Epidemiological, clinical, and genomic landscape of coccidioidomycosis in northeastern Brazil.

Coccidioidomycosis, listed as a priority mycosis by the WHO, is endemic in the United States but often overlooked in Central and South America. Employing a multi-institutional approach, we investigate how disease characteristics, pathogen genetic variation, and environmental factors impact coccidioidomycosis epidemiology and outcomes in South America. We identified 292 cases (1978-2021) and 42 outbreaks in Piauí and Maranhão states, Brazil, the largest series outside the US/Mexico epidemic zone. The male-to-female ratio was 57.4:1 and the most common activity was armadillo hunting (91.1%) 4 to 30 days before symptom onset. Most patients (92.8%) exhibited typical acute pulmonary disease, with cough (93%), fever (90%), and chest pain (77%) as predominant symptoms. The case fatality rate was 8%. Our negative binomial regression model indicates that reduced precipitation levels in the current (p = 0.015) and preceding year (p = 0.001) predict heightened incidence. Unlike other hotspots, acidic soil characterizes this region. Brazilian strains differ genomically from other C. posadasii lineages. Northeastern Brazil presents a distinctive coccidioidomycosis profile, with armadillo hunters facing elevated risks. Low annual rainfall emerges as a key factor in increasing cases. A unique C. posadasii lineage in Brazil suggests potential differences in environmental, virulence, and/or pathogenesis traits compared to other Coccidioides genotypes.

Genomic Architecture Predicts Tree Topology, Population Structuring, and Demographic History in Amazonian Birds.

Geographic barriers are frequently invoked to explain genetic structuring across the landscape. However, inferences on the spatial and temporal origins of population variation have been largely limited to evolutionary neutral models, ignoring the potential role of natural selection and intrinsic genomic processes known as genomic architecture in producing heterogeneity in differentiation across the genome. To test how variation in genomic characteristics (e.g. recombination rate) impacts our ability to reconstruct general patterns of differentiation between species that cooccur across geographic barriers, we sequenced the whole genomes of multiple bird populations that are distributed across rivers in southeastern Amazonia. We found that phylogenetic relationships within species and demographic parameters varied across the genome in predictable ways. Genetic diversity was positively associated with recombination rate and negatively associated with species tree support. Gene flow was less pervasive in genomic regions of low recombination, making these windows more likely to retain patterns of population structuring that matched the species tree. We further found that approximately a third of the genome showed evidence of selective sweeps and linked selection, skewing genome-wide estimates of effective population sizes and gene flow between populations toward lower values. In sum, we showed that the effects of intrinsic genomic characteristics and selection can be disentangled from neutral processes to elucidate spatial patterns of population differentiation.

Waterborne Toxicity to Neotropical Invertebrates and Hazard of Cigarette Butt Leachates in Marine Environments.

Cigarette butts (CBs) are the most common type of beach litter worldwide and contain a complex mixture of chemicals. Given the recent interest in this emerging problem, it is important to assess the toxicity of CB leachates to a range of species from different regions, sensitivities, and ecological traits. We evaluated the waterborne toxicity of smoked CB to tropical invertebrates. Leachates were prepared in the laboratory and characterized for trace elements (Mn, Fe, Co, Ni, Cu, Zn, As, Cd, and Pb), ammonia nitrogen, and polycyclic aromatic hydrocarbons. Then a set of toxicity tests with marine invertebrates was performed as follows: the brine shrimp Artemia sp. (nontoxic); the amphipod Tiburonella viscana (median lethal concentration [LC50] of 0.038 CB/L); the tanaid Monokalliapseudes schubarti (LC50 of 0.126 CB/L); the copepods Tisbe biminiensis (median effect concentration [EC50] of 0.038 CB/L) and Nitokra sp. (EC50 of 0.009 CB/L); pluteus stage larvae of the sea urchin Echinometra lucunter (EC50 of 0.152 CB/L); the sand dollar Mellita quinquiesperforata (EC50 of 0.054 CB/L); and D-stage larvae of the mussel Perna perna (EC50 of 0.005 CB/L). The predicted no-effect concentration was estimated using species sensitivity distribution, producing a 5th percentile hazard concentration of 0.015 CB/L. This preliminary threshold allowed us to estimate the potential impact of a single CB to 67 L of seawater via leaching, contributing to the advancement of knowledge regarding the contamination, toxicity, and ecological risks of cigarette waste. Environ Toxicol Chem 2024;43:374-384. © 2023 SETAC.

Active surveillance for influenza virus and coronavirus infection in Antarctic birds and mammals in environmental fecal samples, South Shetland Islands.

Numerous Antarctic species are recognized as reservoirs for various pathogens, and their migratory behavior allows them to reach the Brazilian coast, potentially contributing to the emergence and circulation of new infectious diseases. To address the potential zoonotic risks, we conducted surveillance of influenza A virus (IAV) and coronaviruses (CoVs) in the Antarctic Peninsula, specifically focusing on different bird and mammal species in the region. During the summer of 2021/2022, as part of the Brazilian Antarctic Expedition, we collected and examined a total of 315 fecal samples to target these respiratory viruses. Although we did not detect the viruses of interest during this particular expedition, previous research conducted by our team has shown the presence of the H11N2 subtype of influenza A virus in penguin fecal samples from the same region. Given the continuous emergence of new viral strains worldwide, it is crucial to maintain active surveillance in the area, contributing to strengthening integrated One Health surveillance efforts.

L-glutathione 1% promotes neuroprotection of nitrergic neurons and reduces the oxidative stress in the jejunum of rats with Walker-256-bearing tumor.

AIMS: Our main goals were to investigate the effects of L-glutathione (1%) treatment in Walker-256 tumor-bearing rats by analyzing immunoreactive neurons (IR), responsive to the nNOS enzyme and 3-Nitrotyrosine, in their jejunum myenteric plexus. Moreover, the oxidative state and inflammatory process in these animals were investigated. METHODS: Four experimental groups were utilized: control (C), control treated with L-glutathione (CGT), Walker-256 tumor-bearing rats (TW), and Walker-256 tumor-bearing rats treated with L-glutathione (TWGT). After 14 days of tumor inoculation, the jejunum was collected for immunohistochemical techniques and assessment of oxidative status. Plasma was collected to evaluate oxidative status and measure cytokines. RESULTS: The TW group exhibited a decrease of reduced glutathione in their jejunum, which was prevented in the L-glutathione treated TWGT group. TW animals presented pronounced oxidative stress by increasing levels of lipoperoxidation in their jejunum and malondialdehyde in their plasma; however, the L-glutathione treatment in TWGT group was not able to avoid it. The total antioxidant capacity was altered in groups TW and TWGT, yet the last one had a better index in their plasma. The IL-10, and TNF-α levels increased in TWGT animals. The nNOS-IR neuron density decreased in the jejunum myenteric plexus of the TW group, which was avoided in the TWGT group. The nNOS +3-Nitrotyrosine neurons quantification did not show significative alterations. CONCLUSION: The treatment with L-glutathione (1%) imposed an important defense to some parameters of oxidative stress induced by TW-256, leading to neuroprotection to the loss in the nNOS-IR neuron density.

Unraveling sources of hydrocarbons in subtropical estuaries with distinct degrees of protection in the Southwestern Atlantic Ocean, Brazil.

Sedimentary aliphatic hydrocarbons and polycyclic aromatic hydrocarbons (PAHs) were studied in subtropical estuaries with distinct degrees of legal protection, located in the Southwestern Atlantic Ocean, São Paulo State, Brazil. A multivariate approach was adopted, using the Hierarchical cluster analysis followed by the Principal Matrix Factorization analysis to support the hydrocarbons sources findings using diagnostic ratios. In general, the sites with the highest values of hydrocarbons were in the vicinity of well-urbanized cities, where sewage discharge, harbor and industrial activities take place. Pyrolitic PAHs were the predominant source of PAHs in the sites. The region can be considered not highly contaminated by hydrocarbons; however, specific sites under local anthropogenic impact from sewage and/or urban drainage, presented relatively high hydrocarbons levels. These findings highlight the importance of sources identification as reliable approach to be included in the management plan of protected areas under the inputs of several vectors of contamination.

Photochemical outcomes triggered by gold shell-isolated nanorods on bioinspired nanoarchitectonics for bacterial membranes.

Boosted by the indiscriminate use of antibiotics, multidrug-resistance (MDR) demands new strategies to combat bacterial infections, such as photothermal therapy (PTT) based on plasmonic nanostructures. PTT efficiency relies on photoinduced damage caused to the bacterial machinery, for which nanostructure incorporation into the cell envelope is key. Herein, we shall unveil the binding and photochemical mechanisms of gold shell-isolated nanorods (AuSHINRs) on bioinspired bacterial membranes assembled as Langmuir and Langmuir-Schaefer (LS) monolayers of DOPE, Lysyl-PG, DOPG and CL. AuSHINRs incorporation expanded the isotherms, with stronger effect on the anionic DOPG and CL. Indeed, FTIR of LS films revealed more modifications for DOPG and CL owing to stronger attractive electrostatic interactions between anionic phosphates and the positively charged AuSHINRs, while electrostatic repulsions with the cationic ethanolamine (DOPE) and lysyl (Lysyl-PG) polar groups might have weakened their interactions with AuSHINRs. No statistical difference was observed in the surface area of irradiated DOPE and Lysyl-PG monolayers on AuSHINRs, which is evidence of the restricted nanostructures insertion. In contrast, irradiated DOPG monolayer on AuSHINRs decreased 4.0 % in surface area, while irradiated CL monolayer increased 3.7 %. Such results agree with oxidative reactions prompted by ROS generated by AuSHINRs photoactivation. The deepest AuSHINRs insertion into DOPG may have favored chain cleavage while hydroperoxidation is the mostly like outcome in CL, where AuSHINRs are surrounding the polar groups. Furthermore, preliminary experiments on Escherichia coli culture demonstrated that the electrostatic interactions with AuSHINRs do not inhibit bacterial growth, but the photoinduced effects are highly toxic, resulting in microbial inactivation.

Convergent genomic signatures of local adaptation across a continental-scale environmental gradient.

Convergent local adaptation offers a glimpse into the role of constraint and stochasticity in adaptive evolution, in particular the extent to which similar genetic mechanisms drive adaptation to common selective forces. Here, we investigated the genomics of local adaptation in two nonsister woodpeckers that are codistributed across an entire continent and exhibit remarkably convergent patterns of geographic variation. We sequenced the genomes of 140 individuals of Downy (Dryobates pubescens) and Hairy (Dryobates villosus) woodpeckers and used a suite of genomic approaches to identify loci under selection. We showed evidence that convergent genes have been targeted by selection in response to shared environmental pressures, such as temperature and precipitation. Among candidates, we found multiple genes putatively linked to key phenotypic adaptations to climate, including differences in body size (e.g., IGFPB) and plumage (e.g., MREG). These results are consistent with genetic constraints limiting the pathways of adaptation to broad climatic gradients, even after genetic backgrounds diverge.

Evolutionary constraint and innovation across hundreds of placental mammals.

Zoonomia is the largest comparative genomics resource for mammals produced to date. By aligning genomes for 240 species, we identify bases that, when mutated, are likely to affect fitness and alter disease risk. At least 332 million bases (~10.7%) in the human genome are unusually conserved across species (evolutionarily constrained) relative to neutrally evolving repeats, and 4552 ultraconserved elements are nearly perfectly conserved. Of 101 million significantly constrained single bases, 80% are outside protein-coding exons and half have no functional annotations in the Encyclopedia of DNA Elements (ENCODE) resource. Changes in genes and regulatory elements are associated with exceptional mammalian traits, such as hibernation, that could inform therapeutic development. Earth's vast and imperiled biodiversity offers distinctive power for identifying genetic variants that affect genome function and organismal phenotypes.

Oysters and mussels as equivalent sentinels of microplastics and natural particles in coastal environments.

Filter-feeder organisms such as oyster and mussels are exposed to particles like microplastics (MPs). Although widely used to monitor MPs contamination, little is known about their performance as sentinels, which are biological monitors accumulating contaminants without significant adverse effects. This study comparatively evaluated the quantitative and qualitative accumulation of MPs by oysters (Crassostrea brasiliana) and mussels (Perna perna) along a gradient of contamination in a highly urbanized estuarine system of Brazil. In the most contaminated site, both species presented the worst status of nutrition and health, and also one of the highest MPs levels reported for molluscs to date (up to 44.1 particles·g-1). Despite some inter-specific differences, oysters and mussels were suitable and showed an equivalent performance as sentinels, reflecting the gradient condition demonstrated for other contaminants in the region. The similarity in MPs accumulation was also observed for qualitative aspects (polymer composition, sizes, shapes and colors). Particles were mostly <1000 µm, fibrous, colorless and composed by cellulose and polymethyl methacrylate (PMMA). Thus, despite small variations, the usage of C. brasiliana and P. perna is recommended and provides reliable information for environmental levels of microplastics.

A Survey of Patient Experience in CML: American and Canadian Perspectives.

Purpose: With treatment, chronic myeloid leukemia (CML) has a favorable prognosis, however, individuals with CML experience impairment to their quality of life (QoL). The aim of this study was to examine the perspectives and experiences of individuals with CML and to understand their challenges communicating with their CML physician. Patients and Methods: An online survey in adults with CML (n=100) in the US and Canada assessed QoL, patient-provider relationships, treatment satisfaction, and understanding of CML and treatment goals via the MD Anderson Symptom Inventory, the Cancer Therapy Satisfaction Questionnaire and de novo survey questions. Participants were recruited via an external patient recruiter and CML Patient Groups. Results: Many participants reported hardships due to CML and its treatment. The main impacts were on the ability to work (21%), engage in personal activities (e.g., hobbies, 28%), and to enjoy sexual relations (median=2.00, IQR=8.50). A substantial proportion (21-39%) wished to discuss additional topics with their providers (e.g., management of CML and/or its impacts). While participants reported satisfaction with therapy overall (median=85.71, IQR=17.86), they indicated low to moderate treatment satisfaction with specific components, including concerns regarding side effects (median=43.75, IQR=43.75). Participants generally had a good understanding of CML (97%) and its treatment goals (92%). Conclusion: These findings advance our understanding of issues that need improvement to support QoL for individuals living with CML. Future work is needed to improve patient-provider relationships, address treatment-related side effects, and provide clinical information that is easier for patients to understand.

Avaliação de letramento de risco em estudantes de medicina / Risk literacy assessment of medical students in Brazil / Evaluación de la alfabetización del riesgo en estudiantes de medicina en Brasil

Introdução: Para o processo de decisão compartilhada é essencial que profissionais da saúde interpretem dados estatísticos das melhores evidências disponíveis para que essas informações possam ser comunicadas para seus pacientes. Nesse contexto, o letramento de risco é a capacidade de avaliar riscos e benefícios de determinada ação. Apesar da importância dessa habilidade, estudos têm mostrado que muitos profissionais e estudantes possuem dificuldade na compreensão de conceitos estatísticos e de probabilidade e, dessa forma, baixo letramento de risco. Objetivo: Este estudo teve como objetivo avaliar o letramento de risco em estudantes de medicina e como isso impacta a capacidade de resolver um problema de cálculo de valor preditivo positivo de um exame de rastreamento. Métodos: Foram convidados estudantes do 4º, 5º e 6º anos da Faculdade de Medicina da Universidade de São Paulo para responder a um questionário composto pelo Berlin Numeracy Test (BNT), instrumento validado para a mensuração de numeracia, e um problema clínico sobre cálculo de valor preditivo positivo (VPP) em rastreamento de câncer de mama com mamografia. Avaliar qual o grau de letramento de risco em estudantes de medicina e verificar se existe associação entre o número de acertos no BNT e a capacidade de resolução do cenário clínico sobre VPP. Resultados: Obtivemos 97 respostas, em que 19 (19,52%) participantes acertaram 3 das 4 questões do BNT, e 61 (62,89%) acertaram todas as questões. Já na pergunta sobre VPP do rastreamento de câncer de mama houve 43 respostas corretas (44,33%). A média de pontuação no BNT da amostra de participantes foi de 3,41. Entre os estudantes que acertaram o cálculo do VPP, a média foi 3,67 e, entre os que erraram, foi de 3,21. Conclusões: Apesar da numeracia alta medida pelo BNT, os estudantes apresentam baixa taxa de acerto no caso clínico. Este estudo reforça os achados prévios de que o letramento de risco é uma habilidade difícil de ser aprendida, mesmo em pessoas com alta numeracia. Entretanto, o baixo número de respostas dificulta a interpretação mais precisa dos resultados.

Background: In order to accomplish the shared decision-making process, it is essential that health professionals are able to understand statistical data of the best available evidence, so that this information can be communicated to their patients. In this context, risk literacy is the ability to evaluate risks and benefits of a given action. Despite the relevance of this skill, research has demonstrated that many professionals and students have difficulty interpreting concepts of statistics and probability, therefore having low risk literacy. Objectives: This study aimed to evaluate risk literacy in medical students and how it impacts their ability to solve a problem concerning the positive predictive value (PPV) of a mass screening. Methods: Medical students from the 4th, 5th, and 6th years of the School of Medicine of Universidade de São Paulo were invited to answer a questionnaire comprised of the Berlin Numeracy Test (BNT), a validated instrument to measure numeracy, and a clinical problem regarding the PPV of a mammogram in the context of mass screening. To measure the level of risk literacy of medical students and to investigate whether there is an association between score in the BNT and the ability to correctly answer the clinical problem regarding PPV. Results: A total of 97 responses were collected, of which 19 (19.52%) participants answered 3 out of 4 questions of the BNT, and 61 (62.89%) correctly answered all the questions. In the clinical problem about PPV of cancer screening, there were 43 correct answers (44.33%). The mean BNT score of the participants was 3.41. Among the students who correctly answered the problem, the mean score was 3.76, and among the ones who answered incorrectly, it was 3.21. Conclusions: Despite the high numeracy measured by the BNT, students had a poor outcome in the clinical problem. This study reinforces previous findings that risk literacy is a difficult skill to be learned, even in individuals with high numeracy. However, the low response rate hinders a more precise interpretation of the results.

Introducción: Para el proceso de toma de decisión compartida, es esencial que los profesionales de la salud sean capaces de interpretar datos estadísticos a partir de las mejores evidencias científicas disponibles para que las informaciones puedan ser comunicadas a sus pacientes. En ese contexto, la alfabetización de riesgo es la capacidad de evaluar riesgos y beneficios de una determinada acción. No obstante la importancia de esa habilidad, estudios han demostrado que muchos profesionales y estudiantes tienen dificultades para comprender conceptos de estadística y de probabilidad y, por consecuencia, baja alfabetización de riesgo. Objetivos: Este estudio tiene como objetivo evaluar la alfabetización de riesgo en estudiantes de medicina y cómo eso impacta la capacidad de resolver un problema de cálculo del valor predictivo positivo (VPP) de un examen de tamizaje. Métodos: Estudiantes de 4º, 5º y 6º año de la Facultad de Medicina de la Universidad de São Paulo fueron invitados a responder un cuestionario compuesto por el Berlin Numeracy Test (BNT), un instrumento validado para medir la numeracia, y un problema clínico sobre el cálculo del VPP en el tamizaje de cáncer de mama con mamografía. Evaluar el grado de alfabetización de riesgo en estudiantes de medicina y verificar si existe asociación entre el número de aciertos en BNT y la capacidad de resolución del escenario clínico de VPP. Resultados: Se obtuvieron 97 respuestas, de las que 19 (19,52%) participantes respondieron correctamente 3 de las 4 preguntas del BNT y 61 (62,89%) respondieron correctamente todas las preguntas. En la pregunta sobre el VPP del tamizaje de cáncer de mama hubo 43 respuestas correctas (44,33%). La puntuación media de BNT de los participantes fue de 3,41. Entre los estudiantes que calcularon correctamente el VPP, el promedio fue de 3,67 y entre los que se equivocaron, fue de 3,21. Conclusiones: A pesar de la alta numeracia medida por el BNT, los estudiantes tienen una baja tasa de éxito en el caso clínico. Este estudio refuerzó los hallazgos previos de que la alfabetización de riesgo es una habilidad difícil de aprender, incluso en personas con un alto nivel de numeracia. Sin embargo, el bajo número de respuestas dificulta una interpretación más precisa de los resultados.

Demography and linked selection interact to shape the genomic landscape of codistributed woodpeckers during the Ice Age.

The influence of genetic drift on population dynamics during Pleistocene glacial cycles is well understood, but the role of selection in shaping patterns of genomic variation during these events is less explored. We resequenced whole genomes to investigate how demography and natural selection interact to generate the genomic landscapes of Downy and Hairy Woodpecker, species codistributed in previously glaciated North America. First, we explored the spatial and temporal patterns of genomic diversity produced by neutral evolution. Next, we tested (i) whether levels of nucleotide diversity along the genome are correlated with intrinsic genomic properties, such as recombination rate and gene density, and (ii) whether different demographic trajectories impacted the efficacy of selection. Our results revealed cycles of bottleneck and expansion, and genetic structure associated with glacial refugia. Nucleotide diversity varied widely along the genome, but this variation was highly correlated between the species, suggesting the presence of conserved genomic features. In both taxa, nucleotide diversity was positively correlated with recombination rate and negatively correlated with gene density, suggesting that linked selection played a role in reducing diversity. Despite strong fluctuations in effective population size, the maintenance of relatively large populations during glaciations may have facilitated selection. Under these conditions, we found evidence that the individual demographic trajectory of populations modulated linked selection, with purifying selection being more efficient in removing deleterious alleles in large populations. These results highlight that while genome-wide variation reflects the expected signature of demographic change during climatic perturbations, the interaction of multiple processes produces a predictable and highly heterogeneous genomic landscape.

A global snapshot of microplastic contamination in sediments and biota of marine protected areas.

Microplastics (MPs) become ubiquitous contaminants in Marine Protected Areas (MPA) that have been planned as a conservation strategy. The present study provides a comprehensive overview of the occurrence, abundance, and distribution of MPs potentially affecting MPA worldwide. Data on MP occurrence and levels in sediment and biota samples were collected from recent peer-reviewed literature and screened using a GIS-based approach overlapping MP records with MPA boundaries. MPs were found in 186 MPAs, with levels ranging from 0 to 9187.5 items/kg in sediment and up to 17,461.9 items/kg in organisms. Peaked MPs concentrations occurred within multiple-use areas, and no-take MPAs were also affected. About half of MP levels found within MPA fell into the higher concentration quartiles, suggesting potential impacts on these areas. In general, benthic species were likely more affected than pelagic ones due to the higher concentrations of MP reported in the tissues of benthic species. Alarmingly, MPs were found in tissues of two threatened species on the IUCN Red List. The findings denote urgent concerns about the effectiveness of the global system of protected areas and their proposed conservation goals.

Microplastic contamination in seawater across global marine protected areas boundaries.

Despite the relatively rich literature on the omnipresence of microplastics in marine environments, the current status and ecological impacts of microplastics on global Marine Protected Areas (MPAs) are still unknown. Their ubiquitous occurrence, increasing volume, and ecotoxicological effects have made microplastic an emerging marine pollutant. Given the critical conservation roles of MPAs that aim to protect vulnerable marine species, biodiversity, and resources, it is essential to have a comprehensive overview of the occurrence, abundance, distribution, and characteristics of microplastics in MPAs including their buffer zones. Here, extensive data were collected and screened based on 1565 peer-reviewed literature from 2017 to 2020, and a GIS-based approach was applied to improve the outcomes by considering boundary limits. Microplastics in seawater samples were verified within the boundaries of 52 MPAs; after including the buffer zones, 1/3 more (68 MPAs) were identified as contaminated by microplastics. A large range of microplastic levels in MPAs was summarized based on water volume (0-809,000 items/m3) or surface water area (21.3-1,650,000,000 items/km2), which was likely due to discrepancy in sampling and analytical methods. Fragment was the most frequently observed shape and fiber was the most abundant shape. PE and PP were the most common and also most abundant polymer types. Overall, 2/3 of available data reported that seawater microplastic levels in MPAs were higher than 12,429 items/km2, indicating that global MPAs alone cannot protect against microplastic pollution. The current limitations and future directions were also discussed toward the post-2020 Global Biodiversity Framework goals.

The direct and indirect costs of cardiovascular diseases in Brazil.

OBJECTIVE: To evaluate the direct and indirect costs of cardiovascular diseases (such as coronary heart disease and stroke) by sex and age group, attributed to the excessive consumption of salt, saturated fat and trans fat in Brazil. MATERIALS AND METHODS: The data for estimating the Population Attributable Fraction (PAF) corresponding to the consumption of salt, saturated fat and trans-fat were obtained from the Household Budget Survey 2017-2018. The calculation of direct costs for cardiovascular diseases (CVD) was made from the accounting sum of costs with hospitalizations and outpatient care found in the National Health System (Hospital Information System and Outpatient Information System), from 2017 to 2019, including the costs of treatment, such as medical consultations, medical procedures, and drugs. Regarding the indirect costs, they were measured by the loss of human capital, given the premature death, resulting in loss of productivity. To define the attributable costs, they were multiplied by the PAF. RESULTS: Higher burden of CVD attributable to the consumption of salt, saturated fat and trans fat were observed in younger individuals, which progressively decreased with advancing age, but still generated economic costs in the order of US$ 7.18 billion, in addition to 1.53 million productive years of life lost (YLL) to premature death, if considering salt as an inducer. Although attributable burden of CVD is higher among younger individuals, the highest costs are associated with males aged 45 to 74 years old for direct costs and 45 to 64 years old for indirect costs. CONCLUSION: The attributable fractions to consumption of salt are the ones that cause the most effects on CVD, followed by saturated fat and trans fat, with direct and indirect costs being higher for males.

Bumetanide in autism spectrum disorder / Bumetanida no transtorno do espectro autista / Bumetanida en el trastorno del espectro autista

Objectives: This study aimed to make a bibliographic update on the already published data on bumetanide, addressing the main information on its use in Autism Spectrum Disorder (ASD). Methods: This was an integrative narrative review in which the following databases were used: Web of Science, MEDLINE, ScienceDirect, and Scielo. The descriptors used were: Autism Spectrum Disorder, Autistic Disorder and Bumetanide. It was considered only articles published in English and French. Original articles, randomized clinical trials, case reports, and review articles were included. Results: The results show that the use of bumetanide alters regions of the brain linked to the positive development of language, improvement of visual contact, improvement in social interactions, among others. Studies are also concerned about the safety and efficacy of bumetanide in ASD since several adverse effects have been reported. The most frequent were hypokalemia, polyuria, and loss of appetite. Conclusion: Bumetanide has proven as effective in improving some important symptoms in ASD, especially linked to language and social interaction, however, studies with larger groups of patients and with longer treatment and observation time are needed to confirm the efficacy and clarify the safety profile in use for people with ASD.

Objetivo: O objetivo deste trabalho foi fazer uma atualização bibliográfica sobre os dados já publicados da bumetanida, abordando as principais informações sobre seu uso no Transtorno do Espectro Autista (TEA). Metodologia: Foi realizada uma revisão do tipo narrativa integrativa, da qual foram utilizadas as bases de dados: Web of Science, MEDLINE, ScienceDirect e Scielo, com a utilização dos seguintes descritores: Autism Spectrum Disorder, Autistic Disorder e Bumetanide. Foram considerados apenas artigos publicados nas línguas inglesa e francesa. Foram incluídos artigos originais, ensaios clínicos randomizados e relatos de caso. Foram excluídos artigos de revisão. Resultados: Os resultados mostram que o uso da bumetanida altera regiões do cérebro ligadas ao desenvolvimento positivo da linguagem, melhora do contato visual, melhora nas interações sociais, entre outros. Os estudos também se preocupam em relacionar a segurança e a eficácia da bumetanida no TEA, do qual foram relatados diversos efeitos adversos, sendo os mais frequentes a hipocalemia, a poliúria e a perda de apetite. Conclusão: A bumetanida mostrou ser eficaz na melhoria de alguns importantes sintomas no TEA, especialmente ligados à linguagem e interação social, entretanto, estudos com grupos maiores de pacientes e com maior tempo de tratamento e observação são necessários para confirmar a eficácia e esclarecer o perfil de segurança no uso para pessoas com TEA.

: Este estudio tuvo como objetivo realizar una actualización bibliográfica sobre los datos ya publicados sobre la bumetanida, abordando la principal información sobre su uso en el Trastorno del Espectro Autista (TEA). Métodos: Se trata de una revisión narrativa integradora en la que se utilizaron las siguientes bases de datos: Web of Science, MEDLINE, ScienceDirect y Scielo. Los descriptores utilizados fueron: Trastorno del Espectro Autista, Trastorno Autista y Bumetanida. Se consideraron sólo los artículos publicados en inglés y francés. Se incluyeron artículos originales, ensayos clínicos aleatorios, informes de casos y artículos de revisión. Resultados: Los resultados muestran que el uso de la bumetanida altera regiones del cerebro relacionadas con el desarrollo positivo del lenguaje, la mejora del contacto visual, la mejora de las interacciones sociales, entre otros. Los estudios también se preocupan por la seguridad y eficacia de la bumetanida en el TEA, ya que se han reportado varios efectos adversos. Los más frecuentes fueron la hipocalemia, la poliuria y la pérdida de apetito. Conclusiones: La bumetanida ha demostrado ser eficaz en la mejora de algunos síntomas importantes en el TEA, especialmente vinculados al lenguaje y la interacción social, sin embargo, se necesitan estudios con grupos más grandes de pacientes y con mayor tiempo de tratamiento y observación para confirmar la eficacia y aclarar el perfil de seguridad en el uso para personas con TEA.

Molecular Detection of Histoplasma capsulatum in Antarctica.

We detected Histoplasma capsulatum in soil and penguin excreta in the Antarctic Peninsula by sequencing after performing species-specific PCR, confirming previous observations that this pathogen occurs more broadly than suspected. This finding highlights the need for surveillance of emerging agents of systemic mycoses and their transmission among regions, animals, and humans in Antarctica.

Using large amounts of firefighting foams releases per- and polyfluoroalkyl substances (PFAS) into estuarine environments: A baseline study in Latin America.

We analyzed per- and polyfluoroalkyl substances (PFAS) in aqueous film-forming foams (AFFFs) used to extinguish a major fire in a petrochemical terminal from the Port of Santos (Brazil). Eight AFFFs from seven known commercial brands and one unknown sample (AFFF-1 to AFFF-8) were evaluated. 17 PFAS were identified and quantified using high performance liquid chromatography (LC/MS). The concentrations of Σ17 PFAS in the AFFFs ranged from 500 to 9000 ng/g, with prevalence of short chain PFAS (~85 %), followed by long chain PFAS. Perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA), included in the global treaty of the Stockholm Convention, were also detected. We estimated that at least 635.96 g of PFAS were introduced in the estuary, representing a massive input of these substances. This investigation reports the PFAS composition of AFFFs used in firefighting in the GRULAC Region (Group of Latin American and Caribbean countries).

Alpha-tocopherol-loaded polycaprolactone nanoparticles improve the inflammation and systemic oxidative stress of arthritic rats.

Background and aim: The present study investigated the effects of orally administered α-tocopherol-loaded polycaprolactone nanoparticles on the articular inflammation and systemic oxidative status of middle-aged Holtzman rats with Freund's adjuvant-induced polyarthritis, a model for rheumatoid arthritis. Intraperitoneally administered free α-tocopherol provided the reference for comparison. Experimental procedure: Two protocols of treatment were followed: intraperitoneal administration of free α-tocopherol (100 mg/kg i.p.) or oral administration of free and nanoencapsulated α-tocopherol (100 mg/kg p.o.). Animals were treated during 18 days after arthritis induction. Results: Free (i.p.) and encapsulated α-tocopherol decreased the hind paws edema, the leukocytes infiltration into femorotibial joints and the mRNA expression of pro-inflammatory cytokines in the tibial anterior muscle of arthritic rats, but the encapsulated compound was more effective. Free (i.p.) and encapsulated α-tocopherol decreased the high levels of reactive oxygen species in the brain and liver, but only the encapsulated compound decreased the levels of protein carbonyl groups in these organs. Both free (i.p.) and encapsulated α-tocopherol increased the α-tocopherol levels and the ratio of reduced to oxidized glutathione in these organs. Conclusion: Both intraperitoneally administered free α-tocopherol and orally administered encapsulated α-tocopherol effectively improved inflammation and systemic oxidative stress in middle-aged arthritic rats. However, the encapsulated form should be preferred because the oral administration route does not be linked to the evident discomfort that is caused in general by injectable medicaments. Consequently, α-tocopherol-loaded polycaprolactone nanoparticles may be a promising adjuvant to the most current approaches aiming at rheumatoid arthritis therapy.