Factors associated with minor psychiatric disorders among women selected from a healthcare center in Rio de Janeiro, Brazil

The aim was to investigate factors potentially associated with minor psychiatric disorders, including maternal nutritional status variables. A cohort was studied with 479 women 15-45 years of age. The reduced General Health Questionnaire (GHQ ­ 12 items) was applied at nine months post-partum with the 312 women who had completed follow-up. Minor psychiatric disorder was defined as a GHQ score of > 4 points and was treated as the response variable. Statistical analysis used hierarchical multivariate logistic regression models. The prevalence of minor psychiatric morbidity was 54.2% (95%CI: 48.6-59.7). According to the final model, the following variables remained statistically associated with minor psychiatric morbidity: level 1: total family income (1st quartile: OR = 2.71, 95%CI: 1.42-5.19; 2nd quartile: OR = 2.13; 95%CI: 1.13-4.04); level 3: body fat > 30% (OR = 1.66; 95%CI: 1.03-2.65). In conclusion, low income and obesity were the only factors potentially associated with minor psychiatric disorders, even after adjusting for confounding variables, while there are few studies relating maternal nutritional status and minor psychiatric morbidity.O objetivo foi investigar fatores potencialmente associados às morbidades psiquiátricas menores, incluindo variáveis do estado nutricional materno. Foi estudada uma coorte com 479 mulheres entre 15 ­ 45 anos. O General Health Questionnaire (GHQ) reduzido (12 itens) foi aplicado, aos nove meses pós-parto, nas 312 mulheres que completaram o seguimento. A presença de morbidades psiquiátricas menores foi definida como valores do escore derivado do GHQ > 4 pontos, sendo analisada como variável dependente. As análises foram realizadas com modelos de regressão logística multivariados hierarquizados. A prevalência de morbidades psiquiátricas menores foi de 54,2% (IC95%: 48,6-59,7). Os resultados do modelo final revelaram que as seguintes variáveis permaneceram estatisticamente associadas: nível 1: renda familiar (1º quartil: OR = 2,71; IC95%: 1,42-5,19; 2º quartil: OR = 2,13; IC95%: 1,13-4,04); nível 3: gordura corporal > 30% (OR = 1,66; IC95%: 1,03-2,65). Conclui-se que a baixa renda e a obesidade foram os únicos fatores potencialmente associados à probabilidade de ocorrência de morbidades psiquiátricas menores, mesmo após o controle para variáveis de confusão, e que são escassos os estudos relacionando estado nutricional materno e morbidades psiquiátricas menores.Universidade Federal do Rio de Janeiro Instituto de Nutrição Josué de CastroUniversidade Federal de Minas Gerais Departamento de Medicina Social e PreventivaUniversidade Federal de Goiás Faculdade de NutriçãoUniversidade Federal de São Paulo (UNIFESP) Departamento de PsiquiatriaUNIFESP, Depto. de PsiquiatriaSciEL

Desarrollo del Modelo Servqual para la Medición de la Calidad del Servicio en la Facultad de Ingeniería de la Universidad de Panamá, 2022- 2023

The evaluation of Diagnostic Quality Management compliance with the development activities of a system in general. This evaluation allows the optimization of processes in the admission system at the engineering faculty of the University of Panama. The objective of the research was to develop the SERVQUAL model for measuring service quality at the Faculty of Engineering of the University of Panama. Quality management evaluation is a continuous activity that allows to optimize processes in any complex organization. The processes of admission to higher education centers such as the Engineering Faculty of the University of Panama are of vital importance since they are the first contact that users interested in joining this study center will have. Currently, it is a necessity at the University of Panama the quality management evaluation process to optimize the admissions process, the methodology used in the research has a quantitative, experimental, prospective approach, the data obtained are of primary source made by the researcher in empirical form. The technique used to carry out this research was the survey and the measuring instrument is the questionnaire of eighteen questions according to the SERVQUAL model, developed by Parasuraman, Zeithaml and Berry (1994) through a sample of 40 applicants to enter the Engineering faculty, for the tabulation of data Microsoft Excel software was used. The result is 87% satisfaction in the quality perceived by users. The results show that the applicants are satisfied by the attention and information received by the Faculty of Engineering during their university admission process. In conclusion, through the evaluation of quality management, the optimization of admission processes was developed at the Faculty of Engineering of the University of Panama. Optimizing the process and making an assessment of the quality of the process helped the admissions management and the Engineering faculty to reduce time, maintain the satisfaction of first-time students and in turn make a continuous improvement of the process under study.La evaluación de la Gestión de Calidad diagnóstica el cumplimiento del desarrollo las actividades de un sistema en general. Esta evaluación permite la optimización de procesos en el sistema de admisión en la facultad de ingeniería de la Universidad de Panamá. El objetivo de la investigación desarrollar el modelo SERVQUAL para la medición de la calidad del servicio en la Facultad de Ingeniería de la Universidad de Panamá. La evaluación de la gestión de calidad es una actividad continua que permite optimizar los procesos en toda organización compleja. Los procesos de admisión en centros superiores de educación como la Facultad de Ingeniería de la Universidad de Panamá son de vital importancia ya que son el primer contacto que tendrán los usuarios interesados en formar parte de ese centro de estudio. Actualmente, es una necesidad en la Universidad de Panamá el proceso de evaluación de la gestión de calidad para optimizar el proceso de admisión, la metodología que se utilizó en la investigación tiene un enfoque cuantitativo, experimental, prospectivo, los datos obtenidos son de fuente primaria realizados por el investigador en forma empírica. La técnica que se utilizó para llevar a cabo esta investigación fue la encuesta y el instrumento de medición es el cuestionario de dieciocho preguntas de acuerdo con el modelo SERVQUAL, desarrollado por Parasuraman, Zeithaml y Berry (1994) mediante una muestra de 40 aspirantes a ingresar a la facultad de Ingeniería, para la tabulación de los datos se utilizó el software Microsoft Excel. El resultado presenta un 87% de satisfacción en la calidad percibida por los usuarios. Los resultados muestran que los aspirantes se encuentran satisfechos por la atención e información recibida por parte de la facultad de Ingeniería durante su proceso de admisión universitaria. En conclusión, mediante la evaluación de la gestión de calidad se desarrolló la optimización de procesos de Admisión en la Facultad de Ingeniería de la Universidad de Panamá. Optimizar el proceso y hacer una evaluación de la calidad del mismo ayudo a la dirección de admisión y a la facultad de Ingeniería a reducir tiempos, mantener la satisfacción de los estudiantes de primer ingreso y a su vez realizar una mejora continua del proceso en estudio

Essential Oil Chemical Composition, Antioxidant and Antibacterial Activities of Eucalyptus largiflorens F. Muell

In this study, we investigated the chemical composition, the antibacterial activity, and the antioxidant properties of extracts obtained from the leaves, flowers, and fruits of Eucalyptus largiflorens F. Muell. The antioxidant effects of the methanolic extract of aerial parts of the plant, obtained by Soxhlet apparatus, were estimated using 1,1-diphenyl-2-picrylhydrazyl (DPPH) and β-carotene/linoleic acid methods. The essential oils were chemically characterized by gas chromatography (GC) coupled with mass spectrometry (MS) and flame ionization detector (FID). Thirty compounds were identified, with 1,8-cineol, α-pinene, aromadendrene, globulol and α-phellandrene being the major components. The antibacterial activities of the essential oils were tested against several bacterial isolates, including Staphylococcus aureus, Staphylococcus epidermidis and Escherichia Coli, using the disc diffusion method. All the essential oils exhibited antibacterial activity. The maximum zone of inhibition was observed for Escherichia coli, with the fruit essential oil in the concentration (100 μL). There was no significant antioxidant activity in the essential oils, while the extracts exhibited considerable antioxidant effects in comparison to butylated hydroxytoluene (BHT). In this regard, the flower extract showed the highest antioxidant activity in both DPPH (IC50 = 21.5±0.2 μg/mL) and β-carotene/linoleic acid tests (Inhibition (%) = 84.3±0.7). Finally, the fruit essential oil exerts a significant antibacterial activity against several bacterial strains and exhibits a significant antioxidant effect in the β-carotene/linoleic acid tests, thus it may represent an innovative nutraceutical tool able to act on bacteria and host oxidative stress related to infections

Case Report - Multinodular goiter in a patient with Congenital Hypothyroidism and Bannayan-Riley-Ruvalcaba syndrome: the possible synergic role of TPO and PTEN mutation

We report the case of a paediatric female patient affected by Bannayan-Riley-Ruvalcaba syndrome (BRRS) and congenital hypothyroidism (CH) with homozygous mutation of the TPO gene. She underwent total thyroidectomy at the age of seven years because of the development of a multinodular goiter. BRRS patients present an increased risk of benign and malignant thyroid disease since childhood because of inactivating mutation of PTEN, an onco-suppressor gene. Instead, homozygous mutations in the TPO gene can be associated with severe forms of hypothyroidism with goiter; previous studies have described cases of follicular and papillary thyroid cancer in CH patients with TPO mutation despite a perfectly controlled thyroid function with Levothyroxine therapy. To our knowledge, this is the first case that describes the possible synergic role of coexisting mutation of both TPO and PTEN in the development of multinodular goiter underlining the importance of a tailored surveillance program in these patients, especially during childhood

Myocarditis in CD8-Depleted SIV-Infected Rhesus Macaques after Short-Term Dual Therapy with Nucleoside and Nucleotide Reverse Transcriptase Inhibitors

Background: Although highly active antiretroviral therapy (HAART) has dramatically reduced the morbidity and mortality associated with HIV infection, a number of antiretroviral toxicities have been described, including myocardial toxicity resulting from the use of nucleotide and nucleoside reverse transcriptase inhibitors (NRTIs). Current treatment guidelines recommend the use of HAART regimens containing two NRTIs for initial therapy of HIV-1 positive individuals; however, potential cardiotoxicity resulting from treatment with multiple NRTIs has not been addressed. Methodology/Principal Findings: We examined myocardial tissue from twelve CD8 lymphocyte-depleted adult rhesus macaques, including eight animals infected with simian immunodeficiency virus, four of which received combined antiretroviral therapy (CART) consisting of two NRTIs [(9-R-2-Phosphonomethoxypropyl Adenine) (PMPA) and (+/−)-beta-2′,3′-dideoxy-5-fluoro-3′-thiacytidine (RCV)] for 28 days. Multifocal infiltrates of mononuclear inflammatory cells were present in the myocardium of all macaques that received CART, but not untreated SIV-positive animals or SIV-negative controls. Macrophages were the predominant inflammatory cells within lesions, as shown by immunoreactivity for the macrophage markers Iba1 and CD68. Heart specimens from monkeys that received CART had significantly lower virus burdens than untreated animals (p<0.05), but significantly greater quantities of TNF-α mRNA than either SIV-positive untreated animals or uninfected controls (p<0.05). Interferon-γ (IFN-γ), IL-1β and CXCL11 mRNA were upregulated in heart tissue from SIV-positive monkeys, independent of antiretroviral treatment, but CXCL9 mRNA was only upregulated in heart tissue from macaques that received CART. Conclusions/Significance: These results suggest that short-term treatment with multiple NRTIs may be associated with myocarditis, and demonstrate that the CD8-depleted SIV-positive rhesus monkey is a useful model for studying the cardiotoxic effects of combined antiretroviral therapy in the setting of immunodeficiency virus infection

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity.

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant

Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study

Background: The SARS-CoV-2 delta (B.1.617.2) variant was first detected in England in March, 2021. It has since rapidly become the predominant lineage, owing to high transmissibility. It is suspected that the delta variant is associated with more severe disease than the previously dominant alpha (B.1.1.7) variant. We aimed to characterise the severity of the delta variant compared with the alpha variant by determining the relative risk of hospital attendance outcomes. Methods: This cohort study was done among all patients with COVID-19 in England between March 29 and May 23, 2021, who were identified as being infected with either the alpha or delta SARS-CoV-2 variant through whole-genome sequencing. Individual-level data on these patients were linked to routine health-care datasets on vaccination, emergency care attendance, hospital admission, and mortality (data from Public Health England's Second Generation Surveillance System and COVID-19-associated deaths dataset; the National Immunisation Management System; and NHS Digital Secondary Uses Services and Emergency Care Data Set). The risk for hospital admission and emergency care attendance were compared between patients with sequencing-confirmed delta and alpha variants for the whole cohort and by vaccination status subgroups. Stratified Cox regression was used to adjust for age, sex, ethnicity, deprivation, recent international travel, area of residence, calendar week, and vaccination status. Findings: Individual-level data on 43 338 COVID-19-positive patients (8682 with the delta variant, 34 656 with the alpha variant; median age 31 years [IQR 17–43]) were included in our analysis. 196 (2·3%) patients with the delta variant versus 764 (2·2%) patients with the alpha variant were admitted to hospital within 14 days after the specimen was taken (adjusted hazard ratio [HR] 2·26 [95% CI 1·32–3·89]). 498 (5·7%) patients with the delta variant versus 1448 (4·2%) patients with the alpha variant were admitted to hospital or attended emergency care within 14 days (adjusted HR 1·45 [1·08–1·95]). Most patients were unvaccinated (32 078 [74·0%] across both groups). The HRs for vaccinated patients with the delta variant versus the alpha variant (adjusted HR for hospital admission 1·94 [95% CI 0·47–8·05] and for hospital admission or emergency care attendance 1·58 [0·69–3·61]) were similar to the HRs for unvaccinated patients (2·32 [1·29–4·16] and 1·43 [1·04–1·97]; p=0·82 for both) but the precision for the vaccinated subgroup was low. Interpretation: This large national study found a higher hospital admission or emergency care attendance risk for patients with COVID-19 infected with the delta variant compared with the alpha variant. Results suggest that outbreaks of the delta variant in unvaccinated populations might lead to a greater burden on health-care services than the alpha variant. Funding: Medical Research Council; UK Research and Innovation; Department of Health and Social Care; and National Institute for Health Research

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant

Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7: an ecological study

Background The SARS-CoV-2 variant B.1.1.7 was first identified in December, 2020, in England. We aimed to investigate whether increases in the proportion of infections with this variant are associated with differences in symptoms or disease course, reinfection rates, or transmissibility. Methods We did an ecological study to examine the association between the regional proportion of infections with the SARS-CoV-2 B.1.1.7 variant and reported symptoms, disease course, rates of reinfection, and transmissibility. Data on types and duration of symptoms were obtained from longitudinal reports from users of the COVID Symptom Study app who reported a positive test for COVID-19 between Sept 28 and Dec 27, 2020 (during which the prevalence of B.1.1.7 increased most notably in parts of the UK). From this dataset, we also estimated the frequency of possible reinfection, defined as the presence of two reported positive tests separated by more than 90 days with a period of reporting no symptoms for more than 7 days before the second positive test. The proportion of SARS-CoV-2 infections with the B.1.1.7 variant across the UK was estimated with use of genomic data from the COVID-19 Genomics UK Consortium and data from Public Health England on spike-gene target failure (a non-specific indicator of the B.1.1.7 variant) in community cases in England. We used linear regression to examine the association between reported symptoms and proportion of B.1.1.7. We assessed the Spearman correlation between the proportion of B.1.1.7 cases and number of reinfections over time, and between the number of positive tests and reinfections. We estimated incidence for B.1.1.7 and previous variants, and compared the effective reproduction number, Rt, for the two incidence estimates. Findings From Sept 28 to Dec 27, 2020, positive COVID-19 tests were reported by 36 920 COVID Symptom Study app users whose region was known and who reported as healthy on app sign-up. We found no changes in reported symptoms or disease duration associated with B.1.1.7. For the same period, possible reinfections were identified in 249 (0·7% [95% CI 0·6–0·8]) of 36 509 app users who reported a positive swab test before Oct 1, 2020, but there was no evidence that the frequency of reinfections was higher for the B.1.1.7 variant than for pre-existing variants. Reinfection occurrences were more positively correlated with the overall regional rise in cases (Spearman correlation 0·56–0·69 for South East, London, and East of England) than with the regional increase in the proportion of infections with the B.1.1.7 variant (Spearman correlation 0·38–0·56 in the same regions), suggesting B.1.1.7 does not substantially alter the risk of reinfection. We found a multiplicative increase in the Rt of B.1.1.7 by a factor of 1·35 (95% CI 1·02–1·69) relative to pre-existing variants. However, Rt fell below 1 during regional and national lockdowns, even in regions with high proportions of infections with the B.1.1.7 variant. Interpretation The lack of change in symptoms identified in this study indicates that existing testing and surveillance infrastructure do not need to change specifically for the B.1.1.7 variant. In addition, given that there was no apparent increase in the reinfection rate, vaccines are likely to remain effective against the B.1.1.7 variant. Funding Zoe Global, Department of Health (UK), Wellcome Trust, Engineering and Physical Sciences Research Council (UK), National Institute for Health Research (UK), Medical Research Council (UK), Alzheimer's Society

Genomic assessment of quarantine measures to prevent SARS-CoV-2 importation and transmission

Mitigation of SARS-CoV-2 transmission from international travel is a priority. We evaluated the effectiveness of travellers being required to quarantine for 14-days on return to England in Summer 2020. We identified 4,207 travel-related SARS-CoV-2 cases and their contacts, and identified 827 associated SARS-CoV-2 genomes. Overall, quarantine was associated with a lower rate of contacts, and the impact of quarantine was greatest in the 16–20 age-group. 186 SARS-CoV-2 genomes were sufficiently unique to identify travel-related clusters. Fewer genomically-linked cases were observed for index cases who returned from countries with quarantine requirement compared to countries with no quarantine requirement. This difference was explained by fewer importation events per identified genome for these cases, as opposed to fewer onward contacts per case. Overall, our study demonstrates that a 14-day quarantine period reduces, but does not completely eliminate, the onward transmission of imported cases, mainly by dissuading travel to countries with a quarantine requirement