ABSTRACT Despite being subject to lower AIDS-related mortality rates and having a higher life expectancy, patients with HIV are more prone to develop non-AIDS events. A low CD4+/CD8+ ratio during antiretroviral therapy identifies people with heightened immune senescence and increased risk of mortality. In clinical practice, finding determinants of a low CD4+/CD8+ ratio may be useful for identifying patients who require close monitoring due to an increased risk of comorbidities and death. We performed a prospective study on the evolution of the CD4+/CD8+ ratio in 60 patients infected with HIV (80% males), who were subjected to two different antiretroviral regimens: early and deferred therapy. The initial CD4+/CD8+ ratio was ≤1 for 70% of the patients in both groups. Older age, CD4+ cell count at inclusion, Nadir CD8+T-cell count, and Initial CD4+/CD8+ ratio ≤ 1 were risk factors for lack of ratio recovery. In the multivariate analysis, a CD4+/CD8+ ratio > 1 at the start of the treatment was found to be a determinant factor in maintaining a CD4+/CD8+ ratio > 1. The nadir CD4+T-cell count was lower in the deferred therapy group (p=0.004), and the last CD4+/CD8+ ratio ≤1 was not associated with comorbidities. Ratio recovery was not associated with the duration of HIV infection, time without therapy, or absence of AIDS incidence. A greater improvement was observed in patients treated early (p=0.003). In contrast, the slope of increase was slower in patients who deferred treatment. In conclusion, the increase in the CD4+/CD8+ ratio occurred mostly for patients undergoing early strategy treatment and its extension did not seem to be related to previous HIV-related factors. AIDSrelated expectancy nonAIDS non events CD4CD8 CDCD CD4 CD8 CD CD4+/CD8 practice death 6 80% 80 (80 males, males , males) regimens 70 groups age inclusion CD8+Tcell CD8Tcell CDTcell CD8+T T analysis CD4+Tcell CD4Tcell CD4+T p=0.004, p0004 p p=0.004 0 004 (p=0.004) infection incidence p=0.003. p0003 p=0.003 . 003 (p=0.003) contrast conclusion HIVrelated CD4CD CD4+/CD 8 (8 7 Tcell CD8T CDT CD4T p000 p=0.00 00 (p=0.004 (p=0.003 ( p00 p=0.0 (p=0.00 p0 p=0. (p=0.0 p=0 (p=0. p= (p=0 (p= (p

Resumo As cultivares de açaí (Euterpe oleracea Mart.) BRS-Pará (BRS-PA) e BRS-Pai d’Égua (BRS-PDE) foram selecionadas para cultivo em regiões de terra firme da Amazônia. Como essas cultivares foram desenvolvidas a partir de diferentesprogenitores,nós postulamos que essas cultivares podem diferir na tolerância ao déficithídrico. Para testar essa hipótese, plantas de ambas os cultivares foram avaliadas em condiçõesadequadas de irrigação (controle) e déficit hídrico (potencial hídrico foliar naantemanhã de – 2,33MPa). Em relação ao controle, o déficit hídrico reduziu a taxa de assimilaçãolíquida de CO2(A) e a transpiração, em 82%, e 86% em ambas as cultivares, enquanto acondutância estomática(gs) foi reduzida em 93% e 87%, nas plantas estressadas de BRS-PDE e BRS-PA. O déficit hídrico aumentou a eficiência instantânea do uso da água em 43%, em ambas as cultivares,enquanto a eficiência intrínseca do uso da água (A/gs) aumentou 193% na BRS-PDE e 33% na BRS-PA. O déficit hídrico induziu o aumento de 44% na prolina foliare um decréscimo de 27% nos carboidratos solúveis totais, enquanto a sacarose foliar diminuiu53% na BRS-PA e 16% na BRS-PDE, em relação ao controle. O conteúdo relativo de águanas plantas estressadas de ambas as cultivares diminuiu em 8,5% em relação ao controle. Emconclusão, o controle da abertura estomática mais eficiente e a maior A/gs, na BRS-PDE,indicam que esta cultivar respondeu melhor ao déficit hídrico que a BRS-PA. Euterpe Mart. Mart BRSPará BRS Pará BRSPA PA (BRS-PA BRSPai Pai dÉgua d Égua BRSPDE PDE (BRS-PDE Amazônia diferentesprogenitoresnós diferentesprogenitores nós déficithídrico hipótese (controle potencial 2,33MPa. 233MPa MPa 2,33MPa . 2 33MPa 2,33MPa) CO2A COA CO2 A CO CO2(A transpiração 82 82% 86 estomáticags gs estomática(gs 93 87 87% BRSPA. PA. 43 43% cultivaresenquanto A/gs Ags (A/gs 193 33 44 27 totais diminuiu53 16 BRSPDE, PDE, 85 8 5 8,5 Emconclusão BRSPDE,indicam BRSPDEindicam PDE,indicam indicam 9 4 19 3 diminuiu5 1 8, PDEindicam

Abstract: Assai (Euterpe oleracea Mart.) cultivars BRS-Pará (BRS-PA) and BRS-Pai d’Égua (BRS-PDE) were selected for cultivation in upland regions of the Amazon. Given these cultivars were developed from different progenitors, we postulated that they differ regarding water-deficit tolerance. To test this hypothesis, plants of both cultivars were evaluated under well-watered (control) and water-deficit conditions (pre-dawn leaf water potential of – 2.33 MPa). Relative to control, the water-deficit decreased net CO2 assimilation rate (A) and transpiration by 82% and 86% in both cultivars, while the stomatal conductance (gs) was reduced by 93% and 87% in stressed plants of BRS-PDE and BRS-PA. The water-deficit improved instantaneous water-use efficiency by 43% in both cultivars, while intrinsic water-use efficiency (A/gs) increased by 193% and 33% in BRS-PDE and BRS-PA. The water-deficit induced 44% increase in foliar proline and 27% decrease in soluble carbohydrates in both cultivars, while foliar sucrose decreased by 53% in BRS-PA and 16% in BRS-PDE in relation to control. The relative water content in stressed plants of both cultivars was decreased by 8.5% in relation to control. In conclusion, the more efficient stomatal opening control and higher A/gs in BRS-PDE indicate this cultivar better copes with drought than BRS-PA. Abstract Euterpe Mart. Mart BRSPará BRS Pará BRSPA PA (BRS-PA BRSPai Pai dÉgua d Égua BRSPDE PDE (BRS-PDE Amazon progenitors waterdeficit deficit tolerance hypothesis wellwatered well watered (control predawn pre dawn 233 2 33 2.3 MPa. MPa . MPa) CO A (A 82 86 gs (gs 93 87 BRSPA. PA. wateruse use 43 Ags (A/gs 193 44 27 53 16 85 8 5 8.5 conclusion 23 3 2. 9 4 19 1 8.

Abstract Background Brazil had high COVID-19 lethality/mortality with multiple social inequalities, where color/race was highly relevant, especially in Rio de Janeiro. Therefore, we hypothesize that COVID-19 hospitalized patients with a highly socially vulnerable background would have more significant in-hospital mortality. Objective To analyze the socioeconomic factors of social vulnerability and their association with COVID-19 mortality. Methods This work was a prospective study of 274 confirmed adult COVID-19 hospitalized patients in the University Hospital of Clementino Fraga Filho (HUCFF). The clinical features/blood chemistry information were collected from the clinical record. The ArcGIS Pro Software (Esri Gis mapping software, Redlands California-US) and a Python-based algorithm were used to determine in-app/in-map variable management relevance to the socioeconomic variables, inequity markers, and vulnerability. Our study also analyzed the transfers from other primary care institutions to our hospital in order to examine its potential delays in advanced medical care. Logistic regression and ROC curve were used to investigate in-hospital mortality for our statistical analysis. The significance level adopted in the statistical analysis was 5% Results: Male sex, total days of hospitalization, age, having more than three comorbidities, intensive care unit (ICU) admission, hemodialysis, and transfer from other hospitals showed statistical significance. Patients living in low-adequate households (p = 0.030) with high in-house individual agglomeration markers (p = 0.017) and transfers from another Primary Health Care (PHC) institution (p = 0.047) were associated with increased in-hospital mortality, with high ICU admission and mechanical ventilation. Conclusions In-hospital mortality due to COVID-19 was influenced by social individual background characteristics of vulnerability. Among other clinical parameters, these markers should be considered to predict the likelihood of complications related to the COVID-19 pandemic. COVID19 COVID 19 COVID-1 lethalitymortality lethality inequalities colorrace color race relevant Janeiro Therefore inhospital 27 HUCFF. HUCFF . (HUCFF) featuresblood features blood record Esri software CaliforniaUS California US California-US Pythonbased Python based inapp/inmap inappinmap app/in map app variables 5 Results sex hospitalization age comorbidities (ICU hemodialysis lowadequate low adequate p 0.030 0030 0 030 inhouse house 0.017 0017 017 PHC (PHC 0.047 0047 047 ventilation Inhospital In parameters pandemic COVID1 1 COVID- 2 (HUCFF inapp inmap appin 0.03 003 03 0.01 001 01 0.04 004 04 0.0 00 0.

Abstract COVID-19, caused by the coronavirus family SARS-CoV-2 and declared a pandemic in March 2020, continues to spread. Its enormous and unprecedented impact on our society has evidenced the huge social inequity of our modern society, in which the most vulnerable individuals have been pushed into even worse socioeconomic situations, struggling to survive. As the pandemic continues, we witness the huge suffering of the most marginalized populations around the globe, even in developed, high-income latitudes, such as North America and Europe. That is even worse in low-income regions, such as Brazil, where the public healthcare infrastructure had already been struggling before the pandemic. Cities with even more evident social inequity have been impacted the most, leaving the most socioeconomically disadvantaged ones, such as slum residents and black people, continuously inflating the statistics of COVID-19 sufferers. Poverty, marginalization, and inequity have been well-known risk factors for morbidity and mortality from other diseases. However, COVID-19 has deepened our society’s wound. It is up to us to heal it up. If we really care for the others and want to survive as a species, we must fight social inequity.

Fruto da experiência de duas universidades públicas e uma privada, o Projeto de Extensão Liga Saúde da Família (LSF) constitui-se numa estratégia de gestão participativa no campo da formação de profissionais da área da saúde, com base nos conceitos de educação permanente em saúde, educação popular em saúde, equipe multiprofissional e interdisciplinar, atenção primária à saúde, promoção da saúde, estratégia saúde da família, metodologias participativas de pesquisa e atuação inserida no território vivo. Este relato apresenta a experiência da integração ensino-serviço-comunidade por meio do Projeto de Extensão Liga Saúde da Família, no contexto do Sistema Municipal de Saúde Escola (SMSE), em Fortaleza-Ceará, que dialoga com a gestão participativa no Sistema Único de Saúde (SUS). Esta proposta do LSF foi implantada no SMSE a partir de uma ação apoiada pelo sistema de saúde de Fortaleza que visa potencializar os espaços de co-gestão docente-assistencial, por meio da proposta do método da roda e da tenda invertida. O protagonismo dos integrantes e da comunidade na construção das atividades do projeto e a ampliação do olhar crítico sobre a realidade social e do trabalho em saúde estão entre os maiores avanços surgidos dessa experiência. Esse projeto permitiu a integração ensino - serviço - comunidade, atendendo a uma perspectiva de gestão participativa e dialógica.

As a result of the experience of two public universities and a private one, the Extension Project "Family Health League" (LSF) introduced a participative management strategy in the field of education of health professionals, with the support of power-ideas such as permanent education in health, popular education, multiprofessional and interdisciplinary groups, primary health attention, family health strategy, participative methodologies and practice inserted in a live territory. This report aims to introduce an experience of integrating teaching to community service through the Family Health League Extension Project (LSF), in the context of the Health-School Municipal System (SMSE) in the city of Fortaleza, Ceará, Brazil. This experience was planned in the spirit of participative management in the National Health System (SUS). The proposal of LSF emerges, in the SMSE, from a recommendation supported by the city's health system which aimed at improving co-management spaces of education and services and used the methods of circle discussion and inverted tent. The protagonism of the project members and of the community in the organization of the project's activities and the amplification of a critical view over social reality and health work are amongst the major advances which emerged from this experience. This project has made possible the integration of teaching, health service and community, from the perspective of a communicative and participative management.

Fruto da experiência de duas universidades públicas e uma privada, o Projeto de Extensão Liga Saúde da Família (LSF) constitui-se numa estratégia de gestão participativa no campo da formação de profissionais da área da saúde, com base nos conceitos de educação permanente em saúde, educação popular em saúde, equipe multiprofissional e interdisciplinar, atenção primária à saúde, promoção da saúde, estratégia saúde da família, metodologias participativas de pesquisa e atuação inserida no território vivo. Este relato apresenta a experiência da integração ensino-serviço-comunidade por meio do Projeto de Extensão Liga Saúde da Família, no contexto do Sistema Municipal de Saúde Escola (SMSE), em Fortaleza-Ceará, que dialoga com a gestão participativa no Sistema Único de Saúde (SUS). Esta proposta do LSF foi implantada no SMSE a partir de uma ação apoiada pelo sistema de saúde de Fortaleza que visa potencializar os espaços de co-gestão docente-assistencial, por meio da proposta do método da roda e da tenda invertida. O protagonismo dos integrantes e da comunidade na construção das atividades do projeto e a ampliação do olhar crítico sobre a realidade social e do trabalho em saúde estão entre os maiores avanços surgidos dessa experiência. Esse projeto permitiu a integração ensino - serviço - comunidade, atendendo a uma perspectiva de gestão participativa e dialógica.

As a result of the experience of two public universities and a private one, the Extension Project "Family Health League" (LSF) introduced a participative management strategy in the field of education of health professionals, with the support of power-ideas such as permanent education in health, popular education, multiprofessional and interdisciplinary groups, primary health attention, family health strategy, participative methodologies and practice inserted in a live territory. This report aims to introduce an experience of integrating teaching to community service through the Family Health League Extension Project (LSF), in the context of the Health-School Municipal System (SMSE) in the city of Fortaleza, Ceará, Brazil. This experience was planned in the spirit of participative management in the National Health System (SUS). The proposal of LSF emerges, in the SMSE, from a recommendation supported by the city's health system which aimed at improving co-management spaces of education and services and used the methods of circle discussion and inverted tent. The protagonism of the project members and of the community in the organization of the project's activities and the amplification of a critical view over social reality and health work are amongst the major advances which emerged from this experience. This project has made possible the integration of teaching, health service and community, from the perspective of a communicative and participative management.