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Abstract Background Primary Care Physicians have a central role in assisting individuals with dementia and evaluating their preparedness to care these patients is fundamental. Our aim is to evaluate the knowledge and attitudes regarding dementia of the Primary Care Physicians (PCP) in Rio Grande do Sul (RS) state, Southern Brazil. Methods We collected sociodemographic data, volume of patients with dementia treated/referred and perception of difficulties in caring for these patients. A previously validated questionnaire was sent: "Quiz on Knowledge and Attitudes in Dementia". Results From March/2022 to June/2023, 296 PCP responded to the questionnaire. They were mostly women (52.7%, 156), with a median [IQR] age of 35 [29–44] years, mostly were White (82.1%, 243) and had 7 (4–16) years of experience as a physician. Less than half of the physicians performed cognitive screening (43.9%) and Mini Mental State Examination was the most screening (63.5%) test used. The mean percentage of correct answers in the Knowledge Quiz was 46.4%. In the attitude quiz, we identified 3 factors: 1) frankly positive attitudes; 2) perceive primary care as important but have a pessimistic attitude towards them; 3) see primary care as important for patient care. Conclusion Knowledge about dementia is low among PCP in RS; however, most have positive attitudes towards these patients or think primary care is important to these patient's care.

Abstract Background Cardiovascular diseases are characterized by chronic inflammation, leading to increased inflammatory markers that can cause cell damage and death. Phase angle has emerged as a marker of cellular health. It is considered a prognostic factor in various acute and chronic conditions. However, few studies have examined its association with cardiovascular disease risk measures. This study aims to investigate the relationship between phase angle, the general Framingham risk score, and the HEARTS cardiovascular risk score. Methods This cross-sectional study included a convenience sample of adult patients of 2 primary health care services. Phase angle was measured using multifrequency bioimpedance analysis at 50 kHz. The risk of cardiovascular events was calculated using the Framingham and HEARTS risk scores. Statistical analysis included generalized linear regression models, unadjusted and adjusted according to sex and age, to determine the association between scores, risk factors, and phase angle. Results The study included 164 individuals with a mean age 52.2 (SD 17.9). According to the HEARTS score, low-risk patients had higher phase angle values than those with high or very high risk [ß = -0.57 (95% CI -0.95; -0.19), P = 0.003]. Framingham scores showed a trend toward significance for higher mean phase angle values in low-risk than high-risk patients [ß = -0.43 (95% CI -0.88 to 0.02), P = 0.06]. Conclusion Phase angle values were lower in high and very high-risk patients than in low-risk patients, which shows that phase angle is a promising risk predictor for patients with cardiovascular diseases.

Introduction and Objectives: Public health policies in metabolic dysfunction-associated steatotic liver disease (MASLD) are still lacking. This study aims to estimate the prevalence and severity of MASLD in primary health care (PHC) through non-invasive markers. Patients and Methods: Two-phase study, including a retrospective (RETR) and a prospective (PROS) one, was carried out in PHC in Brazil. In RETR, metabolic and hepatic profiles of 12,054 patients, including FIB-4, were evaluated. In PROS, 350 patients were randomly selected and submitted to a clinical and nutritional assessment. Results: RETR (65.4 % women, mean age 55.3 years old): dyslipidemia, hypertension, and type 2 diabetes mellitus (T2DM) present in 40.8 %, 34.3 %, and 12.2 % of the electronic health records, respectively. Fasting glucose >100 mg/dL in 34.5 %, and glycated hemoglobin higher than 5.7 % in 51.5 %, total cholesterol >200 mg/dL and triglycerides >150 mg/dL in 40.8 % and 32.1 %, respectively. Median FIB-4 was of 1.33, 5 % >2.67. No one had MASLD as a diagnostic hypothesis; PROS (71.8 % women, mean age 58 years old): body mass index (BMI) ≥30 kg/m² in 31.8 %. MASLD prevalence (FLI≥ 30 + cardiometabolic features) of 62.1 %; 39.4 % of patients had FLI ≥60, with higher BMI, waist circumference, fasting glucose, triglycerides, AST, ALT and GGT, as well as lower HDL-cholesterol (p < 0.001). FIB-4>1.3 in 40 % and NAFLD Fibrosis Score (NFS)>-1.45 in 59.2 % of steatotic patients. Conclusions: There is a high prevalence of MASLD in PHC, with a significant risk of liver fibrosis. These findings reinforce we need to develop public policies to defeat MASLD epidemics.

INTRODUCTION: Diabetic ketoacidosis (DKA) is an emergency often associated with dehydration, and volume replacement is one of its therapeutic pillars. The best fluid for this is uncertain. This study aims to compare the use of Ringer lactate (RL) and saline0.9% (SF0.9%) in the correction of DKA depletion in pediatrics patients. METHODOLOGY: Cross-sectional and analytical study, with ambispective data collection. The inclusion criteria were patients aged 0-14 years, diagnosed with DKA, who received a correction for depletion with SF0, 9% or RL, in the first 24 hours of treatment. The primary outcome was the resolution time of DKA. Secondary outcomes were the amount of insulin infused, volume received and changes in serum sodium, chloride, anion gap, blood glucose, and lactate levels over 24 hours. RESULTS: 48 hospitalizations were included: 33 received 0.9% SF and 15 received RL. The median age was 123.5 (20.9-167.2) months and 54.2% were female. The duration of DKA was observed to be lower in the RL group (median: 18 [4-39] hours) compared to the SF0.9% group (median: 24 [6-80] hours) (p=0.018). Regarding the rate of insulin infusion, a greater percentage change per hour was shown in the SF0,9% group than in the RL group (p

ABSTRACT BACKGROUND: Universal healthcare is a cornerstone of Brazil’s public health system. However, delayed diagnosis and treatment of chronic kidney disease (CKD) remain substantial issues. The scarcity of outpatient dialysis facilities contributes to extended hospital stays. This study aimed to examine how the time to dialysis initiation (TID) impacts mortality in patients with renal disease. OBJECTIVES: This study aimed to evaluate the correlation between variables affecting TID and mortality in hospitalized patients with renal disease. DESIGN AND SETTING: A cross-sectional study was conducted at Santa Marcelina Hospital in São Paulo. METHODS: This cross-sectional study was conducted in a tertiary hospital, involving adults with kidney disease who were referred to the emergency department between 2014 and 2017. Primary outcomes included TID and mortality rates. RESULTS: Among the 402 patients studied, the average age was 58.6 years, and 59.4% were men. The median hospital stay was 44.5 d. Notably, 28.1% of the patients began dialysis under emergency conditions. Diabetes and hypertension were the most prevalent causes of renal disease. A positive correlation was found between age and TID (P = 0.007). CONCLUSIONS: Primary care in Brazil often fails to effectively detect and manage CKD, leading to a higher incidence of emergency dialysis, particularly among older adults. This delay correlates with increased mortality rates. Older age is associated with delayed TID, prolonged hospital stays, and consequently higher mortality. These findings highlight the need for better primary care to effectively manage CKD and reduce hospitalization and mortality.

Sickle cell anemia is a hereditary disease caused by sickle-shaped red blood cells that can lead to vaso-occlusive crises. Treatment options are currently limited, highlighting the need to develop new clinical approaches. Studies demonstrated that elevated levels of fetal hemoglobin (Hb F) are associated with a reduction of mortality and morbidity in sickle cell anemia patients. In light of this, researchers have been trying to elucidate the transcriptional regulation of Hb F to develop new therapeutic interventions. The present study aimed to present the main transcription factors of Hb F and discuss the clinical feasibility of these molecular targets. Two search strategies were used in the PubMed, SciELO, and LILACS databases between July and August 2023 to conduct this review. Manual searches were also conducted by checking references of potentially eligible studies. Eligibility criteria consisted of clinical trials and cohort studies from the last five years that investigated transcription factors associated with Hb F. The transcription factors investigated in at least four eligible studies were included in this review. As a result, 56 eligible studies provided data on the BCL11A, LRF, NF-Y, GATA1, KLF1, HRI, ATF4, and MYB factors. The studies demonstrated that Hb F is cooperatively regulated by transcription factors with the BCL11A factor appearing to be the most specific target gene for γ-globin induction. Although these data are promising, there are still significant gaps and intervention limitations due to the adverse functions of the target genes. New studies that clarify the aspects and functionalities of Hb F regulators may enable new clinical approaches for sickle cell anemia patients.

Este artigo analisará o julgamento da Reclamação 36.476/SP, decidida pelo Superior Tribunal de Justiça (STJ) em 2020, em que o Tribunal adotou o entendimento de que não é cabível a reclamação para garantir a adequada aplicação de precedentes fixados pelo STJ a partir de julgamento de recursos especiais repetitivos. Neste diapasão, a partir de método dedutivo, com utilização de procedimento bibliográfico e documental, analisar-se-á o entendimento adotado pela Corte, em quatro partes: de início, realizar-se-á uma pequena introdução sobre o NCPC e as balizas fixadas por este no que toca à prestação jurisdicional; em seguida, analisar-se-á a visão tradicional dos chamados precedentes e como se inserem no contexto brasileiro e discorrer-se-á sobre a relação da reclamação com os referidos precedentes, com destaque à sua função de uniformização da prestação jurisdicional e, por fim, analisar-se-á a decisão do Superior Tribunal de Justiça, buscando responder se esta satisfaz a lógica de precedentes vinculantes. A investigação demonstrou que a Reclamação 36.476/SP desprestigia a lógica de precedentes vinculantes instituída pelo NCPC, isto porque retira instrumento apto a garantir a vinculatividade dos julgados que gozam de tal estatura o que, por si só, prejudica a unidade do sistema decisório.

Background and aims: Cardiovascular disease remains a leading cause of mortality, with statins widely used to reduce its risk. Despite extensive research, the nuanced impact of statin therapy on cardiorespiratory fitness, particularly the reduction in peak oxygen consumption (VO2), is still an open question. This study aims to contribute fresh insights to the ongoing discussion, highlighting the unresolved nature of this clinical matter. Methods: We retrospectively analyzed maximal cardiopulmonary exercise test (CPET) in male and female participants over 18 years of age who were under statins treatment. They were categorized as physically active or inactive according to self-report of physical activity. From 33,804 CPET, 4,941 participants (76 % men, age 42 ± 13 years; and 24 % women, age 41 ± 13 years) were included in the study. Results: The multivariate linear regression model showed that statins were associated with a significant reduction in VO2 peak (−4.2 [-4.8, −3.5] mL/kg/min, p 600 min/week: 6.9 [5.4; 8.4] mL/kg/min, all p 150 min/week). Future research should explore the mechanisms behind this interaction and identify optimal exercise regimens for individuals on statin therapy.

Several under-explored Aspergillus sp. produce intriguing heptapeptides containing a γ-aminobutyric acid (GABA) residue with as yet unknown biological functions. In this study, a new GABA-containing heptapeptide – unguisin J (1) – along with known unguisin B (2) were isolated from a solid culture of Aspergillus heteromorphus CBS 117.55. The structure of compound 1 was elucidated by extensive 1D and 2D NMR spectroscopic analysis including HSQC, HMBC, COSY, and 2D NOESY as well as HRESIMS. The stereochemistry of 1 and 2 was determined by Marfey’s method. A biosynthetic gene cluster (BGC) encoding unguisins B and J was compared to characterized BGCs in other Aspergillus sp. Since the unguisin family of heptapetides incorporate different amino acid residues at different positions of the peptide, the A and C domains of the UngA NRPS were analyzed in an attempt to understand the lack of substrate specificity observed.

Robotic technologies are affording opportunities to revolutionize the production of specialty crops (fruits, vegetables, tree nuts, and horticulture). They offer the potential to automate tasks and save inputs such as labor, fertilizer, and pesticides. Specialty crops are well known for their high economic value and nutritional benefits, making their production particularly impactful. While previous review papers have discussed the evolution of agricultural robots in a general agricultural context, this review uniquely focuses on their application to specialty crops, a rapidly expanding area. Therefore, we aimed to develop a state-of-the-art review to scientifically contribute to the understanding of the following: (i) the primary areas of robots’ application for specialty crops; (ii) the specific benefits they offer; (iii) their current limitations; and (iv) opportunities for future investigation. We formulated a comprehensive search strategy, leveraging Scopus® and Web of Science™ as databases and selecting “robot” and “specialty crops” as the main keywords. To follow a critical screening process, only peer-reviewed research papers were considered, resulting in the inclusion of 907 papers covering the period from 1988 to 2024. Each paper was thoroughly evaluated based on its title, abstract, keywords, methods, conclusions, and declarations. Our analysis revealed that interest in agricultural robots for specialty crops has significantly increased over the past decade, mainly driven by technological advancements in computer vision and recognition systems. Harvesting robots have arisen as the primary focus. Robots for spraying, pruning, weed control, pollination, transplanting, and fertilizing are emerging subjects to be addressed in further research and development (R&D) strategies. Ultimately, our findings serve to reveal the dynamics of agricultural robots in the world of specialty crops while supporting suitable practices for more sustainable and resilient agriculture, indicating a new era of innovation and efficiency in agriculture.

Background/Objectives: The present work aimed to compare the effects of the standardized dry extract from the leaves of Monteverdia ilicifolia, popularly known as “espinheira-santa”, with omeprazole in the management of dyspepsia related to gastroesophageal reflux disease (GERD). Methods: A double-blind, randomized, non-inferiority and double-dummy clinical trial was conducted. In total, 86 patients with GERD symptoms were randomized into three groups: Omeprazol (20 mg), M. ilicifolia (400 mg), or M. ilicifolia (860 mg). Capsules were provided by SUSTENTEC®, Pato Bragato, Brazil. It was requested that the participants take three capsules before breakfast and dinner for 4 weeks. Clinical outcomes were obtained at the beginning and end of the study, with GERD symptoms (QS-GERD), the impact of heartburn symptoms on quality of life (HBQOL), and medical records. Results: Overall, 75.6% of the participants showed adherence without any differences among the experimental groups. All groups had significant reductions in both QS-GERD and HBQOL scores. Omeprazole and 400 and 860 mg of M. ilicifolia decreased the QS-GERD total scores at the endpoint compared to the baseline (Chi-square = 129.808; p < 0.0001), as well as individual item scores, such as heartburn intensity (Chi-square = 93.568, p < 0.0001) and heartburn after meals (Chi-square = 126.426, p < 0.0001). There were no differences among the experimental groups after the intervention. Conclusions: Our results suggest that capsules with a standardized dry extract from the leaves of M. ilicifolia at a dosage of 400 or 860 mg are non-inferior to omeprazole, a proton pump inhibitor.

Com base em uma incursão crítica por debates sobre literatura mundial e cinema mundial, em que busco interrogar o conceito de mundo, este artigo elabora um argumento duplo, no qual está em jogo a questão da mundação, isto é, da configuração de mundos como partilhas do comum. Por um lado, trata-se de um argumento fundamentalmente teórico. Literatura e cinema operam como dispositivos cosmotécnicos sempre que trabalham no sentido de unificar ordem cósmica e ordem moral, inscrevendo o comum (que se define pela contingência e indeterminação) na ordem pretensamente necessária de um arquivo e determinando-o como comunidade. Quando perturbam a unificação de cosmos e moral, insinuando outras partilhas e criando experiências de invenção de mundos, literatura e cinema operam como aparelhos cosmopoéticos, que restituem ao comum a abertura inquietante de sua contingência e indeterminação. Por outro lado, trata-se de um argumento metodológico. O atlas, entendido como conjunto de mapas, tem sido reivindicado como ferramenta analítica em estudos de literatura mundial e cinema mundial. Nessas abordagens, literatura e cinema tendem a ser identificados à sua operação como dispositivos cosmotécnicos. Para interrogar sua operação como aparelhos cosmopoéticos, é preciso suplementar o atlas como forma de arquivamento do mundo, experimentando com as possibilidades de uma linhagem associada ao atlas de imagens. Esse argumento duplo conduz à proposição de um programa de pesquisa: um atlas de cosmopoéticas.

Resumo A literatura sobre Burocratas de Nível de Rua (BNR) indica diversos motivadores do comportamento que influenciam o desempenho desses profissionais, como discricionariedade, autointeresse, normas e interesse público. Apesar de esses aspectos ocorrerem de maneira simultânea, não se verificam estudos sobre quais agentes do comportamento são determinantes para o desempenho dos BNR. A presente pesquisa tem por objetivo analisar a influência da interação de diferentes motivadores do comportamento do BNR em seu desempenho para implementar políticas públicas. Para isso, foi aplicado um questionário estruturado a 10.014 policiais rodoviários federais ativos no período da pesquisa, sendo 426 o número de respondentes. Os dados foram analisados com modelagem de equações estruturais. Os resultados evidenciaram que discricionariedade, normas e interesse público se associaram positivamente ao desempenho operacional. Para o desempenho institucional, somente as dimensões “normas” e “interesse público” se mostraram positivamente associadas. Os resultados indicam que a relevância dos diferentes motivadores do comportamento dos BNR varia de acordo com o desempenho observado e reiteram a assimetria de percepções entre os diferentes níveis organizacionais.

Objective: To verify whether an infiltrant resin used to inactivate white spot lesions (WSL) on enamel can resist the abrasive challenges promoted by tooth brushing with different dentifrices. Material and Methods: WSL was induced on bovine enamel samples (pH cycling) and then treated with an infiltrant resin (ICON). Afterward, half of the sample was protected. The other half underwent an abrasive challenge using an electric toothbrush with soft bristles., using dentifrices with different abrasiveness (n=10): Group 1: Colgate Maximum Cavity Protection; Group 2: Sensodyne Repair & Protect; Group 3: Colgate Sensitive Pro-Relief; Group 4: Colgate 2 in 1 Watermelon Flavor; e Group 5: Colgate Luminous White Advanced. The wear profile after brushing was evaluated by confocal laser scanning microscopy (µm), and the enamel/resin interface was observed in scanning electron microscopy (SEM). Profilometry data were analyzed using one-way ANOVA followed by Tukey's test (α=5%). Results: Brushing produced more significant wear on group 5 (3.96±0.26) when compared to groups 1 (3.45±0.21), 2(3.22±0,4) and 4(3.11±0.34). Data from Group 3 (3.82±0.6) was similar to G5 but higher than G1, G2, and G4. SEM analysis showed that the adhesive interface remained intact in all groups after the abrasive challenge. Conclusion: Dentifrices with a higher relative dentin abrasiveness produced more significant wear of the infiltrant, but the composite/enamel interface was not altered after the abrasive challenges.

Abstract Background Medical education has evolved based on the application of pedagogical actions that place the student as the protagonist of the learning process through the use of active teaching methodologies. Within this context, higher education teachers should use strategies that focus on the student and his/her context and avoid traditional teaching methods. Specifically in medical schools, there is an even greater challenge since the teaching methods of medical curricula differ from those used in previous schooling. Consequently, students acquire their own style of processing information that is often incompatible with the profile of medical schools. This may be one of the factors responsible for the lack of motivation among undergraduates. Objective The aim of this study was to characterize the learning styles of students enrolled in a Brazilian medical school using the Felder-Soloman Index of Learning Styles (ILS). Methods This was a cross-sectional, descriptive, quantitative study that included students from the 1st to the 6th year of a Brazilian medical school. The students participating in this study voluntarily answered 44 questions about learning styles of the Felder-Silverman instrument validated in Brazil. The instrument was divided so that each domain consisted of 11 questions with two response options in which only one could be selected. For each domain, a score (1 point) was assigned to the selected option (a, b) of the question and the learning style category was determined as the difference between these values. For data collection and tabulation, we used the Learning Syle Platform (EdA Platform) developed based on Felder’s studies since this system processes information about the dimension analyzed, the preferred style, and the most striking characteristics of each style. Results The results showed that sensing was the preferred learning style of the students, followed by the sequential and visual styles. It was not possible to determine whether gender or age influences the choice of learning methods because of the homogeneity of the results. Conclusions The present data will enable teachers of the institution involved in this study to plan pedagogical actions that improve the students’ self-awareness, as well as their teaching-learning skills, by choosing the most adequate active methodologies for the medical education programs considering the individuality of each student and class.

Based on a critical foray through debates on world literature and world cinema in which I seek to interrogate the concept of world, this article elaborates a double argument, in which it is at stake the question of worlding, that is, the configuration of worlds as partitions of the common. On the one hand, it is a fundamentally theoretical argument. Literature and cinema operate as cosmotechnical dispositives whenever they work to unify cosmic order and moral order, inscribing the common (which is defined by contingency and indetermination) in the supposedly necessary order of an archive and determining it as community. When they disturb the unification of cosmos and morality, insinuating other partitions, literature and cinema operate as cosmopoetic apparatuses, which restitute the unsettling openness of the common’s contingency and indetermination. On the other hand, this is a methodological argument. The atlas, understood as a set of maps, has been claimed as an analytical tool in studies of world literature and world cinema. In these approaches, literature and cinema tend to be identified to their operation as cosmotechnical dispositives, defining a research program. To interrogate their operation as cosmopoetic apparatuses, it is necessary to supplement the atlas as a form of archiving the world by experimenting with the possibilities of a lineage associated with the atlas of images. This dual argument leads to the proposition of a research wander (instead of a program): an atlas of cosmopoetics.

Duchenne muscular dystrophy is a genetic disease that is clinically manifested by progressive muscle atrophy, followed by loss of strength, motor coordination and functional impairment. In the final stages of the disease, the patient has severe difficulty in breathing mechanics, due to the involvement of the muscles involved with the mechanics of breathing, including the diaphragm. The present study sought to identify the effects of creatine monohydrate supplementation in MDX mice on the morphology, morphometry and stereology of the striated muscle tissue of the diaphragm of these animals. The results indicate that, despite not influencing the increase in cell volume, supplementation acts in an anti-inflammatory way, reducing the progressive process of fibrosis that occurs in these animals in the face of muscle atrophy followed by the replacement of muscle parenchyma by connective tissue. in this way, supplementation provides a better condition for tissue maintenance, enabling more survival of MDX mice. Monohydrate creatine supplementation has been shown to be a complementary therapeutic alternative, especially for muscular dystrophies and severe myopathies.

Creatine is a dietary supplement with the potential to stimulate the phosphocreatine pathway and protein synthesis, through the stimulation of PI3eK/AKT and mTOR responsible for the proliferation and differentiation of satellite cells, responsible for hypertrophy. The present study aimed to evaluate the morphological effects of the use of creatine monohydrate on the soleus muscle tissue of 26-month-old Wistar rats. Methods: Twelve Wistar rats were divided into two groups of six animals each. Group 1 was not supplemented with creatine and received a standard diet consisting of water and food. Group 2 received the same diet, but was supplemented with creatine monohydrate at a dose of 0.03 mg/kg of body weight diluted in 200 ml of drinking water for 8 weeks. Results: The supplementation promoted morphological and morphometric effects on the soleus muscle tissue, promoting changes in the perimeter and area of the muscles of the animals treated with the supplement. It is estimated that this supplement may promote, in addition to increasing the cross-sectional area of myocytes, increased stimulation of the protein synthesis pathway associated with PI3K/AKT.

ABSTRACT The objective of this work was to characterize reference bacteria strains, belonging to the genus Bacillus and species of correlated genera, by simplified morphological and biochemical methods. The morphological characterization is based on the aspects of the colonies, as well as cytomorphology of the species, by optical and scanning microscopy. For biochemical characterization, the sensitivity test to antimicrobials by disk-diffusion is performed. Moreover, the strains were characterized by extracting intracellular proteins. Characteristics such as shape, color, and consistency of the colonies, in addition to the type of spore and production of protein crystals were determinants for the morphological characterization of these species. The antibiogram revealed high resistance to β-lactam group antibiotics, in species of Bacillus cereus s.l group. In Bacillus subtilis s.l. group there was high susceptibility to antibiograms, mainly for species of B. subtilis. The protein profile provided specific protein patterns for some species, mainly bands of 130 e 65 kDa for B. thuringiensis, 140 e 130 kDa for Lysinibacillus sphaericus, and 115 kDa for Brevibacillus laterosporus. Our results showed that the morphological and biochemical characterizations, provided a simple identification, with easy interpretation, and low cost.

In this work, malachite green dye was removed from an aqueous effluent using acerola seed as an adsorbent. The adsorbent was characterized by Fourier transform infrared (FTIR), X-ray diffraction, zero charge potential, and acid group concentration techniques. The findings revealed that the adsorbent has a characteristic composition of lignocellulosic materials, as described by the FTIR data, besides having a pH-PZC of 3.5 and a concentration of acid groups of 0.2313 mmol g−1. The central composite design was used for batch experiments, and the effects of three variables were analysed. The optimum conditions (pH, particle size, and adsorbent mass) were 10.0, 600 μm, and 0.8 g, respectively, for 97.52% dye removal. Redlich–Peterson isotherm fitted well to the experimental data (R2 = 0.997 and root-mean-square error (RMSE) = 1.168). From the Langmuir isotherm, the maximum adsorption capacity obtained for dye was 103.50 mg g−1. As for the adsorption kinetics, it was found that the pseudo-second-order model sufficiently describes the experimental data (R2 = 0.999 and RMSE = 0.018). Thus, the acerola seed has excellent properties as an adsorbent, demonstrating a remarkable performance and a great capacity to be used in the treatment of aqueous effluents contaminated by dyes. HIGHLIGHTS Biosorption has been investigated as a solution for malachite green dye from wastewater.; Optimization of dye removal on acerola seed was studied through three factors central composite design.; The highest removal yield was for adsorbent mass 0.8 g, pH 10.0, and particle size 600 μm.; From the Langmuir isotherm, the maximum adsorption capacity was 103.5 mg/g. The kinetic data were well fitted by the pseudo-second-order model.;

BackgroundThis study addresses the need for improved transparency and reproducibility in randomized clinical trials (RCTs) within the field of physical activity (PA) interventions. Despite efforts to promote these practices, there is limited evidence on the adherence to established reporting and methodological standards in published RCTs. The research, part of the Strengthening the Evidence in Exercise Sciences Initiative (SEES Initiative) in 2020, assessed the methodological standards and reporting quality of RCTs focusing on PA interventions.MethodsRCTs of PA advice or exercise interventions published in 2020 were selected. Monthly searches were conducted on PubMed/MEDLINE targeting six top-tier exercise science journals. Assessments were conducted by two independent authors, based on 44 items originally from CONSORT and TIDieR reporting guidelines. These items were divided into seven domains: transparency, completeness, participants, intervention, rigor methodology, outcomes and critical analysis. Descriptive analysis was performed using absolute and relative frequencies, and exploratory analysis was done by comparing proportions using the χ2 test (α = 0.05).ResultsOut of 1,766 RCTs evaluated for eligibility, 53 were included. The median adherence to recommended items across the studies was 30 (18-44) items in individual assessments. Notably, items demonstrating full adherence were related to intervention description, justification, outcome measurement, effect sizes, and statistical analysis. Conversely, the least reported item pertained to mentioning unplanned modifications during trials, appearing in only 11.3% of studies. Among the 53 RCTs, 67.9% reported having a registration, and these registered studies showed higher adherence to assessed items compared to non-registered ones.ConclusionsIn summary, while critical analysis aspects were more comprehensively described, aspects associated with transparency, such as protocol registrations/modifications and intervention descriptions, were reported suboptimally. The findings underscore the importance of promoting resources related to reporting quality and transparent research practices for investigators and editors in the exercise sciences discipline.

ABSTRACT This work constitutes one of the outcomes of the “Evaluation of hydrological scenario generation models” activity initiated by the Hydrological Scenario Representation Working Group (GT CH) and coordinated by ONS and CCEE. We introduce the LYNX-Series model, a contemporaneous non-periodic and multivariate variation of the autoregressive moving average model (CARMA) for generating synthetic time series of average inflow discharges to reservoirs in the Brazilian National Interconnected System (SIN). Notably, LYNX-Series couples the synthetic series generator with a multivariate sampling process to select a group of synthetic hydrological scenarios based on a similarity criterion with recent historical data. In addition to reducing the computational burden of the hydrothermal dispatch optimization process, the solution aims to enhance the representativeness of synthetic hydrological scenarios. The paper expounds on the theoretical aspects of the model and presents numerical simulations that validate its ability to replicate hydrological behaviors in various Brazilian basins.

ABSTRACT Synthetic streamflow scenario generation is particularly important in countries like Brazil, where hydroelectric power generation plays a key role and properly handling the uncertainty of future streamflow is crucial. This paper showcases a collaborative effort within the Brazilian electrical sector to enhance streamflow scenario models, focusing on horizons up to one year. Five institutions proposed diverse methodologies, and their effectiveness was evaluated using a comparative framework. The results reveal the strengths and areas for improvement in each model. GHCen emerged as the top performer, excelling in both short-term and moving average analyses, while the PARX model demonstrated superior performance in specific regions. The PAR(p)-A, which is the official methodology in Brazil, was the second-best model in the moving average analysis. This research offers valuable insights for countries facing similar hydrothermal scheduling and scenario generation challenges.

Background Despite previous studies indicating a moderate/high incidence of angiography headache (AH), there is still limited data about the risk factors associated with its occurrence. Objective The present study aimed to assess the associations among demographic, clinical, and technical characteristics of cerebral digital subtraction angiography (DSA) and the occurrence of AH. Methods Cross-sectional analytical observational study with a sample comprised of individuals with a recommendation for elective DSA. Clinical interviews were conducted to assess the occurrence of AH, using a standardized questionnaire. Results Among 114 subjects, the mean age was 52.8 (±13.8) years old, 75.4% (86/114) were women, 29.8% (34/114) had a history of migraines, and 10.5% (12/114) had chronic headaches. The overall frequency of AH was 45.6% (52/114). Of those, 88.4% (46/52) underwent 3D angiography, 7.7% (4/52) underwent aortography, and 1.9% (1/52) underwent both procedures. There was a statistically significant association between AH and previous history of migraine (odds ratio [OR]: 4.9; 95% confidence interval [CI] 1.62–14.7; p = 0.005) and 3D angiography (OR 6.62; 95%CI: 2.04–21.5; p = 0.002). Conclusions 3D angiography is strongly associated with the occurrence of AH, which has never been reported before. The association between a previous history of migraine and AH confirms the results of previous studies.

Abstract Lesions with bone loss may require autologous grafts, which are considered the gold standard; however, natural or synthetic biomaterials are alternatives that can be used in clinical situations that require support for bone neoformation. Collagen and hydroxyapatite have been used for bone repair based on the concept of biomimetics, which can be combined with chitosan, forming a scaffold for cell adhesion and growth. However, osteoporosis caused by gonadal hormone deficiency can thus compromise the expected results of the osseointegration of scaffolds. The aim of this study was to investigate the osteoregenerative capacity of collagen (Co)/chitosan (Ch)/hydroxyapatite (Ha) scaffolds in rats with hormone deficiency caused by experimental bilateral ovariectomy. Forty-two rats were divided into non-ovariectomized (NO) and ovariectomized (O) groups, divided into three subgroups: control (empty defect) and two subgroups receiving collagen/chitosan/hydroxyapatite scaffolds prepared using different methods of hydroxyapatite incorporation, in situ (CoChHa1) and ex situ (CoChHa2). The defect areas were submitted to macroscopic, radiological, and histomorphometric analysis. No inflammatory processes were found in the tibial defect area that would indicate immune rejection of the scaffolds, thus confirming the biocompatibility of the biomaterials. Bone formation starting from the margins of the bone defect were observed in all rats, with a greater volume in the NO groups, particularly the group receiving CoChHa2. Less bone formation was found in the O subgroups when compared to the NO. In conclusion, collagen/chitosan/hydroxyapatite scaffolds stimulate bone growth in vivo but abnormal conditions of bone fragility caused by gonadal hormone deficiency may have delayed the bone repair process.

Abstract Objective The present study describes the preferences and current practices of a sample of knee surgeons in Brazil regarding thromboprophylaxis in total knee arthroplasty (TKA). Method In the present internet survey, surgeons from the Brazilian Knee Surgery Society (SBCJ, in the Portuguese acronym) voluntarily answered an anonymous questionnaire including time of personal surgical experience, perceptions about the best thromboprophylaxis options, and actual practices in their work environment. Results From December 2020 to January 2021, 243 participants answered the questionnaire. All, except for 3 (1.2%), reported using thromboprophylaxis, and most (76%) combined pharmacological and mechanical techniques. The most prescribed drug was enoxaparin (87%), which changed to rivaroxaban (65%) after discharge. The time of thromboprophylaxis initiation varied according to the length of training of the knee surgeon (p ≤ 0.03), and their preferences and practices differed according to the Brazilian region (p< 0.05) and the health system in which the surgeons work (public or private sector; p= 0.024). The option for mechanical thromboprophylaxis also depended on the training time of the surgeon. Conclusion Thromboprophylaxis preferences and practices in TKA are diverse across Brazilian regions and health systems (public or private sectors). Given the lack of a national clinical guideline, most orthopedists follow either their hospital guidelines or none. The mechanical prophylaxis method and the little use of aspirin are the points that most diverge from international guidelines and practices.

Abstract Aromatic L-Amino acid decarboxylase (AADC) deficiency is a rare neurometabolic disorder due to a homozygous or compound heterozygous pathogenic variant of the DDC gene, resulting in low synthesis of the biogenic amines dopamine, serotonin, epinephrine, and norepinephrine. Most patients had severe expression of the disease with global developmental delay, early hypotonia, movement disorders such as oculogyric crises, tremor, and dystonia. Oromandibular dystonia (OMD) is rarely recognized in patients with AADC deficiency. The aim of this study was to describe OMD in detail in 4 patients with AADC deficiency. OMD occurred in isolated form or in association with oculogyric crises, increasing the difficulty in care patients during the crises. The main form of OMD was tongue dystonia associated with mouth opening dystonia. AADC deficiency must be included in the list of genetic causes of OMD.

Severe loss of bone mass may require grafting, and, among the alternatives available, there are natural biomaterials that can act as scaffolds for the cell growth necessary for tissue regeneration. Collagen and elastin polymers are a good alternative due to their biomimetic properties of bone tissue, and their characteristics can be improved with the addition of polysaccharides such as chitosan and bioactive compounds such as jatoba resin and pomegranate extract due to their antigenic actions. The aim of this experimental protocol was to evaluate bone neoformation in experimentally made defects in the mandible of rats using polymeric scaffolds with plant extracts added. Thirty rats were divided into group 1, with a mandibular defect filled with a clot from the lesion and no graft implant (G1-C, n = 10); group 2, filled with collagen/chitosan/jatoba resin scaffolds (G2-CCJ, n = 10); and group 3, with collagen/nanohydroxyapatite/elastin/pomegranate extract scaffolds (G3-CHER, n = 10). Six weeks after surgery, the animals were euthanized and samples from the surgical areas were submitted to macroscopic, radiological, histological, and morphometric analysis of the mandibular lesion repair process. The results showed no inflammatory infiltrates in the surgical area, indicating good acceptance of the scaffolds in the microenvironment of the host area. In the control group (G1), there was a predominance of reactive connective tissue, while in the grafted groups (G2 and G3), there was bone formation from the margins of the lesion, but it was still insufficient for total bone repair of the defect within the experimental period standardized in this study. The histomorphometric analysis showed that the mean percentage of bone volume formed in the surgical area of groups G1, G2, and G3 was 17.17 ± 2.68, 27.45 ± 1.65, and 34.07 ± 0.64 (mean ± standard deviation), respectively. It can be concluded that these scaffolds with plant extracts added can be a viable alternative for bone repair, as they are easily manipulated, have a low production cost, and stimulate the formation of new bone by osteoconduction.

The Golden Parakeet is an endemic Brazilian flagship species that has suffered from poaching and habitat loss, leading to local extinctions in the urbanized parts of the Amazon. We reintroduced six groups of mostly captive-bred parakeets in a protected area. The birds were acclimatized for at least five months at the release site, where they were trained to recognize native foods and develop foraging skills. Subsequently, we conducted a soft release, followed by daily supplementation and monitoring. For three years following the release we recorded their diet, feeding behavior, and how they adapted to wild foraging. The reintroduced birds fed on 23 plant species, with 13 not being previously listed in past studies. The three most consumed species corresponded to 77% of their feeding records. Parakeets spent more time feeding in altered landscapes and secondary vegetation than in the preserved forest. Most of the feeding happened during the rainy season when most of their favorite plants are fruiting. The parakeets’ incorporation of new species in their diet and their transition from supplemental to natural feeding happened gradually, as we did not reduce food offerings. Parakeets that showed site fidelity were able to find native food rapidly following release, but individuals that dispersed immediately had more difficulty finding food. This study showed that captive-bred Golden Parakeets can transition to a wild diet following a gradual reintroduction process.

Background Cancer ranks second as a cause of death in Brazil. Although preventive practices are part of the daily routine of primary healthcare (PHC) teams, organized screening programs are lacking. This study aimed to evaluate the adequacy of preventive interventions in the main cancer types, as defined by the Brazilian government. Methods We analyzed cross-sectional data from a larger project conducted in 2016 with PHC service users and physicians from all over Brazil, interviewed by trained research staff. The sample was stratified by the number of PHC physicians per geographic region, who were eligible for inclusion if they had been working in the same PHC unit for at least one year. Twelve adult patients with at least two encounters were included per participating physician. Only the data from service users were analyzed in this study. We evaluated the questions about preventive practices and calculated the following indicators: coverage, focus, screening errors, and screening ratio. National guidelines and international evidence were used as a comparison parameter. Results The study population consisted of 6160 service users. The data indicate that the recommendations for cervical, breast, and prostate cancer screening and for treatment of tobacco dependence are not adequately followed. Coverage for breast and cervical cancer screening presented an overutilization bias, with rates 50% and 9% above the expected, respectively. The screening focus was also inadequate: 24%, 47%, and 54% of the screening tests for the three cancer types were performed in individuals outside the recommended age range. 31% of smokers were not approached for treatment. Conclusion These findings indicate that the Brazilian population has been subjected to inadequate and potentially iatrogenic interventions in PHC. New policies based on stricter criteria of adequacy and increased use of the concept of quaternary prevention may improve the effectiveness and equity of the health system.

Introdução: O exercício flexão, praticado em muitos esportes e programas de treinamento, possui uma diversidade de técnicas e formas de execução, envolvendo maior risco de lesões articulares. Objetivo: Comparar a execução da flexão entre homens e mulheres praticantes de CrossFit e analisar padrões de movimento prejudiciais às articulações glenoumeral e do cotovelo. Materiais e Métodos: Foram selecionados sete praticantes avançados na modalidade, os quais executaram três repetições de flexão. Os movimentos foram filmados para a coleta dos ângulos das articulações glenoumeral e do cotovelo nas fases inicial, média e final do movimento. A análise cinemática foi realizada com o software Kinovea®. Resultados: Foi identificada uma diminuição significativa do ângulo da articulação glenoumeral no sexo feminino, enquanto no sexo masculino o ângulo sofreu um ligeiro aumento. Os homens adotaram uma posição mais afastada das mãos em comparação com as mulheres. Conclusão: A maior atividade do tríceps braquial nas mulheres levaria à preferência pela posição mais fechada das mãos, priorizando uma maior flexão dos cotovelos em relação aos homens, com maior ativação no peitoral maior e força muscular na adução dos ombros. A posição elevada dos ombros, observada nos homens, ocasiona um risco de impacto no ombro, justificando a adoção do posicionamento fechado ou com os cotovelos mais próximos do tronco no CrossFit.

The Digital Image Correlation (DIC) technique is an important method of evaluating material strain fields. Composite materials have inherently heterogeneous elastic properties, in the function of the different phases present in the composition, whereat the traditional techniques of deformation evaluation may not be sufficient to determine the mechanisms that eventually contribute to the failure of the material. The present work were evaluated, the tensile mechanical properties of polyester matrix composites loaded with an industrial residue of red mud, with a mass fraction of 20%. The properties were surveyed using the conventional technique of strain gauge and compared with the data obtained through DIC. The results showed that the DIC technique was accurate in monitoring the displacements and determining the average deformation of the tested specimens, in addition to providing ample deformation fields, for the evaluation of failure mechanisms throughout the sample request process.

The use of phosphate-solubilizing bacteria (PSB) can be a sustainable strategy to increase phosphorus availability and promote satisfactory crop yields. The objective of this study was to evaluate whether inoculation with PSB in common bean increases (i) growth, (ii) nutrition, (iii) yield, and (iv) grain quality, and (v) reduces the chemical phosphorus application dose to obtain maximum yields. The experiment was conducted in an Oxisol using a randomized block design in a 4 × 4 factorial scheme, with four replicates, using the cultivar IAC 2051. The first factor was four doses of P2O5 (0, 20, 40 and 60 kg ha−1), and the second factor was four doses of PSB (0, 100, 200 and 300 mL ha−1). For leaf area and leaf chlorophyll content, the association of PSB inoculation with a P2O5 dose of 40 kg ha−1 promoted the best conditions for the common bean. P2O5 application increased yield by 79 kg ha−1 for each 10 kg ha−1 added. PSB inoculation at a dose of 192 mL ha−1 promoted P export of 15.3 kg ha−1, and the PSB dose of 159 mL ha−1 increased yield by 389 kg ha−1 (12%) compared to the control. Grain quality remained within the standards required by the consumer market, being little affected by the treatments. Improvements in common bean growth and nutritional and physiological status promoted by P2O5 application and PSB were essential in increasing yield, so these are sustainable production strategies.

Endotracheal intubation is a frequent procedure in intensive care units and emergency care. The rapid intubation sequence (SRI) consists of a series of steps for sequential administration of sedative drugs and neuromuscular blockers, providing the ideal conditions for endotracheal intubation. The objective of this study is to carry out a bibliographic review of the medications used in pediatric SRI, and to propose the institution of an updated protocol that includes a safe analgesic medication. It is suggested to include dextrocetamine or fentanyl, depending on the clinical condition, for SRI.

Objetivo: Investigar relações entre lesões na articulação glenoumeral e a cinemática do movimento barra fixa executado por praticantes da modalidade CrossFit. Materiais e Métodos: 7 praticantes avançados na modalidade executaram três repetições do movimento de barra fixa e foram filmados para a coleta de dados a respeito dos ângulos articulares da articulação glenoumeral. A análise cinemática foi realizada com o software Kinovea®. Resultados: Os voluntários apresentaram um ângulo da articulação glenoumeral acima de 90° na fase média - momento em que o ombro se encontra em elevação e abdução -, posição de alto risco de lesão por impacto subacromial em razão do grau elevado e a uma maior tendência a erros técnicos por fadiga ou desequilíbrios musculares, acarretando à sobrecarga na articulação do ombro. As mulheres atingiram ângulos menores de adução em comparação com os homens e apresentaram um encolhimento dos ombros, ambas ações compensatórias e propensas a lesões por impacto devido a uma maior ativação do trapézio superior e menor ativação do serrátil anterior, aumento da inclinação anterior da escápula e predisposição a uma rotação interna do úmero. Conclusão: Os resultados indicam um potencial de lesão na articulação glenoumeral no exercício barra através das técnicas do CrossFit, no qual deve-se realizar um alto número de repetições. Deste modo faz-se importante um planejamento adequado do volume de treinamento no CrossFit e de exercícios focados no controle do movimento, fortalecimento, reparação de possíveis desequilíbrios musculares e mobilidade dos ombros.

Predicting sugarcane yield by quality allows stakeholders from research centers to industries to decide on the precise time and place to harvest a product on the field; hence, it can streamline workflow while leveling up the cost-effectiveness of full-scale production. °Brix and Purity can offer significant and reliable indicators of high-quality raw material for industrial processing for food and fuel. However, their analysis in a relevant laboratory can be costly, time-consuming, and not scalable. We, therefore, analyzed whether merging multispectral images and machine learning (ML) algorithms can develop a non-invasive, predictive framework to map canopy reflectance to °Brix and Purity. We acquired multispectral images data of a sugarcane-producing area via unmanned aerial vehicle (UAV) while determining °Brix and analytical Purity from juice in a routine laboratory. We then tested a suite of ML algorithms, namely multiple linear regression (MLR), random forest (RF), decision tree (DT), and support vector machine (SVM) for adequacy and complexity in predicting °Brix and Purity upon single spectral bands, vegetation indices (VIs), and growing degree days (GDD). We obtained evidence for biophysical functions accurately predicting °Brix and Purity. Those can bring at least 80% of adequacy to the modeling. Therefore, our study represents progress in assessing and monitoring sugarcane on an industrial scale. Our insights can offer stakeholders possibilities to develop prescriptive harvesting and resource-effective, high-performance manufacturing lines for by-products.

Introdução: As doenças respiratórias crônicas estão entre os principais problemas de saúde pública no mundo. Mesmo sendo sensíveis ao tratamento na Atenção Primária à Saúde, são a terceira principal causa de morte no Brasil. Os serviços de telemedicina apresentam-se como aliados importantes dos profissionais de saúde no que tange ao manejo de doenças respiratórias como a asma e a doença pulmonar obstrutiva crônica. Objetivo: Avaliar a adequabilidade de um serviço de telemedicina diagnóstica em espirometria considerando os indicadores de oferta, utilização e cobertura populacional no estado do Rio Grande do Sul. Resultados: No período estudado, o serviço ofertou 27.672 exames de telespirometria aos usuários do Sistema Único de Saúde do Rio Grande do Sul encaminhados por médicos da Atenção Primária à Saúde. A utilização esteve abaixo de 50% da oferta em todas as macrorregiões de saúde do estado. Conclusões: O estudo demonstrou que a capacidade instalada pelo serviço esteve adequada para atender à demanda populacional do Rio Grande do Sul, no entanto a baixa utilização do serviço pode estar associada ao desconhecimento sobre ele e à dificuldade em reconhecer essas doenças por parte dos profissionais de saúde da Atenção Primária à Saúde.

Neoplasmas primários do sistema urinário são incomuns em cães e gatos. Quando acometem os rins, o carcinoma é o mais comum nos cães e o linfoma nos gatos. Neoplasmas ureterais primários são raros nos cães e não existe relatos em gatos. O principal neoplasma vesical primário descrito em cães e gatos é o carcinoma de células de transição; porém, é mais frequente em cães. Neoplasmas uretrais ocorrem raramente e quando diagnosticados normalmente são amplificações de neoplasmas prostáticos ou de vesícula urinária. Com a finalidade de auxiliar no diagnóstico e na conduta médica para as duas espécies, esse trabalho tem o objetivo de apresentar uma revisão de literatura com os principais neoplasmas de ocorrência no sistema urinário que afetam cães e gatos. Apesar destas alterações serem infrequentes na rotina veterinária, é necessário um diagnóstico precoce para melhor prognóstico dos pacientes.

We assessed the associations of social distancing and mask use with symptomatic, laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection in Porto Alegre, Brazil. We conducted a population-based case-control study during April–June 2020. Municipal authorities furnished case-patients, and controls were taken from representative household surveys. In adjusted logistic regression analyses of 271 case-patients and 1,396 controls, those reporting moderate to greatest adherence to social distancing had 59% (odds ratio [OR] 0.41, 95% CI 0.24–0.70) to 75% (OR 0.25, 95% CI 0.15–0.42) lower odds of infection. Lesser out-of-household exposure (vs. going out every day all day) reduced odds from 52% (OR 0.48, 95% CI 0.29–0.77) to 75% (OR 0.25, 95% CI 0.18–0.36). Mask use reduced odds of infection by 87% (OR 0.13, 95% CI 0.04–0.36). In conclusion, social distancing and mask use while outside the house provided major protection against symptomatic infection.

OBJECTIVES: to carry out a non-systematized bibliographic review and propose a flowchart for the use of HFNC in pediatrics. METHODOLOGY: this is a non-systematic review, where studies published in the last five years were selected with the aim of proposing a flowchart to guide the use of HFNC in pediatrics. RESULTS: we found 34 papers, fifteen were excluded because they only addressed the neonatal population, five because they did not address the topic, one because it did not have the full text and one because it was a study protocol. In addition to the twelve papers in the initial search, we included eleven more papers considered relevant to the objective of this review, selected from the reference lists. From the data obtained in the selected papers, we report on the definition of therapy, components of the device, parameters to be adjusted, mechanisms of action, indications and contraindications, benefits and possible complications of its use, resulting in a flowchart for using this treatment modality. CONCLUSION: studies suggest that high flow is a safe, well-tolerated and easy-to-apply method. In addition, it can avoid the need for non-invasive and invasive mechanical ventilation. A flowchart to optimize its use in pediatrics can be advantageous for the success of therapy.

As ‘Cidades da Floresta” são aquelas regiões planejadas e construídas quase que instantaneamente para abrigar, confortavelmente, apenas o trabalhador do grande projeto de investimento. Áreas desse tipo redefiniram o contexto regional da Comunidade tradicional do Iratapuru/AP, abrigando pessoas de forma temporária para atender a realização de uma determinada construção de modo imediato. Isso resultou em algumas implicações e (re)existência dos povos tradicionais com a construção de uma Usina Hidroelétrica. Logo, o presente trabalho tem como objetivo compreender e analisar as implicações territoriais da construção e do funcionamento Usina Hidrelétrica de Santo Antônio do Jari na Comunidade Tradicional do Iratapuru, na Reserva de Desenvolvimento Sustentável do Iratapuru – RDSI, localizado no sul do Estado do Amapá. Verificou que o empreendimento provocou alterações nas relações socioambientais e na percepção das pessoas no seu sentido de lugar como pertencimento no espaço

Abstract Purpose To evaluate the quality of referrals for a first Rheumatology consultation at a tertiary care center in a southern Brazilian capital (Porto Alegre, RS), having as background findings from a similar survey performed in 2007/2008. Since then, our state has implemented referral protocols and a triage system with teleconsulting support exclusively for referrals from locations outside the capital, permitting a comparison between patients screened and not screened by the new system. Methods Physicians of the Rheumatology Service at Hospital Nossa Senhora da Conceição prospectively collected information regarding first visits over a 6-month period (Oct 2017 to March 2018). We recorded demographic characteristics, diagnostic hypotheses, date of referral, and the municipality of origin (within the state of Rio Grande do Sul). We considered adequate referrals from primary health care when a systemic autoimmune inflammatory disease (SIRD) was suspected at first evaluation by the attending rheumatologist. Results Three hundred fifty-seven patients/appointments were eligible for analysis (193 from the capital and 164 from small and medium towns). In 2007/2008, suspected SIRD occurred in 76/260 (29.2%) and 73/222 (32.9%) among patients from the capital and outside counties, respectively (P = 0.387). In 2017/2018, suspected SIRD occurred in 75/193 (38.9%) and 111/164 (67.7%) in patients from the capital and outside counties, respectively (difference: 28.8, 95% CI: 19.0 to 38.9, P

Abstract The sebaceous gland (SG) is involved in different inflammatory, infectious and neoplastic processes of the skin and can be related to specific diseases, e.g., diabetes mellitus. Sometimes, the histological diagnosis requires complementary tests due to the ability of diseases to mimic other tumors. We evaluated the sebaceous gland density in Non-obese diabetic mice to analyze the N-acetylcystein effects and swimming exercise treatment in sebaceous glands healing, using specific staining in histochemistry and immunohistochemistry reactions in the identification of the lipid expression in the sebaceous gland. We investigated the intracytoplasmic lipid expression and analysis of gland density from SG in dorsal skin samples from the Non-obese diabetic (NOD mice) and diabetic animals submitted to antioxidant treatment and physical exercise. For histological analysis of the sebaceous glands, specific staining in histochemistry with sudan black and immunohistochemistry reaction with adipophilin were used in the evaluation. Statistical analysis showed significant proximity between the values of the control group and the diabetic group submitted to the swimming exercise (DS group) and similar values between the untreated diabetic group (UD group) and diabetic group treated with the antioxidant N-acetylcysteine (DNa group), which did not prevent possible differences where p

Natural polymers are increasingly being used in tissue engineering due to their ability to mimic the extracellular matrix and to act as a scaffold for cell growth, as well as their possible combination with other osteogenic factors, such as mesenchymal stem cells (MSCs) derived from dental pulp, in an attempt to enhance bone regeneration during the healing of a bone defect. Therefore, the aim of this study was to analyze the repair of mandibular defects filled with a new collagen/chitosan scaffold, seeded or not with MSCs derived from dental pulp. Twenty-eight rats were submitted to surgery for creation of a defect in the right mandibular ramus and divided into the following groups: G1 (control group; mandibular defect with clot); G2 (defect filled with dental pulp mesenchymal stem cells—DPSCs); G3 (defect filled with collagen/chitosan scaffold); and G4 (collagen/chitosan scaffold seeded with DPSCs). The analysis of the scaffold microstructure showed a homogenous material with an adequate percentage of porosity. Macroscopic and radiological examination of the defect area after 6 weeks post-surgery revealed the absence of complete repair, as well as absence of signs of infection, which could indicate rejection of the implants. Histomorphometric analysis of the mandibular defect area showed that bone formation occurred in a centripetal fashion, starting from the borders and progressing towards the center of the defect in all groups. Lower bone formation was observed in G1 when compared to the other groups and G2 exhibited greater osteoregenerative capacity, followed by G4 and G3. In conclusion, the scaffold used showed osteoconductivity, no foreign body reaction, malleability and ease of manipulation, but did not obtain promising results for association with DPSCs.

Unmanned aerial vehicles (UAVs) equipped with a global real-time kinematic navigation satellite system (GNSS RTK) could be a state-of-the-art solution to measuring gaps in sugarcane fields and enable site-specific management. Recent studies recommend the use of UAVs to map these gaps. However, low-accuracy GNSS provides incomplete or inaccurate photogrammetric reconstructions, which could easily generate an error in the gap measurement and constrain the applicability of these techniques. Therefore, in this study, we evaluated the potential of UAV RTK imagery for mapping gaps in sugarcane. To compare this solution with conventional UAV approaches, the precision and accuracy of RTK and non-RTK flights were evaluated. To increase the robustness of the research, flights were performed to map gaps found naturally in the field and with plants at different stages of development. Our results showed that the lengths of gaps identified by both RTK and non-RTK UAV imagery were similar, with differences in precision and accuracy of about 1% for both systems. In contrast, RTK was much more efficient and provides stakeholders with guidelines for accurate and precise mapping gaps, allowing them to make confident decisions on site-specific management.

Diabetic retinopathy (DR) is a neurodegenerative and vascular pathology that is considered one of the leading causes of blindness worldwide, resulting from complications of advanced diabetes mellitus (DM). Current therapies consist of protocols aiming to alleviate the existing clinical signs associated with microvascular alterations limited to the advanced disease stages. In response to the low resolution and limitations of the DR treatment, there is an urgent need to develop more effective alternative therapies to optimize glycemic, vascular, and neuronal parameters, including the reduction in the cellular damage promoted by inflammation and oxidative stress. Recent evidence has shown that dietary polyphenols reduce oxidative and inflammatory parameters of various diseases by modulating multiple cell signaling pathways and gene expression, contributing to the improvement of several chronic diseases, including metabolic and neurodegenerative diseases. However, despite the growing evidence for the bioactivities of phenolic compounds, there is still a lack of data, especially from human studies, on the therapeutic potential of these substances. This review aims to comprehensively describe and clarify the effects of dietary phenolic compounds on the pathophysiological mechanisms involved in DR, especially those of oxidative and inflammatory nature, through evidence from experimental studies. Finally, the review highlights the potential of dietary phenolic compounds as a prophylactic and therapeutic strategy and the need for further clinical studies approaching the efficacy of these substances in DR management.

Compound odontoma is an odontogenic tumor of ectomesenchymal origin containing tooth-like structures. Occasionally, this lesion may trigger occlusal, phonetic, and aesthetic disorders. The aim is to report a case of a compound odontoma containing 23 denticles in the anterior region of the maxilla of an infant patient. A 12-year-old male patient was referred for orthodontic treatment at Ribeirão Preto School of Dentistry, University of São Paulo (Ribeirão Preto, Brazil) complaining of a large diastema between the upper central incisors. Panoramic radiograph revealed the presence of a radiopaque lesion with tooth-like structures surrounded by a radiolucent rim in the anterior region of the maxilla, associated with distal displacement of the left central incisor. Surgical approach under general anesthesia revealed and extracted 23 denticles. Post-operative Cone beam computed tomography (CBCT) confirmed removal of all denticles, and further orthodontic treatment could be planned. Multidisciplinary involvement of pediatric dentist, oral and maxillofacial surgeon, and orthodontist was essential to achieve full functional, aesthetic, and psychosocial success.