Pandemia do COVID-19: nível de estresse e qualidade de vida em casos contaminados e não contaminados

Introdução: A pandemia de coronavírus (COVID-19) impactou não apenas a saúde física, em decorrência da síndrome respiratória aguda grave causada pelo vírus, mas também impactou a saúde mental, as áreas econômica e a social. Além disso, o foco do cenário pandêmico foi a contingência do COVID-19, o que propiciou o aparecimento ou o agravamento de outras doenças. Dessa forma, os escopos originados da pandemia tornaram-se potenciais desencadeantes de quadros de estresse e de interferência na qualidade de vida da população. Proposição: avaliar o índice de estresse percebido e a qualidade de vida da população em dois grupos de pessoas: primeiro, as que tiveram diagnóstico confirmado de COVID-19 e, segundo indivíduos que não contraíram a doença. Materiais e Métodos: Participaram da pesquisa 66 indivíduos, entre 18 e 60 anos, sendo 33 de pessoas sem contaminação e 33 pessoas que tiveram diagnóstico confirmado. Os participantes responderam dois questionários: O questionário de estresse percebido (QEP), para avaliar o estresse e outro questionário para avaliação da qualidade de vida (SF-36). Resultados: A análise mostrou que o QEP dos indivíduos não contaminados foi menor (0,64 + 0,04); em comparação aos indivíduos que tiveram o resultado positivo para doença (0,73 + 0,02) (p = 0,0484), diferença estatisticamente significativa, o que mostra que os casos positivos têm percepção que estão mais estressados. Na análise do SF-36, apenas o domínio Capacidade Funcional apresentou diferença estatisticamente significativa, sendo que os voluntários que não tiveram a doença apresentaram um maior valor (93,3 + 2,0), que os contaminados (73,0 + 3,6) (p < 0,0001), o que sugere melhor qualidade de vida aos primeiros. Conclusão: O estudo apresenta resultados que indicam que a pandemia impactou negativamente a saúde da população, pois os participantes diagnosticados com COVID-19 tiveram maior estresse percebido e menor qualidade de vida, em comparação aos não contaminados.Introduction: The coronavirus pandemic (COVID-19) has not only impacted physical health, as result of the severe acute respiratory syndrome caused by the virus, but has also impacted mental health, the economic and social areas. In addition, the focus of pandemic scenario was the COVID-19 contingency, which led to the appearance or worsening of other diseases. Besides the scopes originated from the pandemic became potential triggers of stress and interference in the population’s quality of life. Proposition: to evaluate the perceived stress index and the population’s quality of life in two groups of people: first, those who had a confirmed diagnosis of COVID-19 and, second, individuals who did not contract the disease. Materials and Methods: 66 individuals participated in the research, between 18 and 60 years old, being 33 people without contamination and 33 people who had a confirmed diagnosis. Participants answered two questionnaires: The Perceived Stress Questionnaire (QEP) to assess stress and another questionnaire to assess quality of life (SF-36). Results: The analysis of the results showed that the QEP of non-contaminated individuals was lower (0.64 + 0.04) than that of individuals who tested positive for the disease (0.73 + 0.02) (p = 0.0484), statistically significant difference, which shows that positive cases are perceived to be more stressed. In the analysis of SF-36, only the Functional Capacity domain showed statistically significant difference, and the volunteers who did not have the disease presented higher value (93.3 + 2.0) than contaminated individuals (73.0 + 3.6) (p < 0.0001), suggesting better quality of life. Conclusion: The study presents results that indicate the pandemic negatively impacted the health of the population, as participants diagnosed with COVID-19 had greater perceived stress and lower quality of life, compared to non-contaminated ones

Efflux pumps expression and its association with porin down-regulation and β-lactamase production among Pseudomonas aeruginosa causing bloodstream infections in Brazil

Background: Multi-drug efflux pumps have been increasingly recognized as a major component of resistance in P. aeruginosa. We have investigated the expression level of efflux systems among clinical isolates of P. aeruginosa, regardless of their antimicrobial susceptibility profile.Results: Aztreonam exhibited the highest in vitro activity against the P. aeruginosa isolates studied (64.4% susceptibility), whereas susceptibility rates of imipenem and meropenem were both 47.5%. the MexXY-OprM and MexAB-OprM efflux systems were overexpressed in 50.8% and 27.1% of isolates studied, respectively. Overexpression of the MexEF-OprN and MexCD-OprJ systems was not observed. AmpC beta-lactamase was overexpressed in 11.9% of P. aeruginosa isolates. in addition, decreased oprD expression was also observed in 69.5% of the whole collection, and in 87.1% of the imipenem non-susceptible P. aeruginosa clinical isolates. the MBL-encoding genes bla(SPM-1) and bla(IMP-1) were detected in 23.7% and 1.7% P. aeruginosa isolates, respectively. the bla(GES-1) was detected in 5.1% of the isolates, while bla(GES-5) and bla(CTX-M-2) were observed in 1.7% of the isolates evaluated. in the present study, we have observed that efflux systems represent an adjuvant mechanism for antimicrobial resistance.Conclusions: Efflux systems in association of distinct mechanisms such as the porin down-regulation, AmpC overproduction and secondary beta-lactamases play also an important role in the multi-drug resistance phenotype among P. aeruginosa clinical isolates.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo, Div Infect Dis, BR-04039032 São Paulo, BrazilUniversidade Federal de São Paulo, Div Infect Dis, BR-04039032 São Paulo, BrazilFAPESP: FAPESP - 2006/01716-8CNPq: 307714/2006-3Web of Scienc

SEGURANÇA EM INTERNET DAS COISAS: UM SURVEY DE SOLUÇÕES LIGHTWEIGHT

A conexão intermitente de dispositivos, máquinas e sensores em cenários com inteligência computacionais conectados à internet tem se tornado cada vez mais presente. A essa integração, dá-se o nome de Internet das Coisas (Internet of Things – IoT). Esse novo paradigma traz desafios de segurança, principalmente pela heterogeneidade e a quantidade de dispositivos com baixo poder computacional presentes nesse cenário. Propostas de segurança tradicionais não são viáveis nestes cenários e novas soluções são então necessárias. Surgem então as soluções lightweight. Entende-se por lightweight todas as técnicas, arquiteturas e esquemas de segurança consideradas “leves” em termos de consumo de recursos e adaptáveis a diferentes dispositivos. Neste trabalho é analisado o atual cenário de segurança lightweight em redes IoT, por meio de uma revisão e classificação da Literatura. São apresentadas propostas de algoritmos de criptografia baseadas em credenciais, uso da nuvem para autenticação, redução de latência, de consumo de energia e de perda de pacotes, entre outras vantagens. É pretendido assim, contribuir com o avanço das pesquisas em segurança em Internet das Coisas, apresentando as tecnologias de segurança “leves” em IoT, os desafios, os desenvolvimentos recentes, as questões em aberto e também os pontos futuros de pesquisa

Measurement of the cosmic ray spectrum above 4×10184{\times}10^{18} eV using inclined events detected with the Pierre Auger Observatory

A measurement of the cosmic-ray spectrum for energies exceeding $4{\times}10^{18}$ eV is presented, which is based on the analysis of showers with zenith angles greater than $60^{\circ}$ detected with the Pierre Auger Observatory between 1 January 2004 and 31 December 2013. The measured spectrum confirms a flux suppression at the highest energies. Above $5.3{\times}10^{18}$ eV, the "ankle", the flux can be described by a power law $E^{-\gamma}$ with index $\gamma=2.70 \pm 0.02 \,\text{(stat)} \pm 0.1\,\text{(sys)}$ followed by a smooth suppression region. For the energy ($E_\text{s}$) at which the spectral flux has fallen to one-half of its extrapolated value in the absence of suppression, we find $E_\text{s}=(5.12\pm0.25\,\text{(stat)}^{+1.0}_{-1.2}\,\text{(sys)}){\times}10^{19}$ eV.Comment: Replaced with published version. Added journal reference and DO

Energy Estimation of Cosmic Rays with the Engineering Radio Array of the Pierre Auger Observatory

The Auger Engineering Radio Array (AERA) is part of the Pierre Auger Observatory and is used to detect the radio emission of cosmic-ray air showers. These observations are compared to the data of the surface detector stations of the Observatory, which provide well-calibrated information on the cosmic-ray energies and arrival directions. The response of the radio stations in the 30 to 80 MHz regime has been thoroughly calibrated to enable the reconstruction of the incoming electric field. For the latter, the energy deposit per area is determined from the radio pulses at each observer position and is interpolated using a two-dimensional function that takes into account signal asymmetries due to interference between the geomagnetic and charge-excess emission components. The spatial integral over the signal distribution gives a direct measurement of the energy transferred from the primary cosmic ray into radio emission in the AERA frequency range. We measure 15.8 MeV of radiation energy for a 1 EeV air shower arriving perpendicularly to the geomagnetic field. This radiation energy -- corrected for geometrical effects -- is used as a cosmic-ray energy estimator. Performing an absolute energy calibration against the surface-detector information, we observe that this radio-energy estimator scales quadratically with the cosmic-ray energy as expected for coherent emission. We find an energy resolution of the radio reconstruction of 22% for the data set and 17% for a high-quality subset containing only events with at least five radio stations with signal.Comment: Replaced with published version. Added journal reference and DO

Measurement of the Radiation Energy in the Radio Signal of Extensive Air Showers as a Universal Estimator of Cosmic-Ray Energy

We measure the energy emitted by extensive air showers in the form of radio emission in the frequency range from 30 to 80 MHz. Exploiting the accurate energy scale of the Pierre Auger Observatory, we obtain a radiation energy of 15.8 \pm 0.7 (stat) \pm 6.7 (sys) MeV for cosmic rays with an energy of 1 EeV arriving perpendicularly to a geomagnetic field of 0.24 G, scaling quadratically with the cosmic-ray energy. A comparison with predictions from state-of-the-art first-principle calculations shows agreement with our measurement. The radiation energy provides direct access to the calorimetric energy in the electromagnetic cascade of extensive air showers. Comparison with our result thus allows the direct calibration of any cosmic-ray radio detector against the well-established energy scale of the Pierre Auger Observatory.Comment: Replaced with published version. Added journal reference and DOI. Supplemental material in the ancillary file

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London