Heavy metals in soils derived from sedimentary rocks of the Gurgueia River watershed, Northeast, Brazil: background values, distribution and ecological risk assessment.

The concentrations of heavy metals (HMs) can be increased by various anthropogenic activities such as mining, fuel combustion, pesticide use, and urban development, which can alter the mechanisms determining their spatial variability in the environment. Determining natural concentrations, monitoring, and assessing potential ecological risks are essential in the management of pollution prevention policies and soil conservation in watersheds. The aim of this study was to determine HMs natural concentrations, establish quality reference values (QRVs), and evaluate pollution indices in a watershed-scale. Composite surface soil samples (n = 115) were collected from areas: native vegetation, pasture, perennial crops, urbanization, planted forest, annual crops, and desertification. The soil samples digestion followed the EPA 3051A, and metals determination in ICP-OES. The data were subjected to the Kruskal-Wallis test, Spearman's correlation, multivariate clustering analysis and. geostatistics. The QRVs established (75th) for the Gurgueia River watershed in descending order were (mg kg-1): V (26.16) > Cr (18.06) > Pb (6.24) > Zn (3.86) > Cu (2.66) > Ni (1.45) > Co (0.57) > Mo (0.46) > Cd (0.07). The concentrations of Cd, Co, Cr, Mo, Ni, V, and Zn in types of land and management practices were significantly increased compared to those in natural vegetation. Overall, the watershed falls into the categories of minimal to moderate enrichment, moderate to considerable contamination, and low to moderate potential ecological risk, with Cd presenting elevated values. The percentages of polluted samples ranged from 14.3 to 82.5%, indicating the need for monitoring these areas to ensure environmental quality and food safety.

Marine mesocosm system: A reliable tool for testing bioaccumulation and effects of seawater enrichment with dissolved iron in reef organisms.

In 2015, a marine mesocosm facility was designed and implemented by the Coral Vivo Project in its research station (Porto Seguro, Bahia State, Brazil) to initially study the effects of global impacts, especially ocean warming and acidification, on coral reefs. However, local impacts, including seawater contamination with metal(loid)s, are considered as a major threat to coral reefs. Also, in 2015, the largest disaster involving a mining dam occurred in Brazil. Iron (Fe) mining tailings originated from the dam failure affected not only freshwater ecosystems (rivers, lakes and lagoons), but also adjacent beaches, mangroves, restingas, reefs and other marine systems. Seawater, sediments and biota were contaminated with metal(loid)s, especially Fe, arsenic (As), mercury (Hg) and manganese (Mn). Therefore, we aimed to adapt the marine mesocosm facility of the Coral Vivo Project to evaluate the bioaccumulation and biological impacts of increasing concentrations of dissolved Fe on a diversity of reef organisms. Results obtained indicate a great versatility and reliability of the marine mesocosm system for application in biological and ecological studies on the isolated effect of seawater dissolved Fe on reef organisms of different functional groups simultaneously.•Studies involving seawater enrichment with dissolved Fe can be performed using a marine mesocosm system.•The marine mesocosm is a reliable tool to study the isolated effects of metal(loid)s on reef organisms.

Importância da assistência odontológica dentro do ambiente hospitalar / Importance of dental care within the hospital enviroment

A assistência odontológica é imprescindível para a prevenção de doenças infecciosas e para a manutenção da integridade da cavidade oral de pacientes internatos em unidades de terapia intensiva. O objetivo deste estudo foi avaliar o conhecimento e as práticas de higiene oral dos acadêmicos do curso de Enfermagem de uma instituição de ensino superior, que realizam estágio em hospital, no controle de higiene bucal de pacientes internados em ambiente hospitalar. Participaram do estudo 40 alunos, que responderam 14 perguntas com o intuito de avaliar o conhecimento e as práticas no controle de higiene bucal, realizadas por eles, em pacientes internados em ambiente hospitalar. Os resultados demonstraram que os acadêmicos entrevistados tinham idade média de 25,8 anos, sendo 95% do sexo feminino e apenas 5% do sexo masculino. Destes, 42,5% afirmaram não haver presença de um Cirurgião-Dentista em ambiente hospitalar e 82,5% responderam que o responsável pela saúde bucal dos pacientes é do técnico de enfermagem. Quanto aos cuidados em pacientes internados em UTI, 52,5% dos entrevistados relataram que estes pacientes recebem higienização bucal, porém 30% alegaram que esta pratica não era realizada e 17,5% não sabiam responder. Além disso, 47,5% dos entrevistados afirmam ter insegurança ao realizar os procedimentos de higiene bucal dos pacientes. Pode-se concluir que os acadêmicos entrevistados possuem bom conhecimento acerca da importância dos cuidados com a saúde bucal dos pacientes internados em ambiente hospitalar. No entanto, ainda existem muitas dúvidas relacionadas ao manejo clínico de procedimentos de promoção de saúde bucal, que poderiam ser solucionados com a presença de um profissional de Odontologia inserido em uma equipe multidisciplinar(AU)

Oral care is essential for the prevention of infectious diseases and for maintaining the integrity of the oral cavity of patients hospitalized in intensive care units. The objective of this study is to evaluate the knowledge and oral hygiene practices of Nursing students at a higher education institution, who carry out internships in a hospital, in controlling the oral hygiene of patients admitted to a hospital environment. 40 students participated in the study, who answered 14 questions with the aim of evaluating the knowledge and practices in controlling oral hygiene, carried out by them, on patients hospitalized in a hospital environment. The results demonstrated that the academics interviewed had an average age of 25.8 years, with 95% being female and only 5% being male. Of these, 42.5% stated that there was no presence of a Dental Surgeon in a hospital environment and 82.5% responded that the nursing technician is responsible for the patients' oral health. Regarding care for patients admitted to the ICU, 52.5% of those interviewed reported that these patients receive oral hygiene, however 30% claimed that this practice was not performed and 17.5% did not know how to answer. Furthermore, 47.5% of those interviewed say they are insecure when carrying out oral hygiene procedures for patients. It can be concluded that the academics interviewed have good knowledge about the importance of oral health care for patients hospitalized in a hospital environment. However, there are still many doubts related to the clinical management of oral health promotion procedures, which could be resolved with the presence of a dentistry professional within a multidisciplinary team(AU)

Assessment of space changes in the lower dental arch after the premature unit loss of a primary molar: A randomized clinical trial.

BACKGROUND: Premature loss of primary teeth presents a significant challenge in oral health, with conflicting views on using space maintainers. AIM: To assess mandibular arch space changes associated with premature lower primary molar (PM) loss with or without a space maintainer. DESIGN: A randomized clinical trial with children (6-9 years old) with premature loss of a lower PM divided into two groups: control group (CG), without a space maintainer, and intervention group (IG), with a space maintainer. Dental casts were measured at baseline, 3 months, and 6 months. Linear distance; intercanine width and length; and arch width, length, and perimeter were measured. ANOVA and t-test were applied (p = .05). RESULTS: Twenty-six patients (mean: 7.3 years; standard deviation [SD]: 0.92) were included: 14 in CG and 12 in IG. CG had a greater space loss (-0.9 mm; SD: 0.45) than IG (-0.4 mm; SD: 0.61) at 3 months (p < .05). No difference between the groups was observed after 6 months (p = .610). CG decreases space at 6 months, especially with the first permanent molars without intercuspation (-2 mm; SD: 0.71; p = .007). CONCLUSION: Premature lower PM loss resulted in reduced arch space loss after 6 months, regardless of a space maintainer use. CG showed more loss of space when the first permanent molars lacked intercuspal relationship.

Risks of soil chemical degradation from atmospheric gypsum plumes around selected extraction and processing enterprises, Northeast Brazil.

Gypsum plays a prominent role in agriculture, being considered an effective alternative to alleviate subsurface acidity due to its higher solubility and containing sulfur. However, another significant aspect is which pose long-term risks of groundwater contamination due to excessive applications of salts, pesticides, and other chemicals that will be leached, or even soil chemical depletion. So far, no study has focused on understanding the impacts of the atmospheric gypsum plume originating from gibbsite mining and processing on the leaching of soil bases and chemical degradation surrounding these sites. In this study, we evaluated the behavior of chemical characteristics in soil profiles distributed along the dispersion of the atmospheric plume and in areas without interference from the industrial sector in the state of Maranhão, Northeast Brazil. Fifty-three sampling points were collected at 7 locations based on the dispersion of the dust plume through wind drift. Each sampling point was represented by three composite soil samples at depths of 0.0-0.20, 0.40-0.60, and 1.00-1.20 m, where the chemical soil characteristics were evaluated. The average levels of Ca, Mg, and K in the studied layers are classified as low, with minimum values below the method's detection limit, and they also show imbalance due to higher concentrations of Ca in the surface layer in areas affected by atmospheric dispersion. The sum and saturation of bases at all depths are classified as low. Higher aluminum saturation values were observed in the deeper soil layers. The gypsum dust altered the soil's chemical characteristics at the evaluated depths; therefore, it is necessary to seek means to mitigate gypsum dust release during gibbsite extraction and processing and ensure that the soils in areas near these enterprises maintain their natural characteristics.

Anti-inflammatory and/or immunomodulatory activities of Uncaria tomentosa (cat's claw) extracts: A systematic review and meta-analysis of in vivo studies.

Background: Uncaria tomentosa (Willd. ex Schult.) DC. (Rubiaceae) is traditionally used by Amazonian indigenous groups to treat inflammatory diseases. To date, there are no systematic reviews and meta-analyses on the use of U. tomentosa for inflammation control in animals supporting the traditional knowledge about this species. This study was conducted to evaluate the effect of U. tomentosa extracts in modulating inflammatory mediators and to determine which types of inflammatory diseases can be treated by this species. Methods: We conducted a systematic review and meta-analysis of preclinical studies published before 26 July 2023, identified in PubMed, Embase, and Scopus. Four independent reviewers extracted the data and assessed the risks of bias. The effects of U. tomentosa on inflammatory diseases and the inflammatory mediators involved were extracted from the studies. Standardized mean differences (SMD) and 95% confidence intervals (95%CI) of the outcomes were estimated. The meta-analyses were conducted using RevMan 5.4 (Cochrane Collaboration). This protocol was registered in PROSPERO (CRD42023450869). Results: Twenty-four of 523 studies were included. U. tomentosa extracts decreased the cytokines interleukin (IL)-6 (SMD: -0.72, 95%CI: -1.15, -0.29, p = 0.001) and transcription factor nuclear factor kappa-B (NF-κB) (SMD: -1.19, 95%CI: -1.89, -0.48, p = 0.001). However, the extracts did not significantly alter IL-1 (SMD: -0.16, 95%CI: -0.87, +0.56, p = 0.67), IL-10 (SMD: -0.05, 95%CI:-0.35, 0.45, p = 0.80), or tumor necrosis factor-alpha (TNF-α) levels (SMD: 0.18, 95%CI: -0.25, 0.62, p = 0.41). Conclusion: Many extracts of stem bark, roots, and leaves of U. tomentosa, mostly aqueous and hydroethanolic, exhibited anti-inflammatory and/or immunomodulatory activities and low toxicity. The extracts decreased NF-κB and IL-6. These findings suggest that this species has the potential to treat inflammatory diseases in which these markers are increased, according to the ethnopharmacological use. These activities are not related to a specific class of compounds.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=450869, Identifier CRD42023450869.

Exploring the effect of the menstrual cycle or oral contraception on elite athletes' training responses when workload is not objectively quantifiable: the MILS approach and findings from female Olympians.

Objectives: Develop the Markov Index Load State (MILS) model, based on hidden Markov chains, to assess athletes' workload responses and investigate the effects of menstrual cycle (MC)/oral contraception (OC), sex steroids hormones and wellness on elite athletes' training. Methods: On a 7-month longitudinal follow-up, daily training (volume and perceived effort, n=2200) and wellness (reported sleep quality and quantity, fitness, mood, menstrual symptoms, n=2509) data were collected from 24 female rowers and skiers preparing for the Olympics. 51 MC and 54 OC full cycles relying on 214 salivary hormone samples were analysed. MC/OC cycles were normalised, converted in % from 0% (first bleeding/pill withdrawal day) to 100% (end). Results: MILS identified three chronic workload response states: 'easy', 'moderate' and 'hard'. A cyclic training response linked to MC or OC (95% CI) was observed, primarily related to progesterone level (p=8.23e-03 and 5.72e-03 for the easy and hard state, respectively). MC athletes predominantly exhibited the 'easy' state during the cycle's first half (8%-53%), transitioning to the 'hard' state post-estimated ovulation (63%-96%). OC users had an increased 'hard' state (4%-32%) during pill withdrawal, transitioning to 'easy' (50%-60%) when on the pill. Wellness metrics influenced the training load response: better sleep quality (p=5.20e-04), mood (p=8.94e-06) and fitness (p=6.29e-03) increased the likelihood of the 'easy' state. Menstrual symptoms increased the 'hard' state probability (p=5.92e-02). Conclusion: The MILS model, leveraging hidden Markov chains, effectively analyses cumulative training load responses. The model identified cyclic training responses linked to MC/OC in elite female athletes.

Infections in patients hospitalized for external causes in Intensive Care Units / Infecciones en pacientes hospitalizados por causas externas en Unidades de Cuidados Intensivos / Infecções em pacientes internados por causas externas em Unidades de Terapia Intensiva

Background and Objectives: given the great demand for hospitalization due to external causes, as well as the growing number of cases of infections in health services, it can be said that these are important issues and that they represent a huge challenge to be faced by professionals and health managers around the world. Therefore, this article aims to describe the profile of individuals hospitalized for external causes in an Intensive Care Units (ICUs) who underwent a culture test and identify the main microorganisms that cause infection. Methods: a cross-sectional study carried out with patients suffering from external causes, admitted to an ICU of a general hospital in Bahia. The data were analyzed using descriptive statistics, presented in absolute and relative frequencies. Results: a total of 259 admissions to the ICU due to external causes were identified, of which 59 (22.78%) underwent cultures, of which 48 (81.35%) were men, 43 (72.88%) were brown, 32 (54.24%) did not have a partner and 35 (59.32%) suffered transport accidents. Regarding the use of devices, 54 (91.52%) patients were on invasive mechanical ventilation, 54 (91.50%) used an indwelling urinary catheter and 54 (91.52%) had a central venous catheter. The main microorganisms identified in the culture were of the genera Staphylococcus (17; 28.9%) and Pseudomonas (10; 16.9%). Conclusion: it is concluded that admissions to ICU resulting from external causes in patients who underwent culture were of men, who suffered transport accidents, used invasive devices, and the main infections are related to microorganisms of the genus Staphylococcus.(AU)

Antecedentes y Objetivos: Dada la gran demanda de hospitalización debido a causas externas, así como el creciente número de casos de infecciones en servicios de salud, se puede decir que estos son temas importantes y representan un enorme desafío a enfrentar por profesionales y gestores de salud en todo el mundo. Por lo tanto, este artículo tiene como objetivo describir el perfil de los individuos hospitalizados por causas externas en Unidades de Cuidados Intensivos (UCI) que se sometieron a una prueba de cultivo e identificar los principales microorganismos que causan infección. Métodos: Se realizó un estudio transversal con pacientes que sufrían causas externas, admitidos en una UCI de un hospital general en Bahía. Los datos se analizaron utilizando estadísticas descriptivas, presentadas en frecuencias absolutas y relativas. Resultados: Se identificó un total de 259 ingresos a la UCI debido a causas externas, de los cuales 59 (22,78%) se sometieron a cultivos, de los cuales 48 (81,35%) eran hombres, 43 (72,88%) eran pardos, 32 (54,24%) no tenían pareja y 35 (59,32%) sufrieron accidentes de transporte. En cuanto al uso de dispositivos, 54 (91,52%) pacientes estaban en ventilación mecánica invasiva, 54 (91,50%) usaron catéter urinario de demora y 54 (91,52%) tenían un catéter venoso central. Los principales microorganismos identificados en el cultivo fueron del género Staphylococcus (17; 28,9%) y Pseudomonas (10; 16,9%). Conclusión: Se concluye que los ingresos a la UCI resultantes de causas externas en pacientes que se sometieron al cultivo fueron de hombres, que sufrieron accidentes de transporte, usaron dispositivos invasivos, y las principales infecciones están relacionadas con microorganismos del género Staphylococcus.(AU)

Justificativa e Objetivos: Dada a grande demanda por hospitalização devido a causas externas, assim como o crescente número de casos de infecções em serviços de saúde, pode-se dizer que esses são temas importantes e representam um enorme desafio a ser enfrentado por profissionais e gestores de saúde ao redor do mundo. Portanto, este artigo tem como objetivo descrever o perfil dos indivíduos hospitalizados por causas externas em Unidades de Terapia Intensiva (UTIs) que se submeteram a um teste de cultura e identificar os principais microrganismos que causam infecção. Métodos: Um estudo transversal foi realizado com pacientes que sofriam de causas externas, admitidos em uma UTI de um hospital geral na Bahia. Os dados foram analisados utilizando estatísticas descritivas, apresentadas em frequências absolutas e relativas. Resultados: Um total de 259 internações na UTI devido a causas externas foi identificado, dos quais 59 (22,78%) foram submetidos a culturas, sendo 48 (81,35%) homens, 43 (72,88%) pardos, 32 (54,24%) não tinham parceiro e 35 (59,32%) sofreram acidentes de transporte. Em relação ao uso de dispositivos, 54 (91,52%) pacientes estavam em ventilação mecânica invasiva, 54 (91,50%) usaram cateter urinário de demora e 54 (91,52%) tinham um cateter venoso central. Os principais microrganismos identificados na cultura foram dos gêneros Staphylococcus (17; 28,9%) e Pseudomonas (10; 16,9%). Conclusão: Conclui-se que as internações na UTI decorrentes de causas externas em pacientes que se submeteram à cultura foram de homens, que sofreram acidentes de transporte, usaram dispositivos invasivos, e as principais infecções estão relacionadas a microrganismos do gênero Staphylococcus. (AU)

Exposure to the plasticizer diisopentyl phthalate can cause Vero cell line death.

Phthalates are synthetic plasticizers present in the daily lives of humans, as part of the composition of different products, such as food packaging, water bottles, and toys. These compounds can migrate from plastic materials to the environment changing biological systems. Although diisopentyl phthalate (DiPeP) is largely used in Brazil, there is a lack of information on the possible toxic effects of this compound. This research aims to evaluate the toxicity of DiPeP in the Vero renal cells. These cells were exposed to the 1-1000 µM of DiPeP for 24 and 72 h and subsequently, the cytotoxicity, apoptosis and necrosis-inducing potential, and antioxidant system (SOD, GPx, and GST) were investigated. DiPeP neither caused cytotoxicity nor altered SOD and GPx activity, although GST has been increased at 100 or 1 µM (24 and 72 h, respectively). However, cell death by apoptosis and necrosis was observed. These results indicate that DiPeP caused cell death by a non-oxidative stress-mediated mechanism, which shows the relevance of investigate other process in further researches.

The relationships among Leishmania infantum and phyllostomid bats assessed by histopathological and molecular assays.

Bats have been reported as reservoir host of Leishmania spp. worldwide, mostly by molecular detection. However, it is still unclear whether bats act as reservoirs of Leishmania infantum to sandflies vectors. In this sense, the investigation of amastigotes forms in the target organs, and the characterization of their associated inflammation, may help to clarify the epidemiological importance of bats in endemic areas for leishmaniasis. The aim of this work was to investigate the host-parasite relationships under microscopic evaluation and predict the epidemiological role of two phyllostomid bats species naturally infected by L. infantum in an endemic area for human leishmaniasis. Fragments of skin, liver and spleen of L. infantum positive and negative bats (Artibeus planirostris and Carollia perspicillata) by qPCR, were studied by histological and immunohistochemical techniques. Both groups, positive and negative, did not show differences in the histopathological study, presenting only discrete tissue changes. Liver and skin showed mild inflammatory reactions. Findings on spleen consisted of reactivity of the lymphoid follicles, expressive presence of apoptotic cells and macrophages containing abundant phagocytic cells debris. We did not find amastigote forms in tissues by histological and IHC techniques in positive qPCR bats. Our results allow us to hypothesize that phyllostomid bats seem to have an important role in reducing the risk of transmission, possibly acting as dead-end host.

Lesions in the oral mucosa associated with the use of checkpoint inhibitors: A bibliometric and critical review.

AIMS: Immune-related adverse events (irAEs) linked to the use of immune checkpoint inhibitors (ICIs) have become increasingly frequent. To perform a bibliometric and critical review of the general panorama of publications on oral mucosal lesions (OML) associated with ICIs. METHODS AND RESULTS: Systematized searches were performed in four databases. The included studies were organized and bibliometric and clinical data were extracted and analyzed using VantagePoint and Microsoft Excel. Most of the 35 included studies were reports or case series (n = 33/94.2%). The American authors stood out (n = 17/48.5%), with the majority presenting only one publication. Independent groups carried out most of the publications (n = 31/88.5%). Over the years, publications have increased for users of nivolumab and pembrolizumab. In 21 studies (60%), OML were more common in men, between the 6th and 9th decades of life and who had lung carcinoma (n = 13/37.1%). Pembrolizumab (n = 17/48.5%) was the most used ICI. The patients were affected by one or more OML, including: ulcers (n = 28/80%) and erythema (n = 11/31.4%). Systemic corticosteroids (n = 24/68.5%) and the discontinuation of ICI use (n = 18/51.4%) were the main approaches used. CONCLUSION: OML related to the use of ICIs have become increasingly common. More accurate data need to be published.

Environmental enrichment changes the effects of prenatal and postnatal undernutrition on memory, anxiety traits, Bdnf and TrkB expression in the hippocampus of male adult rats.

Environmental factors such as undernutrition and environmental enrichment can promote changes in the molecular and behavioural mechanisms related to cognition. Herein, we investigated the effect of enriched environment stimulation in rats that were malnourished in the pre- and postnatal periods on changes in the gene expression of brain-derived neurotrophic factor and its receptor in the hippocampus, as well as on anxiety traits and memory. Early undernutrition promoted weight reduction, increased the risk analysis, reduced permanence in the open arm of the elevated plus-maze and induced a reduction in the gene expression of brain-derived neurotrophic factor and tropomyosin receptor kinase B. However, exposure to an enriched environment from 30 to 90 days' old maintained the malnourished phenotype, leading to weight reduction in the control group. In addition, the enriched environment did not alter the risk assessment in the undernourished group, but it did increase the frequency of labyrinth entries. Sixty-day exposure to the enriched environment resulted in a reversal in the gene expression of brain-derived neurotrophic factor and tropomyosin receptor kinase B in the hippocampus of malnourished rats and favoured of long-term memory in the object recognition test in the open-field. These results suggest that an enriched environment may have a protective effect in adult life by inducing changes in long-term memory and anxiety traits in animals that were undernourished in early life. Furthermore, reversing these effects of undernutrition involves mechanisms linked to the molecular signalling of brain-derived neurotrophic factor and tropomyosin receptor kinase B in the hippocampus.

Development and validity of serious game for teaching-learning in surgical site infection prevention / Desarrollo y validación de un juego serio para la enseñanza-aprendizaje sobre la prevención de infecciones del sitio quirúrgico / Desenvolvimento e validação de serious game para ensino-aprendizagem de prevenção de infecção de sítio cirúrgico

ABSTRACT Objective: To develop and validate serious game for teaching-learning regarding surgical site infection prevention. Method: This is a methodological study conducted in stages: game content development and validity based on virtual simulation (preparation, participation and debriefing) and challenges; game development, following the concept, pre-production, prototype, production and post-production stages; and usability validity, using an instrument called Heuristic Evaluation for Digital Educational Games. To assess the game content and usability, 12 nurses and 08 experts in digital games were involved. Results: The serious game script contained three sequential pre-, intra- and post-operative periods, focusing on nursing interventions aimed at preventing surgical site infections. A Content Validity Coefficient above 0.80 was obtained for game content. Regarding gameplay assessment using the assessed heuristics, all statements present in game script were considered adequate, and adjustments were implemented regarding feedback, access to the theoretical framework on preventing surgical site infections, the inclusion of images in the study material and directing players to the debriefing session. Conclusion: The serious game developed was considered valid and a potential pedagogical tool in nursing for learning how to prevent surgical site infections.

RESUMEN Objetivo: desarrollar y validar el serious game para la enseñanza-aprendizaje sobre la prevención de infecciones del sitio quirúrgico. Método: estudio metodológico realizado por etapas: desarrollo y validación del contenido del juego, basado en simulación virtual (preparación, participación y debriefing) y desafíos; desarrollo de juegos, siguiendo las etapas de concepto, preproducción, prototipo, producción y postproducción; y validación de usabilidad mediante el instrumento Heuristic Evaluation for Digital Educational Games. Para evaluar el contenido y usabilidad del juego participaron 12 enfermeros y 08 expertos en juegos digitales. Resultados: el guión del serious game contenía tres períodos pre, intra y postoperatorios secuenciales, centrándose en intervenciones de enfermería destinadas a prevenir infecciones del sitio quirúrgico. Se obtuvo un Coeficiente de Validez de Contenido superior a 0,80 para el contenido del juego. En cuanto a la evaluación de la jugabilidad mediante las heurísticas evaluadas, todas las afirmaciones presentes en el guión del juego fueron consideradas adecuadas y se implementaron ajustes en cuanto a retroalimentación, acceso al marco teórico sobre prevención de infecciones del sitio quirúrgico, inclusión de imágenes en el material de estudio y orientación del jugador en la sesión de debriefing. Conclusión: el serious game desarrollado se consideró válido y potencial herramienta pedagógica en el área de enfermería para aprender a prevenir infecciones del sitio quirúrgico.

RESUMO Objetivo: desenvolver e validar serious game para o ensino-aprendizagem referente à prevenção de infecção de sítio cirúrgico. Método: estudo metodológico conduzido por etapas: desenvolvimento e validação do conteúdo do jogo, baseados na simulação virtual (preparação, participação e debriefing) e desafios; desenvolvimento do jogo, seguindo as etapas de conceito, pré-produção, protótipo, produção e pós-produção; e, validação da usabilidade, por meio do instrumento Heuristic Evaluation for Digital Educational Games. Para avaliação do conteúdo e usabilidade do jogo, contou-se com 12 enfermeiros e 08 especialistas em jogos digitais. Resultados: o script do serious game conteve três períodos sequenciais pré, intra e pós-operatório, com enfoque em intervenções de enfermagem voltadas para prevenção de infecção de sítio cirúrgico. Obteve-se um Coeficiente de Validade de Conteúdo acima de 0,80 para o conteúdo do jogo. Referente à avaliação da jogabilidade pelas heurísticas avaliadas, todas as afirmativas presentes no script do jogo foram consideradas adequadas e houve a implementação de ajustes no que se refere ao feedback, ao acesso ao referencial teórico sobre prevenção de infecção de sítio cirúrgico, à inclusão de imagens no material de estudo e ao direcionamento do jogador à sessão de debriefing. Conclusão: o serious game desenvolvido foi considerado válido e potencial ferramenta pedagógica na área de enfermagem para aprendizagem da prevenção de infecção de sítio cirúrgico.

Desenvolvimento de um design de telessimulação para o suporte básico de vida / Elaboración de un diseño de telesimulación para el soporte vital básico / Development of a telesimulation design for basic life support

Resumo Objetivo Construir e validar um design de telessimulação síncrona e observacional em enfermagem para o atendimento segundo o protocolo de suporte básico de vida intra-hospitalar no adulto. Métodos Estudo metodológico baseado nas fases do procedimento teórico realizado por meio de uma scoping review; fase empírica desenvolvida através da validação de conteúdo do design telessimulado e fase analítica em que adotou-se o índice de validade de conteúdo. Resultados Construiu-se um design para o atendimento segundo o protocolo de suporte básico de vida percorrendo seis etapas: o planejamento, preparação, participação, teledebriefing, avaliação e feedback e a aprendizagem adicional, com Índice de Validade de Conteúdo de 0,96. Conclusão O design desenvolvido foi considerado válido em conteúdo para planejar e executar a telessimulação pela enfermagem e ainda ser adaptado a outros contextos educacionais.

Resumen Objetivo Elaborar y validar un diseño de telesimulación sincrónica y observacional de enfermería para la atención de acuerdo con el protocolo de soporte vital básico intrahospitalario en adultos. Métodos Estudio metodológico basado en las fases del procedimiento teórico realizado por medio de una scoping review, fase empírica llevada cabo a través de la validación de contenido del diseño telesimulado y fase analítica en la que se adoptó el índice de validez de contenido. Resultados Se elaboró un diseño para la atención de acuerdo con el protocolo de soporte vital básico que atravesó seis etapas: planificación, preparación, participación, teledebriefing, evaluación y feedback y aprendizaje adicional, con un Índice de Validez de Contenido de 0,96. Conclusión El diseño elaborado fue considerado válido en contenido para planificar y ejecutar la telesimulación por parte de enfermeros y además puede adaptarse a otros contextos educativos.

Abstract Objective To construct and validate a synchronous and observational telesimulation design in nursing for care according to in-hospital basic life support protocol for adults. Methods A methodological study based on the phases of the theoretical procedure carried out through a scoping review; empirical phase developed through the telesimulated design content validity and analytical phase in which the content validity index was adopted. Results A care design was constructed according to the basic life support protocol, going through six steps: planning, preparation, participation, teledebriefing, assessment and feedback and additional learning, with a Content Validity Index of 0.96. Conclusion The developed design was considered valid in content to plan and execute telesimulation by nursing and still be adapted to other educational contexts.

Cardiovascular health in nursing and medical students.

OBJECTIVE: To verify whether nursing and medical students take measures regarding their cardiovascular health and the associated risk factors. METHOD: Cross-sectional study, online data collection with 413 students in February and March 2021, using specific and validated instruments. Kruskal-Wallis, chi-square and logistic regression were adopted for statistical analyses. RESULTS: 73.3% self-reported that they were healthy. We identified a higher risk for developing cardiovascular diseases in sedentary students (OR = 38.6, p < 0.001), with irregular adherence to physical activity (OR = 16.2, p < 0.001) and with a higher level of perceived stress (OR = 1.12, p < 0.001). CONCLUSION: Students who take action to promote cardiovascular health showed lower risk compared to those who did not. If students do not value their own health during the education process, this may interfere with their professional performance after graduation.

DNA-ICM as an adjuvant method applied on oral cytological specimens.

OBJECTIVE: This study aimed to evaluate cytology diagnosis accuracy using adjuvant methods in clinical routine for oral cancer. STUDY DESIGN: This prospective study was conducted on 98 patients with clinically potentially malignant or malignant oral cavity lesions. One oral lesion smear was taken from each patient using a cytobrush before biopsy and stored at PreservCyt Thinprep. Samples were cytologically analyzed, and DNA ploidy measurement was performed on the same slide. The diagnostic methods' accuracy was then calculated. RESULTS: In clinical inspection, 61 patients had suspicious lesions for malignancy, whereas 37 had potentially malignant disorders. Cytology associated with DNA image cytometry presented a sensitivity of 81.2% and specificity of 90.9%. When analyzing lesions located in high-risk sites to oral malignancies individually, cytology associated with DNA image cytometry presented a sensitivity of 88.2%, specificity of 100.0%, accuracy of 90.0%, and Kappa value of 0.77 (CI 95%: 0.48-1.00). CONCLUSIONS: Association between cytology and DNA image cytometry is an objective and non-invasive diagnostic method that demonstrated high sensitivity and specificity in diagnosing malignant epithelial squamous cell transformation in the oral cavity.

Assessment of the Virulence of the Burkholderia mallei Strain BAC 86/19 in BALB/c Mice.

Burkholderia mallei is an aerobic, Gram-negative, non-motile bacillus. As an obligate mammalian pathogen, it primarily affects solipeds. Although rarely transmitted to humans, the disease it causes, glanders, is classified as a zoonosis. The bacterium was officially eradicated in Brazil in 1969; however, it reemerged after three decades. This study aims to assess the virulence of a specific B. mallei strain, isolated in Brazil, in BALB/c mice through intranasal infection. The strain, B. mallei BAC 86/19, was obtained from the tracheal secretion of a young mare displaying positive serology but no clinical signs of glanders. Post-mortem examinations revealed macroscopic lesions consistent with the disease, however. In mice, the LD50 was determined to be approximately 1.59 × 105 colony-forming units (CFU)/animal. Mice exposed to either 0.1 × LD50 or 1 × LD50 displayed transient weight loss, which resolved after three or five days, respectively. B. mallei persisted within the liver and lung for five days post-infection and in the spleen for seven days. These findings underscore the detectable virulence of the Brazilian B. mallei BAC 86/19 strain in mice, which are relatively resilient hosts. This research points to the importance of the continued investigation of the virulence mechanisms and potential countermeasures associated with B. mallei infections, including their Brazilian isolates.

Establishment of a new equation to estimate gestational age in female dogs.

The objectives of this study were to propose a statistical model to predict the behaviour of the thickness of the uteroplacental junction as a function of the gestation period in female dogs and to determine the relationship between the thickness of the placenta and gestational age in healthy female dogs whose pregnancies had elapsed without maternal-fetal alterations. Eight Border Collie female dogs were selected, aged 3-6 (4.48 ± 0.89) and weighing 16-22 kg (19.06 ± 1.9 kg). Female dogs with gestational ages from 20 to 62 days were examined weekly using B-mode ultrasonography. Ultrasound measurements of the uteroplacental junction were organized into four distinct groups: GT1 (27-36 days of gestation), GT2 (37-46 days of gestation), GT3 (47-56 days of gestation) and GT4 (57-62 days of gestation). Based on multiple linear regression, a statistical model was proposed to predict the behaviour of the thickness of the uteroplacental junction (y) as a function of the length of gestation (x) in female dogs, where b0 is the intercept (linear coefficient) and bp is the slope of the predictors. The analysis relating GT, age and weight could predict placental thickness and resulted in a statistically significant model [F(1,28) = 153,736; p < .001; R2 = .846], but only that relating the length of pregnancy (ß = .92; t = 12.399; p < .001) predicted the thickness of the placenta according to the equation y = b0 + bp.x1 [(thickness in cm) = ß -0.3 + 0.019 × (gestation time in days)]. Only in GT4 was there no correlation between placentas within the same pregnancy (p > .05). Based on the close relationship between the development of the uteroplacental junction thickness during pregnancy and gestational age, it is possible to develop a new tool to complement gestational ultrasound evaluation in female dogs. This is important because it allows better placental evaluation in the search for significant alterations that could compromise maternal-fetal health.

Rotavirus A during the COVID-19 Pandemic in Brazil, 2020-2022: Emergence of G6P[8] Genotype.

Rotavirus A (RVA) remains a leading cause of acute gastroenteritis (AGE) hospitalizations in children worldwide. During the COVID-19 pandemic, a reduction in vaccination coverage in Brazil and elsewhere was observed, and some reports have demonstrated a reduction in AGE notifications during the pandemic. This study aims to investigate the diversity and prevalence of RVA genotypes in children and adults presenting with AGE symptoms in Brazil during the COVID-19 pandemic between 2020 and 2022. RVA was screened using RT-qPCR; then, G and P genotypes were characterized using one-step multiplex RT-PCR. A total of 2173 samples were investigated over the three-year period, and we detected RVA in 7.7% of samples (n = 167), being 15.5% in 2020, 0.5% in 2021, and 13.8% in 2022. Higher RVA prevalence was observed in the Northeastern region (19.3%) compared to the Southeastern (6.1%) and Southern regions (5.5%). The most affected age group was children aged between 0 and 6 months old; however, this was not statistically significant. Genotyping and phylogenetic analysis identified the emergence of G6P[8] during the period; moreover, it was detected in 10.6% of samples in 2020 and in 83.5% in 2022. In contrast, the prevalence of G3P[8], the previous dominant genotype, decreased from 72.3% in 2020 to 11.3% in 2022. We also identified unusual strains, such as G3P[9] and G9P[4], being sporadically detected during the period. This is the first report on the molecular epidemiology and surveillance of RVA during the COVID-19 pandemic period in Brazil. Our study provides evidence for the importance of maintaining high and sustainable levels of vaccine coverage to protect against RVA disease. Furthermore, it highlights the need to maintain nationwide surveillance in order to monitor future trends and changes in the epidemiology of RVA in Brazil.