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Abstract This study aimed to evaluate the association between ultra-processed food (UPF) and dental caries, considering muscle mass (MM), bone mineral density (BMD), and oral hygiene habits (OHH) as mediators. This study has an analytical cross-sectional design with 2,515 adolescents (18–19 years). The main exposure – the UPF intake ratio – was established using the food frequency questionnaire. The outcome was the number of decayed teeth, according to the DMFT index. The model adjustment included socio-economic status (SES), frequency of physical activity, and concurrent risk habits (CRH) as potential confounders. Three latent variables were considered: SES (family income, economic class, household head, and adolescent education), OHH (gingival bleeding on probing index and visible plaque index), and CRH (alcohol and tobacco dependence). The analyses used structural equation modeling, estimating the standardized coefficient (SC) in three models: lumbar BMD(1), femoral BMD(2), and total BMD(3). UPF consumption had a direct (SCmodel1=0.071, SCmodel2=0.072, SCmodel3=0.071; p

Abstract Background The Brazilian Policy for Comprehensive Care for People with Rare Diseases was implemented in 2014; however, national epidemiological data on rare diseases (RDs) are scarce and mainly focused on specific disorders. To address this gap, University Hospitals, Reference Services for Neonatal Screening, and Reference Services for Rare Diseases, all of which are public health institutions, established the Brazilian Rare Diseases Network (RARAS) in 2020. The objective of this study was to perform a comprehensive nationwide epidemiological investigation of individuals with RDs in Brazil. This retrospective survey collected data from patients receiving care in 34 healthcare facilities affiliated with RARAS in 2018 and 2019. Results The survey included 12,530 participants with a median age of 15.0 years, with women representing 50.5% of the cohort. Classification according to skin color demonstrated that 5044 (47.4%) participants were admixed. Most had a confirmed diagnosis (63.2%), with a predominance of phenylketonuria (PKU), cystic fibrosis (CF), and acromegaly. Common clinical manifestations included global developmental delay and seizures. The average duration of the diagnostic odyssey was 5.4 years (± 7.9 years). Among the confirmed diagnoses, 52.2% were etiological (biochemical: 42.5%; molecular: 30.9%), while 47.8% were clinical. Prenatal diagnoses accounted for 1.2%. Familial recurrence and consanguinity rates were 21.6% and 6.4%, respectively. Mainstay treatments included drug therapy (55.0%) and rehabilitation (15.6%). The Public Health System funded most diagnoses (84.2%) and treatments (86.7%). Hospitalizations were reported in 44.5% of cases, and the mortality rate was 1.5%, primarily due to motor neuron disease and CF. Conclusion This study marks a pioneering national-level data collection effort for rare diseases in Brazil, offering novel insights to advance the understanding, management, and resource allocation for RDs. It unveils an average diagnostic odyssey of 5.4 years and a higher prevalence of PKU and CF, possibly associated with the specialized services network, which included newborn screening services.

Abstract The oleaginous yeast species Rhodotorula toruloides is a promising candidate for applications in circular bioeconomy due to its ability to efficiently utilize diverse carbon sources being tolerant to cellular stress in bioprocessing. Previous studies including genome-wide analyses of the multi-stress tolerant strain IST536 MM15, derived through adaptive laboratory evolution from a promising IST536 strain for lipid production from sugar beet hydrolysates, suggested the occurrence of significant modifications in the cell wall. In this study, the cell wall integrity and carbohydrate composition of those strains was characterized to gain insights into the physicochemical changes associated to the remarkable multi-stress tolerance phenotype of the evolved strain. Compared to the original strain, the evolved strain exhibited a higher proportion of glucomannans, fucogalactomannans, and chitin relative to (1→4)-linked glucans, and an increased presence of glycoproteins with short glucosamine derived oligosaccharides, which have been found to be associated to ethanol stress tolerance and physical strength of the cell wall. Furthermore, the evolved strain cells were found to be significantly smaller than the original strain and more resistant to thermal and mechanical disruption, consistent with higher proportion of beta-linked polymers instead of glycogen, conferring a more rigid and robust cell wall. These findings provide further insights into the cell wall composition of this basidiomycetous red yeast species and into the alterations occurring in a multi-stress tolerant evolved strain. This new information can guide yeast genome engineering towards more robust strains of biotechnological relevance.

Abstract Pneumococcal surface protein A (PspA) is an important virulence factor in Streptococcus pneumoniae that binds to lactoferrin and protects the bacterium from the bactericidal action of lactoferricins—cationic peptides released upon lactoferrin proteolysis. The present study investigated if PspA can prevent killing by another cationic peptide, indolicidin. PspA-negative pneumococci were more sensitive to indolicidin-induced killing than bacteria expressing PspA, suggesting that PspA prevents the bactericidal action of indolicidin. Similarly, chemical removal of choline-binding proteins increased sensitivity to indolicidin. The absence of capsule and PspA had an additive effect on pneumococcal killing by the AMP. Furthermore, anti-PspA antibodies enhanced the bactericidal effect of indolicidin on pneumococci, while addition of soluble PspA fragments competitively inhibited indolicidin action. Previous in silico analysis suggests a possible interaction between PspA and indolicidin. Thus, we hypothesize that PspA acts by sequestering indolicidin and preventing it from reaching the bacterial membrane. A specific interaction between PspA and indolicidin was demonstrated by mass spectrometry, confirming that PspA can actively bind to the AMP. These results reinforce the vaccine potential of PspA and suggest a possible mechanism of innate immune evasion employed by pneumococci, which involves binding to cationic peptides and hindering their ability to damage the bacterial membranes.

Abstract Humans exhibit consistent color preferences that are often described as a curvilinear pattern across hues. The recent literature posits that color preference is linked to the preference for objects or other entities associated with those colors. However, many studies examine this preference using isoluminant colors, which don’t reflect the natural viewing experience typically influenced by different light intensities. The inclusion of random luminance levels (luminance noise) in chromatic stimuli may provide an initial step towards assessing color preference as it is presented in the real world. Employing mosaic stimuli, this study aimed to evaluate the influence of luminance noise on human color preference. Thirty normal trichromats engaged in a two-alternative forced-choice paradigm, indicating their color preferences between presented pairs. The chromatic stimuli included saturated versions of 8 standard hues, presented in mosaics with varying diameters under different luminance noise conditions. Results indicated that the inclusion of luminance noise increased color preference across all hues, specifically under the high luminance noise range, while the curvilinear pattern remained unchanged. Finally, women exhibit a greater sensitivity to the presence of luminance noise than men, potentially due to differences between men and women in aesthetic evaluation strategies.

Abstract Background Transthyretin amyloidosis (ATTR) is a multisystem disease caused by the deposition of fibrillar protein in organs and tissues. ATTR genotypes and phenotypes are highly heterogeneous. We present data on physical signs and symptoms, cardiac and neurological assessments and genetic profile of patients enrolled in the Transthyretin Cardiac Amyloidosis Registry of the State of São Paulo, Brazil. Results Six hundred-forty-four patients were enrolled, 505 with the variant form (ATTRv) and 139 with wild-type (ATTRwt). Eleven different mutations were detected, the most common being Val50Met (47.5%) and V142Ile (39.2%). Overall, more than half of the patients presented cardiac involvement, and the difference in this proportion between the ATTRv and ATTRwt groups was significant (43.9 vs. 89.9%; p

Abstract Extra-pulmonary TB (EPTB) is difficult to diagnose due to paucibacillary nature of disease. Current study evaluated accuracy of Truenat MTB and MTB-Rif Dx (TN), for detection of Mycobacterium tuberculosis and resistance to rifampicin. Samples were collected from 2103 treatment naive adults with presumptive EPTB, and tested by smear microscopy, liquid culture (LC) (MGIT-960) and GeneXpert MTB/RIF (GX) (Microbiological Reference Standards, MRS). TN results were compared to MRS and Composite Reference Standards (CRS, Microbiology, histopathology, radiology, clinical features prompting decision to treat, response to treatment). CRS grouped patients into 551 confirmed, 1096 unconfirmed, and 409 as unlikely TB. TN sensitivity and specificity was 73.7% and 90.4% against GX. Against LC, Overall sensitivity of GX was 67.6%, while that of TN was 62.3%. Highest sensitivity by TN was observed in pus samples (89%) and highest specificity (92%) in CSF samples, similar to GX. TN sensitivity was better in fluid and biopsy samples and slightly inferior for lymph node aspirates compared to GX. TN sensitivity for RIF resistance detection was slightly superior to GX. TN and GX results were further compared to Clinical Reference Standards. TN detected 170 TB patients initiated on treatment missed by GX, while GX detected 113 such patients missed by TN. Of 124 samples with RIF resistance discordance between GX and TN, GX reported 103/124 as sensitive, 3/124 as indeterminate and 18 as resistant (13/18 samples had low/very low DNA load) while TN reported RIF resistance indeterminate in 103/111 low/very low DNA load samples. Due to paucibacillary nature of EPTB samples, culture yield was poor and phenotypic drug susceptibility testing failed to resolve the discordance. The study establishes TN at par with GX and can be utilized for quick and accurate diagnosis of EPTB.

Abstract Background Given the health and social needs generated by the COVID-19 pandemic, the Telehealth Network of Minas Gerais, Brazil, implemented a teleconsultation and telemonitoring program to assist patients with suspected or confirmed COVID-19, the TeleCOVID-MG program. The telemonitoring service was conducted by medical students, under the supervision of a physician. The main goal of this study was to analyze the experience of the students while collaborating on the aforementioned telemonitoring program. Methods A questionnaire with 27 questions was developed to address the participation of the students in the telehealth program. The questionnaire included questions about the student’s profile, the system usability, and the satisfaction in participating in such a telehealth program. The questionnaire was generated on Google Forms® platform and sent via email to each student who was part of the telemonitoring team. Results Sixty students were included in the analysis (median age 25 years-old [interquartile range 24–26], 70% women). Of those, 61.6% collaborated on the telehealth program for more than 6 months, 65.1% performed more than 100 telemonitoring calls, 95.2% reported difficulties in contacting the patient through phone calls; 60.3% believe some patients might have felt insecure about being approached by medical students and not by graduate professionals; and 39.6% reported eventual system instabilities. The main strengths reported by the students were related to the system usability and to the self-perception of the quality of healthcare delivered to the patients. Even though 68.3% of the students mentioned technical difficulties, 96.6% reported that they were promptly solved. Finally, 98.3% believed that the program was useful and would recommend it to an acquaintance. Conclusion This study reports a successful experience of undergraduate medical students in a COVID-19 telemonitoring program. Overall, the medical students were satisfied with their participation, especially considering the continuity of clinical practice remotely during a period of classes suspension during the COVID-19 pandemic and their important role in the assistance of patients from low-income regions, which has minimized the health system burden in an emergency context.

Introduction: Approximately 5 to 10% of women of reproductive age suffer from the prevalent endocrine illness known as Polycystic Ovarian Syndrome (PCOS). Copeptin, irrespective of age and weight, has been found to have significant associations with cardiometabolic parameters. Studies on the diagnostic and prognostic significance of copeptin and its correlation with components of metabolic syndrome in PCOS are scarce, particularly in the Indian context. Aim: To assess the utility of copeptin as a diagnostic marker of PCOS and to evaluate the correlation of serum copeptin levels with metabolic syndrome components in women with PCOS. Materials and Methods: This cross-sectional analytical study was conducted at Father Muller Medical College Hospital, Mangalore, Karnataka, India, from June 2022 to September 2023. A total of 60 subjects with PCOS were selected through convenient sampling and divided into two groups: Group 1-subjects with PCOS having metabolic syndrome, and Group 2-subjects with PCOS but not having metabolic syndrome. Blood samples for serum copeptin were taken under aseptic precautions, and levels were analysed using a commercially available Enzyme-Linked Immunosorbent Assay (ELISA) kit (Biovendor, USA) following the manufacturers’ instructions. The copeptin ELISA kit had an assay range of 0-100 pmol/L and results were expressed in ng/mL. Serum insulin levels were measured using specific Electro-chemiluminescence immunoassays. Levels of total cholesterol, High-Density Lipoprotein Cholesterol (HDL-C), and Triglycerides (TG) were determined with enzymatic colorimetric assays by spectrophotometry. Low-Density Lipoprotein Cholesterol (LDL-C) was calculated using the Friedewald formula. Insulin resistance was calculated using the Homeostasis Model Assessment Insulin Resistance Index (HOMA-IR). Statistical analysis was done by using descriptive statistics. A comparison was done by student’s unpaired t-test. The chi-square test and Pearson correlation test were used for categorical data. The Statistical Package for Social Sciences (SPSS) version 24.0 was used for analysis. Results: The mean age of the study participants was 24.24±4.721 years, ranging from 15 to 43 years. The mean age of patients with metabolic syndrome was 23.96±6.3 years, while those without metabolic syndrome was 24.40±3.52 years. The mean Body Mass Index (BMI) was 31.17±5.38 in those with metabolic syndrome and 23.2±4.7 in those without (p=0.0001). The Waist-to-Hip Ratio (WHR) of Group 1 was significantly higher than Group 2 (p=0.001). The two groups did not differ significantly with regard to serum copeptin level, i.e., 7.386±4.58 in Group 1 and 8.66±6.03 in Group 2 (p=0.736). Serum copeptin levels showed a significant correlation with fasting serum insulin (0.006) and Homeostatic Model Assessment - Insulin Resistance (HOMA-IR) (0.012). Conclusion: Serum copeptin cannot be used as an independent marker for the diagnosis of metabolic syndrome in PCOS patients but may indicate other prognostic factors.

Few cases of hantavirus pulmonary syndrome have been reported in northeastern Argentina. However, neighboring areas show a higher incidence, suggesting underreporting. We evaluated the presence of antibodies against orthohantavirus in small rodents throughout Misiones province. Infected Akodon affinis montensis and Oligoryzomys nigripes native rodents were found in protected areas of Misiones.

Inflammatory bowel disease (IBD), comprising ulcerative colitis (UC) and Crohn’s disease (CD), is a global health problem with a worldwide increase in incidence. While previously it was more prevalent in Western countries, especially in North America and Europe, there has been a recent sizeable increase in the incidence of IBD in Asia. This article is a brief overview of the causative factors that contribute to this rise in IBD cases in Asian countries. There is a notable disparity between the Asian IBD population and the Western one in terms of age distribution and gender predilection, and genetic studies reveal both shared and unique susceptibility loci. Changes in environmental factors, including alterations in diet, hygiene, and lifestyle, are thought to play a key role in the epidemiological transition observed in Asia. It is crucial to comprehend how genetic predisposition interacts with environmental factors in order to understand the causes of IBD in the Asian population and develop precise interventions to alleviate its impact.

INTRODUCTION: Due to their relative rarity, the natural history of iliac artery aneurysms and treatment outcomes are poorly understood. However, IAA treatment has evolved, and nowadays, there are a variety of open surgery, endovascular therapy, and hybrid options. This study aimed to compare the outcomes of endovascular treatment versus open surgery for patients with iliac artery aneurysms. METHODS: A systematic review was performed according to the PRISMA statement. An online search was conducted using the Medline database from January 2014 to January 31st, 2023. Only original articles in English or Portuguese, reporting on a minimum of 5 cases, were considered. Studies were included if reporting at least one of the following outcomes: peri-operative complications, length of stay (LS), and 30-day mortality. The software Review Manager 5.4 was used for data analysis. RESULTS: The database search identified 418 articles, of which 413 records were excluded by screening by title/ abstract, and five were read in full and subsequently included. A total of 1837 patients were included. Open surgery was performed in 29.02% (442/1523) and endovascular in 70.58% (1075/1523). More than half of endovascular cases included internal iliac artery preservation techniques (iliac branch design grafts). Patients undergoing endovascular treatment were significantly older (mean difference [MD]: 5.49, 95% confidence interval [CI]: 2.34 to 8.65) and more likely to have congestive heart failure (odd ratio [OR]: 3.74, 95% CI: 1.24-11.27). On the other hand, patients undergoing open surgery were more often smokers (OR: 0.59, 95% CI: 0.42-0.82). The primary outcome - 30-day mortality - was significantly higher for open surgery (OR 0.34, 95% CI 0.19-0.61). Considering other peri-operative outcomes, patients undergoing open surgery presented with longer length of hospital stay (MD: -4.68, 95% CI: -6.43 to -2.92), higher risk of surgical wound infection (OR: 0.31, 95% CI: 0.10- 0.94), renal failure (OR: 0.37, 95% CI: 0.18-0.75) and respiratory infection (OR: 0.19, 95% CI: 0.11-0.33). No significant differences regarding buttock claudication and leg and bowel ischemia were found. The 30-day reintervention rates weren ́t significantly different for open and endovascular surgery (OR 0.83, 95% CI 0.33-2.1). CONCLUSION: Endovascular treatment of iliac artery aneurysms can reduce 30-day mortality, peri-operative complications and length of hospitalization. No differences were identified regarding 30-day reintervention rates. Consequently, endovascular treatment has gained preference over open surgery as the initial approach for patients with suitable anatomy. No other meta-analysis in the literature compares the results of open surgery and endovascular treatment, particularly the results of new endovascular techniques (iliac branch design grafts). Comparing long-term reintervention rates will be essential in the future.

Laboratorial diagnosis of tegumentary leishmaniasis (TL) is hampered by variable sensitivity and/or specificity of the tests, which are still hampered by blood́ invasive collection. In this context, in the present study, we develop a serum- and urine-based ELISA to TL diagnoses. A recombinant protein (rLiHyA), which was previously showed to be antigenic for the disease, as well as a B-cell epitope produced as synthetic peptide and a Leishmania antigenic extract (SLA), were used as antigens. A total of paired 205 urine and serum samples were used, which were comprised by samples from cutaneous (n = 30) and mucosal (n = 30) leishmaniasis patients, as well as from healthy individuals living in endemic region of disease (n = 45), of patients with Chagas disease (n = 30), leprosy (n = 35), malaria (n = 15) or HIV-infected (n = 20). Results showed that serum-based ELISA presented sensitivity of 24.0 %, 100 % and 41.0 %, when SLA, rLiHyA and synthetic peptide were used as antigens, and specificity of 98.4 %, 98.4 % and 98.4 %, respectively. The area under the curve (AUC) was calculated and results were 0.74, 1.0, and 0.71, respectively, when SLA, rLiHyA and synthetic peptide were used as antigens. Performing an urine-based ELISA, sensitivity was 28.0 %, 100 % and 75.0 %, respectively, when SLA, rLiHyA, and synthetic peptide were used, while specificity values were of 98.4 %, 98.4 % and 98.4 %, respectively. In addition, the AUC values were 0.82, 1.0, and 0.94, respectively. A significant drop in specific antibodies levels in both patientś serum and urine samples was found six months after treatment, suggesting a prognostic role of rLiHyA for TL. In conclusion, preliminary data suggest the potential of use patient urine to TL diagnoses.

ABSTRACT Objective: To evaluate the knowledge and practices of gynecologists, obstetricians, and family and community physicians in Brazil regarding breast cancer screening, mammographic findings defined by the BIRADS™ system, and their approach to suspected clinical lesions. Methods: This was an observational, cross-sectional, descriptive study conducted using an online research questionnaire distributed via email to 9,000 gynecologists and obstetricians and 5,600 family and community and preventive medicine doctors actively practicing in Brazil. Results: Among gynecologists and obstetricians, 42.8% follow the 40-74 years screening, 33.5% follow the 50-69 years screening, and 23.6% do not follow any specific protocol. Among the family and community physicians, 76.6% follow the 50-69 years screening protocol, and 23.4% do not follow any specific protocol. When we evaluated the responses regarding the behaviors of each BIRADS™ classification, 46.3% of responses were wrong among gynecologists and obstetricians, and 77.9% were wrong among community and preventive medicine doctors, exhibiting a significant difference. The role of breast ultrasound in screening was evaluated; 39.1% of gynecologists and obstetricians and 20.3% of community and preventive medicine doctors consider it as a screening method. Among gynecologists and obstetricians who do not follow any screening protocol, 94.7% consider ultrasound as a screening method. Among community and preventive medicine doctors, only 26.5% of physicians who follow the 50-69 years screening method consider it as a screening method. Conclusion: Inadequate training results in gynecologists and obstetricians, and family and community physicians performing inadequate screening and not following the recommended practices outlined in the BIRADS™ system.

Immune checkpoint inhibitor and tyrosine kinase inhibitor combinations have become the new standard of care in the first-line treatment of metastatic clear cell renal cell carcinoma. However, there is a growing concern regarding severe immune-related adverse events. A 78-year-old man with metastatic clear cell renal cell carcinoma, treated with pembrolizumab and axitinib, was admitted to the emergency department 30 days after initiating treatment due to rapidly progressive myositis. Myocarditis with severe ventricular dysfunction was identified. Muscular biopsy findings were compatible with inflammatory myopathy associated with immune checkpoint inhibitors. Initial treatment with high-dose corticosteroids showed an insufficient response. Therapeutic escalation on the third day with methylprednisolone, immunoglobulin, and abatacept resulted in clinical improvement. On the eleventh day, a sudden malignant arrhythmia occurred, followed by cardiac arrest. This represents one of the first case reports describing myocarditis and myositis during treatment with pembrolizumab-axitinib. While immune checkpoint inhibitor may play a major role, it is also possible that the tyrosine kinase inhibitor, while attempting to promote immune modulation, also increases severe toxicities.

Objective: Multicomponent physical training, carried out via tele-exercise, can contribute to a healthier lifestyle in the elderly. The objective is to present the intervention protocol of the “Idoso Ativo” (Active Older Adult) program via tele-exercise, synchronously and asynchronously. Method: This is a randomized clinical trial with two groups performing tele-exercise. Participant recruitment will be done via digital platforms, social media pages and printed leaflets distributed in the different regions of Distrito Federal. Both groups will perform exercises three times a week, lasting 50 min, and the intervention period will be 12 weeks. Discussion: The hypothesis is that the multicomponent exercise program offered online will provide improvements in muscular strength, balance and mobility in both groups. A higher adherence rate is expected in relation to the asynchronous group, and it is believed that the positive effects on physical health, minimizing the negative outcomes caused by inactivity, are present in participants in both groups.

Introduction Bruxism is characterised by a repetitive activity in the masticatory muscles that involves teeth clenching or grinding and/or forceful mandibular movements. Its management is typically initiated when individuals start experiencing the adverse effects of the condition. One of the available intervention forms is the administration of botulinum toxin type A (BoNT-A). Numerous systematic reviews have addressed the use of BoNT-A to manage bruxism; however, the results are controversial. The current overview aims to determine BoNT-A’s effectiveness for managing bruxism in relation to placebo, the absence of treatment or alternative interventions in the adult population.Methods and analysis This study will include systematic reviews (SRs), with or without meta-analysis, aiming to evaluate the efficacy of BoNT-A for bruxism in adults. A broad literature search will be carried out on Cochrane Library, EMBASE, LILACS, Livivo, PubMed/MEDLINE, Scopus, Web of Science and the grey literature. Experts in the topic and reference lists of included SRs will also be consulted. The study selection will be conducted in two phases by two independent reviewers. Data collection will be performed by one author and cross-checked by another. The methodological quality of included SRs will be evaluated using AMSTAR-II. A narrative synthesis will be employed as the formal method to combine individual study data. The overlap across studies will be quantified by the corrected covered area and illustrated by the Graphical Representation of Overlap for Overviews.Ethics and dissemination This overview does not require ethics approval, as it uses secondary data from previously published studies. The results will be disseminated through the publication in a high-impact journal.OSF of registration DOI: 10.17605/OSF.IO/RB45T.

Ageism encompasses the creation of negative stereotypes of aging that culminate in the development of prejudicial thoughts and discriminatory actions against people in advanced age. Stereotypes refer to major characteristics, overgeneralized, not supported by observations, that are created to categorize, simplify, and combine complex characteristics, attributes, and behaviors shared by members of a group into more simplistic categories. Negative aging stereotypes include the assumption that old people are weak, reminiscent, sick, and tired, to quote a few. In early age, these views may generate intergenerational conflicts between young and old people, but they seem to have little effect on other aspects of life. However, in middle-aged and older adults, the presence of negative-self stereotypes of aging are significantly associated with several health parameters, including walking speed, cognitive function, mental health problems, and accumulation of amyloid plaques and neurofibrillary tangles. Furthermore, observational studies found that ageism might be associated with cardiovascular events, obesity, dementia, and death. These harmful effects are possibly mediated by the interaction between ageism and fundamental mechanisms of aging, mainly inflammation. Given the clinical implications of this relationship, the present manuscript provides a critical review of the available literature that examined associations between ageism and health parameters. We also discuss the main possible mechanisms underlying this association, the main limitations of the current literature, candidate strategies to counteract ageism, and directions to future studies. Finally, we provide a critical opinion of the current scenario and its potential adaptability to the clinical practice.

ABSTRACT Objective Determining the etiology of hyperprolactinemia is fundamental for selecting the most appropriate treatment strategy. The aim of this study was to evaluate the usefulness and accuracy of prolactin levels in predicting the etiology of nonphysiological hyperprolactinemia. Subjects and methods In this retrospective study, we reviewed medical records of patients with nonphysiological hyperprolactinemia seen at two neuroendocrine reference centers located in Recife, Brazil, from January 2000 to December 2019. Results The study included 770 patients aged 12-73 years (65% female). The three most frequent etiologies of hyperprolactinemia were prolactinomas (n = 263; 34.2%), drug-induced hyperprolactinemia (n = 160; 20.8%), and macroprolactinemia (n = 120; 15.6%). The highest mean prolactin levels were observed in cases of prolactinomas and idiopathic hyperprolactinemia. Most patients with hyperprolactinemia due to other etiologies had prolactin levels < 100 ng/mL, but these levels were also found in 16.5% of patients with microproplactinomas and in 20% of those with idiopathic hyperprolactinemia. Likewise, prolactin levels largely overlapped among patients with microprolactinomas, macroprolactinemia, and drug-induced hyperprolactinemia. Notably, prolactin levels > 250 ng/mL enabled a clear distinction between the etiologies of macroprolactinoma and nonfunctioning pituitary adenoma. Moreover, prolactin levels > 500 ng/mL were highly suggestive of macroprolactinomas, although they were also found in very few patients ( 250 ng/mL allowed a clear distinction between macroprolactinomas and nonfunctioning pituitary adenomas. Furthermore, prolactin levels > 500 ng/mL were almost exclusively found in patients with prolactinomas.

Enquadramento: Os enfermeiros na urgência desempenham um papel fundamental na investigação de crimes, colaborando com os órgãos de Polícia Criminal na colheita de evidências forenses. Esta responsabilidade exige conhecimentos, técnicas e equipamentos adequados. A articulação entre os cuidados de saúde e o sistema jurídico processual, previne a destruição desnecessária de provas, melhorando os resultados na investigação. Objetivo: Construir um protocolo de intervenções de recolha e preservação de vestígios forenses para o serviço de urgência; validar o conteúdo do referido protocolo. Metodologia: Estudo metodológico quantitativo com abordagem descritiva, com recurso à Técnica Delphi realizado com 24 peritos (sete enfermeiros, dois elementos da Guarda Nacional Republicana, seis pertencentes à Polícia Judiciária e nove elementos da Polícia de Segurança Pública). Para a validade de conteúdo utilizou-se o índice de validade de conteúdo = 0,75. Resultados: Após a segunda ronda determinou-se um índice de validade de conteúdo de 0,89, para os 19 itens do protocolo. Conclusão: O protocolo foi considerado um instrumento essencial para melhorar a recolha e preservação de vestígios na urgência.

Background Neutrophils are essential in the early innate immune response to pathogens. Harnessing their antimicrobial powers, without driving excessive and damaging inflammatory responses, represents an attractive therapeutic possibility. The neutrophil population is increasingly recognised to be more diverse and malleable than was previously appreciated. Hypoxic signalling pathways are known to regulate important neutrophil behaviours and, as such, are potential therapeutic targets for regulating neutrophil antimicrobial and inflammatory responses. Methods We used a combination of in vivo and ex vivo models, utilising neutrophil and myeloid specific PHD1 or PHD3 deficient mouse lines to investigate the roles of oxygen sensing prolyl hydroxylase enzymes in the regulation of neutrophilic inflammation and immunity. Mass spectrometry and Seahorse metabolic flux assays were used to analyse the role of metabolic shifts in driving the downstream phenotypes. Results We found that PHD1 deficiency drives alterations in neutrophil metabolism and recruitment, in an oxygen dependent fashion. Despite this, PHD1 deficiency did not significantly alter ex vivo neutrophil phenotypes or in vivo outcomes in mouse models of inflammation. Conversely, PHD3 deficiency was found to enhance neutrophil antibacterial properties without excessive inflammatory responses. This was not linked to changes in the abundance of core metabolites but was associated with increased oxygen consumption and increased mitochondrial reactive oxygen species (mROS) production. Conclusions PHD3 deficiency drives a favourable neutrophil phenotype in infection and, as such, is an important potential therapeutic target.

Enquadramento: O acolhimento é uma estratégia de cuidado às crianças em situação de maus-tratos, pois compreende a organização de um espaço físico, equipa qualificada, fluxo de notificação e atendimento sensível pelos profissionais de saúde. Objetivo: Descrever o conhecimento e a prática dos profissionais de saúde no atendimento de crianças em situação de maus-tratos sob a ótica do acolhimento. Metodologia: Pesquisa qualitativa, descritiva, de caráter exploratório. A colheita foi realizada por entrevista não diretiva individual no ambiente hospitalar. Utilizou-se análise temática. Resultados: Participaram 23 profissionais de saúde. O sexo feminino foi o predominante e 17 participantes não possuíam curso de capacitação. O acolhimento foi apontado no modo de falar, agir e na rotina de cuidado. Conclusão: O conhecimento dos profissionais de saúde foi desenvolvido na prática profissional pelo tempo de formação e pelo cuidado sensível. A capacitação deficiente interfere na identificação de crianças e adolescentes em situação maus-tratos. Crianças menores são mais vulneráveis e podem sofrer negligência. O acolhimento precisa ser articulado com outras esferas com fluxo de atendimento conhecido

Charcot arthropathy of the shoulder caused by syringomyelia is a unusual degenerative disorder, frequently misdiagnosed and with few cases described in the literature. The diagnosis is made by clinical evaluation and radiological examinations with radiography and magnetic resonance imaging. However, the correct diagnosis and treatment is possible by carefully medical evaluation and can improve patient symptoms. Therefore, this study aimed to report two cases of Charcot arthropathy caused by syringomyelia. After achieving correct neurosurgical evaluation and magnetic resonance imaging, the diagnosis was made. The first case is a 53-year-old man with a click on his right shoulder for at least 12 months, associated with local edema, pain and limitation of joint range of motion. The second is a 45-year-old man with pain in the right upper limb and difficulty moving the joint for at least 24 months, associated with progressive worsening of the collection and edema in the ipsilateral upper limb. Posterior fossa decompression was performed, with symptoms relief after surgery. Posterior fossa decompression is a treatment that seems to be effective in reducing symptoms, especially when the diagnosis is early. However, this type of treatment still remains controversial, requiring further studies.

With an ageing global population, healthcare systems confront challenges unique to the elderly. Current care models primarily manage health–illness shifts but frequently miss developmental transitions, particularly for older adults. Meleis’s transition theory offers an underutilized framework to rejuvenate our gerontogeriatric nursing approach. This article aims to articulate and advocate the value of Meleis’s transition theory as a framework for gerontogeriatric nursing, focusing on developmental transitions, thereby seeking a transformative change in the quality of elderly care. The article delves into Meleis’s transition theory’s vital components—transition types, conditions, and nursing therapeutics. It explores how these can be a multifaceted guide for gauging and overseeing ageing’s developmental shifts; adopting this theoretical perspective deepens our comprehension and bears tangible implications. Nurses versed in this theory could appreciate the benefits of a nuanced approach to the elderly, distinguishing it from the conventional biomedical stance. As the demands of an ageing populace grow, the integration of Meleis’s transition theory into nursing practices is not merely beneficial but imperative, setting a new standard for comprehensive and specialized elderly care.

Abstract The aim of this study was to evaluate the mediation role of muscle quantity in the relationship between physical fitness and cardiometabolic risk factors (CMRF) in adolescents. This cross-sectional study conducted with 120 adolescents of both sexes, aged between 10 and 17 years. Body mass, height, fat mass (FM), lean mass, blood pressure, high-density lipoprotein, low-density lipoprotein, triglycerides, glucose, insulin, cardiorespiratory fitness (CRF) and 1 repetition maximum strength (1-RM) with evaluation of the leg press 45° (RM-leg), bench press (RM-bench) and arm curl (RM-arm). Body mass index z-score, appendicular skeletal muscle mass, appendicular skeletal muscle mass index, lean mass index (LMI), muscle-to-fat ratio (MFR), age at peak height velocity, and CMRF z-score were calculated. The direct relation between FM and CMRF was mediated by the LMI (26%) and inverse relation between CRF and CMRF was mediated by the LMI (26%). For girls, the direct relation between FM and CMRF was mediated by the LMI (32%); the inverse relation between CRF, RM-leg, RM-arm and CMRF was mediated by the LMI (32%, 33%, and 32%, respective). For boys, the indirect effect was not significant, indicating that LMI is not a mediator in the relation between FM, CRF, 1-RM with CMRF. The direct relation between RM-leg and CMRF was mediated by the MRF (16%). This finding evidenced the importance of promoting a healthy lifestyle to improve physical fitness levels and the quantity of muscle mass in adolescents.

Healthcare workers often have irregular work schedules and experience significant stress, which can lead to poor sleep quality and frequent mental health issues, especially in the context of the COVID-19 pandemic. In this cross-sectional study, we aimed to assess the prevalence of poor sleep hygiene and mental health complaints among healthcare workers and examine their associations. We investigated participants’ typical sleep–wake patterns on workdays and free days as indicators of sleep hygiene. Sleep efficiency and social jetlag were calculated as the ratio of mean sleep duration to time spent in bed, while sleep rebound was defined as the difference in mean sleep duration between workdays and free days. Social jetlag was determined as the difference in mid-sleep timing between workdays and free days, with mid-sleep defined as the midpoint between bedtime and wake-up time. Insomnia severity was assessed using the Insomnia Severity Index (ISI), daytime sleepiness using the Epworth Sleepiness Scale (ESS), and symptoms of anxiety and depression using the Patient Health Questionnaire 4 (PHQ-4). Fatigue was measured using a single item inspired by the Maslach Burnout Inventory (MBI). A total of 1562 participants (80.5% women, mean age 40.0 years) were included in the study. The results revealed that 25.9% of participants slept less than 6 h, 24.3% had a sleep efficiency of less than 85%, 27.3% experienced a sleep rebound of more than 2 h, and 11.5% reported a social jetlag exceeding 2 h. Additionally, 33.9% of participants reported insomnia, 45.1% reported excessive daytime sleepiness, 13.1% reported fatigue, 16.5% reported symptoms of depression, and 35.7% reported symptoms of anxiety. After adjustment, mean sleep duration and sleep efficiency were associated with most mental health complaints. Sleep rebound and social jetlag were associated with significant insomnia but not with anxiety or depression symptoms. Our findings underscore the high prevalence of poor sleep hygiene and mental health complaints among healthcare workers, exacerbated by the COVID-19 crisis. We advocate for the promotion of sleep health through behavioral sleep strategies to safeguard the well-being of healthcare professionals.

Abstract To evaluate association of vitamin D with sleep quality in adults and the influence of VDR-gene polymorphism FokI (rs2228570;A > G). Cross-sectional population-based study in adults, conducted in Brazil. The outcome was sleep-quality, evaluated by the Pittsburgh Sleep Quality Index. Vitamin D was determined by indirect electrochemiluminescence and classified as deficiency (VDD), 25(OH)D

Abstract The present study aimed at evaluating the YF-specific neutralizing antibody profile besides a multiparametric analysis of phenotypic/functional features of cell-mediated response elicited by the 1/5 fractional dose of 17DD-YF vaccine, administered as a single subcutaneous injection. The immunological parameters of each volunteer was monitored at two time points, referred as: before (Day 0) [Non-Vaccinated, NV(D0)] and after vaccination (Day 30–45) [Primary Vaccinees, PV(D30–45)]. Data demonstrated high levels of neutralizing antibodies for PV(D30–45) leading to a seropositivity rate of 93%. A broad increase of systemic soluble mediators with a mixed profile was also observed for PV(D30–45), with IFN-γ and TNF-α presenting the highest baseline fold changes. Integrative network mapping of soluble mediators showed increased correlation numbers in PV(D30–45) as compared to NV(D0) (532vs398). Moreover, PV(D30–45) exhibited increased levels of Terminal Effector (CD45RA+CCR7−) CD4+ and CD8+ T-cells and Non-Classical memory B-cells (IgD+CD27+). Dimensionality reduction of Mass Cytometry data further support these findings. A polyfunctional cytokine profile (TNF-α/IFN-γ/IL-10/IL-17/IL-2) of T and B-cells was observed upon in vitro antigen recall. Mapping and kinetics timeline of soluble mediator signatures for PV(D30–45) further confirmed the polyfunctional profile upon long-term in vitro culture, mediated by increased levels of IFN-γ and TNF-α along with decreased production of IL-10. These findings suggest novel insights of correlates of protection elicited by the 1/5 fractional dose of 17DD-YF vaccine.

Abstract Bats are efficient reservoirs of a number of viruses with zoonotic potential, and are involved directly in the transmission cycle of many zoonoses. In the present study, which is part of a larger project that is documenting the viromes of the bat species found in the Mid-North states of Maranhão and Piauí, we analyzed 16 pooled samples obtained from four species of bat of the genus Artibeus—Artibeus obscurus, Artibeus cinereus, Artibeus lituratus and Artibeus planirostris. We describe and identify a Hepatovirus, denominated Hepatovirus H isolate sotense, which was found in a pool of internal organs (liver and lungs) extracted from a specimen of A. planirostris, a frugivorous bat, collected in the Cerrado biome of Maranhão state. This material was analyzed using new generation sequencing, which produced a contig of 7390 nucleotides and presented a degree of identity with a number of existing Hepatovirus sequences available for bats (amino acid identity of 61.5% with Bat hepatovirus C of Miniopterus cf. manavi, 66.6% with Bat hepatovirus G of Coleura afra, 67.4% with Hepatovirus G2 of Rhinolophus landeri, and 75.3% with Hepatovirus H2 of Rhinolophus landeri). The analysis of the functional domains of this contig confirmed a pattern consistent with the characteristics of the genus Hepatovirus (Picornaviridae). In the phylogenetic tree with several other Hepatovirus species, this genome also grouped in a monophyletic clade with Hepatovirus H (HepV-H1; HepV-H2, and HepV-H3) albeit on an external branch, which suggests that it may be a distinct genotype within this species. This is the first isolate of Hepatovirus H identified in bats from South America, and represents an important discovery, given that most studies of viruses associated with bats in the state of Maranhão have focused on the family Rhabdoviridae.

Abstract The aim of this study was to assess the effects of substituting traditional forage fiber sources with cottonseed cake in the diet on both the quantitative and qualitative characteristics of carcass and meat in Nelore young bulls. Twenty-four Nelore steers starting with an average weight of 377.8 ± 43.5 kg, were individually housed in stalls and provided with individualized feeding over a 112-day confinement period. The study followed a completely randomized design with two treatments and 12 replications. The diets incorporated either whole plant corn silage (WPCS) and, cottonseed cake (CSC) as fiber sources, at a rate of 300 g/kg of dry matter. The CSC diet promoted higher carcass weight. Aging animal meat for seven days significantly decreased the shear force from 83.4 to 71.6 N. Although diets did not influence meat composition, WPCS diet provided higher concentrations of C16:1, C18:1n9c, C18:3n3, and C22:2 acid, and CSC diet higher concentrations of C15:0, C18:1n9t, C18:2n6c, and 20:3n3. The WPCS diet provided higher concentrations of monounsaturated fatty acids and ω9, and the CSC diet had higher concentrations of ω6 and ω6:ω3 ratio in meat. Cottonseed cake used as a fiber source increases the concentration of polyunsaturated fatty acids and ω6 fatty acids in the meat of young bulls finished in feedlot.

Abstract Maneuvering a spacecraft in the cislunar space is a complex problem, since it is highly perturbed by the gravitational influence of both the Earth and the Moon, and possibly also the Sun. Trajectories minimizing the needed fuel are generally preferred in order to decrease the mass of the payload. A classical method to constrain maneuvers is mathematically modeling them using the Two Point Boundary Value Problem (TPBVP), defining spacecraft positions at the start and end of the trajectory. Solutions to this problem can then be obtained with optimization techniques like the nonlinear least squares conjugated with the Theory of Functional Connections (TFC) to embed the constraints, which recently became an effective method for deducing orbit transfers. In this paper, we propose a tangential velocity (TV) type of constraints to design orbital maneuvers. We show that the technique presented in this paper can be used to transfer a spacecraft (e.g. from the Earth to the Moon) and perform gravity assist maneuvers (e.g. a swing-by with the Moon). In comparison with the TPBVP, solving the TV constraints via TFC offers several advantages, leading to a significant reduction in computational time. Hence, it proves to be an efficient technique to design these maneuvers.

Abstract Mental disorders are intricate and multifaceted and encompass social, economic, environmental, and biological factors. This study aimed to explore the potential association between vitamin D deficiency and anxiety and depression symptoms in adults, considering the role of the vitamin D receptor gene polymorphism FokI (rs2228570). This was a population-based cross-sectional study with stratified and cluster sampling, evaluating anxiety symptoms (AS) and depression symptoms (DS) in 1637 adults. Vitamin D levels were measured using electrochemiluminescence and were considered deficient when

Abstract Bats play an essential role in maintaining ecosystems. Their unique characteristics increase the likelihood of interactions with various species, making them a potential source for the emergence and spread of infectious diseases. Hantaviruses are continuously expanding their range of hosts. This study presents the identification of a partial genome associated with Hantavirus in samples collected from neotropical bats. We conducted a metagenomic study using samples from Carollia perspicillata in Maranhão, Brazil. Tissue fragments were used for RNA extraction and subsequent sequencing. The resulting data was subjected to bioinformatic analysis. A sequence showing an identity of 72.86% with the L gene in the reference genome was obtained. The phylogenetic analysis revealed the study sequence, denoted as Buritiense, clustering within the Mobatvirus clade. The intragroup analysis showed a broader dispersion and were markedly asymmetric. This observation suggests the possibility that Buritiense could potentially represent a new species within the bat-borne hantaviruses, but further analyses are needed to provide additional insights if bats plays a role as reservoirs and the potential for transmission to human populations.

Abstract Dietary supplementation with triglyceride tributyrin (TBT), a butyrate precursor, has been associated with beneficial effects on fish health and improvements in the ability of carnivorous fish to tolerate higher levels of plant-based protein. In this study, we aimed to investigate the effects of a plant-based diet supplemented with TBT on the structural diversity and putative function of the digesta-associated bacterial communities of rainbow trout (Oncorhynchus mykiss). In addition to this, we also assessed the response of fish gut digestive enzyme activities and chyme metabolic profile in response to TBT supplementation. Our results indicated that TBT had no significant effects on the overall fish gut bacterial communities, digestive enzyme activities or metabolic profile when compared with non-supplemented controls. However, a more in-depth analysis into the most abundant taxa showed that diets at the highest TBT concentrations (0.2% and 0.4%) selectively inhibited members of the Enterobacterales order and reduced the relative abundance of a bacterial population related to Klebsiella pneumoniae, a potential fish pathogen. Furthermore, the predicted functional analysis of the bacterial communities indicated that increased levels of TBT were associated with depleted KEGG pathways related to pathogenesis. The specific effects of TBT on gut bacterial communities observed here are intriguing and encourage further studies to investigate the potential of this triglyceride to promote pathogen suppression in the fish gut environment, namely in the context of aquaculture.

Abstract Fifty Holstein calves were allocated in randomized blocks and distributed in a 2 × 2 factorial arrangement; (A) two sources of Ig: (1) Control: bovine colostrum (25% Brix); (2) Enriched colostrum: mid-quality bovine colostrum (20% Brix) enriched with colostrum replacer to 25% Brix; and (B) two transition feeding diets: (1) Whole milk (WM): supply of 4 L/day of whole milk for 3 days after the colostrum feeding; and (2) Formulated transition milk (FTM): supply 4 L/day of whole milk enriched with 70 g/L of colostrum replacer for 3 days after the colostrum feeding. Blood samples were collected at 0, 24, 48, and 72 h of age to determine total serum protein (TSP), glucose, non-esterified fatty acids (NEFA), erythrocyte and leukocyte concentrations. IgG was measured at 48 h. During the preweaning period, calves received 6 L/day of whole milk. Blood samples were collected weekly to determine TSP, glucose, and lactate. The colostrum protocols were equally efficient for transfer of passive immunity with IgG concentration at 48 h ≥ 49.6 g/L. Colostrum or transition feeding program did not influence the erythrocyte and leukocyte concentrations. The TSP concentration measured until 72 h was higher for calves fed maternal colostrum. Calves fed milk in the transition period had higher glucose concentrations. Calves receiving bovine colostrum and FTM had higher glucose concentrations in the preweaning period, while the enriched colostrum decreased plasma lactate concentrations. In summary, enrichment of mid-quality colostrum is an alternative in situations of a shortage of high-quality colostrum; however, feeding 4 L/day of FTM only for 3 days after colostrum feeding does not show additional benefits.

Abstract Atopic dermatitis (AD) is a common inflammatory skin condition that significantly affects patients' lives and imposes both economic and non-economic burdens. The precise societal and individual consequences of AD remain incompletely understood. This study aimed to characterize AD in Portuguese patients and assess its personal, familial, and societal implications, including health status and quality of life. The research, conducted from June 2019 to January 2020, involved 204 confirmed AD patients in Portugal, who completed a 70-question questionnaire. Results show that, on average, patients experienced a two-year delay in diagnosis, with two-thirds having allergic comorbidities. Late-onset AD (after age 20) was found to be correlated with worsening symptoms post-diagnosis. Globally, patients reported substantial effects on health, quality of life, and mental well-being. Effects include significant levels of anxiety, frustration and sleep disorders. Severe AD correlated with more suffering and reduced perceived health, indicating a link between disease severity and quality of life. Remarkably, despite questionable effectiveness, 92% of severe AD patients were prescribed antihistamines, while only 19% received biological treatments. In Portugal, delayed AD diagnosis hinders timely treatment, and despite its profound impact and high comorbidity rates, AD patients tend to remain undertreated. Recognizing the personal and societal repercussions is crucial for enhancing care, contributing to improving QoL, social functioning and global well-being.

ABSTRACT Objective Simulation plays an important role in cardiopulmonary resuscitation training. Comparing postsimulation debriefing with rapid cycle deliberate practice could help determine the best simulation strategy for pediatric cardiopulmonary resuscitation training among pediatric residents. Methods This is a single-blind, prospective, randomized controlled study. First- and second year pediatric residents were enrolled and randomized into two groups (1:1 ratio): rapid cycle deliberate practice group (intervention) or postsimulation debriefing group (control). They participated in two rounds of simulated pediatric cardiopulmonary arrest to assess the simulated pediatric cardiopulmonary resuscitation performance gain (round 1) and retention after a 5-6 week washout period (round 2). Scenarios were video-recorded and analyzed by blinded evaluators. The main outcome was the time to initiation of chest compressions. Secondary outcomes included time to recognize a cardiopulmonary arrest, time to recognize a shockable rhythm, time to defibrillation, time to initiation of chest compressions after defibrillation, and chest compression fraction. Results Sixteen groups participated in the first round and fifteen groups in the second one. Time to intiation of chest compressions decreased from preintervention scenario to the round 1 testing scenario and increased from round 1 to round 2 testing scenario. However, no interaction effects nor group effects were observed (p=0.885 and p=0.329, respectively). There were no significant differences between the two groups regarding the secondary outcomes. Conclusion Despite an overall improvement in simulated pediatric cardiopulmonary resuscitation performance, we did not observe significant differences between the two groups regarding the analyzed variables. The decline in simulated pediatric cardiopulmonary resuscitation performance after 5 weeks suggests the need for shorter time intervals between training sessions.

Objetivo: avaliar os efeitos da equoterapia na paralisia cerebral (PC) mediante a percepção do cuidador. Material e Métodos: estudo de caráter descritivo, corte transversal e análise quantitativa. A amostra foi composta por 13 pais de crianças com PC, com idade de 2 a 16 anos, realizada no Brasil. A coleta de dados foi feita através de questionário online com os pais. Foi utilizado o software SPSS (Statistical Package for the Social Sciences), versão 21, para a análise estatística, e o nível de significância estabelecido para todas as análises foi de 5%. O projeto foi aprovado pelo Comitê de Ética e Pesquisa da Associação Educativa do Brasil (SOEBRAS), conforme o parecer consubstanciado n°: 5.227.943. Resultados: em relação à interação com outras crianças, 69,2% da amostra passaram a interagir melhor, 84,6% apresentaram melhora em ambiente domiciliar, 77,8% apresentaram melhor desempenho em ambiente escolar, e todas as crianças apresentaram melhora da autoconfiança após iniciarem o tratamento. No que se refere à associação entre o tempo de tratamento e a melhora da capacidade da criança em ficar sentada com apoio, foi observada diferença estatisticamente significativa. Conclusão: a percepção dos pais de crianças com PC em relação ao tratamento de equoterapia foi positiva, ao relatar os benefícios obtidos com a melhora das interações sociais, das funções motoras de vida diária e, principalmente, da capacidade de ficarem sentadas com apoio.

Devido aos benefícios sociais, cognitivos, físicos e psíquicos, o esporte-educação pode ser uma estratégia para melhorar os índices de permanência e êxito escolares. Embora seja parte importante da Rede Federal de Educação Profissional, Científica e Tecnológica (RFEPCT), evidências sobre a implementação do esporte-educação são pouco exploradas. Assim, o objetivo desta revisão de escopo é identificar quais estratégias relacionadas ao esporte-educação têm sido implementadas na RFEPCT para estimular a permanência e o êxito dos estudantes. Para tanto, baseou-se na análise dos Planos Estratégicos Institucionais de Permanência e Êxito do Estudante (Peipee) da RFEPCT, publicados on-line desde 2015. Este método seguiu a lista de checagem Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (Tricco et al., 2018). A busca documental foi realizada em 66 sites institucionais, resultando na identificação de 20 Peipee, sendo que 15 apontavam o esporte em ações de permanência e êxito, sendo selecionados para análise. Houve tentativas institucionais de adotar o esporte como ferramenta para melhorar a permanência e o êxito dos estudantes, sobretudo com base nas ações voltadas ao aprimoramento da infraestrutura esportiva, ao desenvolvimento de projetos extensionistas esportivos e/ou aos auxílios estudantis. Ademais, constatou-se a ausência de Peipee em 70% dos sites institucionais. Faz-se necessário, maior engajamento e transparência institucional na formulação e na disponibilização dos Peipee, mais investimentos em esporte, de maneira a mantê-lo ativo nesses documentos. Dessa forma, os Institutos Federais podem transformar os ambientes escolares em locais favoráveis para combater a evasão e promover a retenção dos estudantes.

As intoxicações são um grave problema de saúde pública, pelo impacto na saúde individual e coletiva e pelos custos econômicos e sociais que acarretam. Os agrotóxicos são um dos principais químicos relacionados a esses eventos. Objetiva-se descrever o perfil dos casos e dos óbitos positivos para agrotóxicos que aportaram a um Laboratório de Toxicologia Forense. Trata-se de um estudo transversal com dados periciais criminais (toxicológicos e necroscópicos) entre 2002 e 2018; realização de análises descritivas e de testes de Mann-Whitney, qui-quadrado de Pearson e exato de Fisher para verificação de associações. A maior parte dos 1.606 casos foi proveniente da região central de Minas Gerais, relacionou-se aos inibidores de acetilcolinesterase e era composta de indivíduos do sexo masculino. Houve limitações técnicas laboratoriais para a detecção de agrotóxicos e redução do número de casos ao longo do tempo. Para 296 óbitos avaliados, homens, negros, com idade entre 30-49 anos foram a maior parte das vítimas. A suspeita de suicídio e o uso de inibidores de acetilcolinesterase foram as principais causas da morte. Não foram observados sinais necroscópicos específicos; edema agudo de pulmão e secreção espumosa nas vias aéreas foram as principais alterações observadas. Adultos jovens, do sexo masculino, que utilizaram inibidores de acetilcolinesterase em contexto de suicídio foram os mais prevalentes, podendo ser foco de políticas públicas. Ainda há limitação na detecção dos casos de intoxicações por agrotóxicos, especialmente fatais, o que torna o cruzamento de diferentes bancos de dados uma alternativa para melhorar a sub-captação.

A judicialização da vida consiste na incorporação da lógica do sistema judiciário na abordagem de conflitos cotidianos. Este artigo objetiva analisar expressões desse fenômeno em demandas de Direito de Família recebidas no plantão da Divisão de Assistência Judiciária de uma universidade pública. Foram analisados relatórios dos atendimentos conjuntos da Psicologia e do Direito realizados entre 2016 e 2018 e identificados quinze casos que exemplificam o processo de judicialização da vida. Mediante a análise de conteúdo temática, delinearam-se quatro categorias de discussão: conflitos intrafamiliares não passíveis de intervenção judicial; abandono afetivo; adoção unilateral/multiparentalidade; e susto jurídico. Em um contexto marcado pela judicialização, o sujeito direciona ao Judiciário o que é capaz de formular diante da dificuldade interpessoal vivenciada, buscando resolução. Contudo, as solicitações revelam a trama complexa das dinâmicas e problemáticas familiares, denotando a relevância do trabalho interdisciplinar da Psicologia com o Direito para a construção de saídas não judicializantes.

Introdução: A enurese noturna (EN) tem uma prevalência de 5%-15% nas crianças em idade escolar (IE) e pode estar associada ao impacto na qualidade de vida (QdV) nas crianças e famílias. Com este trabalho, pretende-se estimar a prevalência da EN nas crianças em IE em quatro unidades de saúde familiares (USF) na região Norte e avaliar o impacto na QdV. Métodos: Estudo multicêntrico transversal e descritivo conduzido nas USF em estudo, após aprovação pela Comissão de Ética. Convidaram-se oportunisticamente as crianças em IE, que compareceram nas consultas programadas, para preenchimento de um questionário anónimo. A análise estatística foi conduzida com recurso ao Excel® e SPSS®. Resultados: Registaram-se 158 participantes, 60,1% do sexo feminino, com mediana de idades de 6 anos (IIQ 5-7). Identificaram-se 18 crianças enuréticas (11,4%), sendo que destas a maioria era do sexo masculino (66,7%), e tinha entre 5 e 6 anos (66,7%). Encontrou-se relação significativa entre EN e sexo (p=0,014), história familiar (HF) (p=0,021) e perdas urinárias diurnas (p=0,034). Relativamente à QdV (n=14), as subescalas mais afetadas foram as relações familiares, a autoestima e as relações sociais. Conclusão: Apesar da amostra reduzida condicionar a interpretação de resultados, a prevalência de EN obtida e a associação positiva entre EN e sexo masculino e HF são concordantes com a bibliografia. Além disso, a avaliação da QdV mostrou impacto negativo nas crianças e famílias. Desta forma, salienta-se a importância da abordagem e orientação adequadas desta patologia.

Abstract: The influenza-like illness (ILI) sentinel surveillance operates in Brazil to identify respiratory viruses of public health relevance circulating in the country and was first implemented in 2000. Recently, the COVID-19 pandemic reinforced the importance of early detection of the circulation of new viruses in Brazil. Therefore, an analysis of the design of the ILI sentinel surveillance is timely. To this end, we simulated a sentinel surveillance network, identifying the municipalities that would be part of the network according to the criteria defined in the design of the ILI sentinel surveillance and, based on data from tested cases of severe acute respiratory illness (SARI) from 2014 to 2019, we drew samples for each sentinel municipality per epidemiological week. The draw was performed 1,000 times, obtaining the median and 95% quantile interval (95%QI) of virus positivity by Federative Unit and epidemiological week. According to the ILI sentinel surveillance design criteria, sentinel units would be in 64 municipalities, distributed mainly in capitals and their metropolitan areas, recommending 690 weekly samples. The design showed good sensitivity (91.65% considering the 95%QI) for qualitatively detecting respiratory viruses, even those with low circulation. However, there was important uncertainty in the quantitative estimate of positivity, reaching at least 20% in 11.34% of estimates. The results presented here aim to assist in evaluating and updating the ILI sentinel surveillance design. Strategies to reduce uncertainty in positivity estimates need to be evaluated, as does the need for greater spatial coverage.

In Portugal, approximately 22.9% of the population suffers from a psychiatric disorder, which places it as the second country with the highest prevalence of psychiatric disorders in Europe (Bernardino, 2019). Several approaches have been tested in patients diagnosed with psychosis, in which exercise is included, resulting in an increased number of published documents. The present study aims to identify the main hotspots (countries, sources, authors, keywords, and affiliations) and scientific literature trends regarding exercise's effects on patients with psychosis through a bibliometric analysis. The electronic search was conducted in three databases, PubMed, Scopus and Web of Science, from the 1st of January 2013 to the 5th of June 2023. The following descriptors and Boolean operators were used to formulate the search: [("Physical Exercise" OR "Physical Activity" OR "Exercise") AND "Psychosis"]. The data extracted from Software R(V.4.3.0) in R format was analysed in the Bibliometrix program (http://www.bibliometrix.org (accessed 06/06/2023), and the outcome was organised by countries, sources, authors, keywords, and affiliations. A total of 1749 scientific documents were retrieved from the databases, of which 1186 were included in the sample and analysed. The results show an increase in scientific production since 2013, peaking between 2019 and 2021. The three countries that publish the most are the United States of America, Australia, and Iran, with a vast collaboration network between different countries, authors and institutions. Portugal is in the twenty-sixth position, with 63 published articles. The top three most referenced journals are: Schizophrenia Research, Psychiatry Research, and Frontiers In Psychiatry. The top three authors in this area of research are Brendon Stubbs, Davy Vancampfort and Simon Rosenbaum. Over the past 10 years, the top ten research keywords are: "humans", "man", "woman", "adults", "schizophrenia", "exercise", "young adults", "psychosis", "adolescents", and "middle-aged". The main institutions studying this area of research are the King's College London, the University of Manchester, the University of New South Wales, the University of Washington, and the University of Toronto. This bibliometric highlights the USA, Australia, and the United Kingdom as the most cited countries, with the main reference publications in which are located the main affiliations. Main trends evolved to an increase focused on diagnosed psychotic humans with different ages and exercise. Considering the sizeable collaborative network, future studies must consider the influence of cultural differences on the success of different modes of exercise in psychotic patients.

No Brasil do Século XXI, os desarranjos sociais, em geral, face às históricas e profundas desigualdades sociais, indicam melhorias tímidas, quando se discute a necessidade de avanços nas tratativas das demandas societárias mais latentes. Neste aspecto, emerge o empreendedorismo social como instrumento capaz de contribuir para a reversão do cenário. O estudo objetiva descrever a produção científica na área do empreendedorismo social no período 2000-2020, embasado em periódicos de base territorial nacional, certificados na Plataforma ISSN, analisando as revistas na Plataforma Sucupira (QUALIS/CAPES), estratos A1/A2/B1/B2. Com os filtros utilizados no mapeamento, foram colecionados 1.496 periódicos, contendo 462 revistas nacionais. Destas, 37 publicaram 68 estudos envolvendo o tema. Sob a realidade brasileira, o estudo concluiu que há necessidade de ampliação das pesquisas relacionadas ao empreendedorismo social buscando desvelar novas perspectivas e apontar caminhos visando à solução dos problemas sociais mais urgentes.

Objective: To analyze hemodynamic parameters, kidney and cognitive function, and physical performance of institutionalized older adults with high- and low-strength. Method: Cross-sectional study. Twenty-one older adults (11 women, 10 men) participated in this study. Blood samples were collected for analysis of biochemical parameters. Cognitive function was evaluated using the mini-mental state examination (MMSE), clock drawing test (CDT), and verbal fluency test, while physical performance was assessed using the Short Physical Performance Battery (SPPB) and, blood pressure, heart rate, and Framingham Risk Score were evaluated. Result: Based on the median value, participants were divided into low-strength (81.63 ± 3.03 years) and high-strength (82.10 ± 2.11 years). The high-strength group showed significantly lower systolic (138.8 ± 3.6 vs. 116.5 ± 3.1; p

Introduction One of the paths in the investigation of congenital sensorineural hearing loss (CSNHL) is to try to characterize its etiology through the inner ear evaluation using high resolution computer tomography (CT) scans. With minor malformation, it is not always possible for a simple visual inspection to recognize if the structure in the inner ear is normal or not.