Impact of COVID-19 pandemic in the Brazilian maternal mortality ratio: A comparative analysis of Neural Networks Autoregression, Holt-Winters exponential smoothing, and Autoregressive Integrated Moving Average models.

BACKGROUND AND OBJECTIVES: The acute respiratory infection caused by severe acute respiratory syndrome coronavirus disease (COVID-19) has resulted in increased mortality among pregnant, puerperal, and neonates. Brazil has the highest number of maternal deaths and a distressing fatality rate of 7.2%, more than double the country's current mortality rate of 2.8%. This study investigates the impact of the COVID-19 pandemic on the Brazilian Maternal Mortality Ratio (BMMR) and forecasts the BMMR up to 2025. METHODS: To assess the impact of the COVID-19 pandemic on the BMMR, we employed Holt-Winters, Autoregressive Integrated Moving Average (ARIMA), and Neural Networks Autoregression (NNA). We utilized a retrospective time series spanning twenty-five years (1996-2021) to forecast the BMMR under both a COVID-19 pandemic scenario and a controlled COVID-19 scenario. RESULTS: Brazil consistently exhibited high maternal mortality values (mean BMMR [1996-2019] = 57.99 ±6.34/100,000 live births) according to World Health Organization criteria. The country experienced its highest mortality peak in the historical BMMR series in the second quarter of 2021 (197.75/100,000 live births), representing a more than 200% increase compared to the previous period. Holt-Winter and ARIMA models demonstrated better agreement with prediction results beyond the sample data, although NNA provided a better fit to previous data. CONCLUSIONS: Our study revealed an increase in BMMR and its temporal correlation with COVID-19 incidence. Additionally, it showed that Holt-Winter and ARIMA models can be employed for BMMR forecasting with lower errors. This information can assist governments and public health agencies in making timely and informed decisions.

A cultura de segurança do paciente na perspectiva da equipe de enfermagem / Patient safety culture from the nursing team's perspective / La cultura de seguridad del paciente desde la perspectiva del equipo de enfermería

RESUMO Objetivo: identificar o conhecimento da equipe de enfermagem sobre a segurança do paciente e a ocorrência de eventos adversos em Pronto Atendimento Médico. Método: estudo transversal, quantitativo, desenvolvido em hospital de ensino da região Centro-Oeste do Brasil. Foi realizado com profissionais de enfermagem por meio de um questionário online contendo questões relacionadas à segurança do paciente, aplicado em setembro de 2021. A análise dos dados foi descritiva. Resultado: Noventa profissionais participaram do estudo, sendo 28(31,1%) enfermeiros e 62(68,9%) técnicos de enfermagem. Na avaliação dos itens do questionário, o melhor índice de acerto foi sobre higienização das mãos 84(93,3%), o pior item avaliado foi protocolo de identificação do paciente 45(50%). A lesão por pressão foi apontada como o evento adverso mais frequente 28(33%). Conclusão: os resultados evidenciam que a educação permanente é fundamental para os profissionais aplicarem as metas internacionais de segurança do paciente na prática.

ABSTRACT Objective: to identify the nursing staff knowledge about patient safety and the occurrence of adverse events in Emergency Medical Care. Method: cross-sectional, quantitative study, developed in a teaching hospital in the Midwest region of Brazil. It was conducted with nursing professionals through an online questionnaire containing questions related to patient safety, applied in September 2021. The data analysis was descriptive. Results: Ninety professionals participated in the study, 28(31.1%) being nurses and 62(68.9%) nursing technicians. In the evaluation of the questionnaire items, the best score was about hand hygiene 84(93.3%), the worst evaluated item was patient identification protocol 45(50%). Pressure ulcers were indicated as the most frequent adverse event 28(33%). Conclusion: the results indicate that continuing education is essential for professionals to apply the international patient safety goals in practice.

RESUMEN Objetivo: identificar el conocimiento del equipo de enfermería sobre la seguridad del paciente y la ocurrencia de eventos adversos en la Atención Médica de Urgencia. Método: estudio transversal, cuantitativo, desarrollado en un hospital escuela de la región Centro-Oeste de Brasil. Se realizó a profesionales de enfermería a través de un cuestionario online con preguntas relacionadas con la seguridad del paciente, aplicado en septiembre de 2021. El análisis de los datos fue descriptivo. Resultado: Noventa profesionales participaron en el estudio, siendo 28(31,1%) enfermeros y 62(68,9%) técnicos de enfermería. En la evaluación de los ítems del cuestionario, el mejor porcentaje de aciertos fue sobre higiene de manos 84(93,3%), el ítem peor evaluado fue protocolo de identificación del paciente 45(50%). Las úlceras por presión se señalaron como el acontecimiento adverso más frecuente 28(33%). Conclusión: los resultados muestran que la formación continua es esencial para que los profesionales apliquen en la práctica los objetivos internacionales de seguridad del paciente.

Effect of probiotic supplementation on plasma metabolite profile after Roux-Y gastric bypass: a prospective, randomized, double-blind, placebo-controlled clinical trial.

BACKGROUND/OBJECTIVE: There is evidence that metabolic profile changes after Roux-Y gastric bypass (RYGB), especially due to modifications in the gastrointestinal tract. In addition, previous studies have suggested that probiotics can modify the microbiome and produce metabolites important for metabolic health maintenance. In this sense, the aim of this study was to verify the influence of probiotic supplementation on the plasma metabolite profile after RYGB. METHODS: This was a randomized, double-blind, placebo-controlled clinical trial conducted with 31 patients subjected to RYGB surgery, randomized in probiotic group that was supplemented with a probiotic supplement (FloraVantage®) for 3 months after surgery or a placebo group. Plasma metabonomics was performed using nuclear magnetic resonance (NMR) at the preoperative period (T0) and at 45-50 days (T1) and 90-95 days (T2) during the postoperative period/intervention. RESULTS: Reductions in trimethylamine-N-oxide (TMAO) and alanine were observed in both groups, however this reduction was greater in the probiotic group (TMAO 13.82%, p = 0.01 and alanine 14.03%, p = 0.03) at T2. Additionally, ß-hydroxybutyrate (BHB) levels increased 10.77% in the probiotic group (p = 0.03) compared to the placebo group at T2. CONCLUSION: Supplementation with Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 was able to associate with significant differences in relevant plasma metabolites associated with improved metabolic health.

Vegetable oils: Are they true? A point of view from ATR-FTIR, 1H NMR, and regiospecific analysis by 13C NMR.

Problems related to oil authenticity make it difficult to obtain the benefits associated with each type of vegetable oil. Fraudulent practices have been revealed by several targeted and nontargeted methods. In this paper, spectroscopic techniques (FT-IR, 1H NMR, and 13C NMR) were applied to determine the chemical profiles of 23 Brazilian commercial vegetable oils obtained from five different high-value aggregated matrices (andiroba, babassu, baru, castor, and sweet almond oils) and investigate their adulteration, by comparison with the corresponding reference samples. Each technique is useful for the particular information it provides: differences in free fatty acids by FT-IR; adulteration with omega-3-enriched oils by 1H NMR, and adulteration of unsaturated-enriched oil with another unsaturated oil without linoleic acid by regiospecific analysis. Our findings highlight the importance of fusion-based methods in providing precise information for use in oil quality authentication.

Método canguru: conhecimentos e práticas da equipe multiprofissional / Kangaroo method: knowledge and practices of the multiprofessional team

Objetivo: Analisar o conhecimento e práticas dos profissionais de saúde que atuam na linha pediátrica de um hospital de ensino deCampoGrande/Mato Grosso do Sul sobre o Método Canguru. Métodos:Estudo descritivo e transversal realizado com dados primários, por meio de questionário aplicado de agosto a setembro de 2020 e na primeira quinzena de janeiro de 2021, com 98 profissionais de saúde da linha pediátrica. Os dados coletados foram armazenados e calculados por meio do programa Microsoft Office Excel. Resultados:A maioria foi do sexo feminino, declarada de cor branca e escolaridade de ensino superior com pós-graduação. Quanto aos aspectos profissionais, obteve a predominância de técnicos de enfermagem e tempo de serviço na instituição de aproximadamente 12 anos. A pesquisa demonstrou um maior percentual de respostas adequadas sobre o método, a Posição Canguru e sobre os seus benefícios nas explicaçõesdos profissionais da saúde que tinham o curso do Método Canguru, mais tempo de serviço na linha pediátrica e que atuavam na unidade neonatal. Além disso, a maioria tem conhecimento sobre o método e em quantas etapas se divide. Entretanto, alguns participantes têm a opinião equivocada de que o Método Canguru se restringe àPosição Canguru. Conclusões:Oestudopossibilitou a reflexão sobre o entendimento do método pelos profissionais da saúde que realizam assistência aos recém-nascidos e seus familiares. Tal fato pode contribuir para o aperfeiçoamento assistencial, além de incentivar os gestores de saúde na inserção da educação permanente e continuada dos profissionais da saúde sobre oMétodo Canguru.

Objective: To analyze the knowledge and practices of health professionals working in the pediatric line of a teaching hospital in Campo Grande/Mato Grosso do Sul about the Kangaroo Method. Methods:Descriptive and cross-sectional study carried out with primary data, through aquestionnaire applied from August to September 2020 and in the first half of January 2021, with 98 pediatric healthcare professionals. The collected data were stored and calculated using the Microsoft Office Excel program. Results:The majority were female, declared to be white and had completed higher education with a postgraduate degree. As for professional aspects, there was a predominance of nursing technicians and length of service at the institution of approximately 12 years. The survey showed a higher percentage of adequate answers about the method, the Kangaroo Position and about its benefits in the explanations of health professionals who had taken the Kangaroo Method course, more time in the pediatric line and who worked in the neonatal unit. In addition, most are knowledgeable about the method and how many steps it is divided into. However, some participants are of the mistaken opinion that the Kangaroo Method is restricted to the Kangaroo Position. Conclusion:The study allowed for reflection on the understanding of the method by health professionals who provide care to newborns and their families. This fact can contribute to the improvement of care, in addition to encouraging health managers in the insertion of permanent and continuing education for health professionals about the Kangaroo Method.

NMR-based approach reveals seasonal metabolic changes in mate (Ilex paraguariensis A. St.-Hil.).

Ilex paraguariensis (mate) is a species native to South America and is widely consumed in countries such Argentina, Uruguay, Paraguay, and Brazil. Mate consumption is associated with several phytotherapeutic functions, in addition to its cultural and regional importance. However, the harvest period can affect the properties of the mate, due to variations in the constituent proportions, as a consequence of seasonal changes. In this work, we employed nuclear magnetic resonance and chemometrics to evaluate the chemical variations in leaf extracts of I. paraguariensis over the four seasons of the year. We found significant changes in the levels of glucose, myo-inositol, caffeine, theobromine, and fatty acids. These changes can be related to resource allocation for the flowering period, or to responses to environmental stresses, such as temperature.

Inhibition of Mushroom Tyrosinase Activity by Orsellinates.

Several applications have been proposed for tyrosinase inhibitors in the pharmaceutical, food bioprocessing, and environmental industries. However, only a few compounds are known to serve as effective tyrosinase inhibitors. This study evaluated the tyrosinase-related activity of resorcinol (1), orcinol (2) lecanoric acid (3), and derivatives of this acid (4-15). Subjected to alcoholysis, lecanoric acid (3), a depside isolated from the lichen Parmotrema tinctorum, produces orsellinic acid (2,4-dihydroxy-6-methylbenzoic acid) (4) and orsellinates (2,4-dihydroxy-6-methyl benzoates) (5-15). At 0.50 mM, methyl (5), ethyl (6), n-propyl (7), tert-butyl (11), and n-cetyl orsellinates (15) acted as tyrosinase activators, whereas n-butyl (8), iso-propyl (9), sec-butyl (10), n-pentyl (12), n-hexyl (13), and n-octyl orsellinates (14) behaved as inhibitors. Tyrosinase inhibition rose with chain elongation-n-butyl (8)

Radical-scavenging activity of orsellinates.

Lichens are an important source of phenolic compounds and have been intensively investigated for their biological and pharmacological activities. Lecanoric acid (1), a lichen depside, was isolated from a Parmotrema tinctorum specimen and treated with alcohols to produce orsellinic acid (2) and orsellinates (3) to (9) (2,4-dihydroxy-6-n-methyl benzoates). Free radical scavenging activity of methyl (3), ethyl (4), n-propyl (5), n-butyl (6), iso-propyl (7), sec-butyl (8), tert-butyl (9) orsellinates was evaluated using 2,2'-diphenyl-1-picrylhydrazyl (DPPH) method. Results showed that chain elongation of methyl (3) to n-butyl (6) causes a rise in the antioxidant activity. However, iso-propyl (7) and tert-butyl (9) were more active than the correspondent linear compounds, although sec-butyl (8) was less active among the chain ramified compounds. All the orsellinates were less active than lecanoric acid (1) and orsellinic acid (2). Orcinol (10) and resorcinol (11) were also determined for comparison with activities of orsellinates. Gallic acid (12) was used as control.