ABSTRACT The article analyzes, by using data from the Pesquisa de Orçamentos Familiares (Household Budget Survey - POF) 2017-2018, the impact of the tax policy on income concentration in ten Brazilian states. This work aims to contribute to the debate on taxation and inequality from the hypothesis that inequality indicators may be explained by the regressivity of the tax system. To gauge regressivity and its impact on income distribution, measured by the Lerman-Yitzhaki and Gini indices, the methodology employed by Silveira and Pintos-Payeras is used. The results indicated both regressivity and the increase of inequality in all states. Given the Brazilian economic stagnation and the imminent global economic recession, structural aspects of income concentration in Brazil may accentuate poverty and inequality rates. It is understood that the tax system is an integral part of such persistent structural aspects and this is the reason why this work proposes a tax reform of a progressive nature.

RESUMO O artigo analisa, utilizando dados da Pesquisa de Orçamentos Familiares (POF) 2017-2018, a influência da política tributária na concentração de renda em dez estados brasileiros. Busca-se contribuir para o debate acerca da tributação e desigualdade partindo da hipótese de que os indicadores de desigualdade podem ser explicados pela regressividade do sistema tributário. Para a aferição da regressividade e do seu impacto na distribuição da renda, medidas pelos índices de Lerman-Yitzhaki e Gini, utiliza-se a metodologia empregada por Silveira e Pintos-Payeras. Os resultados indicam tanto a regressividade como o aumento da desigualdade em todos os estados. Diante da estagnação econômica brasileira e da iminente recessão da economia global, os aspectos estruturais de concentração de renda no Brasil podem acentuar as taxas de pobreza e desigualdade. Entende-se que o sistema tributário é parte integrante desses aspectos estruturais persistentes, razão pela qual propõe-se uma reforma tributária de caráter progressivo.

BACKGROUND A positive Trypanosoma cruzi polymerase chain reaction (PCR) is associated with a worse prognosis in patients with chronic Chagas disease (CD). OBJECTIVES To study the association of clinical, electrocardiographic, and echocardiographic characteristics and biomarker blood levels with positive T. cruzi PCR in chronic CD. METHODS This is a single-centre observational cross-sectional study. Positive T. cruzi PCR association with clinical, electrocardiographic, and echocardiographic characteristics, and biomarker blood levels were studied by logistic regression analysis. p values < 0.05 were considered significant. FINDINGS Among 333 patients with chronic CD (56.4% men; 62 ± 10 years), T. cruzi PCR was positive in 41.1%. Stepwise multivariate logistic regression showed an independent association between positive T. cruzi PCR and diabetes mellitus {odds ratio (OR) 0.53 [95% confidence interval (CI) 0.30-0.93]; p = 0.03}, right bundle branch block [OR 1.78 (95% CI 1.09-2.89); p = 0.02], and history of trypanocidal treatment [OR 0.13 (95% CI 0.04-0.38); p = 0.0002]. Among patients with a history of trypanocidal treatment (n = 39), only four (10%) patients had a positive T. cruzi PCR. MAIN CONCLUSIONS Among several studied parameters, only diabetes mellitus, right bundle branch block, and history of trypanocidal treatment showed an independent association with positive T. cruzi PCR. History of trypanocidal treatment was a strong protective factor against a positive T. cruzi PCR.

BACKGROUND The parasite Giardia duodenalis infects a wide range of vertebrate hosts, including domestic and wild animals as well as humans. Giardia is genotyped into eight assemblages (A-H). Zoonotic assemblages A and B have already been identified in humans and wild and domestic animals (non-human primates and cats) from Brazilian Amazon and in the world. Due to its zoonotic/zooanthroponotic nature, surveillance initiatives and the definition of Giardia assemblages are important in order to characterise the epidemiological scenario and to implement further control measures. OBJECTIVES Determine assemblages of G. duodenalis in sloths from the Brazilian Amazon Region. METHODS Faecal parasitological examination of sloths from Amazonas State. Polymerase chain reaction (PCR) targeting the beta giardin (BG), and genes from multilocus sequence typing (MLST) scheme, amplicon sequencing and phylogenetic analysis. FINDINGS Here, we identified, by microscopy, Giardia in two northern sloths (Bradypus tridactylus). These two samples were submitted to molecular assays and it was revealed that both were infected by G. duodenalis assemblage A. Phylogenetic analysis showed that they belong to assemblage A within sequences from humans and wild and domestic animals. CONCLUSION Therefore, besides showing, by the first time, the current presence of this parasite in sloths, our findings reveals that this wild animal species would be part of the zoonotic/zooanthroponotic scenario of this parasite in the Brazilian Amazon.

Resumo Partindo-se do pressuposto de que a criatividade é um recurso chave em uma economia baseada no conhecimento, o presente trabalho visa a identificação de áreas com sinais potenciais de aglomerações produtivas relacionadas ao setor criativo no Brasil e sua provável contribuição para o desenvolvimento local. Utilizou-se o método de análise multivariada de agrupamentos para a estimação de grupos de municípios aproximadamente homogêneos em termos de dinamismo e criatividade, empregando-se os microdados dos Censos de 2000 e 2010, do IBGE. Foram encontrados três grupamentos principais classificados, respectivamente, como grande polo criativo nacional, polo criativo nacional e polo criativo regional, demonstrando um potencial para formação de aglomerados produtivos do setor. As cidades que formaram tais grupamentos se destacam devido à sua infraestrutura urbana, robustez institucional, governança, presença de mão de obra especializada, posição na hierarquia urbana e proximidade ao eixo mais dinâmico do país.

Abstract Based on the assumption that creativity is a key resource in a knowledge-based economy, the current work aimed to identify areas with potential signs of clusters related to the creative sector in Brazil and their likely contribution to local development. The multivariate clustering analysis was utilized to estimate clusters of almost homogeneous municipalities in terms of dynamism and creativity, employing microdata from IBGE's Demographic Census for the years 2000 and 2010. We found three main clusters classified, respectively, as a large national hub, national creative hub and regional creative hub, demonstrating the potential for the formation of productive clusters in the sector. The cities that formed such groups stand out because of their urban infrastructure; institutional robustness; governance; presence of skilled labor; position in the urban hierarchy and proximity to the country’s most dynamic region.

BACKGROUND During routine Coronavirus disease 2019 (COVID-19) diagnosis, an unusually high viral load was detected by reverse transcription real-time polymerase chain reaction (RT-qPCR) in a nasopharyngeal swab sample collected from a patient with respiratory and neurological symptoms who rapidly succumbed to the disease. Therefore we sought to characterise the infection. OBJECTIVES We aimed to determine and characterise the etiological agent responsible for the poor outcome. METHODS Classical virological methods, such as plaque assay and plaque reduction neutralisation test combined with amplicon-based sequencing, as well as a viral metagenomic approach, were performed to characterise the etiological agents of the infection. FINDINGS Plaque assay revealed two distinct plaque phenotypes, suggesting either the presence of two severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strains or a productive coinfection of two different species of virus. Amplicon-based sequencing did not support the presence of any SARS-CoV-2 genetic variants that would explain the high viral load and suggested the presence of a single SARS-CoV-2 strain. Nonetheless, the viral metagenomic analysis revealed that Coronaviridae and Herpesviridae were the predominant virus families within the sample. This finding was confirmed by a plaque reduction neutralisation test and PCR. MAIN CONCLUSIONS We characterised a productive coinfection of SARS-CoV-2 and Herpes simplex virus 1 (HSV-1) in a patient with severe symptoms that succumbed to the disease. Although we cannot establish the causal relationship between the coinfection and the severity of the clinical case, this work serves as a warning for future studies focused on the interplay between SARS-CoV-2 and HSV-1 coinfection and COVID-19 severity.

BACKGROUND Giardia duodenalis is a protozoan parasite that infects humans and other mammals and causes giardiasis worldwide. Giardia is genotyped into eight assemblages (A-H), with assemblages A and B considered zoonotic. OBJECTIVES The aim of this study was to determine the assemblages of G. duodenalis from individuals living in rural and urban areas of the Amazonas State. METHODS 103 human faecal specimens microscopically positive for the presence of Giardia obtained from four municipalities in Amazonas and four animal faecal specimens were genotyped based on the sequences of two genes, triosephosphate isomerase (TPI) and β-giardin (BG). FINDINGS In humans, assemblage A was the most represented with the identification of sub-assemblages AI, AII and AIII based on BG and sub-assemblages AI and AII based on TPI. Similarly, there is a diversity of sub-assemblage B considering BG (B and BIII) and TPI (B, BIII and BIV). In addition, we characterised homogeneous and heterogeneous genotypes comprising assemblages/sub-assemblages A and B in individuals from urban and rural areas. Here, for the first time, it was genotyped Giardia that infects animals from the Brazilian Amazon region. We identified sub-assemblage AI in one Ateles paniscus and two Felis catus and sub-assemblage BIV in one Lagothrix cana. MAIN CONCLUSIONS Therefore, humans and animals from the urban and rural Amazon share Giardia genotypes belonging to assemblages A and B, which are found in cosmopolitan regions around the world.

In the present study, we investigated the genetic diversity of Plasmodium vivax metacaspase 1 (PvMCA1) catalytic domain in two municipalities of the main malaria hotspot in Brazil, i.e., the Juruá Valley, and observed complete sequence identity among all P. vivax field isolates and the Sal-1 reference strain. Analysis of PvMCA1 catalytic domain in different P. vivax genomic sequences publicly available also revealed a high degree of conservation worldwide, with very few amino acid substitutions that were not related to putative histidine and cysteine catalytic residues, whose involvement with the active site of protease was herein predicted by molecular modeling. The genetic conservation presented by PvMCA1 may contribute to its eligibility as a druggable target candidate in vivax malaria.

ABSTRACT Objective The consequences of sleep deprivation in type 1 diabetes (T1D) patients are poorly understood. Our aim was to determine how sleep disorders influence lipid profile and insulin sensitivity in T1D patients. Materials and methods This was a cross-sectional study at a public university hospital. Demographic information and medical histories were obtained during regular scheduled visit of T1D patients to the outpatient clinic. Insulin sensitivity was obtained using the estimated glucose disposal rate (eGDR) formula. Sleep quality was assessed using the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Berlin Questionnaire. Results The adult participants (n = 66, 62% women) had a median age of 28.0 years (interquartile range 21.8-33.0). Six patients (9%) had metabolic syndrome according to the International Diabetes Federation criteria. Thirty patients (46%) were considered poor sleepers according to the Pittsburgh Sleep Quality Index. The LDL-c and total cholesterol levels of poor sleepers were higher than those of good sleepers (103 v. 81; p = 0.003 and 178.0 v. 159.5 mg/dL; p = 0.009, respectively). Three patients (4%) were at high risk of obstructive sleep apnea syndrome (OSAS) according to the Berlin Questionnaire. The eGDR was lower in the group of patients with high probability of having OSAS (6.0 v. 9.1 mg.kg-1.min-1;p = .03). Conclusions Poor subjective quality of sleep and higher risk of OSAS were correlated with a worsened lipid profile and decreased insulin sensitivity, respectively. Therefore, T1D patients with sleep disturbances might have an increased cardiovascular risk in the future.

Resumo Objetivo Nós realizamos uma revisão sistemática para avaliar a efetividade e a segurança do Tribulus terrestris no tratamento da disfunção sexual feminina (DSF). Fontes de dados Nós realizados uma busca eletrônica irrestrita nas seguintes bases de dados: MEDLINE, CENTRAL, EMBASE, LILACS, CINAHL, PsycINFO, WHO-ICTR, Clinicaltrials.gov, e OpenGrey. Seleção dos estudos Nós incluímos todos os ensaios clínico randomizados (ECR) que comparou T. terrestris com controles ativos/inativos. Após o processo de seleção, conduzido por 2 revisores, 5 ECRs (n = 279 participantes) foram incluídos. Extração de dados O processo de extração de dados foi realizado por dois revisores, utilizando-se um formulário de extração de dados pré-estabelecido. Síntese de dados Devido à falta de dados disponíveis e à heterogeneidade clínica entre os estudos incluídos, nós não realizamos meta-análises. O risco de viés foi avaliado pela tabela de risco de viés da Cochrane e, a certeza do corpo da evidência foi avaliada pelo Grading of Recommendations, Assessment, Development and Evaluations (GRADE). Resultados Após 1 a três 3 meses de tratamento, mulheres na pré e pós-menopausa randomizadas ao T. terrestris tiveram um aumento significante nos escores de função sexual. O grupo com 3 meses de tratamento com T. terrestris exibiu um aumento significante dos níveis séricos de testosterona emmulheres pré-menopausa. Não houve relato de eventos adversos graves, e nenhum estudo avaliou qualidade de vida das participantes. A certeza da evidência foi considerada muito baixa, o que significa que existe pouca certeza na estimativa dos efeitos e que é provável que futuros estudos mudem estas estimativas. Conclusão Mais ECRs são importantes para apoiar ou refutar o uso do T. terrestris. A decisão de usar essa intervenção deve ser compartilhada com pacientes, e as incertezas sobre seus efeitos devem ser discutidas durante o processo de decisão clínica.

Abstract Objective We performed a systematic review to assess the effectiveness and safety of Tribulus terrestris to treat female sexual dysfunction (FSD). Data sources We performed unrestricted electronic searches in the MEDLINE, CENTRAL, EMBASE, LILACS, CINAHL, PsycINFO,WHO-ICTR, Clinicaltrials.gov and OpenGrey databases. Selection of studies We included any randomized controlled trials (RCTs) that compared T. terrestris versus inactive/active interventions. After the selection process, conducted by two reviewers, 5 RCTs (n = 279 participants) were included. Data collection Data extraction was performed by two reviewers with a preestablished data collection formulary. Data synthesis Due to lack of data and clinical heterogeneity, we could not perform meta-analyses. The risk of bias was assessed by the Cochrane Risk of Bias (RoB) tool, and the certainty of evidence was assessed with Grading of Recommendations, Assessment, Development and Evaluations (GRADE). Results After 1 to 3 months of treatment, premenopausal and postmenopausal women randomized to T. terrestris had a significant increase in sexual function scores. Three months of treatment with T. terrestris showed a significant increase in the serum testosterone levels of premenopausal women. There was no report of serious adverse events, and none of the studies assessed health-related quality of life. The certainty of the evidence was very low, whichmeans that we have very little confidence in the effect estimates, and future studies are likely to change these estimates. Conclusion MoreRCTs are needed to supportor refute the use of T. terrestris. The decision to use this intervention should be shared with the patients, and the uncertainties around its effects should be discussed in the clinical decision-making process. Number of Protocol registration in PROSPERO database: CRD42019121130

A total of 124 Neisseria gonorrhoeae isolates recovered during a 12-year period (2003-2015) from outpatients assisted at Centro de Referência e Treinamento DST/AIDS-CRT of São Paulo city, Brazil, were analysed. The following resistance rates were observed: penicillin-59.6%, ciprofloxacin-15.3%, and azithromycin-6.7%. Although reduced susceptibility to these drugs was observed since 2003, no ceftriaxone-resistant isolates were detected. Ciprofloxacin- and azithromycin non-susceptible isolates were grouped in 11 clusters. Mutations were detected in GyrA and ParC of isolates 124 and 260, and a C2611T substitution on 23S rRNA alleles was also observed in isolate 260. Both isolates belonged to ST1901/ST6210 (MSLT/NG-MAST schemes).

RESUMO: O objetivo da presente pesquisa foi avaliar as diferenças nas propriedades químicas e na estrutura física do iogurte produzido com leite de diferentes espécies (ovinos, bovinos e caprinos). Para cada experimento, leite de ovelha cru (S), vaca (C) e cabra (G), foram usados para fabricar 4L de iogurtes (Y) de cada espécie (SY, CY e GY, respectivamente). O SY demonstrou os maiores (P<0,05) valores de sólidos totais, proteína e conteúdo lipídico, refletindo em maior (P<0,05) firmeza, viscosidade aparente e capacidade de retenção de água e menor (P<0,05) índice de sinérese do que CY e GY. Consequentemente, o SY exibiu uma microestrutura mais compacta e uma matriz homogênea com menos poros. Além disso, a microestrutura CY e GY continha um maior número de poros, que exibiam maior heterogeneidade de tamanho do que o SY. Portanto, com base nas propriedades físico-químicas e micro estruturais avaliadas do iogurte, o SY demonstrou os valores de parâmetros mais desejáveis para a indústria de laticínios, representando uma alternativa de produto adequada aos iogurtes à base de leite de vaca.

ABSTRACT: The aim of the present research was to evaluate differences in chemical properties and physical structure of yoghurt produced with milk from different species (sheep, cow, and goat). For each trial, whole raw sheep (S), cow (C), and goat (G) milk were used to manufacture 4L of yoghurts (Y) from each species (SY, CY, and GY, respectively). The SY demonstrated the greatest (P<0.05) values of total solids, protein, and lipid contents, reflecting on greater (P<0.05) firmness, apparent viscosity and water-holding capacity, and lower (P<0.05) syneresis index than CY and GY. Consequently, SY exhibited a more compact microstructure and homogeneous matrix with fewer pores. Furthermore, CY and GY microstructure contained a greater number of pores, which exhibited greater size heterogeneity than SY. Therefore, based on the evaluated physicochemical and microstructural properties of yoghurt, SY demonstrated the most desirable parameter values for dairy industry representing an alternative substitution for cow’s milk yogurt.

RESUMO: O objetivo desse estudo foi investigar a influência do tipo muscular na oxidação proteica, perfil de textura (dureza, elasticidade, coesividade e mastigabilidade) e composição centesimal da carne de bovinos Bos indicus (Nelore) terminados com grãos no Brasil. Os músculos longissimus lumborum (LL) e psoas major (PM) foram obtidos 24 horas post mortem de oito (n=8) carcaças de touros Nelore, cortados em cinco bifes (1,5 cm), e dispostos em condições aeróbicas por nove dias a 4 °C. Composição centesimal e perfil de textura foram analisados no dia 0, enquanto que a oxidação proteica foi analisada durante 9 dias de estocagem. Os bifes LL demonstraram maior (P<0.05) concentração de proteína em relação aos bifes PM, enquanto que PM apresentou maior (P<0.05) conteúdo de lipídeos e cinzas que LL. Além disso, os bifes LL exibiram maior (P<0,05) dureza, elasticidade, coesividade e mastigabilidade em relação aos bifes PM. Em contraste, a oxidação proteica foi maior (P<0,05) nos bifes PM do que nos bifes LL em todos os dias de estocagem. Os resultados sugerem que as diferenças no metabolismo e na composição muscular contribuíram para a variação nos atributos bioquímicos e perfil de textura entre os bifes LL e PM. Estratégias músculo-específicas são indicadas a fim de promover a estabilidade de cor nos bifes PM oriundos de bovinos Bos indicus terminados com grãos.

ABSTRACT: The aim of this research was to investigate the influence of muscle type on protein oxidation, texture profile (hardness, springiness, cohesiveness and chewiness) and proximate composition of beef from grain-finished Bos indicus (Nellore) cattle in Brazil. The muscles longissimus lumborum (LL) and psoas major (PM) were collected 24 h post mortem from eight (n=8) Nellore bull carcasses, fabricated into five steaks (1.5-cm) and displayed under aerobic conditions for nine days at 4 °C. Proximate composition and texture profile were analyzed on day 0, whereas protein oxidation was analyzed during 9 days of storage. LL exhibited greater (P<0.05) protein concentration than PM steaks, whereas PM demonstrated greater (P<0.05) lipid and ash content than their correlative LL. In addition, LL steaks exhibited greater (P<0.05) hardness, springiness, cohesiveness and chewiness than PM steaks. In contrast, protein oxidation was greater (P<0.05) in PM than in LL steaks throughout the storage. The results suggest that the differences of muscle metabolism and composition contributed to the variation on biochemical attributes and texture profile of LL and PM steaks. Muscle-specific strategies are indicated to improve the color stability of PM steaks from grain-finished Bos indicus cattle.

The dengue virus (DENV), of the genus Flavivirus (Flaviviridae), has four antigenically distinct serotypes, of which DENV-3 is classified into five genotypes. Here, we describe the detection of DENV-3 genotype I in sera of a Brazilian patient travelling from Singapore to Rio de Janeiro, Brazil, by using multiplex real-time RT-PCR, DNA sequencing of the whole envelope protein gene, and phylogenetic analysis. The virus shares ancestry with those identified in Bali, Indonesia, in 2015. It is possible that arboviruses such as Chikungunya ECSA genotype, DENV-4 genotype I, and Zika were introduced in Brazil from other continents during the multiple international events hosted by the country over the last four years, including World Youth Day, the Soccer World Cup, and the Summer Olympics.

Chikungunya virus (CHIKV) is a mosquito-borne pathogen that emerged in Brazil by late 2014. In the country, two CHIKV foci characterized by the East/Central/South Africa and Asian genotypes, were established in North and Northeast regions. We characterized, by phylogenetic analyses of full and partial genomes, CHIKV from Rio de Janeiro state (2014-2015). These CHIKV strains belong to the Asian genotype, which is the determinant of the current Northern Brazilian focus, even though the genome sequence presents particular single nucleotide variations. This study provides the first genetic characterisation of CHIKV in Rio de Janeiro and highlights the potential impact of human mobility in the spread of an arthropod-borne virus.

Parvovirus B19 (B19V) infects individuals worldwide and is associated with an ample range of pathologies and clinical manifestations. B19V is classified into three distinct genotypes, all identified in Brazil. Here, we report a complete sequence of a B19V genotype 1A that was obtained by high-throughput metagenomic sequencing. This genome provides information that will contribute to the studies on B19V epidemiology and evolution.