This article aims to investigate the resistance profile of bacteria isolated from effluents treated in Latin American wastewater treatment plants. This systematic literature review was developed following PRISMA guidelines. The search was conducted in MEDLINE/PubMed using the PICO strategy. The included cross-sectional analytical studies were filtered according to inclusion and exclusion criteria, and bias risk was assessed using the Joanna Briggs Institute protocol. The results were tabulated during data extraction and analysis. A total of 636 articles were identified, 20 of which were eligible. The studies reported a high frequency of antimicrobial-resistant bacteria, mainly Gram-negative rods, in samples from treatment plants. The articles also noted the identification of strains co-resistant to chlorine/heavy metals and antimicrobials. The most commonly detected antimicrobial resistance genes were associated with β-lactams: blaCTX-M, blaTEM, blaSHV e blaKPC. Wastewater treatment plants may contribute to the spread of antimicrobial-resistant bacteria and antimicrobial resistance genes. Therefore, new treatment methods and joint governmental efforts are necessary to effectively tackle this issue. O objetivo do artigo é investigar o perfil de resistência de bactérias isoladas a partir de efluentes tratados em estações de tratamento de esgoto latino-americanos. Esta revisão sistemática de literatura foi desenvolvida seguindo as diretrizes PRISMA. A busca foi realizada no MEDLINE/PubMed e conduzida pela estratégia PICO. Os trabalhos de corte transversal analítico incluídos foram filtrados a partir dos critérios de inclusão e exclusão e da avaliação do risco de viés, utilizando o protocolo do Joanna Briggs Institute. Os resultados foram tabulados durante a extração e análise de dados. Foram encontrados 636 artigos, dos quais 20 foram elegíveis. Os estudos demonstraram alta frequência de bactérias resistentes a antimicrobianos, sendo a maioria bastonetes Gram-negativos, em amostras de estações de tratamento. Os artigos evidenciaram a identificação de cepas coresistentes ao cloro/metais pesados e antimicrobianos. Os genes resistentes a antimicrobianos mais encontrados tiveram associação com β-lactâmicos: blaCTX-M, blaTEM, blaSHV e blaKPC. As estações podem contribuir para a difusão de bactérias e genes de resistência. Assim, é preciso desenvolver métodos novos de tratamento e ação conjunta governamental para efetivar esse combate. El objetivo de este artículo es Investigar el perfil de resistencia de bacterias aisladas de efluentes tratados en plantas de tratamiento de aguas residuales en América Latina. Esta revisión sistemática se desarrolló según las directrices PRISMA. La búsqueda se realizó en MEDLINE/PubMed con la estrategia PICO. Los estudios transversales incluidos fueron filtrados por criterios de inclusión/exclusión, y el riesgo de sesgo se evaluó con el protocolo del Instituto Joanna Briggs. Los resultados se tabularon durante la extracción y análisis de datos. Se identificaron 636 artículos, de los cuales 20 fueron elegibles. Los estudios informaron alta frecuencia de bacterias resistentes a antimicrobianos, principalmente bacilos Gram negativos, en muestras de plantas de tratamiento. También se identificaron cepas co-resistentes al cloro/metales pesados y antimicrobianos. Los genes de resistencia detectados con mayor frecuencia estuvieron asociados con β-lactámicos: blaCTX-M, blaTEM, blaSHV y blaKPC. Las plantas de tratamiento de aguas residuales pueden contribuir a la propagación de bacterias y genes de resistencia antimicrobiana. Se requieren nuevos métodos de tratamiento y esfuerzos gubernamentales para abordar este problema.
The expansion of information and communication technologies (ICTs) has transformed the way patients access health information and manage their disease. In oncology and hematology care, the use of digital tools and mobile health has increased, especially after the COVID-19 pandemic, although challenges remain regarding adoption, trust, and perceived utility. This study aimed to evaluate the current use of ICTs by patients with cancer receiving antineoplastic and/or supportive therapy, to assess their interest in mobile apps for disease management, and to compare these findings with those obtained in a previous survey conducted in 2017. A comparative cross-sectional survey was conducted in a 1300-bed university hospital between August and December 2023. Adult patients with solid tumors or hematological malignancies receiving antineoplastic and/or supportive therapy were invited to complete a structured paper questionnaire based on a previous survey conducted in 2017. The questionnaire included 30 items regarding sociodemographic and clinical characteristics, ICT use, preferences concerning health apps, and the impact of the COVID-19 pandemic. Descriptive and inferential analyses were performed to compare results between the prepandemic survey conducted in 2017 (2017 study group; n=612) and the postpandemic survey conducted in 2023 (2023 study group; n=690). Missing responses were reported as "no response" and were not imputed. Smartphone use increased from 82.5% (505/612) to 91% (628/690; P<.001), and the proportion of patients with installed health apps rose from 20.3% (124/612) to 53.9% (372/690; P<.001). Familiarity with technological terms and the use of connected devices also improved. However, full trust in online health information remained low (64/690, 9.3%), with most patients reporting trust contingent on source credibility. Preference for videoconferencing as a communication channel with health care professionals increased from 19% (116/612) to 32% (221/690; P<.001), while the use of email and mobile apps for this purpose declined. Willingness to use apps recommended by health care professionals remained high, although it decreased slightly from 81.4% (498/612) to 77.8% (537/690). The use of ICTs and digital health tools among patients with cancer has increased significantly in recent years, particularly after the COVID-19 pandemic. Nevertheless, barriers persist in terms of source credibility, usability, digital skills, and alignment with patient preferences. Strategies such as clinician-curated information sources, co-designed apps, simple communication channels, and targeted digital literacy support may help integrate these technologies more effectively and equitably in cancer care.
The aim of this study is to examine the independent and combined associations of physical activity (PA) and sedentary behavior (SB) with metabolic syndrome (MS) components in older adults. This cross-sectional study included 473 older adults aged ≥60 years, living in the urban area of ​​the municipality of Alcobaça, Brazil, and enrolled in the municipality's Family Health Strategy. Sociodemographic information, anthropometric measurements, laboratory and behavioral data were collected. The prevalence of MS was 52.8%. Longer time spent in SB was associated with central obesity (OR 2.85; 95% CI: 1.52-5.25) and hypertension (OR 1.86; 95% CI: 1.23-2.85). In the combined analysis, insufficiently active older adults with longer SB time were more likely to have two (OR 3.90; 95% CI: 1.46-10.42) to four (OR 4.18; 95% CI: 1.12-15.62) components. Even sufficiently active older adults with longer SB time had higher odds of central obesity (OR 3.44; 95% CI: 1.51-7.87), hypertension (OR 2.30; 95% CI: 1.30-4.05), and low HDL-c levels (OR 1.84; 95% CI: 1.03-3.28). SB is a determining factor in the prevalence of MS in older adults, with implications for public health policies that promote frequent interruptions of sedentary time and encourage regular PA.
Chagas cardiomyopathy is associated with a higher risk of severe cardiovascular events and increased mortality. Among the factors associated with Chagas cardiomyopathy, impairment in functional capacity-commonly assessed using the New York Heart Association (NYHA) functional classification-is notable and may contribute to risk stratification. In this review, we assessed the prognostic value of the NYHA classification on cardiovascular events and mortality in patients with Chagas cardiomyopathy. The search was performed across EMBASE, LILACS, MEDLINE, and Web of Science databases. Prospective and retrospective cohort studies in which the prognostic value of the NYHA classification was assessed were eligible. Risk of bias was assessed using the Quality in Prognostic Studies tool. Evidence was classified using the adapted GRADE system. Eighteen studies were included in the systematic review. The meta-analysis results indicate that the NYHA classification is an important prognostic factor for mortality. Patients with NYHA class III and IV showed a higher risk of death than those with class I and II (hazard ratio, 2.63; 95% confidence interval: 2.00-3.45; moderate GRADE evidence). Patients with NYHA class IV had a higher risk of death than those with class I, II, and III (hazard ratio, 2.80; 95% confidence interval: 1.06-7.43; low GRADE evidence). Very low evidence suggests that the NYHA classification does not predict heart transplantation or stroke, but may predict cardiac pacemaker implantation. Overall, the NYHA classification is a key prognostic indicator of mortality in Chagas cardiomyopathy, although its ability to predict stroke, heart transplantation, and pacemaker implantation is inconsistent.
To assess the self-perception of health and disability of individuals with bilateral hearing loss (HL) before and after one year of using hearing aids, using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Longitudinal, observational and analytical-descriptive study, approved by the research ethics committee under opinion number 6.767.314, in which 15 individuals diagnosed with mild to severe hearing loss and wearing bilateral hearing aids (HA) were assessed. The WHODAS 2.0 was applied at the time of fitting and reapplied after one year of use. The mean scores in the six domains of the instrument (cognition, mobility, self-care, getting along, life activities and participation) were statistically analyzed. A reduction in disability was observed after using HA, with an average reduction of 12% in WHODAS scores. Domains such as cognition, self-care, and participation showed statistical differences. WHODAS 2.0 proved effective in assessing and monitoring disability and its impact on the functioning of individuals with HL, being sensitive to changes promoted by the use of HA, despite the absence of statistical significance in some variables. Avaliar a autopercepção de saúde e deficiência de indivíduos com perda auditiva (PA) bilateral antes e após um ano de uso de aparelho de amplificação sonora individual (AASI), utilizando o World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Estudo longitudinal, observacional e analítico-descritivo, aprovado pelo comitê de ética em pesquisa sob o número de parecer 6.767.314 no qual foram avaliados 15 indivíduos diagnosticados com PA de grau leve a severo, em uso de AASI bilateralmente. O WHODAS 2.0 foi aplicado no momento da adaptação e reaplicado após um ano de uso. As médias dos escores nos seis domínios do instrumento (cognição, mobilidade, autocuidado, relações interpessoais, atividades laborais e participação) foram analisadas estatisticamente. Observou-se redução da incapacidade após o uso do AASI, com redução média de 12% nos escores do WHODAS. Domínios como cognição, autocuidado e participação apresentaram diferença estatística. O WHODAS 2.0 mostrou-se eficaz para avaliar e monitorar a incapacidade e seu impacto na funcionalidade de indivíduos com PA, sendo sensível às mudanças promovidas pelo uso do AASI, apesar da ausência de significância estatística em algumas variáveis.
Primary cardiac leiomyosarcoma is an extremely rare and aggressive sarcoma. Its diagnosis is challenging, and its treatment is not yet standardized, resulting in a poor prognosis. A 29-year-old man presented with a 1-month history of respiratory symptoms, initially treated with antiflu medication and antibiotics, showing no clinical improvement. During cardiology consultation, a cardiac mass was identified on echocardiography and subsequently characterized by cardiac magnetic resonance and positron emission tomography. Histopathological and immunohistochemical studies confirmed the diagnosis. The patient remains alive at 20 months while receiving systemic treatment. The diagnosis of primary cardiac leiomyosarcoma is challenging due to its rarity and aggressive behavior; it requires multimodal imaging and immunohistochemical confirmation. Its treatment remains nonstandardized, with limited evidence supporting the benefit of combining surgery, chemotherapy, and/or radiotherapy. This case highlights the importance of timely diagnosis and documents longer survival than typically reported.
Chikungunya virus (CHIKV) can cause acute arboviral illness, usually accompanied by severe polyarthralgia. In 2025, live-attenuated CHIKV vaccine Ixchiq® (Valneva, Saint-Herblain, France) was authorised for use in Brazil, where CHIKV often co-circulates with other arboviruses. A central public health question emerges: how should this vaccine be optimally deployed in a country characterised by hyperendemic transmission, frequent underdiagnosis, and marked regional disparities? We conducted an epidemiological analysis using notified CHIKV cases from the Notifiable Diseases Information System (SINAN) and socioeconomic indicators from the Brazilian Human Development Atlas. This framework enabled the identification of municipal clusters with shared epidemiological and socioeconomic profiles, allowing exploration of the relationship between disease notification rate and social health determinants. Our results showed that CHIKV transmission exhibited a cyclic pattern with geographic expansion toward the Southeast/South - Brazil's most densely populated regions characterised by low population immunity. Cluster analyses showed that the greatest disease burden is concentrated in socioeconomically disadvantaged municipalities, particularly in the Northeast, where healthcare disparities may further impact diagnostic capacity. Based on the obtained results, we believe in a hybrid immunisation strategy starting from high-incidence municipalities in the northeast and reaching major urban centres in the southeast in order to prevent larger outbreaks. Implementation must account also for current vaccine contraindications in high-risk groups and be guided by real-time epidemiological and entomological surveillance.
In the present study, eleven new records of gasteroid fungi are described in different areas of the Brazilian Cerrado biome, distributed in three families: Geastraceae, Lycoperdaceae, and Nidulariaceae. The species Cyathus amazonicus, C. aurantiogriseocarpus, C. aff. badius, C. aff. earlei, C. gracilis, and C. magnomuralis correspond to the first records for the Brazilian Cerrado. Geastrum minimum, Calvatia nodulata, C. bicolor, and Cyathus stercoreus correspond to the second record for the Brazilian Cerrado. Lycoperdon fuligineum corresponds to the fourth record in the Cerrado areas of Brazil. The rare species Cyathus aurantiogriseocarpus and C. magnomuralis have been described again, for the first time, almost 10 years after their discovery. Both species represent the second record for science and for Brazil. The taxa described are presented on plates with detailed photographs and micrographs for each species and a map of the collection sites.
For decades, clinicians and researchers have struggled to classify pain conditions that do not fit neatly into the nociceptive, neuropathic or nociplastic frameworks. Many common disorders-from chronic low back pain to cancer pain and osteoarthritis-exhibit overlapping mechanisms and have long fallen into the 'grey zone' of mixed pain. This area has intrigued researchers yet frustrated clinicians due to the absence of a clear, unified definition. Through an international consensus process led by global leading experts, mixed pain has now been defined as pain that is associated with a lesion, disease or disorder resulting in an overlap of at least two mechanistic pain descriptors (nociceptive, neuropathic or nociplastic). This new definition may help provide the context needed to align research, refine diagnosis and design mechanism-based therapies for patients with mixed pain. It marks an important step towards conceptual clarification-from confusion to consensus, from overlap to action-transforming mixed pain from an ambiguous concept into a potential framework of modern pain taxonomy. This work provides an internationally unified consensus definition of mixed pain, addressing inconsistency in pain terminology and mechanistic classification. By defining mixed pain as the overlap of at least two mechanistic pain descriptors (nociceptive, neuropathic or nociplastic), the framework clarifies conceptual ambiguity while stressing the importance of identifying the underlying pain descriptors, supports a mechanism-based assessment and may facilitate more individualized treatment approaches in complex pain conditions while providing a practical foundation for future research, validation and clinical application.
Despite universal access to combined antiretroviral therapy in Brazil, substantial inequalities persist in the HIV/AIDS epidemic. This nationwide retrospective study analyzed 753,071 notifications from the Brazilian Notifiable Diseases Information System (SINAN) between 2014 and 2024 to characterize the epidemiological profile, temporal trends, spatial distribution, factors associated with AIDS-stage notification, and predictors of AIDS-related mortality. HIV infection notifications accounted for 491,976 records, while AIDS case notifications accounted for 261,095. HIV infection notifications were concentrated among young adults, particularly men aged 20-29 years, whereas AIDS case notifications were more frequent in older age groups. Spatial analysis showed significant positive autocorrelation of smoothed municipal notification rates (Moran's I = 0.2306; p < 0.001), with significant High-High clusters mainly in the South and Southeast regions. In the multivariable logistic regression model, older age was strongly associated with AIDS-stage notification, reaching the highest odds among individuals aged 60 years or older (AOR = 2.03; 95% CI: 1.96-2.09), while higher education was associated with lower odds. In the Cox model, age at diagnosis was the main predictor of mortality, with increased risk among individuals aged 30-49 years (AHR = 1.42; 95% CI: 1.36-1.49) and 50 years or older (AHR = 1.95; 95% CI: 1.86-2.05). Lower education and injecting drug use were also strongly associated with AIDS-related mortality. These findings indicate that, although AIDS case notifications have declined over time, AIDS-stage notification and mortality remain concentrated in socially and geographically vulnerable groups.
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The proposal for the universalization of primary health care (PHC) has become the main strategy of the Chilean government (2022-2026) for reform of the healthcare system under the values of equity in access, quality of care, and financial protection. The article identifies and analyzes strategies related to the universalization of PHC with regards to operationalization, reform, and measures to expand and qualify access to PHC. A case study was carried out with a qualitative approach based on interviews with key actors during on-site visits complemented by documental analysis. The implementation of the universalization of PHC is supported by an advisory council and commissions that seek to ensure political pluralism with a view to governability. It was initiated through pilot projects currently in 21 "pioneer communes". The following strategies to expand and qualify access to PHC stand out: extended office hours at health centers; remote demand management system; guidelines for the comprehensive management of chronic conditions with "care by pairs" and a "consensual care plan"; "citizen dialogues" and mapping of community assets to strengthen social participation. After the defeat of the proposed Constitution in 2022 and in a context conditioned by political conflicts, low governability, and the neoliberal directives of previous public policies in Chile, the universalization of PHC emerged as possible, consensual, and without substantial resistance, gaining prominence in the face of the impossibility of structural reforms in the healthcare system, which remains polarized. A proposta de universalização da atenção primária à saúde (APS) tornou-se a principal estratégia do governo chileno (2022-2026) de Reforma do Sistema de Saúde, sob os valores da equidade no acesso, qualidade dos cuidados e proteção financeira. O artigo identifica e analisa estratégias relacionadas à “universalização da APS” no que se refere à operacionalização, condução da reforma e medidas para ampliação e qualificação do acesso à APS. Foi realizado estudo de caso, com abordagem qualitativa, com base em entrevistas semiestruturadas com atores-chave, visitas in loco, complementadas por análise documental. A implementação da universalização da APS é apoiada por um Conselho Assessor e Comissões, nas quais se busca garantir o pluralismo político com vistas à governabilidade. Foi iniciada por meio de projetos pilotos, atualmente em 21 “Comunas Pioneiras”, cuja inscrição nos serviços de APS independe do tipo de asseguramento. Entre as estratégias para ampliar e qualificar o acesso à APS destacam-se: horário estendido de funcionamento dos centros de saúde; sistema de gestão remota da demanda; diretrizes para o manejo integral e integrado de condições crônicas com “atenção por duplas” e o “plano de cuidados consensuados”; “diálogos cidadãos” e cartografia dos ativos comunitários para fortalecer a participação social. No Chile, pós-derrota da proposta de Constituição em 2022 e em um contexto condicionado por conflitos políticos, baixa governabilidade, direcionalidade neoliberal das políticas públicas prévias, a universalização da APS emergiu como possível, consensual e sem resistências importantes, ganhando destaque frente à impossibilidade de reformas estruturais no sistema de saúde, que permanece dual. La propuesta de universalización de la atención primaria de salud (APS) se ha convertido en la principal estrategia del Gobierno chileno (2022-2026) para la reforma del sistema sanitario, bajo los valores de equidad en el acceso, calidad de la atención y protección financiera. Este artículo identifica y analiza estrategias relacionadas con la “universalización de la APS” en lo que se refiere a la operatividad, la conducción de la reforma y las medidas para ampliar y mejorar el acceso a la APS. Se realizó un estudio de caso, con un enfoque cualitativo, basado en entrevistas semiestructuradas con actores clave, visitas presenciales, complementadas con análisis documental. La implementación de la universalización de la APS cuenta con el apoyo de un Consejo Asesor y de Comisiones, con el fin de garantizar el pluralismo político con vistas a la gobernabilidad. Se inició mediante proyectos piloto, actualmente en 21 “Comunas Pioneras”, cuya inscripción en los servicios de APS es independiente del tipo de seguro. Entre las estrategias para ampliar y mejorar el acceso a la APS destacan: horario ampliado de funcionamiento de los centros de salud; sistema de gestión remota de la demanda; directrices para el manejo integral e integrado de las afecciones crónicas con “atención por parejas” y el “plan de cuidados consensuados”; “diálogos ciudadanos” y cartografía de los activos comunitarios para fortalecer la participación social. En Chile, tras el rechazo de la propuesta de Constitución en 2022 y en un contexto marcado por los conflictos políticos, la baja gobernabilidad y la orientación neoliberal de las políticas públicas anteriores, la universalización de la APS surgió como una posibilidad consensuada y sin resistencias importantes, ganando protagonismo ante la imposibilidad de llevar a cabo reformas estructurales en el sistema de salud, que sigue siendo dual.
Amorphinopsis atlantica (Halichondriidae) is the only known species of its genus in the Atlantic Ocean. It is a brittle, massive sponge with variable projections and coloration ranging from yellow to dark green, characterized by oxeas and accessory styles. Originally described from Brazil's southwestern coast, it has since been reported in several Caribbean sites, typically inhabiting submerged mangrove stilt-roots in coastal lagoons. Although shallow-water sponges in the Colombian Caribbean have been studied, this conspicuous species had not been previously documented in lagoonal systems of the region. This study reports its presence for the first time in the Mallorquín (Atlántico Department) and La Escollera (Magdalena Department) coastal lagoons. The report includes new information on its morphology, habitat, substrata, distribution, and ecology in the Colombian Caribbean. Two potential threats to the species were identified: in some areas of the Mallorquín coastal lagoon, a high degree of sedimentation was observed, causing individuals to become buried within the sediment, while in La Escollera, recent heavy rainfall and runoff events were followed by the disappearance of sponges from mangrove roots. These findings highlight the need to incorporate A. atlantica into local management plans to ensure its protection.
The aim of this study is to identify the occurrence of work-related stress and associate it with sociodemographic and health aspects in quilombolas living in rural communities in the north of Minas Gerais, Brazil. This is a cross-sectional study carried out in 2019 using semi-structured interviews and applying the Job Stress Scale (JSS). The analysis was carried out using descriptive statistics, univariate and multivariate analysis, using multinomial logistic regression. A positive association was identified between high-strain work and being under 40 years of age (OR: 2.32; 95%CI 1.12-4.80), working as a rural or agricultural employee (OR: 2.36; 95%CI 1.07-5.18), and low social support (OR: 2.5; 95%CI 1.30-5.09). A significant association was also observed among individuals who tested positive for common mental disorders and active work. (OR: 2.96; 95%CI 1.34-6.97). The relationship between stress and the occurrence of common mental disorders in high-burden activities and active work highlights the need for the integration of the National Workers' Health Policy, the Psychosocial Care Network, and professional training institutions, identifying and addressing needs and health issues. O objetivo do estudo é identificar a ocorrência de estresse relacionado ao trabalho e associá-lo a aspectos sociodemográficos e de saúde em quilombolas residentes em comunidades rurais no norte de Minas Gerais, Brasil. Trata-se de estudo transversal realizado em 2019 a partir de entrevistas semiestruturadas e aplicado a Job Stress Scale (JSS). A análise foi realizada pela estatística descritiva, análise univariada e multivariada, pela regressão logística multinomial. Identificou-se associação positiva do trabalho de alto desgaste com idade inferior a 40 anos (OR: 2,32; IC95% 1,12-4,80), empregado rural ou agricultor (OR: 2,36; IC95% 1,07-5,18) e baixo apoio social (OR: 2,5; IC95% 1,30-5,09). Também foi observada associação significativa em indivíduos com resultado positivo para transtornos mentais comuns e trabalho ativo (OR: 2,96; IC95% 1,34-6,97). A relação entre o estresse e ocorrência de transtornos mentais comuns em atividades de alto desgaste e trabalho ativo, evidencia a necessidade de integração da Política Nacional de Saúde do Trabalhador, Rede de Atenção Psicossocial e instituições de qualificação profissional, identificando e intervindo em necessidades e problemas de saúde. El objetivo del estudio es identificar la aparición de estrés relacionado al trabajo y asociarlo a aspectos sociodemográficos y de salud en quilombolas habitantes del campo en el norte de Minas Gerais, Brasil. Se trata de un estudio transversal realizado en 2019 a partir de entrevistas semiestructuradas y aplicado a Job Stress Scale (JSS). El análisis fue realizado por la estadística descriptiva, análisis univariada y multivariada, por la regresión logística multinomial. Se identificó asociación positiva de trabajo de alto daño con edad inferior a 40 años (OR: 2,32; IC95% 1,12-4,80), empleado del campo o agricultor (OR: 2,36; IC95% 1,07-5,18) y bajo apoyo social (OR:2,5; IC95% 1,30-5,09). También fue observada asociación significativa en individuos con resultado positivo para trastornos mentales comunes y trabajo activo (OR: 2,96; IC95% 1,34-6,97). La relación entre el estrés y aparición de trastornos mentales comunes en actividades de alto daño y trabajo activo, evidencia la necesidad de integración de la Política Nacional de Salud del Trabajador, Rede de Atención Psicosocial e instituciones de calificación profesional, identificando y haciendo intervenciones en necesidades y problemas de salud.
Pines and oaks are ecologically and economically important taxa that co-occur in several forest and woodland systems across the northern hemisphere and that have been severely affected by diverse disturbances (e.g., wildfire, drought). Despite their relevance, the value of co-planting pines, that regenerate from seeds, and oaks, which are able to resprout, to improve forest restoration following disturbance has only recently been appreciated. An important consideration with this strategy is whether pines and oaks share root-associated fungal symbionts (ectomycorrhizas -EcM-, arbuscular mycorrhizas -AM- and dark septate endophytes -DSE-) that can be key to tree re-establishment following disturbance. However, the degree of overlap in fungal communities between pines and oaks is poorly understood. To address this knowledge gap, we conducted a systematic literature review of 948 studies published from 1969 to 2024. We hypothesized that both plant taxa would host DSE in addition to EcM, and that ectomycorrhizal fungal (EcMF) assemblages would differ in pines and oaks but that both host genera would share a limited subset of generalist taxa. We found that oaks and pines were mainly colonized by different EcMF species but also shared some taxa (26%), particularly members of the Russulaceae and Cortinariaceae. Few studies measured DSE or AM in addition to EcM, and the EcMF community of pines was better studied (~ 50% of described species) than that of oaks (~ 12%). We also conducted a greenhouse experiment using P. ponderosa and Q. gambelii as model species and the same mixed-forest soil as an EcMF inoculum source. We found that, at early developmental stages, both plant species formed associations with DSE but not AMF. For EcMF, P. ponderosa and Q. gambelii showed distinct communities with 30% of taxa in common. Importantly, when relative abundance of EcMF species was considered rather than occurrence only, the overlap between oaks and pines was more striking, approaching 90%. Taken together, these results support our hypothesis that Pinus and Quercus host distinct EcMF communities, but also share significant numbers of taxa. We discuss the potential relevance of this fungal overlap for understanding belowground linkages in mixed pine-oak systems and for future restoration-oriented research.
Cardiovascular magnetic resonance (CMR) is the reference standard for morphofunctional cardiac assessment. In Brazil, the application of international normal reference values faces challenges related to population admixture, technical heterogeneity among centers, and the absence of national standardization, all of which may affect diagnostic accuracy. To compare normal reference values for morphofunctional parameters obtained by CMR between a multicenter international review and a Brazilian publication, discussing concordance, methodological differences, and implications for Brazilian clinical practice. An analytical-comparative review was performed using summarized data from an international reference-value review and a Brazilian study. Means and standard deviations of key ventricular variables were compared, with assessment of 95% CI overlap, Welch's t-test, and effect size (Hedges' g). Standard-deviation-based cut-off points were proposed for grading abnormality. Overall concordance between means was observed for most variables. Statistically significant differences occurred in a few parameters, mainly ventricular diameters and left ventricular mass, with small to moderate effect sizes. Discrepancies were largely attributed to methodological differences in measurement and indexation. International normal reference values may be used in Brazilian clinical practice, provided they are adjusted for body surface area and interpreted in light of local particularities. Standardization of protocols and national multicenter studies are needed to strengthen regional validation. Keywords: Normal Values, Cardiac Magnetic Resonance, Reference Interval. A ressonância magnética cardiovascular (RMC) é o método de referência para avaliação morfofuncional cardíaca. No Brasil, a aplicação de valores de normalidade internacionais enfrenta desafios relacionados à miscigenação populacional, heterogeneidade técnica entre centros e ausência de padronização nacional, o que pode impactar a acurácia diagnóstica. Comparar valores de normalidade de parâmetros morfofuncionais obtidos por RMC entre uma revisão internacional multicêntrica e uma publicação nacional, discutindo concordância, divergências metodológicas e implicações para a prática clínica brasileira. Revisão analítico-comparativa entre dados sumarizados de uma revisão internacional de valores de referência em RMC e um estudo brasileiro. Foram comparadas médias e desvios-padrão das principais variáveis ventriculares, com avaliação de sobreposição de IC95%, teste t de Welch e tamanho de efeito (Hedges’ g). Propuseram-se pontos de corte baseados em desvios-padrão para gradação de anormalidade. Observou-se concordância global entre as médias na maioria das variáveis. Diferenças estatisticamente significativas ocorreram em poucos parâmetros, principalmente diâmetros ventriculares e massa ventricular esquerda, com tamanhos de efeito pequenos a moderados. As discrepâncias foram atribuídas, em grande parte, a diferenças metodológicas de mensuração e indexação. Os valores internacionais de normalidade podem ser utilizados na prática clínica brasileira, desde que ajustados por superfície corporal e interpretados à luz de particularidades locais. A padronização de protocolos e estudos multicêntricos nacionais são necessários para maior robustez e validação regional.
to identify interventions aimed at improving the mental health of family caregivers, whether or not focused on health literacy and health gains. this systematic review was conducted in accordance with the Joanna Briggs Institute guidelines and involved searches in nine databases. Primary studies published in English, Spanish, and Portuguese were included if they developed, tested, or implemented programmes designed to promote positive mental health among caregivers aged 18 years and older. seven original studies were included, comprising randomised controlled trials, quasi-experimental studies, mixed-methods studies, and pilot studies conducted across different countries. The interventions ranged from home visits and problem-solving techniques to online psychoeducational courses and caregiver training programmes. Significant improvements were observed in depression, anxiety, caregiver burden, and positive mental health, alongside a significant increase in caregivers' skills and knowledge. this review demonstrates that educational and psychosocial approaches contribute positively to improving the mental health of informal caregivers.
to verify the association between adherence to the Mediterranean diet (MedDiet), sociodemographic, clinical, and biochemical factors, and hospital readmission in patients with coronary artery disease. prospective cohort study in a tertiary hospital. MedDiet adherence was analyzed at admission and at three and six months after discharge using the Mediterranean Diet Adherence Screener. C-reactive protein, total cholesterol, LDL cholesterol, and triglycerides were analyzed at admission and six months after discharge; readmission was assessed at three and six months. Associations were verified using the generalized estimating equation model, with p-values ≤0.05 considered significant. a total of 146 patients participated, mostly men, with a mean age of 66 years. MedDiet adherence increased from 3% to 41% and 47% during follow-up and was associated with age, female gender, complete higher education, economic activity, and previous myocardial revascularization. MedDiet adherence was associated with sociodemographic and clinical factors.
We propose using the electrospray cone-jet mode operated near its minimum-flow-rate stability limit for single-cell deposition. Because the jet is much thinner than the cells themselves, individual cells can be clearly visualized or detected during deposition. At such low flow rates, individual cells could potentially be placed at distinct, user-defined locations, even at relatively high cell concentrations. In this sense, our approach provides a spatial resolution at the scale of a single cell. We demonstrate the method's capabilities by depositing cells onto a millimeter-scale droplet of a standard cell-culture medium. Cell viability assays indicate that many cells maintain membrane integrity after exposure to the electrosprayed liquid, suggesting that the process can preserve cell integrity in a substantial fraction of cells under the tested conditions.