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The recently emerged SARS-CoV-2 Omicron sublineages, including the BA.2-derived XBB.1.5 (Kraken), XBB.1.16 (Arcturus), and EG.5.1 (Eris), have accumulated several spike mutations that may increase immune escape, affecting vaccine effectiveness. Older adults are an understudied group at significantly increased risk of severe COVID-19. Here we report the neutralizing activities of 177 sera samples from 59 older adults, aged 62-97 years, 1 and 4 months after vaccination with a 4th dose of ChAdOx1-S (Oxford/AstraZeneca) and 3 months after a 5th dose of Comirnaty Bivalent Original/Omicron BA.4/BA.5 vaccine (Pfizer-BioNTech). The ChAdOx1-S vaccination-induced antibodies neutralized efficiently the ancestral D614G and BA.4/5 variants, but to a much lesser extent the XBB.1.5, XBB.1.16, and EG.5.1 variants. The results showed similar neutralization titers between XBB.1.16 and EG.5.1 and were lower compared to XBB.1.5. Sera from the same individuals boosted with the bivalent mRNA vaccine contained higher neutralizing antibody titers, providing a better cross-protection against Omicron XBB.1.5, XBB.1.16 and EG.5.1 variants. Previous history of infection during the epidemiological waves of BA.1/BA.2 and BA.4/BA.5, poorly enhanced neutralization activity of serum samples against XBBs and EG.5.1 variants. Our data highlight the continued immune evasion of recent Omicron subvariants and support the booster administration of BA.4/5 bivalent vaccine, as a continuous strategy of updating future vaccine booster doses to match newly emerged SARS-CoV-2 variants.

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Analyses of the 2009 H1N1 influenza pandemic and post-pandemic years showed high attack rates and severity among indigenous populations. This study presents the characteristics of the first documented influenza outbreak in indigenous peoples in Brazil, that occurred from 30th March to 14th April 2016 in a Guarani village in Southeast Region. Acute respiratory infections were prospectively investigated. The majority of the 73 cases were influenza-like illness (ILI) (63.0%) or severe acute respiratory infection (SARI) (20.5%). The ILI+SARI attack rate (35.9%) decreased with increasing age. There was a high influenza vaccination rate (86.3%), but no statistically significant difference in vaccination rates between severe and non-severe cases was seen (p = 0.334). Molecular analyses of 19.2% of the cases showed 100% positivity for influenza A(H1N1)pdm09 and/or hRSV. Influenza A(H1N1)pdm09 was included in the 6B.1 genetic group, a distinct cluster with 13 amino acid substitutions of A/California/07/2009-like. The hRSV were clustered in the BA-like genetic group. The early arrival of the influenza season overlapping usual hRSV season, the circulation of a drifted influenza virus not covered by vaccine and the high prevalence of risk factors for infection and severity in the village jointly can explain the high attack rate of ARI, even with a high rate of influenza vaccination. The results reinforce the importance of surveillance of respiratory viruses, timely vaccination and controlling risk factors for infection and severity of in the indigenous populations in order to preventing disease and related deaths, particularly in children.

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From physics to the social sciences, information is now seen as a fundamental component of reality. However, a form of information seems still underestimated, perhaps precisely because it is so pervasive that we take it for granted: the information encoded in the very environment we live in. We still do not fully understand how information takes the form of cities, and how our minds deal with it in order to learn about the world, make daily decisions, and take part in the complex system of interactions we create as we live together. This paper addresses three related problems that need to be solved if we are to understand the role of environmental information: (1) the physical problem: how can we preserve information in the built environment? (2) The semantic problem: how do we make environmental information meaningful? and (3) the pragmatic problem: how do we use environmental information in our daily lives? Attempting to devise a solution to these problems, we introduce a three-layered model of information in cities, namely environmental information in physical space, environmental information in semantic space, and the information enacted by interacting agents. We propose forms of estimating entropy in these different layers, and apply these measures to emblematic urban cases and simulated scenarios. Our results suggest that ordered spatial structures and diverse land use patterns encode information, and that aspects of physical and semantic information affect coordination in interaction systems.

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PURPOSE: Quantitative techniques of diffusion analysis allow for an in-vivo investigation of the physiopathology of epilepsies. The objective of this study was to evaluate the variation of the main diffusion parameters and explore differences between two methodologies of voxel-wise analysis comparing a group of patients with mesial temporal lobe epilepsy (MTLE) with controls. METHODS: 24 patients with a diagnosis of MTLE were selected. All patients and a control group of 36 individuals were submitted to 3T magnetic resonance imaging. Diffusion parameters were obtained from the raw images. Based on the tensors, a customized template was created, and images were registered into standard space. Voxel-based comparisons between patients and controls was performed by whole brain voxel-wise analysis and tract-based spatial statistics (TBSS). Tract-specific analysis (TSA) was performed in the mostly damaged fasciculi. RESULTS: 10 patients presented with right hippocampal sclerosis (HS), 11 with left HS and 3 with bilateral HS with left predominance. Whole brain voxel-wise analysis showed abnormalities mainly localized in the temporal lobes (total volume of 3859mm3). TBSS showed more widespread abnormalities (21931mm3). TSA pointed to abnormalities situated essentially in the temporal stem topography. Fractional anisotropy (FA) and radial diffusivity (RD) were the parameters that showed more abnormalities. CONCLUSION: Whole brain voxel-wise analysis was more restricted than TBSS. The methods were complementary stressing the significance of the findings. The abnormalities were more frequently observed in FA and RD indicating the need for using several diffusion parameters for the investigation of patients with MTLE.

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Analisar a influência da ingestão de álcool durante a lactação na origem do alcoolismo. Métodos: pesquisa de caráter descritivo, com amostra intencional por conveniência com 33 dependentes alcoólicos e suas respectivas mães, avaliando a correlação do consumo de álcool ingerido utilizando os instrumentos Cutdown, Annoyde by criticims, Guilty e Eye-opener, e Tolerance, Annoyed, Cut down e Eye-opener. Resultados: os dependentes são homens, jovens, solteiros, com baixo grau de escolaridade e renda entre um e cinco salários mínimos. Dos pacientes que se consideram alcoólatras, 55,5% possuíam mães que se consideraram alcoólatras e 60,0% delas consumiram álcool durante a lactação, mas esta correlação não foi significativa. Conclusão: não se constatou correlação positiva entre o consumo de álcool pelas mães durante a amamentação com o vício de seus filhos na fase adulta.

Objective: to analyze the influence of alcohol intake during lactation in alcoholism onset. Methods: descriptive research with intentional convenient sample of 33 people addicted to alcohol and their mothers which assessed the correlation between the consumption of alcohol ingested using the instruments Cut down, Annoyde by criticims, Guilty and Eye-opener, and Tolerance, Annoyed, Cut down and Eye-opener. Results: addicts are men, young, single, with low level of education and income between one and five minimum wages. Among the patients who consider themselves alcoholics, 55.5% had mothers who considered themselves alcoholics and 60.0% of them had consumed alcohol during lactation, but this correlation was not significant. Conclusion: a positive correlation between alcohol consumption by mothers during breastfeeding and addiction of their children in adulthood was not found.

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A number of soil-borne microorganisms, such as mycorrhizal fungi and rhizobacteria, establish mutualistic interactions with plants, which can indirectly affect other organisms. Knowledge of the plant-mediated effects of mutualistic microorganisms is limited to aboveground insects, whereas there is little understanding of what role beneficial soil bacteria may play in plant defense against root herbivory. Here, we establish that colonization by the beneficial rhizobacterium Azospirillum brasilense affects the host selection and performance of the insect Diabrotica speciosa. Root larvae preferentially orient toward the roots of non-inoculated plants versus inoculated roots and gain less weight when feeding on inoculated plants. As inoculation by A. brasilense induces higher emissions of (E)-ß-caryophyllene compared with non-inoculated plants, it is plausible that the non-preference of D. speciosa for inoculated plants is related to this sesquiterpene, which is well known to mediate belowground insect-plant interactions. To the best of our knowledge, this is the first study showing that a beneficial rhizobacterium inoculant indirectly alters belowground plant-insect interactions. The role of A. brasilense as part of an integrative pest management (IPM) program for the protection of corn against the South American corn rootworm, D. speciosa, is considered.

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Some species of the genus Anastrepha (Diptera: Tephritidae) are successfully managed by matching the sterile insect technique with parasitoid releases. Such strategies used in integrated pest management can be implemented only where insect mass-rearing programs are feasible. In this study, we show the process of domestication, rearing technology and quality control data obtained from 54 generations of Anastrepha sp.1 aff. fraterculus (Wiedemann, 1830) kept under fully artificial conditions. Eggs were collected by an artificial oviposition panel consisting of one side of the cage made of blue voile fabric externally covered with a thin layer of silicon rubber. They were then air-bubbled in water at 25 ºC for 48 h before seeding. Larvae were reared on the regular laboratory artificial diet with 66 % of agar reduction turning over a semi-liquid diet, which reduced costs and improved insect quality. The adult and larval diets were composed of local ingredients including hydrolyzed yeast. When large-scale production of this fly is contemplated, the critical stage is larval development. This system of artificial rearing for A. fraterculus sp.1 developed in Brazil, allows for the production of a large number of insects of excellent quality using local ingredients and less agar in diet composition than the original medium used for this species. By reducing the interval of egg collection, the system might be optimized in terms of insect yield and, therefore, meet the demands of A. fraterculus sp.1 with regard to integrated pest management purposes.

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Some species of the genus Anastrepha (Diptera: Tephritidae) are successfully managed by matching the sterile insect technique with parasitoid releases. Such strategies used in integrated pest management can be implemented only where insect mass-rearing programs are feasible. In this study, we show the process of domestication, rearing technology and quality control data obtained from 54 generations of Anastrepha sp.1 aff. fraterculus (Wiedemann, 1830) kept under fully artificial conditions. Eggs were collected by an artificial oviposition panel consisting of one side of the cage made of blue voile fabric externally covered with a thin layer of silicon rubber. They were then air-bubbled in water at 25 ºC for 48 h before seeding. Larvae were reared on the regular laboratory artificial diet with 66 % of agar reduction turning over a semi-liquid diet, which reduced costs and improved insect quality. The adult and larval diets were composed of local ingredients including hydrolyzed yeast. When large-scale production of this fly is contemplated, the critical stage is larval development. This system of artificial rearing for A. fraterculus sp.1 developed in Brazil, allows for the production of a large number of insects of excellent quality using local ingredients and less agar in diet composition than the original medium used for this species. By reducing the interval of egg collection, the system might be optimized in terms of insect yield and, therefore, meet the demands of A. fraterculus sp.1 with regard to integrated pest management purposes.(AU)

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The experience of a family with a chronic disease is, at first, difficult and stressful, making the family unsafe and concerned. We aimed to understand the experience and adaptation of the family to a chronic illness (stroke) and describe the actions developed by a project of assistance at home. This is a qualitative study, Case Study type, conducted with a family assisted through home visits by the Project for Assistance and Support for the Family of Chronic Patients at Home, in Maringá, Paraná State. Data were gathered through consultation of the records of the family in May and June 2009, and data were submitted to content analysis. In the beginning there were many difficulties, however, over time the caregivers provided proper assistance, not considering it an obligation, but incorporating the situation to their normal routine, and they proved to be formidable in the process of care to patients, performing procedures with great skill, commitment and immeasurable love, affection and dedication. Accordingly, the responsibility of a health care professional is to intervene by providing appropriate guidance to the family, assisting in the rehabilitation of the family facing the care to this new condition.

A vivência de uma família com a doença crônica é no início, difícil e estressante, podendo tornar a família insegura e preocupada. Objetivou-se compreender a vivência e o processo de adaptação da família em virtude do acidente vascular encefálico e descrever as ações desenvolvidas por um projeto de assistência no domicílio. Estudo qualitativo, do tipo Estudo de Caso, realizado com uma família assistida por meio de visitas domiciliares pelo Projeto de Assistência e Apoio à Família de Pacientes Crônicos no Domicílio, em Maringá, Estado do Paraná. A coleta de dados se deu pela consulta dirigida ao prontuário da família, durante os meses de maio e junho de 2009, sendo os dados submetidos à análise de conteúdo. No início havia muitas dificuldades, porém com o passar do tempo os cuidadores prestavam assistência adequadamente, não visualizando como uma obrigação, mas incorporando a situação a sua rotina, e estes se revelaram formidáveis no processo de cuidado a pacientes, realizando os procedimentos com muita destreza, empenho e com imensurável amor, carinho e dedicação. Nesse sentido, uma das responsabilidades do profissional de saúde é a intervenção por meio de orientações adequadas à família, auxiliando no processo de readaptação da família frente aos cuidados e a essa condição.

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O glioma cordoide é um tumor cerebral raro, recentemente descrito, localizado na região do terceiro ventrículo e com características histológicas, imuno-histoquímicas e ultraestruturais peculiares. Este estudo ilustra um caso de glioma cordoide do terceiro ventrículo em uma paciente de 59 anos de idade.

Chordoid glioma is a recently described and rare brain tumor located in the third ventricular region, with distinctive histological, immunohistochemical and ultrastructural features. The present report describes a case of chordoid glioma of the third ventricle in a 59-year-old female patient.

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BACKGROUND: Coagulase-negative staphylococci (CoNS) are one of the most frequent causative agents of neonatal nosocomial infections, especially in premature and low-weight newborns. Risk factors for infection include extracellular polysaccharide production and consequent biofilm formation that permit adhesion to the smooth surface of catheters and other medical devices. The objective of this study was to identify CoNS strains isolated from 105 newborns admitted to the Neonatal Unit of our hospital, and to evaluate the association of biofilm production and host risk factors with the occurrence of infection. METHODS: CoNS isolates were identified and classified as significant or contaminant based on clinical and laboratory data of the newborn medical records. Perinatal risk factors for infection, neonatal clinical evolution, and antibiotic treatment were analysed. In addition, the presence of genes (icaA, icaC and icaD) responsible for biofilm production in CoNS was investigated. RESULTS: Among the 130 CoNS strains studied, 66 (50.8%) were classified as clinically significant and 64 (49.2%) as contaminant. There was no difference in the detection of biofilm-specific genes between CoNS strains isolated from newborns with (81.8%) and without infection (84.3%), although 11 (91.7%) of the 12 children whose death was related to CoNS were infected with strains that were positive for these genes. Forty-five (83.3%) of the 54 newborns infected with CoNS were premature and 33 (61.1%) had a birth weight ≤ 1,500 g. Most newborns infected with CoNS had been submitted to invasive procedures, including catheter use (85.2%), parenteral nutrition (61.1%), and mechanical ventilation (57.4%). S. epidermidis was the most frequently isolated species (81.5%) and was more related to infection (86.3%) than to contamination (76.5%). CONCLUSION: Most newborns infected with CoNS presented factors that contributed to the colonization and development of infection with these microorganisms, including a birth weight ≤ 1,500 g, catheter complications, use of a drain, and previous antibiotic treatment. The fact that most children who died of CoNS-related infection carried strains positive for biofilm-specific genes indicates the importance of this virulence factor for the outcome of staphylococcal infections.

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OBJETIVO: Utilizar a ultrassonografia do esôfago intra-abdominal para avaliar o tempo de trânsito esofágico para água e iogurte, em posição ortostática, e avaliar a influência do gênero e índice de massa corpórea. MATERIAIS E MÉTODOS: Foram estudados 89 indivíduos adultos jovens, sem clínica de doenças do trato gastrintestinal superior, sendo 40 do gênero feminino (média de 20,13 ± 1,62 anos) e 49 do gênero masculino (média de 20,43 ± 2,17 anos). O tempo de trânsito esofágico foi cronometrado, com o paciente em posição ortostática, durante a deglutição de água e iogurte. RESULTADOS: O tempo de trânsito esofágico para as mulheres e para os homens foi, respectivamente: para água, de 5,84 ± 1,60 segundos versus 6,66 ± 1,68 segundos, e para iogurte, de 9,12 ± 1,96 segundos versus 9,28 ± 1,70 segundos. Não se constatou diferença entre os gêneros masculino e feminino, apesar de o fator índice de massa corpórea ser menor nas mulheres. CONCLUSÃO: Os dados obtidos do tempo de trânsito esofágico para alimento líquido (água) e pastoso (iogurte), em posição ortostática, em adultos jovens não mostraram diferença entre os gêneros, mesmos nas mulheres com índice de massa corpórea menor em relação aos homens.

OBJECTIVE: To utilize intra-abdominal esophagus ultrasonography to evaluate esophageal transit time for water and yogurt in orthostatic position, and to evaluate the influence of gender and body mass index. MATERIALS AND METHODS: The present study included 89 young adults [40 women (mean age, 20.13 ± 1.62 years) and 49 men (mean age, 20.43 ± 2.17 years)] who did not show upper gastrointestinal tract disorder. Esophageal transit time was measured with the patient in orthostatic position during water and yogurt swallowing. RESULTS: Esophageal transit time for women and men was, respectively, 5.84 ± 1.60 seconds versus 6.66 ± 1.68 seconds with water, and 9.12 ± 1.96 seconds versus 9.28 ± 1.70 seconds with yogurt. No difference between genders was observed in spite of the lower body mass index in women. CONCLUSION: Data regarding esophageal transit time for liquid (water) and pasty (yogurt) food swallowed by young adults in the orthostatic position did not demonstrate any difference between genders even in women with lower body mass index as compared with men.

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Despite improvements in care and rehabilitation of burned patients, infections still remain the main complication and death cause. Catheter-related infections are among the four most common infections and are associated with skin damage and insertion site colonization. There are few studies evaluating this kind of infection worldwide in this special group of patients. Padre Albino Hospital Burn Care Unit (PAHBCU) is the only reference center in the Northwestern São Paulo for treatment of burned patients. This paper presents the results of a retrospective study aiming at describing the epidemiological and clinical features of catheter-related infections at PAHBCU.

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Despite improvements in care and rehabilitation of burned patients, infections still remain the main complication and death cause. Catheter-related infections are among the four most common infections and are associated with skin damage and insertion site colonization. There are few studies evaluating this kind of infection worldwide in this special group of patients. Padre Albino Hospital Burn Care Unit (PAHBCU) is the only reference center in the Northwestern São Paulo for treatment of burned patients. This paper presents the results of a retrospective study aiming at describing the epidemiological and clinical features of catheter-related infections at PAHBCU.

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This paper aims at understanding the way nurses experience their patient's death and their patients' dying processes. The researched subjects were nurses that have worked in an Intensive Care Unit of adults. Making use of the phenomenological methodology approach, the data was obtained through a semi-structured interview. The analysis followed the phenomenological approach in the fields of description, reduction and understanding. From such analysis the following categories emerged: the therapeutic obstinacy as a disturbance in the death and dying processes; the hard coexistence among a group of professionals with multiple functions, death and the dying processes; the work dynamics and its implications in death and the patients' dying processes. The professionals need to comprehend that death and dying are an inalienable part of the life and not a challenge to be always overcome.

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O estudo teve como objetivo compreender como os enfermeiros vivenciam o processo de morte e o morrer dos pacientes. Os sujeitos foram os enfermeiros que atuam em uma Unidade de Terapia Intensiva de adultos. Foi utilizada a metodologia fenomenológica e os dados foram colhidos por meio de uma entrevista semiestruturada. Na análise,procedeu-se segundo a descrição, redução e compreensão fenomenológica, e, a partir dela, foram desveladas as seguintes categorias: a obstinação terapêutica como um percalço no processo de morte e morrer; a difícil convivência com a equipe multiprofissional e o processo de morte e morrer; a dinâmica do trabalho e suas implicações na morte e morrer dos pacientes. Os profissionais precisam compreender que a morte e o morrer fazem parte inalienável davida e não um desafio a ser sempre vencido.

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Este trabalho caracterizou-se como qualitativo, de abordagem exploratória e teve como objetivo conhecer a percepção dos mestrandos de enfermagem sobre a religião, como recurso terapêutico no processo de recuperação do ser humano doente e sua família. A população fopi composta por 14 mestrandos. Para a coleta de dados foi utilizado questionário. Das informações emergiram as categorias: religião como apoio pessoal, religião e o cuidado de enfermagem, religião como recurso terapêutico e utilizando a religião na prática do cuidado de enfermagem. Os resultados mostraram que a religião é vista pelos mestrando de enfermagem como um recurso importante e necessário no processo de recuperação do ser humano doente; que este tema deve fazer parte do processo de cuidado de enfermagem e a necessidade de inclusão deste tema como disciplina na academia, ou seja, o cuidado religioso.

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Este artigo é uma reflexão teórico-filosófica que teve como foco o cuidado prestado pela equipe de enfermagem em UTI. Em virtude de constantes situações de emergência, a UTI caracteriza-se como estressante, tanto para os profissionais comopara os pacientes e seus familiares. Observamos que o cuidado mantém o modelo biomédico, vendo o paciente como portador de doença e voltado apenas para o caráter curativo. Como profissionais, não temos o poder de anular as doenças, mas necessitamos direcionar nosso comportamento para proporcionar uma assistência humanizada ao paciente para que o período de internação se torne o menos doloroso possível.

This article is a theoretical and philosophical reflection focusing on the care given by the nursing team in an intensive care unit (ICU). Because of the constant situations of emergency, the ICU is stressful both for the professionals, patients and their family members. We notice that the care has a bio-medical model, seeing the patient as the bearer of a disease and dealing only with the curative aspect. As professionals, we do not have the power to cancel the diseases, but we need to direct our behavior so as to provide humanized assistance to the patient so that the period of hospitalization is the least painful possible.

Este artículo es una reflexión teórico-filosófica enfocada en el cuidado brindado por el equipo de enfermeros en la unidad de terapia intensiva (UTI). Debido a constantes situaciones de emergencia, la UTI se caracteriza como estresante, tanto para los profesionales como para pacientes y sus familiares. Observamos que el cuidado sigue el modelo biomédico que ve al paciente como portador de enfermedad y se preocupa sólo por el carácter curativo. Como profesionales no contamos con el poder de anular enfermedades, pero debemos buscar que nuestro comportamiento le proporcione al paciente una asistencia humanizada para que el periodo de internación sea lo menos doloroso posible.

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O interesse pela realização deste estudo advém do meu mundo-vida, da minha experiência profissional e do contato contínuo com o ambiente da Unidade de Terapia Intensiva (UTI). No cotidiano de trabalho em UTI, os profissionais de enfermagem convivem com as angústias vivenciadas pelos pacientes e seus familiares, em virtude da complexidade do estado deles, da tensão da morte iminente, da realização de grande número de procedimentos complexos e do ritmo intenso de trabalho. Teve como objetivo compreender como os enfermeiros que trabalham, em UTI, vivenciam o processo de morte e o morrer dos pacientes. Neste contexto, a pesquisa fenomenológica mostrou-se adequada permitindo o resgate da subjetividade da experiência vivida, considerando o sujeito em sua dimensão existencial. Os sujeitos desta pesquisa foram os enfermeiros que assinaram o Termo de Compromisso Livre e Esclarecido e atuam em uma UTI/Adulto de um Hospital Escola, localizado no Noroeste do Paraná. A coleta de dados se deu por meio de uma entrevista gravada e transcrita na íntegra, com a seguinte questão norteadora: "O que é para você vivenciar a morte e o morrer de um paciente que está em seus cuidados?". Foram entrevistados oito enfermeiros e a pesquisa encerrou-se no momento em que foi verificada a invariância do fenômeno. Após a transcrição das entrevistas, procedeu-se à análise segundo Martins (1992)...

Interest in current study hails from my life work, my professional experience and the continuous contact with patients in the Intensive Care Unit (ICU). In their daily life at the ICU nurses live with the anguish experienced by patients and their relatives owing to the complexity of their physical and emotional state, especially imminent death, to the accomplishment of a great number of complex procedures and to intense work. Current research aims at understanding the manner nurses who work at ICUs experience the death process and patient's state of dying. The phenomenological research is adequate to recuperate the subjectivity of the experience while considering the subject in his/her existential dimension. The subjects of current research were nurses who signed the Term of Free Commitment and who work at the adult ICU of a school hospital in the northeastern region of the state of Paraná, Brazil. Data were collected through interviews recorded and transcribed wholly. The master question involved: What do the death and the dying of a patient in your care mean? After the interview has been transcribed, analysis followed according to Martins (1992). A close analysis of the interviews showed categories indicated by nurses, or rather, experiencing death and the dying of patients are processes that pervade the following issues...

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