ABSTRACT Zinnia sp. and hairy beggartick (Bidens pilosa) plants exhibiting symptoms of possible virus infection were found in the municipality of Santa Bárbara d’Oeste, São Paulo State, Brazil. Flexuous filamentous particles and cytoplasmatic inclusions typical of potyvirus infection were observed by transmission electron microscopy, respectively, in leaf extracts and cells of symptomatic leaves. Infection of both plants with bidens mottle virus (BiMoV) was confirmed by RT-PCR using potyvirus universal primers, followed by nucleotide sequencing of the amplicons. The nearly complete genome sequence of the Brazilian isolate, named BiMoV-BR, is 9700 nucleotides long and shares 95.6 % identity with the corresponding nucleotide sequence of a BiMoV isolate from the United States. BiMoV-BR was mechanically transmitted and caused systemic infection on plants of Zinnia sp., hairy beggarstick, sunflower (Helianthus annuus), and lettuce (Lactuca sativa). Myzus persicae transmitted the virus to Zinnia sp. plants with efficacy of 8 % and 42 %, using one and ten aphids per plant, respectively. This is the first detection of BiMoV in Brazil. Further studies are necessary to evaluate the distribution of this potyvirus in the country.

Abstract The study investigates the extent to which the sources of school performance inequalities and educational expectations by race / color are the result of socioeconomic disadvantages, the heterogeneity of parenting styles or whether they result from unobservable residual factors. The analyzes use data from the Fundaj (2013) research that provides information on race, future educational aspirations, and a longitudinal evaluation of the student’s school performance. The identification strategy uses the method of propensity score matching (PSM). The results show that the educational disparities between students of the 6th grade of Recife, who declare themselves to be black or of another ethnic group, persist in terms of failure and expectation of entering higher education, even after conditioning in a broad control of observables, suggesting that the source of these disparities stem from factors not observable in the analysis. Despite the fact that families of black students are more actively involved in the school monitoring of their children than families of non-black students, this greater involvement has not been enough to neutralize educational inequalities by race/color. Black students have higher failure rates than their non-black peers and lower expectations of access to higher education by about 5 percentage points, statistically significant differences at 5%.

Resumo Esse artigo investiga em que medida as fontes de desigualdades do desempenho escolar e de expectativas educacionais por raça/cor são resultantes de desvantagens socioeconômicas, da heterogeneidade de estilos parentais ou se advêm de fatores residuais não observáveis. As análises utilizam dados da pesquisa Fundaj que disponibiliza informações relativas à raça/cor, aspirações educacionais futuras e uma avaliação longitudinal do desempenho escolar. A estratégia de identificação utiliza o método de Propensity Score Matching. Os resultados mostram que as disparidades educacionais entre estudantes do 6º ano do ensino fundamental da rede pública do Recife, que se declaram pretos ou de outra raça/cor, persistem em termos de reprovação e expectativa de ingresso ao ensino superior, mesmo após o condicionamento em um amplo controle de observáveis, sugerindo que a fonte dessas disparidades decorre de fatores não observáveis na análise. Apesar das famílias de estudantes pretos se engajarem mais ativamente no acompanhamento escolar de seus filhos do que familiares de estudantes não-pretos, esse maior envolvimento não tem sido suficiente para neutralizar as desigualdades educacionais por raça/cor. Alunos pretos possuem taxas de reprovação maiores do que seus colegas não-pretos e menores expectativas de acesso ao ensino superior em cerca de 5 pontos percentuais, diferenças estatisticamente significantes a 5%.

ABSTRACT Objective: To determine the prevalence and factors associated with the physical rehabilitation of critically ill children in Brazilian pediatric intensive care units. Methods: A 2-day, cross-sectional, multicenter point prevalence study comprising 27 pediatric intensive care units (out of 738) was conducted in Brazil in April and June 2019. This Brazilian study was part of a large multinational study called Prevalence of Acute Rehabilitation for Kids in the PICU (PARK-PICU). The primary outcome was the prevalence of mobility provided by physical therapy or occupational therapy. Clinical data on patient mobility, potential mobility safety events, and mobilization barriers were prospectively collected in patients admitted for ≥ 72 hours. Results: Children under the age of 3 years comprised 68% of the patient population. The prevalence of therapist-provided mobility was 74%, or 277 out of the 375 patient-days. Out-of-bed mobility was most positively associated with family presence (adjusted odds ratios 3.31;95%CI 1.70 - 6.43) and most negatively associated with arterial lines (adjusted odds ratios 0.16; 95%CI 0.05 - 0.57). Barriers to mobilization were reported on 27% of patient-days, the most common being lack of physician order (n = 18). Potential safety events occurred in 3% of all mobilization events. Conclusion: Therapist-provided mobility in Brazilian pediatric intensive care units is frequent. Family presence was high and positively associated with out-of-bed mobility. The presence of physiotherapists 24 hours a day in Brazilian pediatric intensive care units may have a substantial impact on the mobilization of critically ill children.

RESUMO Objetivo: Determinar a prevalência e os fatores associados à reabilitação física de crianças em estado grave em unidades de terapia intensiva pediátrica brasileiras. Métodos: Realizou-se um estudo de prevalência pontual multicêntrico, transversal, de 2 dias, abrangendo 27 unidades de terapia intensiva pediátrica (do total de 738) no Brasil em abril e junho de 2019. Este estudo brasileiro fez parte de um grande estudo multinacional chamado Prevalence of Acute Rehabilitation for Kids in the PICU (PARK-PICU). O desfecho primário foi a prevalência de mobilidade proporcionada pela fisioterapia ou pela terapia ocupacional. Foram coletados prospectivamente dados clínicos sobre a mobilidade do paciente, possíveis eventos de segurança de mobilidade e barreiras de mobilização em pacientes admitidos por ≥ 72 horas. Resultados: As crianças com idade inferior a 3 anos eram 68% da população de pacientes. A prevalência de mobilidade fornecida pelo terapeuta foi de 74%, ou 277 dos 375 pacientes-dia. A mobilidade para fora do leito foi mais positivamente associada à presença de familiares (razão de chance ajustada de 3,31; IC95% 1,70 - 6,43) e mais negativamente associada às linhas arteriais (razão de chance ajustada de 0,16; IC95% 0,05 - 0,57). Foram relatadas barreiras à mobilização em 27% dos pacientes-dia, sendo a mais comum a falta de prescrição médica (n = 18). Registaram-se eventuais eventos de segurança em 3% de todos os eventos de mobilização. Conclusão: A mobilidade proporcionada pelo terapeuta nas unidades de terapia intensiva pediátrica brasileiras é frequente. A presença de familiares foi alta e positivamente associada à mobilidade para fora do leito. A presença de fisioterapeutas 24 horas por dia nas unidades de terapia intensiva pediátrica brasileiras pode exercer papel importante na mobilização de crianças em estado grave.

Abstract Background It is estimated that headache attributed to ischemic stroke occurs in 7.4% to 34% of the cases. Despite its frequency, this headache has been little studied in terms of its risk factors and characteristics. Objective To assess the frequency and clinical characteristics of headache attributed to ischemic stroke and the factors associated with its occurrence. Methods The present was a cross-sectional study which included patients consecutively admitted within 72 hours of the onset of ischemic stroke. A semi-structured questionnaire was used. The patients underwent magnetic resonance imaging. Results A total of 221 patients were included, 68.2% of whom were male, and the mean age was of 68.2 ± 13.8 years. The frequency of headache attributed to ischemic stroke was of 24.9% (95% confidence interval [95%CI]: 19.6-31.1%). The headache had a median duration of 21 hours and most frequently began at the same time as the focal deficit (45.3%), with a gradual onset (83%). It was of moderate intensity, pulsatile (45.3%), bilateral (54.6%), and presented a similar pattern to that of tension-type headache (53.6%). Headache attributed to stroke was significantly associated with previous tension-type headache, and previous migraine with and without aura (logistic regression). Conclusion Headache attributed to stroke is common, with a pattern similar to that of tension-type headache, and it is associated with a history of tension-type and migraine headaches.

Resumo Antecedentes A cefaleia atribuída ao acidente vascular cerebral isquêmico (AVCi) tem uma frequência de 7,4% a 34% dos casos. Apesar de ser considerada frequente, esta cefaleia ainda é pouco estudada em termos de seus fatores de risco e características. Objetivo Avaliar a frequência e as características clínicas da cefaleia atribuída ao AVCi e os fatores associados com a sua ocorrência. Métodos Este foi um estudo transversal que incluiu pacientes admitidos consecutivamente com até 72 horas do início do AVCi. Foi utilizado um questionário semiestruturado. Os pacientes realizaram ressonância magnética. Resultados Foram incluídos 221 pacientes, 68,2% dos quais eram do sexo masculino, e com idade média de 68,2 ± 13,8 anos. A frequência da cefaleia atribuída ao AVCi foi de 24,9% (intervalo de confiança de 95% [IC95%]: 19,6-31,1%). A duração mediana da cefaleia foi de 21 horas, e ela se iniciou com mais frequência ao mesmo tempo em que o déficit focal (45,3%), teve instalação gradual (83%), foi de moderada intensidade, pulsátil (45,3%), bilateral (54,6%) e teve um padrão semelhante ao da cefaleia de tipo tensional (53,6%). A cefaleia atribuída ao AVCi esteve significativamente associada à cefaleia de tipo tensional prévia, e à migrânea com e sem aura prévias (regressão logística). Conclusão A cefaleia atribuída ao AVCi é frequente, tem padrão mais habitual semelhante ao da cefaleia de tipo tensional, e está associada aos antecedentes de cefaleia de tipo tensional e migrânea.

ABSTRACT Objective: To assess Brazilian pediatric intensivists’ general knowledge of extracorporeal membrane oxygenation, including evidence for its use, the national funding model, indications, and complications. Methods: This was a multicenter cross-sectional survey including 45 Brazilian pediatric intensive care units. A convenience sample of 654 intensivists was surveyed regarding their knowledge on managing patients on extracorporeal membrane oxygenation, its indications, complications, funding, and literature evidence. Results: The survey addressed questions regarding the knowledge and experience of pediatric intensivists with extracorporeal membrane oxygenation, including two clinical cases and 6 optional questions about the management of patients on extracorporeal membrane oxygenation. Of the 45 invited centers, 42 (91%) participated in the study, and 412 of 654 (63%) pediatric intensivists responded to the survey. Most pediatric intensive care units were from the Southeast region of Brazil (59.5%), and private/for-profit hospitals represented 28.6% of the participating centers. The average age of respondents was 41.4 (standard deviation 9.1) years, and the majority (77%) were women. Only 12.4% of respondents had taken an extracorporeal membrane oxygenation course. Only 19% of surveyed hospitals have an extracorporeal membrane oxygenation program, and only 27% of intensivists reported having already managed patients on extracorporeal membrane oxygenation. Specific extracorporeal membrane oxygenation management questions were responded to by only 64 physicians (15.5%), who had a fair/good correct response rate (median 63.4%; range 32.8% to 91.9%). Conclusion: Most Brazilian pediatric intensivists demonstrated limited knowledge regarding extracorporeal membrane oxygenation, including its indications and complications. Extracorporeal membrane oxygenation is not yet widely available in Brazil, with few intensivists prepared to manage patients on extracorporeal membrane oxygenation and even fewer intensivists recognizing when to refer patients to extracorporeal membrane oxygenation centers.

RESUMO Objetivo: Avaliar os conhecimentos gerais dos intensivistas pediátricos brasileiros sobre oxigenação por membrana extracorpórea, incluindo evidências de uso, modelo de custeio nacional, indicações e complicações. Métodos: Este estudo foi um inquérito transversal multicêntrico que incluiu 45 unidades de terapia intensiva pediátrica brasileiras. Realizou-se inquérito de conveniência com 654 intensivistas quanto aos seus conhecimentos sobre manejo de pacientes em oxigenação por membrana extracorpórea, suas indicações, complicações, custeio e evidências bibliográficas. Resultados: O inquérito abordou questões relativas aos conhecimentos e à experiência dos intensivistas pediátricos sobre oxigenação por membrana extracorpórea, incluindo dois casos clínicos e seis questões facultativas sobre o manejo de pacientes em oxigenação por membrana extracorpórea. Dos 45 centros convidados, 42 (91%) participaram do estudo, e 412 (63%) dos 654 intensivistas pediátricos responderam ao inquérito. A maioria das unidades de terapia intensiva pediátrica eram da Região Sudeste do Brasil (59,5%), e os hospitais privados com fins lucrativos representavam 28,6% dos centros participantes. A média de idade dos respondentes era de 41,4 (desvio-padrão de 9,1) anos, e a maioria (77%) era mulher. Apenas 12,4% dos respondentes tinham formação em oxigenação por membrana extracorpórea. Dos hospitais pesquisados, apenas 19% tinham um programa de oxigenação por membrana extracorpórea, e apenas 27% dos intensivistas declararam já ter manejado pacientes em oxigenação por membrana extracorpórea. Apenas 64 médicos (15,5%) responderam a questões específicas sobre o manejo de oxigenação por membrana extracorpórea (mediana 63,4%; oscilando entre 32,8% e 91,9%). Conclusão: A maioria dos intensivistas pediátricos brasileiros demonstrou conhecimentos limitados de oxigenação por membrana extracorpórea, incluindo suas indicações e complicações. A oxigenação por membrana extracorpórea ainda não está amplamente disponível no Brasil, com poucos intensivistas preparados para o manejo de pacientes em oxigenação por membrana extracorpórea e ainda menos intensivistas capazes de reconhecer quando devem encaminhar pacientes para centros de oxigenação por membrana extracorpórea.

Resumo O objetivo deste estudo foi analisar os fatores relacionados à saúde mental dos agentes comunitários de saúde (ACS) no contexto da COVID-19. Participaram 1.935 ACS de quatro capitais nordestinas e de quatro cidades do interior do Ceará. Foram coletados dados sociodemográficos e profissiográficos; SRQ-20; WHOQOL-Bref; exposição à violência; Escala de Autoeficácia Geral (EAEG); Escala Multidimensional de Suporte Social Percebido (MSPSS); informações relacionadas à COVID-19 e Escala de Ansiedade para Coronavírus (EAC). 40,5% exibiram SRQ > 7, sinalizando altos níveis de transtornos mentais comuns (TMC)/problemas de saúde mental. Utilizou-se a regressão linear múltiplas (backward). Observou-se que o aumento de risco de TCM foi influenciado pelos seguintes fatores: exposição à violência; EAC; não saber se teve COVID-19; desconhecer as variáveis que diminuíam o risco; os domínios físico e psicológico do WHOQOL-Bref; não ter aumento da jornada de trabalho; e não ter tido COVID-19. Os dados revelam a dinâmica multidimensional da saúde mental e ajudam a compreender a relação entre violência comunitária, COVID-19, qualidade de vida, idade e tempo de atuação na ESF com a saúde mental dos ACS.

Abstract This study aimed to analyze the factors related to the mental health of Community Health Workers (ACS) in the COVID-19 context. A total of 1,935 ACS from four Northeastern capitals and four cities in the inland region of Ceará participated. The following data were collected: sociodemographic; professional; SRQ-20; WHOQOL-Bref, exposure to violence, General Self-Efficacy Scale (EAEG), Multidimensional Scale of Perceived Social Support (MSPSS), COVID-19-related information, and the coronavirus anxiety scale (EAC). Approximately 40.5% had SRQ > 7, signaling high levels of Common Mental Disorders (CMD)/mental health issues. We adopted the Multiple linear (backward) regression. We observed that the increased risk of CMD was influenced by exposure to violence, EAC, not knowing they had COVID-19, not knowing the variables that reduced the risk, the physical and psychological domains of the WHOQOL-Bref, not having increased working hours, and not having had COVID-19. The data reveal the multidimensional dynamics of mental health and help understand the relationship between community violence, COVID-19, quality of life, age, and ESF working time with the mental health of ACS.

Abstract Pathophysiological characteristics of obesity includes chronic inflammation. Complications in the respiratory tract are related to bodily problems, which lead to a restriction of lung function due to reduced volume, inducing an increase in respiratory work. SARS-CoV-2 has a high potential for contamination by respiratory secretions and, therefore, obesity is one of the main risk factors for complications. The relations between obesity and SARS-CoV-2 are complex, since the immunological agents that are activated by these processes are ubiquitous. It is well-known that network analysis can generate results about the dynamics of complex biological phenomena, such as signalling networks, neural networks, immunological networks, and so on. Here we propose and analysis and interpretation of the complex relationships between obesity and COVID-19 in a meta-analysis study using complex network modelling and the theoretical knockouts technique. In a complex network of this kind, vertices are considered as immunological agents and their relation as directed edges. We built two networks: one related to COVID-19 and obesity (synergy) and another only with COVID-19. In both networks, we have performed the knockout of all 52 vertices. These knockouts indicated that, besides the Infected Host Cell and COVID viral particle, IL-17; CD40, AR and AL channels; and Th17, were the most relevant agents in this complex network. Overall, our study indicated the superior role and importance of IL-17 in this context. Such result corroborates with the role of IL-17 in identification and prognosis of Acute Respiratory Discomfort Syndrome (ARDS).

ABSTRACT Purpose To investigate verb fluency performance in individuals with Alzheimer’s disease compared with healthy older adults by analyzing total correct responses, number of clusters, average cluster size, and number of switches. Methods This is a case-control study of 39 healthy older adults and 29 older adults with a diagnosis of Alzheimer’s disease. Verb fluency performance was analyzed in terms of total number of correct verbs retrieved, number of clusters, average cluster size, and number of switches. To obtain the study outcomes, we previously conducted a procedure for categorization of the verbs that would compose the clusters. The classification of verbs was adapted for this study, including assessment by raters and analysis of inter-rater reliability. Results Individuals with Alzheimer’s disease showed significantly poorer performance than healthy controls in the number of switches and total number of correct verbs retrieved. The two groups did not differ significantly in the other measures. Conclusion In this study, individuals with Alzheimer’s disease showed impaired verb fluency, characterized by a reduced number of verbs retrieved and fewer transitions between verb categories. The findings suggest that, in Alzheimer’s disease, verb fluency is more sensitive to cognitive deficits resulting from executive dysfunction than from semantic disruption.

RESUMO Objetivo Investigar o desempenho na tarefa de fluência de verbos de pessoas com doença de Alzheimer em comparação à idosos saudáveis, a partir da análise do número total de palavras corretas evocadas, do número de clusters, do tamanho médio dos clusters e do número de switches. Método Este é um estudo de caso-controle no qual participaram 39 idosos saudáveis e 29 participantes com diagnóstico de doença de Alzheimer. O desempenho da fluência de verbos dos participantes foi analisado quanto ao total de verbos gerados corretamente, número de clusters, tamanho médio dos clusters e número de switches. Para a obtenção dos desfechos do estudo foi realizado um processo prévio de definição das categorias de verbos que constituiriam clusters. A classificação dos verbos foi adaptada para a este estudo, incluindo a análise de juízes com investigação do índice de concordância. Resultados Dentre as variáveis de interesse comparadas entre os grupos estudados, houve um desempenho estatisticamente inferior no grupo de pessoas com doença de Alzheimer quanto ao número de switches e total de verbos gerados corretamente. Nas demais medidas, os grupos foram semelhantes. Conclusão Neste estudo pessoas com doença de Alzheimer apresentaram déficit no desempenho da tarefa de fluência verbal de verbos, caracterizado por uma redução do número total de verbos gerados e uma menor variabilidade de categorias de verbos. Os achados sugerem que, na doença de Alzheimer, a fluência de verbos é mais sensível aos déficits cognitivos decorrentes de disfunção executiva do que aos déficits semânticos.

Abstract This study aimed to analyze the factors related to the mental health of Community Health Workers (ACS) in the COVID-19 context. A total of 1,935 ACS from four Northeastern capitals and four cities in the inland region of Ceará participated. The following data were collected: sociodemographic; professional; SRQ-20; WHOQOL-Bref, exposure to violence, General Self-Efficacy Scale (EAEG), Multidimensional Scale of Perceived Social Support (MSPSS), COVID-19-related information, and the coronavirus anxiety scale (EAC). Approximately 40.5% had SRQ > 7, signaling high levels of Common Mental Disorders (CMD)/mental health issues. We adopted the Multiple linear (backward) regression. We observed that the increased risk of CMD was influenced by exposure to violence, EAC, not knowing they had COVID-19, not knowing the variables that reduced the risk, the physical and psychological domains of the WHOQOL-Bref, not having increased working hours, and not having had COVID-19. The data reveal the multidimensional dynamics of mental health and help understand the relationship between community violence, COVID-19, quality of life, age, and ESF working time with the mental health of ACS.

Resumo O objetivo deste estudo foi analisar os fatores relacionados à saúde mental dos agentes comunitários de saúde (ACS) no contexto da COVID-19. Participaram 1.935 ACS de quatro capitais nordestinas e de quatro cidades do interior do Ceará. Foram coletados dados sociodemográficos e profissiográficos; SRQ-20; WHOQOL-Bref; exposição à violência; Escala de Autoeficácia Geral (EAEG); Escala Multidimensional de Suporte Social Percebido (MSPSS); informações relacionadas à COVID-19 e Escala de Ansiedade para Coronavírus (EAC). 40,5% exibiram SRQ > 7, sinalizando altos níveis de transtornos mentais comuns (TMC)/problemas de saúde mental. Utilizou-se a regressão linear múltiplas (backward). Observou-se que o aumento de risco de TCM foi influenciado pelos seguintes fatores: exposição à violência; EAC; não saber se teve COVID-19; desconhecer as variáveis que diminuíam o risco; os domínios físico e psicológico do WHOQOL-Bref; não ter aumento da jornada de trabalho; e não ter tido COVID-19. Os dados revelam a dinâmica multidimensional da saúde mental e ajudam a compreender a relação entre violência comunitária, COVID-19, qualidade de vida, idade e tempo de atuação na ESF com a saúde mental dos ACS.

Abstract In Brazil, there is low coverage of sewage collection and treatment, a condition that is even more critical in smaller cities. One reason for this is the lack of resources for investment in conventional reactors. The present study therefore compared the costs of different treatment alternatives based on the average values of construction and operation present in the literature, the values of the price per square meter for land acquisition, electricity tariffs, and final sludge disposal by considering different operating times of wastewater treatment plants (WWTPs). This allowed inferences about the costs associated with the choice of the configuration of a municipal WWTP. Based on the scenarios studied, it was observed that the conventional systems evaluated are, in general, more costly, especially after several years of operation. However, the choice of these treatment units may be more interesting in scenarios with high cost per square metre and lower electricity rates or where there is no area availability. For smaller cities and with lower real estate pressure, the natural systems evaluated are more indicated due to the low total costs (construction and operation) and adequate pollutant-removal efficiencies.

Resumo No Brasil, verifica-se baixa cobertura de coleta e tratamento de esgotos, condição que é ainda mais crítica em cidades de menor porte. Um dos motivos apontados é a falta de recursos para investimento em reatores convencionais. Assim, o presente trabalho objetivou comparar custos de diferentes alternativas de tratamento, tendo como base, valores médios de construção e operação, presentes na literatura, valores do preço do metro quadrado para aquisição de terra, de tarifas de energia elétrica e da disposição final do lodo, considerando diferentes tempos de funcionamento das Estações de Tratamentos de Esgotos (ETE), permitindo fazer inferências sobre os custos associados na escolha da configuração de uma ETE municipal. Com base nos cenários estudados, observou-se que os sistemas convencionais avaliados são, em geral, mais onerosos, sobretudo após vários anos de operação. A escolha dessas unidades de tratamento, no entanto, pode ser mais interessante em cenários com alto custo do metro quadrado e tarifas de energia elétrica mais baratas, ou onde não haja disponibilidade de área. Para cidades de menor porte, com menor pressão imobiliária, os sistemas naturais avaliados são mais indicados, pelos baixos custos totais (construção e operação) e adequadas eficiências de remoção de poluentes.

Abstract Water supply services are basic infrastructures to meet the population's water consumption needs. Since the late 1970s, in some developed countries, water supply services have been privatized in an attempt to improve their performance. In this context, the state of Mato Grosso has a unique characteristic in Brazil, as it has a completely municipalized sanitation service. This research aims to analyze the performance, through indicators, of water supply systems in 120 cities in the state of Mato Grosso. The data were extracted from the Municipal Basic Sanitation Plan 106 (PMSB 106) platform, from municipalities with a population of less than 50,000 inhabitants, with reference to the years 2015 to 2017. For this, 26 indicators were selected, followed by the application of the T-test, the ordinary least squares method, and propensity score matching. With the statistical analysis of mean comparison (T-test), it was observed that private service provision outperforms public service, but it should be noted that a simple comparison of means between the public and private systems is not sufficient to infer that one system is more efficient than the other. When applying multivariate analysis (ordinary least squares method and propensity score matching), calculations showed that there were no significant differences between the provision of service by the private or public provider regarding coverage indicators, losses, default rate, and intermittency, according to the selected variables. It is also noteworthy that the discussion on the efficiency of the water supply system must take into consideration the problems arising from political and contractual issues and the absence of competent regulatory entities.

Resumo Os serviços de abastecimento de água são infraestruturas básicas para atender as necessidades de consumo de água da população. Desde o final da década de 1970, em alguns países desenvolvidos, os serviços de abastecimento de água foram privatizados na tentativa de melhorar seu desempenho. Nesse contexto, o estado de Mato Grosso possui uma característica única no Brasil, possui um serviço de saneamento totalmente municipalizado. Essa pesquisa busca analisar o desempenho, por meio de indicadores, dos sistemas de abastecimento de água em 120 cidades do estado de Mato Grosso. Os dados foram extraídos da plataforma do Plano Municipal de Saneamento Básico 106 (PMSB 106), de municípios com população inferior a 50.000 habitantes, com referência aos anos de 2015 a 2017. Para isso, realizou-se a seleção de 26 indicadores, seguindo com a aplicação do teste T, do método dos mínimos quadrados ordinários e do propensity score matching. Com a análise estatística de comparação média (Teste T) observou-se que a prestação de serviço do privado se sobressai em relação ao público, porém, ressalta-se que, uma comparação simples de média entre o sistema público e privado não é suficiente para inferir que um sistema é mais eficiente do que o outro. Ao aplicar a análise multivariada (método de Mínimos Quadrados Ordinários e o Propensity Score Matching), os cálculos mostraram que não há diferenças significativas entre a prestação realizada pelo prestador privado ou público, no que se refere aos indicadores de cobertura, perdas, taxa de inadimplência e intermitência segundo as variáveis selecionadas. Destaca-se ainda que, a discussão sobre eficiência do sistema de abastecimento deve levar em consideração as problemáticas decorrentes de questões políticas, contratuais e a inexistência de entes reguladores competentes.

ABSTRACT Objective To describe the clinical, bronchoscopic, diagnostic, and therapeutic aspects between children and adults. Methods This retrospective study compared the clinical and bronchoscopic characteristics of adults and children who underwent bronchoscopy for suspected foreign body aspiration. Data on sex, outpatient or emergency origin, bronchoscopy results, characteristics of the aspirated foreign body, and complications were analyzed. Results In total, 108 patients were included in the analysis, with foreign body aspiration diagnosed in 69% of patients (30 children and 44 adults). In 91% of patients, there was a clinical history suggestive of aspiration. The mean age of the adults was 65.89 (±19.75) years, and that of the children was 2.28 (±1.78) years. Most of the children were under 3 years of age (80%), while adults were mostly 70 years of age or older (54.5%). Emergency care was more common among children than adults. The most common foreign bodies found in both age groups were organic bodies, primarily seeds. The most frequent locations of foreign bodies were the lobar bronchi in adults and the main bronchi in children. Flexible bronchoscopy is the primary method for diagnosis and treatment. Transient hypoxemia occurred particularly frequently in children (5%). Conclusion Foreign body aspiration, particularly that involving seeds, is more common in the extremes of age. A clinical history suggestive of aspiration is crucial in determining the need for bronchoscopy, which should be performed as early as possible. Flexible bronchoscopy is an effective and safe diagnostic technique.

Resumo O objetivo deste estudo foi avaliar in vitro o efeito do hidróxido de cálcio [Ca(OH)2], clorexidina gel a 2% (CHX) em macrófagos (RAW 264.7) na produção de citocinas pró-inflamatórias e óxido nítrico após pré-tratamento com ácido lipoteicóico (LTA) de Enterococcus faecalis. Quarenta e oito dentes humanos uniradiculares foram instrumentados com R25.08 (RECIPROC) e esterilizados por irradiação gama. LTA foi inoculado no canal radicular de cada espécime por 96 horas. Os espécimes foram instrumentados com 40.06 e 50.05 (RECIPROC) e medicados com: I) solução salina apirogênica (SS); II) CHX 2%; III) Ca(OH)2 + SS; ou IV) Ca(OH)2 + CHX durante 14 dias. Três amostras (S) foram realizadas do canal radicular de cada espécime em: S1) imediatamente após a instrumentação; S2) após ácido etilenodiaminotetracético (EDTA); S3) após a retirada da medicação intracanal. Foi realizada a quantificação subsequente de citocinas (IL-1β, TNF-α, MIP-1α, IP-10, G-CSF e IL-6) por imunoensaio (ELISA) e de óxido nítrico pelo método de Griess. Os dados foram submetidos a um teste de normalidade e então analisados com ANOVA one-way e teste de Tukey com nível de significância de 5% usando GraphPad Prism 6. Ca(OH)2 + SS e Ca(OH)2 + CHX apresentaram níveis mais baixos de TNF -α, TNF-α, IL-6, G-CSF e óxido nítrico. Ca(OH)2 + SS foi o mais eficaz na redução de MIP-1α. CHX foi eficaz na redução de IL-6 e G-CSF. Sendo assim a associação de hidróxido de cálcio e clorexidina é eficaz na redução das citocinas TNF-α, IL-1β, IL-6, G-CSF e óxido nítrico.

Abstract The aim of this study was to evaluate in vitro the effect of calcium hydroxide [Ca(OH)2], 2% chlorhexidine gel (CHX) on macrophages (RAW 264.7) to produce pro-inflammatory cytokines and nitric oxide after pretreatment with lipoteichoic acid (LTA) of Enterococcus faecalis. Forty-eight human single-rooted teeth were instrumented with R25.08 (RECIPROC) and sterilized by gamma irradiation. LTA was inoculated in the root canal of each specimen for 96 hours. Specimens were instrumented with 40.06 and 50.05 (RECIPROC) and medicated with: I) Pyrogen-free saline solution (SS); II) 2% CHX gel; III) Ca(OH)2 + SS; or IV) Ca(OH)2 + CHX for 14 days. Three samples (S) were performed of the root canal of each specimen at: S1) immediately after instrumentation; S2) after Ethylenediaminetetraacetic acid (EDTA); S3) after intracanal medication removal. Subsequent quantification of cytokines (IL-1β, TNF-α, MIP-1α, IP-10, G-CSF and IL-6) by immunosorbent assay (ELISA) and nitric oxide by the Griess method was carried-out. Data were submitted to a normality test and then analyzed with one-way ANOVA and Tukey test with a significance level of 5% using GraphPad Prism 6. Ca(OH)2 + SS and Ca(OH)2 + CHX presented lower levels of TNF-α, TNF-α, IL-6, G-CSF and nitric oxide. Ca(OH)2 + SS was the most effective in reducing MIP-1α. CHX was effective in reducing IL-6 and G-CSF. Therefore, the combined intracanal medication of calcium hydroxide and chlorhexidine is effective in reducing the cytokines TNF-α, IL-1β, IL-6, G-CSF and nitric oxide.

Abstract Objective: To evaluate current practices of tracheostomy in children regarding the ideal timing of tracheostomy placement, complications, indications, mortality, and success in decannulation. Source of data: The authors searched PubMed, Embase, Cochrane Library, Google Scholar, and complemented by manual search. The guidelines of PRISMA and MOOSE were applied. The quality of the included studies was evaluated with the Newcastle-Ottawa Scale. Information extracted included patients’ characteristics, outcomes, time to tracheostomy, and associated complications. Odds ratios (ORs) with 95% CIs were computed using theMantel-Haenszel method. Synthesis of data: Sixty-six articles were included in the qualitative analysis, and 8 were included in the meta-analysis about timing for tracheostomy placement. The risk ratio for “death in hospital outcome” did not show any benefit from performing a tracheostomy before or after 14 days of mechanical ventilation (p = 0.49). The early tracheostomy before 14 days had a great impact on the days of mechanical ventilation (-26 days in mean difference, p < 0.00001). The authors also found a great reduction in hospital length of stay (-31.4 days, p < 0.008). For the days in PICU, the mean reduction was of 14.7 days (p < 0.007). Conclusions: The meta-analysis suggests that tracheostomy performed in the first 14 days of ventilation can reduce the time spent on the ventilator, and the length of stay in the hospital, with no effect on mortality. The decision to perform a tracheostomy early or late may be more dependent on the baseline disease than on the time spent on ventilation.