Mass incarceration as a driver of the tuberculosis epidemic in Latin America and projected impacts of policy alternatives: A mathematical modeling study.

Background: Tuberculosis incidence is increasing in Latin America, where the incarcerated population has nearly quadrupled since 1990. The full impact of incarceration on the tuberculosis epidemic, accounting for effects beyond prisons, has never been quantified. Methods: We calibrated dynamic compartmental transmission models to historical and contemporary data from Argentina, Brazil, Colombia, El Salvador, Mexico, and Peru, which comprise approximately 80% of the region's incarcerated population and tuberculosis burden. Using historical counterfactual scenarios, we estimated the transmission population attributable fraction (tPAF) for incarceration and the excess population-level burden attributable to increasing incarceration prevalence since 1990. We additionally projected the impact of alternative incarceration policies on future population tuberculosis incidence. Findings: Population tuberculosis incidence in 2019 was 29.4% (95% UI, 23.9-36.8) higher than expected without the rise in incarceration since 1990, corresponding to 34,393 (95% UI, 28,295-42,579) excess incident cases across countries. The incarceration tPAF in 2019 was 27.2% (95% UI, 20.9-35.8), exceeding estimates for other risk factors like HIV, alcohol use disorder, and undernutrition. Compared to a scenario where incarceration rates remain stable at current levels, a gradual 50% reduction in prison admissions and duration of incarceration by 2034 would reduce population tuberculosis incidence by over 10% in all countries except Mexico. Interpretation: The historical rise in incarceration in Latin America has resulted in a large excess tuberculosis burden that has been under-recognized to-date. International health agencies, ministries of justice, and national tuberculosis programs should collaborate to address this health crisis with comprehensive strategies, including decarceration. Funding: National Institutes of Health.

Interferon-alpha for treating polycythemia vera yields improved myelofibrosis-free and overall survival.

Interferon-alpha (rIFNα) is the only disease-modifying treatment for polycythemia vera (PV), but whether or not it prolongs survival is unknown. This large single center retrospective study of 470 PV patients compares the myelofibrosis-free survival (MFS) and overall survival (OS) with rIFNα to two other primary treatments, hydroxyurea (HU) and phlebotomy-only (PHL-O). The median age at diagnosis was 54 years (range 20-94) and the median follow-up was 10 years (range 0-45). Two hundred and twenty-nine patients were women (49%) and 208 were high-risk (44%). The primary treatment was rIFNα in 93 (20%), HU in 189 (40%), PHL-O in 133 (28%) and other cytoreductive drugs in 55 (12%). The treatment groups differed by ELN risk score (p < 0.001). In low-risk patients, 20-year MFS for rIFNα, HU, and PHL-O was 84%, 65% and 55% respectively (p < 0.001) and 20-year OS was 100%, 85% and 80% respectively (p = 0.44). In high-risk patients, 20-year MFS for rIFNα, HU, and PHL-O was 89%, 41% and 36% respectively (p = 0.19) and 20-year OS was 66%, 40%, 14% respectively (p = 0.016). In multivariable analysis, longer time on rIFNα was associated with a lower risk of myelofibrosis (HR: 0.91, p < 0.001) and lower mortality (HR: 0.94, p = 0.012). In conclusion, this study supports treatment of PV with rIFNα to prevent myelofibrosis and potentially prolong survival.

A new glance on root-to-shoot in vivo zinc transport and time-dependent physiological effects of ZnSO4 and ZnO nanoparticles on plants.

Understanding nanoparticle root uptake and root-to-shoot transport might contribute to the use of nanotechnology in plant nutrition. This study performed time resolved experiments to probe Zn uptake, biotransformation and physiological effects on Phaseolus vulgaris (L.). Plants roots were exposed to ZnO nanoparticles (40 and 300 nm) dispersions and ZnSO4(aq) (100 and 1000 mg Zn L-1) for 48 h. Near edge X-ray absorption spectroscopy showed that 40 nm ZnO was more easily dissolved by roots than 300 nm ZnO. It also showed that in the leaves Zn was found as a mixture Zn3(PO4)2 and Zn-histidine complex. X-ray fluorescence spectroscopy showed that root-to-shoot Zn-translocation presented a decreasing gradient of concentration and velocity, it seems radial Zn movement occurs simultaneously to the axial xylem transport. Below 100 mg Zn L-1, the lower stem tissue section served as a buffer preventing Zn from reaching the leaves. Conversely, it was not observed for 1000 mg Zn L-1 ZnSO4(aq). Transcriptional analysis of genes encoding metal carriers indicated higher expression levels of tonoplast-localized transporters, suggesting that the mechanism trend to accumulate Zn in the lower tissues may be associated with an enhanced of Zn compartmentalization in vacuoles. The photosynthetic rate, transpiration, and water conductance were impaired by treatments.

Perceptions of the nursing team during the covid-19 pandemic: cross-sectional study / Percepções da equipe de enfermagem durante a pandemia por covid-19: estudo transversal / Percepciones del equipo de enfermería durante la pandemia de covid-19: estudio transversal

Background and Objectives: to identify the perceptions of nursing professionals who worked during the covid-19 pandemic regarding Healthcare-Associated Infections (HAIs) and Hand Hygiene (HH), categorizing them by profession and region in Brazil. Method: An observational study was conducted from November 2020 to December 2021, involving 493 nursing professionals from all regions of Brazil. The Google Forms® platform, disseminated through social media was used. A questionnaire titled "Basic Questionnaire on Healthcare Professionals' Perception of Healthcare-Associated Infections and Hand Hygiene" was administered. The results were analyzed descriptively, presenting absolute and relative frequencies, divided by groups of nursing professionals (nurses, technicians, and assistants) and by regions of Brazil. Results: The results showed that 43.9% of nurses reported a significant impact of HAIs on the clinical progression of patients, whereas only 26.7% of nursing technicians and assistants shared this perception. Regarding HH, 50.8% of nurses considered a substantial effort necessary to perform it adequately, while 68.9% of nursing technicians and assistants agreed with this statement. Conclusion: most nursing professionals had a high perception of HAIs and HH, considering their profession and geographic region. These findings can contribute to the development of future strategies aimed at improving HH practices in nursing care, particularly during outbreaks of infectious diseases such as covid-19.(AU)

Justificativa e Objetivos: identificar as percepções dos profissionais de enfermagem que atuaram durante a pandemia de covid-19 em relação às Infecções Relacionadas à Assistência à Saúde (IRAS) e à Higienização das Mãos (HM), classificando-os por profissão e regiões brasileiras. Método: estudo observacional foi conduzido de novembro/2020 a dezembro/2021, com a participação de 493 profissionais de enfermagem de todas as regiões do Brasil. Utilizou-se o formulário do Google Forms®, divulgado em redes sociais. Foi aplicado um questionário intitulado "Questionário básico sobre a percepção de profissionais de saúde sobre infecções relacionadas à assistência à saúde e à higienização das mãos". Os resultados foram analisados de forma descritiva, apresentando frequências absolutas e relativas, divididos por grupos de profissionais de enfermagem (enfermeiros, técnicos e auxiliares) e por regiões do Brasil. Resultados: Os resultados mostraram que 43,9% dos enfermeiros relataram um impacto muito alto das IRAS na evolução clínica dos pacientes, enquanto apenas 26,7% dos auxiliares e técnicos de enfermagem compartilharam essa percepção. Em relação à HM, 50,8% dos enfermeiros consideraram que é necessário um grande esforço para realizá-la adequadamente, enquanto 68,9% dos auxiliares e técnicos de enfermagem concordaram com essa afirmação. Conclusão: a maioria dos profissionais de enfermagem apresentou uma alta percepção sobre HM e IRAS, levando em consideração a profissão e a região geográfica. Esses resultados podem contribuir para o desenvolvimento de estratégias futuras com o objetivo de aprimorar as práticas de HM na assistência de enfermagem, principalmente durante surtos de doenças infecciosas, como a covid-19.(AU)

Justificación y Objetivos: identificar las percepciones de los profesionales de enfermería que trabajaron durante la pandemia de COVID-19 en relación con las Infecciones Relacionadas con la Atención de la Salud (IRAS) y la Higiene de las Manos (HM), clasificándolos por profesión y región. Métodos: se llevó a cabo un estudio observacional desde noviembre/2020 hasta diciembre/2021, con la participación de 493 profesionales de enfermería de las 5 regiones de Brasil. El formulario de Google® fue difundido en redes sociales. Se aplicó un cuestionario: "Cuestionario básico sobre la percepción de los profesionales de la salud sobre infecciones relacionadas con la atención de la salud y la higiene de las manos". Los resultados se analizaron de manera descriptiva, presentando frecuencias absolutas y relativas, divididos por enfermeros, técnicos y auxiliares y por regiones. Resultados: 43,9% de los enfermeros informaron impacto muy alto de IRAS en la evolución de los pacientes, mientras que solo 26,7% de los auxiliares y técnicos compartieron esta percepción. En cuanto a la HM, 50,8% de los enfermeros consideraron que se requiere gran esfuerzo para llevarla a cabo adecuadamente, mientras que 68,9% de los auxiliares y técnicos de enfermería estuvieron de acuerdo con esta afirmación. Conclusión: la mayoría de los profesionales de enfermería tuvo una percepción alta sobre las IRAS y la HM, teniendo en cuenta la profesión y la región. Esto puede contribuir al desarrollo de estrategias para mejorar las prácticas de HM en la enfermería, especialmente durante enfermedades infecciosas como el covid-19.(AU)

Hand hygiene knowledge among nursing professionals during a pandemic: insights from a cross-sectional study in Brazil / Conhecimento sobre higiene das mãos entre profissionais de enfermagem durante uma pandemia: insights de um estudo transversal no Brasil / Conocimiento de higiene de manos entre profesionales de enfermería durante una pandemia: perspectivas de un estudio transversal en Brasil

Background and Objectives: hand hygiene (HH) is a crucial safety practice, but lack of knowledge can hinder compliance. The objective was to measure and assess the knowledge of nursing professionals who provided care during the COVID-19 pandemic regarding HH and to verify the association between HH knowledge and professional category and regions in Brazil. Methods: an observational study was conducted from November 2020 to December 2021 involving 493 nursing professionals from all regions of Brazil. Data collection was carried out using Google Forms® and social media platforms. The Hand Hygiene Knowledge Test for Healthcare Professionals was used, and results were analyzed descriptively. Pearson's chi-square test (x2) and Fisher's exact test were employed to assess associations. Results: among the participants, the majority (74.7%) had limited or subpar knowledge of HH. Nurses had a higher level of knowledge compared to nursing assistants and licensed practical nurses. Associations were found between professional category and correct answers regarding microorganism destruction time and the type of HH to be used. Conclusion: Brazilian nursing professionals had limited knowledge of HH, with nurses displaying a higher level of knowledge compared to nursing assistants and licensed practical nurse. Continuous education and guidance are necessary to improve HH practices among the nursing staff.(AU)

Justificativas e Objetivos: a higiene das mãos (HM) é uma prática crucial para a segurança, mas a falta de conhecimento pode prejudicar a adesão. Este estudo avaliou o conhecimento dos profissionais de enfermagem que prestaram cuidados durante a pandemia de Covid-19 em relação à HM e explorou a associação entre o conhecimento de HM, categoria profissional e regiões no Brasil. Métodos: um estudo observacional foi conduzido de novembro de 2020 a dezembro de 2021 envolvendo 493 profissionais de enfermagem de todas as regiões do Brasil. A coleta de dados foi realizada usando o Google Forms® e plataformas de mídia social. Foi utilizado o Teste de Conhecimento de Higiene das Mãos para Profissionais de Saúde, e os resultados foram analisados descritivamente. O teste qui-quadrado de Pearson (x2) e o teste exato de Fisher foram empregados para avaliar as associações. Resultados: entre os participantes, a maioria (74,7%) tinha conhecimento limitado ou insuficiente sobre HM. Os enfermeiros apresentaram um nível mais elevado de conhecimento em comparação com os auxiliares e técnicos de enfermagem. Foram encontradas associações entre a categoria profissional e respostas corretas sobre o tempo de destruição de microrganismos e o tipo de HM a ser utilizado. Conclusão: os profissionais de enfermagem brasileiros possuíam conhecimento limitado sobre HM, sendo que os enfermeiros apresentaram um nível mais elevado de conhecimento em comparação com os auxiliares e técnicos de enfermagem. Educação contínua e orientação são necessárias para melhorar as práticas de HM entre a equipe de enfermagem.(AU)

Justificación e Objetivos: la higiene de manos (HM) es una práctica de seguridad crucial, pero la falta de conocimiento puede dificultar el cumplimiento. Este estudio evaluó el conocimiento de los profesionales de enfermería que brindaron atención durante la pandemia de Covid-19 en relación con la HM y exploró la asociación entre el conocimiento de HM, la categoría profesional y las regiones en Brasil. Métodos: se realizó un estudio observacional desde noviembre de 2020 hasta diciembre de 2021 que incluyó a 493 profesionales de enfermería de todas las regiones de Brasil. La recopilación de datos se realizó utilizando Google Forms® y plataformas de redes sociales. Se utilizó el Test de Conocimiento de Higiene de Manos para Profesionales de la Salud, y los resultados se analizaron de manera descriptiva. Se emplearon la prueba chi-cuadrado de Pearson (x2) y la prueba exacta de Fisher para evaluar las asociaciones. Resultados: entre los participantes, la mayoría (74,7%) tenía conocimiento limitado o deficiente de HM. Las enfermeras tenían un nivel de conocimiento más alto en comparación con los auxiliares y técnicos de enfermería. Se encontraron asociaciones entre la categoría profesional y las respuestas correctas sobre el tiempo de destrucción de microorganismos y el tipo de HM que debía utilizarse. Conclusión: los profesionales de enfermería brasileños tenían un conocimiento limitado de HM, siendo que las enfermeras mostraban un nivel de conocimiento más alto en comparación con los auxiliares y técnicos de enfermería. Se requiere educación continua y orientación para mejorar las prácticas de HM entre el equipo de enfermería(AU)

Laboratory Microprobe X-Ray Fluorescence in Plant Science: Emerging Applications and Case Studies.

In vivo and micro chemical analytical methods have the potential to improve our understanding of plant metabolism and development. Benchtop microprobe X-ray fluorescence spectroscopy (µ-XRF) presents a huge potential for facing this challenge. Excitation beams of 30 µm and 1 mm in diameter were employed to address questions in seed technology, phytopathology, plant physiology, and bioremediation. Different elements were analyzed in several situations of agronomic interest: (i) Examples of µ-XRF yielding quantitative maps that reveal the spatial distribution of zinc in common beans (Phaseolus vulgaris) primed seeds. (ii) Chemical images daily recorded at a soybean leaf (Glycine max) infected by anthracnose showed that phosphorus, sulfur, and calcium trended to concentrate in the disease spot. (iii) In vivo measurements at the stem of P. vulgaris showed that under root exposure, manganese is absorbed and transported nearly 10-fold faster than iron. (iv) Quantitative maps showed that the lead distribution in a leaf of Eucalyptus hybrid was not homogenous, this element accumulated mainly in the leaf border and midrib, the lead hotspots reached up to 13,400 mg lead kg-1 fresh tissue weight. These case studies highlight the ability of µ-XRF in performing qualitative and quantitative elemental analysis of fresh and living plant tissues. Thus, it can probe dynamic biological phenomena non-destructively and in real time.

Pilot survey of hen eggs consumed in the metropolitan area of Rio de Janeiro, Brazil, for polyether ionophores, macrolides and lincosamides residues.

A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method, which has recently been developed and validated, was used for the identification and quantification of polyether ionophore, macrolide and lincosamide residues in commercial eggs sold in the metropolitan area of Rio de Janeiro, Brazil. The method was applied to 100 samples and the results showed a high incidence of polyether ionophore residues (25%). Salinomycin was detected in 21% of samples, but only two non-compliant results (5.3 and 53 µg kg(-1)) were found if maximum limits (tolerances) established by European Union were adopted in Brazil and if a method decision limit (CCα) of 3.4 µg kg(-1) was considered. In 8% of analyzed samples, more than one studied coccidiostat was found. The lincosamide, lincomycin, and the macrolide, tylosin, were detected at trace levels in 4 and 1% of the samples, respectively. Lasalocid, clarithromycin and erythromycin were not found.

Pilot survey of commercial pasteurized milk consumed in the metropolitan area of Rio de Janeiro, Brazil, for tetracyclines residues, including the 4-epimers of oxytetracycline, tetracycline and chlortetracycline.

This pilot survey aimed to assess the occurrence of tetracyclines and the 4-epimers of oxytetracycline, tetracycline and chlortetracycline in commercial pasteurized milks sold in the metropolitan area of Rio de Janeiro, Brazil, between October 2009 and March 2010. A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method, developed and validated in our laboratory, was used. All 100 analyzed samples were compliant, but 14 contained oxytetracycline in concentrations ranging from the method limit of detection (3.7 µg l(-1)) to the method limit of quantification (12.2 µg l(-1)). One sample contained oxytetracycline and tetracycline simultaneously (at a concentration slightly higher than method limit of quantification, 7.0 µg l(-1)). The presence of 4-epioxytetracycline and 4-epitetracycline in contaminated samples with the parent drugs could not be confirmed as traces were detected only in the quantification MRM transition. No other tetracyclines were detected.

Simultaneous determination of polyether ionophores, macrolides and lincosamides in hen eggs by liquid chromatography-electrospray ionization tandem mass spectrometry using a simple solvent extraction.

A liquid chromatography-electrospray ionization tandem mass spectrometric (LC-ESI-MS/MS) method was developed and validated for the determination of residues of 6 polyether ionophores (lasalocid, maduramicin, monensin, narasin, salinomycin, semduramicin), 3 macrolides (erythromycin, tylosin, clarithromycin) and 1 lincosamide (lincomycin) in eggs. Nigericin was used as qualitative internal standard. Samples were deproteinizated/extracted with acetonitrile without pH adjustments. Aliquots of the extracts were evaporated and reconstituted for injection in the instrument operated in positive multiple reaction monitoring (MRM) mode. The stability of the antibiotics and the intensity of the formed ions were considered in order to select a suitable solvent for the reconstitution of the obtained dry extracts. No clean-up steps were required and matrix effects were controlled by sample dilution, selection of appropriate chromatographic conditions and reduced injection volume. Good within-laboratory reproducibility was obtained, with relative standard deviations (RSD(R)) from 4.0 (semduramicin at 5 µgkg(-1)) to 18.6 (erythromycin at 25 µgkg(-1)) for the ionophores and macrolides. Lincomycin showed the least precise results, with a maximum RSD(R) of 20.2% at 75 µgkg(-1)). Satisfactory decision limits (CCα) and detection capabilities (CCß) were also attained. Method limits of detection (LODs) from 0.04 (salinomycin) to 1.6 µgkg(-1) (lincomycin) were achieved. Method limits of quantification (LOQs) were from 0.14 to 5.3 µgkg(-1) for the same drugs, respectively. All the LOQs, except that obtained for maduramicin were remarkably below the lowest validation level. The proposed method is suitable for routine application in commercial egg samples.