Volume 11 - 2023 | https://doi.org/10.3389/fbioe.2023.1108396
The field of 3D bioengineering proposes to effectively contribute to the manufacture of artificial multicellular organ/tissues and the understanding of complex cellular mechanisms
3D cell cultures comprise a promising bioengineering possibility for the alternative treatment of organ function loss
potentially improving patient life expectancies
could benefit from treatment until organ transplantation or even undergo organ function restoration
3D bioprinters can produce tissues such as trachea cartilage or artificial skin
Most low-cost 3D bioprinters are built from fused deposition modeling 3D printer frames modified for the deposition of biologically compatible material
ranging between $13.000,00 and $300.000,00
the cost of consumables should also be considered as they
can range from $3,85 and $100.000,00 per gram
our report describes the first prototype of a significantly low-cost 3D bioprinter built from recycled scrap metal and off-the-shelf electronics
We demonstrate the functionalized process and methodology proof of concept and aim to test it in different biological tissue scaffolds in the future
using affordable materials and open-source methodologies
thus democratizing the state of the art of this technology
it stands to reason that low- and middle-income countries may be active participants in this revolution
biology research equipment and medical devices continue to present high price tags and are hard to obtain
due to issues related to the geographical distribution of suppliers
we have developed an open source microextrusion bioprinter for tissue engineering using discarded computer materials
Bioprinters built with low-cost parameters
Technologies applied to 3D bioprinting: general pros and cons
Components used to build the prototype described here
Comparative list of commercially available bioprinters per mechanism and customized prototypes prices
TABLE 5. Prices of materials to build the 3D bioprintera
Access to these types of printers is not easy everywhere
as their cost is still high for certain regions/institutions and logistics problems (importing costs
make the technology difficult to reach outside the global north
and cost-effective bioprinter should be amenable for construction with locally available materials and technologies
The development of a bioprinter employing microextrusion-based bioprint is a necessity and also an opportunity to democratize the teaching of basic technologies
To develop the printer, a Cartesian movement system (three orthogonal axes) was employed. Sourced material was obtained from scrap metal (Figure 1A). Based on available online repositories (DIY Micro Dispensing and Bio Printing, 2022)
several screws and small metal “L” angle brackets
were used to create a 3D positioning subsystem mechanical part
Representative image of the recycled scrap material used to build the scrap metal-based low-cost bioprinter
(B) Injection subsystem: Representative images of the equipment used for the injection subsystems within the extrusion system
After assembly of the motorized mechanical structure (Figure 2), mechanical axes setup was performed (Figure 3), also including the printing table (Inset Figure 4), the optical limit switches (Figure 3), electronic boards (Arduino and Shield), power supply, wiring and limit switches were installed (Figure 4)
Mechanical blocks to construct the three orthogonal axes
(A) X-axis driver set (B) Y-axis driver set (C) Z-axis driver set
Φ: Worm Thread; *: linear guides; Δ: stepper motor; Π: optical assembly support
Mechanical setup of the axes in the 3D movement block
(A) Steel cover plates from CD-ROM boxes used to prepare the main 3D printer structure
A window was cut in the vertical plate to allow for the Y-axis movement
(B) Setup of the X-axis block in the upper parts of the vertical plate
An acrylic plate rectangle was glued onto the optical block support of the X-axis to attach the Z block
(C) Setup of the Z-axis block with the rectangular acrylic plate glued onto the optical block support of the Z-axis with screws used to attach the needle support
Limit switch installation with locations indicated in red squares
Insert: Mechanical assembly of the printing table
The representative image of all the components of this bioprinter is depicted in Figure 5 as a schematic design
In order to begin building the bioprinter injection subsystem
an insulin syringe needle was cut to 3 mm from the end of the barrel using a micro grinder diamond-cutting disc
while the 1.2 mm diameter hypodermic needle was cut at a 30 mm distance from the barrel
The plastic hose of the urethral tube was cut to a length of about 32 cm
The end of the protective cap was coaxially drilled using a 2 mm diameter drill
one end of the plastic hose was inserted into the 1.2 mm diameter needle until the barrel and tied using a few turns of steel wire
tight enough so that the hose would not slip on the needle
the end of the cannon and part of the tube up to the end of the needle were covered with a thick layer of epoxy glue
with the hose inserted through the hole until covering the needle
The plunger of the insulin syringe was removed
the rubber separated from the rod and the rubber end of the plunger pierced with the 2 mm drill bit
so opposite end of the plastic hose is inserted into the hole from the side of the rod fitting
The end of the hose lines was joined with the rubber end of the plunger
(A) Frontal bioprint view indicating all prototype parts
following a (B) schematic design indicating details at the bottom describing the infusion pump
The plunger rubber was inserted into the syringe to about 1 cm below the handle flange
The space to the flange was filled with epoxy glue (∼0.2 mL) and small balls of soft paper (∼3–4 mm in diameter) were inserted between the plastic hose and the syringe wall
filling the space around the hose to act as a plunger for the glue
The assembly was pushed until the rubber plunger touched the bottom of the syringe
to minimize the volume between the hose opening and the syringe needle
The overpressure sensor is a microswitch connected to the injector mechanism
the increased pressure inside the syringe exerts an axial force in the mechanism and produces a small displacement of the driver screw against a spring
enough to press the microswitch and abort the printing
avoiding damages in the injection system due to excessive forces
with the respective pin out identification (id
with the function name of the pins in the same respective order of the corresponding pins in the Arduino
(C) Stepping motor Allegro A4988driver module
with the corresponding functional pin identifications
(D) Transmissive photomicrosensor OMRON EE-SX1235A-P2 used as the limit switch
where the block in the upper right part of the picture
is the phototransistor and the block in the lower right is the LED
(E) Wiring layout drawing of the limit switch connections
(F) Typical photosensor connection as the limit switch
and Z-axes and for the Injector (named “A axis” in the CNC board labels)
(G) Circuit schematic of the overpressure sensor and Emergency Stop Switch
the series of commands that will be interpreted by repetierHost to move the printer sequentially
following the model initially created and extruding bioink
The Y and X-axis parameterized with a one-step 10 µm resolution with a maximum non-printing move speed of 80
usual printing speed range of 2–10 and 36 mm axis range
the Z-axis has a step resolution of 10 μm
40 mm/s of maximum non-printing move speed
a usual speed rage of 2–10 and 20 mm axis range
and subjected to at least 30 min of UV light decontamination prior to use
Peracetic acid solution is used to decontaminate the pathway in which the bioink is strained for bioprinting
The probe is soaked in a 0.2% peracetic acid aqueous solution for 10 min prior to use
The probe is then washed three times with sterile deionized water
a 5 mm × 5 mm x 2.5 mm (L × W × H) cuboid block
The first model was designed in Wings3D and the others were drawn in Tinkercad
exported to STL and imported into repetierHost
where they were scaled and sliced into G-CODE using the Slic3r module
In order to verify the accuracy of our prototype
we printed a construct with pluoronic-F-127 (30%w/v) (#SLBG6026V
United States) without cells and with the addition of an orange food coloring to improve visualization
A 6% sodium alginate solution (4% w/v) (W201502-1 KG
United States) was prepared in 100 mL of 0.9% w/v saline solution (Sorimax
Stirring was maintained throughout the preparation
The temperature was maintained at around 60°C to completely homogenize the alginate
A 3-fold higher calcium chloride (CaCl2) (C50080-500G
United States) concentration was prepared to maintain the final solution concentration
A total of 0.03 g of CaCl2 were mixed with a 0.9% w/v saline solution
Solutions I and ii were mixed at a 3:1 ratio
resulting in a 4% sodium alginate solution containing 30 mM CaCl2
The solutions were then autoclaved and put to use
1 mL of the bioink was drawn with a 3 mL sterile syringe (990174
BD PlastipakTM) and placed in the bioprinter to begin the printing process
500 µL of a 5 mM CaCl2 aqueous solution was dropped on top of the construct for 3 min and the block was cultured at 37°C under a 5% CO2 atmosphere in an oven
United States) (4% w/v) was prepared in 100 mL of a 0.9% w/v saline solution
Stirring was continued throughout the preparation
The temperature was maintained at around 60°C for complete alginate homogenization
A total of 3 g or 4 g of gelatin (G8150-100G
United States) were mixed with the solution mentioned above to prepare a 4% sodium alginate solution containing 3% or 4% gelatin solution
we added cells to the printed construct assess biocompatibility
Around 107 cell/mL HEPG2 lineage was bioprinted
on a 35 mm × 10 mm Petri dish
500 µL of a 5 mM CaCl2 aqueous solution was dropped on top of the construct for 5 min and the block was cultured at 37°C under a 5% CO2 atmosphere in an oven
It is important to note that all solutions can be stored for 1 month after preparation at 4°C
Bioink temperatures of both the alginate and calcium chloride and alginate and gelatin solutions must be used at around 37°C
as cells are maintained at that temperature
The bioinks were placed in a water bath to complete melting
we wait for temperature decreases at 37°C
Cells at the concentration of interest were washed and placed in a polypropylene tube
A total of 1 mL of the bioink was added slowly to avoid bubbles and then placed in a 1 mL syringe
they were maintained at 4 °C for 1 h to improve polymerization
A total of 500 µL of calcium chloride were added to the top of the blocks for 3 or 5 min
The calcium chloride solution was removed with the aid of a pipette and 3 mL of high glucose DMEM (Sigma
United States) medium supplemented with 10% fetal bovine serum (FBS - GIBCO
The culture was performed as described previously
Nebulization device (red square) coupled to the bioprinter equipment to solve submerged calcium chloride printing issues
The materials used to carry out the first calibration injection tests were sodium alginate at 100 mg/mL and calcium chloride at 5 mM
It is important to note that calcium chloride can improve alginate gelification while being biocompatible
In order to better visualize the alginate print in these first tests
The first verified parameter comprised alginate gelling efficiency. Dropping alginate into the calcium chloride solution directly from the extrusion needle produced stable and mechanically resistant-gelled alginate capsules approximately 2 mm in diameter (Figure 8)
Alginate gelification in calcium chloride: (A) dripping and (B) appearance of the gelled capsules
The first tests indicate some issues, as follows (Figure 9)
- Problems with Petri dish alginate adherence
with the alginate remaining attached to the injection needle;
- Low precision of the table adjustment to needle movement coordinates
Representative images of the problems caused by alginate gelification insufficiency: (A) Excess extruded alginate
(B) Lack of extrudated alginate due to needle stickiness
Several materials were tested to solve glass adherence issues, such as tracing paper, polypropylene, and acrylic (Figure 10)
The best adherence material was glass with smaller contact angles
The test was then carried out immersed in a calcium chloride solution with the needle tip moving to check for adhesion or trailing
Adhesion tests employing different material surfaces
Representative images of different materials used to verify alginate adhesion to surfaces from extrusion bioink
the calcium mist minimized the adherence caused by the immersion printing
although the needle still suffered from lumps formed by alginate gelation when extruded
Gelled alginate lumps were observed at the end of the injection needle at the lowest calcium chloride ratio
they spread the deposited alginate and ink the printing
in addition to obstructing nozzle of injection and
The lumps increased as the alginate was attracted by capillary action to the needle
was coated with a protective hydrophobic membrane (e.g.
assigned by vaseline also caused calcium chloride repulsion
This can be minimized by adjusting the position of the chloride injection closer to the end of the alginate injection needle
tests with a 3:1 alginate to calcium chloride ratio were performed
and an insufficient amount of calcium chloride was observed
the chosen model by the Wings3D builder for the tests presented in this report was a standardized 5 × 5 × 2.5 mm block
1:3 and 1:1 alginate to calcium chloride ratios were tested
but excess calcium chloride was noted through higher alginate polymerization and the presence of two bioink phases
the first test proved to be the best ratio
Construct bioprinted with a mix of biopolymers at different concentrations
Bioink comprising 4% alginate and 3% gelatin (A,B)
4% gelatin and post-printing crosslinking with 5 M calcium chloride (C,D)
Scale bar: 1 cm (B,D); 2 cm (A,C)
Accuracy test for resolution of the constructs printed by the bioprinter employing the following: Shape printed with Pluoronic-F127 15% w/v without cells and employing food coloring
(A) Heart-shaped print dimensions 3 mm × 6 mm × 8 mm (B) 3D-shaped print dimension 3 mm × 13 mm × 6.95 mm (C) Star-shaped print dimensions 2 mm × 6.18 mm × 7 mm
Right: rendering of models imported into RepetierHost
and Left: Printed shape from our prototype
Analysis of extrusion influence on bioprinted construct contains cells
Bioprinted constructs employing alginate 4% and gelatin 3% on day 0 (A,B) and in culture after 7 days (C,D) after the bioprinting process
Green: Calcein AM; Red: PI (Propidium iodide)
View of Z stacks—AxioObserver Zeiss microscope
Bioprinted construct viability and maintenance: 4% alginate and 3% gelatin with 107 cells/mL of the HepG2 bioprinted construct on day 0 (A–C) and in culture after 7 days (D–F)
Construct size: 1.42 mm × 1.42 mm—(A–C) Z stack: 129 slices (640 μm) and (D–E) Z stack: 124 slices (356.21 1 μm)
it is difficult to visualize the entire construct fluorescence
which is why the PI fluorescence is almost non-existent
Serial cuts of these constructs could be performed to build a broader image
The confocal images indicate that the PI fluorescence is stronger on day 7
Further analyses are required to confirm that cultured cell viability decreases through time
3D bioprinters comprise cutting edge technology and will certainly become a tool for the improvement of several clinical procedures as therapeutic approaches. However, they are still expensive, keeping them from being broadly adopted and accessed by labs and hospitals worldwide. It is important to note that many proposed low-cost models are high maintenance (Tong et al., 2021)
We proposed the construction of a really low cost
it is important to analyze the functioning and mechanisms behind the assembly and execution of this task
comparing them to the most employed bioprinter models
which strongly affects the cost of bioprinters
stable 3D printing while also maintaining high cell viability
for this technology to be applied in transplants or even in toxicological analyses
The prototype reported herein paves the way for the assembly of low-cost equipment and wide access to laboratories with little funding
subsidies were accumulated for the detailing and improvement of the 3D bioprinter prototype project
the software and equipment designs are both freely available under open source licenses
democratizing access to these technologies
Our proof of concept indicates cell viability at day 0 and day 7
More studies are required to verify how long the constructs remain viable in culture
as a low-cost bioprinter option and an important tool for in vitro bioprinted 3D tissue applied for future transplantations or drug toxicity tests
presenting itself as an alternative to the use of animals in research
All data are available in our github repository (https://github.com/Laboratory-of-Cellular-Communication/E-Waste-3D-bioprinter) as well as in this supplementary material of this manuscript
LA and JC originally conceived the present article
RA and JC provided bioprinter methodological building
LA and AC provided critical reviews to the manuscript
All authors contributed to the article and approved the submitted version
“Redes de Pesquisa em Saúde no Estado do Rio de Janeiro”—Grant number: E-26/010.002422/2019
CNPq and to FAPERJ (Fundação Carlos Chagas Filho de Amparo à Pesquisa do Rio de Janeiro) for their support of this study
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations
Any product that may be evaluated in this article
or claim that may be made by its manufacturer
is not guaranteed or endorsed by the publisher
The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fbioe.2023.1108396/full#supplementary-material
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Received: 26 November 2022; Accepted: 15 March 2023;Published: 07 April 2023
Copyright © 2023 Gomes Gama, Dias, Aguiar Coelho, Chagas, Aguiar Coelho Nt and Alves. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use
distribution or reproduction in other forums is permitted
provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited
in accordance with accepted academic practice
distribution or reproduction is permitted which does not comply with these terms
*Correspondence: Luiz Anastacio Alves, YWx2ZXNsYWE0MEBnbWFpbC5jb20=
†These authors have contributed equally to this work
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations
Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher
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Brazilians cite corruption and lousy government services as key reasons that more than 1 million citizens are protesting
Millions of voices cry out in unison on the streets of Brazil
For about two weeks these people have been protesting against the prices of public transportation
the conditions of public healthcare and education
There are too many issues being discussed at once
there is no obvious focus or specific demand
Only days ago our president allowed government officials to use public money to travel and use hotels to comfortably watch the soccer games of the Confederations Cup
she promises to solve the healthcare problem by importing doctors
This is as helpful as hiring cooks to work in an empty building without a sink
people need to know why they are on the streets and what exactly needs to change first
because only specific issues can be solved one at a time
NEXT: Patrícia Wagner, 25, English teacher
Vaccine hesitancy is a phenomenon that can interfere with the expansion of vaccination coverage and is positioned as one of the top 10 global health threats. Previous studies have explored factors that affect vaccine hesitancy, how it behaves in different locations, and the profile of individuals in which it is most present. However, few studies have analyzed the volatility of vaccine hesitancy.
Identify the volatility of vaccine hesitancy manifested in social media.
Twitter’s academic application programming interface was used to retrieve all tweets in Brazilian Portuguese mentioning the COVID-19 vaccine in 3 months (October 2020, June 2021, and October 2021), retrieving 1,048,576 tweets. A sentiment analysis was performed using the Orange software with the lexicon Multilingual sentiment in Portuguese.
The feelings associated with vaccine hesitancy were volatile within 1 month, as well as throughout the vaccination process, being positioned as a resilient phenomenon. The themes that nurture vaccine hesitancy change dynamically and swiftly and are often associated with other topics that are also affecting society.
People that manifest the vaccine hesitancy present arguments that vary in a short period of time, what demand that government strategies to mitigate vaccine hesitancy effects be agile and counteract the expressed fear, by presenting scientific arguments.
Infectious Diseases: Epidemiology and Prevention
Volume 11 - 2023 | https://doi.org/10.3389/fpubh.2023.1192155
Background: Vaccine hesitancy is a phenomenon that can interfere with the expansion of vaccination coverage and is positioned as one of the top 10 global health threats
Previous studies have explored factors that affect vaccine hesitancy
and the profile of individuals in which it is most present
few studies have analyzed the volatility of vaccine hesitancy
Objective: Identify the volatility of vaccine hesitancy manifested in social media
Methods: Twitter’s academic application programming interface was used to retrieve all tweets in Brazilian Portuguese mentioning the COVID-19 vaccine in 3 months (October 2020
A sentiment analysis was performed using the Orange software with the lexicon Multilingual sentiment in Portuguese
Results: The feelings associated with vaccine hesitancy were volatile within 1 month
as well as throughout the vaccination process
being positioned as a resilient phenomenon
The themes that nurture vaccine hesitancy change dynamically and swiftly and are often associated with other topics that are also affecting society
Conclusion: People that manifest the vaccine hesitancy present arguments that vary in a short period of time
what demand that government strategies to mitigate vaccine hesitancy effects be agile and counteract the expressed fear
Vaccine hesitancy is a global phenomenon. Still, public acceptance of the vaccine varies depending on the region (10). Countries in Asia have higher rates of vaccine acceptance (Malaysia with an acceptance of 94.3%, Indonesia of 93.3%, and China of 91.3%) compared to Europe (France with an acceptance of 58.9%, Poland of 56.3%, and Italy of 53.7%) and the United States (acceptance of 56.9%), which have lower levels of vaccine acceptance (11)
the findings of this research make up a contribution to the mosaic of international studies that address VH
caveats must be taken when generalizing their findings
because they are characteristic of the Brazilian population
The exported data had issues with character encoding (accents and other special formats) and provided a date formatting presented as year
hour (including minutes and seconds) that is different from the Brazilian standards
it was necessary to use the R software to help edit the data
since the database had over 1 million observations
were removed all duplicate tweets and the same tweet from the same user
the data were exported from R as a.csv file
there are no independent or dependent variables
since the paper focused on text sentiment analysis
The.csv data was imported into the Orange Data Mining software to conduct the sentiment analysis
an unsupervised text mining technique (without an initial reference/classification as the initial input into the software) that aims to extract the emotion present in a message
the text corpus was pre-processed to remove stop words (prepositions
Only whole words without numbers or other characters (Regexp) are maintained
Specific features of the Twitter language (for example
the use of hashtag and at signs) are identified and URLs removed from the text
The sentiment analysis of the VH was performed in three different periods of the vaccination process
which are presented in charts divided into 1-week periods
This distribution was planned to observe the sentiment of VH in short periods (week) within the same month
and in longer intervals (over 4 months)
The analysis relied on the selection of 1.047.018 tweets adhering to the topic of vaccine hesitancy
the overall sentiment of the analyzed tweets for October 2020 was −0.0438
The overall sentiment was therefore slightly negative in all periods
It is noteworthy that the sentiment analysis is focused on VH and not on other aspects pointed out in the tweets
The sentences that exemplify the sentiment identified and presented in the first columns of the tables were translated from Portuguese to English to present the research by the authors
Sentiment analysis of the COVID-19 vaccine in October 2020
The data show the onset of vaccine topic within the spectrum of solutions for the COVID-19 pandemic in Brazil
In the first insertion the VH phenomenon is already observed
focusing on the efficacy of the vaccines that are being proposed
The data show an alternation between negative
Sentiment analysis of the COVID-19 vaccine in June 2021
Sentiment analysis of the COVID-19 vaccine in October 2021
The data for October 2021 portray a period of a more advanced stage of the population vaccination process
This period showed a greater VH manifestation
probably due to the availability of the vaccine for everyone
encouraging those who are more resistant to the vaccine to manifest with greater intensity
The data show an alternation between negative and neutral sentiments
with little occurrence of positive sentiments
This indicates that almost a year after the beginning of the vaccination process VH still exists
should be the object of planning and actions aimed at its mitigation
The tweets also indicate the expectation for the end of the COVID-19 pandemic
added to other factors such as the reduction of infection
with the potential interaction among these factors
have set an important milestone for people to interpret the period as the end of the pandemic
that these characteristics observed in the tweets
as well as the brands of vaccines available
the period and priority of vaccination of the population
are related to characteristics of the vaccination process in Brazil
thus presenting intrinsic limitations of generalization of the findings of this research
Previous studies have revealed that vaccine hesitancy (VH) is a dynamic phenomenon influenced by many variables that impact it in a positive or negative way (9, 11). The variables that influence VH operate differently in each region depending on characteristics of the society (10, 11). Residents of sub-Saharan Africa, for example, feared being victims of vaccine experimentation (43)
The inappropriate manifestation of politicians regarding the vaccine strengthens VH
impacting trust in the government and in the COVID-19 vaccine
This suggests that politicians should base their communications on evidence provided by the experts and not on their own feelings about vaccination
The second block of data analyzed concerns the month of June 2021
which is marked by a significant portion of the Brazilian population having already received at least the first dose of the vaccine
VH was expressed as negative sentiments toward the vaccine
three phenomena associated with the VH in relation to the COVID-19 vaccine stood out: pregnant women
the Copa América being held in Brazil (soccer championship between the national teams of South American countries)
The suitability of the COVID-19 vaccine for pregnant women was a dominant theme throughout the period. VH was expressed in questioning the suitability of vaccines in general as well as the suitability of one of the vaccines available (50)
it is possible to ponder that doubting the suitability of the vaccine for pregnant women may cause this negative sentiment toward the vaccine to overflow to the society
This block of analysis (June 2021) shows the possibility of observing multiple social factors interfering with VH at short time intervals (1 month)
This period is also a turning point as the pandemic is concerned
namely the proximity of the end of the crisis
the beginning of manifestations alluding to the approach of the end of the COVID-19 pandemic are identified
and most of them relate this event to the COVID-19 vaccination process
there is a positive feeling toward vaccination and its influence on the end of the crisis
one can also observe the manifestation of regret for having taken the vaccine
This characteristic establishes an important point of future investigation
as it constitutes a new attitude of people that differs from hesitation before the fact – the “vaccine regret” (VR)
The VR can affect the VH and drive people to avoid getting booster doses
This perspective validates VH as a social process under the influence of multiple meanings and logics
circumscribed to the individual and collectivity
during the pandemic the population increased its confidence in health professionals
and in their recommendations for the vaccination
the unspoken vaccine hesitancy of HCW is identified as an element of attention of health systems
as it can influence the reduction of confidence in the vaccine by the public
Two relevant aspects of the participation of HCWs in the HV mitigation process are thus identified: the first is that they influence people’s decision to take the vaccine
so this aspect should be used in favor of awareness campaigns
The second aspect indicates that HCW may have unspoken vaccine hesitancy
which requires health system managers to establish awareness programs
that include autonomy and freedom to express their hesitations
This study defines vaccine hesitancy as a complex and dynamic social phenomenon
Among the considerations and findings of this research are the arguments presented by society for not getting vaccinated
actions aimed at reducing vaccine hesitancy must be agile in capturing the concerns that permeate society
and in presenting information that encourages people to take the vaccine
vaccine hesitancy studies are still in the initial phase
so this research presents itself as a strength
This characteristic establishes limitations
when applying the knowledge developed in this study
in countries with cultures other than Brazilian
The origin of the data did not allow raising variables common to other studies
this study presents additional information on vaccine hesitancy
the data from this study refer to the Brazilian population
so caveats should be established in generalizing the findings of this research to other populations
The datasets presented in this study can be found in online repositories. The names of the repository/repositories and accession number(s) can be found below: https://docs.google.com/spreadsheets/d/1getfuzuxOFc_4V_TT_vm2TZHrxe3efUK/edit?usp=share_link&ouid=117126578285990502154&rtpof=true&sd=true
Ethical review and approval were not required for the study of human participants in accordance with local legislation and institutional requirements
Data were collected from social media preserving anonymity
and RB were involved in the analysis and interpretation of the data
CM and LS-G performed the statistical analysis
and RB improved the quality of the English of the manuscript
CF wrote the final version all the manuscript
All authors revisited critically the manuscript for intellectual content
approved the version to be published and agree to be responsible for all aspects of the work
and involved in the conception and design of the study
This work was funded by a Research Incentive Scholarship offered by the University of São Paulo – USP
We would like to thank University of São Paulo for its support
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Copyright © 2023 Machado Júnior, Mantovani, de Sandes-Guimarães, Romeiro, Furlaneto and Bazanini. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY)
*Correspondence: Celso Machado Júnior, Y2Vsc28uanVuaW9yQG9ubGluZS51c2NzLmVkdS5icg==
we saw that Eric was taken into the woods by the Curupiro
and we didn’t know if he would survive his injuries or not
so Ines used her powers and asked the water to heal him
who told him that his journey was still not over and that his life had a greater purpose
let’s find out what that higher purpose was that Eric was destined to serve in his life
Castro belonged to one of the most influential families in town
which was also infamously known for carrying out illegal mining operations in the Marangatu forests
who was a member of the indigenous tribe and who could transform into a snake
Honorato was apparently the key to a treasure that Castro and Debora had wanted to find and put up for auction
Danilo got frustrated when even after repeatedly asking Honorato
he was not ready to tell him the location of the treasure
though they hadn’t been able to get even a single breakthrough even after wandering for two years
Luna had got to know about a witch named Matinta Perre
who was known to fulfill the wishes of the people and make them get what they truly desired
Matinta told Luna that she could fulfill her desire to be with her father
provided she was ready to give her what she wanted
Luna accepted the offer because she desperately wanted to find her father
Eric had woken up in the river in the Marangatu area
where Castro and his people were trying to find the treasure
Eric was present on the scene when Danilo killed Honorato
An old man named Lazo was held captive at the illegal mining site
as he had the power to locate the gold that otherwise wasn’t visible to the naked eye
Lazo and others like him who possessed the powers considered it a sin rather than a blessing
he realized that Eric had some extraordinary powers that could release him from his curse
Danilo came chasing him and Eric set the entire place on fire and severely injured himself
Eric opened his eyes and found himself in the hospital
as he couldn’t decipher where he was or how long it had been since the incidents in the cedar forest where he had encountered the Curupira
who was around the same age as his daughter
and who claimed that he knew the whereabouts of Luna
Eric went with him and finally found his daughter
He was elated and relieved to find that she was safe
and he hoped that they could go back to living their normal lives
But fate had something else planned for them
Danilo knew that he couldn’t tell his bosses that he had killed the only man who knew where the treasure of Marangatu was hidden
so he put the blame on Eric and told Castro and Debora that the gringo had put the entire facility on fire and killed Honorato
had figured out another way of getting to the treasure
as she had met Metinta Perres and made a deal with her just like Luna did
Eric was just getting a grasp of things after meeting Ines when Metinta arrived out of nowhere in their makeshift house and took Luna with her
and Eric realized that due to some unknown reason
he was able to take the powers of other entities
Metinta told Ines in Episode 2 of “Invisible City” Season 2 that messing with the natural order of things had its consequences
and she had signaled the possibility of Eric turning into something evil
the powers of the latter had been transferred into the former
Eric found that Debora and Castro were holding a private auction where the stakeholders would bid for the gold that they had assumed they were going to have in their possession in the future
and she was forced to help the family take advantage of the loopholes in the legal system and make their illegal activities look like they were being performed within the ambit of the law
as she didn’t want to be with Castro and wanted to start a new life with a priest named Venancio
Clarice told Eric that they would help him rescue his daughter if he removed her powers from within her and gave her freedom from her curse
they went to the auction disguised as stakeholders
Debora had transformed into a snake and bitten Luna
Ines told Eric that there was only one person who could save Luna’s life: an old woman named Jaciara
who was a member of the indigenous tribes and a powerful sorceress and also a soothsayer
It was Jaciara who revealed to Ines that Eric had transformed into something evil and couldn’t be trusted
She made Eric wait outside while she performed the ritual on Luna and tried to save her life
and strains of evil had started becoming more and more evident in his behavior
At the end of Episode 4 of “Invisible City,” Season 2
Ines realized that she needed to keep Luna away from her father
as he was no longer in control of his powers and couldn’t be trusted to do the right thing at that moment
In the fifth episode of “Invisible City,” Season 2
we got to know how humans had penetrated Marangatu and started doing what they were best at
It was Castro’s father who had brought Lazo to Marangatu so that he could use his powers and let him know where the gold was hidden
he brought his men to the place and started plundering the area
Marangatu was a sacred place for the indigenous people
they had been able to maintain the delicate balance and allow the ecosystem to thrive without any sort of disturbance
We got to know that Debora was Honoratu’s sister
and their mother had made them wear the “muiraquitas” i.e.
so that her home could be protected from the invaders
Debora was brought back to her village by Daniel and Telma in the hope that she would be able to remember her roots and her mission in life
and she realized that her mother had been killed by Castro’s father before he had taken her with him
Ines was taking Luna to Marangatu to fulfill her destiny and return the guardian entity that had been given to her by her mother
but he didn’t realize that he had become a menace to everyone’s safety and had ceased to be the savior that he thought himself to be
Eric encountered Bento and Lazo on his way and asked them the direction in which Ines and Luna had gone
but he used his powers to make Bento tell him that they were headed toward Marangatu
Lazo told him that Marangatu was a sacred place for them
and Ines got to know through her psychic powers that Eric had become uncontrollable and that she needed to stop him and buy some time for Luna
Ines told Luna that it was about time they parted ways as she would have to go back to stop Eric
Ines told Luna that she had the utmost faith in her abilities and that she had been ready for the challenge for quite some time now
and just like she did in “Invisible City” Season 1
she once again showed him what had actually happened in the past and how Luna and Debora’s fates were intertwined
Eric saw in his hallucinatory visions that Jaciara had realized that there was nobody to protect their sacred land after the death of Honoratu
she realized that she was wearing the guardian entity that Debora’s mother had once given her
Eric saw in his vision that Gabriela had come to Marangatu sometime in the past and met Honoratu
It was Gabriela who had found the guardian entity near the river
and Honoratu told her that it belonged to his sister
Jaciara had told Gabriela to keep the amulet and give it back to Debora when the time came
Gabriela didn’t understand how she could return the amulet when she didn’t even know where Debora was or what she looked like
and the amulet would find a way back to its real owner
and that’s how the little one had become a pivotal part of this entire mystery
Contrary to what Eric had believed throughout the entire “Invisible City ” season 2
and she had even taken a stand for him in front of Matinta
Ines was ready to sacrifice her powers to bring Eric back on track
even though Matinta had warned her about the dire implications that it could have
Eric begged Jaciara to let him out of his own head
he had done nothing but protect the environment
Eric came back to his senses in the real world
The 200-year-old Cacu’s physical body aged and transformed right in front of Eric’s eyes
and she took her last breath with the hope that Eric would now save the forest and fight for the cause of the indigenous people
Eric finally found Luna and told her that he was ready to do the right thing
Eric sacrificed his life and returned the powers of each and every entity that he had forcefully taken earlier
and he got to know that Debora and others had lost their powers
He took Lazo and Bento to find Luna so that he could take all the gold for himself
though he didn’t know how much they would be able to help his cause without their powers
Lazo was trying to deceive them and lead them astray when all of a sudden
he realized that his powers had come back to him due to the sacrifice that Eric had made
Castro knew that he had to run for his life as Bento and others would have also gotten their powers back and would be coming to hunt them down
Although Castro was able to save his life and escape from Marangatu
Talem was waiting for him in the court of law back in the city
The court found Castro junior guilty of contamination of the water supply
Catro’s family had ruined her entire life
Eric had traversed into the parallel realm
and he had sacrificed his mortal life to save the forest and its inhabitants
The possibility of Eric returning to the mortal realm couldn’t be completely denied
as there are a lot of higher powers at play that are still unknown to us
and maybe if the need arises in the future
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