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Abstract Background To report a case of IgG4-related pachymeningitis presenting with cystic lesions mimicking neurocysticercosis. Case presentation A 40-year-old female patient with tetraparesis, dysphagia and dysphonia was evaluated with clinical examination, magnetic resonance imaging, and meningeal biopsy. Magnetic resonance imaging (MRI) revealed diffuse pachymeningeal enhancement involving the cranial, cervical, thoracic, and lumbar segments with spinal cord compression and cystic lesions. CSF immunology was initially positive for cysticercus cellulosae. After disease progression a meningeal biopsy was compatible with IgG4 related disease. The patient had partial response to rituximab and needed multiple surgical procedures for spinal cord decompression and CSF shunting. Conclusions This case highlights the possibility of IgG4-related disease in patients with diffuse pachymeningitis causing spinal cord compression, even with cystic lesions on MRI. Diagnosis of IgG4-related pachymeningitis is paramount due to the possibility of treatment response to immunotherapy, particularly to anti-CD20 agents.

Abstract The global concern over water pollution caused by contaminants of emerging concern has been the subject of several studies due to the complexity of treatment. Here, the synthesis of a graphene oxide-based magnetic material (GO@Fe3O4) produced according to a modified Hummers’ method followed by a hydrothermal reaction was proposed; then, its application as a photocatalyst in clonazepam photo-Fenton degradation was investigated. Several characterization analyses were performed to analyze the structure, functionalization and magnetic properties of the composite. A 23 factorial design was used for the optimization procedure to investigate the effect of [H2O2], GO@Fe3O4 dose and pH on clonazepam degradation. Adsorption experiments demonstrated that GO@Fe3O4 could not adsorb clonazepam. Photo-Fenton kinetics showed that total degradation of clonazepam was achieved within 5 min, and the experimental data were better fitted to the PFO model. A comparative study of clonazepam degradation by different processes highlighted that the heterogeneous photo-Fenton process was more efficient than homogeneous processes. The radical scavenging test showed that $${O}_{2}^{\cdot -}$$ O 2 · - was the main active free radical in the degradation reaction, followed by hydroxyl radicals (•OH) and holes (h+) in the valence layer; accordingly, a mechanism of degradation was proposed to describe the process.

Background: As global migration increases, nurse managers’ effectiveness in multi-cultural nursing work environments is crucial due to the rising cultural diversity within healthcare teams. Despite the increasing international recruitment of qualified nurses to address the worldwide nursing shortage, no studies have synthesised the impact of nurse managers’ attributes on nurses in multi-cultural nursing teams. Therefore, it was conducted a literature review aimed to synthesise the available literature on how nurse managers’ personality traits, competencies, behaviours, and leadership styles influence nurse outcomes in multi-cultural nursing teams. Methods: Scoping review conducted according to the Joanna Briggs Institute guidelines to map the relationship or influence of nurse managers’ personality traits, competencies, behaviours, and leadership styles on the outcomes of nurses in multi-cultural settings across various clinical environments. Searches were conducted across electronic databases such as CINAHL and MEDLINE, along with grey literature. Results: This review included 39 studies, highlighting 29 personality traits, 9 competencies, 115 behaviours, and 5 leadership styles that impact nurses’ outcomes. Key findings emphasise the importance of nurse managers being supportive, culturally competent, and effective communicators, with transformational leadership style being particularly beneficial. Conclusions: These findings provide insights for planning and developing training programmes to equip current and future nurse managers with skills to effectively lead in multi-cultural care settings.

ABSTRACT A 34-year-old man developed severe envenomation after being bitten by a Crotalus durissus (rattlesnake), which was treated with anticrotalic serum. Three weeks later, the patient reported paresthesia and neuropathic pain in the left hand, which had progressed to all four limbs. Electroneuromyography revealed asymmetric axonal sensorimotor multiple mononeuropathy. The patient was treated with prednisone, and six months later there was significant improvement in sensorimotor conduction. This is the first reported case of multiple mononeuropathy associated with C. durissus envenomation. Post-snake envenomation peripheral neuropathy is a rare complication requiring prompt recognition and treatment to optimize nerve function and enhance patient outcomes.

Vector-borne diseases, such as dengue, chikungunya, zika, and leishmaniasis, represent a global public health challenge. This study aimed to understand the impact of socioeconomic, environmental, and healthcare access variables on the incidence of infectious diseases from 2012 to 2021, investigating patterns and correlations. Variables analyzed included the number of healthcare facilities, average income, population size, Gross Domestic Product (GDP), and accumulated deforestation. Multiple linear regression and correlations were used, with data from the Notifiable Diseases Information System (SINAN) and the National Institute for Space Research (INPE). Dengue showed a strong correlation with GDP, the number of healthcare facilities, and deforestation. Chikungunya was associated with population, GDP, and deforestation. Zika showed correlations with population growth and deforestation. Leptospirosis was negatively influenced by healthcare facilities and GDP, while hantavirus infection was inversely related to population growth and healthcare facilities. Leishmaniasis had positive correlations with GDP, healthcare facilities, and deforestation. This study reveals complex interactions between socioeconomic, environmental, and health variables in the incidence of infectious diseases. Understanding these patterns is crucial for formulating effective public policies, highlighting the need for integrated and holistic strategies in the control and prevention of these diseases.

Resumo Este artigo investiga aspectos legais e soluções éticas envolvidas no comércio ilegal de órgãos, atividade que provoca debates sobre ética e moral. Trata-se de revisão integrativa da literatura realizada por meio de busca nos portais Biblioteca Virtual em Saúde, PubMed e SciELO. Foram analisados 14 artigos, que apontaram baixa oferta associada a alta demanda por órgãos como etiologia principal do problema. Constatou-se que esse mercado se aproveita de populações vulneráveis para coagi-las a doar órgãos, e, além disso, a falta de conexão entre bancos de dados internacionais e instabilidades nos países com altas taxas de tráfico dificultam a ação policial no enfrentamento desse crime. O combate ao tráfico de órgãos deve ter como base o incentivo à doação legal de órgãos, o enfrentamento do “turismo de transplante” e ações direcionadas a países mais vulneráveis. Entidades internacionais têm papel fundamental para que haja trabalho conjunto em diferentes nações na repressão desse tipo de crime.

Abstract Background Progressive Myoclonic Epilepsy (PME) is a group of rare diseases that are difficult to differentiate from one another based on phenotypical characteristics. Case report We report a case of PME type 7 due to a pathogenic variant in KCNC1 with myoclonus improvement after epileptic seizures. Discussion Myoclonus improvement after seizures may be a clue to the diagnosis of Progressive Myoclonic Epilepsy type 7.

Abstract Background Monogenic autoinflammatory disorders result in a diverse range of neurological symptoms in adults, often leading to diagnostic delays. Despite the significance of early detection for effective treatment, the neurological manifestations of these disorders remain inadequately recognized. Methods We conducted a systematic review searching Pubmed, Embase and Scopus for case reports and case series related to neurological manifestations in adult-onset monogenic autoinflammatory diseases. Selection criteria focused on the four most relevant adult-onset autoinflammatory diseases—deficiency of deaminase 2 (DADA2), tumor necrosis factor receptor associated periodic fever syndrome (TRAPS), cryopyrin associated periodic fever syndrome (CAPS), and familial mediterranean fever (FMF). We extracted clinical, laboratory and radiological features to propose the most common neurological phenotypes. Results From 276 records, 28 articles were included. The median patient age was 38, with neurological symptoms appearing after a median disease duration of 5 years. Headaches, cranial nerve dysfunction, seizures, and focal neurological deficits were prevalent. Predominant phenotypes included stroke for DADA2 patients, demyelinating lesions and meningitis for FMF, and meningitis for CAPS. TRAPS had insufficient data for adequate phenotype characterization. Conclusion Neurologists should be proactive in diagnosing monogenic autoinflammatory diseases in young adults showcasing clinical and laboratory indications of inflammation, especially when symptoms align with recurrent or chronic meningitis, small vessel disease strokes, and demyelinating lesions.

Resumo De que forma aspectos organizacionais das instituições de ensino e pesquisa influenciam os custos de transação para efetivação de parcerias com administrações locais? Com base em dados inéditos de um survey online para o conjunto de 95 instituições de ensino, com respostas validadas, o presente artigo se propôs a responder a essa pergunta por meio de um estudo quantitativo buscando verificar a correlação entre características das parcerias firmadas e três aspectos organizacionais selecionados: a descentralização dos campi; existência de estrutura de acolhimento de potenciais parceiros (porta de entrada); e existência de instâncias de aprovação. Com base em proposições relativas aos custos de transação, extraídas da teoria da ação institucional coletiva, foram formuladas hipóteses envolvendo o efeito de cada aspecto organizacional. Os resultados apontaram, ao final, que a descentralização dos campi influencia não apenas na presença como também no número de experiências relevantes de parcerias com municípios. Já a estruturação de “portas de entrada” nas instituições de formação afeta mais especificamente o grau de formalização das parcerias, oferecendo maior segurança jurídica e estabilidade. A presença de instâncias de aprovação para as parcerias negociadas nas instituições de ensino e pesquisa parece não afetar, em sentido positivo ou negativo, a firmação dessas parcerias.

ABSTRACT: The poultry industry faces significant challenges in controlling Salmonella contamination while reducing antibiotic use, particularly with the emergence of Salmonella Heidelberg (SH) strains posing risks to food safety and public health. Probiotics, notably lactic acid bacteria (LAB) and Saccharomyces boulardii (SB) offer promising alternatives for mitigating Salmonella colonization in broilers. Understanding the efficacy of probiotics in combating SH and their impact on gut health and metabolism is crucial for improving poultry production practices and ensuring food safety standards. This study aimed to assess the inhibitory effects of LAB and SB against SH both in vitro and in vivo broilers, while also investigating their impact on fecal metabolites and caecal microbiome composition. In vitro analysis demonstrated strong inhibition of SH by certain probiotic strains, such as Lactiplantibacillus plantarum (LP) and Lacticaseibacillus acidophilus (LA), while others like SB and Lactobacillus delbrueckii (LD) did not exhibit significant inhibition. In vivo testing revealed that broilers receiving probiotics had significantly lower SH concentrations in cecal content compared to the positive control (PC) at all ages, indicating a protective effect of probiotics against SH colonization. Metagenomic analysis of cecal-content microbiota identified predominant bacterial families and genera, highlighting changes in microbiota composition with age and probiotic supplementation. Additionally, fecal metabolomics profiling showed alterations in metabolite concentrations, suggesting reduced oxidative stress, intestinal inflammation, and improved gut health in probiotic-supplemented birds. These findings underscore the potential of probiotics to mitigate SH colonization and improve broiler health while reducing reliance on antibiotics.

The increase in pineapple production has generated a large amount of waste, which, when incorporated into the soil, can lead to contamination and environmental degradation. In this context, this study highlights the innovative combination of pineapple waste and Leucaena hay, offering benefits for animal nutrition while reducing input costs. The objective of this study was to determine the nutritional value of silage from ‘Pérola’ pineapple waste (PS) with different levels of Leucaena hay. A completely randomized design was adopted with six treatments (pre-wilted PS and PS with 0%, 10%, 20%, 30%, and 40% inclusion of Leucaena hay (LH)). The dry matter content of the silage, crude protein, lignin, and pH increased linearly (p < 0.05) as a function of the inclusion of Leucaena hay, while buffering capacity, soluble carbohydrate content, and effluent losses showed an inverse relationship. As LH levels increased, ruminal DM disappearance decreased. Wilting the pineapple plant did not alter the in vitro gas production, in vitro digestibility of organic matter, partition factor (PF), and methane production when compared to the silages added with Leucaena hay. It is recommended to add 20% Leucaena hay in PS silage.

A discriminação racial e o racismo ainda são presentes no cotidiano da sociedade, reverberando em vários aspectos na vida da população negra, inclusive no ensino superior, médio e fundamental, onde o preconceito é intenso, e afeta a permanência desse grupo étnico-racial. Diante disso, o objetivo desse artigo analisar as evidências disponíveis na literatura científica sobre experiências de discriminação racial e racismo contra estudantes negros no Brasil. Trata-se de uma revisão integrativa de literatura, a questão norteadora foi embasada pela estratégia PICo, a busca pelos artigos foi realizado nas bases de dados: MEDLINE via PubMed, Web of Science, Scopus e LILACS. Na busca, foi recuperado um quantitativo de 766 publicações, mas depois das análises dos critérios de inclusão e exclusão, e da leitura na íntegra, 12 obras foram incluídas na amostra final. As obras tinham como principais assuntos abordados três temas, sendo eles: Politicas desenvolvidas e implementadas pela a Universidade (41,66%), Impactos da discriminação racial e racismo na vida acadêmica e social (41,66%) e Manifestações de racismo e discriminação e as formas de enfrentamento (16,68%). Assim, o racismo ainda está presente na vida desses estudantes, este fenômeno afeta diretamente o desempenho acadêmico e vida social dos estudantes.

Background Wyburn-Mason syndrome is a rare, non-hereditary congenital disease, belonging to the group of neurocutaneous syndromes with fewer than 100 cases reported since its first description in 1937.Case report A young adult man was initially evaluated at the age of 2 years for proptosis and progressive visual impairment of the right eye, followed by impairment in ocular abduction, adduction and elevation as well as amaurosis. MRI revealed an expansive formation centred in the right orbit compromising conal spaces with distortion of eye muscles and optic nerve. The lesion extended through the superior orbital fissure into the right cavernous sinus and to the contralateral orbit. Despite embolisation, proptosis and oedema of the periorbital tissue continued to worsen. The combination of facial, ocular and intracranial vascular malformations and the exclusion of alternative aetiologies led to a diagnosis of cerebrofacial arteriovenous metameric syndrome (CAMS) 1 (Wyburn-Mason syndrome).Discussion Important differential diagnoses are other CAMS, such as Sturge-Weber syndrome, as well as other conditions such as retinal cavernous haemangioma and vasoproliferative tumours. The optimal treatment regimen for severe cases of this syndrome is still unclear. Wyburn-Mason syndrome should be considered in patients presenting multiple arteriovenous malformations with orbital apex lesions.

Objective: This study investigates the challenges of female entrepreneurs who started their ventures driven mainly by the need for survival and how they overcome their challenges. In seeking this, it appropriates the literature on motivations, challenges, and drivers of female entrepreneurship to support the reflections. Method: This was a qualitative strategy. Seven women entrepreneurs who started ventures driven mainly by necessity in Brazil participated in this study. Results: Besides need for survival, other motivations influence business creation, including opportunities. The main challenges are reconciling work and family, access to resources, and a lack of human capital. The main driving factors are public and private entrepreneurial support programs and direct social relationships. Conclusion: The contributions are threefold. First, for the literature on entrepreneurial drivers, it expands the understanding of the factors that positively impact female entrepreneurship. Second, it contributes to the literature on entrepreneurial motivations, broadening the current understanding of pull and push factors. Finally, by identifying new entrepreneurial challenges, this study extends the possibilities of understanding the female entrepreneurial phenomena in other developing contexts besides Brazil.

Abstract Background Nursing practice environment has impact on the quality of nursing care and on patients’ and nurses’ outcomes, namely better performances of these healthcare workers. Improving the nursing practice environment is a low-cost organizational strategy to achieve better patients’ outcomes and retain qualified nurses, thus improving nursing care of units, healthcare organizations and healthcare system. This study aims to analyse the relationship between nursing practice environment and the nurses` perception of quality of care, patient safety, and safety culture in Primary Health Care in Portugal. Methods We conducted a descriptive, analytical, and cross-sectional study using data from RN4CAST Portugal. The sample was composed of 1059 nurses from 55 Health Center Groups of the mainland Portugal, 15 Health Centers of the Autonomous Region of Madeira and 6 Health Centers of the Autonomous Region of the Azores. Multivariate analysis and correlation analysis methods were used for data processing. Results Nurses consider that, in the Portuguese Primary Health Care, there is a mixed and unfavourable nursing practice environment, with a perception of a good quality of care, and both acceptable patients’ safety and safety culture. The Collegial Nurse-Physician Relations and Nursing Foundations for Quality of Care dimensions to have the best ratings. The perception of Primary Health Care nurses on the dimension Nurse Participation in Organization Affairs was the one that showed the lowest score, followed by Staffing and Resource Adequacy and Nurse Manager Ability, Leadership, and Support of Nurses. Based on perception of nurses, the relationship between the nursing practice environment and the safety culture is higher, followed by the quality of care and patients’ safety. Conclusions The perception of Primary Health Care nurses is that there is an unfavourable and mixed nursing practice environment, with good quality of care, and acceptable patient safety and safety culture. The quality of the nursing practice environments is associated to better quality and safety of care. Thus, improving the nursing practice environments in healthcare organizations is a low-cost organizational strategy to achieve greater patients and nurses’ outcomes, improving the quality of nursing care to patients in the Primary Health Care units.

Background: Twenty years after the “To Err Is Human” report, one in ten patients still suffer harm in hospitals in high-income countries, highlighting the need to strengthen the culture of safety in healthcare. This scoping review aims to map patient safety culture strengthening strategies described in the literature. Method: This scoping review follows the JBI methodology. It adhered to all scoping review checklist items (PRISMA-ScR) with searches in the Lilacs, MedLine, IBECS, and PubMed databases and on the official websites of Brazilian and North American patient safety organizations. The research took place during the year 2023. Results: In total, 58 studies comprising 52 articles and 6 documents from health organizations were included. Various strategies were identified and grouped into seven categories based on similarity, highlighting the need for a comprehensive organizational approach to improve patient care. The most described strategies were communication (69%), followed by teamwork (58.6%) and active leadership (56.9%). Conclusion: The identified strategies can promote the development of a culture in which an organization can achieve patient safety, involving practices and attitudes that reduce risks and errors in healthcare. However, the identification of strategies is limited because it is restricted to certain databases and websites of international organizations and does not cover a broader spectrum of sources. Furthermore, the effectiveness of these strategies in improving patient safety culture has not yet been evaluated.

Introduction In critically ill children, pain management is complex owing to cognitive development and the nature of hospitalisation in paediatric intensive therapy units. Although there are many protocols and guidelines for pain control via pharmacological interventions, non-pharmacological practices should also be explored and disseminated for their potential benefit.Methods and analysis A systematic literature search will be performed using the following databases: Academic Search Premier, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Excerpta Medica Database, Virtual Health Library, Medical Literature Analysis and Retrieval System Online, ScienceDirect, Scopus, Web of Science Core Collection, Theses from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Dart Europe, Open Access Theses and Dissertations and grey literature from Google Scholar. The research will consider quantitative and qualitative studies, mixed-method studies, systematic reviews, text articles, opinion articles, letters to editors and editorials in any language and from any database. The following will be eligible for inclusion: (1) newborns, infants, children and adolescents; and (2) non-pharmacological therapies used for pain in paediatric intensive care.Ethics and dissemination This study does not require ethical approval. The results of this research will be disseminated through social media channels and podcasts about pain in children.Trial registration number This protocol has been registered with the Open Science Framework (DOI 10.17605/OSF.IO/DZHKT).

Abstract: Brazil has seen a decrease in vaccination coverage since 2016. This study analyzes the immunization status of children born during the COVID-19 pandemic in Fortaleza, Northeastern Brazil. This is a longitudinal analysis that included vaccination data of 313 children aged 12 and 18 months. Vaccination cards were checked for dose application considering the schedule of immunization recommended by the Brazilian Ministry of Health. Factors associated with no retention of vaccination cards and incomplete immunization by 18 months were identified by Tobit regression analysis. About 73% of mothers presented their child’s vaccination card. Non-availability of vaccination cards was associated with maternal age < 25 years and mothers with paid jobs. Only 33% and 45% of the children aged 12 and 18 months had all vaccines up to date, respectively. For 3-dose vaccines, the delay rate was around 10% for the first dose application, but 40% for the third dose. Despite delays, most children with available vaccine cards had coverage above 90% by 18 months of age. Adjusted factors associated with incomplete vaccination included living in a household with more than one child (p = 0.010) and monthly income of less than one minimum wage (p = 0.006). Therefore, delays in child vaccine application were high during the COVID-19 pandemic but a considerable uptake by 18 months of age was found. Poorer families with more than one child were particularly at risk of not fully immunizing their children and should be the target of public policies.

Introduction: Primary melanocytic tumors originating from CNS melanocytes are rare, with a low incidence of 0.7 cases per 10 million annually. This study focuses on primary leptomeningeal melanocytomas, emphasizing their epidemiology, clinical characteristics, and diagnostic challenges. Despite their infrequency, these tumors warrant attention due to their unique features and potential for local recurrence.Case Report: A 32-year-old female presented with syncope and seizures, leading to the discovery of two left-sided supratentorial lesions initially misidentified as convexity meningiomas. Detailed imaging suggested meningioma-like features, but intraoperative findings revealed unexpected hyperpigmented lesions. Histopathological examination, supported by immunohistochemistry, confirmed primary leptomeningeal melanocytoma. The surgical approach and subsequent management are discussed.Discussion: The discussion emphasizes challenges in diagnosing primary leptomeningeal melanocytomas. Treatment debates, especially regarding adjuvant radiotherapy, are explored. Recurrence risks stress the importance of vigilant follow-up, advocating for complete surgical resection as the primary approach. The rarity of supratentorial cases adds complexity to diagnosis, necessitating a multidisciplinary approach. Insights from this case contribute to understanding and managing primary leptomeningeal melanocytomas, addressing challenges in differentiation from more common tumors and prompting ongoing research for refined diagnostics and optimized treatments.Conclusion: This study contributes insights into primary leptomeningeal melanocytomas, highlighting their rarity in supratentorial regions. The case underscores the importance of a multidisciplinary approach, incorporating clinical, radiological, and histopathological expertise for accurate diagnosis and tailored management. Ongoing research is crucial to refine treatment strategies, enhance prognostic precision, and improve outcomes for individuals with this uncommon CNS neoplasm.

Background: Globalisation, wars, competitiveness, and technological innovation have increased workplace diversity, requiring leaders to conduct multinational projects, lead people from different cultural backgrounds, and deliver appropriate services that meet the needs of clients from different cultures. Several concepts are interchangeably used to define and describe leadership in culturally-diverse work environments; one such concept is transcultural leadership. Because of nurses’ global migration and care delivery to patients from different cultural backgrounds, this concept is of interest in the nursing field. While some nurses have been identified as transcultural leaders, no definition of transcultural nursing leadership has been found in the literature. Objective: This study aimed to develop an operational definition of transcultural nursing leadership. Design: A concept analysis was performed using Walker and Avant's method. Methods: A literature search was conducted using electronic databases, including CINAHL and MEDLINE, books, and encyclopaedias. Quantitative, qualitative, mixed- design studies and literature reviews; master's and doctoral theses; interviews; and text and opinion papers published in English, Spanish, or Portuguese that focused on leadership in multicultural work environments overall and in nursing in particular were included. To identify differences and similarities between the concepts, a Correspondence Factor Analysis with the support of the software IRaMuTeQ was undertaken. Results: A total of 45 documents with definitions or descriptions of the concepts was included, of which five were in the nursing area and 40 in other areas of study. The defining attribute of transcultural nursing leadership is guiding the delivery of culturally-congruent care. Its antecedents were culturally-diverse populations, multicultural nursing teams, and the need to prepare healthcare workers, administrators, academics, professors, researchers, and minorities for transcultural nursing. The consequences identified included culturally-congruent care for patients and optimal health outcomes for all populations. The identified attributes, antecedents, and consequences did not cover the complexity of a culturally-diverse nursing work environment. Thus, the antecedents, attributes, and consequences of transcultural leadership identified in the literature were considered and added. Conclusions: Transcultural nursing leadership is a concept grounded in nursing theory that has significant implications for nursing management, education, research, and policy. This holds great promise for advancing culturally-congruent care, addressing health disparities, and building highly inclusive and productive nursing teams in an increasingly diverse world.

Abstract The global consumption of acerola (Malpighia emarginata DC.) has been increasing over the years, both in the form of fresh fruits and in food products derived from its pulp. Consequently, this consumption has led to an increase in the number of by-products (peels, lumps, and seeds) generated. Therefore, this study emphasizes the results reported in the literature regarding the possibilities for using acerola by-products. Due to their high content and the different possibilities of extracting active compounds (mainly phenolic compounds), acerola by-products can serve as raw material for a range of products that can be used in the food industry for the production of flour, cookies, nuggets, and edible coatings, or in high-tech products, such as nano/microparticles and clean energy precursors. The use of acerola by-products is expected to grow exponentially with the consumption of fresh fruit and the derivatives of its pulp. Green alternatives for the reuse of fruit/vegetable by-products in general are environmentally interesting.

O experimento foi instalado na casa de vegetação do Centro Universitário UniBRASÍLIA de Goiás, na cidade de São Luís de Montes Belos – Goiás, foi utilizado o delineamento inteiramente casualizados no esquema fatorial 3x2x6, em que foram testados três tipos de sacos plásticos (pequeno, médio e grande), duas variedades de mamão (Papaia e Formosa) em seis repetições, sendo que cada unidade básica foi composta por 4 plantas, num total de 144 plantas, as sementes foram cobertas com terra fina seca peneirada (1-2 cm) e em seguida foi realizada a rega manual, as mudas foram arranjadas em canteiros de modo a permitir ao pesquisador a realização de tratos fitossanitários e culturais, após 20 dias de germinadas as mudas estavam em média com 5 cm de altura, foi então realizado o descarte permanecendo apenas uma planta por saco e aos 30 pós emergência as plantas estavam com altura variando em média entre 15 e 20 cm, foi feita então seleção de mudas sadias para serem levadas a campo para o plantio definitivo. Como o valor da estatística F (11,554) para tratamentos supera o valor critico no nível de 1% de probabilidade (4,25), ele é significativo nesse nível (P < 0,01), indicando que os tratamentos possuem efeitos significativos sobre a produção de mudas de mamão. Com o desdobramento dos graus de liberdade de tratamento para o estudo dos efeitos dos fatores (Saco Plástico e Variedades) e ainda o efeito da Interação, observamos que o valor da estatística F (7.749) para a interação supera o valor critico no nível de 1% de probabilidade (6,01), logo ele é significativo nesse nível (P < 0,01), indicando assim existir uma relação de dependência entre saco plástico e variedade. Para o estudo dos efeitos de variedade dentro de cada tipo de saco, podemos concluir que quando se utiliza o saco pequeno não há diferença significativa a 5% de probabilidade (P > 0,05), para saco médio e saco grande existe uma diferença significativa a 1% de probabilidade (P < 0,01). Para o estudo dos efeitos de tipos de saco dentro variedades, podemos concluir que os tipos de sacos tem efeito significativo (P < 0,01) na produção de mudas de mamão.

Abstract Dung beetles are efficient indicators to obtain responses regarding the effects of land use change on biodiversity. Although the biological consequences of Cerrado conversion into pasture have been observed at the assemblage scale, there are no cues regarding the effects of tropical savanna conversion into pasture on physiological condition of dung beetle individuals. In this study, we evaluated whether native and non‐native habitats in Cerrado affect the physiological condition and body traits of males and females of Phanaeus palaeno. The individuals were collected from a Cerrado fragment (sensu stricto) and an exotic pasture (Urochloa spp.). Physiological condition was assessed through the estimation of individuals' dry body mass, fat mass, and muscle mass. Body traits were estimated through individual body size and males' horn length. We did not find differences between dung beetle morphological traits between Cerrado and pastures. However, individuals collected in exotic pastures had lower dry mass and fat mass, but higher muscle mass, than in conserved Cerrado. Understanding how the land use change affects individuals' body condition is essential to maintain abundant and healthy populations of dung beetles in human‐modified landscapes. Although the estimation of physiological condition is logistically more complex than species body traits, future studies aiming to present complex and finer ecological responses of dung beetles should incorporate physiological data to their approaches.

Introdução: A leishmaniose tegumentar americana é uma patologia infecciosa causada por diferentes espécies do protozoário Leishmania e transmitida através de mosquitos do gênero Lutzomyia. É considerada um problema de saúde pública no Brasil e uma das 6 mais importantes doenças infecciosas pela Organização Mundial da Saúde, devido a sua alta prevalência e capacidade de causar deformidades. Ela caracteriza-se como uma doença endêmica no país, em especial nos estados da Amazônia. Portanto, buscou-se nesse estudo definir o perfil epidemiológico da população atingida pela leishmaniose tegumentar no estado do Amapá entre 2018 e 2022. Metodologia: Realizou-se um estudo descritivo a partir do uso de dados secundários, coletados do Sistema de Informação de Notificação de Agravos (SINAN), por meio da plataforma do Departamento de Informática do Sistema Único de Saúde (DATASUS). Resultados: Entre os anos de 2018 e 2022, o estado do Amapá apresentou o total de 3.088 casos notificados de leishmaniose tegumentar americana. Ao analisar os anos, observa-se que 2020 teve a maior incidência, com 25,7% dos casos, seguido por 2018 com 24,8%. Quanto à divisão de casos por sexo, é bastante expressiva a predominância dos casos da doença no sexo masculino (78,4%). Na distribuição racial, também nota-se a concentração de casos em indivíduos da cor parda, com 75% do total. A faixa etária mais atingida foi a de adultos entre 20 a 39 anos (47,5%). Além disso, evidencia-se uma proporção significativa de casos na população de baixa escolaridade, com destaque para o grupo com 5ª a 8ª série incompleta (20,8%). Os municípios com os maiores números foram Macapá e Laranjal do Jari, com 22,6% e 20,29% respectivamente. Destaca-se também a quase totalidade de casos representada pela forma cutânea da doença (98,8%) em relação à forma mucosa, com a maioria evoluindo para cura (65,71%), apesar da alta taxa de abandono (20,7%). Conclusão: Diante do exposto, pode-se concluir que, entre 2018 e 2022, a população acometida pela leishmaniose tegumentar americana no estado do Amapá foi predominantemente masculina, de cor parda, de baixa escolaridade e com a forma cutânea da doença. Percebe-se também a persistência do número elevado de casos no estado, apesar da queda após 2020, além de uma alta taxa de abandono. Assim, os dados refletem a importância de promover o diagnóstico adequado e a adesão do paciente ao tratamento da leishmaniose, tendo em vista o seu impacto na qualidade de vida da população.

A Constituição Federal de 1988 prevê o fornecimento de saúde universal ao cidadão como obrigação primária do Estado e na prática concede permissão para que o cidadão ao se verificar impedido de obter o tratamento ou medicamento que necessita busque o Poder Judiciário como a forma de obtê-lo. Nesse sentido, através de ampla pesquisa e coleta de dados oriundos do Governo do Estado de Roraima e do próprio Poder Judiciário estadual, Sistema Processual Digital de Processos (PROJUDI), iniciados entre 2015 e 2018, e nas prestações de contas e relatórios emitidos pelo governo do estado de Roraima no mesmo período, procedeu a verificação da judicialização das questões de saúde no estado e os impactos das sentenças exaradas localmente sobre o financiamento do sistema de saúde estadual e sobre o próprio fornecimento dos serviços de saúde. Entre outros resultados alcançados por esta pesquisa, destaca-se que especialmente em relação a 2017 e a 2018, o estado de Roraima adotou uma postura de permissão e passividade em relação aos bloqueios judiciais em suas contas como forma de prover ao cidadão o medicamento e tratamento buscado, simplesmente por ser a forma mais rápida de garantir os direitos a saúde desses.

Objective: We argue that intergovernmental transfers are a relevant element for understanding the Brazilian federative dynamics and, consequently, for public policies in Brazil. The article aims to answer three sets of questions: (1) What is the size of transfers in terms of transfer values? (2) Which are the federal public administration bodies that carry out these transfers, how much do they transfer and through which instruments? (3) What are the main subnational bodies or institutions that receive these transfers, in which regions and units of the federation are they located and what amounts of resources do they receive? Methodology: A classification of voluntary transfers established by the Brazilian State in the context of fiscal federalism, legal regulations and consolidated administrative practices is proposed. The empirical analysis is unprecedented and of a descriptive-exploratory nature. Results: The results show that, from 2008 to 2017, the average of resources transferred by the federal government underwent large variations, with a significant drop in the year 2013 to 2014. The most expressive values are from the Ministry of Health and Cities; Roraima, Acre and Amapá were, proportionally, the states that received the most funds from the federal government. Contributions: Federated entities are the main actors called to collaborate in the decentralized execution of federal resources. Strengthening the administrative capacities of the federal government is essential to improve federative coordination, while improving the implementation of public policies depends on strengthening subnational governments.

This study investigates the disposition effect with regard to Brazilian investors, with focus on the year 2020. The database is composed by more than 12,000 trades by 274 investors. We follow the method of Odean (1998) to estimate the proportions of gains and losses realized and test the null hypothesis of equality of these proportions in each portfolio. The results suggest that Brazilian investors behave in line with the disposition effect. They sell winning stocks too early and hold losing stocks too long. A stock that is gaining value is more likely to be sold from day to day compared to a stock that is losing value. The disposition effect was not found in March, which suggests that investors employed a loss-limit during periods of market stress, no matter if the stock went up or down.

O transplante cardíaco (TC) é a conduta cirúrgica padrão ouro para tratamento de insuficiência cardíaca (IC) refratária. A realização do procedimento cirúrgico implica na denervação autonômica completa do coração, prejudicando consequentemente o controle rápido da frequência cardíaca (FC), que permanece levemente elevada nestes pacientes. O exercício físico constitui uma alternativa coadjuvante no tratamento destes pacientes, promovendo benefícios como a melhora física e funcional, expressas pelo aumento do consumo máximo de oxigênio (VO2) e da tolerância ao esforço, entretanto o impacto do exercício no processo de reinervação autonômica cardíaca ainda não está bem elucidado. Desta forma, o objetivo desde estudo é avaliar se a prática regular de exercício físico influencia o processo de reinervação cardíacas pós transplante cardíaco. Trata-se de uma revisão sistemática, utilizando os descritores: Physical Exercise, Cardiac Autonomic Control e Heart Transplantation nas bases de dados SciELO e PubMed. Quatro artigos foram selecionados para a elaboração desta revisão, publicados entre os anos de 1996 a 2014. A prática regular de exercício não parece impactar o processo de reinervação que acontece de maneira parcial e fisiológica. Com base na literatura selecionada, os ganhos relacionados ao treinamento como, aumento do VO2 pico, redução da pressão arterial e aumento da tolerância ao esforço são predominantemente de origem periférica, sendo facilmente perdidos caso o paciente deixe de praticar o exercício. Dessa forma, o exercício físico se mostra benéfico para pacientes pós TC, mas não parece exercer influência na reinervação autonômica cardíaca.

Assessing a person’s capacity to engage in self-care behaviours is another added value in identifying one’s potential to care for oneself in the health domain that contributes to planning person-centred care. This study aimed to translate, adapt, and validate the Exercise of Self-Care Agency (ESCA) Scale by Kearney and Fleischer, revised by Riesch and Hauck for the Portuguese version, using a sample of 625 elderly people living at home in Portugal. A cross-cultural adaptation process follows the stages of translation, synthesis, back-translation, and consensual solution for the translation process and pretesting. Construct validity was tested using exploratory factor analysis, and factor structure was subjected to confirmatory factor analysis. Reliability was determined by analysing internal consistency, resorting to Cronbach’s alpha coefficient. This resulted in an instrument formed of 29 items, keeping the factor structure conceptually aligned with the underlying theory. Cronbach’s alpha coefficient values were 0.87 for the global scale and varied between 0.65 and 0.84 for the subscales. The final four-factor model showed an acceptable quality of fit. The Portuguese version of the ESCA shows appropriate validity and reliability for use in future research and health contexts.

The aim of this review was to analyze the scientific evidence about nurses’ well-being at work in the hospital context. Well-being is present in our daily experiences, whether in a personal or professional context. Nurses are frequently put under pressure and stressed at work, which can influence their well-being. Nurses’ well-being at work in a hospital setting is crucial due to its relevance to occupational health, the quality of patient care, and the identification of stress and satisfaction factors. Methods: This systematic review followed the methodological guidelines of the Joanna Briggs Institute (JBI). The databases searched included CINAHL, MEDLINE, Scopus, Cochrane Database of Systematic Reviews, LILACS, Scientific Electronic Library Online (SciELO), and the Open Access Scientific Repositories of Portugal (RCAAP). The following inclusion criteria were defined: studies in Portuguese or English; with abstracts or full texts available; with a publication date from 2018 to 2022; and research containing the identified keywords in the title (TI) or abstract (AB). To organize and synthesize the data, we used a table to extract the significant information from each included study. Results: Eight studies were included, all of them emphasizing the assessment of well-being at work and the manager’s intervention to promote this well-being. We found that most studies indicate that nurses are satisfied with their work. There are several factors that can influence this positive level of well-being at work, such as interaction with management, culture, and organizational commitment. It can be concluded that nurse managers have a decisive role in promoting well-being at work.

A doença pulmonar obstrutiva crônica (DPOC) é uma condição que impacta diretamente a prática de exercício físico. Este trabalho teve como objetivo descrever os efeitos combinados do uso de ventilação não invasiva (VNI) com pressão positiva em dois níveis (bilevel) nas vias aéreas e exercícios físicos em pacientes com DPOC. Foi realizada uma revisão sistemática, utilizando os descritores tolerância ao exercício, VNI e DPOC e seus correspondentes em português e espanhol, nas bases de dados eletrônicas SciELO e PubMed. A busca e seleção dos estudos ocorreu entre dezembro de 2020 a fevereiro de 2021. Os sete artigos incluídos nesta revisão tiveram sua qualidade metodológica avaliada pela escala PEDro. A combinação de VNI do tipo bilevel e exercícios físicos foi benéfica para pacientes com DPOC mesmo nos estágios mais avançados da doença. No sistema respiratório, houve melhora das pressões inspiratória e expiratória máximas, da saturação arterial de oxigênio (O2), da pressão arterial de O2 e redução da dispneia. No sistema cardiovascular, houve redução da frequência cardíaca e da pressão arterial sistólica. Além disso, houve melhora do metabolismo energético, redução das concentrações de lactato, aumento da força muscular periférica e da distância percorrida no teste de caminhada de 6 minutos. Não houve diferença quanto ao uso da VNI antes ou durante o exercício, apresentando bons resultados em ambas as situações. A combinação de VNI do tipo bilevel com exercícios físicos é uma possibilidade terapêutica promissora para pacientes com DPOC, porém são necessários mais estudos para estabelecer melhores parâmetros para a sua utilização.

O presente trabalho tem como objetivo apresentar, na perspectiva nietzschiana, alguns aspectos da teoria da décadence, limitando-se ao seu embate com a arte do século XIX. Para realizar tal empreitada, nos detemos na terceira fase do filósofo e nos escritos do último ano de produção de Nietzsche. Com efeito, no período o autor faz uma investigação minuciosa de Richard Wagner, em O caso Wagner, de 1888. Diante disso, no primeiro momento, a fim de introduzirmo-nos no procedimento genealógico-fisiológico por meio do qual o filósofo investiga a arte da décadence, destacamos alguns aspectos específicos do contexto histórico do conceito de ‘décadence’ no movimento literário francês da segunda metade do século XIX. Em seguida, a análise e os efeitos fisiopsicológicos causados pela música de Wagner, ilustrados por Nietzsche, forneceram a matéria prima para comparar a ‘melodia infinita’ de Wagner com a ‘música mediterrânea’ de Bizet, assim como, os sintomas e efeitos que repercutem na vida do indivíduo.

Key Points Phage M13 remains viable in the bird's intestine if inoculated with E. coli ER2738. Bacteriophage M13 does not damage the chicken gut. Phage M13 remains in the gut without leading to a humoral response up to 42 days.

ABSTRACT Introduction: despite being extremely effective in some cases, up to 70% of patients with melanoma do not respond to anti-PD-1/PD-L1 (primary resistance) and many of the responders eventually progress (secondary resistance). Extensive efforts are being made to overcome this resistance through new strategies, especially aimed at modulating the intestinal microbiota. Objective: to assess whether fecal microbiota transplantation (FMT), associated with immunotherapy, is beneficial in the clinical course of patients with refractory melanoma. Methods: this is a scope review, based on studies collected on the MEDLINE, ScienceDirect, The Cochrane Library, Embase and BMJ Journals; using the terms: “Antibodies, Monoclonal”; “Drug Resistance, Neoplasm”; “Fecal Microbiota Transplantation”; “Host Microbial Interactions”; “Immunotherapy”; “Melanoma”; and “Microbiota”. Clinical trials, in English, with relevant data on the subject and fully available were included. A cut-off period was not determined, due to the limited amount of evidence on the topic. Results: crossing the descriptors allowed the identification of 342 publications and, after applying the eligibility criteria, allowed the selection of 4 studies. From the analyses, it was observed that a considerable part of those studied overcame resistance to immune checkpoint inhibitors after FMT, with better response to treatment, less tumor growth and increased beneficial immune response. Conclusion: it is noted that FMT favors the response of melanoma to immunotherapy, translated into significant clinical benefit. However, further studies are necessary for the complete elucidation of the bacteria and the mechanisms involved, as well as for the translation of new evidence to oncological care practice.

Olhar de modo continuado para problemáticas contemporâneas inseridas no contexto educacional é de suma relevância, por isso o estudo tem como objetivo analisar as novas problemáticas socioemocionais envolvidas na transição do ensino fundamental II e novo ensino médio. Utilizou-se como metodologias a revisão integrativa de literatura nas seguintes bases de dados: biblioteca virtual do Centro Universitário UNIFTC e SciELO, além de dois questionários adaptados acerca das condições emocionais gerais dos estudantes incluídos no estudo. A revisão de literatura em consonância com os resultados apresentados nos dois questionários utilizados fortifica o tema apresentado acerca das problemáticas emocionais secundárias decorrentes do processo transitório educacional, podendo ser ou não a transição ser o principal motivo para o aparecimento e manutenção dos sintomas identificados. A efetivação da lei vigente que exige a presença de psicólogo(a) em instituições de ensino pode reduzir os problemas identificados, tendo como objetivo a manutenção da saúde mental de milhares de estudantes inseridos no contexto educacional brasileiro.

This work presents the design and prototyping of two 1U standard CubeSats for the First Brazilian MCTI Satellite Olympiad, launching one in a stratospheric helium-filled balloon. The nanosatellites were designed for two missions: Internet of Things connectivity in remote areas based on CubeSat (IoSat) and low-orbit harmful gamma radiation mapping (LOHGRM). The IoSat mission aimed to provide server connectivity for a remote sensor network. The LOHGRM CubeSat was designed for sensing and mapping gamma radiation power levels in the satellite’s orbit to construct a heat map to study the gamma radiation effect on the equipment. The prototype’s performance was evaluated based on physical, mechanical, magnetic, thermal, and transmission characterization, with satisfactory results under test conditions. The LOHGRM mission test was carried out on the ground as proof of concept without flying while a stratospheric balloon launched the IoSat prototype. Due to restrictions imposed by the competition, the IoSat nanosatellite only captured and registered altitude, pressure, and temperature data without testing the communication payload. Instead, this data was sent to the ground station through the competition communication system and stored in a memory card to assess its operation during the flying. The satellite’s maximum altitude was 22.6 km, operating under –23.5 °C.

O presente artigo tem como objetivo compreender o processo de aplicação de estratégias de evidence-based policymakingno ensino da administração pública no Brasil. O estudo centra-se no papel exercido pelas escolas de governo como instituições de ensino e pesquisa aplicados. A partir do estudo de caso da trajetória recente da Escola Nacional de Administração Pública (Enap), observa-se que a produção de evidências para as políticas públicas e a ponte entre ensino e serviço púlico são elementos centrais da atuação de escolas de governo, contribuindo para que os programas de aprendizagem permaneçam relevantes e atualizados com as tendências sociais e econômicas, bem como políticas emergentes e prioridades do governo.

This article seeks to point out intrinsic relationships in the works of writers César Aira (1949) and Sérgio Sant’Anna (1941-2020), two names that make up the panorama of Latin American literature in the second half of the 20th century and the beginning of the 21st century. His works, which are guided by the short form (the short story, the novel, the essay), seek to bend the limits of genres and bring into the literary text several other narrative forms that influence his writings and interpenetrate in his techniques: the plastic arts, cinema, photography, music appear in his texts as elements for the construction of his visions of the world. With careful reading of the critical fortune of both authors, in addition to own texts and comments that an author has over the other, we tried to establish and discuss approach points regarding the handling of the techniques of the avant-garde of the twentieth century, in a possible game endless.

Abstract Agriculture is the economic activity which uses water the most in Brazil, particularly in São Francisco River Basin, where water withdrawals for irrigation granted by water authorities amount to 22.3 billion m3 per year, a number which is close to 81% of the total withdrawal. On the other hand, bulk water in Brazil is underpriced. Water charges for agricultural users neither reflect the economic value of water nor induce a rational and efficient use of water resources, two key concepts of the Brazilian water law. Even so, it is common for irrigators to complain about the water prices charged for their use of bulk water. To throw some light on the real impact of charging water in the agriculture sector, this article evaluates the economic value of irrigation water in the São Francisco River basin through the shadow price approach, calculated by using the Residual Value Method. The analysis was performed for the top ten major São Francisco River basin crops in water use terms, namely corn, soybean, mango, beans, coffee bean, banana, cotton, sugar cane, papaya and rice. Results for the 2019 harvests show that except for sugar cane, all water shadow prices were positive, notably mango, beans and papaya. This paper also evaluated water shadow prices interannual variation from 2014 to 2019 for six crops. Except for sugarcane, the other crops have been profitable most of the time in the last 6 years. A wide fluctuation in the shadow price of water was observed over these years due to variations in sales prices and costs of production.

Dystrophinopathies are muscle diseases caused by pathogenic variants in DMD, the largest gene described in humans, representing a spectrum of diseases ranging from asymptomatic creatine phosphokinase elevation to severe Duchenne muscular dystrophy (DMD). Several therapeutic strategies are currently in use or under development, each targeting different pathogenic variants. However, little is known about the genetic profiles of northeast Brazilian patients with dystrophinopathies. We describe the spectrum of pathogenic DMD variants in a single center in northeast Brazil. This is an observational, cross-sectional study carried out through molecular-genetic analysis of male patients diagnosed with dystrophinopathies using Multiplex Ligation-dependent Probe Amplification (MLPA) followed by Next-Generation Sequencing (NGS)-based strategies. A total of 94 male patients were evaluated. Deletions (43.6%) and duplications (10.6%) were the most recurring patterns of pathogenic variants. However, small variants were present in 47.1% of patients, most of them nonsense variants (27.6%). This is the largest South American single-center case series of dystrophinopathies to date. We found a higher frequency of treatment-amenable nonsense single-nucleotide variants than most previous studies. These findings may have implications for diagnostic strategies in less-known populations, as a higher frequency of nonsense variants may mean a higher possibility of treating patients with disease-modifying drugs.

Resumo A produção de políticas públicas é um processo complexo que envolve um conjunto de estímulos e condicionantes. Compreender o que, de fato, tem informado os burocratas e as organizações públicas é um elemento essencial para caracterizar a produção de políticas públicas, assim como para a discussão das potencialidades e dos limites das Políticas Públicas Baseadas em Evidências (PPBE) no contexto brasileiro. Neste estudo, investigamos as diferentes fontes de informação disponíveis aos burocratas brasileiros; dentre as quais, não somente as científicas, mas também as experienciais, as internas e as externas ao Estado. Esta pesquisa traz resultados de um survey respondido por 2.180 servidores da Administração Federal Direta no final de 2019. Os resultados indicam que há variação na utilização de fontes de informação a serem mobilizadas pelos burocratas de acordo com o tipo de trabalho desempenhado e, também, com a área de política pública na qual atuam.

Studies on the nutritional status of habanero pepper (Capsicum chinense Jacquin) in relation to organic fertilization are still incomplete and preliminary. To evaluate the effects of organic fertilizer doses, produced from family farming wastes, a greenhouse experiment was conducted at the Universidade Federal Rural da Amazônia, Belém, Pará, Brazil. The experiment followed an entirely randomized design, with five treatments and four repetitions. Each experimental plot was composed of a pot with a volume of 3.6 dm3 of soil, in which the seeds were sown. Five doses of organic fertilizer were tested (0%, 15%, 30%, 45% and 60%) composed of a mixture of chicken manure (10%), duck manure (20%), cassava peel (15%), cassava leaf (15%), bean straw (15%), rice husk (15%) and corn cob (10%), mixed in volumetric proportions in the substrate. A Yellow Latosol of sandy texture was sampled from the superficial layer (0-20 cm). The best results were achieved at 103 days using the 60% dose of organic manure. The content and accumulation of macronutrients in leaf tissues showed the following order: N˃K≥S˃Ca≥Mg˃P and N˃K˃S˃Mg˃Ca˃P. In the fruits the order was followed: N˃K˃S˃P˃Mg˃Ca.

Despite causing high morbidity, IgG4-related disease (IgG4-RD) and its gastroenterological manifestations lack better and greater theoretical contributions. Therefore, the objective of this work was to evaluate the clinical–epidemiological, diagnostic and treatment aspects of the gastrointestinal manifestations of this disease. A systematic review was carried out using the PubMed, Scopus and Embase databases between January 2012 and March 2023 with the following descriptors: “Immunoglobulin G4-Related Disease” (MeSH) AND #2 “Gastrointestinal Tract” (MeSH). Our data collection grouped a total of 3607 patients from mostly epidemiological cohort studies and cross-sectional follow-ups. In the subgroup analysis, IgG4-RD was associated with male gender, with an estimated prevalence between 54% and 80%. In our findings, the prevalence by topography was presented in the following ranges: lacrimal glands (17–57%); salivary glands (28–72%); pancreas (19–60%); biliary tract (5–40%); retroperitoneal cavity (9–43%). Longitudinal studies are needed to better map the natural history of the gastrointestinal manifestations of IgG4-RD and enable the formulation of individualized treatments.

Supratentorial Lymphocytic Inflammation with Parenchymal Perivascular Enhancement Responsive to Steroids (SLIPPERS) is a rare variant of the CLIPPERS spectrum with less than ten reports published so far. There is ongoing discussion regarding whether SLIPPERS is a disease entity on its own or just an acronym encompassing many underlying diagnoses, such as sarcoidosis, vasculitis and anti-glial fibrillary acidic protein (GFAP)-associated disease. A 40-year-old woman presented with episodes of language and attention impairment. Magnetic resonance imaging (MRI) revealed T2/FLAIR hyperintense lesions in the subcortical white matter associated with a micronodular, curvilinear perivascular contrast-enhancement. Alternative diagnoses were excluded. There was a remarkable response to steroids. A relapse occurred after six years, and the biopsy showed perivascular T-cell lymphocytic infiltrate, without granulomas, vasculitis, or neoplasia. There was complete resolution of the relapse after steroids. This case represents the longest reported follow-up of a patient diagnosed with SLIPPERS, and brain biopsy after 6 years did not suggest alternative diagnoses. This report contributes to the discussion regarding the possibility that exclusive supratentorial CLIPPERS-like pathology might be an isolated disease entity, but more biopsy-proven cases with a longer follow-up are needed to support this hypothesis. Recently, GFAP astrocytopathy has been characterized and might correspond to a significant number of cases previously diagnosed as CLIPPERS or SLIPPERS.

Cerebrotendinous xanthomatosis (CTX) is an autosomal recessive disorder caused by pathogenic variants in CYP27A1, leading to a deficiency in sterol 27-hydroxylase. This defect results in the accumulation of cholestanol and bile alcohols in various tissues, including the brain, tendons and peripheral nerves. We conducted this review to evaluate lipid profile abnormalities in patients with CTX. A search was conducted in PubMed, Embase and the Virtual Health Library in January 2023 to evaluate studies reporting the lipid profiles of CTX patients, including the levels of cholestanol, cholesterol and other lipids. Elevated levels of cholestanol were consistently observed. Most patients presented normal or low serum cholesterol levels. A decrease in chenodeoxycholic acid (CDCA) leads to increased synthesis of cholesterol metabolites, such as bile alcohols 23S-pentol and 25-tetrol 3-glucuronide, which may serve as surrogate follow-up markers in patients with CTX. Lipid abnormalities in CTX have clinical implications. Cholestanol deposition in tissues contributes to clinical manifestations, including neurological symptoms and tendon xanthomas. Dyslipidemia and abnormal cholesterol metabolism may also contribute to the increased risk of atherosclerosis and cardiovascular complications observed in some CTX patients.