Contaminação pelo Covid-19 em profissionais de hospital de referência no Pará / Contamination by Covid-19 in professionals of a reference hospital in Para's state / Contaminación por Covid-19 en profesionales de un hospital de referencia del estado de Pará

A pandemia do novo coronavírus colocou em alerta os sistemas de saúde, estabelecendo sentimentos de instabilidade e de medo. O trabalho é e importante pilar para o traçado de políticas públicas. Objetivo: analisar a contaminação pelo COVID-19 em profissionais de hospital de referência no Pará. Metodologia: Trata-se de estudo retrospectivo, quantitativo, observacional, com aplicação de série temporal no período de março de 2020 a março de 2022. Foram incluídos todos os servidores atuantes durante a pandemia, que apresentaram atestados médicos com diagnóstico de COVID, e/ou testagem positiva, ou atestados por suspeita de contaminação. O perfil de servidores foi analisado, explorando as variáveis sexo, idade, convivência ou não com parceiros, grau de escolaridade, cargo e setor; juntamente com a incidência de casos confirmados e incidência total (suspeitos e confirmados). Resultados: O total de afastamentos do trabalho devido ao diagnóstico de COVID-19 foi de 1.420 casos, mais 839 casos suspeitos; sendo que 173 trabalhadores apresentaram reincidência. A incidência foi maior nos meses de maio de 2020, março de 2021 e janeiro de 2022. Houve predominância do sexo feminino e da categoria de enfermagem. Setores administrativos e financeiros apresentaram maior porcentagem de contaminados durante a pandemia (73,40%), proporcionalmente ao quantitativo de servidores atuantes na lotação. Entretanto, foram servidores da assistência direta ao paciente que apresentaram maior porcentagem de reinfecção. Conclusão: Foi possível visualizar três ondas na distribuição temporal dos casos de COVID-19, com destaque para elevação nos primeiros meses de 2022. O declínio no diagnóstico de casos novos no hospital estudado após dois anos de pandemia pode representar esforços individuais e coletivos em resistir às dificuldades da conjuntura. É importante observar o comportamento da pandemia em distintas regiões do Brasil para atualização de estratégias de enfrentamento como um todo.

The new coronavirus pandemic has put health systems on alert, establishing feelings of instability and fear. Working is an important pillar for the design of public policies. Objective: to analyze the contamination by COVID-19 in professionals of a reference hospital in Para's State. Methodology: This is a retrospective, quantitative, observational study, with the application of a time series from March 2020 to March 2022. All civil servants working during the pandemic, who presented medical certificates with a diagnosis of COVID, and/or or positive test, or attestations for suspected contamination. The servants' profile was analyzed, exploring the variables sex, age, living or not with partners, education level, position and sector; along with the incidence of confirmed cases and total incidence (suspected and confirmed). Results: The total number of absences from work due to the diagnosis of COVID-19 was 1,420 cases, plus 839 suspected cases; 173 workers presented recurrence. The incidence was higher in the months of May 2020, March 2021 and January 2022. There was a predominance of females and the nursing category. Administrative and financial sectors had a higher percentage of people infected during the pandemic (73.40%), proportionally to the number of servers working in the capacity. However, it was direct patient care workers who had the highest percentage of reinfection. Conclusion: It was possible to visualize three waves in the temporal distribution of COVID-19 cases, with emphasis on an increase in the first months of 2022. The decline in the diagnosis of new cases in the hospital studied after two years of the pandemic may represent individual and collective efforts to resist to the difficulties of the situation. It is important to observe the behavior of the pandemic in different regions of Brazil to update coping strategies in a general scenery.

La nueva pandemia de coronavirus ha puesto en alerta a los sistemas de salud, estableciendo sentimientos de inestabilidad y miedo. El trabajo es un pilar importante para el diseño de políticas públicas. Objetivo: analizar la contaminación por COVID-19 en profesionales de un hospital de referencia en el Estado de Pará. Metodología: Se trata de un estudio retrospectivo, cuantitativo, observacional, con la aplicación de una serie de tiempo de marzo de 2020 a marzo de 2022. Todos los funcionarios que trabajaron durante la pandemia, que presentaron certificados médicos con diagnóstico de COVID, y/o o test positivo, o atestados por sospecha de contaminación. Se analizó el perfil de los funcionarios, explorando las variables sexo, edad, convivencia o no con la pareja, nivel de escolaridad, cargo y sector; junto con la incidencia de casos confirmados y la incidencia total (sospechosos y confirmados). Resultados: El número total de bajas laborales por diagnóstico de COVID-19 fue de 1.420 casos, más 839 casos sospechosos; 173 trabajadores presentaron recurrencia. La incidencia fue mayor en los meses de mayo de 2020, marzo de 2021 y enero de 2022. Hubo predominio del sexo femenino y de la categoría de enfermería. Los sectores administrativo y financiero presentaron mayor porcentaje de infectados durante la pandemia (73,40%), proporcionalmente al número de servidores que trabajaban en esa función. Sin embargo, fueron los trabajadores de atención directa al paciente los que presentaron el mayor porcentaje de reinfección. Conclusiones: Fue posible visualizar tres olas en la distribución temporal de los casos de COVID-19, destacándose un aumento en los primeros meses de 2022. La disminución en el diagnóstico de nuevos casos en el hospital estudiado después de dos años de pandemia puede representar esfuerzos individuales y colectivos para resistir a las dificultades de la situación. Es importante observar el comportamiento de la pandemia en diferentes regiones de Brasil para actualizar las estrategias de afrontamiento en un escenario general.

First Evaluation of the Brazilian Advanced Life Support Training (TECA A)

Abstract Background Cardiac arrest (CA) is a common condition associated with high mortality. The Brazilian advanced life support training TECA A (Treinamento em Emergências Cardiovasculares Avançado — Advanced Cardiovascular Emergency Training) was created to train healthcare professionals in the management of CA. However, there are no studies evaluating the effectiveness of TECA A. Objective To assess the impact of TECA A on the management of CA using a simulated CA situation. Methods Fifty-six students underwent a simulated case of CA in a manikin. The students' performance in the management of CA was assessed for the time to first chest compression and defibrillation and for a global assessment score using a structured tool. These items were assessed and compared before and after the TECA A. Exclusion criteria were previous participation in CA trainings and absence from class. Categorical variables were compared using the McNemar test and quantitative variables using the Wilcoxon test. All tests were two-tailed, and statistical significance was set at p < 0.05. Results Compared with before TECA A, median global assessment scores were higher after TECA A (pre-training: 4.0 points [2.0-5.0] vs. 10 points [9.0-10.0]; p<0.001), the time to start chest compressions was shorter (pre-training: 25 seconds [15-34] vs. 19 seconds [16.2-23.0]; p=0.002) and so was the time to defibrillation (pre-training: 82.5 seconds [65.0-108.0] vs. 48 seconds [39.0-53.0]; p<0.001). Conclusions The TECA A promoted a higher adherence to cardiopulmonary resuscitation (CPR) guidelines and a reduction in the time elapsed from CA to first chest compression and defibrillation.

Correlação entre indicadores de desenvolvimento municipal e de saúde bucal em uma mesorregião metropolitana do Brasil / Correlation between municipal development indicators and oral health in a Brazilian metropolitan mesoregion

Resumo Introdução O estudo da relação entre indicadores sociais e indicadores de saúde bucal pode contribuir para a avaliação dos impactos das políticas e ações de saúde. Objetivo Investigar a correlação entre indicadores de desenvolvimento municipal e indicadores de saúde bucal dos municípios integrantes da mesorregião metropolitana de Curitiba, Paraná, Brasil. Método Estudo epidemiológico do tipo ecológico, por meio de dados referentes ao Índice de Desenvolvimento Humano Municipal (IDHM) do ano 2010, obtidos no portal Atlas Brasil; Índice Ipardes de Desempenho Municipal (IPDM) dos anos 2015 e 2016, obtidos no portal do Ipardes; e indicadores de saúde bucal dos anos 2015 a 2018, oriundos do SIA/SUS. Posteriormente, foi empregado o teste de correlação de Spearman. Resultados Verificou-se correlação positiva estatisticamente significativa entre indicadores de desenvolvimento municipal e indicadores de primeira consulta odontológica programática no ano de 2017; correlação negativa entre IDHMs e exodontias nos anos de 2015 e 2016; correlação positiva entre IPDMs e procedimentos odontológicos individuais básicos dos anos 2015 a 2018. Conclusão Houve correlação significativa entre os indicadores de desenvolvimento municipal e os indicadores de saúde bucal. Municípios com maiores índices de desenvolvimento proporcionaram maior acesso aos serviços de saúde bucal e menores proporções de exodontias por habitante.

Abstract Background The study of the correlation between social and oral health indicators can contribute to evaluating the impacts of health policies and actions. Objective To investigate the correlation between municipal development indicators and oral health indicators in the metropolitan region of Curitiba, Paraná, Brazil. Method Epidemiological study of the ecological type was carried out, using data from the Municipal Human Development Index (MHDI) of the year 2010, obtained from the Atlas Brasil portal; Ipardes Municipal Performance Index (IPDM) of the years 2015 and 2016, obtained from the Ipardes portal; and oral health indicators from 2015 to 2018, from SIA/SUS. Subsequently, the Spearman correlation test was used. Results There was a statistically significant positive correlation between municipal development indicators and indicators of the first programmatic dental consultation in 2017; a negative correlation between MHDI and tooth extractions, in the years 2015 and 2016; a positive correlation between IPDM and basic individual dental procedures from the years 2015 to 2018. Conclusion There was a significant correlation between the municipal development indicators and the oral health indicators. Municipalities with higher development rates provided greater access to oral health services and lower proportions of tooth extractions per inhabitant.

Living in the sunlight: micro-environments with higher exposure of sunlight have more abundance and diversity of Hymenoptera in a Brazilian Atlantic Forest fragment

ABSTRACT Tropical forests are three-dimensional with the presence of numerous micro-environments formed by horizontal and vertical gradients. Such micro-environments can affect the nesting preference of organisms, including the trap-nesting Hymenoptera. Bees and wasps are key elements in ecosystems and are considered as sensitive to environmental changes, and trap-nests sampling methodology is widely used in their ecological and conservation studies. However, many uncertainties remain about nesting site preferences. From this perspective, our aim is to assess the diversity descriptors of trap-nesting Hymenoptera in different micro-environments. The sampling was conducted on three micro-environments (canopy, understory and treefall gaps) replicated on ten permanent plots within a Brazilian Atlantic forest hotspot. In each micro-environment, we installed trap-nest stations made by a set of twenty bamboo artificial nests. We found 762 brood cells from ten wasp and five bee species. The rarefaction curves indicate the lower species richness in understory stations, while treefall gaps and canopy stations were not significantly different. We analyzed abundance, mortality and parasitism rates using generalized linear models, but only abundance varies significantly among micro-environments. Our data indicates that trap-nesting Hymenoptera prefer to nest in micro-environments with higher exposure of sunlight. Canopy and treefall gap assemblages are consistently more abundant and diverse than understory probably due the higher temperature and lower humidity. On the other hand, mortality, parasitism rates, and the species composition were similar among environments. Our hypothesis is that the species composition was not affected as these species have a foraging range that encompasses nearby micro-environments.

Prenatal repair of gastroschisis using partial carbon dioxide insufflation fetoscopy: lessons learned

ABSTRACT We report the long-term outcomes of a case of prenatal gastroschisis repair using a fully percutaneous fetoscopic approach with partial carbon dioxide insufflation. Surgery was performed as an experimental procedure before the scheduled elective birth. The fetal intestines were successfully returned to the abdominal cavity without any fetal or maternal complications. Ultrasonography performed 24 hours later revealed bowel peristalsis and no signs of fetal distress. After 48 hours, partial extrusion of the small bowel was observed, and the fetus was delivered. Gastroschisis repair was immediately performed upon delivery using the EXIT-like procedure as per our institutional protocol. The newborn did not require assisted mechanical ventilation, was discharged at 14 days of age and was then exclusively breastfed. At 3-year follow-up, the patient had no associated gastroschisis-related complications. This is the first case of prenatal repair of gastroschisis, which provides baseline knowledge for future researchers on the potential hurdles and management of prenatal repair.

Análise do teor de fluoretos nas águas de abastecimento público em um município da região metropolitana de Curitiba/PR: doze meses de heterocontrole / Analysis of fluoride content in the public water supply in a city of the metropolitan region of Curitiba/PR: twelve months of external control

Resumo Introdução A fluoretação das águas de abastecimento tem sido apontada em estudos nacionais e internacionais como a mais eficiente e equânime forma de acesso a fluoretos na prevenção da cárie dentária. Objetivo Relatar os resultados do heterocontrole nas águas de abastecimento público do município de Colombo/PR, no período de dezembro de 2013 a novembro de 2014. Método Foram coletadas amostras mensais em 15 Unidades Básicas de Saúde, em dias da semana aleatórios, no período de 12/2013 a 11/2014. As amostras foram analisadas pelo método eletrométrico na Faculdade de Odontologia da Universidade Federal Fluminense. Resultados Foram analisadas 180 amostras, que variaram de <0,001 a 1,480 mg/L (média 0,715±0,232 mg/L). De acordo com o critério estabelecido pelo Centro Colaborador do Ministério da Saúde em Vigilância da Saúde Bucal, 51,11% das amostras apresentavam níveis de fluoretos adequados, 13,34% concentrações de flúor acima do ideal, e 35,56% abaixo do ideal. Conclusão O heterocontrole representa uma das principais estratégias de vigilância em saúde bucal, e, dessa forma, deve ser implementado e efetuado em todas as regiões que utilizam água fluoretada, a fim de garantir a manutenção de níveis ótimos de fluoretos.

Abstract Background The fluoridation of water supply has been pointed out in national and international studies as the most efficient and equal way of accessing fluorides in the prevention of dental caries. Objective To report the results of heterocontrol in public water supply in the municipality of Colombo/PR, from December 2013 to November 2014. Method The samples were monthly collected in 15 Basic Health Units, on random days of the week, from 12/2013 to 11/2014. The samples were analyzed by the electrometric method at the Faculty of Dentistry of Fluminense Federal University. Results 180 samples were analyzed, ranging from <0.001 to 1.480 mg/L (mean 0.715 ± 0.232 mg/L). According to the criteria established by the Collaborating Center of the Ministry of Health in Oral Health Surveillance, 51.11% of the samples had adequate fluoride levels, 13.34% above ideal fluoride levels, and 35.56% below ideal levels. Conclusion Heterocontrol could represent one of the main strategies of oral health surveillance, and, therefore, it should be implemented and carried out in all regions that use fluoridated water, in order to guarantee the maintenance of optimal fluoride levels.

Virtual Case-Based Learning: Nova Estratégia de Ensino e de Treinamento Médico Digital Humanizado em Cardiologia / Learning: New Strategy for Humanized Digital Medical Education and Training in Cardiology

Resumo Fundamento A consolidação de novos paradigmas educacionais exige a implantação de estratégias inovadoras com potencial de transformar estudantes em profissionais competentes. Objetivos Analisar o conhecimento e a satisfação de estudantes antes e após a utilização de uma nova metodologia ativa de ensino médico de modelo digital humanizado chamada Virtual Case-Based Learning (VCBL). Métodos Estudo descritivo com análise documental sobre o processo de ensino-aprendizagem de estudantes de medicina. Dados obtidos da avaliação de conhecimento teórico e do instrumento de satisfação dos alunos nos anos de 2018 e 2019 foram analisados, e a nova metodologia proposta VCBL foi comparada com a metodologia ativa de ensino tradicional, o Problem-Based Learning (PBL). As análises descritivas e de associação foram realizadas utilizando o programa Statistical Package for the Social Sciences. Resultados Foram analisados 167 documentos aplicados a estudantes de medicina. Em relação à avaliação do conhecimento teórico, os alunos avaliados em 2018 obtiveram média 41,7%, comparados aos alunos de 2019 que alcançaram 73,3% (p<0,001). Entre os estudantes submetidos à avaliação da satisfação com a metodologia de aprendizagem proposta, 76,0% pontuaram o valor máximo para a questão um, e 83,0% para a questão número dois. Cerca de 70,0% dos estudantes classificaram positivamente o aprendizado adquirido após utilização da plataforma Paciente 360; 78,0% responderam que se sentem preparados para o atendimento ambulatorial; e 94,0% pontuaram de forma positiva a metodologia empregada. Conclusão Neste estudo inicial, os resultados indicaram que a nova ferramenta em metodologia ativa de ensino médico digital humanizado, o VCBL, pode auxiliar no aprimoramento do processo de ensino-aprendizagem, proporcionando conhecimento e satisfação dos estudantes.

Abstract Background The consolidation of new educational paradigms requires the implementation of innovative strategies to transform students into competent professionals. Objectives To assess knowledge and satisfaction of medical students before and after the use of a new humanized digital model of active learning, called virtual case-based learning (VCBL). Methods This was a descriptive, documentary analysis of the teaching-learning process of medical students. Data obtained from theoretical knowledge assessment and satisfaction evaluation questionnaires applied in 2018 and 2019 were analyzed, and the new VCBL was compared with the traditional active methodology PBL (problem-based learning). Descriptive and association analyses were made using the Statistical Package for the Social Sciences. Results A total of 167 evaluation forms administered to medical students were analyzed. In the evaluation of theoretical knowledge, the 2018 and the 2019 student groups had a mean of 41.7% and 73.3%, respectively (p<0.001). Among the students who responded to the satisfaction evaluation form, 76.0% gave the highest rating to question one, and 83.0% to question two. Nearly 70.0% of students positively evaluated knowledge acquisition with the Paciente 360 platform; 78.0% reported to feel prepared for working in outpatient care; and 94.0% positively evaluated the new method. Conclusion In this initial study, the results indicate that the new active method for humanized digital medical education, the VCBL, can help in the betterment of the teaching-learning process, promoting knowledge and satisfaction by the students.

Plantas medicinais na Atenção Primária à Saúde: riscos, toxicidade e potencial para interação medicamentosa / Medicinal plants in primary health care: risks, toxicity and potential for drug interaction

Visando contribuir para o fortalecimento do uso adequado de fitoterápicos na Atenção Primária à Saúde (APS), este estudo apresenta resultados de pesquisa exploratório-descritiva que buscou avaliar o risco associado ao uso de plantas medicinais. Foi realizado um levantamento etnobotânico e etnofarmacológico junto à população da área de abrangência de uma Unidade de Saúde da Família (USF) rural localizada em um município da região Sul do Brasil. Em 80,65% dos domicílios visitados, verificou-se que o uso terapêutico de plantas medicinais estava associado a medicamentos de uso contínuo, e 51,61% dos entrevistados relataram não comunicar o uso de plantas medicinais ao profissional de saúde. 58,33% das espécies identificadas apresentaram possíveis riscos, contraindicações ou toxicidade, e 35,83% apresentaram possíveis interações com medicamentos convencionais de acordo com a literatura consultada. Discute-se sobre os riscos associados ao uso dessas plantas nessa população, e apresentam-se sugestões e orientações para minimizar esses riscos.

To contribute to the strengthening of the appropriate use of herbal medicines in primary health care, this study presents the results of exploratory and descriptive research which sought to assess the risk associated with the use of medicinal plants. It was realized an ethnobotanical and ethnopharmacological survey, carried out with the population of the areacovered by a rural Family Health Care Unit located in a county in the South region of Brazil. In 80.65% of the households visited, it was found that the therapeutic use of medicinal plants was associated with continuous-use medications, and 51.61% of the interviewees reported not communicating the use of medicinal plants to the health professional. 58.33% of the identified species presented possible risks, contraindications, or toxicity, and 35.83% presented possible interactions with conventional drugs according to the literature consulted. It discusses the risks associated with the use of these plants in this population and offers suggestions and guidelines to minimize these risks.

Triatomine fauna in the state of Bahia, Brazil: What changed after 40 years of the vector-control program?

ABSTRACT Background: Neglected tropical diseases are a growing threat to global health, and endemic Chagas disease has emerged as one of the most important health problems in America. The main strategy to prevent Trypanosoma cruzi transmission is chemical control of vectors. This study presents a descriptive analysis of synanthropic triatomines before and after the implementation of a vector-control program in Bahia, Brazil. Methods: Descriptive analysis and geospatial statistics were performed on triatomine data, (1) the relative abundance and (2) proportional spatial distribution, from Bahia during two periods: (A) 1957 to 1971 and (B) 2006 to 2019. Results: We observed a decrease in the relative abundance of Panstrongylus megistus (A: n=22.032, 61.9%; B: n=1.842, 1.0%) and Triatoma infestans (A: n=1.310, 3.7%; B: n=763, 0.43%), as well as an increase in the relative abundance of T. sordida (A: n=8.314, 23.4%, B: n=146.901, 81.6%) and T. pseudomaculata (A: n=894, 2.5%, B: n=16.717, 9.3%). Conclusions: Our results indicate a clear reduction in the occurrence of P. megistus and T. infestans (last record in 2015) and an increase in the relative abundance and geographical distribution of T. sordida and T. pseudomaculata after 40 years of the vector-control program. The high frequency of other triatomine species in the municipalities of the state of Bahia and their abundance in recent years highlight the need to reinforce permanent entomological surveillance actions to prevent Chagas disease.

Os marcos legais das políticas públicas de plantas medicinais e fitoterápicos no Brasil / Legal frameworks of the public policies of medicinal plants and herbal medicines in Brazil

Apresenta-se resultado de pesquisa documental, cujo objetivo é verificar a evolução dos marcos legais associados às políticas públicas de plantas medicinais e fitoterápicos no Brasil. Realizou-se a identificação e análise do conteúdo de Leis, Decretos, Resoluções, Políticas, Portarias e Instruções Normativas relacionadas ao tema. Apesar de consideradas intrínsecas à cultura popular, a legislação instituiu-se de forma recente no Brasil. Constatou-se que as mudanças na legislação sanitária foram significativas e tornaram as exigências para o setor de fitoterápicos brasileiro, especialmente quanto à qualidade dos produtos, mais próximas dos padrões encontrados na legislação internacional. Porém, evidencia-se ainda uma carência de políticas públicas que incentivem a inserção dessas práticas dentro dos serviços de saúde, a fim de preencher a lacuna existente entre a regulamentação e a prática instituída nesses serviços.

A documentary research was carried out with the aim to verify the evolution of legal frameworks associated with public policies of medicinal plants and herbal medicines in Brazil. We conducted the identification and analysis of the content of Laws, Decrees, Resolutions, Policies, Administrative Rules, and Normative Instructions related to the topic. Although it is considered intrinsic to popular culture, legislation has been instituted in Brazil recently. It was found that changes in sanitary legislation were significant, which made the requirements for the Brazilian herbal medicine sector, especially regarding product quality, closer to the international standards. However, there is also a lack of public policies that encourage the insertion of these practices within the health services in order to fill the gap between the regulations and the practice established in these services.

A revised genus-level classification for the Neotropical groups of the cleptoparasitic bee tribe Sphecodini Schenck (Hymenoptera, Apidae, Halictinae)

Abstract Sphecodini are a clade of obligatory parasitic Halictinae, comprising 332 species and five genera worldwide. Recently, Sphecodes Latreille was considered polyphyletic according to the results of a molecular phylogeny. Morphological analysis of Neotropical groups revealed groups of species in Sphecodes s.l. that can be recognized at genus level to improve the classification of the tribe. The main objective of this study is to review the generic classification of Sphecodini, with emphasis on Neotropical groups. I propose Austrosphecodes Michener as a separate genus from Sphecodes s.s. and describe a new genus, Melissocleptis gen. nov. for eight known species. Both genera comprise most of the Neotropical species. Nesosphecodes depressus sp. nov. is described for Brazil and a revised diagnosis for Nesosphecodes Engel is given to accommodate this new species and to include data on male terminalia. A revised key for the genera from the Western Hemisphere is provided.

Phenotypic and genetic variation of Triatoma costalimai (Hemiptera: Reduviidae)

Abstract INTRODUCTION: We aimed to study intraspecific variation in Triatoma costalimai, a potential vector of Chagas disease present in Brazil and Bolivia. METHODS: We analyzed phenotypic (connexivum color patterns, wing morphometrics) and genetic variation (16S mtDNA) of three Brazilian T. costalimai populations. We compared 16S sequences with those of putative Bolivian T. costalimai and its sister species, T. jatai. RESULTS: Brazilian populations had different connexivum color patterns and forewing shapes. A 16S mtDNA haplotype network showed a clear separation of Brazilian T. costalimai from both T. jatai and Bolivian T. costalimai. CONCLUSIONS: We report considerable variability in T. costalimai populations.

Ecological impact and population status of non-native bees in a Brazilian urban environment

Abstract The introduction of species is an important global threat to native ecosystems and yet little is known about invasion risks of non-native bees. Moreover, urbanization is increasing rapidly around the world with impact on the bee fauna. The city of Curitiba (Brazil) could be considered a model system for studies under this scope, with historical samplings and monitoring programs since the 1940s. This paper aims to quantify the current ecological impact of the non-native bee species present in Curitiba by using an integrative measure of impact and to define their current population status by classifying them into a unified framework for biological invasions. Ten sites were actively sampled in the metropolitan area of Curitiba during ten months. In addition to Apis mellifera Linnaeus, 1758, we found two others non-native species, Anthidium manicatum (Linnaeus, 1758) and Melipona scutellaris Latreille, 1811. None of them changed the native bee community structure, but they got different values of impact due to their ranges and abundances. While the honeybee is a known invasive species, A. manicatum was also considered invasive and has persisted in the city since the 1940s, interacting with the non-native plant Leonurus japonicus Houtt. M. scutellaris, a cultivated stingless bee species, had its first record for the city and fits the casual non-native category. We suggest monitoring the non-native bee species and actions centered on beekeepers to avoid future illegal introductions. The honey production or hobby interest on stingless bees can offer additional obstacles for species conservation when decoupled of scientific knowledge.

Aplicações do Deep Learning para diagnóstico de doenças e identificação de insetos vetores / Deep Learning applications for disease diagnosis and identification of insect vectors

RESUMO Deep Learning é uma técnica de aprendizado de máquina na qual o programa computacional aprende padrões diretamente a partir de imagens classificadas previamente. O presente ensaio objetivou apresentar essa técnica e algumas de suas aplicações para diagnóstico de doenças e identificação de insetos vetores para incentivar profissionais da saúde que não tenham conhecimento aprofundado em informática e que desejem utilizar a ferramenta para realizar análises automatizadas. Deep Learning tem sido aplicado para diagnóstico de câncer, fibrose cardíaca, tuberculose, detecção de parasitos como Plasmodium e Leishmania e ainda para identificação de insetos vetores. Na Universidade de Brasília, a técnica tem sido aplicada para desenvolver uma ferramenta para identificar lesões ulceradas de leishmaniose em diagnóstico diferencial e para detectar Leishmania em lâminas de estudos histopatológicos. Além disso, Deep Learning tem sido usado para identificar as espécies de vetores da doença de Chagas - o que é importante para auxiliar na vigilância epidemiológica. O uso da tecnologia envolve desafios éticos e procedimentais que são discutidos no presente ensaio. O ensaio aponta perspectivas de desenvolvimento de aplicativos que auxiliem os profissionais de saúde no diagnóstico de Leishmaniose e de vetores da doença de Chagas, o que vai ao encontro dos objetivos da pesquisa translacional.

ABSTRACT Deep Learning is a machine learning technique in which the computational algorithm learns patterns directly from images previously classified. The present essay aims to show some of its applications for clinical diagnosis and identification of insect vectors to encourage health professionals who do not have deep knowledge of computer science and who wish to use the tool to perform automated analyzes. Deep Learning has been applied to the diagnosis of cancer, cardiac fibrosis, tuberculosis, detection of parasites such as Plasmodium and Leishmania, and to identify insect vectors. At the University of Brasília, Deep Learning has been used to develop a tool to identify ulcers caused by leishmaniasis, as well as to detect Leishmania parasites. Moreover, Deep Learning was applied to identify the species of vectors of Chagas disease, an important contribution to the epidemiological surveillance of the disease. The use of Deep Learning involves some ethical and procedural issues that are discussed in this paper. Finally, the essay points out perspectives of development of apps that assist health professionals in the diagnosis of Leishmaniasis and Chagas disease vectors, which meets the goals of translational research.

Phylogeny of the Augochlora clade with the description of four new species (Hymenoptera, Apoidea)

ABSTRACT The Augochlora clade includes four genera: Augochlora Smith, Augochlorella Sandhouse, Ceratalictus Moure, and Pereirapis Moure. This is one of the richest and most widespread groups of Augochlorini bees. There are about 150 species, which occur from Argentina to Canada. The species of Augochlora clade are considered solitary to facultatively social, except Ceratalictus for which nothing is known. Wood nesting behavior arose once in the clade, in Augochlora sensu strictu. The objective of this study is to describe four new species and to present a revised phylogenetic analysis of the Augochlora clade for the placement of these species. The morphological matrix comprised 77 characters and 42 terminals, and resulted in two most parsimonious trees. The monophyly of the Augochlora clade is corroborated. Ceratalictus and Pereirapis are considered as sister groups and Ceratalictus inflexus sp. nov. came as sister to other species of Ceratalictus. Augochlora and Augochlorella are monophyletic and sister groups. Both extant subgenera of Augochlora were corroborated as monophyletic. Augochlorella comis is considered as sister group to the rest of Augochlorella species. All Augochlorella new species described belong to the Augochlorella ephyra group. Augochlorella kelliae sp. nov. is phylogenetically related to Augochlorella una. Augochlorella procliva sp. nov. and Augochlorella mavricera sp. nov. constitute a clade with Augochlorella acarinata. Including the new species, Augochlorella has 19 species and Ceratalictus 11 species. A revised key for species of Augochlorella and Ceratalictus is also presented in the Supplementary Information.

DNA damage and primordial follicle activation after in vitro culture of sheep ovarian cortex in Morus nigra leaf extract / Dano ao DNA e ativação do folículo primordial após a cultivo in vitro do córtex ovariano de ovelha em extrato de folha de Morus nigra

This study evaluated the effect of Morus nigra leaf extract, with or without supplementation, on morphology, activation and DNA damage of preantral follicles cultured within sheep ovarian tissue. Ovaries were collected and divided into fragments, being one fixed for histological and Terminal deoxynucleotidyl transferase (TdT) mediated dUTP nick-end labeling (TUNEL) analysis (fresh control). The remaining fragments were cultured for 7 days in alpha minimum essential media (α-MEM) supplemented with bovine serum albumin (BSA), insulin, transferrin, selenium, glutamine, hypoxanthine and ascorbic acid (α-MEM+; control medium) or into medium composed of M. nigra extract without supplements (0.1; 0.2 or 0.4mg/mL) or supplemented with the same substances described above for α-MEM+ (MN 0.1+; 0.2+ or 0.4+mg/mL). Then, tissues were destined to histological and TUNEL analysis. The α-MEM+ treatment had more morphologically normal follicles than all M. nigra extract treatments. However, α-MEM+ treatment also showed signs of atresia because the percentage of TUNEL positive cells was similar in α-MEM+ and in 0.1mg/mL M. nigra without and with supplements. Moreover, a reduction in the primordial follicles and an increase in the growing ones were observed in all treatments, except 0.2mg/mL M. nigra. In conclusion, the follicles cultured at 0.1mg/mL M. nigra extract were in good condition and able to continue their development, as demonstrated by the same rates of DNA damage and follicular activation as the control medium.(AU)

Este estudo avaliou o efeito do extrato das folhas de Morus nigra, com ou sem suplementos, sobre a morfologia, a ativação e o dano ao DNA de folículos pré-antrais cultivados inclusos em tecido ovariano. Os ovários foram coletados e divididos em fragmentos, sendo um fixado para análise histológica e ensaio de marcação de terminações dUTP mediada por desoxinucleotidil transferase terminal (TUNEL) (controle fresco). Os fragmentos restantes foram cultivados durante 7 dias em meio essencial mínimo alfa (α-MEM) suplementado com albumina sérica bovina (BSA), insulina, transferrina, selênio, glutamina, hipoxantina e ácido ascorbico (α-MEM+; meio controle) ou em meio composto de extrato de M. nigra sem suplementos (0,1; 0,2 or 0,4mg/mL) ou suplementado com as mesmas substâncias descritas para α-MEM+ (MN 0,1+; 0,2+ or 0,4+mg/mL). Então, os tecidos foram destinados à análise histológica e TUNEL. O tratamento do α-MEM+ apresentou mais folículos morfologicamente normais que todos os tratamentos do extrato de M. nigra. No entanto, o tratamento com α-MEM+ também mostrou sinais de atresia, pois a porcentagem de células TUNEL positivas foi semelhante em α-MEM+ e em 0,1mg/mL M. nigra sem e com suplementos. Além disso, observou-se uma redução nos folículos primordiais e um aumento nos folículos em crescimento em todos os tratamentos, exceto 0,2mg/mL M. nigra. Em conclusão, os folículos cultivados com 0,1mg/mL de extrato de M. nigra estavam em boas condições e aptos a continuar seu desenvolvimento, como demonstrado pelas taxas de dano ao DNA e de ativação folicular semelhantes ao meio controle.(AU)

Desempenho dos Centros de Especialidades Odontológicas da 2ª Regional de Saúde do Paraná / Performance of Dental Care Specialties Centers of the 2nd Health Regional from Paraná

Resumo Introdução Os Centros de Especialidades Odontológicas (CEO) possuem papel importante na redução das iniquidades de acesso aos serviços odontológicos especializados. Assim, eles devem ser avaliados em prol da melhoria contínua do seu desempenho. Objetivo Avaliar o cumprimento das metas de desempenho dos CEO da 2ª Regional de Saúde do Paraná. Método Procedeu-se à avaliação do desempenho dos CEO, por meio do indicador de cumprimento global de metas e indicadores socioeconômicos. Para tal, foram utilizados dados secundários de 2014 do Sistema de Informação Ambulatorial do Sistema Único de Saúde (SIA/SUS), do Cadastro Nacional de Estabelecimentos de Saúde (CNES) e do Instituto Brasileiro de Geografia e Estatística (IBGE). Resultados Em 2014, apenas o CEO do município de Colombo apresentou desempenho ruim (cumprimento de nenhuma meta), estabelecendo divergência ao desempenho ótimo (cumprimento das três metas) obtido pelos demais municípios. Conclusão O desempenho dos CEO sofre influência das caraterísticas contextuais atinentes à região em que estão inseridos. Portanto, observa-se a necessidade de repensar os métodos de avaliação desses estabelecimentos por meio da construção de instrumentos de avaliação que ponderem a singularidade de cada região.

Abstract Background The Dental Specialist Centers (CEO) have an important role in reducing the iniquities of access to specialized dental services. Thus, they should be evaluated for the continuous improvement of their performance. Objective To evaluate compliance with the performance goals of the CEO of the 2nd Health Regional of Paraná. Method The performance of the CEO was assessed by the Global Goal Compliance indicator and socioeconomic indicators. For that, secondary data from 2014 of the Outpatient Information System of the Unified Health System (SIA/SUS), the National Register of Health Establishments (CNES) and the Brazilian Institute of Geography and Statistics (IBGE) were used. Results In 2014, only the CEO of the municipality of Colombo presented poor performance (meeting no goal), establishing divergence to the optimal performance (compliance with the 3 goals) obtained by the other municipalities studied. Conclusion The performance of CEOs is influenced by the contextual characteristics of the region in which they are inserted. Therefore, it is necessary to rethink the evaluation methods of these establishments, through the construction of evaluation instruments that consider the singularity of each region.