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Heavy Metals (HMs) concentrations in a sediment sample from Habbaniyah Lake (HL), Iraq (Cr, Cd, Ni, Fe, Co, Zn, Pb, and Cu). 33 locations have been selected in the field of study from October 2020 to April 2021 to evaluate the contamination of HMs in sediments by using pollution load index (PLI), contamination factor (CF), Contamination degree (CD), and geo-accumulation index (I-geo). Atomic Absorption Spectrometer AAS was used to determine heavy metal concentrations (USA Phoenix-986). The following are the average concentrations: 2152.97 mg/kg for Fe, 47.35 mg/kg for Pb, 25.18 mg/kg for Cr, 18.00 mg/kg for Ni, 10.60 mg/kg for Co, 9.57 mg/kg for Zn, 4.53 mg/kg for Cu and 3.53 mg/kg for Cd during the research time. The average concentration of Pb, Ni, Fe, and Cd surpassed the USEPA recommendation. Cd is responsible for extremely high contamination; Pb is responsible for moderate pollution and severe contamination at some places based on the contamination factor (CF). According to contamination degree (CD), The Lake is classified as significant pollution degree and very pollution degree in some sites. Results indicated that HL is not contaminated with HMs according to geo-accumulation index and PLI for all sample locations during the study period. The lake is unpolluted by Fe, Cr, Co, Ni, Zn, and Cu according to contamination factor (CF), geo-accumulation index (I-geo), pollution load index (PLI), and Contamination degree (CD).

To reduce bleaching side effects, the use of low concentrations of Hydrogen Peroxide (HP) agents associated with hybrid light (violet LED/Diode Laser) has gained interest. Case report: The aim of this report is to describe a case of a 16-year-old patient that presented a complaint related to the color of his teeth and a maxillary midline diastema. In-office bleaching with 6% HP associated with hybrid light (violet LED/Diode Laser) was performed. The bleaching gel was applied once on the teeth and light-activated for 1 minute (15 times) followed by 1min intervals (15 times) with a total bleaching time of 30 minutes. After the bleaching procedure, the teeth were polished and the desensitizer was applied for 4 minutes. Two bleaching sessions were performed at a 1-week interval. The diastema was closed with direct resin composite restorations without any tooth preparation. The conventional 3-step bonding agent was used and A1 dentin shade and B1 enamel shade were used followed by polishing discs. At 3-year recall, discoloration and fractures were not found on the the teeth or restorations and patient was completely satisfied. Conclusion: the conservative and safe option of bleaching with a low-concentrated HP gel associated with violet LED light is an interesting option for young patients and presents longevity over time.

This in vitro study evaluated the effect of three different in-office bleaching techniques on bovine enamel microhardness and the pH variation of peroxide agents during the protocols. Methodology: For Knoop microhardness (KNH) analyses, enamel fragments were divided into 3 groups (n=10): LEDv–hybrid violet LED/Laser light (10x2’ LEDv + 10x30” light-off, 2 cycles); HP6%LEDv–6% HP gel + LEDv/Laser (15x1’ LEDv + 15x1’ light-off); HP35%- 35% HP (1x45’). For pH measurements, bovine teeth were divided into 2 groups (n=10): HP35% and HP6%LEDv. KHN was measured at baseline (T0), 24h after bleaching (T1) and after 7 days in artificial saliva (T7). Initial and final bleaching gels pHs were obtained utilizing a pH-meter. KHN was evaluated by the Wald-type permutation statistic, aligned rank transformation statistical test, Wilcoxon and Mann-Whitney tests; pH levels were evaluated by the Welch-James and Wilcoxon tests (p

The incidence of hip fractures in the elderly is increasing. Minimally displaced and undisplaced hip fractures can be treated with either internal fixation or hemiarthroplasty.To identify the revision rate of internal fixation and hemiarthroplasty in patients 60 years or older with Garden I or II hip fractures and to identify risk factors associated with each method.A retrospective analysis was conducted from 2 Major Trauma Centres and 9 Trauma Units between 01/01/2015 and 31/12/2020. Patients managed conservatively, treated with a total hip replacement and missing data were excluded from the study.1273 patients were included of which 26.2% (n = 334) had cannulated hip fixation (CHF), 19.4% (n = 247) had a dynamic hip screw (DHS) and 54.7% (n = 692) had a hemiarthroplasty. 66 patients in total (5.2%) required revision surgery. The revision rates for CHF, DHS and hemiarthroplasty were 14.4%, 4%, 1.2% (p0.001) respectively. Failed fixation was the most common reason for revision with the incidence increasing by 7-fold in the CHF group [45.8% (n = 23) vs. 33.3% (n = 3) in DHS; p0.01]. The risk factors identified for CHF revision were age80 (p0.05), female gender (p0.05) and smoking (p0.05). The average length of hospital stay was decreased when using CHF compared to DHS and hemiarthroplasty (12.6 days vs 14.9 days vs 18.1 days respectively, p0.001) and the 1 year mortality rate for CHF, DHS and hemiarthroplasty was 2.5%, 2% and 9% respectively.Fixation methods for Garden I and II hip fractures in elderly patients are associated with a higher revision rate than hemiarthroplasty. CHF has the highest revision rate at 14.4% followed by DHS and hemiarthroplasty. Female patients, patients over the age of 80 and patients with poor bone quality are considered high risk for fixation failure with CHF. When considering a fixation method in such patients, DHS is more robust than a screw construct, followed by hemiarthroplasty.

This introduction charts the editors’ evolving understanding of the implications of the COVID-19 pandemic for literary studies in the real time of the crisis. Oriented around the themes of friendship and community, the introduction articulates the overall ambition of the issue as one of maintaining an engaged intellectual community during the isolation imposed by the pandemic. Foregrounding narrative as the issue’s major emphasis, it describes how the issue engages with pandemic storytelling in relation to literary history and literary production, environmental literary studies, and higher education and the profession. Finally, it provides an overview of the issue’s sections and essays.

The sugarcane giant borer, Telchin licus licus, is an insect pest that causes significant losses in sugarcane crops and in the sugar-alcohol sector. Chemical and manual control methods are not effective. As an alternative, in the current study, we have screened Bacillus thuringiensis (Bt) Cry toxins with high toxicity against this insect. Bioassays were conducted to determine the activity of four Cry toxins (Cry1A (a, b, and c) and Cry2Aa) against neonate T. licus licus larvae. Notably, the Cry1A family toxins had the lowest LC50 values, in which Cry1Ac presented 2.1-fold higher activity than Cry1Aa, 1.7-fold larger than Cry1Ab, and 9.7-fold larger than Cry2Aa toxins. In silico analyses were performed as a perspective to understand putative interactions between T. licus licus receptors and Cry1A toxins. The molecular dynamics and docking analyses for three putative aminopeptidase N (APN) receptors (TlAPN1, TlAPN3, and TlAPN4) revealed evidence for the amino acids that may be involved in the toxin–receptor interactions. Notably, the properties of Cry1Ac point to an interaction site that increases the toxin's affinity for the receptor and likely potentiate toxicity. The interacting amino acid residues predicted for Cry1Ac in this work are probably those shared by the other Cry1A toxins for the same region of APNs. Thus, the presented data extend the existing knowledge of the effects of Cry toxins on T. licus licus and should be considered in further development of transgenic sugarcane plants resistant to this major occurring insect pest in sugarcane fields.

Background: HER2 is a tyrosine kinase receptor belonging to the human epidermal receptor family and is considered an important proto-oncogene in the biology of breast carcinoma. HER2 overexpression is determined by a +3 score on the immunohistochemistry (IHC) assay. In addition, tumors with IHC results of +1 or +2 with ISH negative were defined as HER2-low. Recent studies have shown that the clinicopathological characteristics of HER2-low tumors, pointing out potential differences regarding hormone receptor status and new treatment possibilities in this patients. Objective: To assess the frequency and clinicopathological differences between cancer subtypes, as well as the survival of these patients. Methods: All patients with breast cancer diagnosed between 1987 and 2021 included in the Pérola Byington Hospital database were eligible. Patients were excluded if they had bilateral disease, had participated in clinical studies, or had incomplete data. The primary endpoint was overall survival stratified by cancer subtype, secondary endpoints were clinicopathological differences between cancer subtypes and death probability. Both the t-test and the chi-square test were used to analyze the association of each variable between the groups. Multivariate analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for the death outcome. Cox regression was used for survival analysis, with the Log-rank method and the results were presented in a survival graph using the Kaplan-Meier method. The R software version 4.1.1 was used to perform all analyzes, with a p-value < 0.05 being considered statistically significant. Results: 11,234 patients were included: 4,541 (40.42%) had Luminal cancer subtype, 2,955 (26.30%) HER2 Low, 2,242 (19.96%) triple negative, and 1,496 (13.32%) HER2 overexpression. Age, self-reported ethnicity, BMI, presence of comorbidities, clinical stage, nuclear grade, histological grade, family history, radiotherapy, chemotherapy, surgery, local, and systemic recurrence, and death showed statistically significant differences between cancer subtypes (table 1). In the multivariate regression (adjusted for the other evaluated characteristics), patients with HER2 overexpression cancer subtype showed a 44.8% greater probability of death than patients with HER2 Low (OR 1.448, 95%CI 1.046-2.004, p=0.026), while the patient with triple-negative cancer had a 26.1% lower probability of evolving to death when compared to the HER2 Low patient (OR 0.739, 95%CI 0.562-0.969, p=0.0229). The luminal subtype showed no statistically significant difference when compared to the patient with HER2 Low. Overall survival showed a statistically significant difference between cancer subtypes, with a median of 12 years for Luminal HR 0.816 (0.73-0.913), 15 years for HER2 overexpression HR 1.154 (1.003-, 327), and no statistical difference for triple negative HR 0.978 (0.859-1.114) compared to 12 years for HER2 Low. Conclusion: This study in breast cancer patients demonstrates significant differences between cancer subtypes, with a higher probability of progression to death for patients with HER2 overexpression, while patients with Luminal subtype had a lower probability, when compared with HER2 Low. More studies are needed to clarify the impact of these differences between cancer subtypes on response to therapy. Association between cancer subtype and other variables (n=11,234). Citation Format: ANDRE MATTAR, Andressa Amorim, Marina Diogenes, Jorge Shida, Luiz Henrique Gebrim. Clinical and pathological differences between HER2 Low and other cancer subtypes in breast cancer patients [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-04-17.

Background Ductal carcinoma-in-situ (DCIS) is a growing health problem in the world. Before the advent of screening mammography, the incidence of DCIS was low, and patients presented with DCIS that had become clinically symptomatic. Upon this evidence, a strategy of aggressive surgical therapy like the approach with invasive cancer was adopted. The status of the regional lymph nodes is the most important prognostic factor and predictor of survival in breast cancer, but as DCIS is a malignant proliferation of the epithelial inside the breast duct and, therefore, does not have the capacity to generate metastasis. However, an upstaging after surgery is possible. The need for sentinel node biopsy (SNB) in patients with a preoperative biopsy diagnosis of DCIS is still controversial but is done in selected cases. Objectives Our main objective in this study was to evaluate the surgical approach in the axilla (SNB or axillary dissection – AD) of patients diagnosed with DCIS in a single institution and describe the surgical treatment (mastectomy or breast conservative surgery – BCS). In addition, we aimed to find the reasons that led our surgeons to choose one or the other treatment. Methods A retrospective analysis was made using the Pérola Byington Hospital’s database, from January 2011 to December 2019. During this period, 11,373 cases of breast cancer were treated int the institution and 812 (7.4%) were DCIS. Data was available and we could analyze 494 patients who underwent core biopsy or vacuum-guided biopsy guided by mammography or ultrasound and were diagnosed with DCIS and underwent surgical treatment at the Hospital. We grouped the patients into 3 age groups: under 40, 40-49, and 50 and over. In all groups, we had patients who underwent SNB using the patent blue technique or axillary dissection (AD) and were evaluated using the H&E method. We had also evaluated the type of surgery (BCS or mastectomy) in each age group. Results DCIS was diagnosed through mammographic alterations in 62% of all cases and nuclear grade 2 was the most common, with 47%, followed by grade 3 and 1, 46% and 4%, respectively. In 2% of cases the data was missing. Comedonecrosis was present in 78% of our specimens. The type of surgery (radical or BCS) was evaluated and BCS was made in 360 patients (72,87% of the cases), with the axillary approach being performed in 125 patients of these patients (50,20% of cases that went to axillary approach including 9 patients that were submitted to AD). In 27,1% the surgical approach was a radical surgery (total mastectomy or skin sparing mastectomy) and in this group 92,5% were submitted to axillary approach. There was a strong correlation in the type of surgery and axillary approach (p-value 0,000) In the group of patients younger than 40 years, 74% of patients (17 out of 23 in total) underwent an axillary approach regardless of the type of surgery (p-value 0.036) When evaluating the predetermined age groups, we saw that most of our patients were 50 years or more (69%), followed by patients between 40-49 years (26%) and 5% in patients under 40 years. In only 3% of cases (16 in 494) we reclassified the lesion as invasive carcinoma after the surgery. None of them had a lymph node involved by malignant cells after surgery and that’s include the cases reclassified as invasive carcinoma. Conclusion The results obtained in this analysis showing no axillary involvement will make us rethink the indications for the concomitant surgical approach of the breast and the axilla in cases with a diagnosis of DCIS to reduce the axillary surgical overtreatment. It was not our goal to compare the costs, mobility, and complications of the surgical treatment as the survival in these patients that can be addressed in another studies. Citation Format: Marcellus Ramos, Andre Mattar, Andressa Amorim, Felipe Cavagna, Mariana Passos, Raquel Fernandes, Jorge Shida, Luiz Henrique Gebrim. Is axillary evaluation still necessary in DCIS? [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-07-41.

Objectives: This study aimed to explore the nutritional content and quality of food parcels distributed in Lebanon and assess their adherence to dietary guidelines during the COVID-19 pandemic and an unprecedented economic crisis. Design: Cross-sectional study (June–July 2020); phone survey (thirty items). Setting: Lebanon. Participants: Food parcel providers (FPP; n 72) involved in food parcel distribution (FPD), mainly to Lebanese households. Results: FPP included international non-governmental organizations (INGO) (n 3), local non-governmental organizations (n 45) and personal initiatives (n 24). Overall, low adherence to the World Food Programme (WFP) food parcel guidelines were observed among FPP for specific food items, including vegetables, fish, legumes and cereals, whereas salt content significantly surpassed the guidelines (all P-values P-values Conclusions: Findings highlight the need to improve the nutritional content of food parcels and adherence to dietary guidelines to alleviate food and nutrition insecurity while preventing diet-related diseases among vulnerable beneficiaries in Lebanon.

The brazilian trade balance depends on the export of commodities, especially soybeans, whose productivity is increased by maintaining nutrient levels in the soil by using fertilizers. The analysis of this product and the goods necessary for its production is relevant since the occurrence of global geopolitical, climatic and health events with the potential to impact the soybean production chain and, consequently, the national economy. This article aims to carry out an exploratory analysis of the production data published by Conab and the informations about the soybean exports and fertilizer imports available on Comex Stat platform in order to identify patterns and anomalies that occurred in the last five years. The analysis identified the drop in productivity in the 2018/19 and 2021/22 harvests caused by unfavorable weather conditions, as well as showed the national dependence on NPK fertilizers and the reduction in the imports of the russian product at the beginning of the conflict with Ukraine, in 2022. Finally, it highlighted the seasonal pattern of soybean exports throughout the year and presented the main brazilian trading partners related with these products, including China and Russia.

Shewanella algae is an opportunistic Gram-negative bacillus that inhabits marine ecosystems and can cause sepsis in humans. This case report describes an 80-year-old obese woman with liver cirrhosis who presented with neurological and respiratory impairment. Shewanella algae were isolated in the blood cultures. Due to age and comorbidities, sepsis could be the cause of the patient’s fatal outcome. Shewanella algae infection is a risk for immunocompromised people in the tropics.

This paper presents the design of highly efficient rectifiers that can operate at WiFi frequencies (2.45 GHz and 5.8 GHz) and match low input power. The designed dual-band rectifiers use multi-stage dickson voltage multipliers (DVM) (from 1 to 6 stages), and the main idea of this paper is to find the number of stages that offers the best performance and that can be used by applications that operate within the same constraints (operating frequencies, input power). The efficiency and the output voltage (Vout) are the parameters studied to analyze the designed rectifiers. The results showed that as the number of DVM stages increased, the efficiency curves for both frequencies shifted to the higher input power range, even when using the same diode (SMS7630) and the same load (5 KΩ). We concluded that the rectifier with 1-stage DVM is the most suitable to be used for low input power at the selected frequencies since it provides an efficiency of 57.734% at 0 dBm for 2.45 GHz and 36.225% at 1 dBm of input power for 5.8 GHz.

The present report is a summary of the structural analysis of the pump nozzles applying the finite element method by using the Ansys computer program. The IEA-R1 RR is an open pool-type moderated and cooled by light water using beryllium/graphite as a reflector. The reactor can reach up to 5MW of thermal power cooled by the primary and secondary systems. The primary coolant system consists of a piping arrangement, a decay tank, two pumps, and two heat exchangers. The primary pump B1-B presented some failures requiring refurbishment by a new one. The pump used in the IEA-R1 must meet the requirements inherent to the nuclear installation, in addition to the operational requirements for rotating equipment, such as flow and pressure, and structural integrity of the body and nozzles. The supplier specified the type of pump suitable for the System. The pump furnished granted mechanical allowable loads for the nozzles that were lower than the loads imposed by the piping on the nozzles. To enable the installation of the pump in the primary circuit, new support was inserted in the piping system next to the pump minimizing efforts and deformations. A piping stress analysis was carried out to obtain the new efforts imposed on the nozzles. For validation of the motor pump set, a verification of the nozzles was done compared with API 610 standard loads, and the allowable loads of the provider. Finally, a structural analysis of the pump nozzles with the new loads was developed using the finite element method. The calculated stresses meet the limits prescribed by the ASME code; therefore, the new B1-B Pump is approved for operation at the IEA-R1 Nuclear Research Reactor primary circuit.

Abstract. More people than ever in history are being displaced and becoming refugees due to political conflict, climate change, and persecution, among others. Meeting the mental health care needs of refugees has become a global priority. This population’s needs are unique due to the multiple traumatic experiences of refugees, their difficulties in navigating various systemic barriers, and the minimal specialized cultural training in refugee care. In order to improve the health of refugees, it is important to examine how care is delivered and the provider and systemic factors that perpetuate inequities and cultural misunderstandings in providing care. Most of the refugee literature focuses on refugee factors that limit access to care but falls short on discussing providers’ lack of training in refugee care. In the following paper, we present refugee mental health training considerations for providers. These considerations are based on the lessons learned from direct clinical work in a refugee clinic located in a major public academic hospital in the New England area (United States of America). The authors discuss the particular context of caring for refugee populations, the skills needed to work with this population, and considerations for navigating provider and systemic barriers that arise in refugee care. We believe that training mental health providers can have significant implications for refugee mental health care utilization, patient improved treatment outcomes, and on refugees’ increased sense of self-determination.

Introduction: Systemic lupus erythematosus (SLE) may cause irreversible organ damage. Pregnancy with coexisting SLE may have severe life-threatening risks. Severe maternal morbidities (SMM) include maternal death, maternal near miss (MNM), and potentially life-threatening conditions (PLTC). This study aimed to determine the prevalence of SMM in patients with SLE and analyze the parameters that contributed to cases of greater severity. Methods: This is a cross-sectional retrospective study from analysis of data retrieved from medical records of pregnant women with SLE treated at São Paulo Hospital , Brazil, from 2005 to 2015. The pregnant women were divided in control group without complications, group with PLTC, and group with MNM. Results: Out of 149 pregnancies, there were 14 cases of MNM (9.4%), 56 cases of PLTC (37.6%), and no maternal death. The maternal near miss rate was 112.9 per 1,000 live births. The majority of PLTC (83.9%) and MNM (92.9%) cases had preterm deliveries with statistically significant increased risk compared with control group [p=0.0042; OR (95% CI): 12.05 (1.5-96.6) for MNM group and p=0.0001; OR (95% CI): 4.84 (2.2-10.8) for PLTC group]. SMM increases the risk of longer hospitalization [pConclusion: SLE was significantly associated with severe maternal morbidity, longer hospitalizations, and increased risk of poor obstetric and neonatal outcomes, such as prematurity, neonatal death, miscarriage and fetal loss.

The Lebanese Active Healthy Kids Work Group (LAHKWG) synthesized literature published on physical activity (PA) indicators among ages 5- to 17- year-olds, using a recommended harmonized process by the Active Healthy Kids Global Alliance (AHKGA), to explore Lebanon's performance since its previous report card publication.Peer reviewed literature, national surveys, and gray literature published since 2017, on 10 common AHKGA and two LAHKWG recommended indicators were examined. Common indicators included overall PA, organized sport and PA, active play, active transportation, community and environment, sedentary behaviors, physical fitness, family and peers, school, and government. LAHKWG recommended indicators were sleep and weight status. LAHKWG members reviewed 764 records, of which 28 were selected for full review. A grade was assigned for each indicator using AHKGA's grading rubric and established benchmarks on data from nationally representative samples for children and youth.Data from one nationally representative sample were available for ages 13-17 years (i.e., no data13 years). Five indicators received "Incomplete" (organized sport and PA; active Play; physical fitness; family and peers; community and environment); overall PA received a D-; active transportation and sleep received a D+; school and government received a D; sedentary behaviors received a C; and weight status received a B-.The LAHKWG strongly encourages stakeholders to take concrete actions towards prioritizing PA promotion at a national level especially in the education sector. Offering more quality PA opportunities for Lebanese children and youth will be beneficial for their physical and mental health in any context.

Este trabajo pretende contribuir al desarrollo dogmático del deber compensatorio de la desigualdad ante las cargas públicas como correlato o efecto directo de la garantía constitucional homónima. Para tal efecto, procura contradecir las razones jurídicas en las que se funda la omisión compensatoria en ciertas hipótesis del derecho nacional y proponer un listado de hipótesis o casos objetivos en que debe operar la restauración de la simetría perdida.Entre las características del deber compensatorio de cargas públicas asimétricas, cabe destacar que: a) la carga desigual satisface un interés público; b) la desigualdad que motiva la compensación es injustificada; c) la compensación sólo se extiende al daño patrimonial efectivamente causado; y d) la inexistencia u omisión de ejercicio de poderes compensatorios no empece al sujeto gravado sino sólo produce la mutación del título resarcitorio desde la igualdad distributiva hacia la responsabilidad del Estado por daño de interés público no compensado.Si bien el precepto constitucional sobre igualdad de las cargas públicas no consagra la responsabilidad del Estado por gravámenes desiguales, garantiza un deber estatal compensatorio cuya infracción da origen —recién entonces— a la responsabilidad del Estado (arts. 6 y 7 de la Constitución).La regulación de potestades compensatorias específicas no significa que la garantía constitucional requiere de estas para su operatividad. El deber compensatorio emana directamente de la garantía constitucional. La razón de su regulación explícita obedece a la necesidad de incorporar mayores precisiones normativas ante casos particulares. Por tanto, el deber de pago procede incluso ante la ausencia de poderes compensatorios específicos, sólo que bajo la modalidad de responsabilidad del Estado por omisión de pago.La igualdad formal en la imposición de un gravamen público puede configurar igualmente una desigualdad material de aquellos sujetos que han visto frustradas sus confianzas legítimas por la introducción de la carga. Asimismo, la indeterminación parcial de la obligación compensatoria del artículo 19 Nº. 20 tampoco obsta a su exigibilidad, cuando el deber de fijación corresponde al deudor estatal. Las cargas públicas injustificadamente desiguales pueden ser impuestas mediante potestades diversas. Corresponden, inter alia, a actos estatales de interés público que obligan a un sujeto de buena fe a dar o hacer algo en ejercicio de una función; o a soportar la privación o limitación especial de la propiedad sobre bienes corporales o incorporales, la frustración de expectativas favorables protegidas, la reiteración de un procedimiento de gravamen, y la mayor onerosidad del deber legal por hechos imprevisibles e inimputables a las partes.

O presente artigo tem como objetivo analisar o fenômeno da secularização, suas intolerâncias e neutralidades nas visões de José Casanova e Charles Taylor em relação às mulheres afegãs diante do grupo Talibã. O tema proposto se justifica tendo em vista a situação de vulnerabilidade em que as mulheres afegãs se encontram, de modo especial, após a invasão do Talibã a Cabul, no Afeganistão, bem como a relevância das religiões na vida pública, e a necessidade de um significado político da secularização em seus fundamentos epistemológicos; realizando-se a desprivatização da religião, por meio do diálogo e da participação igualitária de todos os grupos e pessoas, de modo especial as mulheres afegãs, na construção cooperativa das estruturas sociais das democracias contemporâneas; valendo-se dos axiomas igualdade, liberdade e fraternidade. Com relação aos resultados da pesquisa, percebe-se que sob o enfoque de uma recuperação sustentável baseada em igualdade de gênero, se propõe reconstruir um novo modelo de desenvolvimento, uma vez que a Agenda 2030 é uma agenda civilizadora, que coloca a dignidade e a igualdade das pessoas no centro e clama por uma mudança em nosso estilo de desenvolvimento em conformidade com o desenvolvimento sustentável. Importante salientar que os Objetivos de Desenvolvimento Sustentável (ODS) são a base da Agenda 2030 e mostram uma perspectiva abrangente, indivisível e uma colaboração internacional renovada. Nesta pesquisa, em meio aos 17 ODS, abordar-se-á os ODS 5 (igualdade de gênero), 10 (redução das desigualdades) e 16 (paz, justiça e instituições eficazes), como bases para a reconstrução da secularização diante de um Estado democrático pluralista. Quanto à metodologia, utilizou-se o método dedutivo, por meio de uma pesquisa bibliográfica e documental como fonte de formação dos postulados defendidos.

To compare the efficacy of quadratus lumborum (QL) block and intrathecal morphine (M) for postcesarean delivery analgesia. Thirty-one pregnant women with ≥ 37 weeks of gestation submitted to elective cesarean section were included in the study. They were randomly allocated to either the QL group (12.5 mg 0.5% bupivacaine for spinal anesthesia and 0.3 ml/kg 0.2% bupivacaine for QL block) or the M group (12.5 mg bupivacaine 0.5% and 100 mcg of morphine in spinal anesthesia). The visual analog scale of pain, consumption of morphine and tramadol for pain relief in 48 hours, and side effects were recorded. Median pain score and/or pain variation were higher in the morphine group than in the QL group ( Quadratus lumborum block and intrathecal morphine are effective for analgesia after cesarean section. Patients undergoing QL block had lower postoperative pain scores without the undesirable side effects of opioids such as nausea, vomiting, and pruritus. Comparar a eficácia do bloqueio do quadrado lombar (QL) e da morfina intratecal (M) na analgesia pós-cesariana. MéTODOS: Trinta e uma gestantes com ≥ 37 semanas de gestação submetidas a cesariana eletiva foram incluídas no estudo. Eles foram alocados aleatoriamente no grupo QL (12,5 mg de bupivacaína a 0,5% para raquianestesia e 0,3 ml/kg de bupivacaína a 0,2% para bloqueio de QL) ou no grupo M (12,5 mg de bupivacaína a 0,5% e 100 mcg de morfina na raquianestesia). A escala visual analógica de dor, consumo de morfina e tramadol para alívio da dor em 48 horas e efeitos colaterais foram registrados. A mediana do escore de dor e/ou variação da dor foi maior no grupo morfina do que no grupo QL (

Introduction: Retinopathy of prematurity (ROP) is a multifactorial disease and a preventable cause of blindness in childhood. Hyperoxia and hypoxia can cause retinal neovascularization resulting in retinal detachment and blindness if left untreated. Besides oxygen treatment, other reasons for ROP development are well known. We prospectively adopt various strategies to keep oxygen saturation (SpO2) within targets, between 91 and 95% for those on supplemental oxygen. By adapting this, we postulated that the incidence of severe ROP might be reduced. Methods: 2018–2019 provided pre-intervention and 2020 post-intervention data for the project. For all babies (≤32 weeks, ≤1,500 g with FiO2 >0.21), target SpO2 between 91 and 95% was measured as a percentage of time spent within and outside target SpO2 during 1–4 weeks of life. Results: 112 and 60 preterm neonates were screened for ROP during the pre- and post-intervention phase. Twenty neonates (18.3%) during pre-intervention and 16 (26.7%) in the post-intervention phase developed severe ROP requiring treatment. Despite a statistically significant increase of 10 percent points in time spent within target SpO2 (91–95%) in the post-intervention phase (p < 0.05), the incidence of severe ROP did not decline. Using a multivariate model, odds of ROP development decreased with gestational age (25%) while increasing with PDA requiring treatment (4.33 times) and glucose ≥10 mg/dL (4.15 times), considering one variable at a time, keeping others constant. Conclusion: Our QI project showed successful attainment of maximum time; the SpO2 remained within targets during supplemental oxygen; however, the incidence of severe ROP had not declined. Factors other than SpO2 might be responsible for a high incidence of ROP in our neonatal intensive care unit.

De um modo geral, pode-se afirmar que os padrões de produção e consumo de energia vêm sendo baseados nas fontes fósseis, o que gera emissões de poluentes locais, gases de efeito estufa (GEEs) e põem em risco o suprimento energético de longo prazo no planeta. No âmbito do transporte urbano, as cidades brasileiras se desenvolveram com ênfase no modo rodoviário. Assim, é relevante estudar a eficiência energética no transporte, para implementar boas soluções, que atendam os deslocamentos dos usuários, e promovam o uso eficiente dos recursos naturais. O objetivo geral deste artigo é estimar, em uma rede de transportes teórica, a eficiência energética do deslocamento de uma determinada demanda de passageiros, utilizando diferentes modos de transporte, a fim de medir a eficiência energética da rede. Especificamente, pretende-se verificar e comparar o consumo de energia e as emissões de gás carbônico no transporte intermodal, pelos modos ferroviário – Veículo Leve sobre Trilhos (VLT) e rodoviário - ônibus. A metodologia foi desenvolvida com base em pesquisa documental e bibliográfica para levantamento de dados, e aplicada técnica de pesquisa operacional para avaliação da eficiência energética da rede simulada. A revisão abrange o estudo do transporte, sua indispensabilidade e influência no meio ambiente. São abordadas a eficiência energética na matriz de transporte e o uso de pesquisa operacional como ferramenta de apoio para modelos de otimização. Ao final, foi possível identificar que a integração modal, sistema alimentador – distribuidor – é uma solução eficiente quanto ao consumo de energia e emissões de GEEs. A metodologia, mostrou-se satisfatória e pertinente, podendo ser utilizada para redes maiores e cenários reais. Como continuidade deste estudo está sendo desenvolvida uma contribuição metodológica para planejamento sustentável de transporte urbano de passageiros (MPTS-URB), a qual pretende estimar o custo monetário da eficiência energética a partir de dados de emissão de poluentes e consumo de energia pelos modos de transporte utilizados na rede.

The overexpression of the soybean GmEXPA1 gene reduces plant susceptibility to M. incognita by the increase of root lignification. Plant expansins are enzymes that act in a pH-dependent manner in the plant cell wall loosening and are associated with improved tolerance or resistance to abiotic or biotic stresses. Plant-parasitic nematodes (PPN) can alter the expression profile of several expansin genes in infected root cells. Studies have shown that overexpression or downregulation of particular expansin genes can reduce plant susceptibility to PPNs. Root-knot nematodes (RKN) are obligate sedentary endoparasites of the genus Meloidogyne spp. of which M. incognita is one of the most reported species. Herein, using a transcriptome dataset and real-time PCR assays were identified an expansin A gene (GmEXPA1; Glyma.02G109100) that is upregulated in the soybean nematode-resistant genotype PI595099 compared to the susceptible cultivar BRS133 during plant parasitism by M. incognita. To understand the role of the GmEXPA1 gene during the interaction between soybean plant and M. incognita were generated stable A. thaliana and N. tabacum transgenic lines. Remarkably, both A. thaliana and N. tabacum transgenic lines overexpressing the GmEXPA1 gene showed reduced susceptibility to M. incognita. Furthermore, plant growth, biomass accumulation, and seed yield were not affected in these transgenic lines. Interestingly, significant upregulation of the NtACC oxidase and NtEFE26 genes, involved in ethylene biosynthesis, and NtCCR and Nt4CL genes, involved in lignin biosynthesis, was observed in roots of the N. tabacum transgenic lines, which also showed higher lignin content. These data suggested a possible link between GmEXPA1 gene expression and increased lignification of the root cell wall. Therefore, these data support that engineering of the GmEXPA1 gene in soybean offers a powerful biotechnology tool to assist in RKN management.

Three studies on the biology of Ornithodoros puertoricensis are available in the literature, using different hosts and incubation temperatures. In a previous study, we identified O. puertoricensis in the Colombian Caribbean. The aim of the present work was to analyze life cycle data along one generation from these specimens under laboratory conditions. Eggs of O. puertoricensis were collected in between fragments of bahareque material in a rural dwelling in the municipality of Planeta Rica (Córdoba Department, Colombia), and transported to the laboratory. All post-egg stages (i.e., larvae, nymphs, and adults) were incubated at 27 °C and 85% RH and fed on laboratory mice (Mus musculus). Sixteen engorged larvae were obtained to start a laboratory colony. Average feeding period for larvae was 4.6 days (4-5). The first nymphal instar (N1) did not require feeding and the subsequent nymphal stages (N2, N3, and N4) and adults had feeding periods ranging from 55 to 75 min. Average pre-molting period in nymphs was 15 days (10-21). Most of the N3 molted to males and all N4 molted to females. Two gonotrophic cycles were recorded: the first had a preoviposition period of 12 days (7-18) and produced 190 eggs (171-223), the second lasted 6.6 days (6-7) and produced 146 eggs (104-201). The mean life cycle duration (from parental eggs to F1 eggs) was 70.7 days (58.7-82.7) without fasting periods. The collected data agree with previous studies even with differences in hosts and maintenance conditions.

In this study, we investigated the modulatory effects of PI3Kγ on IL-17A expression and the progression of experimental periodontitis in vivo.Ligature-induced periodontitis was developed around the first molar of mice. Animals were treated with anti-mouse IL-17A or IPI-549 (PI3Kγ inhibitor). In addition, PI3Kγ-deficient mice (PI3KγNine days after ligature placement, alveolar bone loss scores were significantly increased, with upregulation of Il17a and Rankl genes in the gingival tissues. Treatment with anti-mouse IL-17A (100 µg/mice) significantly attenuated alveolar bone loss. Mice with ligature-induced periodontitis treated with IPI-549 (3 mg/kg) or PI3KγPI3Kγ plays an important role in modulating IL-17A expression and alveolar bone loss in vivo and can be considered a promising pathway for the management of periodontal disease and the development of new therapies.

ObjectiveMorbidity and mortality in rheumatoid arthritis (RA) is partly mitigated by maintaining immune and hematologic homeostasis. Identification of those at risk is challenging. Red cell distribution width (RDW) and absolute lymphocyte count (ALC) associate with cardiovascular disease (CVD) and mortality in the general population, and with disease activity in RA. How these variables relate to inflammation and mortality in RA was investigated.MethodsIn a retrospective single Veterans Affairs (VA) Rheumatology Clinic cohort of 327 patients with RA treated with methotrexate (MTX)+/− a tumor necrosis factor (TNF) inhibitor (TNFi), we evaluated RDW and ALC before and during therapy and in relation to subsequent mortality. Findings were validated in a national VA cohort (n = 13,914). In a subset of patients and controls, we evaluated inflammatory markers.ResultsIn the local cohort, high RDW and low ALC prior to MTX treatment was associated with subsequent mortality over 10 years (bothP< 0.001). The highest mortality was observed in those with both high RDW and low ALC. This remained after adjusting for age and comorbidities and was validated in the national RA cohort. In the immunology cohort, soluble and cellular inflammatory markers were higher in patients with RA than in controls. ALC correlated with age, plasma TNF receptor II, natural killer HLA-DR mean fluorescence intensity, and CD4CM/CD8CM HLA-DR/CD38%, whereas RDW associated with age and ALC. MTX initiation was followed by an increase in RDW and a decrease in ALC. TNFi therapy added to MTX resulted in an increase in ALC.ConclusionRDW and ALC before disease-modifying antirheumatic drug therapy are associated with biomarkers of monocyte/macrophage inflammation and subsequent mortality. The mechanistic linkage between TNF signaling and lymphopenia found here warrants further investigation.

The phytochemical profiles of extracts from closed, semi-opened and opened leaf buds and the summer leaves of Ginkgo biloba were studied. The extraction and purification of bilobalide and ginkgolides, using andrographolide as an internal standard, were optimised. The terpene trilactone concentrations increased with bud development, from 1.07 mg/g dry wt in closed buds to a maximum of 3.75 mg/g dry wt in summer leaves. The major terpene trilactone was bilobalide at all developmental stages. The concentration of flavonol aglycones in hydrolysed extracts was also analysed. The flavonol glycoside concentration increased from the closed bud stage (0.21 ± 0.01% dry wt) to the summer leaf stage (1.15 ± 0.01% dry wt). A linear correlation was observed between the terpene trilactone and flavonoid content during gingko leaf development.

Introduction: Metabolic syndrome can be defined as a set of conditions - central obesity (waist circumference), elevated blood pressure, reduced HDL cholesterol, increased triglycerides and glucose intolerance - which is known to be associated with a higher risk in the development of cardiovascular disease and type 2 diabetes. It affects approximately 30% of the population of women over 50 years of age. In view of the risk factors described above, it is important to seek, in addition to the screening recommended by the Ministry of Health (a mammogram every two years in women aged 50 to 69 years), ways to reduce the risk of breast cancer with regard to to behavioral factors. Practicing the maintenance of adequate weight and physical activities can contribute to the reduction of this pathology. Therefore, even in the pathophysiology of breast cancer, its relationship with the metabolic syndrome is seen, which is often the cause - and even consequence - women treated for breast cancer seem to have an additional risk of metabolic syndrome, resulting from excess adiposity. and effect of treatments. Objectives: To evaluate the relationship between metabolic syndrome at the diagnosis of breast cancer and overall survival, disease-free survival and invasive disease-free survival. Methodology: Retrospective longitudinal observational study of the cohort type carried out in the Mastology sector of the Gynecology and Obstetrics Service of the Hospital do Servidor Público Estadual de São Paulo “Francisco Morato Oliveira. We evaluated the rates of local recurrence, distant metastases and overall survival of patients with malignant breast cancer in each group. Results: From January 2017 to December 2020, 375 patients underwent surgical treatment for breast cancer at the Hospital do Servidor Público Estadual, of which 25 were excluded due to loss of follow-up, 10 due to incomplete data and 5 due to diagnosis of metastases. Thus, 335 patients were eligible for the study, with a mean age of 63.4 ± 1.4 years, and a mean follow-up time of 48 ± 1.4 years. Metabolic syndrome (MS) is present in 109 (32 .5%) patients, while 226 (67.5%) do not have MS. Regarding the characteristics of prognostic factors, that is, KI 67, molecular classification and staging, in table 3 we can observe that patients with metabolic syndrome have a very similar distribution, while those without MS have a KI 67 ≥ 14% in 62.4% of the patients. patients with a significant difference. The molecular profile in MS patients is 39.4% Luminal A patients and 42.5% Luminal B patients without MS, with a significant difference in distribution. Regarding clinical staging, patients with MS have initial clinical stage I and IIA in 54.1%, and advanced stage IIB 20.2% III 25.7%, while patients without MS have initial clinical stage 65%, advanced stage IIB 11.1%m III 23.9, results with a significant difference. When we evaluated the presence of obesity as a factor of worsening of prognostic factors, we did not find significant differences. We evaluated the temporal outcomes of overall survival, disease-free survival, and invasive disease-free survival. The overall sample survival was 37.3 years with a CI 1.1 years, disease-free survival was 35.9 years with a CI 1.2 years, and invasive disease-free survival was 36.9 years with CI 1,3 years. When we compared these outcomes with the presence of MS, we observed a significant difference in all outcomes. Conclusions: The presence of MS at diagnosis does not worsen overall survival, disease-free survival or invasive disease-free survival. Overall Survival (OS) for Breast Cancer and Metabolic Syndrome Overall Survival (OS) for Breast Cancer and Metabolic Syndrome Disease Free Survival (DFS) for Breast Cancer and Metabolic Syndrome Disease Free Survival (DFS) for Breast Cancer and Metabolic Syndrome Invasive Free Survival (IFS) for Breast Cancer and Metabolic Syndrome Invasive Free Survival (IFS) for Breast Cancer and Metabolic Syndrome Citation Format: MARCELO ANTONINI, AMANDA LEAL GUIMARAES, FERNANDA GRACE BAUk RICHTER, ODAIR FERRARO, REGINALDO G. COELHO LOPES, JULIANA M. REAL, ANDRE MATTAR. INFLUENCE OF METABOLIC SYNDROME ON OVERALL SURVIVAL (OS), DISEASE FREE SURVIVAL (DFS) AND INVASIVE FREE SURVIVAL (IFV) IN A COHORT OF PATIENTS TREATED FOR BREAST CANCER IN BRAZIL [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-05-13.

Background: The evaluation of regional lymph nodes in patients with breast cancer is one of the main predictive and prognostic factors for treatment. The most frequently methods of percutaneous evaluation for suspicious lymph nodes are fine needle aspiration (FNA) and core needle biopsy (CNB). According to the international literature, CNB and FNA are considered diagnostic methods with high specificity (98% vs. 99%), however FNA can present up to 21% of inconclusive results due to insufficient material, which leads to recall and delay in treatment approach. Although CNB is well established as a percutaneous method for the diagnostic evaluation of suspicious breast lesions, the literature is still scarce regarding the use of this method for the evaluation of suspicious regional lymph nodes in patients with breast cancer. Objectives: To analyze the results of percutaneous biopsies performed in suspected lymph nodes according to the topography and the type of needle used, and to verify the preferred method used. Methods: This was a retrospective study evaluating a public Hospital in São Paulo – Brazil (Pérola Byington Hospital database). Patients who underwent ultrasound-guided percutaneous lymph node biopsy from May 2015 to November 2017 were included. Data were analyzed and the type of biopsy (FNA or CNB) and the results were analyzed. Results: 106 medical records of patients with previous breast cancer and that underwent lymph node biopsy were reviewed. The mean age was 54.7 years (SD±12.4) in the CNB group and 54.7 years (SD±10.8) in the FNA group. Most of the patients were submitted to CNB (66% - 71 patients) and 34% were evaluated with FNA (35 patients). According to the topography of the lymph nodes, 80% were in the axilla (n=84), 10% in the supraclavicular region (n=11) and 10% in the cervical region (n=11). When analyzing the FNA results, 31% did not present sufficient material (n=11), 37% were malignant (n=13), 20% were benign (n=7) and 12% showed cellular atypia (n=12). Among the CNB performed in suspected lymph nodes, 53% were malignant (n=38) and 31% were benign (n=33), and no one had insufficient material. There were no reports of complications related to the procedures. In the insufficient material group, 27% (n=3) of the patients underwent a new percutaneous biopsy (2 CNB with malignant result and 1 FNA with inconclusive result) and 73% (8) were maintained in follow-up. The mean follow-up time was 24 months, and clinical and imaging stability was confirmed after this period. In the CNB group with malignant result, 10% (4) were diagnosed with neoplasia of other sites (cervix, lymphoma, melanoma and gastrointestinal), 78% (30) presented immunohistochemistry in agreement with that of the breast, 3% (1) presented different immunohistochemistry and in 9% (3) this evaluation was not performed. Conclusion: CNB was the preferred diagnostic method in our Hospital (66% vs 34%), being considered a viable procedure to evaluate lymph nodes in various topographies and with low rates of inconclusive results. Besides that, immunohistochemistry was done in 91% of the cases showing the importance of this analysis in the treatment of the recurrence or even in the diagnosis of other primary tumors. In the future, studies that assess indirect costs may confirm the applicability of CNB in patients with suspicious lymph nodes in terms of achieving greater agility and resolution. Citation Format: Marina Diogenes, ANDRE MATTAR, Andressa Amorim, Maria Isabela Caldas Sawada, Luiz Henrique Gebrim, Jorge Shida. Regional Lymph node percutaneous analysis in patients with breast cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-05-47.

Objective: Pregnancy-associated breast cancer (PABC) is defined as diagnosed during pregnancy or within one year of childbirth, in which current evidence associates with poor prognosis, without showing what clinical characteristics could impact in survival. We aim to explore the impact of heterogeneity in risks on death and disease relapse, suggesting clinical characteristics that might improve PABC clinical outcomes. Methods: Medline, Embase, Cochrane, Lilacs and congress abstracts published since 2000 were used as data sources. Two reviewers independently selected manuscripts and extracted data and a third reviewer solved discrepancies. The primary outcome was overall survival (death), and secondary outcome was disease-free survival (death or relapse). Summarized hazard ratios were recalculated based on reported data. All metaanalyses used a random-effects model and heterogeneity was reported using the I2 method. Results: A total of 7143 studies were identified and 30 studies were included for metaanalyses. PABC is associated with a 96% (HR=1.96, 95%CI 1.58;2.35) higher risk of death and an additional 82% (HR=1.82, 95%CI 1.45;2.20) risk of death or disease relapse in comparison to a population of non-PABC or nulliparous BC. Through sensitivity analyses, we identified that clinical outcomes was impacted, possibly due to Ki-67 levels, poorly differentiated tumors, and triple negative breast cancer (TNBC) frequency in the study. Conclusions: PABC is correlated with poorer prognosis, suggesting that besides early diagnosis, Ki-67 levels, poorly differentiated tumors and TNBC might be relevant sources of inconsistency. So, such clinical sources of heterogeneity should be better investigated regarding the potential to evaluate alternative therapeutic strategies. PABC deaths compared to non-PABC population, represented as hazard ratio PABC deaths or disease relapse compared to non-PABC population, represented as hazard ratio Citation Format: MARCELO ANTONINI, BARROS T. TAIS, JULIANA M. REAL, REGINALDO G. COELHO LOPES, ODAIR FERRARO, ANDRE MATTAR, LUCAS OKUMURA. Influence of Clinical Heterogeneity on Pregnancy Associated Breast Cancer survival: Systematic Review with Metanalysis [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-05-37.

Introduction Breast cancer (BC) it is highly prevalent in the world with a significant mortality rate despite advances in systemic therapies. Obesity increases the risk of this cancer specially in post-menopause women and may even affect the prognosis at all ages. Objective To evaluate the impact of BMI on overall (OS) and disease free interval (DFI) of Brazilian women with BC undergoing NACT and who achieved pCR. Methods This is a retrospective study that included patients with confirmed breast cancer clinical stage I to III, age more than 18 years old and complete records that were submitted to NACT. These patients were divided in four groups based on their BMI by the World Health Organization definition BMI < 18,5 kg/m2: underweight; BMI 18,5 to < 25 kg/m2: healthy weight; BMI 25 a < 30 kg/m2: overweight; BMI ≥30kg/m2: obesity. pCR was defined as absent of invasive tumor in the breast or axilla. Student t test or chi-square test were used to analyze the association of each variable between groups with and without pCR. Univariate and multivariate analyzes were used to calculate odds ratios (OR) and 95% of confidence intervals (CI) of the independent variables BMI, age, clinical stage, immunohistochemistry and correlated with pCR (p value < 0.05 was assumed as statistically significant). The study was approved by local ethics committee. Results A total of 1.481 patients from a single reference center between January 2011 to May 2020 were included. The mean age was 50 years and mean BMI was 28,08 (SD 5,59). Most of the patients presented clinical stage III (67,3%) at diagnosis. Invasive carcinoma nonspecial type was the most frequent (95,11%). After NACT 1.138 (76.84%) still had invasive disease and only 343 (23.16%) had pCR. BMI ratio was 1.6% underweight, 30.5% healthy weight, 34.9% overweight and 33.0% obese. Regarding survival analyses, there was no statistical significance for the different BMI categories for both OS (p=0.43) and DFS (p=0.7) and no statistical significance when evaluated pCR and BMI OS (p=0.26) and DFS (p=0.22). OS was estimated for three groups (healthy weigh: 109 months, overweight: 105 months, obese: 79 months). For patients with underweight, the median OS was not reached. The 5-year OS rate in Brazil, according to this study, was 85.4%. Of these 1,481 women, 387 relapsed after surgery (22 cases: local relapse; 355: systemic relapse; 10: both relapses). Only the underweight reached the median (58 months) but this group is very small, and the other categories still have immature data because the median was not reached to define DFS. The association of the most aggressive subtypes of cancer as predictors of pCR was statistically significant (Luminal B: p=0.019; HER 2: p< 0.001; Triple negative: p< 0.001, in relation to Luminal A). There wasn’t any statistical significance for the different BMI categories. Conclusion This study did not show interference of BMI on OS and/or DFS in Brazilian women with BC undergoing NAC. Few patients reached pCR (23.16%) probably due to the advanced initial stage. On the other hand, pCR was much more frequent in the more aggressive subtypes (Triple negative, HER 2 and Luminal B). Obesity as an independent chronic condition and despite not having an impact on survival in these analyses, most women were overweight or obese (72.85%), showing the frequency of obesity in Brazilian women, which should be understood as a public health problem in the country. In addition, following these women for 10 years can help to understand better the real impact of obesity in breast cancer survival. Table 1. Percentual of breast cancer in different clinical stages. Table 2. Logistic regression considering pCR as an outcome. Citation Format: FERNANDA GRACE BAUk RICHTER, ANDRE MATTAR, Marcelo Antonini, REGINALDO G. COELHO LOPES, Jorge Y. Shida, Luis Henrique Gebrim, Juliana Monte Real. IMPACT OF THE BODY MASS INDEX (BMI) ON THE SURVIVAL OF BREAST CANCER WOMEN WHO ACHIEVED A COMPLETE PATHOLOGICAL RESPONSE (pCR) AFTER NEOADJUVANT CHEMOTHERAPY (NACT) IN BRAZIL [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-05-53.

O objetivo deste estudo é identificar e diferenciar as perceções dos professores do ensino superior português sobre questões de segurança e privacidade nas avaliações online. A investigação assentou entrevistas com 22 docentes, realizadas online entre 15/06/2021 e 09/07/2021, cuja informação recolhida fora analisada através de processos de codificação, categorização e análise de conteúdo. Os resultados evidenciam homogeneidade nas perceções dos docentes em relação à necessidade de segurança nos processos de avaliação online, para garantir: identidade dos estudantes, evitar consulta a materiais não autorizados, e plágio. Em oposição, verificou-se que os professores discordaram em relação ao quanto as estratégias e ferramentas empregadas para o combate a tais condutas violam a legislação de proteção aos dados e privacidade dos estudantes. A pesquisa conclui que o design instrucional de cursos online e híbridos deve contemplar, em relação às avaliações, estratégias e ferramentas que levem em consideração tanto a segurança do processo, quanto o respeito às normas de proteção de dados e privacidade.

O uso do álcool gel em procedimento de antissepsia das mãos e desinfecção de superfícies representa uma prática frequente nas instituições de saúde. Com a pandemia Covid-19, tornou-se hábito da população o uso do mesmo. O objetivo do trabalho foi analisar características físico-químicas bem como a eficácia microbiológica de diferentes marcas de álcool em gel comercializados em farmácias no período da pandemia de Covid-19. As análises físico-químicas compreenderam o teor alcoólico, cor, aspecto, valor de pH e resistência à centrifugação, e para a análise da eficácia microbiológica realizou-se um teste de desinfecção de bancada frente a bactérias Gram-negativas com cepa padrão de Salmonella typhimurium (ATT 14028). As amostras estudadas se encontram dentro dos padrões esperados para os aspectos físico-químicos bem como apresentaram eficiência na eliminação de bactérias em superfície contaminada. Palavras-Chave: Álcool em gel. Eficácia microbiológica. Análise físico-química. Controle de qualidade.

Objectives: The alveolar ridge resorbs and collapses following tooth removal which continues to be a major concern for practitioners. Many researchers concluded that buccal aspect of the ridge is more prone to resorption, as it is primarily supplied by the periodontal tissues and ligaments of the tooth1. Recently, several papers were published concerning the socket shield technique explaining how to maintain the ridge width and height. Socket shield technique aids at retaining the buccal fragment of root in place thus placing the implant behind the lingual aspect of that fragment so as aid in preventing the collapsing of the buccal bone. This would help in improving aesthetics especially during immediate implant placement in the anterior maxillary region (schroop et al, 2003). Materials and Methods: The patient passed through phase I therapy (Supragingival scaling, subgingival debridement and oral hygiene instructions) before any surgical procedures.

Background Hospitalization is rare in anorexia nervosa (AN) and local application of indications is heterogeneous. However, no study has evaluated the effect of these different treatment modalities on the mean length of stay. Our objective was to describe the context and modalities of a wide range of hospital care programs offered to patients with anorexia nervosa in eleven specialized French psychiatric centers for patients from childhood to adulthood. This work was carried out within the framework of the EVHAN (Evaluation of Hospitalization for AN, Eudract number: 2007-A01110-53, registered in Clinical trials) research program. The EVHAN program comprises five main lines: weight objectives at discharge, the practice or not of a separation period, the use of clear nutritional dietary objectives (cognitive/behavioral), the intensity of family involvement in treatment, and the existence or absence of a stabilization phase before ending inpatient treatment. These main lines will make it possible to study the impact of treatment modalities on the future of patients in the short and medium term (at discharge and at 1-year follow-up). Methods The eleven centers are located in France (Bordeaux, Nantes, Paris and Ile-de-France, Rouen and Saint-Etienne). Various staff members (psychiatrists, somatic doctors, nurses, dieticians, psychologists) from each center were interviewed using a semi-structured questionnaire. Data on operating modalities and context of care were collected and analyzed. Results Four of the eleven centers were exclusively child/adolescent centers, and seven of 11 were adolescent (from 11, 13 or 16 years) and young adult centers. All centers offered a graduated approach from outpatient to full hospitalization. The majority had a number of beds allocated for patients with eating disorders. The criteria for hospitalization were homogeneous with respect to somatic and/or psychic severity prefiguring the consensus criteria defined by the French Health Authority (HAS) in 2010. Child/adolescent units used the weight curve to set weight objectives at discharge (between the 10th and 50th percentiles). Most adult units used weight objectives at discharge corresponding to a body mass index between 17 and 20kg/m2. Nine centers used a written or oral care contract. One unit did not separate the patient from her/his usual environment, the others had a practice gradient of partial separation and total separation times. These were either short, lasting a maximum of 3 weeks, or long, lasting more than 3 weeks. Conversely, patients were not isolated within the unit, and benefited from a rich social life, depending on her/his physical condition. The patient's family was in contact with the team and fully supported. The longest periods of separation involved adolescents and adults. Nutritional support varied from a group approach (meals in the dining room, standardized meals of the care center) to very individualized approaches within a specific framework. All the units reported meeting with families at least once during the hospitalization; with the patient's parents for child/adolescent patients and/or unmarried patients and with the husband/wife for married patients. The majority of the centers requested a phase of weight stabilization, whatever the age before hospital discharge. Conclusion There is international and national consensus regarding the indications for hospitalization, and the main lines of multidisciplinary care to be developed within this framework. However, local application of these indications was heterogeneous resulting in diverse modalities of hospital care for anorexia nervosa in France. Specialized teams have developed management strategies arising from their "team culture". The complexity of the anorexic pathology, due to the psyche-soma intrication and the diversity of age groups, highlights the complexity of care available. The impact of this diversity of hospital care on patient outcomes will be studied as a result of this work.