Analyzing the safety of the parasiticide fungus Mucor circinelloides: first insights on its virulence profile and interactions with the avian gut microbial community.

Parasiticide fungi are considered an accurate, sustainable, and safe solution for the biocontrol of animal gastrointestinal (GI) parasites. This research provides an initial characterization of the virulence of the native parasiticide fungus Mucor circinelloides (FMV-FR1) and an assessment of its impact on birds' gut microbes. The genome of this fungus was sequenced to identify the genes coding for virulence factors. Also, this fungus was checked for the phenotypic expression of proteinase, lecithinase, DNase, gelatinase, hemolysin, and biofilm production. Finally, an in vivo trial was developed based on feeding M. circinelloides spores to laying hens and peacocks three times a week. Bird feces were collected for 3 months, with total genomic DNA being extracted and subjected to long-read 16S and 25S-28S sequencing. Genes coding for an iron permease (FTR1), iron receptors (FOB1 and FOB2), ADP-ribosylation factors (ARFs) (ARF2 and ARF6), and a GTPase (CDC42) were identified in this M. circinelloides genome. Also, this fungus was positive only for lecithinase activity. The field trial revealed a fecal microbiome dominated by Firmicutes and Proteobacteria in laying hens, and Firmicutes and Bacteroidetes in peacocks, whereas the fecal mycobiome of both bird species was mainly composed of Ascomycetes and Basidiomycetes fungi. Bacterial and fungal alpha-diversities did not differ between sampling time points after M. circinelloides administrations (P = 0.62 and P = 0.15, respectively). Although findings from this research suggest the lack of virulence of this M. circinelloides parasiticide isolate, more complementary in vitro and in vivo research is needed to conclude about the safety of its administration to birds, aiming at controlling their GI parasites.IMPORTANCEA previous study revealed that the native Mucor circinelloides isolate (FMV-FR1) can develop parasiticide activity toward coccidia oocysts, one of the most pathogenic GI parasites in birds. However, ensuring its safety for birds is of utmost importance, namely by studying its virulence profile and potential effect on commensal gut microbes. This initial study revealed that although this M. circinelloides isolate had genes coding for four types of virulence factors-iron permease, iron receptors, ADP-ribosylation factors, and GTPase-and only expressed phenotypically the enzyme lecithinase, the administration of its spores to laying hens and peacocks did not interfere with the abundances and diversities of their gut commensal bacteria and fungi. Although overall results suggest the lack of virulence of this M. circinelloides isolate, more complementary research is needed to conclude about the safety of its administration to birds in the scope of parasite biocontrol programs.

O percurso pela atenção à crise em saúde mental na cidade do Rio de Janeiro / The journey through mental health crisis care in the city of Rio de Janeiro

Resumo O conceito de crise em saúde metal envolve uma complexa formulação multidimensional, forjada no contexto da Reforma Psiquiátrica Brasileira, que nem sempre é tomado de maneira unívoca pelos envolvidos. Contudo, há de se considerar uma rede capaz de dar respostas adequadas sobre como acolher essa situação, de maneira que o trabalho em rede é uma condição essencial dessa abordagem. Este artigo traz a discussão do manejo da crise em saúde mental nos Centros de Atenção Psicossocial III (CAPS III) do município do Rio de Janeiro, Brasil, a partir da perspectiva dos gestores de saúde de nível central e local, realizada por meio de entrevistas semiestruturadas e analisadas com base na Teoria da Estruturação de Giddens. Este trabalho identificou que o Rio de Janeiro apresenta um modelo de atenção à crise estruturado em rede de atenção centralizada e rede integrada, uma vez que apresenta grande integração da rede de urgência com a Rede de Atenção Psicossocial (RAPS), sobretudo com os CAPS III, e as situações de crises são atendidas preferencialmente em serviços específicos para seu atendimento. Ainda assim, pela perspectiva de Giddens, os CAPS III têm legitimidade para cumprir o papel de atenção à crise em saúde mental.

Abstract The concept of crisis in mental health involves a complex multidimensional formulation, forged in the context of the Brazilian Psychiatric Reform, which is not always taken unequivocally by those involved. However, it is necessary to consider a network capable of providing adequate answers on how to provide care in this situation; thus, networking is an essential condition of this approach. This article discusses the management of the mental health crisis in Psychosocial Care Centers III (CAPS III) in the municipality of Rio de Janeiro, Brazil, from the perspective of central and local health care managers, via semi-structured interviews and analysis based on Giddens' Theory of Structuring. This study found that the municipality of Rio de Janeiro adopts a crisis care model structured into a centralized care network and integrated network, with an emergency network highly integrated with the Psychosocial Attention Network (RAPS), especially with the CAPS III, and the crisis situations are cared for preferably in specific services. Still, from Giddens' perspective, CAPS III have the legitimacy to provide care toward mental health crisis.

What If Root Nodules Are a Guesthouse for a Microbiome? The Case Study of Acacia longifolia.

Acacia longifolia is one of the most aggressive invaders worldwide whose invasion is potentiated after a fire, a common perturbation in Mediterranean climates. As a legume, this species establishes symbioses with nitrogen-fixing bacteria inside root nodules; however, the overall microbial diversity is still unclear. In this study, we addressed root nodules' structure and biodiversity through histology and Next-Generation Sequencing, targeting 16S and 25S-28S rDNA genes for bacteria and fungi, respectively. We wanted to evaluate the effect of fire in root nodules from 1-year-old saplings, by comparing unburnt and burnt sites. We found that although having the same general structure, after a fire event, nodules had a higher number of infected cells and greater starch accumulation. Starch accumulated in uninfected cells can be a possible carbon source for the microbiota. Regarding diversity, Bradyrhizobium was dominant in both sites (ca. 77%), suggesting it is the preferential partner, followed by Tardiphaga (ca. 9%), a non-rhizobial Alphaproteobacteria, and Synechococcus, a cyanobacteria (ca. 5%). However, at the burnt site, additional N-fixing bacteria were included in the top 10 genera, highlighting the importance of this process. Major differences were found in the mycobiome, which was diverse in both sites and included genera mostly described as plant endophytes. Coniochaeta was dominant in nodules from the burnt site (69%), suggesting its role as a facilitator of symbiotic associations. We highlight the presence of a large bacterial and fungal community in nodules, suggesting nodulation is not restricted to nitrogen fixation. Thus, this microbiome can be involved in facilitating A. longifolia invasive success.

Pediatric unplanned extubation risk score: A predictive model for risk assessment.

BACKGROUND: Unplanned extubation is one of the most common preventable adverse events associated with invasive mechanical ventilation. OBJECTIVE: This research study aimed to develop a predictive model to identify the risk of unplanned extubation in a pediatric intensive care unit (PICU). METHODS: This single-center, observational study was conducted at the PICU of the Hospital de Clínicas. Patients were included based on the following criteria: aged between 28 days and 14 years, intubated, and using invasive mechanical ventilation. RESULTS: Over 2 years, 2,153 observations were made using the Pediatric Unplanned Extubation Risk Score predictive model. Unplanned extubation occurred in 73 of 2,153 observations. A total of 286 children participated in the application of the Risk Score. This predictive model was created to categorize the following significant risk factors: 1) inadequate placement and fixation of the endotracheal tube (odds ratio 2.00 [95%CI,1.16-3.36]), 2) Insufficient level of sedation (odds ratio 3.00 [95%CI,1.57-4.37]), 3) age ≤ 12 months (odds ratio 1.27 [95%CI,1.14-1.41]), 4) presence of airway hypersecretion (odds ratio 11.00 [95%CI,2,58-45.26]) inadequate family orientation and/or nurse to patient ratio (odds ratio 5.00 [95%CI,2.64-7.99]), and 6) weaning period from mechanical ventilation (odds ratio 3.00 [95%CI,1.67-4.79]) and 5 risk enhancement factors. CONCLUSIONS: The scoring system demonstrated effective sensitivity for estimating the risk of UE with the observation of six aspects, which overlap as an isolated risk factor or are associated with a risk enhancement factors.

Trajetorias: a dataset of environmental, epidemiological, and economic indicators for the Brazilian Amazon.

The Trajetorias dataset is a harmonized set of environmental, epidemiological, and poverty indicators for all municipalities of the Brazilian Legal Amazon (BLA). This dataset is the result of a scientific synthesis research initiative conducted by scientists from several natural and social sciences fields, consolidating multidisciplinary indicators into a coherent dataset for integrated and interdisciplinary studies of the Brazilian Amazon. The dataset allows the investigation of the association between the Amazonian agrarian systems and their impacts on environmental and epidemiological changes, furthermore enhancing the possibilities for understanding, in a more integrated and consistent way, the scenarios that affect the Amazonian biome and its inhabitants.

Tratamento para mulheres que usam drogas: uma crítica sob a perspectiva do feminismo decolonial / Tratamiento para mujeres que usan drogas: una crítica desde la perspectiva del feminismo descolonial / Treatment for women who use drugs: a critique from the perspective of decolonial feminism

Resumo Este artigo realiza revisão sistemática sobre o tratamento para o uso de drogas por mulheres e aponta lacunas nessa literatura a partir de uma perspectiva feminista decolonial. Foram coletados trabalhos escritos em inglês, português e espanhol publicados entre os anos de 2010 e 2019. Os resultados apontam para a influência dos estigmas sociais, de atitudes julgadoras dos profissionais e da família e a importância de considerar as necessidades sociais e de saúde através de um cuidado singularizado. No entanto, poucos trabalhos sinalizam o fato de que essas mulheres vivem em sociedades sexistas e para o modo como gênero, raça e classe influenciam nos usos de drogas e no tratamento. Por fim, destacamos contribuições do feminismo decolonial para a leitura do fenômeno do uso de drogas e como essa articulação pode fundamentar uma atenção psicossocial nos moldes de uma Reforma Psiquiátrica Antimanicomial feminista e antirracista.

Resumen Este artículo realiza una revisión sistemática sobre el tratamiento del consumo de drogas por parte de mujeres y señala vacíos en esta literatura desde una perspectiva feminista descolonial. Se recogieron artículos escritos en inglés, portugués y español publicados entre 2010 y 2019. Los resultados apuntan a la influencia de los estigmas sociales, las actitudes críticas de los profesionales y familiares y la importancia de considerar las necesidades sociales y de salud a través de una atención singular. Sin embargo, pocos estudios señalan el hecho de que estas mujeres viven en sociedades sexistas y cómo el género, la raza y la clase influyen en el uso y el tratamiento de las drogas. Finalmente, destacamos los aportes del feminismo descolonial a la lectura del fenómeno del consumo de drogas y cómo esta articulación puede apoyar la atención psicosocial en la línea de una Reforma Psiquiátrica Anti-asilo feminista y antirracista.

Abstract This article performs a systematic review on treatment for drug use by women and points out gaps in this literature from a decolonial feminist perspective. Papers written in English, Portuguese and Spanish published between the years 2010 and 2019 were collected. The results point to the influence of social stigmas, judgmental attitudes of professionals and family and the importance of considering social and health needs through a personalized care. However, few studies will point to the fact that these women live in sexist societies and how gender, race and class influence drug use and treatment. Finally, we highlight contributions from decolonial feminism to the reading of the phenomenon of drug use and how this articulation can support psychosocial care along the lines of a feminist and anti-racist Anti-asylum Psychiatric Reform.

Mastadenovirus Molecular Diversity in Waste and Environmental Waters from the Lisbon Metropolitan Area.

In face of the absence of epidemiological data regarding the circulation of human adenoviruses (HAdV) in Portugal, this study aimed at the evaluation of their molecular diversity in waste and environmental waters in the Lisbon Metropolitan Area (LMA). Using samples collected between 2018 and 2021, the HAdV hexon protein-coding sequence was partially amplified using three nested touch-down PCR protocols. The amplification products obtained were analyzed in parallel by two approaches: molecular cloning followed by Sanger sequencing and Next-Generation Sequencing (NGS) using Illumina® sequencing. The analysis of NGS-generated data allowed the identification of a higher diversity of HAdV-A (19%), -B (1%), -C (3%), -D (24%), and -F (25%) viral types, along with murine adenovirus (MAdV-2; 30%) in the wastewater treatment plant samples. On the other hand, HAdV-A (19%), -D (32%), and -F (36%) were identified in environmental samples, and possibly MAdV-2 (14%). These results demonstrate the presence of fecal contamination in environmental waters and the assessment of the diversity of this virus provides important information regarding the distribution of HAdV in LMA, including the detection of HAdV-F41, the most frequently reported in water worldwide.

Are Coping Strategies, Emotional Abilities, and Resilience Predictors of Well-Being? Comparison of Linear and Non-Linear Methodologies.

Emotional intelligence (EI), problem-oriented coping, and resilience have been deeply studied as psychological predictors of wellbeing in stressful daily situations. The aim was to find out whether coping, EI, and resilience are predictors of well-being, using two statistical methodologies (hierarchical regression models and comparative qualitative models). With this objective in mind, we built an online evaluation protocol and administered it to 427 Spanish people, exploring these variables through a selection of validated tests. The extracted data were studied using linear predictive tests (hierarchical regression models), as well as fuzzy set qualitative comparative analysis. We found that EI variables had important associations with coping, positive affect, negative affect, and life satisfaction, and also acted as relevant predictors for all of them, together with resilience and problem-oriented coping. The fuzzy set qualitative comparative analysis showed a series of logical combinations of conditional causes and results of each potential configuration for these variables. The interaction between the presence of EI, resilience, and coping resulted in high levels of well-being. On the other hand, the presence of high emotional attention in interaction with low resilience and low coping abilities resulted in low well-being. These results increase knowledge about protective factors and allow for the creation of intervention programmes to enhance them.

Nanofiltration as an Efficient Tertiary Wastewater Treatment: Elimination of Total Bacteria and Antibiotic Resistance Genes from the Discharged Effluent of a Full-Scale Wastewater Treatment Plant.

Wastewater reuse for agricultural irrigation still raises important public health issues regarding its safety, due to the increasing presence of emerging contaminants, such as antibiotic resistant bacteria and genes, in the treated effluents. In this paper, the potential for a commercial Desal 5 DK nanofiltration membrane to be used as a tertiary treatment in the wastewater treatment plants for a more effective elimination of these pollutants from the produced effluents was assessed on laboratory scale, using a stainless steel cross-flow cell. The obtained results showed high concentrations of total bacteria and target carbapenem and (fluoro)quinolone resistance genes (blaKPC, blaOXA-48, blaNDM, blaIMP, blaVIM, qnrA, qnrB and qnrS) not only in the discharged, but also in the reused, effluent samples, which suggests that their use may not be entirely safe. Nevertheless, the applied nanofiltration treatment achieved removal rates superior to 98% for the total bacteria and 99.99% for all the target resistance genes present in both DNA and extracellular DNA fractions, with no significant differences for these microbiological parameters between the nanofiltered and the control tap water samples. Although additional studies are still needed to fully optimize the entire process, the use of nanofiltration membranes seems to be a promising solution to substantially increase the quality of the treated wastewater effluents.

Time Trend of Overweight and Obesity in Adults from Rio Branco, Acre, Western Brazilian Amazon (2006-2020).

This study aimed to analyze overweight trend and obesity in adults from Rio Branco, Acre, Western Brazilian Amazon, from 2006 to 2020. This is a time series study, with data from Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (VIGITEL). To estimate annual percentage change (APC) and 95% confidence intervals, the software Jointpoint Regression Analysis v.4.6.0.0., was used. In Rio Branco, overweight prevalence ranged from 44.0% in 2006 to 58.9% in 2020, with a bigger frequency among men than that among women. Obesity prevalence has increased from 12.5% in 2006 to 21.4% in 2020, similar between both sexes. From 2006 to 2020, overweight APC was 5.2% (95% CI: 1.4; 9.1) by 2010, and decreased to 1.3% by 2020. Public policies to control obesity and its risks must be both, implemented as strengthened.

O circuito manicomial de atenção: patologização, psicofarmaceuticalização e estigma em retroalimentação / The asylum circuit of care: pathologization, psychopharmaceuticalization and stigma in feedback / El circuito manicomial de atención: patologización, psicofarmacologización y estigma en retroalimentación

Nas reformas psiquiátricas, a ruptura com o manicômio é um problema não apenas legal, mas cultural. Basaglia alertava para o "circuito de controle" na sociedade que define os comportamentos normais e patológicos, punindo e excluindo aqueles que não podem ser domesticados ou neutralizados. Neste artigo, utilizamos dados empíricos para propor o conceito de circuito manicomial do cuidado, desenvolvendo uma configuração própria de institucionalização pela articulação dos processos de patologização, psicofarmaceuticalização e estigma. Esse conjunto de processos garante uma base cultural para os mecanismos de perpetuação do manicômio, pois produz sociabilidades e sensibilidades manicomiais. O circuito manicomial de cuidado opera a céu aberto, por intermédio de um conjunto de discursos, práticas e tecnologias que trabalham de modo interdependente com o manicômio, com a especial participação da família, instituição que tende a manipular psicofármacos ao modo de tecnologias morais. Identificamos três atos que compõem o circuito manicomial do cuidado, por meio da análise hermenêutica de base ricoeuriana de dois casos que selecionamos de uma pesquisa etnográfica sobre trajetórias de (des)institucionalização de pessoas com sofrimento psíquico: a) o processo de alimentação da identidade patológica; b) a espiral do controle: psicofármacos reforçando o estigma patologizante; e c) a domesticação extramuros da solução-manicômio. Com esta análise, busca-se suprir uma das lacunas que têm sido observadas em estudos que examinam como os contextos de Reforma Psiquiátrica têm se ocupado insuficientemente da compreensão de como dinâmicas sociais e culturais impõem desafios ao trabalho de desinstitucionalização.(AU)

In psychiatric reforms, breaking away from the asylum is not only a legal issue, but also a cultural one. Basaglia warned of the "control circuit" in society that defines normal and pathological behaviors, punishing and excluding those who cannot be domesticated or neutralized. In this article, we used empirical data to propose the concept of asylum care circuit, developing its own institutionalization configuration by articulating processes of pathologization, psychopharmaceuticalization, and stigma. This ensemble of processes guarantees a cultural basis to the mechanisms for the asylum's perpetuation, since it produces asylum sociabilities and sensibilities. The asylum care circuit operates in the open, with a set of discourses, practices, and technologies, which work interdependently with the asylum, with special participation of the family, an institution that tends to manipulate psychiatric drugs in the manner of moral technologies. We identified three integral moments that integrate this circuit of care, by Ricoeur-based hermeneutic analysis of two cases we selected from an ethnographic research on trajectories of (de)institutionalization of people suffering psychological distress: a) the bolstering process of pathological identities, b) the control spiral: psychotropic drugs retro-feeding pathologizing stigma, and c) the out-of-the-asylum domestication of the asylum-solution. With this analysis, we seek to fill one of the gaps observed in studies that examine how the contexts of psychiatric reform have insufficiently dealt with understanding how social and cultural dynamics impose challenges to the work of deinstitutionalization.(AU)

En las reformas psiquiátricas, la ruptura con el manicomio no es solo un problema legal, sino cultural. Basaglia advirtió sobre el "circuito de control" en la sociedad que define comportamientos normales y patológicos, castigando y excluyendo a aquellos que no pueden ser domesticados o neutralizados. En este artículo, basado en datos empíricos, proponemos el concepto de circuito manicomial de atención, desarrollando su propia configuración de institucionalización mediante la articulación de los procesos de patologización, psicofarmacologización y estigma. Este proceso propicia una base cultural para los mecanismos de perpetuación del manicomio, ya que produce sociabilidad y sensibilidad al manicomio. El circuito manicomial de cuidado opera mediante discursos, prácticas y tecnologías interdependientes de él, y cuenta con la participación especial de la familia, institución que tiende a manipular los psicofármacos en forma de tecnologías morales. Identificamos tres actos que conforman el circuito manicomial de cuidado a partir de un análisis hermenéutico ricoeuriano de dos casos que seleccionamos de una investigación etnográfica sobre trayectorias de (des)institucionalización de personas con sufrimiento psíquico: a) El proceso de alimentación de la identidad patológica, b) el espiral de control: psicofármacos que refuerzan el estigma patologizante, y c) la domesticación extramuros de la solución-manicomio. Este análisis permite suplir una de las lagunas que se ha observado en los estudios de los contextos de la Reforma Psiquiátrica, debido a la insuficiente preocupación por comprender cómo las dinámicas sociales y culturales imponen desafíos al trabajo de desinstitucionalización.(AU)

Economia solidária e saúde mental: relato de experiência de práticas virtuais / Solidarity economy and mental health: experience report of virtual practices

RESUMO A conexão entre saúde mental e trabalho possui uma extensa trajetória, em muitos momentos implicando opressão e cerceamento da liberdade. Buscando um novo lugar do trabalho para usuários da Rede de Atenção Psicossocial (Raps), a economia solidária vem se destacando enquanto possibilidade múltipla no combate ao estigma, enfatizando a autonomia e a emancipação das pessoas por meio da solidariedade e do cooperativismo. Dessa forma, o presente artigo visa trazer um relato de experiência interprofissional sobre o projeto de extensão universitária de economia solidária e saúde mental. Trata-se de um trabalho descritivo, desenvolvido com base na observação participante e analisado à luz de Mikhail Bakhtin e Paulo Freire. Conclui-se que o presente projeto é de suma importância na construção de saberes múltiplos, visto que contempla profissionais das artes plásticas e cênicas, saúde e artesãos. Sendo assim, a prática formativa de diversos atores favorece um fazer potente por meio da arte, cultura e trabalho para uma gestão que objetiva a inclusão social, a reflexão crítica e a autonomia no campo da saúde mental.

ABSTRACT The connection between mental health and work has a long trajectory, often involving oppression and restriction of freedom. Seeking a new place of work for users of the Psychosocial Care Network (RAPS), the solidarity economy has been highlighted as a multiple possibility in the fight against the stigma, emphasizing people's autonomy and emancipation through solidarity and cooperativism. Thus, this article aims to bring an interprofessional experience report on a universitary extension project of Solidarity Economy in Mental Health. This is a descriptive work, developed based on participant observation and analyzed in the light of Mikhail Bakhtin and Paulo Freire. It is concluded that this project is of paramount importance in the construction of multiple knowledge, as it includes professionals in the plastic and performing arts, health, and artisans. Thus, the training practice of several actors contemplates a powerful action through art, culture, and work for a management that aims at social inclusion, critical reflection, and autonomy in the field of mental health.

Human Polyomaviruses (HPyV) in Wastewater and Environmental Samples from the Lisbon Metropolitan Area: Detection and Genetic Characterization of Viral Structural Protein-Coding Sequences.

Due to the lack of reliable epidemiological information regarding the geographic distribution and genetic diversity of human polyomaviruses (HPyV) in Portugal, we addressed these issues in this initial study by focusing on the Lisbon Metropolitan area, the most populated and culturally diverse hub in the country. The HPyV structural protein-coding sequence was partially amplified using two touch-down PCR multiplex protocols, starting from water samples, collected between 2018 and 2020, where viral genomes were detected. The obtained results disclosed the frequent detection of HPyV1, HPyV2, HPyV5, and HPyV6 in 35.3% (n = 6), 29.4% (n = 5), 47.1% (n = 8) and 29.4% (n = 5), respectively, of the water samples analyzed. The sequences assigned to a given viral species did not segregate to a single genotype, this being especially true for HPyV2 for which five genotypes (including a putative new genotype 9) could be identified. The phylogenetic trees obtained for HPyV5 and HPyV6 had less resolving power than those obtained for HPyV1/HPyV2, but both viruses were shown to be genetically diverse. This analysis emphasizes the epidemiological helpfulness of these detection/genetic characterization studies in addition to being relevant tools for assessment of human waste contamination.

Environmental and Pathogenic Carbapenem Resistant Bacteria Isolated from a Wastewater Treatment Plant Harbour Distinct Antibiotic Resistance Mechanisms.

Wastewater treatment plants are important reservoirs and sources for the dissemination of antibiotic resistance into the environment. Here, two different groups of carbapenem resistant bacteria-the potentially environmental and the potentially pathogenic-were isolated from both the wastewater influent and discharged effluent of a full-scale wastewater treatment plant and characterized by whole genome sequencing and antibiotic susceptibility testing. Among the potentially environmental isolates, there was no detection of any acquired antibiotic resistance genes, which supports the idea that their resistance mechanisms are mainly intrinsic. On the contrary, the potentially pathogenic isolates presented a broad diversity of acquired antibiotic resistance genes towards different antibiotic classes, especially ß-lactams, aminoglycosides, and fluoroquinolones. All these bacteria showed multiple ß-lactamase-encoding genes, some with carbapenemase activity, such as the blaKPC-type genes found in the Enterobacteriaceae isolates. The antibiotic susceptibility testing assays performed on these isolates also revealed that all had a multi-resistance phenotype, which indicates that the acquired resistance is their major antibiotic resistance mechanism. In conclusion, the two bacterial groups have distinct resistance mechanisms, which suggest that the antibiotic resistance in the environment can be a more complex problematic than that generally assumed.

Epidemiology, Biodiversity, and Technological Trajectories in the Brazilian Amazon: From Malaria to COVID-19.

The Amazon biome is under severe threat due to increasing deforestation rates and loss of biodiversity and ecosystem services while sustaining a high burden of neglected tropical diseases. Approximately two thirds of this biome are located within Brazilian territory. There, socio-economic and environmental landscape transformations are linked to the regional agrarian economy dynamics, which has developed into six techno-productive trajectories (TTs). These TTs are the product of the historical interaction between Peasant and Farmer and Rancher practices, technologies and rationalities. This article investigates the distribution of the dominant Brazilian Amazon TTs and their association with environmental degradation and vulnerability to neglected tropical diseases. The goal is to provide a framework for the joint debate of the local economic, environmental and health dimensions. We calculated the dominant TT for each municipality in 2017. Peasant trajectories (TT1, TT2, and TT3) are dominant in ca. fifty percent of the Amazon territory, mostly concentrated in areas covered by continuous forest where malaria is an important morbidity and mortality cause. Cattle raising trajectories are associated with higher deforestation rates. Meanwhile, Farmer and Rancher economies are becoming dominant trajectories, comprising large scale cattle and grain production. These trajectories are associated with rapid biodiversity loss and a high prevalence of neglected tropical diseases, such as leishmaniasis, Aedes-borne diseases and Chagas disease. Overall, these results defy simplistic views that the dominant development trajectory for the Amazon will optimize economic, health and environmental indicators. This approach lays the groundwork for a more integrated narrative consistent with the economic history of the Brazilian Amazon.

Development of a Tetraplex qPCR for the Molecular Identification and Quantification of Human Enteric Viruses, NoV and HAV, in Fish Samples.

Human enteric viruses such as norovirus (NoV) and hepatitis A virus (HAV) are some of the most important causes of foodborne infections worldwide. Usually, infection via fish consumption is not a concern regarding these viruses, since fish are mainly consumed cooked. However, in the last years, raw fish consumption has become increasingly common, especially involving the use of seabass and gilthead seabream in dishes like sushi, sashimi, poke, and carpaccio. Therefore, the risk for viral infection via the consumption of raw fish has also increased. In this study, a virologic screening was performed in 323 fish specimens captured along the Portuguese coast using a tetraplex qPCR optimised for two templates (plasmid and in vitro transcribed RNA) to detect and quantify NoV GI, NoV GII and HAV genomes. A difference of approximately 1-log was found between the use of plasmid or in vitro transcribed RNA for molecular-based quantifications, showing an underestimation of genome copy-number equivalents using plasmid standard-based curves. Additionally, the presence of NoV genomic RNA in a pool of seabass brains was identified, which was shown to cluster with a major group of human norovirus sequences from genogroup I (GI.1) by phylogenetic analysis. None of the analysed fish revealed the presence of NoV GII or HAV. This result corroborates the hypothesis that enteric viruses circulate in seawater or that fish were contaminated during their transportation/handling, representing a potential risk to humans through raw or undercooked fish consumption.

Preliminary comparative analysis of the resolving power of COX1 and 16S-rDNA as molecular markers for the identification of ticks from Portugal.

The utility of mitochondrial cytochrome oxidase subunit I (COX1) and 16S ribosomal DNA (16S-rDNA) sequence analyses as a complementary/alternative tool to classical taxonomy, for the identification of some of the most prevalent hard tick species from Portugal was evaluated using BOLD-ID (COX1 only), BLASTn and phylogenetic tree reconstruction based on multiple nucleotide sequence alignments. Both molecular markers proved suitable for identifying ticks to a species level, but specific aspects that limit their resolving power must be considered. Their accuracy of tick identification in all life stages and of the other tick species described in the South of Europe is required.

Diabetic ketoacidosis with acute severe hypertriglyceridaemia-induced pancreatitis as first presentation of type 2 diabetes.

Acute pancreatitis (AP) is an acute destructive inflammatory condition of the pancreas. Hypertriglyceridaemia is the third most common worldwide cause of AP. Although the presentation of hypertriglyceridaemic pancreatitis (HTGP) is usually similar to other forms of AP, it may cause more severe AP and worse symptoms. Therefore, apart from the supportive care and treatment for AP, it is necessary to treat the underlying aetiology. There are no established guidelines for managing HTGP. Many treatment modalities have been reported, including intravenous insulin infusion, heparin and plasmapheresis. Randomised trials comparing their efficacy are lacking. Diabetic ketoacidosis (DKA) may be a risk factor for AP, but it is uncertain if AP triggers DKA or vice versa. Here, we describe a case of a 44-year-old man who presented with DKA concurrent with acute severe HTGP as first manifestation of type 2 diabetes mellitus. He was successfully managed with supportive care and intravenous insulin infusion.

Com o que sonham os loucos? projetos de vida de usuário(a)s de saúde mental / ¿con qué sueñan los locos? proyectos de vida de usuario(a)s de salud mental / What do crazy people dream of? life projects of mental health users

Resumo Este artigo visa a compreender os projetos de vida formulados por pessoas com experiência de sofrimento psíquico grave e uso abusivo de álcool e outras drogas em processo de desinstitucionalização em saúde mental. Para tal, foi desenvolvido um estudo etnográfico, com finalidade de identificar interações entre operadores de desinstitucionalização, que podem ser entendidos como processos, dinâmicas ou ações que atuam sobre o cotidiano e a inserção social desses sujeitos. Pôde-se verificar que a tessitura desses projetos em direção ao futuro se apresenta como um trabalho de cuidado de si nos termos foucaultianos, em que são manejadas diversas acepções sobre a saúde, tal como concebidas por Fassin (2000).

Resumen El artículo tiene como objetivo comprender los proyectos de vida formulados por personas con experiencia de malestar psicológico severo y abuso de alcohol y otras drogas en el proceso de desinstitucionalización en salud mental. Se desarrolló un estudio etnográfico con el objetivo de identificar interacciones entre operadores de desinstitucionalización, que pueden entenderse como procesos, dinámicas o acciones que actúan sobre la vida cotidiana y la inserción social de estos sujetos. Se pudo comprobar que el tejido de estos proyectos hacia el futuro se presenta como un trabajo de cuidado de sí mismo en los términos foucaultianos, en el que se manejan diferentes significados sobre la salud, tal como lo concibe Fassin (2000).

Abstract This article aims to understand life projects formulated by people with experience of severe psychological distress and abuse of alcohol and other drugs in the process of deinstitutionalization in mental health. To this end, an ethnographic study was developed with the aim of identifying interactions between deinstitutionalization operators, which can be understood as processes, dynamics or actions that act on the daily lives and social insertion of these subjects. We observed that the weaving of these projects towards the future is presented as a work of care of the self in Foucaultian terms, in which different meanings about health are handled, as conceived by Fassin (2000).