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Background: Chronic kidney disease (CKD) is a global health problem with rising prevalence, morbidity, mortality, and associated costs. Early identification and risk stratification are key to preventing progression to kidney failure. However, there is a paucity of data on practice patterns of kidney function assessment to guide the development of improvement strategies, particularly in lower-income countries. Methods: A retrospective observational analysis was conducted in a nationwide laboratory database in Brazil. We included all adult patients with at least one serum creatinine assessment between June 2018 and May 2021. Our primary objective was to determine the proportion of patients with estimated glomerular filtration rate (eGFR) evaluations accompanied by predicted levels of urinary albumin-to-creatinine ratio (pACR) assessments within 12 months. Results: Out of 4,5323,332 serum creatinine measurements, 42% lacked pACR measurements within 12 months. Approximately 10.8% of tests suggested CKD, mostly at stage 3a. The proportion of serum creatinine exams paired with pACR assessment varied according to the CKD stage. Internal Medicine, Cardiology, and Obstetrics/Gynecology were the specialties requesting most of the creatinine tests. Nephrology contributed with only 1.1% of serum creatinine requests for testing. Conclusion: Our findings reveal that a significant proportion of individuals with a creatinine test lack an accompanying urinary albuminuria measurement in Brazil, contrary to the recommendations of the international guidelines. Non-Nephrologists perform most kidney function evaluations, even among patients with presumable advanced CKD. This highlights the urge to incorporate in clinical practice the early detection of CKD and to encourage more collaborative multidisciplinary care to improve CKD management. [ABSTRACT FROM AUTHOR]

This study clinically validated the nursing diagnosis of "sedentary lifestyle" (SL) among 564 Brazilian adolescents. Measures of diagnostic accuracy were calculated for defining characteristics, and Mantel--Haenszel analysis was used to identify related factors. The measures of diagnostic accuracy showed that the following defining characteristics were statistically significant: "average daily physical activity less than recommended for gender and age," "preference for activity low in physical activity," "nonengagement in leisure time physical activities," and "diminished respiratory capacity." An SL showed statistically significant associations with the following related factors: insufficient motivation for physical activity; insufficient interest in physical activity; insufficient resources for physical activity; insufficient social support for physical activity; attitudes, beliefs, and health habits that hinder physical activity; and insufficient confidence for practicing physical exercises. The study highlighted the four defining characteristics and six related factors for making decisions related to SL among adolescents.

Background: Odontogenic tumors (OT) are composed of heterogeneous lesions, which can be benign or malignant, with different behavior and histology. Within this classification, ameloblastoma and ameloblastic carcinoma (AC) represent a diagnostic challenge in daily histopathological practice due to their similar characteristics and the limitations that incisional biopsies represent. From these premises, we wanted to test the usefulness of models based on artificial intelligence (AI) in the field of oral and maxillofacial pathology for differential diagnosis. The main advantages of integrating Machine Learning (ML) with microscopic and radiographic imaging is the ability to significantly reduce intra‐and inter observer variability and improve diagnostic objectivity and reproducibility. Methods: Thirty Digitized slides were collected from different diagnostic centers of oral pathology in Brazil. After performing manual annotation in the region of interest, the images were segmented and fragmented into small patches. In the supervised learning methodology for image classification, three models (ResNet50, DenseNet, and VGG16) were focus of investigation to provide the probability of an image being classified as class0 (i.e., ameloblastoma) or class1 (i.e., Ameloblastic carcinoma). Results: The training and validation metrics did not show convergence, characterizing overfitting. However, the test results were satisfactory, with an average for ResNet50 of 0.75, 0.71, 0.84, 0.65, and 0.77 for accuracy, precision, sensitivity, specificity, and F1‐score, respectively. Conclusions: The models demonstrated a strong potential of learning, but lack of generalization ability. The models learn fast, reaching a training accuracy of 98%. The evaluation process showed instability in validation; however, acceptable performance in the testing process, which may be due to the small data set. This first investigation opens an opportunity for expanding collaboration to incorporate more complementary data; as well as, developing and evaluating new alternative models. [ABSTRACT FROM AUTHOR]

Aim: To analyse the etiological factors of the nursing diagnosis of impaired comfort in children and adolescents with cancer. Design: This cross‐sectional study was carried out in the referral unit for the treatment of childhood cancer in a tertiary hospital located in northeastern Brazil. Methods: A total of 200 children and adolescents who were undergoing cancer treatment were included in this study. Data collection instruments and protocols were constructed with operational and conceptual definitions of clinical indicators and etiological factors for the nursing diagnosis of impaired comfort. A latent class model with adjusted random effects was used to determine impaired comfort and measures of sensitivity and specificity of clinical indicators. A univariate logistic regression analysis was performed for each etiological factor of impaired comfort. Results: The analysis of etiological factors for the nursing diagnosis of impaired comfort in children and adolescents with cancer showed the high prevalence of four factors: noxious environmental stimuli, insufficient situational control, insufficient resources and insufficient environmental control. Illness‐related symptoms, noxious environmental stimuli, and insufficient environmental control increased the chance of impaired comfort occurring. Conclusion: The etiological factors with the highest prevalence and most significant impact on the occurrence of impaired comfort were noxious environmental stimuli, insufficient situational control and illness‐related symptoms. Impact: The results obtained in this investigation can support more accurate nursing diagnostic inference of impaired comfort in children and adolescents with cancer. Moreover, the results can inform direct interventions for the modifiable factors that trigger this phenomenon to avoid or minimize the signs and symptoms of the nursing diagnosis. [ABSTRACT FROM AUTHOR]

Background: In contrast to guidelines related to lipid therapy in other areas, 2012 Kidney Disease Improving Global Outcomes (KDIGO) guidelines recommend conducting a lipid profile upon diagnosis of chronic kidney disease (CKD) and treating all patients older than 50 years without defining a target for lipid levels. We evaluated multinational practice patterns for lipid management in patients with advanced CKD under nephrology care. Methods: We analyzed lipid-lowering therapy (LLT), LDL- cholesterol (LDL-C) levels, and nephrologist-specified LDL-C goal upper limits in adult patients with eGFR < 60 ml/min from nephrology clinics in Brazil, France, Germany, and the United States (2014–2019). Models were adjusted for CKD stage, country, cardiovascular risk indicators, sex, and age. Results: LLT treatment differed significantly by country, from 51% in Germany to 61% in the US and France (p = 0.002) for statin monotherapy. For ezetimibe with or without statins, the prevalence was 0.3% in Brazil to 9% in France (< 0.001). Compared with patients not taking lipid-lowering therapy, LDL-C was lower among treated patients (p < 0.0001) and differed significantly by country (p < 0.0001). At the patient level, the LDL-C levels and statin prescription did not vary significantly by CKD stage (p = 0.09 LDL-C and p = 0.24 statin use). Between 7—23% of untreated patients in each country had LDL-C ≥ 160 mg/dL. Only 7–17% of nephrologists believed that LDL-C should be < 70 mg/dL. Conclusion: There is substantial variation in practice patterns regarding LLT across countries but not across CKD stages. Treated patients appear to benefit from LDL-C lowering, yet a significant proportion of hyperlipidemia patients under nephrologist care are not receiving treatment. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the accuracy of the clinical indicators of the nursing diagnosis Ineffective Health Management in people with hypertension. Methods: This is a cross‐sectional diagnostic accuracy study. The ineffective health management was investigated in 120 people with hypertension in a referral public outpatient clinic in Brazil between August and November 2020. The accuracy measures were analyzed using Rasch analysis, considering the difficulty of clinical indicator and person's ability. Results: Ineffective health management is probably present in 37.5% of people with hypertension. 'Failure to include treatment regimen in daily living' was the clinical indicator with the highest sensitivity value, and 'failure to take action to reduce risk factor' had the highest specificity value. Conclusions: Rasch analysis demonstrated that all clinical indicators contribute significantly to estimating the presence of ineffective health management in people with hypertension in the outpatient scenario. Implications for Nursing Practice: This research contributes by providing accurate clinical indicators of ineffective health management, helping nurses prescribe and deliver the appropriate nursing interventions for people with hypertension by telenursing. [ABSTRACT FROM AUTHOR]

Caryocar coriaceum is an endemic tree of Brazil, occurring mainly in the northeast region in the Cerrado environment. The species, popularly known as "pequi", produces fruits that are used in the manufacture of oil for food and medicinal purposes. This work reviewed studies conducted with the species, highlighting its ethnomedicinal use, its pharmacological potential, including its chemical constituents, and its cultural and socioeconomic importance. Information was obtained through the main scientific research platforms. The keyword "Caryocar coriaceum" was used as the main index for searching the following platforms: PubMed®, PubMed Central®, SciElo, Scopus® and Web of ScienceTM. The compiled papers demonstrate that C. coriaceum has great medicinal, economic and cultural importance for northeastern Brazil. Popularly, the fruits of C. coriaceum are used to treat broncho-pulmonary diseases (bronchitis, colds and flu). The fixed oil is widely used to relieve pain from various causes in the treatment of inflammation, flu, eczema, burns, fever, rickets, indigestion, heart murmurs, fatigue and erectile dysfunction. Some of these uses are corroborated by pharmacological trials, which have demonstrated the antioxidant, healing, anti-inflammatory, gastroprotective, antinociceptive and antimicrobial properties of the species. Chemically, fatty acids and phenolic compounds are the main constituents recorded for the species. Due to its medicinal properties, the fruits and oil of C. coriaceum have a high commercial demand and are one of the main forms of subsistence activities for local populations. On the other hand, the extractive practice of the fruits, associated with anthropic factors and its physiological nature, makes the species threatened with extinction. Thus, public management policies are highly necessary in order to avoid its extinction. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the short‐term survival of the nursing diagnosis of neonatal hyperbilirubinemia in hospitalized neonates within the first 24 h of life and over a maximum of 7 days. Methods: A prospective open cohort study with a longitudinal design was developed with 120 newborns during the first 24 h of life. The survival rate after a nursing diagnosis of neonatal hyperbilirubinemia was analyzed for 7 days. Findings: The number of new cases of neonatal hyperbilirubinemia during the follow‐up was 82 (RR: 90.1%, daily incidence rate: 34.17%). The greatest manifestation of the diagnosis occurred in the first three days (n = 97). The median diagnostic survival time was 2 days (95% CI: 2–2). Yellow‐orange skin color (RR = 8.08), yellow mucous membranes (RR = 2.05), yellow sclera (RR = 1.99), and female gender (RR = 1.36) had the highest risk ratios. Conclusions: A rapid impairment of neonatal hyperbilirubinemia in hospitalized neonates was observed. Some clinical indicators were associated with an increased risk for this diagnosis. Implications for nursing practice: Studies on the prognostic capacity of the clinical indicators of nursing diagnoses like neonatal hyperbilirubinemia strengthen the clinical reasoning of nurses and subsidize diagnostic inferences and accurate clinical decisions. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify diagnostic indicators associated with the nursing diagnosis risk‐prone health behaviors in pregnant adolescents. Methods: We conducted a cross‐sectional study. The sample consisted of 181 pregnant adolescents. A latent class analysis was conducted to verify associations between the defining characteristics of risk‐prone health behaviors and diagnostic accuracy measures. Logistic regression was used to identify factors associated with the manifestation of risk‐prone health behavior. Findings: The prevalence of risk‐prone health behaviors in this sample was 31.04%. The defining characteristics failure to take action that prevents health problems and inappropriate eating habits achieved a high sensitivity. The related factors such as insufficient social support, stressors, low self‐efficacy, social anxiety, isolated region of residence, and restricted access to health services presented significant associations with risk‐prone health behavior. Conclusions: The diagnostic indicators associated with the nursing diagnosis of risk‐prone health behavior were failure to take action that prevents health problems inappropriate eating habits, insufficient social support, stressors, low self‐efficacy, social anxiety, isolated region of residence, and restricted access to health services. Implications for nursing practice: This study contributes to knowledge about the diagnostic indicators of risk‐prone health behavior, which may help nurses reach the proper diagnosis. This will facilitate the application of clinical judgment in nursing care to assist pregnant adolescents. [ABSTRACT FROM AUTHOR]

Background Dialysis patients are typically inactive and their physical activity (PA) decreases over time. Uremic toxicity has been suggested as a potential causal factor of low PA in dialysis patients. Post-dilution high-volume online hemodiafiltration (HDF) provides greater higher molecular weight removal and studies suggest better clinical/patient-reported outcomes compared with hemodialysis (HD). Methods HDFIT was a randomized controlled trial at 13 clinics in Brazil that aimed to investigate the effects of HDF on measured PA (step counts) as a primary outcome. Stable HD patients (vintage 3–24 months) were randomized to receive HDF or high-flux HD. Treatment effect of HDF on the primary outcome from baseline to 3 and 6 months was estimated using a linear mixed-effects model. Results We randomized 195 patients (HDF 97; HD 98) between August 2016 and October 2017. Despite the achievement of a high convective volume in the majority of sessions and a positive impact on solute removal, the treatment effect HDF on the primary outcome was +538 [95% confidence interval (CI) −330 to 1407] steps/24 h after dialysis compared with HD, and was not statistically significant. Despite a lack of statistical significance, the observed size of the treatment effect was modest and driven by steps taken between 1.5 and 24.0 h after dialysis, in particular between 20 and 24 h (+197 steps; 95% CI −95 to 488). Conclusions HDF did not have a statistically significant treatment effect on PA 24 h following dialysis, albeit effect sizes may be clinically meaningful and deserve further investigation. [ABSTRACT FROM AUTHOR]

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Studies that establish the indicators of clinical status deterioration of Ineffective airway clearance remain scarce. Prognostic studies provide data for nurses identify clinical indicators that suggest a higher chance of early development of a nursing diagnosis. Objective: To identify the prognostic indicators of short-term survival of ineffective airway clearance (IAC) in children with acute respiratory infection (ARI). Design: A prospective open cohort study. Methods: This study was with a group of 136 children with acute respiratory infection who were followed for a minimum of six and a maximum of ten consecutive days. Children who had not completed six days of monitoring or who were carriers of diseases that would alter the specific symptoms of respiratory infection were excluded. The survival rate of ineffective airway clearance was calculated using Nelson-Aalen's method. A Cox regression model was used to analyze the influence of clinical indicators on survival time of this diagnosis. Results: The diagnosis survival rate was extremely low (only 0.4% on the 5th day of follow-up). The greatest reduction in survival rate was observed in the first 48 h (survival rate = 2.5%). Four defining characteristics associated with a worse prognosis of IAC among children with ARI: ineffective cough (RR = 5.86; 95% CI: 3.53–9.72), absence of cough (RR = 2.92; 95% CI: 1.68–5.08), adventitious breath sounds (RR = 2.47; 95% CI: 2.01–3.03), and diminished breath sounds (RR = 1.23; 95% CI: 1.05–1.45). Conclusion: Four clinical indicators showed a strong relationship with an increased risk of worsening clinical status associated with this nursing diagnosis. Impact statement: Clinical deterioration related to ineffective airway clearance among children with acute respiratory infection is fast and requires particular attention from nurses. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension is multifactorial, highly prevalent in the hemodialysis (HD) population and its adequate control requires, in addition to adequate volume management, often the use of multiple antihypertensive drugs. We aimed to describe the use of antihypertensive agents in a group of HD patients and to evaluate the factors associated with the use of multiple classes (≥3) of antihypertensives. Methods: We analyzed the baseline data from the HDFit study. Clinically stable patients with HD vintage between 3 and 24 months without any severe mobility limitation were recruited from sites throughout southern Brazil. Fluid status was measured pre‐dialysis with the Body Composition Monitor (BCM; Fresenius, Germany). Fluid overload (FO) was considered when the overhydration index (OH) was greater than 7% of extracellular water (OH/ECW > 7%) and overweight was defined as a body mass index (BMI) greater than 25 kg/m2. Prescriptions of antihypertensive drugs were obtained from participants' reports and medical records. Logistic regression was employed to determine factors associated with excessive use of antihypertensive medication (≥3 classes). Findings Of 195 studied patients, 171 with complete data were included (70% male, 53 ± 15 years old, 57% of them with FO). Pre‐dialysis systolic blood pressure (SBP) was 150 ± 24 mmHg and patients used a median of 2 (1–3) antihypertensive drugs. Vasodilators (20%) were of lowest prevalence, use of other classes varied from 40% to 53%. Sixty‐two (36%) subjects used ≥3 classes and presented a higher prevalence of diabetes and FO, lower prevalence of overweight, and higher SBP. In a logistic regression model age, BMI <25 kg/m2, and OH/ECW > 7% were associated with excessive drug use. Discussion More than one‐third of participants used ≥3 classes of antihypertensive drugs, and it was associated with older age, BMI <25 kg/m2 and FO. Strategies that better manage FO may aid better blood pressure control and avoid the use of multiple antihypertensive medications. [ABSTRACT FROM AUTHOR]

Summary: The latex from Euphorbia tirucalli is used in Brazil as a folk medicine for several diseases, including cancer. Recently, we showed a cytotoxic activity of E. tirucalli euphol in a wide range of cancer cell lines. Moreover, we showed that euphol inhibits proliferation, motility and colony formation in pancreatic cancer cells, induces autophagy and sensitizes glioblastoma cells to temozolomide cytotoxicity. Herein, we report in vitro activity of three semi-synthetic ingenol compounds derived from E. tirucalli, IngA (ingenol-3-trans-cinnamate), IngB (ingenol-3-hexanoate) and IngC (ingenol-3-dodecanoate), against a large panel of human cancer cell lines. Antineoplastic effects of the three semi-synthetic compounds were assessed using MTS assays on 70 cancer cell lines from a wide array of solid tumors. Additionally, their antitumor potential was compared with known compounds of the same class, namely ingenol-3-angelate (Picato®) and ingenol 3,20-dibenzoate and in combination with standard chemotherapeutic agents. We observed that IngA, B, and C exhibited dose-dependent cytotoxic effects. Amongst the semi-synthetic compounds, IngC displayed the best activity across the tumor cell lines. In comparison with ingenol-3-angelate and ingenol 3,20-dibenzoate, IngC showed a mean of 6.6 and 3.6-fold higher efficacy, respectively, against esophageal cancer cell lines. Besides, IngC sensitized esophageal cancer cells to paclitaxel treatment. In conclusion, the semi-synthetic ingenol compounds, in particular, IngC, demonstrated a potent antitumor activity on all cancer cell lines evaluated. Although the underlying mechanisms of action of IngC are not elucidated, our results provide insights for further studies suggesting IngC as a putative therapy for cancer treatment. [ABSTRACT FROM AUTHOR]

Copyright of Revue Generale de Droit is the property of Universite d'Ottawa, Section de Droit Civil and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In order to assess the influence of the Três Marias dam on the reproduction of the white piranha, Serrasalmus brandtii, 1569 specimens captured from June 2011 to May 2012 in three sections of the São Francisco River basin were analyzed: section 1 = Três Marias reservoir (TMR); section 2 = São Francisco River (SFR) segment immediately downstream of TMR; and section 3 = SFR segment at the confluence with the Abaeté River. Total length (TL), body weight (BW), gonadosomatic index (GSI), and gonadal maturation stages were determined for each specimen, while vitellogenic follicle diameter, and absolute (AF) and relative (RF) fecundities were also determined for females. Reproductive activity, including spawned females and spermed males, was recorded throughout the year in the three river segments. Higher frequencies of females and males at the maturing/mature stage were found in the November/December and January/February, which coincided with the period of higher temperature, rainfall, and dissolved oxygen concentration. Mean GSI and vitellogenic follicle diameter were higher in sections 1 and 3 than in section 2 (P <0.05), while AF and RF were higher in section 1 (P <0.05) than in sections 2 and 3. The results of the present study showed that S. brandtii had lower reproductive performance in section 2, probably due to thermal disturbances caused by the dam, thus confirming the influence of dams on the reproduction of fish downstream from hydroelectric plant reservoirs. [ABSTRACT FROM AUTHOR]

PURPOSE: To analyze the accuracy of the defining characteristics of hypothermia in newborns and to verify associations between defining characteristics and clinical variables. METHODS: A cross‐sectional accuracy study with statistical analysis. FINDINGS: Slow capillary refill, decrease in ventilation, peripheral vasoconstriction, and insufficient weight gain were the defining characteristics with the highest specificity values, while slow gastric emptying, skin cool to touch, irritability, and bradycardia were the defining characteristics with the highest values for both sensitivity and specificity. CONCLUSION: Slow gastric emptying, skin cool to touch, irritability, and bradycardia are good clinical indicators to infer initial stages of hypothermia and to confirm its presence. IMPLICATIONS FOR NURSING PRACTICE: Accuracy measures may contribute to the improvement of the diagnostic inferential process. OBJETIVO: Analisar acurácia das características definidoras de Hipotermia em recém‐nascidos e identificar a associação delas com variáveis clínicas. MÉTODO: Estudo de acurácia transversal com análise estatística. RESULTADOS: Preenchimento capilar lento, diminuição da ventilação, vasoconstrição periférica e ganho de peso insuficiente apresentaram valores altos de especificidade enquanto esvaziamento gástrico lento, pele fria, irritabilidade e bradicardia apresentaram valores elevados de sensibilidade e especificidade. CONCLUSÃO: Esvaziamento gástrico lento, pele fria, irritabilidade e bradicardia são úteis para inferir estágios iniciais de hipotermia e para confirmação diagnóstica. IMPLICAÇÕES PARA PRÁTICA DE ENFERMAGEM: Medidas de acurácia podem contribuir para o processo de inferência do diagnóstico hipotermia. [ABSTRACT FROM AUTHOR]

Copyright of Rev Rene is the property of Rev Rene and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives To identify prognostic clinical indicators of short-term survival for ineffective breathing pattern in children with acute respiratory infection. Background Despite the studies of survival for nursing diagnosis, there is not enough evidence about the clinical indicators that are associated with a worse prognosis for ineffective breathing pattern. Design A prospective cohort study. Methods One hundred and thirty-six children were followed up for a minimum of six and a maximum of 10 consecutive days. The survival rate for ineffective breathing pattern was calculated using Nelson-Aalen's method. An extended Cox model was adjusted to identify the main prognostic clinical indicators for this nursing diagnosis. Results Over half of the sample had an ineffective breathing pattern at the first evaluation. The occurrence of new cases was observed until the ninth day of monitoring, and the survival rate after this day was low. According to the Cox model, the main clinical indicators of a poor prognosis were an abnormal breathing pattern, the use of accessory muscles, dyspnoea and increase in the anterior-posterior chest diameter. Conclusions Children with acute respiratory infection who present with an abnormal breathing pattern, the use of accessory muscles to breathe, dyspnoea and increased anterior-posterior diameter have a poor prognosis for an ineffective breathing pattern. Relevance to clinical practice Survival analyses of nursing diagnoses allow the identification of clinical indicators that can be used in clinical practice as prognostic markers. The identification of indicators associated with a poor clinical prognosis allows nurses to intervene early and to maximise the possibility of a good outcome. [ABSTRACT FROM AUTHOR]

Purpose To analyze the statistical characteristics of the weighted inter-rater reliability index for validating nursing diagnoses. Methods From a computational algorithm, the index values were compared with the sample size, frequency of the clinical indicator, number of agreements between raters, and three other agreement estimators. Findings The index moderately correlated with the frequency of the clinical indicator and strongly correlated with the number of agreements and disagreements between the raters. This index showed a poor correlation with sample size. Conclusion This index selects those clinical indicators with high frequency and/or absolute agreement and therefore has a high sensitivity. Implications for Nursing Practice The high sensitivity may result in incorporating false positive clinical indicators. [ABSTRACT FROM AUTHOR]

Aims and objectives The purpose of this study was to assess the prevalence of ineffective breathing pattern and the accuracy of its defining characteristics, among children and adolescents with congenital heart disease. Background The NANDA International nursing diagnosis, ineffective breathing pattern, has been noted to have high prevalence in different clinical contexts and age groups. Despite that, nurses continue to report difficulties in confirming this diagnosis. The lack of data regarding the sensitivity, specificity and predictive values of the defining characteristics contribute to decreased certainty in diagnosing ineffective breathing pattern. Design A diagnostic accuracy study. Methods This study of diagnostic accuracy was conducted with 61 children and adolescents with congenital heart disease. Two nurses were trained by the primary investigator on use of defining characteristics in the diagnostic process for ineffective breathing pattern. Results Ineffective breathing pattern was present in 26·2% of the children and adolescents sampled. When analysing the defining characteristics, alterations in depth of breathing, showed high values of sensitivity and specificity. In addition, orthopnoea, tachypnoea and use of accessory muscles to breathe, showed high values of specificity; d yspnoea showed high values of sensitivity. Finally, assumption of three-point position, bradypnoea and increased anterior-posterior diameter were not found to be statistically significant for this sample population. Conclusion Five defining characteristics of ineffective breathing pattern presented measures of accuracy with statistically significant values in children with congenital heart disease. Relevance to clinical practice The findings can help nurses during the diagnostic process, as they identify which defining characteristics can be used to confirm or rule out the probability of occurrence of the diagnosis. [ABSTRACT FROM AUTHOR]

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Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of International Journal of Nursing Knowledge is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Eletrônica de Enfermagem is the property of Revista Eletronica de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rev Rene is the property of Rev Rene and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rev Rene is the property of Rev Rene and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rev Rene is the property of Rev Rene and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rev Rene is the property of Rev Rene and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Among the agricultural commodities traded in the futures Market in Brazil, the contract for live cattle is what comes with higher growth in trading volume. In addition, there is a significant increase in the price of the commodity in the spot market. The growing volume of trading is explained by the fact that not only attract hedgers, but also other types of participants, called speculators. In light of the foregoing, this study aimed to evaluate the process of financialization of the Brazilian futures market cattle. To this end, we compared the hedge ratio given in the literature and hedge ratio practiced in the market. The results show that the ratio of hedge practiced in the market has overcome the optimal hedge ratio proposed in the literature from 2006, warning signs of possible existence of a process of financialization. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Pulmonology / Jornal Brasileiro de Pneumologia is the property of Sociedade Brasileira de Pneumologia e Tisiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Saúde e Sociedade is the property of Universidade de Sao Paulo, Faculdade de Saude Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim To check the content validity of operational definitions for respiratory indicators of ineffective breathing pattern of children with congenital heart disease. Methods A methodologic study performed with Brazilian expert nurses that assesses the item-objective congruence and adequacy of criteria of operational definitions for indicators of ineffective breathing pattern. Results Thirty two indicators presented item-objective congruence higher than 0.80. The content validity index higher than 0.80 was identified in at least 16 indicators for each criterion. Conclusion Implementation of these concepts is helpful but they need to be kept under review. [ABSTRACT FROM AUTHOR]

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Mesosphaerum suaveolens is a herbaceous plant native to the Caatinga, and has the ability to change the plant composition of surrounding areas, possibly through to the action of allelochemicals. In this study, the effect of M. suaveolens leaf decomposition on the germination and initial growth of two columnar cacti endemic to Brazil, Cereus jamacaru subsp. jamacaru and Pilosocereus gounellei subsp. gounellei , and the existence of autotoxicity were evaluated. The decomposing leaves of M. suaveolens negatively affected the germination and growth parameters of the two cacti, notably reducing the size and dry weight of cladodes. A reduction in photosynthetic pigment content was also observed. Furthermore, autotoxic effects were also observed. UPLC – MS of the soil revealed the presence of five diterpenes, three triterpenes, and one sugar. Considering that terpenoid compounds were the predominant components, our results suggest that they may be some of the allelochemicals used by M. suaveolens to reduce species competition. Thus, we demonstrate that M. suaveolens can negatively impact the growth and development not only of the two cacti studied, but also of the own species through autotoxicity. In areas with spontaneous presence of M. suaveolens , monitoring is recommended due to the negative impact of this plant. • Allelopathic effects of Mesosphaerum suaveolens were investigated. • Leaf decomposition negatively affected the germination and growth of the two cacti. • Leaf decomposition of Mesosphaerum suaveolens also showed autotoxicity. • Terpenoids are possibly responsible for phytotoxic effects observed. [ABSTRACT FROM AUTHOR]

A gauge-only precipitation data quality control and analysis system has been developed for monitoring precipitation at NOAA’s Climate Prediction Center (CPC). Over the past 10 yr the system has been used to develop and deliver many different precipitation products over the United States, Mexico, and Central and South America. Here the authors describe how the system has been applied to develop improved gridded daily precipitation analyses over Brazil. Consistent with previous studies, comparisons between the the gridded analyses and station observations reveal fewer dry days, a greater number of low precipitation days, and fewer extreme precipitation events in the gridded analyses. Even though the gridded analysis system reduces the number of dry days and increases the number of wet days, there is still a good correlation between time series of the gridpoint precipitation values and observations. Retrospective analyses are important for computing basic statistics such as mean daily/monthly rainfall, extremes, and probabilities of wet and dry days. The CPC gridded precipitation analyses can be used in hydrologic and climate variability studies dealing with large spatial-scale anomaly patterns, such as those related to ENSO. The analyses can also be used as a benchmark for evaluating model simulations, serve as a basis for real-time monitoring, and provide statistics on the occurrence of large-scale heavy rainfall events and dry periods. [ABSTRACT FROM AUTHOR]

The circulation features associated with intense precipitation events over the La Plata Basin (LPB) during the austral summers of 2001/02 and 2002/03 are investigated using the Eta Model runs generated at the University of Maryland. Based on the main mode of variability over LPB, two regions were selected: (i) the region of Brazil that is at the core of the South American summer monsoon system (SAMS) and (ii) the central region of LPB in southeastern South America (SESA). First, a comparison between the 24-h total precipitation in the Eta Model and the 24-h observed precipitation was made. Results show that the Eta Model captures well the temporal variability of precipitation events in both regions, although a positive bias is noticed over SAMS. Likewise, the model reproduces the distribution of precipitation rate over SESA, but not over SAMS. Nevertheless, the distribution of the moisture flux convergence intensity, which represents the dynamical forcing, is closer in shape to the observed precipitation distribution, suggesting that the model can be a useful tool in identifying the forcing for heavy precipitation events over both regions. Composites of atmospheric and surface variables were constructed for intense precipitation events during austral summer over both regions. Intense rainfall over the central La Plata Basin (SESA) is linked to an amplified upper-tropospheric midlatitude wave pattern in which rainfall occurs just east of an enhanced cyclonic circulation. Accompanying this circulation pattern, an enhanced low-level jet (LLJ) transports warm, moist air from the Amazon toward the region, contributing to an increase in the thermal contrast over SESA. The combined patterns of thermal and dynamical variables suggest that large-scale systems, like frontal systems, are important in producing intense rainfall events. The SAMS region events have a similar upper-level structure as in SESA, but they are longer lived. In this case, the moisture fluxes are determined by an eastward shift of the LLJ, but also directly from the Amazon Basin to the north. As expected, precipitation events produce large increases of simulated runoff. The largest impact is on the SESA region, affecting the streamflow of the Paraná, Paraguay, and Uruguay, the three main rivers of the LPB. [ABSTRACT FROM AUTHOR]

The consumption of pepper is quite common in Brazil, being used not only in food, but also in the pharmaceutical and hygienic segment, providing health benefits for having antibiotic effects, anti-inflammatory action and several vitamins. The objective of this work was to characterize the growth curve of the biquinho-type pepper plant, using the nonlinear regression models logistic, Gompertz and von Bertalanffy, to the plant's height data subjected to irrigation of 20% of its water requirement. The experiment was conducted in a greenhouse, belonging to the Agricultural Engineering Academic Unit (UAEAg) of the Federal University of Campina Grande - UFCG. All the models used proved to be appropriate, but the von Bertalanffy model was the most adequate to fit the data according to the AIC statistics, estimating a maximum growth of 7.58cm for the plants in 163 days after sowing the crop. with the highest speed of growth per day obtained up to 38 days after sowing, when the height reached was 2.27cm. [ABSTRACT FROM AUTHOR]

Introduction: with the current situation of measles outbreak in Brazil and the sharp drop in immunization coverage nationwide, it is necessary to think about ways to intervene in the face of so many difficulties, since the expansion of immunization coverage is the most effective and safe for the control of infectious diseases. Objective: to analyze vaccine coverage of two National Campaigns during the COVID-19 pandemic in Vitória/ES. Methods: a descriptive experience report on the implementation of an intervention plan to expand vaccination coverage of two National Vaccination Campaigns in 2020 in a Family Health Unit (FHU) during the Curricular Internship I (EC-I). It was based on the Situational Strategic Planning. Descriptive and bivariate statistical analyzes were performed. Results: there was an increase of 5.79 times in the vaccination coverage of the National Measles Vaccination Campaign 2020 in the territory, from 0.86% (vaccination coverage of the triple viral before the start of EC-I) to 4.98% at the end of EC-I (p = 0.438). When comparing the vaccination coverage of the National Multivaccination Campaign 2020 of immunobiologicals administered before and after the EC-I period at the FHU, we observed that there was a statistically significant difference (p = 0.0049). Conclusion: the proposed and implemented intervention plan had a positive outcome on the FHU, as the vaccination coverage of the two campaigns were expanded, despite all the challenges of the pandemic. [ABSTRACT FROM AUTHOR]

Background: Although low-grade inflammation is associated with onset and persistence of depression, most biomarkers display modest predictive effects. GlycA (glycoprotein acetylation) is a unique metabolomic composite of pro-inflammatory acute-phase glycoproteins. We hypothesized that GlycA levels would predict depression incidence, remission and persistence, with higher accuracy than high-sensitivity c-reactive protein (hsCRP). We also explored the additive predictive value of GlycA above and beyond hsCRP.Methods: Cohort design using the sample of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)'s São Paulo site. Baseline GlycA and hsCRP levels were measured in blood plasma. Depression incidence, remission, and persistence were assessed using the Clinical Interview Scheduled Revised (CIS-R) at two time points separated by a mean of 3.8 years. Multivariable Poisson, logistic and linear regression models were used for prediction. Models were adjusted for sociodemographic and clinical confounders, including age, gender, ethnicity, education, cardiovascular assessments, antidepressant and anti-inflammatory drug use, anxiety disorders, alcohol use, and body mass index.Results: We included 4,364 participants (53.2% females, mean age 51.4 ± 8.9 years) with no autoimmune disorders. GlycA robustly predicted depression persistence (relative risk of 7.28, 95% confidence interval 1.33-45.57, p = 0.023 in the fully-adjusted model), but not depression onset. Although hsCRP also predicted depression persistence, its effects were fully explained by confounders and by GlycA levels. GlycA also predicted worsening of depressive symptoms in depressed patients and depression persistence vs. remission in fully-adjusted models.Limitations: Brief depressive episodes could not be measured by our assessments.Conclusions: GlycA might be a new inflammatory prognosis biomarker for depression. [ABSTRACT FROM AUTHOR]

Objective: to evaluate the accuracy of the defining characteristics of the excess fluid volume nursing diagnosis of NANDA International, in patients undergoing hemodialysis. Method: this was a study of diagnostic accuracy, with a cross-sectional design, performed in two stages. The first, involving 100 patients from a dialysis clinic and a university hospital in northeastern Brazil, investigated the presence and absence of the defining characteristics of excess fluid volume. In the second step, these characteristics were evaluated by diagnostic nurses, who judged the presence or absence of the diagnosis. To analyze the measures of accuracy, sensitivity, specificity, and positive and negative predictive values were calculated. Approval was given by the Research Ethics Committee under authorization No. 148.428. Results: the most sensitive indicator was edema and most specific were pulmonary congestion, adventitious breath sounds and restlessness. Conclusion: the more accurate defining characteristics, considered valid for the diagnostic inference of excess fluid volume in patients undergoing hemodialysis were edema, pulmonary congestion, adventitious breath sounds and restlessness. Thus, in the presence of these, the nurse may safely assume the presence of the diagnosis studied. [ABSTRACT FROM AUTHOR]

Objective: the study's objective was the clinical validation of the nursing diagnosis Risk for Aspiration among patients who experienced cerebrovascular accidents (CVA). Method: a prospective cohort study was conducted with 24 patients hospitalized due to a CVA. The instrument used to collect the data addressed the risk factors for respiratory aspiration, validated by concept analysis and by experts. Results: the most frequent risk factors for respiratory aspiration were: dysphagia (54.2%) and impaired physical mobility (41.7%). The prevalence of the nursing diagnosis Risk for Aspiration was 58.3% and the prevalence of respiratory aspiration over the span of 48 hours (monitoring period) was 37.5%. Risk factors for dysphagia and impaired physical mobility were significantly associated with respiratory aspiration. Conclusion: the risk factors dysphagia and impaired physical mobility are good predictors of the nursing diagnosis Risk for Aspiration. This study contributed to improving the NANDA-I Taxonomy and the systematization of the nursing process. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To compare the results of 6-month follow-ups for hospitalized patients who were divided into two groups of low- and high-intensity treatments for smoking cessation and compared to the results of standard hospital treatment. Methods: A total of 2414 patients were screened. Two hundred thirty-seven current smokers were randomly assigned to high-intensity intervention (HII; 30-min motivational interview plus seven routine telephone calls after hospital discharge) or to low-intensity intervention (LII; 15-min counseling about the benefits of quitting) and 80 comprised the usual care (UC) group. Six months after hospital discharge, all participants were contacted by phone. The main outcome measure was smoking cessation. Results: The smoking-cessation rates were 44.9%, 41.7% and 26.3% for the HII, LII and UC groups, respectively (P = .03). The multivariable analysis identified the following variables which are associated with the failure to stop smoking: the absence of a tobacco-related disease (TRD), younger age and a low motivation for cessation at the initial contact. Conclusions: There was a great difference between intervention and nonintervention. The LII had an impact similar to the HII. The variables associated with no smoking cessation demonstrate the need for more personalized interventions for smokers who present lower indexes of motivation, are younger and do not have smoking-related diseases. [Copyright &y& Elsevier]

Recent advances in fruit research have reignited interest in the market of tropical and unconventional fruit varieties, leading to increased investment in this sector. Additionally, consumers are currently seeking healthier food options to maintain the nutritional integrity of their diets and maximize health benefits, which has driven the demand for novel fruits and a deeper understanding of existing varieties. Despite this growing interest, knowledge of the full potential and diversity of these fruits remains insufficient for key stakeholders to reconcile sustainable production with the promotion of healthier diets within the global context. In this context, many endemic fruits from countries renowned for their rich biodiversity, such as Brazil, are still not produced and consumed regularly. Focusing on nutritional value, the distinctive composition of Brazilian fruits offers numerous health benefits, including essential vitamins, minerals, antioxidants, and anti-inflammatory compounds. This review delves into the economic implications of the Brazilian fruit industry, highlighting its capacity to penetrate the global market for novel foods. The introduction of new features, such as new flavors and textures, presents an excellent opportunity for product differentiation and market expansion. Furthermore, it discusses the importance of developing the fruit industry to promote a circular economy, reduce food insecurity, and generate income. This development can bring substantial social, economic, and environmental benefits to various regions around the globe., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

In 2008, Brazil became the country with the highest pesticide use in the world, with over one billion liters of pesticides applied to crops in 2009. The impacts of these products on public health are wide-ranging. Vast territories are affected, involving different population groups, such as workers in various fields of activity, the population that consumes contaminated food, and people living around factories, such as traditional communities. This study aimed to assess human exposure to pesticides through epidemiological and laboratory data of residents of the Santo Antônio quilombola community in Concórdia do Pará, Amazon region, Brazil. Epidemiological data were collected using a semi-structured questionnaire, which included factors such as sex, age, length of residence, and level of exposure to pesticides. The modified Ellman method was used to assess the activity of cholinesterases, and flow cytometry was performed for cytokine analysis. Analysis of collected blood samples showed that, in most cases, there was no significant reduction in the activity of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) compared to other studies in the scientific literature. Meanwhile, there was an increase in the levels of IFN-γ cytokines, especially IL-6, in all groups. The findings of this study highlight the urgent need for a comprehensive monitoring program, considering that some conditions other than pesticide exposure can alter the activities of the biomarkers used in this study.

The São Francisco River, significant in semi-arid areas, faces impacts from hydroelectric plants and agricultural pesticides. Despite extensive research on its aquatic life, especially fish reproductive biology, there's a notable lack of studies on toxicity and its human health implications. This gap highlights the need for targeted research in this vital ecological zone. Consequently, this study aimed to scrutinize the concentrations of Contaminants of Emerging Concern (CECs), including Polychlorinated Biphenyls (PCBs), Polybrominated Diphenyl Ethers (PBDEs), Organochlorine Pesticides (OCPs), pyrethroid pesticides (PPs), triazine pesticides (TPs), and Organophosphorus Pesticides (OPPs) in the water, sediment, and fish (Plagioscion squamosissimus). The findings revealed the presence of all compound classes in sediment, albeit in limited quantities in water. Biotic components exhibited higher concentrations in nerve tissue, followed by the liver and muscle, indicative of a bioaccumulation trend. It is noteworthy that more concerning levels were observed in both water and sediments. In particular, Fenvalerate in water and Prometon in sediments demonstrated the highest Bioaccumulation Factor (BAF) values. While for non-carcinogenic effects and Cancer Risk (CR), the parameters were calculated and all classified in the areas of acceptable or insignificant according to chemical safety agencies. However, the compounds under scrutiny demand vigilant attention, given their nearly ubiquitous presence across various matrices and demonstrated bioaccumulative capacity, potentially posing future repercussions for human health., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: To identify somatic mutations in tumors from young women with triple-negative or luminal breast cancer, through targeted sequencing and to explore the cancer driver potential of these gene variants., Methods: A customized gene panel was assembled based on data from previous sequencing studies of breast cancer from young women. Triple-negative and luminal tumors and paired blood samples from young breast cancer patients were sequenced, and identified gene variants were searched for their driver potential, in databases and literature. Additionally, the authors performed an exploratory analysis using large, curated databases to evaluate the frequency of somatic mutations in this gene panel in tumors stratified by age groups (every 10 years)., Results: A total of 28 young women had their tumoral tissue and blood samples sequenced. Using a customized panel of 64 genes, the authors could detect cancer drivers in 11/12 (91.7 %) TNBC samples and 11/16 (68.7 %) luminal samples. Among TNBC patients, the most frequent cancer driver was TP53, followed by NF1, NOTCH1 and PTPN13. In luminal samples, PIK3CA and GATA3 were the main cancer drivers, and other drivers were GRHL2 and SMURF2. CACNA1E was involved in both TN and luminal BC. The exploratory analysis also indicated a role for SMURF2 in luminal BC development in young patients., Conclusions: The data further indicates that some cancer drivers are more common in a specific breast cancer subtype from young patients, such as TP53 in TNBC and PIK3CA and GATA3 in luminal samples. These results also provide additional evidence that some genes not considered classical cancer-causing genes, such as CACNA1E, GRHL2 and SMURF2 might be cancer drivers in this age group., Competing Interests: Declaration of competing interest Giselly Encinas is an employee of Agilent Technologies. All other authors declare no conflicts of interest., (Copyright © 2024 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.)

Germline TP53 pathogenic variants can lead to a cancer susceptibility syndrome known as Li-Fraumeni (LFS). Variants affecting its activity can drive tumorigenesis altering p53 pathways and their identification is crucial for assessing individual risk. This study explored the functional impact of TP53 missense variants on its transcription factor activity. We selected seven TP53 missense variants (c.129G > C, c.320A > G, c.417G > T, c.460G > A, c,522G > T, c.589G > A and c.997C > T) identified in Brazilian families at-risk for LFS. Variants were created through site-directed mutagenesis and transfected into SK-OV-3 cells to assess their transcription activation capabilities. Variants K139N and V197M displayed significantly reduced transactivation activity in a TP53-dependent luciferase reporter assay. Additionally, K139N negatively impacted CDKN1A and MDM2 expression and had a limited effect on GADD45A and PMAIP1 upon irradiation-induced DNA damage. Variant V197M demonstrated functional impact in all target genes evaluated and loss of Ser15 phosphorylation. K139N and V197M variants presented a reduction of p21 levels after irradiation. Our data show that K139N and V197M negatively impact p53 functions, supporting their classification as pathogenic variants. This underscores the significance of conducting functional studies on germline TP53 missense variants classified as variants of uncertain significance to ensure proper management of LFS-related cancer risks., (© 2024. The Author(s).)