Influence of seasonality and habitat on chemical composition, cytotoxicity and antimicrobial properties of the Libidibia ferrea.

Libidibia ferrea Mart, belonging to the Fabacee family, is a medicinal plant known for its biological properties and production of phenolic compounds. Previous studies reveal the biological activity of its phenolic constituents, making it very promising for the development of new medicines. Seasonality and geographic distribution of species can modify the production of secondary metabolites in Fabaceae species in terms of the preferentially activated metabolic pathways and, consequently, interfere with the medicinal properties of these species. Studying the influence of seasonality on the production of phenolic constituents is essential to establish conditions for "cultivation," species collection, standardization, production, and safety in traditional medicine. This unprecedented study proposed to evaluate the influence of seasonal variations and habitat on the production of phenolic compounds and biological properties of the ethanolic extracts of the stem bark from L. ferrea, whose specimens were collected from the Caatinga and the Atlantic Forest, biomes of Brazil. Antimicrobial activity was determined by broth microdilution. Cytotoxicity was evaluated through a colorimetric assay using MTT. ABTS and DPPH radical reduction methods estimated antioxidant capacities. Folin-Ciocalteu and AlCl3 spectrophotometric methods quantified total phenolics and flavonoids, respectively. In turn, radial diffusion quantified tannin content. PCA score plot and HCA dendogram were obtained by multivariate analysis of 1H NMR data. The cytotoxicity against C6 glioma cells was observed only for Atlantic Forest extracts (EC50 = 0.13-0.5 mg mL-1). These extracts also showed selectivity against Gram-positive bacteria Bacillus subtilis (ATCC 6633) [MICs 500-2000 µg mL-1], B. cereus CCT 0096) [MIC = 250 µg mL-1], Staphylococcus aureus (ATCC 6538) [MICs = 250-500 µg mL-1], S. epidermidis (ATCC 12228) [62.5-1000 µg mL-1], mainly to Staphylococcus sp. Caatinga extracts showed higher production of flavonoids and antioxidants in the summer [7.36 ± 0.19 µg QE mg-1 extract; IC50ABTS = 4.86 ± 0.05 µg mL-1], spring [5.96 ± 0.10 µg QE mg-1 extract; IC50ABTS = 5.96 ± 0.08 µg mL-1 ], winter [4.89 ± 0.25 µg QE mg-1 extract; IC50ABTS = 6.72 ± 0.08 µg mL-1 ]. Regarding habitat, two discriminating compound patterns in the studied biomes were revealed by NMR. The results indicated that the Caatinga biome offers better conditions for activating the production of phenolics [336.34 ± 18.1 µgGAE mg-1 extract], tannins [328.38 ± 30.19 µgTAE mg-1 extract] in the summer and flavonoids in winter, spring, and summer. The extracts that showed the best antioxidant activities were also those from the Caatinga. In turn, extracts from the Atlantic Forest are more promising for discovering antibacterial compounds against Staphylococcus sp and cytotoxic for C6 glioma cells. These findings corroborated the traditional use of L. ferrea bark powder for treating skin wounds and suggest the cytotoxic potential of these extracts for glioblastoma cell lines.

Central Carbon Metabolism in Candida albicans Biofilms Is Altered by Dimethyl Sulfoxide.

The effect of dimethyl sulfoxide (DMSO) on fungal metabolism has not been well studied. This study aimed to evaluate, by metabolomics, the impact of DMSO on the central carbon metabolism of Candida albicans. Biofilms of C. albicans SC5314 were grown on paper discs, using minimum mineral (MM) medium, in a dynamic continuous flow system. The two experimental conditions were control and 0.03% DMSO (v/v). After 72 h of incubation (37 °C), the biofilms were collected and the metabolites were extracted. The extracted metabolites were subjected to gas chromatography-mass spectrometry (GC/MS). The experiment was conducted using five replicates on three independent occasions. The GC/MS analysis identified 88 compounds. Among the 88 compounds, the levels of 27 compounds were markedly different between the two groups. The DMSO group exhibited enhanced levels of putrescine and glutathione and decreased levels of methionine and lysine. Additionally, the DMSO group exhibited alterations in 13 metabolic pathways involved in primary and secondary cellular metabolism. Among the 13 altered pathways, seven were downregulated and six were upregulated in the DMSO group. These results indicated a differential intracellular metabolic profile between the untreated and DMSO-treated biofilms. Hence, DMSO was demonstrated to affect the metabolic pathways of C. albicans. These results suggest that DMSO may influence the results of laboratory tests when it is used as a solvent. Hence, the use of DMSO as a solvent must be carefully considered in drug research, as the effect of the researched drugs may not be reliably translated into clinical practice.

Boarding in the emergency department: challenges and mitigation strategies.

PURPOSE OF REVIEW: Herein, we conducted a review of the literature to better understand the issue of prolonged emergency department (ED) boarding by providing an overview of the current evidence on the available causes, consequences, and mitigation strategies. RECENT FINDINGS: Severely ill patients awaiting transfer to intensive care units (ICU) imposes additional burdens on the emergency care team from both a clinical and management perspective. The reasons for prolonged ED boarding are multifactorial. ED boarding compromises patients' safety and outcomes, and is associated with increased team burnout and dissatisfaction. Mitigation strategies include the optimization of patients' flow, the establishment of resuscitative care units, deployment of mobile critical care teams, and improvements in training. Staffing adjustments, changes in hospital operations, and quality improvement initiatives are required to improve this situation, while active bed management and implementation of capacity command centers may also help. SUMMARY: Considering the characteristics of healthcare systems, such as funding mechanisms, organizational structures, delivery models, access and quality of care, the challenge of ED boarding of critically ill patients requires a nuanced and adaptable approach. Solutions are complex but must involve the entirety of the hospital system, emergency department, staff adjustment, and education.

Assessment of the components of fluid balance in patients with septic shock: a prospective observational study.

BACKGROUND: The optimal amount for initial fluid resuscitation is still controversial in sepsis and the contribution of non-resuscitation fluids in fluid balance is unclear. We aimed to investigate the main components of fluid intake and fluid balance in both survivors and non-survivor patients with septic shock within the first 72 hours. METHODS: In this prospective observational study in two intensive care units, we recorded all fluids administered intravenously, orally, or enterally, and losses during specific time intervals from vasopressor initiation: T1 (up to 24 hours), T2 (24 to 48 hours) and T3 (48 to 72 hours). Logistic regression and a mathematical model assessed the association with mortality and the influence of severity of illness. RESULTS: We included 139 patients. The main components of fluid intake varied across different time intervals, with resuscitation and non-resuscitation fluids such as antimicrobials and maintenance fluids being significant contributors in T1 and nutritional therapy in T2/T3. A positive fluid balance both in T1 and T2 was associated with mortality (p = 0.049; p = 0.003), while nutritional support in T2 was associated with lower mortality (p = 0.040). The association with mortality was not explained by severity of illness scores. CONCLUSIONS: Non-resuscitation fluids are major contributors to a positive fluid balance within the first 48 hours of resuscitation. A positive fluid balance in the first 24 and 48 hours seems to independently increase the risk of death, while higher amount of nutrition seems protective. This data might inform fluid stewardship strategies aiming to improve outcomes and minimize complications in sepsis.

Benefits of a Dual-Task Training on Motor and Cognitive Functions in Community-Dwelling Older Adults: A Controlled Clinical Trial.

OBJECTIVE: The aim of the study is to verify the effects of a 3-mo dual-task training on motor and cognitive functions in community-dwelling older adults. DESIGN: In this prospective, single-blinded, controlled clinical trial, a total of 40 participants were allocated to either the experimental or the control (no-exercise) group. The intervention program consisted of a combination of motor and cognitive exercises conducted twice a week on nonconsecutive days. The main outcome measures were postural stability, mobility, fear of falling, and cognitive functions. Multiple analyses of variance were used to assess the impact of the dual-task training. Effect sizes (η 2 p) were reported. Significance was set at 5%. RESULTS: Compared with the control group, participants who underwent the dual-task training showed positive outcomes in terms of postural stability (η 2 p = 0.298, P = 0.020), mobility (η 2 p = 0.285, P = 0.003), and cognitive functions (η 2 p = 0.536, P = 0.001). No significant differences were observed between the groups in terms of the fear of falling ( P = 0.566). CONCLUSIONS: Three-month dual-task training was beneficial for postural control, mobility, and cognitive functions in community-dwelling older adults. Based on the present findings, healthcare professionals should consider incorporating dual-task training into clinical practice.

Análise da tendência da mortalidade por causas externas em pessoas idosas no Brasil, 2000 a 2022 / Analysis of the trend of mortality from external causes in older adults in Brazil, 2000 to 2022

Resumo Objetivo analisar a tendência de mortalidade por causas externas em pessoas idosas no Brasil no intervalo temporal entre os anos 2000 e 2022 e identificar o perfil sociodemográfico de mortalidade. Método estudo ecológico de série temporal utilizando dados secundários, envolvendo a mortalidade em pessoas idosas por causas externas no Brasil, no período de 2000 a 2022. Os dados foram coletados a partir das bases de dados do Departamento de Informática do Sistema Único de Saúde, das estimativas da população residente e de dados populacionais censitários disponibilizados pelo Instituto Brasileiro de Geografia e Estatística. A frequência absoluta e relativa dos dados foi analisada a partir do software Excel 2010. As análises das tendências das taxas de mortalidade e regressão linear segmentada foram realizadas por meio do Joinpoint, com significância estatística avaliada por meio do teste de Monte Carl Resultados No período investigado, foram identificados 572.608 óbitos por causas externas em pessoas idosas com 60 anos ou mais. Em relação ao comportamento da mortalidade por causas externas em pessoas idosas, observou-se tendência de aumento nas taxas de mortalidade na maior parte do período estudado (2000 a 2013) com uma variação percentual anual (VPA: 1,86; IC95%: 1,5-2,2). Conclusão os resultados indicam uma tendência de crescimento da mortalidade de pessoas idosas por causas externas, refletindo a necessidade de priorização de políticas públicas que intervenham sobre esse evento.

Abstract Objective To analyze the trend of mortality due to external causes in older adults in Brazil within the temporal interval spanning from 2000 to 2022 and to identify the sociodemographic profile of mortality. Method Ecological time-series study utilizing secondary data, encompassing mortality in older adults due to external causes in Brazil, spanning the period from 2000 to 2022. The data were collected from the databases of the Department of Informatics of the Unified Health System, population estimates, and census population data provided by the Brazilian Institute of Geography and Statistics. The absolute and relative frequency of the data were analyzed using Microsoft Excel 2010 software. The analysis of trends in mortality rates and segmented linear regression was conducted using Joinpoint, with statistical significance assessed through the Monte Carlo test. Results During the investigated period, 572,608 deaths due to external causes were identified in individuals aged 60 years or older. Regarding the mortality pattern due to external causes in older adults, an increasing trend in mortality rates was observed for the majority of the studied period (2000 to 2013) with an annual percent change (APC) of 1.86 (95% CI: 1.5-2.2). Conclusion The results indicate a growing trend in mortality among older individuals due to external causes, highlighting the need for prioritizing public policies that address this issue.

Hibiscus acetosella: An Unconventional Alternative Edible Flower Rich in Bioactive Compounds.

The interest in the consumption of edible flowers has increased since they represent a rich source of bioactive compounds, which are significantly beneficial to human health. The objective of this research was to access the bioactive compounds and antioxidant and cytotoxic properties of unconventional alternative edible flowers of Hibiscus acetosella Welw. Ex Hiern. The edible flowers presented pH value of 2.8 ± 0.00, soluble solids content of 3.4 ± 0.0 °Brix, high moisture content of about 91.8 ± 0.3%, carbohydrates (6.9 ± 1.2%), lipids (0.90 ± 0.17%), ashes (0.4 ± 0.0%), and not detectable protein. The evaluation of the scavenging activity of free radicals, such as 2,2-diphenyl-1-picryl-hydrazyl (DPPH) and 2,2'-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), of the flower extract was better than the results observed for other edible flowers (507.8 ± 2.7 µM TE and 783.9 ± 30.8 µM TE, respectively) as well as the total phenolic composition (TPC) value (568.8 ± 0.8 mg GAE/g). These flowers are rich in organic acids and phenolic compounds, mainly myricetin, and quercetin derivatives, kaempferol, and anthocyanins. The extract showed no cytotoxicity for the cell lineages used, suggesting that the extract has no directly harmful effects to cells. The important bioactive compound identified in this study makes this flower especially relevant in the healthy food area due to its nutraceutical potential without showing cytotoxicity.

Mineralocorticoid receptor knockout in Schwann cells alters myelin sheath thickness.

Myelination allows fast and synchronized nerve influxes and is provided by Schwann cells (SCs) in the peripheral nervous system. Glucocorticoid hormones are major regulators of stress, metabolism and immunity affecting all tissues. They act by binding to two receptors, the low-affinity glucocorticoid receptor (GR) and the high-affinity mineralocorticoid receptor (MR). Little is known about the effect of glucocorticoid hormones on the PNS, and this study focuses on deciphering the role of MR in peripheral myelination. In this work, the presence of a functional MR in SCs is demonstrated and the expression of MR protein in mouse sciatic nerve SC is evidenced. Besides, knockout of MR in SC (SCMRKO using Cre-lox system with DesertHedgeHog (Dhh) Cre promoter) was undertaken in mice. SCMRKO was not associated with alterations of performance in motor behavioral tests on 2- to 6-month-old male mice compared to their controls. No obvious modifications of myelin gene expression or MR signaling gene expression were observed in the SCMRKO sciatic nerves. Nevertheless, Gr transcript and GR protein amounts were significantly increased in SCMRKO nerves compared to controls, suggesting a possible compensatory effect. Besides, an increase in myelin sheath thickness was noted for axons with perimeters larger than 15 µm in SCMRKO illustrated by a significant 4.5% reduction in g-ratio (axon perimeter/myelin sheath perimeter). Thus, we defined MR as a new player in peripheral system myelination and in SC homeostasis.

Spatial Distribution of Gestational Syphilis in Brazil: Socioeconomic and Health Services Inequalities.

We aimed to analyze the spatial distribution of gestational syphilis from 2008 to 2018 in Brazil and identify correlations with socioeconomic and health-care aspects. This ecological study used municipalities of Brazil as the unit of analysis. Data collection took place between June and July 2021. Data were extracted for 2008 to 2018, and information on the epidemic in animals in the country was obtained from data records. The gestational syphilis detection rate was the dependent variable, and the independent variables were the Municipal Human Development Index, the proportion of doctors per inhabitant in primary health care (PHC), and the percentage of PHC coverage. The data went through an aggregation process in 482 immediate regions of urban articulation. The global Moran's I index and the local spatial correlation indicator detected territorial clusters using GeoDa software. The gestational syphilis detection rate was distributed unevenly in the immediate regions of urban articulation between 2008 and 2018, and presented a negative spatial correlation with the Municipal Human Development Index (Moran's I = -0.243, P ≤ 0.05), the percentage of PHC coverage (Moran's I = -0.163, P ≤ 0.05), and the proportion of doctors per inhabitants in PHC (Moran's I = -0.164, P ≤ 0.05). Socioeconomic inequalities, mainly related to the availability of human resources and access to health services, are correlated with the spatial distribution of gestational syphilis in Brazil. Investments in social policies and strengthening of PHC are essential for controlling gestational syphilis.

Trichoderma asperellum Extract Isolated from Brazil Nuts (Bertholletia excelsa BONPL): In Vivo and In Silico Studies on Melanogenesis in Zebrafish.

Endophytic fungi are those that present part of their life cycle in healthy tissues of different plant hosts in symbiosis without causing harm. At the same time, fungus-plant symbiosis makes it possible for microorganisms to synthesize their own bioactive secondary metabolites while in the stationary stage. To accomplish this, the endophytic fungus Trichoderma asperellum was isolated from Bertholletia excelsa (Brazil nut) almonds. The fungus was cultivated and extracted with ethyl acetate, obtaining AM07Ac. Then, using HPTLC (High-performance thin-layer chromatography) and nuclear magnetic resonance (1H NMR), ß-amyrin, kaempferol, and brucine were identified as major compounds. Further in vivo assays in zebrafish demonstrated the activity of AM07Ac on melanogenesis by producing a concentration-response inhibitory effect, which, through an in silico study, proved to be related to the noted major compounds known to inhibit tyrosinase activity. The inhibition of tyrosinase prevents melanin accumulation in skin. Therefore, these results imply the importance of investigating microorganisms and their pharmacological activities, in particular the endophytic fungus Trichoderma asperellum as a generator of active metabolites for melanogenesis modulation.

Temporal trend and factors associated with spatial distribution of congenital syphilis in Brazil: An ecological study.

Objective: The study aimed to analyze the temporal trend of congenital syphilis in Brazil in the period from 2008 to 2018 and its spatial distribution in the Immediate Regions of Urban Articulation, and to identify spatial correlations with socioeconomic factors and prenatal care. Methods: Spatial correlations between the incidence of congenital syphilis and socioeconomic conditions and access to prenatal care were assessed. This ecological study conducted a time series analysis in Brazil and spatial analysis in 482 Immediate Regions of Urban Articulation. Cases of congenital syphilis reported in the Notifiable Diseases Information System and the Live Birth Information System from January 1, 2008, to December 31, 2018 were included. Socioeconomic conditions (percentage of individuals with inadequate water supply and sanitation) were extracted from the 2010 census, whereas the Live Birth Information System provided data on access to prenatal care (percentage of live births with 1-3 prenatal care appointments). The Joinpoint Regression software performed the temporal trend analysis, while the GeoDa software assessed territorial clusters using the Moran's I and Local Spatial Association Indicator. Results: The incidence of congenital syphilis showed an upward trend (annual percent change 1 = 26.96; 95% CI: 18.2-36.3; annual percent change 2 = 10.25; 95% CI: 2.7-28.4) and was unevenly distributed across Immediate Regions of Urban Articulation in Brazil (Moran's I = 0.264, p ≤ 0.05). It also presented a direct spatial correlation with the percentage of individuals with inadequate water supply and sanitation (Moran's I = 0.02, p ≤ 0.05) and the percentage of live births with 1-3 prenatal care appointments (Moran's I = 0.03, p ≤ 0.05). Conclusion: Agrowth trend of congenital syphilis in Brazil was observed between 2008 and 2018. Moreover, inequalities in socioeconomic conditions and access to prenatal care influenced the spatial distribution of this disease.

Hierarchical structured surfaces enhance the contact angle of the hydrophobic (meta-stable) state.

The relation between wetting properties and geometric parameters of fractal surfaces are widely discussed on the literature and, however, there are still divergences on this topic. Here we propose a simple theoretical model to describe the wetting properties of a droplet of water placed on a hierarchical structured surface and test the predictions of the model and the dependence of the droplet wetting state on the initial conditions using simulation of the 3-spin Potts model. We show that increasing the auto-similarity level of the hierarchy - called n - does not affect considerably the stable wetting state of the droplet but increases its contact angle. Simulations also explicit the existence of metastable states on this type of surfaces and shows that, when n increases, the metastability becomes more pronounced. Finally we show that the fractal dimension of the surface is not a good predictor of the contact angle of the droplet.

The Use of Spatial Analysis in Syphilis-Related Research: Protocol for a Scoping Review.

BACKGROUND: Latin America, Africa, and Asia have high incidences of syphilis. New approaches are needed to understand and reduce disease transmissibility. In health care, spatial analysis is important to map diseases and understand their epidemiologic aspects. OBJECTIVE: The proposed scoping review will identify and map the use of spatial analysis as a tool for syphilis-related research in health care. METHODS: This protocol was based on the Joanna Briggs Institute manual, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). We will conduct searches in Embase; Lilacs, via the Virtual Health Library (Biblioteca Virtual en Salud; BVS), in Portuguese and English; Medline/PubMed; Web of Science; Cumulative Index to Nursing and Allied Health Literature (CINAHL); and Scopus. Gray literature will be searched for in Google Scholar, the Digital Library of Theses and Dissertations, the Catalog of Theses and Dissertations of the Coordination of Improvement of Higher Education Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior; CAPES), Open Access Theses and Dissertations, ProQuest Dissertations and Theses Global, and the Networked Digital Library of Theses and Dissertations. The main research question is "How has spatial analysis been used in syphilis-related research in health care?" Studies are included if they have the full text available, address syphilis, and use geographic information systems software and spatial analysis techniques, regardless of sample characteristics or size. Studies published as research articles, theses, dissertations, and government documents will also be considered, with no location, time, or language restrictions. Data will be extracted using a spreadsheet adapted from the Joanna Briggs Institute. Quantitative and qualitative data will be analyzed using descriptive statistics and a thematic analysis, respectively. RESULTS: The results will be presented according to the PRISMA-ScR guidelines and will summarize the use of spatial analysis in syphilis-related research in health care in countries with different contexts, factors associated with spatial cluster formation, population health impacts, contributions to health systems, challenges, limitations, and possible research gaps. The results will guide future research and may be useful for health and safety professionals, managers, public policy makers, the general population, the academic community, and health professionals who work directly with people with syphilis. Data collection is projected to start in June 2023 and end in July 2023. Data analysis is scheduled to take place in August and September 2023. We expect to publish results in the final months of 2023. CONCLUSIONS: The review may reveal where syphilis incidence has the highest incidence, which countries most use spatial analysis to study syphilis, and whether spatial analysis is applicable to syphilis in each continent, thereby contributing to discussion and knowledge dissemination on the use of spatial analysis as a tool for syphilis-related research in health care. TRIAL REGISTRATION: Open Science Framework CNVXE; https://osf.io/cnvxe. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/43243.

Spatial Variability of External Egg Quality in Vertical Naturally Ventilated Caged Aviaries.

External egg quality is an essential parameter of egg production as it relates directly to economic losses. This study evaluated the spatial variability of external egg quality in five naturally ventilated caged vertical aviaries. Differences caused by bird age and thermal and luminous variability within aviaries during winter and summer were analyzed. Data on aviary air temperature, relative humidity, light intensity, and external egg quality were collected at evenly distributed points along the aviary length within three levels of cages. The experimental design was completely randomized in a factorial scheme. In the summer, the highest air temperature and lowest relative humidity were found in central cages, mainly in upper center cages; hens produced eggs with a lower weight and shape index in this area. Similar results were obtained in the winter. In the summer, eggs with lower shell weight and thickness were also produced by hens housed in the central cages, but in the winter, the opposite result was obtained. This study of the spatial variability of external egg quality proved efficient in detecting areas within an aviary with poor quality eggs; improvements to design and management in these areas could help management improve production efficiency and contribute to a sustainable egg supply.

Fibrinolytic therapy in patients with COVID-19 and ARDS: protocol for a systematic review and meta-analysis.

INTRODUCTION: In COVID-19-related acute respiratory distress syndrome (ARDS), the clot play a role in gas exchange abnormalities. Fibrinolytic therapy can improve alveolar ventilation by restoring blood flow. In this systematic review and meta-analysis protocol, we aim to assess the safety and efficacy of fibrinolytic therapy in such a population. METHODS: We will perform a systematic search in MEDLINE, EMBASE, Cochrane CENTRAL and LILACS databases without language restrictions for relevant randomised controlled trials (RCTs) and quasi-RCTs. Two review authors will independently perform data extraction and quality assessments of data from included studies. In case of divergence, a third author will be contacted. The Cochrane handbook will be used for guidance. If the results are not appropriate for a meta-analysis, a descriptive analysis will be performed. DISCUSSION: This systematic review and meta-analysis protocol will provide current evidence about the safety and efficacy of fibrinolytic therapy in patients with COVID-19 and ARDS. These findings will provide if fibrinolytic therapy might be an option for a desperate clinical setting, where all medical efforts have been used. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42020187482. ETHICS AND DISSEMINATION: Ethics committee approval is not necessary. We intend to update the public registry, report any protocol amendments and publish the results in a widely accessible journal.

Recovery of methane dissolved in the effluent of a novel upflow anaerobic hybrid reactor (UAHB) submitted to temperature variation.

Recent studies point out losses of 30-40% of the produced methane in the effluent of anaerobic reactors treating sewage, reducing the renewable energy potential and the environmental footprint. A novel bench-scale upflow anaerobic hybrid (UAHB) reactor combining a sludge blanket at the bottom and a filter media at the top, both with three-phase separators, was proposed to evaluate the recovery of dissolved methane. UAHB was operated with volumetric organic loading rate of 1.24 kg COD m-3 d-1 and hydraulic retention time of 8 h for 218 days to evaluate the influence of temperature (18°C, 23°C, and 28°C) in the methane dissolved in the effluent and collected from three-phase separators. Chemical oxygen demand (COD) and total suspended solids (TSS) removals efficiencies remained constant during the operation and equal to 90 and 95%, respectively, related to the activity of biomass retained in the filter media. Temperature increase influenced more the methane production in the sludge blanket rather than in the upper bed. The volume of recovered methane increased about 20% with the installation of the support media and the upper three-phase separator (3PHS). The loss of methane dissolved in the effluent was strongly influenced by the temperature, and higher with the decrease of this parameter. Non-statistically significant correlations were observed between the temperature and the methane production in the upper bed (p-value = 0.0943) and total (p-value = 0.0930). Thus, it can be concluded that the evaluated temperatures did not influence the global efficiency and the total methane yield of the UAHB reactor.

Hospitalized Women Have Anxiety and Worse Mental Health Scores than Men.

This study aimed to assess the levels of anxiety, depression, and quality of life in hospitalized men and women using the Hospital Anxiety and Depression Scale (HADS), Beck's Anxiety Inventory (BAI), and Short Form-36 Health Survey Questionnaire (SF-36). 60 patients of both sexes were recruited from at the outpatient department of the Hospital Universitário de Vassouras (HUV). The HADS-Anxiety (HADS-A) and BAI questionnaires were used to assess anxiety; the HADS-Depression (HADS-D) questionnaire to assess levels of depression, and the SF-36 to assess the quality of life. The results indicated that hospitalized women had higher levels of anxiety when compared to men. No difference was observed in the levels of depression between men and women. Regarding quality of life, women showed more deterioration in general and mental health compared to men. Thus, the findings suggest that hospitalized women have higher levels of anxiety when compared to men and that this increase can lead to worse general and mental health. Professionals should be aware of possible psychological changes in hospitalized women as they can affect the overall quality of life.

Temporal Trend of Gestational Syphilis between 2008 and 2018 in Brazil: Association with Socioeconomic and Health Care Factors.

The increased number of cases in recent years has turned syphilis into a global public health problem. In 2020, 115,371 cases of acquired syphilis were reported (detection rate of 54.5 cases/100,000 inhabitants) in Brazil. In that same period, the country notified 61,441 cases of gestational syphilis (detection rate of 21.6 per 1000 live births). The number of syphilis cases points to the need to reinforce surveillance, prevention, and infection control actions, which is a worrying scenario for government organizations. This study aims to describe the temporal trend of gestational syphilis from 2008 to 2018 in Brazilian regions and to associate its detection rate with socioeconomic and health care indicators. We conducted an ecological study of temporal trends using secondary data from the Department of Informatics of the Unified Health System. The temporal trend was analyzed using the Joinpoint Regression program. The annual percent change (APC) and 95% confidence intervals (95%CI) were estimated and tested; statistical significance was assessed using the Monte Carlo permutation test. Correlations were assessed using Pearson's correlation coefficient, and statistical significance was calculated using Pearson's product-moment correlation. The gestational syphilis detection rate increased between 2008 and 2018. The South region showed the greatest trend, whereas the Midwest region presented the lowest trend. The following variables were significantly correlated with the gestational syphilis detection rate: Municipal Human Development Index, illiteracy rate, percentage of primary health care coverage, and proportion of doctors, nurses, and basic health units per inhabitant. Health policies are needed to mitigate social vulnerabilities and strengthen primary health care.

Spatial distribution of bed variables, animal welfare indicators, and milk production in a closed compost-bedded pack barn with a negative tunnel ventilation system.

This research aimed to characterize, evaluate and compare the spatial distribution of the leading bed variables, animal welfare indicators, and milk production in a closed compost-bedded pack barn (CBP) with a negative tunnel ventilation system, for summer and winter periods. The study was carried out in a CBP located in the Zona da Mata region, Minas Gerais, Brazil. The geostatistical modeling technique evaluated the variables of temperature, moisture content, and pH (on the surface and depth of 0.20m) across the length of the bed. Bed samples were characterized for carbon (C), nitrogen (N), and C:N ratio. Cows housed in the CBP were assessed for locomotion and hygiene scores and average milk production. To evaluate the thermoregulation of the cows, the respiratory rate (RR) and surface temperature (ST) were measured. Geostatistical analysis showed spatial dependence and the non-uniformity of the spatial distribution of bed variables. The worst levels of bed temperature and moisture were found in the regions close to the evaporative cooling plate, surrounding the feeding alley, and in the region with the highest cow stocking. The C:N ratio, obtained in both climatic seasons of the year, remained outside the recommended range for ideal composting. During the summer and winter, the bed variables' values suggest that the material was below levels for optimal composting; however, the aerated inner layer was biologically active. The high animal density significantly impacted the worsening of the bed moisture content and internal temperature. In general, dairy cows showed adequate hygiene (score of 1 and 2) and locomotion (score of 0 and 1) scores for the two climatic seasons evaluated, indicating good welfare conditions. In relation to RR and ST, the summer period presented less favorable environmental conditions. During winter, the average milk production was 28.1 ± 7.2 kg day-1, and during summer, it was 26.9 ± 6.7 kg day-1.