ABSTRACT Tamarind (Tamarindus indica L.) is a species with promising potential for commercial production; therefore, studies involving practices of conducting culture in the initial stage are essential. The present study aimed to evaluate different shading levels and substrate compositions in the seedling production of tamarind. The experimental design was completely randomized in a 4×4 factorial scheme, four levels of shading (0%, 18%, 30%, and 50%) and four substrates (pine bark-based substrate pure and mixed with 50% vermiculite, and sphagnum peat-based substrate pure and mixed with 50% vermiculite), with four replicates of four seedlings. Growth and biometric relationships were evaluated at 40 and 98 d after transplantation (DAT). The results reported that seedlings formed on the sphagnum peat-based substrate on pure or associated with vermiculite at 98 DAT had a height greater than 35 cm and a total 8.5 g DM. In contrast, seedlings produced in pine bark-based substrate did not reach 20 cm in height and had less than 3 g total DM. The condition of 30% and 50% shading promoted greater growth in height, reaching an average height greater than 40 cm, while in the full sun environment, seedlings showed an average of less than 35 cm; however, for the other variables, full sun environment did not differ from 30% shading, producing good quality seedlings. Thus, the cultivation of seedlings in an environment with 0% or 30% shading, associated with the sphagnum peat-based substrate pure or mixed with 50% vermiculite promoted the production of tamarind seedlings with vigorous growth. In the best environments, the best substrates increased, on average, 41.3% number of leaves, 80.5% shoot dry mass, 56.8% root dry mass, and 71.0% total dry mass. In the best substrates, the best environments increased, on average, 18.0% number of leaves, 20.7% shoot dry mass, 8.7% root dry mass, and 14.3% total dry mass.

RESUMO Objetivo: Descrever o desenvolvimento, a implementação e o uso de painéis para a análise epidemiológica de dados abertos durante a pandemia de COVID-19. Métodos: Os painéis foram criados para analisar dados públicos relacionados á COVID-19 de várias fontes, incluindo dados oficiais dos governos e de redes sociais, a nível global. Técnicas de processamento e limpeza foram utilizadas para aglutinar os bancos de dados. Calculamos o coeficiente de correlação de Spearman entre as curvas de sintomas gripais da pesquisa da Universidade de Maryland em conjunto com o Facebook, chamada COVID Trends and Impacts Survey (CTIS), e a curva de casos notificados pelo Ministério da Saúde no Brasil. Resultados: Os painéis obtiveram sucesso em antecipar a chegada de novas ondas de COVID-19 no Brasil. A análise do dado revelou a correlação entre a pesquisa CTIS e o número oficial de casos no país. O artigo destaca o potencial de painéis interativos como uma ferramenta de tomada de decisão no contexto de emergências de saúde pública, como, por exemplo, no uso destes para a comunicação oficial do governo do Rio Grande do Sul. Conclusão: O uso de painéis para prever o avanço da COVID-19 no Brasil foi uma ferramenta útil para a tomada de decisão. A antecipação de ondas da doença possibilita tempo oportuno para que essas decisões sejam potencialmente mais assertivas. Isso esboça a necessidade de mais ações interdisciplinares dessa natureza, com ferramentas de visualização nas pesquisas epidemiológicas.

ABSTRACT Objective: Describe the development, implementation, and utilization of dashboards for epidemiological analysis through open data research during the COVID-19 pandemic. Methods: The dashboards were designed to analyze COVID-19 related public data from various sources, including official government data and social media, at world level. Data processing and cleaning techniques were used to join datasets. We calculated Spearman correlation coefficient between the COVID-like symptoms data of the University of Maryland and Facebook Health research, called COVID Trends and Impacts Survey (CTIS) and the official data of notified COVID-19 cases by the Brazilian Health Ministry. Results: The dashboards were successful in predicting the onset of new waves of COVID-19 in Brazil. The data analysis revealed a correlation between the CTIS and the official number of cases the country. This article shows the potential of interactive dashboards as a decision-making tool in the context of public health emergencies, as it was used by the official communication of the Rio Grande do Sul state government. Conclusion: The use of dashboards for predicting the spread of COVID-19 in Brazil was a useful tool for decision-making. To anticipate waves of the disease gives time so that these decisions can be potentially more assertive. This drafts the need of more interdisciplinary actions of this nature, with visualization tools on epidemiologic research.

ABSTRACT Research on the use of anaerobic filters as an alternative material to gravel is fundamental, especially if they are low cost and highly efficient in the treatment of swine wastewater (SWW). This study aimed to evaluate the efficiency of anaerobic filters filled with waste from the ceramic industry (WCI) as an alternative material to gravel in swine wastewater treatment. The experimental set-up consisted of three anaerobic polyvinyl chloride filters filled with WCI. A randomized block experimental design was used, with four treatments (evaluations of effects at 30, 60, 90, and 120 days) and three blocks, in a scheme of repeated measures over time. The univariate procedure was employed, and we sought to evaluate only the profile of the change in each response variable, between each evaluation time point. The anaerobic filter filled with WCI is a promising option in the treatment of swine effluents from small farms, presenting over 120 days of operation and average removals of 20%–50% of the color, 40%–70% of total solids, 45%– 75% of turbidity, 45%–55% of total nitrogen, and 33%–45% of total phosphorus.

RESUMO Pesquisas utilizando filtros anaeróbios com materiais alternativos à brita tornam-se fundamentais, principalmente se forem de baixo custo e possibilitem elevada eficiência no tratamento de águas residuárias de suinocultura (ARS). Neste estudo, objetivou-se avaliar a eficiência de filtros anaeróbios preenchidos com resíduos de indústrias de cerâmica (RICs) como materiais alternativos à brita, no tratamento A bancada experimental foi constituída de 3 filtros anaeróbios de policloreto de vinila (PVC), preenchidos com RICs. O delineamento experimental utilizado foi o de blocos casualizados, com quatro tratamentos (avaliações dos efeitos aos 30, 60, 90 e 120 dias) e três blocos, em esquema de medidas repetidas no tempo, sendo adotado o procedimento univariado, buscando-se avaliar apenas o perfil das diferenças de cada uma das variáveis-resposta, entre cada uma das idades de avaliação. O filtro anaeróbio preenchido com resíduo de cerâmica apresenta-se como uma opção promissora no tratamento de efluentes de suinocultura de pequenas propriedades familiares, apresentando, ao longo de 120 dias de funcionamento, remoções médias de 20 a 50 % da cor, 40 a 70% de sólidos totais, 45 a 75% de turbidez, 45 a 55% de N-total e 33 a 45% de P-total.

Resumo O artigo tem como objetivo revisitar as Consultas Terapêuticas do psicanalista Donald Winnicott, buscando identificar nesta estratégia clínica subsídios para a sustentação técnica e ética do apoio matricial e das consultas conjuntas no Sistema Único de Saúde (SUS). Para tanto, realiza-se uma releitura de textos de Winnicott e comentadores, colocando-os em debate com aspectos do trabalho em saúde mental na atenção básica. A partir da análise detalhada de uma das consultas descritas pelo psicanalista, abordam-se implicações para a prática do apoio matricial, tanto na intervenção junto à equipe, como na escuta do paciente e sua família. Além disso, com base no estudo dos relatos de consultas de Winnicott, apresentam-se contribuições para as consultas conjuntas no SUS, considerando seus eixos assistencial e formativo. Como resultados técnicos e éticos, destacam-se: (a) a prioridade da escuta direta da pessoa sobre quem advém a queixa; (b) a importância de sustentar o “espaço e tempo” que possibilite uma experiência significativa ao paciente; (c) o uso de instrumentos de entrevista à luz do “brincar partilhado”; (d) o paciente como sujeito ativo na construção de seu projeto terapêutico; (e) a importância da equipe local no suporte e “tradução” da experiência do paciente.

Abstract The scope of this article is to revisit the Therapeutic Consultations of psychoanalyst Donald Winnicott, seeking to identify technical and ethical contributions which can strengthen the “matrix support” and joint consultations in the Unified Health System (SUS). A rereading of Winnicott’s texts and those of commentators is conducted, presenting a debate between the author’s ideas and the work in mental health in primary care. Based on detailed case analysis, the article addresses some implications for the practice of matrix support, both in the intervention by the team, and in listening to the patient and family members. In addition, based on a contextualized study of Winnicott’s consultation reports, the work presents contributions for joint consultations in the SUS, both in its care and in its formative axis. The following stand out in terms of technical and ethical results: (a) the priority of listening directly to the person who gave rise to the complaint; (b) the importance of sustaining “space and time” to allow a meaningful experience for the patient; (c) the use of interview instruments in the light of “shared playing”; (d) the patient as an active subject in the construction of his therapeutic project; (e) the importance of the local team in supporting and “translating” the patient’s experience.

Resumo O artigo tem como objetivo revisitar as Consultas Terapêuticas do psicanalista Donald Winnicott, buscando identificar nesta estratégia clínica subsídios para a sustentação técnica e ética do apoio matricial e das consultas conjuntas no Sistema Único de Saúde (SUS). Para tanto, realiza-se uma releitura de textos de Winnicott e comentadores, colocando-os em debate com aspectos do trabalho em saúde mental na atenção básica. A partir da análise detalhada de uma das consultas descritas pelo psicanalista, abordam-se implicações para a prática do apoio matricial, tanto na intervenção junto à equipe, como na escuta do paciente e sua família. Além disso, com base no estudo dos relatos de consultas de Winnicott, apresentam-se contribuições para as consultas conjuntas no SUS, considerando seus eixos assistencial e formativo. Como resultados técnicos e éticos, destacam-se: (a) a prioridade da escuta direta da pessoa sobre quem advém a queixa; (b) a importância de sustentar o “espaço e tempo” que possibilite uma experiência significativa ao paciente; (c) o uso de instrumentos de entrevista à luz do “brincar partilhado”; (d) o paciente como sujeito ativo na construção de seu projeto terapêutico; (e) a importância da equipe local no suporte e “tradução” da experiência do paciente.

Abstract The scope of this article is to revisit the Therapeutic Consultations of psychoanalyst Donald Winnicott, seeking to identify technical and ethical contributions which can strengthen the “matrix support” and joint consultations in the Unified Health System (SUS). A rereading of Winnicott’s texts and those of commentators is conducted, presenting a debate between the author’s ideas and the work in mental health in primary care. Based on detailed case analysis, the article addresses some implications for the practice of matrix support, both in the intervention by the team, and in listening to the patient and family members. In addition, based on a contextualized study of Winnicott’s consultation reports, the work presents contributions for joint consultations in the SUS, both in its care and in its formative axis. The following stand out in terms of technical and ethical results: (a) the priority of listening directly to the person who gave rise to the complaint; (b) the importance of sustaining “space and time” to allow a meaningful experience for the patient; (c) the use of interview instruments in the light of “shared playing”; (d) the patient as an active subject in the construction of his therapeutic project; (e) the importance of the local team in supporting and “translating” the patient’s experience.

RESUMO Contexto O transplante renal é o tratamento de escolha para pacientes com doença renal terminal e está associado a menor mortalidade quando comparado aos métodos dialíticos. O Brasil é o país com o segundo maior número de transplantes renais do mundo e, entre esses pacientes, observa-se que as alterações hepáticas são comuns. A frequência das alterações hepáticas varia de 20 a 50% pós-transplante e tem importante impacto na sobrevida e qualidade de vida desses pacientes. Existem poucos dados sobre a frequência, causas e características dessas alterações. Objetivo Determinar a prevalência das diferentes causas de anormalidades hepáticas em receptores de transplante renal, associar as características dessas anormalidades a variáveis demográficas, epidemiológicas e clínicas, comparar as características das alterações hepáticas entre diferentes etiologias e avaliar possíveis alterações no diagnóstico em dois períodos diferentes de tempo. Métodos Estudo epidemiológico descritivo, transversal, observacional, realizado no ambulatório “Hepato-Rim” do Hospital São Paulo (EPM/UNIFESP), centro de atendimento especializado a pacientes com anormalidades hepáticas e doenças renais de base. Resultados Quinhentos e oitenta e um pacientes transplantados foram avaliados. As etiologias mais prevalentes de anormalidades hepáticas foram hepatite C e B, sobrecarga de ferro, doença hepática gordurosa não alcoólica e lesão hepática induzida por drogas. A causa mais comum — hepatite C — foi analisada em maiores detalhes. Em comparação com as outras causas, essa infecção foi a mais frequente em pacientes mais velhos, pacientes do sexo feminino e pacientes com mais tempo de transplante e hemodiálise. A análise dos dois períodos mostrou que os pacientes do período 1 (P1 — 1993 a 2005) eram mais velhos e encaminhados com maior frequência devido à sorologia positiva; encaminhamento devido a anormalidades de aminotransferases predominou durante o período 2 (P2 — 2006 a 2018). Os diagnósticos predominantes foram hepatite C e B durante P1 e doença hepática gordurosa não alcoólica e lesão hepática induzida por drogas durante P2. Conclusão A avaliação das principais alterações hepáticas em receptores de transplante renal é importante, pois permite melhor manejo desses pacientes na investigação diagnóstica e no tratamento e contribui para a prevenção de complicações nesta população especial.

ABSTRACT Background Kidney transplant is the treatment of choice for patients with end-stage renal disease and is associated with lower mortality when compared to dialysis methods. Brazil is the country with the second largest number of kidney transplants in the world and among these patients it has been observed that liver abnormalities are common. The frequency of liver abnormalities ranges from 20-50% post-transplantation, and have an important impact on the survival and quality of life of these patients. There are scarce data about the frequency, causes and characteristics of these alterations. Objective To determine the prevalence of the different causes of hepatic abnormalities in kidney transplant recipients, to associate the characteristics of these abnormalities with demographic, epidemiological and clinical variables, to compare the characteristics of hepatic alterations between different etiologies, and to evaluate possible changes in diagnosis over two different periods of time. Methods Descriptive, cross-sectional observational, epidemiological study was conducted at the outpatient “Hepato-Rim”clinic of Hospital São Paulo (EPM/UNIFESP), a center providing specialized care for patients with hepatic abnormalities and underlying kidney diseases. Results Five-hundred eighty-one transplant patients were evaluated. The most prevalent etiologies of liver abnormalities were hepatitis C and B, iron overload, nonalcoholic fatty liver disease (NAFLD), and drug-induced liver injury (DILI). The most common cause — hepatitis C — was analyzed in greater detail. Compared to the other causes, this infection was more frequent in older patients, female patients, and patients with a longer time since transplantation and hemodialysis. Analysis of the two periods showed that patients of period 1 (P1 — 1993 to 2005) were older and were more frequently referred because of positive serology; referral due to aminotransferases abnormalities predominated during period 2 (P2 — 2006 to 2018). The predominant diagnoses were hepatitis C and B during P1 and NAFLD and DILI during P2. Conclusion Assessment of the main hepatic alterations in kidney transplant recipients is important because it permits better management of these patients in terms of diagnostic investigation and treatment and contributes to the prevention of complications in this special population.

Abstract Mugil curema is a pelagic fish species and it is considered the most common species of the Mugilidae family on the Brazilian coast. The objective of this study was to compile the existing information on the metazoan parasites of this host, as well as including new records from specimens captured in the Cabedelo city, state of Paraíba, Brazil. In the present study, we listed 81 taxa belonging to ten groups previously recorded for the host M. curema, and included 16 species recorded in the Cabedelo region. Eight out of 16 parasite taxa found in the Cabedelo region are first host records for M. curema: Ligophorus brasiliensis, Ligophorus sp.1, Ligophorus sp.2 (Monogenea), Fellodistomidae gen. sp., Bucephalidae gen. sp. (Digenea), Pharyngodonidae gen. sp. (Nematoda), Piscicolidae gen. sp. (Hirudinea) and Lernaeopodidae gen. sp. (Copepoda). Monogenea was the most abundant taxonomic group, followed by Copepoda. Despite the number of existing parasitological studies on this host species, new records of occurrence were made for the Cabedelo region and for the host, indicating that the knowledge about the parasites associated with this fish species is still under construction, especially because of its wide geographic distribution.

Abstract Zoonotic spillover is a phenomenon characterized by the transfer of pathogens between different animal species. Most human emerging infectious diseases originate from non-human animals, and human-related environmental disturbances are the driving forces of the emergence of new human pathogens. Synthesizing the sequence of basic events involved in the emergence of new human pathogens is important for guiding the understanding, identification, and description of key aspects of human activities that can be changed to prevent new outbreaks, epidemics, and pandemics. This review synthesizes the connections between environmental disturbances and increased risk of spillover events based on the One Health perspective. Anthropogenic disturbances in the environment (e.g., deforestation, habitat fragmentation, biodiversity loss, wildlife exploitation) lead to changes in ecological niches, reduction of the dilution effect, increased contact between humans and other animals, changes in the incidence and load of pathogens in animal populations, and alterations in the abiotic factors of landscapes. These phenomena can increase the risk of spillover events and, potentially, facilitate new infectious disease outbreaks. Using Brazil as a study model, this review brings a discussion concerning anthropogenic activities in the Amazon region and their potential impacts on spillover risk and spread of emerging diseases in this region.

RESUMO Este estudo teve como objetivo determinar como a disposição e composição dos resíduos culturais afetam o teor de água do solo e a temperatura durante a estação seca na região central do estado do Espírito Santo, Brasil. Um estudo de campo de 19 semanas foi conduzido de abril a agosto de 2017, no esquema fatorial 2 x 4 com quatro repetições, em blocos casualizados. Os fatores foram: preparo do solo [preparo convencional (CT) e sem preparo (ND)] e tipos de cobertura [milho (Zea mays L.), crotalária (Crotalaria juncea L.), mistura de crotalária com milho e sem cobertura morta (controle)]. O teor de água e a temperatura do solo foram medidos semanalmente em intervalos de profundidade pré-determinados. A umidade do solo foi maior no NT do que nos demais tratamentos na profundidade de 0-0.05 m. Todas as coberturas mortas nessa profundidade foram igualmente eficazes na conservação da umidade do solo. Os resíduos da superfície reduziram a temperatura do solo em até 8,4 °C em relação ao controle nas parcelas NT. A Incorporação dos resíduos eliminou todos os benefícios de redução de temperatura fornecidos pela manutenção dos resíduos na superfície. Estes resultados indicam que os resíduos superficiais de cereais, leguminosas ou misturas desses são igualmente eficazes na conservação da água do solo e na moderação da temperatura do solo durante a estação seca. Pesquisas adicionais são necessárias para determinar como as melhores condições ambientais do solo, geradas por resíduos de superfície, afetariam a aquisição de nutrientes e o desempenho da cultura.

ABSTRACT This study aimed to determine how crop residue placement and composition would affect soil water content and temperature during the dry season in the central region of Espírito Santo state, Brazil. A 19-week field study was conducted from April to August 2017. A 2 x 4 factorial study with four replications was implemented using a randomized complete block design. Factors were soil management [conventional tillage (CT) and no soil disturbance (ND)] and residue amendment [maize (Zea mays L.), sunn hemp (Crotalaria juncea L.), a maize-sunn hemp mixture, and a no amendment control]. Soil water content and temperature were measured weekly at predetermined soil depth intervals. Soil water content was higher in ND plots amended with surface residues than under all other treatments in the 0 to 0.05 m depth range. All residue amendments in this range were equally effective in conserving soil water. Surface residues reduced soil temperature by up to 8.4 °C relative to the control in ND plots. Incorporating residue amendments by CT cancelled all temperature-moderating benefits provided by surface residues. These results indicate that surface residues from cereals, legumes, or cereal/legume mixtures are equally effective in conserving soil water and moderating soil temperature during the dry season. Additional research is needed to determine how improved soil environmental conditions, generated by surface residues, would affect nutrient acquisition and crop performance.

RESUMO A utilização de filtros orgânicos produzidos em comunidades locais e com baixo custo financeiro pode proporcionar redução nos impactos ambientais ocasionados pelo lançamento de águas residuárias, sem tratamento, em cursos hídricos receptores. Neste estudo, objetivou-se avaliar a eficiência do processo de filtração de águas residuárias da suinocultura (ARS), utilizando engaço de bananeira como material alternativo em filtro orgânico. A ARS foi aplicada ao filtro orgânico,sendo o volume filtrado convertido em volume de poros. Análises de sólidos totais, turbidez, cor, fósforo total e nitrogênio total foram realizadas no afluente e efluente do filtro para a avaliação da eficiência de tratamento. Análises de regressão foram utilizadas para obtenção de equações na estimativa do desempenho da filtragem na remoção das referidas variáveis da água residuária, tendo-se como variável independente o volume de poros. O filtro de engaço de bananeira não proporcionou a remoção dos sólidos totais e da cor do afluente nele aplicado. Remoções de 10 a 50% da turbidez da ARS foram obtidas pelo engaço de bananeira. O engaço de bananeira proporcionou elevada eficiência na remoção de nitrogênio e fósforo da ARS, alcançando-se remoções médias de 67 e 62%, respectivamente. De um modo geral, o filtro de engaço de bananeira pode ser considerado uma alternativa promissora no tratamento primário de águas residuárias de suinocultura.

ABSTRACT Using organic filters produced in local communities with low financial cost can reduce the environmental impacts caused by the disposal of untreated wastewater into receiving water bodies. In this study, the objective was to evaluate the efficiency of the filtration of swine wastewater (SWW) using banana stalk as an alternative material in an organic filter. SWW was applied to the organic filter and the filtered volume was converted into pore volume. Analyses of total solids, turbidity, color, total phosphorus, and total nitrogen were performed in the filter feed solution and effluent to evaluate treatment efficiency. Regression analyses were used to obtain equations in the estimation of the filtration performance in removing these variables from wastewater, with pore volume as an independent variable. The banana stalk filter did not remove total solids and color from the feed solution applied. Removal of 10–50% of SWW turbidity were obtained by the banana stalk. Banana stalk was highly efficient in removing nitrogen and phosphorus from SWW, reaching mean removals of 67% and 62%, respectively. In general, a banana stalk filter can be considered a promising alternative in the primary treatment of SWW.

Resumo: O objetivo deste trabalho foi avaliar os sintomas de injúria em soja não tolerante ao dicamba (ácido 3,6-dicloro-2-metoxibenzóico), bem como a produtividade da cultura, após a aplicação de subdoses do herbicida para simulação da deriva física em condições tropicais. Doses de dicamba de 0, 5,8, 14,4, 28,8, 57,6 e 576 g de equivalente ácido por hectare foram aplicadas nos estádios vegetativo (V3) e reprodutivo (R1) da soja, com uso de pulverizador costal acionado por CO2, dotado de pontas de jato plano com indução de ar; a pressão e a taxa de aplicação foram de 250 kPa e 200 L ha-1, respectivamente. Foram avaliados injúria visual, índice “soil-plant analysis development” (SPAD) (teor de clorofila das folhas) aos 14 dias após a aplicação do herbicida e produtividade da cultura de soja. Essas variáveis foram influenciadas pelo estádio da cultura em que as doses de dicamba foram aplicadas. Doses inferiores a 28,8 g ha-1 causaram menor injúria na soja quando aplicadas no estádio R1; contudo, não houve diferenças de produtividade entre os estádios. A deriva de dicamba de 1%, em condições tropicais, reduz a produtividade da soja em 12%.

Abstract: The objective of this work was to evaluate injury symptoms on soybean not tolerant to dicamba (3,6-dichloro-2-methoxybenzoic acid), as well as crop yield, after the application of sub-rates of the herbicide to simulate physical drift in tropical conditions. Dicamba rates of 0, 5.8, 14.4, 28.8, 57.6, and 576 g acid equivalent per hectare were applied at the vegetative (V3) and reproductive (R1) stages of soybean, using a backpack sprayer pressurized with CO2, equipped with air-induction flat fan spray nozzles; the pressure and rate of application were 250 kPa and 200 L ha-1, respectively. Visible injury, the soil-plant analysis development (SPAD) index (leaf chlorophyll content) at 14 days after herbicide application, and soybean crop yield were evaluated. These variables were influenced by the crop stage in which the dicamba rates were applied. Rates below 28.8 g ha-1 caused less injury to soybean when applied at the R1 stage; however, there were no differences in yield between stages. A 1% dicamba drift in tropical conditions reduces soybean yield by 12%.

The interaction of HIV-1, human leukocyte antigen (HLA), and elite controllers (EC) compose a still intricate triad. Elite controllers maintain a very low viral load and a normal CD4 count, even without antiretrovirals. There is a lot of diversity in HIV subtypes and HLA alleles. The most common subtype in each country varies depending on its localization and epidemiological history. As we know EC appears to maintain an effective CD8 response against HIV. In this phenomenon, some alleles of HLAs are associated with a slow progression of HIV infection, others with a rapid progression. This relationship also depends on the virus subtype. Epitopes of Gag protein-restricted by HLA-B*57 generated a considerable immune response in EC. However, some mutations allow HIV to escape the CD8 response, while others do not. HLA protective alleles, like HLA-B*27, HLA-B*57 and HLA-B*58:01, that are common in Caucasians infected with HIV-1 Clade B, do not show the same protection in sub-Saharan Africans infected by HIV-1 Clade C. Endogenous pathway of antigen processing and presentation is used to present intracellular synthesized cellular peptides as well as viral protein fragments via the MHC class I molecule to the cytotoxic T-lymphocytes (CTLs). Some epitopes are immunodominant, which means that they drive the immune reaction to some virus. Mutation on an anchor residue of epitope necessary for binding on MHC class I is used by HIV to escape the immune system. Mutations inside or flanking an epitope may lead to T cell lack of recognition and CTL escape. Studying how immunodominance at epitopes drives the EC in a geographically dependent way with genetics and immunological elements orchestrating it may help future research on vaccines or immunotherapy for HIV. 2021 Sociedade Brasileira de Infectologia. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license

RESUMO CONTEXTO: Os antivirais de ação direta revolucionaram o tratamento da hepatite C, inclusive para os pacientes com doença renal crônica (DRC), porém ainda há divergências no emprego do sofosbuvir (SOF) quando taxa de filtração glomerular (TFG) <30 mL/min. OBJETIVO: Avaliar a eficácia e segurança desses esquemas no tratamento da hepatite C em pacientes com DRC e pós-transplante renal, além de avaliar o impacto do SOF sobre a função renal dos não-dialíticos. MÉTODOS: Todos os pacientes com hepatite C e DRC ou transplante renal que realizaram tratamento com antivirais de ação direta em centro referenciado do Brasil no período de janeiro/2016 a agosto/2017 foram incluídos. A eficácia foi avaliada por meio da carga viral (HCV-RNA), considerando-se cura uma resposta virológica sustentada (RVS) com resultado indetectável após 12 e/ou 24 semanas do término do tratamento (RVS12 e RVS24). A segurança foi determinada pelos eventos adversos e a ribavirina, quando associada, foi introduzida de forma escalonada em todos os pacientes com TFG <60 mL/min. Para determinação do impacto do SOF sobre a função renal, foram observadas as dosagens de creatinina basal, durante e após término do tratamento com seu incremento avaliado por meio da classificação de AKIN (acute kidney injury network). RESULTADOS: Foram incluídos 241 pacientes, sendo 52,7% do sexo feminino, com média de idade de 60,72±10,47 anos. A associação de SOF+daclatasvir predominou em 75,6% dos casos e anemia esteve presente em 28% dos pacientes que utilizaram ribavirina (P=0,040). As taxas de RVS12 e RVS24 foram de 99,3% e 97,1%. O tratamento foi bem tolerado, com eventos adversos pouco relevantes, sendo os mais prevalentes: astenia (57,7%), prurido (41,1%), cefaleia (40,7%) e irritabilidade (40,2%). Entre os pacientes em tratamento conservador e transplantados renais, os valores de creatinina sofreram oscilações AKIN I em 12,5% dos casos, durante o tratamento, persistindo em apenas 8,5% da amostra após o término, dos quais 2,0% apresentavam TFG <30 mL/min inicialmente, com queda para 1,1% após uso do SOF. Apenas 0,5% e 1,6% evoluíram com elevação AKIN II e AKIN III. CONCLUSÃO: Os antivirais de ação direta foram seguros e eficazes em pacientes com DRC tratados com esquemas contendo SOF, apresentando altas taxas de RVS, boa tolerabilidade e poucos eventos adversos graves. A associação com ribavirina aumentou o risco de anemia, portanto sua introdução de forma escalonada parece ser útil nos pacientes com TFG <60 mL/min. Em pacientes com TFG <30 mL/min o SOF não apresentou impacto renal significativo, com creatinina sérica retornando a valores próximos ao basal após o tratamento.

ABSTRACT BACKGROUND: Direct-acting antivirals have revolutionized hepatitis C treatment, also for patients with chronic kidney disease (CKD), but some controversy exists regarding the use of sofosbuvir (SOF) in patients with glomerular filtration rate (GFR) <30 mL/min. OBJECTIVE: To evaluate the efficacy and safety of these regimens for hepatitis C treatment of patients with CKD and after renal transplantation, as well as the impact of SOF on renal function in non-dialysis patients. METHODS: All patients with hepatitis C and CKD or renal transplant treated with direct-acting antivirals at a referral center in Brazil between January 2016 and August 2017 were included. Efficacy was evaluated based on viral load (HCV RNA) and a sustained virological response (SVR) consisting of undetectable RNA 12 and/or 24 weeks after the end of treatment (SVR12 and SVR24) was defined as cure. Safety was determined by adverse events and ribavirin, when combined, was administered in escalating doses to all patients with GFR <60 mL/min. The impact of SOF on renal function was determined by the measurement of baseline creatinine during and after the end of treatment and its increase was evaluated using the Acute Kidney Injury Network (AKIN) classification. RESULTS: A total of 241 patients (52.7% females) with a mean age of 60.72±10.47 years were included. The combination of SOF+daclatasvir was the predominant regimen in 75.6% of cases and anemia was present in 28% of patients who used ribavirin (P=0.04). The SVR12 and SVR24 rates were 99.3% and 97.1%, respectively. The treatment was well tolerated and there were no major clinically relevant adverse events, with the most prevalent being asthenia (57.7%), itching (41.1%), headache (40.7%), and irritability (40.2%). Among conservatively treated and renal transplant patients, oscillations of creatinine levels (AKIN I) were observed in 12.5% of cases during treatment and persisted in only 8.5% after the end of treatment. Of these, 2.0% had an initial GFR <30 mL/min and this percentage decreased to 1.1% after SOF use. Only 0.5% and 1.6% of the patients progressed to AKIN II and AKIN III elevation, respectively. CONCLUSION: The direct-acting antivirals were safe and efficacious in CKD patients treated with SOF-containing regimens, with the observation of high SVR rates, good tolerability and few severe adverse events. The combination with ribavirin increased the risk of anemia and the administration of escalating doses seems to be useful in patients with GFR <60 mL/min. In patients with GFR <30 mL/min, SOF had no significant renal impact, with serum creatinine returning to levels close to baseline after treatment.

Resumo Neste estudo, analisamos dados climáticos, um modelo de balanço hídrico e dados de caducifolia de árvores com o objetivo de determinar a fisionomia de uma floresta em São João de Petrópolis, região central do Espírito Santo, Brasil. Hipotetizamos que a floresta estudada seria um remanescente das florestas decíduas relatadas por naturalistas nos séculos XIX e XX, apesar do atual Mapa de Vegetação do Brasil indicar apenas florestas pluviais para a localidade. Dados obtidos de uma estação meteorológica local indicam que o clima é quente e com distribuição sazonal de chuvas. Embora a estação seca tenha durado seis meses em média (abril-setembro), períodos secos mais longos foram recorrentes nas últimas quatro décadas. Dentre 354 árvores amostradas no estrato superior da floresta no final da estação seca, 65,2% não possuíam folhagem, 18,1% possuíam folhagem parcial e 16,7% possuíam folhagem completa. A proporção de árvores sem folhagem foi superior a 60% em todas as classes de altura desse estrato. Esses atributos, bem como alguns registros de espécies arbóreas típicas de florestas estacionais, confirmam que a floresta é estacional decídua. Nossos resultados refinam o Mapa de Vegetação do Brasil e podem fomentar discussões sobre a controversa classificação das florestas do Estado do Espírito Santo.

Abstract In this study we analyzed climatic data, a water balance model, and data on tree deciduousness aiming to determine the physiognomy of a forest in São João de Petrópolis, central Espírito Santo, Brazil. We hypothesized that the studied forest stand would be a remnant of the deciduous forests that were reported by naturalists in both centuries XIX and XX, even though the current Vegetation Map of Brazil indicates only dense rainforests for this place. Data obtained from a local weather station indicate that climate in the site is hot and with seasonal distribution of rainfall. Although the dry season has lasted in average six months (April-September), dry periods longer than six months were recurrent throughout the four last decades. Among the 354 trees that were sampled in the upper storey at the end of the dry season, 65.2% had no foliage, 18.1% had partial foliage, and 16.7% had full foliage. Percentages of deciduous trees were higher than 60% in all height classes of the upper storey. These attributes, as well as some records of tree species that are typical of seasonal forests, confirm that the forest is seasonal deciduous. Our results refine the Vegetation Map of Brazil and may foment discussions about the controversial classification of the forests of Espírito Santo state.