Is Brazil prepared for the new era of infectious disease epidemics?

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Phylogenetic, epidemiological and clinical studies on dengue and dengue virus in Vitória, Espírito Santo state, Brazil

Background: Vitória is an endemic area in Brazil for dengue. This thesis presents the phylogeny of dengue virus serotype 4, the evaluation of dengue dispersion and the influence of serotypes and demographics to severe dengue outcomes in Vitória. Methods: Sequences of envelope (n = 8) and NS1 (n = 4) gene of dengue virus serotype 4 were used to construct phylogenetic trees (2013). Spatial variation in temporal trends was analyzed (2012-2013). Cross-sectional studies were performed to assess associations of serotypes (2009-2013) and demographics (2007-2013) with severe outcomes. Results: Dengue virus serotype 4 genotype I (n = 2) related to a strain from Bahia, and genotype II (n = 8) related to strains from Roraima, Mato Grosso and São Paulo were detected. Five space-time clusters with lower Time Trend Increase presented higher risk for dengue transmission and lower income than the six space-time clusters with higher Time Trend Increase. In 6,703 dengue cases, 11.3% presented severe dengue, which was significantly higher among males (13.0%) than females (10.0%), and among elderlies (15.5%) than children (8.8%), adolescents (12.5%), and adults (10.5%). Children with severe dengue presented hemorrhage (68.8%-86.4%) and plasma leakage (52.4%-62.5%) in a higher proportion than other age groups. Serotype was determined for 485 cases and severe dengue affected 6.6% of them. Severe dengue occurred at a significantly higher frequency in infections caused by dengue virus serotype 2 (32.3%) than in those caused by dengue virus serotype 4 (6.4%) or by dengue virus serotype 1 (4.5%). Conclusion: Apparently, Vitória is not an international route for dengue introduction in Brazil. Living in low-income areas increased the chance of dengue infection. Dengue virus serotype 2 was associated with an elevated occurrence of severe dengue, which also affected more males and elderlies. Manifestations of severe dengue were worse in children than in other age group

Preoperative and Intraoperative Opioid-Sparing Analgesic Techniques to Reduce Postoperative Opioid Consumption in Patients Undergoing Open, Non-Emergent Abdominal Surgeries: An Educational Module

Background: Opioids have long been considered the “gold standard” of pain management; however, the significant side effects associated with opioid use make opioid-sparing analgesic methods appealing for various reasons. Reducing postoperative opioid consumption without compromising pain management is an area requiring further exploration. Objective: This study seeks to assess healthcare providers’ knowledge and confidence regarding the use of various preoperative and perioperative interventions aimed at reducing postoperative opioid consumption following non-emergent open abdominal surgeries. Based on the systematic review performed, Certified Registered Nurse Anesthetists were presented with a pre-assessment test, an educational video presentation, and a post-assessment test. Data Sources: Investigator used Pubmed, CINAHL, and EMBASE databases to answer the PICO (i.e., population, intervention, comparison, outcome) question: In patients undergoing open, nonemergent abdominal surgeries, does the use of multimodal, opioid-sparing pain management techniques during the preoperative and perioperative period reduce postoperative opioid consumption versus non-multimodal pain management? This question became the basis for the educational module by the same name. Pre-assessment and post-assessment testing were used to measure the effects of the intervention. Statistical analysis was applied to assess the effectiveness of the educational intervention. Study Selection: Nine articles were included in the systematic review and the findings were incorporated into the educational presentation. All found that their respective non-opioid interventions reduced postoperative opioid consumption to some degree. A majority reported secondary outcomes of reduced opioid-related side effects such as nausea and vomiting, decreased time to first meal, first ambulation, and foley removal, and increased patient satisfaction. Results: There were nine participants in the study and survey. The pre- and post-test gauged participants’ knowledge and confidence in non-opioid analgesic methods and implementing them in practice. The average number of correct answers in the pre-test was 4.22, compared to 7.44 in the post-test. Confidence for preoperative and intra-operative interventions improved from 44.44% and 33.33% to 88.89% and 100%, respectively. With education, participants were more likely to advocate for opioid-sparing analgesic interventions to improve postoperative outcomes for patients undergoing non-emergent abdominal surgery. All participants selected more correct answers in the post-test than pre-test. Conclusions: The evidence shows that several non-opioid analgesic interventions can reduce postoperative opioid consumption. The implementation of an educational module based on these findings led to a significant increase in providers’ knowledge and confidence of opioid-sparing analgesic methods in patients undergoing non-emergent open abdominal surgery and the benefits associated with non-opioid interventions

New aesthetic, new anxieties

The New Aesthetic was a design concept and netculture phenomenon launched into the world by London designer James Bridle in 2011. It continues to attract the attention of media art, and throw up associations to a variety of situated practices, including speculative design, net criticism, hacking, free and open source software development, locative media, sustainable hardware and so on. In this book we consider the New Aesthetic: as an opportunity to rethink the relations between these contexts in the emergent episteme of computationality. There is a desperate need to confront the political pressures of neoliberalism manifested in these infrastructures. Indeed, these are risky, dangerous and problematic times; a period when critique should thrive. But here we need to forge new alliances, invent and discover problems of the common that nevertheless do not eliminate the fundamental differences in this ecology of practices. In this book, perhaps provocatively, we believe a great deal could be learned from the development of the New Aesthetic not only as a mood, but as a topic and fix for collective feeling, that temporarily mobilizes networks. Is it possible to sustain and capture these atmospheres of debate and discussion beyond knee-jerk reactions and opportunistic self-promotion? These are crucial questions that the New Aesthetic invites us to consider, if only to keep a critical network culture in place

Phylogenetic, epidemiological and clinical studies on dengue and dengue virus in Vitória, Espírito Santo state, Brazil

Background: Vitória is an endemic area in Brazil for dengue. This thesis presents the phylogeny of dengue virus serotype 4, the evaluation of dengue dispersion and the influence of serotypes and demographics to severe dengue outcomes in Vitória. Methods: Sequences of envelope (n = 8) and NS1 (n = 4) gene of dengue virus serotype 4 were used to construct phylogenetic trees (2013). Spatial variation in temporal trends was analyzed (2012-2013). Cross-sectional studies were performed to assess associations of serotypes (2009-2013) and demographics (2007-2013) with severe outcomes. Results: Dengue virus serotype 4 genotype I (n = 2) related to a strain from Bahia, and genotype II (n = 8) related to strains from Roraima, Mato Grosso and São Paulo were detected. Five space-time clusters with lower Time Trend Increase presented higher risk for dengue transmission and lower income than the six space-time clusters with higher Time Trend Increase. In 6,703 dengue cases, 11.3% presented severe dengue, which was significantly higher among males (13.0%) than females (10.0%), and among elderlies (15.5%) than children (8.8%), adolescents (12.5%), and adults (10.5%). Children with severe dengue presented hemorrhage (68.8%-86.4%) and plasma leakage (52.4%-62.5%) in a higher proportion than other age groups. Serotype was determined for 485 cases and severe dengue affected 6.6% of them. Severe dengue occurred at a significantly higher frequency in infections caused by dengue virus serotype 2 (32.3%) than in those caused by dengue virus serotype 4 (6.4%) or by dengue virus serotype 1 (4.5%). Conclusion: Apparently, Vitória is not an international route for dengue introduction in Brazil. Living in low-income areas increased the chance of dengue infection. Dengue virus serotype 2 was associated with an elevated occurrence of severe dengue, which also affected more males and elderlies. Manifestations of severe dengue were worse in children than in other age group

Editorial: Mesenchymal stromal cell therapy for regenerative medicine

Mesenchymal stromal/stem cell (MSC) therapies are increasingly explored as novel regenerative and immunomodulatory approaches to treat or prevent diseases (Pittenger et al., 2019; Hmadcha et al., 2020; Moll et al., 2020b; Ringdén et al., 2022). These cells exhibit potent paracrine properties that can modulate host immune responses, lower inflammation, and orchestrate endogenous tissue repair, at both the local and the systemic level through multiple pathways (Singer and Caplan, 2011; Doorn et al., 2012). MSCs possess tropism toward damaged and inflamed tissues, where they can engraft short-term and exert their therapeutic effects by both direct and indirect mechanisms (Doorn et al., 2012; Galipeau and Sensebe, 2018; Soria et al., 2019). MSC products can be prepared from multiple sources (Moll et al., 2019, 2022), rapidly expanded and biobanked for clinical application. All these advantages make this cell type a versatile tool in regenerative medicine. The goal of our Research Topic is to highlight the latest advances in applications of MSCs for the treatment of a variety of diseases and their modes of action (MoA). A better understanding of the mechanisms underlying the therapeutic effect of MSCs can provide crucial insight into innovative strategies to enhance their effectiveness in clinical application (Singer and Caplan, 2011; Doorn et al., 2012; Galipeau and Sensebe, 2018; Moll et al., 2019, 2020b, 2022; Pittenger et al., 2019; Ringdén et al., 2022). The subjects covered within this Research Topic include: (a) Therapeutic application of MSCs for major clinical indications, (b) Cellular and molecular mechanisms underlying therapeutic effects of MSCs, and (c) Strategies for enhancement of the therapeutic effects of MSCs and their products. Here, we summarize the 37 manuscripts that were submitted to this Research Topic (Figure 1)

A pesquisa visual na Educação Ambiental: produção audiovisual como procedimento investigativo

As part of a doctorade that will be completed in 2023, we share some of its first results: the state of knowledge about research practice in the field of Environmental Education on works tha use audiovisual production as a research procedure. From the study that initially opened up to other areas of knowledge, giving access to authors, theories, methods and research topics, we focused on the field of Environmental Education, concluding that it has a large epistemic gap on the subject so far.Como parte de un doctorado que se completará en 2023, compartimos algunos de sus primeros resultados: el estado del conocimiento sobre la práctica investigadora en el campo de la Educación Ambiental sobre trabajos que utilizan la producción audiovisual como procedimiento de investigación. Desde el estudio que, inicialmente, se abrió a otros campos, dando acceso a autores/as, teorías, métodos y temas de investigación, nos enfocamos en el campo de la Educación Ambiental concluyendo que tiene un gran vacío epistémico sobre el tema hasta ahora.Como parte de um doutorado a ser concluído em 2023, compartilhamos alguns dos primeiros resultados: o estado de conhecimento sobre a prática de pesquisa no campo da Educação Ambiental (EA) referente aos trabalhos que utilizam, como procedimento de investigação, a produção audiovisual. A partir de um estudo que, inicialmente, foi aberto a outros campos do conhecimento, oportunizando o acesso a autores/as, teorias, métodos e temas de pesquisa, damos enfoque ao campo da EA. Concluímos que ele apresenta uma grande lacuna epistêmica sobre o assunto até o presente momento

O ATO FOTOGRÁFICO NA EDUCAÇÃO AMBIENTAL: UMA EXPERIÊNCIA NA REDE PÚBLICA DE EDUCAÇÃO INFANTIL DE JOINVILLE (SC)

O presente artigo apresenta uma narrativa textual-fotográfica elaborada durante a produção do documentário 1, 2, 3 Brincando – Reinventando os espaços escolares, o qual está vinculado a um programa de Educação Ambiental (EA) da rede pública de Educação Infantil de Joinville-SC, e possui a orientação e acompanhamento do grupo de pesquisa Ribombo (FURG/PPGEA). O material textual e fotográfico será problematizado pelo viés de uma abordagem qualitativa, valendo-se do olhar do fotógrafo enquanto elo subjetivo de uma construção narrativa baseada no encontro que se dá entre os sujeitos mediados por uma câmera fotográfica. Com isso, o intuito é realizar uma primeira reflexão crítica acerca das possibilidades de intervenções socioambientais a partir do suporte imagético em espaços de educação formal

Parental alcoholism and associated risk factors

El uso indebido de alcohol de forma precoz actúa como un factor predisponente para problemas de salud, sociales y económicos: delante de eso, la finalidad de esta investigación fue identificar condiciones de riesgo relacionadas a los niños y adolescentes expuestos al alcoholismo parental. Fue llevada a cabo una revisión sistemática, mediante los descriptores "alcoholismo, factores de riesgo y hijos", de artículos publicados entre 2005 y 2009, en las bases de datos Lilacs, Medline, Scielo y Adolec. Fueron verificados problemas respecto al uso de alcohol por los hijos; respecto al comportamiento y/o respecto a los factores emocionales de los hijos, implicando la necesidad de discusión del tema, con vistas a contribuir a la formulación de políticas públicas destinadas a esta población.The abusive use of alcohol at an early age becomes a predisposing factor for health, social and economic problems; thus, this research sought to identify risk conditions related to children and adolescents exposed to parental alcoholism. A systematic review was conducted, using the descriptors "alcoholism, risk factors and children", of papers published between 2005 and 2009 in Lilacs, Medline, Scielo and Adolec databases. Problems were found related to alcohol use by children; in relation to behavior and/or in relation to children's emotional factors, implying the need to discuss the issue in order to contribute to the formulation of public policies aimed at this population.O uso indevido de álcool, de forma precoce torna-se um fator predisponente para problemas de saúde, sociais e econômicos. Face a isso, esta pesquisa buscou identificar condições de risco relacionadas às crianças e adolescentes expostos ao alcoolismo parental. Foi realizada revisão sistemática, por meio dos descritores alcoolismo, fatores de risco e filhos, de artigos publicados nos anos de 2005 a 2009, nas bases de dados LILACS, MEDLINE, SciELO e Adolec. Constataram-se problemas em relação ao uso de álcool pelos filhos, em relação ao comportamento e/ou em relação aos fatores emocionais dos filhos, implicando na necessidade de discussão do tema, a fim de contribuir para a formulação de políticas públicas destinadas a essa população