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BACKGROUND: Coronavirus disease 2019 originated in China and swiftly spread worldwide, posing a significant threat to public health. Caused by SARS-CoV-2, it manifests as a flu-like illness that can escalate to Acute Respiratory Distress Syndrome, potentially resulting in fatalities. In countries where HIV/Leishmania infantum is endemic, the occurrence of concurrent SARS-CoV-2/HIV/Leishmania infantum infections is a reality, prompting inquiries into appropriate clinical management. CASE PRESENTATION: We present the case of a 48-year-old woman who was hospitalized for 36 days across three different hospitals in the state of Pernambuco, Brazil. She was diagnosed with SARS-CoV-2/HIV/L. infantum coinfection. The patient exhibited severe COVID-19 symptoms, including fever, productive cough, and dyspnea. Throughout her hospitalization, she experienced oxygen saturation levels of ≤ 93%, along with fluctuations in blood pressure, respiratory rate, and heart rate. Her blood tests revealed lymphopenia, leukopenia, and neutropenia, while laboratory results indicated abnormal levels of d-dimer, AST, ALT, lactate dehydrogenase, ferritin, and C-reactive protein. A computed tomography scan revealed 75% involvement of the lung parenchyma with patchy ground-glass opacities. CONCLUSION: Against all odds, the patient was discharged. The leukopenia associated with HIV/L. infantum may have played a decisive role. Further studies are necessary to better understand diagnostic strategies and clinical management measures for HIV/L. infantum coinfected patients who are susceptible to SARS-CoV-2 infection.

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The occurrence of bacterial resistance has been increasing, compromising the treatment of various infections. The high virulence of Staphylococcus aureus allows for the maintenance of the infectious process, causing many deaths and hospitalizations. The MepA and NorA efflux pumps are transporter proteins responsible for expelling antimicrobial agents such as fluoroquinolones from the bacterial cell. Coumarins are phenolic compounds that have been studied for their diverse biological actions, including against bacteria. A pharmacokinetic in silico characterization of compounds C10, C11, C13, and C14 was carried out according to the principles of Lipinski's Rule of Five, in addition to searching for similarity in ChemBL and subsequent search for publications in CAS SciFinder. All compounds were evaluated for their in vitro antibacterial and modulatory activity against standard and multidrug-resistant Gram-positive and Gram-negative strains. The effect of coumarins C9, C10, C11, C13, and C14 as efflux pump inhibitors in Staphylococcus aureus strains was evaluated using the microdilution method (MepA or NorA) and fluorimetry (NorA). The behavior of coumarins regarding the efflux pump was determined from their interaction properties with the membrane and coumarin-protein using molecular docking and molecular dynamics simulations. Only the isolated coumarin compound C13 showed antibacterial activity against standard strains of Staphylococcus aureus and Escherichia coli. However, the other tested coumarins showed modulatory capacity for fluoroquinolone and aminoglycoside antibacterials. Compounds C10, C13, and C14 were effective in reducing the MIC of both antibiotics for both multidrug-resistant strains, while C11 potentiated the effect of norfloxacin and gentamicin for Gram-positive and Gram-negative bacteria and only norfloxacin for Gram-negative. Only coumarin C14 produced synergistic effects when associated with ciprofloxacin in MepA-carrying strains. All tested coumarins have the ability to inhibit the NorA efflux pump present in Staphylococcus aureus, both in reducing the MIC and inducing increased ethidium bromide fluorescence emission in fluorimetry. The findings of this study offer an atomistic perspective on the potential of coumarins as active inhibitors of the NorA pump, highlighting their specific mode of action mainly targeting protein inhibition. In molecular docking, it was observed that coumarins are capable of interacting with various amino acid residues of the NorA pump. The simulation showed that coumarin C10 can cross the bilayer; however, the other coumarins interacted with the membrane but were unable to cross it. Coumarins demonstrated their potentiating role in the effect of norfloxacin through a dual mechanism: efflux pump inhibition through direct interaction with the protein (C9, C10, C11, and C13) and increased interaction with the membrane (C10 and C13). In the context of pharmacokinetic prediction studies, the studied structures have a suitable chemical profile for possible oral use. We suggest that coumarin derivatives may be an interesting alternative in the future for the treatment of resistant bacterial infections, with the possibility of a synergistic effect with other antibacterials, although further studies are needed to characterize their therapeutic effects and toxicity.

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Objetivo principal: Conocer la epidemiologia de las fracturas del cuarto distal del radio en el esqueleto en crecimiento y el tratamiento realizado en el CHPR en los años 2017 y 2018. Objetivos específicos: Valorar re-desplazamiento, necesidad de re manipulación, complicaciones, re-fractura. Metodología: Estudio observacional descriptivo retrospectivo. Criterios de inclusión: pacientes de 0 a 14 años con fractura de radio distal (fisaria, metafisaria y suprametafisaria) valorados en el CHPR entre 1 enero del 2017 y 31 diciembre del 2018. Criterios de exclusión: pacientes con radiografía normal, fracturas en miembros con malformaciones, infecciones óseas, patología tumoral maligna o benigna. Obtención de datos: Valoración de radiografías de puño y antebrazo realizadas en el CHPR en 2017 y 18, iniciales y evolutivas. Se analizaron: edad, sexo, fecha fractura, topografía de la fractura, desplazamiento inicial, tratamiento, evolución radiográfica y complicaciones. Resultados: se incluyeron 662 pacientes. Siendo en su mayoría de género masculino (65%), con una media de 9 años, miembro derecho (61%), en los meses de verano (36%). En cuanto a la topografía se evidenció una frecuencia mayor en fracturas tipo rodete y metafisarias (31.72% y 31.57%), seguido por suprametafisaria (18.43%) y fisaria (18.28%). El tratamiento realizado fue ortopédico en el 86.56% de los casos, mientras que quirúrgico fue el 12.84%, en su gran mayoría con alambres de Kirschner (11,2%). El tiempo de inmovilización promedio fue de 6 semanas, con un porcentaje de complicaciones del 14.05% del total de las fracturas. Conclusiones: Se valoraron las características de los pacientes y fracturas de radio distal en el CHPR en los años 2017 y 18, siendo un total de 662 fracturas, en las que su mayoría se realizó tratamiento ortopédico con un índice de complicaciones que ronda el 14%, siendo mayor cuanto mayor es el desplazamiento inicial de la fractura.

Objetivo principal: Conhecer a epidemiologia das fraturas do quarto distal do rádio no esqueleto em crescimento e o tratamento realizado no CHPR nos anos de 2017 e 2018. Objetivos específicos: Avaliar re-deslocamento, necessidade de remanipulação, complicações, refratura. Metodologia: Estudo observacional descritivo retrospectivo. Critérios de inclusão: pacientes de 0 a 14 anos com fratura do rádio distal (fisário, metafisário e suprametafisário) avaliados no CHPR entre 1º de janeiro de 2017 e 31 de dezembro de 2018. Critérios de exclusão: pacientes com radiografias normais, fraturas em membros com malformações, osso infecções, patologia tumoral maligna ou benigna. Coleta de dados: Avaliação das radiografias de punho e antebraço realizadas no CHPR em 2017 e 18, inicial e evolutiva. Foram analisados: idade, sexo, data da fratura, topografia da fratura, deslocamento inicial, tratamento, evolução radiográfica e complicações. Resultados: 662 pacientes foram incluídos. Sendo maioritariamente do sexo masculino (65%), com média de 9 anos, membro direito (61%), nos meses de verão (36%). Em relação à topografia, foi evidenciada maior frequência nas fraturas da borda e metafisárias (31,72% e 31,57%), seguidas das suprametafisárias (18.43%) e fisárias (18.28%). O tratamento realizado foi ortopédico em 86.56% dos casos, enquanto cirúrgico em 12.84%, sendo a maioria com fios de Kirschner (11,2%). O tempo médio de imobilização foi de 6 semanas, com percentual de complicações de 14.05%. Conclusões: Foram avaliadas as características dos pacientes e fraturas do rádio distal no CHPR nos anos de 2017 e 18, com um total de 662 fraturas (0,9 por dia), em que a maioria foi submetida a tratamento ortopédico com índice de complicações que fica em torno de 14%, sendo maior quanto maior for o deslocamento inicial da fratura.

Title: Fractures of the distal end of the radius in the immature skeleton. Epidemiological study at the Pereira Rossell Hospital Center. Main objective: To know the epidemiology of fractures of the distal fourth of the radius in the growing skeleton and the treatment carried out in the CHPR in the years 2017 and 2018. Specific objectives: To assess re-displacement, need for re-manipulation, complications, re- fracture. Methodology: Retrospective descriptive observational study. Inclusion criteria: patients aged 0 to 14 years with distal radius fracture (physeal, metaphyseal and suprametaphyseal) evaluated at the CHPR between January 1, 2017 and December 31, 2018. Exclusion criteria: patients with normal radiographs, fractures in limbs with malformations, bone infections, malignant or benign tumor pathology. Data collection: Assessment of fist and forearm X-rays performed at the CHPR in 2017 and 18, initial and evolutionary. The following were analyzed: age, sex, fracture date, fracture topography, initial displacement, treatment, radiographic evolution and complications. Results: 662 patients were included. Being mostly male (65%), with an average of 9 years, right limb (61%), in the summer months (36%). Regarding the topography, a higher frequency was evidenced in rim and metaphyseal fractures (31.72% and 31.57%), followed by suprametaphyseal (18.43%) and physeal (18.28%). The treatment performed was orthopedic in 86.56% of the cases, while surgical was 12.84%, mostly with Kirschner wires (11.2%). The average immobilization time was 6 weeks, with a percentage of complications of 14.05%. Conclusions: The characteristics of the patients and fractures of the distal radius in the CHPR in the years 2017 and 18 were evaluated, with a total of 662 fractures (0.9 per day), in which the majority underwent orthopedic treatment with an index of complications that is around 14%, being greater the greater the initial displacement of the fracture.

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The discovery of antibiotics has significantly transformed the outcomes of bacterial infections in the last decades. However, the development of antibiotic resistance mechanisms has allowed an increasing number of bacterial strains to overcome the action of antibiotics, decreasing their effectiveness against infections they were developed to treat. This study aimed to evaluate the antibacterial activity of synthetic coumarins Staphylococcus aureus in vitro and analyze their interaction with the MepA efflux pump in silico. The Minimum Inhibitory Concentration (MIC) determination showed that none of the test compounds have antibacterial activity. However, all coumarin derivatives decreased the MIC of the standard efflux inhibitor ethidium bromide, indicating antibacterial synergism. On the other hand, the C14 derivative potentiated the antibacterial activity of ciprofloxacin against the resistant strain. In silico analysis showed that C9, C11, and C13 coumarins showed the most favorable interaction with the MepA efflux pump. Nevertheless, due to the present in silico and in vitro investigation limitations, further experimental research is required to confirm the therapeutic potential of these compounds in vivo.

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Dengue is a global and growing health threat, especially in Southeast Asia, West Pacific and South America. Infection by the dengue virus (DENV) results in dengue fever, which can evolve to severe forms. Cytokines, especially interferons, are involved in the immunopathogenesis of dengue fever, and so may influence the disease outcomes. The aim of this study was to investigate the association between severe forms of dengue and two single nucleotide polymorphisms (SNPs) in the interferon-gamma gene (IFNG): A256G (rs2069716) and A325G (rs2069727). We included 274 patients infected with DENV serotype 3: 119 cases of dengue without warning signs (DWoWS), and 155 with warning signs (DWWS) or severe dengue (SD). DNA was extracted, and genotyped with Illumina Genotyping Kit or real time PCR (TaqMan probes). We estimated the adjusted Odds Ratios (OR) by multivariate logistic regression models. When comparing with the ancestral AA/AA diplotype (A256G/A325G), we found a protective association of the AA/AG against DWWS/SD among patients with secondary dengue (OR 0.51; 95% IC 0.24-1.10, p = 0.085), adjusting for age and sex. The variant genotype at locus A325G of the IFNG, in combination with the ancestral genotype at locus A256G, can protect against severe clinical forms of secondary dengue in Brazilian DENV3-infected patients.

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The resiliency of plastic products against microbial degradation in natural environment often creates devastating changes for humans, plants, and animals on the earth's surface. Biodegradation of plastics using indigenous bacteria may serve as a critical approach to overcome this resulting environmental stress. In the present work, a polyethylene degrading bacterium Alcaligenes faecalis strain ISJ128 (Accession No. MK968769) was isolated from partially degraded polyethylene film buried in the soil at plastic waste disposal site. The biodegradation studies were conducted by employing various methods such as hydrophobicity assessment of the strain ISJ128, measurement of viability and total protein content of bacterial biofilm attached to the polyethylene surface. The proliferation of bacterial cells on polyethylene film, as indicated by high growth response in terms of protein content (85.50 µg mL-1) and viability (1010 CFU mL-1), proposed reasonable suitability of our strain A. faecalis ISJ128 toward polyethylene degradation. The results of biodegradation assay revealed significant degradation (10.40%) of polyethylene film within a short period of time (i.e., 60 days), whereas no signs of degradation were seen in control PE film. A. faecalis strain ISJ128 also demonstrated a removal rate of 0.0018 day-1 along with half-life of 462 days. The scanning electron microscope (SEM) and Fourier transform infrared (FTIR) spectroscopy studies not only displayed changes on polyethylene surface but also altered level of intensity of functional groups and an increase in the carbonyl indexes justifying the degradation of polyethylene film due to bacterial activity. In addition, the secondary structure prediction (M fold software) of 16SrDNA proved the stable nature of the bacterial strain, thereby reflecting the profound scope of A. faecalis strain ISJ128 as a potential degrader for the eco-friendly disposal of polyethylene waste. Schematic representation of methodology.

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BACKGROUND: The severity and distribution of dengue virus (DENV) infections have been attributed to a complex interaction among viral, host and environmental factors. Herein, we investigated the influence of chikungunya (CHIKV) and Zika (ZIKV) viruses on the epidemiological profile of dengue cases, using Recife, Pernambuco state, Brazil, as a study model. In addition, we described and compared the epidemiological profile related to each arbovirus (DENV vs. CHIKV vs. ZIKV). METHODS: All cases of dengue, chikungunya and Zika reported to the Pernambuco Health Department in 2011-2013 (DENV circulation) and 2016-2018 (DENV, CHIKV and ZIKV co-circulation) were included in our study. The cases were classified by sex, age and race/color and their distribution was analyzed by the χ2 test. Furthermore, the data were also analyzed for co-infections. Temperature, humidity and rainfall data were analyzed using one-way ANOVA and paired t-test. RESULTS: During 2011-2013, 15,315 dengue cases were diagnosed, most of them female, brown and 20-29 age group. Between 2016 and 2018, 15,870 dengue cases were described, which presented the same profile described above. In the two triennia, the female/male dengue ratio fluctuated significantly, ranging from 1.07 to 1.52. Regarding chikungunya, 7076 cases were reported, most of them female and brown. The female/male ratio also fluctuated significantly, ranging from 1.62 to 2.1. Two main age groups were observed in chikungunya: ≤ 19 years (minority of diagnoses) and ≥ 20 years (majority of diagnoses). In the same triennium, 266 Zika cases were reported to the Pernambuco Health Department, mainly in females and in the 0-9 and 20-39 age groups. In general, 119 co-infections were identified: 117 DENV-CHIKV, 1 CHIKV-ZIKV and 1 DENV-CHIKV-ZIKV. Concerning climate data, only the humidity in 2011 was significantly different from the other years. CONCLUSION: The epidemiological profile of dengue cases did not change after the introduction of CHIKV and ZIKV. Females were the most diagnosed with dengue, chikungunya or Zika, however we found important differences in the age profile of these arboviruses, which should be considered by public health policies, as well as investigated in future studies of virus-host interaction.

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Medicinal plants have been used for many years by communities to treat illnesses. The need for scientific proof of these vegetable's curative effects is as necessary as the proof of the inexistence of toxicity related to the use of extracts with therapeutic potential. Annona squamosa L. (Annonaceae), popularly known as "pinha", "ata" or "fruta do conde", has been used in traditional medicine for its analgesic and antitumor activities. The toxic effects attributed to this plant have also been explored as a pesticide and an insecticide. The aim of the present study was to investigate the toxicity of the methanolic extract of A. squamosa seeds and pulp against human erythrocytes. Blood samples were treated with methanolic extract at different concentrations, osmotic fragility was determined using saline tension assays and morphological analyzes were performed using optical microscopy. The extracts were analyzed using high performance liquid chromatography with diode array detection (HPLC-DAD) for phenolic quantification. The seed's methanolic extract showed toxicity above 50% from a concentration of 100 µg/mL, while also presenting echinocytes in the morphological analysis. The pulp's methanolic extract did not show toxicity to red blood cells or morphological changes at the concentrations tested. HPLC-DAD analysis revealed the presence of caffeic acid in the seed extract and gallic acid in the pulp extract. The seed's methanolic extract is toxic and the pulp's methanolic extract showed no toxicity against human erythrocytes.

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The increase in antibiotic resistance rates has attracted the interest of researchers for antibacterial compounds capable of potentiating the activity of conventional antibiotics. Coumarin derivatives have been reported to develop effective antibacterials with possible new mechanisms of action for treating infectious diseases caused by bacteria with a profile of drug resistance. In this context, the aim of the present study we have now prepared one variety of new synthetic coumarins evaluating the pharmacokinetic and chemical similarity in silico, their antimicrobial activity against Staphylococcus aureus (ATCC 25923) and Escherichia coli (ATCC 25922), and potential for the modulation of antibiotic resistance against Staphylococcus aureus (SA10) and Escherichia coli (EC06) clinical isolate bacteria by in vitro assay. The antibacterial activity and antibiotic-enhancing properties were evaluated by the broth microdilution method and pharmacokinetically characterized according to the Lipinsk rule of 5 and had their similarity analyzed in databases such as ChemBL and CAS SciFinder. The results demonstrated that only compound C13 showed significant antibacterial activity (MIC ≤256 µg/mL), and all other coumarins did not display relevant antibacterial activity (MIC ≥1024 µg/mL). However, they did modulate the antibiotics activities to norfloxacin and gentamicin, except, compound C11 to norfloxacin against Staphylococcus aureus (SA10). The in silico properties prediction and drug-likeness results demonstrated that all coumarins presented a good drug-likeness score with no violations and promising in silico pharmacokinetic profiles showing that they have the potential to be developed into an oral drug. The results indicate that the coumarin derivatives showed good in vitro antibacterial activity. These new coumarin derivatives also demonstrated the capacity to modulate antibiotic resistance with potential synergy action for current antimicrobials assayed, as antibiotic adjuvants, to reduce the emergence of antimicrobial resistance.

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ABSTRACT Dengue is a global and growing health threat, especially in Southeast Asia, West Pacific and South America. Infection by the dengue virus (DENV) results in dengue fever, which can evolve to severe forms. Cytokines, especially interferons, are involved in the immunopathogenesis of dengue fever, and so may influence the disease outcomes. The aim of this study was to investigate the association between severe forms of dengue and two single nucleotide polymorphisms (SNPs) in the interferon-gamma gene (IFNG): A256G (rs2069716) and A325G (rs2069727). We included 274 patients infected with DENV serotype 3: 119 cases of dengue without warning signs (DWoWS), and 155 with warning signs (DWWS) or severe dengue (SD). DNA was extracted, and genotyped with Illumina Genotyping Kit or real time PCR (TaqMan probes). We estimated the adjusted Odds Ratios (OR) by multivariate logistic regression models. When comparing with the ancestral AA/AA diplotype (A256G/A325G), we found a protective association of the AA/AG against DWWS/SD among patients with secondary dengue (OR 0.51; 95% IC 0.24-1.10, p = 0.085), adjusting for age and sex. The variant genotype at locus A325G of the IFNG, in combination with the ancestral genotype at locus A256G, can protect against severe clinical forms of secondary dengue in Brazilian DENV3-infected patients.

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(1) Background: estragole is a monoterpene found in the essential oils of several aromatic plants, which can be used for several pharmacological activities. The aim of this study was to evaluate the antinociceptive effect of estragole (Es) and its ß-cyclodextrins inclusion complex (Es/ß-CD). (2) Methods: the effects of Es and Es/ß-CD on the central nervous system (CNS) were evaluated through open field and rota-rod assays, and the antinociceptive effect in formalin models, abdominal writhing induced by acetic acid, hot plate, tail flick test and plantar mechanical hyperalgesia. (3) Results: Es and Es/ß-CD showed no alterations on the CNS evaluated parameters and the results suggested there was an antinociceptive action in the formalin, abdominal writhing, hot plate, tail flick tests and plantar mechanical hyperalgesia, proposing the involvement of the nitric oxide, glutamatergic signaling pathways, cyclic guanosine monophosphate and vanilloid pathways. (4) Conclusion: the results suggest that Es and Es/ß-CD have a promising antinociceptive potential as a possible alternative for the pharmacological treatment of pain, also showing that the encapsulation of Es in ß-cyclodextrins probably improves its pharmacological properties, since the complexation process involves much lower amounts of the compound, contributing to better bioavailability and a lower probability of adverse effect development.

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Microbial resistance has become a worrying problem in recent decades after the abusive use of antibiotics causing the selection of resistant microorganisms. In order to circumvent such resistance, researchers have invested efforts in the search for promising natural substances, such as essential oils. Thus, the objective of this work was to determine the chemical composition of the essential oil of Acritopappus confertus leaves, to evaluate its intrinsic effect and its effects in combination with drugs against pathogenic fungi and bacteria, in addition to verifying the inhibition of virulence in Candida strains. To this end, the oil was verified by gas chromatography coupled with mass spectrometry (GC/MS). Candida strains were used for antifungal assays by means of the serial microdilution technique, in order to determine the average inhibitory concentration (IC50), and for the modification assays, sub-inhibitory concentrations (MIC/8) were used. Finally, the natural product's ability to inhibit the formation of filamentous structures was evaluated. In antibacterial tests, the MIC of the oil against strains of Staphylococcus aureus and Escherichia coli and its modifying effects in association with gentamicin, erythromycin, and norfloxacin were determined. The major constituent of the essential oil was the monoterpene myrcene (54.71%). The results show that the essential oil has an antifungal effect, with C. albicans strains being the most susceptible. Furthermore, the oil can potentiate the effect of fluconazole against strains of C. tropicalis and C. albicans. Regarding its effect on micromorphology, the oil was also able to inhibit the filaments in all strains. In combination with antibiotics, the oil potentiated the drug's action by reducing the MIC against E. coli and S. aureus. It can be concluded that the essential oil of A. confertus has potential against pathogenic fungi and bacteria, making it a target for the development of an antimicrobial drug.

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A worrisome fact is the increase in microbial resistance, which has as its main cause the indiscriminate use of antibiotics. Scientific studies have investigated bioactive compounds such as steroidal sapogenins, in the perspective of new beneficial alternatives for the control of bacterial resistance. Therefore, the objective of this work was to verify the antibacterial activity as well as the modifying action of antibiotics associated with solasodine and its ability to inhibit the efflux pump mechanism in strains of Staphylococcus aureus. Tests were performed to verify the minimum inhibitory concentration (MIC). In addition, the action-modifying potential of antibiotics and the inhibitory capacity of the efflux pump NorA and MepA through synergistic effects on the antibiotic and ethidium bromide were evaluated. Solasodine showed significant results for the standard bacteria with an MIC of 512 µg/mL, and when associated with the antibiotics gentamicin and nofloxacin for the multidrug-resistant bacteria S. aureus 10, Escherichia coli 06, and Pseudomonas aeruginosa 24, it showed a 50% reduction in MIC. The association of solasodine with the antibiotic ciprofloxacin against S. aureus K2068 (MepA) showed synergism, with a reduction in the MIC of the antibiotic from 64 µg/mL to 40 µg/mL, and also a reduction in the MIC when the antibiotic was used in conjunction with the efflux pump inhibitors. Solasodine may be acting on the mechanism of action of the antibiotic, as it has shown a potentiating effect when associated with antibiotics, inducing a reduction in the MIC against Gram-positive and Gram-negative bacteria. Therefore, this study demonstrated significant results for the potentiating action of solasodine when associated with antibiotics of clinical importance.

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The inappropriate use of synthetic antibiotics has become a global public health problem. Therefore, the study of new alternatives for the treatment of infectious diseases is relevant and natural bioactive products are on the rise. This study conducted a scientific prospection of bioactive natural products with promising applications in the chemical control of microorganisms. A systematic review of the most recent articles was performed according to the following three steps: (i) eligibility assessment, (ii) screening, and (iii) inclusion of articles and information extraction. There has been an increase in the number of scientific publications on bioactive natural products for microbial control in the CAPES and SciELO databases (2001-2021). Seventeen relevant articles were included, most of which focused on extracts. Ascorbic acid, chlorogenic acid, chrysin, and quercetin were the most cited compounds. Natural products were shown to be effective in inhibiting more than 30 microorganisms. A discussion was presented on the research trends.

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Project managers seem to be puzzled in resolving the global dilemma of project failures across industries. Hence, the present study introduces project management innovation (PMI) as a determinant of project success (PS) and explores whether project governance (PG) and high-performance work practices (HPWPs), strengthen this relationship. To confirm these propositions, study data using adapted scales were collected from project professionals representing software development companies in the emerging IT industry in Pakistan. Structural equation modeling (SEM) was employed to examine the hypothesized relationships and encourage PMI-guided solutions for project failures. SEM results statistically validated that project success is positively influenced by PMI, whereas this relationship is significantly strengthened through the moderating influence of PG and HPWPs, respectively. Theoretically, the present research is the first of its kind to introduce and empirically examine these untested relationships between PMI, PG, HPWPs, and PS in a single framework. These novel findings hold strategic value for both project managers and organizational leaders who oversee a range of project portfolios. Long-lasting advantages and superior achievements can be reinvigorated through PMI, after departure from traditional approaches and answering calls for new solutions to new problems in managing projects. Moreover, project governance and HPWPs should be reconfigured to oversee, as well as meet the special needs of each unique project.

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Owing to the emerging challenges on global food security and the decade of controversies over genetically modified food (hereafter GMF), the present study aims to explore the effects of advertisement framing on health and environmental benefits, sources of perceived risk reduction, and domain-specific knowledge on the acceptance of GMF. The study conducted a quasi-experimental factorial 2 (advertisement message framing: health vs. environmental benefits) × 2 (expert endorsement: present vs. absent) between-subject design involving 300 adult participants from Pakistan. Using a multi-group structural equation model, the four conditions were assigned to each participant group (n = 75) to test the hypothesized relationships. The quasi-experiment results suggested that the advertisement messages (ad-framed) incorporated with the health and environmental benefits, as delineated by experts, can be a viable communication strategy in developing effortless cognitive cues towards GMF acceptance. The pioneer findings validate the significant efficacy of advertisement messages (ad-framed with expert opinions) in reducing perceived risk through augmented objective knowledge that activates the mechanism of favorable development of attitude and acceptance of GMF. The study findings offer strategic directions to policymakers, marketers, and food technologists in raising greater awareness and acceptance towards GMF products.

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INTRODUCTION: Visceral leishmaniasis (VL) is a systemic and neglected parasitic disease. Its main symptoms are fever, splenomegaly with or without hepatomegaly, and anemia, however, most individuals remain asymptomatic. Due to the lack of a gold standard and the limitations of current diagnostic techniques, where parasitology is ethically unfeasible for individuals without symptoms and serological tests do not differentiate between past and present disease, molecular methodologies are the most suitable. AREAS COVERED: We performed a systematic review analyzing the molecular techniques based on PCR used, so far, to detect asymptomatic cases of VL in humans. Structured searches were carried out on PubMed, LILACS, Scopus, and Web of Science databases without time and language restrictions. Two reviewers evaluated the studies, performed data extraction, and quality assessment by assigning scores. EXPERT OPINION: qPCR using RNA targets can be used in the diagnosis of asymptomatic cases of human VL, due to its characteristics. We recommend further studies to analyze the methodology, mainly observing the use of different rRNA targets. Therefore, we hope that this technique contributed to the construction of public policies that address the diagnosis and handling of asymptomatic patients.

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No studies have addressed the way the effectiveness of fear and hope advertisements differs across differently characterized individuals. The present study aims to find out in which situations related to different individual characteristics do fear and hope advertisements work as tools in generating healthy eating intention and physical activity intention. This study conducted an experiment using 283 adults from Chile. The results suggest that fear versus hope appeals in health advertisements have a more positive influence on healthy eating intention. The results suggest that the effect of fear advertisements on healthy eating intention is positively moderated by the frequency of fast food consumption and is negatively moderated by self-efficacy. The results suggest that fear versus hope appeals in health advertisements have no main effect on physical activity intention. However, the results suggest that the effect of fear advertisements on physical activity intention is positively moderated by perceived body weight and past healthy eating behavior and is negatively moderated by subjective norms. The results indicate that when making health advertising, homogenous messages are not persuasive for heterogeneous audiences. The present study results suggest that fear and hope advertisements should be delivered considering the individual characteristics identified in the present study.

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BACKGROUND: The spread of Dengue virus (DENV) infections, as well as their signs and symptoms, are the result of a complex interaction between several factors. In Brazil, especially in the Northeastern, dengue is an important public health problem. Here, we report an epidemiological analysis of dengue cases in Pernambuco state, Northeastern Brazil, during 2015-2017. METHODS: This work is a retrospective cross-sectional observational study on the epidemiological profile of all dengue cases confirmed and reported to the Health Secretary of Pernambuco between 2015 and 2017. These data cover all municipalities of Pernambuco, except Fernando de Noronha. DENV-positive individuals were classified according to the dengue type (without and with warning signs, or severe dengue), age, gender, ethnicity and intermediate geographic region of residence (Recife, Caruaru, Serra Talhada or Petrolina). The distribution of cases over the years was assessed by χ2 test. Temperature and rainfall data were evaluated by Unpaired t-test. p-value < 0.05 and CI 95% were considered in all analyses. RESULTS: Most dengue cases was without warning signs. The most observed characteristics in the less severe dengue phenotypes were: female, mulatto ethnicity and age between 20 and 39 years old; this profile was more clearly observed in 2015. In 2016 and 2017, however, the numbers of dengue without and with warning signs were more evenly distributed and the difference in cases within groups decreased significantly. Regarding severe dengue, mulattoes were the most affected, but it is possible to note a trend towards a more uniform distribution between the genders and ages. Recife was the region with the highest numbers of both total cases and incidence rates and the highest rainfall levels. Overall, over the years, there has been a decrease in dengue cases in all regions of Pernambuco. CONCLUSIONS: We identified the epidemiological profile of dengue in Pernambuco, Brazil, reporting the gender, age, ethnicity and regions most affected by different dengue types. In addition, we observed that these cases were probably more influenced by rainfall than by temperature. Finally, we believe that this epidemiological knowledge is important to direct public health policies to the reality of each population.

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