Blood-borne infections and pregnancies among women attending a sexual violence assistance center in Brazil: A 10-year retrospective study

INTRODUCTION

Sexually transmitted infections (STI) and pregnancy can be consequences of sexual violence. In Brazil, around 50% of women victims of sexual violence do not undergo STI prophylaxis or emergency contraception.

OBJECTIVES

To analyze socio-demographic and epidemiological profile, frequency of procedures performed, frequency of blood-borne infections (BBI), pregnancy, and legal abortion in women assisted by a sexual violence assistance center.

PATIENTS AND METHODS

This 10-year retrospective cohort study (2010-2019) describes the socio-demographic and epidemiological profile and frequencies of clinical procedures, BBI, pregnancies, and legal abortions in 915 women assisted in a sexual violence assistance center in Brazil. We extracted data from the medical records and used descriptive statistics and chi-square and logistic regression.

RESULTS

A total of 93.3% (842/915) were residents in the Metropolitan Area of the capital, 80,83% (733/915) were brown-skinned or white, 42.4% (388/915) were adolescents (12-17 years old), 80.4% (736/915) were single, most had no children, average of 1.8 (±1.0 DP) children. About one-third (313/915) had not had previous sexual intercourse, 1.6% (10/653) were pregnant. Rape predominated with 92.0% (841/915), of which 51.5% (471/915) involved a known or related aggressor, mostly an acquaintance, followed by a stepfather or father. Recurrent cases were 24.0% (227/915).

CLINICAL PROCEDURES

42.6% (390/915) were attended within 72 hours and received STI prophylaxis 43.4% (392/904); emergency contraception 38.6% (349/904); blood collection 71.6% (647/904). Prevalence: syphilis 0.3% (2/653); hepatitis B 0.2% (1/653); pregnancy 1.6% (10/653). Incidences: syphilis 1.1% (7/633); hepatitis B 0.8% (5/633); hepatitis C 0.6% (4/633); pregnancy 27.2% (172/633). There were no HIV cases. Trichomoniasis at 1.9% (2/108), HPV-induced cytological lesions at 4.7% (5/108), and bacterial vaginosis at 20.0% (21/108) were found on cervicovaginal samples. There were 129 legal abortions.

CONCLUSIONS

The socio-demographic aspects and the characteristics of the aggressions in the studied population are like those described in the Brazilian national database, including the remarkable number of adolescents. STI prophylaxis and emergency contraception were performed in less than half of the women. The incidence of pregnancy was higher among those women reporting firearms threats and lower among those receiving STI prophylaxis. The frequency of legal abortion was higher than in national data. Public policies ensuring access to sexual and reproductive health rights and strategies to improve the quality of care for women victims of sexual violence and education improvement may decrease vulnerability to STI and unintended pregnancies.

Trichosporon asahii causing subcutaneous mycoses in an immunocompetent patient: case report and a minireview

Trichosporon spp. are a constituent of the normal flora of humans that can cause both superficial and invasive infections, mainly in immunocompromised and immunocompetent hosts, respectively. Herein, we a report of Trichosporon asahii causing subcutaneous fungal infection (SFI) in an immunocompetent patient after carpal tunnel surgery. Although susceptible to fluconazole, the treatment of SFI failed even using high doses of this azole. The skin lesion improved following the administration of voriconazole. We conducted a literature minireview searching reports on SFI in immunocompetent patients to check for epidemiological, diagnostic, therapeutic, and outcome characteristics. A total of 32 cases were reported. Despite being uncommon, the clinical suspicion and early diagnosis of SFI in immunocompetent patients undergoing previous surgery are important. Our study indicated that the azoles are the most active antifungal agents against Trichosporon spp., except for fluconazole, and voriconazole can be considered the first therapeutic option.

Maternal mortality associated with COVID-19 in Brazil in 2020 and 2021: Comparison with non-pregnant women and men

OBJECTIVE

Mortality rates of pregnant and postpartum women grew in the second COVID-19 pandemic year. Our objective is to understand this phenomenon to avoid further deaths.

METHODS

We collected data from SIVEP-Gripe, a nationwide Brazilian database containing surveillance data on all severe acute respiratory syndrome caused by COVID-19, between the first notified case (February 2020) until the 17th epidemiological week of 2021. We stratified patients into maternal women (which includes pregnant and postpartum women), non-maternal women and men and divided them by time of diagnosis in two periods: first period (February to December 2020) and second period (the first 17 epidemiological weeks of 2021 before pregnant and postpartum women were vaccinated).

RESULTS

During the second period, all patients had higher risk of presenting severe COVID-19 cases, but the maternal population was at a higher risk of death (OR of 2.60 CI 95%: 2.28-2.97)-almost double the risk of the two other groups. Maternal women also had a higher risk of needing intensive care, intubation and of presenting desaturation in the second period. Importantly, maternal women presented fewer comorbidities than other patient groups, suggesting that pregnancy and postpartum can be an important risk factor associated with severe COVID-19.

CONCLUSION

Our results suggest that the Gama variant, which has been related to greater virulence, transmissibility and mortality rates leads to more severe cases of COVID-19 for pregnant and postpartum women.

Differential Expression of Potential Biomarkers of Oral Squamous Cell Carcinoma Development

To evaluate molecular epithelial changes, we investigated whether a profile of survivin, cyclin dependent kinase inhibitor 2A (CDKN2A), epidermal growth factor receptor (EGFR), polo like kinase 1 (PLK1), p63, p40 (Δnp63 isoform), cyclin D1 (CCND1) and BCL2 apoptosis regulator (BCL2) proteins could predict malignant transformation. Different tissue segments (tumor adjacent epithelium; dysplasia and tumor) from a total of 109 patients were analyzed by immunohistochemistry. An increased expression of survivin (p < 0.001), PLK1 (p = 0.001), and p63 (p < 0.001) in parallel to reduced immunostaining of p40 (p < 0.001) and BCL2 (p = 0.029) was observed among the tissue segments analyzed. Our study revealed that survivin, PLK1, p63, p40 and BCL2 play a role in oral tumorigenesis and represent promising biomarkers able to recognize mesenchymal phenotype induction in the transition from nonmalignant cells to tumor cells. These results reveals critical interaction between survivin, PLK1, p63, p40 promising proteins during invasive carcinoma development.

The dimensions of accounting service quality

This study aimed to identify the dimensions of accounting service quality, as assessed by the different agents involved in service development. We performed 20 in-depth interviews with accounting service providers, clients of accounting service providers, consultants, university professors, and accountancy body members. The results revealed six dimensions of accounting service quality: advisory view, capability, efficiency, communication, technological innovation, and trustworthiness. We also identified the items corresponding to each of these dimensions. The results allowed us to develop a conceptual model of accounting service quality. This study also indicated the specificities of accounting services, demonstrating that general models for service quality assessment do not seem to fully fit the characteristics of the accounting context.

Physicochemical characterization and in vitro biological evaluation of solid compounds from furazolidone-based cyclodextrins for use as leishmanicidal agents

The discovery of new drugs and dosage forms for the treatment of neglected tropical diseases, such as human and animal leishmaniasis, is gaining interest in the chemical, biological, pharmaceutical, and medical fields. Many pharmaceutical companies are exploring the use of old drugs to establishing new drug dosage forms and drug delivery systems, in particular for use in neglected diseases. The formation of complexes with cyclodextrins is widely used to improve the stability, solubility, and bioavailability of pharmaceutical drugs, as well as reduce both the toxicity and side effects of many of these drugs. The aim of this study was to characterize solid compounds obtained from the association between furazolidone (FZD) and β-cyclodextrin (β-CD) or hydroxypropyl-β-cyclodextrin (HP-β-CD). The solid compounds were prepared in molar ratios of 1:1 and 1:2 (drug:CD) by kneading and lyophilization. Molecular docking was used to predict the preferred relative orientation of FZD when bound in both studied cyclodextrins. The resulting solid compounds were qualitatively characterized by scanning electron microscopy (SEM), thermal analysis (DSC and TG/DTG), X-ray diffraction (XRD), Raman spectroscopy with image mapping (Raman mapping), and ¹³C nuclear magnetic resonance spectroscopy (¹³C NMR) in the solid state. The cytotoxicity of the compounds against THP-1 macrophages and the 50% growth inhibition (IC₅₀) against Leishmania amazonensis promastigote forms were subsequently investigated using in vitro techniques. For all of the solid compounds obtained, the existence of an association between FZD and CD were confirmed by one or more characterization techniques (TG/DTG, DSC, SEM, XRD, RAMAN, and ¹³C NMR), particularly by a significant decrease in the crystallinity of these materials and a reduction in the melting enthalpy associated with furazolidone thermal events. The formation of more effective interactions occurred in the compounds prepared by lyophilization, in a 1:2 molar ratio of the two CDs studied. However, the formation of an inclusion complex was confirmed only for the solid compound obtained from HP-β-CD prepared by lyophilization (LHFZD1:2). The absence of cytotoxicity on the THP-1 macrophage lineages and the leishmanicidal activity were confirmed for all compounds. MHFZD1:2 and LHFZD1:2 were found to be very active against promastigote forms of L. amazonensis, while all others were considered only active. These results are in line with the literature, demonstrating the existence of biological activity for associations between drugs and CDs in the form of complexes and non-complexes. All solid compounds obtained were found to be promising for use as leishmanicidal agents against promastigote forms of L. amazonensis.

Identification of two novel adenoviruses in smooth-billed ani and tropical screech owl

Avian adenoviruses (AdVs) are a very diverse group of pathogens causing diseases in poultry and wild birds. Wild birds, endangered by habitat loss and habitat fragmentation in the tropical forests, are recognised to play a role in the transmission of various AdVs. In this study, two novel, hitherto unknown AdVs were described from faecal samples of smooth-billed ani and tropical screech owl. The former was classified into genus Aviadenovirus, the latter into genus Atadenovirus, and both viruses most probably represent new AdV species as well. These results show that there is very limited information about the biodiversity of AdVs in tropical wild birds, though viruses might have a major effect on the population of their hosts or endanger even domesticated animals. Surveys like this provide new insights into the diversity, evolution, host variety, and distribution of avian AdVs.

Comparative analysis of the vertebral pneumatization in pterosaurs (Reptilia: Pterosauria) and extant birds (Avialae: Neornithes)

Birds and pterosaurs have pneumatic bones, a feature likely related to their flight capabilities but whose evolution and origin is still poorly understood. Pneumatic foramina are present on the external surface of the bone and are reliable indicators of post-cranial skeletal pneumatization present in Pterosauria, Eusauropoda, and Neotheropoda. Here, we carried out a qualitative analysis of the position, size and number of pneumatic foramina of the cervical and thoracic/dorsal vertebrae of pterosaurs and birds, as they have the potential to challenge hypotheses about the emergence and evolution of the respiratory trait in these groups. We also discussed differences between pneumatic and vascular foramina for identification purposes. Besides phylogenetic representativeness, the pterosaur taxonomic sampling considered the preservation of specimens and, for birds, their life habit, as this relates to the level of pneumatization. Pneumatic foramina on the lateral faces of the centrum of the mid-cervical vertebrae of pterosaurs and birds differ in position and size, and those adjacent to the neural canal additionally differ in number. The avian posterior cervical vertebrae show a higher number of pneumatic foramina in comparison to their mid-cervicals, while the opposite is true for pterosaurs, suggesting differences in the cervical air sac of these clades. Pneumatic foramina were found at the base of the transverse processes of the notarial vertebrae of birds, while they were absent from some of the pterosaurs analyzed here, revealing the presence of a pneumatic hiatus in the vertebral column that might be explained due to the distance of this structure to the cervical air sac. These findings indicate that, although the overall skeletal pneumatization of pterosaurs and birds present deep homologies, some pneumatic features occurred convergently because variation in the number of pneumatic foramina along the vertebral column is related to the position of the air sacs in pterosaurs and birds and/or the habit of each species. There is an evident reduction of the pneumatic foramina in birds that have aquatic foraging and an increase in the ones which perform static soaring. Although we did not find any external anatomical difference between pneumatic and vascular foramina, we observed that vascular foramina occur at specific sites and thus identification on the basis of location is reliable.

Large-Range Polymer Optical-Fiber Strain-Gauge Sensor for Elastic Tendons in Wearable Assistive Robots

This paper presents the development and validation of a polymer optical-fiber strain-gauge sensor based on the light-coupling principle to measure axial deformation of elastic tendons incorporated in soft actuators for wearable assistive robots. An analytical model was proposed and further validated with experiment tests, showing correlation with a coefficient of R = 0.998 between experiment and theoretical data, and reaching a maximum axial displacement range of 15 mm and no significant hysteresis. Furthermore, experiment tests were carried out attaching the validated sensor to the elastic tendon. Results of three experiment tests show the sensor's capability to measure the tendon's response under tensile axial stress, finding 20.45% of hysteresis in the material's response between the stretching and recovery phase. Based on these results, there is evidence of the potential that the fiber-optical strain sensor presents for future applications in the characterization of such tendons and identification of dynamic models that allow the understanding of the material's response to the development of more efficient interaction-control strategies.

Exercise training improves vascular reactivity in ovariectomized rats subjected to myocardial infarction

The aim of this study was to evaluate the effects of exercise training (ET) on the aortic vascular reactivity of ovariectomized and infarcted rats. The animals were divided into 5 groups: Control, Ovariectomized + SHAM sedentary (OVX+SHAMSED), OVX+SHAM and ET (OVX+SHAMET), OVX + Myocardial Infarction sedentary (OVX+MISED), and OVX + MI and ET (OVX+MIET). ET protocol (60 minutes/day, 5x/week) in a motorized treadmill began 15 days after MI and lasted 8 weeks. The endothelium-dependent and endothelium-independent vascular reactivity were evaluated as well as the role of the reactive oxygen species (ROS). Superoxide and nitric oxide (NO) production were analyzed in situ using DHE and DAF-2 fluorescence, respectively. The expression of gp91phox and of the antioxidant enzymes were evaluated by western blotting in the thoracic aorta samples. MI promoted a significant increase in the contractile response and impaired endothelium-mediated relaxation. However, ET prevented the impairment in the vascular reactivity in MI animals. In addition, the protein expression of gp91phox and superoxide production increased and the NO production decreased in the OVX+MISED group but not in the OVX+MIET group. Therefore, ET improves vascular reactivity in MI ovariectomized rats by preventing the increase in the expression of gp91phox and the decrease in the antioxidant enzymes, resulting in a normal ROS and NO production. Thus, ET can be an effective therapeutic strategy for improving the MI-induced vascular alterations in estrogen deficiency condition.

Fiber Bragg Gratings in CYTOP Fibers Embedded in a 3D-Printed Flexible Support for Assessment of Human⁻Robot Interaction Forces

We developed a flexible support with embedded polymer optical fiber (POF) sensors for the assessment of human⁻robot interaction forces. The supports were fabricated with a three-dimensional (3D) printer, where an acrylonitrile butadiene styrene (ABS) rigid structure was used in the region of the support in which the exoskeleton was attached, whereas a thermoplastic polyurethane (TPU) flexible structure was printed in the region where the users placed their legs. In addition, fiber Bragg gratings (FBGs), inscribed in low-loss, cyclic, transparent, optical polymer (CYTOP) using the direct-write, plane-by-plane femtosecond laser inscription method, were embedded in the TPU structure. In this case, a 2-FBG array was embedded in two supports for human⁻robot interaction force assessment at two points on the users' legs. Both FBG sensors were characterized with respect to temperature and force; additionally, the creep response of the polymer, where temperature influences the force sensitivity, was analyzed. Following the characterization, a compensation method for the creep and temperature influence was derived, showing relative errors below 4.5%. Such errors were lower than the ones obtained with similar sensors in previously published works. The instrumented support was attached to an exoskeleton for knee rehabilitation exercises, where the human⁻robot interaction forces were measured in flexion and extension cycles.

Acanthamoeba of three morphological groups and distinct genotypes exhibit variable and weakly inter-related physiological properties

Free-living amoeba of the genus Acanthamoeba can eventually act as parasites, causing infections in humans. Some physiological characteristics of Acanthamoeba have been related to the grade of pathogenicity, allowing inferences about the pathogenic potential. The main goal of this study was to characterize isolates of Acanthamoeba obtained in Brazil and evaluate properties associated with their pathogenicity. A total of 39 isolates obtained from keratitis cases (n = 16) and environmental sources (n = 23) were classified into morphological groups and genotyped by sequencing the 18S rDNA fragments ASA.S1 and GTSA.B1. Samples were also tested regarding their thermo-tolerance, osmo-tolerance, and cytopathogenicity in MDCK cells. Isolates were identified and classified as follows: group I (T17, T18); group II (T1, T3, T4, T11); and group III (T5, T15), with the predominance of genotype T4 (22/39). Clinical isolates were genotyped as T3 (1/16), T4 (14/16) and T5 (1/16). The majority of isolates (38/39) were able to grow at 37 °C, but tolerance to 40 °C was more frequent among environmental samples. The tolerance to 1 M mannitol was infrequent (4/39), with three of these corresponding to clinical samples. The variable ability to cause cytopathic effects was observed among isolates of distinct genotypes and origins. This study identified, for the first time, T1 and T18 in Brazil. It also indicated a weak association between the clinical origin of the isolates and tolerance to high temperatures, high osmolarity, and cytopathogenicity, demonstrating that some in vitro parameters do not necessarily reflect a higher propensity of Acanthamoeba to cause a disease.

The dsRNA Virus Papaya Meleira Virus and an ssRNA Virus Are Associated with Papaya Sticky Disease

Papaya sticky disease, or "meleira", is one of the major diseases of papaya in Brazil and Mexico, capable of causing complete crop loss. The causal agent of sticky disease was identified as an isometric virus with a double stranded RNA (dsRNA) genome, named papaya meleira virus (PMeV). In the present study, PMeV dsRNA and a second RNA band of approximately 4.5 kb, both isolated from latex of papaya plants with severe symptoms of sticky disease, were deep-sequenced. The nearly complete sequence obtained for PMeV dsRNA is 8,814 nucleotides long and contains two putative ORFs; the predicted ORF1 and ORF2 display similarity to capsid proteins and RdRp's, respectively, from mycoviruses tentatively classified in the family Totiviridae. The sequence obtained for the second RNA is 4,515 nucleotides long and contains two putative ORFs. The predicted ORFs 1 and 2 display 48% and 73% sequence identity, respectively, with the corresponding proteins of papaya virus Q, an umbravirus recently described infecting papaya in Ecuador. Viral purification in a sucrose gradient allowed separation of particles containing each RNA. Mass spectrometry analysis indicated that both PMeV and the second RNA virus (named papaya meleira virus 2, PMeV2) were encapsidated in particles formed by the protein encoded by PMeV ORF1. The presence of both PMeV and PMeV2 was confirmed in field plants showing typical symptoms of sticky disease. Interestingly, PMeV was detected alone in asymptomatic plants. Together, our results indicate that sticky disease is associated with double infection by PMeV and PMeV2.

Carbonate Production by Benthic Communities on Shallow Coralgal Reefs of Abrolhos Bank, Brazil

The abundance of reef builders, non-builders and the calcium carbonate produced by communities established in Calcification Accretion Units (CAUs) were determined in three Abrolhos Bank shallow reefs during the period from 2012 to 2014. In addition, the seawater temperature, the irradiance, and the amount and composition of the sediments were determined. The inner and outer reef arcs were compared. CAUs located on the inner reef shelf were under the influence of terrigenous sediments. On the outer reefs, the sediments were composed primarily of marine biogenic carbonates. The mean carbonate production in shallow reefs of Abrolhos was 579 ± 98 g m^-2 y^-1. The builder community was dominated by crustose coralline algae, while the non-builder community was dominated by turf. A marine heat wave was detected during the summer of 2013–2014, and the number of consecutive days with a temperature above or below the summer mean was positively correlated with the turf cover increase. The mean carbonate production of the shallow reefs of Abrolhos Bank was greater than the estimated carbonate production measured for artificial structures on several other shallow reefs of the world. The calcimass was higher than the non-calcareous mass, suggesting that the Abrolhos reefs are still in a positive carbonate production balance. Given that marine heat waves produce an increase of turf cover on the shallow reefs of the Abrolhos, a decrease in the cover represented by reef builders and shifting carbonate production are expected in the near future.