Nurses' perspectives on nurses' work methods.

OBJECTIVES: To analyze nurses' perspectives on nurses' work methods in the hospital context. METHODS: A descriptive study with a qualitative approach was conducted in a hospital in northern Portugal, involving 17 nurses. Semi-structured interviews were used for data collection. Data collected between May and June 2023 underwent content analysis, supported by Atlas.ti software. RESULTS: Three thematic areas emerged: "Nurses' work methods in a hospital context," highlighting the conception and components of work methods and the methods in use; "Implementation of nurses' work methods," emphasizing influencing factors and challenges to implementation; and "Impact of nurses' work methods on patients, nurses, and institutions." FINAL CONSIDERATIONS: Nurses' work methods constitute the structure of nursing care. Some factors influence and some challenges arise in the implementation of these methods, producing impacts on patients, nurses, and institutions.

Models for predicting the risk of illness in leprosy contacts in Brazil: Leprosy prediction models in Brazilian contacts.

OBJECTIVE: This study aims to develop and validate predictive models that assess the risk of leprosy development among contacts, contributing to an enhanced understanding of disease occurrence in this population. METHODS: A cohort of 600 contacts of people with leprosy treated at the National Reference Center for Leprosy and Health Dermatology at the Federal University of Uberlândia (CREDESH/HC-UFU) was followed up between 2002 and 2022. The database was divided into two parts: two-third to construct the disease risk score and one-third to validate this score. Multivariate logistic regression models were used to construct the disease score. RESULTS: Of the four models constructed, model 3, which included the variables anti-phenolic glycolipid I immunoglobulin M positive, absence of Bacillus Calmette-Guérin vaccine scar and age ≥60 years, was considered the best for identifying a higher risk of illness, with a specificity of 89.2%, a positive predictive value of 60% and an accuracy of 78%. CONCLUSIONS: Risk prediction models can contribute to the management of leprosy contacts and the systematisation of contact surveillance protocols.

Metabolic syndrome induces benefits in mice experiencing severe sepsis, comparable to the effects of low-dose aspirin pretreatment in septic mice lacking metabolic syndrome.

BACKGROUND: Sepsis is a complex condition characterized by systemic host inflammation caused by an infection. Experimental and observational studies indicate that obesity, one of the components of metabolic syndrome (MetS), or aspirin (ASA) treatment could be associated with sepsis survival. However, the effects of ASA on septic mice with MetS-induced conditions have not been explored. METHODS: Swiss mice were administered monosodium glutamate (MSG) (4 mg/kg) during their first 5 days of life for MetS induction, while the control mice received an equimolar saline solution. MetS was validated in male mice on their 60th day of life. ASA treatment was administered for 15 days prior to sepsis (40 mg/kg). On the 75th day, sepsis was induced in MetS and control mice through cecal ligation and puncture (CLP). The effects of ASA on septic mice with MSG-induced MetS were assessed by determining survival rates, quantification of nitric oxide (NO), and cytokine levels in the plasma, while correlating these data with hematological, blood glucose and cardiovascular parameters. RESULTS: MetS was validated by Lee-Index (3 body weight/naso-anal length×1000), hypertension, and hyperglycemia in animals receiving MSG as neonates. In control animals, severe sepsis promoted hypoglycemia, which was associated with mortality, as well as increased plasma NO levels, hypotension, hematological alterations, and elevation of proinflammatory cytokines. In contrast, MetS and pre-treatment with ASA were able to prevent sepsis-related alterations. CONCLUSIONS: MetS and ASA pre-treatment provided protection against severe sepsis. However, ASA was ineffective in mice with MetS undergoing severe sepsis.

Medication Literacy Test for Older Adults: psychometric analysis and standardization of the new instrument.

BACKGROUND: Low medication literacy is prevalent among older adults and is associated with adverse drug events. The Medication Literacy Test for Older Adults (TELUMI) was developed and content validated in a previously published study. AIM: To evaluate the psychometric properties and provide norms for TELUMI scores. METHOD: This was a cross-sectional methodological study with older adults selected from the community and from two outpatient services. Descriptive item-analysis, exploratory factor analysis (EFA), item response theory (IRT), reliability, and validity analysis with schooling and health literacy were performed to test the psychometric properties of the TELUMI. The classification of the TELUMI scores was performed using percentile norms. RESULTS: A total of 344 participants, with a mean age of 68.7 years (standard deviation = 6.7), were included; most were female (66.6%), black/brown (61.8%), had low schooling level (60.2%) and low income (55.2%). The EFA pointed to the one-dimensional structure of TELUMI. A three-parameter logistic model was adopted for IRT. All items had an adequate difficulty index. One item had discrimination < 0.65, and three items had an unacceptable guessing index (< 0.35) and were excluded. The 29-item version of TELUMI had excellent internal consistency (KR20 = 0.89). There was a positive and strong association between TELUMI scores and health literacy and education level. The scores were classified as inadequate medication literacy (≤ 10.0 points), medium medication literacy (11-20 points), and adequate medication literacy (≥ 21 points). CONCLUSION: The results suggest that the 29-item version of TELUMI is psychometrically adequate for measuring medication literacy in older adults.

Técnica Boomerang para plástica genital estética feminina / Boomerang technique for female genital aesthetic surgery

Introdução: A hipertrofia de pequenos lábios combinada com capuz clitoriano redundante é uma queixa comum entre mulheres que procuram cirurgia plástica genital cosmética por queixas funcionais, psicológicas e estéticas. O objetivo deste estudo foi descrever a técnica boomerang, um tratamento cirúrgico da hipertrofia labial que se estende a todo o capuz clitoriano. Método: Foi conduzido um estudo retrospectivo, de caráter analítico, para avaliar os prontuários médicos de 48 pacientes consecutivas submetidas a cirurgia estética genital feminina entre julho de 2017 e julho de 2021. Todos os procedimentos cirúrgicos foram realizados pela mesma cirurgiã. A técnica utilizada nas pacientes consistiu na ressecção longitudinal dos excessos de pequenos lábios vaginais associado à ressecção de capô clitoriano em forma de boomerang e à clitoropexia. Resultados: A idade média das pacientes submetidas a cirurgia foi de 36,25 anos (intervalo 18-59 anos), entre as quais 94,44% apresentaram queixas estéticas associadas ou não a queixas funcionais, e 5,56% apresentaram somente queixas funcionais. Duas pacientes apresentaram hematomas nos grandes lábios no pós-operatório imediato, e uma paciente teve deiscência de sutura nos pequenos lábios. Conclusão: A técnica boomerang é reprodutível e proporciona benefícios estéticos e/ou funcionais na genitália feminina.

Introduction: Hypertrophy of the labia minora combined with a redundant clitoral hood is a common complaint among women seeking aesthetic genital cosmetic surgery for functional, psychological, and aesthetic complaints. The objective of this study was to describe the boomerang technique, a surgical treatment for labial hypertrophy that extends to the entire clitoral hood. Method: A retrospective, analytical study was conducted to evaluate the medical records of forty-eight consecutive patients who underwent female genital cosmetic surgery between July 2017 and July 2021. The same surgeon performed all surgical procedures. The technique used in the patients consisted of longitudinal resection of excess small vaginal lips associated with resection of the boomerang-shaped clitoral hood associated with clitoroplasty. Results: The average age of patients undergoing surgery was 36.25 years (range 18-59 years), among whom 94.44% had aesthetic complaints associated or not with functional complaints, and 5.56% had only functional complaints. Two patients had bruises on the labia majora in the immediate postoperative period, and one patient had suture dehiscence on the labia minora. Conclusion: The boomerang technique is reproducible and provides aesthetic and/or functional benefits to the female genitalia.

Habilidades nas transferências para desempenho das atividades cotidianas de pessoas com lesão da medula espinal / Skills in transfers to perform the daily activities of people with spinal cord injury / Habilidades en transferencias para realizar las actividades diarias de personas con lesión médula espinal

Objetivo: refletir sobre a importância do trabalho das equipes de reabilitação, orientando e habilitando os cadeirantes para o desempenho seguro das transferências diárias, fundamentais na realização das atividades cotidianas e inclusão social. Métodos: trata-se de estudo teórico-reflexivo fundamentado na teoria do déficit de autocuidado, com a utilização integrada dos diagnósticos de enfermagem, da classificação internacional das práticas de enfermagem e do instrumento de avaliação das transferências, adequados às necessidades de pessoas com lesão medular, atendidas nos ambientes institucionais de cuidados, visando o preparo para o desempenho das atividades cotidianas. Resultados: cabe aos enfermeiros assumir liderança nas equipes de reabilitação física, norteando suas intervenções no treinamento dessas pessoas e seus cuidadores para o desempenho e ajuda segura nas transferências para cuidar de si. Conclusão: considerando a lesão medular entre os maiores problemas da saúde coletiva que afeta a humanidade contemporânea, tanto pelos comprometimentos na qualidade de vida das pessoas, quanto no aumento das despesas hospitalares e reabilitação requeridos, a adoção de estratégias de cuidados preventivos de complicações musculoesqueléticas é sempre bem-vinda. Essas pessoas, quando não orientadas, executam movimentos repetitivos para se deslocar em transferências de uma superfície para outra, correndo elevados riscos de contrair lesões nas articulações, pele e mucosas. (AU)

Objective: to reflect on the importance of the work of rehabilitation teams, guiding and enabling wheelchair users to safely perform daily transfers, essential for carrying out daily activities and social inclusion. Methods: this is a theoretical-reflective study based on the theory of self-care deficit, with the integrated use of nursing diagnoses, the international classification of nursing practices and the transfer assessment instrument, adapted to the needs of people with spinal cord injury, attended in institutional care environments, aiming to prepare for the performance of daily activities. Results: it is up to nurses to assume leadership in physical rehabilitation teams, guiding their interventions in the training of these people and their caregivers for performance and safe help in transfers to take care of themselves. Conclusion: considering spinal cord injury among the biggest collective health problems that affect contemporary humanity, both because of the compromises in people's quality of life, as well as the increase in hospital and rehabilitation expenses required, the adoption of preventive care strategies for musculoskeletal complications is always welcome. These people, when not guided, perform repetitive movements to move in transfers from one surface to another, running high risks of contracting injuries to the joints, skin and mucous membranes. (AU)

Objetivo: reflexionar sobre la importancia del trabajo de los equipos de rehabilitación, orientando y capacitando a los usuarios de silla de ruedas para realizar con seguridad las tranferencias cotidianas, indispensables para el desarrollo de las actividades cotidianas y la inclusión social. Métodos: se trata de un estudio teórico-reflexivo basado en la teoría del déficit de autocuidado, con el uso integrado de los diagnósticos de enfermería, la clasificación internacional de prácticas de enfermería y el instrumento de evaluación de la transferencia, adaptado a las necesidades de las personas con lesión medular. asistidos en ambientes de atención institucional, con el objetivo de preparar para el desempeño de las actividades diárias. Resultados: corresponde a los enfermeros asumir el liderazgo en los equipos de rehabilitación física, orientando sus intervenciones en la formación de esas personas y sus cuidadores para el desempeño y ayuda segura en las transferencias para cuidarse. Conclusion: considerando la lesión medular entre los mayores problemas de salud colectiva que afectan a la humanidad contemporánea, tanto por los compromisos en la calidad de vida de las personas, como por el aumento de los gastos hospitalarios y de rehabilitación requeridos, la adopción de estrategias de atención preventiva de las complicaciones musculoesqueléticas siempre es bienvenido Estas personas, cuando no están guiadas, realizan movimientos repetitivos para moverse en transferencias de una superficie a otra, corriendo un alto riesgo de contraer lesiones en las articulaciones, piel y mucosas. (AU)

Assessment of anthropogenic pollution in Guanabara Bay (SE Brazil) through biogeochemical data and stable isotope mixing models.

This work intends to identify pollution sources along the margins of Guanabara Bay (GB; SE Brazil) through a multiproxy approach and Bayesian stable isotopic mixture model (BSIMM). For this purpose, 33 surface sediment samples were collected and analyzed for granulometry, geochemistry (heavy metals, total organic carbon-TOC, stable isotopes of carbon and nitrogen-δ13C and δ15N, Rock-Eval pyrolysis parameters-REPP), and physicochemical parameters. Metal concentrations (E) dissolved in water (EW), adsorbed by organic matter (EOM) and by Mn hydroxides (EMn), and total extracted concentrations (ET) were analyzed. Sampling was conducted in 2018 after an oil spill from Reduc Oil Refinery. Potential Ecological risk index (PERI), based on metals, classified 85% of the analyzed stations as having moderate to considerable ecological risk. The metals with the potential to cause the highest ecological risk were CdW, CdOM, PbOM, and HgOM. The combination of BSIMM and REPP data was an effective proxy for oil spill detection by indicating the presence of polycyclic aromatic hydrocarbons (PAHs). Relatively high TOC contents suggested that the analyzed stations are eutrophicated environments. BSIMM discriminated three groups of stations with different sources of organic matter (OM), endorsing the result previously shown by the cluster analysis: (A) Niterói region, Botafogo marina, Glória marina, Fiscal and Fundão islands with diffuse sources of OM, including marine phytoplankton and material of continental origin from highly polluted rivers and domestic sewage; (B) region near Fundão and Governador islands and Mangue Channel outlet with OM (≃70%) supplied by highly polluted streams and a small contribution of PAHs; (C) Duque de Caxias and Botafogo-Urca inlet with significant contributions of PAHs, materials from C-3 plants and rivers polluted by urban sewage. Results of linear regressions in conjunction with BSIMM indicate that HgMn and PbOM mainly affect Group A's stations. Although the eastern margin of GB (Niterói; Group A) showed greater oceanic interaction than the other groups, it presented substantial concentrations of metals, potentially harmful (i.e., Hg and Pb) to marine biota and human health.

Density and behavior of capybara (Hydrochoerus hydrochaeris) ticks (Acari: Ixodidae) Amblyomma sculptum and Amblyomma dubitatum with notes on Rickettsia bellii infection: Assessing human exposure risk.

In several urban and peri­urban areas of Brazil, populations of Amblyomma sculptum and Amblyomma dubitatum ticks are maintained by capybaras (Hydrochoerus hydrochaeris). In some of these areas, this host and these tick species are associated with Brazilian spotted fever (BSF), a lethal human disease caused by the bacterium Rickettsia rickettsii. In this work, we evaluated the risk of human exposure to these tick species using four collection techniques to discern host-seeking behavior. The study was carried out in 10 urban sites inhabited by capybaras in Uberlândia, a BSF-free municipality in southeastern Brazil. Ticks were collected in areas of 400 m2 at each site and at three seasons. Within the same municipality, the distance and speed of A. sculptum nymphs moving towards the CO2 traps were evaluated. In a sample of ticks Rickettsia DNA was investigated. During the study period, 52,953 ticks were collected. Among these, 83.4 % were A. sculptum (1,523 adults, 10,545 nymphs and 32,104 larvae) and 16.6 % were A. dubitatum (464 adults, 2,153 nymphs and 6,164 larvae). An average annual questing tick density of 4.4/m² was observed, with the highest density recorded at one site in autumn (31.8/m²) and the lowest in summer at another site (0.03/m²). The visual search yielded the highest proportion of A. sculptum larvae, constituting 47 % of the total and 63.6 % of all A. sculptum larvae. In contrast, CO2 traps collected a greater proportion of nymphs and adults of A. sculptum ticks. In the case of A. dubitatum, the CO2 trap was the most efficient technique with 57.7 % of captures of this species, especially of nymphs (94.5 % of captures) and adults (97.8 % of captures). Ticks' ambush height on vegetation (9 to 77 cm), observed by visual search 30 times, yielded a total of 20,771 ticks. Of these, 28 (93 %) were A. sculptum ticks, with only two (7 %) identified as A. dubitatum ticks. Among A. sculptum ticks, the nymph was the most attracted stage to humans and larva in the case of A. dubitatum. Amblyomma sculptum adults and nymphs were significantly more attracted to humans than those of A. dubitatum, but A. dubitatum larvae were significantly more attracted than the same stage of A. sculptum. The maximum distance and speed of horizontal displacement for A. sculptum nymphs were five meters and 2.0 m/h, respectively. The only species of Rickettsia detected in ticks, exclusively in A. dubitatum, was R. bellii. Importantly, it was observed that the higher the proportion of A. sculptum in the community of ticks, the lower the rate of infection of A. dubitatum by R. bellii. In conclusion, host-seeking behavior differed between the two tick species, as well as between stages of the same species. A greater restriction of A. dubitatum ticks to the soil was observed, while larvae and nymphs of A. sculptum dispersed higher in the vegetation. The behavior presented by A. sculptum provides greater opportunities for contact with the hosts, while A. dubitatum depends more on an active search for a host, the hunter behavior. Taken together, these observations show that a human being crossing an area infested with A. sculptum and A. dubitatum ticks will have almost exclusive contact with A. sculptum larvae and/or nymphs. Humans in a stationary position (sitting, lying or immobile) are exposed to both tick species, but they are more attractive to adults and mainly nymphs of A. sculptum compared to the corresponding stages of the tick A. dubitatum. The negative effect of A. sculptum on A. dubitatum infection by R. bellii deserves further studies.

One sixth of Amazonian tree diversity is dependent on river floodplains.

Amazonia's floodplain system is the largest and most biodiverse on Earth. Although forests are crucial to the ecological integrity of floodplains, our understanding of their species composition and how this may differ from surrounding forest types is still far too limited, particularly as changing inundation regimes begin to reshape floodplain tree communities and the critical ecosystem functions they underpin. Here we address this gap by taking a spatially explicit look at Amazonia-wide patterns of tree-species turnover and ecological specialization of the region's floodplain forests. We show that the majority of Amazonian tree species can inhabit floodplains, and about a sixth of Amazonian tree diversity is ecologically specialized on floodplains. The degree of specialization in floodplain communities is driven by regional flood patterns, with the most compositionally differentiated floodplain forests located centrally within the fluvial network and contingent on the most extraordinary flood magnitudes regionally. Our results provide a spatially explicit view of ecological specialization of floodplain forest communities and expose the need for whole-basin hydrological integrity to protect the Amazon's tree diversity and its function.

Internal consistency of the Strengths and Difficulties Questionnaire in Amazonian children.

OBJECTIVE: To describe the frequency of behavioral problems and the internal consistency of the parent version of the Strengths and Difficulties Questionnaire (SDQ-P) in Amazonian preschool children during the covid-19 pandemic. METHODS: Data from the Maternal and Child Health and Nutrition in Acre (MINA-Brazil) study, a population-based birth cohort in the Western Brazilian Amazon, were used. The SDQ-P was applied in 2021 at the five-year follow-up visit to parents or caregivers of 695 children (49.4% of which were girls). This instrument is a short behavioral screening questionnaire composed of 25 items reorganized into five subscales: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. Cases of behavioral problems were defined according to the original SDQ cut-offs based on United Kingdom norms. Moreover, cut off points were estimated based on the SDQ-P percentile results of our study sample. Internal consistency was assessed by calculating Cronbach's alpha coefficient and McDonald's omega for each scale. RESULTS: According to the cut-offs based on our studied population distribution, 10% of all children had high or very high total difficulty scores, whereas it was almost twice when the original SDQ cut-offs based on United Kingdom norms, were applied (18%). Differences were also observed in the other scales. Compared to girls, boys showed higher means of externalizing problem and lower means of prosocial behavior. The five-factor model showed a moderate internal consistency of the items for all scales (0.60 ≤ α ≤ 0.40), except for total difficulty scores, which it considered substantial (α > 0.61). CONCLUSIONS: Our results support the usefulness of SDQ in our study population and reinforce the need for strategies and policy development for mental health care in early life in the Amazon.

Alpha 1-acid glycoprotein is upregulated in severe COVID-19 patients and decreases neutrophil NETs in SARS-CoV-2 infection.

Orosomucoid, or alpha-1 acid glycoprotein (AGP), is a major acute-phase protein expressed in response to systemic injury and inflammation. AGP has been described as an inhibitor of neutrophil migration on sepsis, particularly its immunomodulation effects. AGP's biological functions in coronavirus disease 2019 (COVID-19) are not understood. We sought to investigate the role of AGP in severe COVID-19 infection patients and neutrophils infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Epidemiological data, AGP levels, and other laboratory parameters were measured in blood samples from 56 subjects hospitalized in the ICU with SARS-CoV-2 infection. To evaluate the role of AGP in NETosis in neutrophils, blood samples from health patients were collected, and neutrophils were separated and infected with SARS-CoV-2. Those neutrophils were treated with AGP or vehicle, and NETosis was analyzed by flow cytometry. AGP was upregulated in severe COVID-19 patients (p<0.05). AGP level was positively correlated with IL-6 and C-reactive protein (respectively, p=0.005, p=0.002) and negatively correlated with lactate (p=0.004). AGP treatment downregulated early and late NETosis (respectively, 35.7% and 43.5%) in neutrophils infected with SARS-CoV-2 and up-regulated IL-6 supernatant culture expression (p<0.0001). Our data showed increased AGP in COVID-19 infection and contributed to NETosis regulation and increased IL-6 production, possibly related to the Cytokine storm in COVID-19.

Survey of Rickettsia spp. in ticks (Acari: Ixodidae) infesting opossums (Didelphis albiventris) and capybaras (Hydrochoerus hydrochaeris) from an urban park in southeastern Brazil.

Ticks are hematophagous arthropods and, during feeding, may transmit pathogens to vertebrate hosts, including humans. This study aimed to investigate the presence of Rickettsia spp. in ticks collected between 2010 and 2013 from free-ranging capybaras (Hydrochoerus hydrochaeris) and opossums (Didelphis albiventris) that inhabit Sabiá Park in Uberlândia, Brazil. Overall, 1,860 ticks were collected: 1,272 (68.4%) from capybaras (487 of the species Amblyomma sculptum, 475 adults and 12 nymphs; 778 Amblyomma dubitatum, 727 adults and 51 nymphs; and seven larva clusters of the genus Amblyomma); and 588 (31.6%) from opossums (21 A. sculptum, one adult and 20 nymphs; 79 A. dubitatum, all nymphs; 15 Ixodes loricatus, 12 adults and three nymphs; 457 Amblyomma sp. larva clusters; 15 Ixodes sp. larva clusters; and one Argasidae larva cluster). Out of 201 DNA samples tested for the presence of Rickettsia spp. DNA using polymerase chain reaction (PCR) 12 showed amplification of a gtlA gene segment that was specific to Rickettsia bellii, a bacterium non-pathogenic to humans. As there has been a report showing serological evidence of infections caused by Rickettsia species of the spotted fever group (SFG) in capybaras and opossums in the park, including Rickettsia rickettsii, the etiological agent of Brazilian spotted fever, and considering the presence of A. sculptum ticks, which are aggressive to humans, as well as these vertebrate hosts, which are amplifiers of R. rickettsii, it is important to monitor the presence of SFG rickettsiae in the Sabiá Park, which is visited daily by thousands of people.

A Preliminary Study on Hepatoprotective, Hypolipidemic and Aortic Morphometric Effects of Omega-3-Rich Fish Oil in Hypercholesterolemic Mice.

This study aims to evaluate the hepatoprotective, hypolipidemic and aortic morphometric effects of fish oil rich in omega-3 in hypercholesterolemic BALB/c mice. This is an experimental model that included 16 male BALB/c mice (Mus musculus) divided into three groups (G1 (standard commercial chow and 0.9% saline solution), G2 (hypercholesterolemic diet and 0.9% saline solution) and G3 (hypercholesterolemic diet and fish oil)) for 8 weeks. There was no significant difference in the treatment with omega-3-rich fish oil in the lipid profile (p > 0.05). In the histological analysis, group G2 detected the presence of hepatitis and liver tissue necrosis, but this was not observed in group G3. As for the morphometry in the light area of the vessel, the G1 group had a higher score (2.62 ± 0.36 mm2) when compared to G2 (2.10 ± 0.16 mm2) and G3 (2.26 ± 0.25 mm2) (p < 0.05). The vessel wall thickness did not differ between the groups (p > 0.05). It is concluded that supplementation with fish oil rich in omega-3 carried out in this study may have a protective effect on liver tissue, but it has not yet improved the lipid and morphometric profile. Despite this research being preliminary, it is a relevant study with future prospects for improving the doses of EPA and DHA in order to better elucidate the benefits of fish oil in models of dyslipidemia.

Insights into alternative cryoprotectants to freeze sperm of domestic cats.

Globalization and habitat destruction pose a significant threat to wildlife felids. Even though conservation banks for genetic materials have been created, the sperm cryopreservation with minimal cell damage is still a great challenge. Thus, this study aimed to compare the effects of two commercial extenders with different concentrations of alternative cryoprotectants on thawed sperm quality of domestic cats. Five adult cats were anaesthetized (using a combination of 40 µg/kg medetomidine associated to 5 mg/kg ketamine), and the semen was collected by electroejaculation (electrical stimulation of 2-3 V). Semen samples were evaluated for sperm characteristics (kinetics, morphology, membrane integrity and morphometry). Subsequently, they were sorted into two aliquots and centrifuged. The aliquots were added to a commercial extender containing 3% glycerol and 2% methylformamide (extender I) or 2% glycerol and 3% methylformamide (extender II), frozen, thawed (37°C/30 s) and reevaluated. Comparatively, the sperm kinetics and membrane integrity of fresh semen were higher (p < .002) than frozen samples in extender I and II. Total and progressive motility were lowest in the thawed samples. However, the subjective analysis indicated high sperm motility, since the kinetics evaluation was impaired by the low cell number in the thawed samples. There were no differences in sperm morphology between the groups. In the sperm morphometric analysis, a significant difference (p = .04) was identified in the length of the intermediate piece in extender II samples compared with fresh and extender I. Thus, it can be concluded that although the concentrations tested did not maintain the kinetic parameters and membrane integrity of spermatozoa after thawing, the extender with a lower concentration of glycerol was less toxic for maintaining the midpiece length.

Renal biomarkers, clinical parameters, and renal Doppler velocimetry in bitches with cystic endometrial hyperplasia-pyometra complex.

Cystic endometrial hyperplasia (CEH)-pyometra complex is the most common uterine infection in adult and elderly bitches and can cause renal dysfunction. The aim of this study was to measure and compare urinary creatinine, urea, symmetric dimethylarginine (SDMA), urinary protein-creatinine ratio (UPC), measurement of systolic blood pressure (SBP), and Doppler velocimetry of renal arteries in patients with CEH-pyometra complex before and after an average of 6 months of treatment, evaluating the possibility of the changes persisting. The evaluation was conducted at two moments: M1 (at the diagnosis of CEH-pyometra, n = 36) and M2 (after an average of six months of treatment, n = 16). For the control group, eight bitches with no changes in blood tests or history of conditions underwent Doppler ultrasound evaluation of the renal arteries. At both M1 and M2, we measured creatinine, urea, and serum SDMA, UPC, SBP, and Doppler ultrasound of the renal arteries. Patients were evaluated according to the following groups: azotemic (AZO) and non-azotemic (NAZO), and open and closed cervix pyometra. The parameters were compared between animals present in both moments presented as M1R (bitches that were in M1 and M2) and M2. Statistical significance was considered when p < .05. The medians found for creatinine in M1 were as follows: 1.15 mg/dL, being 1.8 mg/dL for AZO (12/36) and 0.95 mg/dL for NAZO (24/36); and in M2: 0.85 mg/dL (16/16), being 1.15 mg/dL for AZO (4/16) and 0.8 mg/dL for NAZO (12/36). For urea, in M1 it was 36 mg/dL (32/36), with AZO being 103 mg/dL (11/32) and 33 mg/dL in NAZO (21/32); and in M2 32 mg/dL (16/ 16), being 29 mg/dL for AZO (4/36), and 31 mg/dL for NAZO (3/15). The median SDMA measured in M1R was 17 µg/dL (15/16), with AZO being 31 µg/dL (3/15), and NAZO being 16.5 µg/dL (12/15); and in M2, SDMA was 12 µg/dL (16/16), with AZO being 12.5 µg/dL (4/16), and NAZO being 12 µg/dL (12/16). The median UPC measured in M1 was 1.15 (10/36), with AZO being 0.25 (1/10), and NAZO being 1.38 (9/10); and in M2, it was 0.2 (13/16), being 0.1 in AZO (4/13), and 0.2 (9/16) in NAZO. For SBP, in M1, it was 118 mmHg (30/36), with AZO being 102 mmHg (10/30) and 133 mmHg in NAZO (20/30); and in M2 142.5 mmHg (12/16), being 155 mmHg for AZO (4/12), and 140 mg/dL for NAZO (8/12). When comparing animals with open and closed cervixes, a difference was found between SDMA measurements (p = .001). There was a distinction between PI and RI of the left and right kidneys consecutively (p = .007; p = .033; p = .019; p = .041). Correlations found in M1: SDMA × PI RIM DIR (r = 0.873; p = .002), SDMA × PSV RIM ESQ (r = 0.840; p = .004), SDMA × EDV RIM ESQ (r = 0.675; p = .046). With this study, we conclude a return to normality of renal biomarkers and clinical parameters after six months. Yet, there is a persistence of Doppler velocimetric measurements between the two moments. Thus, this parameter is not suitable for identifying and classifying chronic kidney injury in bitches with pyometra.

Comparison between ultrasonography and computed tomography for measuring skeletal muscle mass in critically ill patients with different body mass index.

BACKGROUND & AIM: Among critical patients, there is an early onset of changes in both the quantity and quality of muscle mass. It is essential to find tools that promptly identify this muscle mass loss. The aim of this study was to compare the ultrasonography of the quadriceps femoris to the gold standard, thigh computed tomography (CT) for assessing the musculature of critically ill patients with different body mass index who have suffered traumatic brain injury. METHODS: This is a prospective validation study in an Intensive Care Unit (ICU) specialized in trauma care, located at a tertiary teaching hospital. Our study involved a convenience sample of patients. Sequential ultrasound and CT scans were performed at three distinct time intervals: upon admission, between 24 and 96 h' post-admission, and finally, between 96 and 168 h' post-admission. For all ultrasound measurements, we conducted simultaneous quadriceps CT measurements. The correlation between measurements obtained by ultrasound and computed tomography at three different times and in three BMI ranges was analyzed, in individuals with normal weight, overweight and obese. RESULTS: Results: We analyzed 252 images in 49 patients in time 1, 40 patients in time 2, and 37 in time 3 to compare the thickness quadriceps muscle using US and CT. Of these, 18 patients had a BMI ≤ 24.9 kg/m2 (normal weight), 18 patients from 25 to 29.9 kg/m2 (overweight), and 8 patients had a BMI ≥ 30 kg/m2 (obese). The mean age was 37 years, the majority (94%) were male and the main comorbidities were: hypertension 12%, diabetes 4% and 14% smoking. The results revealed minor discrepancies between measurements obtained through the two methods, these changes were not influenced by the body mass index, with these variations being practically insignificant in the context of clinical application. Thus, the correlation and concordance between the values obtained found a strong positive correlation with good limits of agreement. The Spearman's correlation coefficients obtained were r = 0.89, 0.91 and 0.88, p < 0.01 at T1, T2 and T3 respectively for normal weight, r = 0.91, 0.80 and 0.81, p < 0.01 at T1, T2 and T3 respectively for overweight and r = 0.89, 0.94 and 0.84, p < 0.01 at T1, T2 and T3 respectively for obesity. In addition to a positive correlation, we observed a high agreement between the methods. The Bland & Altman analysis at time 1 showed, respectively, the bias of 1.46, 2.03 and 0.76. At time 2, the bias was 0.42, 3.11 and 2.12. At time 3, the bias was 2.26, 3.38 and 2.11 mm. CONCLUSION: Our findings suggest that measure femoral quadriceps muscle thickness ultrasound-based exhibits a comparable performance to thigh CT. This conclusion stems from the excellent correlation and good agreement observed between ultrasound and CT, which is considered the gold standard for muscle assessment in critically ill patients. TRIAL REGISTRATION: This clinical trial is registered at REBEC https://ensaiosclinicos.gov.br/ identifier: RBR-2bzspnz. The protocol was approved, on July 30, 2019, by the Research Ethics Committee of the Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto - Trial Registration Number: 3,475,851.

Assessment of the ecological quality status of the Sepetiba Bay (SE Brazil): When metabarcoding meets morphology on foraminifera.

In recent years, the region surrounding Sepetiba Bay (SB; SE Brazil) has become a hub of intense urban expansion and economic exploitation in response to ore transport and industrial and port activities. As a result, contaminants have been introduced into the bay, leading to an overall worsening of the environmental quality. The present work applies for the first time a foraminiferal morphology-based approach (M) and eDNA-based metabarcoding sequencing (G), along with geochemical data to assess the ecological quality status (EcoQS) in the SB. Principal component analysis shows that the eDNA and morphospecies diversity as well as most of the taxa relative abundance decline in response to the environmental stress (ES) gradient related to total organic carbon (TOC) and metal pollution. Based on ecological indices, Exp(H'bc) (G), Exp(H'bc) (M), foraminifera ATZI marine biotic index (Foram-AMBI), Foram Stress Index (FSI), and geochemical indices (TOC and Potential Ecological Risk Index), the lowest values of EcoQS (i.e., bad to moderate) are inferred in the innermost part of the SB. Despite minor discrepancies among the six EcoQS indices, an agreement has been found for 63% of the stations. To improve the agreement between the ecological indices, it is necessary to fill the gap in species ecology; information on the ecology of many species is still unknown. This work reinforces the importance of molecular analysis and morphological methods in environmental impact studies and confirms the reliability of foraminiferal metabarcoding in EcoQS assessment. This is the first study evaluating the EcoQS in the South Atlantic by using combined foraminiferal eDNA metabarcoding with morphological data.

Environmental health practice and quality of Nursing care: a protocol for systematic review

OBJECTIVE: To systematically synthesize studies that analyze the relationship between a healthy practice environment and quality of nursing care in hospital settings; to identify the most commonly used instruments to assess nurses' perceptions of a healthy practice environment; to identify the most commonly used instruments to assess nurses' perceptions of quality of nursing care. METHOD: A systematic literature review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The literature search will be conducted in the principal databases. Review of international scientific articles published in the last ten years, accessed through the database of the Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, on nurses' perceptions of the influence of the environment on healthy nursing practice and quality of care. Inclusion: Articles published after 2012 in Portuguese, Spanish, and English. The identified, selected and included studies will be highlighted for the selection process using the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P). If possible, quantitative data will be pooled into a meta-analysis using the Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument (MASTARI).

Molecular detection of Borrelia sp. in Ornithodoros cavernicolous (Acari: Argasidae) in midwestern Brazil.

Ticks are obligate hematophagous parasites that can transmit to vertebrate hosts several pathogens, including viruses, bacteria, protozoa and helminths. Among these agents, some Borrelia species some Borrelia species cause disease in humans and other vertebrate hosts; therefore, they have medical and veterinary health importance. To gather additional information on Borrelia species in Brazil, the current study aimed to detect the presence of these species in Ornithodoros cavernicolous ticks collected in September 2019 from cement pipes that are used by bats as shelter in a farm located in the midwestern region of Brazil. DNA samples obtained from 18 specimens of O. cavernicolous were subjected of two polymerase chain reactions, targeting a segment of the Borrelia fla B gene. Of the samples tested, only one (6 %, 1/18) showed amplification. The nucleotide sequence of the amplified DNA showed more than 97 % (293/300) identity with a sequence of a Borrelia sp. detected in blood collected from a bat from Macaregua Cave, Colombia, and more than 97 % (292/300) detected in lungs from vampire bats from northeastern Brazil. The deduced amino acid sequences were identical to each other. Phylogenetic analysis indicated that these sequences formed a group of Borrelia species (putatively associated with bats) that is closely related to sequences of Borrelia species of the Lyme borreliosis group. Further investigations should be carried out in order to determine whether the sequence of the Borrelia sp. we found belongs to a new taxon. It will also be of great importance to determine which vertebrate hosts, besides bats, O. cavernicolous ticks can parasitize in order to investigate whether the Borrelia sp. we found may be transmitted and cause disease to the other vertebrate hosts.

Letramento funcional em saúde em renais crônicos: um desafio na abordagem preventiva / Alfabetización funcional en salud en pacientes renales crónicos: un desafío en el enfoque preventivo / Functional health literacy in chronic kidney disease patients: a challenge in the preventive approach

Resumo Objetivo Identificar a prevalência de letramento funcional em saúde e analisar a associação entre os níveis de letramento funcional em saúde e as variáveis clínicas e sociodemográficas em pacientes renais crônicos não dialíticos. Métodos Estudo transversal realizado com 167 renais crônicos em acompanhamento no ambulatório de nefrologia de um município de grande porte do estado de Minas Gerais, Brasil. Para as entrevistas foram utilizados questionário sociodemográfico e clínico e a versão brasileira do Short Assessment of Health Literacy for Portuguese Speaking Adults - SAHLPA-18, para mensurar o letramento funcional em saúde. Realizado estatística descritiva para variáveis sociodemográficas e clínicas; testes de correlação e modelos de regressão lineares para associação com letramento funcional em saúde. Resultados A maior parte dos participantes era idosa com mediana de idade de 68 anos, 33,3% (56 pacientes) se encontravam no estágio 3B da doença renal crônica e 53,9% (90 pacientes) apresentaram letramento funcional em saúde inadequado. Não houve associação entre os níveis de letramento funcional em saúde e as variáveis clínicas. A maioria referiu não usar internet e o estágio mais avançado da doença renal crônica apresentou menores escores de letramento. Piores escores de letramento funcional em saúde também foi identificado naqueles com menor renda. Conclusão A maioria dos participantes apresentou letramento funcional em saúde inadequado. As variaveis clínicas não foram preditoras dos ecores de letramento. No entanto, escores mais baixos de letramento em saúde foram identificados naqueles em estágio mais avancado da doença renal, menor renda e menor uso da internet.

Resumen Objetivo Identificar la prevalencia de la alfabetización funcional en salud y analizar la asociación entre los niveles de alfabetización funcional en salud y las variables clínicas y sociodemográficas en pacientes renales crónicos no dializados. Métodos Estudio transversal realizado con 167 pacientes renales crónicos con seguimiento en consultorios externos de nefrología de un municipio de gran porte del estado de Minas Gerais, Brasil. Para las entrevistas se utilizó un cuestionario sociodemográfico y clínico y la versión brasileña del Short Assessment of Health Literacy for Portuguese Speaking Adults - SAHLPA-18, para medir la alfabetización funcional en salud. Se realizó estadística descriptiva para variables sociodemográficas y clínicas, pruebas de correlación y modelos de regresión lineales para asociación con alfabetización funcional en salud. Resultados La mayoría de los participantes eran personas mayores de 68 años de mediana de edad, el 33,3 % (56 pacientes) se encontraba en la etapa 3B de la enfermedad renal crónica y el 53,9 % (90 pacientes) presentó alfabetización funcional en salud inadecuada. No hubo asociación entre los niveles de alfabetización funcional en salud y las variables clínicas. La mayoría relató que no usaba internet y la etapa más avanzada de la enfermedad renal crónica presentó menor puntaje de alfabetización. Se identificaron peores puntajes de alfabetización funcional en salud en aquellos con menores ingresos. Conclusión La mayoría de los participantes presentó alfabetización funcional en salud inadecuada. Las variables clínicas no fueron predictoras de los puntajes de alfabetización. Sin embargo, se identificaron puntajes más bajos de alfabetización en salud en aquellos en etapa más avanzada de la enfermedad renal, con menores ingresos y menor uso de internet.

Abstract Objective To identify the prevalence of functional health literacy and analyze the association between functional health literacy levels and clinical and sociodemographic variables in non-dialysis chronic kidney disease patients. Methods This is a cross-sectional study carried out with 167 chronic kidney disease patients being monitored at the nephrology outpatient clinic of a large city in the state of Minas Gerais, Brazil. For the interviews, a sociodemographic and clinical questionnaire and the Brazilian version of the Short Assessment of Health Literacy for Portuguese Speaking Adults (SAHLPA-18) were used to measure functional health literacy. Descriptive statistics were performed for sociodemographic and clinical variables, and correlation tests and linear regression models for association with functional health literacy. Results Most participants were older adults with a median age of 68 years, 33.3% (56 patients) were in stage 3B of chronic kidney disease and 53.9% (90 patients) had inadequate functional health literacy. There was no association between functional health literacy levels and clinical variables. The majority reported not using the internet and the more advanced stage of chronic kidney disease had lower literacy scores. Worse functional health literacy scores were also identified in those with lower income. Conclusion Most participants had inadequate functional health literacy. Clinical variables were not predictors of literacy scores. However, lower health literacy scores were identified in those with more advanced stage kidney disease, lower income and less internet use.