system for snakebite treatment. A qualitative study was conducted to understand the experiences of health care professionals (HCPs) who provide biomedical care to indigenous peoples with SBEs in the Brazilian Amazon. Focus group discussions (FGDs) were carried out in the context of a three-day training session for HCPs who work for the Indigenous Health Care Subsystem. A total of 56 HCPs participated, 27 in Boa Vista and 29 in Manaus. Thematic analysis resulted in three key findings: Indigenous peoples are amenable to receiving antivenom but not to leaving their villages for hospitals; HCPs require antivenom and additional resources to improve patient care; and HCPs strongly recommend a joint, bicultural approach to SBE treatment. Decentralizing antivenom to local health units addresses the central barriers identified in this study (e.g., resistance to hospitals, transportation). The vast diversity of ethnicities in the Brazilian Amazon will be a challenge, and additional studies should be conducted regarding preparing HCPs to work in intercultural contexts.

The occurrence of pristine and functionalized fullerenes as constituents of airborne aerosols.

We investigated if pristine and functionalized fullerenes could be actual constituents of fine atmospheric aerosols. Comprehensive profiles of fullerenes from 1 µL extracts were made through matrix laser desorption ionization Time-of-Flight Mass Spectrometry (MALDI-MS) within a few minutes. The ion with m/z 720, corresponding to [C60]-•, was identified as fullerene after 1 µL of α-cyano-4-hydroxycinnamic acid matrix solution was spotted over the dried extracts. The ions with the m/z corresponding to C70, C76, C84, C100, C118, C128, and C130 were also attributed to other fullerene species detected within the samples. The ion m/z 878 was found to be the fullerene derivative diethyl methano[60]fullerene dicarboxylate. Since ions of fragmented fullerene molecules were not detected even at high laser energies, we considered the fullerenes' occurring as original constituents of real atmospheric particle matrices instead of being formed as artifacts of the laser action on samples. Therefore, this protocol would be helpful in the understanding of the distribution of either pristine or functionalized fullerenes in the environment and their participation in atmospheric chemistry under typical conditions, as well as its application in vitro and in vivo (eco)toxicity studies.

Perceptions of nurses regarding the management of snakebite envenomations: Limits and possibilities.

Snakebites can be caused by harmless or venomous snakes and, according to their severity and frequency, can be considered events of medical importance. In health facilities in remote areas, nurses work in the first line of care of patients that are victims of these envenomations. The aim was to discover the perception of nurses regarding the management of snakebites, its limitations and possibilities, with a view to professional empowerment in the context of primary health care. This is exploratory and descriptive research, with a qualitative approach, developed at FMT-HVD in Manaus, Amazonas state, Brazil, in the year 2021. The participants were nurses who work in basic health units in the municipalities of Careiro da Várzea, Ipixuna and Boa Vista do Ramos in the state of Amazonas. For data collection, the focus group strategy was adopted. Thematic content analysis was employed, which was carried out in the stages of pre-analysis; exploration or coding of the material; treatment of the results, inference and interpretation. After processing the data obtained, four topics emerged from the coding: Topic 1 - limitations in the primary care. Topic 2 - the need for infrastructure and personnel. Topic 3 - the need for continuing education. Topic 4 - the perception of training regarding the management of snakebite envenomations. The results showed a lack of antivenom in the healthcare units where nurses work. Another aspect highlighted by the nurses is the absence of a doctor in situ to perform the primary care or out of hours care in the units. The nurses' perceptions regarding the management of snakebite envenomations revealed the existence of failures in relation to the subject, such as the lack of antivenom, poor infrastructure in the units and the lack of a doctor, which must be solved, since the nurses are the most active professionals in primary health care, in addition to the high incidence of snakebite envenomations in the Brazilian Amazon.

Perspectives on snakebite envenoming care needs across different sociocultural contexts and health systems: A comparative qualitative analysis among US and Brazilian health providers.

With the advancements in therapeutics and available treatment options, almost all deaths and permanent disabilities from snakebite envenoming (SBE) are preventable. The challenge lies in implementing these evidence-based treatments and practices across different settings and populations. This study aims to compare data on provider perceptions of SBE care across health systems and cultural contexts to inform potential implementation science approaches. We hypothesize different health systems and cultural contexts will influence specific perceived needs to provide adequate snakebite care within central tenets of care delivery (e.g., cost, access, human resources). We previously conducted exploratory descriptive studies in the US and Brazil in order to understand the experience, knowledge, and perceptions of health professionals treating SBE. In the US, in-depth interviews were performed with emergency physicians from January 2020 to March 2020. In BR, focus group discussions were conducted with health professionals from community health centers at the end of June 2021. The focus group discussions (BR) were originally analyzed through an inductive thematic analysis approach. We conducted a secondary qualitative analysis in which this codebook was then applied to the interviews (US) in a deductive content analysis. The analysis concluded in August 2022. Brazil participants were physicians (n=5) or nurses (n=20) from three municipalities in the State of Amazonas with an average of three years of professional experience. US participants were emergency physicians (n=16) with an average of 15 years of professional experience. Four main themes emerged: 1) barriers to adequate care on the patient and/or community side and 2) on the health system side, 3) perceived considerations for how to address SBE, and 4) identified needs for improving care. There were 25 subthemes within the four themes. These subthemes were largely the same across the Brazil and US data, but the rationale and content within each shared subtheme varied significantly. For example, the subtheme "role of health professionals in improving care" extended across Brazil and the US. Brazil emphasized the need for task-shifting and -sharing amongst health care disciplines, whereas the US suggested specialized approaches geared toward increasing access to toxicologists and other referral resources. Despite similar core barriers to adequate snakebite envenoming care and factors to consider when trying to improve care delivery, health professionals in different health systems and sociocultural contexts identified different needs. Accounting for, and understanding, these differences is crucial to the success of initiatives intended to strengthen snakebite envenoming care. Implementation science efforts, with explicit health professional input, should be applied to develop new and/or adapt existing evidence-based treatments and practices for SBE.

Plastic pellets make Excirolana armata more aggressive: Intraspecific interactions and mortality in field and laboratory ecotoxicological assays.

Microplastics, including plastic pellets, get stranded on sandy beaches. They persist in the oceans for long periods and frequently carry contaminants. Acute and chronic toxicity has been observed when marine organisms are exposed to high densities of plastic pellets in laboratory assays. We investigated the toxicity of beach-stranded plastic pellets on macrobenthic populations (Excirolana armata; Crustacea; Isopoda) under natural conditions (in situ). We simulated different pellets densities on a beach not contaminated by pellets, exposing isopods for 6 h and testing possible behavioral responses (i.e., vertical displacement) and mortality effects. No effect was observed on vertical displacement, but higher mortality was reported for organisms exposed to plastic pellets. The lowest pellet density tested commonly found in coastal areas was sufficient to trigger mortality. We also observed that lethargic individuals (near-death) were preyed on by the healthy individuals remaining in the test chambers.

Occurrence of mercury in polychaete species (Annelida) and their associated sediments from an important Southern Atlantic Ocean Bay.

In the present study, the Hg levels in freshly collected polychaete species and their associated sediments were evaluated from Todos os Santos Bay, Northeastern Brazil. Additionally, it was also measured the Hg distribution along the annelids' body parts (anterior region, abdomen, and posterior region). Total Hg concentration was as follows: 13.6-144 µg kg-1 (Scolelepis chilensis, deposit feeder), 8.2-122 µg kg-1 (Laeonereis acuta, deposit feeder), 95-612 µg kg-1 (Armandia agilis, deposit feeder); 96.6-206 µg kg-1 (Lumbrineris sp., carnivorous), 75.3-112 µg kg-1 (Goniada echinulate, carnivorous), and 115-198 µg kg-1 (Branchiomma sp., suspension feeder). In turn, Hg levels in sediments ranged from 2.77 ± 0.24 to 6.38 ± 0.15 µg kg-1. Hg concentrations found in polychaete soft tissues were higher than those found in the sediments. Specific habits, feeding behavior, trophic level, and stressful environmental conditions are the main factors affecting the Hg levels in the species studied. The bioaccumulation factor (BAF), contamination factor (CF), and ecological risk assessment (Er) were calculated. The BAF values were higher than 1 for all studied species, indicating Hg bioaccumulation in the annelids, but the low levels of CF e Er showed those Hg levels present low to no significant ecological risk for the biota and benthonic organisms living in the sediments. Finally, no statistically significant difference was observed for Hg concentration levels along the polychaete body parts.

In silico approaches for drug repurposing in oncology: Protocol for a scoping review of existing evidence.

Drug repurposing has been applied in the biomedical field to optimize the use of existing drugs, leading to a more efficient allocation of research resources. In oncology, this approach is particularly interesting, considering the high cost related to the discovery of new drugs with therapeutic potential. Computational methods have been applied to predict associations between drugs and their targets. However, drug repurposing has not always been promising and its efficiency has yet to be proven. Therefore, the present scoping review protocol was developed to screen the literature on how in silico strategies can be implemented in drug repurposing in oncology. The scoping review will be conducted according to the Arksey and O'Malley framework (2005) and the Joanna Briggs Institute recommendations. We will search the PubMed/MEDLINE, Embase, Scopus, and Web of Science databases, as well as the grey literature. We will include peer-reviewed research articles involving in silico strategies applied to drug repurposing in oncology, published between January 1, 2003, and December 31, 2021. Data will be charted and findings described according to review questions. We will report the scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review guidelines (PRISMA-ScR).

Validation of a Culturally Relevant Snakebite Envenomation Clinical Practice Guideline in Brazil.

Snakebite envenoming (SBE) is a neglected tropical disease with significant global morbidity and mortality. Even when antivenom is available in low-resource areas, health workers do not receive adequate training to manage SBEs. This study aims to develop and validate a clinical practice guideline (CPG) for SBE management across Brazil. A panel of expert judges with academic and/or technical expertise in SBE management performed content validation. The content validity index (CVI) score was 90% for CPG objectives, 89% for structure and presentation and 92% for relevance and classified the CPG as valid. A semantic validation was performed by analyzing focus group discussions with doctors and nurses from three municipalities of the Brazilian Amazon, after a 5-day meeting during which the CPG was presented. Two central themes emerged: knowledge acquired during the meeting and recommendations for improving the CPG. Based on these results, the CPG was revised into a final version. This study presents the successful development and validation process of a CPG for SBE management, which is targeted to a specific low-resource, high-burden setting. This development and validation process can be adapted to other settings and/or other neglected tropical diseases.

Method development using chemometric tools for determination of endocrine-disrupting chemicals in bottled mineral waters.

A simple method was developed to determine 14 endocrine-disrupting chemicals (EDCs) in bottled waters, based on dispersive micro-solid phase extraction (d-µ-SPE) and liquid chromatography-mass spectrometry (LC-MS). Extraction was optimized using 2 k-1 factorial and Doehlert experimental designs. Optimized conditions were 80 mg C18, 25 min extraction at 1000 rpm, and 6 min desorption time. Repeatability was below 17 % for all EDCs. LOD and LOQ varied from 1.60 ng L-1 (estradiol, E2) to 23.2 ng L-1 (dimethylphthalate, DMP) and from 5.33 ng L-1 (E2) to 77.3 ng L-1 (DMP). We found DMP and bisphenol A (BPA) in samples after the heat treatment. DMP was up to 58.7 µg L-1, while BPA was up to 1.34 µg L-1. Tolerance of daily intake (TDI) for DMP were 2.50-2.94 µg kg-1 day-1 (children) and 1.43-1.68 µg kg-1 day-1 (adults). TDI for BPA were 0.03-0.07 µg kg-1 day-1 (children) and 0.01-0.04 µg kg-1 day-1 (adults).

Occurrence, sources, and risk assessment of unconventional polycyclic aromatic compounds in marine sediments from sandy beach intertidal zones.

This study investigated the concentrations of polycyclic aromatic compounds (PACs), including parent polyaromatic hydrocarbons (PAHs) and their nitrated and oxygenated derivatives, in 48 sediment samples from the intertidal region of sandy beaches in Baía de Todos os Santos (BTS), Salvador, State of Bahia, Brazil. The total PAH (∑PAH) concentration, total nitro-PAH (∑nitro-PAH) concentration, and total oxy-PAH (∑oxy-PAH) concentration ranged from 2.11 µg g-1 dry weight (dw) to 28.0 µg g-1 dw, 2.58 µg g-1 dw to 30.2 µg g-1 dw, and 0.34 µg g-1 dw to 3.65 µg g-1 dw, respectively. Elevated concentrations of parent PAHs and nitro-PAHs were found in samples from two sites in BTS, which were also characterized by high percentages of fine-medium sand and low organic matter contents. Potent mutagenic 3-nitrobenzanthrone (3-NBA) was found in 86% of the samples at concentrations ranging from 0.200 µg g-1 dw to 0.690 µg g-1 dw. Furthermore, calculations of the benzo[a]pyrene toxicity equivalency (BaPTEQ) indicated that three carcinogenic high-molecular-weight PAHs accounted for 98.7% of the total maximum PAH concentration. Finally, we assessed the possible environmental risks posed to benthic species living in the sediments of BTS. The results showed that the risk quotient for PAHs (RQPAHs) was ≥1. In turn, the summed RQ for all PACs (∑RQmixture) ranged from 1 to 30, but did not exceed the maximum allowable threshold; thus, the risks posed to benthic species were moderate for all sediment samples.

Validation of a culturally relevant snakebite envenomation clinical practice guideline in Brazil

Snakebite envenoming (SBE) is a neglected tropical disease with significant global morbidity and mortality. Even when antivenom is available in low-resource areas, health workers do not receive adequate training to manage SBEs. This study aims to develop and validate a clinical practice guideline (CPG) for SBE management across Brazil. A panel of expert judges with academic and/or technical expertise in SBE management performed content validation. The content validity index (CVI) score was 90% for CPG objectives, 89% for structure and presentation and 92% for relevance and classified the CPG as valid. A semantic validation was performed by analyzing focus group discussions with doctors and nurses from three municipalities of the Brazilian Amazon, after a 5-day meeting during which the CPG was presented. Two central themes emerged: knowledge acquired during the meeting and recommendations for improving the CPG. Based on these results, the CPG was revised into a final version. This study presents the successful development and validation process of a CPG for SBE management, which is targeted to a specific low-resource, high-burden setting. This development and validation process can be adapted to other settings and/or other neglected tropical diseases