Perceptions about Aging and Ageism from 14 Cross-sectional Cohorts of Undergraduate Dental Students.

BACKGROUND: Although positive and negative views of aging and older adults exist, how undergraduate dental students imagine their lives to be as they grow older remains to be fully explored. This study aimed at determining the self-perceived views of being 65, 75, or 85 y of age, as expressed by undergraduate dental students at the University of British Columbia (UBC), Vancouver, Canada. METHODS: A 14-y cross-sectional study design was utilized involving third-year undergraduate dental students at UBC's Faculty of Dentistry. Brief individual essays (150 words) encompassing students' self-perceived views were gathered as part of a dental geriatric course from 2009 to 2022; however, essays were not mandatory. Saldaña's inductive coding and thematic analysis of textual data were used. Themes and categories of information were identified and matched with their excerpts while aiming for data saturation. RESULTS: Over the 14-y period, 657 students were enrolled in UBC's undergraduate dental geriatric course, and 561 essays were collected. Inductive coding and thematic analysis identified 5 main themes and 11 categories. While themes included "oral health, general health, and the mind" and "me, myself, and familial relationships," the categories focused on "(un)able bodies" and "general health." Positive views about the aging process were shared, while less optimistic ideas-and even ageism-were apparent when students saw themselves as not employable or living in isolation. Positive and negative views were not bound by the students' academic year but might have been influenced by the COVID-19 pandemic. CONCLUSION: Although the number of older adults already surpasses the number of children in many countries, ageism appears to have permeated through students' views of 3 older ages. More positive yet realistic views of growing older were also shared. Follow-up studies are needed to explore the impact of dental education on decreasing ageism. KNOWLEDGE TRANSFER STATEMENT: As the proportion of older adults in the global population steadily grows, it is important to educate heath care providers about normal and pathologic aging to avoid ageism-stereotypes, prejudices, and discrimination against older adults. This cross-sectional study involved 14 cohorts of undergraduate dental students exploring their self-perceived views of growing older. Although positive and negative views of aging were shared, dental education must focus on decreasing ageism.

Marketing strategies to maintain and attract customers during the COVID-19 pandemic in gyms of Ribeirao Preto-SP, Brazil

Introduction: Brazil is ranked third in the world in fitness service billing, with 34,509 registered gyms. However, the COVID-19 pandemic brought challenges and a drop in this revenue. Consequently, the gyms were forced to adopt new management and marketing strategies to stay in the market facing the contemporary context. Background: To identify the sports marketing strategies used by gym managers in Ribeirao Preto, SP, Brazil, to keep and attract new customers during the COVID-19 pandemic. Methods: A qualitative study was performed through semi-structured interviews, conducted through the Google Meet tool, recorded to be transcribed and analyzed. Results: Among the strategies used by the six managers interviewed stand out: gym safety and cleanliness as marketing;the prioritization of the relationship with customers as the main form of retention;the overuse of bonus marketing;packages and more attractive monthly fees to keep and at the same time attract new customers;and, also the use of social networks as the main form of attraction. The problems were similar among the managers, with at least 1/3 indicating the lack of a specific budget for marketing, centralized campaigns in other locations or franchises, inefficient live broadcasts, and traditional marketing with a very high cost. Final words: The managers needed to overcome the pandemic obstacles to plan and promote marketing strategies for gyms with different objectives, public, and size. There are still few studies on the relationship between marketing and Brazil's fitness market, highlighting the importance of more studies that address this theme.

Acidente Vascular Encefalico Isquemico Associado a Plaquetopenia Apos Vacinacao Para Covid-19

Objetivo: Relatar caso de Trombocitopenia Trombotica Imune induzida por Vacina (VITT) ocorrido na cidade de Uberaba - MG. Resultado: Paciente, 22 anos, admitida no dia 14/04/22 em Pronto Atendimento (PA) da cidade de Uberaba devido quadro de cefaleia, febre e plaquetopenia. Pela suspeita de dengue, foi internada em Unidade de Terapia Intensiva, onde realizou AngioTC de cranio, sem evidencia de tromboses ou sangramentos. Dado inicio de recuperacao plaquetaria e estabilidade clinica, recebeu alta hospitalar dois dias apos. Os testes laboratoriais para dengue foram negativos. Entretanto, retornou ao PA depois de 8 dias devido a rebaixamento do nivel de consciencia, com exame de imagem evidenciando isquemia em lobo parietal esquerdo com transformacao hemorragica. Propedeutica laboratorial mostrava plaquetopenia moderada, dimero D elevado (12.670) e hipofibrinogenemia. Dada a informacao sobre historico de vacinacao com Astrazeneca 10 dias antes de abertura do quadro, foi levantada suspeita de VITT e iniciada terapia com imunoglobulina humana e corticoide em dose imunossupressora, e solicitada pesquisa de anticorpos Antifator-4-Plaquetario (anti-F4P). A anticoagulacao foi contraindicada devido a gravidade do sangramento em sistema nervoso central e previsao de possivel abordagem cirurgica. Apesar da terapia instituida, paciente evoluiu com novas complicacoes tromboticas em outros sitios (pulmonar e membro inferior) e novas areas de isquemia em sistema nervoso central associado a sangramento, culminando no obito 6 dias apos a readmissao. Posteriormente, o resultado do anti-F4P foi liberado como reativo em altos titulos (IgG: 2996, IgM + IgA + IgG: 2631 sendo o valor de referencia menor que 0,4), preenchendo assim os criterios diagnosticos para VITT. Discussao: Durante a pandemia de COVID-19, em resposta ao crescente numero de casos e mortes, e ao consequente impacto economico e social resultante, vacinas foram desenvolvidas e administradas em campanhas de vacinacao no mundo inteiro. Neste contexto, efeitos colaterais raros associados a vacina comecaram a ser observados. Dentre eles, destaca-se a VITT, a qual e uma condicao rara e grave, descrita quase exclusivamente apos a AstraZeneca-Oxford e Johnson & Johnson, sem predominio entre os sexos, e com maior risco relatado em individuos mais jovens. O principal mecanismo fisiopatologico descrito, assim como ocorre na trombocitopenia induzida por Heparina (HIT), e o desenvolvimento de anticorpos contra o fator-4-plaquetario, porem a forma como a vacina induz esta resposta imunologica ainda nao e bem compreendida. Clinicamente apresenta-se como uma coagulopatia que se desenvolve 5 a 30 dias apos a vacinacao, com trombose venosa e/ou arterial, plaquetopenia, D-dimero elevado e hipofibrinogenemia, alem da presenca de anti-F4P. O tratamento assemelha-se ao de HIT, baseando-se em modulacao da resposta autoimune e anticoagulacao (opcoes sem heparina). A paciente descrita apresentou todos os criterios definidores de VITT. Conclusao: A VITT e uma entidade de identificacao recente, com poucos casos descritos em literatura, e, portanto, com fisiopatologia, clinica e arsenal terapeutico ainda em estudo. Os estudos evidenciam alta taxa de mortalidade, principalmente em pacientes que evoluem com complicacoes hemorragicas. A divulgacao de casos clinicos visa enriquecer o conhecimento disponivel sobre esta condicao e ressaltar a importancia da suspeicao precoce e instituicao de terapia direcionada. Copyright © 2022

OPPORTUNITIES FOR INSTRUCTIONAL CRISIS COMMUNICATION THROUGH SOCIAL MEDIA Communicating Self-Protective Actions for Food Safety during the COVID-19 Pandemic

Health-related crises, particularly pandemics, create considerable uncertainty and fear. Addressing this fear, uncertainty, and resulting confusion requires instructional crisis communication that promotes cognitive, affective, and behavioral learning. The primary objective of this instruction is to promote self-protective actions that are proven through empirical evidence to reduce an individual's risk. During the first months of the COVID-19 crisis in the United States, considerable concern and confusion emerged among publics about the safety of their food and the potential contamination of food packaging. Using the IDEA model (emphasizing internalization of risk, explanation of the crisis, distribution of the messages, and action steps for protection), we analyzed the communication efforts of the International Food Information Council (IFIC) to provide accurate, evidence-based instructional information to consumers through social media about the food-related risk of contracting COVID-19. IFIC has over 500,000 followers (@foodinsight on Facebook, Twitter, Instagram) and more than 3.5 million consumers visit the IFIC website (https://foodinsight.org/) annually. This analysis suggests that instructional crisis communication must be nimble enough to adjust to the changing needs of those at risk and consistent enough to provide viewers with trustworthy and stable guidelines for ongoing safety and protection. © 2022 Taylor and Francis.

Communicating the Science of COVID-19 to Children: Meet the Helpers

This chapter describes and evaluates WUCF’s efforts to adapt their Meet the Helpers program to address the long-standing threat of a global pandemic. It offers a more detailed review of the IDEA (internalization, distribution, explanation, and action) model and introduce the concept of collective efficacy as the ultimate behavioral learning outcome desired in response to COVID’19. The IDEA model has demonstrated its utility as a viable framework for designing and distributing effective instructional messages for mitigating harm and taking protective actions, thereby, providing the theoretical grounding for this analysis. The chapter describes the adaptations made in the Meet the Helpers program to meet the challenge of collective efficacy. Meet the Helpers was distributed through a variety of channels with a consistent message about what the coronavirus is and how to stay safe and healthy. The chapter provides conclusions and recommendations for communicating collective efficacy to children in healthrelated crises such as pandemics. © 2021 John Wiley and Sons Inc.

ROLLING CIRCLE AMPLIFICATION-ON-A-CHIP TOWARDS PORTABLE ISOTHERMAL DETECTION OF SARS-COV-2 RNA

Rolling Circle Amplification (RCA) has shown significant potential for pathogen diagnostics providing high specificity and sensitivity combined with relatively low temperature (<37 °C) isothermal amplification. In the context of the ongoing COVID-19 pandemic, we report the development of an RCA-based method allowing direct detection of SARS-CoV-2 RNA in microfluidics. The viral RNA was hybridized to biotinylated oligos and L-probes in solution, enriched in a microchannel and subsequently amplified in situ using padlock probes against the L-probes. This method allowed the detection of 1x103 viral copies/μL within 90 minutes of amplification, demonstrating an alternative approach to current isothermal amplification methods. © 2021 MicroTAS 2021 - 25th International Conference on Miniaturized Systems for Chemistry and Life Sciences. All rights reserved.

POINT-OF-CARE ISOTHERMAL NUCLEIC ACID AMPLIFICATION PLATFORM FOR COVID-19 DIAGNOSTICS IN RESOURCE-LIMITED SETTINGS

The demand for scalable, rapid and sensitive COVID-19 diagnostics is particularly pressing at present to help contain the spread of infection and prevent overwhelming the capacity of health systems. While high-income countries have managed to rapidly expand diagnostic capacities, such is not the case in resource-limited settings of low- to medium-income countries. We report the development of an integrated modular centrifugal microfluidic platform costing less than 250 USD to perform loop-mediated isothermal amplification (LAMP) of viral RNA directly from heat-inactivated nasopharyngeal swab samples. The platform was validated with a panel of 131 nasopharyngeal swab samples collected from symptomatic COVID-19 patients. © 2021 MicroTAS 2021 - 25th International Conference on Miniaturized Systems for Chemistry and Life Sciences. All rights reserved.

SINGLE-STEP QUANTIFICATION OF SPECIFIC NUCLEIC ACID SEQUENCES IN MICROFLUIDICS USING A MULTILABELED HYBRID DNA DUPLEX

The rapid and specific detection of nucleic acid sequences is highly demanded for several applications including pathogen diagnostics, quality control of biopharmaceutical products and forensics. Nucleic acid amplification methods based on mixtures of primers and polymerase enzymes such as polymerase chain reaction (PCR) and other isothermal methods are typically the standard approach. Here, using SARS-CoV-2 ORF1ab sequence as a model, we report the development of a simple enzyme-free and single-step competitive hybridization method allowing the specific detection of any type of nucleic acid sequence (ss/dsDNA or RNA) within 15 min with 89% sequence homology and sensitivity in the pM-range. © 2021 MicroTAS 2021 - 25th International Conference on Miniaturized Systems for Chemistry and Life Sciences. All rights reserved.

Digital detection and quantification of SARS-CoV-2 in a droplet microfluidic all-fiber device

Silica fibers and capillaries offer opportunities for compact integration of optics with microfluidics while adding advantages such as;flexibility within a high aspect ratio format, uniaxial arrangements, and measurement-at-a-distance. Here, we describe droplet microfluidics-based nucleic acid detection of SARS-CoV-2 in a lab-in-a-fiber platform. The fiber component integrates three modules with key functions: droplet generation, incubation, and fluorescence detection. Within the scope of this work, we developed the component specifically to target the quantification of SARS-CoV-2 viral RNA through reverse-transcription loop-mediated isothermal amplification (RT-LAMP). The all-fiber component could successfully generate uniform droplets and differentiate pre-amplified positive LAMP reaction from negative sample. © 2021 MicroTAS 2021 - 25th International Conference on Miniaturized Systems for Chemistry and Life Sciences. All rights reserved.

IMPACTO DA PANDEMIA DE COVID-19 NO MOVIMENTO TRANSFUSIONAL DE HOSPITAL ONCOLÓGICO DE SÃO PAULO

Introdução: A pandemia de COVID-19 trouxe uma série de impactos sociais, econômicos, culturais e políticos para o país e o mundo. Na saúde, observamos a sobrecarga do sistema, com mudança do perfil epidemiológico dos pacientes e necessidade de reestruturação da rede de atendimento devido à alta transmissibilidade do vírus. No setor privado, observamos ainda redução das internações por doenças crônicas não transmissíveis e das cirurgias eletivas. Objetivo: Avaliar o impacto da pandemia COVID-19 na demanda transfusional de um hospital privado de perfil oncológico na cidade de São Paulo. Método: Realizada análise retrospectiva, a partir de dados dos sistemas informatizados, do número total de hemocomponentes transfundidos. O movimento médio transfusional foi correlacionado com a taxa de ocupação hospitalar e oscilações de fases da pandemia na cidade de São Paulo. Resultados: Em 2019 tivemos um total de 7.869 transfusões e média mensal de 656 transfusões. Enquanto a taxa de ocupação média ficou em 86,04%. Em 2020 tivemos 6.618 transfusões, com média de 551 transfusões/mês e taxa de ocupação de 83,67%. No primeiro semestre de 2021 foram realizadas 3.472 transfusões, com média de 579 transfusões/mês e taxa média de ocupação de 83,07%. Analisando mês a mês, observamos as piores taxas transfusionais nos meses de maio, junho e julho de 2020 e todo período de 2021. As oscilações de fase da pandemia de covid-19 tiveram picos expressivos em julho e agosto de 2020 e março e abril de 2021. Discussão: Pacientes oncológicos, principalmente onco-hematológicos, demandam um elevado suporte transfusional durante o tratamento, não podendo ser postergado em grande parte dos casos. Os pacientes oncológicos, devido a imunossupressão, fazem parte do grupo de risco para Covid-19. Com isso, foram implantadas rigorosas medidas para contenção da propagação do vírus, tornando seguros os ambientes e atendimento, reduzindo o risco de exposição para os pacientes e colaboradores, como a restrição de acesso para visitantes e acompanhantes, reagendamento de consultas e cirurgias, fechamento do pronto socorro e encaminhamento dos casos suspeitos para rede referenciada. Houve queda na procura de atendimento hospitalar, redução de agenda cirúrgica eletiva e diminuição das taxas de ocupação e rotatividade de leitos. Consecutivamente, a redução do volume transfusional no cenário de pandemia foi inevitável em comparação ao período anterior (2019). Os períodos com reduções expressivas estiveram em concordância com o agravamento do cenário pandêmico. Conclusão: A redução do movimento transfusional está diretamente relacionada a queda da taxa de ocupação de leitos oncológicos e fases do cenário pandêmico na cidade de São Paulo. O movimento atual é de retomada no volume de atendimento e aprimoramento das práticas de medidas de proteção aos pacientes oncológicos em toda a linha de cuidado.

IMPACTO DA PANDEMIA DE COVID-19 NAS SOLICITAÇÕES DE RESERVAS CIRÚRGICAS EM HOSPITAL REFERÊNCIA PARA CIRURGIAS ORTOPÉDICAS EM SÃO PAULO

Introdução: A Covid-19 é uma infecção respiratória aguda causada pelo coronavírus SARS-CoV-2, de elevada transmissibilidade e distribuição global. A chegada da pandemia de Covid-19 ao Brasil ocorreu em fevereiro de 2020 impactando diretamente a vida dos brasileiros e das instituições de saúde, que tiveram de se adaptar diante de um vírus até então desconhecido e da mudança do perfil epidemiológico dos pacientes. No setor privado, observamos ainda redução das taxas de internações não relacionada ao COVID-19 e das cirurgias eletivas. Objetivo: Avaliar o impacto nas taxas de solicitações de reservas de hemocomponentes para as cirurgias eletivas em hospital de referência ortopédica na cidade de São Paulo. Método: Realizada análise retrospectiva, a partir de dados dos sistemas informatizados, através do número de reservas de hemocomponentes solicitados e utilizados, no período de janeiro de 2019 a junho de 2021. Os dados encontrados foram correlacionados com o número total de cirurgias e fases da pandemia na cidade de São Paulo. Resultados: Em 2019 foram reservados 1.797 hemocomponentes, com uma média mensal de 150 reservas e taxa de utilização de 19,66%. Neste período a média mensal de cirurgias realizadas foi de 931. No ano de 2020 foram reservados 1.211 hemocomponentes, com média 101 reservas ao mês, com taxa de utilização de 18,58% e média mensal de 749 cirurgias. No primeiro semestre de 2021 foram solicitados 557 hemocomponentes para reservas cirúrgicas, com média de 93 reservas ao mês, consumo médio de 22,16% e a realização média de 7801 cirurgias por mês. Analisando o período, observamos uma queda significativa nas taxas de reserva de hemocomponentes segundo trimestre de 2020 e nos meses de março e abril de 2021. O decreto de pandemia no estado de São Paulo teve início no mês de março de 2020, com picos expressivos nos meses de julho e agosto de 2020 e março e abril de 2021. Discussão: Segundo a Associação Nacional de Hospitais Privados (ANHP) em 2020 houve uma redução de 32% das cirurgias eletivas agendadas em todo o país. Em nosso serviço observamos uma queda importante do número de cirurgias, mais expressiva no segundo trimestre de 2020, com recuperação gradual ao longo do ano, contudo, com nova queda nos meses de março e abril de 2021. Esses períodos correspondem ao início da pandemia no país e a segunda onda de transmissão na cidade de São Paulo ocorreu em 2021, quando ocorreu a redução estratégica das cirurgias eletivas com objetivo reduzir a taxa de ocupação hospitalar e aguardar a melhora da taxa de giro de leito. Consecutivamente, observamos uma queda das solicitações de reservas de hemocomponentes para cirurgias, mais expressiva nos meses com menor número de cirurgias. Contudo, essa queda não foi observada na taxa de utilização de hemocomponentes reservados, sugerindo que não houve alteração do perfil dos pacientes cirúrgicos da instituição no período. Conclusão: A pandemia de covid-19 teve um impacto negativo no número de cirurgias, de solicitações de reserva cirúrgica, assim como observado em diferentes hospitais durante o cenário de incertezas da pandemia. A retomada dos índices a valores pré-pandemia tem acontecido de forma gradual e ainda com baixa expressão.

REATIVAÇÃO DE CITOMEGALOVÍRUS EM PACIENTES COM DIAGNÓSTICO DE MIELOMA MÚLTIPLO OU AMILOIDOSE EM TRATAMENTO COM BORTEZOMIBE NO SERVIÇO DE HEMATOLOGIA E HEMOTERAPIA DO HOSPITAL DAS CLÍNICAS DA USP RIBEIRÃO PRETO/SP NO ANO DE 2020: UMA SÉRIE DE CASOS

Introdução: O Bortezomibe (Velcade®) é um inibidor do proteassoma, especificamente do proteassoma 26S, cuja ligação irreversível leva à ativação de cascatas de sinalização que culminam com a parada do ciclo celular e apoptose. Ele foi aprovado e incluído como quimioterapia de primeira linha nas Diretrizes Diagnósticas e Terapêuticas do Mieloma Múltiplo (Portaria n.° 2017) publicadas em agosto de 2015 mas apenas em setembro de 2020 foram publicadas três Portarias do Ministério da Saúde que incorporaram este medicamento para o tratamento de pacientes com Mieloma Múltiplo no SUS (para pacientes não tratados, inelegíveis ao transplante de células-tronco;para pacientes não tratados, elegíveis ao transplante e para pacientes previamente tratados). Esta incorporação permitiu o uso mais amplo desta medicação e trouxe à tona complicações possivelmente relacionadas ao seu uso como a reativação de citomegalovírus e suas diversas formas de apresentação clínica como pneumonites, infecções gastrointestinais, hepatites, encefalites, retinites, entre outras. Série de casos: No ano de 2020, foram identificados 5 casos de infecção por citomegalovírus em pacientes em tratamento de Mieloma Múltiplo e Amiloidose em uso de esquemas quimioterápicos contendo Bortezomibe no serviço de Hematologia e Hemoterapia do Hospital das Clínicas de Ribeirão Preto/SP. Três casos foram identificados na investigação etiológica de diarréia subaguda, um foi identificado na estratificação de colite neutropênica com características enteroinvasivas e o último na investigação de pneumonite aguda com sinais de infecção viral em tomografia de tórax (neste caso, foi excluída infecção por Covid-19 após dois testes PCR-RT negativos). Em todos os casos, após identificação da infecção por CMV (por sorologia - Elisa e confirmação de carga viral por PCR-RT), foi instituída terapêutica específica com antiviral, tanto Ganciclovir endovenoso quanto Valganciclovir via oral. Apesar da alta morbimortalidade associada a esta infecção em pacientes imunossuprimidos, apenas um dos cinco pacientes faleceu de complicações associadas. Discussão: A soroprevalência elevada de infecção por citomegalovírus no Brasil está relacionada a fatores socioeconômicos e condições precárias de saneamento básico e aumenta a morbimortalidade em pacientes imunossuprimidos. O uso mais frequente do Bortezomibe como primeira linha em pacientes com Mieloma Múltiplo e Amiloidose no nosso serviço e no Brasil traz à tona este agente como diagnóstico diferencial nas suspeitas clínicas infecciosas de diversos órgãos e sistemas.

Cutaneous Manifestations Related to COVID-19: Caused by SARS-CoV2 and Use of Personal Protective Equipment

SARS-CoV2-related infections have drawn the researchers’ attention to skin lesions. The motivation and purpose to present the cutaneous manifestations related to COVID-19 caused by SARS-CoV2 and the prolonged use of Personal Protective Equipment (PPE) by health professionals. The aim of the study is performed a systematic review of studies and official documents were carried out, in order to explore and synthesize the evidences and recommendations about the cutaneous manifestations related to SARS-CoV2 and the use of PPE. An integrative literature review was carried out with a search on the VHL library (LILACS, MEDLINE, SciELO). Articles from the period 2019 to june 2020 were included. In the results, 37 references were included, 10 original articles, 03 literature reviews and 24 other types of scientific publications. The conclusions demonstrated that the skin manifestations related to COVID-19 can be directly associated with the new SARS-CoV2, however it is necessary to have more conclusive studies. Skin lesions that have affected patients and frontline health professionals who need special care with the use of PPE. © 2022, Springer Nature Switzerland AG.

Evaluation of the Generation of Technofossils by Different Coffee Brewing Methods During COVID-19 Pandemic

Coffee is the second most consumed beverage in the world and an important international agricultural commodity, but the increasing use of single-serve coffee machines has led to major environmental concerns, as they produce non-biodegradable solid waste called technofossils, which are considered anthropogenic markers of the technosphere in the Anthropocene. Currently, Brazil is the world's largest coffee producer and the second largest consumer of this beverage. In this study, we evaluated the production of solid waste (biodegradable and technofossil) by the three most commonly used coffee preparation methods in Brazil during the COVID-19 pandemic: the "Brazilian coffee brewing method" (with cloth filter), electric coffee machine (with paper filter) and machines using single-serve Keurig Cups (R) (K-Cups). K-Cups produce a total waste mass 56% and 42% higher than those generated by the methods using the "Brazilian coffee brewing method" and the electric coffee machine, respectively. The K-Cups produce about 10 times more technofossil waste than the other two methods, but have a nearly equal distribution among all their generated waste (biodegradable: 50.5% and technofossil waste: 49.5%), with no statistically significant difference (p > 0.05). On the other hand, the "Brazilian coffee brewing method" and the one using an electric coffee machine, basically produce biodegradable solid waste, predominantly 93.5% for the "Brazilian coffee brewing method" and 84.0% for the one using an electric coffee machine, respectively. The technofossil residues generated mainly by the method that uses K-Cups are difficult to recycle, which poses increasing environmental risks if these solid residues are inadequately treated in the environment. This fact is worrisome, since during the COVID-19 pandemic a significant increase in the generation of municipal solid waste (>10%) was observed, as well as a significant increase in coffee consumption in Brazilian and worldwide households.

LEUCOENCEFALOPATIA MULTIFOCAL PROGRESSIVA EM PACIENTE PORTADORA DE RETROVIROSE

Introdução: A leucoenfalopatia multifocal progressiva (LEMP) é uma doença desmielinizante do sistema nervoso central, causada pelo vírus JC, pertencente à família dos poliomavírus. Após a primo-infecção, o vírus pode permanecer latente em vários tecidos. Nesses casos, a reativação é secundária à imunossupressão grave, sendo mais comum em indivíduos coinfectados pelo vírus da imunodeficiência humana (HIV). Relato de caso: LRC, 48 anos, usuária de drogas ilícitas, deu entrada no serviço de Infectologia com queixa de redução de força em hemicorpo esquerdo associada à odinofagia e à disartria. Com diagnóstico recente de HIV, contagem de linfócitos TCD4 de 129/mm3 e carga viral de 1282578 cópias/mL, em uso de Lamivudina, Darunavir, Ritonavir e Doluteglavir, portadora de insuficiência renal crônica. Durante a internação, evoluiu com insuficiência respiratória aguda e recebeu diagnóstico de Histoplasmose com Banda M positiva. A tomografia de tórax demonstrou espessamento liso de septos interlobulares bilaterais, discretos focos em vidro fosco e consolidativos de permeio. Amostras para PCR de Covid-19 foram negativas. Iniciado Anfotericina B lipossomal, alterada, após, para Itraconazol por piora de função renal e necessidade de hemodiálise. Realizado tratamento empírico com Primaquina para Pneumocistose. Paciente evoluiu com piora de déficit focal, hemiparesia e hiperreflexia à esquerda. A tomografia de crânio apresentou áreas hipoatenuantes na substância branca dos hemisférios cerebrais. Foi iniciado tratamento empírico alternativo para Neurotoxoplasmose com Clindamicina, Pirimetamina e Ácido folínico. A punção lombar apresentou PCR (qualitativo) positivo para o vírus JC. A ressonância magnética de crânio mostrou lesões confluentes e assimétricas das substâncias brancas cortical e periventricular bilateral, com predomínio fronto-parietal, principalmente à direita, com hipersinal em T2 FLAIR e hipossinal em T1, confirmando LEMP. Comentário: LEMP usualmente é uma doença terminal, com sobrevida média de 1 a 6 meses, sendo mais comum ocorrer com CD4 abaixo de 100/mm3. No caso apresentado foi evidenciado LEMP em uma paciente com contagem de CD4 129/mm3 que evoluiu com hemiplegia à esquerda. Continua em uso de antirretrovirais, tratamento para Histoplasmose, bem como profilaxia para Neurotoxoplasmose e Pneumocistose.

THE UNCONSTITUTIONALITY OF THE RELATIVIZATION OF FUNDAMENTAL RIGHTS IN PANDEMIC TIMES OF COVID-19: A BRIEF STUDY OF LOCKDOWN IN THE STATE OF MARANHÃO

Objective: The present study aims to analyze the emergency mechanisms adopted in Brazil, highlighting the risks of extrapolating the constitutional limit to Brazilian democracy. Methodology: For this purpose, the present theoretical incursion will make a documentary analysis of the national and international instruments for controlling the pandemic of COVID-19, with theoretical bibliographic contributions to support the study in a critical and reflective way. Results: It remains to be demonstrated that Brazil adopt mechanisms of social, commercial and business isolation, based on the recommendations of the World Health Organization and the national Ministry of Health. Within this context, it is important to note that the allocation of fundamental rights to combat the pandemic must follow constitutional dictates. Contributions: The main contribution of this work is to demonstrate the importance of complying with the constitutional text for the application of preventive measures during the pandemic, under the risk of threatening the Democratic Rule of Law and the 1988 Constitution itself. © 2022, Centro Universitario Curitiba - UNICURITIBA. All rights reserved.

Evaluation of Pedagogical Strategies used in the State of Rio de Janeiro for Teaching Chemistry, Physics and Biology in High School During the First Year of the COVID-19 Pandemic

On March 11, 2020, the World Health Organization declared that the epidemic of the new Coronavirus disease (COVID-19) was out of control and had become a global zoonotic pandemic. Consequently, more than 190 countries have implemented measures to contain the outbreak of the disease, including the Lockdown, mainly to avoid the saturation of their health systems. Humanity found itself in an unprecedented disruptive moment, in which basic education was compelled to change, compulsorily. the traditional paradigm of the teaching-learning process and to adopt emergency remote teaching, mediated massively by technological alternatives. In the Brazilian state of Rio de Janeiro, it was decreed that there would be no loss of school days during the year 2020. Therefore, teachers of Chemistry, Physics and Biology were forced to develop assignments and digital skills online, for which they were not prepared. In the private education network in Rio de Janeiro, science teachers had more favorable technological conditions, as well as a better return from synchronous and asynchronous online activities by students and family. In spite of these factors, the exacerbation of fatigue and professional exhaustion have been reported. In the federal education network, basic education classes were cancelled in 2020, as a pedagogical policy to mitigate the inequalities within the students. On the other hand, in the state education network, which is responsible for education of nearly 500,000 students in the state of Rio de Janeiro, classes were not cancelled. Among the numerous approaches adopted by teachers of Chemistry, Physics and Biology at the state network, the creation of 36 video classes that were broadcast on an open television station and on TV ALERJ stands out. An exponential drop was observed in the visualizations of the video classes, which may result in the loss of the scientific literacy quality of high school students. In this way, they may become more vulnerable to fake news and fake sciences and may have a worse formation as citizens and a poor critical sense.

P18-12 mRNA vaccines against SARS-CoV-2: review of non-clinical challenge studies and potential contagiosity in Non Human Primates

SARS-CoV-2 infects humans by the use of the extracellular Spike protein (S) to attach to specific cell surface receptors. Due to its indispensable role, the S protein is a major target of virus neutralizing antibodies and has become a key antigen for vaccine candidates development. Recent improvements in mRNA vaccines act to increase protein translation, modulate innate and adaptive immunogenicity and improve delivery. mRNA vaccines are a new type of vaccine to protect against infectious diseases and were the first COVID-19 vaccines authorized worldwide. Relevant animal models are critical for a successful development of all SARS-CoV-2 vaccine candidates and are necessary to characterize the immune response induced by a SARS-CoV-2 vaccine candidate before moving into larger clinical studies, so as to address the theoretical risk for SARS-CoV-2 vaccine-induced disease enhancement. If vaccines are effective on disease severity and reduce hospitalizations, the question is whether vaccination reduces virus transmission. Even, protection against reinfection with SARS-CoV-2 has been observed in rhesus monkeys, who formed neutralising antibodies on initial exposure and a minimum neutralising antibody titre has been proposed, no formals studies have been conducted from a non-clin-ical or clinical point of view, assessing the effect of the vaccination on a potential reduction in transmission nor the transmission between individuals. This review provides an overview of the non-clinical data of the two different covid-19 RNA vaccines approved on the market, the different animal models studied as well as the virus transmission between individuals. The objective is to make a comparison of the results of the challenge study on Non Human Primates (NHP), analysing all criteria that can approach this activity on the transmission of the infection (i.e. Viral RNA in nasal and oropharyngeal swabs and bronchoalveolar lavage after vaccination, clinical signs,...) However, since SARS-CoV-2 is a novel pathogen, any surrogate endpoints identified in animal studies would ideally need validation in clinical trials to ensure that they adequately predict efficacy in humans.

An approach to the satisfaction of those responsible for tourist accommodation to the allocation of resources in Portuguese municipalities

Managing is always a difficult task since there are too many variables involved and it becomes even more complicated when future perspectives are uncertain. Effectively, as of the end of 2019, due to the spread of SARS-CoV2, tourism became highly vulnerable and those responsible for tourist accommodations had huge revenue shortfalls. The objective of this article is to analyze, in what way the heads of the tourism accommodation companies perceive, in terms of satisfaction, the allocation of resources that is made by the municipalities. For this purpose, statistical methodologies were used, such as: descriptives, principal component analysis, multiple linear regression and ordinal logistic regression. The conclusions refer to the importance of the promotion made by the municipalities in the overall satisfaction of those responsible for tourist accommodations. However, support to tourists and hold events was also shown to be relevant in terms of resource allocation by the municipalities.