Seasonality and Activity of Arbuscular Mycorrhizal Fungi in the Rhizosphere of Endemic Tree Species.

This study analyzed arbuscular mycorrhizal fungi (AMF) activity and soil chemical properties in Aspidosperma pyrifolium, Bauhinia ungulata, Caesalpinia pyramidalis, and Caesalpinia ferrea. AMF spores, root colonization, total glomalin-related soil protein (T-GRSP), easily extracted GRSP (EE-GRSP), and soil chemical properties were measured four times (July 2019, 2020 and December 2019, 2020). Significant differences were observed in AMF spores, root colonization, T-GRSP, and EE-GRSP among the plant species and across seasons. For soil chemical properties, we observed differences among plant species. During the dry season, B. ungulata and C. pyramidalis had the highest AMF spores and root colonization (57.3 ± 0.27 spores 50 g soil-1 and 48.8 ± 1.05, respectively), whereas during the rainy season, C. pyramidalis and C. ferrea showed the highest AMF spores and root colonization (36.6 ± 0.13 spores 50 g soil-1 and 62.2 ± 1.17, respectively). A. pyrifolium showed the highest T-GRSP in both seasons. On the basis of the soil chemical properties, we found that (i) A. pyrifolium, B. ungulata, and C. ferrea showed the highest soil organic carbon (1.32 ± 0.03 g kg-1), phosphorus (7.01 ± 0.26 mg kg-1), and soil pH (5.85 ± 0.23) and (ii) C. pyramidalis showed the highest Ca2+, Mg2+, Na+, H+ + Al3+, K+, and soil total nitrogen (1.36 ± 0.04, 0.73 ± 0.01, 3.72 ± 0.85, 4.56 ± 0.12 cmolc kg-1, 15.43 ± 1.53 mg kg-1, and 0.16 ± 0.01 g kg-1, respectively). Our results highlight the advantage of AMF spores as perennating structures over other AM fungal propagules in seasonal vegetation like Caatinga.

Clinical validation of the nursing diagnosis "Fall risk in adults (00303)" in elderly people in the community-dwelling.

PURPOSE: To identify the risk factors for the nursing diagnosis of fall risk in adults (00303) in elderly people in the community-dwelling. METHOD: This is a methodological study, with a quantitative approach, carried out with elderly people living in the city of Ribeirão Preto, SP, Brazil, from February to December 2018. For data collection, the demographic profile, Mini-Mental State Examination, diseases self-reported, functional independence measure, Lawton and Brody scale, geriatric depression scale, and self-perception of gait instruments were used. Tests of accuracy and association of risk factors with p ≤ 0.05 were performed. FINDINGS: A total of 262 elderly people, aged over 80 years (55.7%), 71% of which were female and 42.7% were widowed, were included in the sample. A total of 82.1% had vascular diseases, 72.1% had diabetes, and 20.6% had depression. The predominant risk factors were difficulty performing instrumental activities of daily living (58.8%), cognitive dysfunction (43.5%), and depressive symptoms (26.3%). Difficulty performing instrumental activities of daily living had a sensitivity greater than 60%. The positive and negative predictive values were mostly greater than 50%. In the regression analysis, it was found that the elderly have a higher risk of suffering a fall if they present anxiety (p = 0.05), impaired physical mobility (p = 0.02), and difficulty to perform instrumental activities of daily living as risk factors (p = 0.03). CONCLUSION: It was possible to identify the presence of risk factors for the diagnosis fall risk in adults (00303) in the clinical context of the elderly in home settings and contribute to the clinical validation of the taxonomy, increase the evidence and importance of the diagnosis, and generate new knowledge for gerontological nursing. IMPLICATIONS FOR NURSING PRACTICE: To help nurses identify risk factors that lead elderly people to suffer falls at home and to implement preventive actions in their community with the support of their families.

OBJETIVO: Identificar os fatores de risco para o diagnóstico de enfermagem Risco de Quedas em adultos (00303) em idosos do domicílio. MÉTODO: Trata­se de um estudo metodológico, com abordagem quantitativa, realizado com idosos residentes na cidade de Ribeirão Preto, SP, Brasil, no período de fevereiro a dezembro de 2018. Para coleta de dados foram utilizados instrumentos de perfil sociodemográfico, Mini exame do Estado Mental, doenças autorreferidas, Medida de Independência Funcional, Escala de Lawton e Brody, Escala de Depressão Geriátrica e autopercepção da marcha. Foram realizados testes de acurácia e associação de fatores de risco com p ≤ 0,05. RESULTADOS: Participaram 262 idosos, com idade superior a 80 anos (55,7%), sendo 71% do sexo feminino e 42,7% viúvos. Um total de 82,1% tinha doenças vasculares, 72,1% tinham diabetes e 20,6% tinham depressão. Os fatores de risco predominantes foram dificuldade para realizar atividades instrumentais de vida diária (58,8%), déficit cognitivo (43,5%) e sintomas depressivos (26,3%). A dificuldade para realizar atividades instrumentais da vida diária apresentou sensibilidade superior a 60%. Os valores preditivos positivos e negativos foram em sua maioria superiores a 50%. Na análise de regressão constatou­se que os idosos apresentam maior risco de sofrer queda se apresentarem Ansiedade (p = 0,05), Mobilidade física prejudicada (p = 0,02) e Dificuldade para realizar atividades instrumentais de vida diária (p = 0,03). CONCLUSÃO: Foi possível identificar a presença de fatores de risco para o diagnóstico Risco de queda em adultos (00303) no contexto clínico do idoso em ambiente domiciliar e contribuir para a validação clínica da taxonomia, aumentar a evidência e a importância do diagnóstico e gerar novos conhecimentos para a enfermagem gerontológica. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Ajudar os enfermeiros a identificar os fatores de risco que levam os idosos a sofrer quedas no domicílio e a implementar ações preventivas na sua comunidade com o apoio dos seus familiares.

Attitudes and perceptions about ageism among nursing students: a scoping review.

OBJECTIVE: to map scientific knowledge on nursing students' attitudes and perceptions regarding ageism. METHOD: scoping review according to the recommendations of the Joanna Briggs Institute. The study question was: What are scientific evidence available on the attitudes and perceptions of nursing students regarding ageism? The search was conducted in 12 databases using the Rayyan application and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. The studies were selected by two reviewers using a data extraction tool. RESULTS: of the 4,595 files, 46 that were published between 1984 and 2022 were selected, and the quantitative method was the most used. The most commonly used instrument was the Kogan's Attitudes Toward Old People Scale. Positive, negative, mixed, neutral, and inconclusive attitudes and perceptions were identified. CONCLUSION: attitudes and perceptions about ageism are diverse and not conclusive. Future intervention studies are recommended to detect changes in the behavior of nursing students in the face of ageism. BACKGROUND: (1) Attitudes and perceptions about ageism are diverse and not conclusive. BACKGROUND: (2) Importance of discussing ageism in the training of nursing students. BACKGROUND: (3) Intervention studies to identify paradigm shifts in nursing students.

Attitudes and perceptions about ageism among nursing students: a scoping review / Actitudes y percepciones sobre edadismo entre los estudiantes de enfermería: una revisión de alcance / Atitudes e percepções sobre idadismo em estudantes de enfermagem: revisão de escopo

Objective: to map scientific knowledge on nursing students' attitudes and perceptions regarding ageism. Method: scoping review according to the recommendations of the Joanna Briggs Institute. The study question was: What are scientific evidence available on the attitudes and perceptions of nursing students regarding ageism? The search was conducted in 12 databases using the Rayyan application and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. The studies were selected by two reviewers using a data extraction tool. Results: of the 4,595 files, 46 that were published between 1984 and 2022 were selected, and the quantitative method was the most used. The most commonly used instrument was the Kogan's Attitudes Toward Old People Scale. Positive, negative, mixed, neutral, and inconclusive attitudes and perceptions were identified. Conclusion: attitudes and perceptions about ageism are diverse and not conclusive. Future intervention studies are recommended to detect changes in the behavior of nursing students in the face of ageism.

Objetivo: mapear el conocimiento científico sobre las actitudes y percepciones de los estudiantes de enfermería respecto al edadismo. Método: La pregunta del estudio fue: ¿Qué evidencia científica está disponible sobre las actitudes y percepciones de los estudiantes de enfermería respecto al edadismo? La búsqueda se realizó en 12 bases de datos utilizando la aplicación Rayyan y la Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews . Los estudios fueron seleccionados por dos revisores mediante una herramienta de extracción de datos. Resultados: de los 4.595 artículos, se seleccionaron 46 publicados entre 1984 y 2022, siendo el método cuantitativo el más utilizado. La herramienta más utilizada fue el Kogan's Attitudes Toward Old People Scale . Se identificaron actitudes y percepciones positivas, negativas, mixtas, neutras y no concluyentes. Conclusión: las actitudes y percepciones sobre la discriminación por edad son diversas y no concluyentes. Se recomiendan futuros estudios de intervención para detectar cambios en el comportamiento de los estudiantes de enfermería ante el edadismo.

Objetivo: mapear o conhecimento científico sobre as atitudes e percepções dos estudantes de enfermagem em relação ao idadismo. Método: revisão de escopo segundo as recomendações do Joanna Briggs Institute . A pergunta de estudo foi: Quais são as evidências científicas disponíveis sobre as atitudes e percepções dos estudantes de enfermagem no que diz respeito ao idadismo? A busca foi realizada em 12 bases de dados utilizando o aplicativo Rayyan e o Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews . Realizou-se a seleção dos estudos por dois revisores, com uso de um instrumento para a extração dos dados. Resultados: dos 4.595 arquivos, selecionaram-se 46 publicados entre 1984 e 2022, sendo que a maioria utilizou o método quantitativo. O instrumento mais utilizado foi o Kogan's Attitudes Toward Old People Scale e os estudos mostraram que os estudantes apresentaram atitudes e percepções positivas, negativas, mistas, neutras e não conclusivas. Conclusão: as atitudes e percepções sobre idadismo são diversificadas e não conclusivas. Recomenda-se estudos futuros de intervenção para detecção de mudanças de comportamento dos estudantes de enfermagem frente ao idadismo.

Cutaneous Naganishia albida (Cryptococcus albidus) infection: a case report and literature review.

Naganishia albida (Cryptococcus albidus) is considered saprophytic fungi, and is rarely reported as a human pathogen. Cutaneous infections caused by non-neoformans cryptococcus are rare. We describe a case of an immunocompetent older male with cutaneous cryptococcosis caused by Naganishia albida following skin trauma, and conduct a literature review in PubMed, Lilacs, and Embase. Only six previous similar reports were found. The seven cases (including ours) were widely distributed geographically (Brazil, the US, the UK, Hungary, South Korea, and Iran), all males, and their ages varied, ranging from 14 to 86 years. Four individuals had underlying skin diseases (Sezary Syndrome, psoriasis, and skin rash without etiology) plus potentially immunosuppressive underlying conditions (diabetes mellitus, kidney transplantation, and the use of etanercept, adalimumab, and methylprednisolone). Cutaneous presentation was polymorphic, with lesions characterized as warts, ulcers, plaques, and even macules. Two patients presented disseminated disease. Serum cryptococcal antigen was negative in six patients, and diagnosis was made by fungal culture in all. There is a lack of data on optimal antifungal treatment and outcomes.

CD68 in Cerebral Aneurysms of Smokers and Nonsmokers: An Immunohistochemical Analysis.

BACKGROUND: There is some evidence indicating that inflammation of the aneurysmal wall is related to aneurysmal growth and rupture. The presence of CD68 may indicate greater inflammatory activity. The objective of this study is to evaluate CD68 immunoexpression in surgically resected brain aneurysms and its association with smoking. METHODS: The resected brain aneurysmal walls after microsurgical clipping were envoyed to immunohistochemistry investigation. The objective was to evaluate the expression of CD68 and CD34 antibodies. The associations between inflammatory markers, smoking, and rupture were tested using Fischer's exact test. RESULTS: CD68 immunoexpression in the tunica media was associated with larger aneurysms: 7.0 mm (7.0-9.0 mm) versus 5.0 mm (3.5-5 mm; p = 0.011). There was no statistically significant association between smoking and CD68 expression in the tunica media (p = 0.234) or in either the tunica media or the tunica intima (p = 0.628). There was also no statistically significant association between hemorrhagic presentation of the aneurysm and CD68 expression in the tunica media (p = 0.689) or in either the tunica media or the tunica intima (p = 0.348). Therefore, the presence of CD68-positive cells in the aneurysmal walls indicates an association with size, especially if the tunica media is exclusively compromised (p = 0.011). CONCLUSION: Immunohistochemistry investigation for CD68 antibodies was used to determine histiocytic infiltration. Adequately powered studies are necessary to further investigate the association between CD68-positive cells and both smoking history and hemorrhagic presentation of aneurysms.

Rivaroxaban to prevent major clinical outcomes in non-hospitalised patients with COVID-19: the CARE - COALITION VIII randomised clinical trial.

Background: COVID-19 progression is associated with an increased risk of arterial and venous thrombosis. Randomised trials have demonstrated that anticoagulants reduce the risk of thromboembolism in hospitalised patients with COVID-19, but a benefit of routine anticoagulation has not been demonstrated in the outpatient setting. Methods: We conducted a randomised, open-label, controlled, multicentre study, evaluating the use of rivaroxaban in mild or moderate COVID-19 patients. Adults ≥18 years old, with probable or confirmed SARS-CoV-2 infection, presenting within ≤7 days from symptom onset with no clear indication for hospitalization, plus at least 2 risk factors for complication, were randomised 1:1 either to rivaroxaban 10 mg OD for 14 days or to routine care. The primary efficacy endpoint was the composite of venous thromboembolic events, need of mechanical ventilation, acute myocardial infarction, stroke, acute limb ischemia, or death due to COVID-19 during the first 30 days. ClinicalTrials.gov: NCT04757857. Findings: Enrollment was prematurely stopped due to sustained reduction in new COVID-19 cases. From September 29th, 2020, through May 23rd, 2022, 660 patients were randomised (median age 61 [Q1-Q3 47-69], 55.7% women). There was no significant difference between rivaroxaban and control in the primary efficacy endpoint (4.3% [14/327] vs 5.8% [19/330], RR 0.74; 95% CI: 0.38-1.46). There was no major bleeding in the control group and 1 in the rivaroxaban group. Interpretation: On light of these findings no decision can be made about the utility of rivaroxaban to improve outcomes in outpatients with COVID-19. Metanalyses data provide no evidence of a benefit of anticoagulant prophylaxis in outpatients with COVID-19. These findings were the result of an underpowered study, therefore should be interpreted with caution. Funding: COALITION COVID-19 Brazil and Bayer S.A.

Association between Sarcopenia, Falls, and Cognitive Impairment in Older People: A Systematic Review with Meta-Analysis.

With the aging process, elderly people present changes in their bodies that can lead them to suffer several geriatric syndromes. The present study aimed to analyze and synthesize the literature produced concerning the association of sarcopenia with falls in elderly people with cognitive impairment. This is a systematic review study on etiology and risk, conducted according to the JBI methodology using the Medline (Pubmed), Cinahl, Embase, Scopus, and Web of Science databases. The gray literature search was conducted in the CAPES Brazilian Digital Library of Theses and Dissertations, Google Scholar, Networked Digital Library of Theses and Dissertations (NDLTD), EBSCO Open Dissertations, DART-e, and ACS Guide to Scholarly Communication. The identification of the association between the variables was extracted from the articles themselves (Odds Ratio and the 95% Confidence Intervals). Four articles published between 2012 and 2021 were included in this review. A prevalence of falls was identified, ranging from 14.2% to 23.1%, of cognitive impairment ranging from 24.1% to 60.8%, and of sarcopenia ranging from 6.1 to 26.6%. The meta-analysis found that elderly people with cognitive impairment who suffer falls are at a 1.88 times greater risk of presenting sarcopenia (p = 0.01). There is evidence of an association between the variables, but it is necessary to conduct follow-up studies to support this association as well as other factors that may influence the senescence and senility process.

Simulating exposure-related human mobility behavior at the neighborhood-level under COVID-19 in Porto Alegre, Brazil.

Modeling experts have been continually researching the interplay of human mobility and COVID-19 transmission since the outbreak of the pandemic. They tried to address this problem and support the control of the pandemic spreading at the national or regional levels. However, these modeling approaches had little success in producing empirically verifiable results at the neighborhood level due to a lack of data and limited representation of low spatial scales in the models. To fill this gap, this research aims to present an agent-based model to simulate human mobility choices in the context of COVID-19, based on social activities of individuals in the neighborhood. We apply the VIABLE model to the decision-making process of heterogeneous agents, who populate the system's environment. The agents adapt their mobility and activities autonomously at each iteration to improve their well-being and respond to exposure risks. The study reveals significant temporal variations in mobility choices between the groups of agents with different vulnerability levels under the Covid-19 pandemic. Agents from the same group with similar economic backgrounds tend to select the same mobility patterns and activities leading to segregation at this low scale. We calibrated the model with a focus on Porto Alegre in Brazil.

Cutaneous Naganishia albida (Cryptococcus albidus) infection: a case report and literature review

ABSTRACT Naganishia albida (Cryptococcus albidus) is considered saprophytic fungi, and is rarely reported as a human pathogen. Cutaneous infections caused by non-neoformans cryptococcus are rare. We describe a case of an immunocompetent older male with cutaneous cryptococcosis caused by Naganishia albida following skin trauma, and conduct a literature review in PubMed, Lilacs, and Embase. Only six previous similar reports were found. The seven cases (including ours) were widely distributed geographically (Brazil, the US, the UK, Hungary, South Korea, and Iran), all males, and their ages varied, ranging from 14 to 86 years. Four individuals had underlying skin diseases (Sezary Syndrome, psoriasis, and skin rash without etiology) plus potentially immunosuppressive underlying conditions (diabetes mellitus, kidney transplantation, and the use of etanercept, adalimumab, and methylprednisolone). Cutaneous presentation was polymorphic, with lesions characterized as warts, ulcers, plaques, and even macules. Two patients presented disseminated disease. Serum cryptococcal antigen was negative in six patients, and diagnosis was made by fungal culture in all. There is a lack of data on optimal antifungal treatment and outcomes.

Temporal Stability of the Zulliger Test in Brazilian Adults / Estabilidade Temporal do Teste de Zulliger em Adultos Brasileiros / Estabilidad Temporal del Test de Zulliger en Adultos Brasileños

Abstract The reliability of a test obtained over time is an indispensable measure to ensure the use of the instrument. This study aims to explore the temporal stability of the Zulliger test in Brazilian adults. A total of 20 participants, aged 18 to 59 years, answered a sociodemographic questionnaire and the Zulliger in Comprehensive System (ZCS). Data collection took place from 2009 to 2019 (Test) and in 2021 (Retest). ANOVA did not show differences between the values of 90 (99%) ZCS variables analyzed between test and retest; 68% of the variables showed agreement between 0.40 and 1.00, and 18%. Reflex responses; human movement, animal movement; weighted sum of color responses; sum of animal+inanimate movements; mixed determinants; art and clouds contents; Responses to card I; felt stimulation; cooperative movement; sum of critical special codes; degree of control and stress tolerance denoted high and excellent stability levels intraclass correlation coeficiente (ICC≥0,70). The ZCS demonstrates temporal stability, reliability, and psychometric properties that support its safe use.

Resumo A fidedignidade de um teste obtida ao longo do tempo é uma medida indispensável para assegurar o uso dos instrumentos. Este estudo teve por objetivo explorar a estabilidade temporal do teste de Zulliger em adultos brasileiros. Vinte participantes, entre 18 e 59 anos de idade, responderam formulário de dados sociodemográficos e o Zulliger no Sistema Compreensivo (ZSC). A coleta de dados ocorreu de 2009 a 2019 (teste) e em 2021 (reteste). A ANOVA não mostrou diferenças entre os valores de 90 (99%) variáveis do ZSC analisadas entre o teste e reteste; 68% das variáveis apresentaram concordância entre 0,40 e 1,00 e 18%. Respostas reflexo; movimento humano, movimento animal; soma de cor ponderada; soma de movimentos animal+inanimado; determinantes mistos; conteúdos Arte e nuvem; Respostas para cartão I, estimulação sentida; movimento cooperativo; soma códigos especiais críticos; grau de controle e tolerância ao estresse denotaram níveis de estabilidade alto e excelente Coeficiente de Correlação Intraclasse (ICC≥0,70). O ZSC demonstra estabilidade temporal, confiabilidade e propriedades psicométricas que respaldam o seu uso com segurança.

Resumen La confiabilidad de una prueba realizada a lo largo del tempo es una medida necesaria para asegurar el uso del instrumento. El objetivo de este estudio fue explorar la estabilidad temporal de la prueba de Zulliger en adultos brasileños. Veinte participantes, con edades entre 18 y 59 años, respondieron un formulario de datos sociodemográficos y el Zulliger en el Sistema Comprensivo (ZSC). La recolección de datos tuvo lugar de 2009 a 2019 (test) y en 2021 (retest). ANOVA no mostró diferencias entre los valores de 90 (99%) variables ZSC analizadas entre test y retest; El 68% de las variables mostró acuerdo entre 0,40 y 1,00, y 18%. Respuestas reflejo; respuestas de movimiento humano y animal, suma ponderada de color, suma de movimiento animal+inanimado; determinantes mixtos; Arte y contenido en la nube; Respuestas a la Tarjeta I; estimulación sentida; movimiento cooperativo; suma códigos especiales críticos; grado de control y tolerancia al estrés denotaron niveles de estabilidad altos y excelentes Coeficiente de correlación intraclase (ICC≥0,70). El ZSC demuestra estabilidad temporal, confiabilidad y propiedades psicométricas que respaldan su uso seguro.

Percepción del enfermero peruano en el cuidado del paciente con covid-19 / Percepção da enfermeira peruana no cuidado de pacientes com covid-19 / Perception of the peruvian nurse in the care of the patient with covid-19

Objetivo: analizar la percepción del enfermero sobre la atención del paciente hospitalizado por COVID-19 en tres hospitales peruanos. Método: estudio descriptivo de análisis cualitativo con 47 enfermeras entrevistadas entre febrero a junio de 2021. Se utilizó la técnica del Análisis de Contenido Temático con uso del software Interface de R pour les Analyses multidimensionnelles de textes et de questionnaires. Resultados: fueron identificadas cinco clases temáticas: 1- Miedo de contagiar a los familiares con el virus de la COVID-19; 2- Frustración e impotencia de los profesionales de enfermería; 3- El papel de la enfermería: pasado, presente y futuro en el cuidado del paciente; 4- Capacitación para el establecimiento de nuevos protocolos y uso de Equipos de Protección Personal; 5- Doloroso proceso de adaptación para los profesionales de la salud. Consideraciones finales: el enfermero percibió que durante la pandemia su trabajo fue sufrido con carencias de recursos humanos, materiales y dilemas éticos.

Objetivo: analisar a percepção do enfermeiro sobre o atendimento do paciente hospitalizado por COVID-19 em três hospitais peruanos. Método: estudo descritivo de análise qualitativa com 47 enfermeiras entrevistadas entre fevereiro e junho de 2021. Utilizou-se a técnica da Análise de Conteúdo Temático com uso do software Interface de R pour les Analyses multidimensionnelles de textes et de questionnaires. Resultados: foram identificadas cinco classes temáticas: 1- Medo de contagiar os familiares com o vírus da COVID-19; 2- Frustração e impotência dos profissionais de enfermagem; 3- O papel da enfermagem: passado, presente e futuro no cuidado do paciente; 4- Capacitação para o estabelecimento de novos protocolos e uso de Equipamentos de Proteção Pessoal; 5- Doloroso processo de adaptação para os profissionais de saúde. Considerações finais: o enfermeiro percebeu que durante a pandemia seu trabalho foi sofrido com carências de recursos humanos, materiais e dilemas éticos.

Objective to analyze the perception of the nurse on the care of the patient hospitalized by COVID-19 in three Peruvian hospitals. Method: Descriptive qualitative analysis study with 47 nurses interviewed between February and June 2021. The Thematic Content Analysis technique was used using the R pour les Analyses multidimensionnelles de textes et de questionnaires. Results: five thematic classes were identified: 1- Fear of infecting relatives with the COVID-19 virus; 2- Frustration and impotence of nursing professionals; 3- The role of nursing: past, present and future in patient care; 4- Training for the establishment of new protocols and use of Personal Protection Equipment; 5- Painful adaptation process for health professionals. Final considerations: the nurse perceived that during the pandemic his work was suffered with shortages of human resources, materials and ethical dilemmas.

Risco de quedas e seus fatores associados na pessoa idosa hospitalizada / Risk of falls and its associated factors in hospitalized older adults

Resumo Objetivo analisar o risco de queda e sua associação com as variáveis demográficas, clínicas, estado cognitivo, risco de sarcopenia e fragilidade da pessoa idosa hospitalizada em uma clínica médica de um hospital universitário. Método Estudo quantitativo, observacional, transversal e analítico realizado com 60 pessoas idosas hospitalizadas na clínica médica de um hospital universitário da cidade de São Paulo - SP, Brasil, com o uso dos seguintes questionários: perfil demográfico, dados clínicos, Mini Exame do Estado Mental, Escala de Morse, Escala SARC-F e Índice de Fragilidade Tilburg. Foram realizadas análises descritivas e teste de normalidade de Kolmogorov-Smirnov. Para as variáveis quantitativas foi utilizado o teste de correlação de Spearman e para categóricas, o teste U Mann-Whitney. Para identificar a associação, foi utilizada a regressão linear múltipla e adotado um nível de significância de 5%. Resultados Predomínio do sexo feminino, entre 60-79 anos e sem companheiro (a). Ademais, 80% apresentavam comprometimento cognitivo, 88,3% foram categorizados como frágeis, 60% apresentavam risco para sarcopenia e 75% possuíam alto risco de queda durante a hospitalização. Verificou-se associação do comprometimento cognitivo, ser frágil e ter risco de sarcopenia com o risco de queda na pessoa idosa hospitalizada. Conclusão o elevado risco de quedas em idosos hospitalizados está diretamente relacionado com a presença de deficit cognitivo, síndrome da fragilidade e o risco para sarcopenia, afirmando que esses fatores merecem atenção dos gestores e profissionais de enfermagem.

Abstract Objective To analyze the risk of falls and its association with demographic and clinical variables, cognitive status, risk of sarcopenia and frailty among older adults hospitalized in a medical clinic of a university hospital. Method A quantitative, observational, cross-sectional analytical study of 60 older adults hospitalized in the medical clinic of a university hospital in São Paulo city, São Paulo state, Brazil, was carried out. Questionnaires collecting demographic profile and clinical data, the Mini-Mental State Examination, Morse Scale, SARC-F Scale and Tilburg Frailty Indicator were applied. Descriptive analyses and the Kolmogorov-Smirnov normality test were performed. Spearman's correlation test was used for quantitative variables and the Mann-Whitney U-test for categorical variables. Multiple linear regression was used to identify the associations and a significance level of 5% was adopted. Results The study sample comprised predominantly individuals that were female, aged 60-79 years and without a partner. Overall, 80% had cognitive impairment, 88.3% were diagnosed as frail, 60% were at risk for sarcopenia, and 75% had a high risk of falls during hospitalization. Cognitive impairment, frailty and sarcopenia risk were associated with risk of falls in the hospitalized older adults. Conclusion High risk of falls in the hospitalized older adults was directly associated with the presence of cognitive impairment, frailty syndrome and sarcopenia risk, confirming that these factors warrant attention from managers and nursing professionals.

Dapagliflozin and Kidney Outcomes in Hospitalized Patients with COVID-19 Infection: An Analysis of the DARE-19 Randomized Controlled Trial.

BACKGROUND AND OBJECTIVES: Patients who were hospitalized with coronavirus disease 2019 (COVID-19) infection are at high risk of AKI and KRT, especially in the presence of CKD. The Dapagliflozin in Respiratory Failure in Patients with COVID-19 (DARE-19) trial showed that in patients hospitalized with COVID-19, treatment with dapagliflozin versus placebo resulted in numerically fewer participants who experienced organ failure or death, although these differences were not statistically significant. We performed a secondary analysis of the DARE-19 trial to determine the efficacy and safety of dapagliflozin on kidney outcomes in the overall population and in prespecified subgroups of participants defined by baseline eGFR. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The DARE-19 trial randomized 1250 patients who were hospitalized (231 [18%] had eGFR <60 ml/min per 1.73 m2) with COVID-19 and cardiometabolic risk factors to dapagliflozin or placebo. Dual primary outcomes (time to new or worsened organ dysfunction or death, and a hierarchical composite end point of recovery [change in clinical status by day 30]), and the key secondary kidney outcome (composite of AKI, KRT, or death), and safety were assessed in participants with baseline eGFR <60 and ≥60 ml/min per 1.73 m2. RESULTS: The effect of dapagliflozin versus placebo on the primary prevention outcome (hazard ratio, 0.80; 95% confidence interval, 0.58 to 1.10), primary recovery outcome (win ratio, 1.09; 95% confidence interval, 0.97 to 1.22), and the composite kidney outcome (hazard ratio, 0.74; 95% confidence interval, 0.50 to 1.07) were consistent across eGFR subgroups (P for interaction: 0.98, 0.67, and 0.44, respectively). The effects of dapagliflozin on AKI were also similar in participants with eGFR <60 ml/min per 1.73 m2 (hazard ratio, 0.71; 95% confidence interval, 0.29 to 1.77) and ≥60 ml/min per 1.73 m2 (hazard ratio, 0.69; 95% confidence interval, 0.37 to 1.29). Dapagliflozin was well tolerated in participants with eGFR <60 and ≥60 ml/min per 1.73 m2. CONCLUSIONS: The effects of dapagliflozin on primary and secondary outcomes in hospitalized participants with COVID-19 were consistent in those with eGFR below/above 60 ml/min per 1.73 m2. Dapagliflozin was well tolerated and did not increase the risk of AKI in participants with eGFR below or above 60 ml/min per 1.73 m2.

BENEFITS OF THE WALANT TECHNIQUE AGAINST THE COVID-19 PANDEMIC.

OBJECTIVE: Evaluate the experience of private and public health services with the WALANT procedure in the COVID-19 pandemic. METHODS: This is a retrospective, multicenter longitudinal study gathering cases of hand surgery subjected to the WALANT technique in the Hospitals Dr. Radamés Nardini and IFOR during the COVID-19 pandemic (August 2020). As a parameter, the verbal numerical rating scale for twenty patients referring to the preoperative, intraoperative and postoperative periods was applied. RESULTS: The patients did not feel any pain during surgery, which showed the efficiency of the anesthetic technique in its purpose. CONCLUSION: The results indicate the WALANT technique as beneficial when facing the COVID-19 pandemic, as the main differential of the technique is that it is applied by a well-trained orthopedic hand surgeon. Level of Evidence IV, Case Series.

OBJECTIVE: Avaliar a experiência dos serviços privado e público de saúde com o procedimento WALANT frente à pandemia COVID-19. MÉTODOS: Trata-se de um estudo longitudinal retrospectivo, multicêntrico, de casos de cirurgia de mão submetidos à técnica WALANT nos hospitais Dr. Radamés Nardini e IFOR, durante a pandemia da COVID-19, em agosto de 2020. Como parâmetro, foi aplicada a Escala Verbal de Dor para 20 pacientes referente ao pré-operatório, intra-operatório e no pós-operatório. RESULTADOS: Os pacientes não sentiram nenhuma dor durante a cirurgia, tendo a técnica anestésica de mostrado eficaz. CONCLUSÃO: Pelas análises, foi possível considerar segura e benéfica a técnica WALANT diante da pandemia da COVID-19, que apresenta o diferencial de ser aplicada por um cirurgião ortopédico especialista em mão bem treinado. Nível de Evidência IV, Série de Casos.

Genetic risk factors and Covid-19 severity in Brazil: results from BRACOVID Study

The Covid-19 pandemic has changed the paradigms for disease surveillance and rapid deployment of scientific-based evidence for understanding disease biology, susceptibility, and treatment. We have organized a large-scale genome-wide association study in Sars-Cov-2 infected individuals in Sao Paulo, Brazil, one of the most affected areas of the pandemic in the country, itself one of the most affected in the world. Here we present the results of the initial analysis in the first 5,233 participants of the BRACOVID study. We have conducted a GWAS for Covid-19 hospitalization enrolling 3533 cases (hospitalized Covid-19 participants) and 1700 controls (non-hospitalized Covid-19 participants). Models were adjusted by age, sex and the 4 first principal components. A meta-analysis was also conducted merging BRACOVID hospitalization data with the Human Genetic Initiative (HGI) Consortia results. BRACOVID results validated most loci previously identified in the HGI meta-analysis. In addition, no significant heterogeneity according to ancestral group within the Brazilian population was observed for the two most important Covid-19 severity associated loci: 3p21.31 and Chr21 near IFNAR2. Using only data provided by BRACOVID a new genome-wide significant locus was identified on Chr1 near the genes DSTYK and RBBP5. The associated haplotype has also been previously associated with a number of blood cell related traits and might play a role in modulating the immune response in Covid-19 cases.

Benefits of the walant technique against the covid-19 pandemic / Benefícios da técnica walant em cirurgias da mão frente a pandemia da covid-19

ABSTRACT Objective: Evaluate the experience of private and public health services with the WALANT procedure in the COVID-19 pandemic. Methods: This is a retrospective, multicenter longitudinal study gathering cases of hand surgery subjected to the WALANT technique in the Hospitals Dr. Radamés Nardini and IFOR during the COVID-19 pandemic (August 2020). As a parameter, the verbal numerical rating scale for twenty patients referring to the preoperative, intraoperative and postoperative periods was applied. Results: The patients did not feel any pain during surgery, which showed the efficiency of the anesthetic technique in its purpose. Conclusion: The results indicate the WALANT technique as beneficial when facing the COVID-19 pandemic, as the main differential of the technique is that it is applied by a well-trained orthopedic hand surgeon. Level of Evidence IV, Case Series.

RESUMO Objective: Avaliar a experiência dos serviços privado e público de saúde com o procedimento WALANT frente à pandemia COVID-19. Métodos: Trata-se de um estudo longitudinal retrospectivo, multicêntrico, de casos de cirurgia de mão submetidos à técnica WALANT nos hospitais Dr. Radamés Nardini e IFOR, durante a pandemia da COVID-19, em agosto de 2020. Como parâmetro, foi aplicada a Escala Verbal de Dor para 20 pacientes referente ao pré-operatório, intra-operatório e no pós-operatório. Resultados: Os pacientes não sentiram nenhuma dor durante a cirurgia, tendo a técnica anestésica de mostrado eficaz. Conclusão: Pelas análises, foi possível considerar segura e benéfica a técnica WALANT diante da pandemia da COVID-19, que apresenta o diferencial de ser aplicada por um cirurgião ortopédico especialista em mão bem treinado. Nível de Evidência IV, Série de Casos.

Functional respiratory capacity in the elderly after COVID-19 -- a pilot study

BackgroundThe pandemic spread of SARS-CoV-2 has led to an unprecedented outbreak of viral pneumonia. Despite the current focus of worldwide research being the characterization of post-COVID-19 sequelae, the level of functional impact that this disease causes in the elderly who have presented moderate, severe or critical manifestations is still unknown. ObjectiveTo identify the main consequences/sequelae on functional respiratory capacity in the elderly after CoViD-19. MethodologyA cross-sectional study was carried out in the community. Functional aerobic capacity (2min step test), dyspnea perception (modified Medical Research Council Dyspnea Questionnaire), respiratory and peripheral muscle strength (maximum inspiratory and expiratory pressure, grip strength) and the Frailty Index (Clinical Fragility Scale) were assessed in 25 community-dwelling individuals aged [≥]65 years, who have had a diagnosis of CoViD-19 for up to 6 months, and in an equal number of elderly people with the same characteristics without a known diagnosis of CoViD-19. ResultsThe elderly with a diagnosis of CoViD-19 up to 6 months presented a decrease in the values of maximum inspiratory pressure (p=0.001) and maximum expiratory pressure (p=0.015), in aerobic capacity (p<0.001) with significant presence of desaturation on exertion (p<0.001), and increased values of dyspnea perception (p=0.001) and Frailty Index (p=0.026). ConclusionSignificant changes were found in the functional respiratory capacity of elderly patients diagnosed with CoViD-19 for up to 6 months, when compared with elderly individuals without a known diagnosis of CoViD-19. It is not possible to extrapolate the results obtained to the Portuguese population, however these results may be an important indicator in the characterization of sequelae in the elderly after infection by SARS-CoV-2.

Environmental, field and impurity factors to increase the agricultural performance of Brazilian and Australian sugarcane mills.

This study aims to identify explanatory factors to increase the agricultural performance of Brazilian and Australian sugarcane mills. The relevance of Brazil and Australia for the sugar industry motivated the development this study based on the most important factors in both countries responsible for increasing the efficiency in sugarcane production. Thus, this study is designed to assess the hypothesis that there are a few explanatory variables that are deeply responsible for the agricultural efficiency in the sugar-energy sector. As a specific objective, it proposes a DEA (Data Envelopment Analysis) model that seeks to optimize the production of Total Recoverable Sugar (TRS) by planted area, and simultaneously, minimizes mineral and vegetable impurities. The sample consists of 82 observations from 32 sugarcane mills. An agricultural efficiency study was performed using the two-stage DEA, in which the evaluated mills according to the level of efficiency in the proposed model. Then, a Multiple Linear Regression Analysis was performed to identify the variables with the greatest influence on the performance of the mills in terms of efficiency. The results revealed six relevant variables for increasing the agricultural performance in the production of sugarcane: rainfall (mm weekly), chopped cane delivery (%), delivery time (h), borer (%), air humidity (%), and rods in raw wine (× 105/mL). Finally, semi-structured interviews with Brazilian and Australian experts in the sugar-energy sector allowed the identification of five other relevant complementary factors that were unavailable in the database: genetic variety, agricultural cultivation activities, edaphoclimatic factors, renewal of sugarcane fields and irrigation system. The results of this study were grouped into the dimensions of environment, yield, and impurities, providing quantification and better understanding of the identified explanatory factors and the agricultural performance in terms of production efficiency, offering fundamental information that enables managers to make decisions and prioritize the aspects that contribute more significantly to the increase in agricultural productivity of the planted area.

The Role of ß-Cyclodextrin in the Textile Industry-Review.

ß-Cyclodextrin (ß-CD) is an oligosaccharide composed of seven units of D-(+)-glucopyranose joined by α-1,4 bonds, which is obtained from starch. Its singular trunk conical shape organization, with a well-defined cavity, provides an adequate environment for several types of molecules to be included. Complexation changes the properties of the guest molecules and can increase their stability and bioavailability, protecting against degradation, and reducing their volatility. Thanks to its versatility, biocompatibility, and biodegradability, ß-CD is widespread in many research and industrial applications. In this review, we summarize the role of ß-CD and its derivatives in the textile industry. First, we present some general physicochemical characteristics, followed by its application in the areas of dyeing, finishing, and wastewater treatment. The review covers the role of ß-CD as an auxiliary agent in dyeing, and as a matrix for dye adsorption until chemical modifications are applied as a finishing agent. Finally, new perspectives about its use in textiles, such as in smart materials for microbial control, are presented.