Ambush strategy enhances organisms' performance in rock-paper-scissors games.

We study a five-species cyclic system wherein individuals of one species strategically adapt their movements to enhance their performance in the spatial rock-paper-scissors game. Environmental cues enable the awareness of the presence of organisms targeted for elimination in the cyclic game. If the local density of target organisms is sufficiently high, individuals move towards concentrated areas for direct attack; otherwise, they employ an ambush tactic, maximising the chances of success by targeting regions likely to be dominated by opponents. Running stochastic simulations, we discover that the ambush strategy enhances the likelihood of individual success compared to direct attacks alone, leading to uneven spatial patterns characterised by spiral waves. We compute the autocorrelation function and measure how the ambush tactic unbalances the organisms' spatial organisation by calculating the characteristic length scale of typical spatial domains of each species. We demonstrate that the threshold for local species density influences the ambush strategy's effectiveness, while the neighbourhood perception range significantly impacts decision-making accuracy. The outcomes show that long-range perception improves performance by over 60%, although there is potential interference in decision-making under high attack triggers. Understanding how organisms' adaptation their environment enhances their performance may be helpful not only for ecologists, but also for data scientists, aiming to improve artificial intelligence systems.

Ontogenetic and sexual differences in the venom of Bothrops moojeni: insights from a litter and its mother.

Variability in snake venom composition is well-documented and crucial for understanding snake ecology and predicting snakebites. In this study, we characterize the venom composition and biological activities of newborn female and male Bothrops moojeni and their mother. Our results reveal significant differences between the venom of newborn females and males, demonstrating a broad and diverse range of proteins. The venoms of newborn females showed higher serine protease effects, increased hemorrhagic activity, and greater lethality compared to the venom of newborn males. However, no differences were observed in phospholipase A2 and coagulant activity. The differences in protein composition and toxic activities between maternal and neonatal venom, as well as between the venoms of newborn females and males, contribute to understanding the diverse outcomes of snakebites. These results underscore the importance of considering sex and ontogeny in understanding venom composition in snakes.

When residents die in Portuguese care facilities: The experiences and practices of care facility directors before and during the COVID-19 pandemic.

This qualitative exploratory study aimed to describe the experiences and practices of care facility directors regarding residents dying in Portuguese residential care facilities (RCFs) before and during the COVID-19 pandemic. Data was obtained from 17 care director facilities who participated in focus groups. The data analysis followed the interpretative phenomenological approach. Participants stated that practices surrounding the death of the residents in Portuguese RCFs changed significantly from before to during the pandemic, regarding both those who died from COVID-19 infection and from other conditions. Four themes emerged that illustrated the situation during the peaks of the pandemic. During the pandemic, practices and experiences quite different from the usual ones have emerged. These results support the importance of a good death, and dying with dignity in RCFs, and the need for policies, practices, and training on the death of residents in RCFs in Portugal.

Methodology optimization to quantify microplastic presence in planktonic copepods, chaetognaths and fish larvae.

Two of the groups most impacted by microplastics (MPs) are zooplankton and fish larvae, either through MPs ingestion or absorption. Although there has been an increase of studies focusing on MPs ingestion by these organisms, there is still no standardized methodology for the quantification of MPs present in plankton. For example, some reagents normally used to digest plankton and recover MPs appear adversely to affect some plastic characteristics. This can potentially lead to underestimating the amount and types of MPs present in the organisms analyzed. Hence, this work aimed to optimize a methodology to quantify MPs present in plankton, namely zooplankton and fish larvae, and ensuring MPs integrity. Hence, the planktonic organism tissues were digested using 30% (v/v) H2O2 solution at different temperatures and incubation periods while preserving the integrity and polymer characteristics of 13 types of MPs. MPs' characteristics were register before and after the tests, by visual inspection and Fourier Transform Infrared Spectroscopy (FTIR) analysis, to evaluate the integrity and features of MPs. With this methodology, MPs recovery was above 85% for all types of plastic tested. The proposed methodology is a rapid protocol, with a maximum of 7 h of incubation, that ensures simultaneously the full digestion of the organism tissues and the complete preservation of all the plastic characteristics, namely color, size and polymer type.•A methodology was optimized to quantify microplastics present in zooplankton (copepods, chaetognaths and fish larvae).•Thirteen types of microplastics (fibers and fragments of different polymers) were used to test the efficiency of the methodology ensuring the maintenance of the integrity of plastics.•With this methodology, microplastic recovery was above 85% for all the types of microplastic tested and no changes in their characteristics were observed.

Potential of Marine Strains of Pseudoalteromonas to Improve Resistance of Juvenile Sea Bass to Pathogens and Limit Biofilm Development.

The European sea bass (Dicentrarchus labrax), one of the most produced marine fish species in Europe, is acutely vulnerable to multiple infectious hazards. In this study, we investigated the potential probiotic effect of some marine Pseudoalteromonas bacterial strains against two major pathogens of this species, Vibrio harveyi and the nervous necrosis virus (NNV), and examined their antibiofilm effect. Impregnation phase was done by repeated immersion of juvenile's sea bass during 8 to 12 weeks in seawater containing the probiotic candidates at a concentration of 106 CFU/mL. Four candidates were tested: (1) a combination of two strains producing antimicrobial compounds, hCg-42 and hOe-125; (2) strain 3J6, with known antibiofilm properties; (3) strain RA15, from the same genus, but with no identified probiotic effect; and (4) a control group without probiotics. At the end of the impregnation phase, fish underwent an infection challenge with V. harveyi or with a pathogenic strain of NNV and mortality was monitored. For the V. harveyi challenge, improved survival rates of 10 and 25% were obtained for the RA15 and the mix hCg-42 + hOe-125-impregnated groups, respectively. For the NNV challenge, no significant benefic effect of the probiotics on infection kinetics or cumulative mortality was observed. At the end of the impregnation phase, the maximal thickness of biofilm was significantly lower in the 3J6, double strain, and RA15 groups, compared with the non-impregnated control group. This study highlights the interesting probiotic potential of marine bacteria to limit mortalities induced by bacterial pathogens as well as biofilm development.

Improvement of indirect immunofluorescence technique to detect antineutrophil cytoplasmic antibodies and its impact on test positivity rate.

The indirect immunofluorescence (IIF) technique for antineutrophil cytoplasmic antibodies (ANCA) detection is subject to substantial differences across laboratories. This study aimed to assess the impact of improvements in the IIF-ANCA technique on the positivity rate of ANCA tests. A cross-sectional study was performed with serum samples from patients with ANCA-associated vasculitis (AAV), autoimmune hepatitis (AIH), and ulcerative colitis (UC). A paired analysis was performed for IIF-ANCA results using the traditional method and a modified protocol after a series of specific adjustments in the technique based on the protocol of IIF-ANCA test performed at a nation-wide private laboratory in Brazil. ANCA specificity was assessed by ELISA for anti-proteinase 3 (PR3) and anti-myeloperoxidase (MPO) antibodies. Sixty-one patients were evaluated. The positivity rate of IIF-ANCA tests at disease presentation performed at the University reference laboratory was 32.3% in AAV, AIH, and UC patients, whereas the positivity rates of IIF-ANCA and ELISA tests in other laboratories were 75.0 and 72.7%, respectively. After modifications in the IIF-ANCA technique, there was a significant increase in the positivity rate (14.8 vs 34.3%; P=0.0002) and in median titers [1/40 (1/30-1/160) vs 1/80 (1/40-1/80); P=0.0003] in AAV, AIH, and UC patients. UC had the highest increment in positive results from 5.3 to 36.8%. There was poor agreement between MPO- or PR3-ANCA and both IIF-ANCA techniques. In conclusion, modifications in the IIF-ANCA protocol led to a significant improvement in its positivity rate and titers.

Are biopesticides safe for the environment? Effects of pyrethrum extract on the non-target species Daphnia magna.

Biopesticides are natural compounds considered more safe and sustainable for the environment. However, it is also important to evaluate the potential risk in non-target organisms. Pyrethrum extract (PE) is a biopesticide, widely used for agriculture, veterinary, and aquaculture. This work aimed to evaluate acute (0.6 - 40.0 µg/L; 96 h; E(L)C50 toxicity) and sub-chronic (0.7 - 1.1 µg/L; 10 d; life-history parameters) effects of PE on Daphnia magna. Moreover, a biomarkers approach using antioxidant and biotransformation capacity, lipid peroxidation (LPO), neurotoxicity, and energy reserves content were evaluated. Acute effects (mortality, changes in swimming behavior, oxidative stress, lipid peroxidation, neurotoxicity) were recorded with the increase in PE concentration. Sub-chronic assay showed an increase in energy reserves content, antioxidant parameters, and LPO demonstrating that PE unbalances oxidative metabolism. This study can conclude that PE potentiates toxic effects in D. magna and demonstrates the vulnerability of a non-target organism to PE that is considered environmentally safe.

Stabilization of biomass ash granules using accelerated carbonation to optimize the preparation of soil improvers.

After the revision of the Fertilizer Regulation (EC 2019/1009), biomass ash can be used as component material for soil improvers to be placed on the EU market. This provides opportunities for large scale recycling of biomass ash. However, this material cannot be directly applied to soil without stabilization by carbonation, which also creates an opportunity for CO2 capture and storage. Here, accelerated carbonation in an atmospheric fixed-bed reactor (AFR) was applied to prepare ash granules (AG). Relative humidity of gas, temperature, reaction time and CO2 concentration were optimized and further tested in a closed high-pressure reactor (HPR). Materials resulting from both reactors were compared with those obtained after 1-year of carbonation under atmospheric conditions. This study showed that AFR accelerated tests resulted in a significant reduction of the reaction time than HPR to achieve a similar pH adjustment. Also, under 100 vol.% CO2 atmospheric conditions, pH and electrical conductivity reached target values faster than under 15 vol.% CO2 conditions. Based on results obtained here we recommend AFR operating at 25 °C and 100 vol.% CO2 for 20 h, as the optimal procedure for stabilization of AG. In this study we provide evidence that accelerated carbonation enables a much faster and cost-efficient preparation of potentially valuable soil additives than natural carbonation. Also, leaching tests revealed that plant nutrient availability (B, Mg, Mn, Mo and P) was increased under accelerated carbonation compared to natural carbonation. The present work paves the way towards the development of optimized protocols to effectively recycle biomass ashes for soil recovery.

Prevalencia y tratamiento del asma en adultos: análisis descriptivo de la encuesta nacional de salud de Chile 2016-2017 / Prevalence and treatment of asthma in adults: descriptive analysis of the Chilean National Health Survey 2016-2017

Objetivo: Describir la prevalencia de diagnóstico autorreportado de asma, comorbilidades, patrones de tratamiento y calidad de vida (CdV) autopercibida en la población chilena, utilizando datos de la Encuesta Nacional de Salud (ENS) de 2016-2017. Métodos: Se analizó la población de la ENS 2016-2017 con ≥ 15 años. Los individuos con asma fueron identificados por autorreporte. Se evaluaron variables sociodemográficas, CdV y salud (autopercepción y/o EQ-5D-3L), estado nutricional, comorbilidades y patrón de tratamiento. Resultados: La prevalencia de asma fue de 5,4% (IC 95%: 4,5-6,5). Se reportó una frecuencia casi 2 veces mayor de CdV autopercibida (6,3% [IC 95%: 3,4-11,3] frente a 3,6% [IC 95%: 2,8-4,5]) y de salud (16,4% [IC 95%: 11,4-23,1] frente a 7,7% [IC 95%: 6,6-8,9]) muy mala/mala/menos que regular en el grupo con asma en comparación con el total de individuos de la ENS. El grupo de asma tuvo mayor frecuencia de al menos algunos problemas en todos los dominios EQ-5D-3L. La comorbilidad más frecuente fue la sintomatología depresiva. El 63% de los encuestados que reconocían tener asma no recibían ningún tratamiento en el momento de la encuesta. Con mayor frecuencia el tratamiento para el asma fue prescrito por un médico general (62,4%/55,4%, medicación de rescate/controlador) y el acceso fue a través del sistema público (65,9%/82,5%, medicación de rescate/controlador). Alrededor de un tercio de la población utilizaba monoterapia con SABA (32,8%). Conclusión: La prevalencia de asma fue del 5,4% y los asmáticos relataron peor CdV y salud. Se observó una baja tasa de tratamiento y de los tratados la mayoría usaba solo medicación de rescate.

Objective: To describe diagnosed asthma prevalence, self-reported comorbidities, treatment patterns and self-perceived quality of life (QoL) in Chilean population, using National Health Survey (NHS) data from 2016-2017. Methods: 2016-2017 NHS population aged ≥ 15 years was analyzed. Asthma individuals were identified by self-report. Sociodemographic variables, QoL and health (self-perception and/or EQ-5D-3L), nutritional status, comorbidities and treatment pattern were evaluated. Results: Asthma prevalence was 5.4% (95% CI: 4.5-6.5). Compared with NHS total individuals, asthma group showed almost 2 times higher frequency of self-perceived QoL (6.3% [95% CI: 3.4-11.3] vs 3.6% [95% CI: 2.8-4.5]) and health (16.4% [95% CI: 11.4-23.1] vs 7.7% [95% CI: 6.6-8.9]) named as very bad/bad/less than regular. In addition, asthma group had a greater frequency of at least some problems in all EQ-5D-3L domains. Depressive symptoms were the most frequently observed comorbidity. 63% of respondents who acknowledged having asthma were not receiving any treatment at the time of the survey. Asthma treatment was most frequently prescribed by a general physician (62.4%/55.4%, rescue/controller medication) and the access occurs in the public system (65.9%/82.5%, rescue/controller medication). About one third of the population used SABA monotherapy (32.8%). Conclusion: Asthma prevalence was 5.4% and asthmatics reported worse QoL and health. A very low treatment rate was observed and those treated, most were under rescue medication.

Improvement of indirect immunofluorescence technique to detect antineutrophil cytoplasmic antibodies and its impact on test positivity rate

The indirect immunofluorescence (IIF) technique for antineutrophil cytoplasmic antibodies (ANCA) detection is subject to substantial differences across laboratories. This study aimed to assess the impact of improvements in the IIF-ANCA technique on the positivity rate of ANCA tests. A cross-sectional study was performed with serum samples from patients with ANCA-associated vasculitis (AAV), autoimmune hepatitis (AIH), and ulcerative colitis (UC). A paired analysis was performed for IIF-ANCA results using the traditional method and a modified protocol after a series of specific adjustments in the technique based on the protocol of IIF-ANCA test performed at a nation-wide private laboratory in Brazil. ANCA specificity was assessed by ELISA for anti-proteinase 3 (PR3) and anti-myeloperoxidase (MPO) antibodies. Sixty-one patients were evaluated. The positivity rate of IIF-ANCA tests at disease presentation performed at the University reference laboratory was 32.3% in AAV, AIH, and UC patients, whereas the positivity rates of IIF-ANCA and ELISA tests in other laboratories were 75.0 and 72.7%, respectively. After modifications in the IIF-ANCA technique, there was a significant increase in the positivity rate (14.8 vs 34.3%; P=0.0002) and in median titers [1/40 (1/30-1/160) vs 1/80 (1/40-1/80); P=0.0003] in AAV, AIH, and UC patients. UC had the highest increment in positive results from 5.3 to 36.8%. There was poor agreement between MPO- or PR3-ANCA and both IIF-ANCA techniques. In conclusion, modifications in the IIF-ANCA protocol led to a significant improvement in its positivity rate and titers.

A quality improvement study: Optimizing pneumococcal vaccination rates in children with cochlear implants.

Children with cochlear implants are at increased risk of invasive pneumococcal disease, with national and international guidelines recommending additional pneumococcal vaccines for these children. This study aimed to examine the pneumococcal immunization status and rate of invasive pneumococcal disease in children with cochlear implants at a tertiary paediatric hospital over a 12-year period. Additionally, the impacts of vaccination reminders and a dedicated immunization clinic on pneumococcal vaccination rates were assessed. This quality improvement study included 200 children who had received a cochlear implant through the Children's Hearing Implant Program at a tertiary paediatric hospital servicing the state of Western Australia. The majority of children (88%) were not up to date with additionally recommended pneumococcal vaccinations. Over the 12-year study period, 2% of children developed invasive pneumococcal disease associated with cochlear implant infections. Generic and personalized electronic immunization reminders improved pneumococcal vaccine up-take in this paediatric cochlear implant setting from 12% (19/153) at baseline to 49% (75/153, p < 0.0001) post implementation. The value of a nurse-led dedicated immunization clinic was also demonstrated with all children (42/42, 100%) up to date with Prevenar13 and the majority (34/42, 81%) up to date with Pneumovax23 post initiation of this referral pathway. These data support the expansion of this model to other medically-at-risk paediatric groups that have been highlighted consistently to be under-vaccinated.

A phenomenological model for interfacial water near hydrophilic polymers.

We propose a minimalist phenomenological model for the 'interfacial water' phenomenon that occurs near hydrophilic polymeric surfaces. We achieve this by combining a Ginzburg-Landau approach with Maxwell's equations which leads us to a well-posed model providing a macroscopic interpretation of experimental observations. From the derived governing equations, we estimate the unknown parameters using experimental measurements from the literature. The resulting profiles of the polarization and electric potential show exponential decay near the surface, in qualitative agreement with experiments. Furthermore, the model's quantitative prediction of the electric potential at the hydrophilic surface is in excellent agreement with experiments. The proposed model is a first step towards a more complete parsimonious macroscopic model that will, for example, help to elucidate the effects of interfacial water on cells (e.g. neuronal excitability), the effects of infrared neural stimulation or the effects of drugs mediated by interfacial water.

Cellulose-based hydrogel on quantum dots with molecularly imprinted polymers for the detection of CA19-9 protein cancer biomarker.

Molecularly imprinted polymers MIPs were successfully assembled around quantum dots (QDs), for the detection of the protein biomarker CA19-9 associated to pancreatic cancer (PC). These imprinted materials MIP@QDs were incorporated within the cellulose hydrogel with retention of its conformational structure inside the binding cavities. The concept is to use MIPs which function as the biorecognition elements, conjugated to cadmium telluride QDs as the sensing system. The excitation wavelength was set to 477 nm and the fluorescence signal was measured at its maximum intensity, with an emission range between 530 and 780 nm. The fluorescence quenching of the imprinted cellulose hydrogels occurred with increasing concentrations of CA19-9, showing linearity in the range 2.76 × 10 -2 - 5.23 × 10 2 U/ml, in a 1000-fold diluted human serum. Replicates of the imprinted hydrogel show a linear response below the cut-off values for pancreatic cancer diagnosis (< 23 U/ml), a limit of detection of 1.58 × 10 -3 U/ml and an imprinting factor (IF) of 1.76. In addition to the fact that the imprinted cellulose hydrogel displays good stability and selectivity towards CA19-9 when compared with the non-imprinted controls, the conjugation of MIPs to QDs increases the sensitivity of the system for an optical detection method towards ranges within clinical significance. This fact shows potential for the imprinted hydrogel to be applied as a sensitive, low-cost format for point-of-care tests (PoCTs).

Specialists' opinion regarding factors related to wet loads after steam sterilization.

BACKGROUND: Episodes of wet loads after steam sterilization are frequent; however, the factors related to these events are still unclear. AIM: To evaluate the strength of relationship of factors related to wet loads after steam sterilization. METHODS: By adapting the Delphi technique, steam sterilization specialists assigned a score for the relation strength of a list of 37 factors (f.01-37) related to wet load, grouped into: cycle parameters, sterilizer, steam, load, and environment. Sixty-seven specialists distributed on five continents participated in all phases of this study. FINDINGS: Certain factors related to wet loads are better established, such as vacuum depth in the drying phase, whereas others are still controversial, such as those related to the environment. The factor that obtained the highest average score was the vacuum depth in the drying phase (f.12), with a value of 4.28, and the lowest score of 2.66 was obtained in the delay time when the set reaches the value of vacuum or steam in the conditioning phase (f.05). CONCLUSION: Specialists' opinions diverge in most of the factors related to the occurrence of wet loads. The results obtained will enable further research and the establishment of normative requirements.

Detection of enteroparasites in foliar vegetables commercialized in street- and supermarkets in Aparecida de Goiânia, Goiás, Brazil / Detecção de enteroparasitas em hortaliças comercializadas em feiras e supermercados em Aparecida de Goiânia, Goiás, Brasil

Foliar vegetables contaminated with fecal residues are an important route of transmission of intestinal parasites to humans. The aim of this study was to evaluate the presence of parasitic forms of protozoa and helminths on lettuces (Lactuca sativa) and collard greens (Brassica oleracea) sold in street- and supermarkets in the city of Aparecida de Goiânia, Goiás, Brazil. A total of 30 samples of each vegetable (15 samples from each supermarkets and street markets) was analyzed. All samples were processed by spontaneous sedimentation method and centrifugal flotation. In 45% of the samples, immature forms of intestinal parasites were identified with 66.7% helminths eggs and 33.3% protozoan cysts or oocysts. Significantly more lettuce samples were contaminated with eggs, cysts or oocyst of at least one parasite than collard green samples (U=216; Z=-3.45; P <0.001). The parasitic forms were identified morphologically up to the family level with eggs of Ancylostomatidae, Strongyloididae, Ascarididae and Taeniidae, or oocysts of Eimeriidae, to the genus with Cystoisospora sp. and Toxocara sp., and to the species level with Cystoisospora canis, Dipylidium caninum and Hymenolepis nana. The presence of these infective agents in lettuce and collard green from both street- and supermarkets highlights the high risk of spreading parasites by eating raw vegetables sold in Aparecida de Goiânia.

Hortaliças contaminadas com resíduos fecais são importantes vias de transmissão de parasitas intestinais ao homem. O objetivo deste estudo foi avaliar a presença de formas parasitárias de protozoários e helmintos em alface (Lactuca sativa) e couve (Brassica oleracea) vendidas em feiras e supermercados na cidade de Aparecida de Goiânia, Goiás, Brasil. Um total de 30 amostras de cada vegetal (15 amostras de supermercados e 15 de feiras livres) foi analisado. Todas as amostras foram processadas pelos métodos de sedimentação espontânea e centrífugo-flutuação. Em 45% das amostras foram identificadas formas imaturas de parasitas intestinais sendo 66,7% ovos de helmintos e 33,3% de cistos ou oocistos de protozoários. Significativamente, mais amostras de alface estavam contaminadas com ovos, cistos ou oocistos de pelo menos um parasita do que as amostras de couve (U = 216; Z = -3,45; P <0,001). As formas parasitárias foram identificadas morfologicamente ao nível de família com ovos de Ancylostomatidae, Strongyloididae, Ascarididae e Taeniidae ou oocistos de Eimeriidae, dos gêneros Cystoisospora sp. e Toxocara sp., e ao nível de espécies com Cystoisospora canis, Dipylidium caninum e Hymenolepis nana. A presença desses agentes infecciosos em alface e couve, provenientes tanto de feiras quanto de supermercados, ressalta o alto risco de veiculação de parasitas pela ingestão de hortaliças cruas comercializadas em Aparecida de Goiânia.

Detection of enteroparasites in foliar vegetables commercialized in street- and supermarkets in Aparecida de Goiânia, Goiás, Brazil / Detecção de enteroparasitas em hortaliças comercializadas em feiras e supermercados em Aparecida de Goiânia, Goiás, Brasil

Foliar vegetables contaminated with fecal residues are an important route of transmission of intestinal parasites to humans. The aim of this study was to evaluate the presence of parasitic forms of protozoa and helminths on lettuces (Lactuca sativa) and collard greens (Brassica oleracea) sold in street- and supermarkets in the city of Aparecida de Goiânia, Goiás, Brazil. A total of 30 samples of each vegetable (15 samples from each supermarkets and street markets) was analyzed. All samples were processed by spontaneous sedimentation method and centrifugal flotation. In 45% of the samples, immature forms of intestinal parasites were identified with 66.7% helminths eggs and 33.3% protozoan cysts or oocysts. Significantly more lettuce samples were contaminated with eggs, cysts or oocyst of at least one parasite than collard green samples (U=216; Z=-3.45; P <0.001). The parasitic forms were identified morphologically up to the family level with eggs of Ancylostomatidae, Strongyloididae, Ascarididae and Taeniidae, or oocysts of Eimeriidae, to the genus with Cystoisospora sp. and Toxocara sp., and to the species level with Cystoisospora canis, Dipylidium caninum and Hymenolepis nana. The presence of these infective agents in lettuce and collard green from both street- and supermarkets highlights the high risk of spreading parasites by eating raw vegetables sold in Aparecida de Goiânia.

Hortaliças contaminadas com resíduos fecais são importantes vias de transmissão de parasitas intestinais ao homem. O objetivo deste estudo foi avaliar a presença de formas parasitárias de protozoários e helmintos em alface (Lactuca sativa) e couve (Brassica oleracea) vendidas em feiras e supermercados na cidade de Aparecida de Goiânia, Goiás, Brasil. Um total de 30 amostras de cada vegetal (15 amostras de supermercados e 15 de feiras livres) foi analisado. Todas as amostras foram processadas pelos métodos de sedimentação espontânea e centrífugo-flutuação. Em 45% das amostras foram identificadas formas imaturas de parasitas intestinais sendo 66,7% ovos de helmintos e 33,3% de cistos ou oocistos de protozoários. Significativamente, mais amostras de alface estavam contaminadas com ovos, cistos ou oocistos de pelo menos um parasita do que as amostras de couve (U = 216; Z = -3,45; P <0,001). As formas parasitárias foram identificadas morfologicamente ao nível de família com ovos de Ancylostomatidae, Strongyloididae, Ascarididae e Taeniidae ou oocistos de Eimeriidae, dos gêneros Cystoisospora sp. e Toxocara sp., e ao nível de espécies com Cystoisospora canis, Dipylidium caninum e Hymenolepis nana. A presença desses agentes infecciosos em alface e couve, provenientes tanto de feiras quanto de supermercados, ressalta o alto risco de veiculação de parasitas pela ingestão de hortaliças cruas comercializadas em Aparecida de Goiânia.

Detection of enteroparasites in foliar vegetables commercialized in street- and supermarkets in Aparecida de Goiânia, Goiás, Brazil

Abstract Foliar vegetables contaminated with fecal residues are an important route of transmission of intestinal parasites to humans. The aim of this study was to evaluate the presence of parasitic forms of protozoa and helminths on lettuces (Lactuca sativa) and collard greens (Brassica oleracea) sold in street- and supermarkets in the city of Aparecida de Goiânia, Goiás, Brazil. A total of 30 samples of each vegetable (15 samples from each supermarkets and street markets) was analyzed. All samples were processed by spontaneous sedimentation method and centrifugal flotation. In 45% of the samples, immature forms of intestinal parasites were identified with 66.7% helminths eggs and 33.3% protozoan cysts or oocysts. Significantly more lettuce samples were contaminated with eggs, cysts or oocyst of at least one parasite than collard green samples (U=216; Z=-3.45; P 0.001). The parasitic forms were identified morphologically up to the family level with eggs of Ancylostomatidae, Strongyloididae, Ascarididae and Taeniidae, or oocysts of Eimeriidae, to the genus with Cystoisospora sp. and Toxocara sp., and to the species level with Cystoisospora canis, Dipylidium caninum and Hymenolepis nana. The presence of these infective agents in lettuce and collard green from both street- and supermarkets highlights the high risk of spreading parasites by eating raw vegetables sold in Aparecida de Goiânia.

Resumo Hortaliças contaminadas com resíduos fecais são importantes vias de transmissão de parasitas intestinais ao homem. O objetivo deste estudo foi avaliar a presença de formas parasitárias de protozoários e helmintos em alface (Lactuca sativa) e couve (Brassica oleracea) vendidas em feiras e supermercados na cidade de Aparecida de Goiânia, Goiás, Brasil. Um total de 30 amostras de cada vegetal (15 amostras de supermercados e 15 de feiras livres) foi analisado. Todas as amostras foram processadas pelos métodos de sedimentação espontânea e centrífugo-flutuação. Em 45% das amostras foram identificadas formas imaturas de parasitas intestinais sendo 66,7% ovos de helmintos e 33,3% de cistos ou oocistos de protozoários. Significativamente, mais amostras de alface estavam contaminadas com ovos, cistos ou oocistos de pelo menos um parasita do que as amostras de couve (U = 216; Z = -3,45; P 0,001). As formas parasitárias foram identificadas morfologicamente ao nível de família com ovos de Ancylostomatidae, Strongyloididae, Ascarididae e Taeniidae ou oocistos de Eimeriidae, dos gêneros Cystoisospora sp. e Toxocara sp., e ao nível de espécies com Cystoisospora canis, Dipylidium caninum e Hymenolepis nana. A presença desses agentes infecciosos em alface e couve, provenientes tanto de feiras quanto de supermercados, ressalta o alto risco de veiculação de parasitas pela ingestão de hortaliças cruas comercializadas em Aparecida de Goiânia.

Detection of enteroparasites in foliar vegetables commercialized in street- and supermarkets in Aparecida de Goiânia, Goiás, Brazil.

Foliar vegetables contaminated with fecal residues are an important route of transmission of intestinal parasites to humans. The aim of this study was to evaluate the presence of parasitic forms of protozoa and helminths on lettuces (Lactuca sativa) and collard greens (Brassica oleracea) sold in street- and supermarkets in the city of Aparecida de Goiânia, Goiás, Brazil. A total of 30 samples of each vegetable (15 samples from each supermarkets and street markets) was analyzed. All samples were processed by spontaneous sedimentation method and centrifugal flotation. In 45% of the samples, immature forms of intestinal parasites were identified with 66.7% helminths eggs and 33.3% protozoan cysts or oocysts. Significantly more lettuce samples were contaminated with eggs, cysts or oocyst of at least one parasite than collard green samples (U=216; Z=-3.45; P <0.001). The parasitic forms were identified morphologically up to the family level with eggs of Ancylostomatidae, Strongyloididae, Ascarididae and Taeniidae, or oocysts of Eimeriidae, to the genus with Cystoisospora sp. and Toxocara sp., and to the species level with Cystoisospora canis, Dipylidium caninum and Hymenolepis nana. The presence of these infective agents in lettuce and collard green from both street- and supermarkets highlights the high risk of spreading parasites by eating raw vegetables sold in Aparecida de Goiânia.

Diagnostic yield of muscle biopsies in pediatric population: a tertiary center experience. / Rendimiento diagnóstico de las biopsias musculares en la población pediátrica: experiencia de un centro terciario.

BACKGROUND AND AIM: Muscle biopsy is still an important exam on the investigation of neuromuscular diseases although data regarding its diagnostic yield can be disappointing. We aimed to analyze the diagnostic yield of muscle biopsies in the pediatric population. PATIENTS AND METHODS: We retrospectively analyzed a tertiary Neuropathology laboratory database to identify patients (<18 years old), submitted to muscle biopsy between January 2015 and August 2019. Demographics, clinical presentation, diagnosis, treatment, and follow-up were evaluated. Descriptive statistical analysis was performed. RESULTS: One-hundred and six patients were included, 52,8% (n = 56) were male. Median age at biopsy was 6 years (IQR 10 years). Patients were divided into 8 groups, according to clinical diagnostic suspicion: mitochondrial myopathies (n = 29), congenital myopathies (n = 9), inflammatory myopathies (n = 8), muscular dystrophies (n = 7), raised CK values in serum (n = 7), metabolic myopathies (n = 5), weakness /other neuromuscular symptoms (n = 30) and multiple clinical suspicions (n = 11). Biopsy was normal in 50 patients. Of the remaining, 27 displayed specific diagnostic features, with 88,9% (n = 24) allowing a definite diagnosis: muscular dystrophies (n = 7), metabolic myopathies (n = 5), congenital myopathies (n = 4), inflammatory myopathies (n = 4), mitochondrial myopathies (n = 3) and spinal muscular atrophy (n = 1). Histology led to a change of treatment in 4 patients, all diagnosed with inflammatory myopathies. Median length of follow-up was 1 year (IQR 2 years). CONCLUSION: Biopsy diagnostic yield was 22,6%, and it was useful either in diagnostic or therapeutic approaches in 35,8%. Although advances of molecular techniques led to a decrease in muscle biopsy indications, it remains an important tool on the diagnosis of neuromuscular diseases.

TITLE: Rendimiento diagnóstico de las biopsias musculares en la población pediátrica: experiencia de un centro terciario.Introducción. La biopsia muscular es un examen importante en la investigación de enfermedades neuromusculares, aunque su rendimiento diagnóstico puede ser decepcionante. Objetivo. Analizar el rendimiento diagnóstico de las biopsias musculares en la población pediátrica. Pacientes y métodos. Se analizó retrospectivamente una base de datos de un laboratorio terciario de neuropatología para identificar a pacientes (mayores de 18 años) sometidos a biopsia muscular entre enero de 2015 y agosto de 2019. Se evaluaron los datos demográficos, la presentación clínica, el diagnóstico, el tratamiento y el seguimiento. Resultados. Se incluyó a 106 pacientes, de los que el 52,8% (n = 56) eran varones. La mediana de edad fue de 6 años (rango intercuartílico: 10 años). Los pacientes se dividieron en ocho grupos, según sospecha diagnóstica clínica: miopatías mitocondriales (n = 29), miopatías congénitas (n = 9), miopatías inflamatorias (n = 8), distrofias musculares (n = 7), valores elevados de creatincinasa en el suero (n = 7), miopatías metabólicas (n = 5), otros síntomas neuromusculares (n = 30) y múltiples sospechas clínicas (n = 11). La biopsia fue normal en 50 pacientes. De los restantes, 27 mostraron características diagnósticas específicas, y el 88,9% (n = 24) permitió un diagnóstico definitivo: distrofias musculares (n = 7), miopatías metabólicas (n = 5), miopatías congénitas (n = 4), miopatías inflamatorias (n = 4), miopatías mitocondriales (n = 3) y atrofia muscular espinal (n = 1). La histología llevó a un cambio de tratamiento en cuatro pacientes. La mediana de seguimiento fue de un año (rango intercuartílico: 2 años). Conclusiones. El rendimiento diagnóstico de biopsia fue del 22,6% y fue útil en la orientación diagnóstica o terapéutica en el 35,8%. Las técnicas moleculares llevaron a una disminución de las indicaciones de biopsia muscular, pero ésta sigue siendo una herramienta importante para el diagnóstico de enfermedades neuromusculares.