Ent-kaurane diterpenoids and other constituents from the stem of Xylopia laevigata (Annonaceae)

Phytochemical investigation of the hexane extract from the stem of Xylopia laevigata led to the isolation of the ent-kaurane diterpenoids, ent-kaur-16-en-19-oic acid, 4-epi-kaurenic acid, ent-16β-hydroxy-17-acetoxy-kauran-19-al, ent-3β-hydroxy-kaur-16-en-19-oic acid, and ent-16β,17-dihydroxy-kauran-19-oic acid, as well as spathulenol and a mixture of β-sitosterol, stigmasterol and campesterol. The identification of the compounds was performed on the basis of spectrometric methods including GC-MS, IR, and 1D and 2D NMR. Potent larvicidal activity against Aedes aegypti larvae with LC50 of 62.7 µg mL-1 was found for ent-3β-hydroxy-kaur-16-en-19-oic acid. This compound also showed significant antifungal activity against Candida glabrata and Candida dubliniensis with MIC values of 62.5 µg mL-1

Impact of COVID-19 In-hospital Mortality in Chagas Disease Patients

The COVID-19 virus infection caused by the new SARS-CoV-2 was first identified in Rio de Janeiro (RJ), Brazil, in March 2020. Until the end of 2021, 504,399 COVID-19 cases were confirmed in RJ, and the total death toll reached 68,347. The Evandro Chagas National Institute of Infectious Diseases from Oswaldo Cruz Foundation (INI-Fiocruz) is a referral center for treatment and research of several infectious diseases, including COVID-19 and Chagas disease (CD). The present study aimed to evaluate the impact of COVID-19 on in-hospital mortality of patients with CD during the COVID-19 pandemic period. This observational, retrospective, longitudinal study evaluated all patients with CD hospitalized at INI-Fiocruz from May 1, 2020, to November 30, 2021. One hundred ten hospitalizations from 81 patients with CD (58% women; 68 ± 11 years) were evaluated. Death was the study's main outcome, which occurred in 20 cases. The mixed-effects logistic regression was performed with the following variables to test whether patients admitted to the hospital with a COVID-19 diagnosis would be more likely to die than those admitted with other diagnoses: admission diagnosis, sex, age, COVID-19 vaccination status, CD clinical classification, and the number of comorbidities. Results from multiple logistic regression analysis showed a higher risk of in-hospital mortality in patients diagnosed with COVID-19 (OR 6.37; 95% CI 1.78–22.86) compared to other causes of admissions. In conclusion, COVID-19 infection had a significant impact on the mortality risk of INI-Fiocruz CD patients, accounting for one-third of deaths overall. COVID-19 presented the highest percentage of death significantly higher than those admitted due to other causes during the COVID-19 pandemic

AVANÇOS TECNOLÓGICOS PARA A MANUTENÇÃO DA SAÚDE MENTAL NO CLIMATÉRIO: UMA REVISÃO INTEGRATIVA

INTRODUÇÃO: Trata-se de uma revisão integrativa que possibilita investigar as tecnologias educacionais para promoção da saúde mental no climatério, abordando temáticas de prevenção, monitoramento e diminuição dos sintomas e processos vivenciados no climatério. METODOLOGIA: Tendo como método para realizar essa revisão integrativa, foi seguido o protocolo proposto por Mendes, Silveira e Galvão, de abordagem qualitativa da literatura científica. A análise dos artigos incluídos foi feita de forma qualitativa, buscando identificar as tecnologias educacionais relacionadas à promoção da saúde mental no climatério e avaliar sua efetividade e acessibilidade. O objetivo desta revisão integrativa foi identificar e analisar as tecnologias educacionais disponíveis para promoção da saúde mental no climatério, a fim de contribuir para a ampliação do conhecimento nessa área e subsidiar a prática clínica e a tomada de decisão dos profissionais de saúde. RESULTADOS: As tecnologias em saúde minimizam as inseguranças e incertezas que perpassam esse período e que dão autonomia para o autocuidado e comunicação facilitada, podendo reduzir alguns dos sintomas psicológicos e físicos com apoio remoto, possibilitando uma troca de experiências e apontando resultados positivos em relação ao desaparecimento de sintomas mentais que geralmente estão presentes nesse processo. CONCLUSÃO: A partir da análise descrita foi possível identificar a influência desses fatores no cotidiano e a escassez dessas tecnologias tão importantes no processo do climatério

Avanços nas Técnicas de Cirurgia Geral e Plástica para Correção de Fissura Palatina: Uma Revisão Sistemática

This article aims to evaluate advances in surgical techniques for the correction of cleft palate, highlighting the associated benefits and challenges. The specific objectives include identifying and describing the latest techniques, assessing their effectiveness in improving speech, comparing recovery times and complications, studying the success rate in preventing postoperative complications, and examining the need for complementary interventions such as speech therapy. The methodology used was a descriptive and qualitative bibliographic review, analyzing studies published between 2009 and 2024, in Portuguese and English. The databases consulted were PubMed, Scielo, and Google Scholar. The analysis focused on the effectiveness of surgical techniques in improving speech function, reducing recovery times, preventing postoperative complications, and evaluating the need for complementary interventions. The results indicate that recent advances, such as endoscopic surgery and the use of dynamic tension devices, have shown significant benefits, including less tissue trauma, reduced scarring, and better functional and aesthetic outcomes. Additionally, robotic surgery and 3D printing have contributed to personalized surgical planning, resulting in more precise and predictable procedures. Techniques such as Furlow and Bardach present higher success rates in speech correction and prevention of postoperative complications. The conclusion highlights the critical importance of surgical techniques for the correction of cleft palate, evidencing significant advances and associated challenges. Early surgical correction is essential to restore palate integrity, promoting improvements in speech, feeding, hearing, and facial aesthetics. A multidisciplinary approach involving surgeons, speech therapists, orthodontists, and other healthcare professionals is fundamental to ensure the best long-term outcomes for patients with cleft palate. Continued research in this area is crucial to enhance treatment strategies, ensure the safety and efficacy of procedures, and improve patients' quality of life.Este artigo tem como objetivo geral avaliar os avanços nas técnicas cirúrgicas para a correção de fissura palatina, destacando os benefícios e desafios associados. Os objetivos específicos incluem identificar e descrever as técnicas mais recentes, avaliar sua eficácia na melhora da fala, comparar tempos de recuperação e complicações, estudar a taxa de sucesso na prevenção de complicações pós-operatórias e examinar a necessidade de intervenções complementares, como fonoaudiologia. A metodologia utilizada foi uma revisão bibliográfica descritiva e qualitativa, analisando estudos publicados entre 2009 e 2024, em português e inglês. As bases de dados consultadas foram PubMed, Scielo e Google Scholar. A análise focou na eficácia das técnicas cirúrgicas em melhorar a função da fala, reduzir tempos de recuperação, prevenir complicações pós-operatórias e avaliar a necessidade de intervenções complementares. Os resultados indicam que os avanços recentes, como a cirurgia endoscópica e a utilização de dispositivos de tensão dinâmica, têm mostrado benefícios significativos, incluindo menor trauma tecidual, cicatrizes reduzidas e melhores resultados funcionais e estéticos. Além disso, a cirurgia robótica e a impressão 3D têm contribuído para o planejamento cirúrgico personalizado, resultando em procedimentos mais precisos e previsíveis. Técnicas como a de Furlow e a de Bardach apresentam melhores taxas de sucesso na correção da fala e na prevenção de complicações pós-operatórias. A conclusão destaca a importância crítica das técnicas cirúrgicas para a correção da fissura palatina, evidenciando os avanços significativos e os desafios associados. A correção cirúrgica precoce é essencial para restaurar a integridade do palato, promovendo melhorias na fala, alimentação, audição e estética facial. A abordagem multidisciplinar envolvendo cirurgiões, fonoaudiólogos, ortodontistas e outros profissionais de saúde é fundamental para garantir os melhores resultados a longo prazo para pacientes com fissura palatina. A continuidade de pesquisas nesta área é crucial para aprimorar as estratégias de tratamento, garantir a segurança e eficácia dos procedimentos e melhorar a qualidade de vida dos pacientes. &nbsp

High anti-SARS-CoV-2 antibody seroconversion rates before the second wave in Manaus, Brazil, and the protective effect of social behaviour measures: results from the prospective DETECTCoV-19 cohort

Background: The city of Manaus, Brazil, has seen two collapses of the health system due to the COVID-19 pandemic. We report anti-SARS-CoV-2 nucleocapsid IgG antibody seroconversion rates and associated risk factors in Manaus residents before the second wave of the epidemic in Brazil. Methods: A convenience sample of adult (aged ≥18 years) residents of Manaus was recruited through online and university website advertising into the DETECTCoV-19 study cohort. The current analysis of seroconversion included a subgroup of DETECTCoV-19 participants who had at least two serum sample collections separated by at least 4 weeks between Aug 19 and Oct 2, 2020 (visit 1), and Oct 19 and Nov 27, 2020 (visit 2). Those who reported (or had no data on) having a COVID-19 diagnosis before visit 1, and who were positive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at visit 1 were excluded. Using an in-house ELISA, the reactivity index (RI; calculated as the optical density ratio of the sample to the negative control) for serum anti-SARS-CoV-2 nucleocapsid IgG antibodies was measured at both visits. We calculated the incidence of seroconversion (defined as RI values ≤1·5 at visit 1 and ≥1·5 at visit 2, and a ratio >2 between the visit 2 and visit 1 RI values) during the study period, as well as incidence rate ratios (IRRs) through cluster-corrected and adjusted Poisson regression models to analyse associations between seroconversion and variables related to sociodemographic characteristics, health access, comorbidities, COVID-19 exposure, protective behaviours, and symptoms. Findings: 2496 DETECTCoV-19 cohort participants returned for a follow-up visit between Oct 19 and Nov 27, 2020, of whom 204 reported having COVID-19 before the first visit and 24 had no data regarding previous disease status. 559 participants were seropositive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at baseline. Of the remaining 1709 participants who were seronegative at baseline, 71 did not meet the criteria for seroconversion and were excluded from the analyses. Among the remaining 1638 participants who were seronegative at baseline, 214 showed seroconversion at visit 2. The seroconversion incidence was 13·06% (95% CI 11·52–14·79) overall and 6·78% (5·61–8·10) for symptomatic seroconversion, over a median follow-up period of 57 days (IQR 54–61). 48·1% of seroconversion events were estimated to be asymptomatic. The sample had higher proportions of affluent and higher-educated people than those reported for the Manaus city population. In the fully adjusted and corrected model, risk factors for seroconversion before visit 2 were having a COVID-19 case in the household (IRR 1·49 [95% CI 1·21–1·83]), not wearing a mask during contact with a person with COVID-19 (1·25 [1·09–1·45]), relaxation of physical distancing (1·31 [1·05–1·64]), and having flu-like symptoms (1·79 [1·23–2·59]) or a COVID-19 diagnosis (3·57 [2·27–5·63]) between the first and second visits, whereas working remotely was associated with lower incidence (0·74 [0·56–0·97]). Interpretation: An intense infection transmission period preceded the second wave of COVID-19 in Manaus. Several modifiable behaviours increased the risk of seroconversion, including non-compliance with non-pharmaceutical interventions measures such as not wearing a mask during contact, relaxation of protective measures, and non-remote working. Increased testing in high-transmission areas is needed to provide timely information about ongoing transmission and aid appropriate implementation of transmission mitigation measures. Funding: Ministry of Education, Brazil; Fundação de Amparo à Pesquisa do Estado do Amazonas; Pan American Health Organization (PAHO)/WHO.World Health OrganizationRevisión por pare

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost