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Abstract Background The pandemic caused by SARS-CoV-2 has not only affected humans but also raised concerns about its transmission to wild animals, potentially creating natural reservoirs. Understanding these dynamics is critical for preventing future pandemics and developing control strategies. This study aims to investigate the presence of SARS-CoV-2 in wild mammals at the Belo Horizonte Zoo in Brazil, analyzing the virus's evolution and zoonotic potential. Methods The study was conducted at the Belo Horizonte Zoo, Minas Gerais, Brazil, covering a diverse population of mammals. Oropharyngeal, rectal, and nasal swabs were collected from 47 captive animals between November 2021 and March 2023. SARS-CoV-2 presence was determined using RT-PCR, and positive samples were sequenced for phylogenetic analysis. Consensus genomes were classified using Pangolin and NextClade tools, and a maximum likelihood phylogeny was inferred using IQ-Tree. Results Of the 47 animals tested, nine (19.1%) were positive for SARS-CoV-2. Positive samples included rectal, oropharyngeal, and nasal swabs, with the highest positivity in rectal samples. Three genomes were successfully sequenced, revealing two variants: VOC Alpha in a maned wolf (Chrysocyon brachyurus) and a fallow deer (Dama dama), and VOC Omicron in a western lowland gorilla (Gorilla gorilla gorilla). Phylogenetic analysis indicated potential human-to-animal transmission, with animal genomes clustering close to human samples from the same region. Conclusions This study highlights the presence of SARS-CoV-2 in various wild mammal species at the Belo Horizonte Zoo, emphasizing the virus's zoonotic potential and the complexity of interspecies transmission. The detection of different variants suggests ongoing viral evolution and adaptation in new hosts. Continuous monitoring and genomic surveillance of SARS-CoV-2 in wildlife are essential for understanding its transmission dynamics and preventing future zoonotic outbreaks. These findings underscore the need for integrated public health strategies that include wildlife monitoring to mitigate the risks posed by emerging infectious diseases.

Objectives: There is a limited number of updated epidemiological Brazilian data on head and neck squamous cell carcinoma (HNSCC). This study aimed to describe demographic and clinical characteristics of HNSCC patients from Brazilian public and private systems. Methods: This is a retrospective observational study that included patients diagnosed with HNSCC from Brazilian public and private settings from 2016 to 2018. As for the public scenario, data were drawn from the public hospital national cancer registry database. As for the private sector, the data were extracted from medical records of patients from Oncoclinicas, a large Brazilian oncology group. Results: A total of 37,121 patients were included in the study, with 36,914 from the public and 207 from the private system. Patients in the public sector were younger than those in the private sector, with medians ages of 61.2 and 66.9 years, respectively. In both cohorts, a predominance of men with a history of tobacco and alcohol consumption and an advanced locoregional stage at diagnosis was observed. The main site of the primary tumor was the oropharynx in the private sector and oral cavity in the public sector. Among patients with oropharyngeal cancer, only those in the private sector were tested for HPV, with the majority being positive. Conclusions: This real-world data study provides epidemiologic characteristics of patients with HNSCC in two different Brazilian healthcare settings, presenting relevant insights into possible opportunities for improvements in the patient's journey with HNSCC.

Background/Objectives: The influenza vaccination of healthcare workers (HCWs) is recommended each autumn and winter season by the relevant authorities in EU/EEA countries. The objective of this study was to evaluate the impact of repeated trivalent influenza vaccine (TIV) uptake during the 2017/2018 and 2018/2019 seasons on vaccine-derived immunity against influenza. Methods: A cohort study of HCWs vaccinated with an annual TIV was conducted from October 2017 to June 2019. The protective antibodies against the influenza vaccine strains were assessed at three time points: prior to vaccination and at one and six months following vaccination for each season. Sera were tested by hemagglutination inhibition assay. Participants were grouped according to their history of TIV vaccination over four seasons (since 2015/16), with the groups designated as “frequently vaccinated” (≥3 vaccines) and “occasionally vaccinated” (≤2 vaccines). Seroprevalence, geometric mean titer (GMT) and seroconversion rate were compared between the frequently and occasionally vaccinated groups. Results: A total of 97 healthcare workers (HCWs) were enrolled in the study; 49 HCWs participated in both seasons. Thirty-two (43.2%) and forty-three (59.7%) individuals had ≥3 vaccines since 2015/2016, at recruitment and during the 2017/2018 and 2018/2019 influenza seasons, respectively. One month following vaccination, HCWs who had received occasional vaccinations demonstrated a higher prevalence of protective antibodies and a greater GMT for both influenza A(H1N1)pdm09 and A(H3N2) viruses. For influenza B Victoria, the frequently vaccinated HCWs demonstrated a higher seroprevalence rate, seroconversion, and GMT. Conclusions: Previous vaccination can influence the immune response, although without substantially compromising the immunogenicity of annual influenza vaccination. HCW annual influenza vaccination is required to re-establish and maintain the antibody titers against influenza.

The aim of the study is to evaluate the treatment patterns, time to start treatment, and healthcare resources utilization (HCRU) of cervical cancer (CC) patients within the Brazilian public health system (SUS). This is an observational retrospective study using SUS administrative database (DATASUS). Data from January-2014 to December-2020 was gathered from patients with the ICD-10 C53 codes. From 2014 to 2020, 206,861 women were included, among whom 90,073 (43.5%) had stage information. Of staged patients, 60.7% (54,719) had advanced disease (stages III and IV) and the most performed treatments were chemoradiotherapy (CRT) (41.6%), surgery + CRT (19.1%), radiotherapy (RT) only (16.8%) and chemotherapy (CT) only (13.3%). The proportion of patients submitted to CT in advanced stages was higher than in non-advanced stages (I and II), in contrast to RT, which was more frequent in stage I than stage IV. Median time to initiate treatment surpassed two months in approximately 30% of the cases, regardless of stage. Conization was the most performed surgical procedure. The hospitalization rate per patient per month for stage IV was twice as high as stage I (0.05 [95%CI 0.05-0.05] and 0.11 [0.11-0.11], respectively). The same trend was observed for outpatient visits (0.54 [95%CI 0.53-0.55] and 0.96 [0.93-0.98], respectively). This study demonstrated a high proportion of advanced CC at diagnosis in Brazil. The treatment pattern showed that chemoradiotherapy was the most frequent regimen overall and the use of chemotherapy and HCRU increased with staging. These results could provide information to improve public policies towards access to prevention, diagnosis, and treatment of CC in Brazil.

Introduction The IMPACT study focuses on chronic low back pain (CLBP) and depression symptoms, a prevalent and complex problem that represents a challenge for health professionals. Acceptance and Commitment Therapy (ACT) and Brief Behavioural Activation Treatment for Depression (BATD) are effective treatments for patients with persistent pain and depression, respectively. The objectives of this 12 month, multicentre, randomised, controlled trial (RCT) are (i) to examine the efficacy and cost-utility of adding a group-based form of ACT or BATD to treatment-as-usual (TAU) for patients with CLBP and moderate to severe levels of depressive symptoms; (ii) identify pre–post differences in levels of some physiological variables and (iii) analyse the role of polymorphisms in the FKBP5 gene, psychological process measures and physiological variables as mediators or moderators of long-term clinical changes.Methods and analysis Participants will be 225 patients with CLBP and moderate to severe depression symptoms recruited at Parc Sanitari Sant Joan de Déu (St. Boi de Llobregat, Spain) and Hospital del Mar (Barcelona, Spain), randomly allocated to one of the three study arms: TAU vs TAU+ACT versus TAU+BATD. A comprehensive assessment to collect clinical variables and costs will be conducted pretreatment, post-treatment and at 12 months follow-up, being pain interference the primary outcome measure. The following physiological variables will be considered at pretreatment and post-treatment assessments in 50% of the sample: immune-inflammatory markers, hair cortisol and cortisone, serum cortisol, corticosteroid-binding globulin and vitamin D. Polymorphisms in the FKBP5 gene (rs3800373, rs9296158, rs1360780, rs9470080 and rs4713916) will be analysed at baseline assessment. Moreover, we will include mobile-technology-based ecological momentary assessment, through the Pain Monitor app, to track ongoing clinical status during ACT and BATD treatments. Linear mixed-effects models using restricted maximum likelihood, and a full economic evaluation applying bootstrapping techniques, acceptability curves and sensitivity analyses will be computed.Ethics and dissemination This study has been approved by the Ethics Committee of the Fundació Sant Joan de Déu and Hospital del Mar. The results will be actively disseminated through peer-reviewed journals, conference presentations, social media and various community engagement activities.Trial registration number NCT04140838

Introdução: A identificação e referenciação precoce dos doentes com necessidades paliativas é fundamental para que em tempo útil possam usufruir da efetividade da intervenção precoce de cuidados paliativos. Referenciar para cuidados Paliativos é um importante, crescente e complexo desafio e processo para a prática dos profissionais de saúde, nomeadamente para os médicos. A falta de informação e formação podem impedir a proatividade no processo de referenciação precoce. Atualmente, existem já alguns instrumentos multidimensionais que ajudam a identificar a população com necessidades paliativas. A pergunta surpresa, validada para Portugal, “Ficaria surpreendido se este doente morresse durante o próximo ano?” é uma ferramenta importante, útil e fiável para esta identificação. Objetivo: determinar a prevalência de doentes adultos com necessidades paliativas internados em hospitais públicos. Como objetivos secundários, determinar o número de doentes referenciados para cuidados paliativos e identificar os motivos de não referenciação destes doentes. Materiais e Métodos: Estudo analítico, observacional e transversal, realizado no primeiro trimestre de 2015 em 11 hospitais do SNS. O instrumento de colheita de dados consistiu num questionário com caracterização demográfica e clinica, a pergunta surpresa relativa a 1 ano, 6 e 1 mês e, 15 dias, e 19 possíveis motivos para não referenciação dos doentes. Os dados recolhidos forma analisados com recurso à estatística descritiva e analítica, considerando-se significância estatística se p

O presente estudo teve como objetivo apontar os motivos da não adesão dos idosos à campanha de vacinação contra a influenza. Trata- se de uma revisão bibliográfica do tipo atualização, tomando-se como base dissertações e teses, trabalhos de conclusão de curso e artigos científicos sobre o tema, disponíveis nas bases de dados das ciências da saúde on-line: Scielo e Lilacs. Vários foram os motivos encontrados para a não adesão dos idosos à vacinação, destacando-se o medo das reações adversas, sendo necessário maior envolvimento dos profissionais da saúde quanto às orientações sobre a importância da vacinação contra a Influenza dirigidas à população idosa.

Abstract Background The World Falls guidance includes medication review as part of its recommended multifactorial risk assessment for those at high risk of falling. Use of Falls Risk Increasing Drugs (FRIDs) along with polypharmacy and anticholinergic burden (ACB) are known to increase the risk of falls in older people. Method The impact of a community falls pharmacist within a hospital Trust, working as part of a multi-professional community falls prevention service, was evaluated in 92 people aged 65 years or older, by analysing data before and after pharmacist review, namely: number and type of FRIDs prescribed; anticholinergic burden score using ACBcalc®; appropriateness of medicines prescribed; bone health review using an approved too; significance of clinical intervention; cost avoidance, drug cost savings and environmental impact. Results Following pharmacist review, there was a reduction in polypharmacy (mean number of medicines prescribed per patient reduced by 8%; p

This research offers a systematic review and meta-analysis of forgiveness training programs conducted with university students. A search of international databases (Web of Science, SCOPUS, PUBMED and Dialnet) revealed 316 articles published up to 2023, 20 of these articles were finally included in the systematic review, following the PRISMA protocol. Of these, eleven randomized-controlled trials (n = 11) and one quasi-experimental study (n = 1) were used in the meta-analysis. The results of the analysis show that Forgiveness Interventions (FI) have a positive effect on the capacity to forgive in experimental groups which showed significantly higher scores in empathy, self-esteem and hope, with a reduction in negative symptomologies such as anxiety and depression. The findings also suggest that an important facilitating variable in FI is the length of the interventions. The two most commonly utilized programs were Worthington’s REACH program and the Enright Forgiveness Process Model. The intervention program used both face-to-face sessions with trainers and autonomous group work sessions. Given the significant benefits these programs offer in terms of mental health and well-being, it is recommended that FI programs should be offered at universities and colleges as part of a comprehensive and truly competence-based education.

AbstractBackground Some patients with severe asthma may benefit from treatment with biologics, but evidence has been mostly collected from randomized controlled trials (RCTs), in which patients’ characteristics are different from those encountered in asthma patients in the real-world setting. The aim of this study was to describe the clinical features of complete responders versus non-complete responders to long-term treatment with biologics in patients with severe asthma attended in routine daily practice.Methods Data of a cohort of 90 patients with severe asthma who were treated with biologics (omalizumab, benralizumab, and mepolizumab) for at least 12 months and were followed up to March 2022. Data recorded included clinical characteristics and effectiveness of treatment (exacerbation, Asthma Control Test [ACT] score, lung function, use of maintenance oral corticosteroids [mOCS]), FeNO, and blood eosinophils at baseline, at 12 months, and at the end of follow-up. Complete response is considered if, in addition to not presenting exacerbations or the use of mOCS, the ACT score was >20 and, the FEV1 >80% predicted.Results An improvement in all asthma control parameters was observed after 12 months of treatment and a mean follow-up of 55 months. After 12 months of treatment 27.2% of patients met the criteria of complete response and this percentage even increased to 35.3% at the end of follow-up. Long-term complete response was associated to better lung function with mepolizumab and omalizumab treatment and to less previous exacerbations in the benralizumab group. The main cause of not achieving a complete response was the persistence of an airflow obstructive pattern.Conclusions This study shows that omalizumab, benralizumab, and mepolizumab improved the clinical outcomes of patients with severe asthma in a clinic environment with similar effect sizes to RCTs in the long term follow-up. Airflow obstruction, however, was a predictor of a non-complete response to biologics.

RESUMO Introdução: O elitismo no ensino da medicina é um fenômeno histórico. Desde as universidades europeias da Idade Média, o ensino da medicina tornou-se um monopólio da elite. No Brasil, a elitização do conhecimento médico ocorreu com a vinda da família real em 1808, reforçando o papel dos médicos como protagonistas da saúde, enquanto práticas curativas populares foram desvalorizadas. Nos Estados Unidos, Abraham Flexner influenciou o ensino médico mundial com um modelo elitizado baseado na lógica biomédica. Objetivo: Este estudo teve como objetivos compreender os fatores que reproduzem o contexto elitista no ensino da medicina, investigar como esses aspectos influenciam a exclusão de determinados grupos sociais no meio médico e apontar caminhos para a discussão e o enfrentamento do problema. Método: Trata-se de uma revisão integrativa de literatura realizada a partir de 14 artigos selecionados entre 182, publicados no período de 2012 a 2022 e filtrados das bases de dados PubMed, SciELO, Lilacs, Web of Science e Scopus. Resultado: Percebem-se semelhanças entre o grupo privilegiado na medicina, formado por homens, brancos, heterossexuais e cisgênero, de condição socioeconômica favorável, em comparação ao grupo sistematicamente marginalizado de mulheres pertencentes a minorias étnico-raciais, de baixa classe socioeconômica e/ou parte da população LGBTQIA+. Essa coincidência tem bases históricas e econômicas que refletem uma estrutura maior, que distribui privilégios partindo dos critérios de raça, gênero, classe social e orientação sexual. Entre os processos históricos que reproduzem esse padrão, cita-se o processo de colonização de países como o Brasil, marcado pela exploração, pelo apagamento e pela imposição de uma cultura e ciência médica balizada por um padrão europeu; o racismo e machismo que, como ideologias, continuam sendo critérios para a distribuição de privilégios na sociedade de classes; e a heterocisnormatividade, que também atua excluindo corpos e orientações sexuais e produção de conhecimentos e práticas de cuidado em saúde. Conclusão: Epistemologias críticas como as presentes no pensamento interseccional do feminismo negro e na colonialidade do poder de Aníbal Quijano e Audre Lorde apresentam-se como caminhos à ruptura dessa norma, propiciando o questionamento de suas raízes para a organização de lutas coletivas e formas de produção de conhecimento que venham ao encontro dos interesses dos grupos historicamente oprimidos.

No presente artigo, a discussão parte de dados produzidos em uma pesquisa de doutoramento. Buscou-se uma etnografia descolonizadora, estabelecem-se conversas com seis mulheres do quilombo Fazenda Santa Cruz, localizada na região do Alto Jequitinhonha, no município do Serro, em Minas Gerais. Apoia-se em autoras do pensamento feminista negro e decolonial, entre elas Patricia Collins (2016), Curriel (2014), Angela Davis (2016), bell hooks (2018), Gonzalez (1981, 1984), Beatriz Nascimento (1974) e Oyeronke Oyewumi (2010). Observou-se as práticas educativas relacionadas a cuidado, que atravessam as práticas culturais desenvolvidas por elas, ocorrendo de forma compartilhada por meio de um “cuidado familiar” anunciado pela territorialidade.

Propomo-nos ponderar as (des)vantagens da presente proliferação de mensagens e encontros, de “amizades”, proporcionadas com a utilização de tecnologias digitais. Concomitantemente, confrontar o conceito de “amizade” subjacente ao relacionamento interpessoal hodierno, fruto da adesão a aplicações digitais, com a definição de amizade em Aristóteles; uma conceção, do ponto de vista ético-social, que foi influência marcante ao longo dos tempos na sociedade ocidental. E, assim, avaliar algumas ruturas ocasionadas em termos de (des)integração de referenciais pessoais e sociais e de enquadramentos coletivos, tradicionalmente estruturantes e emblemáticos na consideração do viver humano autêntico.

The paper discusses Damasio’s homeostasis theory and its potential connection to design. It starts with the evolution of physiological regulation from the Hippocratic theory of body humours through Claude Bernard’s milieu intérieur, Walter Cannon’s formulation of the concept of homeostasis, culminating with Damasio’s homeostasis theory emphasising conscious homeostatic feelings, besides the unconscious mechanisms of physiological control. Next, it shows the importance of Damasio’s homeostasis theory in perception, consciousness, as well as affect and wellbeing, and how it can inform the design discourse, specifically regarding emotions, embodiment, and environment. It poses questions such as whether design could be viewed as an extension of ourselves, acting as a psychic stabiliser or destabiliser. It argues that how we feel may eventually serve as a homeostatic design guide and that knowledge of homeostasis may improve wellbeing and the built environment.

Abstract The objective of this work was to investigate the influence of the reproductive stage of closed-flowering barley on Fusarium graminearum infection and to evaluate the efficacy of pre-inoculation fungicide application in controlling Fusarium head blight (FHB) and reducing grain contamination with the deoxynivalenol (DON) mycotoxin. Two experiments, in a completely randomized design with eight replicates, were conducted in a growth chamber at different temperatures. The statistical analysis was nonparametric, using the Kruskal-Wallis test. Potted plants of the BRS BRAU barley cultivar were inoculated by spraying a conidial suspension at the following three reproductive stages: anthesis halfway, grain at medium milk, and soft dough. The tebuconazole fungicide was sprayed 48 hours before pathogen inoculation. The FHB symptoms caused by the inoculation with F. graminearum at the medium milk stage are fully visible, although fungicide application before pathogen inoculation controls the disease, but mild at the anthesis halfway and soft dough stages. Inoculation at the three stages results in grain contamination with DON, which is reduced by pre-inoculation fungicide application.

ABSTRACT Objective: This descriptive observational study aimed to determine clinically relevant and applicable data of enamel thickness (ETH), considering the mesio-distal differences of anterior and posterior permanent teeth and their relationships. Material and Methods: The sample consisted of right-sided standardized radiographs of 34 individuals (21 females and 13 males), aged between 13 and 24 (average 16) years, with all permanent teeth intact and without crowding. Four periapical and four interproximal radiographs were obtained and digitized. ETH measurements (mesial to distal contact points at the dentin-enamel junction) were performed after correction for radiographic image magnification. The Students’ t-test was applied to the differences between paired means, with the Pearson correlation to evaluate the correlation between them. Results: The mesial and distal ETH increased from the anterior to the posterior teeth. Incisor ETH ranged between 0.60 and 0.84 mm. Canines, premolars, and molars were more than 1.0 mm thick, and molar enamel reached values between 1.26 and 1.44 mm. Conclusion: Distal ETH was significantly greater than the mesial ETH, and progressively thicker from the anterior to posterior teeth. Interproximal reduction (IPR) of the lower central and upper lateral incisors should be avoided, reduced, or performed on their distal surfaces. There is a positive and significant correlation between ETH and the mesial and distal surfaces of the teeth. Periapical radiographs and evaluation of the remaining ETH are necessary in cases of retreatment. The location and number of tooth size discrepancies should be considered in treatment planning and appropriately compensated with IPR.

A incidência da linguagem sobre o corpo resulta em perda de aproveitamento. Esse momento de castração oferece um ponto de partida para o exame psicanalítico do trauma e sua incidência nos corpos fantasmáticos e sintomáticos e, consequentemente, no corpo que os conduz. O corpo pode ser visto como um produto da linguagem; quando a linguagem atua sobre o organismo, o corpo passa a existir. Longe dos olhos, escondido, como as partes heimliche (íntimas) do corpo. Essa ocultação é atribuída ao caráter do desconhecido e, portanto, não familiar. Nessa investigação, Freud encontra a definição interessante que estará presente em toda a sua obra, a saber, unheimliche. Unheimliche significa tudo o que deveria ter permanecido secreto e oculto, mas veio à luz. Ocorre então uma fusão do corpo sintomático do paciente histérico com sua fantasia, censurando o primeiro capítulo de sua história, o dessa perda de gozo, esse traumatismo que ocorre quando o vivente entra no mundo da linguagem.

Neste artigo, analisamos continuidades e mudanças na construção de práticas epistêmicas em dois contextos instrucionais distintos: investigativo (EnCI) e sociocientífico (QSC). Baseados na Etnografia em Educação, acompanhamos estudantes de uma turma do 8° ano do Ensino Fundamental ao longo de um ano em aulas de ciências. Selecionamos um evento para análise das práticas epistêmicas a partir de interações discursivas. Os resultados da análise deste evento, à luz de outros eventos ocorridos ao longo do ano, indicam relações complementares entre as abordagens EnCI e QSC. Atividades em contexto investigativo favoreceram o posicionamento consciente e justificado pelos estudantes em discussões sociocientíficas. Atividades em contexto sociocientífico, por sua vez, catalisaram a emergência de práticas epistêmicas mais complexas. Defendemos, portanto, as vantagens pedagógicas de articulações entre o EnCI e as QSC, entendidas como complementares, tendo em vista os objetivos da educação científica no século XXI.

This paper analyzes continuities and changes in the constructing epistemic practices in two different instructional contexts: inquiry-based science teaching (IBST) and socioscientific issues (SSI). Based on Ethnography in Education, we followed students in an 8th-grade elementary school classroom for over a year in science lessons. We selected an event to analyze epistemic practices in discursive interactions. Considering other events over the year, the analysis of this event indicates reciprocal relationships between the IBST and SSI approaches. Inquiry-based activities fostered conscious and justified positioning by students in socio-scientific discussions. Socioscientific activities, in turn, catalysed the construction of more complex epistemic practices. Therefore, we defend the pedagogical advantages of articulations between IBST and SSI activities to support science education aims in the 21st century.

Ethnographic researchers have long relied upon observation as a powerful means to learn about social relations. This paper discusses research observation that was conducted as a part of an institutional ethnography (IE) investigating how people use the language and ideas of neurodiversity across different settings. While our research protocol initially called for ethnographic observation to take place at in-person events in Southern Ontario, our approach needed to be re-formulated with the switch to online events during the COVID-19 pandemic. After the shift to online-only spaces, a total of 52 sessions at 7 online events related to neurodiversity or autism were observed by a team of 5 researchers: these events were no longer geographically restricted but were officially “hosted” by institutions in Canada, the US, and the UK. This paper reflects upon the challenges and opportunities we encountered as we conducted observations in digital spaces, including our experiences of navigating the “chat” feature. We discuss the need to analyze the format as well as the content of online events, and present findings on how neurodiversity appeared in these social spaces. Finally, we consider the implications of this research for people who are conducting ethnographic observation in an increasingly online world.

Objective: to construct and validate the content of a nursing history for a Long Stay Institution for the Elderly. Methods: a methodological study divided into the following stages: identification of the main Nursing Diagnoses in the literature, development of the instrument, validation with specialists using the Delphi technique, and restructuring of the instrument based on the Self-Care Deficit Theory. Results: the 41 articles selected resulted in 78 main Nursing Diagnoses, which supported the development of an instrument with 104 items. A total of 37 experts were selected and invited for validation, and 10 agreed to contribute. After validation, the record was finalized with 90 items, with a Content Validation Index between 0.80 and 1.0 in the first round. The suggestions validated in the second round achieved 80-100% agreement to complete the validation of the instrument's content. Conclusion: the content of a nursing history for a Long-Stay Institution for the Elderly based on the Self-Care Deficit Theory was constructed and validated. Contributions to practice: this is an important resource that can be used in clinical practice.

During the COVID-19 pandemic, the Oswaldo Cruz Foundation (Fiocruz), a Brazilian federal research institution supported by the Brazilian Health Ministry, established a biobank. This biobank began by preserving the SARS-CoV-2 virus and human biological material related to COVID-19. This innovative initiative combined human and biodiversity materials within a single infrastructure. Designed for supporting research, development, and innovation in healthcare and preparedness and response to emerging and re-emerging infectious diseases, the biobank’s focus has since expanded to include various biological materials, leading to its renaming as the Biodiversity and Health Biobank - Fiocruz-BBS (Portuguese: Biobanco da Biodiversidade e Saúde da Fiocruz – BBS-Fiocruz). This paper outlines the challenges of creating and maintaining an adequate infrastructure in a developing country for promoting and supporting scientific research and biotechnological innovation activities in health through processes of depositing, characterizing, preserving, and supplying human and biodiversity biological materials, alongside associated data, while complying with prevailing legal and ethical rules. These processes adhere to stringent quality, biosafety, and biosecurity standards set forth in ISO 20387:2018. Additionally, the challenges of ensuring the Biobank’s long-term sustainability is discussed. This involves a) establishing benchmarks and best practices, b) developing a comprehensive business plan, c) forging partnerships, d) diversifying funding sources, e) ensuring ethical and legal compliance, f) implementing rigorous quality control procedures, and g) investing in human resources and infrastructure. The insights shared in this paper will benefit other biobanks engaged in services related to tropical infectious diseases.

Objetivo: Mapear a evidência científica sobre a exposição dos enfermeiros aos riscos ocupacionais em contexto hospitalar. Método: Protocolo de scoping review desenvolvido de acordo com a metodologia de Joanna Briggs Institute e registado na Open Science Framework: https://osf.io/yfqk9. As bases de dados consultadas foram a CINHAHL® Complete e MEDLINE® via EBSCO e Scielo. Serão considerados elegíveis os estudos que respondem à questão de investigação “Quais os riscos ocupacionais a que estão expostos os enfermeiros em contexto hospitalar?”. A seleção dos estudos será realizada por dois revisores independentes e recorrer-se-á a um terceiro revisor em caso de discordância. Os estudos serão arquivados e eliminados os duplicados através do software Qatar Computing Research Institute (Rayyan QCRI®). Para a síntese e extração das informações recolhidas os autores irão utilizar o formulário previamente elaborado. Espera-se que a scoping review contribua para a análise crítica dos riscos ocupacionais a que estão expostos os enfermeiros em contexto hospitalar. ABSTRACT Objective: To map the scientific evidence on nurses' exposure to occupational risks in a hospital context. Method: Scoping review protocol developed according to the Joanna Briggs Institute methodology and registered in the Open Science Framework: https://osf.io/yfqk9. The databases consulted were CINHAHL® Complete and MEDLINE® via EBSCO and Scielo. Studies that answer the research question “What occupational risks are nurses exposed to in a hospital context?” will be considered eligible. The selection of studies will be carried out by two independent reviewers and a third reviewer will be used in case of disagreement. The studies will be archived and duplicates will be eliminated using the Qatar Computing Research Institute (Rayyan QCRI®) software. To summarize and extract the information collected, the authors will use the previously prepared form. It is expected that the scoping review will contribute to the critical analysis of the occupational risks to which nurses are exposed in a hospital context.

RESUMO: Neste editorial apresentamos as perspectivas de ciência aberta adotada pelo periódico dando destaque para as práticas de dados abertos e dados compartilhados. A disponibilização de dados de pesquisa pode aprimorar a transparência, a colaboração, a reprodutibilidade, a replicação, o reuso e o enriquecimento da produção científica no campo da Educação em Ciências. Por isso, neste editorial, trazemos novas perspectivas à temática com base em nossos aprendizados ao longo de 2023 na implementação de uma editoria de dados, a qual detalhamos o trabalho em um fluxograma. Além disso, abordamos algumas das possíveis implicações do compartilhamento ético de dados na área e relatamos alguns dos frutos das interações entre nossa equipe editorial, pessoas autoras e a comunidade acadêmica envolvida nas discussões sobre ciência aberta e sintetizamos os caminhos que temos trilhado nessa seara.

ABSTRACT Physical properties of the Technosols formed by the tailings deposition may constitute a physical barrier that limits water movement and plant development due to the properties received from those sediments. This study aimed to evaluate the physical quality of the Technosols formed by the deposition of sediments displaced by the Fundão Dam failure, Mariana, Minas Gerais State, Brazil, based on the evaluation of physical properties and Load Bearing Capacity Models (LBCM). For that, three areas under different vegetation types were selected: eucalyptus (Euc), forest with human-assisted revegetation (RF), and forest with native vegetation (NF). Three sampling subareas were demarcated in each area: non-impacted areas (Ni), and Technosols formed in directly impacted areas (Di), and partially impacted areas (Pi). Undisturbed samples were collected in two layers and subjected to the uniaxial compression test after equilibration at five matric potentials. Soil compression curves and LBCM were determined. Soil bulk density (BD), total porosity (TP), organic matter (OM), granulometry, and particle density (PD) were also determined. Clay content was less significant, and the silt and very fine sand content was significantly higher in the Technosols, generating an increase in BD and reduction in TP. Technosols generally exhibited greater load-bearing capacity due to higher pre-consolidation pressure values attained by these soils due to the lower clay and OM contents. High resistance of these soils is one limitation for revegetation of the areas evaluated, being necessary management practices to improve physical properties of the Technosols.

El desarrollo formativo de las competencias genéricas es necesario en cualquier ámbito. En este sentido, son cada vez más promovidas en la educación y más demandadas en las empresas. El objetivo de este artículo es presentar y validar las puntuaciones de un instrumento de medición sobre competencias genéricas básicas; para ello, definido el constructo de competencias genéricas, se identificaron las dimensiones subyacentes, subdimensiones e indicadores, y se elaboraron los ítems. La versión final del cuestionario se aplicó a una muestra de 547 alumnos de primer año de universidad de la Comunidad de Madrid; los análisis indican que las puntuaciones del cuestionario son fiables y válidas, y apoyan el modelo teórico. Los resultados muestran un cuestionario adecuado para medir el nivel de desarrollo de las competencias genéricas básicas y para valorar la formación impartida en esta materia.

Abstract Introduction Professional identity formation (PIF) is recognized worldwide as an outcome of medical education grounded in the psychology of adult development and the literature on medical professionalism. However, instruments to assess and support PIF are scarce. The Professional Identity Essay (PIE) is an open-ended question assessment of PIF that elicits short narrative responses from learners and that can be analyzed to provide formative feedback and an overall stage of development. In this study, our aim was to translate and adapt the PIE to Brazilian Portuguese. Methods We followed a systematic procedure for the translation and cross-cultural adaptation of the instrument. A pilot study was conducted with medical students from the University of São Paulo. After providing individual formative feedback, we administered an online questionnaire to the Brazilian students to better understand the consequences of using the PIE. Content analyses of qualitative data were performed, we employ manifest content analysis, and the categories of analysis emerged from the participants’ speeches. Results Students found the instrument’s questions easy to interpret and self-reflective. It also gave students the opportunity to consider their PIF. The PIE was perceived as reliable and brought more awareness of the students’ own processes in addition to a sense of capability to foster their own development. In the same way, the students emphasized the importance of being helped in this process. Conclusion We found sufficient evidence of the validity of the PIE in terms of content, face validity, and consequences of use. The PIE enhances self-assurance in PIF through formative assessment and is sensitive to different cultures, making it a potential tool for educators.

The dataset presented here is the quartzite and quartz reference collection from the National Research Centre of Human Evolution of Spain (CENIEH), Burgos. This dataset or online lithotheque consists of 73 archaeological and geological samples obtained in different projects in which the CENIEH has been involved in the last 15 years. Most of the samples described here were collected from the Iberian Peninsula, while a few others were chosen from Eastern Africa. The samples have been petrographically described using thin section, stereomicroscopy and de visu petrographic observations and they have been characterised according to their petrogenesis. This dataset consists of a comprehensive report, an alphanumeric dataset with relevant features and an extensive picture archive. The dataset collection is stored at the CENIEH and it is open for researchers who want to use it for establishing their reference collection and describing quartzites in archaeological contexts.

Legume flours are an increasingly popular food ingredient. Thermal treatments applied prior to milling legumes and granulometry can modify flour properties, altering sensory, digestibility and functional attributes. Raw and treated (soaked and cooked) lentil flours of different granulometry were produced. The applied treatment resulted in an increase in fiber content (25.4 vs. 27.6% for raw and treated lentil flour, respectively) and water absorption capacity. It also led to a decrease in ash content (3.3 vs. 1.8% for raw and treated, respectively) and a darker flour. Treated lentil flour was mainly composed of fractions of high granulometry, which could be beneficial for products where a lower glycemic index is sought, as they demonstrated higher fiber and lower carbohydrate content than the finer fractions. Treated flour may be used as an ingredient in the development of raw products, including beverages and desserts, due to its reduced anti-nutritional compounds’ content and enhanced organoleptic aspects. The obtained results allow an in-depth characterization of raw and treated lentils flour with different particle sizes to consider a formal and complete standardization of these flours and for understanding their utility and specific food applications.

Given the continuous changes in the world, with an increasing trend of unhealthy lifestyles, metabolic comorbidities, and increased susceptibility to cardiovascular diseases (CVDs), researchers change their attention to improve not only the therapeutic platform but also current CVD predictive and prognostic tools to improve disease outcomes. As CVD is characterized by an inflammatory paradigm involving, to some degree, the innate and adaptative immune systems, the neutrophil-to-lymphocyte ratio (NLR) emerged as a potential low-cost, rapidly available, and reliable inflammatory marker, with substantial recent evidence showing its potential utility in clinical practice. Thus, in this literature review, we will present an up-to-date discussion of the prognostic role of NLR in the most frequent CVDs, such as acute and chronic coronary disease, atherosclerotic disease, heart failure, cardiac valvopathies, and cardiac arrhythmias with predilection to atrial fibrillation.

RESUMO Objetivo: O objetivo deste estudo foi analisar o comportamento alimentar de crianças e adolescentes com transtorno do espectro autista. Métodos: Participaram deste estudo 21 crianças e adolescentes com TEA, na faixa etária de 2 a 14 anos de idade, de ambos os sexos. Foi aplicado um questionário sobre o comportamento alimentar com os 21 pais e/ou responsáveis das crianças. Esse instrumento é composto por 53 questões, distribuídas nas seguintes categorias: Motricidade na mastigação; Seletividade alimentar; Aspectos comportamentais; Sintomas gastrointestinais; Sensibilidade sensorial e Habilidades nas refeições. Resultados: A análise dos dados obtidos revela que as crianças com TEA apresentaram maiores alterações no comportamento alimentar nas categorias Seletividade alimentar (34,4%), Aspectos comportamentais (27,1%) e Motricidade na mastigação (21,9%). E houve correlação entre a categoria Motricidade na mastigação com todas as outras categorias. Houve também correlação entre seletividade alimentar com aspectos comportamentais e aspectos comportamentais com sensibilidade sensorial e habilidades nas refeições. Conclusão: Portanto, é possível observar que, no comportamento alimentar de crianças e adolescentes com TEA, há uma tendência a seletividade alimentar, comportamentos habituais durante as refeições e dificuldades motoras no que se refere à mastigação e à ingestão dos alimentos.

Abstract The advances in pediatric acute lymphoblastic leukemia (ALL) care have substantially increased survival, and the late effects of treatment are a growing concern. Obesity development is frequent following ALL therapy and may significantly contribute to long-term morbidity and mortality. We examined the body mass trajectory of 208 children with ALL, from the diagnosis to the completion of therapy. We found that 7.2% of children were overweight or obese at diagnosis, which increased to 19.7% at the end of induction therapy and 20.8% after completion of treatment. In a multivariable linear regression model, age at ALL diagnosis, the type of chemotherapy regimen, and body mass index (BMI) z-score at diagnosis were significant predictors of BMI z-score after induction therapy, whereas BMI z-score at diagnosis was the only significant predictor of BMI z-score at the completion of treatment. In a subgroup of 120 children, we found no association between nutrition status at diagnosis and the risk of ALL relapse or poorer overall survival. Our findings indicate that weight gain occurs early during ALL therapy and is predicted by weight status at diagnosis. Therefore, nutritional status should be assessed throughout treatment, and weight management interventions should be considered early, particularly for patients with higher weight at diagnosis.

RESUMO: Neste editorial resgatamos a história da revista Ensaio Pesquisa em Educação em Ciências evidenciando acontecimentos chave que marcaram a trajetória do periódico como importante veículo de comunicação científica da área de Educação em Ciências. Esse resgate é uma homenagem a todas as pessoas editoras que passaram por nossa revista e deram efetivas contribuições à pesquisa no campo da Educação em Ciências. Diante de uma série de desafios, alguns presentes desde o nascimento da revista e outros novos, também é uma forma de situar nosso periódico diante das tendências e demandas editoriais vigentes, delineando perspectivas e vislumbrando novos horizontes para a Ensaio.

Resumo: Esta pesquisa, do tipo Estado da Arte, apresenta um recorte sobre temas e conteúdos abordados nos estudos sobre Educação em Astronomia produzidos em cursos de pós-graduação no Brasil, de 1973 a 2018. Foram recuperados e analisados 490 estudos, por meio da ferramenta metodológica Análise de Conteúdo. Identificados os mais abordados, correlaciona-se a abordagem com as diferentes etapas da Educação Básica, com o Ensino Superior e com a Educação Não Escolar. O Sistema Sol-Terra-Lua destaca-se no Ensino Fundamental e Médio, enquanto no Ensino Superior, observa-se a predominância de estudos em Mecânica Celeste e Gravitação. As pesquisas na Educação Não Escolar, em geral, não se dedicam a temas específicos. A correlação entre Temas e Conteúdos e o Foco Temático têm ênfase em Conteúdo e Método, refletindo atenção central nos processos de ensino e aprendizagem. Desse modo, indica-se tendências e lacunas com o propósito de contribuir com o desenvolvimento da área.

O tétano é causado pelas toxinas sintetizadas pelo Clostridium tetani, bactéria Gram-positiva, esporulada e anaeróbica obrigatória. A espécie equina possui uma alta exposição e sensibilidade ao patógeno. Sendo assim, as medidas profiláticas como vacinação, antissepsia de feridas com água oxigenada e soro antitetânico em feridas cirúrgicas são necessárias Os sinais clínicos apresentados são a principal ferramenta diagnóstica, pois na maioria das vezes os sinais são patognomônicos, sendo eles posição de cavalete, andar rígido, cauda em bandeira, protusão de 3ª pálpebra, sensibilidade a estímulos sonoros e luminosos, dispneia e disfagia. A toxi-infecção ocorre a partir de feridas pré-existentes ou decorrente de lesões gastrointestinais. O objetivo deste estudo é relatar um caso de tétano em uma égua de 10 anos, SRD, abordando características diagnósticas e terapêuticas. O tratamento clínico se demonstrou eficaz, com resultados satisfatórios após aplicação intratecal e intravenosa de soro antitetânico, somados com antibioticoterapia e medicações que promovem relaxamento

Este texto propõe (re)equacionar a pessoa como um rosto-alma, numa comunidade de sentido, face à cultura da imagem e da virtualidade, da cultura e sociedade contemporâneas, que têm fragmentado o homem e transformado a experiência pessoal em experiências anónimas e impessoais, próprias do alheamento. Uma configuração em que se procura colocar o íntimo e o profundo como categorias essenciais à compreensão do humano e à construção da pessoa. O que implica questionar uma crescente sensibilidade pós-orgânica pelo resgate de uma sensibilidade ontológica e articular a experiência do pensar com a experiência de ser pessoa.

Objetivo: Descrever as principais características clínica de mulheres submetidas à histerectomia obstétrica por consequência da hemorragia pós-parto. Métodos: estudo descritivo-exploratório, de abordagem quantitativa e caráter documental. Adotou-se como critérios de inclusão, prontuários de mulheres que pariram via parto vaginal ou cesariana, com idade igual ou acima de 18 anos; que tenham sido submetidas a histerectomia obstétrica em decorrência da hemorragia pós-parto; e submetidas ao procedimento cirúrgico de janeiro de 2018 a junho de 2022. Diante disso, 15 prontuários atenderam aos critérios. Resultados: a cesariana foi a principal via de parto (93,3%) e o sofrimento fetal a maior indicação dessa via (21,4%). A hemorragia pós-parto foi classificada como primária (93,3%) e teve a atonia uterina como maior causa (86,6%). A histerectomia subtotal foi a técnica cirúrgica mais utilizada (93,3%) e o tempo médio da expulsão do feto até a realização da histerectomia obstétrica ficou em 6,4 horas. Conclusão: Este estudo permitiu evidenciar a importância do tema tratado, uma vez que a hemorragia pós-parto é uma das principais causas de mortalidade materna em todo mundo. Portanto, conhecer o perfil clínico dessas mulheres é primordial para fornecer assistência de qualidade além de ofertar subsídios para protocolos e pesquisas futuras.

A study with a descriptive qualitative approach is presented, supported by quantitative data that aimed to characterize the mental health status and psychosocial risk factors in a group of mothers with child abuse records due to neglect. The sample consisted of 5 women who, between the years 2019 and 2020, had open legal proceedings in the five family police stations of the municipality of Rionegro (Antioquia, Colombia) for alleged threat, violation or non-observance of their children's rights. The findings show that these mothers present symptoms of depression, severe anxiety and low satisfaction with life; in addition to precarious socioeconomic conditions and low availability of support networks. It is concluded that mental health is a fundamental condition for the exercise of respectful parenting.

The rapid development of 5G networks and the anticipation of 6G technologies have ushered in an era of highly customizable network environments facilitated by the innovative concept of network slicing. This technology allows the creation of multiple virtual networks on the same physical infrastructure, each optimized for specific service requirements. Despite its numerous benefits, network slicing introduces significant security vulnerabilities that must be addressed to prevent exploitation by increasingly sophisticated cyber threats. This review explores the application of cutting-edge technologies—Artificial Intelligence (AI), specifically Machine Learning (ML), Software-Defined Networking (SDN), and Network Functions Virtualization (NFV)—in crafting advanced security solutions tailored for network slicing. AI’s predictive threat detection and automated response capabilities are analysed, highlighting its role in maintaining service integrity and resilience. Meanwhile, SDN and NFV are scrutinized for their ability to enforce flexible security policies and manage network functionalities dynamically, thereby enhancing the adaptability of security measures to meet evolving network demands. Thoroughly examining the current literature and industry practices, this paper identifies critical research gaps in security frameworks and proposes innovative solutions. We advocate for a holistic security strategy integrating ML, SDN, and NFV to enhance data confidentiality, integrity, and availability across network slices. The paper concludes with future research directions to develop robust, scalable, and efficient security frameworks capable of supporting the safe deployment of network slicing in next-generation networks.

Landiolol is an ultra-short-acting, selective β1-adrenergic receptor blocker that was originally approved in Japan for the treatment of intraoperative tachyarrhythmias. It has gained attention for its use in the management of tachyarrhythmias and perioperative tachycardia, especially atrial fibrillation for both cardiac and non-cardiac surgeries. It can be the ideal agent for heart rate control due to its high β1-selectivity, potent negative chronotropic effect, a limited negative inotropic potential, and an ultrashort elimination half-life (around 4 min); moreover, it may have a potential therapeutic effects for sepsis and pediatric patients. Landiolol seems to be superior to other short-acting and selective beta-blockers such as esmolol. This review aims to provide a comprehensive overview of landiolol, a new ultra-short-acting β1 selective antagonist, including its pharmacology, clinical applications, efficacy, safety profile, and future directions in research and clinical data.

ABSTRACT Objective: to analyze pressure injury (PI) incidence and risk factors in patients with COVID-19 admitted to an Intensive Care Unit and characterize the identified PIs. Method: a retrospective cohort study, consisting of 668 patients, carried out between March 2020 and February 2021. Clinical/demographic and PI variables were collected from medical records and electronic database. Data were analyzed using descriptive and inferential statistics. Logistic regression was performed to analyze risk factors for PI. Results: PI incidence was 30.2% (n=202), with the majority located in the sacral region (52.9%) and in stage 1 (39%). Risk factors were age (p

Purpose: We describe the design and development of the European Platform to Promote health and wellbeing in the workplace (EMPOWER) digital intervention that provides an integrative user programme meeting the needs of employees and employers in addressing work stress. Results: A user-centred design process was followed from January 2020 until November 2021. A tailored algorithm was developed to provide support at the individual employee level and the company level. Each element of the digital intervention was developed in English and then translated in Spanish, English, Polish and Finnish. The digital intervention consists of a website and a mobile application (app) that provides algorithm-based personalised content after assessing a user's somatic and psychological symptoms, work functioning, and psychosocial risk factors for work stress. It has a public section and an employer portal that provides recommendations to reduce psychosocial risks in their company based upon clustered input from employees. Usability testing was conducted and showed high ease of use and completion of tasks by participants. Conclusion: The EMPOWER digital intervention is a tailored multimodal intervention addressing wellbeing, work stress, mental and physical health problems, and work productivity. This will be used in a planned RCT in four countries to evaluate its effectiveness.

Introducción: En el ámbito socio-sanitario es habitual el trabajo en equipo interdisciplinar y, por ello, las competencias básicas y generales de los títulos universitarios suelen incluir habilidades transversales, que permite el desempeño de esta tarea. Y con el fin de conseguir los resultados de aprendizaje esperados, se planteó como objetivo general de este proyecto fomentar el trabajo en equipo entre los grados de Ciencias de la Salud. Metodología: Esta actividad se desarrolló cursos académicos en las asignaturas Terapia Ocupacional comunitaria y Nutrición comunitaria. Se impartieron 3 sesiones por parte del profesorado, aportando información para el desarrollo y gestión de un caso clínico conjunto. Posteriormente, se desarrolló la parte práctica por parte del alumnado y se recogieron los resultados del aprendizaje y satisfacción. Resultados: Los resultados de la autoevaluación y evaluación del equipo obtuvieron puntuaciones por encima del 1,6 sobre 2 en todos los ítems, siendo más elevadas en la segunda edición. La satisfacción del alumnado se encontró por encima del 3,7 sobre 5 en todos los ítems, mostrando mayor satisfacción en la primera edición. La solicitud de mejora en la primera edición estuvo dirigida a la realización de forma presencial y en la segundo a contar con mayor guía por parte del profesorado. Conclusiones: La actividad resultó de interés y utilidad para el alumnado, pero se plantea la necesidad de mayor dedicación al desarrollo de las habilidades implicadas en la coordinación de profesionales y el trabajo en equipo.

Pensando na promulgação da Lei de Diretrizes e Bases da Educação Nacional (LDB) em 1961, as versões subsequentes e os impactos para a área da Educação Especial, problematizou-se como as transformações políticas ocorridas entre as décadas de 1950 e 1990 influenciaram no percurso dos diferentes documentos das versões da LDB e na construção dos capítulos destinados à área da Educação Especial. Para isso, este artigo visa, a partir de uma contextualização histórica e política à época, descrever e comparar os avanços e retrocessos contidos nos capítulos destinados à Educação Especial nos três documentos promulgados da Lei de Diretrizes e Bases da Educação Nacional. Assim, por meio de uma pesquisa descritiva com análise documental e bibliográfica, o presente trabalho apresenta as transformações históricas, políticas e mudanças terminológicas ocorridas na LDB 4.024/61, LDB 5.692/71 e na LDB 9.394/96, no que se refere à Educação Especial. Os resultados apontam para o direcionamento e descompromisso do Estado com a educação dos alunos da Educação Especial. Conclui-se que as transformações histórico-políticas têm impacto direto no modo como a Educação Especial é vista no campo educacional, assim como nas terminologias utilizadas e nos serviços prestados ao público alvo.