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Ethane is the most abundant non-methane hydrocarbon in the troposphere, where it impacts ozone and reactive nitrogen and is a key tracer used for partitioning emitted methane between anthropogenic and natural sources. However, quantification has been challenged by sparse observations. Here, we present a satellite-based measurement of tropospheric ethane and demonstrate its utility for fossil-fuel source quantification. An ethane spectral signal is detectable from space in Cross-track Infrared Sounder (CrIS) radiances, revealing ethane signatures associated with fires and fossil fuel production. We use machine-learning to convert these signals to ethane abundances and validate the results against surface observations (R2 = 0.66, mean CrIS/surface ratio: 0.65). The CrIS data show that the Permian Basin in Texas and New Mexico exhibits the largest persistent ethane enhancements on the planet, with regional emissions underestimated by seven-fold. Correcting this underestimate reveals Permian ethane emissions that represent at least 4-7% of the global fossil-fuel ethane source.

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Caesarean scar pregnancy (CSP) occurs when the gestational sac implants in the region of a scar from a previous caesarean delivery. CSP can lead to life-threatening complications, including severe haemorrhage, uterine rupture, placenta accreta spectrum (PAS) and hysterectomy. A 40-year-old woman with one previous caesarean was referred to the specialist centre at 17+1 weeks of gestation with concerns about CSP. At 19 weeks, she was admitted with abdominal pain. Due to raised body habitus, accurate ultrasound assessment was challenging, necessitating reliance on magnetic resonance imaging (MRI). The patient desired to continue the pregnancy, but due to pain and concerns about uterine rupture she consented to a laparotomy to potentially terminate the pregnancy. Findings during the laparotomy were reassuring, leading to the decision not to terminate the pregnancy. The patient remained hospitalised until delivery by caesarean-hysterectomy at 33+6 weeks. Histopathology confirmed the PAS diagnosis. This case highlights the importance of achieving early diagnosis and obtaining clear sonographic findings. It emphasises the pitfalls of relying on MRI due to its tendency to over-diagnose severity. It emphasises the urgency for improved training in this domain. Early sonographic diagnosis allows safer performance of termination of pregnancy. It also provides women who continue with the pregnancy useful prognostic signs to facilitate decisions on the optimal gestation for delivery. Determining optimal conservative management for CSP remains an ongoing challenge. This case emphasises the importance of multidisciplinary discussion, comprehensive patient counselling and involving patients in their care planning, to create an individualised and adaptable treatment plan.

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The US Environmental Protection Agency (EPA) estimates on-road vehicles emissions using the Motor Vehicle Emission Simulator (MOVES). We developed updated ammonia emission rates for MOVES based on road-side exhaust emission measurements of light-duty gasoline and heavy-duty diesel vehicles. The resulting nationwide on-road vehicle ammonia emissions are 1.8, 2.1, 1.8, and 1.6 times higher than the MOVES3 estimates for calendar years 2010, 2017, 2024, and 2035, respectively, primarily due to an increase in light-duty gasoline vehicle NH3 emission rates. We conducted an air quality simulation using the Community Multi-Scale Air Quality (CMAQv5.3.2) model to evaluate the sensitivity of modeled ammonia and fine particulate matter (PM2.5) concentrations in calendar year 2017 using the updated on-road vehicle ammonia emissions. The average monthly urban ammonia ambient concentrations increased by up to 2.3 ppbv in January and 3.0 ppbv in July. The updated on-road NH3 emission rates resulted in better agreement of modeled ammonia concentrations with 2017 annual average ambient ammonia measurements, reducing model bias by 5.8 % in the Northeast region. Modeled average winter PM2.5 concentrations increased in urban areas, including enhancements of up to 0.5 µg/m3 in the northeast United States. The updated ammonia emission rates have been incorporated in MOVES4 and will be used in future versions of the NEI and EPA's modeling platforms.

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OBJETIVO: Este trabalho apresenta aspectos de uma observação participante em um Hospital Universitário do nível terciário da rede SUS localizado em Vitória, capital da região sudeste do Brasil, durante o primeiro semestre de 2023. Logo, o relato a seguir pretende provocar e incitar a discussão sobre os desafios enfrentados pela psicologia em contexto hospitalar, dentre eles o racismo estrutural impregnado nos corpos e nos gestos que se atualizam naquele estabelecimento. MÉTODO: Trata-se de um relato de experiência, de caráter qualitativo, vivido através do acompanhamento da dinâmica hospitalar da clínica cirúrgica e da clínica médica do referido Hospital. O percurso metodológico foi realizado por meio da análise institucional de linhagem francesa, calcada em discussões de orientações do estágio, onde os diários de campo, observações e participações no campo eram semanalmente discutidas. RESULTADOS: Destaca a produção e reafirmação do racismo estrutural no país, que se expressa tanto no trato com pacientes quanto com funcionários e estudantes. A escuta da equipe profissional do hospital é marcada, muitas vezes, por práticas assistencialistas e por processos de exclusão preconceituosos, fazendo-nos indagar: "A psicologia hospitalar tem cor?" CONCLUSÃO: O objetivo da pesquisa foi cumprido e, além disso, relatar essa experiência suscitou ao campo diversas questões como: de que forma colocar em funcionamento uma gestão hospitalar que propicie uma política de compartilhamento de atenção ao paciente entre os equipamentos da atenção?

OBJECTIVE: This work presents aspects of participant observation in a University Hospital at the tertiary level of the SUS network located in Vitória, capital of the southeast region of Brazil, during the first half of 2023. Therefore, the following report intends to provoke and incite discussion about the challenges faced by psychology in a hospital context, among them the structural racism permeated in the bodies and gestures that are updated in that establishment. METHOD: This is an experience report, of a qualitative nature, experienced through monitoring the hospital dynamics of the surgical clinic and the medical clinic of the aforementioned Hospital. The methodological path was carried out through institutional data analysis, based on discussions of internship guidelines, where field diaries, observations and participation in the internship were discussed weekly. RESULTS: Highlights the production and reaffirmation of structural racism in the country, which is expressed both in dealings with patients, employees and students. Listening to the hospital's professional team is often marked by welfare practices and prejudiced exclusion processes, making us ask: "Does hospital psychology have color?" CONCLUSION: The objective of the research was fulfilled and, in addition, reporting this experience raised several questions in the field, such as: how to put into operation hospital management that provides a policy of sharing patients between care equipment?

OBJETIVO: Este trabajo presenta aspectos de la observación participante en un Hospital Universitario del nivel terciario de la red SUS ubicado en Vitória, capital de la región sureste de Brasil durante el primer semestre de 2023. Por lo tanto, el siguiente informe pretende provocar e incitar a la discusión sobre los desafíos que enfrenta la psicología en el contexto hospitalario, entre ellos el racismo estructural permeado en los cuerpos y gestos que se actualizan en ese establecimiento. MÉTODO: Se trata de un relato de experiencia, de carácter cualitativo, vivida a través del seguimiento de la dinámica hospitalaria de la clínica quirúrgica y de la clínica médica del mencionado Hospital. El recorrido metodológico se realizó a través del análisis de datos institucionales, a partir de discusiones sobre lineamientos de pasantía, donde semanalmente se discutieron diarios de campo, observaciones y participación en la pasantía. RESULTADOS: Destaca la producción y reafirmación del racismo estructural en el país, que se expresa tanto en el trato con pacientes, empleados y estudiantes. La escucha del equipo profesional del hospital muchas veces está marcada por prácticas asistencialistas y procesos de exclusión prejuiciosos, lo que nos lleva a preguntarnos: "¿Tiene color la psicología hospitalaria?". CONCLUSIÓN: El objetivo de la investigación fue cumplido y, además, relatar esta experiencia generó varias preguntas en el campo, tales como: ¿cómo poner en funcionamiento una gestión hospitalaria que prevea una política de reparto de pacientes entre equipos de atención?

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Uncertainty in ammonia (NH3) emissions causes the inaccuracy of fine particulate matter simulations, which is associated with human health. To address this uncertainty, in this work, we employ the iterative finite difference mass balance (iFDMB) technique to revise NH3 emissions over East Asia using the Cross-track Infrared Sounder (CRIS) satellite for July, August, and September 2019. Compared to the emissions, the revised NH3 emissions show an increase in China, particularly in the North China Plain (NCP) region, corresponding to agricultural land use in July, August, and September and a decrease in South Korea in September. The enhancement in NH3 emissions resulted in a remarkable increase in concentrations of NH3 by 5 ppb. in July and September, there is an increase in ammonium (NH4+) and nitrate (NO3-) concentrations by 5 µg/m3, particularly in the NCP region, while in August, both NH4+ and NO3- concentrations exhibit a decrease. For sulfate (SO42-), in August and September, the concentrations decreased over most regions of China and Taiwan, as a result of the production of ammonium sulfate; increased concentrations of SO42-, however, were simulated over South Korea, Japan, and the southern region of Chengdu, caused by higher relative humidity (RH). In contrast, during the month of July, our simulations showed an increase in SO42- concentrations over most regions of China. To gain a more comprehensive understanding, we defined a sulfur conversion ratio ( [Formula: see text] ), which explains how changes in sulfur in the gas phase affect changes in sulfate concentrations. A subsequent sensitivity analysis performed in this study indicated the same relationship between changes in ammonia and its effect on inorganic fine particulate matter (PM2.5). This study highlights the challenge of controlling and managing inorganic PM2.5 and indicates that reducing the emissions of air pollutants do not necessarily lead to a reduction in their concentrations.

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Myofibroblast activation is a cellular response elicited by a variety of physiological or pathological insults whereby cells initiate a coordinated response intended to eradicate the insult and then revert back to a basal state. However, an underlying theme in various disease states is persistent myofibroblast activation that fails to resolve. Based on multiple observations, we hypothesized that the secreted factors harvested from co-culturing amniotic stem cells might mimic the anti-inflammatory state that cell-free amniotic fluid (AF) elicits. We optimized an amnion epithelial and amniotic fluid cell co-culture system, and tested this hypothesis in the context of myofibroblast activation. However, we discovered that co-cultured amniotic cell conditioned media (coACCM) and AF have opposing effects on myofibroblast activation: coACCM activates the epithelial-mesenchymal transition (EMT) and stimulates gene expression patterns associated with myofibroblast activation, while AF does the opposite. Intriguingly, extracellular vesicles (EVs) purified from AF are necessary and sufficient to activate EMT and inflammatory gene expression patterns, while the EV-depleted AF potently represses these responses. In summary, these data indicate that coACCM stimulates myofibroblast activation, while AF represses it. We interpret these findings to suggest that coACCM, AF, and fractionated AF represent unique biologics that elicit different cellular responses that are correlated with a wide variety of pathological states, and therefore could have broad utility in the clinic and the lab.

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Objetivo: A partir da produção de uma cartilha de exercícios domiciliares "Orientações para a Manutenção da Qualidade de Vida Espinha Bífida", objetivou-se validar o conteúdo, realizar a avaliação do material (cartilha) pelos cuidadores, e analisar a adesão ao uso da cartilha. Métodos: Para validação do conteúdo, 8 juízes especialistas avaliaram a cartilha por meio de um questionário adaptado e foi estabelecido o índice de validade de conteúdo (IVC) para cada aspecto abordado. Na avaliação do material realizada pelos cuidadores e na análise da adesão ao uso da cartilha, participaram 10 crianças e adolescentes com espinha bífida e seus cuidadores. O pesquisador leu a cartilha e treinou os exercícios na presença do paciente e de seu cuidador, indicando como deveriam ser realizados em domicílio. Após a entrega foi marcado um retorno presencial, em 15 dias, para que os cuidadores pudessem relatar sobre a avaliação do material assim como, descrever sobre a adesão desses participantes ao uso da cartilha. Por fim, foi agendado um segundo encontro - follow-up ­ para analisar a adesão em longo prazo. Resultados: Dos 27 aspectos abordados na validação do conteúdo, 24 destes receberam pontuação acima do índice aceitável (IVC = 1,00). A maior parte dos cuidadores responderam "concordo" ou "concordo totalmente" para todos os itens analisados referente à avaliação do material. Em curto prazo foi observada uma taxa de adesão de 25% dos participantes e em longo prazo de 12,5%. Conclusão: A cartilha "Orientações para a Manutenção da Qualidade de Vida ­ Espinha Bífida" por apresentar clareza dos itens apresentados, facilidade de leitura e adequada compreensão, segundo a avaliação dos juízes especialistas e dos cuidadores, mostrou ser um ótimo recurso para incrementar o tratamento fisioterapêutico de criança e adolescentes com espinha bífida, porém evidenciou uma moderada/baixa adesão por parte dos participantes. [au]

Objective: From the production of a booklet of home exercises "Orientações para a Manutenção da Qualidade de Vida ­ Espinha Bífida", the aim was to validate the content, carry out the evaluation of the material (booklet) by caregivers, and analyze the adherence to the use of the booklet. Methods: For content validation, 8 expert judges evaluated the booklet through an adapted questionnaire, and the content validity index (CVI) was established for each aspect addressed. In the evaluation of the material carried out by the caregivers and in the analysis of adherence to the use of the booklet, 10 children and adolescents with spina bifida participated in this study. The booklet was read with the patients and their caregivers,who were trained to perform the exercises that are in the booklet at home. After delivery, a face-to-face return was scheduled, in 15 days, so that caregivers could report on the evaluation of the material as well as describe the adherence of these participants to the use of the booklet. Finally, a second meeting was scheduled - follow-up - to analyze long-term adherence. Results: Of the 27 aspects addressed in the content validation, 24 of these received scores above the acceptable index (CVI = 1.00). Most caregivers answered "agree" or "strongly agree" to all items analyzed regarding the evaluation of the booklet. In the short term, there was an adherence rate of 25% of the participants, and in the long term, 12.5%. Conclusion: The booklet "Orientações para a Manutenção da Qualidade de Vida ­ Espinha Bífida" proved to be a great resource to increase the physical therapy treatment of children and adolescents with spina bifida, according to the evaluation of expert judges and caregivers, for presenting adequate content, language and appearance, but showed moderate/low adherence by the participants. [au]

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We conduct the first 4D-Var inversion of NH3 accounting for NH3 bi-directional flux, using CrIS satellite NH3 observations over Europe in 2016. We find posterior NH3 emissions peak more in springtime than prior emissions at continental to national scales, and annually they are generally smaller than the prior emissions over central Europe, but larger over most of the rest of Europe. Annual posterior anthropogenic NH3 emissions for 25 European Union members (EU25) are 25% higher than the prior emissions and very close (<2% difference) to other inventories. Our posterior annual anthropogenic emissions for EU25, the UK, the Netherlands, and Switzerland are generally 10%-20% smaller than when treating NH3 fluxes as uni-directional emissions, while the monthly regional difference can be up to 34% (Switzerland in July). Compared to monthly mean in-situ observations, our posterior NH3 emissions from both schemes generally improve the magnitude and seasonality of simulated surface NH3 and bulk NH x wet deposition throughout most of Europe, whereas evaluation against hourly measurements at a background site shows the bi-directional scheme better captures observed diurnal variability of surface NH3. This contrast highlights the need for accurately simulating diurnal variability of NH3 in assimilation of sun-synchronous observations and also the potential value of future geostationary satellite observations. Overall, our top-down ammonia emissions can help to examine the effectiveness of air pollution control policies to facilitate future air pollution management, as well as helping us understand the uncertainty in top-down NH3 emissions estimates associated with treatment of NH3 surface exchange.

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Soft drinks are food matrices propitious to the growth of acidophilic bacteria, yeasts, and filamentous fungi due to their pH, water activity, and the presence of nutrients. Off-flavor, clouding, and package stuffing are the only parameters producers have to detect spoilage when it is often too late for the brand's reputation. In this work, microbiological analyses were performed on non-alcoholic beverages of Brazilian and Bolivian brands. As a result, Gram-positive, Gram-negative, yeast, and filamentous fungi were isolated. Zygosaccharomyces bisporus yeast was isolated from different flavored stuffed products, and Gluconacetobacter liquefaciens and Brevibacillus agri were isolated from packages without visible signs of deterioration. These microorganisms were identified by MALDI-TOF. For products with visible growth of filamentous fungi, microscopic identification keys identified Aspergillus flavus, Penicillium citrinum, Paecilomyces niveus, and Paecilomyces variotii. These work's findings reflect a failure to sanitize raw materials since the isolates' primary origin is the soil and the water, pointing to the lack of process control in soft drinks.

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BACKGROUND: Occupational accidents are a complex phenomenon and a major public health problem. Occupational health surveillance actions are essential for prevention of injuries of this nature. OBJECTIVE: To ascertain the prevalence of and the variables associated with occupational accidents in the city of Itajubá (MG). DESIGN AND SETTING: A cross-sectional study with a quantitative approach, based on a household survey with random sampling, was conducted in areas covered by the Family Health Strategy (FHS) in Itajubá (MG). METHODS: Questionnaires were applied to 292 people. The data were analyzed by means of logistic regression. RESULTS: The prevalence of occupational accidents was 8.6%. The underreporting rate was 60.0%. The scenario for these accidents, according to the model established through the regression analysis, was most likely to involve males who declared their skin color as white and who did not have a formal employment contract. CONCLUSION: This study makes a contribution towards unveiling the relationship between healthcare and work, and thus serve as support for the development of strategies to prevent underreporting. Lastly, the results provide the basis for future public health intervention actions and for future studies.

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ABSTRACT BACKGROUND: Occupational accidents are a complex phenomenon and a major public health problem. Occupational health surveillance actions are essential for prevention of injuries of this nature. OBJECTIVE: To ascertain the prevalence of and the variables associated with occupational accidents in the city of Itajubá (MG). DESIGN AND SETTING: A cross-sectional study with a quantitative approach, based on a household survey with random sampling, was conducted in areas covered by the Family Health Strategy (FHS) in Itajubá (MG). METHODS: Questionnaires were applied to 292 people. The data were analyzed by means of logistic regression. RESULTS: The prevalence of occupational accidents was 8.6%. The underreporting rate was 60.0%. The scenario for these accidents, according to the model established through the regression analysis, was most likely to involve males who declared their skin color as white and who did not have a formal employment contract. CONCLUSION: This study makes a contribution towards unveiling the relationship between healthcare and work, and thus serve as support for the development of strategies to prevent underreporting. Lastly, the results provide the basis for future public health intervention actions and for future studies.

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Objetivo: analisar os fatores limitadores à doação de órgãos e tecidos para transplantes de um serviço hospitalar. Método: estudo documental, realizado em um hospital do Paraná, Brasil. Analisou-se os "Relatórios de Óbitos e Monitoramento de Doações Mensais", compreendidos no período de janeiro a dezembro de 2016, registrados pela Comissão Intra-Hospitalar de Doação de Órgãos e Tecidos para Transplantes, por meio de estatística descritiva. Resultados: prevaleceram óbitos por parada cardiorrespiratória, tendo o doador contrário a doação em vida como motivo de não autorização. Dos 54 potenciais doadores, foi autorizada a doação de 27 (50%) indivíduos, que resultou na doação de 68 órgãos/tecidos, com destaque para córneas. Conclusão: a falta de conscientização da população que gerou a negativa na autorização da doação e o fato de que óbitos por parada cardiorrespiratória dificultaram a captação de múltiplos órgãos frente a isquemia imediata, constituíram os principais limitadores à doação de órgãos no serviço investigado.

Objective: To analyze the limiting factors for organ and tissue donation for transplantation in a hospital service. Method: documentary study, performed in a hospital in Paraná, Brazil. The "Reports of Deaths and Monthly Donation Monitoring", from January to December 2016, recorded by the Intra-Hospital Committee on Donation of Transplant Organs and Tissues, were analyzed using descriptive statistics. Results: deaths due to cardiopulmonary arrest prevailed, with the donor opposing the donation in life as a reason for non-authorization. Of the 54 potential donors, 27 (50%) individuals were authorized to donate, resulting in 68 organs / tissues, especially corneas. Conclusion: the lack of awareness of the population that led to the negative authorization of the donation and the fact that deaths from cardiopulmonary arrest made it difficult to capture multiple organs in the face of immediate ischemia were the main limitation of organ donation in the investigated service.

Objetivo: analizar los factores que limitan la donación de órganos y tejidos para trasplante. Método: estudio documental, realizado en un hospital de Paraná, Brasil. Los "Informes de defunciones y monitoreo mensual de donaciones", de enero a diciembre de 2016, registrados por el Comité intrahospitalario de donación de órganos y tejidos de trasplantes, se analizaron mediante estadísticas descriptivas. Resultados: prevalecieron las muertes por paro cardiopulmonar, y el donante se opuso a la donación en la vida como motivo de no autorización. De los 54 posibles donantes, 27 (50%) individuos fueron autorizados a donar, lo que resultó en 68 órganos/tejidos, especialmente córneas. Conclusión: la falta de conciencia de la población que condujo a la autorización negativa de la donación y el hecho de que las muertes por paro cardiopulmonar dificultaron la captura de múltiples órganos ante la isquemia inmediata fueron la principal limitación de la donación de órganos en el servicio investigado.

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The aim of this research was to optimize the growth parameters (pH, ethanol tolerance, initial cell concentration and temperature) for Saccharomyces boulardii and its tolerance to in vitro gastrointestinal conditions for probiotic alcoholic beverage development. Placket-Burman screening was used to select only statistically significant variables, and the polynomial mathematical model for yeast growth was obtained by central composite rotatable design. Confirmation experiments to determine the kinetic parameters for yeast growth were carried out by controlling the temperature and pH. Soon after, the survivability of yeast was tested under in vitro conditions mimicking the human upper gastrointestinal transit. S. boulardii had suitable resistance to alcohol and gastrointestinal conditions for probiotic alcoholic beverage development.

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Tiger nut milk is a nutrient rich drink with great commercialization potential. However, it is highly perishable. Microencapsulation of tiger nut milk by a blend of inulin and modified tiger nut starch resulted in a product with good characteristics. The microspheres of lyophilized tiger nut milk were spherical with and average particle size of 1.01 µm. It's thermal degradation occurred above 346 °C, denoting an excellent thermal resistance. There was no significant structural alteration in the active material after microencapsulation and no loss of stability within 60 days, which confirms that this process enables the preservation of freshness and chemical characteristics of tiger nut milk. During 30-90 days, vitamin C contents were stable in the presence or absence of light. Microsphere with tiger nut milk presented a shelf life of 60 days. Total aerobic mesophiles and total fungi counts were below 106 CFU/mL, showing good microbiological stability.

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Ammonia surface flux is bidirectional; that is, net flux can be either upward or downward. In fertilized agricultural croplands and grasslands there is usually more emission than deposition especially in midday during warmer seasons. In North America, most of the ammonia emissions are from agriculture with a significant fraction of that coming from fertilizer. A new bidirectional ammonia flux modeling system has been developed in the Community Multiscale Air Quality (CMAQ) model, which has close linkages with the Environmental Policy Integrated Climate (EPIC) agricultural ecosystem model. Daily inputs from EPIC are used to calculate soil ammonia concentrations that are combined with air concentrations in CMAQ to calculate bidirectional surface flux. The model is evaluated against surface measurements of NH3 concentrations, NH4 + and SO4 2- aerosol concentrations, NH4 + wet deposition measurements, and satellite retrievals of NH3 concentrations. The evaluation shows significant improvement over the base model without bidirectional ammonia flux. Comparisons to monthly average satellite retrievals show similar spatial distribution with the highest ammonia concentrations in the Central Valley of California (CA), the Snake River valley in Idaho, and the western High Plains. In most areas the model underestimates, but in the Central Valley of CA, it generally overestimates ammonia concentration. Case study analyses indicate that modeled high fluxes of ammonia in CA are often caused by anomalous high soil ammonia loading from EPIC for particular crop types. While further improvements to parameterizations in EPIC and CMAQ are recommended, this system is a significant advance over previous ammonia bidirectional surface flux models.

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BACKGROUND: In recent decades some outbreaks of food-borne acute Chagas disease (ACD) in humans were identified by clinical and epidemiological characterization after association through the ingestion of açaí pulp probably contaminated with Trypanosoma cruzi. Whereas Belém and Abaetetuba stood out as important risk regions for disease transmission, the importance of Rhodnius pictipes, and Philander opossum for the biological cycle of T. cruzi, and data from agribusiness market of açaí, to study T. cruzi from vector and reservoir of the Brazilian Amazon region is critical for this context. Thus, the purpose of this study was to verify the infective capacity and the virulence of T. cruzi in açaí pulp from vector and reservoir at Pará State experimentally. METHODS: 105T. cruzi I in in natura açaí pulp from Belém at Pará State, at room temperature, after forced sieving, by intraperitoneal, gavage or oral route of inoculation in B6.129S7Rag1-/-tmMom/J Unib allowed food-borne ACD analysis using common light microscopy. PRINCIPAL FINDINGS: T. cruzi in in natura açaí pulp from R. pictipes (Val-De-Cans Forest, Belém, and Ajuaí River, Abaetetuba, Pará), and P. opossum (Combu Island, Belém, Pará) caused ACD and death between 17 and 52 days after experimental infections in murine immunodeficient hosts. CONCLUSIONS: T. cruzi from different sources and locations at Pará State in in natura açaí pulp retained its infective capacity and virulence, and can cause new outbreaks of ACD by oral transmission. Additionally, quality basic education will facilitate efficient hygiene practices throughout the açaí productive chain can eradicate food-borne ACD in the coming decades.

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Variable tumor cellularity can limit sensitivity and precision in comparative genomics because differences in tumor content can result in misclassifying truncal mutations as region-specific private mutations in stroma-rich regions, especially when studying tissue specimens of mediocre tumor cellularity such as lung adenocarcinomas (LUADs). To address this issue, we refined a nuclei flow-sorting approach by sorting nuclei based on ploidy and the LUAD lineage marker thyroid transcription factor 1 and applied this method to investigate genome-wide somatic copy number aberrations (SCNAs) and mutations of 409 cancer genes in 39 tumor populations obtained from 16 primary tumors and 21 matched metastases. This approach increased the mean tumor purity from 54% (range 7-89%) of unsorted material to 92% (range 79-99%) after sorting. Despite this rise in tumor purity, we detected limited genetic heterogeneity between primary tumors and their metastases. In fact, 88% of SCNAs and 80% of mutations were propagated from primary tumors to metastases and low allele frequency mutations accounted for much of the mutational heterogeneity. Even though the presence of SCNAs indicated a history of chromosomal instability (CIN) in all tumors, metastases did not have more SCNAs than primary tumors. Moreover, tumors with biallelic TP53 or ATM mutations had high numbers of SCNAs, yet they were associated with a low interlesional genetic heterogeneity. The results of our study thus provide evidence that most macroevolutionary events occur in primary tumors before metastatic dissemination and advocate for a limited degree of CIN over time and space in this cohort of LUADs. Sampling of primary tumors thus may suffice to detect most mutations and SCNAs. In addition, metastases but not primary tumors had seeded additional metastases in three of four patients; this provides a genomic rational for surgical treatment of such oligometastatic LUADs. Copyright © 2018 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

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A organização da atenção básica expressa desafios relacionados às características municipais, à configuração prévia do sistema de saúde local e ao caráter da implantação da Estratégia Saúde da Família. Com a nova Política Nacional de Atenção Básica (2017) houve uma revisão de diretrizes para a organização da atenção básica e a proposição de mudanças, como por exemplo, em relação os tipos de equipes existentes e suas configurações. Essas mudanças expressam mais desafios à atenção básica, e nesse estudo, pretendeu-se suscitar reflexões em torno das perspectivas para a organização da atenção primária à saúde no estado do Rio de Janeiro em relação aos tipos de equipe abordados na nova Política Nacional de Atenção Básica, com foco nos aspectos estruturais e organizacionais. Foi realizada uma pesquisa exploratória documental comparativa não exaustiva, com base na Política Nacional de Atenção Básica (PNAB) de 2011 e de 2017. Para análise dessas mudanças propostas foi feita uma comparação da PNAB de 2017 com a de 2011. Após as leituras, a busca de dados secundários e análise das duas PNAB, os resultados foram apresentados em dois grupos: a atenção básica no estado do Rio de Janeiro, no âmbito do SUS; tipos de equipes, aspectos estruturais e organizacionais. Os resultados apresentados basearam a discussão sobre as perspectivas para a organização da atenção básica no estado do Rio de Janeiro em relação aos tipos de equipes. Além de equipes de saúde da família, equipe de saúde bucal, equipe de consultório na rua, equipe de agentes comunitários de saúde, existem outras equipes propostas pela Política Nacional de Atenção Básica (2017) e que compõem estratégias de organização e fortalecimento da atenção primária à saúde, como: equipe de Atenção Básica, o atualmente chamado núcleo ampliado de saúde da família e atenção básica e equipe de atenção básica prisional. As mudanças propostas para a organização da atenção básica, nos aspectos citados, trazem impactos e demandam novos esforços para adequação. Entretanto, é fundamental mostrar a importância que o fortalecimento e a reorganização da atenção básica adquirem no contexto da política setorial. Nesse sentido, a principal conclusão deste estudo é que as mudanças propostas na nova política e os resultados a serem alcançados têm que ser avaliados dentro do contexto de mudanças mais gerais que decorrem do papel indutor da esfera federal e da capacidade de resposta dos municípios na gestão relacionada a este nível de atenção

The organization for basic attention, has expressed issues related to the social procedures within districts in the previous local health administration and the approach of the Family Health Strategy, when carrying out these protocols. As a result of the new National Policy of Basic Attention (2017) the guidelines for the organization of basic attention were revised and a proposal for changes suggested. One example being the types of existing teams and their administrations. These changes express further issues in the area of basic attention and this study aims for its audience to reflect on the objectives of the organization of primary health care in the state of Rio de Janeiro in relation to the types of teams outlined in the new National Policy of Basic Attention. It will be focusing on the structural aspects as well as the organizations. An exploratory non-extensive documentary of research was conducted, based on the National Policy of Basic Attention (PNAB) of 2011 and 2017. For the analysis of these changes, a comparation was made between the PNAB of 2017, with that of 2011. After the readings, the results for secondary data and analysis of the two PNAB, were presented in two groups: basic health care in the state of Rio de Janeiro, under SUS; types of teams and structural and organizational aspects. The results were presented as a discussion of the objectives of the organization for primary care in the state of Rio de Janeiro in relation to the types of teams. In addition to family health teams, oral health team, the street office team, the community health agents, there are other teams proposed by the National Policy of Basic Attention (2017) which comprise strategies on organization and strengthening of primary health care, such as: basic attention team, the now-called expanded nuclear family health and basic care and the staff of prison basic attention. The proposed changes to the organization of basic attention, in the aforementioned mentioned citings, aim to make an impact by outlining higher standards and new targets of adequacy. However, it is fundamental to show the importance of the strengthening and re-organization of basic attention in the context of sectoral policy. For this reason, the main conclusion of this study is that the changes proposed in the new policy and the results to be achieved have to be within the context of more general changes that derive from the sphere's inductive role and the responsiveness of district management related to this standard for basic attention

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RESUMEN

Amostras de açaí (Euterpe oleracea Mart.) tipo fino congeladas e sem adição de quaisquer outros ingredientes foram adquiridas no comércio varejista da cidade do Rio de Janeiro. Foram analisadas microbiologicamente 54 amostras, pertencentes a 6 diferentes marcas (A, B, C, D, E e F). Todas as amostras analisadas encontravam-se dentro do prazo de validade estabelecido pelo fabricante e as empresas eram registradas no MAPA. Os micro-organismos analisados foram: Salmonella, Escherichia coli, fungos filamentosos e leveduras, de acordo com o preconizado pela legislação brasileira vigente. Considerando-se o limite máximo possível estabelecido pela lei, 2 lotes de cada marca B, E e F e 1 lote de cada marca C e D apresentaram contagens acima do permitido para fungos filamentosos e leveduras. Apenas 2 amostras apresentaram contagens de Escherichia coli, ambas estando fora do máximo estabelecido pela legislação vigente. Constatou- -se ausência de Salmonella em todas as amostras analisadas. A presença de fungos filamentosos, leveduras e Escherichia coli pode ser um indicativo de práticas inadequadas durante a fabricação do açaí. Assim, é importante ressaltar a necessidade de um controle rigoroso da cadeia do frio, uma vez que esses micro-organismos podem ser responsáveis pela deterioração do produto.

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Objetivou-se descrever o percurso de uma ação educativa contextualizada, participativa e dialógica na temática sexualidade. Trata-se de estudo qualitativo do tipo pesquisa-ação crítica, delineado seguindo o referencial teórico-metodológico de Freire, tendo como público alvo 151 alunos matriculados no curso de graduação em enfermagem de uma universidade pública do Noroeste do Estado do Paraná, durante o mês de março de 2014. Destes, participaram 20 acadêmicos na fase de investigação temática e nove nos Círculos de Cultura. Seguiu todos os preceitos éticos. Pautado em situações-limites, desenvolveram-se Círculos de Cultura abordando os seguintes temas: "Conceito de Sexualidade", "Dimensão Psicológica e Social da Sexualidade" e "Assistência Integral em Sexualidade". Conclui-se que o desenvolvimento da ação educativa dialógica, pautada em situações-problemas reais, apresentou-se como um caminho viável para a reflexão da temática e para a construção de novos conhecimentos às práticas de cuidado que envolvem a sexualidade humana (AU).

The objective of this study was to describe the trajectory of a contextualized, participatory and dialogical educational action about sexuality. It was a qualitative study using critical action research, in accordance with the theoretical and methodological framework of Brazilian educator Paulo Freire. This investigation included 151 undergraduate nursing students in a public university in the northwest region of the state of Paraná, Brazil, and occurred in March 2014. Of this population, twenty students participated in the thematic investigation phase and nine in the culture circles. All ethical precepts were followed. Based on limit situations, the culture circles addressed the following themes: "The Concept of Sexuality", "Psychological and Social Dimensions of Sexuality", and "Comprehensive Care in Sexuality". The development of dialogical educational action, based on real-life problem situations was presented as a viable path for reflecting on the theme and building new knowledge for care practices involving human sexuality (AU).

Se objetivó describir el itinerario de una acción educativa contextualizada, participativa y dialógica en la temática sexualidad. Estudio cualitativo, tipo investigación-acción crítica, delineado siguiendo el referencial teórico-metodológico de Freire, con un público objetivo de 151 alumnos matriculados en curso de grado en enfermería de universidad pública del Noroeste del Estado de Paraná, durante marzo de 2014. De ellos, participaron 20 estudiantes en la fase de investigación temática, y nueve en los Círculos de Cultura. Se respetaron todos los preceptos éticos. Pautado en situaciones límite, se desarrollaron Círculos de Cultura, abordando los temas: "Concepto de Sexualidad"; "Dimensión Psicológica y Social de la Sexualidad"; y "Atención Integral en Sexualidad". Se concluyó en que el desarrollo de la acción educativa dialógica, pautada en situaciones-problemas reales, se mostró como un camino viable para la reflexión de la temática y para construir nuevos conocimientos a las prácticas de cuidado que involucran la sexualidad humana (AU).

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