Disentangling the contemporary and historical effects of landscape on the population genomic variation of two bird species restricted to the highland forest enclaves of northeastern Brazil.

Investigating the impact of landscape features on patterns of genetic variation is crucial to understand spatially dependent evolutionary processes. Here, we assess the population genomic variation of two bird species (Conopophaga cearae and Sclerurus cearensis) through the Caatinga moist forest enclaves in northeastern Brazil. To infer the evolutionary dynamics of bird populations through the Late Quaternary, we used genome-wide polymorphism data obtained from double-digestion restriction-site-associated DNA sequencing (ddRADseq), and integrated population structure analyses, historical demography models, paleodistribution modeling, and landscape genetics analyses. We found the population differentiation among enclaves to be significantly related to the geographic distance and historical resistance across the rugged landscape. The climate changes at the end of the Pleistocene to the Holocene likely triggered synchronic population decline in all enclaves for both species. Our findings revealed that both geographic distance and historical connectivity through highlands are important factors that can explain the current patterns of genetic variation. Our results further suggest that levels of population differentiation and connectivity cannot be explained purely on the basis of contemporary environmental conditions. By combining historical demographic analyses and niche modeling predictions in a historical framework, we provide strong evidence that climate fluctuations of the Quaternary promoted population differentiation and a high degree of temporal synchrony among population size changes in both species.

Electroosmotic flow in fused deposition modeling (FDM) 3D-printed microchannels.

Electroosmotic flow (EOF) was determined in tridimensional (3D)-printed microchannels with dimensions smaller than 100 µm. Fused deposition modeling 3D printing using thermoplastic filaments of PETG (polyethylene terephthalate glycol), PLA (polylactic acid), and ABS (acrylonitrile butadiene styrene) were used to fabricate the microchannels. The current monitoring method and sodium phosphate solutions at different pH values (3-10) were used for the EOF mobility (µEOF ) measurements, which ranged from 2.00 × 10-4 to 12.52 × 10-4  cm2  V-1  s-1 . The highest and the smallest µEOF were obtained for the PLA and PETG microchannels, respectively. Adding the cationic surfactant cetyltrimethylammonium bromide to the sodium phosphate solution caused EOF direction reversion in all the studied microchannels. The obtained results can be interesting for developing 3D-printed microfluidic devices, in which EOF is relevant.

Comparative clinical and radiologic evaluation between patients undergoing standard reversed shoulder arthroplasty or bony increased offset

Background@#Modifications of the medialized design of Grammont-type reverse shoulder arthroplasty (RSA) using a bony increased offset (BIO-RSA) has shown better clinical results and fewer complications. The aim of this study is to compare the clinical results, complications, and radiological outcomes between patients undergoing standard RSA and BIO-RSA. @*Methods@#A retrospective review was performed of 42 RSA procedures (22 standard RSA and 20 BIO-RSA). With a minimum of one year of follow-up, range of motion (ROM), Constant shoulder score (CSS), visual analog scale (VAS), and subjective shoulder score (SSS) were compared. Radiographs and computed tomography (CT) scan were examined for scapular notching, glenoid and humeral fixation, and graft healing. @*Results@#At a mean follow-up of 27.6 months (range, 12–48 months), a significant difference was found for active-internal rotation (P=0.038) and for passive-external rotation (P=0.013), with better results in BIO-RSA. No other differences were found in ROM, CSS (P=0.884), VAS score, and SSS. Graft healing and viability were verified in all patients with CT scan (n=34). The notching rate was 28% in the standard RSA group and 33% in the BIO-RSA group, but the standard RSA had more severe notching (grade 2) than BIO-RSA (P=0.039). No other significative differences were found in glenoid and humeral fixation. @*Conclusions@#Bone-graft lateralization is associated with better internal and external rotation and with less severe scapular notching compared to the standard RSA. Integration of the bone graft occurs effectively, with no relevant changes observed on radiographic evaluation.Level of evidence: Level III; Retrospective cohort design treatment study

Assistência ao paciente com tuberculose na atenção primária à saúde: uma revisão integrativa / Care for patients with tuberculosis in primary health care: an integrative review / Atención a pacientes con tuberculosis en la atención primaria de salud: una revisión integradora

Introdução: A Tuberculose (TB) é uma patologia milenar, no qual desde seu surgimento apresentou taxas de incidência elevadas provocando inúmeros óbitos entre as populações. Atualmente, esta doença ainda se constitui como um problema de saúde pública em todo mundo. A assistência prestada na Atenção Primária à Saúde (APS) interfere diretamente na adesão terapêutica. Objetivo: analisar na literatura a assistência ao paciente com TB na APS. Metodologia: Trata-se de uma revisão integrativa da literatura, na qual a busca foi feita nas bases de dados Scielo, Pubmed e Scopus, com uso de descritores e booleanos aplicados em cada base de dados. Ao todo 14 estudos foram incluídos nesta revisão. Resultados: A maioria dos estudos tinha como ênfase apontar os principais desafios que permeiam a assistência à saúde dos pacientes com TB, no qual foram identificadas tanto as barreiras a nível dos pacientes quanto aquelas encontradas pelos profissionais nos serviços de saúde. Verificou-se dificuldades na acessibilidade aos serviços, barreiras socioculturais, organizacionais, geográficas e econômicas, falta de vínculo entre profissionais e pacientes, falta de comprometimento dos pacientes e até mesmo o despreparo da equipe. Conclusão: Desta forma, torna-se necessário um maior comprometimento dos pacientes e também uma maior efetivação das ações de controle da doença por parte dos profissionais da APS para que ocorra a diminuição das taxas de abandono do tratamento e consequentemente aumentando as taxas de curas dos pacientes com TB e assim a melhora da assistência.

Introduction: Tuberculosis (TB) is an ancient pathology, which since its inception has had high incidence rates, causing numerous deaths among populations. Currently, this disease is still a public health problem worldwide. The assistance provided in Primary Health Care (PHC) directly interferes with therapeutic adherence. Objective: to analyze in the literature the assistance to patients with TB in PHC. Methodology: This is an integrative literature review, in which the search was carried out in the Scielo, Pubmed and Scopus databases, using descriptors and Booleans applied to each database. A total of 14 studies were included in this review. Results: Most studies focused on pointing out the main challenges that permeate the health care of patients with TB, in which both the barriers at the level of patients and those encountered by professionals in health services were identified. There were difficulties in accessing services, sociocultural, organizational, geographic and economic barriers, lack of bond between professionals and patients, lack of commitment from patients and even the unpreparedness of the team. Conclusion: In this way, it is necessary a greater commitment of the patients and also a greater effectiveness of the actions of control of the disease on the part of the PHC professionals so that the dropout rates of the treatment occur and consequently increasing the cure rates of the patients. patients with TB and thus the improvement of care.

Introducción: La tuberculosis (TB) es una patología milenaria, que desde sus inicios ha tenido altas tasas de incidencia, provocando numerosas muertes entre las poblaciones. Actualmente, esta enfermedad sigue siendo un problema de salud pública a nivel mundial. La asistencia prestada en la Atención Primaria de Salud (APS) interfiere directamente en la adherencia terapéutica. Objetivo: analizar en la literatura la asistencia a pacientes con TB en la APS. Metodología: Se trata de una revisión integrativa de la literatura, en la que la búsqueda se realizó en las bases de datos Scielo, Pubmed y Scopus, utilizando descriptores y booleanos aplicados a cada base de datos. En esta revisión se incluyeron un total de 14 estudios. Resultados: La mayoría de los estudios se centraron en señalar los principales desafíos que permean la atención a la salud de los pacientes con TB, en los que se identificaron tanto las barreras a nivel de los pacientes como las encontradas por los profesionales en los servicios de salud. Hubo dificultades en el acceso a los servicios, barreras socioculturales, organizacionales, geográficas y económicas, falta de vínculo entre profesionales y pacientes, falta de compromiso de los pacientes e incluso la falta de preparación del equipo. Conclusión: De esta forma, es necesario un mayor compromiso de los pacientes y también una mayor efectividad de las acciones de control de la enfermedad por parte de los profesionales de APS para que se produzcan las tasas de abandono del tratamiento y consecuentemente aumentar las tasas de curación. de los pacientes con TB y con ello la mejora de la atención.

Mortalidade materna: perfil dos óbitos maternos ocorridos no estado do Maranhão no período de 2010 a 2019 / Maternal mortality: profile of maternal deaths that occurred in the state of Maranhão from 2010 to 2019 / Mortalidad materna: perfil de las muertes maternas ocurridas en el estado de Maranhão de 2010 a 2019

Objetivo: Analisar os casos de óbitos maternos no Estado do Maranhão no período de 2010 a 2019, uma vez que, os números de óbitos maternos são um importante indicador sobre as condições de vida da população e atenção à saúde da mulher, onde a maior parte dos casos ocorre entre mulheres em situação de vulnerabilidade. Metodolo- gia: Trata-se de estudo ecológico de série temporal, com uso de dados secundários pro- venientes de sistemas de informação em saúde. Resultados: Foi observado que, mulheres com baixo nível de escolaridade, pardas e entre a faixa etária de 20 a 29 anos foram as mais afetadas. Foi evidenciado ainda que, o ano de 2010 trouxe maior incidência de casos, onde posteriormente houve um declínio entre o espaço temporal de 2015 a 2019, vale destacar que os municípios de São Luís, Imperatriz e Caxias foram os locais com maiores proporções de casos de óbitos notificados. Considerações finais: Neste sentido, a enfermagem exerce importante papel para a diminuição do número de óbitos maternos, pois os profissionais da enfermagem têm contato direto com as gestantes durante todo o pré-natal, possibilitando a descoberta precoce de patologias nas mulheres. Destaca-se ainda que a equipe multidisciplinar que atuam na atenção primária podem realizar busca ativa e ofertar um tratamento integral as mulheres durante toda a gravidez e puerpério.

Objective: To analyze the cases of maternal deaths in the State of Maranhão from 2010 to 2019, since the numbers of maternal deaths are an important indicator of the living conditions of the population and attention to women's health, where the Most cases occur among vulnerable women. Methodology: This is an ecological time series study, using secondary data from health information systems. Results: It was observed that women with a low level of education, brown and between the ages of 20 and 29 years were the most affected. It was also evidenced that the year 2010 brought a higher incidence of cases, where later there was a decline between the time period from 2015 to 2019, it is worth noting that the municipalities of São Luís, Imperatriz and Caxias were the places with the highest proportions of cases of reported deaths. Final considerations: In this sense, nursing plays an important role in reducing the number of maternal deaths, as nursing professionals have direct contact with pregnant women throughout the prenatal period, enabling the early discovery of pathologies in women. It is also noteworthy that the multidisciplinary team working in primary care can carry out an active search and offer comprehensive treatment to women throughout pregnancy and the puerperium.

Objetivo: Analizar los casos de muertes maternas en el Estado de Maranhão de 2010 a 2019, ya que los números de muertes maternas son un indicador importante de las condiciones de vida de la población y atención a la salud de las mujeres, donde la mayoría de los casos ocurren entre mujeres vulnerables. Metodología: Se trata de un estudio de series temporales ecológicas, utilizando datos secundarios de los sistemas de información en salud. Resultados: Se observó que las mujeres con bajo nivel educativo, morenas y entre 20 y 29 años de edad fueron las más afectadas. También se evidenció que el año 2010 trajo una mayor incidencia de casos, donde luego hubo una disminución entre el período de tiempo de 2015 a 2019, se destaca que los municipios de São Luís, Imperatriz y Caxias fueron los locales con mayor proporciones de casos de muertes notificadas. Consideraciones finales: En este sentido, la enfermería juega un papel importante en la reducción del número de muertes maternas, ya que los profesionales de enfermería tienen contacto directo con las gestantes durante todo el período prenatal, posibilitando el descubrimiento precoz de patologías en la mujer. También cabe destacar que el equipo multidisciplinar que trabaja en atención primaria puede realizar una búsqueda activa y ofrecer un tratamiento integral a la mujer durante todo el embarazo y el puerperio.

Acquired Hip Dysplasia in Children with Congenital Zika Virus Infection in the First Four Years of Life.

Acquired hip dysplasia has been described in children with cerebral palsy (CP); periodic surveillance is recommended in this population to prevent hip displacement and dislocation. Children with congenital zika syndrome (CZS) may present a spectrum of neurological impairments with changes in tonus, posture, and movement similar to children with CP. However, the relationship between CZS and hip dysplasia has not been characterized. In this prospective cohort study, we aimed to describe the occurrence of hip dysplasia in patients with CZS. Sixty-four children with CZS from 6 to 48 months of age were included and followed at a tertiary referral center in Rio de Janeiro, Brazil, with periodic radiologic and clinical hip assessments. Twenty-six (41%) patients were diagnosed with hip dysplasia during follow-up; mean age at diagnosis was 23 months. According to the Gross Motor Function Classification System (GMFCS), 58 (91%) patients had severe impairment (GMFCS IV and V) at the first evaluation. All patients with progression to hip dysplasia had microcephaly and were classified as GMFCS IV or V. Pain and functional limitation were reported by 22 (84%) caregivers of children with hip dysplasia. All patients were referred to specialized orthopedic care; eight (31%) underwent surgical treatment during follow-up. Our findings highlight the importance of implementing a hip surveillance program and improving access to orthopedic treatment for children with CZS in order to decrease the chances of dysplasia-related complications and improve quality of life.

Chromatographic profile, in silico and in vivo study of the pharmacokinetic and toxicological properties of major constituent present in kefir, the kefiran.

Kefiran is a polysaccharide present in kefir grains that have been widely explored due to its potential health benefits. The objective of this work was to characterize and quantify the components present in the ethanolic extract of milk kefir grains; to study its pharmacokinetic and toxicological properties in silico and evaluate the acute toxicity of the kefiran in zebrafish. The prediction of pharmacokinetic properties was performed by QikProp software. In silico toxicity assessment was performed using the DEREK (deductive estimate of risk from existing knowledge) software. In the chromatographic, kefiran was identified as the major component. Results showed that the kefiran had low human oral absorption and intestinal absorption its due poor solubility profile; low logP value, indicating its lipophilicity and the low MDCK and Caco-2 cells permability, and unable to cross the blood-brain barrier. Kefiran did not present any structural warning for in silico toxicity. In zebrafish, the dose of 2,000 mg/kg of kefiran produced nonsignificant alterations in the analyzed organs. It can be said then that kefiran has an acceptable degree of safety for use in the development of drugs or functional foods. Further research such as in vivo testing to confirm its pharmacological potential is currently underway.

Design of Multitarget Natural Products Analogs with Potential Anti-Alzheimer's Activity.

BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative condition and the most common type of dementia among the elderly. The enzymes acetylcholinesterase (AChE) and nitric oxide synthase (NOS) have a pivotal role in the pathophysiology of this disease. OBJECTIVE: This study aimed to select medicinal plant-derived molecules with reported inhibition of AChE and design optimized molecules that could inhibit not only AChE, but also NOS, potentially increasing its efficacy against AD. METHODS: 24 compounds were selected from the literature based on their known AChE inhibitory activity. Then, we performed molecular orbital calculations, maps of electrostatic potential, molecular docking study, identification of the pharmacophoric pattern, evaluation of pharmacokinetic and toxicological properties of these molecules. Next, ten analogs were generated for each molecule to optimize their effect where the best molecules of natural products had failed. RESULTS: The most relevant correlation was between HOMO and GAP in the correlation matrix of the molecules' descriptors. The pharmacophoric group's derivation found the following pharmacophoric features: two hydrogen bond acceptors and one aromatic ring. The studied molecules interacted with the active site of AChE through hydrophobic and hydrogen bonds and with NOS through hydrogen interactions only but in a meaningful manner. In the pharmacokinetic and toxicological prediction, the compounds showed satisfactory results. CONCLUSION: The design of natural products analogs demonstrated good affinities with the pharmacological targets AChE and NOS, with satisfactory pharmacokinetics and toxicology profiles. Thus, the results could identify promising molecules for treating Alzheimer's disease.

The SARS-CoV-2 infection among students in the University of Porto: a cross-sectional study

IntroductionIncidence based on notified cases of SARS-CoV-2 infection underestimates the real extension of the infection. We aimed to quantify SARS-CoV-2 specific antibodies seroprevalence among University students in Porto. MethodsA rapid point of care testing for SARS-CoV-2 specific immunoglobulin (Ig) M and IgG antibodies was performed, and a questionnaire was applied to the 6512 voluntary students from September to December 2020. We computed the apparent IgM, IgG and IgM or IgG prevalence, and the true prevalence and 95% credible intervals (95% CI) using Bayesian inference. ResultsWe found an apparent prevalence (IgM or IgG) of 9.7%, the true prevalence being 7.9% (95% CI 4.9-11.1). Prevalence was significantly higher among males (10.9% vs 9.2%), international students (18.1% vs 10.4% local vs 8.8% nationally displaced) and increased with age. Those with a known risk contact, that experienced quarantine, had symptoms, or a previous negative molecular test had a higher seroprevalence. Of the 91 (1.4%) students who reported a molecular diagnosis, 86.7% were reactive for IgM or IgG. ConclusionBased on immunological evidence infection was 5.6 times more frequent than if based on a molecular diagnosis. The higher seroprevalence among male, older, and international students emphasizes the importance of identifying particular groups.

Incidence of SARS-CoV-2 infection in a cohort of workers from the University of Porto

BackgroundRepeated serosurveys in the same population provide more accurate estimates of the frequency of SARS-CoV-2 infection and more comparable data than notified cases. We aimed to estimate the incidence of SARS-CoV-2 infection, identify associated risk factors, and assess time trends in the ratio of serological/molecular diagnosis in a cohort of university workers. MethodsParticipants had a serological rapid test for SARS-CoV-2 Immunoglobulins M and G, and completed a questionnaire, in May-July 2020 (n=3628) and November 2020-January 2021 (n=2661); 1960 participated in both evaluations and provided data to compute the incidence proportion and the incident rate. Crude and adjusted incidence rate ratios (aIRR) and 95% confidence intervals (CI) were computed using generalised linear models with Poisson regression. ResultsThe incidence rate was 1.8/100 person-month (95%CI 1.6-2.1), and the 6 months cumulative incidence was 10.7%. The serological/molecular diagnosis ratio was 10:1 in the first evaluation and 3:1 in the second. Considering newly identified seropositive cases at the first (n=69) and second evaluation (n=202), 29.0% and 9.4% never reported symptoms, respectively, 14.5% and 33.3% reported contact with a confirmed case and 82.6%, and 46.0% never had a molecular test. Males (aIRR: 0.59; 95%CI: 0.42-0.83) and "high-skilled white-collar" workers (aIRR: 0.73, 95%CI: 0.52-1.02) had lower incidence of infection. ConclusionUniversity workers presented a high SARS-CoV-2 incidence while restrictive measures were in place. The time decrease in the proportion of undiagnosed cases reflected the increased access to testing, but opportunities continued to be missed, even in the presence of COVID-19 like symptoms. What is already known on this subjectO_LIThe median ratio of seroprevalence to the corresponding cumulative incidence is 18, however, there is great variability between studies. C_LIO_LISeroprevalence studies are essential to estimate the true burden of the infection. C_LIO_LIFew cohort studies focused on essential non-healthcare workers, such as university workers. C_LI What this study addsO_LIThis longitudinal seroprevalence study among university workers found a SARS-CoV-2-specific IgM or IgG incidence rate of 1.8/100 person-month, and a 6 months cumulative incidence of 10.7%. C_LIO_LIThe undiagnosed fraction was 3:1 in the second evaluation, representing a decrease from a 10:1 in the first evaluation in the same population showing that a gap to test-trace-isolate remained in this highly educated working population. C_LIO_LISeropositive participants were mostly pauci- or symptomatic with no known contact with a COVID-19 confirmed case; "high-skilled white-collar" workers were at lower risk of being an incident seropositive case. C_LI

Hypoglycemic Activity of Aqueous Extract of Latex from Hancornia speciosa Gomes: A Study in Zebrafish and In Silico.

Hancornia speciosa Gomes is a tree native to Brazil and has therapeutic potential for several diseases. Ethnopharmacological surveys have reported that the plant is used as a hypoglycemic agent and to lose weight. This study aimed to evaluate the effects of the aqueous extract from H. speciosa latex (LxHs) in a zebrafish model of diabetes. The extract was evaluated through high-performance thin-layer chromatography (HTPLC), nuclear magnetic resonance (NMR), and Fourier-transform infrared spectroscopy (FT-IR). We then tested treatments with LxHs (500, 1000, and 1500 mg/kg) by assessing blood glucose levels in alloxan-induced diabetic animals, and metformin was used as a control. The toxicity was evaluated through histopathology of the pancreas and biochemical assessment of serum levels of AST, ALT, creatinine, and urea. The extract was also assessed for acute toxicity through several parameters in embryos and adult animals. Finally, we performed in silico analysis through the SEA server and docking using the software GOLD. The phytochemical study showed the compounds cornoside, dihydrocornoide, and 1-O-methyl-myoinositol (bornesitol). The treatment with all doses of LxHs significantly decreased alloxan-induced hyperglycemia without any significant histological or biochemical abnormalities. No significant frequency of teratogenesis was observed in the embryos exposed to the extract, and no significant behavioral changes or deaths were observed in adult animals. In silico, the results showed a potential interaction between inositol and enzymes involved in carbohydrates' metabolism. Overall, the results show a hypoglycemic activity of the extract in vivo, with no apparent toxicity. The computational studies suggest this could be at least partially due to the presence of bornesitol, since inositols can interact with carbohydrates' enzymes.

Pyrocarbon Humeral Head in a Shoulder Hemiarthroplasty: Preliminary Results at 3 Years Follow-Up and Review of the Current Literature.

Shoulder hemiarthroplasty is a viable option in young patients with an intact rotator cuff in order to preserve the native glenoid. To avoid the dreaded and expected wear of the glenoid in very active shoulders, implants with humeral head coated with a high resistant and elastic material-pyrolytic carbon-are now an option. The authors present the first pyrocarbon coated hemishoulder arthroplasty performed at our Orthopedic Department in a patient with osteonecrosis of the humeral head. At three years of follow-up, the patient is pain free and without limitations in his daily work. The Constant score was applied pre- and postoperatively, and an improvement of 32 points was reported. Larger cohorts with long-term follow-up are required to confirm our promising results.

Prevalence of SARS-CoV-2 antibodies among workers of the public higher education institutions of Porto, Portugal

ObjectivesTo assess the prevalence of SARS-CoV-2 specific immunoglobulin (Ig) M and IgG antibodies among workers of the three public higher education institutions of Porto, Portugal, up to July 2020. MethodsA rapid point of care test for specific IgM and IgG antibodies of SARS-CoV-2 was offered to all workers. Testing was performed to and a questionnaire was completed by 4592 workers on a voluntary basis. We computed the apparent IgM, IgG, and combined IgM or IgG prevalence, along with the true prevalence and 95% credible intervals (95% CI) using Bayesian inference. ResultsWe found an apparent prevalence of 3.1% for IgM, 1.0% for IgG, and 3.9% for either antibody class. The estimated true prevalence was 2.0% (95% CI 0.1-4.3) for IgM, 0.6% (95% CI 0.0-1.3) for IgG and 2.5% (95% CI 0.1-5.3) for IgM or IgG. A SARS-CoV-2 molecular diagnosis was reported by 21 (0.5%) workers, and of these, 90.5% had a reactive IgG result. Seroprevalence was higher among those reporting known contacts with confirmed cases, having been quarantined, having a previous molecular negative test, or having had symptoms. ConclusionsThe seroprevalence among workers from the three public higher education institutions of Porto after the first wave of the SARS-CoV-2 infection was relatively low. However, the estimated true seroprevalence was approximately five times higher than the reported SARS-CoV-2 infection based on a molecular test result.

Depression and anxiety before and during the COVID-19 lockdown: a longitudinal cohort study with university students

BackgroundFor young people, just as in the general population, COVID-19 caused many changes in their lives, including an increased risk for mental illness symptoms. We aimed to study the impact of the COVID-19 pandemic in anxiety and depression symptoms in a cohort of university students. MethodsThis study is part of broader longitudinal research on university students mental health with data of the Portuguese version of The Patient Health Questionnaire (PHQ-9) and the Portuguese version of the Generalised Anxiety Disorder (GAD-7) with evaluations on January, May and October 2019 and June 2020, as well as socio-demographic information. Results341 university students (257 females and 84 males) were included, with a mean age of 19.91 (SD=1.58). In June 2020, the mean for perceived wellbeing loss was 60.47% (SD=26.56) and 59.54% (SD=28.95) for mental health loss. The proportion of students with scores equal to or above 15 in the PHQ-9 ranged between 22.6% and 25.5% in 2019 and 37.0% in June 2020. The proportion of GAD-7 scores above cut-off ten ranged between 46.0% and 47.8% in 2019 and 64.5% in 2020. Compared with preceding trends, PHQ-9 scores were 3.11 (CI=2.40-3.83) higher than expected, and GAD-7 scores were 3.56 (CI=2.75-5.37) higher. DiscussionCOVID-19 impacted negatively depressive and anxiety symptoms, confirming previous studies and young peoples vulnerability in such uncertain times.

Violência nas escolas públicas brasileiras: uma revisão sistemática da literatura / Violence in Brazilian public schools: A systematic review

O objetivo do presente estudo é realizar uma revisão sistemática da literatura sobre a violência nas escolas públicas brasileiras. Foram selecionados 11 artigos empíricos publicados no período de janeiro de 2014 até dezembro de 2018, nas bases Scopus, SciELO, LILACS, Web of Science e Pepsic. A seleção das bases escolhidas se deu em função de que elas reúnem estudos acerca do objeto pesquisado, além de disporem de respaldo científico, reconhecimento e confiabilidade nas informações disponibilizadas. Para a seleção dos manuscritos, foram utilizadas as seguintes palavras-chave: violência, escola, violência nas escolas e violência escolar. Os estudos encontrados, em sua maioria, abrangeram estados das regiões Nordeste, Sul e Sudeste do país, uma vez que esta é uma pesquisa realizada no Brasil. Os artigos foram divididos em quatro categorias de análise: 1) Relação professor, aluno e violência escolar; 2) Discente e situações de violência; 3) Violência escolar na perspectiva docente; e 4) Violência, mediação de conflitos e equipe escolar. Os resultados demonstraram que a violência é algo presente em todos os segmentos sociais, surgindo de forma física e verbal, ocasionando interferência nas relações interpessoais.

The objective of the present study is to carry out a systematic review of the literature about violence in Brazilian public schools. Eleven empirical papers published in the period from January 2014 to December of 2018 were selected based on Scopus, SciELO, LILACS, Web of Science, and Pepsic databases. The selection of the chosen bases occurred because they indexed studies about the researched object, scientific support, recognition and reliability in the information provided. For the selection of manuscripts, the following keywords were used: violence, school, school violence and school violence. Most of the studies found included states in the Northeast, South and Southeast of the country, since this is a research conducted in Brazil. The articles were divided into four categories of analysis: 1) Teacher, student and school violence relationship; 2) Student and situations of violence; 3) School violence from the teaching perspective; and 4) Violence, conflict mediation and school staff. The results showed that violence is present in all social segments, acting physically and verbally, causing interference in interpersonal relationships.

Urban rail transport and SARS-CoV-2 infections: an ecological study in Lisbon Metropolitan Area

Introduction: Large number of passengers, limited space and shared surfaces can transform public transportation into a hub of epidemic spread. This study was conducted to investigate whether proximity to railway stations, a proxy for utilization, was associated with higher rates of SARS-CoV-2 infection across small-areas of Lisbon Metropolitan Area (Portugal). Methods: The number of SARS-CoV-2 confirmed infections from March 2 until July 5, 2020 at parish-level was obtained from the National Epidemiological Surveillance System. We used a Geographic Information System to estimate proximity to railway stations from the six railway lines operating in the area. Then, we fitted a quasi-Poisson generalized linear regression model to estimate the relative risks (RR) and corresponding 95% Confidence Intervals (95%CI). Results: Between May 2 and July 5, 2020, there were a total of 17,168 SARS-CoV-2 infections in the Lisbon Metropolitan Area, with wide disparities between parishes. Globally, parishes near one of the railway lines (Sintra) presented significantly higher SARS-CoV-2 infection rates (RR=1.42, 95%CI 1.16, 1.75) compared to those parishes located far away from railway stations, while the opposite happened for parishes near other railway lines (Sado/Fertagus), whose infection rates were significantly lower than those observed in parishes located far away from railway stations (RR=0.66, 95%CI 0.50, 0.87). However, the associations varied according to the stage of the epidemic and according to mitigation measures in place. Regression results also revealed an increasing influence of socioeconomic deprivation on SARS-CoV-2 infections. Conclusions: We found no consistent association between proximity to railway stations and SARS-CoV-2 infection rates in the most affected metropolitan area of the country, suggesting that other factors (e.g. socioeconomic deprivation) might play a more prominent role in the epidemic dynamics.

Virtual screening, ADME/Tox predictions and the drug repurposing concept for future use of old drugs against the COVID-19.

The new Coronavirus (SARS-CoV-2) is the cause of a serious infection in the respiratory tract called COVID-19. Structures of the main protease of SARS-CoV-2 (Mpro), responsible for the replication of the virus, have been solved and quickly made available, thus allowing the design of compounds that could interact with this protease and thus to prevent the progression of the disease by avoiding the viral peptide to be cleaved, so that smaller viral proteins can be released into the host's plasma. These structural data are extremely important for in silico design and development of compounds as well, being possible to quick and effectively identify potential inhibitors addressed to such enzyme's structure. Therefore, in order to identify potential inhibitors for Mpro, we used virtual screening approaches based with the structure of the enzyme and two compounds libraries, targeted to SARS-CoV-2, containing compounds with predicted activity against Mpro. In this way, we selected, through docking studies, the 100 top-ranked compounds, which followed to subsequent studies of pharmacokinetic and toxicity predictions. After all the simulations and predictions here performed, we obtained 10 top-ranked compounds that were again in silico analyzed inside the Mpro catalytic site, together some drugs that are being currently investigated for treatment of COVID-19. After proposing and analyzing the interaction modes of these compounds, we submitted one molecule then selected as template to a 2D similarity study in a database containing drugs approved by FDA and we have found and indicated Apixaban as a potential drug for future treatment of COVID-19.

Synergic effect of simvastatin in combination with amphotericin B against environmental strains of Cryptococcus neoformans from northeastern Brazil: a prospective experimental study.

BACKGROUND: Statins are used as cholesterol-lowering drugs and may also have direct antimicrobial effects. OBJECTIVE: To evaluate synergic interactions between simvastatin and both amphotericin B and fluconazole, against environmental strains of Cryptococcus neoformans isolated from captive birds' droppings. DESIGNAND SETTING: Experimental study conducted at Federal University of Piauí, Parnaíba, in collaboration with Federal University of Triângulo Mineiro, Uberaba, Brazil. METHODS: Statin susceptibility tests of Cryptococcus neoformans samples were performed as prescribed in standards. Interactions of simvastatin with amphotericin and fluconazole were evaluated using the checkerboard microdilution method. Presence of these interactions was quantitatively detected through determining the fractional inhibitory concentration index (FICI). RESULTS: Isolates of Cryptococcus neoformans were obtained from 30 of the 206 samples of dry bird excreta (14.5%) that were collected from pet shops and houses. Ten isolates were selected for susceptibility tests. All of them were susceptible to amphotericin and fluconazole. All presented minimum inhibitory concentration (MIC) > 128 µg/ml and, thus, were resistant in vitro to simvastatin. An in vitro synergic effect was shown through combined testing of amphotericin B and simvastatin, such that six isolates (60%) presented FICI < 0.500. Two isolates showed considerable reductions in MIC, from 1 µg/ml to 0.250 µg/ml. No synergic effect was observed through combining fluconazole and simvastatin. CONCLUSION: These results demonstrate that simvastatin should be considered to be a therapeutic alternative, capable of potentiating the action of amphotericin B. However, further studies are necessary to clarify the real effect of simvastatin as an antifungal agent.

Pregnancy and breastfeeding during COVID-19 pandemic: A systematic review of published pregnancy cases

BackgroundThe COVID-19 pandemic is an emerging concern regarding the potential adverse effects during pregnancy. This study reviews knowledge on the impact of COVID-19 on pregnancy and describes the outcome of published cases of pregnant women diagnosed with COVID-19. MethodsSearches were conducted in PubMed(R) up to 8 April 2020, using PRISMA standards, to identify original published studies describing pregnant women at any gestational age diagnosed COVID-19. There were no date or language restrictions on the search. All identified studies were included irrespective of assumptions on study quality. ResultsWe identified 30 original studies reporting 212 cases of pregnant women with COVID-19 (30 discharged while pregnant), 200 from China and 12 from other countries. The 182 published deliveries resulted in one stillbirth and 185 live births. Four women with severe COVID-19 required admission to an intensive care unit but no cases of maternal death were reported. There was one neonatal death. Preterm births occurred in 28.7% of cases, but it is unclear whether this was iatrogenic. All cases with amniotic fluid, placenta, and/or cord blood analyzed for the SARS-CoV-2 virus were negative. Four newborns were positive for SARS-CoV-2 and three newborns had high levels of IgM antibodies. Breast milk samples from 13 mothers and described in seven studies showed no evidence of SARS-CoV-2. ConclusionThe evidence related to the effect of COVID-19 on pregnant women is still limited. Pregnant women and newborns should be considered particularly vulnerable populations regarding COVID-19 prevention and management strategies.

Synergic effect of simvastatin in combination with amphotericin B against environmental strains of Cryptococcus neoformans from northeastern Brazil: a prospective experimental study

BACKGROUND: Statins are used as cholesterol-lowering drugs and may also have direct antimicrobial effects. OBJECTIVE: To evaluate synergic interactions between simvastatin and both amphotericin B and fluconazole, against environmental strains of Cryptococcus neoformans isolated from captive birds' droppings. DESIGNAND SETTING: Experimental study conducted at Federal University of Piauí, Parnaíba, in collaboration with Federal University of Triângulo Mineiro, Uberaba, Brazil. METHODS: Statin susceptibility tests of Cryptococcus neoformans samples were performed as prescribed in standards. Interactions of simvastatin with amphotericin and fluconazole were evaluated using the checkerboard microdilution method. Presence of these interactions was quantitatively detected through determining the fractional inhibitory concentration index (FICI). RESULTS: Isolates of Cryptococcus neoformans were obtained from 30 of the 206 samples of dry bird excreta (14.5%) that were collected from pet shops and houses. Ten isolates were selected for susceptibility tests. All of them were susceptible to amphotericin and fluconazole. All presented minimum inhibitory concentration (MIC) > 128 µg/ml and, thus, were resistant in vitro to simvastatin. An in vitro synergic effect was shown through combined testing of amphotericin B and simvastatin, such that six isolates (60%) presented FICI < 0.500. Two isolates showed considerable reductions in MIC, from 1 µg/ml to 0.250 µg/ml. No synergic effect was observed through combining fluconazole and simvastatin. CONCLUSION: These results demonstrate that simvastatin should be considered to be a therapeutic alternative, capable of potentiating the action of amphotericin B. However, further studies are necessary to clarify the real effect of simvastatin as an antifungal agent.