Sharing lessons learned from COVID-19 vaccine introductions: a global community forum for countries.

To optimize the efficient introduction and deployment of COVID-19 vaccines across the globe during the COVID-19 pandemic, in April 2021 WHO launched a new process and tools for countries to rapidly review the early phase of countries' COVID-19 vaccine introduction. This methodology is called the COVID-19 vaccination intra-action review, also known as mini COVID-19 vaccine post-introduction evaluation (mini-cPIE). As of November 2022, 46 mini-cPIEs had been conducted. In collaboration with Project ECHO, WHO convened and facilitated real-time experience sharing and peer-learning among countries following their mini-cPIEs through a virtual global real-time learning forum. This five-session clinic series was attended by 736 participants from 129 countries. Based on post-session feedback surveys, when asked about the utility of the sessions, half of the participants said that sessions led them to review national guidelines and protocols or make other changes to their health systems. The post-series survey sent following the end of the clinic series showed that at least eight countries subsequently conducted a mini-cPIE after participating in the clinics, and participants from at least nine countries indicated the experience shared by peer countries on the clinic largely benefited their COVID-19 vaccine introduction and deployment. In this article, we highlight the benefits and importance of creating a global experience-sharing forum for countries to connect and share pertinent learnings in real-time during an international public health emergency. Moving forward, it is critical to foster a culture of individual and collective learning within and between countries during public health emergencies, with WHO playing an important convening role.

Body Condition Scores in Cats and Associations with Systolic Blood Pressure, Glucose Homeostasis, and Systemic Inflammation.

BACKGROUND: Feline obesity is the most common nutritional disease in cats. This study aimed to investigate the differences between systolic blood pressure (SBP) and circulating concentrations of glucose, fructosamine, and serum amyloid-A (SAA) in ideal-weight, overweight, and obese cats. METHODS: The animals were divided into three groups: ideal-weight (BCS 5, N = 20), overweight (BCS 6, N = 20), and obese cats (BCS ≥ 7, N = 20). SBP, circulating concentrations of glucose, fructosamine, and SAA were evaluated. RESULTS: The SBP values of the ideal-weight, overweight, and obese cats were 140.0 mmHg, 160.0 mmHg, and 160.0 mmHg, respectively. The blood glucose and fructosamine levels for the ideal, overweight, and obese cats were 104.0 mg/dL and 245.0 µmol/L, 123.0 mg/dL and 289.0 µmol/L, and 133.0 mg/dL and 275.0 µmol/L, respectively, for each group. The SAA values were <5 ug/mL in all the groups. The SBP values of the cats with ideal BCS were significantly lower compared to overweight (p = 0.019) and obese (p = 0.001) cats. The blood glucose values of obese cats were higher than those of ideal-weight cats (p = 0.029). There was no statistical difference between the groups for fructosamine and SAA. CONCLUSIONS: Obese cats had significantly higher SBP and blood glucose concentrations than ideal-weight cats, showing the effect of BSC on these parameters.

Citizen science data on urban forageable plants: a case study in Brazil.

This paper presents two key data sets derived from the Pomar Urbano project. The first data set is a comprehensive catalog of edible fruit-bearing plant species, native or introduced to Brazil. The second data set, sourced from the iNaturalist platform, tracks the distribution and monitoring of these plants within urban landscapes across Brazil. The study includes data from the capitals of all 27 federative units of Brazil, focusing on the ten cities that contributed the most observations as of August 2023. The research emphasizes the significance of citizen science in urban biodiversity monitoring and its potential to contribute to various fields, including food and nutrition, creative industry, study of plant phenology, and machine learning applications. We expect the data sets presented in this paper to serve as resources for further studies in urban foraging, food security, cultural ecosystem services, and environmental sustainability.

Leveraging citizen science for monitoring urban forageable plants.

Urbanization brings forth social challenges in emerging countries such as Brazil, encompassing food scarcity, health deterioration, air pollution, and biodiversity loss. Despite this, urban areas like the city of São Paulo still boast ample green spaces, offering opportunities for nature appreciation and conservation, enhancing city resilience and livability. Citizen science is a collaborative endeavor between professional scientists and nonprofessional scientists in scientific research that may help to understand the dynamics of urban ecosystems. We believe citizen science has the potential to promote human and nature connection in urban areas and provide useful data on urban biodiversity.

Assessing the phytotoxicity of wastewater from the structured-bed hybrid baffled reactor (SBHBR) for agricultural reuse during the germination phase.

This study investigated the quality of anaerobic (AnE) and oxic/anoxic (O/A) effluents from a continuous-feed structured-bed hybrid baffled reactor (SBHBR) treating dairy wastewater impacts on lettuce and cucumber germination. While sustainable technologies like SBHBR have successfully removed organic matter and total nitrogen from dairy wastewater, residual concentrations may still represent a risk to water resources. Therefore, phytotoxicity bioassays were conducted with lettuce and cucumber seeds in contact with effluent during early stages to evaluate the potential implications of dairy wastewater reuse in agriculture. The study also explored the potential of SBHBR technology in promoting water resource preservation and creating a sustainable energy and nutrient cycling system. The physicochemical parameters of both effluents were characterized, and the phytotoxicity was evaluated by measuring the germination index (GI), root length (RL), the number of germinated seeds (SG), and epicotyl elongation (EE) for both lettuce and cucumber. The study revealed that the O/A effluent demonstrated lower phytotoxicity than the AnE effluent. The mean results indicate that the O/A zone wastewater was more conducive to cucumber germination than the AnE zone. Moreover, a positive influence of organic matter in the effluent on root growth and epicotyl elongation in cucumber, as well as the presence of nitrogen on the germination index, in both plant species. These findings emphasize the importance of considering effluent characteristics for suitable irrigation, highlighting SBHBR's potential as an effective solution for treating and reusing dairy wastewater in agriculture. This approach helps conserve water resources and promote a sustainable energy and nutrient cycling system.

Efficacy of an oral formulation of afoxolaner and milbemycin oxime against Tunga penetrans in naturally infected dogs.

BACKGROUND: The sand flea Tunga penetrans is one of the agents of tungiasis, an important parasitic skin disease affecting humans and several mammalian species. Tungiasis is mainly observed in disadvantaged rural and peripheral urban communities in Latin America and sub-Saharan Africa. The dog is a major reservoir of Tunga fleas. Hematophagous adult female Tunga spp. embed and grow in their host's epidermis and cause cutaneous inflammatory disorders. NexGard Spectra® is an orally administered endectocide for dogs, a co-formulation of the isoxazoline afoxolaner and the macrocyclic lactone milbemycin oxime. The objective of this study was to assess the efficacy of this product against canine tungiasis. METHODS: A blinded, negative-controlled field trial was conducted in a Brazilian community known to be highly endemic for tungiasis. Sixty-six dogs naturally infected with live T. penetrans were randomly allocated to a treated group (44 dogs) and an untreated control group (22 dogs). In a first phase, dogs from the treated group were treated on days 0, 30, and 60. Efficacy was evaluated on the basis of the macroscopic parasitic skin lesions (Fortaleza classification) on days 7, 14, 21, 30, 45, 60, 75, and 90. In a second phase, to evaluate natural reinfections, all dogs were treated on day 90 and evaluated every 2 weeks thereafter until at least 30% of dogs were infected with live sand fleas. RESULTS: During the first phase, efficacy (reduction in live sand fleas) of 92.4% was demonstrated on day 7. From day 14 until day 90, the efficacy of NexGard Spectra® was 100%. In the second phase, all dogs were free of live T. penetrans from 15 until 45 days after the day 90 treatment; 60 days post-treatment, 11% of dogs were reinfected, and 75 days post-treatment, 40% of dogs were reinfected. CONCLUSIONS: NexGard Spectra® was demonstrated to be highly effective against canine tungiasis. In addition to an obvious beneficial effect on the health and welfare of the treated dog, the use of this product may have a one-health benefit on human cases by controlling the main reservoir of sand fleas.

Microbiological environmental contamination in a Pediatric Intensive Care Unit / Contaminação ambiental microbiológica em Unidade de Terapia Intensiva Pediátrica / Contaminación ambiental microbiológica en una Unidad de Cuidados Intensivos Pediátricos

Background and objectives: inanimate surfaces and equipment in the hospital environment are considered reservoirs of resistant and pathogenic microorganisms. In Pediatric Intensive Care Units, the risk of infection is also related to the severity of pathologies associated with the immaturity of the immune system of this population. This study aimed to investigate microbiological environmental contamination in a Pediatric Intensive Care Unit. Method: this is an exploratory cross-sectional study, carried out in a Pediatric Intensive Care Unit of a highly complex university hospital, located in southern Brazil. To assess environmental contamination, sterile swabs were rubbed on surfaces corresponding to the patient unit and in the common area. Results: twenty-eight surfaces were analyzed, 12 of which were located in units occupied by patients at the time of collection and 16 surfaces in the common use area. In the total number of surfaces analyzed by microbiological cultures, the patient unit showed 66.67% contamination by microorganisms, while surfaces in the common area showed 56.25%. Regarding the microbiological profile, all isolated microorganisms were Gram-positive and showed resistance, namely Staphylococcus aureus and coagulase-negative Staphylococcus. Conclusion: there was evidence of a high frequency of contamination on inanimate surfaces and equipment near and far from patients, essentially by pathogenic and multi-resistant microorganisms to antimicrobials.(AU)

Justificativa e objetivos: superfícies e equipamentos inanimados no ambiente hospitalar são considerados reservatórios de microrganismos resistentes e patogênicos. Nas Unidades de Cuidados Intensivos Pediátricos, o risco de infeção também está relacionado com a gravidade das patologias associadas à imaturidade do sistema imunitário desta população. Este estudo teve como objetivo investigar a contaminação microbiológica ambiental em uma Unidade de Terapia Intensiva Pediátrica. Método: trata-se de um estudo exploratório transversal, realizado em uma Unidade de Terapia Intensiva Pediátrica de um hospital universitário de alta complexidade, localizado no Sul do Brasil. Para avaliar a contaminação ambiental, foram esfregados swabs estéreis nas superfícies correspondentes à unidade do paciente e na área comum. Resultados: foram analisadas vinte e oito superfícies, sendo 12 localizadas em unidades ocupadas por pacientes no momento da coleta e 16 superfícies em área de uso comum. No total de superfícies analisadas por culturas microbiológicas, a unidade paciente apresentou 66,67% de contaminação por microrganismos, enquanto as superfícies da área comum apresentaram 56,25%. Quanto ao perfil microbiológico, todos os microrganismos isolados eram Gram-positivos e apresentavam resistência, nomeadamente Staphylococcus aureus e Staphylococcus coagulase-negativa. Conclusão: houve evidência de elevada frequência de contaminação em superfícies inanimadas e equipamentos próximos e distantes dos pacientes, essencialmente por microrganismos patogênicos e multirresistentes aos antimicrobianos.(AU)

Fundamento y objetivos: las superficies y equipos inanimados del ambiente hospitalario son considerados reservorios de microorganismos resistentes y patógenos. En las Unidades de Cuidados Intensivos Pediátricos el riesgo de infección también se relaciona con la gravedad de patologías asociadas a la inmadurez del sistema inmunológico de esta población. Este estudio tuvo como objetivo investigar la contaminación ambiental microbiológica en una Unidad de Cuidados Intensivos Pediátricos. Método: se trata de un estudio exploratorio transversal, realizado en una Unidad de Cuidados Intensivos Pediátricos de un hospital universitario de alta complejidad, ubicado en el sur de Brasil. Para evaluar la contaminación ambiental se frotaron hisopos estériles en las superficies correspondientes a la unidad de pacientes y en el área común. Resultados: se analizaron veintiocho superficies, 12 de las cuales estaban ubicadas en unidades ocupadas por los pacientes en el momento de la recogida y 16 superficies en el área de uso común. Del total de superficies analizadas por cultivos microbiológicos, la unidad de pacientes presentó un 66,67% de contaminación por microorganismos, mientras que las superficies del área común presentaron un 56,25%. En cuanto al perfil microbiológico, todos los microorganismos aislados fueron Gram positivos y presentaron resistencia, concretamente Staphylococcus aureus y Staphylococcus coagulasa negativo. Conclusión: se evidenció alta frecuencia de contaminación en superficies inanimadas y equipos cercanos y lejanos de los pacientes, esencialmente por microorganismos patógenos y multirresistentes a los antimicrobianos.(AU)

Predictors of Trypanosoma cruzi PCR positivity in patients with chronic Chagas disease.

BACKGROUND: A positive Trypanosoma cruzi polymerase chain reaction (PCR) is associated with a worse prognosis in patients with chronic Chagas disease (CD). OBJECTIVES: To study the association of clinical, electrocardiographic, and echocardiographic characteristics and biomarker blood levels with positive T. cruzi PCR in chronic CD. METHODS: This is a single-centre observational cross-sectional study. Positive T. cruzi PCR association with clinical, electrocardiographic, and echocardiographic characteristics, and biomarker blood levels were studied by logistic regression analysis. p values < 0.05 were considered significant. FINDINGS: Among 333 patients with chronic CD (56.4% men; 62 ± 10 years), T. cruzi PCR was positive in 41.1%. Stepwise multivariate logistic regression showed an independent association between positive T. cruzi PCR and diabetes mellitus {odds ratio (OR) 0.53 [95% confidence interval (CI) 0.30-0.93]; p = 0.03}, right bundle branch block [OR 1.78 (95% CI 1.09-2.89); p = 0.02], and history of trypanocidal treatment [OR 0.13 (95% CI 0.04-0.38); p = 0.0002]. Among patients with a history of trypanocidal treatment (n = 39), only four (10%) patients had a positive T. cruzi PCR. MAIN CONCLUSIONS: Among several studied parameters, only diabetes mellitus, right bundle branch block, and history of trypanocidal treatment showed an independent association with positive T. cruzi PCR. History of trypanocidal treatment was a strong protective factor against a positive T. cruzi PCR.

Learning strategies of undergraduate nursing students during the COVID-19 pandemic.

OBJECTIVES: to analyze the learning strategies used by nursing students from a public university, in remote teaching, during the COVID-19 pandemic. METHODS: a cross-sectional study developed with nursing students who attended remote teaching classes. The sample was obtained by convenience and data were collected online, with 112 participants. Student and Mann-Whitney tests were performed for data analysis. RESULTS: the most frequently used learning strategies were self-regulatory and cognitive. There was moderate use of interpersonal help-seeking and emotional control strategies. Male students, with a private study environment and good internet connection, used emotional control strategies more frequently. CONCLUSIONS: self-regulatory and cognitive learning strategies, appropriate for higher education, were frequently used by nursing students, which is an important tool for adapting these students to the university context.

Blood components requirement in Brazilian dengue outbreaks: A retrospective analysis between 2008 to 2019.

INTRODUCTION: Dengue is the most fatal virus disease spread by mosquito bites and Aedes aegypti is the main transmitting agent. It is an endemic disease in the tropical and subtropical regions, currently affecting more than 100 countries. Although most patients present mild forms of the disease, a considerable proportion of individuals has severe alterations in the blood count. The aim of this study was to evaluate the consumption pattern of blood components in epidemic and non-epidemic periods and to verify if there was an impact on dengue cases and the death rate. METHOD: This is a retrospective cross-sectional study conducted through the collection and analysis of data from the Brazilian Ministry of Health from 2008 to 2019 on new cases and deaths from dengue, as well as the consumption of blood components in the period mentioned by hemovigilance bulletins of the Brazilian authority. RESULTS: Regarding the results, no significant difference was found between the absolute amount of blood components used in years with an epidemic peak. Regarding the relative values, an important variation was shown among the distributive consumption patterns of blood components in the outbreak years. In the univariate linear regression analysis, there was statistical significance between the increase in the number of dengue cases and deaths from dengue with the increase in the consumption of red blood cell concentrates (RBP), platelet concentrates (PP), fresh frozen plasma (FFP) and cryoprecipitate (Cryo) (p-value < 0.05). The increase in dengue cases was related to the increase in Cryo consumption with clinical significance (R² > 0.5), but dengue deaths were not correlated to the same. In multivariate analysis, all regression models had clinical and statistical significance. CONCLUSION: The data obtained in the present study demonstrate that there is a relevant relationship between the increase in cases and deaths from dengue with the blood components usage, especially PP, FFP and cryoprecipitate.

"Educational Material on HIV": validity of health educational technology for people living with HIV.

OBJECTIVES: to validate the educational technology "Educational Material on HIV" (INPI - BR 10 2020 003765 0). METHODS: a methodological study with 39 expert judges in HIV/AIDS, using a 5-point Likert scale for assessment. Data were tabulated, processed and analyzed through descriptive analysis. Cronbach's alpha and McDonald's omega tests were performed to analyze internal consistency, and the Intraclass Correlation Coefficient, for reliability. Agreement was established by a Level Content Validity Index greater than 0.90. RESULTS: the assessment instrument showed high internal consistency (Cronbach's alpha of 0.89; McDonald's omega of 0.91) with reliable values. Based on the Intraclass Correlation Coefficient, judges' answers showed acceptable reliability, mean score 0.89 (p<0.001). Agreement among judges was greater than 0.90 in the three assessed dimensions (objectives, presentation and relevance). CONCLUSIONS: the technology was considered a qualified and adequate tool by the judges regarding its objectives, presentation and relevance.

Biomarkers and Echocardiographic Predictors of Cardiovascular Outcome in Patients With Chronic Chagas Disease.

Background Chagas disease (CD) presents an ominous prognosis. The predictive value of biomarkers and new echocardiogram parameters in adjusted models have not been well studied. Methods and Results There were 361 patients with chronic CD (57.6% men, 61±11 years of age, clinical forms: indeterminate 27.1%, cardiac 56.6%, digestive 3.6%, cardiodigestive 12.7%) included in this single-center, observational, prospective longitudinal study. Echocardiographic evaluation included strain analyses of left atrial, left ventricular (LV), and right ventricular and 3-dimensional analyses of left atrial and LV volumes. Biomarkers included cardiac troponin I, brain natriuretic peptide, transforming growth factor ß1, tumor necrosis factor, matrix metalloproteinases, and Trypanosoma cruzi polymerase chain reaction. The studied end point was a composite of CD-related mortality, heart transplant, hospital admission due to worsening heart failure, or new cardiac device insertion. Event-free survival was analyzed by multivariable regression analyses adjusted for competing risks. P values <0.05 were considered significant. The composite event occurred in 79 patients after 4.9±2.0 years follow-up. LV end-diastolic volume (hazard ratio [HR], 1.01 [95% CI, 1.00-1.02]; P=0.02), peak negative global atrial strain (HR, 1.08 [95% CI, 1.00-1.17]; P=0.04), LV global circumferential strain (HR, 1.12 [95% CI, 1.04-1.21]; P=0.003), LV torsion (HR, 0.55 [95% CI, 0.35-0.81]; P=0.003), brain natriuretic peptide (HR, 2.03 [95% CI, 1.23-3.34]; P=0.005), and positive T cruzi polymerase chain reaction (HR, 1.80 [95% CI, 1.12-2.91]; P=0.01) were end point predictors independent from age, sex, 2-dimensional echocardiographic indexes, hypertension, previous cardiac device, and CD cardiac form. Conclusions Two-dimensional strain- and 3-dimensional-derived parameters, brain natriuretic peptide, and positive T cruzi polymerase chain reaction can be useful for prediction of CD cardiovascular events.

Monitoring the Evolution of the Aroma Profile of Lager Beer in Aluminium Cans and Glass Bottles during the Natural Ageing Process by Means of HS-SPME/GC-MS and Multivariate Analysis.

Headspace solid-phase microextraction coupled to gas chromatography-mass spectrometry (HS-SPME/GC-MS), sensory evaluation, and multivariate analysis were applied to monitor and compare the evolution of the aromatic profile of a lager beer in different types of containers (aluminum cans and glass bottles) during the natural ageing process. Samples were aged naturally for a year in the absence of light with a controlled temperature of around 14 °C +/- 0.5 °C. The sensory evaluation applied was a blind olfactometric triangle test between canned and bottled samples at different periods of aging: fresh, 6 months, and 11 months. The sensory evaluation showed that the panelists were able to differentiate between samples, except for the fresh samples from the brewery. A total of 34 volatile compounds were identified using the HS-SPME/GC-MS technique for both packaging types in this experiment. The application of multivariate analysis to the GC-MS data showed that the samples could not be differentiated according to the type of packaging but could be differentiated by the ageing time. The results showed that the combination of sensory, HS-SPME-GC-MS, and multivariate analysis seemed to be a valuable tool for monitoring and identifying possible changes in the aroma profile of a beer during its shelf life. Furthermore, the results showed that storing beer under optimal conditions helped preserve its quality during its shelf life, regardless of the type of packaging (aluminum can and glass bottle).

Association between the Processed Dietary Pattern and Tumor Staging in Patients Newly Diagnosed with Head and Neck Squamous Cell Carcinoma.

PURPOSE: This study aimed to assess the association between dietary patterns and tumor staging and the degree of cell differentiation in patients with head and neck squamous cell carcinoma (HNSCC). METHODS: This cross-sectional study included 136 individuals newly diagnosed with different stages of HNSCC, aged 20- to 80 years-old. Dietary patterns were determined by principal component analysis (PCA), using data collected from a food frequency questionnaire (FFQ). Anthropometric, lifestyle, and clinicopathological data were collected from patients' medical records. Disease staging was categorized as initial stage (stages I and II), intermediary (stage III), and advanced (stage IV). Cell differentiation was categorized as poor, moderate, or well-differentiated. The association of dietary patterns with tumor staging and cell differentiation was evaluated using multinomial logistic regression models and adjusted for potential confounders. RESULTS: Three dietary patterns, "healthy," "processed," and "mixed," were identified. The "processed" dietary pattern was associated with intermediary (odds ratio (OR) 2.47; 95% confidence interval (CI) 1.43-4.26; p = 0.001) and advanced (OR 1.78; 95% CI 1.12-2.84; p = 0.015) staging. No association was found between dietary patterns and cell differentiation. CONCLUSION: A high adherence to dietary patterns based on processed foods is associated with advanced tumor staging in patients newly diagnosed with HNSCC.

Incidência de lesão por pressão no pós-operatório de cirurgias cardíacas / Incidence of pressure injuries in the postoperative period of cardiac surgeries

OBJETIVO: Identificar a incidência de Lesão por Pressão em pacientes submetidos à cirurgia cardíaca no ato da admissão na Unidade de Terapia Intensiva. MÉTODO: Estudo transversal e prospectivo. Realizado no pós-operatório de Cirurgia Cardíaca Adulto de um hospital público de grande porte. A amostra deste estudo compõe-se de 99 pacientes através de amostragem por conveniência. A coleta de dados se deu pelo preenchimento de um formulário semiestruturado contendo as variáveis sociodemográficas e cirúrgicas, as do pós-operatório e as relacionadas à lesão por pressão através das informações obtidas via prontuário eletrônico do paciente. RESULTADO: Evidencia-se no presente estudo uma incidência de lesão por pressão de 8,1%, com as classificações mais frequentes no estágio II (62%), seguida do estágio I (50%), lesão por presssão tissular profunda (25%) e por fim, lesões não classificáveis e por dispositivos médicos com 12%. Quanto ao local acometido identificou-se à região sacral (75%), seguido de calcâneo esquerdo e direto, glúteo esquerdo (25% em cada) e em demais locais como glúteo direito, labial, trocânter, maléolo e occipital (12%). A mortalidade foi maior nos pacientes que desenvolveram lesão por pressão e que a principal complicação no pós-operatório foi à presença de arritmia. CONCLUSÃO: Os achados evidenciaram a existência de associação de lesão por pressão em condições clínicas e procedimentos realizados no pós operatório de cirurgia cardiaca. Dessa forma, é essencial o conhecimento prévio do enfermeiro de preditores e complicações que amenizam a ocorrência de lesão por pressão para melhorar a qualidade de vida e segurança do paciente.

Molecular profile of patients with myelofibrosis: a 10-year experience.

OBJECTIVE: To analyze the karyotype test and myeloid panel with next-generation sequencing findings in patients with myelofibrosis, and to compare transplant characteristics in patients referred for bone marrow transplantation. METHODS: Retrospective, single-center study with patients diagnosed with myelofibrosis treated at Hospital Israelita Albert Einstein between 2010 and 2020. RESULTS: A total of 104 patients with myelofibrosis were examined. Patients who had not been submitted to tests in our service were excluded. The final sample comprised 69 patients. Of these 69, 56 were submitted to karyotyping and 22 to myeloid panel with next-generation sequencing. Karyotype was normal in 60% of the patients and altered in 40%. The prevalence of high-risk molecular mutations was higher in patients referred for bone marrow transplantation (100% versus 50%). The median follow-up of transplant patients was 2.4 years and the overall survival at 2 years was 80% (95%CI: 62-100%). CONCLUSION: The molecular analysis enables estimating the patient's risk and thus instituting more aggressive treatment such as bone marrow transplant for patients at higher risk, being a relevant tool to guide therapy. Given the significance of molecular analysis for therapeutic decision-making in myelofibrosis, collection and disclosure of data on the prevalence of cytogenetic changes and findings of next-generation sequencing in affected patients is important.

Multivariate Analysis of the Influence of Microfiltration and Pasteurisation on the Quality of Beer during Its Shelf Life.

Gas chromatography-mass spectrometry (GC-MS), physicochemical and microbiological analyses, sensory descriptive evaluation, and multivariate analyses were applied to evaluate the efficiencies of microfiltration and pasteurization processes during the shelf life of beer. Samples of microfiltered and pasteurised beer were divided into fresh and aged groups. A forced ageing process, which consisted of storing fresh samples at 55° C for 6 days in an incubator and then keeping them under ambient conditions prior to analysis, was applied. Physicochemical analysis showed that both microfiltered and pasteurised samples had a slight variation in apparent extract, pH, and bitterness. The samples that underwent heat treatment had lower colour values compared with those that were microfiltered. Chromatographic peak areas of vicinal diketones increased in both fresh and aged samples. The results of the microbiological analysis revealed spoilage lactic acid bacteria (Lactobacillus) and yeasts (Saccharomyces and non-Saccharomyces) in fresh microfiltered samples. In the GC-MS analysis, furfural, considered by many authors as a heat indicator, was detected only in samples that underwent forced ageing and not in samples that were subjected to thermal pasteurisation. Finally, sensory analysis found differences in the organoleptic properties of fresh microfiltered samples compared with the rest of the samples.

Molecular profile of patients with myelofibrosis: a 10-year experience

ABSTRACT Objective To analyze the karyotype test and myeloid panel with next-generation sequencing findings in patients with myelofibrosis, and to compare transplant characteristics in patients referred for bone marrow transplantation. Methods Retrospective, single-center study with patients diagnosed with myelofibrosis treated at Hospital Israelita Albert Einstein between 2010 and 2020. Results A total of 104 patients with myelofibrosis were examined. Patients who had not been submitted to tests in our service were excluded. The final sample comprised 69 patients. Of these 69, 56 were submitted to karyotyping and 22 to myeloid panel with next-generation sequencing. Karyotype was normal in 60% of the patients and altered in 40%. The prevalence of high-risk molecular mutations was higher in patients referred for bone marrow transplantation (100% versus 50%). The median follow-up of transplant patients was 2.4 years and the overall survival at 2 years was 80% (95%CI: 62-100%). Conclusion The molecular analysis enables estimating the patient's risk and thus instituting more aggressive treatment such as bone marrow transplant for patients at higher risk, being a relevant tool to guide therapy. Given the significance of molecular analysis for therapeutic decision-making in myelofibrosis, collection and disclosure of data on the prevalence of cytogenetic changes and findings of next-generation sequencing in affected patients is important.

Predictors of Trypanosoma cruzi PCR positivity in patients with chronic Chagas disease

BACKGROUND A positive Trypanosoma cruzi polymerase chain reaction (PCR) is associated with a worse prognosis in patients with chronic Chagas disease (CD). OBJECTIVES To study the association of clinical, electrocardiographic, and echocardiographic characteristics and biomarker blood levels with positive T. cruzi PCR in chronic CD. METHODS This is a single-centre observational cross-sectional study. Positive T. cruzi PCR association with clinical, electrocardiographic, and echocardiographic characteristics, and biomarker blood levels were studied by logistic regression analysis. p values < 0.05 were considered significant. FINDINGS Among 333 patients with chronic CD (56.4% men; 62 ± 10 years), T. cruzi PCR was positive in 41.1%. Stepwise multivariate logistic regression showed an independent association between positive T. cruzi PCR and diabetes mellitus {odds ratio (OR) 0.53 [95% confidence interval (CI) 0.30-0.93]; p = 0.03}, right bundle branch block [OR 1.78 (95% CI 1.09-2.89); p = 0.02], and history of trypanocidal treatment [OR 0.13 (95% CI 0.04-0.38); p = 0.0002]. Among patients with a history of trypanocidal treatment (n = 39), only four (10%) patients had a positive T. cruzi PCR. MAIN CONCLUSIONS Among several studied parameters, only diabetes mellitus, right bundle branch block, and history of trypanocidal treatment showed an independent association with positive T. cruzi PCR. History of trypanocidal treatment was a strong protective factor against a positive T. cruzi PCR.

Learning strategies of undergraduate nursing students during the COVID-19 pandemic / Estrategias de aprendizaje de estudiantes de pregrado en enfermería durante la pandemia de COVID-19 / Estratégias de aprendizagem de estudantes de graduação em Enfermagem durante a pandemia da COVID-19

ABSTRACT Objectives: to analyze the learning strategies used by nursing students from a public university, in remote teaching, during the COVID-19 pandemic. Methods: a cross-sectional study developed with nursing students who attended remote teaching classes. The sample was obtained by convenience and data were collected online, with 112 participants. Student and Mann-Whitney tests were performed for data analysis. Results: the most frequently used learning strategies were self-regulatory and cognitive. There was moderate use of interpersonal help-seeking and emotional control strategies. Male students, with a private study environment and good internet connection, used emotional control strategies more frequently. Conclusions: self-regulatory and cognitive learning strategies, appropriate for higher education, were frequently used by nursing students, which is an important tool for adapting these students to the university context.

RESUMEN Objetivos: analizar las estrategias de aprendizaje utilizadas por estudiantes de enfermería de una universidad pública, en la docencia a distancia, durante la pandemia del COVID-19. Métodos: estudio transversal desarrollado con estudiantes de enfermería que asistieron a clases de enseñanza a distancia. La muestra se obtuvo por conveniencia, y los datos se recolectaron en línea, con 112 participantes. Se realizaron las pruebas t de Student y Mann-Whitney para el análisis de datos. Resultados: las estrategias de aprendizaje más utilizadas fueron la autorregulatoria y la cognitiva. Hubo un uso moderado de estrategias de búsqueda de ayuda interpersonal y control emocional. Los estudiantes varones, con un ambiente de estudio privado y buena conexión a internet, utilizaron con mayor frecuencia estrategias de control emocional. Conclusiones: las estrategias de autorregulación y aprendizaje cognitivo, propias de la educación superior, fueron utilizadas con frecuencia por los estudiantes de enfermería, lo que constituye una herramienta importante para la adaptación de estos estudiantes al contexto universitario.

RESUMO Objetivos: analisar as estratégias de aprendizagem utilizadas por graduandos de enfermagem de uma universidade pública, no ensino remoto, durante a pandemia da COVID-19. Métodos: estudo transversal, desenvolvido com graduandos de enfermagem que cursaram as aulas no ensino remoto. A amostra foi obtida por conveniência, e os dados foram coletados de forma online com 112 participantes. Realizaram-se os Testes t de Student e Mann-Whitney para análise dos dados. Resultados: as estratégias de aprendizagem utilizadas com mais frequência foram as autorregulatórias e cognitivas. Houve uso moderado das estratégias de busca de ajuda interpessoal e de controle emocional. Estudantes do sexo masculino, com ambiente de estudo privativo e boa conexão com a internet, utilizaram mais frequentemente estratégias de controle emocional. Conclusões: estratégias de aprendizagem autorregulatórias e cognitivas, apropriadas ao Ensino superior, foram frequentemente utilizadas pelos graduandos de enfermagem, o que se configura importante ferramenta para adaptação desses estudantes ao contexto universitário.