Search

In 2018, there were 227,920 deaths in Brazil due to neoplasms, 19,692 referring to the female population in the northwest of the state of Rio Grande do Sul. It is estimated that by 2020, 115,780 new cases of cancer affected the Brazilian female population, which justifies the main focus of the present study. This study assessed the association between the sociodemographic, clinical, and family characteristics of women recently diagnosed with cancer and their place of residence. This is a cross-sectional and observational study, in which data collection took place from August 2018 to January 2019 through the application of a questionnaire applied to 143 women recently diagnosed with cancer. These subjects were attended in a High Complexity Oncology Center (CACON) of a size IV general hospital (300 or more beds) which were subdivided into three groups: Rural, Urban without Rural Exposure, and Urban with Rural Exposure. It was found that 51% of women were under the age of 60 years old, and comorbidities such as obesity, depression, and breast cancer showed a significant association in relation to the place of residence (p=0.035, p=0.028 p=0.032, respectively). It is concluded that despite the urban environment providing greater infrastructure in the diagnosis, treatment, and measures to prevent the occurrence of cancer, urban, rural and women exposed to the rural environment, demonstrated similar occurrences for the incidence of some types of cancers.

Background Several European countries face a shortage of general practitioners (GPs), in part due to GP attrition. Most studies of GP attrition have focussed on why GPs decide to leave. Yet understanding why GPs decide to remain may also elicit potential interventions to reduce attrition. Objectives This study examined GP graduates’ career trajectories and underlying decisions to elucidate the factors influencing GP attrition. Methods We conducted semi-structured interviews of early to mid-career general practice graduates having completed training in Belgian French-speaking universities between 1999 and 2013. We sampled participants from three categories: full-time GPs, part-time GPs, no longer working as GPs. We analysed each participant’s career trajectory and broke it down into major phases. We performed thematic analysis of the factors influencing participants’ trajectories. We compared and contrasted trajectories to develop a typology of career trajectories. Results We identified six types of career trajectories: ‘stable’ (never considered leaving general practice), ‘reaffirmed’ (had considered leaving but made substantial changes whilst remaining), ‘reactional reorientations’ (had left to escape the challenges of general practice), ‘inspired reorientations’ (had left to pursue a different job), ‘reorientations out of loyalty’ (had never wanted to practice as GPs and had remained true to their original professional aspirations) and ‘mobiles’ (valued change and did not want to set-up practice). Conclusion Reasons GPs leave the profession are multiple. The typology that emerged indicates that only some of the career trajectories would benefit from interventions to reduce attrition such as improving working conditions and providing psychological support for GPs.

Abstract Background Diabetes and its sequelae such as diabetic foot ulcer are rising health hazards not only in western countries but all over the world. Effective, yet safe treatments are desperately sought for by physicians, healthcare providers, and of course patients. Methods/design APOSEC, a novel, innovative drug, is tested in the phase I/II study MARSYAS II, where its efficacy to promote healing of diabetic foot ulcers will be determined. To this end, the cell-free secretome of peripheral blood mononuclear cells (APOSEC) blended with a hydrogel will be applied topically three times weekly for 4 weeks. APOSEC is predominantly effective in hypoxia-induced tissue damages by modulating the immune system and enhancing angiogenesis, whereby its anti-microbial ability and neuro-regenerative capacity will exert further positive effects. In total, 132 patients will be enrolled in the multicenter, randomized, double-blind, placebo-controlled, parallel group, dose-ranging phase I/II study and treated with APOSEC at three dose levels or placebo for 4 weeks, followed by an 8-week follow-up period to evaluate safety and efficacy of the drug. Wound area reduction after 4 weeks of treatment will serve as the primary endpoint. Conclusion We consider our study protocol to be suitable to test topically administered APOSEC in patients suffering from diabetic foot ulcers in a clinical phase I/II trial. Trial registration EudraCT 2018-001653-27 . Registered on 30 July 2019. ClinicalTrials.gov NCT04277598 . Registered on 20 February 2020. Title: “A randomized, placebo-controlled, double-blind study to evaluate safety and dose-dependent clinical efficacy of APO-2 at three different doses in patients with diabetic foot ulcer (MARSYAS II)”

Faladeiras extension project is a feminist project and it is linked to the Center for Studies in Social Work and Popular Organization (NESSOP) of the Department of Social Work at the Federal University of Santa Catarina. It is characterized as an action with the community, with gender violence as its main focus. From its first edition in 2017 so far, the original project has undergone modifications, especially through permanent evaluations with the participants. Thus, the main objective of this experience report is, in addition to socializing the practice of an extension project, signaling the importance of the context to indicate the needs for changes, which can be seen in the presentation of the editions. This must be the commitment of the Public University with the defense of the population's rights, in the struggle against all kinds of current oppression and exploitation.

Objetivo: Verificar o uso da polimedicação em usuários de varfarina e sua associação com variáveis clínicas. Métodos: estudo transversal, com usuários de varfarina, de ambos os sexos. Para a coleta dos dados foi utilizado questionário estruturado, com perguntas abertas e fechadas, sobre dados socioeconômicos, clínicos e aspectos relacionados à farmacoterapia (reações adversas, interações medicamentosas, índices de pressão arterial sistêmica, valores de glicemia de jejum, prática de automedicação, sobrepeso, episódios de sangramento e de tromboembolismo). Resultados: a média de idade dos participantes foi de 69,1 ± 13,6 anos, maioria do sexo feminino (64,6%), casado (43,8%), e de etnia branca (85,4%). Quanto a escolaridade, 41,7% cursaram ensino fundamental incompleto. Os pacientes polimedicados totalizaram 89,6%, e os pacientes em uso de dez ou mais medicamentos, 31,3%. A média de medicamentos foi 8,2 ± 3,5 fármacos/paciente. Ocorreu associação entre polimedicação, ocorrência de reações adversas (94,7% vs 5,3%; p = 0,042) e o número de potenciais interações medicamentosas, totais (8,9 ± 5,0 vs 1,2 ± 1,6; p = 0,001) e graves (3,1 ± 2,4 vs 0,4 ± 0,6; p = 0,017). As demais variáveis estudadas não foram associadas com a polimedicação. Conclusão: os resultados demonstraram interferência negativa da polimedicação na ocorrência de reações adversas, e nas potenciais interações medicamentosas totais e graves. Há necessidade de conhecer o impacto destas variáveis no paciente anticoagulado polimedicado para o planejamento de estratégias de redução de riscos e para a otimização dos benefícios.

Background: The impact of the gut and its microbiota are increasingly appreciated in health and disease. Short-chain fatty acids (SCFAs) are among the main metabolites synthesized from bacterial fermentation. Recently, we showed the anti-inflammatory and potentially neuroprotective effect of propionic acid (PA) in multiple sclerosis (MS). Osteoporosis is one of the most common co-morbidities for MS patients with limited therapeutic options available. Osteoporosis is closely linked to an imbalance of cells of the immune system and an immune-mediated impact on bone structure via the gut has been shown. Interestingly, intake of SCFA leads to bone mass increase and concomitant reduction of inflammation-induced bone loss in mice. Objective: To determine the impact of PA supplementation on markers of bone metabolism in MS patients. Methods: We investigated the influence of 14 days supplementation with PA on bone metabolism in 20 MS patients. To this end, β-CrossLaps and osteocalcin, established markers of bone metabolism, were measured in serum before and after PA intake and correlated with phenotypic and functional immunodata. Results: Supplementation with PA induced a significant increase in serum levels of osteocalcin, a surrogate marker for bone formation. Levels of β-CrossLaps, a marker for bone resorption, were significantly decreased after therapy. Regulatory T-cell (Treg) numbers and suppressive capacity positively correlated with serum levels of osteocalcin while Th17 cell numbers showed an inverse correlation. Our findings are in line with animal studies showing that SCFA induced increased bone formation and reduced bone resorption. Conclusion: In addition to its immune regulatory, disease-modifying effect on MS disease course, supplementation with PA beneficially influences serum levels of β-CrossLaps and osteocalcin and may thus also protect against osteoporosis, a common co-morbidity in MS.

Successful subunit vaccination with recombinant proteins requires adjuvants. The glycolipid trehalose-dibehenate (TDB), a synthetic analog of the mycobacterial cord factor, potently induces Th1 and Th17 immune responses and is a candidate adjuvant for human immunization. TDB binds to the C-type lectin receptor Mincle and triggers Syk-Card9-dependent APC activation. In addition, interleukin (IL)-1 receptor/MyD88-dependent signaling is required for TDB adjuvanticity. The role of different innate immune cell types in adjuvant-stimulated Th1/Th17 responses is not well characterized. We investigated cell recruitment to the site of injection (SOI) and to the draining lymph nodes (dLNs) after immunization with the TDB containing adjuvant CAF01 in a protein-based vaccine. Recruitment of monocytes and neutrophils to the SOI and the dramatic increase in lymph node cellularity was partially dependent on both Mincle and MyD88. Despite their large numbers at the SOI, neutrophils were dispensable for the induction of Th1/Th17 responses. In contrast, CCR2-dependent monocyte recruitment was essential for the induction of Th1/Th17 cells. Transport of adjuvant to the dLN did not require Mincle, MyD88, or CCR2. Together, adjuvanticity conferred by monocytes can be separated at the cellular level from potential tissue damage by neutrophils.

In this work, we have tested individual and combination of applications of ozonolysis and liquid hot water (LHW) to pretreat sugarcane bagasse (SCB) for the removal of enzyme and/or microbial inhibitors and generation of potential value-added chemicals. A solid content with 80% cellulose and a liquid phase (liquor) rich in phenolic derived compounds (3 g.L−1) from lignin, sugars (>20 g.L−1), and other compounds, such as furfural and hydroxymethylfurfural (HMF), were generated. Maximal (59%) glucan conversion occurred in the presence of double-pretreated bagasse, which had 32–50% more glucan available than the samples that were individually LHW or ozone-pretreated, resulting in maximal ethanol production (92% after 42 h) from double-pretreated SCB enzyme hydrolyzate. In summary, this work showed that ozone reacts effectively with lignin without the use of any other chemical reagent, and LHW pretreatment, followed by a washing step, was effective in solubilizing and cleaning up the fiber enzyme and microbial inhibitory compounds with ozone being effective against phenolics. Moreover, the generated cellulose-rich substrate is readily fermentable. The acidic liquor fraction removed by sequential washings and containing mainly sugars and phenolic compounds may be evaluated for use in green chemistry bioconversions processes.

Madagascar is a large island to the south-east of Africa and in many ways continental in size and ecological complexity. Here we aim to define how skull morphology of an endemic and monophyletic clade of rodents (sub-family Nesomyinae), that show considerable morphological variation, have evolved and how their disparity is characterized in context of the geographical and ecological complexity of the island. We performed a two-dimensional geometric morphometric analysis on 370 dorsal and 399 ventral skull images of 19 species (comprising all nine extant endemic genera) and tested the influence of three ecological parameters (climate, locomotor habitat and nychthemeral cycle) in a phylogenetic context on size and shape. The results indicate that skull shape appears to importantly reflect phylogeny, whereas skull size does not carry a significant phylogenetic signal. Skull shape is significantly influenced by climate while, skull size is not impacted by any of the ecological factors tested, which is controversial to expectations in an insular context. In conclusion, Nesomyinae must have evolved under unusual types of local constraints, preventing this radiation from demonstrating strong ecological release.

Various subspecies of Apis mellifera L. were introduced to Central America since colonization 500 years ago. Hybridization increased with the entrance of the Africanized bee in Nicaragua in 1984. Rustic beekeeping activities and numerous feral swarms define the genetic pattern, reflected in phenotypic heterogeneity and remarkable differences in the behaviour of the bee colonies, especially the nest defence. Due to these facts, the question emerge about the degree of Africanization of honeybee colonies in Nicaragua. In this study, we identified Africanized honeybee colonies based on the single character "mean forewing length" and we corroborated our results by determining mitotypes using mtDNA analysis. Morphometric and genetic approaches were realized in three different geographical zones of Nicaragua and related to beehive characteristics and management. Worker bee samples were taken from the inside of 146 hives from 26 apiaries. Abdominal colour as phenotypic character was the first examination, followed by measurement of 1460 right forewings to determine corresponding probability of Africanization. More than 60% of the beehives showed phenotypic heterogeneity and mean forewing length of 8.74 mm (SD 0.16 mm) indicated a high degree of Africanization. Those results provided a selection of 96 worker bees to perform PCR of two worker bees per hive. For mitochondrial DNA analysis 14 samples from sentinel apiaries were added. Three from 61 beehives presented bees with different mtDNA. Throughout, three mitotypes of the African (A) lineage were detected; one mitotype is still unidentified. Mitotype A1 A. mellifera iberiensis was represented by 88 bees and mitotype A4 A. mellifera scutellata by 21 bees. Phylogenetic analysis confirmed the PCR findings. No associations were found between mitotypes, forewing length, beehive characteristics and management. A high degree of Africanization in A. mellifera colonies represented by two predominating mitotypes from the A lineage, prevail in Neotropical Nicaragua, with mitotype A4 predominating at higher altitudes.

The root extracellular trap (RET) consists of root-associated, cap-derived cells (root AC-DCs) and their mucilaginous secretions, and forms a structure around the root tip that protects against biotic and abiotic stresses. However, there is little information concerning the changes undergone by the RET during droughts, especially for tree species. Morphological and immunocytochemical approaches were used to study the RET of black poplar (Populus nigra L.) seedlings grown in vitro under optimal conditions (on agar-gelled medium) or when polyethylene glycol-mediated (PEG6000—infused agar-gelled medium) was used to mimic drought conditions through osmotic stress. Under optimal conditions, the root cap released three populations of individual AC-DC morphotypes, with a very low proportion of spherical morphotypes, and equivalent proportions of intermediate and elongated morphotypes. Immunolabeling experiments using anti-glycan antibodies specific to cell wall polysaccharide and arabinogalactan protein (AGP) epitopes revealed the presence of homogalacturonan (HG), galactan chains of rhamnogalacturonan-I (RG-I), and AGPs in root AC-DC cell walls. The data also showed the presence of xylogalacturonan (XGA), xylan, AGPs, and low levels of arabinans in the mucilage. The findings also showed that under osmotic stress conditions, both the number of AC-DCs (spherical and intermediate morphotypes) and the total quantity of mucilage per root tip increased, whereas the mucilage was devoid of the epitopes associated with the polysaccharides RG-I, XGA, xylan, and AGPs. Osmotic stress also led to reduced root growth and increased root expression of the P5CS2 gene, which is involved in proline biosynthesis and cellular osmolarity maintenance (or preservation) in aerial parts. Together, our findings show that the RET is a dynamic structure that undergoes pronounced structural and molecular remodeling, which might contribute to the survival of the root tip under osmotic conditions.

Summary: Background: Enteric fever is a serious public health concern in many low-income and middle-income countries. Numerous data gaps exist concerning the epidemiology of Salmonella enterica serotype Typhi (S Typhi) and Salmonella enterica serotype Paratyphi (S Paratyphi), which are the causative agents of enteric fever. We aimed to determine the burden of enteric fever in three urban sites in Africa and Asia. Methods: In this multicentre population-based study, we did a demographic census at three urban sites in Africa (Blantyre, Malawi) and Asia (Kathmandu, Nepal and Dhaka, Bangladesh) between June 1, 2016, and Sept 25, 2018. Households were selected randomly from the demographic census. Participants from within the geographical census area presenting to study health-care facilities were approached for recruitment if they had a history of fever for 72 h or more (later changed to >48 h) or temperature of 38·0°C or higher. Facility-based passive surveillance was done between Nov 11, 2016, and Dec 31, 2018, with blood-culture collection for febrile illness. We also did a community-based serological survey to obtain data on Vi-antibody defined infections. We calculated crude incidence for blood-culture-confirmed S Typhi and S Paratyphi infection, and calculated adjusted incidence and seroincidence of S Typhi blood-culture-confirmed infection. Findings: 423 618 individuals were included in the demographic census, contributing 626 219 person-years of observation for febrile illness surveillance. 624 S Typhi and 108 S Paratyphi A isolates were collected from the blood of 12 082 febrile patients. Multidrug resistance was observed in 44% S Typhi isolates and fluoroquinolone resistance in 61% of S Typhi isolates. In Blantyre, the overall crude incidence of blood-culture confirmed S Typhi was 58 cases per 100 000 person-years of observation (95% CI 48–70); the adjusted incidence was 444 cases per 100 000 person-years of observation (95% credible interval [CrI] 347–717). The corresponding rates were 74 (95% CI 62–87) and 1062 (95% CrI 683–1839) in Kathmandu, and 161 (95% CI 145–179) and 1135 (95% CrI 898–1480) in Dhaka. S Paratyphi was not found in Blantyre; overall crude incidence of blood-culture-confirmed S Paratyphi A infection was 6 cases per 100 000 person-years of observation (95% CI 3–11) in Kathmandu and 42 (95% CI 34–52) in Dhaka. Seroconversion rates for S Typhi infection per 100 000 person-years estimated from anti-Vi seroconversion episodes in serological surveillance were 2505 episodes (95% CI 1605–3727) in Blantyre, 7631 (95% CI 5913–9691) in Kathmandu, and 3256 (95% CI 2432–4270) in Dhaka. Interpretation: High disease incidence and rates of antimicrobial resistance were observed across three different transmission settings and thus necessitate multiple intervention strategies to achieve global control of these pathogens. Funding: Wellcome Trust and the Bill & Melinda Gates Foundation.

Summary: Background: Antimicrobial resistance (AMR) is a serious threat to global public health. WHO emphasises the need for countries to monitor antibiotic consumption to combat AMR. Many low-income and middle-income countries (LMICs) lack surveillance capacity; we aimed to use multiple data sources and statistical models to estimate global antibiotic consumption. Methods: In this spatial modelling study, we used individual-level data from household surveys to inform a Bayesian geostatistical model of antibiotic usage in children (aged

Background: Typhoid and paratyphoid fever (enteric fever) is a common cause of non-specific febrile infection in adults and children presenting to health care facilities in low resource settings such as the South Asia. A 7-day course of a single oral antimicrobial such as ciprofloxacin, cefixime, or azithromycin is commonly used for its treatment. Increasing antimicrobial resistance threatens the effectiveness of these treatment choices. We hypothesize that combined treatment with azithromycin (active mainly intracellularly) and cefixime (active mainly extracellularly) will be a better option for the treatment of clinically suspected and culture-confirmed typhoid fever in South Asia. Methods: This is a phase IV, international multi-center, multi-country, comparative participant-and observer-blind, 1:1 randomised clinical trial. Patients with suspected uncomplicated typhoid fever will be randomized to one of the two interventions: Arm A: azithromycin 20mg/kg/day oral dose once daily (maximum 1gm/day) and cefixime 20mg/kg/day oral dose in two divided doses (maximum 400mg bd) for 7 days, Arm B: azithromycin 20mg/kg/day oral dose once daily (max 1gm/day) for 7 days AND cefixime-matched placebo for 7 days. We will recruit 1500 patients across sites in Bangladesh, India, Nepal, and Pakistan. We will assess whether treatment outcomes are better with the combination after one week of treatment and at one- and three-months follow-up. Discussion: Combined treatment may limit the emergence of resistance if one of the components is active against resistant sub-populations not covered by the other antimicrobial activity. If the combined treatment is better than the single antimicrobial treatment, this will be an important result for patients across South Asia and other typhoid endemic areas. Clinicaltrials.gov registration: NCT04349826 (16/04/2020)

Introdução: O acesso à água em quantidade e qualidade sufcientes, compatíveis com o padrão de potabilidade estabelecido na legislação é um direito humano fundamental. A carência de universalização desse acesso, bem como de saneamento básico gera impactos sociais e econômicos. Objetivo: Identifcar na literatura científca o que tem sido evidenciado sobre qualidade da água destinada ao consumo humano, distribuída coletivamente no Brasil. Método: Revisão integrativa da literatura realizada com 28 estudos selecionados na Biblioteca Virtual em Saúde (BVS) e Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) no período de agosto a setembro de 2019. Resultados apresentados descritivamente e apresentados em forma de tabelas e fguras. Resultados: Foram obtidas duas categorias: 1. Fatores ambientais que interferem na qualidade da água – inconformidades quanto ao preconizado se relacionaram às ações antrópicas no meio ambiente; 2. Qualidade da água quanto ao padrão de potabilidade e vigilância – houve semelhanças entre os parâmetros microbiológicos, fluoretação e turbidez. Conclusões: Foram encontrados poucos estudos sobre vigilância da qualidade da água destinada ao consumo humano, especialmente com abordagem sobre atuação nos estados e municípios brasileiros e estes refletem difculdades no cumprimento de alguns parâmetros recomendados pela legislação referente a qualidade da água.

ABSTRACT Objectives: to analyze and compare levels of stress and resilience in nurses before and after the assessment for maintenance of the Hospital Accreditation Certification. Methods: quantitative, observational, and longitudinal research, with 53 nurses from a philanthropic hospital, in the Rio Grande do Sul. Data collected in two stages, March, and July 2019, before the assessment visit and 60 days after, using the Bianchi Stress Scale and Resilience Scale. Descriptive and analytical statistics were employed. Results: the majority of participants showed an average stress level before and after the evaluation. The highest stress scores were related to Domains E (coordination of unit activities) and C (activities related to personnel administration). In both moments of the study, the participants had medium and high resilience. Conclusions: managing people, processes, and assistance are stressful activities in the Accreditation process and increase the nurses’ stress levels.

ABSTRACT Objectives To analyze the strategies to control delayed onset muscle soreness (DOMS) and fatigue used by Brazilian paracanoe para-athletes. Methodology: 34 para-athletes were interviewed during the Brazilian canoeing championship in 2017. The interview was divided into four parts: athlete's personal data, disability characteristics, sport practice, and relationship of performance with fatigue and DOMS. Results: 91% of the para-athletes reported DOMS and 88% fatigue. However, despite feeling DOMS and fatigue, 70% of the para-athletes did not undertake prevention or recovery interventions. Conclusion: Although Brazilian paracanoe para-athletes reported intense and frequent DOMS and fatigue, they do not use any strategy to control or reduce them.

ABSTRACT Sulfur metabolism in fuel-biodesulfurizing bacteria and the underlying physiological adaptations are not understood, which has impeded the development of a commercially viable bioprocess for fuel desulfurization. To fill these knowledge gaps, we performed comparative proteomics and untargeted metabolomics in cultures of the biodesulfurization reference strain Rhodococcus qingshengii IGTS8 grown on either inorganic sulfate or the diesel-borne organosulfur compound dibenzothiophene as a sole sulfur source. Dibenzothiophene significantly altered the biosynthesis of many sulfur metabolism proteins and metabolites in a growth phase-dependent manner, which enabled us to reconstruct the first experimental model for sulfur metabolism in a fuel-biodesulfurizing bacterium. All key pathways related to assimilatory sulfur metabolism were represented in the sulfur proteome, including uptake of the sulfur sources, sulfur acquisition, and assimilatory sulfate reduction, in addition to biosynthesis of key sulfur-containing metabolites such as S-adenosylmethionine, coenzyme A, biotin, thiamin, molybdenum cofactor, mycothiol, and ergothioneine (low-molecular weight thiols). Fifty-two proteins exhibited significantly different abundance during at least one growth phase. Sixteen proteins were uniquely detected and 47 proteins were significantly more abundant in the dibenzothiophene culture during at least one growth phase. The sulfate-free dibenzothiophene-containing culture reacted to sulfate starvation by restricting sulfur assimilation, enforcing sulfur-sparing, and maintaining redox homeostasis. Biodesulfurization triggered alternative pathways for sulfur assimilation different from those operating in the inorganic sulfate culture. Sulfur metabolism reprogramming and metabolic switches in the dibenzothiophene culture were manifested in limiting sulfite reduction and biosynthesis of cysteine, while boosting the production of methionine via the cobalamin-independent pathway, as well as the biosynthesis of the redox buffers mycothiol and ergothioneine. The omics data underscore the key role of sulfur metabolism in shaping the biodesulfurization phenotype and highlight potential targets for improving the biodesulfurization catalytic activity via metabolic engineering. IMPORTANCE For many decades, research on biodesulfurization of fossil fuels was conducted amid a large gap in knowledge of sulfur metabolism and its regulation in fuel-biodesulfurizing bacteria, which has impeded the development of a commercially viable bioprocess. In addition, lack of understanding of biodesulfurization-associated metabolic and physiological adaptations prohibited the development of efficient biodesulfurizers. Our integrated omics-based findings reveal the assimilatory sulfur metabolism in the biodesulfurization reference strain Rhodococcus qingshengii IGTS8 and show how sulfur metabolism and oxidative stress response were remodeled and orchestrated to shape the biodesulfurization phenotype. Our findings not only explain the frequently encountered low catalytic activity of native fuel-biodesulfurizing bacteria but also uncover unprecedented potential targets in sulfur metabolism that could be exploited via metabolic engineering to boost the biodesulfurization catalytic activity, a prerequisite for commercial application.

Abstract Aim: This study aimed to compare the recruitment of the anterior deltoid, pectoralis major, triceps (long head), and latissimus dorsi muscles during rowing, in paracanoe and canoe athletes. Methods: This is a cross-sectional study, with ethical approval, including a sample of five paraplegic athletes, four lower limb amputees, and four athletes without disabilities. Surface electromyography of the anterior deltoid, pectoralis major, triceps (long head), and latissimus dorsi muscles. The athletes rowed for three minutes in an ergometer kayak. The Root Mean Square (RMS) signal of the second minute of data collection, normalized by the RMS peak (% RMS), was considered for analysis. Results: The results of paraplegic athletes, amputees, and athletes without disabilities were similar, as follows; the anterior deltoid: 10.81 ± 3.1; 9.6 ± 3.13 and 9.92 ± 3.12 (p = 0.83), pectoralis major: 7.71 ± 0.66; 8.66 ± 0.66 and 8.53 ± 2.62 (p = 0.72), long head of the triceps: 8.41 ± 3.05; 4.79 ± 1.2 and 6.66 ± 1.01 (p = 0.08), and latissimus dorsi: 8.18 ± 1.97; 6.39 ± 2.64 and 6.95 ± 1.64 (p = 0.45). Conclusion: Paracanoe and canoe athletes present similar muscle recruitment of the upper limbs and trunk during rowing.

Abstract Background Antimicrobial resistance (AMR) is an increasing threat to global health. There are > 14 million cases of enteric fever every year and > 135,000 deaths. The disease is primarily controlled by antimicrobial treatment, but this is becoming increasingly difficult due to AMR. Our objectives were to assess the prevalence and geographic distribution of AMR in Salmonella enterica serovars Typhi and Paratyphi A infections globally, to evaluate the extent of the problem, and to facilitate the creation of geospatial maps of AMR prevalence to help targeted public health intervention. Methods We performed a systematic review of the literature by searching seven databases for studies published between 1990 and 2018. We recategorised isolates to allow the analysis of fluoroquinolone resistance trends over the study period. The prevalence of multidrug resistance (MDR) and fluoroquinolone non-susceptibility (FQNS) in individual studies was illustrated by forest plots, and a random effects meta-analysis was performed, stratified by Global Burden of Disease (GBD) region and 5-year time period. Heterogeneity was assessed using the I 2 statistics. We present a descriptive analysis of ceftriaxone and azithromycin resistance. Findings We identified 4557 articles, of which 384, comprising 124,347 isolates (94,616 S. Typhi and 29,731 S. Paratyphi A) met the pre-specified inclusion criteria. The majority (276/384; 72%) of studies were from South Asia; 40 (10%) articles were identified from Sub-Saharan Africa. With the exception of MDR S. Typhi in South Asia, which declined between 1990 and 2018, and MDR S. Paratyphi A, which remained at low levels, resistance trends worsened for all antimicrobials in all regions. We identified several data gaps in Africa and the Middle East. Incomplete reporting of antimicrobial susceptibility testing (AST) and lack of quality assurance were identified. Interpretation Drug-resistant enteric fever is widespread in low- and middle-income countries, and the situation is worsening. It is essential that public health and clinical measures, which include improvements in water quality and sanitation, the deployment of S. Typhi vaccination, and an informed choice of treatment are implemented. However, there is no licenced vaccine for S. Paratyphi A. The standardised reporting of AST data and rollout of external quality control assessment are urgently needed to facilitate evidence-based policy and practice. Trial registration PROSPERO CRD42018029432.

The fifth generation (5G) of mobile radio technologies has been defined as a new delivery model where services are tailored to specific vertical industries. 5G supports three types of services with different and heterogeneous requirements, i.e. enhanced Mobile Broadband (eMBB), Ultra-Reliable Low-Latency Communications (URLLC) and massive Machine-Type Communications (mMTC). These services are directly related to exemplary verticals such as media, vehicular communications or the Industry 4.0. This work provides a detailed analysis and performance evaluation of 5G New Radio (NR) against a set of Key Performance Indicators (KPI), as defined in the International Mobile Telecommunications 2020 (IMT-2020) guidelines, and provides an overview about the fulfillment of their associated requirements. The objective of this work is to provide an independent evaluation, complementing the Third Generation Partnership Project (3GPP) contribution. From the original group of sixteen KPIs, eleven of them have been carefully selected, paying special attention to eMBB services. Results show that 5G NR achieves all considered requirements, therefore fulfilling the specific market's needs for years to come.

The risk of falls and the administration of medications are related to the safety of hospitalized patients. Thus, this study aimed to identify classes of drugs and drug interactions that increase the risk of hospital falls. This was a quantitative, cross-sectional study, in the southern region of Brazil, with 612 patients from inpatient units. Data were collected using a specific instrument for demographic data, Morse Scale and medical chart analysis from June to August 2015. In the univariate statistical analysis, absolute and relative frequencies were used and in the bivariate analysis, a chi-squared test with a level of 5% significance was used. 612 patients participated in the study, with use of drugs that act on the cardiovascular and nervous systems prevailing. The main classes of drugs related to high risk of falls were antiparkinsonian (76.2%) and calcium channel blockers (57.1%). The number of medications was also associated with a high risk of falling, present in 56.2% of patients using five or more drugs. 2,187 drug interactions were identified, of which 9.1% were potentiating the risk of falls, among the drugs involved in serious or contraindicated interactions there was a higher frequency among patients taking morphine (16.5%) and metoclopramide (6.0%). The most frequent serious interaction was morphine and tramadol (7.7%). It was observed that drugs frequently used by hospitalized patients are associated with an increased risk of falls and that the existence of potential drug interactions also can increase the risk of falls. Knowing the profile of the drugs used and their relationship with the risk of falls in the hospital environment helps administrators implement preventive actions.

Chronic Kidney Disease is associated with the use of polypharmacy and is associated with increased risk of adverse events, drug interactions and decreased adherence to drug treatment. The aim of the present study was to evaluate treatment adherence in patients with chronic kidney disease undergoing hemodialysis. We conducted a cross-sectional, descriptive and analytical survey of all patients enrolled and followed in the Nephrology services of the Ijuí Charity Hospital and the Kidney Clinic, attached to the Santo Ângelo Hospital, from January to June 2017. Data collection was performed through an individual interview, using a structured and validated questionnaire. Depression was assessed by applying the Beck Depression Inventory and adherence was by the Morisky Adhesion Scale. 184 patients were interviewed, and among those interviewed, 66.2% had low adherence. Infarction, repetitive infections and depression were factors statistically significantly associated with poor adherence, as well as the use of more than six medications. Performing physical activities was associated with a greater adherence to medication use. 45.7% of patients responded that they had at some point forgotten to take their medication, and 42.4% stopped taking their medication when they felt their symptoms were under control. Therefore, health education actions, as well as pharmacotherapeutic follow-up of these patients, should be performed with a focus on improving adherence and quality of life, with a view to increasing survival.

Objetivo: Verificar o perfil de saúde, baseado no cadastro individual e-SUS, de usuários dos serviços de atenção básica da cidade de Ijuí/RS. Métodos: Estudo transversal, com amostra de 400 usuários cadastrados em 15 Estratégias de Saúde da Família, na faixa etária de 20 a 59 anos, baseado no cadastro individual e-SUS. Resultados: Verificou-se predomínio de assalariado com carteira de trabalho, baixa escolaridade. Os usuários com escolaridade baixa tiveram cinco vezes mais chance de desenvolver diabetes mellitus (DM) (p=0,01), com escolaridade alta internaram com maior frequência (p=0,03). Observou associação entre participar de grupo comunitário e o sexo feminino (p=0,013) e apresentar alta escolaridade e possuir plano de saúde privado (p=0,001). Conclusão: O perfil dos usuários mostra relação direta da baixa escolaridade com doenças crônicas não transmissíveis e inversa as internações. Descritores: Características da População, Estratégia Saúde da Família, Atenção Primária à Saúde, Sistema Único de Saúde.

The postoperative period of cardiac surgery interferes with peripheral muscle strength, which can be assessed by a 1-minute sit-to-stand test (STST). Our objective was to correlate STST and preoperative physical-functional variables and secondarily to correlate with gender, clinical and surgical variables, comorbidities, risk factors and postoperative complications. Cross-sectional and analytical study of patients undergoing elective cardiac surgery between 2010 and 2017. On the day before surgery, an evaluation was performed to quantify performance of the STST and the functional physical variables (six-minute walk test - 6MWT, respiratory muscle strength assessed by maximal inspiratory (MIP) and expiratory (MEP) pressure and waist circumference). Clinical and surgical variables (ejection fraction, time on mechanical ventilation, length of stay in the intensive care unit and total length of stay), comorbidities and risk factors (hypertension, diabetes mellitus, chronic obstructive pulmonary disease, acute myocardial infarction, smoking, alcoholism, physical inactivity and stress) and postoperative complications were collected from patient’s medical records. A population of 154 individuals obtained a mean of 17.32±5.02 repetitions in STST. There was a direct correlation with the 6MWT (r= 0.330; p= 0.004), the percentage of MIP (r= 0.115; p= 0.001) and MEP (r= 0.212; p= 0.004) and an inverse correlation with waist circumference (r= -0.238; p= 0.003) and age (r= -0.294; p= 0.001). There was a better performance of STST correlated with males (p= 0.032) and those with lower stress levels (p= 0.012). It is concluded that there is a correlation between the STST and the 6MWT, respiratory muscle strength and waist circumference, as well as male gender and stress.

Objetivo: Descrever o perfil sociodemográfico e clínico de idosos usuários crônicos de omeprazol. Método: Trata-se de um estudo transversal com usuários com idade superior a 60 anos, que retiraram o omeprazol na Farmácia Pública de Panambi/RS. Resultados: Participaram da pesquisa 60 idosos, com idade média de 67,90 ±5,6 anos. Duas interações graves foram identificadas envolvendo citalopram e clopidogrel. Observou-se a presença nas prescrições de medicamentos que tem a sua absorção alterada pelo uso concomitante com o omeprazol como captopril (25%) e enalapril (16,7%). Conclusão: Desta forma, evidenciou-se uma população suscetível a riscos que necessita de acompanhamento farmacêutico.