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A review on planar printed structures that are based on Matryoshka-like geometries is presented. These structures use the well-known principle of Matryoshka dolls that are successively nested inside each other. The well-known advantages of the planar printed technology and of the meandered nested Matryoshka geometries are combined to generate miniaturized, multi-resonance, and/or wideband configurations. Both metal and complementary slot structures are considered. Closed and open configurations were analyzed. The working principles were explored in order to obtain physical insight into their behavior. Low-cost and single-layer applications as frequency-selective surfaces, filters, antennas, and sensors, in the microwave frequency region, were reviewed. Potential future research perspectives and new applications are then discussed.

Introduction: The coverage of the human papillomavirus (HPV) vaccine remains low worldwide. The Family Health Strategy (FHS) in Brazil has an important role in health promotion in communities. Given the FHS's close contact with assisted communities, the coverage of the HPV vaccine should be high in children. This study aims to investigate the acceptance of the HPV vaccine of parents or guardians of a peripheral community of the Brazilian Amazon region assisted by the FHS and influencing factors., Methods: A cross-sectional community-based study recruiting the residents of a subnormal agglomerate of Belém (Pará-Brazil) and covered by the FHS was conducted. Data were collected from September 30 to November 5, 2019. The questionnaire "Knowledge and Acceptability of HPV and Its Vaccine" was used. Data were analyzed through binary and multiple regression analyses., Results: A total of 247 participants were included in this study, and 85 of which (34.4%) declared that they did not vaccinate their children. Hesitation to vaccinate was related to few years of schooling (odds ratio [OR]: 0.79, p =0.008), having sons (OR: 3.14, p =0.000), inadequate knowledge about doses of the HPV (OR: 2.44, p =0.015), and knowledge of anyone who received the HPV vaccine (OR: 7.07, p =0.000)., Conclusion: Results suggested the low efficiency of FHS in increasing the HPV vaccination coverage in the assisted communities. A strategy involving a dialog with assisted families and continuous health education to health professionals should be implemented to combat fake news and increase HPV vaccination coverage., Competing Interests: The authors declare no conflict of interest., (© Glenda Roberta Oliveira Naiff Ferreira et al., 2022; Published by Mary Ann Liebert, Inc.)

Background: Prehabilitation is a process that occurs before surgery and aims to improve patient functional capacity and enhance surgical recovery. This process includes medical, nutritional, physical, and psychological interventions that may reduce the duration of hospital stay and provide postoperative physical benefits., Primary Objective: To evaluate the impact of a prehabilitation program on postoperative recovery time for patients who will undergo gynecological surgery following the Enhanced Recovery After Surgery (ERAS) guidelines., Study Hypothesis: A multidisciplinary, preoperative prehabilitation program for patients who will undergo gynecological surgery leads to a reduction in the length of hospital stay and improves patient functional capacity., Trial Design: Prospective, interventionist, and randomized controlled trial in a 1:1 ratio, open to multidisciplinary team and patients, blinded to surgeons and anesthesiologists. The control group will undergo ERAS standard preoperative care while the intervention group will have ERAS standard preoperative care plus prehabilitation., Major Inclusion Criteria: Patients scheduled to undergo gynecologic surgery performed by laparotomy with a preoperative schedule that allows prehabilitation intervention for 2 to 3 weeks., Primary Endpoint: To compare time between surgery and the day the patient is ready for discharge in patients who underwent the prehabilitation process versus those who did not. Readiness for discharge is defined as the ability to take care of one's-self, to walk alone, and to ingest at least 75% of daily recommended calorie intake., Sample Size: 194 participants ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS: At present, 30 patients have been recruited. Accrual should be completed by 2023-24., Trial Registration: The study is approved by the IBCC - São Camilo Oncologia ethics committee (reference number 4.256.553) and is registered at clinicaltrials.gov (NCT04596800)., Competing Interests: Competing interests: None declared., (© IGCS and ESGO 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Adherence is an important aspect of the effectiveness of family interventions for universal drug prevention. Some approaches suggest adherence assessments should be improved because they are partial and do not take into account all dimensions. The objective of the study is to analyze adherence and retention measures used in family intervention programs for the prevention of substance use in young people aged 10-14 years. To this end, the literature was reviewed on universal programs which have obtained good preventive results. The information sources consulted are: PubMed, PsycINFO (EBSCO), PsycArticles (EBSCO), Social Work abstracts (EBSCO), CINAHL (EBSCO) SocIndex (EBSCO), Scopus, Academic Search Premier (EBSCO), SCIC-ISOC, Cochrane Database of Systematic Reviews, ERIC, ScienceDirect, Web of Science, Project Cork, Researchgate, and consultation with experts. The search results show 21 studies belonging to 6 family programs: Strengthening Families Program 10-14, Parents Who Care, Family Check-Up, Linking Lives Health, Prevention of Alcohol use in Students, and Örebro Prevention Program. The studies analyzed provide little information on the different elements involved in adherence. Retention and differential attribution are the data that appear most frequently, while other aspects such as active participation do not appear in the studies. The results are discussed and recommendations are made to improve the evaluation of adherence and retention in family prevention programs.

Objective: To know the experiences of family members of children with cystic fibrosis under the light of the theory of Callista Roy., Method: Qualitative research that used the adaptation theoretical framework of Callista Roy for inductive content analysis. Fifteen family members, in a university hospital, between 23 and 63 years old, participated in the study, from September to October 2018., Results: Two categories were elaborated: "Evaluation of stimuli" and "Evaluation of behaviors". The first has three subcategories: "focal", "contextual" and "residual". And the second, four subcategories: "physiological domain", "self-concept", "role function" and "interdependence"., Final Considerations: During the evaluation of stimuli, work overload and stress were identified as focal stimuli. Regarding contextual stimuli, it was noticed that the social life of caregivers was prejudiced. As for residual stimuli, the fear of loss is constant, and it appears that the emotional aspect of family members is the most affected comparing with physical exhaustion.

There is evidence of an association between childhood maltreatment and lifelong cognitive impairment. Few studies investigate cognitive functioning in maltreated children. The objective of this study was to investigate whether there are differences in executive processing between maltreated and nonmaltreated children. Additionally, clinical symptoms were compared between groups and possible associations between clinical symptoms, and deficits in executive functions were investigated. The sample consisted of 55 children (8-12 years), 30 with a history of maltreatment and 25 with no history of maltreatment. An interview was conducted with the child's legal guardian and instruments were administered: Juvenile Victimization Questionnaire (JVQ), Child Behavior Checklist (CBCL), and Spence Children's Anxiety Scale (SCAS). The following clinical instruments were administered to the children: JVQ, Trauma Symptom Checklist for Children (TSCC), and Children's Depression Inventory (CDI). Children underwent neuropsychological assessment. Data were analyzed by comparing the groups for clinical and cognitive variables. Differences were found between the groups in all executive functions. Most clinical symptomatology scales showed differences between the groups. Few associations were found between clinical and executive impairment profiles. Cognitive stimulation interventions, focused on inhibitory control, should be proposed in combination with psychotherapy.

Multimorbidity patterns of a population can be influenced by socioeconomic and lifestyle-related factors. Some of these factors are preventable when healthy habits are promoted to the population. This study analyzed the main grouping patterns of chronic diseases and the relationship with socioeconomic and lifestyle-related factors of the Brazilian population (over the age of 18), based on a population-based survey (2013 National Health Survey). A total of 60,202 participants were included. Cluster analysis was carried out to identify the combinations of chronic diseases. Bivariate and multivariate analyses were carried out to verify the relationship between disease clusters and independent variables, utilizing Poisson's regression with robust variance, considering a 95% confidence interval. Cluster analysis revealed four disease clusters:cardiometabolic diseases/cancer, mental/occupational diseases, musculoskeletal diseases and respiratory diseases, all significantly associated with the female gender, current/past smoking habits and overweight/obesity in multivariate analyses. These aspects must be considered when planning health services and developing strategies and guidelines for the prevention and treatment of multiple chronic conditions., Competing Interests: The authors have declared that no competing interests exist.

An immune attack by anti-glutamic acid decarboxylase (GAD) antibodies is believed to cause a deficiency in gamma-aminobutyric acid-mediated neurotransmission in the cerebellum. This, in turn, leads to several eye movement disorders, including spontaneous downbeat (DBN) and periodic alternating nystagmus. We describe a 68-year-old diabetic woman with disabling paroxysmal positioning upbeat nystagmus (UBN) exclusively in the supine position, associated with asymptomatic spontaneous DBN, alternating skew deviation and hyperactive vestibulo-ocular reflex responses on head impulse testing, in whom high titers of anti-GAD antibodies were detected. After treatment with intravenous immunoglobulin, a complete resolution of positioning UBN and spontaneous DBN occurred, along with a decrease in anti-GAD antibody titers. Positioning UBN in this case may reflect a transient disinhibition of the central vestibular pathways carrying posterior semicircular canal signals, due to lack of normal inhibitory input from the cerebellar nodulus/uvula. Immunoglobulin restored cerebellar inhibitory output, possibly by improving gamma-aminobutyric acid neurotransmission.

Knowledge on the occurrence of multimorbidity is important from the viewpoint of public policies, as this condition increases the consumption of medicines as well as the utilization and expenses of health services, affecting life quality of the population. The objective of this study was to estimate prevalence of self-reported multimorbidity in Brazilian adults (≥18 years old) according to socioeconomic and demographic characteristics. A descriptive study is presented herein, based on data from the National Health Survey, which was a household-based survey carried out in Brazil in 2013. Data on 60,202 adult participants over the age of 18 were included. Prevalences and its respective confidence intervals (95%) were estimated according to sex, age, education level, marital status, self-reported skin color, area of residence, occupation and federative units (states). Poisson regression models univariate and multivariate were used to evaluate the association between socioeconomic and demographic variables with multimorbidity. To observe the combinations of chronic conditions the most common groups in pairs, trios, quartets and quintets of chronic diseases were observed. The prevalence of multimorbidity was 23.6% and was higher among women, in individuals over 60 years of age, people with low educational levels, people living with partner, in urban areas and among unemployed persons. The states of the South and Southeast regions presented higher prevalence. The most common groups of chronic diseases were metabolic and musculoskeletal diseases. The results demonstrated high prevalence of multimorbidity in Brazil. The study also revealed that a considerable share of the economically active population presented two or more chronic diseases. Data of this research indicated that socioeconomic and demographic aspects must be considered during the planning of health services and development of prevention and treatment strategies for chronic diseases, and consequently, multimorbidity.

The purpose of this study was to evaluate the influence of adding Lactobacillus acidophilus to a triple regimen for Helicobacter pylori eradication in untreated patients with peptic ulcers or ulcer-scars. This was a pre-randomized, single-blind, interventional, treatment-efficacy study with active controls and parallel-assignment, set in Coimbra, Portugal, on 62 consecutive H. pylori-positive untreated adults with peptic ulcers or ulcer-scars, diagnosed by gastroduodenoscopy, with pre-treatment direct Gram-staining and culture of gastric biopsies. The first 31 patients received esomeprazole 20 mg, amoxicillin 1000 mg and clarithromycin 500 mg (EAC), all b.i.d., for 8 days. The remaining 31 added L. acidophilus, 5 × 10(9) organisms per capsule, 3 + 2 i.d. for 8 days (EACL). The main outcome measure was (13)C urea breath test (UBT), ≥6 weeks after completion of therapy. Successful eradication (UBT-negativity after treatment), was similar in both groups (EAC = 80.6%; EACL = 83.9%, p = 0.740) by both intention-to-treat and per-protocol analysis. The non-eradicated strains were susceptible in vitro to both antibiotics. Adding L. acidophilus to EAC triple therapy did not increase H. pylori eradication rates. Considering the cost and the burden of ingesting five extra capsules daily, supplementing the EAC therapy with L. acidophilus, at this dose, shows no benefit. Further studies with different dosages and duration of treatment, and other probiotics or probiotic combinations are required to improve eradication.

The present study describes the determination of the bioavailability of a new commercial tablet formulation of lamivudine (CAS 134678-17-4) compared with a reference formulation. The comparative bioequivalence of the test and a reference formulation (each 3 x 150 mg) was assessed in 24 healthy volunteers by means of a randomized two-way crossover design. Prior to the study both the test and reference formulations were examined for conformation to chromatographic purity and drug content. Each volunteer received the test (T) and the reference formulation (R) with a one-week drug-free interval between administrations. The plasma concentrations of T were monitored over a period of 12 h after drug administration using a sensitive HPLC method. Pharmacokinetic parameters for T were determined from plasma concentration-time data. Statistical tests were carried out at 90% confidence intervals using a parametric method (three-way ANOVA) for AUC and Cmax, and non-parametric method for Tmax. The present study showed that both formulations were bioequivalent for the geometric mean of AUC(0-12), AUC0-infinity), Cmax, and Tmax at the 90% confidence interval. The bioavailability of the test (%) was 96.7, 93.3, 99.7, 100.3, respectively. The T:R ratio was, in each case, well within the acceptable range of 100 +/- 20%.