COVID-19 mortality in an area of northeast Brazil: epidemiological characteristics and prospective spatiotemporal modelling.

This study aimed to analyse the spatial-temporal distribution of COVID-19 mortality in Sergipe, Northeast, Brazil. It was an ecological study utilising spatiotemporal analysis techniques that included all deaths confirmed by COVID-19 in Sergipe, from 2 April to 14 June 2020. Mortality rates were calculated per 100 000 inhabitants and the temporal trends were analysed using a segmented log-linear model. For spatial analysis, the Kernel estimator was used and the crude mortality rates were smoothed by the empirical Bayesian method. The space-time prospective scan statistics applied the Poisson's probability distribution model. There were 391 COVID-19 registered deaths, with the majority among ⩾60 years old (62%) and males (53%). The most prevalent comorbidities were hypertension (40%), diabetes (31%) and cardiovascular disease (15%). An increasing mortality trend across the state was observed, with a higher increase in the countryside. An active spatiotemporal cluster of mortality comprising the metropolitan area and neighbouring cities was identified. The trend of COVID-19 mortality in Sergipe was increasing and the spatial distribution of deaths was heterogeneous with progression towards the countryside. Therefore, the use of spatial analysis techniques may contribute to surveillance and control of COVID-19 pandemic.

Spatial clustering, social vulnerability and risk of leprosy in an endemic area in Northeast Brazil: an ecological study.

BACKGROUND: Despite the global decline in the detection of leprosy cases, its incidence has remained unchanged in certain settings and requires the determination of the factors linked to its persistence. We examined the spatial and space-time distribution of leprosy and the influence of social vulnerability on the occurrence of the disease in an endemic area of Northeast Brazil. METHODS: We performed an ecological study of all leprosy cases reported by Sergipe state, Northeast Brazil from 2001 to 2015, to examine the association of the Social Vulnerability Index and the prevalence and persistence of leprosy among the State's municipalities. Socio-economic and leprosy surveillance information was collected from the Brazilian information systems, and a Bayesian empirical local model was used to identify fluctuations of the indicators. Spatial and space-time clusters were identified using scan spatial statistic tests and to measure the municipalities' relative risk of leprosy. RESULTS: Leprosy clusters and burden of disease had a strong statistical association with the municipalities' Social Vulnerability Index. Municipalities with a high social vulnerability had higher leprosy incidence, multibacillary leprosy and newly diagnosed cases with grade 2 disability than areas with low social vulnerability. CONCLUSION: Social vulnerability is strongly associated with leprosy transmission and maintenance of disease incidence. Leprosy control programmes should be targeted to the populations with high social vulnerability.

A nano particle vector comprised of poly lactic-co-glycolic acid and monophosphoryl lipid A and recombinant Mycobacterium avium subsp paratuberculosis peptides stimulate a pro-immune profile in bovine macrophages.

AIMS: We evaluated the potential of a nanoparticle (NP) delivery system to improve methods of delivery of candidate peptide-based vaccines for Paratuberculosis in cattle. METHODS AND RESULTS: Peptides derived from Mycobacterium avium subsp. paratuberculosis (Map), and the pro-inflammatory monophosphoryl lipid A (MPLA) were incorporated in polymeric NPs based on poly (d,l-lactide-co-glycolide) (PLGA). The PLGA/MPLA NPs carriers were incubated with macrophages to examine their effects on survival and function. PLGA/MPLA NPs, with and without Map antigens, are efficiently phagocytized by macrophages with no evidence of toxicity. PLGA/MPLA NP formulations did not alter the level of expression of MHC I or II molecules. Expression of TNFα and IL12p40 was increased in Map-loaded NPs. T-cell proliferation studies using a model peptide from Anaplasma marginale demonstrated that a CD4 T-cell recall response could be elicited with macrophages pulsed with the peptide encapsulated in the PLGA/MPLA NP. CONCLUSIONS: These findings indicate PLGA/MPLA NPs can be used as a vehicle for delivery and testing of candidate peptide-based vaccines. SIGNIFICANCE AND IMPACT OF THE STUDY: These results will assist on more in depth studies on PLGA NP delivery systems that may lead to the development of a peptide-based vaccine for cattle.

The impact of the COVID-19 pandemic on TB diagnosis in the Brazilian prison population, 2020-2021.

BACKGROUND: TB is an infectious disease with a worldwide impact. TB is closely associated with social and housing conditions, exerting a significant impact on the prison population, which is particularly susceptible to the disease. Evidence suggests that the COVID-19 pandemic has exacerbated social vulnerability. This study therefore aimed to analyse the impact of the pandemic on the diagnosis of new cases of TB in the Brazilian prison population in the years 2020 and 2021.METHODS: This is an ecological study involving cases of TB recorded in the prison population of Brazil from 2015 to 2021. Data were collected from the Brazil's Information System for Notifiable Diseases.RESULTS: The incidence of TB in the prison population in Brazil fell from 1,005.9/100,000 population between 2015 and 2019 to 852.3/100,000 population between 2020 and 2021. In 2021, there was a deficit of 539 cases (-7.6%) compared to what was expected for the year. In 2020, there was a 10% reduction in TB diagnoses in January and February, reaching 3.8% in March. A negative percentage was observed in most of the subsequent months. In 2021, the year began with a 21.6% decline in January, returning to positive values only in August and September.CONCLUSION: The first years of the COVID-19 pandemic resulted in underdiagnosis of TB in the Brazilian prison population.

Increased folate intake with no changes in serum homocysteine and decreased levels of C-reactive protein in patients with inflammatory bowel diseases.

In order to increase dietary folic acid intake and to improve nutritional status regarding folate by controlling homocysteine concentrations, ten patients with inflammatory bowel diseases (Crohn's disease in the colon and ulcerative colitis) received individualized nutritional guidance and were followed up as outpatients for 2 months. The following procedures were performed at the beginning of the study (T0), after 1 month (T1) and at the end of the study (T2): collection of anthropometric data (weight and height), dietary data (24 h diet recall), and blood under fasting condition for the determination of serum folic acid, homocysteine, C-reactive protein, and vitamin B12. Plasma folic acid deficiency was not detected but hyperhomocysteinemia was present in six individuals and C-reactive protein (CRP) was increased (>0.5 mg/dl) in seven patients. After the patients were instructed there was a significant increase in vitamin B6 intake (about 35%) and in folate intake (49.6%). Mean plasma levels of folic acid, homocysteine, and vitamin B12 did not change, but there was a significant decrease of CRP at T1, 0.36 mg dl(-1) on average (P = 0.01), which was maintained at T2. We conclude that the increased folate intake reported by this group of patients was not reflected in improved serum concentrations of folic acid and homocysteine. However, the guidelines for the patients probably induced them to choose a more adequate diet, providing nutrients that help control the inflammatory process.

Fischer-Tropsch synthesis on anchored Co/Nb2O5/Al2O3 catalysts: the nature of the surface and the effect on chain growth.

A series of Co/x%Nb2O5/Al2O3 catalysts were prepared by anchoring niobia on an Al2O3 support at different niobia concentrations. Characterization of the structure and nature of surface active sites was attempted in order to correlate the CO hydrogenation activity of these systems with those of the Co/Al2O3 and Co/Nb2O5 catalysts. The effect of the reduction temperature on the CO hydrogenation activity and selectivity was studied, showing that interaction of cobalt and niobia surface species favored the selectivity for hydrocarbon chain growth. However, this effect is less pronounced on the niobia-promoted Co/Al2O3 compared to Co/Nb2O5 catalysts. X-ray photoelectron spectroscopy (XPS) and diffuse reflectance spectroscopy (DRS) results on Co/x%Nb2O5/Al2O3 showed prevailing amounts of Co2+ and Co3+ after calcination and reduction at 573 K, while, after reduction at 773 K, besides metallic cobalt, the Co2+ species still remains in contact with alumina, even for higher niobia loading. It seems that during this process formation and destruction of new interfaces involving Co0-NbOx sites takes place. Results suggest that Co0, Co0-Co2+, and Co0-NbOx are the active sites at the surface. The relative abundance of Co2+ species affects greatly the performance of the catalysts. DRIFTS and selectivity results suggest that these sites might be responsible for the reaction chain growth and therefore for the drastic change in the selectivity of CH4 and C5+ hydrocarbons mainly on the Co/Nb2O5 catalyst. DRIFTS results on Co/Nb2O5/Al2O3 showed the formation of -C=C- and -CH3- besides CHxO species. With increasing reduction temperature, the -C=C- species disappear while -CH3- fragments increased markedly, suggesting the formation of increasing amounts of hydrocarbons with higher chain length.

Evaluation of propofol and remifentanil for intravenous sedation for reducing shoulder dislocations in the emergency department.

OBJECTIVES: To assess the combination of propofol and remifentanil for sedation to reduce shoulder dislocations in an ED. METHODS: Eleven patients with anterior glenohumeral dislocation were given propofol 0.5 mg/kg and remifentanil 0.5 microg/kg iv over 90 seconds and then further doses of 0.25 mg/kg and 0.25 microg/kg, respectively, if needed. Another practitioner attempted reduction using the Milch technique. RESULTS: Reduction was achieved in all patients within four minutes of giving sedation (range 0.3-4; mean 1.6). Seven required one attempt at shoulder reduction, three required two attempts, and one required three attempts. Mean time to recovery of alert status was three minutes (range 1-6). The mean pain score during the reduction was 1.7 out of 10 (range 0-5). Nine patients had full recall, one had partial recall, and one had no recall at all. Eight patients were "very satisfied" with the sedation and three were "satisfied". There were no respiratory or haemodynamic complications that required treatment. CONCLUSIONS: Propofol and remifentanil provide excellent sedation and analgesia for the reduction of anterior glenohumeral dislocation, enabling rapid recovery.

Imaging D2 receptor occupancy by endogenous dopamine in humans.

The impact of endogenous dopamine on in vivo measurement of D2 receptors in humans was evaluated with single photon emission computerized tomography (SPECT) by comparing the binding potential (BP) of the selective D2 radiotracer [123I]IBZM before and after acute dopamine depletion. Dopamine depletion was achieved by administration of the tyrosine hydroxylase inhibitor alpha-methyl-para-tyrosine (AMPT), given orally at a dose of 1 g every six hours for two days. AMPT increased [123I]IBZM BP by 28 +/- 16% (+/- SD, n = 9). Experiments in rodents suggested that this effect was due to removal of endogenous dopamine rather than D2 receptor upregulation. Synaptic dopamine concentration was estimated as 45 +/- 25 nM, in agreement with values reported in rodents. The amplitude and the variability of the AMPT effect suggested that competition by endogenous dopamine introduces a significant error in measurement of D2 receptors in vivo with positron emission tomography (PET) or SPECT. However, these results also imply that D2 receptor imaging coupled with acute dopamine depletion might provide estimates of synaptic dopamine concentration in the living human brain.

[123I]Iomazenil SPECT benzodiazepine receptor imaging in schizophrenia.

Deficient inhibitory neurotransmission of gamma-aminobutyric acid (GABA) has been implicated in the pathophysiology of schizophrenia based on postmortem studies. However, in vivo studies have shown predominantly negative or conflicting results. The goal of this study was to better characterize possible changes of the regional GABA(A)-benzodiazepine receptor distribution volume (BZR V3-p) in schizophrenia in vivo, using a larger sample size than previous studies. Single photon emission computed tomography (SPECT) with [123I]iomazenil was used with a constant infusion paradigm to measure the BZR V3-p under sustained radiotracer equilibrium conditions. Twenty-five patients with schizophrenia and 24 matched healthy control subjects were studied. Positive and Negative Syndrome Scale (PANSS) ratings were done in all subjects. Statistical parametric mapping (SPM) 96 was used to compare patients and control subjects as well as to study the relationship between SPECT results and composite PANSS scores based on two factorial models: the pentagonal model (positive, negative, dysphoric mood, activation, and autistic preoccupation factors) and the taxometric model (disorganized dimension). On the basis of 'absolute' values of V3-p with no normalization for total brain uptake, the schizophrenic patients showed no significant differences in BZR levels compared to the healthy control subjects. With a global normalization procedure, which is more sensitive to relative regional differences in activity, BZR V3-p was significantly decreased in the patients in the left precentral gyrus (BA 6). The relative BZR V3-p showed a significant positive correlation with duration of illness in the superior occipital gyri (BA 19). No significant correlations were observed between either absolute or relative BZR V3-p and either age or any of the composite PANSS scores based on any of the two factorial models in either patients or control subjects. No significant differences were observed between cigarette smoking vs. non-smoking patients, nor between the patients on atypical antipsychotics vs. on typical antipsychotics vs. not on any antipsychotics. In general, no significant differences in BZR V3-p were observed between patients and control subjects, except for a decrease in relative BZR V3-p in the left precentral gyrus. Grey matter atrophy is unlikely to be the cause for this decrease. However, we could not exclude that possibility. The positive correlation with duration of illness might reflect the relative preservation of neurons expressing BZR in the superior occipital gyri as compared to other cortical brain regions in schizophrenia.

[Congenital hypothyroidism screening program: preliminary results]. / Resultados preliminares de um programa de detecção precoce para o hipotireoidismo congênito.

OBJECTIVE: The authors report early results of a screening program for Congenital Hypothyroidism in Santa Catarina, Brazil. METHODS: All the assays (82.709) analysed by Laboratório Central (LACEN) between July 1993 and December 1994 were studied. A blood sample was collected on filter paper for serum Thyroid Stimulating Hormone (TSH) measurement by fluoroimmunoassay, in triplicate. All children who had persistent abnormal TSH values (cord blood: TSH > 30 micro U/ml; from 2 to 7 days: >20 micro U/ml; older than 7 days: > 10 micro U/ml) were recalled for clinical evaluation. RESULTS: Out of 82.709 infants aged from 0 to 60 days (40% of the deliveries in this period), 304 presented abnormal results of TSH and 34 were confirmed as Congenital Hypothyroidism. The mean age of beginning the treatment was 45 days of life. CONCLUSIONS: The prevalence (1:2500) was higher than that observed in other countries, probably because some children had Transient Congenital Hypothyroidism. Nevertheless, sex prevalence was similar to that described in the literature. Clinical manifestations were inespecific which reinforces the importance of this kind of screening. Efforts have been done to improve the program in order to begin earlier treatment.

Mycobacterium tuberculosis 38kDa antigen and its encoding gene-experience in diagnostic applications.

Our experience has revealed that the detection of 38 kDa antigen or antibody to the antigen in various fluids is useful in diagnosis of various mainfestations of tuberculosis. The PCR developed for 340bp sequence of its encoding gene also shows a high degree of sensitivity and specificity. Thus the 38 kDa antigen/antibody combination or the PCR are ideal for development of kits for diagnosis. These immunoassays to be successful, isolation of the 38 kDa antigen in large quantities is essential. Using recombinant DNA technology and expression inE. coli this has been achieved. However, such recombinant antigen does not have the same immunological properties as the native antigen and hence not suitable in immunodiagnosis. To fully realise the potential of the MoAb defined antigens such as the 38 kDa antigen, 19 kDa antigen and others it is essential to devise alternative vector-host systems that help in glycosylation, do not accumulate as inclusion bodies and can be isolated with less damage.

Scent glands in legume flowers.

Scent glands, or osmophores, are predominantly floral secretory structures that secrete volatile substances during anthesis, and therefore act in interactions with pollinators. The Leguminosae family, despite being the third largest angiosperm family, with a wide geographical distribution and diversity of habits, morphology and pollinators, has been ignored with respect to these glands. Thus, we localised and characterised the sites of fragrance production and release in flowers of legumes, in which scent plays an important role in pollination, and also tested whether there are relationships between the structure of the scent gland and the pollinator habit: diurnal or nocturnal. Flowers in pre-anthesis and anthesis of 12 legume species were collected and analysed using immersion in neutral red, olfactory tests and anatomical studies (light and scanning electron microscopy). The main production site of floral scent is the perianth, especially the petals. The scent glands are distributed in a restricted way in Caesalpinia pulcherrima, Anadenanthera peregrina, Inga edulis and Parkia pendula, constituting mesophilic osmophores, and in a diffuse way in Bauhinia rufa, Hymenaea courbaril, Erythrostemon gilliesii, Poincianella pluviosa, Pterodon pubescens, Platycyamus regnellii, Mucuna urens and Tipuana tipu. The glands are comprised of cells of the epidermis and mesophyll that secrete mainly terpenes, nitrogen compounds and phenols. Relationships between the presence of osmophores and type of anthesis (diurnal and nocturnal) and the pollinator were not found. Our data on scent glands in Leguminosae are original and detail the type of diffuse release, which has been very poorly studied.

Expression level of quiescin sulfhydryl oxidase 1 (QSOX1) in neuroblastomas.

Neuroblastoma is the most common extracranial solid malignant tumor observed during childhood. Although these tumors can sometimes regress spontaneously or respond well to treatment in infants, genetic alterations that influence apoptosis can, in some cases, confer resistance to chemotherapy or result in relapses and adversely affect prognosis for these patients. The aim of this study was to correlate immunohistochemical expression of the protein QSOX1 (quiescin sulfhydryl oxidase 1) in samples obtained from untreated neuroblastomas with the patients' clinical and pathological prognostic factors and clinical course. Neuroblastoma samples (n=23) obtained from histology blocks were arrayed into tissue microarrays and analysed by immunohistochemistry. The cases were classified according to the following clinical and pathological prognostic factors: age at diagnosis greater or less than/equal to 18 months; location of the lesion at diagnosis (abdominal or extra-abdominal); presence or absence of bone-marrow infiltration; tumor differentiation (well or poorly differentiated); Shimada histopathologic classification (favourable or unfavourable); state of the tumor extracellular matrix (Schwannian-stroma rich or poor); amplification of the MYCN oncogene; and clinical course (dead or alive with or without relapses/residual lesions). Twelve of the cases were female, 9 children were over 18 months old, 9 cases presented with extra-abdominal tumors and 9 cases exhibited tumors with unfavourable histologies. Fifteen patients underwent bone-marrow biopsy, and 4 of these were positive for metastasis. Nine patients died. The higher immunohistochemical expression of QSOX1 was more common in well-differentiated samples (P=0.029), in stroma-rich samples (P=0.029) and in samples from patients with a high prevalence of relapses/residual disease. The functions of QSOX1 include extracellular matrix maturation and the induction of apoptosis. Therefore, QSOX1 may be involved in neuroblastoma differentiation and regression and may thus function as a biomarker for identifying risk groups for this neoplasm.

Efeito do ômega 3 e da vitamina B12 no espermograma, na histomorfometria dos órgãos reprodutivos e nas temperaturas do corpo com termografia infravermelha em ratos Wistar / Effect of Omega 3 and Vitamin B12 on the spermogram, histomorphometry of the reproductive organs and body temperatures with infrared thermography in Wistar rats

Objetivou-se estudar o efeito do ômega 3 e da vitamina B12 no espermograma, na histomorfometria dos órgãos reprodutivos e na temperaturas do corpo com termografia infravermelha em ratos Wistar. Utilizaram-se 16 ratos, em quatro grupos (n=4), que receberam injeções diárias por 30 dias, sendo: grupo controle - solução salina; grupo ômega 3 - óleo de peixe 1g/kg; grupo B12 - vitamina B12 3µg; e grupo ômega 3 + B12 - óleo de peixe 1g/kg e vitamina B12 3µg. Imagens termográficas de áreas do corpo foram obtidas. No 30º dia, os ratos foram sacrificados e realizaram-se as análises de morfologia espermática e histomorfometria. Os dados foram submetidos à análise de variância e ao teste de Tukey a 5%. A temperatura da superfície do escroto foi superior no grupo B12 (P<0,05). Não houve diferenças entre grupos (P>0,05) para temperaturas do globo ocular. Houve correlação entre temperatura da superfície do escroto e porcentagem de gota citoplasmática distal (P=0,678). A elevação da temperatura do escroto resulta no aumento da porcentagem de gotas citoplasmáticas distais. A temperatura do globo ocular não sofre influência significativa do ômega 3 e da vitamina B12. O ômega 3 reduz o epitélio seminífero, e a vitamina B12 minimiza esse efeito.(AU)

The objective of this study was to study the effect of Omega 3 and vitamin B12 on spermogram, histomorphometry of reproductive organs and body temperature with infrared thermography in Wistar rats. Sixteen rats were used in four groups (n= 4) who received daily injections for 30 days. Control Group - saline solution; Group Omega 3 - fish oil 1g/kg; Group B12 - vitamin B12 3μg and Group Omega 3 + B12 - fish oil 1g/kg and vitamin B12 3μg. Thermographic images of body were obtained. On the 30th day the rats were sacrificed and analyzes of sperm morphology and histomorphometry were performed. Data were submitted to analysis of variance and Tukey's test at 5%. The surface temperature of the scrotum was higher in group B12 (P< 0.05). There were no differences between groups (P> 0.05) for eyeball temperatures. There was a correlation between scrotal temperature and distal cytoplasmic droplet (P= 0.678). Elevation of scrotum temperature results in an increase in the percentage of distal cytoplasmic droplets. The temperature of the eyeball is not significantly influenced by Omega 3 and vitamin B12. Omega 3 reduces the seminiferous epithelium and vitamin B12 minimizes this effect.(AU)

Impacts of introducing a new tool for the manual harvesting of sugar cane: the ergonomic analysis contribution.

The purpose of this study was to evaluate the impact of introduction a new work tool on health and productivity of manual harvesting sugarcane workers. In this study it was performed aErgonomic Work Analysis (EWA) to analyze the work tool changes.The study included sugarcane workers, drivers, fiscals, and technical's safety at work.During the analysis process, 134 questionnaires were applied,aimed to identify the constraints that such workers are submitted,to evaluate the tool introduced, in order to propose modifications to improve it.The results showed a decrease in perceived exertion and discomfort, without compromising the cut quality. The main contributions of Ergonomic Work Analysis were the possibility of bringing the logic of the worker, in order to understand the inherent real work characteristics, to the process of developing the new tool. Besides, it was also noted that this methodology, based on the analysis workers activity in a real usage, as an application tool in design projects, providing innovations from the workers perspective.

Review paper: modulation of mononuclear phagocyte function by Mycobacterium avium subsp. paratuberculosis.

Pathogenic mycobacteria are highly adapted for survival within host mononuclear phagocytes. This is largely due to the organism's capacity to prevent macrophage activation, block phagosome acidification and maturation, and attenuate presentation of antigens to the immune system. Mycobacterium avium subsp. paratuberculosis (MAP) is one such organism that modulates the ruminant innate immune response. It is the causative agent in paratuberculosis, a chronic progressive granulomatous enteritis in ruminants. MAP initially interacts with cell membrane receptors on bovine mononuclear phagocytes and initiates cell signaling responses and phagocytosis. Mannosylated liparabinomannan (Man-LAM) is a major component of the MAP cell wall that interacts with the cell membrane of mononuclear phagocytes and may be a major virulence factor. Toll-like receptor 2 (TLR2) has been incriminated as major signaling receptor that binds to MAP and initiates signaling though the mitogen-activated protein kinase (MAPK)-p38 pathway. This pathway induces transcription of interleukin (IL)-10. Early production of IL-10 suppresses proinflammatory cytokines, chemokines, IL-12, and major histocompatability factor class-II expression. Both IL-10 dependent and IL-10 independent mechanisms appear to be involved in attenuation of phagosome acidification and phagolysosome fusion. Many of the suppressive effects of MAP on bovine mononuclear phagocytes can be reproduced by exposure of bovine monocytes to Man-LAM. Therefore, MAP Man-LAM-induced TLR2-MAPK-p38 signaling with resultant excessive IL-10 expression has emerged as one of the mechanisms by which MAP organisms suppress inflammatory, immune, and antimicrobial responses and promote their survival within host mononuclear phagocytes.