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Description of the subject. The growth of new antibiotic-resistant strains of pathogens represents a huge problem in poultry rearing. There is evidence that dietary yeast could be effective in the protection against a variety of pathogens that can affect poultry health and cause foodborne diseases in humans. Since still few or contradictory information are available for this topic. Objectives. The objective of this study was to investigate the effects of live yeast supplementation in broiler chickens on Salmonella enteritidis and Campylobacter jejuni content in feces, cecum, and skin. Method. Supplemented yeast consisted of Saccharomyces cerevisiae (Levucell® SB20, type boulardii I-1079, Lallemand, France) and was administered at a rate of 1 x 106 CFU·g-1 of feed. On day ten of life, birds were orally challenged with S. enteritidis (1 x 105 CFU/bird) and C. jejuni (3 x 105 CFU/bird). Growth performance, and coliforms, yeasts and lactobacilli enumeration were evaluated on day 0, 10, 20 and 38. Ten and eighteen days post infection (PI), 10 animals per replicate were slaughtered and pooled ceca content were analyzed for yeast enumeration and Salmonella and Campylobacter frequency and enumeration. The presence and the enumeration of Salmonella and Campylobacter in neck and breast skin were performed on one subject per replicate. Results. Dietary S. cerevisiae increased yeast and lactobacilli (p = 0.01) count, while Salmonella enumeration and frequency significantly decreased in neck (p = 0.03) and tended to decrease in cecum (p = 0.06), feces (p = 0.06), and breast (p = 0.08). On 10d PI Campylobacter presence was decreased in cecum (p = 0.01), feces (p < 0.01), breast skin (p = 0.04) and neck skin (p < 0.01), while the enumeration was found to be lower in feces (p < 0.01) and neck skin (p = 0.05). At the end of the trial the frequency of this pathogen was decreased in feces (p < 0.01), and breast skin (p = 0.02), while the enumeration was diminished in cecum (p < 0.05) and feces (p < 0.05). Conclusions. The present study shows that the inclusion of Levucell® SB20 can significantly control Campylobacter carriage in chickens with some positive effects also on Salmonella presence, thus reducing the contamination of carcasses at slaughtering and preventing human foodborne diseases.

INTRODUCTION: Operationalized research criteria for mild cognitive impairment with Lewy bodies (MCI-LB) were published in 2020. The aim of this systematic review and meta-analysis was to review the evidence for the diagnostic clinical features and biomarkers in MCI-LB set out in the criteria. METHODS: MEDLINE, PubMed, and Embase were searched on 9/28/22 for relevant articles. Articles were included if they presented original data reporting the rates of diagnostic features in MCI-LB. RESULTS: Fifty-seven articles were included. The meta-analysis supported the inclusion of the current clinical features in the diagnostic criteria. Evidence for striatal dopaminergic imaging and meta-iodobenzylguanidine cardiac scintigraphy, though limited, supports their inclusion. Quantitative electroencephalogram (EEG) and fluorodeoxyglucose positron emission tomography (PET) show promise as diagnostic biomarkers. DISCUSSION: The available evidence largely supports the current diagnostic criteria for MCI-LB. Further evidence will help refine the diagnostic criteria and understand how best to apply them in clinical practice and research. HIGHLIGHTS: A meta-analysis of the diagnostic features of MCI-LB was carried out. The four core clinical features were more common in MCI-LB than MCI-AD/stable MCI. Neuropsychiatric and autonomic features were also more common in MCI-LB. More evidence is needed for the proposed biomarkers. FDG-PET and quantitative EEG show promise as diagnostic biomarkers in MCI-LB.

BackgroundDrugs taken during pregnancy can affect maternal and child health outcomes, but few studies have compared the safety and virological efficacy of different antiretroviral therapy (ART) regimens. We report the primary safety outcomes from enrolment up to 50 weeks post partum and a secondary virological efficacy outcome at 50 weeks post partum of three commonly used ART regimens for HIV-1.MethodsIn this multicentre, open-label, randomised, controlled, phase 3 trial, we enrolled pregnant women aged 18 years or older with confirmed HIV-1 infection at 14-28 weeks of gestation. Women were enrolled at 22 clinical research sites in nine countries (Botswana, Brazil, India, South Africa, Tanzania, Thailand, Uganda, the USA, and Zimbabwe). Participants were randomly assigned (1:1:1) to one of three oral regimens: dolutegravir, emtricitabine, and tenofovir alafenamide; dolutegravir, emtricitabine, and tenofovir disoproxil fumarate; or efavirenz, emtricitabine, and tenofovir disoproxil fumarate. Up to 14 days of antepartum ART before enrolment was permitted. Women with known multiple gestation, fetal anomalies, acute significant illness, transaminases more than 2·5 times the upper limit of normal, or estimated creatinine clearance of less than 60 mL/min were excluded. Primary safety analyses were pairwise comparisons between ART regimens of the proportion of maternal and infant adverse events of grade 3 or higher up to 50 weeks post partum. Secondary efficacy analyses at 50 weeks post partum included a comparison of the proportion of women with plasma HIV-1 RNA of less than 200 copies per mL in the combined dolutegravir-containing groups versus the efavirenz-containing group. Analyses were done in the intention-to-treat population, which included all randomly assigned participants with available data. This trial was registered with ClinicalTrials.gov, NCT03048422.FindingsBetween Jan 19, 2018, and Feb 8, 2019, we randomly assigned 643 pregnant women to the dolutegravir, emtricitabine, and tenofovir alafenamide group (n=217), the dolutegravir, emtricitabine, and tenofovir disoproxil fumarate group (n=215), and the efavirenz, emtricitabine, and tenofovir disoproxil fumarate group (n=211). At enrolment, median gestational age was 21·9 weeks (IQR 18·3-25·3), median CD4 count was 466 cells per μL (308-624), and median HIV-1 RNA was 903 copies per mL (152-5183). 607 (94%) women and 566 (92%) of 617 liveborn infants completed the study. Up to the week 50 post-partum visit, the estimated probability of experiencing an adverse event of grade 3 or higher was 25% in the dolutegravir, emtricitabine, and tenofovir alafenamide group; 31% in the dolutegravir, emtricitabine, and tenofovir disoproxil fumarate group; and 28% in the efavirenz, emtricitabine, and tenofovir disoproxil fumarate group (no significant difference between groups). Among infants, the estimated probability of experiencing at least one adverse event of grade 3 or higher by postnatal week 50 was 28% overall, with small and non-statistically significant differences between groups. By postnatal week 50, 14 infants whose mothers were in the efavirenz-containing group (7%) died, compared with six in the combined dolutegravir groups (1%). 573 (89%) women had HIV-1 RNA data available at 50 weeks post partum: 366 (96%) in the dolutegravir-containing groups and 186 (96%) in the efavirenz-containing group had HIV-1 RNA less than 200 copies per mL, with no significant difference between groups.InterpretationSafety and efficacy data during pregnancy and up to 50 weeks post partum support the current recommendation of dolutegravir-based ART (particularly in combination with emtricitabine and tenofovir alafenamide) rather than efavirenz, emtricitabine, and tenofovir disoproxil fumarate, when started in pregnancy.FundingNational Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Institute of Mental Health.

This cross-sectional and descriptive study examined the family quality of life (FQoL) among 72 Brazilian families who have children with Williams syndrome, a rare genetic disorder in which most individuals have an intellectual disability, usually mild. Data were collected using sociodemographic and clinical data forms and the Beach Center FQoL Scale. The overall FQoL score was 3.90 ± 0.45, below the limit of four points considered satisfactory. Families felt more satisfied with the family interaction (4.11 ± 0.57), parenting (4.07 ± 0.42), and disability-related support (3.94 ± 0.62) domains, and less satisfied with the family's emotional (3.49 ± 0.73) and physical/material well-being (3.73 ± 0.74) domains. Paternal education, children's cardiopathy and autonomy in activities of daily living explained 24.5% of the variance in the overall FQoL. Measures are necessary to improve the emotional and physical/material well-being of families to reduce the family burden. Monitoring the child's cardiac condition and promoting independence in activities of daily living are also the main procedures.

Summary: Background & Aims: Nutritional impairments may negatively impact different outcomes, including survival, in patients with thoracic malignancies. Despite this, a low number of patients are screened for nutritional risk and referred to an appropriate service. The aim of this study is to evaluate the feasibility of an Assess-Advise-Refer approach to implementing the engagement of the medical staff to refer patients at nutritional risk to a dedicated dietician. Methods: Thoracic oncologists were trained to: i) administer the Nutritional Risk Screening (NRS-2002) tool to the patients during the first oncological evaluation to identify the nutritional risk, ii) advise patients about the importance of nutrition in cancer, and iii) refer patients at nutritional risk to the dedicated dietetic service. Results: Between July 2022 and February 2023, 40% of patients scheduled for a first oncological evaluation received nutritional screening from oncologist. All the screened patients were advised about the importance of nutritional aspects during cancer care. Overall, seven patients were detected at nutritional risk and referred to the dietetic service. Additionally, other four patients were referred to the dietitian upon their request. Conclusion: Whereas advice and referral appear to be better implemented, nutritional screening needs to be more integrated into the clinical practice routine.

BackgroundFrailty, defined as multidimensional prognostic index (MPI), has been recently identified as strong predictor of disability and mortality in the elderly with acute ischemic stroke (AIS). The stress hyperglycemia ratio (SHR) is a recently introduced biomarker significantly associated with poor outcome in AIS.ObjectivesThis study aimed to investigate in what extent frailty, measured by MPI, and SHR affects the 3-months outcome of patients > 65 years-old with AIS.MethodsConsecutive patients with AIS >65 years-old who underwent intravenous thrombolysis (IVT) from 2015 to 2019 were enrolled in a German and an Italian Stroke Unit. The SHR was calculated by dividing the fasting plasma glucose at admission with glycated hemoglobin. Demographics and clinical premorbid data, stroke-related variables, including baseline and post-treatment NIHSS score were included in a logistic regression model. The 3-months functional outcome was evaluated by using modified Rankin scale (mRS); good outcome was defined as mRS 0–2, poor as mRS ≥ 3.ResultsOne hundred and fifty-five AIS patients were enrolled in the study. Median MPI was 0.19 [0.13–0.31]; 118 (76.1%) patients were classified as “robust” and 37 (23.9%) as “frail.” In regression analysis, age, NIHSS, and MPI demonstrated as the most significant predictor of 3-months good outcome in the whole cohort. In robust patients, SHR values were significantly associated with the outcome.ConclusionsMPI is associated with the 3-months outcome in our cohort, in particular with good outcome. Conversely, SHR seems to be associated with a 3-months poor outcome in “robust” patients but not in frail patients.

Objetivo: Este Boletim Informativo tem o objetivo de apresentar a Política Nacional de Saúde Integral de Lésbicas, Gays, Bissexuais, Travestis e Transexuais (LGBT), seus objetivos e desafios de implementação como política de equidade do Sistema Único de Saúde (SUS). A sigla que representa a diversidade sexual e de gênero, abrange pessoas que se identificam como Lésbicas, Gays, Bissexuais, Travestis e Transexuais e/ou Transgêneros, Queer, Intersexuais, Assexuais, Pansexuais, Pessoas Não-Binárias e outras expressões de gênero e sexualidade. Conclusão: Esse grupo populacional historicamente sofre desassistência na saúde que está relacionado ao preconceito e discriminação pelos profissionais da saúde e pelo medo de passarem por constrangimentos nos serviços de saúde. Embora a criação da Política seja um avanço no acesso à saúde dessa população, existem desafios a serem enfrentados que incluem a vulnerabilidade social e o preconceito. Percebe-se a necessidade de implementação de ações que contemplem a saúde bucal, assim como ações e pesquisas específicas para identificar os principais problemas, estabelecer planos resolutivos e fazer o monitoramento permanente dessas ações, assim como possibilitar o acesso facilitado aos serviços de saúde bucal no SUS.

Accurate and detailed datasets are crucial for assessing climate change impacts. Regional climate models provide high-resolution simulations and are key tools but often exhibit systematic biases. Therefore, this paper presents a dataset derived from bias-corrected Eta regional model simulations and projections driven by four global CMIP5 models. The correction applied to daily precipitation, potential evapotranspiration, actual evapotranspiration, and 2-m air temperature, was conducted on a 0.2° x 0.2° grid over South America. The dataset covers two periods: 1976-2005 (baseline) and 2006-2099 (future) under RCP4.5 and RCP8.5 scenarios. Empirical quantile mapping was used to adjust the Eta model outputs to better match observational data. This method modified the accumulated probability curves of the Eta model outputs to align with observational curves for both baseline and future climates. Two observational datasets were used for correction and evaluation. The new dataset shows that bias correction significantly reduced the errors in the Eta simulations, especially for the frequent values of precipitation, potential evapotranspiration, and 2-m temperature, and also corrected the annual cycle and frequency distribution of these variables, approaching the observations. The pattern of extreme precipitation indices from the bias-corrected Eta dataset also reduced error. Bias correction was applied to future projections. The comparison against the raw Eta dataset showed that the trends of changes were preserved, but in general, the peaks of the changes were smoothed. As in the raw Eta dataset, the RCP8.5 scenario showed a higher change rate than RCP4.5. This work also revealed the large uncertainty of the observational dataset; some of the remaining errors after the bias correction were mostly due to differences between the two correction and evaluation observational datasets. The described dataset is freely available from the CNPq LattesData repository at the following link: https://doi.org/10.57810/lattesdata/WAVGSL.

Objetivo: Este Boletim Informativo retoma a Política Nacional de Atenção Integral à Saúde das Pessoas Privadas de Liberdade no Sistema Prisional (PNAISP), instituída em 2014, e destaca pontos importantes para sua implementação e para o enfrentamento das desigualdades sociais visíveis na população carcerária. Reforça a necessidade de atenção à saúde bucal da população carcerária, as dificuldades enfrentadas durante o período de enchentes no Rio Grande do Sul e as dificuldades e negligências das mulheres privadas de liberdade. Conclusão: É necessário dar visibilidade à PNAISP, pois este grupo populacional já tem suas condições de saúde agravadas por questões socioeconômicas e culturais e deve receber o cuidado integral como prevê a política.

BackgroundIntegrase inhibitors have been associated with excess gestational weight gain that may lead to adverse pregnancy outcomes (APOs). This post hoc analysis of NICHD P1081 compared antepartum changes in weight and body mass index (BMI) in pregnant women initiating raltegravir- or efavirenz-based combined antiretroviral therapy (cART) and examined associations between rates of weight gain and APOs.SettingNICHD P1081 enrolled antiretroviral-naive pregnant women living with HIV in the second and third trimester in Brazil, Tanzania, South Africa, Thailand, Argentina, and the United States.MethodsTwo hundred eighty-one women enrolled between 20 and 31 gestational weeks were randomized to raltegravir- or efavirenz-based cART and followed for ≥4 weeks. A low rate of weight gain was defined as 0.59 kg/wk. We compared weight gain and BMI increase between treatment arms using Kruskal-Wallis tests. Logistic regression was used to investigate the association between weight gain and APOs.ResultsRaltegravir-based cART was associated with significantly higher antepartum weight gain (median 0.36 kg/wk versus 0.29 kg/wk, P = 0.01) and BMI increase (median 0.14 kg/m 2 /wk versus 0.11 kg/m 2 /wk, P = 0.01) compared with efavirenz-based treatment. Women on raltegravir had less low weight gain (18% versus 36%) and more high weight gain (21% versus 12%) ( P = 0.001). Women with low weight gain were more likely than those with normal weight gain to have small for gestational age infants or a composite of APOs.ConclusionsA raltegravir-based antiretroviral regimen was associated with significantly higher antepartum rate of weight gain and BMI increase compared with efavirenz-based treatment in antiretroviral-naive pregnant women.