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The spleen plays a pivotal role in the pathogenesis of visceral leishmaniasis. In severe forms of the disease, the spleen undergoes changes that can compromise its function in surveilling blood-circulating pathogens. In this study, we present an integrated analysis of the structural and gene expression alterations in the spleens of three patients with relapsing visceral leishmaniasis, two of whom were coinfected with HIV. Our findings reveal that the IL6 signaling pathway plays a significant role in the disorganization of the white pulp, while BCL10 and ICOSLG are associated with spleen organization. Patients coinfected with HIV and visceral leishmaniasis exhibited lower splenic CD4+ cell density and reduced expression of genes such as IL15. These effects may contribute to a compromised immune response against L. infantum in coinfected individuals, further impacting the structural organization of the spleen.

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Understanding the normal physiology of the canine mammary gland (CMG) is crucial, as it provides a foundational reference for understanding canine mammary neoplasms. The relation between the Proliferation Index (PI) indicated by Ki-67 expression, along with the Apoptotic Index (AI) determined through Caspase-3 expression during the oestrous cycle, is inadequately documented in existing literature. This study seeks to offer insights into the interplay between PI and AI in the CMG across oestrous cycle phases. An extensive investigation was conducted on a diverse case series of bitches (n = 18). Oestrous cycle stages were determined through vaginal cytology, histological examination of the reproductive tract and serum progesterone and oestradiol concentrations. The entire mammary chain was histologically examined, and proliferation and apoptosis were assessed via double immunohistochemistry employing anti-Ki-67 and Caspase-3 antibodies. PI and AI were evaluated through a systematic random sampling approach, counting a minimum of 200 cells for each cell type. There was a significantly higher PI during early dioestrus in all mammary gland components, with a greater proportion of positive cells observed in epithelial cells compared to stromal cells. The highest PI was detected in epithelial cells within the end buds. Significant differences were found in Ki-67 labelling across the cranial mammary glands. A positive and strong correlation was noted between progesterone concentration and PI in epithelial cells. The AI remained consistently low throughout the oestrous cycle, with few differences observed across histological components. Caspase-3 labelling displayed the highest positivity in caudal mammary pairs. A negative and moderate correlation was identified between progesterone concentration and AI in interlobular mesenchymal cells. This study highlights the influence of endocrine regulation on cell proliferation indices in mammary tissue, emphasizing the need to consider these hormonal variations in toxicopathological studies involving canine mammary gland.

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ABSTRACT Objective: to assess multidisciplinary team professionals' knowledge, attitude and practice regarding pain management in newborns admitted to a Neonatal Intensive Care Unit. Method: this is a quantitative descriptive study of the Knowledge, Attitude and Practice survey type, developed with 37 healthcare professionals in a Neonatal Intensive Care Unit of a university hospital in southern Brazil, which adopts the Kangaroo Method as a basis of care. Results: in the knowledge item, the majority of professionals recognized that pain is present in newborns (94.6%) and there was a unanimous understanding that, when not treated properly, can cause short and long-term consequences (100.0%). In their attitude, they recognize that all professionals are responsible for pain management (100.0%) and that they should prioritize it over invasive procedures (97.3%). In practice, professionals assess pain or use an assessment scale (97.3%) and perform this practice when checking vital signs or performing a physical examination (94.6%). However, there was a lower proportion of professionals who considered analgesia necessary when carrying out daily procedures such as changing diapers, weighing and checking vital signs (48.6%) or who recorded pain assessments (67.6%) or pain management in medical records (56.8%). Conclusion: professionals recognize newborn pain, value management and apply measures to prevent and treat pain in invasive procedures. However, advances are needed in records as well as the incorporation of management into less complex daily procedures.

RESUMEN Objetivo: evaluar el conocimiento, actitud y práctica de los profesionales del equipo multidisciplinario sobre el manejo del dolor en el recién nacido ingresado en la Unidad de Cuidados Intensivos Neonatales. Método: estudio descriptivo cuantitativo del tipo encuesta de Conocimientos, Actitudes y Prácticas, desarrollado con 37 profesionales de la salud en una Unidad de Cuidados Intensivos Neonatales de un hospital universitario de la Región Sur de Brasil, que adopta el Método Canguro como base de atención. Resultados: en el ítem conocimiento, la mayoría de los profesionales reconoció que el dolor está presente en el recién nacido (94,6%) y hubo unanimidad en que, cuando no se trata adecuadamente, puede provocar consecuencias a corto y largo plazo (100,0%). En su actitud reconocen que todos los profesionales son responsables del manejo del dolor (100,0%) y que deben priorizarlo frente a los procedimientos invasivos (97,3%). En la práctica, los profesionales evalúan el dolor o utilizan una escala de valoración (97,3%), realizan esta práctica al comprobar los signos vitales o realizar un examen físico (94,6%). Sin embargo, hubo una menor proporción de profesionales que consideran necesaria la analgesia al realizar procedimientos diarios como cambio de pañales, pesaje y control de signos vitales (48,6%) o que registran en la historia clínica las valoraciones del dolor (67,6%) o el manejo del dolor (56,8%). Conclusión: los profesionales reconocen el dolor del recién nacido, valoran el manejo y aplican medidas para prevenir y tratar el dolor en procedimientos invasivos. Sin embargo, se necesitan avances en los registros, así como la incorporación de la gestión a procedimientos diarios menos complejos.

RESUMO Objetivo: avaliar o conhecimento, atitude e prática dos profissionais da equipe multiprofissional sobre o manejo da dor no recém-nascido internado em Unidade de Terapia Intensiva Neonatal. Método: estudo quantitativo descritivo do tipo inquérito Conhecimento, Atitude e Prática, desenvolvido com 37 profissionais de saúde em uma Unidade de Terapia Intensiva Neonatal de um hospital universitário na Região Sul do Brasil, que adota o Método Canguru como base de assistência. Resultados: no item conhecimento, a maioria dos profissionais reconheceu que a dor está presente nos recém-nascidos (94,6%) e foi unânime a compreensão de que, quando não tratada adequadamente, pode causar consequências a curto e longo prazo (100,0%). Na atitude, reconhecem que todos os profissionais são responsáveis pelo manejo da dor (100,0%) e que devem priorizá-lo diante de procedimentos invasivos (97,3%). Na prática, os profissionais avaliam a dor ou utilizam uma escala de avaliação (97,3%), realizam esta prática ao verificar os sinais vitais ou realizar o exame físico (94,6%). Contudo foi menor a proporção de profissionais que considera ser necessária a analgesia na realização de procedimentos diários como troca de fralda, pesagem e verificação dos sinais vitais (48,6%) ou que faz o registro da avaliação da dor (67,6%) ou do manejo da dor no prontuário (56,8%). Conclusão: os profissionais reconhecem a dor do recém-nascido, valorizam o manejo e aplicam medidas para prevenir e tratar a dor em procedimentos invasivos. No entanto, são necessários avanços nos registros, bem como na incorporação do manejo nos procedimentos diários de menor complexidade.

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We aimed to evaluate the effects of post-ruminal supply of urea (PRU) on nutritional status, and liver metabolism of pregnant beef cows during late gestation. Twenty-four Brahman dams, pregnant from a single sire, and weighing 545 kg ± 23 kg were confined into individual pens at 174 ± 23 d of gestation, and randomly assigned into one of two dietary treatments up to 270 d of gestation: Control (CON, n = 12), consisting of a basal diet supplemented with conventional urea, where the cows were fed with diets containing 13.5 g conventional urea per kg dry matter; and PRU (PRU, n = 12), consisting of a basal diet supplemented with a urea coated to extensively prevent ruminal degradation while being intestinally digestible, where the cows were fed with diets containing 14,8 g urea protected from ruminal degradation per kg dry matter. Post-ruminal supply of urea reduced the urine levels of 3-methylhistidine (P = 0.02). There were no differences between treatments for dry matter intake (DMI; P = 0.76), total digestible nutrient (TDN) intake (P = 0.30), and in the body composition variables, such as, subcutaneous fat thickness (SFT; P = 0.72), and rib eye area (REA; P = 0.85). In addition, there were no differences between treatments for serum levels of glucose (P = 0.87), and serum levels of glucogenic (P = 0.28), ketogenic (P = 0.72), glucogenic, and ketogenic (P = 0.45) amino acids, neither for urea in urine (P = 0.51) as well as urea serum (P = 0.30). One the other hand, enriched pathways were differentiated related to carbohydrate digestion, and absorption, glycolysis, pyruvate metabolism, oxidative phosphorylation, pentose phosphate pathway, and biosynthesis of amino acids of the exclusively expressed proteins in PRU cows. Shifting urea supply from the rumen to post-ruminal compartments decreases muscle catabolism in cows during late gestation. Our findings indicate that post-ruminal urea supplementation for beef cows at late gestation may improve the energy metabolism to support maternal demands. In addition, the post-ruminal urea release seems to be able to trigger pathways to counterbalance the oxidative stress associated to the increase liver metabolic rate.

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The introduction of new fish species to the aquaculture industry is essential to halt the progressive decline of natural fish stocks. The sheepshead Archosargus probatocephalus is a commercially valuable sparid fish with potential for breeding in captivity, but with limited information regarding parasitic infections that could pose a significant threat for its sustainable production. Thus, the present study aimed to study the myxozoan diversity infecting A. probatocephalus. A novel Henneguya sp. was detected forming plasmodia in the gill lamellae of specimens inhabiting the Brazilian coast, and is characterized based on morphological, histopathological, ultrastructural, molecular, and phylogenetic data. Myxospore total length was 21.3 ± 0.8 µm, with myxospore body 10.0 ± 0.5 µm long, 6.2 ± 0.3 µm wide, and 4.8 ± 0.5 µm thick. Caudal appendages were 10.3 ± 0.5 µm long and did not present any type of coating. Two pyriform polar capsules, 3.4 ± 0.3 µm long and 1.5 ± 0.2 µm wide, each containing an isofilar polar tubule with 4-5 coils. Histopathological analyses showed large intralamellar polysporic plasmodia associated with vascular congestion of the gill filament and gill lamellae, as well as epithelial hyperplasia causing partial or total fusion of gill lamellae. Maximum likelihood and Baysesian inference SSU rDNA-based phylogenetic analyses showed the novel sequence grouped within the marine clade of Henneguya spp. that mostly parasitize fishes belonging to Eupercaria incertae sedis.

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Introduction: Since the start of the COVID-19 pandemic thousands of people have experienced teleworking and this practice is becoming increasingly commonplace. This review aims to highlight the differences in exposure to psychosocial risk factors for health between part-time and full-time teleworking from home. Methods: The protocol of the systematic review of the literature was registered on PROSPERO 2020 platform according to the PRISMA statement guidelines. The key words "telework" and "frequency" ("part-time" or "full-time"), together with their synonyms and variations, were searched. Independent researchers conducted the systematic search of 7 databases: Scopus, SciELO, PePSIC; PsycInfo, PubMed, Applied Social Sciences Index and Abstracts (ASSIA) and Web of Science. Of the 638 articles identified from 2010 to June 2021, 32 were selected for data extraction. The authors evaluated the risk of bias and quality of evidence of the studies included using the Mixed Methods Appraisal Tool. Main themes categorized include 7 dimensions of psychosocial risk factors: work intensity and working hours; emotional demands; autonomy; social relationships at work; conflict of values, work insecurity and home/work interface. Results: The results revealed scant practice of full-time teleworking prior to the pandemic. Regarding the psychosocial risk factors found, differences were evident before and during the COVID-19 pandemic. For part-time and full-time telework prior to the pandemic, the dimensions of intensification of work and working hours, social relationships at work, and the home-work interface were the most prominent factors. However, studies performed during the COVID-19 pandemic where teleworking was mostly performed full-time, there was an increase in focus on emotional demands and the home-work interface, and a reduction in the other dimensions. Discussion: Full-time telework brings important changes in working conditions and has the potential to affect living and health conditions of teleworkers. Part-time teleworking may have positive impact on psychosocial risk factors, favoring work-home balance, communication, and social relationships. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=191455, PROSPERO 2020 CRD4202019 1455.

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Resumo A pandemia do novo coronavírus levou o trabalho para a residência de milhares de trabalhadores no mundo, de maneira compulsória. Portanto, este ensaio objetiva evidenciar os fatores psicossociais de riscos à saúde e o panorama do teletrabalho no primeiro ano da pandemia de covid-19 e, neste contexto, analisar a política do teletrabalho no Brasil. Apresentamos os diferentes conceitos do teletrabalho e discutimos sobre como não é uma modalidade ausente de riscos. Fatores psicossociais, como o isolamento social e profissional, a intensificação do trabalho e sobreposição de atividades profissionais e familiares são alguns dos destacados na literatura. A partir de dados secundários obtidos da Pesquisa Nacional por Amostra de Domicílios e análises do Instituto de Pesquisa Econômica Aplicada durante a pandemia, revelou-se um panorama de desigualdade no perfil daqueles que tem acesso ao teletrabalho, além da acentuação das diferenças regionais. Por fim, identificamos um descompasso entre a regulamentação do teletrabalho e as necessidades dos trabalhadores, impactadas pela pandemia de covid-19. Assim, é necessária a elaboração, reformulação e implementação de políticas, visando garantir os direitos e saúde dos teletrabalhadores.

Abstract The new coronavirus pandemic compulsorily brought work into the homes of thousands of workers worldwide. Therefore, this essay aims to highlight the psychosocial factors of health risks and telework's panorama in the first year of the COVID-19 pandemic and, in this context, to analyze the telework policy in Brazil. We presented the different concepts of telework and discuss how and why it is not a risk-free modality. The literature highlights psychosocial factors, such as social and professional isolation, work intensification and overlapping of professional and family activities. Secondary data obtained from the National Household Sample Survey and analyses by the Institute of Applied Economic Research during the pandemic revealed a panorama of inequality in the profile of those who have access to telework, in addition to the accentuation of regional differences. Finally, we identified a mismatch between the regulation of telework and the workers' needs, impacted by the COVID-19 pandemic. Thus, it is necessary to elaborate, reformulate and implement policies, aiming to guarantee the rights and health of teleworkers.

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ABSTRACT: This study evaluated the effect of maternal protein supplementation during mid or late gestation on energy metabolism of the skeletal muscle of beef calves. Sixteen pregnant cows were divided into 3 groups: CTRL (not supplemented); MID (supplemented from 30 to 180 days of gestation); and LATE (supplemented from 181 to 281 days of gestation). The supplement contained 30% crude protein. Thirty days after birth, blood and muscle samples of the calves were collected for analyses of gene expression, proteins, and metabolites. No differences (P ≥ 0.15) in birth weight, performance at weaning, or muscle expression of the genes evaluated (P ≥ 0.21) were observed. Calves born to CTRL cows had a lower ratio (P = 0.03) of p-AMPK/AMPK protein in the skeletal muscle. Calves born to MID cows had lower (P = 0.04) glucose concentration than those born to LATE cows. Changes in p-AMPK/AMPK protein, indicated a possible metabolic inflexibility in the skeletal muscle of calves born to CTRL cows. These results indicated that lack of protein supplementation in pregnant cows alter the energy metabolism of their calves and reflect in a metabolic inflexibility.

RESUMO: O objetivo deste estudo foi avaliar o efeito da suplementação proteica materna sobre o metabolismo energético do músculo esquelético de bezerros de corte. Dezesseis matrizes gestantes foram divididas em três grupos: CONTROLE (não suplementado); MÉDIO (suplementados entre 30 e 180 dias de gestação); e FINAL (suplementado entre 181 e 281 dias de gestação). O suplemento continha 30% de proteína bruta e foi fornecido em quantidades totais iguais aos tratamentos. Trinta dias após o nascimento, amostras de sangue e músculo dos bezerros foram coletadas para análises de expressão gênica, abundância de proteínas e metabólitos. Não foram observadas diferenças (P ≥ 0,15) no peso ao nascimento ou parâmetros de desempenho ao desmame, bem como na expressão dos genes avaliados (P ≥ 0,21). Os bezerros nascidos de matrizes do tratamento CONTROLE apresentaram menor proporção (P = 0,03) de proteína p-AMPK/AMPK no músculo esquelético. Os bezerros nascidos de matrizes do tratamento MÉDIO apresentaram concentração de glicose menor (P = 0,04) do que aqueles nascidos de matrizes do tratamento FINAL. Os resultados observados indicam que a ausência de suplementação proteica em matrizes gestantes pode alterar o metabolismo energético da progênie e refletir em uma inflexibilidade metabólica, a qual pode ocasionar limitações quanto à eficiência energética do tecido muscular esquelético e consequentemente, limitar o desempenho da progênie ao longo da fase pós-natal.

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CONTEXT: Globally, depression affects more than 322 million people. Studies exploring the relationship between diet and depression have revealed the benefits of certain dietary patterns and micronutrients in attenuating the symptoms of this disorder. Among these micronutrients, selenium stands out because of its multifaceted role in the brain. OBJECTIVE: To assess the impact of selenium intake and status on symptoms of depression. DATA SOURCES: A systematic search was performed in databases, including PubMed, Web of Science, EMBASE, PsycINFO, Scopus, and gray literature (on April 6, 2021, updated on January 28, 2022), without restrictions of date, language, or study type. DATA EXTRACTION: Studies of adults (18-60 y of age) with depression or depressive symptoms were included. Data on selenium biomarkers and/or intake were included. The risk of bias was assessed using the Joanna Briggs Institute checklists. DATA ANALYSIS: Of the 10 studies included, 2 were cohorts (n = 13 983 and 3735), 3 were cross-sectional (n = 736, 7725, and 200), 1 was case-control (n = 495), and 4 were randomized controlled trials (n = 30, 11, 38, and 63). Several studies have indicated that low selenium intake or concentration may be associated with symptoms of depression. However, this association was inconsistent across the studies included in this systematic review; due to the high heterogeneity, it was not possible to perform meta-analyses. The main contributing factors to the high heterogeneity include the different methodological designs, methods for diagnosing depression, selenium assessment, and clinical conditions. CONCLUSION: Overall, there is insufficient evidence to support a positive role of selenium status in depression. Studies with more accurate methods and adequate assessment of selenium status are needed to better understand the role of this nutrient in depression. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42021220683.

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Exercise-induced hypoalgesia (EIH) is characterized as the pain reduction after an exercise session and it seems to be related to the release of plasma ß-endorphin. In this sense, the core stabilization training (CT) has been suggested for patients with chronic nonspecific low back pain (CNSLBP), but it is unclear whether it induces EIH. Patients with CNSLBP have neuromotor dysfunctions that can affect the performance of functional tasks, thus, performing functional training (FT) could improve motor control and promote EIH, since functional training uses multi-joint exercises that aim to improve the functionality of actions performed in daily life. EIH is usually assessed using quantitative sensory tests (QST) such as conditioned pain modulation, pressure pain threshold, and temporal summation. Thus, the sum of parameters from quantitative sensory tests and plasma ß-endorphin would make it possible to understand what the neuroendocrine effects of FT and CT session are. Our study compared the acute effect of CT and FT on the EIH and plasma ß-endorphin release, and correlated plasma ß-endorphin with quantitative sensory testing in patients with CNSLBP. Eighteen women performed two training sessions (CT and FT) with an interval of 48 h between sessions. EIH was assessed by QST and plasma ß-endorphin levels. Results showed that only FT significantly increased plasma ß-endorphin (FT p < 0.01; CT p = 0.45), which correlated with pain pressure threshold (PPT) and conditioned pain modulation (CPM). However, QST values were not different in women with CNSLBP after CT or FT protocols. Plasma ß-endorphin correlated with PPT and CPM, however, the same did not occur with a temporal summation.

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We aimed to investigate the effects of the maternal plane of nutrition during gestation on the proteome profile of the skeletal muscle of the newborn. Pregnant goats were assigned to the following experimental treatments: restriction maintenance (RM) where pregnant dams were fed at 50% of their maintenance requirements from 8−84 days of gestation, and then feed of 100% of the maintenance requirements was supplied from 85­parturition (n = 6); maintenance restriction (MR) where pregnant dams were fed at 100% of their maintenance requirements from 8−84 days of gestation, and then experienced feed restriction of 50% of the maintenance requirements from 85­parturition (n = 8). At birth, newborns were euthanized and samples of the Longissimus dorsi muscle were collected and used to perform HPLC-MS/MS analysis. The network analyses were performed to identify the biological processes and KEGG pathways of the proteins identified as differentially abundant protein and were deemed significant when the adjusted p-value (FDR) < 0.05. Our results suggest that treatment RM affects the energy metabolism of newborns' skeletal muscle by changing the energy-investment phase of glycolysis, in addition to utilizing glycogen as a carbon source. Moreover, the RM plane of nutrition may contribute to fatty acid oxidation and increases in the cytosolic α-KG and mitochondrial NADH levels in the skeletal muscle of the newborn. On the other hand, treatment MR likely affects the energy-generation phase of glycolysis, contributing to the accumulation of mitochondrial α-KG and the biosynthesis of glutamine.

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OBJECTIVES: To immobilize Candida rugosa lipase in Accurel MP 1000 (CRL-AMP) by physical adsorption in organic medium and apply in the synthesis of wax esters dodecanoyl octadecanoate 1 and hexadecanoyl octadecanoate 2 in a heptane medium, as well as evaluating the stability and recyclability of CRL-AMP in six reaction cycles. RESULTS: The specific activity (Asp) for CRL-AMP was 200 ± 20 U mg-1. Its catalytic activity was 1300 ± 100 U g-1. CRL-AMP was used in the synthesis of esters in heptane medium with a 1:1 acid:alcohol molar ratio at 45 °C and 200 rpm. In synthesis 1, conversion was 62.5 ± 3.9% in 30 min at 10% m v-1 and 56.9 ± 2.8% in 54 min at 5% m v-1; while in synthesis 2, conversion was 79.0 ± 3.9% in 24 min at 10% m v-1, and 46.0 ± 2.4% in 54 min at 5% m v-1. Reuse tests after six consecutive cycles of reaction showed that the biocatalyst retained approximately 50% of its original activity for both reaction systems. CONCLUSIONS: CRL-AMP showed a high potential in the production of wax esters, since it started from low enzymatic load and high specific activities and conversions were obtained, in addition to allowing an increase in stability and recyclability of the prepared biocatalyst.

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The productive traits of beef cattle are orchestrated by their genetics, postnatal environmental conditions, and also by the intrauterine background. Both under- or overnutrition, as specific dietary components, are able to promote persistent effects on the offspring. This occurs because dietary factors act not only affecting the availability of substrates for fetal anabolism and oxidative metabolism, but also as signals that regulate several events toward fetal development. Therefore, this study aimed to summarize the gestational nutrition effects on the offspring performance and meat quality in a long term. Overall, studies have shown that many of these alterations are under the control of epigenetic mechanisms, as DNA methylation, histones modification, and non-coding RNA. The current knowledge has indicated that the fetal programming responses are dependent on the window of fetal development in which the dietary treatment is applied, the intensity of maternal nutritional stimuli, and the treatment application length. Collectively, studies demonstrated that muscle cell hyperplasia is impaired when maternal requirements were not achieved in the second third of gestation, which limits the formation of a greater number of muscle fibers and the offspring growth potential in a long term. Changes in muscle fibers metabolism and in collagen content were also reported as consequence of a dietary perturbation during pregnancy. In contrast, a maternal overnutrition during the late pregnancy has been associated with beneficial responses on meat quality. In summary, ensuring an adequate maternal environment during the fetal development is crucial to enhance the productive responses in beef cattle operations.(AU)

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Resumo O objetivo deste estudo foi avaliar a abrangência do enfrentamento da obesidade nos Planos Municipais de Saúde (PMS) do Estado do Tocantins, dado que, diante da crescente prevalência da obesidade no Brasil, seu enfrentamento deveria estar no foco de ação da saúde pública e previsto nos instrumentos de gestão. Trata-se de um estudo qualitativo, com análise documental, que analisou os PMS no período de vigência de 2018 a 2021 nos 139 municípios desse estado. Foram selecionados dezessete termos relacionados à obesidade e verificada a frequência e contexto nos PMS. Do total de 139 PMS, foram avaliados 129 (92,8%). Os termos "academia da saúde" e "Sisvan" foram os mais frequentes, e "obesidade" apareceu em apenas 28% dos planos, totalizando 71 citações. Destas, somente 32,4% relacionavam-se diretamente com o enfrentamento da doença, com destaque nas regiões de saúde Bico do Papagaio e Médio Norte Araguaia. Os contextos relevantes de abordagem da obesidade mais frequentes foram a caracterização da situação epidemiológica, quadros de metas de ações e indicadores. Concluiu-se que o enfrentamento da obesidade pactuado nos PMS está ausente em mais de 70% dos municípios do Tocantins, e que ações de direcionamento para inclusão dessa doença dentro dos instrumentos de gestão são urgentes.

Abstract This documentary analysis evaluated the scope of addressing obesity in the Municipal Health Plans (PMS) in the state of Tocantins, Brazil, since the growing prevalence of obesity in Brazil should put its confrontation at the center of public health action and management instruments. To analyze the PMS performance from 2018 to 2021 in the 139 municipalities of this state, 17 terms related to obesity were selected and had their frequency and context in the PMS verified. Of the existing 139 PMS, 129 (92.8%) were evaluated. "Health academy" and "SISVAN" were the most frequent terms used, whereas "obesity" appeared in only 28% of the plans, totaling 71 mentions. Of these, only 32.4% were directly related to combating the disease, mainly in the health regions of Bico do Papagaio and Médio Norte Araguaia. Relevant contexts for addressing obesity included the characterization of the epidemiological profile, tables of action goals, and indicators. PMS's role in combating obesity is absent in more than 70% of municipalities in Tocantins, which points to the urgent inclusion of this disease within the management instruments.

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BACKGROUND: Corticosteroid injection and dry needling have been used in the treatment of musculoskeletal conditions, but it is unclear which intervention is the most effective. The purpose of this study was to compare the effects of corticosteroid injection and dry needling for musculoskeletal conditions at short-, medium-, and long-term follow-up. METHODS: Electronic databases were searched up to 31 October 2021. Two researchers independently screened titles, abstracts and full-text articles. Randomized clinical trials (RCTs) that investigated the effectiveness of dry needling compared to corticosteroid injection in patients over 18 years with a musculoskeletal condition were included in the review. The studies had to report pain and/or disability as outcome. Risk of bias was assessed by using the revised Cochrane Collaboration tool (RoB 2.0). Quality of evidence was evaluated by using the GRADE approach. RESULTS: Six studies were included (n = 384 participants). Four musculoskeletal conditions were investigated. There is very low-quality evidence that CSI is superior to DN for reducing heel pain (plantar fasciitis) and lateral elbow pain at short- and medium-term follow-up, but not for myofascial pain and greater trochanteric pain. There is very low-quality evidence that DN is more effective than CSI at long-term follow-up for reducing pain in people with plantar fasciitis and lateral epicondylitis. Very low-certainty evidence shows that there is no difference between DN and CSI for disability at short-term follow-up. One study showed that CSI is superior to DN at medium-term follow-up and another observed that DN is superior to CSI for reducing disability at long-term. CONCLUSIONS: There are no differences between DN and CSI in pain or disability for myofascial pain and greater trochanteric pain syndrome. Very-low certainty evidence suggests that CSI is superior to DN at shorter follow-up periods, whereas DN seems to be more effective than CSI at longer follow-up durations for improving pain in plantar fasciitis and lateral epicondylitis. Large RCTs with higher methodological quality are needed in order to draw more incisive conclusions. PROSPERO REGISTRATION NUMBER: CRD42020148650.

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Resumo Introdução Gestação está associada à vida e saúde, mas pode acompanhar algum processo de adoecimento, como é o caso do diabetes mellitus, na condição prévia (tipo 1 ou 2) ou gestacional. Compreender a vivência dessas gestantes pode instrumentalizar para a construção de uma proposta de atenção pré-natal especializada e humanizada. Objetivo interpretar os sentidos e significados da gestação com diabetes, sob a perspectiva de mulheres no ciclo gravídico-puerperal. Métodos Estudo de natureza qualitativa com o objetivo de retratar o processo de viver com diabetes mellitus (DM) na gestação, sob a perspectiva das gestantes. Participaram 17 puérperas adultas, com diagnóstico de DM prévio ou gestacional, que realizaram o pré-natal e tiveram seus filhos em uma maternidade pública do Rio de Janeiro. Foram adotadas as técnicas de observação sistemática, bem como entrevistas semiestruturadas e levantamento de dados de prontuário institucional. A interpretação dos dados foi realizada por meio de uma aproximação com o referencial da hermenêutica de profundidade, com adaptação de suas fases, utilizando-se da análise de conteúdo temática, adaptada de Bardin. Resultados Foram identificadas duas categorias, extraídas do corpus das entrevistas: (1) refém do diabetes, relacionando o DM a situações irreversíveis que comprometem a qualidade de vida; e (2) doença da vigilância, associando o DM ao conjunto de medidas terapêuticas necessárias ao seu gerenciamento, como restrição e privação alimentares. Conclusão Concluiu-se que o processo de gestar com DM é permeado por sentidos que merecem ser compreendidos, pois exercem influências sobre o autocuidado e o desfecho da gestação.

Abstract Background Pregnancy is associated with life and health, but it can accompany some illness process, such as diabetes melittus, in the previous (type 1 or 2) or gestational condition. Understanding the experience of these pregnant women can provide instruments for the construction of a proposal for specialized and humanized prenatal care. Objective to interpret the senses and meanings of pregnancy with diabetes, from the perspective of women in the pregnancy-puerperal cycle. Method A qualitative study aimed to bring forward the process of living with diabetes mellitus (DM) during pregnancy, from the perspective of pregnant women. Participants were 17 postpartum women, diagnosed with DM and who underwent prenatal care and had their children in public maternity in Rio de Janeiro. The techniques of systematic observation, semi-structured interviews, and data collection of institutional records were adopted. The interpretation of the data was carried out using an approximation with the reference of the Depth Hermeneutics, with an adaptation of its phases, using Thematic Content Analysis, adapted from Bardin. Results Two categories were identified, extracted from the interview corpus: (1) diabetes hostage, linking DM to irreversible situations that impair quality of life, and (2) disease of surveillance, associating DM with the therapeutic measures necessary for its management, as food restriction and deprivation. Conclusion It was concluded that the process of gestation with DM is permeated by senses, which deserve to be understood since they exert influence on self-care and the outcome of gestation.

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BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.33-derived lineage named N.9 was described recently in Brazil and it's considered a potential variant of interest (VOI) due to the presence of E484K substitution at the receptor-binding domain (RBD) of the Spike (S) protein. OBJECTIVE: To describe the first detection of variant N.9 in Rio de Janeiro State. METHODS: SARS-CoV-2 N.9 was confirmed by quantitative reverse transcription polymerase chain reaction (qRT-PCR), whole-genome sequencing and phylogenetic analysis. FINDINGS: Here, we report two SARS-CoV-2 N.9 lineage strains in Rio de Janeiro. One of them had only the E484K substitution of the six N.9 lineage-defining mutations. Other three strains pre-defined as N.9 have the same genomic profile. These four strains are grouped within the B.1.1.33 lineage and basal to the N.9 lineage in our phylogenetic analysis, and we call them "N.9-like/B.1.1.33 + E484K". MAIN CONCLUSIONS: The phylogenetic analysis shows four independent introductions of N.9 in the state of Rio de Janeiro in October and December 2020, January and March 2021. SARS-CoV-2 N.9 dissemination in the Rio de Janeiro could have been limited by the emergence and dominance of other variants, mainly by the lineage P.2 VOI Zeta that emerged in the same period and co-circulated with N.9, as observed in the neighboring State of São Paulo.

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OBJECTIVE: To assess the credibility and the quality content of COVID-19 pandemic information on Brazilian websites. METHODS: We performed Google searches and screened the first 45 websites. The websites were categorized as academic, commercial, government, hospital, media, nongovernmental organizations, and professionals. The credibility was assessed by JAMA benchmark criteria and HONCODE. A checklist with WHO information about COVID-19 was developed to assess the quality content. For each website, the level of agreement with WHO information was categorized into "total," "partial," or "disagreement". RESULTS: A total of 20 websites were analyzed. None of the websites had HONCODE certification. Six websites (30%) met none of the four JAMA criteria and only one website (5%) fulfilled all the four criteria. Only 11 out of 20 websites showed overall coverage >50% for the checklist. Overall, 70% (14/20) of the websites had at least 50% total agreement with WHO items. The government websites presented more disagreement with the WHO items than media websites in the overall quality content analysis. CONCLUSION: The COVID-19 information on Brazilian websites have a moderate-to-low credibility and quality, particularly on the government websites.

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OBJECTIVE: This article aims to demonstrate the ways in which port workers collectively respond to task demands, work organization and functional turnover instituted in a Portuguese port. METHODS: Based on both the theoretical debate on the cooperative aspects during the performance of the activity and the contextual research matrix of the activity ergonomics, the investigation conducted focused on the room for maneuvering that is assigned to the work teams and, more specifically, how collective action materializes more visibly in the elaboration of new rules of action with a view to the arbitration between the preservation of health, the guarantee of safety and the response to the required performance levels. RESULTS: The results of the analysis of port activity make evident the development of a high degree of operational synchronization between the professional skills articulated in the team, specialized communication in certain work subprocesses, and strategies for collective surveillance of risks.

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In 2016, the world experienced the unprecedented Zika epidemic. The ZIKV emerged as a major human pathogen due to its association with the impairment of perinatal development and Guillain-Barré syndrome. The occurrence of these severe cases of Zika points to the significance of studies for understanding the molecular determinants of flavivirus pathogenesis. Reverse genetics is a powerful method for studying the replication and determinants of pathogenesis, virulence, and viral attenuation of flaviviruses, facilitating the design of vaccines and therapeutics. However, the main hurdle in the development of infectious clones is the instability of full-length cDNA in Escherichia coli. Here, we described the development of a genetically stable and efficient infectious clone based on the ZIKV Rio-U1 isolated in the 2016 epidemic in Brazil. The employed strategy consisted of cloning the viral cDNA genome into two stable plasmid subclones and obtaining a high-quality cDNA template with increment in DNA mass for in vitro transcription by PCR amplification. The strategy for developing a ZIKV infectious cDNA clone designed in this study was successful, yielding a replicative and efficient clone-derived virus with high similarities with its parental virus, Rio-U1, by comparison of the proliferation capacity in mammal and insect cells. The infection of AG129 immunocompromised mice caused identical mortality rates, with similar disease progression and morbidity in the animals infected with the parental and the cDNA-derived virus. Histopathological analyses of mouse brains infected with the parental and the cDNA-derived viruses revealed a similar pathogenesis degree. We observed meningoencephalitis, cellular pyknosis, and neutrophilic invasion adjacent to the choroid plexus and perivascular cuffs with the presence of neutrophils. The developed infectious clone will be a tool for genetic and functional studies in vitro and in vivo to understand viral infection and pathogenesis better.