The high biodiversity of benthic organisms in a coastal ecosystem revealed by an integrative approach / A alta biodiversidade de organismos bentônicos em um ecossistema costeiro revelada por uma abordagem integrativa

Abstract Increasing habitat modification and species loss demand consistent efforts to describe and understand biodiversity patterns. The BIOTA/FAPESP Program was created in this context and it has been a successful initiative to promote studies on biodiversity and conservation in Brazil. The BIOTA/Araçá is an interdisciplinary project that provided a detailed evaluation of the biodiversity of Araçá Bay, a coastal seascape located on the North coast of the state of São Paulo, Southeast Brazil. The bay encompasses multiple habitats, such as beaches, mangroves, rocky shores, and a tidal flat, and provides important ecosystem services. Unfortunately, the bay is the subject of complex social-environmental conflicts that oppose economic, social, and environmental demands (i.e., the expansion of neighboring harbor activities vs. small-scale artisanal fisheries and protection of biodiversity). The present study presents a survey of the benthic species occurring in the different habitats of Araçá Bay, including data obtained during the BIOTA/Araçá project and previous assessments of the area. The benthic species play an important role in marine environments and studying the diversity of these organisms that live associated with the bottom is indispensable for comprehending the environment's functioning. The macrofauna, meiofauna, and microorganisms associated with soft and hard bottom were listed, and additional information, such as the habitat and geographical distribution, were provided for each species. The checklist includes 826 species, almost 70% recorded during the BIOTA/Araçá project. The most speciose taxa were the annelids (225 spp.), mollusks (194 spp.), and crustaceans (177 spp.). Seven benthic species are endemic to Araçá Bay, 14 are considered threatened, and seven are economically exploited. Furthermore, the bay is the type locality of many taxa, and 11 new benthic species were described based on specimens sampled during the project. This project shows the importance of Araçá Bay as a unique biologically rich environment and highlights the need for conservation efforts in light of the current threats.

Resumo O aumento da modificação dos habitats e da perda de espécies demanda esforços consistentes para descrever e compreender os padrões de biodiversidade. O programa BIOTA/FAPESP foi criado nesse contexto e é uma iniciativa de sucesso para promover estudos em biodiversidade e conservação no Brasil. O BIOTA/Araçá é um projeto interdisciplinar que promoveu uma avaliação detalhada da biodiversidade da Baía do Araçá, um ecossistema costeiro localizado ao Norte do estado de São Paulo, Sudeste do Brasil. A baía engloba múltiplos habitats, tais como praias, manguezais, costões rochosos, e uma planície de maré, e também fornece importantes serviços ecossistêmicos. Infelizmente, a baía está sujeita à conflitos sócio-ambientais complexos que contrastam demandas econômicas, sociais e ambientais (i.e. a expansão das atividades do porto vizinho vs. a pesca artesanal de pequena escala e a proteção da biodiversidade). O presente estudo apresenta um levantamento das espécies bentônicas que ocorrem nos diferentes habitats da Baía do Araçá, incluindo dados obtidos durante o projeto BIOTA/Araçá e de investigações realizadas anteriormente na área. As espécies bentônicas desempenham um papel importante no ambiente marinho, e estudar a diversidade desses organismos que vivem associados ao fundo é indispensável para compreender o funcionamento do meio ambiente. A macrofauna, meiofauna, e microorganismos associados aos fundos consolidado e inconsolidado foram listados, e informações adicionais foram fornecidas para cada espécie, tais como a distribuição geográfica e nos habitats. O checklist inclui 826 espécies, quase 70% registradas durante o projeto BIOTA/Araçá. Os taxa mais especiosos foram os anelídeos (225 spp.), moluscos (194 spp.), e crustáceos (177 spp.). Entre as espécies bentônicas listadas, sete são endêmicas da Baía do Araçá, 14 são consideradas ameaçadas de extinção, e sete são exploradas economicamente. A baía é a localidade tipo de vários taxa, e 11 novas espécies bentônicas foram descritas com base em espécimes amostrados durante o projeto. Este projeto mostra a importância da Baía do Araçá como um ambiente de riqueza biológica única e demonstra a necessidade de esforços para a sua conservação considerando as atuais ameaças.

Higher IL-6 and IL-4 plasma levels in depressed elderly women are influenced by diabetes mellitus

Abstract Objective This study aimed at investigating a set of peripheral cytokines in elderly female patients with MDD, comparing them to controls, and assessing the potential influence of clinical comorbidities on inflammatory markers. Methods Twenty-five elderly female patients diagnosed with MDD and 19 age-matched female controls were enrolled on this study. Plasma levels of interleukin (IL)-4, IL-6, IL-10, interferon (IFN)-γ and tumor necrosis factor (TNF)-α were evaluated with commercially-available assays. Results Elderly female patients with MDD exhibited higher plasma IL-6 and IL-4 levels when compared to controls. In a logistic regression model taking cytokine levels, comorbidities, and age into account, only type 2 diabetes mellitus (DM2) remained associated with MDD. Conclusion Diabetes influences the association between MDD and higher levels of cytokines in elderly female patients. Future studies should take this evidence into account in order to mitigate confounding factors.

Space-time patterns and drivers of migrant bird communities in coastal Piauí State, Brazil

Introduction: Migration is a natural phenomenon that includes annual movements of many bird species in response to seasonal cycles. With approximately one third of all living bird species, South America has an important avifauna, and many migrants land in Brazil at stopping points and wintering sites. Objective: To identify associations between migrant birds and coastal vegetation, and environmental influence of on migration. Methods: At 10 points along the coast of Piauí State, Brazil, we made visual censuses and mist net captures, between April 2009 and February 2016. Results: We identified 82 migrant bird species (13 orders; 28 families) that represented 41 intracontinental migrating species, 26 northern visiting species, 14 nomad species and one vagrant species. The richness peaks were at the beginning and end of both dry and rainy seasons, matching insolation and atmospheric pressure. There were spatial pattern differences among vegetation complexes. Chrysolampis mosquitus is an indicator of caatinga vegetation, Numenius phaeopus of wetland, Charadrius collaris of non-flooding fields, Rostrhamus sociabilis of forest-grassland transition, and Columbina picui of orchards. Despite differences in number and species composition within vegetation types, the temporal pattern in species richness was similar among flooded fields, non-flooded fields, and transition grassland categories. Conclusions: Migrant birds occupy specific environments during their permanence along the coast of Piauí State, with richness matching insolation and atmospheric pressure.

Introducción: La migración es un fenómeno natural que incluye los movimientos anuales de muchas especies de aves en respuesta a los ciclos estacionales. Con aproximadamente un tercio de todas las especies de aves conocidas, América del Sur tiene una avifauna importante y muchas aves migratorias tienen puntos de parada e invernada en Brasil. Objetivo: Identificar asociaciones entre las aves migratorias y la vegetación costera, y la influencia del medio ambiente en la migración. Métodos: En 10 puntos a lo largo de la costa del Estado de Piauí, Brasil, realizamos censos visuales y capturas con redes de niebla, entre abril 2009 y febrero 2016. Resultados: Identificamos 82 especies de aves migratorias (13 órdenes; 28 familias) que representaron 41 especies migratorias intracontinentales, 26 especies visitantes del norte, 14 especies nómadas y una especie vagante. Los picos de riqueza se dieron al principio y al final de las estaciones seca y lluviosa, coincidiendo con la insolación y la presión atmosférica. Hubo diferencias en el patrón espacial entre los complejos de vegetación. Chrysolampis mosquitus es un indicador de vegetación de caatinga, Numenius phaeopus de humedales, Charadrius collaris de campos que no se inundan, Rostrhamus sociabilis de transición bosque-pastizales y Columbina picui de huertos. A pesar de las diferencias en el número y composición de especies dentro de los tipos de vegetación, el patrón temporal en la riqueza de especies fue similar entre las categorías de campos inundados, campos no inundados y pastizales de transición. Conclusiones: Las aves migratorias ocupan ambientes específicos durante su permanencia a lo largo de la costa del estado de Piauí, con una riqueza acorde con la insolación y la presión atmosférica.

Influence of Congenital Heart Defect Types over Cardiopulmonary Bypass, Aortic Cross-Clamping, and Intensive Care Unit Length of Stay and Their Association with Genetic Factors

Aim: Surgical correction of congenital heart defects (CHD) often requires interruption of blood flow through cardiopulmonary bypass (CPB) and aortic cross-clamping (ACC), for which duration(s) are considered to be prognostic factors, along with intensive care unit (ICU) length of stay (ICULOS). The aim of this study was to evaluate these surgical prognostic factors in pediatric patients with different types of CHD regarding their type of lesion and associated genetic factors. Study Design: Cross-sectional cohort study with 307 pediatric patients. Place and Duration of Study: Pediatric Intensive Care Unit (ICU) of Hospital da Criança Santo Antônio, in Porto Alegre/RS, Brazil, from 2006-2009 (3 years) Methodology: After inclusion criteria, we studied 266 pediatric patients admitted for the first time in a reference cardiac pediatric ICU from Southern Brazil following cardiac surgery. Intraoperative prognostic factors such as duration of CPB, ACC and ICULOS, in addition to dysmorphological and cytogenetic examinations were compiled and analyzed. P-values of <0.05 were considered significant. Results: CPB time was associated to four outflow tract defects (Tetralogy of Fallot [ToF], transposition of the great arteries [TGA], double outlet right ventricle, and truncus arteriosus [TA]), atrioventricular septal defect, and hypoplastic left heart syndrome (HLHS) (P < 0.001). ACC duration was associated with three outflow tract defects (ToF, TGA, and TA) and HLHS (P < 0.001). Moreover, CPB and ACC times showed an association with cyanotic and complex heart defects, as well as prolonged ICULOS (P < 0.001). There was no relationship between these prognostic factors and syndromic aspects or cytogenetic findings. Conclusions: CHD type has an impact over CPB and ACC duration and ICULOS, whereas genetic factors are not associated with those prognostic factors.

Emotional, hyperactivity and inattention problems in adolescents with immunocompromising chronic diseases during the COVID-19 pandemic

Abstract Objective: To assess factors associated with emotional changes and Hyperactivity/Inattention (HI) motivated by COVID-19 quarantine in adolescents with immunocompromising diseases. Methods: A cross-sectional study included 343 adolescents with immunocompromising diseases and 108 healthy adolescents. Online questionnaires were answered including socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and validated surveys: Strengths and Difficulties Questionnaire (SDQ), Pittsburgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0). Results: The frequencies of abnormal emotional SDQ scores from adolescents with chronic diseases were similar to those of healthy subjects (110/343 [32%] vs. 38/108 [35%], p = 0.548), as well as abnormal hyperactivity/inattention SDQ scores (79/343 [23%] vs. 29/108 [27%], p = 0.417). Logistic regression analysis of independent variables associated with abnormal emotional scores from adolescents with chronic diseases showed: female sex (Odds Ratio [OR = 3.76]; 95% Confidence Interval (95% CI) 2.00-7.05; p < 0.001), poor sleep quality (OR = 2.05; 95% CI 1.08-3.88; p = 0.028) and intrafamilial violence during pandemic (OR = 2.17; 95% CI 1.12-4.19; p = 0.021) as independently associated with abnormal emotional scores, whereas total PedsQL score was inversely associated with abnormal emotional scores (OR = 0.95; 95% CI 0.93-0.96; p < 0.0001). Logistic regression analysis associated with abnormal HI scores from patients evidenced that total PedsQL score (OR = 0.97; 95% CI 0.95-0.99; p = 0.010], changes in medical appointments during the pandemic (OR = 0.39; 95% CI 0.19-0.79; p = 0.021), and reliable COVID-19 information (OR = 0.35; 95% CI 0.16-0.77; p = 0.026) remained inversely associated with abnormal HI scores. Conclusion: The present study showed emotional and HI disturbances in adolescents with chronic immunosuppressive diseases during the COVID-19 pandemic. It reinforces the need to promptly implement a longitudinal program to protect the mental health of adolescents with and without chronic illnesses during future pandemics.

Soursop (Annona muricata L.) Fruit Peels as Source of Phenolic Constituents and Annonacin with Biological Activities

Aims: In this study, chemical constituents and biological activities of the Annona muricata L. fruit peels were evaluated using methanol extract (MEAM) and hexane (HFAM), dichloromethane (DFAM), ethyl acetate (EFAM), and butanol (BFAM) fractions. Place and Duration of Study: All the experiments were done in the Department of Pharmaceutical Sciences and Department of Biochemistry, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, 36026-900, Brazil, between January 2012 and July 2016. Methodology: Phytochemical screening (specific chemical reactions), total phenolic and flavonoid contents (Spectrophotometric methods) and chemical compounds were assessed (High performance liquid chromatography analysis). The antioxidant activity was determined by 2,2-diphenyl-1-picrylhydrazyl (DPPH), ferric reducing antioxidant power (FRAP), beta-carotene, and thiobarbituric acid assays. The inhibitory effect against digestive enzymes (lipase, ?-amylase and ?-glucosidase) was measured by spectrophotometric assays and and toxicity by the brine shrimp lethality bioassay. Results: Tannins, flavonoids, coumarins, terpenes and steroids, saponins, and alkaloids were detected. EFAM had the highest values of total phenolic and flavonoids, while a similar compound to annonacin was found in MEAM by HPLC. EFAM was also more active in DPPH and FRAP assays, and HFAM was effective in inhibiting the linoleic acid oxidation and the malondialdehyde. MEAM and fractions blocked lipase, ?-amylase and ?-glucosidase, while HFAM and DFAM were toxic against Artemia salina. Conclusion: The results showed that the A. muricata fruit peels have important biological effects, which can bring great benefits to human and animal health.

FAPESP and the São Paulo state freshwater algal flora: history and challenges / A FAPESP e a flórula de algas de águas continentais do Estado de São Paulo: história e desafios

Abstract The BIOTA/FAPESP Program made the "São Paulo State algal flora" possible through a very intensive sampling program that aimed at (1) collecting as equally as possible from lentic, semi-lentic, and lotic environments, (2) performing the most uniform possible coverage of the state's territory, and (3) fostering the collection of periphytic and surface sediments materials that had been extremely neglected till then. The study of all this material made it clear that the biodiversity of the Zygnematophyceae increased by 100%, the Euglenophyceae by 34%, and the Chlorophyceae by 97%, the last being only due to the study of the Chlorococcales. The Bacillariophyceae are in the final phase of their floristic survey, but it is already possible to see an increase in biodiversity of over 700%. Byproducts from the BIOTA/FAPESP algae are a key for the taxonomic identification of freshwater algal genera occurring in Brazil in its third edition, and the production of the most complete algal flora ever carried out in Brazil, that of the Ipiranga River Sources State Park that already totals 919 taxa.

Resumo O Programa BIOTA/FAPESP possibilitou a organização da "Flora ficológica do Estado de São Paulo" com o desenvolvimento de um programa intensivo de coleta que visou (1) amostrar de forma equivalente os ambientes lêntico, semilêntico e lótico, (2) realizar da forma mais uniforme possível a cobertura do território do Estado e (3) privilegiar a coleta de materiais perifítico e de sedimentos superficiais, que haviam sido extremamente negligenciados até então. O estudo de todo esse material mostrou que as Zygnematophyceae apresentaram aumento de 100% de sua biodiversidade, as Euglenophyceae de 34% e as Chlorophyceae de 97%, porcentual este, entretanto, devido à conclusão apenas do estudo das Chlorococcales. As Bacillariophyceae estão na fase de conclusão de seu levantamento florístico, mostrando que o aumento da biodiversidade deverá suplantar os 700%. Há, finalmente, produtos laterais gerados pelo Programa BIOTA/FAPESP representados pela publicação de uma chave para identificação dos gêneros de algas de águas continentais que ocorrem no Brasil, que se encontra na terceira edição; e a realização da flora ficológica mais completa já produzida em nível brasileiro, a do Parque Estadual das Fontes do Ipiranga que soma, em fase de finalização, 919 táxons.

Mental health of Brazilian university students during the Covid-19 / Saúde mental dos estudantes universitários brasileiros durante a pandemia de Covid-19 / Salud mental de estudiantes universitarios brasileños durante la pandemia Covid-19

This study aimed to investigate the effects of positive and negative affects, anxiety, and obsessive and compulsive thoughts and behaviors on Brazilian university students during the Covid-19 pandemic. Participated in this study 492 students, aged 18 years or over, from all regions of the country. The survey was conducted between April and May 2020, using self-report instruments applied in the online format. The results indicated that 37% (N=182) of the students had a high level of anxiety and 46.1% (N=227) moderate levels for obsessive and compulsive thoughts and behaviors. In addition, it was found that positive affects were negatively correlated with anxiety, as well as with obsessive and compulsive thoughts and behaviors, while negative affects were positively correlated with independent variables. It is concluded that the mental health of university students must be monitored during pandemics.

Este estudo teve como objetivo investigar os efeitos dos afetos positivos e negativos, da ansiedade e dos pensamentos e comportamentos obsessivos e compulsivos nos estudantes universitários brasileiros durante a pandemia da Covid-19. Participaram deste estudo 492 estudantes de todas as regiões do país e com idades a partir de 18 anos. A pesquisa foi realizada entre os meses de abril e maio de 2020, por meio de instrumentos de autorrelatos aplicados no formato on-line. Os resultados indicaram que 37% (N = 182) dos estudantes apresentaram alto nível de ansiedade e 46,1% (N = 227) níveis moderados para os pensamentos e comportamentos obsessivos e compulsivos. Além disso, verificou-se que os afetos positivos se relacionaram negativamente à ansiedade, assim como se relacionaram negativamente aos pensamentos e comportamentos obsessivos e compulsivos, enquanto os afetos negativos se relacionaram positivamente às variáveis independentes. Conclui-se que a saúde mental dos estudantes universitários deve ser monitorada durante pandemias.

Este estudio tuvo como objetivo investigar los efectos de los afectos positivos y negativos, la ansiedad y los pensamientos y comportamientos obsesivos y compulsivos en estudiantes universitarios brasileños durante la pandemia de Covid-19. En este estudio participaron 492 estudiantes de todas las regiones del país y mayores de 18 años. La encuesta se realizó entre los meses de abril y mayo de 2020, utilizando instrumentos se autoinforme aplicados en formato online. Los resultados indicaron que el 37% (N = 182) de los estudiantes tenían niveles altos de ansiedad y el 46,1% (N = 227) niveles moderados de pensamientos y comportamientos obsesivos y compulsivos. Además, se encontró que los afectos positivos se correlacionaron negativamente con la ansiedad, así como el pensamiento y el comportamiento obsesivo y compulsivo se correlacionaron negativamente, mientras que los afectos negativos se correlacionaron positivamente con variables independientes. Se concluye que la salud mental de los estudiantes universitarios debe ser monitoreada durante las pandemias.

Family, religion, and sex education among women with vaginismus: a qualitative study / Família, religião e educação sexual em mulheres com vaginismo: um estudo qualitativo / Familia, religión y educación sexual en mujeres con vaginismo: un estudio cualitativo

The diagnosis and treatment of vaginismus are complex, involving biopsychological factors and insufficient etiological assessment. For this reason, we discuss the aspects implicated in vaginismus concerning religion, family, and sex education from the perspective of women affected by vaginismus. This qualitative, exploratory study addressed nine women who experienced vaginismus, accompanied by dyspareunia or not. Data were collected through semi-structured interviews and analyzed using content analysis. The results are distributed into two categories: learned concepts about sex and searching for knowledge to fill in information gaps concerning sexuality and sexual dysfunctions. Inadequate sex education leads to ignorance, rigidity, and misconceptions, generating insecurity. Thus, it is relevant to instruct and sensitize families, workers, and those in religious contexts regarding a healthy and constructive way to address sexuality while respecting beliefs and values. There is also a need to improve the health care services provided to this population.

O diagnóstico e o tratamento do vaginismo são complexos porque envolvem fatores biopsicossociais e insuficiente avaliação etiológica. Por conta disso, buscou-se discutir aspectos do vaginismo referentes à religião, família e educação sexual, sob a perspectiva de mulheres que apresentam essa disfunção. Trata-se de um estudo qualitativo, de caráter exploratório, com nove mulheres que experienciaram vaginismo acompanhado ou não de dispareunia. Os dados foram coletados por meio de entrevistas semiestruturadas e analisados a partir da análise de conteúdo. Os resultados foram dispostos em duas categorias referentes às concepções apreendidas sobre sexo e a busca por conhecimento diante das lacunas de informações sobre sexualidade e disfunções sexuais. Percebe-se que uma educação sexual inadequada propicia desconhecimento, rigidez e equívocos, o que gera insegurança. Portanto, é necessário instruir e conscientizar as famílias, os profissionais e os contextos religiosos acerca de formas saudáveis e construtivas de abordar a sexualidade, respeitando crenças e valores. Aponta-se ademais para a necessidade aprimoramento na prestação de serviços em saúde para essa população.

El diagnóstico y tratamiento del vaginismo son complejos, implican factores biopsicosociales y una evaluación etiológica insuficiente. Debido a esto, buscamos discutir aspectos del vaginismo relacionados con religión, familia y educación sexual, desde la perspectiva de las mujeres con vaginismo. Este es un estudio exploratorio cualitativo con nueve mujeres que experimentaron vaginismo, con o sin dispareunia. Los datos se recopilaron a través de entrevistas semiestructuradas y se analizaron en función del análisis de contenido. Los resultados fueron organizados en dos categorías con respecto a los conceptos aprendidos sobre sexo y la búsqueda de conocimiento frente a lagunas de información sobre sexualidad y disfunciones sexuales. Se percibe que una educación sexual inadecuada proporciona ignorancia, rigidez y malentendidos, generando inseguridad. Por lo tanto, es necesario instruir y crear conciencia entre familias, profesionales y contextos religiosos sobre formas saludables y constructivas de abordar la sexualidad, respetando creencias. También señala la necesidad de mejorar la provisión de servicios de salud para esta población.

Avaliação da ação germicida da luz ultravioleta de cabine de segurança biológica frente às espécies bacterianas / Evaluation of the germicidal action of ultraviolet light in biosafety cabinet concerning bacterial species

RESUMO: Introdução: A cabine de segurança biológica (CBS) é um equipamento de proteção coletiva, utilizado para efe-tuar a contenção de aerossóis produzidos nos procedimentos laboratoriais. A CBS protege tanto os trabalhadores, quanto o material manipulado e o meio ambiente. Dispõe de lâmpadas de luz ultravioleta (UV) que possui ação germicida, alterando os ácidos nucleicos dos micro-organismos. Objetivo: O objetivo do presente estudo foi avaliar a ação germicida da luz UV da CBS classe II, tipo A2, frente à cultura de duas espécies de bactérias com diferentes condições de exposição a luz UV. Material e Métodos: Para o desenvolvimento da pesquisa foram utilizadas as bactérias Staphylococcus aureus ATCC 25923 e Klebsiella pneumoniae ATCC 10031, na concentração de 1,5x108 Unidades Formadoras de Colônias/ml (UFC/ml), que após a semeadura em biplacas de Petri foram expostas à luz UV em diferentes condições e tempos. Resultados: Os resultados obtidos revelaram que as espécies de bactérias apresentaram igual perfil de crescimento ou inibição quando submetidas às diferentes condições de exposição. As biplacas de Petri com as tampas abertas e protegidas ou não com embalagem de esterilização apresentaram, nos tempos 15 e 20 minutos, inibição bacteriana. Nas biplacas protegidas pelo papel alumínio e nas biplacas com a tampa fechada, independentemente do tempo e da condição, os micro-organismos apresentaram crescimento bacteriano. Conclusão: Com os resultados obtidos, sugere-se que a ação germicida da luz UV foi eficaz, garantindo a descontaminação adequada e assegurando a qualidade na biossegurança laboratoria. (AU)

ABSTRACT: Introduction: The biological safety cabinet (BSC) is a collective protective device used to hold aerosols produced in laboratory procedures. The BSC protects workers, material handling, and the environment. It relies on ultraviolet light (UV) lamps that have germicidal action, altering the nucleic acids of microorganisms. Objective: The objective of the present study was to evaluate the germicidal action of BSC class II type A2 UV light against the culture of two bacterial species with different conditions of exposure to UV light. Methods: For the research, the bacteria Sta-phylococcus aureus ATCC 25923 and Klebsiella pneumoniae ATCC 10031 were used, at a concentration of 1.5x108Colony Forming Units/ml (CFU/ml), which were seeded in Petri biplates. Use UV light under different conditions and times. Results: The bacterial species showed the same growth or inhibition profile when subjected to different exposure conditions. Petri dishes with the cover open and protected or not with sterilization packaging showed bacterial inhibition at 15 and 20 minutes. The microorganisms in the biplates protected by the aluminum foil and in the biplates with the cover on, regardless of the time and condition, showed bacterial growth. Conclusion: With the results obtained, it is suggested that the germicidal action of UV light was effective, ensuring adequate decon-tamination and ensuring quality in laboratory biosafety. (AU)

Influence of treatment access on survival of metastatic renal cell carcinoma in brazilian cancer center

ABSTRACT Background: Tyrosine kinase inhibitors (TKI) and immunotherapy improved survival in metastatic renal cell carcinoma (mRCC). Disparities in treatment access are present in healthcare systems globally. The aim of this study was to analyze survival outcomes of mRCC patients treated with first-line TKIs in the public (PHS) and private (PrS) health system in a Brazilian Cancer Center. Materials and Methods: Records from all mRCC patients treated with first-line TKIs from 2007-2018 were reviewed retrospectively. Categorial variables were compared by Fisher's exact test. Survival was estimated by Kaplan-Maier method and survival curves were compared using the log-rank test. Prognostic factors were adjusted by Cox regression model. Results: Of the 171 eligible patients, 37 (21.6%) were PHS patients and 134 (78.4%) were PrS patients. There were no difference in age, gender, or sites of metastasis. PHS patients had worse performance status (ECOG ≥2, 35.1% vs. 13.5%, p=0.007), poorer risk score (IMDC poor risk, 32.4% vs. 16.4%, p=0.09), and less nephrectomies (73% vs. 92.5%, p=0.003) than PrS patients. Median lines of therapy was one for PHS versus two for PrS patients (p=0.03). Median overall survival (OS) was 16.5 versus 26.5 months (p=0.002) and progression-free survival (PFS), 8.4 versus 11 months (p=0.01) for PHS and PrS patients, respectively. After adjusting for known prognostic factors on multivariate analysis, PHS patients still had a higher risk of death (HR: 1.61, 95% CI: 1.01-2.56, p=0.047). Conclusion: Patients with mRCC treated via the PHS had worse overall survival, possibly due to poorer prognosis at presentation and less drug access.

Predictors of gaming disorder in children and adolescents: a school-based study

Objective: To determine whether psychiatric and gaming pattern variables are associated with gaming disorder in a school-based sample. Methods: We analyzed data from the Brazilian High-Risk Cohort for Psychiatric Disorders, a community sample aged 10 to 18, using questionnaires on gaming use patterns. We applied the Gaming Addiction Scale to diagnose gaming disorder and the Development and Well-Being Behavior Assessment for other diagnoses. Results: Out of 407 subjects, 83 (20.4%) fulfilled the criteria for gaming disorder. More role-playing game players were diagnosed with gaming disorder that any other genre. Gaming disorder rates increased proportionally to the number of genres played. Playing online, being diagnosed with a mental disorder, and more hours of non-stop gaming were associated with higher rates of gaming disorder. When all variables (including age and gender) were considered in a logistic regression model, the number of genres played, the number of non-stop hours, the proportion of online games, and having a diagnosed mental disorder emerged as significant predictors of gaming disorder. Conclusion: Each variable seems to add further risk of gaming disorder among children and adolescents. Monitoring the length of gaming sessions, the number and type of genres played, time spent gaming online, and behavior changes may help parents or guardians identify unhealthy patterns of gaming behavior.

Identification of dental calcification stages as a predictor of skeletal development phase

ABSTRACT Objective: This study aimed to establish a correlation between the stages of tooth calcification of mandibular canines and second molars with the phases of skeletal development. Methods: In a consecutive series of panoramic, cephalometric and hand-wrist radiographs of 113 individuals (60 females and 53 males) with an average age of 12.24 ± 1.81 years, the stages of mandibular canine and second molar calcification, cervical vertebrae maturation indicators (CVMI) and skeletal maturity indicators (SMI) were classified. The variables were correlated by means of the Spearman's Rank test: chronological age, SMI, CVMI and tooth calcification stages. In order to assess whether the CVMI and tooth calcification stages were significant predictors of the SMI, an ordinal regression analysis was carried out. Results: The stages of CVMI (OR = 16.92; CI 95% = 6.45-44.39; p< 0.001) and calcification of the second molars (OR = 3.22; CI 95% = 1.50-6.92; p= 0.003) were significant predictors of SMI, however similar result was not observed for canines (OR = 0.52, CI 95% = 0.18-1.54; p= 0.239). Calcification stage E for boys, and E and F for girls corresponded to the pre-peak phase of pubertal growth. Stages G and H for boys, and F and G for girls coincided with peak of growth. In the final growth phase, the majority of second molars presented with root apex closure (stage H). Conclusion: The stages of calcification of the second molar may be considered predictors of the stage of skeletal development in the population studied.

RESUMO Objetivo: O presente estudo objetivou estabelecer uma correlação entre os estágios de calcificação dentária de caninos e segundos molares inferiores e as fases do desenvolvimento esquelético. Métodos: Em uma série consecutiva de radiografias panorâmicas, cefalométricas e de mão e punho de 113 indivíduos (60 meninas e 53 meninos) com idade média de 12,24 ± 1,81 anos, foram classificados os estágios de calcificação do canino e do segundo molar inferiores, indicadores de maturação das vértebras cervicais (IMVC) e indicadores de maturação esquelética (IME). As variáveis foram correlacionadas pelo teste de Correlação de Rank de Spearman: idade cronológica, IME, IMVC e estágios de calcificação dentária. A fim de avaliar se os estágios do IMVC e da calcificação dentária foram preditores significativos do IME, foi realizada uma análise de regressão ordinal. Resultados: Os estágios de IMVC (OR = 16,92; IC 95% = 6,45-44,39; p< 0,001) e calcificação dos segundos molares (OR = 3,22; IC 95% = 1,50-6,92; p= 0,003) foram preditores significativos de IME; no entanto, esse não foi o caso com dentes caninos (OR = 0,52, IC 95% = 0,18-1,54; p= 0,239). Os estágios de calcificação E para meninos e E e F para meninas corresponderam à fase pré-pico de crescimento puberal. Os estágios G e H para meninos e F e G para meninas coincidiram com o pico de crescimento. Na fase final de crescimento, a maioria dos segundos molares apresentou fechamento do ápice radicular (estágio H). Conclusão: Os estágios de calcificação do segundo molar podem ser considerados preditores do estágio de desenvolvimento esquelético na população estudada.

Radiomic analysis of mri to predict sustained complete response after radiofrequency ablation in patients with hepatocellular carcinoma - a pilot study

OBJECTIVES: To investigate whether quantitative textural features, extracted from pretreatment MRI, can predict sustained complete response to radiofrequency ablation (RFA) in patients with hepatocellular carcinoma (HCC). METHODS: In this IRB-approved study, patients were selected from a maintained six-year database of consecutive patients who underwent both pretreatment MRI imaging with a probable or definitive imaging diagnosis of HCC (LI-RADS 4 or 5) and loco-regional treatment with RFA. An experienced radiologist manually segmented the hepatic nodules in MRI arterial and equilibrium phases to obtain the volume of interest (VOI) for extraction of 107 quantitative textural features, including shape and first- and second-order features. Statistical analysis was performed to evaluate associations between textural features and complete response. RESULTS: The study consisted of 34 patients with 51 treated hepatic nodules. Sustained complete response was achieved by 6 patients (4 with single nodule and 2 with multiple nodules). Of the 107 features from the arterial and equilibrium phases, 20 (18%) and 25 (23%) achieved AUC >0.7, respectively. The three best performing features were found in the equilibrium phase: Dependence Non-Uniformity Normalized and Dependence Variance (both GLDM class, with AUC of 0.78 and 0.76, respectively) and Maximum Probability (GLCM class, AUC of 0.76). CONCLUSIONS: This pilot study demonstrates that a radiomic analysis of pre-treatment MRI might be useful in identifying patients with HCC who are most likely to have a sustained complete response to RFA. Second-order features (GLDM and GLCM) extracted from equilibrium phase obtained highest discriminatory performance.

COMVC-19: A Program to protect healthcare workers' mental health during the COVID-19 Pandemic. What we have learned

OBJECTIVE: In 2020, the COVID-19 pandemic brought a work and stress overload to healthcare workers, increasing their vulnerability to mental health impairments. In response, the authors created the COMVC-19 program. The program offered preventive actions and mental health treatment for the 22,000 workers of The Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). This paper aims to describe its implementation and share what we have learned from this experience. METHODS: Workers were able to easily access the program through a 24/7 hotline. Additionally, a mobile phone app that screened for signs and symptoms of emotional distress and offered psychoeducation and/or referral to treatment was made available. Data from both these sources as well as any subsequent psychiatric evaluations were collected. RESULTS: The first 20 weeks of our project revealed that most participants were female, and part of the nursing staff working directly with COVID-19 patients. The most frequently reported symptoms were: anxiety, depression and sleep disturbances. The most common diagnoses were Adjustment, Anxiety, and Mood disorders. CONCLUSIONS: Implementing a mental health program in a multimodal intervention was feasible in a major quaternary public hospital. Our data also suggests that preventive actions should primarily be aimed at anxiety and depression symptoms, with a particular focus on the nursing staff.

Economic burden of chronic urticaria in Brazil: a 1 year real life study / Carga econômica da urticária crônica no Brasil: um estudo de vida real no período de 1 ano

Background: The costs of chronic urticaria (CU) are unknown in Brazil. The objective of this study was to describe the costs associated with the treatment of CU. Methods: This longitudinal, descriptive study recruited patients with chronic spontaneous urticaria and/or chronic inducible urticaria, who attended at least 4 visits to a specialized outpatient clinic within a 12-month period. Patients with other skin diseases and those who discontinued treatment were excluded. Patients underwent a provocation test and an objective evaluation, before receiving treatment according to the most recent guidelines. Data on direct and indirect costs of treatment were collected at each visit, and analyzed using Chisquare tests, the Mann-Whitney test, analysis of variance (ANOVA), paired t-tests, Tukey post-hoc tests and Wilcoxon tests. A p-value of 5% was considered significant. Results: From November 2016 to December 2018, 55 out of 68 enrolled patients completed the protocol. The cost of absenteeism was US$ 21,125.84 and that of transportation was US$ 3,755.69. The total indirect cost of CU was US$ 24,881.53 (US$ 452.39 per patient-year; SD, 461.11). The cost of medical appointments was US$ 3,838.17, and that of laboratory tests, US$ 6,607.39. The total cost of medications was US$ 174,697.58, of which US$ 141,582.91 was associated with the use of omalizumab in 12 patients. The total direct cost of CU was US$ 185,143.14 (US$ 3,366.23 per patient-year; SD, 6,446.58), resulting in an overall annual cost of US$ 210,024.67 (US$ 3,818.63 per patient-year). The higher the household income, the higher the costs of CU treatment. Conclusion: CU had a significant cost to the study population. The total estimated mean cost of illness was US$ 3,818.63 patient-year. The cost of medication was significantly increased by the use of omalizumab, an effective option for patients with CU refractory to high-dose antihistamine therapy, but a major contributor to the economic burden of patients with CU.

Introdução: Os custos da urticária crônica (UC) são desconhecidos no Brasil. O objetivo deste estudo é descrever os custos relacionados ao seu tratamento. Métodos: Estudo longitudinal descritivo de pacientes com urticária crônica espontânea e/ou urticária crônica induzível, que compareceram a pelo menos quatro consultas em um ambulatório especializado em um período de 12 meses. Foram excluídos aqueles com outras doenças de pele e que interromperam o tratamento. Os pacientes foram submetidos a testes de provocação, avaliação objetiva e tratamento de acordo com as diretrizes mais recentes. Dados sobre custos diretos e indiretos do tratamento foram coletados em cada visita. Foram utilizados os testes qui-quadrado, Mann-Whitney, Anova, t-pareado, post-hoc Tukey, e Wilcoxon's. Foi considerado significativo p < 0,05. Resultados: De novembro de 2016 a dezembro de 2018, 55 pacientes dos 68 inscritos completaram o protocolo. O custo do absenteísmo foi de US$ 21.125,84, e o transporte, de US$ 3.755,69. O custo indireto total foi de US$ 24.881,53 (US$ 452,39 paciente-ano; DP ± 61,11). As despesas com consultas foram de US$ 3.838,17, e o custo total de exames laboratoriais foi de US$ 6.607,39. O custo total com medicamentos foi de US$ 174.697,58, dos quais US$ 141.582,91 relacionados ao uso de omalizumabe em 12 pacientes. O custo direto total foi de US$ 185.143,12 (US$ 3.366,23 por paciente-ano, DP ± 6.446,58), resultando em um custo anual global relacionado à doença de US$ 210.024,67 (US$ 3.818,63 paciente-ano). Quanto maior a renda familiar, maiores os custos com a urticária crônica. Conclusão: A UC tem um custo significativo para a população do estudo. O custo médio total estimado foi de US$ 3.818,63 paciente-ano. Os altos custos com medicamentos, aumentados pelo uso do omalizumabe, que é uma opção eficaz em pacientes com altas doses de anti-histamínicos, resultam na maior carga econômica entre os pacientes com UC.

Childhood trauma and bipolar spectrum: a population-based sample of young adults

Abstract Introduction Childhood trauma has been suggested to be involved in susceptibility to bipolar disorder (BP). However, it remains unclear whether the occurrence of childhood trauma is differently distributed in subthreshold bipolar disorder (SBP). Objective To assess childhood trauma in young adults with SBP, as compared to young adults with BP and population controls (PC). Method This was a cross-sectional, population-based study. The Mini International Neuropsychiatric Interview (MINI) was used to define the groups with BP (subjects with a lifetime or current manic episode or lifetime or current hypomania with a history of a depressive episode), SBP (subjects with a history of hypomanic episode without lifetime or current depressive episode), and subjects without mood disorders (PC). Childhood trauma was assessed using de Childhood Trauma Questionnaire (CTQ). We investigated differences regarding childhood trauma across the three groups (BP, SBP and PC). Result Except for sexual abuse, all subtypes of childhood trauma remained associated with the BP group as compared to PC. Additionally, when we compared SBP and BP, significant differences were found only for emotional abuse. No significant differences were found in relation to childhood trauma between the SBP and PC groups after adjusting for confounding factors. Conclusion These findings suggest that investigating childhood trauma, with a particular focus on emotional abuse, could be considered a preventive measure and potentially improve the prognosis.

Factors associated with levels of empathy among students and professionals in the health field: a systematic review

Abstract Objective This study aimed to investigate factors associated with empathy and identify instruments used to measure this ability in professionals and students in the health field. Method A systematic review was performed. Searches were conducted on the PsycINFO, PubMed, Web of Science, and Scopus databases using the keywords "empathy" and "health professional". We selected 29 articles published in English, with no restriction imposed regarding the year of publication. Results Based on the findings of the articles selected, sociodemographic factors (female gender, being married, being older, having siblings, and having children) are associated with higher levels of empathy. Professional experience (years of practice) and being on the final years of the course also contributed to higher levels of empathy. Different versions of the Jefferson Scale of Empathy were the most prevalent assessment tools employed in the different studies. Conclusion The articles analyzed describe several factors that influence the level of empathy among health professionals and students. Thus, future studies should take sociodemographic factors into account when evaluating levels of empathy in this population.

Inventário abrangente de prosperidade: evidências de propriedades psicométricas no Brasil / Comprehensive inventory of thriving: evidence of psychometric properties in Brazil / Inventario integral de la prosperidad: evidencias de propiedades psicométricas en Brasil

O Inventário Abrangente de Prosperidade (IAP) constitui um instrumento que acessa o bem-estar, concebendo o construto numa perspectiva hedônica. Este estudo avaliou as propriedades psicométricas do IAP em 501 adultos brasileiros. A metodologia de análise consistiu em combinação entre análise fatorial confirmatória e análise de redes, incluindo também análise da confiabilidade e validade convergente. Os resultados confirmam a estrutura de 18 fatores de primeira ordem e a de sete fatores de segunda ordem original. O artigo também apresenta uma terceira estrutura com quatro fatores de segunda ordem - χ²/gl = 1,75, CFI = 0,92, TLI = 0,91, RMSEA = 0,042. Foram detectadas diferenças para o ajuste, considerando o sexo dos participantes, em que o modelo obtido tem melhor ajuste para homens. O IAP apresenta validade convergente ao se correlacionar positivamente com felicidade e florescimento no trabalho. Portanto, a versão brasileira do IAP apresenta evidências iniciais de validade para uso em adultos no Brasil. AU

The Comprehensive Inventory of Thriving (CIT) is an instrument that accesses well-being, conceiving the construct from a hedonic perspective. This study evaluated the psychometric properties of the IAP in 501 Brazilian adults. The framework of analysis consisted of a combination of confirmatory factor analysis and network analysis, including reliability analysis and convergent validity. The results confirm the structure of 18 first order factors and seven second order factors from the original research. The present study also presents a third structure with four second order factors - χ²/gl=1.75, CFI=.92, TLI=.91, RMSEA=.042. Differences were detected for the fit considering the gender of the participants, where the model obtained presented a better fit for men. The CIT has convergent validity, correlating positively with happiness and flourishing at work. Therefore, the Brazilian version of the CIT presents initial evidence of validity for use with adults in Brazil. AU

El Inventario Integral de la Prosperidad (IIP) constituye un instrumento que accede al bienestar, concibiendo el constructo en una perspectiva hedónica. Este estudio evaluó las propiedades psicométricas del IIP en 501 adultos brasileños. La metodología de análisis consistió en combinación entre el análisis factorial confirmatorio y el análisis de redes, incluyendo también el análisis de la confiabilidad y validez convergente. Los resultados confirman la estructura de dieciocho factores de primer orden y la de siete factores de segundo orden original. El artículo también presenta una tercera estructura con cuatro factores de segundo orden - χ²/gl=1.75, CFI=.92, TLI=.91, RMSEA=.042. Se detectaron diferencias para el ajuste considerando el sexo de los participantes, donde el modelo obtenido tiene mejor ajuste para hombres. El IIP presenta validez convergente al correlacionarse positivamente con felicidad y desarrollo profesional. Por lo tanto, la versión brasileña del IIP presenta evidencias iniciales de validez para uso en adultos en Brasil. AU