Identification of a Zika NS2B epitope as a biomarker for severe clinical phenotypes

The identification of specific biomarkers for Zika infection and its clinical complications is fundamental to mitigate the infection spread, which has been associated with a broad range of neurological sequelae. We present the characterization of antibody responses in serum samples from individuals infected with Zika, presenting non-severe (classical) and severe (neurological disease) phenotypes, with high-density peptide arrays comprising the Zika NS1 and NS2B proteins. The data pinpoints one strongly IgG-targeted NS2B epitope in non-severe infections, which is absent in Zika patients, where infection progressed to the severe phenotype. This differential IgG profile between the studied groups was confirmed by multivariate data analysis. Molecular dynamics simulations and circular dichroism have shown that the peptide in solution presents itself in a sub-optimal conformation for antibody recognition, which led us to computationally engineer an artificial protein able to stabilize the NS2B epitope structure. The engineered protein was used to interrogate paired samples from mothers and their babies presenting Zika-associated microcephaly and confirmed the absence of NS2B IgG response in those samples. These findings suggest that the assessment of antibody responses to the herein identified NS2B epitope is a strong candidate biomarker for the diagnosis and prognosis of Zika-associated neurological disease

Ongoing monkeypox virus outbreak, Portugal, 29 April to 23 May 2022

Up to 27 May 2022, Portugal has detected 96 confirmed cases of monkeypox. We describe 27 confirmed cases (median age: 33 years (range: 22–51); all males), with an earliest symptom onset date of 29 April. Almost all cases (n = 25) live in the Lisbon and Tagus Valley health region. Most cases were neither part of identified transmission chains, nor linked to travel or had contact with symptomatic persons or with animals, suggesting the possible previously undetected spread of monkeypox.info:eu-repo/semantics/publishedVersio

Land use, land cover change and sustainable intensification of agriculture and livestock in the Amazon and the Atlantic Forest in Brazil.

The Amazon and the Atlantic Forest are Brazilian biomes that suffered an intense land use and land cover change, marked by the loss of native forest and expansion of agriculture and livestock. This article aims to analyze land use and land cover change history and to propose a sustainable alternative for agriculture and livestock as an opportunity for rural development in these biomes. The statistics of the platform from the Annual Mapping Project for Land Use and Land Cover in Brazil (MapBiomas) were used in an annual historical series from 1985 to 2020. The analysis of land use and land cover changes indicates that the Amazon native forest was reduced by 44.53 million hectares (Mha), while pasture, agriculture and planted forest increased by 38.10, 6.06 and 0.26 Mha, respectively, over the 35 years (1985 to 2020). In the Atlantic Forest, for the same period, forest and pasture reduced by 0.99 and 11.53 Mha, respectively, while agriculture expanded by 8.06 Mha and planted forest by 2.99 Mha. Sustainable land use strategies, such as the Integration Crop-Livestock-Forest (ICLF), can support the increase in agricultural production while recovering and preserving the environment. Policies and programs should consider regional particularities and barriers for more significant adoption of this strategy

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): study protocol for a randomized controlled trial

BACKGROUND: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). METHODS/DESIGN: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH2O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure 6430 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. DISCUSSION: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration metho

Caracterização morfológica de nanocristais de celulose por microscopia de força atômica

RESUMO O isolamento de nanocristais de celulose (CNCs) de fibras vegetais é uma alternativa promissora para sua aplicação como reforço em matrizes poliméricas. A caracterização dos CNCs é fundamental para a confiabilidade da técnica, além de determinar as aplicações possíveis a partir de cada tipo de fibra. A partir da técnica de microscopia de força atômica, um estudo da morfologia e distribuição dos CNCs de semente de manga, vagem de algaroba, pseudocaule da bananeira e fibra do mesocarpo de dendê foi realizado neste trabalho. Os CNCs foram obtidos via reação hidrolítica com ácido sulfúrico em concentrações que variaram de acordo com a fonte da fibra. Os resultados obtidos revelaram dimensões variando de 300 a 500 nm em comprimento e 4 a 16 nm em diâmetro. A apresentação morfológica em forma de agulha demonstrou que o isolamento das fibras de celulose em CNCs foi efetiva. A razão de aspecto associada à formação cilíndrica em agulha dos CNCs isolados evidenciou o alto potencial das fontes de dendê e de vagem de algaroba para o reforço de bionanocompósitos

Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry

Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P\ua0 64 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P\ua0=\ua00.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P\ua075 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF 6445%