Dengue virus non-structural protein 3 inhibits mitochondrial respiration by impairing complex I function.

Dengue virus (DENV) infection is known to affect host cell metabolism, but the molecular players involved are still poorly known. Using a proteomics approach, we identified six DENV proteins associated with mitochondria isolated from infected hepatocytes, and most of the peptides identified were from NS3. We also found an at least twofold decrease of several electron transport system (ETS) host proteins. Thus, we investigated whether NS3 could modulate the ETS function by incubating recombinant DENV NS3 constructs in mitochondria isolated from mouse liver. We found that NS3pro (NS3 protease domain), but not the correspondent catalytically inactive mutant (NS3proS135A), impairs complex I (CI)-dependent NADH:ubiquinone oxidoreductase activity, but not the activities of complexes II, III, IV, or V. Accordingly, using high-resolution respirometry, we found that both NS3pro and full-length NS3 decrease the respiratory rates associated with malate/pyruvate oxidation in mitochondria. The NS3-induced impairment in mitochondrial respiration occurs without altering either leak respiration or mitochondria's capacity to maintain membrane potential, suggesting that NS3 does not deeply affect mitochondrial integrity. Remarkably, CI activity is also inhibited in DENV-infected cells, supporting that the NS3 effects observed in isolated mitochondria may be relevant in the context of the infection. Finally, in silico analyses revealed the presence of potential NS3 cleavage sites in 17 subunits of mouse CI and 16 subunits of human CI, most of them located on the CI surface, suggesting that CI is prone to undergo proteolysis by NS3. Our findings suggest that DENV NS3 can modulate mitochondrial bioenergetics by directly affecting CI function. IMPORTANCE: Dengue virus (DENV) infection is a major public health problem worldwide, affecting about 400 million people yearly. Despite its importance, many molecular aspects of dengue pathogenesis remain poorly known. For several years, our group has been investigating DENV-induced metabolic alterations in the host cells, focusing on the bioenergetics of mitochondrial respiration. The results of the present study reveal that the DENV non-structural protein 3 (NS3) is found in the mitochondria of infected cells, impairing mitochondrial respiration by directly targeting one of the components of the electron transport system, the respiratory complex I (CI). NS3 acts as the viral protease during the DENV replication cycle, and its proteolytic activity seems necessary for inhibiting CI function. Our findings uncover new nuances of DENV-induced metabolic alterations, highlighting NS3 as an important player in the modulation of mitochondria function during infection.

Galactose-1-phosphate inhibits cytochrome c oxidase and causes mitochondrial dysfunction in classic galactosemia.

Classic galactosemia is an inborn error of metabolism caused by mutations in the GALT gene resulting in the diminished activity of the galactose-1-phosphate uridyltransferase enzyme. This reduced GALT activity leads to the buildup of the toxic intermediate galactose-1-phosphate and a decrease in ATP levels upon exposure to galactose. In this work, we focused our attention on mitochondrial oxidative phosphorylation in the context of this metabolic disorder. We observed that galactose-1-phosphate accumulation reduced respiratory rates in vivo and changed mitochondrial function and morphology in yeast models of galactosemia. These alterations are harmful to yeast cells since the mitochondrial retrograde response is activated as part of the cellular adaptation to galactose toxicity. In addition, we found that galactose-1-phosphate directly impairs cytochrome c oxidase activity of mitochondrial preparations derived from yeast, rat liver, and human cell lines. These results highlight the evolutionary conservation of this biochemical effect. Finally, we discovered that two compounds - oleic acid and dihydrolipoic acid - that can improve the growth of cell models of mitochondrial diseases, were also able to improve galactose tolerance in this model of galactosemia. These results reveal a new molecular mechanism relevant to the pathophysiology of classic galactosemia - galactose-1-phosphate-dependent mitochondrial dysfunction - and suggest that therapies designed to treat mitochondrial diseases may be repurposed to treat galactosemia.

Aerobic granulation and resource production under continuous and intermittent saline stress.

Three sequential batch reactors (SBR) were operated to evaluate salt addition's impact on granulation, performance, and biopolymer production in aerobic granular sludge (AGS) systems. System R1 was fed without adding salt (control); system R2 operated with saline pulses, i.e., one cycle with salt (2.5 g NaCl/L) addition followed by another without salt; and R3 received continuous supplementation of 2.5 g NaCl/L. The results indicated that the reactors supplemented with salt presented higher concentrations of mixed liquor volatile suspended solids (MLVSS) and better settleability than R1, showing that osmotic pressure contributed to biomass growth, accelerated granulation, and improved physical characteristics. The faster granulation occurred in R2, thus proving the beneficial effects of intermittent salt addition through alternating pulses. Salt addition did not impair the simultaneous removal of carbon, nitrogen, and phosphorus. In fact, R2 showed better carbon removals. In conclusion, continuous or intermittent (pulsed) supplementation of 2.5 g NaCl/L did not lead to increased production of extracellular polymeric substances (EPS) and alginate-like exopolymers (ALE). This outcome could be attributed to the low saline concentration employed, a higher food-to-microorganism (F/M) ratio observed in R1, and possibly greater endogenous consumption of biopolymers in the famine period in R2 and R3 due to the greater solids retention time (SRT). Therefore, this study brings important results that contribute to a better understanding of the effect of salt in continuous dosing or in pulses as a selection pressure strategy to accelerate granulation, as well as the behavior of the AGS systems for saline effluents.

Carbon source affects the resource recovery in aerobic granular sludge systems treating wastewater.

This study evaluated the influence of carbon sources on alginate-like exopolymers (ALE) and tryptophan (Trp) biosynthesis in the aerobic granular sludge (AGS). With acetate, the highest biopolymers levels, per gram of volatile suspended solids (VSS) (418.7 mgALE∙g-1 and 4.1 mgTrp∙gVSS-1), were found likely due to biomass loss throughout the operation, which resulted in lower sludge age (4-7 days) and shorter famine period. During granulation, encouraging results on ALE production were obtained with propionate (>250 mgALE∙gVSS-1), significantly higher than those found with glycerol, glucose, and sucrose. Regarding tryptophan production, propionate and glycerol proved to be good substrates, although the content was still lower than acetate (1.6 mgTrp∙gVSS-1). Granules fed with glucose showed the worst results compared to the other substrates (38.5 mgALE∙VSS-1 and 0.6 mgTrp∙gVSS-1) due to the filamentous microorganisms' abundance found. Therefore, this study provides insights to value the production of compounds of industrial interest in AGS systems.

Mobilidade de contaminantes em solos arenosos após a aplicação de águas residuárias tratadas produzidas em indústria siderúrgica / Contaminant mobility in sandy soils after application of treated wastewater produced in the steel industry

RESUMO Este trabalho teve como objetivo realizar um estudo de modelagem da dispersão de contaminantes no solo com águas residuárias produzidas e tratadas em uma indústria siderúrgica. Para isso, foram realizados ensaios de coluna de lixiviação utilizando amostras de solo coletadas nas áreas dentro da indústria onde aconteceria o reúso das águas residuárias tratadas nas estações de tratamento da própria siderúrgica. Com base nos ensaios, foram geradas curvas de eluição (breakthrough curves), para análise da mobilidade dos contaminantes no solo, e obtidos os parâmetros de transporte (coeficiente de dispersão, retardamento e dispersividade). As águas residuárias produzidas na siderúrgica apresentam baixas concentrações de metais pesados após o tratamento realizado, sendo apenas o ferro e o zinco, contaminantes de maior preocupação para a disposição no solo. Os solos analisados, com elevado percentual de areia, demonstraram ineficiência na retenção dos contaminantes presentes, aumentando os riscos de contaminação da água subterrânea. Conclui-se que, para a indústria siderúrgica realizar o reúso não potável das águas residuárias, deve-se associar este a técnicas de manejo e conservação do solo que aumentem a capacidade do solo em adsorver contaminantes, ou de impermeabilização na área de resfriamento de placas.

ABSTRACT This research aimed to carry out a modeling study on the dispersion of contaminants in the soil with wastewater produced and treated in a steel industry. For this purpose, column leaching tests were performed using soil samples collected in areas inside the industry where the reuse of treated wastewater would occur. Based on the tests, elution curves (breakthrough curves) were generated to analyze the mobility of contaminants in the soil, and transport parameters were obtained (dispersion coefficient, delay, and dispersivity). The wastewater produced in the steelworks has low concentrations of heavy metals after the wastewater treatment is carried out, with only iron and zinc posing a risk for wastewater disposal. The analyzed soils, with a high percentage of sand, showed a low retention capacity for the contaminants present, increasing the risks of groundwater contamination. Therefore, the non-potable reuse of treated wastewater is possible in the steel industry, but it must be associated with soil management and conservation techniques that increase the capacity of the soil to adsorb its contaminants or the impermeabilization in the area of plate cooling.

Mesenchymal Stromal Cells From Emphysematous Donors and Their Extracellular Vesicles Are Unable to Reverse Cardiorespiratory Dysfunction in Experimental Severe Emphysema.

Although bone marrow-derived mesenchymal stromal cells (BM-MSCs) from patients with chronic obstructive pulmonary disease (COPD) appear to be phenotypically and functionally similar to BM-MSCs from healthy sources in vitro, the impact of COPD on MSC metabolism and mitochondrial function has not been evaluated. In this study, we aimed to comparatively characterize MSCs from healthy and emphysematous donors (H-MSCs and E-MSCs) in vitro and to assess the therapeutic potential of these MSCs and their extracellular vesicles (H-EVs and E-EVs) in an in vivo model of severe emphysema. For this purpose, C57BL/6 mice received intratracheal porcine pancreatic elastase once weekly for 4 weeks to induce emphysema; control animals received saline under the same protocol. Twenty-four hours after the last instillation, animals received saline, H-MSCs, E-MSCs, H-EVs, or E-EVs intravenously. In vitro characterization demonstrated that E-MSCs present downregulation of anti-inflammatory (TSG-6, VEGF, TGF-ß, and HGF) and anti-oxidant (CAT, SOD, Nrf2, and GSH) genes, and their EVs had larger median diameter and lower average concentration. Compared with H-MSC, E-MSC mitochondria also exhibited a higher respiration rate, were morphologically elongated, expressed less dynamin-related protein-1, and produced more superoxide. When co-cultured with alveolar macrophages, both H-MSCs and E-MSCs induced an increase in iNOS and arginase-1 levels, but only H-MSCs and their EVs were able to enhance IL-10 levels. In vivo, emphysematous mice treated with E-MSCs or E-EVs demonstrated no amelioration in cardiorespiratory dysfunction. On the other hand, H-EVs, but not H-MSCs, were able to reduce the neutrophil count, the mean linear intercept, and IL-1ß and TGF-ß levels in lung tissue, as well as reduce pulmonary arterial hypertension and increase the right ventricular area in a murine model of elastase-induced severe emphysema. In conclusion, E-MSCs and E-EVs were unable to reverse cardiorespiratory dysfunction, whereas H-EVs administration was associated with a reduction in cardiovascular and respiratory damage in experimental severe emphysema.

Resource recovery in aerobic granular sludge systems: is it feasible or still a long way to go?

Lately, wastewater treatment plants are much often being designed as wastewater-resource factories inserted in circular cities. Among biological treatment technologies, aerobic granular sludge (AGS), considered an evolution of activated sludge (AS), has received great attention regarding its resource recovery potential. This review presents the state-of-the-art concerning the influence of operational parameters on the recovery of alginate-like exopolysaccharides (ALE), tryptophan, phosphorus, and polyhydroxyalkanoates (PHA) from AGS systems. The carbon to nitrogen ratio was identified as a parameter that plays an important role for the optimal production of ALE, tryptophan, and PHA. The sludge retention time effect is more pronounced for the production of ALE and tryptophan. Additionally, salinity levels in the bioreactors can potentially be manipulated to increase ALE and phosphorus yields simultaneously. Some existing knowledge gaps in the scientific literature concerning the recovery of these resources from AGS were also identified. Regarding industrial applications, tryptophan has the longest way to go. On the other hand, ALE production/recovery could be considered the most mature process if we take into account that existing alternatives for phosphorus and PHA production/recovery are optimized for activated sludge rather than granular sludge. Consequently, to maintain the same effectiveness, these processes likely could not be applied to AGS without undergoing some modification. Therefore, investigating to what extent these adaptations are necessary and designing alternatives is essential.

Effect of calcium addition to aerobic granular sludge systems under high (conventional SBR) and low (simultaneous fill/draw SBR) selection pressure.

This paper investigated the effect of calcium addition on the formation and properties of aerobic granules under high (conventional SBR) and low (simultaneous fill/draw SBR) selection pressure. Additionally, the simultaneous removal of carbon, nitrogen, and phosphorus, and the operational stability were assessed. The conventional SBRs showed earlier granule development (20 days) than the simultaneous fill/draw SBRs. The effect of calcium on granulation was more accentuated in conventional SBRs, forming larger granules in a shorter interval of time due to the higher EPS production. Additionally, higher amounts of calcium were found in the EPS matrix, mainly during the formation of granules. The operation regime and the addition of calcium did not affect the removal of carbon, nitrogen, and phosphorus. However, they both influenced the granulation time, settleability characteristics, size, and granule composition.

Parabens in aerobic granular sludge systems: Impacts on granulation and insights into removal mechanisms.

This work assessed the impact of methylparaben, ethylparaben, propylparaben, and butylparaben (200 µg L-1 each) on the granulation process as well as on the organic matter and nutrient removal of an aerobic granular sludge (AGS) system (6-h cycle). Additionally, some insights into the main paraben removal mechanisms were provided. In the presence of parabens, aerobic granules with good settleability, but with fragile and irregular structure, were grown. No significant effect of parabens on organic matter (>90%) and nitrogen (~70%) removal was evidenced. On the other hand, phosphorus removal was slightly impaired, although high removal efficiencies (~70%) were reached. High paraben removal efficiencies were achieved (>85%) in the AGS system, with methylparaben being the most recalcitrant compound. Concerning the removal mechanisms, biotransformation was the main mechanism in the removal of all parabens (85.5% for methylparaben and 100% for the others), whereas, apparently, adsorption played a role only in the removal of methylparaben. In addition, this compound was also suggested as a probable intermediate of the degradation of the larger alkyl-chain parabens. Lastly, regarding the microbial community, with the exception of Mycobacterium, the reactors shared the same genera, which may explain their comparable operational performances. Additionally, some genera that developed more in the presence of parabens may be related to their degradation. Therefore, although antimicrobial agents such as parabens compromised the granule structure, AGS system maintained a good operational performance and showed to be very efficient in paraben removal.

Effects of the antibiotics trimethoprim (TMP) and sulfamethoxazole (SMX) on granulation, microbiology, and performance of aerobic granular sludge systems.

This work assessed the effect of the antibiotics trimethoprim (TMP) and sulfamethoxazole (SMX) on the granulation process, microbiology, and organic matter and nutrient removal of an aerobic granular sludge (AGS) system. In addition, after the maturation stage, the impact of the redox mediator anthraquinone-2,6-disulfonate (AQDS) (25 µM) on the biotransformation of the antibiotics was evaluated. The reactor R1 was maintained as a control, and the reactor R2 was supplemented with TMP and SMX (200 µg L-1). The ability to remove C, N, and P was similar between the reactors. However, the structural integrity of the AGS was impaired by the antibiotics. Low TMP (∼30%) and SMX (∼60%) removals were achieved when compared to anaerobic or floccular biomass aerobic systems. However, when the system was supplemented with AQDS, an increase in the removal of TMP (∼75%) and SMX (∼95%) was observed, possibly due to the catalytic action of the redox mediator on cometabolic processes. Regarding the microbial groups, whereas Proteobacteria and Bacterioidetes increased, Planctomycetes decreased in both reactors. However, TMP and SMX presence seemed to inhibit or favor some genera during the formation of the granules, possibly due to their bactericidal action.

Effects of coal ash supplementation on aerobic granular sludge cultivated in a simultaneous fill/draw sequencing batch reactor / Efeitos da suplementação de cinzas de carvão mineral em lodo granular aeróbio cultivado em reator em batelada sequencial de alimentação/descarte simultâneos

ABSTRACT This study aimed to verify if coal ash, a residue from thermal power plants, could act as a granulation nucleus, cations source, and abrasive element to favor granules formation and stability in aerobic granular sludge (AGS) systems. Two simultaneous fill/draw sequencing batch reactors (SBRs) (R1 and R2) were operated with 6-h cycles, i.e., the filling and drawing phases occurred simultaneously, followed by the reaction and settling phases. R1 was maintained as control, while R2 was supplemented with coal ash (1 g·L-1) on the first day of operation. Granulation was achieved in both reactors, and no significant differences were observed in terms of settleability, biomass retention, morphology, resistance to shear, and composition of the EPS matrix. However, the ash addition did not change the settleability, biomass retention, granule morphology, shear resistance, and extracellular polymeric substances (EPS) content significantly. COD removal was high (≥ 90%), while nitrogen (~50%) and phosphorus (~40%) removals were low, possibly due to the presence of nitrate during the anaerobic phase. With granulation, microbial population profile was altered, mainly at the genus level. In general, the operational conditions had a more considerable influence over granulation than the ash addition. The possible reasons are because the ash supplementation was performed in a single step, the low sedimentation rate of this particular residue, and the weak interaction between the ash and the EPS formed in the granular sludge. These factors appear to have decreased or prevented the action of the ash as granulation nucleus, source of cations, and abrasive element.

RESUMO O objetivo deste estudo foi verificar se a cinza de carvão mineral, um resíduo de usinas termelétricas, poderia atuar como núcleo de granulação, fonte de cátions e elemento abrasivo em sistemas de lodo granular aeróbio (LGA) para favorecer a formação e estabilidade dos grânulos. Dois reatores em batelada sequencial (RBS) (R1 e R2) foram operados em regime de alimentação/descarte simultâneos com ciclos de 6 h, ou seja, as fases de alimentação e descarte do efluente ocorreram simultaneamente, seguidas das fases de reação e de decantação. O R1 foi mantido como controle, enquanto o R2 foi suplementado com as cinzas (1 g·L-1) no primeiro dia de operação. A granulação foi alcançada em ambos os reatores, não havendo diferenças marcantes em termos de sedimentabilidade, retenção de biomassa, morfologia do grânulo, resistência ao cisalhamento e conteúdo de substâncias poliméricas extracelulares (SPE). A remoção de DQO foi alta (≥ 90%), enquanto as remoções de nitrogênio (~50%) e fósforo (~40%) foram baixas, possivelmente pela presença de nitrato na fase anaeróbia. Após a granulação, o perfil da comunidade microbiana mudou, especialmente em termos de gênero. Globalmente, as condições operacionais tiveram maior influência sobre a granulação do que a adição das cinzas, possivelmente porque elas só foram adicionadas uma vez e possuem baixa velocidade de sedimentação, bem como devido a uma fraca interação das cinzas com a matriz de SPE formada no lodo aeróbio. Esses fatores podem ter diminuído, ou mesmo impedido, a ação das cinzas como núcleo de grânulo, fonte de cátions ou elemento abrasivo.

[Case Series of 103 Children with SARS-CoV-2 Infection in Portugal]. / Série de Casos de 103 Crianças com Infeção por SARS-CoV-2 em Portugal.

INTRODUCTION: The North Lisbon University Hospital Center was activated for referral of SARS-CoV-2 infected patients on the 11th March 2020. The aim of this study is to describe the experience at the Department of Pediatrics in the approach and the clinical outcomes of infected children. MATERIAL AND METHODS: A descriptive observational study was performed. Children and adolescents (0 to 18 years) with SARS-CoV-2 infection, diagnosed in the emergency room or admitted to the Department of Pediatrics between March 11th and June 18th, were included. Hospital records and Trace COVID-19 platform were reviewed and patient caregivers were interviewed to assess follow up. RESULTS: Among 103 diagnosed children, 83% had a known previous contact with an infected patient, 43% presented fever and 42% presented respiratory symptoms. Ten percent had risk factors and 21% were aged under one year old. Ten percent were hospitalised, one needing intensive care, with paediatric inflammatory multisystem syndrome. Blood tests were performed in 9% and chest radiograph in 7%. No children required ventilation, antiviral therapy or underwent thoracic computed tomography scan. Eight percent of children returned to the emergency room and one child was hospitalised. The clinical outcome is known in 101 patients and is favourable in all. DISCUSSION: Most children had an epidemiological link and little clinical repercussion, even during the first year of life. The expected mild severity in children justified the use of established clinical criteria and recommendations for similar conditions, regarding tests and hospitalizations. No antiviral treatments were given due to lack of evidence of its benefits. CONCLUSION: This strategy contributed to a low consumption of hospital resources and proved safe in this series.

Introdução: O Centro Hospitalar Universitário Lisboa Norte foi ativado para referência de doentes com infeção SARS-CoV-2 em 11 de março de 2020. O objetivo deste estudo é descrever a experiência do Departamento de Pediatria na abordagem e evolução clínica de crianças infetadas.Material e Métodos: Realizámos um estudo observacional descritivo. Incluímos as crianças e adolescentes (0 aos 18 anos) com infeção por SARS-CoV-2 diagnosticados na urgência e internamento do nosso departamento entre 11 de março e 18 de junho de 2020. Consultámos registos internos e a plataforma Trace COVID-19 e contactámos os cuidadores para avaliação de seguimento.Resultados: De 103 crianças diagnosticadas, 83% tiveram contacto prévio identificado com doente infetado, 43% doentes apresentaram febre e 42% sintomas respiratórios. Em 10% havia fatores de risco; 21% tinham idade inferior a um ano. Foram internadas 10% das crianças, uma em cuidados intensivos com síndrome inflamatória multissistémica pediátrica. Foi efetuada avaliação laboratorial em 9%, radiografia torácica em 7%. Nenhum recebeu suporte ventilatório, terapêutica antiviral ou realizou tomografia computorizada torácica. Foram reobservadas em serviço de urgência 8% das crianças, sendo internada uma. A evolução foi conhecida em 101 casos sendo favorável em todos.Discussão: A maioria dos doentes tinha link epidemiológico familiar e pouca repercussão clínica, mesmo no primeiro ano de vida. A menor gravidade esperada na criança motivou a adoção de critérios habituais noutros quadros clínicos semelhantes para a realização de exames complementares de diagnóstico e internamento hospitalar. Não foi administrada terapêutica antiviral em nenhum doente por se considerar haver pouca evidência de benefício.Conclusão: Esta estratégia traduziu-se num baixo consumo de recursos hospitalares e revelou-se segura nesta série.

[Correction to the article "Case Series of 103 Children with SARS-CoV-2 Infection in Portugal", published on Acta Med Port 2020 Dec;33(12):795-802]. / Errata ao artigo "Série de Casos de 103 Crianças com Infeção por SARS-CoV-2 em Portugal", publicado em Acta Med Port 2020 Dec;33(12):795-802.

On page 801, fifth, where it reads: "No início da pandemia, teorizou-se que a vacina BCG pudesse ter um efeito protetor relativamente à COVID-19,27,28 mas não se encontrou até à data evidência para tal, não estando atualmente recomendada a vacinação BCG na prevenção da COVID-19.28,29 No nosso estudo, a maioria dos doentes (76%) tinha sido vacinada. Analisámos separadamente o subgrupo de crianças nascidas após janeiro de 2016, altura em que passaram a ser vacinadas apenas as crianças pertencentes a grupos de risco.30 A taxa de vacinação neste grupo foi de 51%, sendo superior à taxa de 30,1% estimada para crianças nascidas em Portugal com um ano de idade referido a 2019.31" It should read: "No início da pandemia, teorizou-se que a vacina BCG pudesse ter um efeito protetor relativamente à COVID-19,27,28 mas não se encontrou até à data evidência para tal, não estando atualmente recomendada a vacinação BCG na prevenção da COVID-19.28 No nosso estudo, a maioria dos doentes (76%) tinha sido vacinada. Analisámos separadamente o subgrupo de crianças nascidas após janeiro de 2016, altura em que passaram a ser vacinadas apenas as crianças pertencentes a grupos de risco.29 A taxa de vacinação neste grupo foi de 51%, sendo superior à taxa de 30,1% estimada para crianças nascidas em Portugal com um ano de idade referido a 2019.30" Paper published with errors: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14537.

Na página 801, quinto parágrafo, onde se lê: "No início da pandemia, teorizou-se que a vacina BCG pudesse ter um efeito protetor relativamente à COVID-19,27,28 mas não se encontrou até à data evidência para tal, não estando atualmente recomendada a vacinação BCG na prevenção da COVID-19.28,29 No nosso estudo, a maioria dos doentes (76%) tinha sido vacinada. Analisámos separadamente o subgrupo de crianças nascidas após janeiro de 2016, altura em que passaram a ser vacinadas apenas as crianças pertencentes a grupos de risco.30 A taxa de vacinação neste grupo foi de 51%, sendo superior à taxa de 30,1% estimada para crianças nascidas em Portugal com um ano de idade referido a 2019.31" Deverá ler-se: "No início da pandemia, teorizou-se que a vacina BCG pudesse ter um efeito protetor relativamente à COVID-19,27,28 mas não se encontrou até à data evidência para tal, não estando atualmente recomendada a vacinação BCG na prevenção da COVID-19.28 No nosso estudo, a maioria dos doentes (76%) tinha sido vacinada. Analisámos separadamente o subgrupo de crianças nascidas após janeiro de 2016, altura em que passaram a ser vacinadas apenas as crianças pertencentes a grupos de risco.29 A taxa de vacinação neste grupo foi de 51%, sendo superior à taxa de 30,1% estimada para crianças nascidas em Portugal com um ano de idade referido a 2019.30"Artigo publicado com erros: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14537.

Efficacy of trial-based cognitive therapy, behavioral activation and treatment as usual in the treatment of major depressive disorder: preliminary findings from a randomized clinical trial.

INTRODUCTION: Major depressive disorder (MDD) is a prevalent, debilitating and disabling disorder, and its prevalence is increasing. Antidepressants (AD), cognitive-behavioral therapy (CBT) and behavioral activation (BA) are the main treatments for MDD. Trial-based cognitive therapy (TBCT) addresses and restructures dysfunctional negative core beliefs (CBs) and is a novel and promising approach. OBJECTIVE: The aim of this study was to compare the efficacy of TBCT, BA and treatment as usual (TAU) in the treatment of MDD. METHODS: A total of 76 patients with MDD were randomized into 1 of 3 groups and evaluated at baseline, after 6 weeks and at week 12 (final evaluation). The primary outcome was changing in HAM-D scores, and the secondary outcomes included scores on the BDI, CD-Quest, Sheehan Disability Scale (SDS) and WHOQOL. RESULTS: Both TBCT and BA (which also included AD) were different from TAU (which included antidepressants alone) in reducing the HAM-D and BDI scores and other measures. TBCT and BA were different from TAU in the reduction of disability in SDS and WHOQOL physical domain scores. Besides limited by a small sample size, the dropout rate in the TAU arm was higher, and only 10 patients completed the 3 evaluations. CONCLUSION: This trial provides evidence that TBCT and BA combined with antidepressants were more efficacious than the TAU (drug alone) in reducing the severity of depressive symptoms and disability, showing that this combination can be useful for clinical practice.

Effect of calcium addition on the formation and maintenance of aerobic granular sludge (AGS) in simultaneous fill/draw mode sequencing batch reactors (SBRs).

This work investigated the effect of Ca2+ (100 mg L-1) addition on the formation and maintenance of aerobic granular sludge in a simultaneous fill/draw mode sequencing batch reactor (SBR), operated with a low liquid upflow velocity (0.92 m h-1), in order to verify if Ca2+ presence compensates the low selection pressure imposed. Additionally, carbon and nutrients removals, granules characteristics and microbial community were evaluated. For this, two SBRs (R1, control, and R2, Ca2+-supplemented) were operated (6-h cycle). In general, Ca2+ supplementation affected positively the sludge settleability, although a larger fraction of inert solids was found in the granules. The total extracellular polymeric substances were the same for both reactors, and no remarkable differences were observed between their polysaccharides and proteins contents. Overall, Ca2+ addition in a simultaneous fill/draw mode SBR neither accelerated the granule formation nor improved the operational performance. The microbial community structure, especially in terms of bioactivity, was not affected as well. Therefore, the effect of divalent cations might be more pronounced in conventional SBRs, in which the selection pressure is higher.

Relação entre independência funcional e qualidade de vida de idosos participantes de grupos de convivência / Relationship between functional independence and quality of life of elderly participants in partnership groups / Relación entre la independencia funcional y la calidad de vida de los participantes mayores en los grupos de asociación

Objetivou-se investigar a independência funcional e suas relações na qualidade de vida dos idosos participantes de grupos de convivência de Unidades Básicas de Saúde. Observa-se que a independência funcional apresenta correlação com a qualidade de vida dos idosos, havendo significância estatística para os domínios 'Funcionamento do sensório', 'Autonomia' e 'Participação Social'. Concluiu-se que idosos funcionalmente independentes apresentam melhor qualidade de vida.

This study aimed to investigate the functional independence and its relations in the quality of life of elderly participants Basic Units of community groups Health. It was observed that the functional independence presents correlation with the quality of life of the elderly, with statistical significance for the domains 'functioning of the sensorium', 'autonomy' and 'social participation'. Cloncluded that functionally independent elderly present a better quality of life.

El objetivo de este estudio fue investigar la independencia funcional y su relación con la calidad de vida de los ancianos que participan en grupos de convivencia en Unidades Básicas de Salud. Se observa que la independencia funcional se correlaciona con la calidad de vida de los ancianos, con significación estadística para los dominios 'Función sensorial', 'Autonomía' y 'Participación social'. Se concluyó que las personas mayores funcionalmente independientes tienen una mejor calidad de vida.

Iniciação científica, vivências acadêmicas e rendimento de graduandos em Odontologia e Medicina / Scientific mentorship, academic experiences and undergraduate performance of Dentistry and Medicine students

O Programa de Iniciação Cientifica (PIC) busca despertar a vocação e estimular o desenvolvimento do pensamento científico em graduandos, tendo sido identificado previamente que a participação no PIC institucional apresentou impacto positivo no coeficiente de rendimento (CR) de estudantes de Odontologia, o que não ocorreu com os de Medicina. Desta forma, desenvolveu-se o presente estudo observacional, que visa avaliar aspectos pessoais, contextuais e vocacionais das vivências acadêmicas que possam ter influenciado este achado. Participaram 123 alunos PIC, sendo 74 (60,2%) do curso de Odontologia (O) e 49 (39,9%) do curso de Medicina (M). A versão reduzida do Questionário de Vivências Acadêmicas (QVA-r com 54 questões e resposta em escala do tipo Likert) foi aplicada. Os dados foram tabulados e analisados utilizando-se o teste t de Student (α=5%). Os principais resultados apontaram que as dimensões carreira, estudo e institucional diferiram entre os grupos, com maiores pontuações médias para estudantes do curso de Medicina na dimensão carreira (M=4,1±0,6; O=3,8±0,4). Para os do curso de Odontologia, maiores pontuações médias foram observadas nas dimensões estudo (M=3,6±0,5; O=3,9±0,7) e institucional (M=3,7±0,2; O=4,1±0,2). Não houve diferença entre os cursos considerando as dimensões pessoal e interpessoal e o QVAr geral. Conclui-se que vivências acadêmicas diferenciadas podem ter influenciado o antagônico impacto do PIC no CR dos estudantes de Odontologia e Medicina (AU).

The Scientific Mentorship Program (SMP) seeks to foster vocational aims and encourage the development of scientific thought in undergraduate students, and participation in the program has been found to have a positive impact on the performance coefficient (PC) of Dentistry students, but not in students from the Medicine course. The present observational study was therefore conducted to identify the personal, contextual and vocational aspects of the academic experiences of Medicine and Dentistry students, which may have influenced this finding. A total of 123 students participated in the study, of whom 74 (60.2%) were from the Dentistry (D) course and 49 (39.9%) from the Medicine (M) course. The short version of the Student Academic Experience Questionnaire (or QVA-r) was applied (54 questions/Likert Scale responses). The data were tabulated and submitted to statistical analysis using the Student's t-test (α=5%). The main results revealed that the career, study and institutional dimensions differed between the groups, with higher mean scores obtained by the students of the Medicine course in the career dimension (M=4.1±0.6a; D=3.8±0.4b). Higher scores were obtained for students from the Dentistry course in the study (M=3.6±0.5 b; D=3.9±0.7a) and institutional (M=3.7±0.2 b; D=4.1±0.2a) dimensions. There was no difference between the courses in the personal and interpersonal dimensions, or in the overall QVAr score. It was concluded that different academic experiences may have influenced the contrasting impact of the SMP on the PC of the Dentistry and Medicine students (AU).

Sala de professores em instalação: considerações sobre a vivência estética na formação de educadores / Teachers' lounge in installation: considerations on the aesthetic grasp of living experience in the formation of teachers / Sala de profesores en instalación: consideraciones sobre la vivencia estética enla formación de educadores

A oficina com recursos expressivos e apresentada neste artigo como um método de formação contínua para profissionais da educação. Através da vivência estética foram problematizadas questões organizacionais, técnico-profissionais e pessoais pertinentes à organizaçãodo trabalho educativo, relacionando-as à estruturação de práticas pedagógicas inseridas no contexto específico de cada escola. Para a análise desta temática, foi realizada pesquisa participante em grupo com diferentes segmentos de trabalhadores de uma escola pública municipal de São Paulo. A ontologia de Martin Heidegger ofereceu suporte teórico e metodológico para a estruturação das oficinas e análise das produções estéticas. As considerações de Hannah Arendt sobre a crise da educação na América nortearam a compreensão a respeito da diluição da tradição e seus reflexos sobre a desvalorização da profissão docente. A leitura de Bachelard e Baudrillard, dentre outros, abriu possibilidades de superação dessa problemática, através do desvelamento da dimensão poética do espaço de trabalho. Para os participantes, as oficinas com recursos expressivos constituiram-se em um trabalho de alicerce, a partir da reflexão e construção de novos sentidos para o fazer educativo, evidenciando-se o caráter político e pedagógico da vivência estética

The workshop with expressive recourses is herein presented as a method of continous formation of professionals in the field of education. Through the aesthetic grasp of livind experience, organizational, techcnical-professional and personal matters were questioned, pertaining to the organization of the educational chores, relating them to the structuralization of pedagogical practices inserted in the specific context of each school. For analyzing such theme, participant research was carried out in group of workes of different segments of the public-school net of the state of São Paulo. Marting Heidegger's ontology offered the theoretical and methodological supports of the aesthetical production. Hannah Arendt's considerations on the educational crisis in the Americas set north to understanding the dilution of the tradition and its consequences on the devaluation of the teaching professionals. The reading of Bachelard and Baudrillard, among others, opened the possibilities for overcoming this problem through the revelation of the poetic dimension of the working space. For the participants, the workshops with expressive recourses were a foundation-laying activity from the reflection and construction of new feelings towards the educational deeds, evidencing the political and pedagogical character of the aesthetic grasp of living experience.

Sala de professores em instalação: considerações sobre a vivência estética na formação de educadores / Teachers' lounge in installation: considerations on the aesthetic grasp of living experience in the formation of teachers / Sala de profesores en instalación: consideraciones sobre la vivencia estética enla formación de educadores

A oficina com recursos expressivos e apresentada neste artigo como um método de formação contínua para profissionais da educação. Através da vivência estética foram problematizadas questões organizacionais, técnico-profissionais e pessoais pertinentes à organizaçãodo trabalho educativo, relacionando-as à estruturação de práticas pedagógicas inseridas no contexto específico de cada escola. Para a análise desta temática, foi realizada pesquisa participante em grupo com diferentes segmentos de trabalhadores de uma escola pública municipal de São Paulo. A ontologia de Martin Heidegger ofereceu suporte teórico e metodológico para a estruturação das oficinas e análise das produções estéticas. As considerações de Hannah Arendt sobre a crise da educação na América nortearam a compreensão a respeito da diluição da tradição e seus reflexos sobre a desvalorização da profissão docente. A leitura de Bachelard e Baudrillard, dentre outros, abriu possibilidades de superação dessa problemática, através do desvelamento da dimensão poética do espaço de trabalho. Para os participantes, as oficinas com recursos expressivos constituiram-se em um trabalho de alicerce, a partir da reflexão e construção de novos sentidos para o fazer educativo, evidenciando-se o caráter político e pedagógico da vivência estética (AU)

The workshop with expressive recourses is herein presented as a method of continous formation of professionals in the field of education. Through the aesthetic grasp of livind experience, organizational, techcnical-professional and personal matters were questioned, pertaining to the organization of the educational chores, relating them to the structuralization of pedagogical practices inserted in the specific context of each school. For analyzing such theme, participant research was carried out in group of workes of different segments of the public-school net of the state of São Paulo. Marting Heidegger's ontology offered the theoretical and methodological supports of the aesthetical production. Hannah Arendt's considerations on the educational crisis in the Americas set north to understanding the dilution of the tradition and its consequences on the devaluation of the teaching professionals. The reading of Bachelard and Baudrillard, among others, opened the possibilities for overcoming this problem through the revelation of the poetic dimension of the working space. For the participants, the workshops with expressive recourses were a foundation-laying activity from the reflection and construction of new feelings towards the educational deeds, evidencing the political and pedagogical character of the aesthetic grasp of living experience. (AU)

A dimensão político-pedagógica da vivência estética no projeto da escola / Political-pedagogical dimension of aesthetic experience in school project

O projeto político-pedagógico da escola tem sido tema de debates, leituras e pesquisas para diferentes profissionais da educação preocupados com a qualidade do ensino público no Brasil. No entanto, o modo como essa discussão vem ocorrendo reflete a fragmentação do trabalho educativo, com a ruptura entre teoria e prática pedagógica, como também a ausência de condições técnico-financeiras para a plena execução de diferentes propostas, as quais vêm se sobrepondo sem a devida avaliação e continuidade. A partir de uma crítica ontológica do projeto, a pesquisa investigou as possibilidades de contribuição das oficinas com recursos expressivos para a análise e intervenção do psicólogo escolar junto aos eixos constituintes do projeto político-pedagógico. Inseridas como método de formação profissional contínua, as oficinas criaram um espaço em que diferentes segmentos de trabalhadores da escola puderam problematizar juntos, através da vivência estética, questões pertinentes à organização do trabalho educativo, em suas dimensões organizacionais, administrativas e técnico-profissionais, relacionando-as a totalidade de suas vidas. Tratou-se de uma pesquisa interventiva com fundamentação na filosofia existencial de Martin Heidegger, a qual norteou uma concepção de projeto lastreada na condição humana e ofereceu subsídios para a construção de uma proposta de intervenção e análise do processo vivencial dos grupos. A pesquisadora participou como facilitadora de três grupos de oficinas, acompanhada de dispositivos de registro imediato das vivências. Foram acolhidos como material de análise: entrevistas e depoimentos no decorrer do cotidiano de trabalho, relatos experienciais dos participantes das oficinas e a descrição das suas produções estéticas. A pesquisa ocorreu em uma escola municipal de ensino fundamental de São Paulo durante o ano letivo de 2003. As oficinas com recursos expressivos foram consideradas pelos participantes como espaço de apropriação de novos sentidos para os diferentes aspectos do trabalho educativo pertinentes ao projeto político-pedagógico da escola. Dificuldades antes tratadas de modo isolado foram reconhecidas como experiências comuns, adquirindo outros significados ao serem comunicadas no fazer poético...(AU)