Gravidez não planejada no Brasil: estudo nacional em oito hospitais universitários

OBJECTIVE: To estimate the prevalence of unplanned pregnancy in eight public university hospitals, distributed in the five regions that make up Brazil. METHODS: A secondary analysis of a national multicenter cross-sectional study, carried out in eight public university hospitals between June 1 and August 31, 2020, in Brazil. Convenience sample including women who gave birth within sixty consecutive days and met the following criteria: over 18 years old; gestational age over 36 weeks at delivery; with a single and live newborn, without malformations. RESULTS: Sample composed of 1,120 postpartum women, of whom 756 (67.5%) declared that the pregnancy had not been planned. The median prevalence of unplanned pregnancy was 59.7%. The prevalence of unplanned pregnancy across hospitals differed significantly: Campinas (54.8%), Porto Alegre (58.2%), Florianópolis (59%), Teresina (61.2%), Brasília (64.3%), São Paulo (64.6%), Campo Grande (73.9%) and Manaus (95.3%) (p < 0.001). Factors significantly associated with unplanned pregnancy were maternal age, black color, lower family income, greater number of children, greater number of people living in household, and not having a partner. CONCLUSION: In the studied sample, about two thirds of the pregnancies were declared as unplanned. The prevalence of unplanned pregnancies was related to social and demographic factors and varied significantly across the university hospitals evaluated.OBJETIVO: Estimar a prevalência de gestação não planejada (GNP) em oito hospitais públicos universitários, distribuídos nas cinco regiões que compõem o Brasil. MÉTODOS: Análise secundária de um estudo transversal multicêntrico nacional, realizado em oito hospitais universitários públicos, entre 1º de junho e 31 de agosto de 2020, no Brasil. Amostra por conveniência incluindo mulheres que deram à luz em período de sessenta dias consecutivos e atenderam aos seguintes critérios: maiores de 18 anos; idade gestacional acima de 36 semanas no parto; com recém-nascido único e vivo, sem malformações. RESULTADOS: Amostra composta por 1.120 puérperas, das quais 756 (67,5%) declararam que a gravidez não tinha sido programada. A mediana da prevalência de GNP foi de 59,7%. Observou-se diferença significativa na prevalência de GNP entre os hospitais: Campinas (54,8%), Porto Alegre (58,2%), Florianópolis (59%), Teresina (61,2%), Brasília (64,3%), São Paulo (64,6%), Campo Grande (73,9%) e Manaus (95,3%) (p < 0,001). Foram fatores significativamente associados a GNP a idade materna, cor negra, menor renda familiar, maior número de filhos, maior número de pessoas convivendo em casa e não ter parceiro. CONCLUSÃO: na amostra estudada, cerca de dois terços das gestações foram declaradas como não programadas. A prevalência de gestação não planejada teve relação com fatores sociais e demográficos e variou significativamente entre os hospitais universitários avaliados

Verb phrase ellipsis: The view from information structure.

Abstract Findings from three experimental studies are presented in support of the hypothesis that the reduced acceptability associated with antecedent mismatch under ellipsis reflects violation of an information structural constraint governing contrastive topic structures, and not an ellipsis-specific licensing constraint as previously assumed. Magnitude estimation data show that the penalty associated with a mismatched antecedent is larger for contrastive topic ellipses as compared to ellipses which exhibit simple (non-contrastive topic) focus. The same pattern of acceptability is also observed for non-ellipsis controls, however. Online reading times indicate increased processing costs associated with antecedent mismatch, and the cost is greater in contrastive topic as compared to simple focus ellipses. Elevated reading times for mismatched contrastive topics are observed throughout the target clause, however, including regions prior to the ellipsis site.

Lack of AcrB Efflux Function Confers Loss of Virulence on Salmonella enterica Serovar Typhimurium

AcrAB-TolC is the paradigm resistance-nodulation-division (RND) multidrug resistance efflux system in Gram-negative bacteria, with AcrB being the pump protein in this complex. We constructed a non-functional AcrB mutant by substituting D408, a highly conserved residue essential for proton translocation. Western blotting confirmed that the AcrB D408A mutant had the same native level of expression of AcrB as the parental strain. The mutant had no growth deficiencies in rich or minimal media. However, compared with wild-type SL1344, the mutant had increased accumulation of the Hoechst 33342 dye, decreased efflux of ethidium bromide and was multidrug hyper-susceptible. The D408A mutant was attenuated in vivo in a mouse model and showed significantly reduced invasion into intestinal epithelial cells and macrophages in vitro. A dose dependent inhibition of invasion was also observed when two different efflux pump inhibitors were added to the wild-type strain during infection of epithelial cells. RNAseq revealed down-regulation of bacterial factors necessary for infection, including those in the Salmonella Pathogenicity Islands 1, 2 and 4, quorum sensing genes and phoPQ. Several general stress response genes were up-regulated, probably due to retention of noxious molecules inside the bacterium. Unlike loss of AcrB protein, loss of efflux function did not induce overexpression of other RND efflux pumps. Our data suggests that gene deletion mutants are unsuitable for studying membrane transporters and, importantly, that inhibitors of AcrB efflux function will not induce expression of other RND pumps

Impact of the COVID-19 pandemic on maternal anxiety in Brazil

Background: The coronavirus disease 2019 (COVID-19) pandemic may have an effect on maternal anxiety and influence postpartum experience. Objective: To study the prevalence of maternal anxiety in late pregnancy in the context of the COVID-19 outbreak in Brazil and to analyze its association with maternal knowledge and concerns about the pandemic. Methods: This was a national multicenter cross-sectional study performed in 10 different public university hospitals, between 1 June and 31 August 2020, in Brazil. The inclusion criteria were: maternal age more than 18 years; gestational age more than 36 weeks at childbirth; single alive newborn without malformations; and absence of mental disorders. We applied a structured questionnaire to explore the knowledge and concerns about COVID-19. Maternal anxiety was assessed using the Beck Anxiety Inventory (BAI). Results: Of the 1662 women interviewed, the BAI score in late pregnancy indicated that 13.9% presented moderate and 9.6% severe maternal anxiety. Moderate or severe maternal anxiety was independently associated with the fear of being unaccompanied at childbirth (aOR1.12, 95% CI 1.10–1.35), and independent protective factors were confidence in knowing how to protect oneself from COVID-19 (aOR0.89, 95% CI 0.82–0.97) and how to safely breastfeed (aOR0.89, 95% CI 0.83–0.95). Conclusion: The COVID-19 pandemic has a significant impact on maternal anxiety

Binding specificity and mRNA targets of a C. elegans PUF protein, FBF-1

Sequence-specific RNA–protein interactions underlie regulation of many mRNAs. Here we analyze the RNA sequence specificity of Caenorhabditis elegans FBF-1, a founding member of the PUF protein family. Like other PUF proteins, FBF-1 binds to the 3′ UTR of target mRNAs and decreases expression of those target genes. Here, we show that FBF-1 and its close relative, FBF-2, bind with similar affinity to multiple RNA sites. We use mutagenesis and in vivo selection experiments to identify nucleotides that are essential for FBF-1 binding. The binding elements comprise a “core” central region and flanking sequences. The core region is similar but distinct from the binding sites of other PUF proteins. We combine the identification of binding elements with informatics to predict new FBF-1 binding sites in a C. elegans 3′ UTR database. These data identify a set of new candidate mRNA targets of FBF-1 and FBF-2

A single C. elegans PUF protein binds RNA in multiple modes

PUF proteins specifically bind mRNAs to regulate their stability and translation. Here we focus on the RNA-binding specificity of a C. elegans PUF protein, PUF-11. Our findings reveal that PUF-11 binds RNA in multiple modes, in which the protein can accommodate variable spacings between two distinct recognition elements. We propose a structural model in which flexibility in the central region of the protein enables the protein to adopt at least two distinct structures, one of which results in base flipping

Cyst nematode bio-communication with plants: implications for novel management approaches

Bio-communication occurs when living organisms interact with each other, facilitated by the exchange of signals including visual, auditory, tactile and chemical. The most common form of bio-communication between organisms is mediated by chemical signals, commonly referred to as ‘semiochemicals’, and it involves an emitter releasing the chemical signal that is detected by a receiver leading to a phenotypic response in the latter organism. The quality and quantity of the chemical signal released may be influenced by abiotic and biotic factors. Bio-communication has been reported to occur in both above- and below-ground interactions and it can be exploited for the management of pests, such as cyst nematodes, which are pervasive soil-borne pests that cause significant crop production losses worldwide. Cyst nematode hatching and successful infection of hosts are biological processes that are largely influenced by semiochemicals including hatching stimulators, hatching inhibitors, attractants and repellents. These semiochemicals can be used to disrupt interactions between host plants and cyst nematodes. Advances in RNAi techniques such as host-induced gene silencing to interfere with cyst nematode hatching and host location can also be exploited for development of synthetic resistant host cultivars

Valuing Rivers: How the Diverse Benefits of Healthy Rivers Underpin Economies

Though critical to all life – and to most economic activity – water has consistently been undervalued relative to the wide range of uses and benefitsit provides. However, with new valuation methods and frameworks being developed, governments, the private sector and financial institutions are beginning to make progress in recognizing the wider value of water. As these discussions advance, we believe it is important to shine a light on a paralleland equally critical challenge: the consistent failure of economies andsocieties to value rivers for their full spectrum of benefits

Achieving water security’s full goals through better integration of rivers’ diverse and distinct values

Healthy rivers provide a broad range of services that benefit economies and communities but the concepts of water security, as well as water management in practice, have tended to focus on a narrow set of those services. Accomplishing the diverse objectives bundled under water security—including water quantity and quality, linkages with food security, risk management and ecosystem conservation—will require a more holistic valuing of rivers’ services coupled with policies and mechanisms to maintain and restore those values. Rivers have typically been viewed as sources of water to support irrigation, water supply or hydropower. While the water that rivers provide often has immense value to economies—and thus it is this role where rivers are well represented within frameworks for water security—rivers provide a diverse range of other services that encompass, but extend beyond, water as a resource that can be defined by volume or quality. These services can also produce vital benefits for economies and communities and they are generated by rivers as complex biophysical systems, not just as conduits for delivering water. Examples of these services include fisheries, floodplains that reduce flood risk, sediment delivery to deltas, and components of the channel network that regulate water quantity and quality. Concepts such as natural capital and ecosystem services are intended to better value these services, however the valuations produced are often not effectively integrated into decisions or management. Although rigorous science provides an important foundation for embedding the value of rivers within water security, translating those values into management and policy will require the communication of river values into terms and numbers that matter to key audiences and the assembly of coalitions to translate value into action

A hidden mismatch between experiences of young athletes with overuse injuries of the wrist and sports physicians' perceptions: a focus group study

BACKGROUND: Although overuse wrist injuries can have serious consequences, young athletes often do not immediately report their injury to a physician. This qualitative study aimed to identify symptoms and limitations related to overuse wrist injuries that young athletes consider important and to compare those with sports physicians' opinions, in order to improve the diagnostic process for early identification of overuse wrist injuries. METHODS: Twenty-one athletes aged 13-25 years in wrist-loading sports (gymnastics, tennis, judo, field hockey, volleyball and rowing) with a (previous) overuse wrist injury were included. In five focus groups, participants discussed important signals and limitations of their injury, as well as a list of relevant items previously composed by sports physicians. Data were grouped into themes and (sub)categories and subsequently coded. RESULTS: Of the resulting 224 signals and 80 limitations, respectively 81 and 20 were labelled important. Athletes considered both pain and limitations during daily life activities important indicators of overuse wrist injury, as well as long pain duration, acute onset of pain, and accompanying symptoms like swelling, cracking and discoloration. All of the sports physicians' items were also considered important by the athletes, but sport-related pain and limitations were regarded by many athletes as a natural part of their sport. CONCLUSIONS: Discrepancies exist between the opinions of young athletes and sports physicians on sport-related pain reporting and competing regardless of pain or limitations. Although clinicians may be inclined to focus on these aspects, they are advised to also inquire specifically about limitations and pain during daily life activities in young athletes with overuse wrist injuries