Bodies-territories and intersectionalities: contributions to public health surveillance. / Corpos-territórios e interseccionalidades: contribuições para uma vigilância popular em saúde.

Multiple bodies and territories experience impacts, conflicts, and socioenvironmental injustices in different ways. The consequences of the neoextractivist accumulation patterns weigh differently on women, especially non-white women. This text brings narratives of a wide range of women who live in different territories and experience different impacts from major undertakings. Through their narratives, we seek to understand how they constitute their territorial bodies; how they are impacted; and how they resist colonialist domination, defend life, and restore health. These impacts affect women's means and ways of life, and restrict their ways of being, power, and knowledge in these territories, rendering them vulnerable, subject to the precariousness of life, immersed in systemic intoxication, reaching situations classified as genocide. Faced with such threats, they manage collective resistance; trigger what makes them active subjectivity; and decolonize themselves as beings, knowledge, and power. In this way they defend life and restore their health and that of their environments. These experiences indicate ways to strengthen public health surveillance perspectives and networks.

Corpos e territórios múltiplos vivenciam de diferentes formas impactos, conflitos e injustiças socioambientais. As consequências do padrão de acumulação neoextrativista recai de modo diferenciado sobre as mulheres, em especial não brancas. Esse texto traz narrativas de mulheres plurais, que vivem em diferentes territórios e que experienciam distintos impactos de grandes empreendimentos. Por meio de suas narrativas, buscamos compreender como constituem seus corpos-territórios, como são impactados e como resistem a dominação colonialista, defendem a vida e restituem a saúde. Os impactos analisados atingem os meios e modos de vida das mulheres, cerceiam suas formas de ser, poder e saber nesses territórios, tornam-nas vulnerabilizadas, sujeitas à precarização dos meios e modos de vida, imersas em intoxicações sistêmicas, chegando a situações classificadas como genocídios. Frente a tais ameaças, elas agenciam a resistência coletiva, acionam o que lhes torna subjetividade ativa, descolonizam-se como ser, saber e poder. Assim defendem a vida e restituem a saúde de si mesmas e de seus ambientes. Essas experiências apontam caminhos para o fortalecimento de perspectivas e redes de vigilância popular em saúde.

Measurement properties of activity monitoring for a rehabilitation (AMoR) platform in post-stroke individuals in a simulated home environment.

AIM: The aim of this study was to evaluate the measurement properties of activity monitoring for a rehabilitation (AMoR) platform for step counting, time spent in sedentary behavior, and postural changes during activities of daily living (ADLs) in a simulated home environment. METHODS: Twenty-one individuals in the post-stroke chronic phase used the AMoR platform during an ADL protocol and were monitored by a video camera. Spearman's correlation coefficient, mean absolute percent error (MAPE), intraclass correlation coefficient (ICC), and Bland-Altman plot analyses were used to estimate the validity and reliability between the AMoR platform and the video for step counting, time spent sitting/lying, and postural changes from sit-to-stand (SI-ST) and sit-to-stand (ST-SI). RESULTS: Validity of the platform was observed with very high correlation values for step counting (rs = 0.998) and time spent sitting/lying (rs = 0.992) and high correlation for postural change of SI-ST (rs = 0.850) and ST-SI (rs = 0.851) when compared to the video. An error percentage above 5% was observed only for the SI-ST postural change (7.13%). The ICC values show excellent agreement for step counting (ICC3, k = 0.999) and time spent sitting/lying (ICC3, k = 0.992), and good agreement for SI-ST (ICC3, k = 0.859) and ST-SI (ICC3, k = 0.936) postural change. Values of the differences for step counting, sitting/lying time, and postural change were within the limits of agreement according to the analysis of the Bland-Altman graph. CONCLUSION: The AMoR platform presented validity and reliability for step counting, time spent sitting/lying, and identification of SI-ST and ST-SI postural changes during tests in a simulated environment in post-stroke individuals.

Vulnerabilities mediating the Healthcare encounter: by an intersectional agency. / Vulnerabilidades mediando o encontro do Cuidado em Saúde: por uma agência interseccional.

This essay elucidates the Healthcare and Intersectionality notions to prompt reflections on the interaction between healthcare professionals and individuals referred to as Nanás: elderly, poor, and Black women who represent a historically marginalized profile throughout Brazilian history. By delving into the arguments about the concept of Intersectionality and the multifaceted Care dimensions, it becomes apparent that there is a pressing need to broaden the perspective on women who access healthcare services, as they are inherently shaped by their life experiences. Moreover, it is imperative to acknowledge how the intersecting factors inherent in their profiles can influence the approach taken by those providing Care, which underscores the essentiality of an intersectional agency on the part of the agents involved in this encounter, namely the Nanás and healthcare workers, to effectively uphold the principles of comprehensiveness and equity within the Unified Health System (SUS).

O presente ensaio articula os conceitos de Cuidado em Saúde e Interseccionalidade para suscitar reflexões sobre o encontro entre o/a trabalhador/a de saúde e aquelas que aqui denominamos uma Naná: uma mulher, negra, idosa e periférica, perfil historicamente vulnerabilizado ao longo da história brasileira. Considerando as argumentações que envolvem o conceito de Interseccionalidade e as diferentes vertentes acerca do Cuidado, observamos a necessidade de se ampliar o olhar sobre estas que buscam os serviços de saúde já atravessadas por suas histórias de vida, e ponderar sobre os atravessamentos que seu perfil pode acionar em quem exerce o Cuidado. Aponta ser primordial uma agência interseccional por parte das/os agentes deste encontro, Nanás e profissionais de saúde, para que se concretizem os princípios de integralidade e equidade no Sistema Único de Saúde (SUS).

Unveiling the antifungal mechanisms of CTP, a new copper(II)-theophylline/1,10-phenanthroline complex, on drug-resistant non-albicans Candida species.

Candida species undeniably rank as the most prevalent opportunistic human fungal pathogens worldwide, with Candida albicans as the predominant representative. However, the emergence of non-albicans Candida species (NACs) has marked a significant shift, accompanied by rising incidence rates and concerning trends of antifungal resistance. The search for new strategies to combat antifungal-resistant Candida strains is of paramount importance. Recently, our research group reported the anti-Candida activity of a coordination compound containing copper(II) complexed with theophylline (theo) and 1,10-phenanthroline (phen), known as "CTP" - Cu(theo)2phen(H2O).5H2O. In the present work, we investigated the mechanisms of action of CTP against six medically relevant, antifungal-resistant NACs, including C. auris, C. glabrata, C. haemulonii, C. krusei, C. parapsilosis and C. tropicalis. CTP demonstrated significant efficacy in inhibiting mitochondrial dehydrogenases, leading to heightened intracellular reactive oxygen species production. CTP treatment resulted in substantial damage to the plasma membrane, as evidenced by the passive incorporation of propidium iodide, and induced DNA fragmentation as revealed by the TUNEL assay. Scanning electron microscopy images of post-CTP treatment NACs further illustrated profound alterations in the fungal surface morphology, including invaginations, cavitations and lysis. These surface modifications significantly impacted the ability of Candida cells to adhere to a polystyrene surface and to form robust biofilm structures. Moreover, CTP was effective in disassembling mature biofilms formed by these NACs. In conclusion, CTP represents a promising avenue for the development of novel antifungals with innovative mechanisms of action against clinically relevant NACs that are resistant to antifungals commonly used in clinical settings.

Feline Leishmaniasis: Evidence-based Treatments and Challenges to be Solved.

Leishmaniasis is a neglected tropical disease caused by protozoa parasites from the Leishmania genus. Vertebrate hosts acquire the infection through the bite of a female sandfly, initiating a complex parasite development cycle. Contrary to previous beliefs regarding cats' resistance, these animals have recently been identified as potential reservoirs for leishmaniasis. Clinical symptoms in cats can manifest in diverse forms, including cutaneous, mucocutaneous, and visceral manifestations. The diagnosis of feline leishmaniasis is complicated by nonspecific symptoms and the relatively lower specificity of serological tests. The recommended treatment for feline leishmaniasis involves the administration of medications; however, success varies in each cat. This review aims to present cases of feline leishmaniasis, highlighting clinical symptoms, diagnostic methods, therapy schedules, and outcomes. Among the 24 cases documented in the available literature, 12 achieved successful treatment without relapses, resulting in a reduced parasite load and improved symptoms. Three cases responded well but presented persistent sequelae. Two feline leishmaniasis cases initially had treatment success but later experienced recurrences. Finally, no response was observed in seven cases, leading to the euthanasia of cats due to ineffectiveness or irregularities along the therapy. Conventional treatments, despite potential hepatotoxicity and nephrotoxicity, exhibit a high efficacy in reducing parasitic load, thereby improving clinical symptoms and increasing the life expectancy of affected cats. Nevertheless, consistent adherence is crucial, as interruptions may render the therapy ineffective and contribute to parasite resistance. Therefore, addressing the challenges associated with feline leishmaniasis treatment necessitates the development of new strategies to ensure a more effective and sustained approach.

Remineralizing effect of the association of nano-hydroxyapatite and fluoride in the treatment of initial lesions of the enamel: A systematic review.

OBJECTIVE: Assessed the effect of dental products containing nano-hydroxyapatite (nano-HA) + fluoride on the remineralization of white spot lesions (WSL) in vivo or in situ. METHODS: Seven databases were explored using a two-pronged approach (intervention/treatment). After screening, full-text assessment, and further exclusion, the qualitative synthesis of five studies (four clinical and one in situ) was performed. Based on the Cochrane collaboration guidelines relevant data of the studies were collected and summarized. The Cochrane risk of bias tool for randomized trials (RoB 2.0) was used to appraise the studies' methodological quality and the GRADE guidelines to assess their level of evidence. The RoB 2.0 domains were rated on their risk of bias (RoB) as low, high, or with some concerns, and an adaptation of the tool was used to the in situ study. RESULTS: The included studies assessed 151 WSL in anterior permanent teeth, on patients with varying ages. The protocol application, treatment length (7d-12 w), and control groups varied greatly between the studies making the performance of a quantitative analysis unfeasible. The general RoB of the clinical studies was classified as being of low risk (n = 2) or some concerns (n = 2). The in situ study was considered as being of low risk. The level of the evidence was moderate. Most of the studies found moderate evidence regarding the superiority of this association in clinical settings. CONCLUSION: Even with the nano-HA + fluoride promising results for the remineralization treatment of WSL, due to the restricted number of studies and types of products, its extended use cannot be recommended based on the current systematic review, especially when considering the moderate level of the evidence found. CLINICAL SIGNIFICANCE: Due to the biocompatibility and higher surface coverage of nano-HA and the remineralization capacity of fluoride formulations, the association of these elements to remineralize WSL has been positively reported. After the collection and qualitative appraise of the data, the clinical evidence of the use of these dental products is promising but limited.

Evaluation of the usability of the Quali+ mobile application for people with high blood pressure.

OBJECTIVE: To evaluate the usability of the "Quali+" mobile application prototype for people with high blood pressure. METHOD: Descriptive, cross-sectional study of heuristic evaluation of a mobile application prototype carried out between June and July 2021, in a university hospital. Participants were 22 people with arterial hypertension in the city of Campina Grande, PB, Brazil. To measure usability, the Smartphone Usability questionnaiRE instrument was applied. Levels (70 points have good usability. Descriptive statistics were used. RESULTS: The overall usability average was 105.8(7.44 points, with the lowest score being 83 and the highest being 113. Usability was at the highest level(80 points). CONCLUSION: The usability evaluation showed that, although it is a prototype, the application has good usability and can be considered for routine use in health self-management. Future research is needed to verify its effectiveness.

Interventions to Change Movement Behaviors After Stroke: A Systematic Review and Meta-analysis.

OBJECTIVE: This systematic review aimed to determine which interventions increase physical activity (PA) and decrease sedentary behavior (SB) based on objective measures of movement behavior in individuals with stroke. DATA SOURCES: The PubMed (Medline), EMBASE, Scopus, CINAHL (EBSCO), and Web of Science databases were searched for articles published up to January 3, 2023. STUDY SELECTION: The StArt 3.0.3 BETA software was used to screen titles, abstracts, and full texts for studies with randomized controlled trial designs; individuals with stroke (≥18 years of age); interventions aimed at increasing PA or decreasing SB; and objective measurement instruments. DATA EXTRACTION: Data extraction was standardized, considering participants and assessments of interest. The risk of bias and quality of evidence of the included studies were assessed. DATA SYNTHESIS: Twenty-eight studies involving 1855 patients were included. Meta-analyses revealed that in the post-stroke acute/subacute phase, exercise interventions combined with behavior change techniques (BCTs) increased both daily steps (standardized mean difference [SMD]=0.65, P=.0002) and time spent on moderate-to-vigorous intensity physical activities (MVPAs) duration of PA (SMD=0.68, P=.0004) with moderate-quality evidence. In addition, interventions based only on BCTs increased PA levels with very low-quality evidence (SMD (low-intensity physical activity)=0.36, P=.02; SMD (MVPA)=0.56, P=.0004) and decreased SB with low-quality evidence (SMD=0.48, P=.03). In the post-stroke chronic phase, there is statistical significance in favor of exercise-only interventions in PA frequency (steps/day) with moderate-quality evidence (SMD=0.68, P=.002). In general, the risk of bias in the included studies was low. CONCLUSIONS: In the acute/subacute phase after stroke, the use of BCTs combined with exercise can increase the number of daily steps and time spent on MVPA. In contrast, in the post-stroke chronic phase, exercise-only interventions resulted in a significant increase in daily steps.

Antifungal potential of the new copper(II)-theophylline/1,10-phenanthroline complex against drug-resistant Candida species.

Candida spp. are the commonest fungal pathogens worldwide. Antifungal resistance is a problem that has prompted the discovery of novel anti-Candida drugs. Herein, 25 compounds, some of them containing copper(II), cobalt(II) and manganese(II) ions, were initially evaluated for inhibiting the growth of reference strains of Candida albicans and Candida tropicalis. Eight (32%) of the compounds inhibited the proliferation of these yeasts, displaying minimum inhibitory concentrations (MICs) ranging from 31.25 to 250 µg/mL and minimum fungicidal concentration (MFCs) from 62.5 to 250 µg/mL. Drug-likeness/pharmacokinetic calculated by SwissADME indicated that the 8 selected compounds were suitable for use as topical drugs. The complex CTP, Cu(theo)2phen(H2O).5H2O (theo = theophylline; phen = 1,10-phenanthroline), was chosen for further testing against 10 medically relevant Candida species that were resistant to fluconazole/amphotericin B. CTP demonstrated a broad spectrum of action, inhibiting the growth of all 20 clinical fungal isolates, with MICs from 7.81 to 62.5 µg/mL and MFCs from 15.62 to 62.5 µg/mL. Conversely, CTP did not cause lysis in erythrocytes. The toxicity of CTP was evaluated in vivo using Galleria mellonella and Tenebrio molitor. CTP had no or low levels of toxicity at doses ranging from 31.25 to 250 µg/mL for 5 days. After 24 h of treatment, G. mellonella larvae exhibited high survival rates even when exposed to high doses of CTP (600 µg/mL), with the 50% cytotoxic concentration calculated as 776.2 µg/mL, generating selectivity indexes varying from 12.4 to 99.4 depending on each Candida species. These findings suggest that CTP could serve as a potential drug to treat infections caused by Candida species resistant to clinically available antifungals.

Orthodontic treatment of a patient with special needs: a case report / Tratamento ortodôntico de um paciente com necessidades especiais: um relato de caso

ABSTRACT This report presents the case of an adult patient with mental and intellectual limitations, whose main complaint was dental aesthetics. Dental treatment was performed at the Piracicaba Dental School and approved by the Ethics Committee (CAAE: 65752322.2.0000.5418). Clinically, the patient had inadequacies in the dental arrangement, with periodontal involvement that put the dental elements at risk. In intraoral clinical aspects, the deficiency was identified as maxillary atresia. The buccolingual inclination of the mandibular anterior teeth highlighted the severe crowding and anterior crossing of these teeth. Dental treatment was carried out aiming at the remission of periodontal and orthodontic problems in an integrated manner and with approaches that allowed greater interaction, participation, and patient compliance during treatment. Supra and subgingival scrapings and extraction of the upper left lateral incisor were performed. After three months of periodontal treatment, orthodontic treatment was started with fixed orthodontic appliances. The main objective was to level and align the teeth in both arches to achieve better aesthetic and functional conditions. Due to the COVID-19 pandemic, treatment has been discontinued. This resulted in the regression of the results obtained, including regarding self-care. People with disabilities require dental care with specific strategies for their needs, which must be carried out by a multidisciplinary team. Despite the access limitation imposed by the pandemic, the patient reestablished his motivation to restart treatment, which was facilitated by the bond of trust established between him and the team.

RESUMO Este relato apresenta o caso de um paciente adulto com limitações mentais e intelectuais, cuja queixa principal era a estética dental. O tratamento odontológico foi realizado na Faculdade de Odontologia de Piracicaba e aprovado pelo Comitê de Ética (CAAE: 65752322.2.0000.5418). Clinicamente, o paciente apresentava inadequações no arranjo dentário, com comprometimento periodontal, que colocava em risco os elementos dentais. Nos aspectos clínicos intrabucais, a deficiência foi identificada como atresia maxilar. A inclinação vestíbulo-lingual dos dentes anteriores inferiores destacou o apinhamento severo e o cruzamento anterior desses dentes. O tratamento odontológico foi realizado visando à remissão dos problemas periodontais e ortodônticos de forma integrada e com abordagens que permitissem maior interação, participação e adesão do paciente durante o tratamento. Foram realizadas raspagens supra e subgengivais e extração do incisivo lateral superior esquerdo. Após três meses de tratamento periodontal, iniciou-se o tratamento ortodôntico com aparelhos ortodônticos fixos. O objetivo principal foi nivelar e alinhar os dentes em ambas as arcadas para alcançar melhores condições estéticas e funcionais. Devido à pandemia de COVID-19, o tratamento foi interrompido. Isso resultou na regressão dos resultados obtidos, inclusive quanto ao autocuidado. As pessoas com deficiência requerem atendimento odontológico com estratégias específicas para suas necessidades, que devem ser realizadas por uma equipe multidisciplinar. Apesar da limitação de acesso imposta pela pandemia, o paciente restabeleceu sua motivação para reiniciar o tratamento, o que foi facilitado pelo vínculo de confiança estabelecido entre ele e a equipe.

Atuação de um programa de extensão em uma comunidade periférica na região nordeste do Brasil / Performance of an extension program in a peripheral community in the northeast region of Brazil / Realización de un programa de extensión en una comunidad periférica de la región noreste de Brasil

Objetivo: Inquérito coproscópico para reavaliar na população do estudo a frequência de parasitos intestinais identificados numa primeira etapa e investigar mudanças nos fatores de risco, adesão ao tratamento e às ações de prevenção e controle de enteroparasitoses. Método:Realização de exames coproscópicos e aplicação de um formulário estruturado para determinar a prevalência de enteroparasitoses e o perfil socioeconômico e sanitário da população de três microáreas do bairro Mangabeira na cidade de Feira de Santana, Bahia. Resultados:Em 2013 (primeiro período do estudo) a prevalência de enteroparasitos foi de 44,3% com maior frequência para Ascaris lumbricoides(32,3%), Trichuris trichiura(25,8%), Schistosoma mansoni(9,7%) e Giardia intestinalis(9,7%). No segundo período (2016) observou-se aumento da frequência do S. mansoni(19,3%) e G. intestinalis(16,1%), além do diagnóstico de Entamoeba histolytica/dispar(3,2%) não identificadas no inquérito anterior. Não foram observadas alterações das variáveis socioeconômicas e sanitárias na população reavaliada. Atividades educativas foram realizadas levando em consideração o perfil epidemiológico da população. Os portadores positivos foram encaminhados para tratamento, porém as taxas de curas foram baixas. Conclusão:Observou-se a necessidade de intensificação da promoção das ações de educação em saúde de forma continuada, associada à melhoria das condições sanitáriase ambientais da comunidade.

Objective: Coproscopic survey to reassess in study population the frequency of intestinal parasites identified in a first stage and investigate changes in risk factors, adherence to treatment and prevention and control for enteroparasitosis Method:Carrying out coproscopic exams and applying a structured form to determine the prevalence of enteroparasitosis and the socioeconomic and health profile of the population of three micro-areas of the Mangabeira neighborhood in city of Feira de Santana, Bahia. Results:In 2013 (first period) the prevalence of enteroparasites was 44.3%, with a higher frequency for Ascaris lumbricoides (32.3%), Trichuris trichiura (25.8%), Schistosoma mansoni (9.7%) and Giardia intestinalis (9.7%). In the second period (2016), an increase in the frequency of S. mansoni (19.3%) and G. intestinalis (16.1%) was observed, in addition to the diagnosis of Entamoeba histolytica/dispar (3.2%) not identified in the previous survey. No changes were observed in socioeconomic and health variables in the reevaluated population. Educational activities were carried out considering the epidemiological profile of the population. Positive carriers were referred for treatment, but cure rates were low. Conclusion:There was a need to intensify the promotion of health education actions on an ongoing basis, associated with improving the sanitary and environmental conditions of the community.

Objetivo: Encuesta coproscópica para reevaluar la población de estudio la frecuencia de parásitos intestinales identificados en una primera etapa e investigar cambios en los factores de riesgo, adherencia al tratamiento y acciones de prevención y control de enteroparasitosis. Método:Realización de exámenes coproscópicos y aplicación de un formulario estructurado para determinar la prevalencia de enteroparasitosis y el perfil socioeconómico y de salud de la población de tres microáreas del barrio Mangabeira de la ciudad de Feira de Santana, Bahía. Resultados:En 2013 la prevalencia de enteroparásitos fue 44,3%, con mayor frecuencia para Ascaris lumbricoides (32,3%), Trichuris trichiura (25,8%), Schistosoma mansoni (9,7%) y Giardia intestinalis (9,7%). En el segundo período se observó un aumento en la frecuencia de S. mansoni (19,3%) y G. intestinalis (16,1%), además Entamoeba histolytica/dispar (3,2%) no identificado en la encuesta anterior. No se observaron cambios en las variables socioeconómicas y de salud en la población reevaluada. Las actividades educativas se realizaron teniendo en cuenta el perfil epidemiológico de la población. Los portadores positivos fueron remitidos para tratamiento, pero las tasas de curación fueron bajas. Conclusión:Necesario intensificar la promoción de acciones de educación en salud de manera continua, asociadas al mejoramiento de las condiciones sanitarias y ambientales de la comunidad.

Micro duelo: adaptação do jogo Yu-Gi-Oh para o ensino da Microbiologia / Micro duel: adaptation of the game Yu-Gi-Oh for teaching Microbiology / Micro duelo: adaptación del juego Yu-Gi-Oh para la enseñanza de Microbiología

Objetivo: Relatar a experiência de professores tutores e professores da Educação Básica, participantes do curso EAD Ensino de Ciências para a Promoção de Saúde na Escola Básica, na construção de um material didático-pedagógico para ser utilizado em sala de aula. Método: Para diversificar a rotina de aulas no ensino de Ciências e Biologia, direcionadas para alunos do ensino médio, os professores da Educação Básica que trabalharam os conteúdos do módulo de Saúde e Educação, desenvolveram um jogo de cartas que aborda a microbiologia, inspirado em Yu-Gi-Oh, uma série animada de mangá (histórias japonesas em quadrinhos), onde os jogadores usam cartas para duelar, em uma batalha simulada. Resultados: O material didático descreve os principais conceitos utilizados nojogo (duelo, pontos de vida, tipos de cartas etc.), as fases do duelo e os passos para iniciar o jogo. As cartas foram adaptadas para os assuntos abordados na microbiologia e continham nome do agente, tipo, descrição, atributo em cores, nível de ação em estrelas, número da carta e os pontos de ataque e de defesa. Conclusão: Espera-se estimular a interação e o aprendizado dos estudantes, através da aquisição de habilidades indispensáveis ao desenvolvimento intelectual e facilitação dos conceitos relacionados à microbiologia.

Objective: Report the experience of tutors and Basic Education teachers, participants in the EAD course Teaching Science for Health Promotion in Basic Schools, in the construction of didactic-pedagogical material to be used in the classroom. Method: To diversify the routine of teaching Science and Biology classes, aimed at high school students, the Basic Education teachers who worked on the contents of the Health and Education module, developed a card game that addresses microbiology, inspired by Yu-Gi-Oh, an animated manga series (Japanese comic books), where players use cards to duel in a simulated battle. Results: The teaching material describes the main concepts used in the game (duel, life points, types of cards, etc.), the phases of the duel and the steps to start the game. The cards were adapted to the subjects covered in microbiology and contained the agent's name, type, description, attribute in colors, action level in stars, card number and attack and defense points. Conclusion: It is expected to stimulate student interaction and learning, through the acquisition of skills essential for intellectual development and facilitation of concepts related to microbiology.

Objetivo: Reportar la experiencia de tutores y docentes de Educación Básica, participantes del curso EADEnseñanza de Ciencias para la Promoción de la Salud en Escuelas Básicas, en la construcción de material didáctico-pedagógico para ser utilizado en aula. Método: Para diversificar la rutina de enseñanza de las clases de Ciencias y Biología, dirigidas a estudiantes de secundaria, los docentes de Educación Básica que trabajaron los contenidos Salud y Educación desarrollaron un juego de cartas que aborda la microbiología, inspirado en Yu-Gi-Oh, una serie animada de manga (cómics japoneses), donde los jugadores usan cartas para batirse en duelo en una batalla simulada. Resultados: El material didáctico describe los principales conceptos utilizados en el juego (duelo, puntos de vida, tipos de cartas, etc.), las fases del duelo y los pasos para iniciar el juego. Las tarjetas estaban adaptadas a los temas tratados en microbiología y contenían el nombre del agente, tipo, descripción, atributo en colores, nivel de acción en estrellas, número de tarjeta y puntos de ataque y defensa. Conclusión: Se espera estimular la interacción y el aprendizaje de los estudiantes, a través de la adquisición de habilidades esenciales para el desarrollo intelectual y la facilitación de conceptos relacionados con la microbiología.

Aplicativo para prevenção de lesão por pressão para cuidadores de idosos / Aplicación para prevención de úlcera por presión para cuidadores de personas mayores / Application to prevent pressure injury in elderly caregivers

Resumo Objetivo Desenvolver e validar o conteúdo de um protótipo de aplicativo móvel sobre Prevenção de Lesão por Pressão (LP) para cuidadores de idosos. Métodos Estudo metodológico de produção tecnológica do tipo protótipo em aplicativo móvel. O desenvolvimento do aplicativo foi guiado pelo modelo de Design Instrucional Contextualizado (DIC). A etapa de validação de conteúdo foi realizada com sete enfermeiros docentes de um curso técnico para cuidador de idosos em uma instituição federal de ensino com a aplicação do instrumento Suitability Assessement of Materials (SAM). Os dados foram analisados usando a estatística descritiva. Resultados O protótipo, que foi nomeado LPPrev, contém informações sobre conceito, estadiamento, causas das LP, principais locais de acometimento, além de lembretes para reposicionar o idoso no leito; há também possibilidade de registro de informações nutricionais, hidratação oral, higiene corporal e íntima e disponibilização de orientações sobre cuidados preventivos. A avaliação de conteúdo obteve 96,6% de concordância entre os docentes, sendo considerado um material de qualidade superior. Conclusão O LPPrev é um protótipo de aplicativo adequadamente estruturado segundo as categorias avaliadas pelo SAM, com informações relevantes aos cuidadores de idosos acamados e dependentes, contribuindo para o conhecimento teórico e cuidados fundamentais na prevenção de lesão por pressão, estando preparado para avançar para as demais etapas do modelo de DIC.

Resumen Objetivo Elaborar y validar el contenido de un prototipo de aplicación móvil sobre la prevención de úlcera por presión (UP) para cuidadores de personas mayores. Métodos Estudio metodológico de producción tecnológica de prototipo en aplicación móvil. El desarrollo de la aplicación fue guiado por el modelo de diseño educativo contextualizado (DEC). La etapa de validación de contenido fue realizada por siete enfermeros docentes de un curso técnico para cuidadores de personas mayores de una institución educativa nacional, mediante la aplicación del instrumento Suitability Assessement of Materials (SAM). Los datos se analizaron con estadística descriptiva. Resultados El prototipo, que fue llamado LPPrev, contiene información sobre el concepto, estadificación, causas de la UP, principales lugares de acometimiento, además de recordatorios para reposicionar a la persona mayor en la cama. También tiene la posibilidad de registrar información nutricional, hidratación oral, higiene corporal e íntima y dispone de instrucciones sobre cuidados preventivos. La evaluación de contenido obtuvo un 96,6 % de concordancia entre los docentes, por lo que es considerado un material de calidad superior. Conclusión El LPPrev es un prototipo de aplicación bien estructurado según las categorías evaluadas por el SAM, con información relevante para los cuidadores de personas mayores encamadas y dependientes. Contribuye para el conocimiento teórico y los cuidados fundamentales para la prevención de úlcera por presión y está preparado para avanzar hacia las siguientes etapas del modelo de DEC.

Abstract Objective To develop and validate the content of a mobile application prototype on Pressure Injury (PI) Prevention for elderly caregivers. Methods Methodological study of prototype-type technological production in mobile application. The application development was guided by the Contextualized Instructional Design (CID) model. The content validation stage was carried out by seven teaching nurses of a technical course for elderly caregivers in a federal educational institution with the application of the Suitability Assessment of Materials (SAM) instrument. Data were analyzed using descriptive statistics. Results The prototype, which was named LPPrev, contains information about the concept, staging, causes of LP, and main affecting sites, in addition to reminders to reposition the elderly in bed; registration of nutritional information, oral hydration, body and intimate hygiene, and guidance on preventive care is also possible. The content evaluation obtained 96.6% of agreement between professors, being considered a material of superior quality. Conclusion LPPrev is an application prototype properly structured according to the categories evaluated by the SAM, with relevant information for caregivers of bedridden and dependent elderly, contributing to theoretical knowledge and fundamental care in the prevention of injury by pressure, being prepared to move on to the other stages of the DIC model.

Evaluation of the usability of the Quali+ mobile application for people with high blood pressure / Evaluación de la usabilidad de la aplicación móvil Quali+ para personas con hipertensión arterial / Avaliação da usabilidade do aplicativo móvel Quali+ para pessoas com hipertensão arterial

ABSTRACT Objective: To evaluate the usability of the "Quali+" mobile application prototype for people with high blood pressure. Method: Descriptive, cross-sectional study of heuristic evaluation of a mobile application prototype carried out between June and July 2021, in a university hospital. Participants were 22 people with arterial hypertension in the city of Campina Grande, PB, Brazil. To measure usability, the Smartphone Usability questionnaiRE instrument was applied. Levels (70 points have good usability. Descriptive statistics were used. Results: The overall usability average was 105.8(7.44 points, with the lowest score being 83 and the highest being 113. Usability was at the highest level(80 points). Conclusion: The usability evaluation showed that, although it is a prototype, the application has good usability and can be considered for routine use in health self-management. Future research is needed to verify its effectiveness.

RESUMEN Objetivo: Evaluar la usabilidad del prototipo de aplicación móvil "Quali+" para personas con hipertensión arterial. Método: Estudio descriptivo, transversal, de evaluación heurística de un prototipo de aplicación móvil realizado entre junio y julio de 2021, en un hospital universitario. Los participantes fueron 22 personas con hipertensión arterial en la ciudad de Campina Grande, PB, Brasil. Para medir la usabilidad se aplicó el instrumento Smartphone Usability QuestionnaiRE. Los niveles ( 70 puntos tienen buena usabilidad. Se utilizó estadística descriptiva. Resultados: Los principales hallazgos del estudio deben presentarse de manera concisa y clara, sin excesivos detalles. Los resultados deben estar alineados con la sección de resultados del artículo completo, proporcionando información más detallada sobre los análisis estadísticos realizados y los principales resultados encontrados. Conclusión: La evaluación de la usabilidad mostró que, aunque se trata de un prototipo, la aplicación tiene una buena usabilidad y puede considerarse para uso rutinario en la autogestión de la salud. Se necesita investigación futura para verificar su eficacia.

RESUMO Objetivo: Avaliar a usabilidade do protótipo de aplicativo móvel "Quali+" para pessoas com hipertensão arterial. Método: Estudo descritivo, transversal, de avaliação heurística de um protótipo de aplicativo móvel realizado entre junho e julho de 2021, em hospital universitário. Participaram 22 pessoas com hipertensão arterial, na cidade de Campina Grande, PB, Brasil. Para mensuração da usabilidade, aplicou-se o instrumento Smartphone Usability questionnaiRE. Níveis (70 pontos apresentam boa usabilidade. Utilizou-se da estatística descritiva. Resultados: A média geral de usabilidade foi 105,8(7,44 pontos, obtiveram-se como menor escore 83 e, maior 113. A usabilidade se enquadrou no nível mais elevado (80 pontos). Conclusão: A avaliação da usabilidade constatou que, ainda que se trate de um protótipo, o aplicativo apresenta boa usabilidade, podendo ser considerado para o uso rotineiro na autogestão em saúde. Pesquisas futuras são necessárias para verificar a eficácia.

Metalloproteinases in Restorative Dentistry: An In Silico Study toward an Ideal Animal Model.

In dentistry, various animal models are used to evaluate adhesive systems, dental caries and periodontal diseases. Metalloproteinases (MMPs) are enzymes that degrade collagen in the dentin matrix and are categorized in over 20 different classes. Collagenases and gelatinases are intrinsic constituents of the human dentin organic matrix fibrillar network and are the most abundant MMPs in this tissue. Understanding such enzymes' action on dentin is important in the development of approaches that could reduce dentin degradation and provide restorative procedures with extended longevity. This in silico study is based on dentistry's most used animal models and intends to search for the most suitable, evolutionarily close to Homo sapiens. We were able to retrieve 176,077 mammalian MMP sequences from the UniProt database. These sequences were manually curated through a three-step process. After such, the remaining 3178 sequences were aligned in a multifasta file and phylogenetically reconstructed using the maximum likelihood method. Our study inferred that the animal models most evolutionarily related to Homo sapiens were Orcytolagus cuniculus (MMP-1 and MMP-8), Canis lupus (MMP-13), Rattus norvegicus (MMP-2) and Orcytolagus cuniculus (MMP-9). Further research will be needed for the biological validation of our findings.

Validation of the hospital resources assessment scale for the preservation of urinary continence in the elderly.

OBJECTIVES: to validate the internal structure of the Hospital Resources Assessment Scale for the Preservation of Urinary Continence in the Elderly. METHODS: validation study of the internal structure of a scale constructed based on the Donabedian conceptual model and an integrative review, with prior content validation. The scale was applied to the target population, and 124 nurses responded to the questionnaire. Exploratory Factor Analysis was performed using the FACTOR software, employing multiple techniques. RESULTS: a factorial model with 11 items organized into two dimensions (support for human resources and material resources) was obtained. The "physical structure" dimension was removed from the initial model and adopted as a complementary checklist to the instrument, as it was not possible to obtain a factorable model with this dimension. CONCLUSIONS: we provide a valid scale that can measure indicators, identifying weaknesses and/or strengths related to hospital resources for the preservation of urinary continence in the elderly.

The impact of obesity on the outcome of periodontal disease treatment: Systematic review and meta-analysis.

Background: Obesity and periodontitis are two commonly occurring disorders that affect a considerable amount of the world's population. Several studies have mentioned that there may be a link between the two. The purpose of this systematic review was to determine whether there was a difference in response to nonsurgical periodontal therapies (NSPTs) between obese and nonobese individuals. Materials and Methods: An online search was assembled with a combination of Medical Subject Headings terms and free-text words of the literature published up to December 2020, to identify interventional studies limited to an adult human population. Titles, abstracts, and finally full texts were scrutinized for possible inclusion by two independent investigators. Reduction in periodontal pocket depth was the primary parameter used to assess the outcome of NSPT. Results: The primary search yielded 639 significant titles and abstracts. After filtering, data extraction, and quality assessment, 34 full-text studies were selected. All studies matching inclusion criteria, suggest a positive association between obesity and periodontal disease. Conclusion: Although a possible correlation exists between periodontitis and obesity, as with other oral-systemic disease implications, some controversy exists. While some studies have reported a distinct correlation between periodontitis and obesity, other papers have suggested only moderate or no association between the two conditions at all. These results advise of a difference between response to NSPT amid obese and nonobese individuals. However, with few quality studies and variable reported findings, there is limited evidence of any significant difference in clinical practice. However, it can be a positive warning that obesity is a risk factor toward the outcome of periodontal disease treatment.

Para além dos limites da saúde: cuidado em perspectiva interdisciplinar / Beyond the limits of health: care from an interdisciplinary perspectivea / Más allá de los límites de la salud: cuidado desde una perspectiva interdisciplinaria

Este relato apresenta reflexões sobre uma experiência interdisciplinar que envolveu idealização, planejamento, organização, realização e divulgação de um evento científico virtual como requisito da disciplina Seminários Avançados de Pesquisa 1, oferecida pelo Programa de Pós-graduação em Informação e Comunicação em Saúde desenvolvido pelo Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, uma das unidades técnico-científicas da Fundação Oswaldo Cruz. Os doutorandos da turma de 2020 promoveram o webinário "Para além dos limites da saúde: cuidado em perspectiva interdisciplinar", como parte da formação acadêmica, e este relato é produto científico daquele evento. Além do desenvolvimento de habilidades e atitudes, essa experiência representou um aprendizado pessoal, intangível e emocional do cuidado para além dos limites da saúde, e também ético sobre as "coisas negligenciadas" e acerca da força dos consensos diante de um cenário complexo marcado por uma pandemia causada pelo vírus SARS-CoV-2, a pandemia de covid-19

This report presents reflections about an interdisciplinary experience that involved the idealization, planning, organization, implementation and dissemination of a virtual scientific event as requisite for the Seminários Avançados de Pesquisa 1 (Advanced Research Seminars 1), one of the disciplines offered by the Programa de Pós-graduação em Informação e Comunicação em Saúde (Postgraduate Program in Health Information and Communication) developed by the Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (Institute of Communication and Scientific and Technological Information in Health), one of the technical-scientific units of the Fundação Oswaldo Cruz (Oswaldo Cruz Foundation). The students who began in 2020 their classes to obtain the PhD Degree promoted the webinar "Beyond the limits of health: care from an interdisciplinary perspective" as part of the academic education, and this report is a scientific product of that event. In addition to the development of skills and attitudes, that experience represented a personal, intangible and emotional learning of the care beyond the limits of health as well as an important ethical learning about the "neglected things" and the strength of consensus in the face of a complex scenario marked by a pandemic caused by the SARS-CoV-2, the Covid-19 pandemic

Este relato presenta reflexiones sobre una experiencia interdisciplinar que implicó la idealización, planificación, organización, realización y difusión de un evento científico virtual como requisito de la disciplina Seminários Avançados de Pesquisa 1 (Seminarios Avanzados de Investigación 1), ofrecida por el Programa de Pós-graduação em Informação e Comunicação em Saúde (Programa de Posgrado en Información y Comunicación en Salud) desarrollado por el Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (Instituto de Comunicación y Información Científica y Tecnológica en Salud), una de las unidades técnicas y científicas de la Fundação Oswaldo Cruz (Fundación Oswaldo Cruz). Los doctorandos del curso de 2020 promovieron el webinario "Más allá de los límites de la salud: cuidado desde una perspectiva interdisciplinaria" como parte de la formación académica, y este relatoes producto científico de aquel evento. Además del desarrollo de habilidades y actitudes, esa experiencia representó un aprendizaje personal, intangible y emocional del cuidado más allá de los límites de la salud, y también un importante aprendizaje ético sobre las "cosas tratadas con negligencia" y aún acerca de la fuerza de los consensos ante un escenario complejo marcado por una pandemia provocada por el virus SARS-CoV-2, la pandemia de Covid-19

Development of Echinocandin Resistance in Candida haemulonii: An Emergent, Widespread, and Opportunistic Fungal Pathogen.

Echinocandins, used for the prevention and treatment of invasive fungal infections, have led to a rise in breakthrough infections caused by resistant Candida species. Among these species, those belonging to the Candida haemulonii complex are rare multidrug-resistant (MDR) yeasts that are frequently misidentified but have emerged as significant healthcare-associated pathogens causing invasive infections. The objectives of this study were to investigate the evolutionary pathways of echinocandin resistance in C. haemulonii by identifying mutations in the FKS1 gene and evaluating the impact of resistance on fitness. After subjecting a MDR clinical isolate of C. haemulonii (named Ch4) to direct selection using increasing caspofungin concentrations, we successfully obtained an isolate (designated Ch4'r) that exhibited a high level of resistance, with MIC values exceeding 16 mg/L for all tested echinocandin drugs (caspofungin, micafungin, and anidulafungin). Sequence analysis revealed a specific mutation in the resistant Ch4'r strain, leading to an arginine-histidine amino acid substitution (R1354H), occurring at the G4061A position of the HS2 region of the FKS1 gene. Compared to the wild-type strain, Ch4'r exhibited significantly reduced growth proliferation, biofilm formation capability, and phagocytosis ratio, indicating a decrease in fitness. Transmission electron microscopy analysis revealed alterations in cell wall components, with a notable increase in cell wall thickness. The resistant strain also exhibited higher amounts (2.5-fold) of chitin, a cell wall-located molecule, compared to the wild-type strain. Furthermore, the resistant strain demonstrated attenuated virulence in the Galleria mellonella larval model. The evolved strain Ch4'r maintained its resistance profile in vivo since the treatment with either caspofungin or micafungin did not improve larval survival or reduce the fungal load. Taken together, our findings suggest that the acquisition of pan-echinocandin resistance occurred rapidly after drug exposure and was associated with a significant fitness cost in C. haemulonii. This is particularly concerning as echinocandins are often the first-line treatment option for MDR Candida species.