INFO IST Setembro 2024 / INFO IST September 2024

Jornal na sua 9ª edição (setembro 2024) com a análise e elaboração de conteúdo pela gerência de IST/AIDS e gerência de Hepatites Virais - SES- RJ.

Serological and Molecular Survey of Rickettsial Agents in Wild Boars (Sus scrofa) from Midwestern Brazil.

Wild boars (Sus scrofa L.) are considered among the most harmful invasive species worldwide, causing irreversible ecosystem damage, acting as zoonotic spreaders and reservoirs, threatening human and animal health, and having an important economic impact. Accordingly, the present study has assessed the rickettsial exposure, tick infestation of wild boars, and rickettsial DNA presence in ticks from infested animals from the Cerrado biome in midwestern Brazil. Anti-Rickettsia spp. antibodies were detected in serum samples of wild boars by immunofluorescence assay. Overall, 106/285 (37.2%) wild boar serum samples from 13 to 18 (72.2%) municipalities showed seroreactivity to at least one of the four Rickettsia spp. antigens tested, the largest number of wild boars serologically tested to Rickettsia spp. in this type of study. Among the 106 seroreactive animals, 34 showed possible homologous reactions between R. parkeri, R. amblyommatis, and R. bellii, with endpoint titers between 128 and 512. A sample of 45 ticks collected from four culled wild boars was identified as Amblyomma sculptum, and all tested negative for rickettsial DNA presence. In conclusion, this study has provided a reliable sampling seroprevalence and indicated high exposure of wild boars to rickettsial agents, with a potential interaction with Rickettsia spp. from the spotted fever group within the Cerrado biome from midwestern Brazil.

Burden of disease and costs for the Unified Health System in Brazil due to diseases whose alcohol consumption is a necessary cause: an ecological study.

OBJECTIVE: This study aimed to quantify the health and economic impacts of alcohol consumption in Brazil for 2019. STUDY DESIGN: Ecological study using secondary data sources. METHODS: We calculated the disease burden using estimates from the Global Burden of Disease study, which incorporated data from health surveys and hospital records. Costs were estimated based on direct expenses recorded in the Hospital and Outpatient Information System of the Unified Health System, with data by sex, age group, cause, and Federative Units. RESULTS: Alcohol consumption was a necessary cause for 30,355 deaths and approximately 1.69 million disability-adjusted life years in Brazil, representing 2.2% and 2.6% of the national totals, respectively. The impact was more pronounced among men, in the Northeast region and within the 40- to 64-year-old age group. The total costs attributed to these outcomes reached approximately Int$43.1 million, with hospital admissions accounting for 94.16% of these expenses. CONCLUSION: In 2019, alcohol consumption had a significant impact on both the health of Brazilians and the expenses of the health system. As a preventable risk factor, alcohol consumption necessitates effective intersectoral strategies to mitigate its burden.

Do exotic invasive mammals disturb the native fauna? Spatiotemporal distribution and overlap between species in a national park of Argentina.

Monitoring the invasive exotic species and their effect on native fauna is fundamental for their effective control. The objective of this research is to evaluate the spatiotemporal distribution and overlap of medium-large-sized fauna in El Palmar National Park, Argentina, to consider potential negative interactions between native and exotic species. Camera traps were distributed in 27 sites between 2017 and 2019. Spatial and temporal overlap was estimated for every pair of exotic-native taxa. With 2673 camera days, two exotic and seven native taxa were recorded. All species were distributed along the extension of the National Park but in different numbers of sites. Exotic axis deer (Axis axis) was recorded in all sites but one, and exotic wild boar (Sus scrofa) occurred at only one-third of the sites surveyed. The occurrence of native mammals ranged between 26% (Geoffroy's cat, Leopardus geoffroyi) and 67% (capybara, Hydrochoerus hydrochaeris). Spatial overlap between native and exotic species was high overall and was higher in winter when species moved over larger areas to look for limited resources. Except for greater rhea (Rhea americana), which was diurnal, all species had crepuscular or nocturnal patterns. Both exotic species had an intermediate/high overlap in their activity pattern with almost all native species, including some species with similar diets, but the hours of their maximum activities did not strictly coincide. However, the existence of differences in the exotic species' activity patterns compared to their patterns in other areas where they inhabit could indicate segregation in daily activity to relax competition.

Molecular identification of Sarcocystis species in wild boar (Sus scrofa) and pigs (Sus scrofa domesticus) in Brazil.

Sarcocystis spp. are protozoan parasites that form cysts in the organs and musculature of various animal species. The species Sarcocystis miescheriana and Sarcocystis suihominis are pathogenic to pigs and wild boars (Sus scrofa), acting as intermediate hosts, while humans are the definitive host for S. suihominis. To date, there have been no reports of the identification of these coccidian species in Sus scrofa in Brazil. Therefore, in this study, we conducted the first molecular identification of Sarcocystis species using PCR-RFLP and sequencing. A total of 210 samples were analyzed, of this total, 67 tested positive for Sarcocystis spp., representing 31.9% of the total samples assessed. Out of the total positive samples, 55 (82.1%) were identified as S. miescheriana and 8 (11.9%) as S. suihominis, a zoonotic species. Additionally, other species related to bovines, such as S. cruzi and zoonotic S. hominis, were detected in 3.0% of the samples, serving as contaminants in the pork products. The presence of S. suihominis in swine and wild boar samples is concerning due to the zoonotic risk and potential environmental contamination, as humans act as definitive hosts, also for the presence of S. hominis as a bovine contaminant in pork sausages. Furthermore, we confirmed the efficacy of the PCR-RFLP technique as a reliable tool for the identification of Sarcocystis species, demonstrating its potential use in laboratories for molecular diagnosis and rapid identification of these parasites, aiming to protect public health and ensure food safety.

A formação acadêmica em educação física para a atenção básica do SUS: uma revisão integrativa em teses e dissertações / Academic training in physical education for primary care in the SUS: an integrative review of theses and dissertations / La formación académica en educación física para la atención primaria en el SUS: una revisión integradora de tesis y disertaciones

Faz-se necessário abordar criticamente a promoção da saúde e os elementos que impactam o processo saúde/doença no cotidiano da formação do professor de Educação Física (EF). Portanto, este estudo tem como objetivo analisar teses e dissertações produzidas sobre a formação acadêmica em EF e sua relação com a saúde no contexto do Sistema Único de Saúde (SUS), por meio de uma revisão integrativa. O estudo encontrou seis dissertações que mostraram que apesar da percepção das universidades de que a formação acadêmica permite aos professores de EF atuar no SUS, é possível identificar a manutenção do discurso conservador e biomédico, o que afeta a compreensão, a percepção e a ação dos professores de EF em equipes multiprofissionais no contexto da Saúde Coletiva presente no SUS (AU).

It is necessary to critically approach health promotion and the elements that impact the health/disease process in the daily training of Physical Education (PE) teachers. Therefore, this study aims to analyze the theses and dissertations produced on academic training in PE and its relationship with health in the context of the Unified Health System (SUS), through an integrative review. The study found six dissertations that showed that, despite the universities' perception that academic training allows PE teachers to work in the SUS, it is possible to identify the maintenance of the conservative and biomedical discourse, which affects understanding, perception and action of PE teachers in multidis-ciplinary teams in the context of Collective Health in the present SUS (AU)

Es necesario abordar críticamente la promoción de la salud y los elementos que impactan el proceso salud/enfermedad en la formación diaria de los docentes de Educación Física (EF). Por lo tanto, este estudio tiene como objetivo analizar tesis y disertaciones producidas sobre la formación académica en EF y su relación con la salud en el contexto del Sistema Único de Salud (SUS), a través de una revisión integradora. El estudio encontró seis disertaciones que demostraron que, a pesar de la percepción de las universidades de que la formación académica permite que los profesores de EF actúen en el SUS, es posible identificar el mantenimiento del discurso conservador y biomédico, que afecta la comprensión, la percepción y la acción de los profesores de EF en equipos multidisciplinarios en el contexto de la Salud Colectiva en el SUS actual

The Impact of Diabetes Education on Continuous Glucose Monitoring in SUS-Dependent Patients in a Northeastern Brazilian City.

BACKGROUND: Diabetes Mellitus (DM) is an important chronic disease that occurs worldwide. AIMS: This study aims to investigate how the use of the FreeStyle® Libre system in Unified Health System (SUS) patients impacts diabetes parameters in patients who receive education on proper insulin administration and the use of the continuous monitoring device, as well as how this affects patients without any concomitant multidisciplinary support in Sergipe, Brazil. METHODS: We conducted a prospective randomized study in a diabetes clinic in Sergipe, Brazil, using the flash method FreeStyle® Libre (Abbott). The participants were divided into two groups: one receiving diabetes education on CGM (continuous glucose monitoring), while the other did not. Before the intervention, the patient's treatment motivation and quality of life were assessed using a questionnaire, and baseline levels of glycated hemoglobin were measured using high-performance liquid chromatography (HPLC) and the point of care AlereTM Afinion with boronate fixation. We compared first- and second-phase data with respect to glycated hemoglobin, mean interstitial blood glucose, time on and above target for hypoglycemic and hyperglycemic events, and mean hypoglycemic duration. RESULTS: In group A, which received the diabetes education intervention, there was a significant reduction in average HbA1c levels from 8.6% to 7.9% after 3 months (p = 0.001). However, there was no significant difference in average glycemic values. Time above target decreased significantly from 50.62% to 29.43% (p = 0.0001), while time below target decreased from 22.90% to 20.21% (p = 0.002). There was no significant change in the number of hypoglycemic events, but the duration of hypoglycemia decreased significantly from 130.35 min to 121.18 min after 3 months (p = 0.0001). In Group B, there was no significant difference in mean HbA1c levels before (7.07%) and after (7.28%) sensor installation. This group maintained lower HbA1c levels compared to the other group. Average blood glucose levels also remained similar before (148.37 mg/dL) and after (154.65 mg/dL) the intervention. Although the time above the target glucose level increased significantly from 35.94% to 48.17%, the time at target decreased from 50.40% to 37.97%. No significant changes were observed in the time below target, the number of hypoglycemic events, or the duration of hypoglycemia. CONCLUSIONS: Our findings indicate that utilizing continuous glucose monitoring technology can enhance glycemic control, particularly in motivated, educated, low-income patients dependent on the SUS. To achieve positive results with FreeStyle Libre, it is imperative to allocate resources for multidisciplinary support.

Identification of eQTLs using different sets of single nucleotide polymorphisms associated with carcass and body composition traits in pigs.

BACKGROUND: Mapping expression quantitative trait loci (eQTLs) in skeletal muscle tissue in pigs is crucial for understanding the relationship between genetic variation and phenotypic expression of carcass traits in meat animals. Therefore, the primary objective of this study was to evaluate the impact of different sets of single nucleotide polymorphisms (SNP), including scenarios removing SNPs pruned for linkage disequilibrium (LD) and SNPs derived from SNP chip arrays and RNA-seq data from liver, brain, and skeletal muscle tissues, on the identification of eQTLs in the Longissimus lumborum tissue, associated with carcass and body composition traits in Large White pigs. The SNPs identified from muscle mRNA were combined with SNPs identified in the brain and liver tissue transcriptomes, as well as SNPs from the GGP Porcine 50 K SNP chip array. Cis- and trans-eQTLs were identified based on the skeletal muscle gene expression level, followed by functional genomic analyses and statistical associations with carcass and body composition traits in Large White pigs. RESULTS: The number of cis- and trans-eQTLs identified across different sets of SNPs (scenarios) ranged from 261 to 2,539 and from 29 to 13,721, respectively. Furthermore, 6,180 genes were modulated by eQTLs in at least one of the scenarios evaluated. The eQTLs identified were not significantly associated with carcass and body composition traits but were significantly enriched for many traits in the "Meat and Carcass" type QTL. The scenarios with the highest number of cis- (n = 304) and trans- (n = 5,993) modulated genes were the unpruned and LD-pruned SNP set scenarios identified from the muscle transcriptome. These genes include 84 transcription factor coding genes. CONCLUSIONS: After LD pruning, the set of SNPs identified based on the transcriptome of the skeletal muscle tissue of pigs resulted in the highest number of genes modulated by eQTLs. Most eQTLs are of the trans type and are associated with genes influencing complex traits in pigs, such as transcription factors and enhancers. Furthermore, the incorporation of SNPs from other genomic regions to the set of SNPs identified in the porcine skeletal muscle transcriptome contributed to the identification of eQTLs that had not been identified based on the porcine skeletal muscle transcriptome alone.

Training of community health agents - a strategy for earlier recognition of mucopolysaccharidoses.

Primary Health Care (PHC) is the gateway for patients in the Brazilian unified health system (Sistema Único de Saúde-SUS), playing an extremely important role in the identification of potential patients with genetic diseases, and referral to specialized and tertiary health services. The PHC is composed of a multidisciplinary team, including the Community Health Agent, who is in direct contact with the community. To implement an educational program aimed at community health agents working in several municipalities in the state of Rio Grande do Sul (RS), Brazil. The training was focused on genetic diseases in general, with a special focus on identifying patients with Mucopolysaccharidosis (MPS). Tests were applied before and after the educational intervention, in order to assess the participants' knowledge on the topic at these two moments. The study covered a total of ten training sessions carried out in eight municipalities in the RS state, training 374 community health agents. The number of correct answers in the pre-test (n = 339) was 8,4 (SD 1.2), while in the post-test (n = 361) it was 9,2 (SD 0.8). Statistical analysis showed that the educational intervention effectively provided information about genetic diseases to the participants. Considering that community health agents are of fundamental importance in the identification and prevention of diseases and in the better navigation of the patients on the SUS, these professionals play a key role in the field of rare genetic diseases, and continuous training strategies should be taken.

A territorialidade da alta complexidade na Região Metropolitana de Belém, Brasil: a saúde especializada é subsidiada pelo SUS? / Territorial dynamics of highly complex health services in the Belém Metropolitan Region, Brazil: is specialized health care subsidized by the SUS?

Resumo O artigo apresenta uma análise sobre a atuação da rede de atenção especializada do SUS, com a delimitação dos serviços de média e de alta complexidade da rede hospitalar dos municípios que compõem a Região Metropolitana de Belém. A discussão se fundamenta na revisão dos dados secundários captados na plataforma do DATASUS e disponibilizados no Cadastro Nacional de Estabelecimentos de Saúde do Brasil (CNES) até janeiro de 2022. Constatou-se que a territorialidade da alta complexidade é formada majoritariamente pela rede privada, contudo a capacidade de atendimento da rede SUS sobrepôs à oferta direcionada ao atendimento não universal, em razão da ampla reserva de serviços privados ao convênio SUS, na qual os hospitais filantrópicos apresentaram maior disposição à demanda universal. Em contrapartida, a ampla presença do Estado nos serviços de alta complexidade não deve ser pensada como uma cobertura universal, devido ao fato de as formas de acesso a esses serviços apresentarem filtros de natureza jurídico-institucional, ou, em outras palavras, o que o SUS denomina de hospitais de portas abertas ou fechadas.

Abstract This article presents an analysis of the territorial dynamics of the specialized healthcare network, focusing on medium and high complexity care in hospitals in the municipalities that make up the Belém Metropolitan Region. The analysis is based on secondary data from DATASUS available on the National Health Facility Registry (CNES) up to January 2022. The findings show that the private network accounts for the largest proportion of services in the region; however, the service capacity of the SUS is greater than that of the private sector due to the large volume of services outsourced to private facilities via public-private partnerships, with philanthropic hospitals allocating the largest proportion of services to public patients. This should not be confused with universal coverage, as public patient access to private services may be restricted by legal and institutional barriers depending on the form of access (open-door or closed-door).

Quem pode atuar com acupuntura no Brasil? / Who can work with acupuncture in Brazil?

Resumo A acupuntura é ofertada no Sistema Único de Saúde (SUS), mas seu exercício é disputado juridicamente. Este estudo analisa os aspectos desse exercício por diferentes profissionais da área da saúde. Realizou-se uma análise de literatura científica e institucional (brasileira e internacional), cuja seleção foi intencionalmente orientada. Os resultados abordam aspectos da disputa sobre o exercício da acupuntura; o ensino da acupuntura e suas normativas; e a operacionalização dos registros do exercício da acupuntura no SUS. A ausência de regras unificadas desse exercício gerou regramento infralegal de instituições governamentais e corporações profissionais no Brasil, admitindo a prática multiprofissional, em conformidade com a Organização Mundial de Saúde .

Abstract Acupuncture is offered in the Brazilian National Health System (SUS), but its practice is matter of legal disputes. This study analyzes aspects of this practice by different professionals of the field of health. An analysis of scientific and institutional literature (Brazilian and international), whose selection was intentionally guided, was carried out. The results address aspects of the dispute over the practice of acupuncture; the teaching of acupuncture and its regulations; and the operationalization of records of acupuncture practice in the SUS. The absence of unified rules for this exercise generated infra-legal regulation of governmental institutions and professional corporations in Brazil, admitting multidisciplinary practice, in accordance with the guidelines of the World Health Organization.

Sistema Único de Saúde: acessibilidade das pessoas surdas no interior da Bahia / Unified Health System: accessibility of deaf people in the countryside of Bahia state / Sistema Único de Salud: accesibilidad de las personas sordas en el interior de Bahia

A acessibilidade das pessoas surdasno Sistema Único de Saúde ainda é precária devido às barreiras de comunicação. O objetivo do estudo foi analisar o acesso e o atendimento ofertado à comunidade surda nos serviços de saúde públicos, no município de Vitória da Conquista, Bahia, por meio de uma pesquisa qualitativa. Participaram oito profissionais de saúde e treze usuários surdos, cujos dados foram coletados com aplicação de um questionário e um roteiro de entrevista semiestruturada. Os resultados, com base na análise do conteúdo, apontaram que não há capacitação, as Unidades Básicas de Saúde não apresentam estratégias de acessibilidade nos atendimentos, têm rara comunicação em Libras e um número reduzido de intérpretes ­ o que dificulta a comunicação entre o profissional de saúde e o usuário surdo. A formação em Libras e a presença de um intérprete são apontadas como estratégias para um atendimento de qualidade às pessoas surdas

The accessibility of deaf people in the Unified Health System is still precarious due to communication barriers. The objective of the study was to analyze the access and care offered to the deaf community in public health services, in the city of Vitória da Conquista, Bahia, through qualitative research. Eight health professionals and thirteen deaf users took part in the research, whose data were collected using a questionnaire and a semi-structured interview script. Based on the content analysis, the results showed that there is no training, the Basic Health Units do not have accessibility strategies in care, rarely communicate in Libras and a have a small number of interpreters in their ranks ­ hindering the communication between health professional and deaf user. Training in Libras and the presence of an interpreter are identified as strategies for quality care for deaf people

La accesibilidad para los sordos en el Sistema Único de Salud todavía es precaria debido a las barreras de comunicación. El objetivo del estudio fue analizar el acceso y la atención ofrecida a este público en los servicios de salud públicos, en el municipio de Vitória da Conquista, Bahia, con una investigación cualitativa. Participaron ocho profesionales de la salud y trece usuarios sordos, cuyos datos fueron recolectados a través de cuestionario y guión de entrevista semiestructurada. Los resultados, basados en el análisis de contenido, mostraron que no hay capacitación, las Unidades Básicas de Salud no tienen estrategias de accesibilidad, y tienen poca comunicación en Libras y reducido número de intérpretes ­ lo que dificulta la comunicación entre el profesional de la salud y el usuario sordo. La formación en Libras y la presencia de un intérprete se identifican como estrategias para la atención de calidad a los sordos

Genetic diversity in creole pigs in south central Peru.

The creole pigs represent 67% of the national population in Peru. They are a source of economic income in rural communities, and due to their rusticity, they are not much labor demanding. However, knowledge about its genetic diversity remains scarce. The objective of this study was to determine the population structure and genetic diversity of creole pigs from rural communities in south central Peru. Thirteen microsatellites were used to characterize 120 creole pigs from the departments of Ayacucho (57) and Apurimac (63). The samples were taken from hair follicles and ear tissue. Nine microsatellites were highly polymorphic and informative (PIC > 0.5) for both departments. The Ayacucho population had a mean number of alleles (MNA) and expected heterozygosity (HE) of 8.8 and 0.68, respectively, while in the Apurimac population, these were 8.9 and 0.71, respectively. Both populations showed in less than 50% of their loci a deviation from Hardy-Weinberg equilibrium. There was a moderate genetic structure according to the analysis of molecular variance and the FST statistics (0.06), which was corroborated by Bayesian methods. In conclusion, the genetic diversity was mostly due to the intrapopulation variance (91%). Some individuals from Ayacucho shared similar alleles with those from Apurimac. This latter result may be due to their geographic proximity and the introduction of the same new exotic breeds. This is the first research on the genetic diversity of creole pigs in south central Peru. In fact, this study could serve as a basis for conservation strategies and actions in this region.

COVID-19 inpatient mortality in Brazil from 2020 to 2022: a cross-sectional overview study based on secondary data.

BACKGROUND: In Brazil, the COVID-19 pandemic found the universal and public Unified Health System (SUS) with problems accumulated over time, due, among other reasons, to low investments, and disparities in resource distribution. The preparedness and response of the healthcare system, involving the SUS and a private sector, was affected by large socioeconomic and healthcare access inequities. This work was aimed at offering an overview of COVID-19 inpatient mortality during the pandemic in Brazil, exploring factors associated with its variations and, specifically, differences across public, private (for-profit) and philanthropic (private non-profit) inpatient healthcare units, providers, and non-providers of services to the SUS. METHODS: This cross-sectional study used public secondary data. The main data source was the SIVEP-Gripe, which comprises data on severe acute respiratory illness records prospectively collected. We also employed the National Record of Health Establishments, the SUS' Hospitalization Information System and municipalities' data from IBGE. We considered adult COVID-19 hospitalizations registered in SIVEP-Gripe from February 2020 to December 2022 in inpatient healthcare units with a minimum of 100 cases in the period. Data analyses explored the occurrence of inpatient mortality, employing general linear mixed models to identify the effects of patients', health care processes', healthcare units' and municipalities' characteristics on it. RESULTS: About 70% of the COVID-19 hospitalizations in Brazil were covered by the SUS, which attended the more vulnerable population groups and had worse inpatient mortality. In general, non-SUS private and philanthropic hospitals, mostly reimbursed by healthcare insurance plans accessible for more privileged socioeconomic classes, presented the best outcomes. Southern Brazil had the best performance among the macro-regions. Black and indigenous individuals, residents of lower HDI municipalities, and those hospitalized out of their residence city presented higher odds of inpatient mortality. Moreover, adjusted inpatient mortality rates were higher in the pandemic peak moments and were significantly reduced after COVID-19 vaccination reaching a reasonable coverage, from July 2021. CONCLUSIONS: COVID-19 exposed socioeconomic and healthcare inequalities and the importance and weaknesses of SUS in Brazil. This work indicates the need to revert the disinvestment in the universal public system, a fundamental policy for reduction of inequities in the country.

O financiamento da Atenção Básica no Brasil: um balanço de duas décadas (2000-2020) / The financing primary care in Brazil: a balance of two decades (2000-2020)

Este artigo analisa o financiamento da Atenção Básica do Brasil entre 2000 e 2020 a partir de uma revisão integrativa das produções científicas disponíveis nas bases científicas eletrônicas BVS, SciELO e MEDLINE. Foram elegíveis artigos com acesso gratuito e situados no Brasil, excluindo duplicados e textos não científicos. Após aplicados os critérios de inclusão e exclusão, foram selecionados dez artigos, os quais foram submetidos à análise de conteúdo temática e organizados em duas categorias: (1) "Diferenças municipais no financiamento da Atenção Básica" e (2) "Financiamento tripartite da Atenção Básica". Os resultados apontam para diversas desigualdades no financiamento desse nível de atenção. Apesar do crescimento da participação federal, as transferências ocorreram por incentivos à adoção de programas federais que não alcançaram os municípios homogeneamente. Houve maior dependência das transferências federais em municípios pequenos e nas regiões Norte e Nordeste, além de baixa participação estadual no financiamento. Um dos limites do estudo foi não alcançar, pelo recorte temporal, estudos analisando os impactos das atuais políticas que agravaram o desfinanciamento da Atenção Básica, que provavelmente tem piorado o contexto apresentado e colocado ainda mais em risco a qualidade e preservação dela.

This article analyzes the primary healthcare financing in Brazil between 2000 and 2020. We conducted an integrative review of the scientific productions available in the electronic scientific databases BVS, Scielo, and MEDLINE in December 2020. After including articles undertaken in Brazil, with free access, and excluding duplicates and non-scientific texts, ten articles were selected. Those articles were submitted to Thematic Content Analysis and organized into two categories (1) "Municipal differences in the financing of Primary Care" and (2) "Tripartite Financing of Primary Care". The results of this review pointed out several inequalities in the financing of primary healthcare. Although federal participation in the budget has grown during the analyzed period, the transfers occurred due to incentives for the adoption of federal programs that did not reach the municipalities homogeneously. Compared to the South and Southeast, small municipalities in the North and Northeast regions had greater dependence on federal transfers. In addition, there was lower state participation in the overall financing in the North and Northeast regions. The main limitation of our review was not including studies published since 2021 analyzing the impacts of recent policies that aggravated the underfunding of primary healthcare in Brazil, which could have potentially worsened the results presented in this study and put primary healthcare quality and preservation even more at risk.

O Complexo Econômico-Industrial da Saúde (CEIS) como espaço estratégico para a modernização do SUS e para a geração dos empregos do futuro / The Health Economic-Industrial Complex (HEIC): a strategic area for both the modernization of the Unified Health System (SUS) and the creation of future jobs

Resumo Esse artigo apresenta os primeiros resultados da pesquisa sobre o novo mundo do trabalho da saúde no contexto da revolução 4.0 que buscou, além de identificar o perfil e o volume de emprego gerado pelas atividades de saúde no Brasil, analisar as principais transformações no mundo do trabalho e do emprego provocadas pelas novas tecnologias e seus potenciais efeitos no âmbito do Complexo Econômico-Industrial da Saúde (CEIS). A metodologia busca contribuir para uma nova visão dos profissionais de saúde, pois além de caracterizar o perfil ocupacional, incluindo seu conteúdo tecnológico, incorpora profissionais alocados, direta e indiretamente, no CEIS. Os resultados apresentados, fruto da aplicação da metodologia nas bases de dados da RAIS e da PNAD Contínua, para os anos entre 2012 e 2019, revelam a elevada capacidade de geração de bons empregos no CEIS, mesmo em contexto de crise econômica. O mercado de trabalho em saúde, tanto por sua escala, complexidade e diversidade, quanto por seu dinamismo e potencial em termos de incidência das tecnologias 4.0, indica que o desenvolvimento do CEIS pode se constituir em motor do desenvolvimento do país, associando inovação e produção à modernização do Sistema Único de Saúde (SUS) e à geração de bons empregos.

Abstract This article presents the initial results of the ongoing research on the new world of healthcare work in the context of the 4th Technological Revolution. In addition to identifying the profile and volume of employment generated by health activities in Brazil, this investigation also analyzes the main transformations in the world of work and employment caused by new technologies and their potential impacts upon the field of the Health Economic-Industrial Complex (HEIC). The methodology seeks to contribute to a new vision of health professionals, which includes not only the employment profile with its technological content, but also the professionals directly and indirectly assigned to HEIC. Applying this methodology to the databases of RAIS and Continuous PNAD from 2012 to 2019, reveals HEIC's high capacity to generate good jobs, even in a context of economic crisis. The health labor market, both for its scale, complexity, and diversity, and for its dynamism and potential in terms of the incidence of 4.0 technologies, indicates that the development of HEIC can become the engine of the country's development, associating innovation and production with the modernization of the Unified Health System (SUS) and the generation of good jobs.

Genetic characterization of Sus scrofa papillomavirus type 1 from domestic pigs in Guangxi Province, China.

Sus scrofa papillomatosis (SsP) is a tumour caused by Sus scrofa papillomaviruses (SsPVs). To investigate the presence of SsPVs in China, 354 domestic pig skin samples collected from Guangxi Province were examined for SsPV DNA by PCR. Three SsPV1s (GX12, GX14, and GX18) were identified with a prevalence of 0.847% (3/354). Sequence analysis showed that L1 of SsPV1/GX12 and SsPV1/GX14 had 99.7% and 99.6% nucleotide identify with the reference SsPV1a, respectively. Phylogenetic and evolutionary analyses showed that SsPV1/GX12 and SsPV1/14 clustered into SsPV1a and that SsPV1/GX18 clustered into SsPV1b. Compared with other SsPV L1 and L2 proteins, we found that the SsPV1/GX18 and SsPV1b strains shared the same unique substitutions, and SsPV1/GX12, SsPV1/GX14, and SsPV1a shared almost identical amino acid sequences. This study reports the first detection of SsPV DNA in China based on whole genome information and provides a scientific basis for the development of SsPV pathogenic biology, epidemiology, and prevention, as well as control technology research.

The re-parameterized inverse Gaussian regression to model length of stay of COVID-19 patients in the public health care system of Piracicaba, Brazil.

Among the models applied to analyze survival data, a standout is the inverse Gaussian distribution, which belongs to the class of models to analyze positive asymmetric data. However, the variance of this distribution depends on two parameters, which prevents establishing a functional relation with a linear predictor when the assumption of constant variance does not hold. In this context, the aim of this paper is to re-parameterize the inverse Gaussian distribution to enable establishing an association between a linear predictor and the variance. We propose deviance residuals to verify the model assumptions. Some simulations indicate that the distribution of these residuals approaches the standard normal distribution and the mean squared errors of the estimators are small for large samples. Further, we fit the new model to hospitalization times of COVID-19 patients in Piracicaba (Brazil) which indicates that men spend more time hospitalized than women, and this pattern is more pronounced for individuals older than 60 years. The re-parameterized inverse Gaussian model proved to be a good alternative to analyze censored data with non-constant variance.

One Health at gunpoint: Impact of wild boars as exotic species in Brazil - A review.

Wild boars have been listed among the 100 most invasive species worldwide, spreading impacts to all continents, with the exception of Antarctica. In Brazil, a major source of introduction was a commercial livestock importation for exotic meat market, followed by successive escapes and releases to natural ecosystems. Currently found in all six Brazilian biomes, with reports in 11 Brazilian states, wild boars have invaded natural and agricultural areas. Wild boars have been reportedly indicated as hosts and reservoirs of several zoonotic diseases in Brazil, including toxoplasmosis, salmonelosis, leptospirosis, brucellosis, tuberculosis, trichinellosis, and hepatitis E. Wild boars have been also associated with Brazilian spotted fever and rabies, infected while providing plentiful exotic blood supply for native ticks and hematophagous bats. Due to their phylogenetic proximity, wild boars may present ecological niche overlapping and direct disease risk to native white-lipped and collared peccaries. Moreover, wild boars may post an economical threat to Brazilian livestock industry due to restrictive diseases such as Aujeszky, enzootic pneumonia, neosporosis, hemoplasmosis, and classic swine fever. Finally, wild boars have directly impacted in environmentally protected areas, silting up water springs, rooting and wallowing native plants, decreasing native vegetal coverage, disbalancing of soil components, altering soil structure and composition. Wild boar hunting has failed as a control measure to date, according to the Brazilian Ministry of Environment, due to private hunting groups mostly targeting males, intentionally leaving females and piglets alive, disseminating wild boar populations nationwide. Meanwhile, non-government animal welfare organizations have pointed to animal cruelty of hunting dogs and wild boars (and native species) during hunting. Despite unanimous necessity of wild boar control, eradication and prevention, methods have been controversial and should focus on effective governmental measures instead occasional game hunting, which has negatively impacted native wildlife species while wild boars have continuously spread throughout Brazil.