Search

Abstract To cope with environmental stresses, bacteria have developed different strategies, including the production of small heat shock proteins (sHSP). All sHSPs are described for their role as molecular chaperones. Some of them, like the Lo18 protein synthesized by Oenococcus oeni, also have the particularity of acting as a lipochaperon to maintain membrane fluidity in its optimal state following cellular stresses. Lipochaperon activity is poorly characterized and very little information is available on the domains or amino-acids key to this activity. The aim in this paper is to investigate the importance at the protein structure and function level of four highly conserved residues in sHSP exhibiting lipochaperon activity. Thus, by combining in silico, in vitro and in vivo approaches the importance of three amino-acids present in the core of the protein was shown to maintain both the structure of Lo18 and its functions.

ABSTRACTTrypanosoma cruzi is the etiologic agent of the most prevalent human parasitic disease in Latin America, Chagas disease. Its genome is rich in multigenic families that code for virulent antigens and are present in the rapidly evolving genomic compartment named Disruptive. DNA replication is a meticulous biological process in which flaws can generate mutations and changes in chromosomal and gene copy numbers. Here, integrating high-throughput and single-molecule analyses, we were able to identify Predominant, Flexible, and Dormant Orc1Cdc6-dependent origins as well as Orc1Cdc6-independent origins. Orc1Cdc6-dependent origins were found in multigenic family loci, while independent origins were found in the Core compartment that contains conserved and hypothetical protein-coding genes, in addition to multigenic families. In addition, we found that Orc1Cdc6 density is related to the firing of origins and that Orc1Cdc6-binding sites within fired origins are depleted of a specific class of nucleosomes that we previously categorized as dynamic. Together, these data suggest that Orc1Cdc6-dependent origins may contribute to the rapid evolution of the Disruptive compartment and, therefore, to the success of T. cruzi infection and that the local epigenome landscape is also involved in this process.IMPORTANCETrypanosoma cruzi, responsible for Chagas disease, affects millions globally, particularly in Latin America. Lack of vaccine or treatment underscores the need for research. Parasite’s genome, with virulent antigen-coding multigenic families, resides in the rapidly evolving Disruptive compartment. Study sheds light on the parasite’s dynamic DNA replication, discussing the evolution of the Disruptive compartment. Therefore, the findings represent a significant stride in comprehending T. cruzi’s biology and the molecular bases that contribute to the success of infection caused by this parasite.

Abstract Biofilms represent a major concern in the food industry and healthcare. The use of probiotic bacteria and their derivatives as an alternative to conventional treatments to fight biofilm development is a promising option that has provided convincing results in the last decades. Recently, membrane vesicles (MVs) produced by probiotics have generated considerable interest due to the diversity of roles they have been associated with. However, the antimicrobial activity of probiotic MVs remains to be studied. In this work, we showed that membrane vesicles produced by Lacticaseibacillus casei BL23 (LC-MVs) exhibited strong antibiofilm activity against Salmonella enterica serovar Enteritidis (S. Enteritidis) without affecting bacterial growth. Furthermore, we found that LC-MVs affected the early stages of S. Enteritidis biofilm development and prevented attachment of bacteria to polystyrene surfaces. Importantly, LC-MVs did not impact the biomass of already established biofilms. We also demonstrated that the antibiofilm activity depended on the proteins associated with the LC-MV fraction. Finally, two peptidoglycan hydrolases (PGHs) were found to be associated with the antibiofilm activity of LC-MVs. Overall, this work allowed to identify the antibiofilm properties of LC-MVs and paved the way for the use of probiotic MVs against the development of negative biofilms.

ABSTRACT The formation of membrane vesicles (MVs) by Gram-positive bacteria has gained increasing attention over the last decade. Recently, models of vesicle formation have been proposed and involve the digestion of the cell wall by prophage-encoded or stress-induced peptidoglycan (PG) hydrolases and the inhibition of PG synthesis by β-lactam antibiotics. The impact of these mechanisms on vesicle formation is largely dependent on the strain and growth conditions. To date, no information on the production of vesicles by the lactobacilli family has been reported. Here, we aimed to characterize the MVs released by the Gram-positive bacteria Lacticaseibacillus casei BL23 and also investigated the mechanisms involved in vesicle formation. Using electron microscopy, we established that the size of the majority of L. casei BL23 vesicles ranged from 50 to 100 nm. Furthermore, we showed that the vesicles were released consistently throughout the growth of the bacteria in standard culture conditions. The protein composition of the vesicles released in the supernatant was identified and a significant number of prophage proteins was detected. Moreover, using a mutant strain harboring a defective PLE2 prophage, we were able to show that the spontaneous and mitomycin-triggered induction of the prophage PLE2 contribute to the production of MVs by L. casei BL23. Finally, we also demonstrated the influence of prophages on the membrane integrity of bacteria. Overall, our results suggest a key role of the prophage PLE2 in the production of MVs by L. casei BL23 in the absence or presence of genotoxic stress. IMPORTANCE The last few decades have demonstrated that membrane vesicles (MVs) produced by microorganisms can have a wide variety of functions. This diversity places MVs at the crossroads of major research topics in current microbiology such as antibiotic resistance, horizontal gene transfer, cell communication, biofilm development, bacteriophage resistance, and pathogenesis. In particular, vesicles produced by probiotic strains have been shown to play a significant role in their beneficial effects. Thus, the study of vesicle biogenesis is a key element for promoting and improving their release. Overall, our results suggest a key role of spontaneous and mitomycin-triggered prophage induction in MV production by the Gram-positive bacteria Lacticaseibacillus casei BL23. This phenomenon is of great interest as prophage-induced MVs could potentially influence bacterial behavior, stress resistance, and vesicle functions.

BackgroundNutritional status in patients with cancer has a determining role in the evolution of the disease and tolerance to treatments. Severity of undernutrition impacts morbidity and mortality in cancer patients and can limit patient response to the optimal therapies if nutritional issues are not appropriately addressed and managed. Despite the importance of malnutrition for the clinical evolution of oncology patients, there is not yet a universally accepted standard method for evaluating malnutrition in such patients. The aim of this study was to stratify the nutritional status of inpatients at an Oncology Department.MethodsThis is an observational study with 561 cancer patients, assessed at admission to a Medical Oncology Department from November 2016 to February 2020. All patients were considered eligible. Non-compliant and/or comatose patients were excluded. Nutritional status was assessed using the PG-SGA, BMI classified with the WHO criteria, and calculation of the percentage of weight loss in the previous 3–6 months.ResultsA total of 561 patients (303 F: 258 M; mean age 65 ± 13 years) were included. One-third of the patients, n=191/561 (34%), lost 6% of their weight in the month prior to admission and 297/561 (53%) patients lost 10.2% of weight in the previous 6 months. Mean BMI was 24.1 ± 5.8 kg/m2; N = 280/561 (50%) patients had regular BMI according to the WHO criteria. N = 331/561 (59%) patients reported eating less in the month prior to admission. N = 303/561 (54%) had moderate/severe deficits of muscle and adipose compartments. The PG-SGA identified 499/561 (89%) patients as moderately/severely malnourished, of which 466/561 (83%) patients scored ≥9 points, meeting criteria for a critical need for nutritional support. Fifteen percent of patients scored >4 points, indicating a need for directed therapy for symptom control and only 1% scored

Abstract The human immunodeficiency virus (HIV) remains a leading cause of maternal morbidity and mortality in Sub-Saharan Africa. Prevention of mother-to-child transmission (PMTCT) has proven an effective strategy to end paediatric infections and ensure HIV-infected mothers access treatment. Based on cross-sectional data collected from June 2008 to May 2013, we assessed changes in HIV prevalence, risk factors for HIV, provision of PMTCT antiretroviral treatment (ART), and the association between HIV infection, birth outcomes and maternal characteristics at the Simão Mendes National Hospital, Guinea-Bissau’s largest maternity ward. Among 24,107 women, the HIV prevalence was 3.3% for HIV-1, 0.8% for HIV-2 and 0.9% for HIV-1/2. A significant decline in HIV-1, HIV-2, and HIV-1/2 prevalence was observed over time. HIV infection was associated with age and ethnicity. A total of 85% of HIV-infected women received ART as part of PMTCT, yet overall treatment coverage during labour and delivery declined significantly for both mothers and infants. Twenty-two percent of infants did not receive treatment, and 67% of HIV-2-infected mothers and 77% of their infants received ineffective non-nucleoside reverse transcriptase inhibitors for PMTCT. Maternal HIV was associated with low birth weight but not stillbirth. Inadequate continuity of care and ART coverage present challenges to optimal PMTCT in Guinea-Bissau.

The exponential growth of electric and hybrid vehicles in the last five years forecasts a waste problem when their batteries achieve end-of-life. Li-ion batteries for vehicles have been assembled using materials from natural resources (as Li, Fe, Al, Cu Co, Mn and P). Among them, LiFePO4 cathode materials have demonstrated advantages such as charge–discharge cycles, thermal stability, surface area and raw materials availability (against Ni and Co systems). Due to the performance, LFP batteries stand out in heavy duty fleet, achieving 90% of new energy buses in China. To achieve the circular economy, the recycling of LFP batteries may be carried out by pyrometallurgy (thermal processing), hydrometallurgy (aqueous processing) or both in combination. Comparatively, hydrometallurgical processing is more advantageous due to its low energy consumption and CO2 emissions. In addition, Li may be recovered in a high-pure grade. This work is a literature review of the current alternatives for the recycling of LFP batteries by hydrometallurgy, comparing designed processes in the literature and indicating solutions towards a circular economy. The major recycling steps of hydrometallurgy routes such as pre-treatments, leaching and purification steps will be gathered and discussed in terms of efficiency and environmental impact.

Histone variants play a crucial role in chromatin structure organization and gene expression. Trypanosomatids have an unusual H2B variant (H2B.V) that is known to dimerize with the variant H2A.Z generating unstable nucleosomes. Previously, we found that H2B.V protein is enriched in tissue-derived trypomastigote (TCT) life forms, a nonreplicative stage of Trypanosoma cruzi, suggesting that this variant may contribute to the differences in chromatin structure and global transcription rates observed among parasite life forms. Here, we performed the first genome-wide profiling of histone localization in T. cruzi using epimastigotes and TCT life forms, and we found that H2B.V was preferentially located at the edges of divergent transcriptional strand switch regions, which encompass putative transcriptional start regions; at some tDNA loci; and between the conserved and disrupted genome compartments, mainly at trans-sialidase, mucin and MASP genes. Remarkably, the chromatin of TCT forms was depleted of H2B.V-enriched peaks in comparison to epimastigote forms. Interactome assays indicated that H2B.V associated specifically with H2A.Z, bromodomain factor 2, nucleolar proteins and a histone chaperone, among others. Parasites expressing reduced H2B.V levels were associated with higher rates of parasite differentiation and mammalian cell infectivity. Taken together, H2B.V demarcates critical genomic regions and associates with regulatory chromatin proteins, suggesting a scenario wherein local chromatin structures associated with parasite differentiation and invasion are regulated during the parasite life cycle.

Sarcopenia is a progressive skeletal muscle disease, often present in oncological patients, that is associated with multiple adverse events such as worse prognosis, physical performance, and quality of life. Body composition evaluation by CT cross-section at the L3 vertebrae region appears to be a precise method to quantify skeletal muscle. The optimal cut-off for the definition of sarcopenia is not yet established, therefore the incidence of sarcopenia varies according to different studies. The main goal was to evaluate the presence of sarcopenia in patients with metastatic colorectal cancer (mCRC) and its impact on overall survival (OS) and dose-limiting toxicities (DLT). A retrospective cohort study of 178 patients with mCRC under first-line chemotherapy (ChT) in association with target therapy, in two hospital units, between January 2015 and December 2018. Skeletal mass area (SMA) was quantified with the NIH ImageJ software in CT cross-sectional images at the L3 vertebrae region. Statistical analysis was performed with IBM SPSS v25 softwarehttps://www.ibm.com/analytics/spss-statistics-software. The median age was 62 (SD ± 11) years old, 65% were men and 62.9% had an Eastern Cooperative Oncology Group (ECOG) performance status of 0. The cut-off value was established based on ROC analysis, with sarcopenia defined as SMI < 49.12 cm2/m2 for men and < 35.85 cm2/m2 for women. Despite the mean body mass index (BMI) of 25.71 (± 4.71) kg/m2, half of the patients presented sarcopenia. In a multivariate analysis using a Cox regression model, an association was observed between OS and higher ECOG PS (p = 0.014; HR 5.46, CI 95% [1.42–21.10]), neutrophil-to-lymphocyte ratio (NLR) >2.80 (p = 0.038; HR 2.20, CI 95% [1,05–4.62]), and sarcopenia (p = 0.01; HR 4.73, CI 95% [1.85–12.09]). Additionally, in a logistic regression model, age (p = 0.014; OR 1.09, IC 95% [1.02–1.16]) and sarcopenia (p= 0.030, OR 4.13, IC 95% [1.15-14.8]) were associated with higher incidence of DLT. The CT evaluation of the body composition at the L3 region allows for the quantification of sarcopenia, providing prognostic information and predictive value of DLT in patients with mCRC, although the establishment of optimal cut-off values are required for implementation in clinical practice. A multimodal strategy to delay muscle waste should be considered in these patients.

Polygonum cuspidatum (P. cuspidatum) is among the world’s most problematic invasive plant species with negative ecological, socio-economic and security consequences. Management operations in areas invaded systematically generate a large quantity of plant waste, most often without outlets. Using this plant material could constitute a new alternative treatment for sustainable management. P. cuspidatum is well known to have numerous biological properties, containing notably stilbenes, quinones, flavonoids and phenolic acids. The present work proposes a reliable strategy using powerful techniques for the screening and the evaluation of the dermo-cosmetic potential of its aerial parts (AP) and root parts (RP). To the best of our knowledge, only antioxidant and anti-tyrosinase activities were previously evaluated on P. cuspidatum among the targets studied (superoxide dismutase, hyaluronidase, elastase, collagenase and tyrosinase). The results revealed strong antioxidant and anti-collagenase activities, moderate anti-hyaluronidase activity, while weak anti-elastase and anti-tyrosinase activities were observed for ethanolic extracts. Different standards selected and screened on the same targets made it possible to correlate the observed residual activities of produced extracts of P. cuspidatum from Savoie Mont Blanc and their chemical compositions. A structure-activity study was thus conducted on main molecular families, widely represented in the genus Polygonum.

IntroductionLung cancer (LC) is highly prevalent worldwide, with elevated mortality. In this population, taste and smell alterations (TSAs) are frequent but overlooked symptoms. The absence of effective therapeutic strategies and evidence-based guidelines constrain TSAs’ early recognition, prevention and treatment (Tx), promoting cancer-related malnutrition and jeopardizing survival outcomes and quality of life.ObjectivesTo systematically review the literature on TSAs in LC patients, understand the physiopathology, identify potential preventive and Tx strategies and to further encourage research in this area.MethodsLiterature search on English language articles indexed to PubMed, CINALH, SCOPUS and Web of Science using MeSH terms “Lung neoplasms”,”Dysgeusia”, “Olfaction Disorders”, “Carcinoma, Small Cell”,”Carcinoma, Non- Small-Cell Lung “Adenocarcinoma of Lung”,”Carcinoma, Large Cell”, and non-MeSH terms “Parageusia”, “Altered Taste”, “Smell Disorder”, “Paraosmia”, “Dysosmia”,”Lung Cancer” and “Oat Cell Carcinoma”.ResultsThirty-four articles were reviewed. TSAs may follow the diagnosis of LC or develop during cancer Tx. The estimated prevalence of self-reported dysgeusia is 35-38% in treatment-naïve LC patients, and 35-69% in those undergoing Tx, based on studies involving LC patients only.One prospective pilot trial and 1 RCT demonstrated a clinically significant benefit in combining flavor enhancement, smell and taste training and individualized nutritional counselling; a systematic review, 1 RCT and 1 retrospective study favored using intravenous or oral zinc-based solutions (150mg 2-3 times a day) for the prevention and Tx of chemotherapy (CT) and radiotherapy (RT) -induced mucositis and subsequent dysgeusia.ConclusionsThis is the first review on dysgeusia and dysosmia in LC patients to our knowledge. We propose combining taste and smell training, personalized dietary counselling and flavor enhancement with oral zinc-based solutions (150mg, 2-3 times a day) during CT and/or RT in this population, in order to prevent and help ameliorate Tx-induced dysgeusia and mucositis. However due to study heterogeneity, the results should be interpreted with caution. Developing standardized TSA measurement tools and performing prospective randomized controlled trials to evaluate their effect are warranted.

Este ensaio propõe-se a problematizar a prática da amizade por Michel Foucault como peça de resistência ao modo de vida neoliberal. Para tanto, o texto organiza-se a partir das discussões produzidas por Foucault sobre a amizade como um modo de vida e um exercício político de resistência a um poder governamental, e as discussões sobre o neoliberalismo em Nascimento da biopolítica. Por conseguinte, busca, com o auxílio de comentadores da obra de Foucault, primeiramente, apresentar o neoliberalismo e seu prazer-mor: a concorrência. Na sequência, apresentar a noção de amizade para Foucault dentro do quadro do cuidado de si e do epicurismo, para na continuação, discorrer sobre a amizade como uma prática política e, como tal, um exercício de resistência ao neoliberalismo, como uma prática ontológica sobre nós mesmos, contrapondo-se ao empresariamento de si e a concorrência, e nossas considerações finais, acentuando as invenções e arte de existência que a amizade oportuniza.

A Educação em Direitos Humanos propõe uma transformação da prática docente e da formação inicial e continuada dos profissionais da Educação. É alicerçada em sete princípios e tem a dignidade da pessoa humana como o eixo de um processo humanizador da formação de cidadãos e da prática profissional da Educação. O presente trabalho é, pois, um esforço de compreensão conjunta dos sentidos de dois pareceres, que subsidiam as diretrizes do processo de formação inicial e continuada dos profissionais e dos cidadãos nas escolas, desde a Educação Infantil aos cursos de Pós-graduação da Educação Superior, com vistas a contribuir nesse processo de mediação entre o texto normativo e os profissionais da educação. Trata-se de uma necessidade manifesta de apresentação dos propósitos e valores existentes nos documentos, para que seja possível a construção de caminhos como possibilidades de dar vida às diretrizes no lugar e no tempo em que o processo educativo humanizador deve ocorrer de fato – a escola. Para tanto, parte-se de uma análise documental, para relatar algumas construções que vêm sendo desenvolvidas pelo Grupo de Pesquisa Observatório de Políticas Públicas (UTFPR) a partir de ações de pesquisa, extensão e ensino integradas em um processo de envolvimento crescente de pesquisadores e de alunos no biênio 2013-2015. Tais construções contaram com a contribuição das experiências na licenciatura em Matemática do Programa de Mestrado Profissional em Ensino, bem como das participações em eventos. Espera-se oferecer uma contribuição ao processo de compreensão das Diretrizes e das formas pelas quais é possível humanizar a educação brasileira.

Objetivo: avaliar a associação da Lesão Renal Aguda com os desfechos clínicos dos pacientes em Unidade de Terapia Intensiva. Método: trata-se do recorte de dados de coorte com visão prospectiva, realizada em uma unidade intensiva privada na capital sergipana entre outubro de 2018 e julho de 2019. A amostra foi por conveniência e não probabilística. Os dados foram analisados com os testes de Kolmogorov-Sminorv; exato de Fisher e t-Student através do Statistical Package for the Social Sciences. Resultados: participaram do estudo 100 pacientes, 29% apresentaram Lesão Renal Aguda, sendo 62,1% destes do sexo masculino e com 70±16 anos. Foi evidenciada associação da injúria com infecção (p=0,018), ventilação mecânica por mais de 48 horas (p=0,016), morte (p=0,010) e lesão por pressão (p=0,037). Conclusão: O estudo contribuirá para identificação precoce da lesão renal, promovendo auxílio no planejamento do plano para reduzir as complicações da doença.

Abstract: The objective of this work was to evaluate the effect of storage on the physiological quality of cedar (Cedrela fissilis) seeds, as well as to correlate the germination and vigor of the seeds with their main biochemical changes. The experiments were carried out in a completely randomized design, in a 3×5 factorial arrangement (three environments × five storage periods). Seeds were stored for 0, 135, 280, 381, and 515 days in: a humidity chamber at 5±2ºC and 80% relative humidity, a drying chamber at 20±2ºC and 60% relative humidity, and an uncontrolled environment (laboratory) at 16±10ºC and 60±25% relative humidity. In all storage periods, the content of moisture on a wet basis and the percentages of proteins, lipids, total carbohydrates, and ash were evaluated. For the viability and vigor tests, the percentage of germination and mean germination time were calculated. At sampling time, seeds showed 11.5% water content, 85.5% germination, and mean germination time of 13.5 days, and all were negatively influenced by storage period. Protein percentage showed a downward trend, while that of carbohydrates increased as the storage period was extended. Seed germination and vigor reduce drastically with storage.

Abstract INTRODUCTION: This work aims to develop a biomathematical transmission model of COVID-19, in the State of Sergipe, Brazil, to estimate the distribution of cases over time and project the impact on the spread of the epidemic outbreak due to interventions and control measures over the local population. METHODS: This is an epidemiological mathematical modeling study conducted to analyze the dynamics of the accumulated cases of COVID-19, which used a logistic growth model that adds a term of withdrawal of individuals as a control measure. Three possible COVID-19 propagation scenarios were simulated based on three different rates of withdrawal of individuals. They were adjusted with real data of the infected and measures of control over the population. RESULTS: The lockdown would be the best scenario, with a lower incidence of infected people, when compared to the other measures. The number of infected people would grow slowly over the months, and the number of symptomatic individuals in this scenario would be 40,265 cases. We noticed that the State of Sergipe is still in the initial stage of the disease in the scenarios. It was possible to observe that the peak of cases and the equilibrium, in the current situation of social isolation, will occur when reaching the new support capacity, at the end of August in approximately 1,171,353 infected individuals. CONCLUSIONS: We established that lockdown is the intervention with the highest ability to mitigate the spread of the virus among the population.

Treatment and control of schistosomiasis still rely on only one effective drug, praziquantel (PZQ) and, due to mass treatment, the increasing risk of selecting for schistosome strains that are resistant to PZQ has alerted investigators to the urgent need to develop novel therapeutic strategies. The histone-modifying enzymes (HMEs) represent promising targets for the development of epigenetic drugs against Schistosoma mansoni. In the present study, we targeted the S. mansoni lysine-specific demethylase 1 (SmLSD1), a transcriptional corepressor, using a novel and selective synthetic inhibitor, MC3935, which was used to treat schistosomula and adult worms in vitro. By using cell viability assays and optical and electron microscopy, we showed that treatment with MC3935 affected parasite motility, egg-laying, tegument, and cellular organelle structures, culminating in the death of schistosomula and adult worms. In silico molecular modeling and docking analysis suggested that MC3935 binds to the catalytic pocket of SmLSD1. Western blot analysis revealed that MC3935 inhibited SmLSD1 demethylation activity of H3K4me1/2. Knockdown of SmLSD1 by RNAi recapitulated MC3935 phenotypes in adult worms. RNA-Seq analysis of MC3935-treated parasites revealed significant differences in gene expression related to critical biological processes. Collectively, our findings show that SmLSD1 is a promising drug target for the treatment of schistosomiasis and strongly support the further development and in vivo testing of selective schistosome LSD1 inhibitors.

O basquetebol é uma atividade física intermitente que faz uso de vias metabólicas cujo principal substrato energético é o carboidrato (CHO). São poucos os estudos sobre a suplementação de CHO neste esporte, principalmente com adolescentes. Por isso, o objetivo foi avaliar os efeitos da suplementação de CHO no desempenho durante sessões de treinamento de basquetebol. Os voluntários, praticantes de basquetebol do sexo masculino, foram divididos em dois grupos: Grupo 1 (G1) na faixa etária de 11-13 anos (n=14) e Grupo 2 (G2) de 14-15 anos (n=11). Para avaliação do desempenho físico e técnico foram utilizados dois testes que simulavam situações de jogo. O CHO (1 g/Kg peso corporal; concentração de 10%) foi consumido antes ou durante o treinamento. A glicemia foi medida pré e pós-treino, e a percepção subjetiva de esforço (PSE) foi referida pelos voluntários no pós-treino. O consumo de CHO antes e durante o treinamento provocou aumento da glicemia no G2 (p

Em uma entrevista com Jacques Chancel, em 10 de março de 1975, Michel Foucault é indagado sobre a sua docência, a escola, as implicações da família em relação à escolarização, ao ambiente escolar e à atitude dos jovens na escola. Trata-se de um fragmento de dez minutos de uma entrevista com cerca de sessenta realizada para o Radioscopie, programa tradicional do rádio francês. Os elementos que emergem desse diálogo possibilitam, mais de quatro décadas após, pensar a docência e a escola brasileira. Dessa forma e com essa perspectiva, pretende-se ultrapassar a mera descrição para problematizar alguns elementos da formação docente e da construção da relação de ensino-aprendizagem com esse outro – o aluno.

[This corrects the article DOI: 10.1371/journal.pone.0199819.].

Este texto propone discutir el populismo en Venezuela como caso en Latinoamérica, comenzando por una fuente - la Carta de Miraflores (1999). Se trata de un trabajo que pretende revisar algunos elementos del itinerario histórico contemporáneo de Venezuela con vista a la defensa de una historiografía que considere el contexto sociocultural para identificar los rasgos de movimientos populistas en cada realidad. La fuente historiográfica posibilita, a partir de la reanudación del contexto y de la comprensión profundizada de las lógicas implicadas, un desvelar de las razones y de las comprensiones que posibilitan esta o aquella opción popular o, aún, este o aquel movimiento político. De esta forma, se ofrecen elementos para comprender el caso venezolano a partir de una fuente fundamental para la reescritura de la historia: una historia local, contextualizada y que se presenta como inmunizada frente a vectores externos, pero sobre todo en cuanto a las lógicas y a los intereses externos. Como resultados, llegamos a la comprensión de que sólo el contexto es capaz de iluminar el fenómeno identificado como populismo, así como la no-exclusividad de los países periféricos o en desarrollo en cuanto a ese movimiento político-popular.

Cryptococcal antigenemia may precede development of cryptococcal meningitis and death among patients with advanced HIV infection. Among 200 retrospectively and randomly selected ART-naïve patients with CD4 counts 100 cells/l from Guinea-Bissau, 20 (10%) had a positive cryptococcal antigen test. Self-reported headache and fever were predictors of a positive test, while cryptococcal antigenemia was a strong predictor of death within the first year of follow-up, MRR 2.22 (95% CI: 1.15-4.30). Screening for cryptococcal antigenemia should be implemented for patients with advanced HIV in Guinea-Bissau. Pre-emptive anti-fungal therapy should be initiated prior to ART-initiation if the screening is positive.

BACKGROUND:The World Health Organization recommends HIV testing is included in routine screening tests for all pregnant women in order to prevent mother-to-child-transmission of HIV and reduce maternal morbidity and mortality. OBJECTIVES:To assess the proportion of women approached and tested for HIV at delivery and factors associated with non-testing at the maternity ward of the Simão Mendes National Hospital (HNSM) in Bissau, Guinea-Bissau. METHODS:We conducted a retrospective cross-sectional study among women presenting for delivery from June 2008 until May 2013. During the study period, national policy included opt-out HIV-testing at delivery. Modified Poisson regression models were used to examine the association of maternal characteristics with HIV testing. Time trends were determined using Pearson's χ2 test. RESULTS:Seventy-seven percent (24,217/31,443) of women presenting for delivery were counselled regarding PMTCT, of whom 99.6% (24,107/24,217) proceeded with HIV testing. The provision of opt-out HIV testing at labour increased from 38.1% (1,514/3973) in 2008 to 95.7% (2,021/2,113) in 2013, p

Objectives: To estimate the prevalence and determine the clinical presentation of risk factors of hepatitis C virus (HCV) among HIV-infected patients in Bissau, Guinea-Bissau. Methods: In this cross-sectional study, we included individuals who had a routine blood analysis performed during the period April 28 to September 30, 2011. Patient samples were tested for HCV antibodies (anti-HCV) with a chemiluminescence test (Architect, Abbott, USA) and INNO-LIA HCV Score (Innogenetics, Belgium). HCV viral load and genotype were analyzed using an in-house real-time PCR method. Results: In total, 576 patients were included (417 HIV-1, 104 HIV-2, and 55 HIV-1/2). Ten (1.7%) patients were anti-HCV-positive and eight (1.4%) patients had detectable HCV RNA; all were genotype 2. In a multivariable logistic regression analysis, age >50 years was associated with anti-HCV reactivity (p

Problem The introduction of antiretroviral therapy (ART) for HIV infection in sub-Saharan Africa has improved the quality of life of millions of people and reduced mortality. However, substantial problems with the infrastructure for ART delivery remain. Approach Clinicians and researchers at an HIV clinic in Guinea-Bissau identified problems with the delivery of ART by establishing a clinical database and by collaborating with international researchers. Local setting The Bissau HIV cohort study group was established in 2007 as a collaboration between local HIV physicians and international HIV researchers. Patients were recruited from the HIV clinic at the country’s main hospital in the capital Bissau. Relevant changes Between 2005 and 2013, 5514 HIV-positive patients were treated at the clinic. Working together, local health-care workers and international researchers identified the main problems affecting ART delivery: inadequate drug supply; loss of patients to follow-up; and inadequate laboratory services. Solutions to these problems were devised. The collaborations encouraged local physicians to start their own research projects to find possible solutions to problems at the clinic. Lessons learnt The HIV clinic in Bissau faced numerous obstacles in delivering ART at a sufficiently high quality and patients’ lives were put in jeopardy. The effectiveness of ART could be enhanced by delivering it as part of an international research collaboration since such collaborations can help identify problems, find solutions and increase the capacity of the health-care system.

Este artigo tem como objetivo propor um modelo para a gestão estratégica organizacional de Instituições de Ensino Superior, por meio da estruturação de um Balanced Scorecard (BSC) - ferramenta eficaz que traduz a visão e a estratégia organizacional em metas operacionais. Ressalta-se que embora as perspectivas originais sugeridas por Kaplan e Norton (1997) sejam as mais utilizadas, algumas IES geram perspectivas diferenciadas, como a perspectiva Sociedade no caso da Faculdade Alfa (nome fictício), particularmente aqui estudada. A abordagem da pesquisa é qualitativa e quanto aos objetivos se considera exploratória. As estratégias de pesquisa utilizadas foram bibliográfica, documental e estudo de caso. Os dados foram coletados por meio de estudo observacional, bem como de fontes secundárias. Os resultados da pesquisa indicam que: (i) as estratégias da instituição estão traduzidas em iniciativas e ações, por meio da ferramenta BSC; (ii) a instituição traduziu os objetivos estratégicos do Plano de Desenvolvimento Institucional em metas operacionais e (iii) o mapeamento da instituição desenvolvido por meio da metodologia BSC gerou uma visão holística e alinhada das estratégias desdobrando-as até seu nível operacional. This article aims at proposing an organizational strategic management model for higher education institutions - HEIs, through the structuring of a Balanced Scorecard (BSC) – an effective tool that translates the organizational vision and strategy into operational goals. It is noteworthy that although the unique perspectives suggested by Kaplan and Norton (1997) are the most commonly used, some HEIs generate differentiated perspectives like a society dimension, as for Faculdade Alfa (fictitious name) particularly studied here. The research approach is qualitative, and the objectives are considered exploratory. The research strategies used were bibliographic, documentary, and case study. Data were collected through observational study and secondary sources. The survey results show that: (i) the institution's strategies are based on initiatives and actions through the BSC tool, (ii) the institution translated the strategic objectives of the Institutional Development Plan into operational goals, and (iii) the mapping of the institution developed through the BSC methodology generated a holistic and aligned vision of the strategies deploying them up to their operational level.

INTRODUCTION: HIV infected individuals with late presentation (LP) and advanced disease (AD) have been associated with higher mortality, higher cost of medical management, impaired CD4 cell count increment and potentially ongoing risk of HIV transmission. Here we describe the proportion of patients with LP and AD at an HIV clinic in Guinea-Bissau, identify risk factors and evaluate the outcome of these patients. METHODS: we included all patient 15 years diagnosed with HIV-1 and/or HIV-2 at the outpatient HIV clinic at Hospital National Simão Mendes, during June 2005 - December 2013 in a retrospective cohort study. Patients were followed until December 2014. LP and AD was defined as a baseline CD4 cell count of 200-349 cells/L and =200 cells/L, respectively. RESULTS: a total of 3,720/5,562 (65.7%) patients had a CD4 cell count measured within the first 90 days of HIV diagnosis. Forty-eight percent had AD and 23% had LP. Risk factors for presentation with AD were male sex, age =30 years, Fula and Mandinga ethnicity. HIV-2 and HIV-1/2 dually infected patients had lower risk of AD compared with HIV-1 infected patients. Although antiretroviral therapy (ART) was initiated for 64.4% of patients, those with AD progression had a 3.82 times higher mortality compared to patients with non-LP. CONCLUSION: the majority of HIV infected patients presented late. Most of the late-presenters had advanced disease and patients with advanced disease had a very high mortality. Initiatives to enroll patients in care at an earlier point are needed and should focus on risk groups.

Co-infection with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) may lead to accelerated hepatic disease progression with higher rates of liver cirrhosis and liver-related mortality compared with HBV mono-infection. Co or super-infection with hepatitis Delta virus (HDV) may worsen the liver disease and complicate treatment possibilities.In this cross-sectional study we included HIV-infected individuals who had a routine blood analysis performed at an HIV clinic in Bissau, Guinea-Bissau between the 28th of April and 30th of September 2011. All patients were interviewed, had a clinical exam performed and had a blood sample stored. The patients' samples were tested for HBV and HDV serology, and HBV/HDV viral loads were analyzed using in-house real-time PCR methods.In total, 576 patients (417 HIV-1, 104 HIV-2 and 55 HIV-1/2) were included in this study. Ninety-four (16.3%) patients were HBsAg positive of whom 16 (17.0%) were HBeAg positive. In multivariable logistic regression analysis, CD4 cell count

HIV-2 is endemic in West Africa. There is a lack of evidence-based guidelines on the diagnosis, management and antiretroviral therapy (ART) for HIV-2 or HIV-1/HIV-2 dual infections. Because of these issues, we designed a West African collaborative cohort for HIV-2 infection within the framework of the International epidemiological Databases to Evaluate AIDS (IeDEA).We collected data on all HIV-2 and HIV-1/HIV-2 dually seropositive patients (both ARV-naive and starting ART) and followed-up in clinical centres in the IeDEA-WA network including a total of 13 clinics in five countries: Benin, Burkina-Faso Côte d'Ivoire, Mali, and Senegal, in the West Africa region.Data was merged for 1,754 patients (56% female), including 1,021 HIV-2 infected patients (551 on ART) and 733 dually seropositive for both HIV-1 and HIV 2 (463 on ART). At ART initiation, the median age of HIV-2 patients was 45.3 years, IQR: (38.3-51.7) and 42.4 years, IQR (37.0-47.3) for dually seropositive patients (p = 0.048). Overall, 16.7% of HIV-2 patients on ART had an advanced clinical stage (WHO IV or CDC-C). The median CD4 count at the ART initiation is 166 cells/mm(3), IQR (83-247) among HIV-2 infected patients and 146 cells/mm(3), IQR (55-249) among dually seropositive patients. Overall, in ART-treated patients, the CD4 count increased 126 cells/mm(3) after 24 months on ART for HIV-2 patients and 169 cells/mm(3) for dually seropositive patients. Of 551 HIV-2 patients on ART, 5.8% died and 10.2% were lost to follow-up during the median time on ART of 2.4 years, IQR (0.7-4.3).This large multi-country study of HIV-2 and HIV-1/HIV-2 dual infection in West Africa suggests that routine clinical care is less than optimal and that management and treatment of HIV-2 could be further informed by ongoing studies and randomized clinical trials in this population.