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Resumo: O artigo analisa os impactos socioterritoriais provocados por desastres com barragens à luz da Vigilância Socioassistencial. Adotou-se o método qualitativo, por meio de análise documental e técnica, de cidades impactadas por desastres com barragens de mineradoras em Minas Gerais (Brasil). Concluiu-se que as condições objetivas de respostas no campo da Assistência Social estão aquém dos preceitos internacionais de Gestão Integral de Riscos e de Desastres (GIRD), destacando foco para o aprimoramento específico para uma gestão planejada e compartilhada de Redução de Riscos de Desastres (RRD).

El objetivo de esta investigación fue determinar la influencia de la técnica de las 3Rs relacionadas a las actitudes ambientales de los niños y niñas de la Institución Educativa de educación primaria ubicada en una zona rural del distrito de Moya, Huancavelica. Métodos: investigación aplicada, con un diseño preexperimental, para el cuál se ha diseñado instrumentos para una prueba de actitud ambiental, hoja de aplicación y ficha de observación. La muestra poblacional fue de 22 alumnos, entre niños y niñas del primero al sexto grado, de la Institución Educativa N° 36053. Se aplicó la prueba de la actitud ambiental sobre la técnica de las 3Rs (3 erres); luego, se hizo la evaluación de las actitudes ambientales a través de una prueba de actitud ambiental y hoja de aplicación. Los resultados muestran en la prueba de entrada, el 77% (17) del total de la muestra de estudio, tienen una actitud negativa, y solo el 23% (5) tienen actitud positiva; es decir, al inicio de la investigación la actitud ambiental fue negativa; después de la aplicación de la técnica de las 3Rs, la situación se revierte, porque la mayoría (86%) de los niños y niñas obtuvieron una actitud ambiental positiva; en tanto que en el 14% (3) de los niños no demuestran cambio respecto a la actitud ambiental. Conclusión: la técnica de las 3Rs influye de manera muy significativa en las actitudes ambientales de los niños y niñas de dicha institución.

The introduction of hippos into the wild in Colombia has been marked by their rapid population growth and widespread dispersal on the landscape, high financial costs of management, and conflicting social perspectives on their management and fate. Here we use population projection models to investigate the effectiveness and cost of management options under consideration for controlling introduced hippos. We estimate there are 91 hippos in the middle Magdalena River basin, Colombia, and the hippo population is growing at an estimated rate of 9.6% per year. At this rate, there will be 230 hippos by 2032 and over 1,000 by 2050. Applying the population control methods currently under consideration will cost at least 1–2 million USD to sufficiently decrease hippo population growth to achieve long-term removal, and depending on the management strategy selected, there may still be hippos on the landscape for 50–100 years. Delaying management actions for a single decade will increase minimum costs by a factor of 2.5, and some methods may become infeasible. Our approach illustrates the trade-offs inherent between cost and effort in managing introduced species, as well as the importance of acting quickly, especially when dealing with species with rapid population growth rates and potential for significant ecological and social impacts.

Abnormal aggregation of the Amyloid β (Aβ) peptides into fibrils play a critical role in the development of Alzheimer’s disease. A two-stage “dock-lock” model have been proposed for the Aβ fibril elongation process. However, the mechanisms of the Aβ monomer-fibril binding process have not been elucidated with the necessary molecular-level precision, and so it remains unclear how the lock phase dynamics leads to the overall in-register binding of the Aβ monomer onto the fibril. To gain mechanistic insight into this critical step during the fibril elongation process we used molecular dynamics (MD) simulations with a physics-based coarse-grained UNited-RESidue (UNRES) force field we sampled extensively the dynamics of the lock phase process, in which a fibril-bound Aβ((9–40)) peptide rearranges to establish the native docking conformation. Analysis of the MD trajectories with Markov State Models was used to quantify the kinetics of the rearrangement process and the most probable pathways leading to the overall native docking conformation of the incoming peptide. These revealed a key intermediate state in which an intra-monomer hairpin is formed between the central core amyloidogenic patch (18)VFFA(21) and the C-terminal hydrophobic patch (34)LMVG(37). This hairpin structure is highly favored as a transition state during the lock phase of the fibril elongation. We propose a molecular mechanism for the facilitation of the Aβ fibril elongation by amyloidogenic hydrophobic patches.

Antecedentes: la prevalencia global de sobrepeso y obesidad en escolares ha aumentado drásticamente. Objetivo: evaluar el impacto de una intervención educativa en la variabilidad alimentaria de los cuidadores de niños con obesidad y sobrepeso, utilizando la herramienta “Mi Plato”. Métodos: estudio descriptivo y longitudinal con 60 cuidadores de niños con obesidad y sobrepeso. El estudio comprendió tres etapas: 1. Determinación de la variabilidad dietética basal; 2. Intervención educativa basada en la herramienta “Mi Plato”; 3. Evaluación de la variabilidad dietética posintervención. En el análisis de las variables cuantitativas se aplicaron la media, la mediana y la desviación estándar. La distribución de los datos se evaluó mediante la prueba de Shapiro-Wilk y para la homogeneidad de la varianza se dispuso la prueba de Levene. En el análisis de la diferencia de las medias se empleó la T de Student y se consideró una significancia estadística ≤ 0,05. El programa estadístico empleado fue SPSS v15.00. Resultados: la variabilidad dietética aumentó luego de la intervención educativa, p < 0,001. El promedio de la variabilidad dietética global antes de la intervención de 8,2 fue menor que el de la posintervención de 9,8, con un 95 % de confianza (valor de p < 0,001). Conclusiones: se comprobó que la intervención educativa con la herramienta “Mi Plato” en los cuidadores de niños en condición de obesidad y sobrepeso mejora la variabilidad dietética.

Se trata de la presentación de la Coletanea producida en el Núcleo de Estudios, Investigación y Extensión de Familias e Politicas Públicas da la Universidad Federal de Sao Paulo Brazil, Ensino em Saúde, Trabajo Social

An explanation is provided of how extensive reading was used in the second-year reading courses in two majors—the Teaching of English as a Foreign Language (Bachillerato en la Enseñanza del Inglés, BEI) and English as a Foreign Language (Bachillerato en Inglés, BI), both of the Universidad Nacional (Heredia, Costa Rica)—to improve their language proficiency. To implement this, the time and activities were organized in student-centered sessions so that the learners could select readings for their individual use. Se explica cómo se utilizó la lectura extensiva en los cursos de lectura con estudiantes de segundo año en el Bachillerato en Inglés y Bachillerato en la Enseñanza del Inglés en la Universidad Nacional (Heredia, Costa Rica), para mejorar su competencia lingüística. Para su puesta en ejecución, se organizó el tiempo y las actividades centradas en el alumno, con el fin de que escogieran las lecturas para su uso individual. Escuela de Literatura y Ciencias del Lenguaje

α-Synuclein is a 140 amino-acid intrinsically disordered protein mainly found in the brain. Toxic α-synuclein aggregates are the molecular hallmarks of Parkinson’s disease. In vitro studies showed that α-synuclein aggregates in oligomeric structures of several 10th of monomers and into cylindrical structures (fibrils), comprising hundred to thousands of proteins, with polymorphic cross-β-sheet conformations. Oligomeric species, formed at the early stage of aggregation remain, however, poorly understood and are hypothezised to be the most toxic aggregates. Here, we studied the formation of wild-type (WT) and mutant (A30P, A53T, and E46K) dimers of α-synuclein using coarse-grained molecular dynamics. We identified two principal segments of the sequence with a higher propensity to aggregate in the early stage of dimerization: residues 36–55 and residues 66–95. The transient α-helices (residues 53–65 and 73–82) of α-synuclein monomers are destabilized by A53T and E46K mutations, which favors the formation of fibril native contacts in the N-terminal region, whereas the helix 53–65 prevents the propagation of fibril native contacts along the sequence for the WT in the early stages of dimerization. The present results indicate that dimers do not adopt the Greek key motif of the monomer fold in fibrils but form a majority of disordered aggregates and a minority (9–15%) of pre-fibrillar dimers both with intra-molecular and intermolecular β-sheets. The percentage of residues in parallel β-sheets is by increasing order monomer < disordered dimers < pre-fibrillar dimers. Native fibril contacts between the two monomers are present in the NAC domain for WT, A30P, and A53T and in the N-domain for A53T and E46K. Structural properties of pre-fibrillar dimers agree with rupture-force atomic force microscopy and single-molecule Förster resonance energy transfer available data. This suggests that the pre-fibrillar dimers might correspond to the smallest type B toxic oligomers. The probability density of the dimer gyration radius is multi-peaks with an average radius that is 10 Å larger than the one of the monomers for all proteins. The present results indicate that even the elementary α-synuclein aggregation step, the dimerization, is a complicated phenomenon that does not only involve the NAC region.

Introduced species can have strong ecological, social and economic effects on their non-native environment. Introductions of megafaunal species are rare and may contribute to rewilding efforts, but they may also have pronounced socio-ecological effects because of their scale of influence. A recent introduction of the hippopotamusHippopotamus amphibiusinto Colombia is a novel introduction of a megaherbivore onto a new continent, and raises questions about the future dynamics of the socio-ecological system into which it has been introduced. Here we synthesize current knowledge about the Colombian hippopotamus population, review the literature on the species to predict potential ecological and socio-economic effects of this introduction, and make recommendations for future study. Hippopotamuses can have high population growth rates (7–11%) and, on the current trajectory, we predict there could be 400–800 individuals in Colombia by 2050. The hippopotamus is an ecosystem engineer that can have profound effects on terrestrial and aquatic environments and could therefore affect the native biodiversity of the Magdalena River basin. Hippopotamuses are also aggressive and may pose a threat to the many inhabitants of the region who rely upon the Magdalena River for their livelihoods, although the species could provide economic benefits through tourism. Further research is needed to quantify the current and future size and distribution of this hippopotamus population and to predict the likely ecological, social and economic effects. This knowledge must be balanced with consideration of social and cultural concerns to develop appropriate management strategies for this novel introduction.

α-Synuclein is an intrinsically disordered protein occurring in different conformations and prone to aggregate in β-sheet structures, which are the hallmark of the Parkinson disease. Missense mutations are associated with familial forms of this neuropathy. How these single amino-acid substitutions modify the conformations of wild-type α-synuclein is unclear. Here, using coarse-grained molecular dynamics simulations, we sampled the conformational space of the wild type and mutants (A30P, A53P, and E46K) of α-synuclein monomers for an effective time scale of 29.7 ms. To characterize the structures, we developed an algorithm, CUTABI (CUrvature and Torsion based of Alpha-helix and Beta-sheet Identification), to identify residues in the α-helix and β-sheet from Cα -coordinates. CUTABI was built from the results of the analysis of 14,652 selected protein structures using the Dictionary of Secondary Structure of Proteins (DSSP) algorithm. DSSP results are reproduced with 93% of success for 10 times lower computational cost. A two-dimensional probability density map of α-synuclein as a function of the number of residues in the α-helix and β-sheet is computed for wild-type and mutated proteins from molecular dynamics trajectories. The density of conformational states reveals a two-phase characteristic with a homogeneous phase (state B, β-sheets) and a heterogeneous phase (state HB, mixture of α-helices and β-sheets). The B state represents 40% of the conformations for the wild-type, A30P, and E46K and only 25% for A53T. The density of conformational states of the B state for A53T and A30P mutants differs from the wild-type one. In addition, the mutant A53T has a larger propensity to form helices than the others. These findings indicate that the equilibrium between the different conformations of the α-synuclein monomer is modified by the missense mutations in a subtle way. The α-helix and β-sheet contents are promising order parameters for intrinsically disordered proteins, whereas other structural properties such as average gyration radius, R g , or probability distribution of R g cannot discriminate significantly the conformational ensembles of the wild type and mutants. When separated in states B and HB, the distributions of R g are more significantly different, indicating that global structural parameters alone are insufficient to characterize the conformational ensembles of the α-synuclein monomer.

Ausencia, movilidad y metáfora son las constantes que convergen en mi trabajo. Con ellas describo -a través de los procesos de la gráfica-, una serie de posibilidades en donde el individuo está ausente de un discurso filosófico, un lugar o una metáfora.

ensayo

Anais do VII Congresso Acadêmico Unifesp realizado em junho de 2021 no formato online.

Los grupos de Investigación en Microbiología, Industria y Ambiente (GIMIA) y en Química y Biotecnología (QUIBIO) hacen parte del Centro de Estudios e Investigaciones en Ciencias Básicas Ambientales y Desarrollo Tecnológico (CICBA), adscrito a la Facultad de Ciencias Básicas de la Universidad Santiago de Cali. Desde su comienzo esta unidad académico-administrativa ha procurado estar a la vanguardia en la investigación, en la tecnología y en la innovación. Es por ello que los grupos de investigación acordes con esta macrolínea se han preocupado por compartir sus avances en investigación e innovación en un marco de responsabilidad social. Es por ello que, en este libro llamado “Estudios en resistencia a los antibióticos beta-lactámicos en bacterias Gram negativas”, se recopilan tres trabajos de investigadores que forman parte de la producción intelectual de los grupos GIMIA y QUIBIO, en alianza con el Grupo de Resistencia y Epidemiología Hospitalaria (RAEH) de la Universidad El Bosque.

One of the hallmarks of Alzheimer’s disease is the formation of aggregates of the tau protein, a process that can be facilitated by the presence of fibrils formed by the Amyloid β peptide (Aβ). However, the mechanism that triggers tau aggregation is still a matter of debate. The effect of Aβ(40) fibrils on the aggregation of the repeat domain of tau (TauRD) is investigated here by employing coarse-grained molecular dynamics simulations. The results indicate that the repeat domain of tau has high affinity for Aβ(40) fibrils, with the (261)GSTENLK(267) fragment of tau driving TauRD towards the (16)KLVFFA(21) fragment in Aβ(40). Monomeric Aβ(40), in which the (16)KLVFFA(21) fragment is rarely found in an extended conformation (as in the fibril), has low affinity for the TauRD, indicating that the ability of Aβ(40) fibrils to bind to the TauRD depends on the (16)KLVFFA(21) fragment of Aβ adopting an extended conformation.

Energy frameworks are generally perceived to have little to no social content or implications; however, gender neutral energy frameworks may inadvertently discriminate against women. To understand the extent to which gender is being mainstreamed in energy frameworks at the national level, the authors have conducted three analyses on energy-related frameworks. This chapter captures the main findings of these analyses, aligning them with existing frameworks for assessing the gender responsiveness of energy policies, identifying if those elements are found in existing energy frameworks and providing examples of how gender considerations can be further addressed to support the development of a more gender-responsive energy transition.

Incluye contenido parcial de los autores Biological invasion is one of the main threats to native biodiversity. For a speciesto become invasive, it must be voluntarily or involuntarily introduced by humans into a nonna-tive habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this dataset, we make available occurrence and abundance data on mammal species that (1) transposeda geographical barrier and (2) were voluntarily or involuntarily introduced by humans into theNeotropics. Our data set is composed of 73,738 historical and current georeferenced recordson alien mammal species of which around 96% correspond to occurrence data on 77 speciesbelonging to eight orders and 26 families. Data cover 26 continental countries in the Neotrop-ics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Floridain the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 coun-tries of Caribbean islands. Our data set also includes neotropical species (e.g.,Callithrixsp.,Myocastor coypus,Nasua nasua)considered alien in particular areas of Neotropics. The mostnumerous species in terms of records are fromBossp. (n=37,782),Sus scrofa(n=6,730), andCanis familiaris(n=10,084); 17 species were represented by only one record (e.g., Syncerus caf-fer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of spe-cies in the data set (n=20 species), partly because of uncertainties regarding taxonomicidentification of the generaCallithrix,which includes the speciesCallithrix aurita, Callithrixflaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, andtheir hybrids. This unique data set will be a valuable source of information on invasion riskassessments, biodiversity redistribution and conservation-related research. There are no copy-right restrictions. Please cite this data paper when using the data in publications. We alsorequest that researchers and teachers inform us on how they are using the data

Compliance with the client requirements is a key factor for the success of projects. However, this compliance is not always easy to monitor and verify. SCRUM framework flexibility makes it possible to include a variety of techniques and good practices from other methods to help software development teams to achieve their goals. Some of these tools can track historical changes in the code (versioning), perform code inspection to identify bugs, vulnerabilities, code duplication, and code smells that can affect the software quality. This paper presents a preventive software quality assurance environment that aims at improving the quality of the development process.

The low aspect ratio spherical tokamak (ST) MEDUSA-CR is currently being re-commissioned at Instituto Tecnologico de Costa Rica. One of the proposed first tasks is to simulate the magnetic confinement considering the particular coils arrangement of the device. This work presents the resulting shape of the plasma cross-section. MEDUSA-CR main specifications are: plasma major radius R0 approx. 0.14 m, plasma minor radius a approx. 0.10 m, toroidal field at the vessel geometrical center BT smaller than 0.5 T, plasma current Ip lesser than 40 kA, central electron temperature Te lesser than 140 eV, discharge duration lesser than 3 ms [1]. The free boundary equilibrium solver Fiesta has been used to obtain the plasma shaping and some equilibrium parameters. The code works the magnetic confinement for the static Magneto-Hydro-Dynamic (MHD) equilibrium case solving the Grad-Shafranov equation. A central solenoid was added to the original magnetic configuration aiming to create a limiter with an ergodic behavior in order to enhance the plasma confinement [2], [3]. The resulting cross-section (without divertor, i.e., natural divertor) for the plasma volume is a “bean” shape. The elongation is found to be 1.43 and the triangularity 0.547. A bean shape cross section is found to produce a higher triangularity, which have a significant effect on MHD stability [4]. Further simulations with FIESTA could be used as proof of principle for the effect of the plasma shape on transport and stability.

espanolObjetivo: analizar los conocimientos sobre higiene de manos demostrados por las enfermeras que han acreditado sus competencias con el Programa de Acreditacion de la Agencia de Calidad Sanitaria de Andalucia (ACSA) y determinar si existen diferencias en funcion a las caracteristicas individuales de dichos profesionales. Metodo: estudio descriptivo transversal basado en el Hand Hygiene Knowledge Questionnaire for Health-Care Workers de la OMS (traducido y validado para el entorno espanol) realizado sobre 2.136 pruebas aportadas por las enfermeras durante sus procesos de acreditacion, desde julio de 2011 hasta enero de 2016. La recogida de datos se realizo a traves de la aplicacion informatica ME_jora P. Para los analisis se utilizaron el software SPSS v.13 y R Package. Resultados: las enfermeras mostraron un alto nivel de conocimientos respecto a la higiene de manos, presentandose diferencias significativas en cuanto al numero de respuestas correctas en funcion del sexo, la edad, el puesto de trabajo y el nivel de acreditacion conseguido. Conclusiones: el conocimiento sobre aspectos criticos de la higiene de las manos del conjunto de enfermeras analizadas fue notable. Las enfermeras con mayor nivel de acreditacion (experto y excelente) son las que presentaron mayor media de respuestas correctas, teniendo mas probabilidades de ser referentes en higiene de manos. EnglishObjective: to analyze the knowledge about hand hygiene demonstrated by nurses with their competence accredited through the Accreditation Program by the Agency for Healthcare Quality from Andalusia (ACSA), and to determine if there are differences according to the individual characteristics of said professionals. Method: a descriptive transversal study based on the Hand Hygiene Knowledge Questionnaire for Health-Care Workers by the WHO (translated and validated for the Spanish setting), conducted on 2,136 tests provided by nurses during their accreditation processes, from July, 2011 to January, 2016. Data collection was conducted through the computer application ME_jora P. The SPSS v.13 software and R Package were used for analysis. Results: nurses showed a high level of knowledge regarding hand hygiene; there were significant differences in terms of correct answers according to gender, age, position, and the level of accreditation achieved. Conclusions: there was a remarkable level of knowledge on essential aspects of hand hygiene among the nurses tested. Those nurses with the highest level of accreditation (Expert and Excellent) presented the highest mean level of correct answers, and had more probabilities to become leaders in terms of hand hygiene.

Significant improvements in haploidentical stem cell transplantation (haplo-SCT) have confirmed its therapeutic role in severe aplastic anemia (SAA) and led to the evolution of treatment algorithms. However, the optimal conditioning regimen for haplo-SCT for SAA remains undefined. A recent review demonstrated haplo-SCT using NMA and RIC, engraftment between 75 to100% and OS one year of 75-100%. In our Institutions we started a double source since Jan 2017 using a RIC protocol that is the objective of this presentation. There were nine haplo-SCT in eight patients in two Brazilian centers, Hospital Santa Marcelina (n=5) and Hospital São Paulo (n=3). All patients were male, median age 26 years old (14-39), nocturnal paroxysmal hemoglobinuria clonality in five (62,5%); treated with Cyclosporine, Thymoglobulin (n=4), Eltrombopag (n=1), Eculizumab (n=2) and/or Alemtuzumab (n=1). Median time disease to transplant was 15,7 months (3.8-192). All patients submitted more than 20 RBC transfusions, and median of ferritin was 2,283 ng/mL (753-3,486). One patient had carbapenem-resistant gram-negative bacilli (CRNGB: Escherichia coli, Klebsiella pneumoniae and/or Pseudomonas aeruginosa). Panel reactive antibody was negative in all patients. The donor was a sibling in 44% (n=4), father and mother 22% each (n=2) and one patient received cells from his cousin after an early failure of engraftment from mother first transplant. The cause of this failure was a JC virus and adenovirus acute infections. The second haplo-SCT conditioning was Fludarabine, Cyclophosphamide and 600 cGy TLI. There were seven male donors. RIC was consisted of Fludarabine, Cyclophosphamide and total body irradiation (TBI) 200 cGy. The source was G-CSF primed bone marrow (G-BM) grafts in combination with PBSC no ex-vivo T cells depleted, and Cyclophosphamide 50 mg/Kg/day IV on days +3 and +4 post-transplant (PTCy), as well as graft versus host disease (GvHD) prophylaxis. The median of G-BM MNCs was 5.4 x 10⁸/Kg (2.3-8.7), and PBSC was 10 x 10⁶CD34+/Kg (4-18.7). One (11%) patient died for sepsis at day +13, he was the only with a confirmed CRGNB colonization before transplant. The ANC recovery was at day +17 (13-24). No one had Sinusoidal Obstructive Syndrome. Acute GvHD grade II and moderate chronic GvHD was observed in two patients (25%). Two patients had engrafting failure: the first at day +30 and received a successfully new haplo-SCT; the second at day +60, with a partial donor reconstitution without dependence of transfusion after immunosuppressive therapy. These two patients had female donors. The OS and DFS at two years were 87.5% and 75%, respectively. In conclusion, with a median follow-up of 30 months, haplo-SCT, PTCy with double source keep the 87.5% overall survival, with no one severe chronic GvHD. Our data suggests an excellent results for haplo-SCT, PTCy, RIC, double source in the SAA treatment. However, prospective well-designed trials need to confirm these results. Disclosures No relevant conflicts of interest to declare.

Follicular lymphoma (FL) is a heterogeneous disease with varying prognosis owing to differences in clinical, laboratory, and disease parameters. Although FL is considered incurable disease with standard chemotherapy, advances in treatment have improved disease its management and clinical outcomes. Treatment for relapsed or refractory patients is influenced by initial first-line therapy and the duration and quality of the response. Presently, there is no consensus for treatment of patients with early or multiple relapsed disease; however, numerous drugs, combination regimens, and transplant options have demonstrated efficacy. Considering that there is no consensus to treat such patients, we are reporting this case. A 37-yo woman presented in Sep 2005 with abdominal masses, constitutional symptoms and two years of recurrence of urinary and pelvic infections, with previous lymph nodes biopsies revealing hiperplasia. At this time grade I FL, stage IVB, with bone marrow involved was done. There was no response to four cycles of Rituximab and three of COP. In Jan 2006 a histological review confirmed the diagnosis. Then she underwent to six cycles of R-CHOP 21, resulting in complete remission (CR) was ruled out. Consolidation therapy consisted to IL-2 monthly four cycles, and an eight quarterly Rituximab for two years. Supportive care with polyclonal immunoglobuline infusion monthly was demanded to overcome frequent urinary and respiratory infections. After nine years, Dec 2015, constitutional symptoms returned and PET/CT was positive in mediastinum and there was bone marrow involvement. From Jan to Jun 2016, 6 cycles of Rituximab and Chlorambucil was done, and after the second one she complicated with pulmonary aspergillosis and there underwent voriconazole for 18 months. In Jul and Nov 2016 PET/CT revealed a second CR. Just four months later, BMB and pulmonary infiltrated disclosed a new relapse. Four cycles of Fludarabine 30 mg/m², Mitoxantrone 8 mg/m², Rituximab 375 mg/m² and dexamethasone were attempted, since Apr to Jul 2017. A fosfomycin therapy was done to prevent a recurrence of Escherichia coli multi-resistant urinary tract infections. The patient achieved a third CR at PET/CT in Aug 2017. Based on the last rapidly progression of the disease, and bone marrow involvement in all relapses, we proposed an allogeneic stem cell transplantation (allo-SCT). But she didn't have a match related donor. So, her twelve years old son was considered as an haploidentical donor. A reduced intensity conditioning (RIC) was performed with Cyclophosphamide 14.5 mg/Kg D-6 and D-5, Fludarabine 30 mg/m² D-6 to D-3, TBI 200 cGy at D-1. A double source of stem cells: primed-bone marrow (TNC 4.49 x 10⁸/Kg) plus peripheral blood stem cell (4.48 x 10⁶ CD34+/Kg) was infused on Oct-10-2017. Immunosuppressive therapy consisted of Cyclophosphamide 50 mg/Kg at D+3 and D+4 (PT-Cy), Tacrolimus and MMF starting at D+5, and G-CSF from D+5 until neutrophil engraftment. The neutrophil engraftment reached at D+14. Cytokine Releasing Syndrome, febrile neutropenia, rectal prolapse and grade I/II acute graft versus host disease (aGvHD) were immediate complications. Discharge occurred at day +18. CMV PCR positive was preemptive treated from Nov to Dec 2017. Steroid therapy was given for grade II aGvHD, Nov 2017 till Dec 2018. She had an Orthostatic Tachycardia Syndrome from Feb to Oct 2018; Respiratory Syncytial Virus, from Jul to Aug 2018; Rhino and B Influenza upper airway infection on Mar 2019. A complete chimerism was achieve at +100, +180 and +365 days. PET/CT confirmed CR at D+180 and +365. At the present she is off treatment since Jan 2019. In this situation a double source haplo-SCT was a successfully therapy overcame the complicated comorbidities before transplantation, with a good quality of life nowadays. Disclosures No relevant conflicts of interest to declare.

Fibrils formed by the β-amyloid (Aβ) peptide play a central role in the development of Alzheimer’s disease. In this study, the principles governing their growth and stability are investigated by analyzing canonical and replica-exchange molecular dynamics trajectories of Aβ(9–40) fibrils. In particular, an unstructured monomer was allowed to interact freely with an Aβ fibril template. Trajectories were generated with the coarse-grained united-residue force field, and one- and two-dimensional free-energy landscapes (FELs) along the backbone virtual-bond angle θ and backbone virtual-bond-dihedral angle γ of each residue and principal components, respectively, were analyzed. Also, thermal unbinding (unfolding) of an Aβ peptide from the fibril template was investigated. These analyses enable us to illustrate the entire process of Aβ fibril elongation and to elucidate the key residues involved in it. Several different pathways were identified during the search for the fibril conformation by the monomer, which finally follows a dock-lock mechanism with two distinct locking stages. However, it was found that the correct binding, with native hydrogen bonds, of the free monomer to the fibril template at both stages is crucial for fibril elongation. In other words, if the monomer is incorrectly bound (with nonnative hydrogen bonds) to the fibril template during the first “docking” stage, it can remain attached to it for a long time before it dissociates and either attempts a different binding or allows another monomer to bind. This finding is consistent with an experimentally-observed “stop-and-go” mechanism of fibril growth.

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by the accumulation of plaque deposits in the human brain. The main component of these plaques consists of highly ordered structures called amyloid fibrils, formed by the amyloid β-peptide (Aβ). The mechanism connecting Aβ and AD is yet undetermined. In a previous study, a coarse-grained united-residue model and molecular dynamics simulations were used to model the growth mechanism of Aβ amyloid fibrils. On the basis of these simulations, a dock/lock mechanism was proposed, in which Aβ fibrils grow by adding monomers at either end of an amyloid fibril template. To examine the structures in the early time-scale formation and growth of amyloid fibrils, simulated two-dimensional ultraviolet spectroscopy is used. These early structures are monitored in the far ultraviolet regime (λ = 190-250 nm) in which the computed signals originate from the backbone nπ* and ππ* transitions. These signals show distinct cross-peak patterns that can be used, in combination with molecular dynamics, to monitor local dynamics and conformational changes in the secondary structure of Aβ-peptides. The protein geometry-correlated chiral xxxy signal and the non-chiral combined signal xyxy-xyyx were found to be sensitive to, and in agreement with, a dock/lock pathway.

The accreditation of professional competence: the analysis of nursing interventions to control anxiety in surgical patients.The preoperative anxiety is a state of discomfort or unpleasant tension resulting from concerns about illness, hospitalization, anesthesia, surgery or the unknown. Nurses play a vital role reducing preoperative anxiety. An accreditation program was developed in Andalusia (Spain) to measure nurses' competences in this and others fields.To analyze the accredited nurses' interventions spectrum to reduce anxiety in surgical patients and to check if their range of interventions depends upon their professional skills accreditation level.Cross-sectional study. From 20016 to 2014, 1.282 interventions performed by 303 operating room nurses accredited through the Professional Skills Accreditation Program of the Andalusian Agency for Health Care Quality (ACSA) were analyzed with the latent class analysis (LCA) and multinomial logistic regression.Two-thirds of the sample was accredited in Advanced level, about 31% in Expert level and 2.6% in Excellent level. Mean age of patients was 58.5±19.8 years. Three professional profiles were obtained from the LCA. Those nurses classified in Class I (22.4% of the sample) were more likely to be women, to can for younger patients, and to be accredited in Expert or Excellent Level and to perform the larger range of interventions, becoming therefore the most complete professional profile.Those nurses who perform a wider range of interventions and specifically two evidence based interventions such Calming Technique and Coping Enhancement are those who have a higher level of accreditation level.

Edible films and coatings : fundamentals and applications , Edible films and coatings : fundamentals and applications , کتابخانه مرکزی دانشگاه علوم پزشکی تهران

The mechanism of growth of fibrils of the β-amyloid peptide (Aβ) was studied by means of a physics-based coarse-grained united-residue (UNRES) model and molecular dynamics (MD) simulations. To identify the mechanism of monomer addition to an Aβ1–40 fibril, an unstructured monomer was placed at a 20 Å distance from a fibril template, and allowed to interact freely with it. The monomer was not biased towards the fibril conformation, by either the force field or the MD algorithm. By using a coarse-grained model with replica exchange MD, a longer time scale was accessible making it possible to observe how the monomers probe different binding modes during their search towards the fibril conformation. Although different assembly pathways were seen, they all follow a dock-lock mechanism, with two distinct locking stages, which is consistent with data from experiments on fibril elongation. Whereas these experiments have not been able to characterize the conformations populating the different stages, we have been able to describe these different stages explicitly by following free monomers as they dock onto a fibril template and adopt the fibril conformation; i.e., we describe fibril elongation step by step, at the molecular level. During the first stage of the assembly, “docking”, the monomer tries different conformations. After docking, the monomer is locked into the fibril through two different locking stages. In the first stage the monomer forms hydrogen bonds with the fibril template along one of the strands in a two-stranded β hairpin; in the second stage, hydrogen bonds are formed along the second strand, locking the monomer into the fibril structure. The data reveal a free-energy barrier separating the two locking stages. The importance of hydrophobic interactions and hydrogen bonds in the stability of the Aβ fibril structure was examined by carrying out additional canonical MD simulations of oligomers with different numbers of chains (4 to 16 chains) with the fibril structure as the initial conformation. The data confirm that the structures are stabilized largely by hydrophobic interactions and show that the intermolecular hydrogen bonds are highly stable and contribute to the stability of the oligomers as well.

As virtual worlds become more widely utilized in education to deliver instruction, the need to measure learning in this environment will continue to grow. Building upon McKerlich and Anderson's (2008) exploratory study, the researchers of this study utilized the Community of Inquiry's (CoI) Multi-User Virtual Environment Education Evaluation Tool (MUVEEET), and the CoI Survey to measure observational and perceptual data in the multi-user virtual environment (MUVE), Second Life (SL), among instructional technology graduate students. Specifically examined in this study was the existence of the three CoI constructs — cognitive presence, social presence, and teaching presence. Results indicated that the CoI model served as a promising framework to measure all three constructs within MUVEs. Specifically, both the CoI survey and MUVEEET results indicated that the participants and coders experienced a developed community of inquiry during two SL classes.

In cotton plant, Xanthomonas-induced hypersensitive response (HR) is accompanied by a lipid peroxidation process involving a 9-lipoxygenase (LOX), GhLox1. Initiation of this oxidative metabolism implies the release of the LOX substrates, or polyunsaturated fatty acids. Since patatin-like proteins (PLPs) are likely candidates for mediating the latter step, we searched for genes encoding such enzymes, identified and cloned one of them that we named GhPat1. Biochemical and molecular studies showed that GhPat1 expression was up-regulated during the incompatible interaction, prior to the onset of the corresponding galactolipase activity and cell death symptoms in tissues. Protein sequence analysis and modelling also revealed that GhPat1 catalytic amino acids and fold were conserved across plant PLPs. Based on these results and our previous work (Jalloul et al. in Plant J 32:1–12, 2002), a role for GhPat1, in synergy with GhLox1, during HR-specific lipid peroxidation is discussed.

Here we present a full overview of the Critical Assessment of Protein Structure Prediction (CASP7) function prediction category. Predictions were submitted for Gene Ontology molecular function terms, Enzyme Commission numbers, and ligand binding site residues. The first two categories were difficult to assess because very little new functional information becomes available after the experiment. The majority of the known Gene Ontology terms and all the Enzyme Commission numbers were available a priori to predictors before the experiment, so prediction for these two categories was not blind. Nevertheless, for Gene Ontology terms we were able to demonstrate that some groups made better predictions than others. In the binding residue category, the predictors did not know in advance which ligands were bound and therefore blind evaluation was possible, but there were disappointingly few predictions in this category. After CASP 6 and 7 the need to organize a more effective blind function prediction category is obvious, even if it means focusing on binding site prediction as the only category that can be truly assessed in the CASP spirit. Proteins 2007. © 2007 Wiley-Liss, Inc., Funded by; BioSapiens. Grant Number: LSHC-CT-2003-505265. GENEFUN. Grant Number: LSHG-CT-2004-503567

The implementation of molecular dynamics with the united-residue (UNRES) force field is extended to treat multichain proteins. Constant temperature was maintained in the simulations with Berendsen or Langevin thermostats. The method was tested on three alpha-helical proteins (1G6U and GCN4-p1, each with two chains, and 1C94, with four chains). Simulations were carried out for both the isolated single chains and the multichain complexes. The proteins were folded by starting from the extended conformation with random initial velocities and with the chains parallel to each other. No symmetry constraints or structure information were included for the single chains or the multichain complexes. In the case of single-chain simulations, a high percentage of the trajectories (100% for 1G6U, 90% for GCN4-p1, and 80% for 1C94) converged to nativelike structures (assumed as the experimental structure of a monomer in the multichain complex), showing that, for the proteins studied in this work with the UNRES force field, the interactions between chains are not critical for stabilization of the individual chains. In the case of multichain simulations, the native structures of the 1G6U and GCN4-p1 complexes, but not that of 1C94, are predicted successfully. The association of the subunits does not follow a unique mechanism; the monomers were observed to fold both before and simultaneously with their association.

T cell activation takes place in the context of a spatial and kinetic reorganization of cell surface proteins and signaling molecules at the contact site with an antigen presenting cell, termed the immunological synapse. Coordination of the activation, recruitment, and signaling from T cell receptor (TCR) in conjunction with adhesion and costimulatory receptors regulates both the initiation and duration of signaling that is required for T cell activation. The costimulatory receptor, CD28, is an essential signaling molecule that determines the quality and quantity of T cell immune responses. Although the functional consequences of CD28 engagement are well described, the molecular mechanisms that regulate CD28 function are largely unknown. Using a micropipet adhesion frequency assay, we show that TCR signaling enhances the direct binding between CD28 and its ligand, CD80. Although CD28 is expressed as a homodimer, soluble recombinant CD28 can only bind ligand monovalently. Our data suggest that the increase in CD28-CD28 binding is mediated through a change in CD28 valency. Molecular dynamic simulations and in vitro mutagenesis indicate that mutations at the base of the CD28 homodimer interface, distal to the ligand-binding site, can induce a change in the orientation of the dimer that allows for bivalent ligand binding. When expressed in T cells, this mutation allows for high avidity CD28-CD80 interactions without TCR signaling. Molecular dynamic simulations also suggest that wild type CD28 can stably adopt a bivalent conformation. These results support a model whereby inside-out signaling from the TCR can enhance CD28 ligand interactions by inducing a change in the CD28 dimer interface to allow for bivalent ligand binding and ultimately the transduction of CD28 costimulatory signals that are required for T cell activation.

Through the Andalusian Agency for Healthcare Quality's Skills Accreditation Model, professionals observe and recognize the proximity that exists between their real skills and those defined in their Skills Manuals. This article describe the elements contained in these Manuals, referred to the Best Professionals Practices which promote the fulfilment of the Patient's Safety strategies.Cross-sectional descriptive analysis of the elements contained in the Skills Manuals which refer to the Safety strategies.38 elements related to the Safety were identified in the Skills Manuals. Currently 618 nurses have obtained their accreditation in the Andalusian Public Health System. The Best Practices and/or Evidence, related to the Safety and that are shown up during these Accreditation Processes more frequently are related to "Implementing continuous improvement activities in relation to their results evaluation" and training in "Life Support".The submission of the evidence related to Safety made by accredited nurses shows their Skills level, offers the opportunity to identify areas for improvement and professional development and enables a safer practice, preventing damage and minimizing the healthcare risks.

Potassium channel tetramerization domain (KCTD) proteins contain a bric-a-brac, tramtrak and broad complex (BTB) domain that is most similar to the tetramerization domain (T1) of voltage-gated potassium channels. Some BTB-domain-containing proteins have been shown recently to participate as substrate-specific adaptors in multimeric cullin E3 ligase reactions by recruiting proteins for ubiquitination and subsequent degradation by the proteasome. Twenty-two KCTD proteins have been found in the human genome, but their functions are largely unknown. In this study, we have characterized KCTD5, a new KCTD protein found in the cytosol of cultured cell lines. The expression of KCTD5 was upregulated post-transcriptionally in peripheral blood lymphocytes stimulated through the T-cell receptor. KCTD5 interacted specifically with cullin3, bound ubiquitinated proteins, and formed oligomers through its BTB domain. Analysis of the interaction with cullin3 showed that, in addition to the BTB domain, some amino acids in the N-terminus of KCTD5 are required for binding to cullin3. These findings suggest that KCTD5 is a substrate-specific adaptor for cullin3-based E3 ligases.

[Background] Rice tungro bacilliform virus (RTBV) is a pararetrovirus, and a member of the family Caulimoviridae in the genus Badnavirus. RTBV has a long open reading frame that encodes a large polyprotein (P3). Pararetroviruses show similarities with retroviruses in molecular organization and replication. P3 contains a putative movement protein (MP), the capsid protein (CP), the aspartate protease (PR) and the reverse transcriptase (RT) with a ribonuclease H activity. PR is a member of the cluster of retroviral proteases and serves to proteolytically process P3. Previous work established the N- and C-terminal amino acid sequences of CP and RT, processing of RT by PR, and estimated the molecular mass of PR by western blot assays., [Results] A molecular mass of a protein that was associated with virions was determined by in-line HPLC electrospray ionization mass spectral analysis. Comparison with retroviral proteases amino acid sequences allowed the characterization of a putative protease domain in this protein. Structural modelling revealed strong resemblance with retroviral proteases, with overall folds surrounding the active site being well conserved. Expression in E. coli of putative domain was affected by the presence or absence of the active site in the construct. Analysis of processing of CP by PR, using pulse chase labelling experiments, demonstrated that the 37 kDa capsid protein was dependent on the presence of the protease in the constructs., [Conclusion] The findings suggest the characterization of the RTBV protease domain. Sequence analysis, structural modelling, in vitro expression studies are evidence to consider the putative domain as being the protease domain. Analysis of expression of different peptides corresponding to various domains of P3 suggests a processing of CP by PR. This work clarifies the organization of the RTBV polyprotein, and its processing by the RTBV protease.

Amyloid fibrils formed by peptides found in semen have been shown to enhance HIV infectivity in vitro. The first of these peptides to be identified was the 248–286 fragment of prostatic acid phosphatase (PAP248–286) (Munich et al., 2007). PAP248–286 is highly cationic, and its fibrils might facilitate infection by decreasing the electrostatic repulsion between the negatively charged surfaces of the virus and the target cell. Whereas PAP248–286 can easily form fibrils in seminal fluid, it needs rapid agitation in other environments, and certain ions have been shown to be critical for its assembly into fibrils (Olsen et al., 2012). However, mutation of the positively charged residues to alanine results in a peptide (PAP248–286Ala) that can more easily form fibrilar aggregates. We studied PAP248–286 and PAP248–286Ala fibril formation in water and water + NaCl environments. While PAP248-286Ala can efficiently form fibrils in both water and water + NaCl, PAP248-286 can only do so in a water + NaCl solution. Th...

Understanding the aggregation mechanism of amyloid fibrils is a critical step in the investigation of several neurodegenerative disorders associated with the misfolding of proteins. In a previous study (Rojas et al., JMB 2010 404, 537--552), the growth mechanism of β-amyloid peptide fibrils which is associated with Alzheimer's disease (AD), was successfully modeled by using a physics-based coarse-grained united-residue model and molecular dynamics (MD) simulations. We report a simulation study of coherent two-dimensional chiral signals based on the trajectories obtained by Rojas et al. to monitor this growth mechanism at different simulation times. Far ultraviolet signals (FUV)(λ = 190--250 nm) originated from the backbone nπ∗ and ππ∗ transitions, and near ultraviolet signals (NUV) ( λ >= 250 nm) are associated with aromatic side-chains (Phe and Tyr). These signals display distinct cross peak patterns in the two-dimensional spectra that can be used, in combination with MD, to monitor local dynamics and conformational changes in the secondary structure of Aβ peptides during the aggregation process. 2DUV total chiral signals in the aggregation process are combinations of subset of chiral signals from a monomer Aβ peptide, an amyloid fibril and the interactions between them.

Social policies in Brazil, under the justification of social protection and reproducing the modus operandi of developing countries, have assumed the income transfer as the flagship car that serves the families in poverty situation. Statistical data and their uses in the management of poverty reduction and / or increase are shown in this study. It draws on national official data and multilateral organizations that study the issue on screen. It presents the discussion of the contrary tendencies that will allow reflecting on the success and or the trap on the perpetuation of the poverty in this socioeconomic configuration and its proficuity in the practice of the social assistance.

Introdução - O Vale do Ribeira, localizado ao Sul do Estado de São Paulo é estigmatizado por concentrar municípios que possuem altíssimos índices de pobreza e vulnerabilidade social, suscitando a necessidade de prospectar investimento público para reduzir as mazelas e desigualdades sociais ali representadas. O apagão regional é associado à regulamentação das áreas de preservação ambiental, que limitam a exploração do território aos moldes industrial, agroexportador e especulativo imobiliário, afetando de maneiras diferentes a formação técnica e acadêmica explorada na região e a atividade comercial desempenhada por homens e mulheres residentes. Objetivos - Analisar os modos de vida constituídos historicamente no Vale do Ribeira e a influência das políticas públicas como fator determinante ao desenvolvimento regional. Metodologia - Trata-se de estudo qualitativo composto por pesquisa documental e revisão integrativa, a saber: (1) documentar a historiografia do Vale do Ribeira contemplando o período escravagista e o processo de reestruturação produtiva local, (2) examinar os indicadores sociais dos municípios do Vale do Ribeira, (3) analisar as leis e decretos estaduais promulgados entre 2000 e 2020 que regulamentam ações de saúde no Vale do Ribeira e (4) identificar a existência de produção científica sobre o Vale do Ribeira, saúde pública e as políticas sociais para mulheres. Resultados e discussão - Foram encontrados: a) 3 planejamentos estratégicos regionais, dos quais 2 contemplam a participação de atores sociais em seu processo de elaboração e 1 foi produzido pelo Governo do Estado de São Paulo; b) 5 planos plurianuais contendo atividades previstas pelo Governo do Estado de São Paulo no período de 2004 a 2023; c) 2 planos estaduais de assistência e desenvolvimento social; d) 13 Leis Estaduais; e) 69 Decretos Estaduais, dos quais 15 promovem ações de saúde no Vale do Ribeira; f) 12 indicadores sociais e g) 10 artigos científicos. Conclusão - Os resultados obtidos demonstram que as mazelas sociais presentes no Vale do Ribeira tem origem multifatorial e são perpetuadas devido ao discurso desenvolvimentista encontrado nos planejamentos estratégicos analisados (perspectiva dissonante das características ambientais da região) e devido à ausência da participação social no processo de elaboração, implementação, monitoramento e avaliação de políticas públicas, elemento fundamental à superação das questões sociais reproduzidas. Introduction - Ribeira Valley, located in the south of the State of São Paulo, is stigmatized for concentrating municipalities that have very high levels of poverty and social vulnerability, raising the need to prospect public investment to reduce the problems and social inequalities identified there. The regional blackout is associated with the regulation of environmental preservation areas, which limit the exploitation of the territory to industrial, agro-export and speculative real estate patterns, affecting in different ways technical training and the type of commercial activity carried out by resident men and women. Objectives - To analyze the historically constituted ways of life in Ribeira Valley and the influence of public policies as a determining factor for regional development. Methodology - This is a qualitative study consisting of documentary research and integrative review, namely: (1) documenting the historiography of Ribeira Valley contemplating the slavery period and the process of local productive restructuring, (2) examining the social indicators of the municipalities of Ribeira Valley, (3) analyze the laws and state decrees enacted between 2000 and 2020 that regulate health actions in the Ribeira Valley and (4) identify the existence of scientific production on the Ribeira Valley, public health and social policies for women. Results and discussion - The following were found: a) 3 regional strategic plans, 2 of which contemplate the participation of social actors in their elaboration process and 1 was produced by the Government of the State of São Paulo; b) 5 multi-year plans containing activities planned by the Government of the State of São Paulo from 2004 to 2023; c) 2 state assistance and social development plans; d) 13 State Laws; e) 69 State Decrees, of which 15 promote health actions in Vale do Ribeira; f) 12 social indicators and g) 10 scientific articles. Conclusion - The results obtained demonstrate that the social ills present in the Ribeira Valley have a multifactorial origin and are perpetuated due to the developmental discourse found in the analyzed strategic plans (dissonant perspective of the environmental characteristics of the region) and due to the absence of social participation in the elaboration process, implementation, monitoring and evaluation of public policies, a fundamental element in overcoming the social issues reproduced.

A intersetorialidade é uma categoria em expansão, em particular no campo da promoção da saúde, que tem um olhar voltado para um conceito ampliado de saúde e a integralidade dos sujeitos. O trabalho em saúde, historicamente setorial, tem absorvido essas novas proposições na busca por alcançar determinantes de saúde favoráveis a indivíduos e comunidades. A hipótese que norteou esta pesquisa é de que o Núcleo de Apoio à Saúde da Família, embora um serviço potencial para realizar a intersetorialidade através de políticas, programas e ações existentes (consenso discursivo), com vista a atender as demandas da população de referência, não vem conseguindo materializar toda esta potencialidade em práticas intersetoriais (dissenso prático). A metodologia é de abordagem qualitativa, realizada a partir de pesquisas bibliográfica, documental e de campo. A pesquisa de campo foi realizada em 3 etapas de coleta de dados: o caminhar pelo território, as entrevistas semi-estruturadas e a observação de campo. O local de estudo é o município de Santos, São Paulo, mais especificamente a Zona Noroeste da cidade, uma região que apresenta as expressões da questão social oriundas do processo de exploração capitalista e de pobreza crescente, uma realidade contrastante com outras regiões da cidade. A intersetorialidade tem se mostrado uma estratégia importante para a construção de práticas que orientem para a integralidade em casos complexos do cotidiano do trabalho em saúde da equipe NASF. Intersectoriality is an expanding category, particularly in the field of health promotion, which focuses on an expanded concept of health and the integrality of the subjects. Health work, historically sectoral, has absorbed these new propositions in the search to reach determinants of health favorable to individuals and communities. The hypothesis that guided this research is that the Family Health Support Center, although a potential service to carry out the intersectoriality through existing policies, programs and actions (discursive consensus), in order to meet the demands of the reference population, has not been able to materialize all this potential in intersectoral practices (practical dissent). The methodology is a qualitative approach, based on bibliographical, documentary and field research. Field research was carried out in 3 stages of data collection: walking through the territory, semi-structured interviews and field observation. The study site is the municipality of Santos, São Paulo, more specifically the Northwest Zone of the city, a region that presents the expressions of the social question arising from the process of capitalist exploration and increasing poverty, a contrasting reality with other regions of the city. Intersectoriality has been shown to be an important strategy for the construction of practices that guide the integrality in complex cases of NASF team health work.