Abstract This article aims to analyse the relationship between physical activity (PA) environment at schools, sex, age, and obesity in children, using a network approach. This is a cross-sectional study, with 1,200 children (8.1±1.0 years old) from eight public schools in the same municipality. Weight and height measurements were assessed to calculate the Body Mass Index (BMI) and classified as healthier weight or overweight. To assess the PA environment at school, a interview with the school´s manager was conducted. The association between the PA environment at school and obesity was tested using a Network Analysis performed on the Jasp software. Positive associations between BMI and Physical Education classes (0.847), physical education teacher (0.349), break duration (0.564), and indoor sports court (0.662) were observed. Negative associations were seen with sex (-0.212) age (-0.387), extracurricular PA (-0.492), and playground (-0.557). Additionally, the centrality indicators highlighted extracurricular PA (1.789) as the variables with the highest betweenness values, and BMI with the highest closeness (2.239) and strength (1.230) values. Extracurricular PA and the presence of playgrounds in school´s environment are associated with healthier weight in low-income children.

Resumo O objetivo deste artigo é analisar a relação entre ambiente de atividade física (AF) nas escolas, sexo, idade e obesidade em crianças, usando uma abordagem de rede. Trata-se de um estudo transversal com 1.200 crianças (8,1±1,0 anos) de oito escolas públicas do mesmo município. Peso e estatura foram avaliadas para cálculo do Índice de Massa Corporal (IMC) e classificadas como peso saudável ou sobrepeso. Para avaliar o ambiente de AF na escola, foi aplicado um questionário por meio de entrevista com o gestor da escola. A associação entre o ambiente de AF na escola e a obesidade foi testada por meio Análise de Redes realizada no software Jasp. Foram observadas associações positivas entre o IMC e as aulas de Educação Física (0,847), professor de educação física (0,349), duração do intervalo (0,564) e quadra poliesportiva (0,662). Associações negativas foram observadas com sexo (-0,212), idade (-0,387), AF extracurricular (-0,492) e playground (-0,557). Adicionalmente, os indicadores de centralidade destacaram a AF extracurricular (1,789) como a variável com o maior valor de intermediação, e o IMC com o maior valor de proximidade (2,239) e força (1,230). A AF extracurricular e a presença de playgrounds no ambiente escolar estão associadas a um peso mais saudável em crianças de baixa renda.

Resumo Analisou-se a prevalência e fatores associados à realização da Triagem Neonatal Completa (TNC) entre crianças (<2 anos de idade) no Brasil incluídas na Pesquisa Nacional Saúde 2013 (n=4.442) e 2019 (n=5.643). Estudo transversal comparou as estimativas de prevalência e intervalos de confiança de 95% (IC95%) da TNC (testes do olhinho, orelhinha e pezinho). Diferenças foram consideradas estatisticamente significante ao nível de 5%. Regressões de Poisson bruta e ajustada foram realizadas para estimar Razões de Prevalência (RP) e IC95% para a associação das variáveis socioeconômicas, demográficas e de saúde com a TNC. Verificou-se aumento estatisticamente significante da TNC: 67,4% (IC95%: 65,5-69,3) em 2019, ante 49,2% (IC95%: 47,1-51,3) em 2013. Porém, ainda existem desigualdades e defasagens entre os estados da federação e variáveis sociodemográficas. Entre os anos, a TNC foi menor nas crianças de cor/raça parda e preta, dos três piores quintis de renda, sem plano de saúde, cadastradas na Estratégia de Saúde da Família, da região norte, de cidades do interior e da zona rural do Brasil. Apesar de o aumento da prevalência de TNC, desigualdades e defasagens individuais e contextuais permaneceram, indicando os desafios das políticas de saúde.

Abstract This study analyzed the prevalence of complete neonatal screening (CNS) of children aged under 2 years in Brazil and associated factors using data from the 2013 (n=4,442) and 2019 (n=5,643) national health surveys. We conducted a cross-sectional study to compare prevalence of CNS (eye, ear and heel prick tests) adopting 95% confidence intervals (95%CI) and a 5% significance level. Crude and adjusted Poisson regression was performed to estimate prevalence ratios (PR) and 95%CI to assess the association between socioeconomic, demographic and health variables and CNS. There was a statistically significant increase in CNS prevalence, from 49.2% (95%CI: 47.1-51.3) in 2013 to 67.4% (95%CI: 65.5-69.3) in 2019. However, large disparities persist across states and between sociodemographic groups. In both years, CNS prevalence was lowest among brown and black children, those from families in the three lowest income quintiles, children without health insurance, those from families registered in the Family Health Strategy and children living in the North, cities outside the state capital/metropolitan regions and rural areas. Despite the increase in prevalence of CNS, deep individual and contextual inequalities persist, posing challenges for health policies.

Abstract This article analyzes the risks to children's rights, with an emphasis on education and health in humanitarian situations circumscribed by child poverty, combined with the pandemic health crisis. The argument was based on the question: according to the students' perception what are the impacts of the pandemic and the post-pandemic period on education and health? Therefore, the objective of the study was to map students’ perceptions of their Rights in their daily lives, in six different Latin American countries. Empirical data were obtained through online forms (with open and closed questions) via Google Forms applied in two stages of qualitative research carried out in the second half of 2020 and 2022. The first stage covered 504 basic education students (10-18 years old) from eight educational institutions and the second 462 of thirteen institutions also from basic education. Thus, the contributions of 966 students are discussed in this text in dialogue with bibliographic and documentary references. Closed questions were statistically systematized and content analysis was applied to open questions (Bardin, 2009), as a whole, the data is analyzed using a qualitative approach. Students highlight the right to education and health as the most priority when speaking out about the Rights necessary in their daily lives. Such perceptions reveal specificities of educational communities and the challenges experienced in guaranteeing Rights in everyday spaces which affect the processes of access, permanence and results of education, as well as physical and emotional health problems which emerged and/or worsened during the period. Therefore, in this context the risks increased and worsened in a scenario in which a historical weakness in guaranteeing children's rights was already identified, especially regarding the rights to education and health.

Resumen Este artículo analiza los riesgos para los derechos de los niños, niñas y adolescentes, con énfasis en la educación y la salud en contextos de situación humanitaria circunscritos por la pobreza infantil, combinada con la crisis sanitaria pandémica. El argumento se basó en la pregunta: ¿según la percepción del estudiantado, ¿cuáles son los impactos de la pandemia y del período postpandemia en educación y en salud? Por lo tanto, el objetivo del estudio fue mapear, en la actualidad, las percepciones estudiantiles sobre los derechos de la niñez en la vida cotidiana en seis diferentes países latinoamericanos. Los datos empíricos se obtuvieron a través de formularios en línea (con preguntas, abiertas y cerradas) con el uso de Google Forms, aplicados en dos etapas de investigación cualitativa, realizadas en el segundo semestre de 2020 y 2022. La primera etapa abarcó a 504 estudiantes de primaria y secundaria (10-18 años), de ocho instituciones educativas y la segunda a 462 de trece instituciones, también de primaria y secundaria. Así, en este texto se discuten las aportaciones de 966 estudiantes, en diálogo con las referencias bibliográficas y documentales. Las preguntas cerradas se sistematizaron estadísticamente y a las preguntas abiertas se aplicó el análisis de contenido (Bardin, 2009), en su conjunto los datos son analizados bajo un enfoque cualitativo. Al hablar sobre los Derechos necesarios en su vida diaria, los estudiantes destacan el derecho a la educación y a la salud como la máxima prioridad. Tales percepciones revelan las especificidades y los desafíos experimentados en la garantía de Derechos en los espacios cotidianos, los cuales afectan los procesos de acceso, permanencia y resultados de la educación, así como los problemas de salud física y emocional, surgidos y/o agravados en el período de la crisis sanitaria pandémica. En este contexto, por lo tanto, los riesgos han aumentado y empeorado, en un escenario en el que ya se identificó una fragilidad en la historia de garantía de los derechos de la niñez, especialmente en lo que respecta a los derechos a la educación y a la salud.

Resumo Este artigo analisa os riscos sobre os direitos da infância, com ênfase na educação e na saúde em contextos de situação humanitária circunscritos pela pobreza infantil, aliada à crise sanitária pandêmica. O argumento baseou-se na pergunta: segundo a percepção dos estudantes, quais os impactos da pandemia e do período pós-pandemia na educação e na saúde? Portanto, o objetivo do estudo foi mapear as percepções de estudantes sobre seus Direitos nos cotidianos, em seis diferentes países latino-americanos. Os dados empíricos foram obtidos por meio de formulários online (com perguntas, abertas e fechadas) via Google Forms, aplicados em duas etapas de investigação qualitativa, realizadas no segundo semestre de 2020 e de 2022. A primeira etapa abrangeu 504 estudantes da educação básica (10-18 anos), de oito instituições de ensino e a segunda 462 de treze instituições, também da educação básica. Assim, as contribuições de 966 estudantes são discutidas neste texto, em diálogo com as referências bibliográficas e documentais. As questões fechadas foram sistematizadas estatisticamente e a análise de conteúdo foi aplicada às questões abertas (Bardin, 2009), como um todo os dados são analisados sob abordagem qualitativa. Ao se manifestarem sobre os Direitos necessários em seus cotidianos, os estudantes destacam o direito à educação e à saúde como os mais prioritários. Tais percepções revelam especificidades das comunidades educativas e os desafios vivenciados na garantia de Direitos nos espaços cotidianos, que afetam os processos de acesso, permanência e resultados da educação, bem como os problemas de saúde física e emocional, surgidos e/ou agravados no período. Nesse contexto, portanto, aumentaram e se agravaram os riscos, num cenário no qual já se identificava uma histórica fragilidade na garantia dos Direitos das crianças, especialmente quanto aos direitos à educação e à saúde.

Abstract This study aimed to evaluate whether bacterial inoculation improves the fermentative, microbiological, and chemical characteristics of silages of the elephant grass cv. BRS Capiaçu on different regrowth days. The experimental design was completely randomized and set up in a 3x2 factorial arrangement (three regrowth days, with and without inoculant), with four replications. There was a significant interaction between the regrowth days and inoculant on the pH, ammoniacal nitrogen (N-NH3), and effluent losses (EL) of the silages. Inoculation decreased the EL with the advance of regrowth days and increased the dry matter recovery index compared to the silages without inoculant. The population of molds and yeasts decreased when inoculation was adopted to the forage harvested after 85 d. There was a significant interaction between the dry matter (DM), crude protein (CP) and neutral detergent fiber corrected for ash and protein (NDFap) contents of the silages. Inoculation in the grass harvested after 85 d increased the DM contents of the silage. The highest CP contents were observed in the silages after 85 d. The NDFap contents of the grasses harvested after 110 and 135 d were higher than those of the grass harvested after 85 d. The NDFap contents of the silages without inoculant increased with the harvest age. The BRS Capiaçu forage silage harvested at 110 d demonstrated favorable performance for silage production. However, the influence of inoculant use was low for the characteristics evaluated.

Resumen Este estudio tuvo como objetivo evaluar si la inoculación bacteriana mejora las características fermentativas, microbiológicas y químicas de los ensilados del pasto elefante cv. BRS Capiaçu en diferentes días de rebrote. El diseño experimental fue completamente al azar y se estableció en un arreglo factorial 3x2 (tres días de rebrote, con y sin inoculante), con cuatro repeticiones. Hubo una interacción significativa entre los días de rebrote y el inoculante sobre el pH, el nitrógeno amoniacal (N-NH3) y las pérdidas por efluentes (PE) de los ensilados. La inoculación disminuyó la PE con el avance de los días de rebrote y aumentó la tasa de recuperación de materia seca en comparación con los ensilados sin inoculante. La población de mohos y levaduras disminuyó cuando se adoptó la inoculación al forraje cosechado después de 85 d. Hubo una interacción significativa entre la materia seca (MS), la proteína cruda (PC) y la fibra detergente neutro corregida por los contenidos de cenizas y proteína (FDNcp) de los ensilados. La inoculación en el pasto cosechado después de 85 días aumentó el contenido de MS del ensilado. Los mayores contenidos de PC se observaron en los ensilados después de 85 días. Los contenidos de FDNcp de los pastos cosechados después de 110 y 135 días fueron mayores que el del pasto cosechado después de 85 días. El contenido de FDNcp de los ensilados sin inoculante aumentó con la edad de cosecha. El ensilado de forraje de BRS Capiaçu cosechado a los 110 días demostró un desempeño favorable para la producción de ensilado. Sin embargo, la influencia del uso de inoculantes fue baja para las características evaluadas.

Abstract Background: Real-world, primary data on the treatment of psoriasis are scarce, especially concerning the role of soluble biomarkers as outcome predictors. Objective: The authors evaluated the utility of Th1/Th17 serum cytokines along with clinical characteristics as predictors of drug survival in the treatment of psoriasis. Methods: The authors consecutively included participants with moderate to severe psoriasis who were followed up for 6 years. Baseline interferon-α, tumor necrosis factor-α, and inter-leukin (IL)-2, IL-4, IL-6, IL-10, and IL-17A were measured using a cytometric bead array; clinical data were assessed. The authors calculated hazard ratios (HRs) for drug survival using a Cox proportional hazards model. Results: The authors included 262 patients, most of whom used systemic immunosuppressants or biologics. In the multivariate model, poor quality of life measured by the Dermatology Life Quality Index (HR = 1.04; 95% CI 1.01–1.07; p = 0.012) and elevated baseline IL-6 (HR = 1.99; 95% CI 1.29–3.08; p = 0.002) were associated with treatment interruption. Study limitations: The main limitation of any cohort study is the presence of confounders that could not be detected in clinical evaluation. Conclusions: Poor quality of life and elevated baseline serum IL-6 level predicted treatment interruption in patients with moderate to severe psoriasis. Although IL-6 is not the most important mediator of the inflammatory pathway in the skin environment, it is an interesting biomarker candidate for predicting psoriasis treatment response.

Resumo Objetivou-se realizar uma análise espacial da taxa de mortalidade hospitalar (TMH) por síndrome respiratória aguda grave (SRAG) atribuída à COVID-19 em crianças e adolescentes no Brasil no período de 2020 a 2021. Utilizou-se o método de cluster para agrupar as unidades federativas (UFs) com base na TMH. Em 2020, clusters com altas TMHs foram formados por UFs Norte/Nordeste. Em 2021, houve redução na TMH. Os clusters com maiores taxas permaneceram na região N/NE. Diferenças regionais foram observadas nas TMHs. Os achados podem refletir as desigualdades sociais e o acesso à atenção hospitalar, principalmente na faixa etária de menores de 1 ano pela gravidade da doença neste grupo.

Abstract The objective was to perform a spatial analysis of the hospital mortality rate (HMR) due to severe acute respiratory syndrome (SARS) attributed to COVID-19 among children and adolescents in Brazil from 2020 to 2021. A cluster method was used to group federal units (FUs) based on HMR. In 2020, clusters with high HMRs were formed by north/northeast FUs. In 2021, there was a reduction in HMR. Clusters with higher rates remained in the N/NE region. Regional differences were observed in the HMR. The findings may reflect social inequalities and access to hospital care, especially in the under 1-year-old age group due to the severity of the disease in this group.

Abstract The objective was to perform a spatial analysis of the hospital mortality rate (HMR) due to severe acute respiratory syndrome (SARS) attributed to COVID-19 among children and adolescents in Brazil from 2020 to 2021. A cluster method was used to group federal units (FUs) based on HMR. In 2020, clusters with high HMRs were formed by north/northeast FUs. In 2021, there was a reduction in HMR. Clusters with higher rates remained in the N/NE region. Regional differences were observed in the HMR. The findings may reflect social inequalities and access to hospital care, especially in the under 1-year-old age group due to the severity of the disease in this group.

Resumo Objetivou-se realizar uma análise espacial da taxa de mortalidade hospitalar (TMH) por síndrome respiratória aguda grave (SRAG) atribuída à COVID-19 em crianças e adolescentes no Brasil no período de 2020 a 2021. Utilizou-se o método de cluster para agrupar as unidades federativas (UFs) com base na TMH. Em 2020, clusters com altas TMHs foram formados por UFs Norte/Nordeste. Em 2021, houve redução na TMH. Os clusters com maiores taxas permaneceram na região N/NE. Diferenças regionais foram observadas nas TMHs. Os achados podem refletir as desigualdades sociais e o acesso à atenção hospitalar, principalmente na faixa etária de menores de 1 ano pela gravidade da doença neste grupo.

ABSTRACT BACKGROUND AND OBJECTIVES: The social distancing of COVID-19 pandemic exacerbated symptoms of chronic pain patients. Furthermore, it is necessary to consider the sociocultural context of coping with the pandemic in different countries. The objective of this study was to evaluate pain, psychoemotional symptoms, sleep quality, and level of physical activity in chronic pain patients during the COVID-19 pandemic in Brazil. METHODS: Individuals with fibromyalgia, migraine and chronic low back pain were included. The survey was performed through a questionnaire elaborated by researchers on the Forms application, from Google Drive, in the period between October 2020 and March 2021, with straight and clear questions about pain, psychoemotional aspects, sleep quality, and level of physical activity. Binary or multinominal logistic regression analysis was performed to identify possible predictors. RESULTS: 973 people were evaluated, 63.5% had fibromyalgia, and 98.3% were female. Anxiety increased the odds ratio in 395% of chronic pain patients to feel pain (ß: 1.375; OR: 3.956; p=0.001) and a greater intensity of pain increases in 62.3% the chance of these individuals not performing physical activity (ß: -0.474; OR: 0.623; p=0.001). Pain intensity increased the odds ratio of having insomnia by 186.9% (ß: 0.625; OR: 1.869; p=0.001) and the chance of taking sleep drugs by 160.4% (ß: 0.472; OR: 1.604; p=0.001). CONCLUSION: The social isolation of COVID-19 pandemic maximized the vicious cycle between painful symptoms, anxiety, and sleep disorders in chronic pain patients in Brazil. The intensification of these factors is associated with the reduction of physical activity levels.

RESUMO JUSTIFICATIVA E OBJETIVOS: A pandemia de COVID-19 exacerbou os sintomas de pacientes com dor crônica. Porém, é necessário considerar o contexto sociocultural de enfrentamento da pandemia nos diferentes países. O objetivo deste estudo foi avaliar a dor, os sintomas psicoemocionais, a qualidade do sono e o nível de atividade física em pacientes com dor crônica durante a pandemia de COVID-19 no Brasil. MÉTODOS: Foram incluídos indivíduos com fibromialgia, enxaqueca e dor lombar. O levantamento foi realizado por meio de questionário elaborado pelos pesquisadores no aplicativo Forms, do Google Drive, entre outubro de 2020 e março de 2021, com perguntas diretas e claras sobre dor, aspectos psicoemocionais, qualidade do sono e nível de atividade física. Análise de regressão logística binária ou multinominal foi realizada para identificar possíveis preditores. RESULTADOS: Foram avaliadas 973 pessoas, 63,5% apresentavam fibromialgia, sendo 98,3% do sexo feminino. A ansiedade aumentou a razão de chances em 395% dos pacientes com dor crônica sentirem dor (ß: 1,375; OR: 3,956; p= 0,001) e a dor aumentou em 62,3% a chance desses indivíduos não realizarem atividade física (ß: -0,474; OR: 0,623; p=0,001). A intensidade da dor aumentou a razão de chances de ter insônia em 186,9% (ß: 0,625; OR: 1,869; p= 0,001) e a chance de tomar fármacos para dormir em 160,4% (ß: 0,472; OR: 1,604; p=0,001). CONCLUSÃO: O isolamento social da pandemia de COVID-19 maximizou o ciclo vicioso entre sintomas dolorosos, ansiedade e distúrbios do sono em pacientes com dor crônica no Brasil. A intensificação desses fatores está associada à redução de atividade física.

Abstract The objective was to perform a spatial analysis of the hospital mortality rate (HMR) due to severe acute respiratory syndrome (SARS) attributed to COVID-19 among children and adolescents in Brazil from 2020 to 2021. A cluster method was used to group federal units (FUs) based on HMR. In 2020, clusters with high HMRs were formed by north/northeast FUs. In 2021, there was a reduction in HMR. Clusters with higher rates remained in the N/NE region. Regional differences were observed in the HMR. The findings may reflect social inequalities and access to hospital care, especially in the under 1-year-old age group due to the severity of the disease in this group.

Resumo Objetivou-se realizar uma análise espacial da taxa de mortalidade hospitalar (TMH) por síndrome respiratória aguda grave (SRAG) atribuída à COVID-19 em crianças e adolescentes no Brasil no período de 2020 a 2021. Utilizou-se o método de cluster para agrupar as unidades federativas (UFs) com base na TMH. Em 2020, clusters com altas TMHs foram formados por UFs Norte/Nordeste. Em 2021, houve redução na TMH. Os clusters com maiores taxas permaneceram na região N/NE. Diferenças regionais foram observadas nas TMHs. Os achados podem refletir as desigualdades sociais e o acesso à atenção hospitalar, principalmente na faixa etária de menores de 1 ano pela gravidade da doença neste grupo.

ABSTRACT Wild birds have great prominence in the transmission of diseases to humans, mainly due to their ease of access to human populations, raising concerns about the potential impact of that proximity on public health. The present study reports ARV and PBV occurrence in wild birds from an environmental protection area in the Amazon biome, in Pará state, Brazil. We obtained 155 fecal specimens from 47 species of wild birds for RNA extraction, ARV and PBV detection utilizing molecular methods, nucleotide sequencing, and phylogenetic analysis. ARV prevalence was 0.6% (1/155), being positive in an individual of Myrmotherula longipennis, and PBV prevalence was 1.29% (2/155), affecting two individuals of Guira guira. The PBV strains were assigned to genogroup I based on phylogenetic analysis, and they shared a strong phylogenetic link with strains isolated from different geographic locations. The ARV strain was more closely related to strains that had previously circulated in the same region. The presence of ARV and PBV in this habitat suggests that infection cycles of these agents occur naturally in the wild ecosystem, potentially triggering transmission events between bird species and humans. This is the first study on ARV detection in wild birds in Brazil and the first report on the occurrence of PBV in wild Guira guira. Additional studies are required to determine the epidemiology, origin, evolution, and emergence of new potentially pathogenic viruses in the Amazon.

RESUMO As aves silvestres têm grande destaque na transmissão de doenças ao homem, principalmente pela facilidade de acesso à população humana, levantando preocupações sobre o potencial impacto dessa proximidade no contexto da saúde pública. O presente estudo relata a ocorrência de ARV e PBV em aves silvestres de uma área de proteção ambiental no bioma Amazônico. Obtivemos 155 espécimes fecais de 47 espécies de aves silvestres, que foram submetidos a extração de RNA, detecção de ARV e PBV por técnicas moleculares, sequenciamento nucleotídico e análise filogenética. A prevalência de infecção por ARV foi 0,6% (1/155), sendo positivo em um indivíduo de Myrmotherula longipennis, e a prevalência de PBV foi 1,29% (2/155), afetando dois insdivíduos de Guira guira. A análise filogenética agrupou as cepas de PBV no genogrupo I, mostrando intensa relação filogenética com cepas isoladas de outras regiões geográficas. A cepa de ARV esteve mais relacionada filogeneticamente a cepas previamente circulantes na mesma região. Este é o primeiro estudo sobre detecção de ARV em aves silvestres no Brasil e o primeiro relato sobre a ocorrência de PBV em Guira guira. A circulação de ARV e PBV nesse ambiente demonstra que os ciclos desses agentes estão ocorrendo de forma natural no ecossistema silvestre, o que pode desencadear possíveis eventos de transmissão entre as espécies aviárias e humanos. Estudos adicionais são necessários para determinar a epidemiologia, origem, evolução e surgimento de novos vírus potencialmente patogênicos na Amazônia.

Abstract Diabetes mellitus (DM) is a major cause of chronic kidney disease (CKD) and changes in lipoprotein. Literature data suggest that cholesterol associated with high-density lipoprotein (HDLc) plays a protective role against albuminuria and diabetic nephropathy. These factors are related with changes in serum apolipoproteins such Apo A-I. This work aims to evaluate the correlation of apolipoprotein A-I with renal function in diabetic outpatients. Samples were collected from 281 outpatients for analyses of glycated hemoglobin (HbA1c), serum creatinine (SCr), urea (BUN), cholesterol (TC), triglycerides (TG), HDL-cholesterol (HDLc) and estimation of glomerular filtration rate (eGFR). Urinary samples were obtained to assess urine albumin creatinine ratio (UACR). Triglyceride-glucose index (TyG) was calculated to estimate insulin resistance. The mean age was 61,5 ± 16,4 years. Most patients were female, Afro-Mestizo and over 50 years of age. Pearson's revealed negative correlation of creatinine with HDLc and Apo A-I. There was a correlation of eGFR with HbA1c, TG and HDLc. TyG presented a negative correlation with Apo A-I and HDLc. The highest quartiles of UACR presented the highest TyG and the lowest Apo A-I. In conclusion, Apo A-I indicated an association with insulin resistance and changes in renal function parameters, especially as a factor associated with the onset of albuminuria, with a better predictive potential than the HDLc.

Abstract We investigated the Biogran on bone repair and metabolism at several time-intervals upon grafting into rat tibia artificial defects. The biomaterial was thoroughly characterized in vitro, and its dissolution behavior upon immersion was assessed in simulated body fluid (SBF) solution for 1, 3, 7, 14, and 30 days. Biogran was also assessed by in vitro hydroxyapatite formation in SBF solution, which is a marker for bioactive behavior. In vivo, distal and proximal bone defects were performed in the Wistar rat's right tibia and filled according to the experimental groups: I) negative control, no filling; II) positive control, 10 mg of autogenous bone; and III) 10 mg of Biogran. Animals were euthanized at 1, 2, 3, 4, 7, and 10 weeks. Bone neoformation was analyzed using histomorphometry (proximal defect), and local levels of bone morphogenetic protein 2 (BMP-2) were measured using the ELISA assay (distal defect). In vitro, the Biogran sample showed a fast dissolution rate within the first 7 days, parallel to the formation of the hydroxyapatite layer. In vivo, the sample was progressively resorbed at a higher rate within the first month until it became almost absent at week 10th. The sample presented similar or higher bone neoformation concerning the autogenous bone. BMP-2 levels were sustained in the Biogran group (around 200 pg/mg) and detected until the last experimental time with a significant difference compared with the controls. Results suggest Biogran is a candidate for hard tissue engineering even in highly active bone remodeling sites.

Resumo Este estudo investigou pela primeira vez, a eficácia de banhos terapêuticos com óleo essencial (OE) de Piper hispidum contra monogenéticos Anacanthorus spathulatus, Notozothecium janauachensis, Mymarothecium boegeri e Linguadactyloides brinkmanni das brânquias de Colossoma macropomum, bem como os efeitos hematológicos e histológicos neste peixe. Foram usados 100 mg/L de óleo essencial de P. hispidum e dois grupos controles (água do tanque de cultivo e água do tanque de cultivo com álcool 70%) expostos durante 1 hora por dia, com intervalos de 48 horas durante 3 dias, três repetições cada. Banhos terapêuticos com 100 mg/L de OE de P. hispidum tiveram uma eficácia de 78,6% contra monogenéticos. A toxicidade foi baixa, pois ocorreram poucas alterações fisiológicas e histopatológicas que não comprometeram o funcionamento das brânquias dos peixes. Portanto, houve eficácia de 100 mg/L de OE de P. hispidum para controle de monogenéticos em C. macropomum, quando usados banhos terapêuticos curtos sem prejudicar a saúde dos peixes expostos.

Abstract This study investigated for the first time the effectiveness of therapeutic baths with essential oil (EO) of Piper hispidum against monogeneans Anacanthorus spathulatus, Notozothecium janauachensis, Mymarothecium boegeri and Linguadactyloides brinkmanni from the gills of Colossoma macropomum, as well as the hematological and histological effects on this fish. In therapeutic baths, 100 mg/L of P. hispidum essential oil and two control groups (water from the culture tank and water from the culture tank with 70% alcohol) were exposed for 1 h/day, with intervals of 48 hours for 3 days, and three replicates each were used. Therapeutic baths with 100 mg/L of P. hispidum essential oil had an efficacy of 78.6% against monogeneans. The toxicity of this essential oil was low, since there were a few physiological and histopathological changes that did not compromise the functioning of the gills of the fish. Therefore, 100 mg/L of P. hispidum essential oil was effective for controlling monogeneans in C. macropomum, when short therapeutic baths were used without compromising the health of the exposed fish.

Abstract The objective was to perform a spatial analysis of the hospital mortality rate (HMR) due to severe acute respiratory syndrome (SARS) attributed to COVID-19 among children and adolescents in Brazil from 2020 to 2021. A cluster method was used to group federal units (FUs) based on HMR. In 2020, clusters with high HMRs were formed by north/northeast FUs. In 2021, there was a reduction in HMR. Clusters with higher rates remained in the N/NE region. Regional differences were observed in the HMR. The findings may reflect social inequalities and access to hospital care, especially in the under 1-year-old age group due to the severity of the disease in this group.

Resumo Objetivou-se realizar uma análise espacial da taxa de mortalidade hospitalar (TMH) por síndrome respiratória aguda grave (SRAG) atribuída à COVID-19 em crianças e adolescentes no Brasil no período de 2020 a 2021. Utilizou-se o método de cluster para agrupar as unidades federativas (UFs) com base na TMH. Em 2020, clusters com altas TMHs foram formados por UFs Norte/Nordeste. Em 2021, houve redução na TMH. Os clusters com maiores taxas permaneceram na região N/NE. Diferenças regionais foram observadas nas TMHs. Os achados podem refletir as desigualdades sociais e o acesso à atenção hospitalar, principalmente na faixa etária de menores de 1 ano pela gravidade da doença neste grupo.

RESUMO Objetivo: Analisar os fatores associados à hospitalização em enfermaria e unidade de terapia intensiva (UTI), e ao óbito pela COVID-19 em gestantes com caso confirmado. Métodos: Pesquisa observacional, transversal, realizada com dados de gestantes com caso confirmado para COVID-19 provenientes do Sistema de Informação de Vigilância Epidemiológica da Gripe e do Sistema Estadual Notifica COVID-19, do Paraná. Investigou-se a associação entre variáveis independentes e dependentes (hospitalização em enfermaria e UTI, e óbito) pelo modelo de regressão de Poisson com variância robusta. Resultados: 4.719 gestantes compuseram a população do estudo; 9,6 e 5,1% foram hospitalizadas em enfermaria e UTI, respectivamente; 1,9% evoluíram para óbito. Houve associação entre a idade materna avançada e internação em enfermaria (RP=1,36; IC95% 1,10–1,62) e UTI (RP=2,25; IC95% 1,78–2,71), e óbito (RP=3,22; IC95% 2,30–4,15). Verificou-se associação entre o terceiro trimestre gestacional e hospitalização em enfermaria (RP=5,06; IC95% 2,82–7,30) e UTI (RP=6,03; IC95% 3,67–8,39) e óbito (RP=13,56; IC95% 2,90–24,23). O segundo trimestre associou-se à internação em UTI (RP=2,67; IC95% 1,36–3,99). Gestantes com cardiopatia apresentaram maior frequência de hospitalização em enfermaria (RP=2,24; IC95% 1,43–3,05) e UTI (RP=2,66; IC95% 1,46–3,87). A obesidade foi associada à admissão em UTI (RP=3,79; IC95% 2,71–4,86) e ao óbito (RP=5,62; IC95% 2,41–8,83). Conclusão: A idade materna avançada, o final do período gestacional e comorbidades foram fatores associados a quadros graves de COVID-19.

ABSTRACT Objective: To analyze the factors associated with hospitalization in the ward and intensive care unit (ICU), and with death from COVID-19 in pregnant women with confirmed cases. Methods: Observational, cross-sectional study, carried out with data from pregnant women with a confirmed case of COVID-19 from the Influenza Epidemiological Surveillance Information System and the Paraná’s state COVID-19 notification system. The association between the independent and dependent variables (hospitalization in the ward and ICU, and death) was investigated using the Poisson regression model with robust variance. Results: 4,719 pregnant women comprised the study population. 9.6 and 5.1% were hospitalized in wards and ICU, respectively. 1.9% died. There was an association between advanced maternal age and hospitalization in wards (PR=1.36; 95%CI 1.10–1.62) and ICU (PR=2.25; 95%CI 1.78–2.71), and death (PR=3.22; 95%CI 2.30–4.15). An association was found between the third trimester and hospitalization in wards (PR=5.06; 95%CI 2.82–7.30) and ICU (PR=6.03; 95%CI 3.67–8.39) and death (PR=13.56; 95%CI 2.90–24.23). The second trimester was associated with ICU admission (PR=2.67; 95%CI 1.36–3.99). Pregnant women with cardiovascular disease had a higher frequency of hospitalization in wards (PR=2.24; 95%CI 1.43–3.05) and ICU (PR=2.66; 95%CI 1.46–3.87). Obesity was associated with ICU admission (PR=3.79; 95%CI 2.71–4.86) and death (PR=5.62; 95%CI 2.41–8.83). Conclusions: Advanced maternal age, the end of the gestational period and comorbidities were associated with severe COVID-19.