Association between swallowing dynamics, tongue pressure and pulmonary function in patients with idiopathic pulmonary fibrosis.

BACKGROUND: Swallowing is a complex process that requires the coordination of muscles in the mouth, pharynx, larynx, and esophagus. Dysphagia occurs when a person has difficulty swallowing. In the case of subjects with respiratory diseases, the presence of oropharyngeal dysphagia potentially increases lung disease exacerbations, which can lead to a rapid decline in lung function. This study aimed to analyze the swallowing of patients with idiopathic pulmonary fibrosis (IPF). METHODS: Patients with IPF were evaluated using the Eating Assessment Tool (EAT-10), tongue pressure, the Timed Water Swallow Test (TWST), and the Test of Mastication and Swallowing Solids (TOMASS). The findings were related to dyspnea severity assessed by the modified Medical Research Counsil (mMRC) score; the nutritional status screened with Mini Nutritional Assessment (MNA) tool; and pulmonary function tests, specifically spirometry and measurement of the diffusing capacity for carbon monoxide (DLCO), the maximal inspiratory pressure (PImax), and the maximal expiratory pressure (PEmax). RESULTS: The sample consisted of 34 individuals with IPF. Those who exhibited swallowing modifications scored lower on the MNA than those who did not (9.6 ± 0.76 vs. 11.64 ± 0.41 points; mean difference 1.98 ± 0.81 points; p = 0.02). They also showed poorer lung function when considering the predicted force vital capacity (FVC; 81.5% ± 4.61% vs. 61.87% ± 8.48%; mean difference 19.63% ± 9.02%; p = 0.03). The speed of liquid swallowing was altered in 31of 34 of the evaluated subjects (91.1%). The number of liquid swallows correlated significantly with the forced expiratory volume in 1 s (FEV1)/FVC ratio (r = 0.3; p = 0.02). Solid eating and swallowing assessed with the TOMASS score correlated with lung function. The number of chewing cycles correlated negatively with PImax% predicted (r = -0.4; p = 0.0008) and PEmax% predicted (r = -0.3; p = 0.02). FVC% predicted correlated with increased solid swallowing time (r = -0.3; p = 0.02; power = 0.6). Swallowing solids was also impacted by dyspnea. CONCLUSION: Patients with mild-to-moderate IPF can present feeding adaptations, which can be related to the nutritional status, lung function, and the severity of dyspnea.

Systematic review of literature to evaluate global distribution of species of the Sporothrix genus stored in culture collections.

Introduction: Sporotrichosis is a subcutaneous mycosis caused by fungi of the genus Sporothrix sp. Phenotypic and genotypic differences have been associated with their geographic distribution, virulence, or clinical manifestation of sporotrichosis. In the past decade, the interest in identifying species of the Sporothrix sp. has been increasing, due to its epidemiological importance and, in consequence, is important to know how to preserve them for future studies, in culture collection. Aims: The purposes of this study were to analyze the global distribution of environmental isolates and/or causal agents of sporotrichosis identified by polyphasic taxonomy, with mandatory use of molecular identification, and to evaluate the percentages and distribution of isolates stored in culture collections. Methods: A systematic review of articles on animal and human sporotrichosis and/or environmental isolation of the fungus, from 2007 to 2023, was done. Results: Our results demonstrated that, S. globosa, S. schenckii, and S. brasiliensis were the most identified species. With respect to the deposit and maintenance of species, we observed that only 17% of the strains of Sporothrix sp. isolated in the world are preserved in a culture collection. Conclusions: This systematic review confirmed a difficulty in obtaining the frequency of Sporothrix species stored in culture collection and insufficient data on the molecular identification mainly of animal sporotrichosis and isolation of Sporothrix sp. in environmental samples.

Geotechnologies on the phosphorus stocks determination in tropical soils: General impacts on society.

Phosphorus (P) is a critical nutrient for primary production in terrestrial and aquatic ecosystems. As P mineral reserves are finite and non-renewable, there is an increasing discussion on its sustainable utilization to safeguard food security for future generations. Understanding the spatial distribution of soil P is central in advancing effective phosphorus management and fostering sustainable agricultural practices. This study aims to digitally map the stocks of available P (AP) and total P (TP) in Brazil at a fine resolution (30 m). Using the Random Forest machine learning algorithm and a database of topsoil (0-20 cm) with 28,572 samples for AP and 3154 for TP, we predicted P stocks based on environmental covariates related to soil formation processes. By dividing Brazil into two sub-regions, representing areas with native coverage and anthropogenic ones, we built independent predictive models for each sub-region. Our results show that Brazil has a TP stock of 531 Tg and an AP stock of 17.4 Tg. The largest soil TP stocks are in the Atlantic Forest biome (73.8 g.m2), likely due to higher organic carbon stocks in this biome. The largest AP stocks were in the Caatinga biome (2.51 g.m2) because of younger soils with low P adsorption capacity. We also found that fertilizer use significantly increased AP stocks in agricultural areas compared to native ones. Our results indicated that AP stocks strongly influenced Brazil's agricultural production, with a correlation coefficient ranging from 0.20 for coffee crops to 0.46 for soybean. The maps generated in this study are expected to contribute to the sustainable use of P in agriculture and environmental systems.

Effects of Cranberry Extract (Vaccinium macrocarpon) Supplementation on Lipid Peroxidation and Inflammation in Patients with Chronic Kidney Disease (Stages 3-4): A Randomized Controlled Trial.

Background: Growing evidence suggests that bioactive compounds in berry fruits may mitigate inflammation in patients with chronic kidney disease (CKD). Objectives: To evaluate cranberry (Vaccinium macrocarpon) supplementation effects on modulation of transcription factors involved in inflammation and oxidative stress in nondialysis (stages 3 and 4) patients with CKD. Design/Participants. A randomized, double-blind, placebo-controlled study was performed with 30 patients to receive capsules containing cranberry extract (1000 mg/day) or placebo (1000 mg/day of corn starch) for two months. Measurements. The mRNA expression of nuclear factor-erythroid 2-related factor-2 (Nrf2) and nuclear factor-kB (NF-kB) was evaluated in peripheral blood mononuclear cells (PBMCs) by quantitative real-time polymerase chain reaction. Thiobarbituric acid reactive substances (TBARS) were measured in the plasma to assess oxidative stress. Interleukin-6 (IL-6) plasma levels were assessed by enzyme-linked immunosorbent assay and C-reactive protein (CRP) by immunoturbidimetric method. Results: Twenty-five patients completed the study: 12 in the cranberry group (56.7 ± 7.5 years and body mass index (BMI) of 29.6 ± 5.5 kg/m2) and 13 in the placebo group (58.8 ± 5.1 years and BMI 29.8 ± 5.4 kg/m2). There were no differences in NF-kB or Nrf2 mRNA expressions (p = 0.99 and p = 0.89) or TBARS, CRP, and IL-6 plasma levels after cranberry supplementation. Conclusions: The cranberry extract administration (1000 mg/day) did not affect Nrf2 and NF-kB mRNA expression, oxidative stress, or inflammatory markers levels in nondialysis CKD patients. This trial is registered with NCT04377919.

Decidual production of interferon lambda in response to ZIKV persistence: Clinical evidence and in vitro modelling.

Zika virus (ZIKV) infections during pregnancy can result in Congenital Zika Syndrome (CZS), a range of severe neurological outcomes in fetuses that primarily occur during early gestational stages possibly due to placental damage. Although some placentas can maintain ZIKV persistence for weeks or months after the initial infection and diagnosis, the impact of this viral persistence is still unknown. Here, we aimed to investigate the immunological repercussion of ZIKV persistence in term placentas. As such, term placentas from 64 pregnant women diagnosed with Zika in different gestational periods were analyzed by ZIKV RT-qPCR, examination of decidua and placental villous histopathology, and expression of inflammation-related genes and IFNL1-4. Subsequently, we explored primary cultures of term decidual Extravillous Trophoblasts (EVTs) and Term Chorionic Villi (TCV) explants, as in vitro models to access the immunological consequences of placental ZIKV infection. Placenta from CZS cases presented low IFNL1-4 expression, evidencing the critical protective role of theses cytokines in the clinical outcome. Term placentas cleared for ZIKV showed increased levels of IFNL1, 3, and 4, whether viral persistence was related with a proinflammatory profile. Conversely, upon ZIKV persistence placentas with decidual inflammation showed high IFNL1-4 levels. In vitro experiments showed that term EVTs are more permissive, and secreted higher levels of IFN-α2 and IFN-λ1 compared to TCV explants. The results suggest that, upon ZIKV persistence, the maternal-skewed decidua contributes to placental inflammatory and antiviral signature, through chronic deciduitis and IFNL upregulation. Although further studies are needed to elucidate the mechanisms underlying the decidual responses against ZIKV. Hence, this study presents unique insights and valuable in vitro models for evaluating the immunological landscape of placentas upon ZIKV persistence.

Overweight and Blood Pressure in Pre-Pubertal Children: A Longitudinal Study.

OBJECTIVE: To analyze the longitudinal relationship between overweight and hypertension in school children. METHODS: This cohort study enrolled children 6-8 years of age who were then prospectively followed up over a 24 months period with repeat assessments performed at an interval of 11-13 months. Information on participation in physical education classes in school, sports practice outside of school, and economic status were obtained through questionnaires answered by parents/guardians. The measurement of blood pressure, weight, height, and waist circumference was performed during the serial follow-up visits in school. RESULTS: The proportion of hypertension did not change significantly over the 24 months (7.1% to 8.2%; P = 0.690). However, children with overweight and obesity throughout the period, had a 198% [HR (95% CI) 2.98 (1.40, 6.35)] higher risk of having hypertension diagnosed during follow-up when compared to eutrophic children in the same period. CONCLUSION: The development trajectory of overweight and obesity in children aged 6-8 years was associated with hypertension.

HIHISIV: a database of gene expression in HIV and SIV host immune response.

In the battle of the host against lentiviral pathogenesis, the immune response is crucial. However, several questions remain unanswered about the interaction with different viruses and their influence on disease progression. The simian immunodeficiency virus (SIV) infecting nonhuman primates (NHP) is widely used as a model for the study of the human immunodeficiency virus (HIV) both because they are evolutionarily linked and because they share physiological and anatomical similarities that are largely explored to understand the disease progression. The HIHISIV database was developed to support researchers to integrate and evaluate the large number of transcriptional data associated with the presence/absence of the pathogen (SIV or HIV) and the host response (NHP and human). The datasets are composed of microarray and RNA-Seq gene expression data that were selected, curated, analyzed, enriched, and stored in a relational database. Six query templates comprise the main data analysis functions and the resulting information can be downloaded. The HIHISIV database, available at  https://hihisiv.github.io , provides accurate resources for browsing and visualizing results and for more robust analyses of pre-existing data in transcriptome repositories.

Transcriptional profile of ribosome-associated quality control components and their associated phenotypes in mammalian cells.

During protein synthesis, organisms detect translation defects that induce ribosome stalling and result in protein aggregation. The Ribosome-associated Quality Control (RQC) complex, comprising TCF25, LTN1, and NEMF, is responsible for identifying incomplete protein products from unproductive translation events, targeting them for degradation. Although RQC disruption causes adverse effects on vertebrate neurons, data regarding mRNA/protein expression and regulation across tissues are lacking. Employing high-throughput methods, we analyzed public datasets to explore RQC gene expression and phenotypes. Our findings revealed widespread expression of RQC components in human tissues; however, silencing of RQC yielded only mild negative effects on cell growth. Notably, TCF25 exhibited elevated mRNA levels that were not reflected in the protein content. We experimentally demonstrated that this disparity arose from post-translational protein degradation by the proteasome. Additionally, we observed that cellular aging marginally influenced RQC expression, leading to reduced mRNA levels in specific tissues. Our results suggest the necessity of RQC expression in all mammalian tissues. Nevertheless, when RQC falters, alternative mechanisms seem to compensate, ensuring cell survival under nonstress conditions.

Changes on risky drinking after the COVID-19 outbreak in Brazil: results from three consecutive web surveys.

INTRODUCTION: Risky drinking (RD) is associated with an increased risk of chronic and infectious diseases, injuries, and violence. This study aimed to assess changes in risky drinking (RD) in Brazil after COVID-19 outbreak, both overall and among individuals with self-reported chronic diseases and mental health disorders. METHODS: We conducted three independent, anonymous web surveys in Brazil including adult participants: S1 (April/2020, n=19,257), S2 (August/2020, n=1,590), and S3 (January/2021, n=859). Participants were recruited through adapted snowball sampling and sponsored social network advertisements. RD was assessed using the Alcohol Use Disorder Identification Test-Concise, designed to identify individuals at risk of alcohol-related problems. Logistic regression analyses with bootstrapping (B=2,000) were performed, with stratification by sex, age, education, employment, household size, and the presence of chronic and mental health conditions, as well as lifestyle factors, to address sample imbalances. RESULTS: The estimated prevalence of RD was 45.8% [95%CI 45.5, 46.1] in S1, 35.3% [95%CI 34.9, 35.6] in S2, and 33.7% [95%CI 33.3, 34.0] in S3. Participants with chronic diseases consistently presented lower RD prevalence across all three surveys, compared to those without such conditions. Conversely, individuals with mental health disorders presented higher RD prevalence than those without such diagnoses in S1 and S2, but not in S3. DISCUSSION: Despite the decrease in RD prevalence, monitoring of alcohol consumption trends remains essential for shaping effective public health policies. Additionally, the observed variations among individuals reporting chronic and mental health disorders highlight the need for targeted interventions in future crises.

Can curcumin supplementation break the vicious cycle of inflammation, oxidative stress, and uremia in patients undergoing peritoneal dialysis?

BACKGROUND & AIMS: Turmeric (a source of curcumin) is an excellent food to modulate oxidative stress, inflammation, and gut dysbiosis in patients with chronic kidney disease (CKD). However, no studies report the benefits of curcumin in patients undergoing peritoneal dialysis (PD). This study aims to evaluate the effects of curcuminoid supplementation on oxidative stress, inflammatory markers, and uremic toxins originating from gut microbiota in patients with CKD undergoing PD. METHODS: This longitudinal, randomized, single-blind, placebo-controlled trial evaluated 48 patients who were randomized into two groups: Curcumin (three capsules of 500 mg of Curcuma longa extract, with 98.42 % total curcuminoids) or placebo (three capsules of 500 mg of starch) for twelve weeks. In the peripheral blood mononuclear cells (PBMCs), the transcriptional expression levels of Nrf2, HOX-1 and NF-κB were evaluated by quantitative real-time PCR. Oxidative stress was evaluated by malondialdehyde (MDA) and total Thiol (T-SH). TNF-α and IL-6 plasma levels were measured by ELISA. P-cresyl sulphate plasma level, a uremic toxin, was evaluated by high-performance liquid chromatography (HPLC) with fluorescent detection. RESULTS: Twenty-four patients finished the study: 10 in the curcumin group (57.5 ± 11.6 years) and 14 in the placebo group (56.5 ± 10.0 years). The plasma levels of MDA were reduced after 12 weeks in the curcumin group (p = 0.01), while the placebo group remained unchanged. However, regarding the difference between the groups at the endpoint, no change was observed in MDA. Still, there was a trend to reduce the p-CS plasma levels in the curcumin group compared to the placebo group (p = 0.07). Likewise, the concentrations of protein thiols, mRNA expression of Nrf2, HOX-1, NF-κB, and cytokines plasma levels did not show significant changes. CONCLUSION: Curcuminoid supplementation for twelve weeks attenuates lipid peroxidation and might reduce uremic toxin in patients with CKD undergoing PD. This study was registered on Clinicaltrials.gov as NCT04413266.

Racial Inequalities in the Health Establishment Access to the Treatment of COVID-19 in Brazil in 2020.

The Brazilian health system simultaneously allows for the existence of the public and private sectors, which often imposes financial barriers to access to services and affects the health of exposed groups. Studies have shown evidence of higher lethality risks among Black/Biracial and Indigenous People admitted to hospitals due to COVID-19 during the pandemic when compared to White People. This paper evaluated the association between access to treatment for COVID-19, race, and COVID-19-related deaths among the five macro-regions of Brazil in 2020. We conducted a retrospective, cross-sectional observational, and population-wide study. Logistical models were used including first-order interactions between race and the health establishment administration sector using deaths as outcome, adjusted for covariates. The lethality risk, defined as the percentage of deaths among hospitalized patients, of Black/Biracial and Indigenous People was up to 78% (in the Midwest) and 29% (in the South) higher when compared to White People, respectively. The association of the race/access interaction with COVID-19-related deaths suggested the possibility of institutional racism in health establishments. The results highlight the need to guarantee adequate funding to the public health sector to improve equity in access to healthcare and the constant development of educational activities and increased participation of racialized minorities in the healthcare workforce at influential positions for health workers on topics such as racism.

Sulforaphane Supplementation Did Not Modulate NRF2 and NF-kB mRNA Expressions in Hemodialysis Patients.

BACKGROUND: Patients with chronic kidney disease (CKD) have reduced expression of erythroid nuclear factor-related factor 2 (NRF2) and increased nuclear factor κB (NF-κB). "Food as medicine" has been proposed as an adjuvant therapeutic alternative in modulating these factors. No studies have investigated the effects of sulforaphane (SFN) in cruciferous vegetables on the expression of these genes in patients with CKD. OBJECTIVE: The study aimed to evaluate the effects of SFN on the expression of NRF2 and NF-κB in patients on hemodialysis (HD). DESIGN AND METHODS: A randomized, double-blind, crossover study was performed on 30 patients on regular HD. Fourteen patients were randomly allocated to the intervention group (1 sachet/day of 2.5 g containing 1% SFN extract with 0.5% myrosinase) and 16 patients to the placebo group (1 sachet/day of 2.5 g containing corn starch colored with chlorophyll) for 2 months. After a washout period of 2 months, the groups were switched. NRF2 and NF-κB mRNA expression was evaluated by real-time quantitative polymerase chain reaction, and tumor necrosis factor alpha and interleukin-6 levels were quantified by enzyme-linked immunosorbent assay. Malondialdehyde was evaluated as a marker of lipid peroxidation. RESULTS: Twenty-five patients (17 women, 55 [interquartile range = 19] years and 55 [interquartile range = 74] months on HD) completed the study. There was no significant difference concerning the expression of mRNA NRF2 (P = .915) and mRNA NF-κB (P = .806) after supplementation with SFN. There was no difference in pro-inflammatory and oxidative stress biomarkers. CONCLUSION: 150 µmol of SFN for 2 months had no antioxidant and anti-inflammatory effect in patients with CKD undergoing HD.

Serum Magnesium Levels in Patients with Chronic Kidney Disease: Is There a Relationship with Inflammation Status?

BACKGROUND: Magnesium (Mg2+) is a fundamental mineral that maintains cellular function, and low levels may be linked to inflammation in patients with chronic kidney disease (CKD). This cross-sectional study evaluated the correlation between serum Mg2+ levels and the inflammatory status in patients undergoing dialysis. METHODS: Two hundred patients with CKD [150 undergoing hemodialysis (HD), 50 (18) years; BMI 24 (4.8) kg/m²; and 50 patients on peritoneal dialysis (PD), 54 (17.7) years; BMI, 27.5 (7.3) kg/m²] were included. Serum Mg2+ levels were evaluated using a colourimetric test and commercial kit. Inflammatory markers were assessed by ELISA and multiplex bead-based assay. Lipid peroxidation was evaluated using thiobarbituric acid-reactive substances. RESULTS: The median serum Mg2+ levels were 2.3 (0.5) mg/dL, and 21% of patients presented Mg2+ deficiency (< 2.07 mg/dL or 0.85 mmol/L). We found no difference in Mg2+ serum levels between the two groups. A significant negative correlation was observed between serum Mg2+ levels and plasma hs-CRP (r =-0.17, p = 0.01), IL-8 (r =-0.35, p = 0.01), and MCP-1 (r =-0.31, p = 0.03) levels. CONCLUSION: Mg2+ serum levels were negatively correlated with inflammatory status in patients with CKD on dialysis.

Were public interventions relevant for containing the covid-19 pandemic in Brazil in 2020?

OBJECTIVE: Flattening the curve was the most promoted public health strategy worldwide, during the pandemic, to slow down the spread of the SARS-CoV-2 virus, and, consequently, to avoid overloading the healthcare systems. In Brazil, a relative success of public policies was evidenced. However, the association between public policies and the "flatten the curve" objectives remain unclear, as well as the association of different policies to reach this aim. This study aims to verify if the adoption of different public policies was associated with the flattening of the infection and death curves by covid-19 first wave in 2020. METHODS: Data from the Sistema de Informação da Vigilância Epidemiológica da Gripe (Influenza Epidemiological Surveillance Information System - SIVEP-Gripe) and the Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics - IBGE) were used to compute standardized incidence and mortality rates. The Oxford Covid-19 Government Response Tracker (OxCGRT) was used to obtain information about governmental responses related to the mitigation of pandemic effects, and the Human Development Index (HDI) was used as a measure of socioeconomic status. A non-linear least-square method was used to estimate parameters of the five-parameter sigmoidal curve, obtaining the time to reach the peak and the incremental rate of the curves. Additionally, ordinary least-square linear models were used to assess the correlation between the curves and the public policies adopted. RESULTS: Out of 51 municipalities, 261,326 patients had SARS-CoV-2 infection. Stringency Index was associated with reducing covid-19 incremental incidence and death rates,in addition to delaying the time to reach the peak of both pandemic curves. Considering both parameters, economic support policies did not affect the incidence nor the mortality rate curves. CONCLUSION: The evidence highlighted the importance and effectiveness of social distancing policies during the first year of the pandemic in Brazil, flattening the curves of mortality and incidence rates. Other policies, such as those focused on economic support, were not effective in flattening the curves but met humanitarian and social outcomes.

The impact of early anti-SARS-CoV-2 antibody production on the length of hospitalization stay among COVID-19 patients.

IMPORTANCE: The study provides valuable insights into the sociodemographic characteristics, clinical outcomes, and humoral immune response of those affected by the virus that has devastated every field of human life since 2019; the COVID-19 patients. Firstly, the association among clinical manifestations, comorbidities, and the production of neutralizing antibodies (Nabs) against SARS-CoV-2 is explored. Secondly, varying levels of Nabs among patients are revealed, and a significant correlation between the presence of Nabs and a shorter duration of hospitalization is identified, which highlights the potential role of Nabs in predicting clinical outcomes. Lastly, a follow-up conducted 7 months later demonstrates the progression and persistence of Nabs production in recovered unvaccinated individuals. The study contributes essential knowledge regarding the characteristics of the study population, the early humoral immune response, and the dynamics of Nabs production over time. These findings have significant implications for understanding the immune response to COVID-19 and informing clinical management approaches.

Covid-19: a sobrecarga de trabalhona luta pela vida. Representações sociaisde profissionais de enfermagem / Covid-19: work overload in the fight for life. Social representations of nursing professionals

Conhecer as representações sociais de profissionais de enfermagem que atuaram no atendimento aos pacientes acometidos pela COVID-19 diante da sobrecarga de trabalho. Método: Estudo de natureza descritiva com abordagem qualitativa utilizando como referencial a Teoria das Representações Sociais. O cenário foi um hospital que atendeu pacientes acometidos pela COVID-19. Os participantes foram profissionais de enfermagem. Os dados se deram através de entrevistas semiestruturadas. A análise ocorreu conforme a perspectiva de Bardin. Resultados: As representações retrataram condições de trabalho identificando desgaste mental diante em um cenário de inúmeras incertezas, de modo a suprir as necessidades exigida pela crise sanitária, impactando diretamente na sua saúde mental. Conclusão: Possibilidade da construção de um modelo de assistência que reestruture no processo de trabalho da enfermagem, minimizando possíveis sobrecarga de trabalho associados à sua saúde mental, otimizando assim a melhoria das suas condições de trabalho, fortalecendo respostas rápidas e precisas quando necessárias.(AU)

Objective: To learn about the social representations of nursing professionals who worked in the care of patients affected by COVID-19 in the face of work overload. Method: A descriptive study with a qualitative approach, using the Theory of Social Representations as a reference. The setting was a hospital that treated patients affected by COVID-19. The participants were nursing professionals. The data was collected through semi-structured interviews. The analysis took place according to Bardin's perspective. Results: The representations portrayed working conditions identifying mental exhaustion faced in a scenario of countless uncertainties, in order to meet the needs demanded by the health crisis, directly impacting on their mental health. Conclusion: The possibility of building a care model that restructures the nursing work process, minimizing possible work overload associated with their mental health, thus optimizing the improvement of their working conditions, strengthening quick and precise responses when necessary.(AU)

Objetivo: Conocer las representaciones sociales de los profesionales de enfermería que han trabajado en el cuidado de pacientes afectados por COVID-19 ante la sobrecarga de trabajo. Método: Estudio descriptivo con enfoque cualitativo, tomando como referencia la Teoría de las Representaciones Sociales. El escenario fue un hospital que atendía a pacientes afectados por COVID-19. Los participantes fueron profesionales de enfermería. Los datos se recogieron mediante entrevistas semiestructuradas. El análisis se realizó según la perspectiva de Bardin. Resultados: Las representaciones retrataron condiciones de trabajo que identifican agotamiento mental enfrentado en un escenario de innumerables incertidumbres, para atender a las necesidades demandadas por la crisis de salud, impactando directamente en su salud mental. Conclusión: Es posible construir un modelo de atención que reestructure el proceso de trabajo de enfermería, minimizando la posible sobrecarga de trabajo asociada a su salud mental, optimizando así la mejora de sus condiciones de trabajo, fortaleciendo respuestas rápidas y precisas cuando sea necesario.(AU)

Assessment of early harvest in the prevention of aflatoxins in peanuts during drought stress conditions.

The present study aimed to evaluate the effectiveness of early harvest in preventing aflatoxins in peanuts under drought-stress conditions. A field experiment was conducted on the 2018-2019 and 2019-2020 growing seasons in a greenhouse with an irrigation system to induce three drought stress conditions: no stress, mild, and severe stress. In addition, three harvest dates were proposed: two weeks earlier, one week earlier, and ideal harvest time. The mean peanut yield was 2634 kg/ha, considering the two growing seasons, and the drought stress conditions and harvest dates did not influence significantly. The shelling percentage was significantly higher in samples harvested at ideal harvest (77.7 %) than two weeks earlier (76.2 %) and was not influenced by drought stress conditions. Although a low mean percentage of grains with insect damage was identified, this percentage was statistically higher under severe stress (0.4 %) compared to no-stress conditions (0.2 %). The soil contamination ranged from 2.52 × 103 to 1.64 × 104 CFU/g of Aspergillus section Flavi, and the drought stress resulted in significantly higher concentrations in mild and severe stressed samples. A. section Flavi was found to infect all the peanut kernel samples. The drought stress resulted in higher percentages of A. section Flavi infections in samples from mild and severe stress conditions. The harvest date did not influence the soil and peanut kernel occurrence of A. section Flavi. A total of 435 and 796 strains of A. section Flavi were isolated from soil and peanut kernels, respectively. The potential of aflatoxin production by soil isolates was 31, 44, and 25 % for aflatoxin non-producers, aflatoxin B producers, and aflatoxin B and G producers, respectively, while in peanut kernel isolates were 44, 44, and 12 %. Three different A. section Flavi species were identified from peanut kernels: A. flavus, A. parasiticus, and A. pseudocaelatus. The mean aflatoxin concentration in peanut kernels was 42, 316, and 695.5 µg/kg in samples under no stress, mild stress, and severe stress conditions, respectively. Considering the harvest time, the mean aflatoxin concentration was 9.9, 334.3, and 614.2 µg/kg in samples harvested two weeks earlier, one week earlier, and in ideal harvest, respectively. In conclusion, the early harvest proved to be a viable, cost-free alternative for controlling aflatoxin in the peanut pre-harvest, resulting in a safer product and a better quality for sale and economic gain.

Use of fractional exhaled nitric oxide as a potential predictor of bronchodilator response.

Nitric oxide (NO) is an important product of eosinophilic metabolism, and its increase is associated with bronchial remodeling and airway hyperresponsiveness. Fractional exhaled NO (FENO) in the expired air of patients with suspected or diagnosed asthma has been used as a marker for eosinophilic inflammation. This cohort study included asthmatic patients classified under steps 3, 4, or 5 of the global strategy for asthma management and prevention. In the morning of the same day, all patients underwent blood collection for eosinophil counts, followed by FENO measurement and spirometry. We considered 2 groups based on the bronchodilation (BD) response on spirometry (>10% of FVC or FEV1): positive (BD+) and negative (BD-). Differences between the 2 groups were analyzed for demographic features, FENO values, and predictive correlations between FENO and BD. Both groups of patients showed an increase in the eosinophil count (BD+, P = .03; BD-, P = .04) and FENO values (P = .015 for both) with an increase in the asthma severity from step 3 to step 5 of the global strategy for asthma management and prevention. The correlations of FENO and eosinophils as well as FENO values and BD + were 0.127 (95% confidence interval,-0.269 to -0.486) and 0.696 (95% confidence interval, 0.246-0.899; P = .007), respectively. Measuring FENO levels may be useful for identifying patients with BD+.

Lifestyle changes during the COVID-19 pandemic in Brazil: results from three consecutive cross-sectional web surveys.

OBJECTIVE: The importance of a healthy lifestyle in preventing morbidity and mortality is well-established. The COVID-19 pandemic brought about significant lifestyle changes globally, but the extent of these changes in the Brazilian population remains unclear. The objective of this study was to evaluate changes in lifestyle among the Brazilian general population during the first year of the pandemic. DESIGN: Three consecutive anonymous web surveys were carried out: survey 1 (S1)-April 2020, S2-August 2020 and S3-January 2021. SETTING: Brazil. PARTICIPANTS: The study included 19 257 (S1), 1590 (S2) and 859 (S3) participants from the general population, who were ≥18 years, of both sexes, with access to the internet, self-reporting living in Brazil and who agreed to participate after reading the informed consent. PRIMARY OUTCOME: Lifestyle changes were assessed using the Short Multidimensional Instrument for Lifestyle Evaluation-Confinement (SMILE-C). The SMILE-C assesses lifestyle across multiple domains including diet, substance use, physical activity, stress management, restorative sleep, social support and environmental exposures. We used a combination of bootstrapping and linear fixed-effect modelling to estimate pairwise mean differences of SMILE-C scores overall and by domain between surveys. RESULTS: In all the surveys, participants were mostly women and with a high education level. Mean SMILE-C scores were 186.4 (S1), 187.4 (S2) and 190.5 (S3), indicating a better lifestyle in S3 as compared with S1. The pairwise mean differences of the overall SMILE-C scores were statistically significant (p<0.001). We also observed a better lifestyle over time in all domains except for diet and social support. CONCLUSIONS: Our findings indicate that individuals from a large middle-income country, such as Brazil, struggled to restore diet and social relationships after 1 year of the pandemic. These findings have implications for monitoring the long-term consequences of the pandemic, as well as future pandemics.

Effects of Polydextrose Supplementation on Intestinal Function in Hemodialysis Patients: A Double-Blind, Randomized, Placebo-Controlled Trial.

OBJECTIVES: Intestinal constipation is a frequent complication in hemodialysis (HD) patients. Polydextrose (PDX), a nondigestible oligosaccharide, has been reported as a fermentable fiber with potential benefits. This study aimed to investigate the possible influence of PDX supplementation on intestinal function in HD patients. METHODS: This randomized, double-blind, placebo-controlled trial included 28 patients who received daily oral supplementation with 12 g of PDX or placebo (corn starch) for 2 months. ROME IV criteria were used to define constipation and questionnaires were applied to patient assessment of constipation symptoms (PAC-SYM) and their impact on the patient assessment of constipation quality of life. The Bristol scale was used to assess stool consistency. Commercial Enzyme-Linked Immuno Sorbent Assay kits were used to evaluate the interleukin-6 and tumor necrosis factor-α plasma levels. RESULTS: 25 patients completed the study; 16 in the PDX group [7 females, 48.5 years (IQR = 15.5)] and 9 in the control group [3 females, 44.0 years (IQR = 6.0)]. According to ROME IV criteria, 55% of patients were diagnosed with constipation. PAC-SYM faecal symptoms domain was reduced after 2 months of PDX supplementation (P = .004). We also observed a significant reduction in the PAC-QoL-concerns domain (P = .02). The average values for PAC-SYM and patient assessment of constipation quality of lifewere reduced significantly after intervention with PDX. There were no significant changes after the intervention period concerning biochemical variables, food intake, and inflammation markers. No adverse effects were observed during the supplementation period. CONCLUSIONS: The results of the present study suggest that short-term PDX supplementation may have favourable results on intestinal function and the quality of life of chronic kidney disease patients in HD.