Morphostructural influence and neotectonic activity in the geomorphological configuration of southeast Paraíba and northeast Pernambuco, Brazil.

The current study provides critical insights into the field of geomorphology by examining the impact of lithological structures and tectonic activities on the geomorphological configuration of terrain and drainage networks in the southeast of Paraíba and northeast of Pernambuco, Brazil. This geographical region is characterized by phenomena of uplift and fluvial incision at various sites, yet remains inadequately explored with respect to its active deformation and the broader context of its recent geology. Therefore, the primary aim of this research is to elucidate the morphostructural and neotectonic influences on the geomorphological formations in these sectors of Brazil. The methodology encompasses morphostructural analysis, leveraging data derived from altimetry, slope, and geomorphology maps, categorized into taxonomic terrain units. Additionally, this research incorporates the use of morphometric indices, including the Stream Length-Gradient Index (SL), Valley Floor Width (VF), and Asymmetry Factor (AF) to quantify geomorphological anomalies. The analysis of the SL index indicates that a significant portion (87.5 %) of the drainage network exhibits anomalies. Furthermore, the VF index results reveal that 66 % of the profiles analyzed manifest anomalies of various magnitudes. Within the study region, the AF index elucidates the distribution of sub-basins into categories of low (0-30), medium (31-50), and high (>51) asymmetry, comprising 25 %, 31 %, and 44 % of the sub-basins, respectively. The sub-basins demonstrate channel disequilibrium, as evidenced by the SL index, attributed to numerous transient knickpoints along the drainage profiles. This observation is consistent with previous findings in the Koyna-Warna Shallow Seismic Region. The study's outcomes reveal both qualitatively and quantitatively anomalous patterns in the drainage network and terrain forms, which are likely indicative of recent tectonic events affecting the entire eastern edge of Northeast Brazil. Consequently, the findings highlight the significant role of post-Miocene tectonic events in shaping the relief of the study area.

Differential diagnosis of exanthematous viruses during the 2022 Mpox outbreak in Minas Gerais, Brazil.

The monkeypox virus (MPXV) outbreak, primarily endemic to Africa, has spread globally, with Brazil reporting the second-highest number of cases. The emergence of MPXV in non-endemic areas has raised concerns, particularly due to the co-circulation of other exanthematous viruses such as varicella-zoster virus (VZV) and molluscum contagiosum virus (MOCV). To perform an accurate differential diagnosis of MPXV during the ongoing outbreak in Minas Gerais, Brazil, a 5PLEX qPCR assay targeting orthopoxviruses (OPV), VZV, and MOCV was used to retrospectively analyze all clinical samples that tested negative for MPXV in the initial screening conducted at Funed. In summary, our study analyzed 1,175 clinical samples received from patients suspected of MPXV infection and found a positivity rate of 33.8% (397 samples) for MPXV using the non-variola qPCR assay. Testing the 778 MPXV-negative clinical samples using the 5PLEX qPCR assay revealed that 174 clinical samples (22.36%) tested positive for VZV. MOCV DNA was detected in 13 and other OPV in 3 clinical samples. The sequencing of randomly selected amplified clinical samples confirmed the initial molecular diagnosis. Analysis of patient profiles revealed a significant difference in the median age between groups testing positive for MPXV and VZV and a male predominance in MPXV cases. The geographic distribution of positive cases was concentrated in the most populous mesoregions of Minas Gerais state. This study highlights the challenges posed by emerging infectious diseases. It emphasizes the importance of epidemiological surveillance and accurate diagnosis in enabling timely responses for public health policies and appropriate medical care. IMPORTANCE: Brazil ranks second in the number of cases during the global monkeypox epidemic. The study, conducted in Minas Gerais, the second most populous state in Brazil with over 20 million inhabitants, utilized differential diagnostics, revealing a significant number of positive cases for other exanthematous viruses and emphasizing the need for accurate diagnoses. During the study, we were able to assess the co-circulation of other viruses alongside monkeypox, including varicella-zoster virus, molluscum contagiosum virus, and other orthopoxviruses. The significance of the research is underscored by the concentration of positive cases in populous areas, highlighting the challenges posed by emerging infectious diseases. This demographic context further amplifies the importance of the research in guiding public health policies and medical interventions, given the substantial population at risk. The study not only addresses a global concern but also holds critical implications for a state with such a large population and geographic expanse within Brazil. Overall, the study emphasizes the pivotal role of surveillance and precise diagnosis in guiding effective public health responses and ensuring appropriate medical interventions.

Serosurvey of Coxiella burnetii in Descendants of Former Black Slaves (Quilombola Communities) of Southern Brazil.

Brazilian descendants of former Black-slave (quilombola) communities have been predisposed to several zoonotic diseases due to social vulnerability, characterized by subsistence and close contact with livestock and companion animals. Accordingly, the present study has assessed anti-Coxiella burnetii antibodies in 200 individuals and 20 dogs from four quilombola communities located in Paraná State, southern Brazil. Serum samples were tested by indirect immunofluorescence assay (IFA) using in-house and commercial diagnostic protocols, with analysis of seropositive titers and antibody type. Fisher's exact test was used to compare seropositivity to C. burnetti with binary variables, with variables with three or more possible responses submitted to logistic regression. In total, 44/200 (22%; 95% CI 16.82-28.24) people tested positive, and 4.5% had titers higher than 128, indicating a recent onset of C. burnetii infection. Seropositive individuals were statistically associated with the Limitão community (p = 0.0013), urban workers as occupations (p = 0.0475), consumption of undercooked meat (p = 0.0159), and contact with animal abortion (p = 0.0276). No seropositivity association was found for age, sex, education, habit of entering forest areas, consumption of game meat, consumption of raw milk, flea and tick bites, dog contact, or history of female miscarriage. Only one of 20 dogs was seropositive with a titer of 128, probably related to an acute animal infection. Despite the prevalence here being higher than previous Brazilian reports, including with symptomatic populations, the results were within range for worldwide outbreaks and occupational risk populations. To the reader's knowledge, this is the first human survey of Q fever in southern Brazil and should be considered a warning for C. burnetii in vulnerable populations, particularly Quilombola communities.

Coxiella burnetii seroprevalence in sheep herd from Paraguay: First evidence of bacterial circulation in the country.

Coxiella burnetii is the agent of Q fever, a disease that poses risks to public health and damages livestock. We discovered the circulation of C. burnetii for the first time in Paraguay, based on the seropositivity of a flock of >300 sheep. The animals were tested by IFA for anti-C. burnetii antibodies and by SAM for anti-Leptospira spp. antibodies, an important differential diagnosis for reproductive disorders in sheep in Paraguay. C. burnetii seropositivity was determined in 45%, in contrast to Leptospira spp. which had no reactive samples. Cases of miscarriage and fetal resorption were associated with high seropositivity titers. This study suggests the circulation of a unique genotype in the country and an imminent risk to public health, since in addition to being highly transmissible and infectious to humans, Q fever is still not a cause for concern on the part of government and health agencies in the country.

Chemical Characterization, Phenolic Compounds Quantification, and Assessment of Antioxidant and Anti-Acetylcholinesterase Activities of Byrsonima sericea DC fruits.

Byrsonima sericea is a species native to Brazil that is widely used in traditional medicine. The seed ethanol extract (SEE) had the highest content of total phenols (179.35 mg GAE g-1 extract) and flavonoids (10.42 mg QE g-1 extract) and was the most active in relation to antioxidant activity (DPPH: IC50 =4.25 µg mL-1 and ABTS: IC50 =4.82 µg mL-1 ). The peel/pulp ethanol extract (PEE) had the best anticholinesterase activity (IC50 =6.02 µg mL-1 ). Chromatographic investigation identified gallic acid, isoquercitrin, quercetin and amentoflavone in SEE, and gallic acid, isoquercitrin, quercetin and rutin in PEE. Six fatty acid methyl esters and seven triterpenes were identified, highlighting oleic acid in the seed hexane extract (61.85 %) and in the peel/pulp hexane extract (52.61 %), and betulin in the peel/pulp hexane extract (5.25 %). The substances and biological activities identified in B. sericea characterize this fruit as a functional food for future studies.

A systematic review to investigate whether birth weight affects the autonomic nervous system in adulthood / Uma revisão sistemática para investigar se o peso ao nascer afeta o sistema nervoso autônomo na vida adulta

ABSTRACT Objective: To evaluate the relationship between birth weight and the autonomic nervous system in adulthood through a systematic review. Data source: This is a systematic review of publications without limitation of year and language. We included studies involving the autonomic nervous system and birth weight in adults. Manuscripts were selected based on electronic searches of Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science Cochrane Library and Scopus databases, using "Autonomic Nervous System" OR "Heart Rate" OR "Heart Rate Variability" AND "Birth Weight" as a search strategy. This review is registered on the International Prospective Register of Systematic Reviews — PROSPERO (ID: CRD42020165622). Data synthesis: We found 894 articles; 215 were excluded for duplicity. Of the remaining 679 studies, 11 remained. Two were excluded because they did not specifically treat the autonomic nervous system or birth weight. There were nine publications, two cohort and seven cross-sectional studies. The main findings were that extreme, very low, low or high birth weight may have some impact on the autonomic nervous system in adult life. Conclusions: Birth weight outside the normality rate may have a negative influence on the autonomic nervous system, causing autonomic dysfunction and increasing the risk of cardiovascular diseases in adult life. Thus, the importance of the follow-up of health professionals from pregnancy to gestation and throughout life, with preventive care being emphasized.

RESUMO Objetivo: Avaliar a relação entre o peso ao nascer e o sistema nervoso autônomo na vida adulta por meio de uma revisão sistemática. Fontes de dados: Esta é uma revisão sistemática de publicações, sem limitação de ano e idioma. Incluímos estudos envolvendo o sistema nervoso autônomo e peso ao nascer em adultos. Os manuscritos foram selecionados das bases de dados eletrônicos Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science Cochrane Library e Scopus, utilizando "Autonomic Nervous System" OR "Heart Rate" OR "Heart Rate Variability" AND "Birth Weight" como estratégia de busca. Esta revisão está registrada pelo International Prospective Register of Systematic Reviews — PROSPERO (ID: CRD42020165622). Síntese dos dados: Nós encontramos 894 artigos. Deles, 215 foram excluídos por duplicidade. Entre os 679 remanescentes, 11 permaneceram, dos quais dois foram excluídos por não tratarem especificamente do sistema nervoso autônomo ou do peso ao nascer. Restaram nove publicações, sendo duas longitudinais e sete transversais. Os principais achados foram que o peso extremo baixo, muito baixo, baixo ou alto ao nascer pode ter algum impacto no sistema nervoso autônomo na vida adulta. Conclusões: O peso ao nascer fora da normalidade pode influenciar negativamente o sistema nervoso autônomo, causando disfunção autonômica e aumentando o risco de doenças cardiovasculares na vida adulta. Assim, ressalta-se a importância do acompanhamento dos profissionais de saúde desde a gravidez até a gestação, pré-natal e ao longo da vida, com cuidados preventivos para esta situação.

A systematic review to investigate whether birth weight affects the autonomic nervous system in adulthood.

OBJECTIVE: To evaluate the relationship between birth weight and the autonomic nervous system in adulthood through a systematic review. DATA SOURCE: This is a systematic review of publications without limitation of year and language. We included studies involving the autonomic nervous system and birth weight in adults. Manuscripts were selected based on electronic searches of Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science Cochrane Library and Scopus databases, using "Autonomic Nervous System" OR "Heart Rate" OR "Heart Rate Variability" AND "Birth Weight" as a search strategy. This review is registered on the International Prospective Register of Systematic Reviews - PROSPERO (ID: CRD42020165622). DATA SYNTHESIS: We found 894 articles; 215 were excluded for duplicity. Of the remaining 679 studies, 11 remained. Two were excluded because they did not specifically treat the autonomic nervous system or birth weight. There were nine publications, two cohort and seven cross-sectional studies. The main findings were that extreme, very low, low or high birth weight may have some impact on the autonomic nervous system in adult life. CONCLUSIONS: Birth weight outside the normality rate may have a negative influence on the autonomic nervous system, causing autonomic dysfunction and increasing the risk of cardiovascular diseases in adult life. Thus, the importance of the follow-up of health professionals from pregnancy to gestation and throughout life, with preventive care being emphasized.

Dereplication of tropane alkaloids from four Erythroxylum species using liquid chromatography coupled with ESI-MSn and HRESIMS.

RATIONALE: Tropane alkaloids represent an important class of secondary metabolites, but many of these compounds are already described in the scientific literature, so the use of guided identification and isolation strategies, such as dereplication, represent a fast and safe alternative. METHODS: For the annotation of the tropane alkaloids the chloroform phases of the four Erythroxylum species were analyzed by high-performance liquid chromatography coupled to mass spectrometry with positive-mode electrospray ionization, then the ions of their protonated molecules, molecular formulas and fragmentation patterns were observed and a comparison of the obtained data with those present in the scientific literature was performed. The compounds not fully annotated were isolated and characterized by 1 H and 13 C nuclear magnetic resonance spectroscopy. RESULTS: The annotation of 29 tropane alkaloids was performed, some being described for the first time in the family Erythroxylaceae. The chemical profiles of these secondary metabolites in the four Erythroxylum species analyzed were traced and compared. Isolation of three compounds whose mass spectral data were not sufficient for their full annotation was performed. They were 6-(benzoyloxy)-3-(3,5-dimethoxy-4-hydroxybenzoyloxy)tropane, 6-(benzoyloxy)-3-(3,4,5-trimethoxybenzoyloxy)tropane and 6-(benzoyloxy)-3-(3,4,5-trimethoxycinamoyloxy)tropane, first reported in the species Erythroxylum revolutum Mart. CONCLUSIONS: This work contributes to the phytochemical knowledge of the genus Erythroxylum, and demonstrates the efficiency and importance of using guided isolation methodologies of secondary metabolites in natural products research. Since safe results were presented in the annotation of the compounds evidenced, employing small quantities of organic solvents, when compared to classical methodologies, besides promoting an optimization in the research time.

Comparison of Three Serologic Tests for the Detection of Anti-Coxiella burnetii Antibodies in Patients with Q Fever.

The performance of a commercial immunofluorescence assay (IFA commercial), an in-house immunofluorescence assay (IFA in-house) and an indirect enzyme-linked immunosorbent assay (ELISA) were evaluated in the detection of antibodies anti-C. burnetii in the serum of Q fever patients and persons without the disease. For the study, seropositive and seronegative samples for Q fever (n = 200) from a serum bank of the Instituto Adolfo Lutz in Brazil were used. Commercial IFA was considered in this study as the gold standard for diagnosing Q fever. The in-house IFA demonstrated good agreement with the commercial test, showing high sensitivity (91%) and specificity (97%) compared to the gold standard, with a Kappa coefficient of 0.8954. The indirect ELISA test showed lower agreement with the gold standard, showing low sensitivity (67%), although the specificity of the technique was high (97%) and the Kappa coefficient was moderate (0.6631). In-house IFA is an excellent alternative for diagnosing Q fever.

Overview of Q fever in Brazil: an underestimated zoonosis.

This review aims to provide current information about Q fever, elucidating the etiological, epidemiological, pathogenic, clinical, diagnostic, therapeutic, and prophylactic aspects of the disease for the medical community. We discuss the main forms of presentation of the agent, its ability to persist in the body, the infinite possibilities of susceptible hosts, the main known forms of transmission, its importance in populations at occupational risk, and the role of arthropods in the natural history of the disease. Focusing on Brazil, we present the cases already described and studies developed since its first report, and how there is still much to unravel. We are aware of the possibilities of the persistence of the agent and the development of severe clinical pictures and the specific treatments currently instituted. We also wish to raise awareness about the future, the new genotypes that are emerging, the need to study the effects of vaccines, and the impact of Q fever on the population. Q fever is a poorly understood disease in Latin America, and recent studies, especially in Brazil, have revealed the importance of developing new studies.

Preparation and Characterization of a Coordination Polymer Based on Iron (III)-Cyamelurate as a Superior Catalyst for Heterogeneous Fenton-Like Processes.

We report on a new iron (iii)-cyamelurate-based coordination polymer. The new material based on a heptazine derivative was prepared in aqueous medium and characterized by a variety of techniques including TGA, FTIR, XRD, HRTEM, and STEM. Due to the high structural stability of the complex in aqueous media, its heterogeneous Fenton-like catalytic activity was evaluated using a model molecule. The results obtained showed a high catalytic activity in both in basic and acid media. The pseudo-first-order rate constants normalized by iron(III) concentrations was approximately 1000 times higher than the result obtained for traditional heterogeneous catalysts based on iron(III) oxyhydroxides. The best observed catalytic activities were attributed to the increase in the binding sites of Fe3+ ions, in parallel with the increased exposure of the catalytic sites, leading to a higher atomic efficiency of the reaction.

Comparative proteomics of saliva of healthy and gingivitis individuals from Rio de Janeiro.

PURPOSE: In this work, we identified human and bacterial proteomes in the saliva from volunteers with gingivitis or healthy. EXPERIMENTAL DESIGN: The reported population consisted of 18 volunteers (six with gingivitis and 12 healthy controls). Proteomics characterization was performed using a quantitative mass spectrometry method. RESULTS: A total of 74 human and 116 bacterial proteins were identified in saliva. The major functional category that was modified in the human proteome was the immune response, followed by transport and protease inhibition. In the bacterial proteome, most of the proteins identified were from the Fusobacteria phylum, followed by Chlamydiae and Spirochaetes. CONCLUSIONS AND CLINICAL RELEVANCE: We observed statistically relevant differences in the data between the groups. The 15 most important human proteins affecting the variation between case and control groups included cystatin S, alpha amylase, lactotransferrin, and negative elongation factor E. We found that bacterial proteins from Porphyromonas gingivalis and Fusobacterium nucleatum subsp. nucleatum related to the red and orange complexes were closely correlated with the occurrence of periodontal diseases.

Ultrastructural analysis of monkeypox virus replication in Vero cells.

In early May 2022, the first worldwide monkeypox virus (MPXV) outbreak was reported, with different clinical aspects from previously studied human monkeypox infections. Despite monkeypox medical importance, much of its biological aspects remain to be further investigated. In the present work, we evaluated ultrastructural aspects of MPXV asynchronous infections in Vero cells by transmission electron microscopy (TEM). The viral strain was isolated from a male patient infected during the 2022 outbreak. TEM analysis showed: (i) adhered intracellular mature virus particles before entry of the host cell; (ii) a reorganization of the rough endoplasmic reticulum cisternae into the so-called "mini-nuclei" structure associated with genome replication; and (iii) noticeably different sites within the viral factory presenting granular or fibrillar aspects. We also observed viral crescents, different MPXV particle morphotypes, and cellular alterations induced by infection, such as changes in the cytoskeleton structure and multimembrane vesicles abundance. Taken together, to the best of our knowledge, these results revealed for the first-time ultrastructural aspects of different steps of the MPXV cycle.

Complete recovery of quadriceps muscle peripheral fatigue after running in Olympic, but not Sprint, triathlon.

This study compared central and peripheral fatigue development between the Sprint and Olympic distance triathlon. Fifteen male triathletes performed Sprint and Olympic triathlon simulations in a randomized and counterbalanced order. Central and peripheral fatigue was evaluated from changes in voluntary activation level (VAL) and twitch responses of quadriceps muscle (Qtw,pot), respectively. Qtw,pot reduced from baseline to post-swimming similarly between triathlon simulations (Sprint,-17±11%; Olympic, -13±9%). In post-cycling, Qtw,pot further declined to a similar extent between triathlon distances (Sprint, -31±15%; Olympic, -28±11%). In post-running, Qtw,pot was fully recovered in the Olympic triathlon (-4±10%), whereas there was only a partial recovery of Qtw,pot in the Sprint triathlon (-20±11%). VAL was not reduced in post-swimming, but reduction was similar between triathlon distances in post-cycling (Sprint, -10±9%; Olympic, -8±8%) and post-running (Sprint, -15±14%; Olympic, -16±8%). In the Sprint triathlon, the swimming speed (1.07±0.13m.s-1) was above (p <.001) critical speed (1.01±0.14m.s-1), the cycling power (179.7±27.2W) was below the respiratory compensation point (216.3±27.8W, p <.001) and running speed (13.7±1.05km.h-1) similar to the respiratory compensation point (13.2±0.70km.h-1, p =.124). In the Olympic triathlon, swimming speed (1.03±0.13m.s-1) was similar to critical speed (p =.392), and cycling power (165.3±27.3W) and running speed (12.6±1.05km.h-1) were below the respiratory compensation point (p ≤.007). In conclusion, peripheral fatigue progressed until post-cycling regardless of triathlon distances. However, peripheral fatigue was fully recovered after running in Olympic but not in Sprint triathlon. The central fatigue started in post-cycling and progressed until post-running regardless of triathlon distances.HighlightsThe quadriceps muscle peripheral fatigue progresses similarly in Sprint and Olympic triathlons until post-cycling.The quadriceps muscle peripheral fatigue is completely recovered after running in the Olympic triathlon, whereas it is partially recovered in the Sprint triathlon.The central fatigue starts in post-cycling and progresses similarly until post-running in Sprint and Olympic triathlons, regardless of triathlon distances.

Cell phenotypes as activity biomarkers in patients with Systemic Lupus Erythematosus

Abstract The pathogenesis of systemic lupus erythematosus (SLE) is complex. Few studies in Brazilian population have addressed cell phenotypes associated with immunological responses and their associations with SLE activity. The aim of this study is to investigate cell phenotypes associated to SLE diagnosis, treatment and activity. Twenty-eight SLE female patients (17 inactive, 11 active) and 10 healthy women were included in this study. Markers of natural killer (Nk), T and B cells in peripheral blood were evaluated by flow cytometry. Nkt cells were decreased only in SLE active patients. Activated CD4+, regulatory T FoxP3+ and B cells were decreased in both active and inactive SLE patients, compared to control group. The data corroborate the disruption of immune regulatory response in SLE patients and suggest phenotipic changes as possible biomarkers of SLE activity.

Suicídio no Espírito Santo e em sua Região Serrana, 1996-2020: análise temporal / Suicidio en Espírito Santo y su Región Serrana, 1996-2020: análisis temporal / Suicide in Espirito Santo and its Mountain Region, 1996-2020: temporal analysis

Resumo Objetivo Analisar a tendência da mortalidade por suicídio no estado do Espírito Santo e em sua Região Serrana no período de 1996 a 2020. Métodos Estudo descritivo e analítico de série temporal com dados consolidados dos óbitos por suicídio na população acima de 15 anos de idade obtidos no Sistema de Informações sobre Mortalidade. As unidades de análise foram o estado do Espírito Santo e sua Região Serrana. A análise da tendência foi verificada pela regressão de Prais-Winsten e pelo cálculo da variação percentual anual. Resultados Foram notificados 3.922 óbitos por suicídio no Espírito Santo e, destes, 525 na Região Serrana. A tendência da mortalidade por suicídio no estado foi crescente na população geral acima de 15 anos (APC= 5,1; IC95%= 0,28-9,92; p=0,039). A tendência da mortalidade se manteve crescente entre a população feminina, tanto em relação ao estado (APC= 6;5; IC95%= 1,55-14,46; p=0,012) como na região serrana (APC= 15,2; IC95%= 1,21-29,20; p=0,035). A mortalidade foi crescente na faixa etária de 30 a 59 anos no estado (APC= 3,4; IC95%= 0,62-6,10; p=0,018) e na Região Serrana (APC= 2,9; IC95%= 2,02-3,86; p <0,001). Conclusão A tendência foi crescente na população geral do estado do Espírito Santo e em sua Região Serrana entre adultos jovens e do sexo feminino. A relevância da violência autoprovocada verificada nas taxas analisadas neste estudo aponta para a necessidade do emprego de estratégias preventivas, especialmente entre as mulheres.

Resumen Objetivo Analizar la tendencia de la mortalidad por suicidio en el estado de Espírito Santo y en su Región Serrana en el período de 1996 a 2020. Métodos Estudio descriptivo y analítico de serie temporal con datos consolidados de las muertes por suicidio en la población mayor de 15 años obtenidos del Sistema de Información sobre Mortalidad. Las unidades de análisis fueron el estado de Espírito Santo y su Región Serrana. El análisis de la tendencia se verificó por regresión de Prais-Winsten y por cálculo de la variación porcentual anual. Resultados Se notificaron 3.922 muertes por suicidio en Espírito Santo, de las cuales 525 fueron en la Región Serrana. La tendencia de la mortalidad por suicidio en el estado fue creciente en la población general mayor de 15 años (APC= 5,1; IC95 %= 0,28-9,92; p=0,039). La tendencia de la mortalidad se mantuvo creciente en la población femenina, tanto con relación al estado (APC= 6;5; IC95 %= 1,55-14,46; p=0,012) como en la Región Serrana (APC= 15,2; IC95 %= 1,21-29,20; p=0,035). La mortalidad fue creciente en el grupo de edad de 30 a 59 años en el estado (APC= 3,4; IC95 %= 0,62-6,10; p=0,018) y en la Región Serrana (APC= 2,9; IC95 %= 2,02-3,86; p <0,001). Conclusión La tendencia fue creciente en la población general del estado de Espírito Santo y en su Región Serrana en adultos jóvenes y de sexo femenino. La relevancia de la violencia autoprovocada verificada en los índices analizados en este estudio indica la necesidad de emplear estrategias preventivas, específicamente en mujeres.

Abstract Objective To analyze the trend of suicide mortality in the state of Espirito Santo and its Mountain Region from 1996 to 2020. Methods Descriptive and analytical time series study with consolidated data on deaths by suicide in the population over 15 years old obtained from the Mortality Information System. The units of analysis were the state of Espirito Santo and its Mountain Region. The trend analysis was verified by Prais-Winsten regression and by calculating the annual percentage change. Results A total of 3922 deaths by suicide were reported in Espirito Santo and of these, 525 in the mountain Region. The trend of suicide mortality in the state was increasing in the general population over 15 years old (APC= 5.1; 95%CI= 0.28-9.92; p=0.039). The mortality rate continued to grow among the female population, both in relation to the state (APC= 6.5; 95%CI= 1.55-14.46; p=0.012) and in the mountain region (APC= 15.2; 95%CI= 1.21-29.20; p=0.035). Mortality increased in the age group from 30 to 59 years old in the state (APC= 3.4; 95%CI= 0.62-6.10; p=0.018) and in the Mountain Region (APC= 2.9; 95%CI= 2.02-3.86; p<0.001). Conclusion The suicide trend was growing in the general population of the state of Espirito Santo and its Mountain Region among young and female adults. The relevance of self-inflicted violence verified in the rates analyzed in this study points to the need to use preventive strategies, especially among women.

Overview of Q fever in Brazil: an underestimated zoonosis

ABSTRACT This review aims to provide current information about Q fever, elucidating the etiological, epidemiological, pathogenic, clinical, diagnostic, therapeutic, and prophylactic aspects of the disease for the medical community. We discuss the main forms of presentation of the agent, its ability to persist in the body, the infinite possibilities of susceptible hosts, the main known forms of transmission, its importance in populations at occupational risk, and the role of arthropods in the natural history of the disease. Focusing on Brazil, we present the cases already described and studies developed since its first report, and how there is still much to unravel. We are aware of the possibilities of the persistence of the agent and the development of severe clinical pictures and the specific treatments currently instituted. We also wish to raise awareness about the future, the new genotypes that are emerging, the need to study the effects of vaccines, and the impact of Q fever on the population. Q fever is a poorly understood disease in Latin America, and recent studies, especially in Brazil, have revealed the importance of developing new studies.

Vigilância epidemiológica das tentativas de suicídio: Avaliando a qualidade dos dados / Epidemiological surveillance of attempted suicide: assessing the data quality

Resumo Contexto: A ocorrência de uma notificação para tentativa de suicídio (TS) é apontada como um importante fator de risco para o suicídio e constitui-se a primeira etapa para a inclusão do indivíduo nas linhas de cuidado. Objetivo: Avaliar a completitude do preenchimento dos formulários de registros dos casos de TS notificados no SINAN no município de Afonso Cláudio-Espírito Santo, Brasil, no período de 2014 a 2019. Método: Estudo descritivo com dados do Sistema de Informação de Notificação de Agravos. Adotou-se escore proposto por Romero e Cunha. Foi calculado o coeficiente não paramétrico de correlação linear de Spearman (rs). Resultados: Na FNI violência interpessoal/autoprovocada, as variáveis "encaminhamento" classifcou-se com completitude "ruim" e correlação positiva (rs=0,357; p=0,007); "escolaridade", obteve resultado "ruim" na completitude e correlação não significativa (rs=-0,076; p=0,058); "possui algum tipo de deficiência/transtorno" completitude "regular" e correlação positiva (rs =0,511; p<0,001); "ocorreu outras vezes" e "suspeita de uso de álcool" denotaram grau de completitude "ruim", com correlação positiva fraca (rs = 0,340; p =0,011) e resultado não significativo da correlação, respectivamnete. Na FI de notificação intoxicação exógena para TS, as variáveis "escolaridade", obteve completitude "ruim"; "evolução do caso" e "classificação final", ambas apresentaram completitude "muito ruim", com correlação significativa decrescente para "classificação final" (rs= -0,430; p< 0,001). Conclusão: A análise revelou que há lacunas importantes na qualidade da informação acerca do atributo completitude.

Abstract Context: The occurrence of an attempted suicide notification (TS) is pointed as an important risk fator for suicide and constitutes the first step to including the person into the care system. Goal: To avaluate the form filling completeness of the TS cases informed to SINAN in the municipality of Afonso Claudio-Espirito Santo, Brazil, from 2014 to 2019. Methodology: a descriptive data study of the Harm Notification Information System. It was adopted the score recommended by Romero and Cunha. It was calculated the Spearman's nonparametric coefficient of linear correlation (rs). Results: In the FNI interpersonal/self-generated harm, the variable "referral" was classified as "poor" in the positive correlation (rs=0.357; p=0.007); variable "schooling" tested "poor" in completeness and non significative correlation of (rs=0.076; p=0.058); variable "having any kind of disability/disorder" presented "regular" completeness and positive correlation of (rs=0.511; p<0.001); "happened previously" and "alcohol intake suspicion" presented "poor" completeness score, with a weak positive correlation of (rs=0.340; p=0.011) and a non significative result of the correlation, respectively. In FI of exogenous intoxication notification for TS, the variable "schooling" obtained "poor" completeness score, with a decreasing significative correlation for the "final classification" (rs= -0.430; p< 0.001). Conclusion: The study showed that there are important gaps on the data quality of the completeness attribute.

Classification of Parkinson's disease motor phenotype: a machine learning approach.

To assess the cortical activity in people with Parkinson's disease (PwP) with different motor phenotype (tremor-dominant-TD and postural instability and gait difficulty-PIGD) and to compare with controls. Twenty-four PwP (during OFF and ON medication) and twelve age-/sex-/handedness-matched healthy controls underwent electrophysiological assessment of spectral ratio analysis through electroencephalography (EEG) at resting state and during the hand movement. We performed a machine learning method with 35 attributes extracted from EEG. To verify the efficiency of the proposed phenotype-based EEG classification the random forest and random tree were tested (performed 30 times, using a tenfolds cross validation in Weka environment). The analyses based on phenotypes indicated a slowing down of cortical activity during OFF medication state in PwP. PD with TD phenotype presented this characteristic at resting and the individuals with PIGD presented during the hand movement. During the ON state, there is no difference between phenotypes at resting nor during the hand movement. PD phenotypes may influence spectral activity measured by EEG. Random forest machine learning provides a slightly more accurate, sensible and specific approach to distinguish different PD phenotypes. The phenotype of PD might be a clinical characteristic that could influence cortical activity.

Role of Cytokines, Chemokines and IFN-γ+ IL-17+ Double-Positive CD4+ T Cells in Patients with Multiple Sclerosis.

Multiple sclerosis is mediated by self-reactive myelin T and B cells that lead to axonal and myelin damage. The immune response in multiple sclerosis involves the participation of CD4+ T cells that produce cytokines and chemokines. This participation is important to find markers for the diagnosis and progression of the disease. In our work, we evaluated the profile of cytokines and chemokines, as well as the production of double positive CD4+ T cells for the production of IFNγ IL-17 in patients with multiple sclerosis, at different stages of the disease and undergoing different treatments. We found that relapsing-remitting patients had a significant increase in IL-12 production. About IL-5, its production showed significantly higher levels in secondarily progressive patients when compared to relapsing-remitting patients. IFN-γ production by PBMCs from secondarily progressive patients showed significantly higher levels. This group also had a higher percentage of CD4+ IFNγ+ IL-17+ T cells. The combination of changes in certain cytokines and chemokines together with the presence of IFNγ+ IL-17+ double positive lymphocytes can be used to better understand the clinical forms of the disease and its progression.