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Chronic non-infectious diseases are important to research as they are the main causes of death in Brazil and worldwide. One very important chronic non-infectious disease is cardiovascular disease, whose risk factors (diabetes, dyslipidemia, and renal failure) can be detected through assessments of serum biochemical components. The objective of this study was to evaluate the analytical performance of Raman spectroscopy for analysis of lipid profile (total cholesterol, triglycerides, and HDL cholesterol), non-protein nitrogenous compounds (urea and creatinine), and glucose in 242 human serum samples. Models to discriminate and quantify the samples were developed using the predicted concentration by quantitative regression model based on partial least squares (PLS). The analytical error for the "leave-one-out" cross-validation based on the predicted PLS concentration was 10.5 mg/dL for total cholesterol, 21.4 mg/dL for triglyceride, 13.0 mg/dL for HDL cholesterol, 4.9 mg/dL for urea, 0.21 mg/dL for creatinine, and 15.4 mg/dL for glucose. The Kappa coefficient indicate very good agreement for cholesterol (0.83), good for triglyceride (0.77), urea (0.70) and creatinine (0.66), and fair for HDL cholesterol (0.38) and glucose (0.30). The results of the analytical performance demonstrated that Raman spectroscopy can be considered an important methodology to screen the population, especially for serum triglycerides and cholesterol. [ABSTRACT FROM AUTHOR]

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In the 1960s Edu Lobo was recognized through aesthetic and social concerns in his music. The elements in the preparation of these compositions came from Brazilian Northeastern's music, bossa nova and later on from *classical* music. Dealing with some concepts of hybridism, we sought to understand the musical sources developed by Edu Lobo, specifically in the song Memórias de Marta Saré (Marta Saré's Memories, 1968 - Edu Lobo and Gianfrancesco Guarnieri). The result of this study shows some aspects that explain the uniqueness of the composer, the hybrids produced by him, and also how the very concepts of hybridism blend in this piece, which score is published on pp.159-166 in this Per Musi issue. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has disproportionately impacted low-income immigrant communities. There is concern that the current uptake of COVID-19 vaccines is suboptimal and that this may be contributing to COVID-19 inequities. However, little is known about the acceptability of COVID-19 vaccines among immigrants in the U.S. Our goal was to gauge COVID-19 vaccine intentions among Brazilian immigrant women living in the U.S., Methods: We conducted an online survey between July and August 2020 offered in Portuguese and English languages among a convenience sample of Brazilian immigrant women ages 18 years and older. Women were recruited through online advertisements by community-based organizations and social media groups to complete a survey that assessed intention to get a COVID-19 vaccine, attitudes toward vaccines, and perceptions about the pandemic., Results: Of the total sample (N = 353), most (70.8%) indicated they intended to get a COVID-19 vaccine. In bivariate analyses, vaccine intentions were significantly associated with perceptions about the severity of the pandemic, trusted sources of health information, and the number of years lived in the U.S. Multinomial logistic regression models revealed that those who did not intend to be vaccinated had lived a longer time in the U.S. (OR: -0.12 95% CI: -0.19, -0.05), perceived the pandemic to be a minor issue (OR: 1.52, 95% CI: 0.62, 2.42), and trusted information from social networks (OR: -1.94, 95% CI: -3.25, -0.63) or private news sources (OR: -1.71, 95% CI: -2.78, -0.63)., Conclusions: While most women reported they would get a COVID-19 vaccine, efforts to reach those who may be hesitant should target those who have lived in the U.S. for longer periods of time and do not perceive the pandemic to be a major crisis. Healthcare providers may be particularly suited to deliver this information given high levels of trust., Competing Interests: The authors have declared that no competing interests exist.

While an increasing body of data suggests that marginalized groups have been disproportionately impacted by COVID-19, little has been published about the specific impact on Brazilian immigrants in the U.S. We conducted 15 key informant interviews, one of which included two participants ( n = 16), with representatives from social service agencies, healthcare, and faith-based organizations serving Brazilian immigrants. Key informants were asked about the community's experiences with COVID-19 testing and treatment, responses to CDC (Centers for Disease Control) guidelines, perceptions about the virus, and the pandemic's impact on physical and mental health. Results suggest that COVID-19 has profoundly impacted Brazilian immigrants' mental and physical health. Key informants perceived that community members faced higher risk of COVID-19 infection due to overcrowded living conditions and over-representation in public-facing and informal (e.g., housecleaning) jobs. They reported barriers to COVID-19-related healthcare services including language, immigration status, and fear of deportation. Brazilian cultural norms surrounding hygiene practices, social distancing, and information distribution have shaped the community's pandemic response. The Brazilian community has faced extensive social, economic, and health ramifications due to the pandemic. While not unique to this community, pre-existing concerns about social disadvantage suggest a particular vulnerability of this population to the virus.

Aim: To identify potential predictors of community integration in individuals after stroke using a residential setting-based strategy., Method: A prospective cohort of post-stroke individuals was recruited from the Stroke Unit of the Roberto Santos General Hospital (UAVC-HGRS). All included individuals were aged over 18 years, received a diagnosis of ischemic stroke confirmed by neuroimaging and resided in the city of Salvador (Bahia, Brazil). Following discharge from the stroke unit, the individuals themselves, or their responsible parties, were contacted by telephone to schedule a home visit no less than three months after discharge. All subjects were examined in their homes, at which time the Community Integration Questionnaire (CIQ) was also applied. A robust linear regression model was used to assess community reintegration using CIQ score as the outcome variable., Results: A total of 124 individuals effectively fulfilled the eligibility criteria: 51.6% were females, the median (IQR) age was 63(53-69) years, 82.3% were non-white, 53.2% were married, the median (IQR) of years of schooling was 6 (4-12) and family income averaged two minimum monthly wages. Investigated individuals presented a median (IQR) NIH Stroke Scale (NIHSS) score of 7 (4-12). Multivariate linear regression identified the following independent predictors of community integration: age (β = -0.095; 95% CI = -0.165 to -0.025; p = 0.008), diabetes mellitus (β = -2.348; 95% CI = -4.125 to -0.571; p = 0.010), smoking habit (β = -2.951; 95% CI = -5.081 to -0.821; p = 0.007), functional capacity upon hospital discharge (β = 0.168; 95% CI = 0.093 to 0.242; p = <0.001) and stroke severity (β = -0.163; CI = -0.318 to -0.009); p = 0.038)., Conclusions: Regardless of length of time since stroke, individuals present restrictions that compromise their reintegration into their respective communities. The demographic, clinical and functional factors identified herein as potential predictors should be considered when conducting regular follow-up, as well as in the rehabilitation of individuals after stroke with the purpose to identify the interventions necessary to optimize their reintegration into the community., Competing Interests: The authors have declared that no competing interests exist.

Objective: To assess the gross motor development of children with presumed congenital Zika virus (ZIKV) infection over the first 2 years of their lives., Methods: Seventy-seven children were assessed at the median ages of 11, 18, and 24 months, using the evaluative instrument Gross Motor Function Measure (GMFM-66). At the third assessment, the children with diagnoses of cerebral palsy (CP) were classified by severity through the Gross Motor Function Classification System (GMFCS) and stratified by topography indicating the predominantly affected limbs. With these instruments in combination and using the motor development curves as reference, the rate of development and functional ability were estimated., Results: At 2 years of age, all children had the diagnosis of CP. Seventy-four (96.1%) presented gross motor skills similar to those of children aged 4 months or younger, according to the World Health Organization's standard. The GMFM-66 median score among the 73 (94.8%) children with quadriplegia and GMFCS level V showed significant change between 11 and 18 months (p < 0.001) and between 11 and 24 months (p < 0.001). No significant difference (p = 0.076) was found between 18 and 24 months., Conclusion: Despite showing some gross motor progress during the initial 18 months of life, these children with presumed congenital ZIKV infection and CP experienced severe motor impairment by 2 years of age. According to the motor development curves, these children with quadriplegia have probably already reached about 90% of their motor development potential.

Zika virus (ZIKV) infection appeared in Brazil in 2015, causing an epidemic outbreak with increased rates of microcephaly and other serious birth disorders. We reviewed 102 cases of children who were diagnosed with microcephaly at birth and who had gestational exposure to ZIKV during the outbreak. We describe the clinical, neuroimaging, and neurophysiological findings. Most mothers (81%) reported symptoms of ZIKV infection, especially cutaneous rash, during the first trimester of pregnancy. The microcephaly was severe in 54.9% of the cases. All infants presented with brain malformations. The most frequent neuroimaging findings were cerebral atrophy (92.1%), ventriculomegaly (92.1%), malformation of cortical development (85.1%), and cortical⁻subcortical calcifications (80.2%). Abnormalities in neurological exams were found in 97.0% of the cases, epileptogenic activity in 56.3%, and arthrogryposis in 10.8% of the infants. The sensorineural screening suggested hearing loss in 17.3% and visual impairment in 14.1% of the infants. This group of infants who presented with microcephaly and whose mothers were exposed to ZIKV early during pregnancy showed clinical and radiological criteria for congenital ZIKV infection. A high frequency of brain abnormalities and signs of early neurological disorders were found, and epileptogenic activity and signs of sensorineural alterations were common. This suggests that microcephaly can be associated with a worst spectrum of neurological manifestations.

Backgrounds: The study was conducted to evaluate intensive care unit (ICU) patients that ultimately died but could have met criteria for end-of-life management/palliative care (ELM-PC), and to analyse the application of components of palliative care, either "unperformed procedures" or elements of "futile/unnecessary treatment"., Methods: An observational prospective cohort in five ICUs in Southern Brazil. Adult patients who died were evaluated, searching for criteria for ELM-PC. The correct application of nine preselected items by the ICU team was studied., Results: Among 253 admissions, 52 patients died; among these, 38.5% met criteria for ELM-PC. Among ELM-PC candidates (n = 20), the ELM-PC was started later (after day 3) in 60%, and only three patients received adequate palliative care. "Analgesia" and "daily family interviews" were the most correctly applied ELM-PC elements. "Terminal extubation/weaning" was not performed in any of the patients. A reduction in the lifespan from the onset of ELM-PC to death was observed in patients who underwent "correct" interventions - 66.6% died on the first day of ELM-PC., Conclusions: In a patient cohort from a low-medium-income country, one-third of patients who died in the ICU had criteria (indications) for ELM-PC; however, the palliative care was adequately performed for only 15% of patients, with great heterogeneity and delays regarding its initiation.

The aquatic systems responsible for water supply in the Brazilian Federal District (FD) have been threatened by anthropogenic pressures, especially considering the expressive demographic increase in the region during the last decades. The purposes of this research were: (a) to assess the water quality in streams located in the FD by monitoring physical-chemical variables; (b) to define baselines for these variables among different ecological status categories. The 14 investigated streams were sampled between 2006 and 2009, in the dry (August-September, 2006, 2008, 2009) and rainy (March-April, 2008, 2009) seasons. All sampling sites were classified in four categories ("very impacted", "impacted", "in transition" and "natural") using an adaptation of a rapid habitat assessment protocol. Differences in water quality among sites were generally well predicted in the four ecological status categories defined by the protocol, which showed a gradient in nutrient concentrations from reference sites classified as "natural" (medians: electrical conductivity = 7.3 μS cm(-1); nitrate = 0.040 mg L(-1); ammonium = 0.039 mg L(-1); soluble reactive phosphorus (SRP) = <0.001 mg L(-1); total phosphorus (TP) = 0.006 mg L(-1); ) to those classified as "very impacted" (medians: electrical conductivity = 87.7 μS cm(-1); nitrate = 0.247 mg L(-1); ammonium = 0.219 mg L(-1); SRP = 0.010 mg L(-1); TP = 0.035 mg L(-1)). Point sources inputs were the main factor for water quality deterioration. The nutrient baselines reported were relatively low when compared to data collected from reference areas in Brazil (e.g., São Paulo State) or temperate regions, especially for TP.

Patients with diabetes mellitus and hypertension (HT) diseases are predisposed to kidney diseases. The objective of this study was to identify potential biomarkers in the urine of diabetic and hypertensive patients through Raman spectroscopy in order to predict the evolution to complications and kidney failure. Urine samples were collected from control subjects (CTR) and patients with diabetes and HT with no complications (lower risk, LR), high degree of complications (higher risk, HR), and doing blood dialysis (DI). Urine samples were stored frozen (-20°C) before spectral analysis. Raman spectra were obtained using a dispersive spectrometer (830-nm, 300-mW power, and 20-s accumulation). Spectra were then submitted to principal component analysis (PCA) followed by discriminant analysis. The first PCA loading vectors revealed spectral features of urea, creatinine, and glucose. It has been found that the amounts of urea and creatinine decreased as disease evoluted from CTR to LR/HR and DI (PC1, p<0.05), and the amount of glucose increased in the urine of LR/HR compared to CTR (PC3, p<0.05). The discriminating model showed better overall classification rate of 70%. These results could lead to diagnostic information of possible complications and a better disease prognosis.

Introduction: Viral hepatitis is a major public health concern in Brazil. There are few past studies on this issue, especially among riparian communities. This study aims at determining the seroprevalence of viral hepatitis B and C in the riparian community of Pacuí Island, within the Cametá municipality of Pará State, Brazil. Moreover, this study aims to investigate the principal risk factors that this community is exposed to., Methods: The current study has accessed blood samples from 181 volunteers who have answered an epidemiological questionnaire. Analyses on serological markers have been tested with commercial ELISA kits for detecting HBsAg, total anti-HBc, anti-HBs, and anti-HCV. Within seroreactive patients for HCV, RT-PCR and line probe assay have been performed to identify the viral genotype., Results: In the serological marker analysis for hepatitis B, no reactivity for HBsAg, rate of 1.1% for total anti-HBc, and rate of 19.3% for anti-HBs have been observed. On hepatitis C, 8.8% seroprevalence has been found, in which 62.5% have gotten viral RNA. Among the risk factors studied, the following have been highlighted: non-use of condoms, sharing of cutting instruments, use of illicit drugs, and reports of family disease with HBV or HCV., Conclusions: The vaccination coverage against HBV is low, and the high prevalence of HCV within this community has been observed.