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Hepatitis A is a fecal-oral infection caused by hepatitis A virus (HAV). Men who have sex with men (MSM) and transgender women (TW) have been reported as target groups for HAV infection. This study aimed to determine the seroprevalence, risk factors, and circulating strains associated with HAV infection among MSM and TW in Central Brazil. A cross-sectional study was conducted from November 2011 to September 2013. Serum samples were collected from 425 individuals for anti-HAV antibody testing and HAV molecular characterization. Of them, 149 (35.1%) participants were self-identified as transgender women. Statistical analysis was performed to evaluate the risk factors of HAV seropositivity. The seroprevalence of HAV exposure was 69.7% (95% Confidence Interval: 65.3-74.0%). Serological evidence of HAV was significantly higher in participants who self-identified as transgender women (83.2%) than MSM (62.3%). Increasing age, non-white race, and lower monthly household income were independently associated with HAV exposure among MSM. Only lower monthly household income was independently associated with HAV exposure among TW. One anti-HAV IgM positive sample, from a transgender woman (0.2%), was detected and classified as subgenotype IA. High HAV prevalence was observed, markedly among TW. Considering the risky sexual behaviors this population is exposed to, HAV vaccination and prevention programs targeting this population should be considered to prevent outbreaks and the burden of the disease.

Human T-cell leukemia virus type 1 (HTLV-1) has worldwide distribution and is considered endemic in southwestern Japan. HTLV-1 infection has been associated with adult T-cell leukemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) besides other diseases. This cross-sectional study aimed to investigate the prevalence, risk factors and molecular characterization of HTLV-1, among the world’s largest population of Japanese immigrants and their descendants outside of Japan, in São Paulo, Southeast Brazil, as well as to analyze the phylogenetic relationship among isolates of HTLV-1. From July to December 2017, 2,139 individuals from five Japanese associations were interviewed and submitted to blood collection. All serum samples were first tested for the presence of anti-HTLV-1/2 antibodies by ELISA and then peripheral blood from individuals with positive serological results were analyzed for the presence of HTLV-1 5’LTR proviral DNA. Partial sequencing of the 5’LTR region of HTLV-1 proviral DNA was performed by Sanger. The prevalence of HTLV-1 infection was 5.1% (CI 95%: 4.2–6.0). In the multiple logistic regression model, HTLV-1 infection was associated with age ≥ 45 years, female sex, being first and second-generation Japanese immigrants, and having sexual partners with history of blood transfusion. The phylogenetic analysis revealed that all HTLV-1 were classified as Cosmopolitan (1a) subtype. Of them, 47.8% were classified as Transcontinental (A) subgroup and 52.2% as belonging to the Japanese (B) subgroup. Although most HTLV-1-infected patients were asymptomatic (97.3%), blurred vision was associated with HTLV-1 infection. The high prevalence of HTLV-1 infection found in this studied population and especially the intra- and interfamily HTLV-1 transmission presents an urgent call for preventive and control responses of this infection in Brazil.

Mixing of complementary tree species may increase stand productivity, mitigate the effects of drought and other risks, and pave the way to forest production systems which may be more resource-use efficient and stable in the face of climate change. However, systematic empirical studies on mixing effects are still missing for many commercially important and widespread species combinations. Here we studied the growth of Scots pine (Pinus sylvestris L.) and European beech (Fagus sylvatica L.) in mixed versus pure stands on 32 triplets located along a productivity gradient through Europe, reaching from Sweden to Bulgaria and from Spain to the Ukraine. Stand inventory and taking increment cores on the mainly 60-80 year-old trees and 0.02-1.55 ha sized, fully stocked plots provided insight how species mixing modifies the structure, dynamics and productivity compared with neighbouring pure stands. In mixture standing volume (+12 %), stand density (+20 %), basal area growth (+12 %), and stand volume growth (+8 %) were higher than the weighted mean of the neighbouring pure stands. Scots pine and European beech contributed rather equally to the overyielding and overdensity. In mixed stands mean diameter (+20 %) and height (+6 %) of Scots pine was ahead, while both diameter and height growth of European beech were behind (-8 %). The overyielding and overdensity were independent of the site index, the stand growth and yield, and climatic variables despite the wide variation in precipitation (520-1175 mm year(-1)), mean annual temperature (6-10.5 A degrees C), and the drought index by de Martonne (28-61 mm A degrees C-1) on the sites. Therefore, this species combination is potentially useful for increasing productivity across a wide range of site and climatic conditions. Given the significant overyielding of stand basal area growth but the absence of any relationship with site index and climatic variables, we hypothesize that the overyielding and overdensity results from several different types of interactions (light-, water-, and nutrient-related) that are all important in different circumstances. We discuss the relevance of the results for ecological theory and for the ongoing silvicultural transition from pure to mixed stands and their adaptation to climate change.

We report 13 multiple myeloma (MM) or lymphoma patients who were failing PBSC mobilization after disease-specific chemotherapy and granulocyte-CSF (G-CSF), and received plerixafor to successfully collect PBSCs. Patients were considered poor mobilizers when the concentration of PB CD34 + cells was always lower than 10 cells/μL, during the recovery phase after chemotherapy and/or were predicted to have inadequate PBSC collection to proceed to autologous transplantation. Plerixafor (0.24 mg/kg) was administered subcutaneously for up to three consecutive days, while continuing G-CSF, 10–11 h before the planned leukapheresis. Plerixafor administration was safe and no significant adverse events were recorded. We observed a 4.7 median fold-increase in the number of circulating CD34 + cells after plerixafor as compared with baseline CD34 + cell concentration (from a median of 6.2 (range 1–12) to 21.5 (range 9–88) cells/μL). All patients collected >2 × 10 6 CD34 + cells/kg in 1–3 leukaphereses. In all, 5/13 patients have already undergone autograft with plerixafor-mobilized PBSCs, showing a rapid and durable hematological recovery. Our results suggest that the pre-emptive addition of plerixafor to G-CSF after chemotherapy is safe and may allow the rescue of lymphoma and MM patients, who need autologous transplantation but are failing PBSC mobilization.

Human activities have the potential to enhance carbon sequestration by the world’s forests and contribute to climate change mitigation. Voluntary carbon trading is currently the only option to pursue and reward carbon sequestration by forestry activities. Carbon credits for enhanced sequestration can be sold to partners wishing to offset their own emissions. Here we illustrate the steps taken to design guidelines for the generation of voluntary carbon credits by improved forest management in Piemonte, Italy. The guidelines have been developed in a joint effort by academia, regional administrations, forest owners and professional consultants. In particular, we show how to compute the baseline and the additionality of credit-generating forest management activities, and how to reconcile the generation of forest carbon credits with law requirements, technical limitations, and the provision of other ecosystem services. To illustrate the profitability of carbon credit generation, we simulated the application of carbon credit guidelines to two forest-rich mountain watersheds in the southern part of the Piemonte region. The two dominating tree species are beech (Fagus sylvatica L.) and chestnut (Castanea sativa Mill.). We computed current forest carbon stock and carbon credits generated in 20 years under business as usual and an alternative biomass retention scenario. The IFM resulted in an avoided harvest of 39.362 m3 for a net total of 64.014 MgCO2e after subtracting harvest emissions, or 38 Mg ha-1 throughout the permanence period of 20 years. These steps can be replicated in other mountain regions where there is interest in promoting this ecosystem service as an alternative or an addition to production-oriented forest management.

KEY MESSAGE : In the inner-Alpine Aosta Valley, severe growth reductions occurred in Scots pine stands during 1987–1993 and 2003–2005. Trees more sensitive to May precipitation exhibited stronger growth decline during these periods. Over the last decades, Scots pine (Pinus sylvestris L.) decline has involved large areas in the European Alps. Although the species is supposed to be drought resistant, increased temperatures and droughts are often indicated as predisposing causes of the decline. Nevertheless, the exact climate conditions that initiate the decline, and the reasons why they differentially affect individual trees, are largely unknown. Our aims were to identify climate constraints on Scots pine growth, and elucidate the effect of individual characteristics, such as tree age, size, crown condition, mistletoe occurrence, competition, and sensitivity to climate, on tree growth decline and recovery after repeated climatic stress. We analysed 232 trees in four second-growth stands located at 985–1350 m a.s.l. in the inner-Alpine Aosta Valley, NW Italy. Multi-year growth declines, occurred in 1987–1993 and 2003–2005, were related to repeated May precipitation shortage, while temperatures and summer precipitations played a minor role. Growth decline was stronger in the stand at lower elevation and with higher competition intensity. At the individual scale, trees more sensitive to May precipitation exhibited lower growth rates during both dry periods, but not a faster recovery. In the lower elevation stand, tree growth decline was significantly related to both crown transparency and mistletoe abundance, which was almost absent in the other stands. We conclude that future variations in the spring precipitation regime could threaten Scots pine more than warming per se, in inner-Alpine valleys around 1000–1400 m a.s.l. Still, different individual sensitivity to precipitation will likely result in patchy patterns of healthy and declining trees within the same stand.

Objectives: Radiosynovectomy can be an effective treatment for difficult-to-treat monoarthritis resistant to systemic and local standard therapy. The objective of our study was to determine predictors of good response to radiosynovectomy in routine care and give an overview of this underused technique. Methods: Retrospective observational study of all the patients who underwent radiosynovectomy during a 6-year inclusion period. All the procedures were ultrasound guided and the radiopharmaceutical used was chosen according to joint size. The patient was considered to have an effective response to radiosynovectomy if the attending physician reported a positive outcome and there was no need to increase local and or systemic treatment due to arthritis in the affected joint during the next 12 months following the procedure. Results: We included 67 patients who underwent radiosynovectomy in the knee (73.1%), wrist (16.4%), and elbow (10.5%). Overall, 44 (65.7%) procedures were considered effective. In the multivariate analysis, infiltration of wrists (odds ratio = 0.192; confidence interval = 0.046–0.79) and pigmented villonodular synovitis (odds ratio = 0.13; confidence interval = 0.021–0.82) were independently associated with a noneffective response. No patients experienced complications associated with radiosynovectomy during follow-up. Conclusion: Infiltrations of wrists with joint damage seem less likely to have a response to radiosynovectomy. In pigmented villonodular synovitis, radiosynovectomy as an adjuvant therapy for relapse might not be effective when performed more than 6 months after surgery. Overall, radiosynovectomy is an effective and safe treatment for persistent monoarthritis.

Human T-lymphotropic virus type 1 (HTLV-1) has worldwide distribution and is considered endemic in many world regions, including southwestern Japan and Brazil. Japanese immigrants and their descendants have a high risk of acquiring this infection due to intense population exchange between Brazil and Japan. This cross-sectional study aimed to estimate the prevalence of HTLV, analyze the main risk factors associated with this infection, identify the main circulating types and subtypes of HTLV in Japanese immigrants and descendants living in Campo Grande-MS (Middle-West Brazil), as well as analyze the phylogenetic relationship among isolates of HTLV. A total of 219 individuals were interviewed and submitted to blood collection. All collected blood samples were submitted for detection of anti-HTLV-1/2 using the immunoassay ELISA and confirmed by immunoblot method. The proviral DNA of the 14 samples HTLV- 1 positive were genotyped by nucleotide sequencing. The overall prevalence of HTLV-1 was 6.8% (IC 95%: 3,5-10,2). Descriptive analysis of behavioral risk factors showed statistical association between HTLV-1 and age greater than or equal to 45 years. The proviral DNA of HTLV-1 was detected in all HTLV-1 positive samples. Of these, 14 were sequenced and classified as Cosmopolitan subtype, and 50% (7/14) belonged to subgroup A (transcontinental) and 50% (7/14) to the subgroup B (Japanese). The high prevalence of HTLV-1 found evidence of the importance of early diagnosis and counseling of individuals infected with HTLV-1 for the control and prevention of the spread of this infection among Japanese immigrants and their descendants in Central Brazil.

This study aimed to characterize the epidemiological aspects of PrEP use and barriers to accessing this prophylaxis. This cross-sectional study was conducted between January 2021 and April 2022, encompassing 140 PrEP users treated at the Testing and Counseling Center (CTA) in Campo Grande, Mato Grosso do Sul. Data on sociodemographic characteristics and factors associated with PrEP discontinuation were obtained using a standardized questionnaire. Most PrEP users were cisgender men (92.00%), predominantly white (51.00%), over 30 years of age (56.50%), homosexual-oriented (76.50%), and had a minimum of 12 years of education (77.50%). Approximately 60.00% admitted to inconsistent condom use in recent sexual encounters, primarily involving anal intercourse. Approximately 88.00% perceived themselves as at risk of contracting STIs in the upcoming year. Regarding new presentation forms, 54.00% indicated a willingness to use “on-demand PrEP,” and 92.00% expressed interest in using “injectable PrEP.” After 6 months of follow-up, 43.60% (95.00% CI: 35.50–52.00) discontinued PrEP use, primarily due to changes in sexual behavior (38.30%) and difficulties accessing healthcare services (21.28%). This study underscores the need to involve diverse key populations and highlights the significance of PrEP as an ongoing monitoring strategy for HIV/STI prevention in addition to the importance of incorporating new formulations such as daily oral PrEP into the Brazilian National Health System (SUS).

Aim The study evaluated the theoretical knowledge and practical ability of students in paediatric dentistry concerning basic life support (BLS) and cardiopulmonary resuscitation (CPR) in children and babies. Methods Seventy paediatric dentistry students answered a questionnaire and also performed a simulation of the manoeuvres of BLS and CPR on baby and child manikins. Results The results showed that 41 (58%) students had never received BLS training. When questioned about the correct ratio of compression and ventilation during CPR, most students answered incorrectly. For the CPR of babies in the presence of a first responder only 19 (27.1%) answered correctly (30 × 2), and for babies with two rescuers, 23 (32.8%) answered correctly (15 × 2); in relation to the correct rhythm of chest compressions, 38 (54.4%) answered incorrectly; when asked if they felt prepared to deal with a medical emergency in their dental surgeries, only 12 (17.1%) stated “yes”. In the practice evaluation, 51 (73%) students who had been assessed in CPR manoeuvres for children and 55 (78%) in the manoeuvres for babies scored inadequately. Conclusions The evaluated students did not have adequate knowledge about CPR in children and babies.