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In this population-based cohort study that included data on all live births in Brazil from 2015 to 2018, infants with congenital Zika syndrome had substantially higher mortality over the first 3 years of life than those without the syndrome.

Non-alcoholic fatty liver disease (NAFLD) is a chronic disease with several degrees of histological features which may progress to cirrhosis. Obesity is an important risk factor and although NAFLD has no specific pharmacological treatment, bariatric surgery has been associated with NAFLD regression in severely obese patients. However, few longitudinal histological studies support this finding. Therefore, firstly, a retrospective study was performed including clinical and histological data of 895 obese patients who underwent bariatric surgery. In addition, histological analyses of 30 patient’s liver biopsies were evaluated at two timepoints (T1 and T2). The retrospective analysis of the total number of patients revealed that the average body mass index (BMI) was 35.91 ± 2.81 kg/m 2 . The liver biopsies during bariatric surgery showed that 53.52% did not present NAFLD, 30.16% had NASH, 15.98% isolated steatosis and 0.34% liver cirrhosis. The median BMI of the longitudinal cohort decreased from 37.9 ± 2.21 kg/m 2 at the time of bariatric surgery (T1) to 25.69 ± 3.79 kg/m 2 after 21 ± 22 months after the procedure (T2). The prevalence of NAFLD in T1 was 50%, and 16.67% in T2. The histological area of collagen fiber was lower in T2 compared to T1 (p = 0.0152) in the majority of patients, which was also illustrated by immunohistochemistry for Kupffer cell and myofibroblast formation markers. These findings confirmed the NAFLD regression after bariatric surgery and, for the first time, showed the amelioration of these features using more accurate histopathological techniques.

Objective Visceral leishmaniasis (VL) is an endemic parasitic disease in Latin America, and its clinical picture is aggravated in coinfections with the human immunodeficiency virus (HIV). The objective of this study was to investigate clinical factors and laboratory variables associated with VL relapse and death in VL/HIV coinfected patients. Methods A prospective longitudinal study was conducted from January 2013 to July 2020 among 169 patients coinfected with VL and HIV. The outcomes investigated were the occurrence of VL relapse and death. Chi-square test, Mann–Whitney test and logistic regression models were used for statistical analysis. Results The occurrence rates were 41.4% for VL relapse and 11.2% for death. Splenomegaly and adenomegaly were associated with the increased risk of VL relapse. Patients with VL relapse had higher levels of urea ( p  = .005) and creatinine ( p  < .001). Patients who died had lower red blood cell counts ( p  = .012), hemoglobin ( p  = .017) and platelets ( p  < .001). The adjusted model showed that antiretroviral therapy for more than 6 months was associated with a decrease in VL relapse, and adenomegaly was associated with an increase in VL relapse. In addition, edema, dehydration, poor general health status, and paleness were associated with an increase in hospital death. Conclusion The findings suggest that adenomegaly, antiretroviral therapy, and renal abnormalities can be associated with VL relapse, while hematological abnormalities, and clinical manifestations like paleness, and edema can be associated with an increased odds of hospital death. Trial registration number: The study was submitted to the Ethics and Research Committee of the Federal University of Maranhão (Protocol: 409.351).

We evaluated the effect of leaves of native and exotic tree species on the feeding activity and performance of the larvae of Triplectides gracilis, a typical caddisfly shredder in Atlantic Forest streams. Leaves of four native species that differ in chemistry and toughness (Hoffmannia dusenii, Miconia chartacea, Myrcia lineata and Styrax pohlii) and the exotic Eucalyptus globulus were used to determine food preferences and rates of consumption, production of fine particulate organic matter (FPOM), growth and survival of shredders. We hypothesized that the consumption rates of leaves of Eucalyptus and their effects on the growth and survival of shredders could be predicted by leaf chemistry and toughness. The larvae preferred to feed on soft leaves (H. dusenii and M. chartacea) independently of the content of nutrients (N and P) and secondary compounds (total phenolics). When such leaves were absent, they preferred E. globulus and did not consume the tough leaves (M. lineata and S. pohlii). In monodietary experiments, leaf consumption and FPOM production differed among the studied leaves, and the values observed for the E. globulus treatments were intermediate between the soft and tough leaves. The larvae that fed on H. dusenii and M. chartacea grew constantly over five weeks, while those that fed on E. globulus lost biomass. Larval survival was higher on leaves of H. dusenii, M. chartacea and S. pohlii than on E. globulus and M. lineata leaves. Although E. globulus was preferred over tougher leaves, long-term consumption of leaves of the exotic species may affect the abundance of T. gracilis in the studied stream. Additionally, our results suggest that leaf toughness can be a determining factor for the behavior of shredders where low-quality leaves are abundant, as in several tropical streams.

The co-circulation of different arboviruses in the same time and space poses a significant threat to public health given their rapid geographic dispersion and serious health, social, and economic impact. Therefore, it is crucial to have high quality of case registration to estimate the real impact of each arboviruses in the population. In this work, a Vector Autoregressive (VAR) model was developed to investigate the interrelationships between discarded and confirmed cases of dengue, chikungunya, and Zika in Brazil. We used data from the Brazilian National Notifiable Diseases Information System (SINAN) from 2010 to 2017. There were three peaks in the series of dengue notification in this period occurring in 2013, 2015 and in 2016. The series of reported cases of both Zika and chikungunya reached their peak in late 2015 and early 2016. The VAR model shows that the Zika series have a significant impact on the dengue series and vice versa, suggesting that several discarded and confirmed cases of dengue could actually have been cases of Zika. The model also suggests that the series of confirmed and discarded chikungunya cases are almost independent of the cases of Zika, however, affecting the series of dengue. In conclusion, co-circulation of arboviruses with similar symptoms could have lead to misdiagnosed diseases in the surveillance system. We argue that the routinely use of mathematical and statistical models in association with traditional symptom-surveillance could help to decrease such errors and to provide early indication of possible future outbreaks. These findings address the challenges regarding notification biases and shed new light on how to handle reported cases based only in clinical-epidemiological criteria when multiples arboviruses co-circulate in the same population.

The objective of this study was to identify the health conditions considered potential risk factors for severe Covid-19 and analyze its association with the BMI of elderly people living in Long-Term Care Facilities (LTCF). This is a descriptive and cross-sectional study, with a quantitative approach, carried out in eight LTCF in the Metropolitan Region of Natal, Rio Grande do Norte, with a population of 267 elderly people, between the months of February and December 2018. The Elderly Health Handbook was used to collect data on sociodemographic, health and risk factors. The Pearson’s Chi-square test and odds ratio were used for the analysis. A higher frequency of low weight was observed in elderly people with cognitive impairment (24.6%), and overweight in those hypertensive (23.3%) and diabetics (12.9%). BMI was associated with the age group of 80 years or over, hypertension and diabetes (p = 0.013; p < 0.001; p = 0.001). Hypertensive elderly people were more likely to have low weight when compared to non-hypertensive individuals (RC = 3.6; 95% CI 1.5–8.6). The institutionalized elderly individuals present health conditions that may contribute to the occurrence of adverse outcomes in case of infection by Covid-19. The importance of protective measures for this population must be reinforced, in view of the devastating action of this disease in these institutions.

In this work, hydrophobic surfaces on cotton fabrics were obtained using a sol–gel technique to produce coatings applied using a spray of precursor solution followed by drying and heat treatments. Different types of treatments using the sol–gel process were performed in order to assess the influence on fabric hydrophobicity, with alteration of parameters including the concentrations of citric acid and tetraethyl orthosilicate (TEOS), the number of sprays, and curing of the fabric after obtaining the hydrophobic coating. The absorption of water into material samples were tested according to the AATCC test method 79. Scanning electron microscopy, contact angle, and Fourier-transform infrared spectroscopy (FT-IR) analysis were also studied. Excellent results were obtained for the contact angle (>150°), hence characterizing all the treatments as super-hydrophobic. FT-IR analyses revealed differences according to the citric acid concentration employed. The best results were obtained for samples treated using a higher concentration of citric acid and spraying the sol–gel solution twice. Mathematical models of the contact angle and the time for water absorption by the fabric treated with TEOS and citric acid showed good agreement with the experimental data. Highlights A hydrophobic coating on porous materials was achieved using a simple, single-step, and inexpensive procedure employing TEOS, citric acid, and ethanol, without any fluorinated compounds. The hydrophobic solution was applied using a spray of fine droplets released at a distance of 15 cm from the porous material. Better resistance to washing processes was obtained using higher concentrations of citric acid for formation of the hydrophobic solution employed for the porous coating on the cotton fabric.

The article addresses the formulation and characterization of the polyvinyl alcohol membrane (PVA) with citric acid, succinic acid and their mixing as crosslinking agents. PVA is highly hydrophilic and has excellent film (membrane) properties. Chemical crosslinking is the most common approach to stabilize and produce PVA membranes with enhanced mechanical resistance. Thus, we prepared membranes with variable PVA and crosslinking agents. The thermal properties of the membranes were analyzed using thermogravimetric method (TGA), while the functional groups formed in the membrane were determined using Fourier-transform infrared spectroscopy. The water absorption of the membranes was determined by the degree of swelling. The oxidative stability was obtained using the Fenton test. The ion exchange capacity was also evaluated. Membrane structure, morphology and surface properties were analyzed by topography and adhesion force using atomic force microscopy. The scanning electron microscopy was used to elucidate the fractures. The results indicated that the membranes exhibited roughness uniformly distributed, indicating homogeneous films and excellent crosslinking features allied to enhanced adhesion and strength properties with good stability.

Trace metal pollution has become an increasing concern in urban areas, mainly due to industrial activities and heightened human activities near water bodies. This study aimed to quantify the level of pollution caused by the trace metals Co, Cr, Cu, Mn, Ni, and Zn in surface sediments of Aurá and Guamá rivers, as well as Guajará Bay, in the metropolitan region of Belém (Northern Brazil). A total of 33 sediment samples were collected—14 from the Aurá River, 7 from the Guamá River, and 12 from Guajará Bay—during both the wet and dry seasons to capture seasonal variability. The studied trace metals were measured through inductively coupled plasma optical emission spectrometry (ICP-OES), and the decreasing order of concentration detected was the following: Mn > Zn > Cr > Ni > Co > Cu. To assess the degree of pollution, three geochemical indicators were employed: the Geoaccumulation Index (Igeo), which compares observed concentrations with natural background levels to classify contamination severity; the Enrichment Factor (EF), which helps distinguish between natural and anthropogenic sources of metals using a reference element (typically aluminum or iron); and the Mean-ERM-Quotient, which evaluates the potential ecotoxicological risk of the metals based on benchmark values for adverse effects on aquatic organisms. Based on these indicators, the sediments of the studied area can be classified as showing “moderate contamination and enrichment”. The metals Zn and Cu exhibited the highest degrees of enrichment, likely of anthropogenic origin. Overall, this study revealed that areas closer to sites of intense human activity are more susceptible to trace metal contamination, especially during the wet season. Frequent monitoring of areas classified as “contaminated” and time-series data are necessary to examine more deeply the pollution of river sediments and their potential changes concerning shifts in the status of urbanization and industrialization.

High-throughput sequencing (HTS) of three pear trees ( Pyrus communis ) resulted in the identification of two isolates of a Tepovirus species and one isolate of a Robigovirus species, both genera from the family Betaflexiviridae and never reported in pears. Their complete genomes were fully characterized, revealing genomes of about 6.8 kb ( Tepovirus ) and 8.4 kb ( Robigovirus ). According to the species demarcation criteria in the family Betaflexiviridae , the tepovirus isolates reported here are divergent isolates of Prunus Virus T (PrVT). The robigovirus isolate had enough difference in pairwise comparison with its closer related species, cherry virus Turkey (CVTR) and it should be considered a new species of this genus, tentatively named as pomes virus Greece (PVGR). A survey was conducted using specific primers designed for each of the viruses and one additional pear accession tested positive to PrVT. Furthermore, both viruses were successfully graft-transmissible to Malus domestica or Malus micromalus, suggesting their potential to be transmitted to Malus species. This study expands the list of viruses infecting pome fruit trees and augments our knowledge on the molecular diversity and host range evolution of betaflexiviruses.