[Brazilian Ministry of Health strategy to increase vaccination coverage at bordersEstrategia del Ministerio de Salud de Brasil para aumentar las tasas de cobertura de vacunación en las fronteras]. / Estratégia do Ministério da Saúde do Brasil para aumento das coberturas vacinais nas fronteiras.

Objective: Evaluate the implementation of the Ministry of Health's "Action Plan: Border Vaccination Strategy - Agenda 2022" in the Brazil's 33 twin cities and evaluate the increase in the country's vaccination coverage (VC). Methodology: Pre-post community clinical trial. Implementation of the strategy was analyzed, and pre- and post-intervention VC were compared in two stages: P1 (pre-intervention) and P2 (post-intervention). Based on statistical analyses of P1 and P2 coverage, calculations were made of municipal averages, standard deviation, and difference in VC between the two periods. Results: Integration was observed between the primary health care (PHC), surveillance, immunization, and special indigenous health district (DSEI) teams, although there were difficulties, for example, in relation to migratory flows. While immigration flows present challenges in the areas of immunization, PHC, and DSEI, the difficulties are compounded by the polarization of these services, which hinders intersectoral integration. After carrying out the workshops, a total of 50 977 doses were administered in the general population in the 33 twin cities. There was an increase in vaccination coverage in children up to 1 year of age in the locations evaluated after the intervention, which may be relevant in terms of increasing VC in Brazil. Conclusion: There was an increase in vaccination coverage in children up to 1 year of age in the locations evaluated after the intervention, helping to increase VC in Brazil.

Objetivo: Evaluar la aplicación de la Estrategia de Vacunación en las Fronteras - Agenda 2022, que forma parte del Plan de Acción del Ministerio de Salud en las 33 ciudades hermanas y evaluar el aumento de las tasas de cobertura de vacunación en Brasil. Métodos: Ensayo clínico comunitario realizado antes y después de la intervención correspondiente. Se analizó la aplicación de la estrategia y se compararon las tasas de cobertura de vacunación antes y después de la intervención en dos periodos: P1 (pre-intervención) y P2 (post-intervención). En los análisis estadísticos de la tasa de cobertura de vacunación en P1 y P2 se calcularon los valores de media y desviación estándar de los municipios y la diferencia entre las tasas de cobertura de los dos periodos. Resultados: Se observó una integración entre los equipos de Atención Primaria de Salud, Vigilancia, Inmunización y el Distrito Especial de Salud Indígena (DISEI), pero con dificultades, como las inherentes al flujo migratorio. Cabe destacar que el flujo migratorio es uno de los desafíos en el contexto de la inmunización, la atención primaria de salud y el DISEI, dificultad que se ve agravada por la polarización entre los servicios (inmunización, atención primaria de salud y el DISEI), lo que supone un reto para la integración de los sectores. Por lo que respecta al análisis de las tasas de cobertura de vacunación llevado a cabo después de realizar los talleres, se administró un total de 50 977 dosis a la población general en las 33 ciudades hermanas de Brasil. Hubo un aumento de las tasas de cobertura de vacunación de menores de hasta un año de edad en los lugares evaluados después de la intervención, lo que puede ser importante para aumentar las tasas de cobertura de Brasil. Conclusión: Después de la intervención hubo un aumento de las tasas de cobertura de vacunación de menores de hasta un año de edad en los lugares evaluados, lo cual influyó en el incremento de las tasas de cobertura de Brasil.

Bisifusarium lunatum causing cladode soft rot in pear cactus (Nopalea cochenillifera L. Salm-Dyck) in Brazil.

Cactus pear var. miúda (Nopalea cochenillifera L. Salm-Dyck) is an important crop for the Northeast region of Brazil, composing one of the main sources of animal feed. By April 2021, cladode rot caused death of several cactus pear plants in a production area located in Itaporanga, Paraíba state, Brazil (7°21'55.35" S and 38°11'38.68" W). The infected cladodes showed brown circular necrotic spots, and soft rot with perforations that extended throughout the cladode, followed by tipping over and death of the infected plants. The incidence of the disease ranged from 10 to 30% of the plants. Bisifusarium strains were isolated and cultured on potato dextrose agar (PDA) and syntetic-nutrient-poor-agar (SNA). The colonies showed purple color on PDA. On SNA, macroconidia (n = 100) were abundant, hyaline, slightly falcate, three-septate, measuring 11.0-23.1 x 2.3-4.1 µm. Microconidia (n = 100) were oval, generally aseptate, measuring 4.1-8.7 x 2.3-3.0 µm. Conidiogenic cells formed into short monophialides. Chlamydospores were not observed. According to these morphological features, the pathogen was initially identified as Bisifusarium lunatum (Gryzenhoutm et al. 2017). For further confirmation of the identification, the partial sequences of translation elongation factor 1-alpha (TEF1-α) and the second largest subunit of RNA polymerase II (RPB2) genes were sequenced for a representative isolate (CMA 34: GenBank accession no: TEF1-α: OR536502; and RPB2: OR553509) and compared to other Bisifusarium species from GenBank database. Subsequently, it was subjected to a phylogenetic analysis of maximum likelihood including previously published sequences. According to BLAST searches, the TEF1-α and RPB2 sequences were 99% (637/640 nt) and 100% (312/312 nt) similar to B. lunatum (COUFAL0213: TEF1-α (MK640219), and RPB2 (MK301291)), respectively. The isolate was also clustered in a clade containing the ex-type of B. lunatum with 100% support (SH-aLRT and UFboot), being confidently assigned to this species. The pathogenicity test was performed after Medeiros et al. (2015), by using healthy two months old cactus pear seedlings (n = 10) cultivated in a greenhouse. Sterile toothpicks were distributed over colonies of the representative isolate grown on PDA at 25 ± 2 °C for seven days. Seedling cladodes were stuck with the toothpicks, moistened with sterile water and covered with transparent plastic bags for 24h, thus simulating a humid chamber. Following three months, all control plants (stuck with sterile toothpicks) remained healthy, while those inoculated with the representative isolate exhibited rot symptoms. This test was performed twice. B. lunatum was reisolated from symptomatic cladodes and identified as previously described, thus fulfilling the Koch's postulates. To our best knowledge, this is the first report of B. lunatum causing soft rot on N. cochenillifera in Brazil. Besides N. cochenillifera, this species was also reported on Opuntia ficus-indica in India (Gryzenhoutm et al., 2017), which raises concern regarding its ability to infect other forage sources for cattle feed in Brazilian semiarid regions. The present study highlights that the precise identification of B. lunatum is a key factor to adjust control strategies and management of the disease to prevent the spread of this disease to prevent its spread to other crops.

Factors associated to mortality in children with critical COVID-19 and multisystem inflammatory syndrome in a resource-poor setting.

SARS-CoV-2 infection in children is usually asymptomatic/mild. However, some patients may develop critical forms. We aimed to describe characteristics and evaluate the factors associated to in-hospital mortality of patients with critical COVID-19/MIS-C in the Amazonian region. This multicenter prospective cohort included critically ill children (1 mo-18 years old), with confirmed COVID-19/MIS-C admitted to 3 tertiary Pediatric Intensive Care Units (PICU) in the Brazilian Amazon, between April/2020 and May/2023. The main outcome was in-hospital mortality and were evaluated using a multivariable Cox proportional regression. We adjusted the model for pediatric risk of mortality score version IV (PRISMIV) score and age/comorbidity. 266 patients were assessed with 187 in the severe COVID-19 group, 79 included in the MIS-C group. In the severe COVID-19 group 108 (57.8%) were male, median age was 23 months, 95 (50.8%) were up to 2 years of age. Forty-two (22.5%) patients in this group died during follow-up in a median time of 11 days (IQR, 2-28). In the MIS-C group, 56 (70.9%) were male, median age was 23 months and median follow-up was 162 days (range, 3-202). Death occurred in 17 (21.5%) patients with a median death time of 7 (IQR, 4-13) days. The mortality was associated with higher levels of Vasoactive Inotropic-Score (VIS), presence of acute respiratory distress syndrome (ARDS), higher levels of Erythrocyte Sedimentation Rate, (ESR) and thrombocytopenia. Critically ill patients with severe COVID-19 and MIS-C from the Brazilian Amazon showed a high mortality rate, within 12 days of hospitalization.

Estratégia do Ministério da Saúde do Brasil para aumento das coberturas vacinais nas fronteiras / Brazilian Ministry of Health strategy to increase vaccination coverage at borders / Estrategia del Ministerio de Salud de Brasil para aumentar las tasas de cobertura de vacunación en las fronteras

[RESUMO]. Objetivo. Avaliar a implementação de estratégia do “Plano de Ação: Estratégia de Vacinação nas Fronteiras – Agenda 2022” do Ministério da Saúde nas 33 cidades gêmeas e avaliar o incremento das coberturas vacinais (CV) brasileiras. Métodos. Ensaio clínico comunitário, do tipo antes e depois. Analisou-se a realização da estratégia, bem como comparadas as CV pré e pós-intervenção em dois tempos: P1 (pré-intervenção) e P2 (pós-intervenção). Análises estatísticas sobre a CV, no P1 e P2, foram calculados os valores de média entres os municípios, desvio padrão e diferença entre as coberturas dos dois períodos. Resultados. Observou-se integração entre as equipes de Atenção Primária à Saúde (APS), Vigilância, Imunização e Distrito Sanitário Especial Indígena (DSEI), porém com dificuldades, como aquelas inerentes ao fluxo migratório. Ressalta-se que o fluxo imigratório é um dos desafios no contexto da imunização, APS e DSEI, entretanto, a esta dificuldade soma-se a polarização entre os serviços (imunização, APS e DISEI), ocasionando um desafio para a integração dos setores. Em relação à análise das CV, após a realização das oficinas, foram totalizadas 50 977 doses aplicadas na população geral nas 33 cidades-gêmeas do Brasil. Houve incremento das coberturas vacinais de crianças de até um ano de idade nos locais avaliados após a intervenção, o que pode ser importante para aumentar as CV no Brasil. Conclusão. Houve incremento das coberturas vacinais das crianças até um ano de idade nos locais avalia- dos após a intervenção e isso influenciou no aumento das CV no Brasil.

[ABSTRACT]. Objective. Evaluate the implementation of the Ministry of Health’s “Action Plan: Border Vaccination Strategy – Agenda 2022” in the Brazil’s 33 twin cities and evaluate the increase in the country’s vaccination coverage (VC). Methodology. Pre-post community clinical trial. Implementation of the strategy was analyzed, and pre- and post-intervention VC were compared in two stages: P1 (pre-intervention) and P2 (post-intervention). Based on statistical analyses of P1 and P2 coverage, calculations were made of municipal averages, standard deviation, and difference in VC between the two periods. Results. Integration was observed between the primary health care (PHC), surveillance, immunization, and special indigenous health district (DSEI) teams, although there were difficulties, for example, in relation to migratory flows. While immigration flows present challenges in the areas of immunization, PHC, and DSEI, the difficulties are compounded by the polarization of these services, which hinders intersectoral integration. After carrying out the workshops, a total of 50 977 doses were administered in the general population in the 33 twin cities. There was an increase in vaccination coverage in children up to 1 year of age in the locations evaluated after the intervention, which may be relevant in terms of increasing VC in Brazil. Conclusion. There was an increase in vaccination coverage in children up to 1 year of age in the locations evaluated after the intervention, helping to increase VC in Brazil.

[RESUMEN]. Objetivo. Evaluar la aplicación de la Estrategia de Vacunación en las Fronteras - Agenda 2022, que forma parte del Plan de Acción del Ministerio de Salud en las 33 ciudades hermanas y evaluar el aumento de las tasas de cobertura de vacunación en Brasil. Métodos. Ensayo clínico comunitario realizado antes y después de la intervención correspondiente. Se analizó la aplicación de la estrategia y se compararon las tasas de cobertura de vacunación antes y después de la intervención en dos periodos: P1 (pre-intervención) y P2 (post-intervención). En los análisis estadísticos de la tasa de cobertura de vacunación en P1 y P2 se calcularon los valores de media y desviación estándar de los municipios y la diferencia entre las tasas de cobertura de los dos periodos. Resultados. Se observó una integración entre los equipos de Atención Primaria de Salud, Vigilancia, Inmu- nización y el Distrito Especial de Salud Indígena (DISEI), pero con dificultades, como las inherentes al flujo migratorio. Cabe destacar que el flujo migratorio es uno de los desafíos en el contexto de la inmunización, la atención primaria de salud y el DISEI, dificultad que se ve agravada por la polarización entre los servicios (inmunización, atención primaria de salud y el DISEI), lo que supone un reto para la integración de los sectores. Por lo que respecta al análisis de las tasas de cobertura de vacunación llevado a cabo después de realizar los talleres, se administró un total de 50 977 dosis a la población general en las 33 ciudades hermanas de Brasil. Hubo un aumento de las tasas de cobertura de vacunación de menores de hasta un año de edad en los lugares evaluados después de la intervención, lo que puede ser importante para aumentar las tasas de cobertura de Brasil. Conclusión. Después de la intervención hubo un aumento de las tasas de cobertura de vacunación de menores de hasta un año de edad en los lugares evaluados, lo cual influyó en el incremento de las tasas de cobertura de Brasil.

Obstacles in combating multidrug resistant tuberculosis in pediatric patients: a scope review / Obstáculos no combate à tuberculose multidroga resistente em pacientes pediátricos: uma revisão de escopo

Abstract Objectives: to identify the scientific evidence on excessively resistant and multidrug resistant tuberculosis in pediatric patients. Methods: this is a scope review of the literature, with a guiding question: "What is the scientific evidence on multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis in pediatric patients?". The research used the descriptors: "extensively drug-resistant tuberculosis" OR "multidrug-resistant tuberculosis" AND "pediatrics". The research was carried out in a double-blind manner in the following databases of the Medical Literature Analysis and Retrieval System Online, Regional Office for the Western Pacific's Institutional Repository for Information Sharing, Embase/Elsevier and International Clinical Trials Registry Platform, with a temporal cut-off from 2011 to 2021, sending a final synthesized sample of 18 articles, which evaluated the methodological content through the level of evidence. Results: the results show the lack of research with a high level of evidence related to MDR-TB in children, the lack of adequate dosage of second-line drugs for the pediatric population and the importance of drug sensitivity testing for the cases of treatment Conclusions: it was identified that the obstacles to MDR-TB treatment were concentrated in the lack of detailed protocols, safe drug dosages with a low side effect, and mainly in the social health determinants and disease process involving MDR-TB.

Resumo Objetivos: identificar as evidências científicas sobre tuberculose excessivamente resistente e multidroga resistente em pacientes pediátricos. Métodos: trata-se de uma revisão de escopo da literatura, tendo como questão norteadora: "Quais as evidências científicas sobre tuberculose multidroga-resistente (TB-MDR) e tuberculose extensivamente resistente em pacientes pediátricos?" A pesquisa usou os descritores: "tuberculose extensivamente resistente a medicamentos" OR "tuberculose resistente a múltiplos medicamentos" AND "pediatria". A pesquisa foi realizada de modo duplo-cego nas bases de dados Medical Literature Analysis and Retrieval System Online, Regional Office for the Western Pacific's Institutional Repository for Information Sharing, Embase/Elsevier e International Clinical Trials Registry Platform, com um corte temporal de 2011 a 2021, sendo a amostra final sintetizada de 18 artigos, nos quais avaliou-se o conteúdo metodológico por meio do nível de evidência. Resultados: os resultados mostraram a escassez de pesquisas de alto nível de evidência relacionadas à TB-MDR em crianças, ausência de posologia adequada das drogas de segunda linha para o público pediátrico e a importância do teste de sensibilidade a drogas para o tratamento dos casos. Conclusões: identificou-se que os obstáculos do tratamento TB-MDR se concentraram na ausência de protocolos detalhados, de dosagens medicamentosas seguras e com menor efeito colateral, e, principalmente, nos determinantes sociais do processo saúde e doença que envolvem a TB-MDR.

Capacidade para o trabalho dos profissionais que assistem à COVID-19 em um hospital universitário / Work capacity of professionals who assist patients with COVID -19 in a university hospital / Capacidad de trabajo de los profesionales que asisten a pacientes con COVID -19 en un hospital universitario

Resumo Objetivo: avaliar a capacidade para o trabalho dos profissionais da saúde que assistem à covid-19 em um hospital universitário de Pernambuco. Metodologia: pesquisa quantitativa, transversal, exploratória e descritiva, com amostra de 77 trabalhadores. Foi aplicado o Índice de Capacidade para o Trabalho, instrumento que aborda a autopercepção do trabalhador sobre a sua própria saúde e sua capacidade para o trabalho. A soma de seus escores permitiu classificar a capacidade para o trabalho em adequada ou inadequada. Foram descritos o perfil sociodemográfico e ocupacional calculando a frequência absoluta e relativa. Também se realizou análise descritiva do índice de capacidade para o trabalho, calculando a média, mediana, moda e desvio padrão, através do Epi info 7.0. Resultados: O perfil da amostra foi constituído por 81,8% trabalhadores da saúde do sexo feminino; 48% estão na faixa etária dos 35 a 45 anos de idade. A capacidade para o trabalho esteve inadequada em 44,2% dos pesquisados. Conclusões: as médias da capacidade para o trabalho foram bastante próximas e de maneira geral a capacidade para o trabalho desses profissionais precisa ser melhorada. Por se tratar de dados mutáveis, há necessidade da aplicação desse instrumento nas organizações periodicamente para subsidiar as tomadas de decisões.

Abstract Objective: to evaluate the work ability of health professionals who assist covid-19 in a university hospital in Pernambuco. Methods: quantitative, cross-sectional, exploratory and descriptive research, with a sample of 77 workers. The Work Ability Index was applied, an instrument that addresses the worker's self-perception of their own health and ability to work. The sum of their scores allowed classifying the ability to work as adequate or inadequate. The sociodemographic and occupational profile were described, calculating the absolute and relative frequency. A descriptive analysis of the work ability index was also carried out, calculating the mean, median, mode and standard deviation, using Epi info 7.0. Results: The sample profile consisted of 81.8% female health workers; 48% are in the age group of 35 to 45 years old. The ability to work was inadequate in 44.2% of those surveyed. Conclusion: the means of work ability were very close and, in general, the work ability of these professionals needs to be improved. As these are mutable data, there is a need to apply this instrument periodically in organizations to support decision-making.

Resumen Objetivo: evaluar la capacidad de trabajo de los profesionales que asisten a covid-19 en un hospital universitario de Pernambuco. Métodos: investigación cuantitativa, transversal, exploratoria y descriptiva, con una muestra de 77 trabajadores. Se aplicó el Índice de Capacidad para el Trabajo, instrumento que aborda la autopercepción del trabajador sobre su propia salud y capacidad para el trabajo. La suma de sus puntajes permitió clasificar la capacidad para el trabajo como adecuada o inadecuada. Se describió el perfil sociodemográfico y ocupacional mediante el cálculo de la frecuencia absoluta y relativa. También se realizó un análisis descriptivo del índice de capacidad para el trabajo, calculándose la media, la mediana, la moda y la desviación estándar mediante Epi info 7.0. Resultados: El perfil de la muestra estuvo conformado por 81,8% mujeres trabajadoras de la salud; El 48% está en el grupo de edad de 35 a 45 años. La capacidad de trabajo fue inadecuada en el 44,2% de los encuestados. Conclusión: los medios de capacidad de trabajo fueron muy cercanos y, en general, la capacidad de trabajo de estos profesionales necesita ser mejorada. Por tratarse de datos modificables, existe la necesidad de aplicar este instrumento en las organizaciones periódicamente para apoyar la toma de decisiones.

Cactus Endophytic Fungi and Bioprospecting for their Enzymes and Bioactive Molecules: A Systematic Review.

Endophytic fungi are associated with plant health and represent a remarkable source of potential of enzymes and bioactive compounds, but the diversity of endophytes remains uncertain and poorly explored, especially in Cactaceae, one of the most species-rich families adapted to growing in arid and semi-arid regions. The aim of this study was to conduct a systematic review on the diversity and bioprospecting of endophytic fungi from Cactaceae. We analysed peer-reviewed articles from seven databases using PRISMA guidelines. The results showed that the Cactaceae family is a source of new taxa, but the diversity of endophytic fungi of Cactaceae is little explored, mainly the diversity among tissues and by metagenomics. Bioprospecting studies have shown that these microorganisms can be used in the production of enzymes and larvicidal and antifungal compounds. Our results are relevant as a starting point for researchers to develop studies that expand the knowledge of plant mycobiota in arid and semi-arid ecosystems, as well as comprising a remarkable source of fungal compounds with several biotechnological applications.

Human papillomavirus vaccination coverage in Northeast Brazil, 2013-2021: a descriptive study.

OBJECTIVE: to describe human papillomavirus (HPV) vaccination coverage in the Northeast region of Brazil, in the period from 2013 to 2021. METHODS: this was a descriptive study conducted with data obtained from the National Immunization Program, which sets a goal of 80% coverage of HPV vaccination in girls aged between 9 and 14 years and boys aged between 11 and 14 years. RESULTS: HPV vaccination coverage in girls was 73.9%, regarding the first dose, and 54.3% regarding the second dose, and for boys, the coverage of each dose was 49.7% and 32.6%, respectively; with the exception of the states of Ceará and Paraíba, which reached coverage above 80% regarding the first dose in girls, none of the states reached the goal for both doses. CONCLUSIONS: between 2013 and 2021, HPV vaccination coverage was below the target for both sexes, with the exception of the states of Ceará and Paraíba, which reached the goal for the first dose in the girls.

Critical disease related to SARS-CoV-2 infection in children from the Amazon region: an observational study.

This is a multicentre prospective cohort including critically ill children and adolescents, with confirmed critical disease related to SARS-CoV-2, admitted to three tertiary paediatric intensive care units in the Brazilian Amazon, between April 2020 and July 2022. 208 patients were included (median age was 3.5 years). The majority had malnutrition (62%) and comorbidities (60.6%). Mechanical ventilation support, cardiogenic shock and acute respiratory distress syndrome occurred in 47%, 30% and 34.1% of patients, respectively. There were 37 (18%) deaths. A poor outcome of severe COVID-19 and multisystem inflammatory syndrome in children was observed in children and adolescents from the Brazilian Amazon.

Educational material production and validity: educational instrument for home care for premature newborns.

OBJECTIVE: to produce and validate a booklet, based on Jean Watson's Theory, on home care for premature newborns, based on caregivers' experiences. METHOD: a methodological study, developed in the following stages: diagnosis of knowledge needs about home care; survey of scientific content; educational material production; and validity by judges/experts. RESULTS: the literature review resulted in 19 articles. The main themes (breastfeeding, bath care, bond building, infection prevention and support network) were listed for producing the booklet "Booklet for Premature Newborns: Demystifying Home Care". The booklet content and appearance received the overall Content Validity Index of 0.85, considered suitable within the scientific rigor of validity. FINAL CONSIDERATIONS: the booklet produced and validated is an educational material whose main role is to provide knowledge and awaken caregivers' autonomy in providing home care to newborns.

Limosilactobacillus fermentum Strains with Claimed Probiotic Properties Exert Anti-oxidant and Anti-inflammatory Properties and Prevent Cardiometabolic Disorder in Female Rats Fed a High-Fat Diet.

This study assessed the effects of a mixed formulation containing Limosilactobacillus (L.) fermentum 139, L. fermentum 263, and L. fermentum 296 on cardiometabolic parameters, inflammatory markers, short-chain fatty acid (SCFA) fecal contents, and oxidative stress in colon, liver, heart, and kidney tissues of female rats fed a high-fat diet (HFD). Female Wistar rats were allocated into control diet (CTL, n = 6), HFD (n = 6), and HFD receiving L. fermentum formulation (HFD-LF, n = 6). L. fermentum formulation (1 × 109 CFU/mL of each strain) was administered two twice a day for 4 weeks. Administration of L. fermentum increased acetate and succinate fecal contents and reduced hyperlipidemia and hyperglycemia in rats fed a HFD (p < 0.05). Administration of L. fermentum decreased low-grade inflammation and improved antioxidant capacity along the gut, liver, heart, and kidney tissues in female rats fed a HFD (p < 0.05). Administration of L. fermentum prevented dyslipidemia, inflammation, and oxidative stress in colon, liver, heart, and kidney in female rats fed a HFD.

Cobertura da vacinação contra papilomavírus humano no Nordeste do Brasil, 2013-2021: estudo descritivo / Human papillomavirus vaccination coverage in Northeast Brazil, 2013-2021: a descriptive study / Cobertura de vacunación contra el virus del papiloma humano en el Nordeste de Brasil, 2013-2021: un estudio descriptivo

Objetivo: descrever a cobertura da vacina contra papilomavírus humano (HPV) na região Nordeste do Brasil, no período de 2013 a 2021. Métodos: estudo descritivo conduzido com dados obtidos do Programa Nacional de Imunizações, que estabelece a meta de 80% para a vacina contra o HPV para meninas entre 9 e 14 anos e meninos entre 11 e 14 anos. Resultados: as coberturas para as meninas foram de 73,9%, na primeira, e de 54,3% na segunda dose, e para meninos, as coberturas de cada dose foram de 49,7% e 32,6%, respectivamente; excetuando-se Ceará e Paraíba, que alcançaram coberturas acima de 80% na primeira dose para as meninas, nenhum estado alcançou a meta para as duas doses. Conclusões: entre 2013 e 2021, as coberturas da vacina contra HPV estiveram abaixo da meta para ambos os sexos, com exceção de Ceará e Paraíba, que atingiram a meta para a primeira dose no grupo de meninas.

Objective: to describe human papillomavirus (HPV) vaccination coverage in the Northeast region of Brazil, in the period from 2013 to 2021. Methods: this was a descriptive study conducted with data obtained from the National Immunization Program, which sets a goal of 80% coverage of HPV vaccination in girls aged between 9 and 14 years and boys aged between 11 and 14 years. Results: HPV vaccination coverage in girls was 73.9%, regarding the first dose, and 54.3% regarding the second dose, and for boys, the coverage of each dose was 49.7% and 32.6%, respectively; with the exception of the states of Ceará and Paraíba, which reached coverage above 80% regarding the first dose in girls, none of the states reached the goal for both doses. Conclusions: between 2013 and 2021, HPV vaccination coverage was below the target for both sexes, with the exception of the states of Ceará and Paraíba, which reached the goal for the first dose in the girls.

Objetivo: describir las coberturas de la vacuna contra el papilomavirus humano en la Región Nordeste de Brasil y sus estados, de 2013 a 2021. Métodos: se trata de un estudio descriptivo realizado con datos de cobertura vacunal obtenidos del Programa Nacional de Immunizaciones, que establece la meta del 80% para la vacuna. Los datos de población se obtuvieron del Departamento de Informática del Ministerio de Salud. Resultados: la cobertura de vacunación en niñas fue del 73,9% en la primera y del 54,3% en la segunda dosis; en niños la cobertura de cada dosis fue del 49,7% y 32,6%; Ceará y Paraíba alcanzaron una cobertura superior al 80% para la primera dosis en niñas, y ningún estado alcanzó la meta para las dos dosis. Conclusiones: la cobertura de la vacuna está por debajo de la meta para ambos sexos, con excepción de la primera dosis en niñas en Ceará y Paraíba.

Ações em tecnologia assistiva com mulheres hospitalizadas / Actions in assistive technology with hospitalized women

Resumo Introdução A saúde da mulher pode se tornar mais frágil durante a internação hospitalar por diversos motivos, o que pode afetar sua autonomia e independência. Nesse contexto, intervenções em tecnologia assistiva podem ser realizadas para favorecer o desempenho ocupacional da mulher. Objetivo Identificar quais ações em tecnologia assistiva são realizadas por terapeutas ocupacionais com mulheres no contexto hospitalar. Método Estudo descritivo, retrospectivo e exploratório, de abordagem quantitativa, realizado de agosto a dezembro de 2021, por meio de dados secundários extraídos de 155 prontuários de mulheres que foram assistidas em terapia ocupacional nas enfermarias de Neurologia, Oncologia e Saúde Mental em um hospital universitário do Recife, PE, Brasil. Foram utilizados como instrumentos um questionário estruturado de caracterização e um checklist de rastreamento de ações em tecnologia assistiva. Para análise dos dados, foi utilizada estatística descritiva por meio da planilha eletrônica do Microsoft Excel. Resultados 48 pacientes receberam intervenções dos terapeutas ocupacionais em tecnologia assistiva, contemplando os serviços de avaliação, prescrição, confecção, orientação de uso e treino, tendo como principais dispositivos órteses de membros superiores e de auxílio para atividades de vida diária no setor de neurologia e o coxim no setor de oncologia, apresentando como predominância nos objetivos o favorecimento do desempenho ocupacional. Conclusão Foi identificado o predomínio das ações de tecnologia assistiva nas enfermarias de oncologia e neurologia com produtos de baixo custo; necessidade de melhorar o processo de acompanhamento de uso da tecnologia assistiva e de se investir no serviço de Tecnologia Assistiva; aumento de estudos sobre essa temática para gerar evidências.

Abstract Introduction Hospitalization can render women's health more fragile for a variety of reasons, potentially impacting their autonomy and independence. Within this scenario, interventions using assistive technology can enhance women's occupational performance. Objective To discern the assistive technology actions undertaken by occupational therapists for women in hospital settings. Method This descriptive, retrospective, and exploratory study with a quantitative approach was conducted from August to December 2021. It utilized secondary data from 155 medical records of women who received occupational therapy in neurology, oncology, and mental health wards at a university hospital in Recife, state of Pernambuco, Brazil. Instruments included a structured questionnaire for characterization and a checklist to trace assistive technology actions. Data analysis was performed using Microsoft Excel. Results Out of 155, 48 patients benefited from assistive technology interventions by occupational therapists. These interventions included evaluation services, prescription, manufacturing, use guidance, and training. The primary devices were orthoses for upper limbs and aids for activities of daily living in the neurology sector, with cushions being prominent in the oncology sector. A common goal was the enhancement of occupational performance. Conclusion Most assistive technology actions occurred in the oncology and neurology wards, focusing on low-cost products. There is a recognized need to refine the monitoring process for assistive technology use, invest more in assistive technology services, and promote research in this field to generate further evidence.

Educational material production and validity: educational instrument for home care for premature newborns / Producción y validación de material educativo: instrumento educativo para el cuidado domiciliario del recién nacido prematuro / Produção e validação de material educativo: instrumento educativo para o cuidado domiciliar ao recém-nascido prematuro

ABSTRACT Objective: to produce and validate a booklet, based on Jean Watson's Theory, on home care for premature newborns, based on caregivers' experiences. Method: a methodological study, developed in the following stages: diagnosis of knowledge needs about home care; survey of scientific content; educational material production; and validity by judges/experts. Results: the literature review resulted in 19 articles. The main themes (breastfeeding, bath care, bond building, infection prevention and support network) were listed for producing the booklet "Booklet for Premature Newborns: Demystifying Home Care". The booklet content and appearance received the overall Content Validity Index of 0.85, considered suitable within the scientific rigor of validity. Final considerations: the booklet produced and validated is an educational material whose main role is to provide knowledge and awaken caregivers' autonomy in providing home care to newborns.

RESUMEN Objetivo: producir y validar una cartilla, basada en la Teoría de Jean Watson, sobre el cuidado domiciliario del recién nacido prematuro, a partir de las experiencias de los cuidadores. Método: estudio metodológico, desarrollado en las siguientes etapas: diagnóstico de las necesidades de conocimiento sobre el cuidado domiciliario; encuesta de contenido científico; producción de material educativo; y validación por jueces/expertos. Resultados: la revisión de la literatura resultó en 19 artículos. Se enumeraron los temas principales (lactancia materna, cuidado del baño, creación de vínculos, prevención de infecciones y red de apoyo) para la producción del folleto "Cuaderno para Recién Nacidos Prematuros: Desmitificando el Cuidado Domiciliario". El contenido y apariencia del cuadernillo recibió el Índice de Validez de Contenido Global de 0,85, considerado adecuado dentro del rigor científico de la validez. Consideraciones finales: la cartilla producida y validada es un material educativo que tiene como función principal proporcionar conocimientos y despertar la autonomía de los cuidadores en la atención domiciliaria al recién nacido.

RESUMO Objetivo: produzir e validar cartilha, baseado na Teoria de Jean Watson, sobre os cuidados domiciliares ao recém-nascido prematuro, a partir de vivências de cuidadores. Método: estudo metodológico, desenvolvido nas etapas: diagnóstico das necessidades de conhecimento sobre os cuidados domiciliares; levantamento dos conteúdos científicos; produção de material educativo; e validação por juízas/experts. Resultados: a revisão da literatura resultou em 19 artigos. Elencaram-se os principais temas (amamentação, cuidados com o banho, construção de vínculo, prevenção de infecções e rede de apoio), para produção da cartilha intitulada "Cartilha de Cuidados com o Recém-Nascido Prematuro: Desmistificando o Cuidar no Domicílio". O conteúdo e aparência da cartilha recebeu o Índice de Validade de Conteúdo Global de 0,85, considerado adequado dentro do rigor científico de validade. Considerações finais: a cartilha produzida e validada é um material educativo cujo papel principal é proporcionar conhecimento e despertar a autonomia dos cuidadores na prestação dos cuidados domiciliares ao recém-nascido.

A Single Session of Virtual Reality Improved Tiredness, Shortness of Breath, Anxiety, Depression and Well-Being in Hospitalized Individuals with COVID-19: A Randomized Clinical Trial.

BACKGROUND: In 2020, the world was surprised by the spread and mass contamination of the new Coronavirus (COVID-19). COVID-19 produces symptoms ranging from a common cold to severe symptoms that can lead to death. Several strategies have been implemented to improve the well-being of patients during their hospitalization, and virtual reality (VR) has been used. However, whether patients hospitalized for COVID-19 can benefit from this intervention remains unclear. Therefore, this study aimed to investigate whether VR contributes to the control of pain symptoms, the sensation of dyspnea, perception of well-being, anxiety, and depression in patients hospitalized with COVID-19. METHODS: A randomized, double-blind clinical trial was designed. Patients underwent a single session of VR and usual care. The experimental group (n = 22) received VR content to promote relaxation, distraction, and stress relief, whereas the control group (n = 22) received non-specific VR content. RESULTS: The experimental group reported a significant decrease in tiredness, shortness of breath, anxiety, and an increase in the feeling of well-being, whereas the control group showed improvement only in the tiredness and anxiety. CONCLUSIONS: VR is a resource that may improve the symptoms of tiredness, shortness of breath, anxiety, and depression in patients hospitalized with COVID-19. Future studies should investigate the effect of multiple VR sessions on individuals with COVID-19.

First Report of an Asymptomatic Leishmania (Viannia) shawi Infection Using a Nasal Swab in Amazon, Brazil.

The state of Pará has recorded seven Leishmania species that cause tegumentary leishmaniasis (TL). Leishmania species induce distinct immunological responses from the host and exhibit resistance to Glucantime, the first-line drug treatment for TL in Brazil. OBJECTIVE: Identify the etiology of TL in an Amazonian city in the state of Pará. MATERIAL AND METHODS: Eleven patients with TL were recruited and nasal swabs, lesion swabs, and skin fragments samples were collected. In the control group (n = 6), only the nasal swabs were collected. Polymerase Chain Reaction (PCR) amplification of the gene region hsp70-234 was performed using the extracted DNA from the samples, from which nine patients with TL and five in the control group were positive. Products were sequenced, mounted in CAP3 software, aligned using MAFFT v.7.221, edited in Geneious software v.8.1.7, and compared and aligned with sequences available in GenBank using the BLAST tool. RESULTS: For patients with TL, six molecular diagnosis at the species level (L. (Viannia) braziliensis (n = 5/9), L. (Viannia) shawi (n = 1/9)) and three at the genus level (Leishmania sp. (n = 3/9)) were obtained. In the control group, four individuals were infected with Leishmania sp. (n = 4/5) and L. (V.) shawi (n = 1/5). CONCLUSION: This is the first report of L. (V.) shawi infection in the mucosal secretion of a healthy person in Brazil. Moreover, genetic variants were identified in the haplotypes of L. (V.) braziliensis in the gene sequence hsp70-234.

Limosilactobacillus fermentum, Current Evidence on the Antioxidant Properties and Opportunities to be Exploited as a Probiotic Microorganism.

The unbalance in the production and removal of oxygen-reactive species in the human organism leads to oxidative stress, a physiological condition commonly linked to the occurrence of cancer, neurodegenerative, inflammatory, and metabolic disorders. The implications of oxidative stress in the gut have been associated with gut microbiota impairments and gut dysbiosis. Some lactobacilli strains have shown an efficient antioxidant system capable of protecting against oxidative stress and related-chronic diseases. Recently, in vitro and experimental studies and some clinical trials have demonstrated the efficacy of the administration of various Limosilactobacillus fermentum strains to modulate beneficially the host antioxidant system resulting in the amelioration of a variety of systemic diseases phenotypes. This review presents and discusses the currently available studies on identifying L. fermentum strains with anti-oxidant properties, their sources, range of the administered doses, and duration of the intervention in experiments with animals and clinical trials. This review strives to serve as a relevant and well-cataloged reference of L. fermentum strains with capabilities of inducing anti-oxidant effects and health-promoting benefits to the host, envisaging their broad applicability to disease control.

Fusarium pseudocircinatum causing stunting and malformation of sunflower plants in Brazil.

Sunflower (Helianthus annuus L.) is among the main oleaginous crops used in Brazil. During January, 2017, at CCA/UFPB laboratory and greenhouses (Areia/Brazil, 6°58'12″ S; 35°42'15″ W), we observed various sunflower seeds (cultivar Olisun 3, 2017-2018 crop) highly infested with Fusarium. Those seeds were from crops in the municipality of Alagoinha -PB/Brazil (06º57'00'' S; 35º32'42'' W), supplied by Empresa Brasileira de Pesquisa Agropecuária/EMBRAPA. The emerged seedlings from these seeds were also contaminated, with 5% to 26% of them exhibiting stunting and malformation. Fusarium strains were isolated from symptomatic plants, and a single spore was used to grow pure colonies on potato-dextrose-agar (PDA) and synthetic-nutrient-poor-agar (SNA) media. Mycelia of PDA colonies were floccous and dense varying from yellow to orange. Fungal colonies developed aerial mycelium, producing orange pigments. On SNA, hyaline macroconidia, measuring 2.9-4.1 x 32.4-65.0 µm, slightly falcate with three to six septa. Oval microconidia, measuring 2.4-3.6 x 5.1-9.0 µm, were abundant in false heads forming on monophyalides. Chlamydospores were absent. Sterile hyphae were rarely formed. Colectively, the morphological features corresponded to species that belong to the Fusarium fujikuroi species complex (Leslie & Summerell, 2006). To assure the species identity, we sequenced the elongation factor 1α region of two representative isolates (i.e., F2 and F3, GenBank access numbers: MZ666934 and MZ666935, respectively) and compared them to the other Fusarium species found at Fusarium-ID and GenBank databases. Subsequently, we performed a maximum likelihood phylogenetic analysis including previously published sequences (Nicolli et al., 2020). Both isolates exhibited 100% similarity with Fusarium pseudocircinatum (MN386745), and clustered with its ex-type at 100% bootstrap values. The isolates were then grown on PDA amended with manitol to adjust the osmotic pressure to -1.0 Mpa, at 25 ± 2 ° C, for seven days (Sousa et al., 2008). A total of 100 disinfested sunflower seeds (cultivar Olisun 3, 2018-2019 crop) were distributed over the colonies and 48h later they were sown on sterile substrate maintained inside a greenhouse. About 30 days after inoculation, the emerged plants exhibited symptoms of stunting and malformation (60%) compared to controls, which were healthy. F. pseudocircinatum was reisolated from the symptomatic plants, completing Koch's postulates and identified based on above morphological and molecular biological methods. This test was performed twice. Fusarium pseudocircinatum is a broadly distributed and ecologicaly diverse species that infects several wild and cultivated plants. For instance, it was reported on seeds of the wild 'Peroba Rosa' (Aspidosperma polyneuron Muell. Arg.) in Brazil (Mazarotto et al. 2020). Infection of sunflowers may cause plant stand failures, thus resulting in yield and economic losses for Brazilian growers. The correct identification of any pathogen, especialy a generalist one such as F. pseudocircinatum, is crucial to develop eficient management strategies. To our best knowledge, this is the first report of F. pseudocircinatum causing stunting and malformation of sunflower plants in Brazil.

Limosilactobacillus fermentum prevents gut-kidney oxidative damage and the rise in blood pressure in male rat offspring exposed to a maternal high-fat diet.

Oxidative stress along the gut-kidney axis is a risk factor for developing arterial hypertension in offspring from dams fed a high-fat diet. Considering the antioxidant capacity of probiotic strains, this study evaluated the effects of a daily multistrain formulation with Limosilactobacillus fermentum 139, 263, and 296 on blood pressure (BP), renal function, and oxidative stress and along the gut-kidney axis in male offspring from dams fed a high-fat high-cholesterol (HFHC) diet during pregnancy and lactation. Dams were fed a diet control or HFHC diet during pregnancy and lactation. At 100 days of age, part of the male offspring from dams fed a HFHC diet received Limosilactobacillus fermentum formulation for 4 weeks (HFHC + Lf) daily. After the 4-week intervention, BP (tail-cuff plethysmography) and urinary and biochemical variables were measured. In addition, malondialdehyde levels, enzymatic activities of superoxide dismutase, catalase, glutathione-S-transferase, and nonenzymatic antioxidant defense (thiols content) were measured in the colon and renal cortex. Male offspring from dams fed a HFHC had increased blood pressure, impaired renal function, and oxidative stress along the gut-kidney axis. Administration of Limosilactobacillus fermentum reduced systolic, diastolic, and mean blood pressure levels and alleviated renal function impairment and oxidative stress along the gut-kidney axis in male offspring from dams fed a HFHC diet. Administration of Limosilactobacillus fermentum formulation attenuated programmed hypertension in the HFHC group through oxidative stress modulation along the gut-kidney axis.