Abstract This overview aimed to describe the situation of healthcare access in sub-Saharan Africa, excluding South Africa, during the COVID-19 pandemic. A PubMed® search from March 31, 2020, to August 15, 2022, selected 116 articles. Healthcare access and consequences of COVID-19 were assessed based on comparisons with months before its onset or an identical season in previous years. A general reduction of healthcare delivery, associated with the decline of care quality, and closure of many specialty services were reported. The impact was heterogeneous in space and time, with an increase in urban areas at the beginning of the pandemic (March-June 2020). The return to normalcy was gradual from the 3rd quarter of 2020 until the end of 2021. The impact of COVID-19 on the health system and its use was attributed to (a) conjunctural factors resulting from government actions to mitigate the spread of the epidemic (containment, transportation restrictions, closures of businesses, and places of entertainment or worship); (b) structural factors related to the disruption of public and private facilities and institutions, in particular, the health system; and (c) individual factors linked to the increase in costs, impoverishment of the population, and fear of contamination or stigmatization, which discouraged patients from going to health centers. They have caused considerable socio-economic damage. Several studies emphasized some adaptability of the healthcare offer and resilience of the healthcare system, despite its unpreparedness, which explained a return to normal activities as early as 2022 while the COVID-19 epidemic persisted. There appears to be a strong disproportion between the moderate incidence and severity of COVID-19 in sub-Saharan Africa, and the dramatic impact on healthcare access. Several articles make recommendations for lowering the socioeconomic consequences of future epidemics to ensure better management of health issues. subSaharan sub Saharan Africa COVID19 COVID 19 COVID-1 PubMed 31 15 11 years delivery quality reported time MarchJune June 2020. . 2020) rd 202 2021 (a containment, containment (containment restrictions businesses worship worship) b (b institutions particular c (c costs population stigmatization centers socio economic damage unpreparedness persisted issues COVID1 1 COVID- 3 20 2

ABSTRACT. The species Nasutitermes corniger (Motschulsky) is an arboreal termite, causes damage in urban and agricultural areas. Despite its economic importance, there are no studies on the basic aspects for its management in the laboratory, which will lay the foundations for the future development of control strategies. The objective of the study was to evaluate in the laboratory the survival of N. corniger at different conditions of relative humidity, temperature, humidity of the substrate and its preference for different types of wood. Relative humidities were tested between 9 and 100%, temperatures of 20, 25 and 30 oC, six substrates: pine, cedar, pink poui, eucalyptus, macuilís, coconut fiber and four substrate humidities of 0 to 60% were tested. The results indicate a significant effect on all the variables measured. The highest survival of N. corniger was had with a relative humidity of 100%, a temperature of 20o C and a humidity of the substrate of 60%, while the most preferred substrate was eucalyptus. In the appropriate percentages, the interaction of these three factors provides the best conditions for the survival of N. corniger.

RESUMEN. La especie Nasutitermes corniger (Motschulsky) es una termita arbórea, que causa daño en zonas urbanas y agrícolas. A pesar de su importancia económica, no hay estudios sobre aspectos básicos de su manejo en laboratorio, lo cual sentará las bases para el desarrollo futuro de estrategias de control. El objetivo del estudio fue, evaluar en laboratorio la supervivencia de N. corniger a diferentes condiciones de humedad relativa, temperatura, humedad del sustrato y su preferencia a distintos tipos de maderas. Se probaron humedades relativas entre el 9 y 100%, las temperaturas de 20, 25 y 30 oC, seis sustratos: pino, cedro, tinto, eucalipto, macuilís, fibra de coco y cuatro humedades de sustrato de 0 hasta 60%. Los resultados indican efecto significativo en todas las variables medidas. La mayor supervivencia de N. corniger se tuvo con la humedad relativa del 100%, temperatura de 20 oC y humedad del sustrato de 60%, mientras que el sustrato de mayor preferencia fue el eucalipto. En los porcentajes adecuados, la interacción de estos tres factores propicia las mejores condiciones para la supervivencia de N. corniger.

Abstract INTRODUCTION: The present study investigated the association of the rs2794521 polymorphism in the CRP gene in individuals with chronic hepatitis B and C, correlating it with markers of hepatic inflammation, fibrosis scores, viral load, and plasma protein levels. METHODS: The study analyzed 185 blood samples obtained from patients with hepatitis B (n=74) and hepatitis C (n=111) and 300 samples from healthy donors. Genotyping was performed by real-time polymerase chain reaction, and protein levels were quantified using the automated immunoturbidimetric method. RESULTS: The TT genotype was the most frequent in all studied groups and was associated with higher plasma levels of the protein but not with the progression of liver disease. Low levels of C-reactive protein were associated with increased viremia and scores indicative of severe fibrosis and cirrhosis. CONCLUSIONS: The present results demonstrated a close relationship between the ability of the virus to replicate and cause liver damage and low serum concentrations of C-reactive protein. Future research may determine if these results can be interpreted as a possible form of escape for the virus by decreasing its action as an opsonin and decreasing phagocytosis, which are functions of C-reactive protein in the immune response.

RESUMO Introdução: A obesidade caracteriza-se pela deposição excessiva de gordura no tecido adiposo e está associada ao desenvolvimento de danos patológicos em vários processos metabólicos que estão relacionados com o estresse oxidativo e a inflamação. Objetivo: Avaliar os níveis de adiponectina, marcadores inflamatórios e marcadores oxidativos, com o objetivo de determinar um perfil de biomarcadores em adultos que influencie o risco metabólico de desenvolver síndrome metabólica (SMet). Métodos: Os grupos estudados incluíram 84 adultos (48 sem SMet e 36 com SMet). Parâmetros gerais e bioquímicos foram determinados. Níveis de adiponectina, marcadores inflamatórios [proteína C reativa ultrassensível (PCR-us), interleucina 6 (IL-6), adenosina deaminase (ADA), dipeptidil peptidase-IV (DPP-IV)] e marcadores oxidativos [thiobarbituric acid reactive species (TBARS), sulfhydryl (SH) grupos, total antioxidante capacity ferric (FRAP) e vitamina C] também foram medidos. Resultados: O grupo com SMet apresentou aumento significativo de insulina, triglicerídeos, colesterol, colesterol da llipoproteína de baixa densidade (LDL-C), transaminase glutâmica pirúvica (TGP) e ácido úrico, bem como gamaglutamiltransferase (GGT), transaminase glutâmica oxalacética (TGO), hemoglobina glicada (HbA1C), homeostasis model assessment of insulin resistance (HOMA-IR), glicose, SH e TBARS, e redução significativa de sensibilidade insulínica (SI), lipoproteína de alta densidade (HDL-C) e vitamina C. Conclusão: A combinação de IL-6, PCR-us, ADA, DPP-IV e o aumento de TBARS, com a redução de vitamina C, grupos SH e adiponectina promovem inflamação e comprometem a sensibilidade à insulina, apresentando assim um papel ativo na patogênese da SMet. Esses achados são significativos porque podem auxiliar no monitoramento de alterações clínicas, na prevenção de futuros eventos cardiometabólicos em indivíduos com SMet e na identificação de marcadores inflamatórios e oxidativos que auxiliam no monitoramento e na prevenção da SMet.

ABSTRACT Introduction: Obesity is characterized by excessive deposition of fat in adipose tissue and is associated with the development of pathological damage in several metabolic processes that are associated with oxidative stress and inflammation. Objective: To evaluate the levels of adiponectin, inflammatory markers and oxidative markers, with the objective of determining a biomarkers profile in adults that influences the metabolic risk of developing the metabolic syndrome (MetS). Methods: The groups studied included 84 adults (48 Without MetS and 36 With MetS). General and biochemical parameters were determined. Adiponectin levels, inflammatory markers [C-reactive protein (CRP)], interleukin 6 (IL-6), adenosine deaminase (ADA), dipeptidyl peptidase-IV (DPP-IV) and oxidative markers [thiobarbituric acid reactive substances (TBARS), sulfhydryl groups (SH), total ferric antioxidant power (FRAP) and vitamin C] were also measured. Results: The MetS group presented a significant increase in insulin, triglycerides, cholesterol, low-density lipoprotein cholesterol (LDL-C), glutamic-pyruvic transaminase (GPT) and uric acid, as well as gamma-glutamyl transferase (GGT), glutamic-oxaloacetic transaminase (GOT), and vitamin C. Conclusion: The combination of IL-6, ultra-sensitive C-reactive protein (us-CRP), ADA, DPP-IV and the increase of TBARS, with the reduction of vitamin C, SH groups and adiponectin, promote inflammation and compromise insulin sensitivity, thus presenting an active role in the pathogenesis of MetS. These findings are significant because they may assist in monitoring clinical changes, in the prevention of future cardiometabolic events in individuals with MetS, and in the identification of inflammatory and oxidative markers that assist in the monitoring and prevention of MetS.

Abstract Background: Osteoarthritis (OA) can be defined as degradation of articular cartilage of the joint, and is the most common degenerative disease. To regenerate the damaged cartilage, different experimental approaches including stem cell therapy have been tried. One of the major limitations of stem cell therapy is the poor post-transplantation survival of the stem cells. Anoikis, where insufficient matrix support and adhesion to extracellular matrix causes apoptotic cell death, is one of the main causes of the low post-transplantation survival rate of stem cells. Therefore, enhancing the initial interaction of the transplanted stem cells with chondrocytes could improve the therapeutic efficacy of stem cell therapy for OA. Previously, protein kinase C activator phorbol 12-myristate 13-acetate (PMA)- induced increase of mesenchymal stem cell adhesion via activation of focal adhesion kinase (FAK) has been reported. In the present study, we examine the effect PMA on the adipose-derived stem cells (ADSCs) adhesion and spreading to culture substrates, and further on the initial interaction between ADSC and chondrocytes. Results: PMA treatment increased the initial adhesion of ADSC to culture substrate and cellular spreading with increased expression of adhesion molecules, such as FAK, vinculin, talin, and paxillin, at both RNA and protein level. Priming of ADSC with PMA increased the number of ADSCs attached to confluent layer of cultured chondrocytes compared to that of untreated ADSCs at early time point (4 h after seeding). Conclusion: Taken together, the results of this study suggest that priming ADSCs with PMA can increase the initial interaction with chondrocytes, and this proof of concept can be used to develop a non-invasive therapeutic approach for treating OA. It may also accelerate the regeneration process so that it can relieve the accompanied pain faster in OA patients. Further in vivo studies examining the therapeutic effect of PMA pretreatment of ADSCs for articular cartilage damage are required.

Aiming to determine an appropriate protocol for short-term storage of the sperm of San Pedro Mártir trout, Oncorhynchus mykiss nelsoni, wild fish previously matured in captivity were anesthetized and the semen, obtained by abdominal pressure, was suspended in Erdhal and Graham extender at 1:3, 1:6 and 1:9 dilution ratios and kept at 4° C for 9 days with an undiluted sample as control. The percentages of sperm motility and membrane integrity were assessed daily. The results indicated that sperm suspended at a dilution of 1:9 can be stored at 4° C with ≥ 80% motility and ≥ 65% membrane integrity for 7 and 6 days respectively. In addition, the results show that membrane integrity decreased more rapidly than motility, which suggests that it may be used as an early indicator of sperm damage during short-term cold storage. The results obtained are important to support future conservation programs of this trout.

Con el objetivo de determinar un protocolo apropiado para el almacenamiento a corto plazo de los espermatozoides de trucha de San Pedro Mártir, Oncorhynchus mykiss nelsoni, se anestesiaron peces silvestres previamente madurados en cautiverio y el esperma, obtenido por presión abdominal, fue suspendido en una solución extender de Erdhal y Graham a tasas de dilución de 1:3, 1:6 y 1:9 y mantenido a 4° C durante 9 días con una muestra control sin diluir. Los porcentajes de movilidad e integridad de membrana fueron evaluados diariamente. Los resultados indicaron que los espermatozoides suspendidos en una dilución de 1:9 se pueden almacenar a 4° C con movilidad ≥ 80% e integridad de membrana ≥ 65% por 7 y 6 días respectivamente. Además, los resultados muestran que la movilidad disminuye más lentamente que la integridad de la membrana, lo que sugiere que ésta puede utilizarse como un indicador temprano del daño al esperma durante el almacenamiento a corto plazo en bajas temperaturas. Los resultados obtenidos son importantes para apoyar los programas de conservación de esta trucha.

Existing masonry buildings are often the result of constructions, changes and alterations that have developed over the centuries. Therefore, the adaptation and improvement of existing masonry buildings must be accompanied by an adequate level of knowledge of their history. The tragic consequences of the recent earthquakes, in Italy and abroad, have stimulated the belief that, sometimes, the cause of seismic damage might be just the wrong intervention of improvement or adaptation. in most cases, this is attributable to retrofit works which are carried out without any knowledge concerning the construction rules of the building. The case study presented here regards the seismic analysis of the Sant' Agostino Church in LAquila (seriously damaged by the earthquake occurred in April 2009), which takes into account the in-depth knowledge of the factory, respecting all three evaluation levels of seismic safety provided by the Italian seismic Guidelines for Cultural Heritage (Eurocode 8, 2003; NTC, 2008). In particular for LV1 (Evaluation Level 1), all the analyses requested to fill the annexes of the Directive of December 10th, 2007 were carried out, starting from Module A, which is the "identifier registry", passing through Module B, which concerns the study of "sensitivity factors", and ending with Module C, which considers the "morphology of the elements". From this examination, we concluded that the ground acceleration during the earthquake of April 6th, 2009 surpassed the acceleration value corresponding to the limit state of collapse. For LV2 (Evaluation Level 2), we especially focused on the verification of all macro-elements as a potential source of damage mechanisms. in particular, we found that these mechanisms concerned mostly the facade, the hall, the dome, the apse/presbytery, the roofing, the side chapels, the joints between horizontal and vertical alignment, and finally, the bell tower. Once we collected all data regarding the site, the geometry of construction, the characteristics of the materials, the structure, the soil, etc., we carried out a dynamic FEM modal analysis on the structure, valid for LV3 (Evaluation Level 3). Moreover, these dynamic tests are essential for the evaluation of seismic safety and they also present the clear advantage of being non-destructive. Finally, the analysis provided the most significant vibration modes and suggested the optimal structural interventions to remedy the existing damage and prevent the formation of these mechanisms under the action of future earthquakes.

A menudo, las construcciones existentes en albañilería son el resultado de construcciones, cambios y modificaciones que se han ido desarrollando durante siglos. Por lo tanto, las adaptaciones y mejoras de las edificaciones en albañilería deben ir acompañadas de un nivel adecuado de conocimiento de su historia. Las trágicas consecuencias de los recientes terremotos ocurridos en Italia y otros países, han llevado a pensar que, a veces, la causa del daño sísmico podría ser justamente una errada intervención de la mejora o adaptación que se les ha realizado. En la mayoría de los casos, este hecho es atribuible a las modificaciones realizadas sin tener los conocimientos necesarios sobre las normas constructivas de esa edificación. El estudio de caso presentado en este trabajo se refiere al análisis sísmico de la iglesia de Sant' Agostino en L'Aquila (gravemente dañada por el sismo ocurrido en abril de 2009), y considera en profundidad los tres niveles de evaluación de la seguridad sísmica establecidos en el Código Italiano para la evaluación y reducción del riesgo sísmico del patrimonio cultural Eurocode 8: Design of structures for earthquake resistance, (2003), Decreto Legislativo (2004), Norme tecniche per le costruzioni, DM. (2005), Norme tecniche per le costruzioni, DM. (2008), Circolare n. (2010), Direttiva del Presidente del Consiglio dei ministri per la valutazione e la riduzione del rischio sismico del patrimonio culturale con riferimento alle Norme Tecniche per le Costruzioni. G.U. (2008). Así, para el LV1 (Nivel de evaluación 1) se realizaron todos los análisis exigidos en los anexos de la Directiva del 10 de diciembre de 2007, comenzando por el Módulo A que corresponde al "registro de identificación", continuando con el Módulo B que se refiere al estudio de los "factores de sensibilidad" y finalizando con el Módulo C que considera la "morfología de los elementos". A partir de esta evaluación, hemos concluido que la aceleración máxima del terreno durante el sismo del 6 de abril de 2009 superó el valor de aceleración correspondiente a los estados límite de colapso. Para el LV2 (Nivel de evaluación 2), nos enfocamos principalmente en la verificación de todos los macroelementos como una fuente potencial del mecanismo de daños. Descubrimos que los mecanismos ocurridos estaban mayormente relacionados con la fachada, la nave, la cúpula, el ábside/presbiterio, la techumbre, capillas laterales, las juntas entre la alineación horizontal y vertical, y por último, el campanario. Un vez recopilados todos los datos relacionados con el sitio, la geometría de la construcción, las características de los materiales, la estructura, el suelo, etc., realizamos un análisis modal a la estructura utilizando el Método de Elemento Finito dinámico (FEM, en inglés), válido para el LV3 (Nivel de evaluación 3). Además, estos ensayos dinámicos son esenciales para la evaluación de la seguridad sísmica y poseen la ventaja de no ser destructivos. Finalmente, el análisis entregó los modos de vibración más importantes y sugirió las intervenciones estructurales óptimas para reparar el daño existente y evitar la formación de los mismos mecanismos bajo la acción de un futuro sismo.

Objetivo Analizar el nivel de la salud psíquica de los profesionales de salud en las enfermerías de los hospitales del Estado de Rio Grande do Norte, Brasil. Material y Métodos Fue realizado un estudio descriptivo transversal con 95 profesionales de salud (muestra estratificada proporcional). Se utilizó un cuestionario constando las características socio-demográficas y laborales, así como el Cuestionario de Salud General de Goldberg (QSG). Resultados Los empleados son del sexo femenino, casadas, con edad superior a 45 años. Cuentan con una carga horaria laboral de 40 horas semanales, además de presentar múltiples vínculos de trabajo. La salud psíquica global de los sujetos se encuentra en un nivel bueno, pero también hay individuos en número significativo de procesos de agravamiento, en relación al estrés (37,9 %) y a los disturbios psicosomáticos (34,7 %) independientemente. Conclusiones Hay un indicativo de alerta sobre la necesidad de acciones preventivas,de modo a evitar mayores complicaciones con posibles daños a las condiciones desalud psíquica de estos trabajadores.

Objectives Analysing the level of psychic health in health workers from public hospitals in the State of Rio Grande do Norte, Brazil. Materials and Methods This was a descriptive, traverse cohort (stratified proportional) study of a sample of 95 health workers; a socio-demographic and work-based questionnaire and the Goldberg's General Health Questionnaire (GGHQ) were used. Results 82 % of the subjects were female, 60 % were married, 81 % catholic, 48 % were aged more than 45, 73 % had a workload of 40 hours per week and 63 % worked at other places. 64 % presented a good level of overall psychic health, the psychic health of 31 % of them was becoming affected and 5% were in extreme danger. Conclusions The need for preventative action should be stressed, even with psychically healthy professionals, being, to avoid future damage or more serious worsening of these workers' psychic health.

Objetivo Analisar o nível de saúde psíquica dos profissionais de saúde nas enfermarias dos hospitais públicos do Estado do Rio Grande do Norte, Brasil. Materiais e Métodos Foi realizado um estudo descritivo transversal com 95 profissionais de saúde (amostra estratificada proporcional). Utilizou-se um questionário constando características sócio-demográficas e de trabalho, assim como o Questionário de Saúde Geral de Goldberg (QSG). Resultados Os empregados são do sexo feminino, casados, de idade acima de 45 anos. Contam com uma carga horária de trabalho de 40 horas semanais, além de apresentar múltiplos vínculos de trabalho. A saúde psíquica global dos sujeitos encontrase em um nível bom, no entanto, também há indivíduos em número significativo de processo de agravamento, quanto ao stress (37,9 %) e distúrbios psicossomáticos (34,7 %) isoladamente. Conclusões Há um indicativo de alerta quanto à necessidade de ações preventivas, de modo a evitar maiores agravamentos com possíveis danos às condições de saúde psíquica destes trabalhadores.

Although the interaction between alcohol and the liver has been the subject of intensive investigation since many years, several uncertainties remain to be solved. Good examples of what we need to learn are: The real number of patients with alcohol-induced liver disease (AILD), the dose of alcohol "safe" for the liver, the genetic predisposition to the damage or, on the other side of the coin, protecting from the damage. Rather recently, however, part of these questions started to be clarified, thus permitting a better definition of the role of each of these factors in AILD. In parallel to the clinical approach to AILD, the unveiling of the molecular and biochemical mechanisms involved in AILD has progressed and proved to be important in both a better understanding of the disease and, more important, in a more rational treatment of these disorders. This review will focus on what we currently know of AILD in clinical, biochemical and molecular terms and what we need to address in the future (Rev Med Chile 2002; 130: 681-690).

Aunque la interacción entre el alcohol y el hígado ha sido un tema de intensa investigación desde hace muchos años, varias incertidumbres requieren todavía ser resueltas. Buenos ejemplos de lo que necesitamos aprender son: el número real de pacientes con enfermedad hepática alcohólica (EHA), la dosis "segura" de alcohol (que no dañaría el hígado), la predisposición genética para el daño hepático o, en la otra cara de la moneda, que protege de este daño. Sin embargo, recientemente comenzaron a aclararse algunas de estas preguntas, permitiendo una mejor definición del rol de cada uno de estos factores en la patogenia de la EHA. Paralelamente con el enfoque clínico de la EHA, la pesquisa de los mecanismos moleculares y bioquímicos involucrados en la EHA ha progresado, demostrando su importancia tanto para una mejor comprensión de la enfermedad como para diseñar su tratamiento más racional. Esta revisión actualiza los conocimientos clínicos, bioquímicos y moleculares sobre la EHA y bosqueja lo que debemos seguir investigando