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Digital Health is a new way for medicine to work together with computer engineering and ICT to carry out tests and obtain reliable information about the health status of citizens in the most remote places in Brazil in near-real time, applying new technologies and digital tools in the process. InovaHC is the technological innovation core of the Clinics Hospital of the Faculty of Medicine of the University of São Paulo (HCFMUSP). It is the first national medical institution to seek new opportunities offered by 5G technology and test its application in the first private network for Digital Health in the largest hospital complex in Latin America through the OpenCare5G Project. This project uses an Open RAN concept and network disaggregation with lower costs than the traditional concept used by the telecommunications industry. The technological project connected to the 5G network was divided into two phases for proof-of-concept testing: the first with an initial focus on carrying out examinations with portable ultrasound equipment in different locations at HCFMUSP, and the second focusing on carrying out remote examinations with health professionals in other states of Brazil, who will be working in remote areas in other states with little or no ICT infrastructure together with a doctor analyzing exams in real time at HCFMUSP in São Paulo. The objective of the project is to evaluate the connectivity and capacity of the 5G private network in these the proof-of-concept tests for transmitting the volume of data from remote exams with higher speed and lower latency. We are in the first phase of the proof of concept testing to achieve the expected success. This project is a catalyst for innovation in health, connecting resources and entrepreneurs to generate solutions for the innovation ecosystem of organizations. It is coordinated by Deloitte with the participation of the Escola Politécnica da USP (The School of Engineering-University of São Paulo), Airspan, Itaú Bank, Siemens Healthineers, NEC, Telecom Infra Projet, ABDI and IDB. The use of 5G Open RAN technology in public health is concluded to be of extreme social, economic, and fundamental importance for HCFMUSP, citizens, and the development of health research to promote great positive impacts ranging from attracting investment in the country to improving the quality of patient care.

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PURPOSE: Patients submitted to radiotherapy (RT) may present in their healthy tissues surrounding the treated tumor, some typical acute inflammatory reactions induced by ionizing radiation (IR). The manifestation of inflammatory processes is a result of exacerbation of the immune system, as a response to radiation exposure, and this can be a limiting factor for RT protocols. To counteract this, some thiazolidinediones, such as LPSF/GQ-16, may be useful for modulating the patient's radioinduced inflammatory response in normal tissues. In this context, the present work aims to evaluate the activity of LPSF/GQ-16 on the levels of cytokines and the expression of the gene PPARγ in mononuclear cells irradiated in vitro, to analyze the immunomodulatory activity of the molecule and its action on radiomitigation. MATERIALS AND METHODS: For this, blood samples from eight donors were collected and irradiated with 2 Gy, then the PBMC (peripheral blood mononuclear cells) were cultured and treated with LPSF/GQ-16. The levels of cytokines TNF-α, IFN-γ, IL-2 and IL-4 were quantified by CBA, while the genes of TNF-α, IFN-γ and PPARγ were analyzed by RT-PCR. RESULTS: LPSF/GQ-16 significantly reduced the expression of proinflammatory cytokines (IFN-γ and TNF-α) in irradiated and nonirradiated groups. There was no significant reduction of anti-inflammatory cytokines (IL-2 and IL-4) by LPSF/GQ-16. The mRNA expression of PPAR-γ, IFN-γ and TNF-α in the presence of LPSF/GQ-16 was higher in the nonirradiated sample. CONCLUSION: LPSF/GQ-16 showed effective activity after irradiation, with an important immunomodulatory activity in irradiated PBMCs.

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Human cases of dengue virus based on the National Dengue Control Plan were compared with the molecular detection of the dengue virus in trapped mosquitoes, verifying the prediction and efficacy potentials of vector control between the two methodologies in a city with three endemic frontiers. Molecular detection of dengue virus in trapped mosquitoes was significantly higher than in human cases (p = 0.0435). Thus, molecular detection could be used as an early indicator to help prevent more human cases of dengue.

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INTRODUCTION: The objective of this study was to determine how different people perceive distinct malocclusions with the use of eye tracking and to compare the results with scores from the subjective visual attractiveness scale (VAS) following 3 grades obtained from the Aesthetic Component of the Index of Orthodontic Treatment Need (AC-IOTN) scale. METHODS: Ninety participants were equally distributed into 3 groups-dentists, orthodontists, and laypeople-and underwent 1 eye-tracking session. After being positioned and calibrated, they were shown 3 dental images. The images reflected the AC-IOTN grades of 1 (close to ideal), 5 (borderline need for treatment), and 8 (definite need for treatment). During the viewing, eye-tracker data were collected for fixation points, duration, and attractiveness (according to the VAS) for each image. The variables were statistically tested with the use of 2-way analysis of variance and complete factorial model (between groups, grades, and for the interactions between them). RESULTS: Grade 1 received the highest subjective score independently from the participant group. This was in contrast to grades 5 and 8, which received similar scores, although the means of fixation points and duration were not significantly different among the grades (P > 0.05). The scores obtained from the dentist group were significantly higher than those from the other groups when the comparison was independent from the grade. In terms of fixation points, there were differences between dentists and orthodontists and between orthodontists and laypeople. The fixation point mean was higher for orthodontists than for dentists and was similar to that for laypeople. CONCLUSIONS: Orthodontists were able to closely analyze the occlusal problems presenting with more severe malocclusions, and the specialists noticed more fixation points. Duration times, however, were not significantly different, because the orthodontists had greater interest, even in situations of unfavorable esthetics.

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BACKGROUND: There is an increased demand for nursing homes (NHs) in middle-income countries such as Brazil. To monitor the quality of NHs, there is a need for reliable instruments to assess the extent to which the care provided meets the expectations and rights of residents and their families. PURPOSE: To evaluate the reliability, applicability, and measurement results of an instrument for assessing the quality of NH care assessment. METHODS: We conducted a cross-sectional study in 31 NHs, applying the Observable Indicators of Nursing Home Care Quality Instrument (OINHQ) adapted to the Brazilian context. The instrument includes 30 infrastructure and process indicators measured by direct observation grouped into seven domains: Communication; Care Delivery; Grooming; Odors; Environment-Basic; Environment-Access; and Environment-Homelike. To assess feasibility and reliability, 3 pairs of raters with different profiles (health professionals, health inspectors, and potential residents) were independently involved in data collection. We calculated Cronbach α for internal consistency of the instrument, Overall Agreement Index (OAI), and Prevalence-Adjusted Bias-Adjusted Kappa (PABAκ) for interrater reliability and analyzed the baseline NH quality through individual indicators, dimensions, and facilities. RESULTS: The OINHQ was in general reliable, with good internal consistency (Cronbach α = 0.93) and interrater agreement (mean OAI = 75%; PABAκ = 0.49). NH quality is not homogeneous (overall mean = 2.9, ranging by facility between 1.9 and 3.7, on a scale of 1-5). Process-related indicators (mean = 2.7) are generally worse than structure-related indicators (mean = 3.5). The best domains were associated with Odors (mean = 4.1) and Grooming (mean = 3.9), whereas the priority domains for receiving improvement interventions were Care Delivery (mean = 2.0) and Environment-Homelike (mean = 2.5). CONCLUSIONS: Baseline evaluation of NH quality shows remarkable variability among facilities and ample room for improvement.

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Psoriasis is a chronic and recurrent dermatitis, mediated by keratinocytes and T cells. Several proinflammatory cytokines contribute to formation and maintenance of psoriatic plaque. The Th1/Th17 pathways and some of IL-1 family members were involved in psoriasis pathogenesis and could contribute to disease activity. Therefore, we sought to analyse skin transcript levels of IL17A, IL22, RORC, IL8, IFNG, IL33, IL36A, FOXP3, and IL10 and correlate with clinic of patients with plaque-type psoriasis. In order to conduct that, we collected punch biopsies from lesional skin and obtained tissue RNA. After reverse transcription, qRT-PCR quantified the relative mRNA expression. The main results revealed increased transcripts levels of IL17A, IFNG, and FOXP3 in moderate-severe patients. Despite this, only IL17A can increase the chance to worsen disease severity. We also observed many significant positive correlations between each transcript. In conclusion, IL17A is elevated in lesional skin from psoriasis patients and plays crucial role in disease severity.

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The marine clam Anomalocardia brasiliana is a candidate as a sentinel animal to monitor the contamination levels of coliforms in shellfish-harvesting areas of Brazil's northeastern region. The aim of the present study was to search enterotoxin-encoding genes plus the mecA gene among coagulase-negative staphylococci (CNS) isolates from shellfish meats of A. brasiliana. The specimen clam (n=48; 40 clams per sample) was collected during low tide in the bay area of Mangue Seco from April through June 2009, and random samples of chilled and frozen shelled clam meat (n=33; 250 g per sample) were obtained from retail shops from January through March 2012. Seventy-nine CNS isolates were identified, including Staphylococcus xylosus, S. cohnii spp. urealyticus, S. sciuri, and S. lentus. A high percentage of isolates resistant to erythromycin (58.5%), penicillin (51.2%), and tetracycline (43.9%), and the fluoroquinolones levofloxacin (39%) and ciprofloxacin (34.1%) were recorded from those environmental samples. Isolates from retail shops were particularly resistant to oxacillin (55.3%) and penicillin (36.8%). All CNS resistant to oxacillin and/or cefoxitin were positive for the presence of the mecA gene, but phenotypically susceptible to vancomycin. Also, the enterotoxin-encoding genes seg and seh were detected through multiplex-polymerase chain reaction in 77.7% and 88.8% of the isolates from environmental samples, versus 90.5% and 100% of the isolates from retail shops, respectively. The data reveal the risk to public health due to consuming raw or undercooked shellfish containing enterotoxigenic plus methicillin-resistant CNS.

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The ventrolateral caudoputamen (VLCP) is well known to participate in the control of orofacial movements and forepaw usage accompanying feeding behavior. Previous studies from our laboratory have shown that insect hunting is associated with a distinct Fos up-regulation in the VLCP at intermediate rostro-caudal levels. Moreover, using the reversible blockade with lidocaine, we have previously suggested that the VLCP implements the stereotyped actions seen during prey capture and handling, and may influence the motivational drive to start attacking the roaches, as well. However, considering that (1) lidocaine suppresses action potentials not only in neurons, but also in fibers-of-passage, rendering the observed behavioral effect not specific to the ventrolateral caudoputamen; (2) the short lidocaine-induced inactivation period had left a relatively narrow window to observe the behavioral changes; and (3) that the restriction stress to inject the drug could have also disturbed hunting behavior, in the present study, we have examined the role of the VLCP in predatory hunting by placing bilateral NMDA lesions three weeks previous to the behavior testing. We were able to confirm that the VLCP serves to implement the stereotyped sequence of actions seen during prey capture and handling, but the study did not confirm its role in influencing the motivational drive to hunt. Together with other studies from our group, the present work serves as an important piece of information that helps to reveal the neural systems underlying predatory hunting.

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On account of the impacts caused by urbanization in natural populations and the impact caused bychiroptera in urban environment, the study of urban bats is indispensable. The objective of this study was toperform a survey on bats occurring in the urban area of Itabira city, state of Minas Gerais, southeastern Brazil.Bats were collected in three areas within the city of Itabira: Intelecto Forest, Campus of FUNCESI and a smallfarm named Geralda. Fieldwork was carried once a month in each area, during September/2004 to August /2005.Four mist nets were opened between 18:00h and 1:00h and were checked in intervals of 30 minutes. One hundredeighty individuals belonging to three families were captured: Phyllostomidae (96%), Vespertilionidae (3%) andMolossidae (1%), in a total of 13 species. Three species were common to the three areas: Artibeus lituratus, Platyrrhinus lineatus and Glossophaga soricina. Two species, Pygoderma bilabiatum and Lasiurus ega, were collected exclusively in Mata do Intelecto. Phyllostomus hastatus and Molossus molossus were collected exclusively in the small farm of Geralda. Most captured bats were generalist frugivores species, what could beattributed to selectivity, due to capture with mist nets. The higher number of species found in Mata do Intelectocould be attributed to its larger preserved area, and consequently higher habitat heterogeneity.

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On account of the impacts caused by urbanization in natural populations and the impact caused bychiroptera in urban environment, the study of urban bats is indispensable. The objective of this study was toperform a survey on bats occurring in the urban area of Itabira city, state of Minas Gerais, southeastern Brazil.Bats were collected in three areas within the city of Itabira: Intelecto Forest, Campus of FUNCESI and a smallfarm named Geralda. Fieldwork was carried once a month in each area, during September/2004 to August /2005.Four mist nets were opened between 18:00h and 1:00h and were checked in intervals of 30 minutes. One hundredeighty individuals belonging to three families were captured: Phyllostomidae (96%), Vespertilionidae (3%) andMolossidae (1%), in a total of 13 species. Three species were common to the three areas: Artibeus lituratus, Platyrrhinus lineatus and Glossophaga soricina. Two species, Pygoderma bilabiatum and Lasiurus ega, were collected exclusively in Mata do Intelecto. Phyllostomus hastatus and Molossus molossus were collected exclusively in the small farm of Geralda. Most captured bats were generalist frugivores species, what could beattributed to selectivity, due to capture with mist nets. The higher number of species found in Mata do Intelectocould be attributed to its larger preserved area, and consequently higher habitat heterogeneity.

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The citrus leafminer, Phyllocnistis citrella (Gracillariidae), is among the main pests of citrus in Brazil. The objective of this work was to conduct a survey of parasitoids attacking CLM in Jaguariúna, State of São Paulo, Brazil, before and after the introduction of Ageniaspis citricola (Encyrtidae). Collections of new leaves were made weekly at citrus groves from July-1997 to April-1999. During the survey period, A. citricola was introduced in the area. Before this introduction, Galeopsomyia fausta (Eulophidae) was the predominant species (about 91.83% of the species composition), but A. citricola became predominant after its establishment (60.10% against 38.30% G. fausta). Other parasitoids found were Cirrospilus sp. C (Eulophidae), Horismenus sp. (Eulophidae), Elasmus sp. (Elasmidae), Eupelmus sp. (Eupelmidae) and Conura (Ceratosmicra) sp. (Chalcididae).

A larva-minadora-da-folha-dos-citros, Phyllocnistis citrella (Gracillariidae), é atualmente uma praga de importância econômica na citricultura nacional. O objetivo deste trabalho foi identificar o complexo de parasitóides desta praga em Jaguariúna, SP, Brasil, antes e depois da introdução de Ageniaspis citricola (Encyrtidae). Coletas de brotações infestadas pela praga foram realizadas semanalmente, no período de Julho/96 a Abril/99. Durante o período do levantamento, A. citricola foi introduzido nesta área. Antes dessa introdução, Galeopsomyia fausta (Eulophidae) era a principal espécie a atacar P. citrella (91,83% dos parasitóides encontrados), mas A. citricola tornou-se predominante após seu estabelecimento na área de liberação (60,10% contra 38,30% de G. fausta). Também outros parasitóides foram encontrados: Cirrospilus sp. C (Eulophidae), Horismenus sp. (Eulophidae), Elasmus sp. (Elasmidae), Eupelmus sp. (Eupelmidae) and Conura (Ceratosmicra) sp. (Chalcididae).

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The citrus leafminer, Phyllocnistis citrella (Gracillariidae), is among the main pests of citrus in Brazil. The objective of this work was to conduct a survey of parasitoids attacking CLM in Jaguariúna, State of São Paulo, Brazil, before and after the introduction of Ageniaspis citricola (Encyrtidae). Collections of new leaves were made weekly at citrus groves from July-1997 to April-1999. During the survey period, A. citricola was introduced in the area. Before this introduction, Galeopsomyia fausta (Eulophidae) was the predominant species (about 91.83% of the species composition), but A. citricola became predominant after its establishment (60.10% against 38.30% G. fausta). Other parasitoids found were Cirrospilus sp. C (Eulophidae), Horismenus sp. (Eulophidae), Elasmus sp. (Elasmidae), Eupelmus sp. (Eupelmidae) and Conura (Ceratosmicra) sp. (Chalcididae).

A larva-minadora-da-folha-dos-citros, Phyllocnistis citrella (Gracillariidae), é atualmente uma praga de importância econômica na citricultura nacional. O objetivo deste trabalho foi identificar o complexo de parasitóides desta praga em Jaguariúna, SP, Brasil, antes e depois da introdução de Ageniaspis citricola (Encyrtidae). Coletas de brotações infestadas pela praga foram realizadas semanalmente, no período de Julho/96 a Abril/99. Durante o período do levantamento, A. citricola foi introduzido nesta área. Antes dessa introdução, Galeopsomyia fausta (Eulophidae) era a principal espécie a atacar P. citrella (91,83% dos parasitóides encontrados), mas A. citricola tornou-se predominante após seu estabelecimento na área de liberação (60,10% contra 38,30% de G. fausta). Também outros parasitóides foram encontrados: Cirrospilus sp. C (Eulophidae), Horismenus sp. (Eulophidae), Elasmus sp. (Elasmidae), Eupelmus sp. (Eupelmidae) and Conura (Ceratosmicra) sp. (Chalcididae).