Novel insight into the genetic diversity of strongylid nematodes infecting South-East and East Asian primates.

With many non-human primates (NHPs) showing continued population decline, there is an ongoing need to better understand their ecology and conservation threats. One such threat is the risk of disease, with various bacterial, viral and parasitic infections previously reported to have damaging consequences for NHP hosts. Strongylid nematodes are one of the most commonly reported parasitic infections in NHPs. Current knowledge of NHP strongylid infections is restricted by their typical occurrence as mixed infections of multiple genera, which are indistinguishable through traditional microscopic approaches. Here, modern metagenomics approaches were applied for insight into the genetic diversity of strongylid infections in South-East and East Asian NHPs. We hypothesized that strongylid nematodes occur in mixed communities of multiple taxa, dominated by Oesophagostomum, matching previous findings using single-specimen genetics. Utilizing the Illumina MiSeq platform, ITS-2 strongylid metabarcoding was applied to 90 samples from various wild NHPs occurring in Malaysian Borneo and Japan. A clear dominance of Oesophagostomum aculeatum was found, with almost all sequences assigned to this species. This study suggests that strongylid communities of Asian NHPs may be less species-rich than those in African NHPs, where multi-genera communities are reported. Such knowledge contributes baseline data, assisting with ongoing monitoring of health threats to NHPs.

Genetic analysis of the tomato russet mite provides evidence of oligophagy and a widespread pestiferous haplotype.

Worldwide, the tomato russet mite (TRM), Aculops lycopersici (Eriophyidae), is a key pest on cultivated tomato in addition to infesting other cultivated and wild Solanaceae; however, basic information on TRM supporting effective control strategies is still lacking, mainly regarding its taxonomic status and genetic diversity and structure. As A. lycopersici is reported on different species and genera of host plants, populations associated with different host plants may constitute specialized cryptic species, as shown for other eriophyids previously considered generalists. The main aims of this study were to (i) confirm the TRM taxonomic unity of populations from different host plants and localities as well as the species' oligophagy, and (ii) to advance the understanding of TRM host relationship and invasion history. For this purpose, we evaluated the genetic variability and structure of populations from different host plants along crucial areas of occurrence, including the area of potential origin, based on DNA sequences of mitochondrial (cytochrome c oxidase subunit I) and nuclear (internal transcribed spacer, D2 28S) genomic regions. Specimens from South America (Brazil) and Europe (France, Italy, Poland, The Netherlands) were collected from tomato and other solanaceous species from the genera Solanum and Physalis. Final TRM datasets were composed of 101, 82 and 50 sequences from the COI (672 bp), ITS (553 bp) and D2 (605 bp) regions, respectively. Distributions and frequencies of haplotypes (COI) and genotypes (D2 and ITS1) were inferred; pairwise genetic distance comparisons, and phylogenetic analysis were performed, including Bayesian Inference (BI) combined analysis. Our results showed that genetic divergences for mitochondrial and nuclear genomic regions from TRM associated with different host plants were lower than those observed in other eriophyid taxa, confirming conspecificity of TRM populations and oligophagy of this eriophyid mite. Four haplotypes (cH) were identified from the COI sequences with cH1 being the most frequent, representing 90% of all sequences occurring in all host plants studied (Brazil, France, The Netherlands); the other haplotypes were present exclusively in Brazilian populations. Six variants (I) were identified from the ITS sequences: I-1 was the most frequent (76.5% of all sequences), spread in all countries and associated with all host plants, except S. nigrum. Just one D2 sequence variant was found in all studied countries. The genetic homogeneity among populations highlights the occurrence of a highly invasive and oligophagous haplotype. These results failed to corroborate the hypothesis that differential symptomatology or damage intensity among tomato varieties and solanaceous host plants could be due to the genetic diversity of the associated mite populations. The genetic evidence, along with the history of spread of cultivated tomato, corroborates the hypothesis of a South American origin of TRM.

Show me your best side: Lateralization of social and resting behaviors in feral horses.

Growing evidence shows a variety of sensorial and motor asymmetries in social and non-social interactions in various species, indicating a lateralized processing of information by the brain. Using digital video cameras on tripods and drones, this study investigated lateralization in frequency and duration of social behavior patterns, in affiliative, agonistic, and resting contexts, in a feral population of horses (Equus ferus caballus) in Northern Portugal, consisting of 37 individuals organized in eight harem groups. Affiliative interactions (including grooming) were more often performed, and lasted longer, when recipients were positioned to the right side. In recumbent resting (animals lying down) episodes on the left side lasted longer. Our results of an affiliative behavior having a right side tendency, provide partial support to the valence-specific hypothesis of Ahern and Schwartz (1979) - left hemisphere dominance for positive affect, affiliative behaviors. Longer recumbent resting episodes on the left side may be due to synchronization. However, in both instances it is discussed how lateralization may be context dependent. Investigating the position asymmetries of social behaviors in feral equids will contribute to a better understanding of differential lateralization and hemispheric specialization from the ecological and evolutionary perspectives.

SARS-CoV-2 Detection via RT-PCR in Matched Saliva and Nasopharyngeal Samples Reveals High Concordance in Different Commercial Assays.

BACKGROUND: Self-collected saliva samples can increase the diagnostic efficiency and benefit healthcare workers, patient care, and infection control. This study evaluated the performance of self-collected saliva samples compared to nasopharyngeal swabs using three commercial kits for the qualitative detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: Matched nasopharyngeal and saliva samples were collected from 103 patients with either asymptomatic or symptomatic COVID-19. Both samples were evaluated using three commercial kits (TaqCheck, Allplex, and TaqPath). To evaluate sample stability, viral RNA extraction was performed in the presence or absence of an RNA-stabilizing solution. Storage conditions, including the duration, temperature, and stability after freezing and thawing of the samples, were also evaluated. RESULTS: All the saliva samples showed 100% concordance with the nasopharyngeal swab results using TaqCheck and Allplex kits, and 93% using TaqPath kit. No difference was observed in the samples that used the RNA-stabilizing solution compared to the group without the solution. The Ct values of the freeze-thawed samples after 30 days were higher than those on day 0; however, the results were consistent the fresh samples. CONCLUSION: The high concordance of SARS-CoV-2 detection via reverse transcription-polymerase chain reaction (RT-PCR) in matched saliva and nasopharyngeal samples using different commercial assays reinforces the concept that self-collected saliva samples are non-invasive, rapid, and reliable for diagnosing SARS-CoV-2 infection.

Application of Augmentative and Alternative Communication to stimulate communicative intention and cognition in patients with Autism Spectrum Disorder / A aplicação da Comunicação Suplementar e Alternativa para a estimulação da intenção comunicativa e da cognição em pacientes com Transtorno do Espectro Autista

ABSTRACT Purpose: to assess the advancement in communicative intention and cognition in children with autism spectrum disorder after applying a personalized alternative communication method. Methods: patients had their communicative intention and cognition (Vineland-3) assessed before and after the intervention with 10 structured alternative communication sessions. The "Demystifying Alternative Communication" podcast was developed as supplementary material to this study. Student's t-test was used, setting the significance level at p < 0.05. Results: patients improved their communicative intention, with higher scores after the intervention, and no changes were found in relation to cognition. Conclusion: even though the patients' equivalent age was inferior to their real age in the communication subdomain assessment, they progressed in expressive communication, language, and writing.

RESUMO Objetivo: avaliar o avanço da intenção comunicativa e da cognição em crianças com Transtorno do Espectro Autista após a aplicação de metodologia personalizada de comunicação alternativa. Métodos: foram realizadas dez sessões estruturadas de comunicação alternativa e os pacientes foram avaliados antes e após a intervenção quanto a intenção comunicativa e cognição (Vineland-3). Como material suplementar deste trabalho, foi elaborado o podcast "Desmistificando a Comunicação Alternativa". Foi utilizado teste t-Student com o p <0,05 onsiderado significante. Resultados: os pacientes apresentaram melhoras quanto à intenção comunicativa, demonstrando maiores escores após a realização da intervenção. Conclusão: apesar de os pacientes apresentarem uma idade equivalente inferior à idade real na avaliação do subdomínio da comunicação, estes demonstraram avanços quanto às variáveis de comunicação expressiva, linguagem e escrita.

Tecnologia de informação para atendimento de urgência e emergência: Revisão integrativa / Information technology for urgent and emergency care: Integrative review

RESUMO Objetivo: Identificar na literatura científica as tecnologias desenvolvidas para integração e otimização dos serviços de urgência e emergência. Metodologia: Trata-se de uma revisão integrativa de literatura. Para seleção dos artigos, utilizou-se acesso on-line nas bases de dados MedLine, PubMed, Lilacs; Scielo; BVS; Science Direct; Cochrane Library; Scopus e o buscador Google Acadêmico, publicados no período de 2011 a 2019, e a coleta de dados ocorreu de outubro a dezembro de 2019. A análise dos dados ocorreu mediante a leitura exploratória, seletiva, analítica e interpretativa dos artigos e os resultados foram apresentados sob a forma de quadros. Resultados: Identificou-se que nos 11 artigos selecionados dentre as tecnologias elencadas principalmente as classificadas como "dura" contêm múltiplas funções, inclusive registro de dados clínicos, monitorando o serviço médico, cálculo programado de medicações, tele radiologia entre outros serviços que propiciam a otimização dos serviços prestados dentro da Rede de Atenção às Urgências e Emergências Conclusão: Os estudos mostraram que as tecnologias digitais, são uma ferramenta adequada para apoiar as práticas do cuidado ao paciente crítico dentro dos serviços de atendimento de urgência e emergência. Verificou-se também que os aplicativos móveis podem ser eficazes, pois foram considerados úteis no acompanhamento da dor, manejo clínico de especialidades, preparo de medicamentos, mapeamento de áreas críticas, classificação de risco, reprodução de exames de imagens assim como no auxílio aos clientes no que se diz respeito a fornecer informações sobre a ordem e rapidez do atendimento.

RESUMEN Objetivo: Identificar en la literatura científica las tecnologías desarrolladas para la integración y optimización de los servicios de urgencia y emergencia. Método: Se trata de una revisión integrativa de literatura. Para la recopilación de los artículos, se utilizó acceso online a las bases de datos MedLine, PubMed, Lilacs, Scielo, BVS, Science Direct, Cochrane Library, Scopus. Además, se usó el buscador Google Académico. Se buscaron artículos publicados en el período de 2011 a 2019. Dicha recolección de información se dio de octubre a diciembre de 2019. El análisis de los datos se realizó por intermedio de la lectura exploratoria, selectiva, analítica e interpretativa de los artículos. Los resultados se presentaron en cuadros. Resultados: Se identificó que los 11 artículos seleccionados entre las tecnologías especificadas, principalmente las clasificadas como "duras", contienen múltiples funciones. Entre estas, registro de datos clínicos, monitoreo del servicio médico, cálculo programado de medicaciones, teleradiología, entre otros servicios que propician la optimización de los servicios ofrecidos por la Red de Atención las Urgencias y Emergencias Conclusión: Los estudios apuntaron a que las tecnologías digitales son una herramienta adecuada para apoyar las prácticas del cuidado al paciente crítico, dentro de los servicios de atención de urgencia y emergencia. Se verificó también que las aplicaciones para móviles pueden ser eficaces, pues se consideraron útiles en el acompañamiento del dolor, manejo clínico de especialidades, preparación de medicamentos, mapeo de áreas críticas, clasificación de riesgo, reproducción de exámenes de imágenes, así como en la ayuda a los clientes con relación a ofrecer información sobre la orden y rapidez de la atención.

ABSTRACT Objective: To identify in the scientific literature the technologies developed for the integration and optimization of urgent emergency services. Method: This is an integrative literature review. To select the articles, the researchers accessed the online databases MedLine, PubMed, Lilacs, Scielo, BVS, Science Direct, Cochrane Library, Scopus, and the Google Academic search engine. The articles considered were the ones published from 2011 to 2019, and the data were collected from October to December 2019. Data analysis occurred throughout an exploratory, selective, analytical, and interpretive reading of the articles, and the results were presented in boxes. Results: Eleven articles were selected, and among the technologies listed in them, those classified as "hard" are the ones that contain the most multiple functions; these include clinical data recording, medical service monitoring, programmed calculation of medications, teleradiology, among other services that optimize the services provided in the Urgent and Emergency Care Network. Conclusion: Studies have shown that digital technologies are an adequate tool to support critical patient care practices within the urgent and emergency care services. Mobile applications can be effective as they were considered useful for pain monitoring, clinical management of specialties, drug preparation, mapping of critical areas, risk classification, reproduction of imaging tests as well as in helping clients to provide them information on the order and speed of service.

Tecnologia de informação para atendimento de urgência e emergência: revisão integrativa

Objetivo: Identificar na literatura científica as tecnologias desenvolvidas para integração e otimização dos serviços de urgência e emergência. Metodologia: Trata-se de uma revisão integrativa de literatura. Para seleção dos artigos, utilizou-se acesso on-line nas bases de dados MedLine, PubMed, Lilacs; Scielo; BVS; Science Direct; Cochrane Library; Scopus e o buscador Google Acadêmico, publicados no período de 2011 a 2019, e a coleta de dados ocorreu de outubro a dezembro de 2019. A análise dos dados ocorreu mediante a leitura exploratória, seletiva, analítica e interpretativa dos artigos e os resultados foram apresentados sob a forma de quadros. Resultados: Identificou-se que nos 11 artigos selecionados dentre as tecnologias elencadas principalmente as classificadas como "dura" contêm múltiplas funções, inclusive registro de dados clínicos, monitorando o serviço médico, cálculo programado de medicações, tele radiologia entre outros serviços que propiciam a otimização dos serviços prestados dentro da Rede de Atenção às Urgências e Emergências Conclusão: Os estudos mostraram que as tecnologias digitais, são uma ferramenta adequada para apoiar as práticas do cuidado ao paciente crítico dentro dos serviços de atendimento de urgência e emergência. Verificou-se também que os aplicativos móveis podem ser eficazes, pois foram considerados úteis no acompanhamento da dor, manejo clínico de especialidades, preparo de medicamentos, mapeamento de áreas críticas, classificação de risco, reprodução de exames de imagens assim como no auxílio aos clientes no que se diz respeito a fornecer informações sobre a ordem e rapidez do atendimento.

Objetivo: Identificar en la literatura científica las tecnologías desarrolladas para la integración y optimización de los servicios de urgencia y emergencia. Método: Se trata de una revisión integrativa de literatura. Para la recopilación de los artículos, se utilizó acceso online a las bases de datos MedLine, PubMed, Lilacs, Scielo, BVS, Science Direct, Cochrane Library, Scopus. Además, se usó el buscador Google Académico. Se buscaron artículos publicados en el período de 2011 a 2019. Dicha recolección de información se dio de octubre a diciembre de 2019. El análisis de los datos se realizó por intermedio de la lectura exploratoria, selectiva, analítica e interpretativa de los artículos. Los resultados se presentaron en cuadros. Resultados: Se identificó que los 11 artículos seleccionados entre las tecnologías especificadas, principalmente las clasificadas como "duras", contienen múltiples funciones. Entre estas, registro de datos clínicos, monitoreo del servicio médico, cálculo programado de medicaciones, teleradiología, entre otros servicios que propician la optimización de los servicios ofrecidos por la Red de Atención las Urgencias y Emergencias Conclusión: Los estudios apuntaron a que las tecnologías digitales son una herramienta adecuada para apoyar las prácticas del cuidado al paciente crítico, dentro de los servicios de atención de urgencia y emergencia. Se verificó también que las aplicaciones para móviles pueden ser eficaces, pues se consideraron útiles en el acompañamiento del dolor, manejo clínico de especialidades, preparación de medicamentos, mapeo de áreas críticas, clasificación de riesgo, reproducción de exámenes de imágenes, así como en la ayuda a los clientes con relación a ofrecer información sobre la orden y rapidez de la atención.

Objective: To identify in the scientific literature the technologies developed for the integration and optimization of urgent emergency services. Method: This is an integrative literature review. To select the articles, the researchers accessed the online databases MedLine, PubMed, Lilacs, Scielo, BVS, Science Direct, Cochrane Library, Scopus, and the Google Academic search engine. The articles considered were the ones published from 2011 to 2019, and the data were collected from October to December 2019. Data analysis occurred throughout an exploratory, selective, analytical, and interpretive reading of the articles, and the results were presented in boxes. Results: Eleven articles were selected, and among the technologies listed in them, those classified as "hard" are the ones that contain the most multiple functions; these include clinical data recording, medical service monitoring, programmed calculation of medications, teleradiology, among other services that optimize the services provided in the Urgent and Emergency Care Network. Conclusion: Studies have shown that digital technologies are an adequate tool to support critical patient care practices within the urgent and emergency care services. Mobile applications can be effective as they were considered useful for pain monitoring, clinical management of specialties, drug preparation, mapping of critical areas, risk classification, reproduction of imaging tests as well as in helping clients to provide them information on the order and speed of service.

Resistance to diseases of sour, sweet and wild passion fruit genotypes

The cultivation of passion fruit is important for Brazil, since the country is currently the largest producer and consumer of fruit in the world. However, the fields of passion fruit still face important problems due to the incidence and severity of diseases in the field. Thus, the present study aimed to assess resistance to bacterial and fungal diseases in 13 genotypes of sour, sweet and wild passion fruit, in field conditions in the Distrito Federal, Brazil. For this, a field experiment was installed in a randomized block design, with four replications and 13 treatments (genotypes). The characteristics of incidence, severity and degree of resistance for bacteriosis, septoriosis, scab and anthracnose diseases were evaluated in 5 fruits per plot of each genotype. Genetic parameters of the evaluated traits were also estimated. High heritability values and CVg/Cve ratio were observed for most of the evaluated characteristics. The genotypes presented mean values of incidence and severity of bacteriosis, septoriosis, scab and anthracnose different among them, and the one that presented the best results in the degree of resistance for all diseases was F1 (MAR20 # 24 x ECL7 P1 R4).

Case Report of Rare Parathyroid Tumor with Atypical Presentation and Early Diagnosis.

Parathyroid carcinoma is a rare condition, accounting for 1% of cases of hyperparathyroidism. Other causes of hyperparathyroidism main group are single adenoma and parathyroid hyperplasia. The clinics presented by the patients are typical of hyperparathyroidism (fatigue, weakness, weight loss, and anorexia), bone impairment, pain, and fractures, in addition to affecting the renal system The diagnosis of parathyroid carcinoma is most often done postoperatively by means of a histological study. The case report is a 49-year-old male patient who came to the emergency room of Mackenzie Evangelical University Hospital complaining of progressive "muscle weakness" and "joint" that started about 2 months ago. To raise the suspicion of parathyroid carcinoma, it is essential to perform the correlation of the clinical picture, biochemical values, and imaging exams, but to obtain the definitive diagnosis, intraoperative recognition of the tumor and the result of the histopathological examination of the resected tumor are necessary.

Heterologous versus homologous COVID-19 booster vaccination in previous recipients of two doses of CoronaVac COVID-19 vaccine in Brazil (RHH-001): a phase 4, non-inferiority, single blind, randomised study.

INTRODUCTION: The inactivated whole-virion SARS-CoV-2 vaccine (CoronaVac, Sinovac) has been widely used in a two-dose schedule. We assessed whether a third dose of the homologous or a different vaccine could boost immune responses. METHODS: RHH-001 is a phase 4, participant masked, two centre, safety and immunogenicity study of Brazilian adults (18 years and older) in São Paulo or Salvador who had received two doses of CoronaVac 6 months previously. The third heterologous dose was of either a recombinant adenoviral vectored vaccine (Ad26.COV2-S, Janssen), an mRNA vaccine (BNT162b2, Pfizer-BioNTech), or a recombinant adenoviral-vectored ChAdOx1 nCoV-19 vaccine (AZD1222, AstraZeneca), compared with a third homologous dose of CoronaVac. Participants were randomly assigned (5:6:5:5) by a RedCAP computer randomisation system stratified by site, age group (18-60 years or 61 years and over), and day of randomisation, with a block size of 42. The primary outcome was non-inferiority of anti-spike IgG antibodies 28 days after the booster dose in the heterologous boost groups compared with homologous regimen, using a non-inferiority margin for the geometric mean ratio (heterologous vs homologous) of 0·67. Secondary outcomes included neutralising antibody titres at day 28, local and systemic reactogenicity profiles, adverse events, and serious adverse events. This study was registered with Registro Brasileiro de Ensaios Clínicos, number RBR-9nn3scw. FINDINGS: Between Aug 16, and Sept 1, 2021, 1240 participants were randomly assigned to one of the four groups, of whom 1239 were vaccinated and 1205 were eligible for inclusion in the primary analysis. Antibody concentrations were low before administration of a booster dose with detectable neutralising antibodies of 20·4% (95% CI 12·8-30·1) in adults aged 18-60 years and 8·9% (4·2-16·2) in adults 61 years or older. From baseline to day 28 after the booster vaccine, all groups had a substantial rise in IgG antibody concentrations: the geometric fold-rise was 77 (95% CI 67-88) for Ad26.COV2-S, 152 (134-173) for BNT162b2, 90 (77-104) for ChAdOx1 nCoV-19, and 12 (11-14) for CoronaVac. All heterologous regimens had anti-spike IgG responses at day 28 that were superior to homologous booster responses: geometric mean ratios (heterologous vs homologous) were 6·7 (95% CI 5·8-7·7) for Ad26.COV2-S, 13·4 (11·6-15·3) for BNT162b2, and 7·0 (6·1-8·1) for ChAdOx1 nCoV-19. All heterologous boost regimens induced high concentrations of pseudovirus neutralising antibodies. At day 28, all groups except for the homologous boost in the older adults reached 100% seropositivity: geometric mean ratios (heterologous vs homologous) were 8·7 (95% CI 5·9-12·9) for Ad26.COV2-S vaccine, 21·5 (14·5-31·9) for BNT162b2, and 10·6 (7·2-15·6) for ChAdOx1 nCoV-19. Live virus neutralising antibodies were also boosted against delta (B.1.617.2) and omicron variants (B.1.1.529). There were five serious adverse events. Three of which were considered possibly related to the vaccine received: one in the BNT162b2 group and two in the Ad26.COV2-S group. All participants recovered and were discharged home. INTERPRETATION: Antibody concentrations were low at 6 months after previous immunisation with two doses of CoronaVac. However, all four vaccines administered as a third dose induced a significant increase in binding and neutralising antibodies, which could improve protection against infection. Heterologous boosting resulted in more robust immune responses than homologous boosting and might enhance protection. FUNDING: Ministry of Health, Brazil.

Tecnologias da informação e comunicação: visão dos profissionais do atendimento móvel de urgência e emergência / Information and communication technologies: the perspective of the urgency and emergency mobile care service professionals / Tecnologías de la información y la comunicación: la perspectiva de los profesionales del servicio móvil de urgencias y emergencias

RESUMO Objetivo: avaliar o interesse, acesso e conhecimento dos profissionais do Atendimento Móvel de Urgência e Emergência em relação às Tecnologias da Informação e Comunicação no Serviço. Método: estudo descritivo e transversal realizado com profissionais (médicos, enfermeiros, técnicos de enfermagem e condutores) do Serviço de Atendimento Móvel de Urgência do noroeste do Paraná, Brasil, em setembro e outubro de 2020. Os dados foram coletados por meio de instrumento estruturado e analisados por estatística descritiva. Resultados: dos 30 profissionais participantes, 80% relataram acesso apenas a um celular simples e 86,7% acreditam na viabilidade de um sistema informatizado que auxilie no atendimento e no tempo/resposta da ocorrência. Conclusão: apesar do déficit de tecnologias dentro do serviço pesquisado e da insatisfação desses profissionais, estes anseiam por tecnologias que agilizem o atendimento gerando diminuição do tempo/resposta da ocorrência. Assim, os resultados podem subsidiar a gestão dos serviços e contribuir positivamente para a prática profissional da equipe do SAMU.

ABSTRACT Objective: to assess the interest, access and knowledge of the Urgency and Emergency Mobile Care Service professionals in relation to Information and Communication Technologies in such service. Method: a descriptive and cross-sectional study conducted with Urgency and Emergency Mobile Care Service professionals (physicians, nurses, nursing technicians and drivers) in September and October 2020 in the Northwest region of the state of Paraná, Brazil. The data were collected through a structured instrument and analyzed by means of descriptive statistics. Results: of the 30 participants, 80% reported access only to a simple cell phone, and 86.7% believed in the viability of a computerized system to assist in care provision and in the improvement of the response time for the event. Conclusion: despite the technological deficit in the service researched and dissatisfaction of its professionals, they wish for technologies to streamline care, thus reducing the response time for the event. Thus, the results can support management of the services and bring about positive contributions to the SAMU team professional practice.

RESUMEN Objetivo: evaluar el interés, acceso y conocimiento de los profesionales del Servicio Móvil de Urgencias y Emergencias en relación con las Tecnologías de la Información y la Comunicación en dicho servicio. Método: estudio descriptivo y transversal realizado con profesionales (médicos, enfermeros, técnicos de enfermería y choferes) del Servicio Móvil de Atención de Urgencias del noroeste de Paraná, Brasil, en los meses de septiembre y octubre de 2020. Los datos se recolectaron por medio de un instrumento estructurado y se los analizó a través de estadística descriptiva. Resultados: de los 30 profesionales participantes, el 80% informó tener acceso solamente a un celular simple y el 86,7% cree en la viabilidad de un sistema informatizado que asista en la atención y en el tiempo de respuesta ante el evento. Conclusión: a pesar de la falta de tecnologías dentro del servicio investigado y la insatisfacción de estos profesionales, anhelan tecnologías que agilicen el servicio, generando una reducción en el tiempo de respuesta ante el evento. De esta manera, los resultados pueden sustentar la gestión de los servicios y contribuir en forma positiva a la práctica profesional del equipo del SAMU.

Efficacy of Brazilian green propolis (EPP-AF®) as an adjunct treatment for hospitalized COVID-19 patients: A randomized, controlled clinical trial.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) promotes challenging immune and inflammatory phenomena. Though various therapeutic possibilities have been tested against coronavirus disease 2019 (COVID-19), the most adequate treatment has not yet been established. Propolis is a natural product with considerable evidence of immunoregulatory and anti-inflammatory activities, and experimental data point to potential against viral targets. We hypothesized that propolis can reduce the negative effects of COVID-19. METHODS: In a randomized, controlled, open-label, single-center trial, hospitalized adult COVID-19 patients were treated with a standardized green propolis extract (EPP-AF®ï¸) as an adjunct therapy. Patients were allocated to receive standard care plus an oral dose of 400 mg or 800 mg/day of green propolis for seven days, or standard care alone. Standard care included all necessary interventions, as determined by the attending physician. The primary end point was the time to clinical improvement, defined as the length of hospital stay or oxygen therapy dependency duration. Secondary outcomes included acute kidney injury and need for intensive care or vasoactive drugs. Patients were followed for 28 days after admission. RESULTS: We enrolled 124 patients; 40 were assigned to EPP-AF®ï¸ 400 mg/day, 42 to EPP-AF®ï¸ 800 mg/day, and 42 to the control group. The length of hospital stay post-intervention was shorter in both propolis groups than in the control group; lower dose, median 7 days versus 12 days (95% confidence interval [CI] -6.23 to -0.07; p = 0.049) and higher dose, median 6 days versus 12 days (95% CI -7.00 to -1.09; p = 0.009). Propolis did not significantly affect the need for oxygen supplementation. In the high dose propolis group, there was a lower rate of acute kidney injury than in the controls (4.8 vs 23.8%), (odds ratio [OR] 0.18; 95% CI 0.03-0.84; p = 0.048). No patient had propolis treatment discontinued due to adverse events. CONCLUSIONS: Addition of propolis to the standard care procedures resulted in clinical benefits for the hospitalized COVID-19 patients, especially evidenced by a reduction in the length of hospital stay. Consequently, we conclude that propolis can reduce the impact of COVID-19.

Sustainable public procurement in a Brazilian higher education institution.

Public policies have required public agencies to adopt sustainable public procurement. It is necessary to understand the importance of the requirement for sustainable purchases to happen. Thus, this study aims to examine the main difficulties in adopting SPP at a public university in Brazil. To that end, research on the topic was carried out based on critical theory using qualitative methodology through a case study. Semi-structured interviews were conducted with three groups selected intentionally: requesters, purchasers and suppliers. Aspects related to the understanding of sustainability, SPP and the relationship between ethics and sustainability were analysed. The study revealed that the interviewees understand that ethics is directly related to the practice of sustainability, but it is a difficult issue because of its historical roots and changes in paradigms. Due to the complexity of the SPP theme, one of the main implementation difficulties mentioned by the interviewees was the lack of training. For suppliers, the understanding of sustainability was already consolidated, but it required agreement between being sustainable and economically viable for the company. Thus, this work sought to expose how those involved in SPP understood, refuted or validated sustainability issues in government procurement. Previous studies revealed the difficulties and conceptions of buyers, but we did not find research that investigated requesters and suppliers. It is hoped that this information will serve actions in favour of sustainable production and consumption and as a basis for other studies on sustainable public procurement.

Sífilis gestacional e congênita: incidência e fatores associados à transmissão vertical / Gestational and congenital syphilis: incidence and factors associated with vertical transmission

Objetivou-se analisar a incidência de sífilis congênita e os fatores associados à transmissão vertical na 16ª Regional de Saúde do Estado do Paraná. Trata-se de uma pesquisa transversal realizada mediante pareamento das notificações nos bancos de dados do Sinan, Sinasc e SIM entre 2012 e 2017. A análise estatística foi calculada através das frequências absolutas e relativas e da aplicação do teste Qui-quadrado ,com grau de confiança de 95%. A incidência de sífilis congênita passou de 0.41/1.000 nascidos vivos para 6.07/1.000 e esteve associada ao diagnóstico realizado no terceiro trimestre de gestação (OR= 2,051), teste treponêmico não realizado ou ignorado no diagnóstico da sífilis gestacional (OD=2,339) e titulações do teste não treponêmico entre 1:8 e 1:16 (OD= 2,386) e entre 1:32 a 1:64 (OD= 2,353). A variável neonatal associada à sífilis foi anomalia congênita (p=0,037). Concluiu-se que é necessário o aprimoramento da assistência quanto ao diagnóstico precoce, tratamento correto e seguimento.

The objective was to analyze the incidence of congenital syphilis and the factors associated with vertical transmission in the 16th Regional Health System of the State of Paraná. This is a cross-sectional survey conducted by pairing the notifications in the Sinan, Sinasc and SIM databases between 2012 and 2017. The statistical analysis was calculated using absolute and relative frequencies and the Chi-square test, with a 95% confidence level. The incidence of congenital syphilis rose from 0.41/1,000 live births to 6.07/1. 000 and was associated with the diagnosis made in the third trimester of pregnancy (OR= 2.051), treponemic test not performed or ignored in the diagnosis of gestational syphilis (OD=2.339) and titrations of the non treponemic test between 1:8 and 1:16 (OD= 2.386) and between 1:32 and 1:64 (OD= 2.353). The neonatal variable associated with syphilis was a congenital anomaly (p=0.037). It was concluded that it is necessary to improve the assistance regarding early diagnosis, correct treatment and follow-up.

Caraterização e distribuição espacial dos acidentes de trânsito não fatais / Space characterization and distribution of non-fatal traffic accidents

Resumo Introdução Acidentes de trânsito geram mortes e sequelas que impactam a qualidade de vida das pessoas. Objetivo Caracterizar e distribuir espacialmente os acidentes de trânsito não fatais ocorridos em uma metrópole do noroeste paranaense. Método Trata-se de um estudo ecológico e transversal, com informações oriundas de uma amostragem probabilística de 423 vítimas procedentes dos Boletins de Ocorrência de Acidente de Trânsito (BOAT) do 4º Batalhão da Polícia Militar de Maringá, Paraná. Verificaram-se distribuições percentuais com respectivos intervalos de confiança para as variáveis qualitativas e medidas de tendência central para as quantitativas. A produção cartográfica foi realizada pelos softwares Excel® e QGIS® 2.6.1. Resultados Predominaram vítimas do sexo masculino (85,0%), com idade inferior a 30 anos (58,4%), possuíam ocupação remunerada (92,3%), 55,0% eram motociclistas, 89,4% com tempo de habilitação superior a dois anos e 59,3% foram hospitalizadas devido às lesões. Quanto à distribuição espacial, os bairros Centro e seus arredores, como Alvorada, Zona 7 e Vila Morangueira, apresentaram maior número de ocorrências. Conclusão Características das vítimas: homens jovens menores de 30 anos, trabalhadores, motociclistas com ocorrências predominantes na região central e arredores. Há necessidade de intervenções para reduzir e identificar pontos críticos de localização e suas consequências mais graves.

Abstract Background Traffic accidents result in deaths and injuries that impact people's quality of life. Objective The objective of this study aimed to characterize and spatially distribute the non-fatal traffic accidents in a metropolis in the Northwest of Paraná. Method This work was characterized by an ecological and cross-sectional study, with information from a probability sampling of 423 victims from the Traffic Accident Reporting Bulletins (in Portuguese Boletins de Ocorrência de Acidente de Trânsito (BOAT)) of the 4th Military Police Battalion of Maringá, in the state of Paraná. Percent distributions with respective confidence intervals for the qualitative variables, as well as measures of central tendency for the quantitative variables were verified. Cartographic production was carried out with the aid of Excel® and QGIS® 2.6.1 software. Results There was a predominance of male victims (85.0%), under the age of 30 (58.4%), including paying jobs (92.3%), in which 55.0% of them were motorcyclists, 89.4% of drivers with up two years of driving experience, and 59.3% were hospitalized due to injuries. Regarding the spatial distribution, the central districts of the city and its neighborhoods, such as, Alvorada, Zona 7 and Vila Morangueira, presented the largest number of occurrences. Conclusion Characteristics of the victims: young men under 30, workers, motorcyclists with predominance of occurrence rates in the central region and neighborhoods. Interventions need to be done to reduce and identify the location of critical points and their most serious consequences.

Genomic Evidence of SARS-CoV-2 Reinfection Involving E484K Spike Mutation, Brazil.

Uncertainty remains about how long the protective immune responses against severe acute respiratory syndrome coronavirus 2 persists, and suspected reinfection in recovered patients has been reported. We describe a case of reinfection from distinct virus lineages in Brazil harboring the E484K mutation, a variant associated with escape from neutralizing antibodies.

Novel polyprenylated benzophenone derivatives from Clusia burle-marxii.

Three new caged polyprenylated benzophenone derivatives named burlemarxiones D-F (1-3) were isolated from the hexane extract of Clusia burle-marxii trunks. Burlemarxione D (1) contains the tetracyclo[8.3.1.03,11.05,10]tetradecane core skeleton also observed for burlemarxione A, its probable immediate precursor. However, two additional rings are formed to produce an unprecedented complex-caged core skeleton. These additional rings could be formed by a radical cyclization reaction of one prenyl group at C-5 with C-1 and C-33, followed by oxidative dehydrogenation (rearomatization) or by an intramolecular [4 + 2] radical cycloaddition (Diels-Alder reaction), followed by an enolization reaction (rearomatization). Burlemarxiones E and F were isolated after methylation with diazomethane that was necessary to avoid the interconversion of the pair of ß-diketones in tautomeric equilibrium. The proposed biosynthetic pathway for burlemarxiones D-F involves the condensation of either lavandulyl pyrophosphate or 2-(1-methylvinyl)-hexa-5-enyl pyrophosphate with the acylphloroglucinol derivative 6-benzoyl-5-hydroxy-5-cyclohexen-1,3-dione, followed by consecutive prenylation reactions. Therefore, Clusia burle-marxii reinforces the claim that the genus Clusia is an important source of sophisticated caged polyprenylated benzophenone derivatives.

Ocupação antirracista e decolonial do espaço psicanalítico / Anti-racist and decolonial occupation of the psychoanalytical space

O objetivo do presente artigo é descentralizar o texto de Jacques Lacan a partir de uma geopo-lítica que pretende se fazer interpretante, uma vez que o autor acentua a importância de o analista visar, no horizonte de sua práxis, a subjetividade de sua época. Parte-se de uma posi-ção na qual o analista não é neutro frente às tendências racistas e ao modo como o discurso dominante de uma época incide sobre o inconsciente. Em um contexto historicamente marcado pela abolição tardia da escravidão, encarceramento e genocídio da população negra e diversas práticas segregativas, como no caso brasileiro, é premente tomar o racismo como uma catego-ria sob o olhar da psicanálise em seu campo clínico e político, ao lado das demais disciplinas sociais. Pretendemos, assim, identificar algumas premissas para iniciar a desmontagem dos ar-tefatos teóricos dominantes e seguir em direção a um novo arcabouço epistêmico, fundamen-tando uma prática clínica antirracista. (AU)

The goal of this article is to decentralize Jacques Lacan’s text through a geopolitical perspec-tive that intends to make itself the one that interprets, since the author emphasizes the im-portance of the analyst seeking, on the scope of the analyst’s praxis, the subjectivity of the analyst’s time, implying that defining a position in which the analyst isn’t neutral before the racist tendencies and the ways that one’s time dominant discourse influences overthe uncon-scious. In a historical background scarred by late abolition of slavery, imprisonment and geno-cide of the black population, and a diversity of segregationist practices, as it is in Brazil, it is crucial to take racism as a category in the psychoanalysis view in its clinical and political field. Therefore, we intend to identify some premises to initiate a dismantling of dominant theori-cal artifacts, to go in the direction of a new epistemic framework, grounding an antiracist clinical practice. (AU)

The mother/woman disjunction from a conversation practice / A disjunção mãe/mulher a partir de uma prática de conversação

RESUMO: Em Freud, a mulher é irremediavelmente ligada a uma reivindicação fálica jamais satisfeita e a assunção da feminilidade coincide com a maternidade. Que o feminino não se deixe recobrir inteiramente pela mãe é, por outro lado, destacado por Lacan. A prática da conversação com adolescentes mães e gestantes realizada no âmbito de uma pesquisa revela que, apesar das diversas conquistas das mulheres nas últimas décadas, a maternidade fornece ainda hoje significado e imagem com os quais se revestem o feminino pela via do ter fálico. Contudo, a tentativa de encerrar o feminino na mãe não cessa de fracassar.

Abstract: For Freud, the woman is inexorably linked to a phallic claim and the assumption of feminility does coincide with motherhood. For Lacan, on the other hand, the feminility does not overlap completely with motherhood. The conversation practice we conducted with teenagers, both mothers and pregnant, has shown that, in spite of all the progress made by women in the last decades, the meaning and the image of motherhood around the feminility are still defined by the phallic. However, all the efforts to close the feminility in motherhood does not stop failing.