Infection in asymptomatic carriers of SARS-CoV-2 can interfere with the achievement of robust immunity on a population scale.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread worldwide as a severe pandemic, and a significant portion of the infected population may remain asymptomatic. Given this, five surveys were carried out between May and September 2020 with a total of 3585 volunteers in the municipality of Foz do Iguaçu, State of Paraná, a triple border region between Brazil/Argentina/Paraguay. Five months after the first infection, volunteers were re-analysed for the production of IgG anti-Spike and anti-RBD-Spike, in addition to analyses of cellular immunity. Seroconversion rates ranged from 4.4 % to a peak of 37.21 % followed by a reduction in seroconversion to 21.1 % in September, indicating that 25 % of the population lost their circulating anti-SARS-CoV-2 antibodies 3 months after infection. Analyses after 5 months of infection showed that only 17.2 % of people still had anti-RBD-Spike antibodies, however, most volunteers had some degree of cellular immune response. The strategy of letting people become naturally infected with SARS-CoV-2 to achieve herd immunity is flawed, and the first contact with the virus may not generate enough immunogenic stimulus to prevent a possible second infection.

Malathion insecticide resistance in Aedes aegypti: laboratory conditions and in situ experimental approach through adult entomological surveillance.

OBJECTIVE: In Brazil, the most common method of controlling outbreaks of arbovirus is by the use of chemical sprays, which kill the insect vector, Aedes aegypti. The main objective of this study was to evaluate the resistance of Ae. aegypti to the insecticide, malathion, in situ. The location of this study was the municipality of Foz do Iguaçu, in the state of Paraná, Brazil. METHODS: Ultra-low-volume (ULV) fogging equipment was used, by vehicle, to apply the insecticide in situ, and mosquito populations after treatment were compared with those of control areas. The resistance of strains collected from the municipality was compared to the Rockefeller strain under laboratory conditions. RESULTS: We found 220 adult female specimens and 7423 eggs of Ae. aegypti in the areas subjected to UBV treatment, whereas 245 adult females and 10 557 eggs were found in the control areas. The UBV treatment area showed no significant difference compared to the control area, for all the indices. Mortality of the Rockefeller colony varied more quickly when there were slight variations in malathion concentration than the Foz do Iguaçu population.

OBJECTIF: Au Brésil, la méthode la plus courante de lutte contre les épidémies d'arbovirus consiste à utiliser des pulvérisations chimiques qui tuent l'insecte vecteur, Aedes aegypti. L'objectif principal de cette étude était d'évaluer la résistance de Ae. aegypti à l'insecticide, le malathion, in situ. Le lieu de cette étude était la municipalité de Foz do Iguaçu, dans l'état du Paraná, au Brésil. MÉTHODES: Un équipement de brumisation à très faible volume (ULV) a été utilisé, par véhicule, pour appliquer l'insecticide in situ et les populations de moustiques après le traitement ont été comparées à celles des zones témoins. La résistance des souches collectées dans la municipalité a été comparée à la souche Rockefeller dans des conditions de laboratoire. RÉSULTATS: Nous avons trouvé 220 spécimens femelles adultes et 7.423 œufs d'Ae. aegypti dans les zones soumises au traitement ULV, alors que 245 femelles adultes et 10.557 œufs ont été trouvés dans les zones témoins. La zone de traitement ULV n'a montré aucune différence significative par rapport à la zone témoin, pour tous les indices. La mortalité de la colonie de Rockefeller variait plus rapidement lorsqu'il y avait de légères variations dans la concentration de malathion que la population de Foz do Iguaçu.

Ponderal index classifies obesity in children and adolescents more accurately than body mass index z-scores.

BACKGROUND: We aimed to compare the accuracy of the ponderal index (PI) vs. BMI-for-age z-scores transformed (BMIz) in estimating body fat levels and classifying obesity in children and adolescents from a Brazilian urban population. METHODS: This is a cross-sectional study with 1149 participants (53.2% male), aged 6 to 18 years. Body fat percent (BFP) was obtained by multi-frequency bioelectrical impedance. Non-linear regression analysis provided the accuracy of both BMIz and PI in estimating BFP. False positive rate was obtained from the proportion of individuals placed at or above the 95th percentile for BMIz or PI, whereas their BFP was discordantly below the 95th percentile. RESULTS: PI and BMIz appeared with similar stability from childhood to adolescence for both boys and girls. The portion of the variability in BFP explained by BMIz (R2 = 0.74 and R2 = 0.75) was close to the variability in BFP explained by PI (R2 = 0.73 and R2 = 0.75) for boys and girls, respectively. False positive rate was higher for BMIz compared with PI among boys (21.8% vs. 3.9%) and girls (28.5% vs. 17.5%). CONCLUSIONS: PI is a promising index for replacing BMIz in children and adolescents due to its potential to reduce false diagnosis of obesity.

Hypothyroidism and hyperthyroidism change ectoenzyme activity in rat platelets.

The purinergic system has an important role in the regulation of vascular functions. The interference of thyroid hormones in this system and in cardiovascular events has been studied in recent years. However, the mechanisms involved in vascular, purinergic, and oxidative changes in thyroid disorders are not completely understood. Therefore, the present study aimed to assess purinergic enzyme activity in platelets from rats with hypothyroidism and hyperthyroidism induced, respectively, by continuous exposure to methimazole (MMI) at 20 mg/100 mL or L-thyroxine at 1.2 mg/100 mL in drinking water for 1 month. Results showed that rats exposed to L-thyroxine had a significant decrease in NTPDase activity, wherein ATP hydrolysis was 53% lower and ADP hydrolysis was 40% lower. Moreover, ecto-5'-nucleotidase activity was decreased in both groups, by 39% in the hypothyroidism group and by 52% in the hyperthyroidism group. On the other hand, adenosine deaminase (ADA) activity was increased in hyperthyroidism (75%), and nucleotide pyrophosphatase/phosphodiesterase (NPP) activity was increased in animals with hypothyroidism (127%) and those with hyperthyroidism (128%). Our findings suggest that changes in purinergic enzyme and purine levels could contribute to the undesirable effects of thyroid disturbances. Moreover, oxidative stress and, in particular, a high level of ROS production, showed a causal relation with changes in ectonucleotidase activity and nucleotide and nucleoside levels.

Spirituality in palliative care: experiences of an interdisciplinary team. / Espiritualidade nos cuidados paliativos: experiência vivida de uma equipe interdisciplinar.

Objective To understand the experience of spirituality in the daily routine of a palliative care interdisciplinary team. Method A qualitative study was conducted with an oncological palliative care team in southern Brazil. The data was collected through phenomenological interviews in 2014, and interpreted using a hermeneutic phenomenological approach. Results Six professionals participated in the study. Spiritually-related activities, such as prayer and providing comprehensive care, were useful therapeutic resources for offering comfort, survival with dignity and humanization of death, in addition to helping the team and patients understand the end-of-life process and search for meaning in the suffering caused by illness. Conclusion Spirituality on the part of professionals with patients imparted meaning to their palliative care work and facilitated the formation of bonds between teams, patients, and family members.

Hypothyroidism Enhanced Ectonucleotidases and Acetylcholinesterase Activities in Rat Synaptosomes can be Prevented by the Naturally Occurring Polyphenol Quercetin.

Thyroid hormones have an influence on the functioning of the central nervous system. Furthermore, the cholinergic and purinergic systems also are extensively involved in brain function. In this context, quercetin is a polyphenol with antioxidant and neuroprotective properties. This study investigated the effects of (MMI)-induced hypothyroidism on the NTPDase, 5'-nucleotidase, adenosine deaminase (ADA), and acetylcholinesterase (AChE) activities in synaptosomes of rats and whether the quercetin can prevent it. MMI at a concentration of 20 mg/100 mL was administered for 90 days in the drinking water. The animals were divided into six groups: control/water (CT/W), control/quercetin 10 mg/kg, control/quercetin 25 mg/kg, methimazole/water (MMI/W), methimazole/quercetin 10 mg/kg (MMI/Q10), and methimazole/quercetin 25 mg/kg (MMI/Q25). On the 30th day, hormonal dosing was performed to confirm hypothyroidism, and the animals were subsequently treated with 10 or 25 mg/kg quercetin for 60 days. NTPDase activity was not altered in the MMI/W group. However, treatment with quercetin decreased ATP and ADP hydrolysis in the MMI/Q10 and MMI/Q25 groups. 5'-nucleotidase activity increased in the MMI/W group, but treatments with 10 or 25 mg/kg quercetin decreased 5'-nucleotidase activity. ADA activity decreased in the CT/25 and MMI/Q25 groups. Furthermore, AChE activity was reduced in all groups with hypothyroidism. In vitro tests also demonstrated that quercetin per se decreased NTPDase, 5'-nucleotidase, and AChE activities. This study demonstrated changes in the 5'-nucleotidase and AChE activities indicating that purinergic and cholinergic neurotransmission are altered in this condition. In addition, quercetin can alter these parameters and may be a promising natural compound with important neuroprotective actions in hypothyroidism.

Relationship between the risk factors for human papillomavirus infection and lower genital tract precursor lesion and cancer development in female transplant recipients.

BACKGROUND: This study aimed to analyze the relationship between the several risk factors for human papillomavirus (HPV) infection and its persistence and to assess the prevalence of the lower genital tract precursor lesions, cancer, and HPV infection in female transplant recipients, besides the most prevalent HPV types. METHODS: The methodology adopted was a cross-sectional study with a random sample of 61 patients. RESULTS: The results indicated 10 cases (16.4%) of lesions, 54.5% of the overall prevalence of HPV infection, and HPV 16 was the most common high-risk HPV type, followed by HPV 51/53/70. A multiple logistic regression was done and hormone use presented a statistically significant association with high-risk HPV infection (P=.037). No statistically significant association was identified for the set of all factors with the lesions studied. CONCLUSIONS: The high prevalence of HPV infection and its precursor lesions confirmed the importance of differential screening and follow-up of transplanted patients. Condom use must be encouraged. The study result also confirmed the importance of knowledge of the viral type, in order to analyze the impact of HPV immunization, particularly against HPV types that are not 16/18. The reasonable rate of other genotypes, besides the vaccine types, should be considered to evaluate vaccination strategies.

Protective effect of quercetin in ecto-enzymes, cholinesterases, and myeloperoxidase activities in the lymphocytes of rats exposed to cadmium.

The ex vivo and in vitro effects of quercetin on NTPDase, adenosine deaminase (ADA), and acetycholinesterase (AChE) activities in lymphocytes, as well as the effects of quercetin on butyrylcholinesterase (BChE) activity in serum and myeloperoxidase (MPO) activity in plasma were determined in rats. For the ex vivo experiment, animals were orally exposed to Cadmium (Cd) for 45 days. Animals were divided into eight groups: saline/ethanol, saline/Querc 5 mg/kg, saline/Querc 25 mg/kg, saline/Querc 50 mg/kg, Cd/ethanol, Cd/Querc 5 mg/kg, Cd/Querc 25 mg/kg, and Cd/Querc 50 mg/kg. The ex vivo data showed an increase in the ATP and ADP hydrolysis and ADA activity in Cd-exposed rats when compared to the control group. The treatment with quercetin 25 and 50 mg/kg prevented this increase in the ATP and ADP hydrolysis, while the treatment with quercetin 5, 25, and 50 mg/kg prevented the increase in the ADA activity. AChE, BChE, and MPO activities ex vivo presented an increase in the Cd-exposed group when compared to the control group, and the treatment with quercetin 5, 25, and 50 mg/kg prevented this increase caused by Cd exposure. The in vitro experiment showed that quercetin 5, 10, 25, or 50 µM decreased the ADA activity proportionally to the increase of the concentrations of quercetin when compared to the control group. Thus, we can suggest that the quercetin is able to modulate NTPDase, ADA, AChE, and MPO activities and contribute to maintain the levels of ATP, adenosine, and acetylcholine normal, respectively, exhibiting potent pro-inflammatory and anti-inflammatory actions.

Study of 138 vulvar lichen sclerosus patients and the malignant risk transformation.

Objective: To report the prevalence of malignant transformation of vulvar lichen sclerosus (VLS) and possible risk factors. Methods: This is a cohort study with data analysis from medical records of 138 patients with histological diagnosis of VLS registered at the Vulvar Pathology Outpatient Clinic of the University Hospital, between 2007 and 2017. Predominance of risk factors was performed using logistic regression analysis. The variables studied were the length of follow-up, age, regular or irregular follow up; presence of symptoms (dyspareunia, pruritus and/or vulvar burning); histology characteristics, the presence of epithelial hyperplasia; and the presence of autoimmune diseases. Results: There were 138 patients included in the study, and among them five progressed to malignant transformation. The patients had a median age of 59 years and 83% were symptomatic. The most frequent symptom was itching with 72%. Autoimmune diseases were present in 11.6%, the most prevalent being thyroid disease. All five case of malignant transformation (0.6%) had an irregular follow up. The logistic regression analysis was used among the studied variables, and no statistical significance was found among them (p ≥ 0.05). The relationship between hyperplasia and the clinical outcome of malignant transformation, in which non-significant but acceptable p value close to 0.05 was observed. Conclusion: The prevalence of malignant transformation in patients with VLS was 0.6%, and common factors were the lack of adherence to medical treatments and the loss of follow-up.

Political factors and arrangements influencing primary health care financing and resource allocation: A scoping review protocol.

INTRODUCTION: Primary health care is a key element in the structuring and coordination of health systems, contributing to overall coverage and performance. PHC financing is therefore central in this context, with variations in sufficiency and regularity depending on the "political dimension" of health systems. Research that systematically examines the political factors and arrangements influencing PHC financing is justified from a global and multidisciplinary perspective. The scoping review proposed here aims to systematically map the evidence on this topic in the current literature, identifying groups, institutions, priorities and gaps in the research. METHODS AND ANALYSIS: A scoping review will be conducted following the method proposed by Arksey and O'Malley to answer the following question: What is known from the literature about political factors and arrangements and their influence on and repercussions for primary health care financing and resource allocation models? The review will include peer-reviewed papers in Portuguese, English or Spanish published between 1978 and 2023. Searches will be performed of the following databases: Medline (PubMed), Embase, BVS Salud, Web of Science, Scopus and Science Direct. The review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Inclusion and exclusion criteria will be used for literature screening and mapping. Screening and data charting will be conducted by a team of four reviewers. REGISTRATION: This protocol is registered on the Open Science Framework (OSF) platform, available at https://doi.org/10.17605/OSF.IO/Q9W3P.

A link between circulating immune complexes and acute kidney injury in human visceral leishmaniasis.

Visceral leishmaniasis (VL) is an infectious disease caused by Leishmania infantum. Clinically, VL evolves with systemic impairment, immunosuppression and hyperactivation with hypergammaglobulinemia. Although renal involvement has been recognized, a dearth of understanding about the underlying mechanisms driving acute kidney injury (AKI) in VL remains. We aimed to evaluate the involvement of immunoglobulins (Igs) and immune complexes (CIC) in the occurrence of AKI in VL patients. Fourteen VL patients were evaluated between early treatment and 12 months post-treatment (mpt). Anti-Leishmania Igs, CIC, cystatin C, C3a and C5a were assessed and correlated with AKI markers. Interestingly, high levels of CIC were observed in VL patients up to 6 mpt. Concomitantly, twelve patients met the criteria for AKI, while high levels of cystatin C were observed up to 6 mpt. Plasmatic cystatin C was positively correlated with CIC and Igs. Moreover, C5a was correlated with cystatin C, CIC and Igs. We did not identify any correlation between amphotericin B use and kidney function markers in VL patients, although this association needs to be further explored in subsequent studies. Our data reinforce the presence of an important renal function impairment during VL, suggesting the involvement of Igs, CIC, and C5a in this clinical condition.

Ectoenzymes and cholinesterase activity and biomarkers of oxidative stress in patients with lung cancer.

We aimed to examine the nucleoside triphosphate diphosphohydrolases (NTPDase) in lymphocytes; adenosine deaminase (ADA) and butyrylcholinesterase (BChE) in serum; and acetylcholinesterase (AChE), superoxide dismutase (SOD), and catalase (CAT) activity in whole blood; since these enzymes are involved in inflammation responses as well as in oxidative stress conditions. We also checked the levels of total thiols (T-SH), non-protein thiols (NPSH), and thiobarbituric acid reactive substances (TBARS) in serum of patients with lung cancer. We collected blood samples from patients (n = 31) previously treated for lung cancer with chemotherapy. Patients were classified as stage IIIb and IV according to the Union for International Cancer Control (UICC). The results showed a significant increase in the hydrolysis of ATP, ADP, and adenosine in patients when compared with the control group. The activity of AChE, SOD, and CAT as well as the T-SH and NPSH levels were higher in patients group and TBARS levels were lower in patients compared with the control group. These findings demonstrated that the enzymes activity involved in the control of inflammatory and immune processes as well as the oxidative stress parameters are altered in patients with lung cancer.

Physical training prevents oxidative stress in L-NAME-induced hypertension rats.

The present study investigated the effects of a 6-week swimming training on blood pressure, nitric oxide (NO) levels and oxidative stress parameters such as protein and lipid oxidation, antioxidant enzyme activity and endogenous non-enzymatic antioxidant content in kidney and circulating fluids, as well as on serum biochemical parameters (cholesterol, triglycerides, urea and creatinine) from Nω-nitro-L-arginine methyl ester hydrochloride (L-NAME)-induced hypertension treated rats. Animals were divided into four groups (n = 10): Control, Exercise, L-NAME and Exercise L-NAME. Results showed that exercise prevented a decrease in NO levels in hypertensive rats (P < 0·05). An increase in protein and lipid oxidation observed in the L-NAME-treated group was reverted by physical training in serum from the Exercise L-NAME group (P < 0·05). A decrease in the catalase (CAT) and superoxide dismutase (SOD) activities in the L-NAME group was observed when compared with normotensive groups (P < 0·05). In kidney, exercise significantly augmented the CAT and SOD activities in the Exercise L-NAME group when compared with the L-NAME group (P < 0·05). There was a decrease in the non-protein thiols (NPSH) levels in the L-NAME-treated group when compared with the normotensive groups (P < 0·05). In the Exercise L-NAME group, there was an increase in NPSH levels when compared with the L-NAME group (P < 0·05). The elevation in serum cholesterol, triglycerides, urea and creatinine levels observed in the L-NAME group were reverted to levels close to normal by exercise in the Exercise L-NAME group (P < 0·05). Exercise training had hypotensive effect, reducing blood pressure in the Exercise L-NAME group (P < 0·05). These findings suggest that physical training could have a protector effect against oxidative damage and renal injury caused by hypertension.

Acid hydrolysis conditions do affect the non-extractable phenolic compounds composition from grape peel and seed.

This study aimed to evaluate the effect of hydrolysis conditions on non-extractable phenolic compounds (NEPC) composition of grape peel and seed powder. The effect of temperature (50-90 °C), hydrochloric acid concentration (0.1-15.0 %), and time (5-20 min) were evaluated to understand their impact on NEPC release/extraction and degradation. The use of 1.0 and 8.0 % of HCl concentrations (v/v) and temperatures of 65 and 80 °C produced extracts with higher concentrations and a larger set of compounds. These conditions promoted a balance between release/extraction and degradation processes, thereby maximizing the NEPC content in the extracts. Furthermore, the results suggest that hydrolysis conditions can be set to modulate the release of specific classes. Non-extractable proanthocyanidins showed higher concentrations when intermediate values of temperature and acid concentration were applied. Hydrolysable tannins and hydroxybenzoic acids, on the other hand, were better extracted using higher acid concentrations and higher temperatures. The results suggest that the concentration and composition of NEPC are influenced by the hydrolysis conditions and the type of matrix. Hence, it is crucial to account for this compositional variation when conducting research on the biological effects of NEPC and when using this fraction as supplements or food ingredients.

Uncovering the phenolic diversity of Guabiju fruit: LC-MS/MS-based targeted metabolomics approach.

The comprehensive composition of phenolic compounds (PC) from seven genotypes of guabiju were analyzed by high-performance liquid chromatography coupled to a diode array detector and mass spectrometry (HPLC-ESI-qTOF-MS/MS), and a targeted metabolomic approach was utilized to explore the PC-related similarities among the genotypes. Sixty-seven phenolic compounds were annotated and twenty-four were quantified in all genotypes of guabiju. The phenolic acids and anthocyanins were the major PC, representing more than 63% (w/w) of the total PC. Di-O-galloylquinic and tri-O-galloylquinic acids and ellagitannins were reported for the first time in guabiju. The results of hierarchical clustering and principal components analysis (PCA) suggested seven groups as suitable clusters to be formed according to phenolic composition. Eleven PC were selected as relevant for sample clustering, and six of them were highlighted as the most informative (in decreasing order of importance): epicatechin, catechin, (epi)gallocatechin gallate II, di-O-galloylquinic acid I, tri-O-galloylquinic acid and delphinidin 3-O-glucoside. To the best of our knowledge, this study contributes to the literature with the most complete phenolic profile of guabiju genotypes up to date. Moreover, guabiju susceptibility to fungal infestation related to PC composition was briefly discussed based on a parallel study using the same genotypes.

Cellular Pathophysiology of Leptospirosis: Role of Na/K-ATPase.

Inada and Ido identified Leptospira sp. as the pathogen responsible for Weil's Disease in 1915. Later, it was confirmed that Leptospira causes leptospirosis. The host microorganism's interaction at the cellular level remained misunderstood for many years. Although different bacterial components have been isolated and purified, the complexity of the molecular interactions between these components and the host and the molecular mechanisms responsible for the systemic dysfunctions still needs to be fully unveiled. Leptospirosis affects virtually all animal species. Its cellular pathophysiology must involve a ubiquitous cellular mechanism in all eukaryotes. Na/K-ATPase is the molecular target of the leptospiral endotoxin (glycolipoprotein-GLP). Na/K-ATPase dysfunctions on different types of cells give rise to the organ disorders manifested in leptospirosis. Concomitantly, the development of a peculiar metabolic disorder characterized by dyslipidemia, with increased levels of circulating free fatty acids and an imbalance in the fatty acid/albumin molar ratio, triggers events of cellular lipotoxicity. Synergistically, multiple molecular stimuli are prompted during the infection, activating inflammasomes and Na/K-ATPase signalosome, leading to pro-inflammatory and metabolic alterations during leptospirosis. Leptospirosis involves diverse molecular mechanisms and alteration in patient inflammatory and metabolic status. Nonetheless, Na/K-ATPase is critical in the disease, and it is targeted by GLP, its components, and other molecules, such as fatty acids, that inhibit or trigger intracellular signaling through this enzyme. Herein, we overview the role of Na/K-ATPase during leptospirosis infection as a potential therapeutic target or an indicator of disease severity.

Exercise training prevents ecto-nucleotidases alterations in platelets of hypertensive rats.

In this study, we investigated the effect of 6 weeks of swimming training on the ecto-nucleotidase activities and platelet aggregation from rats that developed hypertension in response to oral administration of L-NAME. The rats were divided into four groups: control (n = 10), exercise (n = 10), L-NAME (n = 10), and exercise L-NAME (n = 10). The animals were trained five times per week in an adapted swimming system for 60 min with a gradual increase of the workload up to 5 % of animal's body weight. The results showed an increase in ATP, ADP, AMP, and adenosine hydrolysis, indicating an augment in NTPDase (from 35.3 ± 8.1 to 53.0 ± 15.1 nmol Pi/min/mg protein for ATP; and from 21.7 ± 7.0 to 46.4 ± 15.6 nmol Pi/min/mg protein for ADP as substrate), ecto-5'-nucleotidase (from 8.0 ± 5.7 to 28.1 ± 6.9 nmol Pi/min/mg protein), and ADA (from 0.8 ± 0.5 to 3.9 ± 0.8 U/L) activities in platelets from L-NAME-treated rats when compared to other groups (p < 0.05). A significant augment on platelet aggregation in L-NAME group was also observed. Exercise training was efficient in preventing these alterations in the exercise L-NAME group, besides showing a significant hypotensive effect. In conclusion, our results clearly indicated a protector action of moderate intensity exercise on nucleotides and nucleoside hydrolysis and on platelet aggregation, which highlights the exercise training effect to avoid hypertension complications related to ecto-nucleotidase activities.

New insights into non-extractable phenolic compounds analysis.

Most of the studies regarding phenolic compounds (PC) have been focused only on one fraction of PC, named extractable phenolic compounds (EPC). As the name suggests, EPC can be directly extracted from the food matrix by using an appropriate solvent. Otherwise, non-extractable phenolic compounds (NEPC) remain in the food matrix after the conventional extraction, and their analysis depends on a hydrolysis process. NEPC is a relevant fraction of PC that acts in the colon, where they are extensively fermented by the action of the microbiota. To understand the health effects associated with the NEPC intake, it is necessary to know which types of compounds are present and their content in foods. In this review, 182 studies published in the last five years about NEPC in foods were evaluated, focusing on critical points of the NEPC analysis. First, EPC exhaustive extraction should be performed before the hydrolysis processes to avoid overestimation of the NEPC fraction. NEPC hydrolysis by aggressive methods modifies their original structure and makes their complete elucidation difficult. These methods must be optimized considering the research objective, as different conditions may result in different amounts and profiles of compounds. Concerning quantification, the widely used spectrophotometric Folin-Ciocalteu method should be avoided as it leads to overestimation. Liquid chromatography coupled to a diode array detector is the most appropriate technique for this purpose. Although pure standard compounds are unavailable in most cases, standards representative of a PC family can be used, and results can be expressed as equivalent. The best approach for NEPC identification is liquid chromatography coupled to a diode array detector and tandem high-resolution mass spectrometry, which generates information regarding chromatographic behavior, UV-vis absorption, accuracy mass and fragmentation pattern. The identification process should associate manual data handling with the bioinformatics-assisted approach.

Entomo-virological surveillance followed by serological active survey of symptomatic individuals is helpful to identify hotspots of early arbovirus transmission.

Arboviruses transmitted by Aedes aegypti in urban environments have spread rapidly worldwide, causing great impacts on public health. The development of reliable and timely alert signals is among the most important steps in designing accurate surveillance systems for vector-borne diseases. In July and September 2017, we conducted a pilot study to improve an existing integrated surveillance system by using entomo-virological surveillance to prioritize areas to conduct active searches for individuals with arbovirus infection symptoms. Foz do Iguaçu City has a permanent entomo-virological surveillance system with approximately 3,500 traps to capture Aedes sp. in the adult stage. The Aedes aegypti females are captured alive and human samples are submitted to RT-qPCR (real-time qPCR) screening for DENV, ZIKV, and CHIKV diagnosis. Of the 55 Ae. aegypti mosquitoes tested in July 2017, seven (12.7%) were considered positive for DENV-2 and three (5.4%) for CHIKV. In September, we tested a sample of 54 mosquitoes, and 15 (27.7%) were considered infected by DENV-2. We created 25 circumferences with 150-m radius each to perform an active survey to identify symptomatic householders. In July, we selected one circumference, and five (35.7%) patients were positive for DENV, whereas two (14.3%) for CHIKV. In September, we selected four circumferences, and, from the 21 individuals sampled, nine (42.8%) were positive for DENV-2. A statistical model with a binomial response was used to estimate the number of cases in areas without active surveys, i.e., 20 circumferences. We estimated an additional 83 symptomatic patients (95% CI: 45-145) to be found in active searches, with 38 (95% CI: 18-72) of them confirming arbovirus infection. Arbovirus detection and serotyping in mosquitoes, but also in symptomatic individuals during active surveys, can provide an alert signal of early arbovirus transmission.

Entomo-Virological Aedes aegypti Surveillance Applied for Prediction of Dengue Transmission: A Spatio-Temporal Modeling Study.

Currently, DENV transmitted primarily by Aedes aegypti affects approximately one in three people annually. The spatio-temporal heterogeneity of vector infestation and the intensity of arbovirus transmission require surveillance capable of predicting an outbreak. In this work, we used data from 4 years of reported dengue cases and entomological indicators of adult Aedes collected from approximately 3500 traps installed in the city of Foz do Iguaçu, Brazil, to evaluate the spatial and temporal association between vector infestation and the occurrence of dengue cases. Entomological (TPI, ADI and MII) and entomo-virological (EVI) indexes were generated with the goal to provide local health managers with a transmission risk stratification that allows targeting areas for vector control activities. We observed a dynamic pattern in the evaluation; however, it was a low spatio-temporal correlation of Ae. aegypti and incidence of dengue. Independent temporal and spatial effects capture a significant portion of the signal given by human arbovirus cases. The entomo-virological index (EVI) significantly signaled risk in a few areas, whereas entomological indexes were not effective in providing dengue risk alert. Investigating the variation of biotic and abiotic factors between areas with and without correlation should provide more information about the local epidemiology of dengue.