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Background: Bedside ultrasonography, also known as point-of-care ultrasound (PoCUS), is a promising technological tool that enhances clinical assessment, enriching diagnostic capabilities and clinical reasoning. Its use in nursing spans various patient populations and health care settings, providing nurses with a valuable health assessment tool to improve care quality and patient safety. Despite its growing integration into clinical practice, PoCUS training has mainly focused on physicians, leaving a gap for trained nurses who demonstrate similar proficiency in conducting scans and interpreting images. Previous research highlights the value of digital tools in PoCUS training, showing their role in improving professionals' and students' knowledge, image interpretation skills, and clinical acumen., Objective: This study aimed to (1) establish an assessment instrument gauging nurses' competency milestones in PoCUS and evaluate its content and appearance validity, (2) develop a series of 5 educational videos focused on PoCUS and assess their content and appearance validity, and (3) construct an online learning environment tailored to nurses' PoCUS training needs and evaluate its content and appearance validity., Methods: We will conduct a methodological study of technological production guided by Rogers' diffusion of innovations theory. Subproject 1 will design and validate a comprehensive assessment tool for evaluating nurses' competency milestones in PoCUS use. For this purpose, a scoping review will be conducted. The review will be based on JBI Collaboration guidelines and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extended for Scoping Reviews (PRISMA-ScR) checklist. Subproject 2 involves an evaluation of content and appearance validity for a series of 5 educational videos on PoCUS, designed specifically for nurses about applying peripherally inserted central catheter lines, inserting nasogastric feeding tubes, assessing gastric residual volume, assessing pressure injuries and soft tissue conditions, and assessing muscle mass to monitor patient nutritional status. In subproject 3, a comprehensive online learning environment dedicated to PoCUS training for nurses will be developed and validated. The launch of an online learning environment represents a cornerstone of our dissemination strategy, scheduled to coincide with the inaugural Brazilian PoCUS symposium for nurses, an event organized by the project members. This platform will serve as a pivotal resource for continuous learning and professional development., Results: Subproject 1 will start in the second half of 2024 and is expected to be completed by mid-2025. Subproject 2 is currently ongoing and is expected to be completed in early 2026. Subproject 3 is set to begin in early 2025 and is planned to be completed by 2026., Conclusions: Through these concerted efforts, the project aims to bridge the existing gap in PoCUS training for nurses, thereby fostering their proficiency and enhancing patient care outcomes., International Registered Report Identifier (irrid): PRR1-10.2196/58030., (©Fernanda Raphael Escobar Gimenes, Angelita Maria Stabile, Rodrigo Magri Bernardes, Vinicius Batista Santos, Mayra Gonçalves Menegueti, Patricia Rezende do Prado, Mauricio Serra Ribeiro, Flavia Giron Camerini, Soraia Assad Nasbine Rabeh. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 23.10.2024.)

In this work, we describe for the first time the synthesis of a thiazole bis-imine fluorometric sensor for the selective determination of Pb 2+ in environmental, biological, and food samples. The novel molecules were obtained through a multicomponent reaction using a green and environmentally sustainable methodology. Synthesized chemical sensors were characterized using spectroscopic techniques to structural elucidation, including UV-Vis, FTIR-ATR, 1 H and 13 C NMR. One of these sensors exhibited remarkable selectivity for the Pb 2+ ion at pH 3, forming a stable 1:1 (metal:ligand) complex. Additionally, the reaction conditions for complex formation were optimized, resulting in a method with a linear range of 0.667-10  μg L -1 and a detection limit of 0.18  μg L -1 . Furthermore, method validation reinforced its reliability, showing low relative standard deviation in both intra-day and inter-day analyses. Recovery experiments ranged from 83.53 % to 119.10 %. This study represents a significant and innovative advancement in the development of rapid, sensitive, and alternative methods for the detection of potentially toxic metals in a wide range of samples employing a green multicomponent reaction of thiazole bis-imines., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Pulmonary arterial hypertension (PAH) can have several consequences on sexual function, which can lead to worsened quality of life., Aim: The study sought to assess sexual function and its association with health functionality and quality of life in females with PAH., Methods: A descriptive cross-sectional study was carried out in pulmonary circulation outpatient clinics from January 2022 to March 2023 in females diagnosed with pulmonary hypertension. Assessment was carried out through the application of the Female Sexual Function Index, the 36-item World Health Organization Disability Assessment Schedule, and the Medical Outcome Study 36-Item Short Form Survey., Outcomes: Data were analyzed using SPSS version 22.0 and JASP, and Spearman's correlation tests were applied between the instruments, with a P value <.05 considered significant., Results: A total of 91 females were assessed. It was identified that 90.1% of females had sexual dysfunction, with worse scores in females with sexual dysfunction in the domains of satisfaction, arousal, and desire, with average health functionality and quality of life. There were significant correlations between the domains of mobility, getting along, life activities, and the overall functionality score with some domains of sexual function, especially arousal and satisfaction. We found significant correlations between some domains of quality-of-life assessment with the domains of desire, arousal, and satisfaction, and with the overall score of sexual function assessment, as well as strong correlations between health functionality and quality of life., Clinical Implication: The data reinforce the need for rehabilitation programs and social support for this population., Strengths and Limitations: This is one of the few studies to evaluate sexual function, quality of life, and health functionality in women with PAH. Due to limitations in data collection, we were unable to assess certain factors such as hormone levels and a history of sexual abuse., Conclusion: We identified a high prevalence of sexual dysfunction in females with PAH with mild functional impairment and a moderate quality-of-life score with correlations between sexual function, health functionality, and quality of life., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society for Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: to identify in the literature the main nursing diagnoses according to the NANDA-I diagnostic classification for people hospitalized with heart failure., Methods: an integrative literature review, carried out in February 2019 and updated in July 2023, in the MEDLINE via PubMed, LILACS, SciELO and CINAHL databases. Given the use of acronym PEO, studies without a time cut in Portuguese, English and Spanish were included. Descriptive analysis was carried out to present the identified information., Results: analysis of 27 articles identified 24 nursing diagnoses, with emphasis on Decreased Cardiac Output, Excessive Fluid Volume, Decreased Activity Tolerance and Fatigue., Final Considerations: evidence can contribute to better diagnostic decisions centered on people with heart failure in search of more assertive health results and have the potential to support future studies on a possible syndromic pattern in this population.

Objective: to assess validity evidence of an educational video on safe sexual activity after acute coronary syndrome., Method: study in three phases: video development; content validity analysis by 11 experts; and analysis of validity based on response processes by seven people with coronary disease. The content validity ratio (CVR) was calculated with critical values for the second phase of 0.63 and for the third of 1.0., Results: the video addressed the importance of resuming sexual activity and positions that consume less energy, clinical warning signs, the importance of adhering to treatment and a welcoming environment for sexual practice. A CVR above the critical value was obtained with a total of 4 minutes and 41 seconds., Conclusion: the educational video brings together adequate content validity evidence and can be used as a tool for patients after acute coronary syndrome.

To assess the ideal time for caffeine administration in preterms, identifying its effects and safety. Study Design: Meta-analysis conducted including preterms <32 weeks GA or BW < 1500 g, comparing caffeine administration time: <24 x ≥24HOL, <48 x ≥48HOL, <72 x ≥72HOL. 18 studies included 76.998 patients. The median age of starting caffeine was the first 24 HOL. In the overall comparisons, there was reduction in patent ductus arteriosus (OR 0.71 [0.55, 0. 92]; low evidence), retinopathy of prematurity (OR 0.71 [0.54, 0.93]; moderate evidence), severe brain injury (OR 0.79 [0.70, 0.91]; moderate evidence), bronchopulmonary dysplasia (BPD) (OR 0.69 [0.59, 0.81]; moderate evidence), composite outcome of BPD or death (OR 0.76 [0.66, 0.88]; moderate evidence). Mortality increase was found (OR 1.20 [1.12, 1.29], very low evidence).Caffeine in the first 24 HOL has benefits in reducing morbidities associated with prematurity. Mortality finding is potentially due to survival bias., (© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Purpose: To evaluate the content validity evidence of the nursing outcome "sexual functioning" from the Nursing Outcomes Classification (NOC)., Methods: A multi-method study, including a methodological study analyzing the content validity evidence of the NOC outcome and sexual functioning, and a quantitative, descriptive, cross-sectional study. In the first phase, a literature review was conducted to map and identify clinical indicators associated with sexual functioning to construct the conceptual (CD) and operational definitions (ODs) of each outcome indicator. In the second phase, experts assessed the CD and OD for clarity, theoretical relevance, and theoretical pertinence. The critical validity ratio (CVR) was calculated for each indicator. In the third phase, a pilot test of sexual functioning measurement was conducted with 33 patients hospitalized for coronary artery disease. Internal consistency was calculated through Cronbach's alpha., Results: The CD and OD were constructed based on 120 articles and analyzed by 13 experts; four rounds were required to achieve the critical CVR in each phase. In the pilot test, the nursing outcome achieved a Cronbach's alpha of 0.95, and the mean assessment time was 26 min. Indicators with the highest mean scores were related to knowledge of personal needs and capabilities and comfort with one's own body., Conclusion: The CD and OD developed for the NOC outcome, sexual functioning, had adequate evidence of content validity. The outcome content has high internal consistency. Further studies on the validity of the nursing outcome should be conducted to increase its validity., Implications for Practice: The nursing outcome, sexual functioning, can be a tool used by nurses to evaluate the effect of nursing education and interventions on sexual functioning in the adult population., (© 2024 NANDA International, Inc.)

Objective: To analyze the evidence of content validity of the Nursing Outcomes "Mechanical Ventilation Response: Adult" and "Mechanical Ventilation Weaning Response: Adult", for patients with severe COVID-19., Method: Methodological study developed in two stages: literature review to construct the definitions of the indicators and analysis of the evidence of content validity of the nursing outcomes by a focus group., Results: All the conceptual and operational definitions developed for the 56 indicators were considered clear and precise. However, 17 indicators were excluded because they were deemed not to be relevant. The definitions of the magnitudes for 17 indicators of the Nursing Outcome "Mechanical Ventilation Response: Adult" and 22 indicators "Mechanical Ventilation Weaning Response: Adult" were thus constructed., Conclusion: The development of definitions and validation by experts makes the use of these outcomes and their indicators more understandable and precise, favoring their use in clinical practice and providing greater detail in assessment and recording.

Background: Photobiomodulation (PBM) is indicated to accelerate the recovery of athletes and reduce muscle damage caused by physical exercise. The objective of this study was to establish the best time to apply photobiomodulation to increase the functional performance and ergogenic response of rugby athletes., Methods: Randomized crossover clinical trial with 18 rugby athletes of both sexes. The interventions were carried out from January to May 2019. The blood levels of creatine kinase (CK) and lactate, and performance in the Modified Star Excursion Balance Test, Single Hop Test, Triple Hop Test, Bangsbo Sprint test (BST), and Yo-Yo intermittent recovery level 1 (YoyoIR1) were evaluated. The athletes underwent two blocks of exercises with the BST and Yoyo-IR1, as well as the random application of four interventions: without application of photobiomodulation (CO), pre-exercise photobiomodulation (PBpre), PBM during the exercise interval (PBint), or post-exercise photobiomodulation (PBpos). The photobiomodulation using light-emitting diodes (850 nm, 8 J/cm 2 ) lasted 10 min and was applied to the quadriceps, hamstrings, and triceps surae muscles. The results were compared between groups and times, and the effect size for the interventions was established., Results: No differences were found between groups in CK, lactate, and performance in the functional tests between groups and times. Only the PBpre presented improved performance in the first Yoyo-1R1 test (p < 0.01), while the PBint improved in the second Yoyo-IR1 test and BST (p < 0.05)., Conclusion: The PBM did not change muscle damage markers or performance in the functional tests. For an ergogenic response, photobiomodulation applied before exercise improves performance, which can be maintained when PBM is performed in the exercise interval., Competing Interests: Declaration of competing interest There are no known conflicts of interest associated with this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: to evaluate the evidence of validity of the internal structure and reliability of the Brazilian version of the Smoking Cessation Counseling instrument., Method: psychometric study of confirmatory factor analysis and reliability carried out on 250 nurses in clinical practice. For the analysis of the convergent validity of the factor model, Average Variance Extracted values were calculated, and discriminant analysis was carried out using the Fornell-Larcker criterion. Reliability was examined using Cronbach's alpha coefficient and composite reliability., Results: it was necessary to exclude seven items from the Advanced Counseling domain and one item from the Basic Counseling domain in order to properly obtain the Average Variance Extracted values and the Fornell-Larcker criterion. The composite reliability ranged from 0.76 to 0.86 and the overall Cronbach`s alpha coefficient was 0.86, ranging from 0.53 to 0.84 depending on the domain assessed. The final version of the instrument was made up of 16 items divided into 4 domains., Conclusion: the Brazilian version of Smoking Cessation Counseling obtained adequate psychometric evidence of validity and reliability. Further studies are needed to refine the instrument., Background: (1) Instrument shows adequate internal consistency and validity., Background: (2) Evaluate counseling practices and their impact on patient care., Background: (3) Instrument for evaluating smoking cessation counseling., Background: (4) Provides important information for planning nursing care.

Herein, we report a KIO 3 -catalyzed oxidative coupling of thiols to their corresponding disulfides in water, in a short time and at ambient temperature. The reaction has a broad scope and exhibits good functional group tolerance, resulting in the desired products in excellent yields. This approach allows the reuse of the reaction system in multiple cycles and scale-up. Furthermore, the current protocol demonstrates compatibility for in situ generation of disulfides and post application in C(sp 2 )-H bond sulfenylation.

The aim was to evaluate the effect of different energy diets available in adulthood on the longevity, dispersal capacity and sexual performance of Aedes aegypti produced under a mass-rearing system. To evaluate the effects of diets in relation to the survival of the adult male insects of Ae. aegypti , six treatments were used: sucrose at a concentration of 10%, as a positive control (sack10); starvation, as a negative control (starvation); sucrose at a concentration of 20% associated with 1 g/l of ascorbic acid (sac20vitC); wild honey in a concentration of 10% (honey10); demerara sugar in a 10% concentration (demerara10); and sucrose at a concentration of 20% associated with 1 g/l of ascorbic acid and 0.5 g/l of amino acid proline (sac20vitCPr). Each treatment had 16 cages containing 50 adult males. For the tests of flight ability and propensity to copulation, five treatments were used (saca10; sac20vitC; mel10; demerara10; and sac20vitCPr), with males each for flight ability and females copulated by a single male for copulation propensity. The diet composed of sucrose at a concentration of 20% associated with ascorbic acid, as an antioxidant, improved the survival, flight ability and propensity to copulate in Ae. aegypti males under mass-rearing conditions, and may be useful to enhance the performance of sterile males, thus improving the success of sterile insect technique programmes.

Objective: To identify the predictors of self-care behaviors in individuals with heart failure., Method: A cross-sectional study including 405 patients with heart failure. Self-care behaviors were assessed by the Self-Care of Heart Failure Index. Sociodemographic and clinical characteristics were investigated as predictors of self-care maintenance, management and confidence through logistic regressions., Results: The predictors of self-care maintenance were number of children (p<0.01), left ventricular ejection fraction (p<0.01), positive feeling about disease (p=0.03), obesity (p=0.02) and dialytic chronic kidney disease (p<0.01). The predictors of self-care management were having married children (p<0.01) and sleep apnea (p<0.01). The predictors of self-care confidence were family income (p<0.01), number of hospitalizations in the previous 12 months (p=0.01), number of daily medication doses (p<0.01) and sedentarism (p<0.01)., Conclusion: Some predictors related to the self-care behaviors were found, so some intensified education and social aid should be aimed at patients with these specific characteristics.

In the present work, we report the development of a novel cotton thread-based colorimetric sensor modified by carboxymethylcellulose (CMC) and cuprizone (CPZ) with smartphone detection and its application for the quantitative determination of cupric ions in water and cachaça. The cotton thread/smartphone detection-based colorimetric method is an easily affordable, low-cost technique which allows one to perform real-time and on-field determination analyses, especially with limited financial resources. The method involves the complexation of Cu(II) with CPZ, which causes a change in the coloration of the cotton thread from a shade of white to blue in the detection zone of the colorimetric sensor. The immobilization of CPZ on CMC in the cotton thread leads to the pre-concentration of Cu(II) via a complexation mechanism with colorimetric reaction. The application of the colorimetric sensor allows the quantification of copper in the range from 1 to 12 mg L -1 , with a low limit of detection of 0.21 mg L -1 . In addition, the recovery assays conducted in samples of water and cachaça resulted in recovery percentages ranging from 84.9% to 107%, which is indicative of a precise method. To validate the precision of the proposed colorimetric method, the values obtained from the quantification analysis were compared with those of the flame atomic absorption spectrometry and a good agreement at the 95% confidence level was obtained.

This study is taken up to evaluate the effect of an exercise program on adolescents' obesity and overweight profile. For this purpose, a 1-group pretest-posttest study was conducted with 72 adolescents who underwent a physical activity program supervised by one health professional 5 times a week; the sessions were distributed over 12 weeks and lasted from 50 to 60 minutes. The primary outcomes were anthropometric measurements, whereas the secondary outcomes were lipid profile, blood glucose, and blood pressure. Outcomes were assessed before the intervention and 1 day after the program ended; significance was established at P < .05. As a result, a significant improvement was verified in all the primary outcomes ( P < .001) and in most secondary outcomes (capillary blood glucose, P = .0001; triglycerides, P = .0001; and systolic blood pressure, P = .005). In conclusion, the supervised exercise program significantly reduced anthropometric measurements and blood glucose, triglycerides, and systolic blood pressure levels.

The present work describes a laboratory-on-a-drone (Lab-on-a-Drone) developed to perform in situ detection of contaminants in environmental water samples. Toward this goal, the system was mounted on an unmanned aerial vehicle (UAV) (drone) and remotely controlled via Wi-Fi to acquire a water sample, perform the electrochemical detection step, and then send the voltammetry data to a smartphone. This Lab-on-a-Drone system was also able to recharge its battery using a solar cell, greatly increasing the autonomy of the system, even in the absence of a power line. As a proof of concept, the Lab-on-a-Drone was employed for the detection of Pb 2+ in environmental waters, using a simple electrochemical cell containing a miniaturized screen-printed boron-doped diamond electrode (SP-BDDE) as a working electrode, an Ag/AgCl as a reference electrode, and a graphite ink as a counter electrode. For quantification purposes, analytical curves were constructed covering a concentration range from 1.0 μg L -1 (4.83 nmol L -1 ) to 80.0 μg L -1 (386.10 nmol L -1 ), featuring a detection limit of 0.062 μg L -1 (0.30 nmol L -1 ). The Lab-on-a-Drone was applied to monitor a water reservoir in the Metropolitan Region of Recife, Brazil. To evaluate its performance regarding accuracy and precision, a reference method based on inductively coupled plasma optical emission spectrometry (ICP-OES) was applied, and the results obtained by both methods showed no statistical differences ( t -test at 95% confidence level, n = 3). These results represent the first demonstration of the capabilities of an adapted UAV for the quantification of electroactive environmental contaminant using voltammetry, with real-time data transmission. Thus, the Lab-on-a-Drone makes it possible to reach difficult-to-access environmental reserves and to monitor potentially polluting activity in distant water bodies. Thus, this tool can be used by governments and non-profit organizations to monitor environmental waters using fast, low-cost, process autonomy with accurate and precise data useful to decision making.

Objective: To analyze the evidence of content validity of telephone messages regarding preventive measures against COVID-19., Method: Methodological study, in which messages containing text and image were developed through a narrative literature review and whose content was evaluated by eight judges in terms of clarity, practical relevance, theoretical relevance and vocabulary. The content validity index (CVI) was calculated, and messages that reached levels above 90% were considered to have adequate evidence of validity., Results: Eighteen text messages/images were developed containing information about COVID-19, hand hygiene, use and handling of masks and the importance of social distancing. After second round of evaluation, a content validity index above 90% was obtained in all evaluated indicators., Conclusion: The telephone messages were developed and showedadequate evidence of content validity.

Objectives: to assess the evidence of reliability and convergent construct validity of the King's Parkinson's Disease Pain Questionnaire., Methods: psychometric study of 75 older adults with Parkinson's disease. The instrument was applied by two researchers separately and reapplied by one researcher 15 days later. In terms of reliability, internal consistency was assessed using the Cronbach's alpha test and stability using the intraclass correlation coefficient. Scores of the King's Parkinson's Disease Pain Questionnaire were compared to those of the Geriatric Pain Measure in the assessment of construct validity., Results: the mean Cronbach's alpha obtained between the three assessments was above 0.60, the intraclass correlation between the three assessments was above 0.90, and there was a weak but significant correlation between the two applied scales., Conclusions: the instrument showed adequate evidence of convergent construct validity and reliability, and can be used in clinical practice.

Given the importance of identifying the presence of biomarkers of human diseases in DNA samples, the main objective of this work was to investigate, for the first time, the electro-catalytic oxidation of 7-methyl-guanine (7-mGua) and 5-methyl-cytosine (5-mCyt) on a boron doped diamond electrode pre-treated cathodically (red-BDDE), using differential pulse voltammetry (DPV) and cyclic voltammetry (CV). The anodic peak potentials of 7-mGua and 5-mCyt by DPV were at E = 1.04 V and E = 1.37 V at pH = 4.5, indicating excellent peak separation of approximately 330 mV between species. Using DPV, experimental conditions such as supporting electrolyte, pH and influence of interferents were also investigated to develop a sensitive and selective method for individual and simultaneous quantification of these biomarkers. The analytical curves for the simultaneous quantification of 7-mGua and 5-mCyt in the acid medium (pH = 4.5) were: concentration range of 0.50-5.00 μmol L -1 (r = 0.999), detection limit of 0.27 μmol L -1 for 7-mGua; from 3.00 to 25.00 μmol L -1 (r = 0.998), with a detection limit of 1.69 μmol L -1 for 5-mCyt. A new DP voltammetric method for the simultaneous detection and quantification of biomarkers 7-mGua and 5-mCyt using a red-BDDE is proposed., Competing Interests: Declaration of interest statement I certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Dysarthria is one of the most frequent communication disorders in patients with Multiple Sclerosis (MS), with an estimated prevalence of around 50%. However, it is unclear if there is a relationship between dysarthria and the severity or duration of the disease., Objective: Describe the speech pattern in MS, correlate with clinical data, and compare with controls., Methods: A group of MS patients ( n  = 73) matched to healthy controls ( n  = 37) by sex and age. Individuals with neurological and/or systemic conditions that could interfere with speech were excluded. MS group clinical data were obtained through the analysis of medical records. The speech assessment consisted of auditory-perceptual and speech acoustic analysis, from recording the following speech tasks: phonation and breathing (sustained vowel/a/); prosody (sentences with different intonation patterns) and articulation (diadochokinesis; spontaneous speech; diphthong/iu/repeatedly)., Results: In MS, 72.6% of the individuals presented mild dysarthria, with alterations in speech subsystems: phonation, breathing, resonance, and articulation. In the acoustic analysis, individuals with MS were significantly worse than the control group (CG) in the variables: standard deviation of the fundamental frequency ( p  = 0.001) and maximum phonation time ( p  = 0.041). In diadochokinesis, individuals with MS had a lower number of syllables, duration, and phonation time, but larger pauses per seconds, and in spontaneous speech, a high number of pauses were evidenced as compared to CG. Correlations were found between phonation time in spontaneous speech and the Expanded Disability Status Scale (EDSS) ( r  = - 0.238, p  = 0.043) and phonation ratio in spontaneous speech and EDSS ( r  = -0.265, p  = 0.023), which indicates a correlation between the number of pauses during spontaneous speech and the severity of the disease., Conclusion: The speech profile in MS patients was mild dysarthria, with a decline in the phonatory, respiratory, resonant, and articulatory subsystems of speech, respectively, in order of prevalence. The increased number of pauses during speech and lower rates of phonation ratio can reflect the severity of MS., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Kieling, Finkelsztejn, Konzen, dos Santos, Ayres, Klein, Rothe-Neves and Olchik.)

The present study reports, for the first time, the development and application of a highly efficient method based on digital imaging analysis for the simultaneous determination of Cu 2+ and furfural in cachaça samples using a two-phase system and chemometrics tools. Furfural reacts with aniline in an acidic medium to form a Schiff base, which exhibits a pink color. On the other hand, Cu 2+ reacts with cuprizone in a basic medium to form a blue complex. The two reactions were performed on a porcelain plate, and a smartphone was used to capture the colorimetric images. Partial least squares (PLS) regression was used to construct the prediction models for Cu 2+ and furfural contents in cachaça samples. After finding the best PLS models, the ordered predictor selection (OPS) analysis was performed in order to select the most predictive variables. The method developed was found to be effective in estimating the amounts of Cu 2+ and furfural in cachaça samples, with a mean absolute error of 0.2 mg L -1 for the Cu 2+ model, and 0.3 mg per 100 mL of anhydrous alcohol for the furfural model. The method proposed in this study is simple and straightforward; it does not require complex technical knowledge and can be used by the producers themselves in the cachaça manufacturing process.

Background: The basal ganglia and cerebellum both have a role in speech production although the effect of isolated involvement of these structures on speech fluency remains unclear., Objective: The study aimed to assess the differences in the articulatory pattern in patients with cerebellar vs. basal ganglia disorders., Methods: A total of 20 individuals with Parkinson's disease (PD), 20 with spinocerebellar ataxia type 3 (SCA3), and 40 controls (control group, CG) were included. Diadochokinesis (DDK) and monolog tasks were collected., Results: The only variable that distinguished SCA3 carriers from the CG was the number of syllables in the monolog, with SCA3 patients of a significantly lower number. For patients with PD, the number of syllables, phonation time, DDK, and monolog were significantly lower than for CG. Patients with PD were significantly worse compared to patients with SCA3 in the number of syllables and phonation time in DDK, and phonation time in monolog. Additionally, there was a significant correlation between the number of syllables in the monolog and the MDS-UPDRS III for participants with PD, and the Friedreich Ataxia Rating Scale for participants with SCA3 suggesting a relationship between speech and general motor functioning., Conclusion: The monolog task is better at discriminating individuals with cerebellar vs. Parkinson's diseases as well as differentiating healthy control and was related to the severity of the disease., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 dos Santos, Ayres, Kieling, Miglorini, Jardim, Schumacher-Schuh, Rieder, Castilhos, Spencer, Rothe-Neves and Olchik.)

This analytical, cross-sectional study aimed to analyze the relationship between depressive symptoms, appetite, and quality of life (QoL) in 86 patients hospitalized with heart failure. Patients were assessed for depressive symptoms, appetite, and QoL using the Beck Depression Inventory-II, the Simplified Nutritional Appetite Questionnaire, and the Minnesota Living with Heart Failure Questionnaire, respectively. Relationships between sociodemographic and clinical variables, depressive symptoms, appetite, and QoL were analyzed using bivariate tests and linear regression models, with p  < .05 considered significant. The factors associated with QoL were dependence for four activities of daily living (ADLs) (estimate = 15.4, 95% CI = 0.23 to 30.64, p  = .046), minor depressive symptoms (estimate = -20.0, 95% CI = -28.3 to -11.73, p  < .001), and appetite (estimate = -11.08, 95% CI = -20.5 to -1.62, p  = .022). These results can support multi-professional assessment and development of interventions to promote better QoL, including addressing impaired appetite and food intake, the presence or increased intensity of depressive symptoms, especially in patients dependent for ADLs.

Background: Traumatic brain injury (TBI) has substantial physical, psychological, social and economic impacts, with high rates of morbidity and mortality. Considering its high incidence, the aim of this study was to identify epidemiological and clinical characteristics that predict mortality in patients hospitalized for TBI in intensive care units (ICUs)., Methods: A retrospective cohort study was carried out with patients over 18 years old with TBI admitted to an ICU of a Brazilian trauma referral hospital between January 2012 and August 2019. TBI was compared with other traumas in terms of clinical characteristics of ICU admission and outcome. Univariate and multivariate analyses were used to estimate the odds ratio for mortality., Results: Of the 4816 patients included, 1114 had TBI, with a predominance of males (85.1%). Compared with patients with other traumas, patients with TBI had a lower mean age (45.3 ± 19.1 versus 57.1 ± 24.1 years, p < 0.001), higher median APACHE II (19 versus 15, p < 0.001) and SOFA (6 versus 3, p < 0.001) scores, lower median Glasgow Coma Scale (GCS) score (10 versus 15, p < 0.001), higher median length of stay (7 days versus 4 days, p < 0.001) and higher mortality (27.6% versus 13.3%, p < 0.001). In the multivariate analysis, the predictors of mortality were older age (OR: 1.008 [1.002-1.015], p = 0.016), higher APACHE II score (OR: 1.180 [1.155-1.204], p < 0.001), lower GCS score for the first 24 h (OR: 0.730 [0.700-0.760], p < 0.001), greater number of brain injuries and presence of associated chest trauma (OR: 1.727 [1.192-2.501], p < 0.001)., Conclusion: Patients admitted to the ICU for TBI were younger and had worse prognostic scores, longer hospital stays and higher mortality than those admitted to the ICU for other traumas. The independent predictors of mortality were older age, high APACHE II score, low GCS score, number of brain injuries and association with chest trauma., (© 2023. The Author(s).)

This study aimed to evaluate the relationship between frailty, sociodemographic and clinical characteristics, and disease severity of older adults with acute coronary syndrome (ACS). A total of 57 hospitalized patients ≥60 years with ACS were assessed for frailty through the Tilburg Frailty Indicator. Disease severity was assessed by the Global Registry of Acute Coronary Events, by the maximum troponin level, and by the number of severely obstructed coronary arteries. The relationship between variables was assessed by Mann Whitney's test, Pearson's chi-square test, likelihood-ratio test, Fisher's exact test, or Student's t test. Analyses were bootstrapped to 1,000 to reduce potential sample bias. About 54.4% were frail. Frailty was associated with ethnicity ( p  = .02), marital status ( p  = .05), ischemic equivalents ( p  = .01), self-perceived health ( p  = .002), arthritis/rheumatism/arthrosis ( p  = .002), and number of severely obstructed coronary arteries ( p  = .05). These relationships can support intensified surveillance planning for the elderly at greatest risk, structuring of transitional care, appropriate nurse-coordinated secondary prevention delivery in primary care, and cardiac rehabilitation following ACS.

Interspecific hybrids are highly complex organisms, especially considering aspects related to the organization of genetic material. The diversity of possibilities created by the genetic combination between different species makes it difficult to establish a large-scale analysis methodology. An example of this complexity is Tambacu, an interspecific hybrid of Colossoma macropomum (Tambaqui) and Piaractus mesopotamicus (Pacu). Either genotype represents an essential role in South American aquaculture. However, despite this importance, the genetic information for these genotypes is still highly scarce in specialized databases. Using RNA-Seq analysis, we characterized the transcriptome of white muscle from Pacu, Tambaqui, and their interspecific hybrid (Tambacu). The sequencing process allowed us to obtain a significant number of reads (approximately 53 billion short reads). A total of annotated contigs were 37,285, 96,738, and 158,709 for Pacu, Tambaqui, and Tambacu. After that, we performed a comparative analysis of the transcriptome of the three genotypes, where we evaluated the differential expression (Tambacu vs Pacu = 11,156, and Tambacu vs Tambaqui = 876) profile of the transcript and the degree of similarity between the nucleotide sequences between the genotypes. We assessed the intensity and pattern of expression across genotypes using differential expression information. Clusterization analysis showed a closer relationship between Tambaqui and Tambacu. Furthermore, digital differential expression analysis selected some target genes related to essential cellular processes to evaluate and validate the expression through the RT-qPCR. The RT-qPCR analysis demonstrated significantly (p < 0.05) elevated expression of the mafbx, foxo1a, and rgcc genes in the hybrid compared to the parents. Likewise, we can observe genes significantly more expressed in Pacu (mtco1 and mylpfa) and mtco2 in Tambaqui. Our results showed that the phenotype presented by Tambacu might be associated with changes in the gene expression profile and not necessarily with an increase in gene variability. Thus, the molecular mechanisms underlying these "hybrid effects" may be related to additive and, in some cases, dominant regulatory interactions between parental alleles that act directly on gene regulation in the hybrid transcripts., Competing Interests: Declaration of competing interest The authors have no relevant financial or non-financial interests to disclose., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Purpose: To assess the association between acute disease severity and 1-year quality of life in patients discharged after hospitalisation due to coronavirus disease 2019 (COVID-19)., Methods: We conducted a prospective cohort study nested in 5 randomised clinical trials between March 2020 and March 2022 at 84 sites in Brazil. Adult post-hospitalisation COVID-19 patients were followed for 1 year. The primary outcome was the utility score of EuroQol five-dimension three-level (EQ-5D-3L). Secondary outcomes included all-cause mortality, major cardiovascular events, and new disabilities in instrumental activities of daily living. Adjusted generalised estimating equations were used to assess the association between outcomes and acute disease severity according to the highest level on a modified ordinal scale during hospital stay (2: no oxygen therapy; 3: oxygen by mask or nasal prongs; 4: high-flow nasal cannula oxygen therapy or non-invasive ventilation; 5: mechanical ventilation)., Results: 1508 COVID-19 survivors were enrolled. Primary outcome data were available for 1156 participants. At 1 year, compared with severity score 2, severity score 5 was associated with lower EQ-5D-3L utility scores (0.7 vs 0.84; adjusted difference, - 0.1 [95% CI - 0.15 to - 0.06]); and worse results for all-cause mortality (7.9% vs 1.2%; adjusted difference, 7.1% [95% CI 2.5%-11.8%]), major cardiovascular events (5.6% vs 2.3%; adjusted difference, 2.6% [95% CI 0.6%-4.6%]), and new disabilities (40.4% vs 23.5%; adjusted difference, 15.5% [95% CI 8.5%-22.5]). Severity scores 3 and 4 did not differ consistently from score 2., Conclusions: COVID-19 patients who needed mechanical ventilation during hospitalisation have lower 1-year quality of life than COVID-19 patients who did not need mechanical ventilation during hospitalisation., (© 2022. Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: to develop and analyze content validity evidence of a website for patients with coronary artery disease., Methods: a methodological study, carried out in the phases: Definition - determined contents for inclusion in the website, architecture and design; Implementation - subjects included in the website; Assessment - website submitted to analysis by 13 experts and eight laypersons regarding organization, content and design, on a scale of 1 (no agreement) to 4 (complete agreement). Items that reached Content Validity Ratio (CVR) higher than the established critical values and Content Validity Index greater than 0.80 were considered valid., Results: eight domains related to secondary prevention in coronary heart disease were included on the website. Critical CVR and adequate CVI were obtained according to professional and lay experts., Conclusions: the website was developed, achieving adequate content validity evidence, and can be used as an educational tool for this population.

Objective: To identify information needs of patients with coronary artery disease and develop and validate the content of educational messages for mobile phones for these patients., Method: The study was carried out in three phases: 1) Identification of information needs in relation to coronary artery disease of patients hospitalized for an acute coronary event; 2) Development of templates containing text and pictures about the disease and treatment; 3) Content validity analysis of template evidence through the assessment of 10 experts. Templates were considered validated when the Content Validity Ratio (CVR) was equal to or greater than 0.80., Results: A total of 67 patients were included, and all the information that emerged about the disease was classified as important to very important. Thirty templates were developed (heart function, recommendations on nutrition and exercise, treatments and medications, and clinical signs related to the disease and risk factor control), and the CVR obtained was greater than 0.80., Conclusion: All information needs were categorized by patients as important or very important. The templates were developed and validated considering content and design.

Objective: To describe the speech pattern of patients with hereditary Spastic Paraplegia type 4 (SPG4) and correlated it with their clinical data., Methods: Cross-sectional study was carried out in two university hospitals in Brazil. Two groups participated in the study: the case group (n = 28) with a confirmed genetic diagnosis for SPG4 and a control group (n = 17) matched for sex and age. The speech assessment of both groups included: speech task recording, acoustic analysis, and auditory-perceptual analysis. In addition, disease severity was assessed with the Spastic Paraplegia Rating Scale (SPRS)., Results: In the auditory-perceptual analysis, 53.5% (n = 15) of individuals with SPG4 were dysarthric, with mild to moderate changes in the subsystems of phonation and articulation. On acoustic analysis, SPG4 subjects' performances were worse in measurements related to breathing (maximum phonation time) and articulation (speech rate, articulation rate). The articulation variables (speech rate, articulation rate) are related to the age of onset of the first motor symptom., Conclusion: Dysarthria in SPG4 is frequent and mild, and it did not evolve in conjunction with more advanced motor diseases. This data suggest that diagnosed patients should be screened and referred for speech therapy evaluation and those pathophysiological mechanisms of speech involvement may differ from the length-dependent degeneration of the corticospinal tract., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2022 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: With the COVID-19 pandemic, hospitals in low-income countries were faced with a triple challenge. First, a large number of patients required hospitalisation because of the infection's more severe symptoms. Second, there was a lack of systematic and broad testing policies for early identification of cases. Third, there were weaknesses in the integration of information systems, which led to the need to search for available information from the hospital information systems. Accordingly, it is also important to state that relevant aspects of COVID-19's natural history had not yet been fully clarified. The aim of this research protocol is to present the strategies of a Brazilian network of hospitals to perform systematised data collection on COVID-19 through the WHO platform., Methods and Analysis: This is a multicentre project among Brazilian hospitals to provide data on COVID-19 through the WHO global platform, which integrates patient care information from different countries. From October 2020 to March 2021, a committee worked on defining a flowchart for this platform, specifying the variables of interest, data extraction standardisation and analysis., Ethics and Dissemination: This protocol was approved by the Research Ethics Committee (CEP) of the Research Coordinating Center of Brazil (CEP of the Hospital Nossa Senhora da Conceicao), on 29 January 2021, under approval No. 4.515.519 and by the National Research Ethics Commission (CONEP), on 5 February 2021, under approval No. 4.526.456. The project results will be explained in WHO reports and published in international peer-reviewed journals, and summaries will be provided to the funders of the study., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)

Objective: To evaluate the effectiveness of the educational intervention through an informative manual in reducing anxiety, stress, and changes in vital signs in patients awaiting cardiac catheterization., Methods: Parallel, randomized, controlled, blind clinical trial. The study excluded patients waiting for cardiac catheterization; those who received the information manual were randomized to the intervention group, and those who received routine information from the unit went to the control group. The study used the State Anxiety Inventory and Perceived Stress Scale and the ANOVA test to analyze the outcomes between the groups. Clinical Trials NCT03369873., Results: There was no change concerning time, first and second moment (anxiety, P=0.225; and stress, P=0.696), interaction (anxiety, P=0.183; and stress, P=0.444), or groups, control, and intervention (anxiety, P=0.341; and stress, p=0.624)., Conclusion: Although the educational intervention performed did not have an impact on the reduction of anxiety and stress, this type of intervention should be maintained for greater comfort and safety of patients and family members.

In this work, a simple, low-cost and easy-to-handle analytical procedure based on carbon quantum dots (CQDs) is proposed to check commercially available formulated microbicides that are used to mitigate the transmission of viruses, such as SARS-COV-2, or bacterial diseases. For this purpose, CQDs were synthesized via pyrolysis using citric acid and ethylenediamine as precursors to produce an intense fluorescence that is used to measure the concentration of hypochlorite, an important biocidal agent present in sanitizing mats, by quenching mechanisms. The characterization of the CQDs was performed using IR spectrophotometry, UV-Vis spectrophotometry, spectrofluorometry, thermogravimetric analysis, scanning electron microscopy, dynamic light scattering, X-ray diffraction, energy-dispersive spectroscopy, and zeta potential measurements. For analytical purposes, fluorescence was measured in a UV chamber irradiated using an LED with the maximum emission at 350 nm. A smartphone was coupled to the UV chamber to measure the fluorescence quenching due to the presence of hypochlorite, and further the digital images were decomposed by RGB data using free software. Tests of pH, CQD concentration and stability of the fluorescence emitted were performed. The stability study of the fluorescence emitted by the CQD solution showed a relative standard deviation lower than 5.0%. The fluorescence digital image-based (FDIB) method resulted in a linear range from 17.44 μmol L -1 to 90.0 μmol L -1 with an LOD of 3.30 μmol L -1 for the determination of hypochlorite using a microplate made of PLA (polylactic acid) customized using a 3D printer. Furthermore, the hypochlorite concentration was tested in situ for its compliance in a sanitizing mat, in a real use situation (daily, a group of four people, each one kept their feet on the mat for 30 s). After 2.5 h, the monitored concentration of hypochlorite was 0.04953% (w/v) or 7.63 mmol L -1 , and therefore, it was inefficient to act as a sanitizing agent. Thus, for the first time in the literature, an FDIB method with CQDs is used to verify in situ microbicide practices with a fast and low-cost analytical procedure.

Purpose: To assess the validity of a Written Clinical Reasoning Prompt (WCRP) to help nursing students' clinical reasoning (CR)., Method: This is a methodological study of translation and cross-cultural adaptation into Brazilian Portuguese of instruments that aim to promote CR improvement, composed of (1) WCRP; (2) two case studies; (3) a questionnaire about students' perceptions during decision-making in case studies; (4) a scoring rubric for correcting case studies. For translation and cross-cultural adaptation, stages 1-8 of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Consortium Network were adopted. Agreement values among experts >80% and content validity coefficient (CVC) > 0.8 were considered satisfactory. For the pretest, a randomized clinical trial was carried out with 24 nursing students (intervention group, n = 14, using the WCRP to solve case studies; control group, n = 10, without using the WCRP)., Findings: The WCRP was translated and adapted into Brazilian Portuguese, requiring minimal adjustments to obtain agreement among the judges above 80% and CVC above 0.80. Regarding face validation, an adequate agreement was obtained in the assessment by students. There was no difference in the accuracy of nursing diagnoses between the intervention and control groups in the pretest., Conclusion: The WCRP was translated and adapted into Brazilian Portuguese and had adequate face and content validity estimates; however, there was no association with improving nursing students' diagnostic accuracy., Implications for Nursing Practice: The translated and adapted versions of all instruments into Brazilian Portuguese had adequate evidence of content and face validity. The use of WCRP was not associated with a significant improvement in nursing students' diagnostic accuracy. New studies with larger samples, a sample power of at least 80%, and a level of significance of 5% are needed., (© 2021 NANDA International, Inc.)

Objective: To identify the need of family members of patients hospitalized in a coronary intensive care unit and their degree of satisfaction with the care provided., Methods: An observational and cross-sectional study including family members of patients hospitalized in the coronary intensive care unit for acute coronary syndrome in Killip I or II. After the second visit of the same family member to the patient in the unit, a 43-item inventory of needs and stressors of family members was applied. Family members assessed each need for its importance and satisfaction using a four-point Likert scale. The scores in each dimension of importance and satisfaction were compared using the Wilcoxon test, considering a value of p<0.05 as significant., Results: One hundred family members were interviewed. The most important needs were related to assurance and information. Family members had satisfaction scores corresponding to be very satisfied or totally satisfied, but with lower scores when compared to the needs scores (p<0.01)., Conclusion: The most important needs of family members of patients hospitalized in the coronary intensive care unit were related to assurance and information. Multiprofessional interventions involving better communication of patient information to family members should be incorporated into the coronary intensive care unit.

Background: Patients with acute coronary syndrome (ACS) are often admitted to intensive cardiac care units (ICCUs) to have their vital signs and ventricular function monitored. In most cases, they are conscious and bedbound, causing high stress and anxiety levels., Aims and Objectives: To assess the stressors affecting patients admitted to ICCUs., Design: This is a cross-sectional study performed in a public hospital in São Paulo, Brazil., Methods: A sample of 100 patients with ACS admitted to an ICCU, after 24 hours of hospitalization, was recruited. Sociodemographic and clinical data were collected, and the Intensive Care Unit Stressor Assessment Scale (ICESS) was applied to investigate stressors. The ICESS' internal consistency was estimated by Cronbach's alpha, and the stressors were analysed by descriptive statistics, association tests, and correlation tests., Results: Most patients were male, married, and aged 51 to 60 years. The ICESS showed an excellent internal consistency. The mean score identified in patients pointed to a non-stressed to moderately stressed condition. The indicators considered to be more stressful were as follows: "Not knowing ICU length of stay," "Being unable to fulfil family roles," "Missing husband or wife," and "Loss of self-control.", Conclusions: Stress levels were considered to be non-stressful to moderately stressful. The main stressors were related to psychological distress and physical discomfort dimensions., Relevance to Clinical Practice: Mapping the main stressors of patients with coronary artery disease will allow health professionals to implement strategies to reduce them and consequently reduce their anxiety levels., (© 2021 British Association of Critical Care Nurses.)

Background: Inflammation may be an important factor contributing to the progression of Eisenmenger syndrome (ES). The purpose of the current study was to: characterize the inflammatory profile in ES patients and compare measures to reference values for congenital heart disease and pulmonary arterial hypertension (CHD-PAH); and investigate whether inflammatory markers are associated with other clinical markers in ES., Methods: Twenty-seven ES patients were prospectively selected and screened for systemic inflammatory markers, including interleukin (IL)-1β, tumor necrosis factor-alpha (TNF-α) and IL-10. Clinical data and echocardiographic parameters were obtained, with concomitant analysis of ventricular function. Functional capacity was assessed using the 6-min walk test (6MWT). Renal function and blood homeostasis were evaluated by the level of blood urea nitrogen (BUN), creatinine, and plasma electrolytes., Results: Patients with ES expressed higher IL-10, IL-1β and TNF-α compared to reference values of patients with CHD-PAH. IL-10 was negatively associated with BUN (r = -0.39,p = 0.07), creatinine (r = -0.35, p = 0.002), sodium (r = -0.45, p = 0.03), and potassium (r = -0.68, p = 0.003). IL-10 was positively associated with bicarbonate (r = 0.45, p = 0.02) and trended toward a positive association with right ventricular fractional area change (RV FAC ) (r = 0.35, p = 0.059). IL-1β was negatively associated with potassium (r = -0.5, p = 0.01). TNF-α demonstrated positive association with creatinine (r = 0.4,p = 0.006), BUN (r = 0.63,p = 0.003), sodium (r = 0.44, p = 0.04), potassium (r = 0.41, p = 0.04), and was negatively associated with RV FAC (r = -0.38,p = 0.03) and 6MWT distance (r = -0.54, p = 0.004)., Conclusion: ES patients exhibit a more severe inflammatory profile compared to reference values for CHD-PAH. Furthermore, inflammatory markers are related to renal dysfunction, right ventricular impairment and poorer functional capacity., (Copyright © 2021. Published by Elsevier B.V.)

Chagas disease (CD) continues to be a major public health burden in Latina America. Information on the interplay between COVID-19 and CD is lacking. Our aim was to assess clinical characteristics and in-hospital outcomes of patients with CD and COVID-19, and to compare it to non-CD patients. Consecutive patients with confirmed COVID-19 were included from March to September 2020. Genetic matching for sex, age, hypertension, diabetes mellitus and hospital was performed in a 4:1 ratio. Of the 7018 patients who had confirmed COVID-19, 31 patients with CD and 124 matched controls were included (median age 72 (64-80) years-old, 44.5% were male). At baseline, heart failure (25.8% vs. 9.7%) and atrial fibrillation (29.0% vs. 5.6%) were more frequent in CD patients than in the controls (p < 0.05). C-reactive protein levels were lower in CD patients compared with the controls (55.5 [35.7, 85.0] vs. 94.3 [50.7, 167.5] mg/dL). In-hospital management, outcomes and complications were similar between the groups. In this large Brazilian COVID-19 Registry, CD patients had a higher prevalence of atrial fibrillation and chronic heart failure compared with non-CD controls, with no differences in-hospital outcomes. The lower C-reactive protein levels in CD patients require further investigation., (© 2021. The Author(s).)

Although it is predominantly a muscular disease, impairments in the central nervous system in patients with facioscapulohumeral muscular dystrophy (FSHD) have been described in the literature., Objective: To describe the cognitive profile of patients with FSHD and to correlate the impairments found with clinical variables and quality of life., Methods: Cross-sectional and case-control study that evaluated FSHD patients using a series of cognitive assessments (Mini-Mental State Examination - MMSE, Montreal Cognitive Assessment - MoCA, verbal fluency with phonological restriction - FAS, categorical verbal fluency - FAS-cat, trail-making test - TMT, and Rey's Verbal Auditory Learning Test); a neurological severity scale (Gardner-Medwin-Walton - GMWS); and a quality of life measurement tool (Medical Outcomes Study 36-Item Short-Form Health Survey)., Results: Individuals with FSHD (13) and healthy controls (26) were paired by gender and age. Significant differences between case and control groups were found in MMSE, TMT A, and A7 (p≤0.05) and MOCA (p≤0.001) performances. A positive correlation was verified in long-term memory impairments and the age in which symptoms appear (r=-0.593, p=0.033). Regarding quality of life assessment, the emotional domain correlated to MEEM (r=0.657, p=0.015), TMT A (r=-0.601, p=0.030), and A7 (r=0.617, p=0.025) performances., Conclusions: Individuals with FSHD presented mild impairments in the performance of tasks that involve attention, planning, and long-term memory functions. Those impairments were associated neither with the disease duration nor with its neurological severity., Competing Interests: Disclosure: The authors report no conflicts of interest.

Objective: to carry out translation, cross-cultural adaptation to Portuguese and assess the reliability of the four versions of the Coronary Revascularization Outcome Questionnaire - adapted., Methods: a methodological study of translation and cross-cultural adaptation into Portuguese, as proposed by Beaton et al., and reliability analysis, by calculating Cronbach's alpha coefficient and item-total correlation of the four versions of the Coronary Revascularization Outcome Questionnaire - adapted., Results: the adaptations made facilitated the understanding of the items. All domains had Cronbach's alpha above 0.70, except two in the post-percutaneous coronary intervention version and two in the post-myocardial surgical revascularization version. All items had item-total correlation values greater than 0.20, except two in the post-percutaneous coronary intervention version, one in the pre-coronary intervention version and six in the post-myocardial surgical revascularization version., Conclusion: the cross-cultural adaptation to Portuguese was considered satisfactory. Pre-procedure versions were considered reliable, while the post-procedures require other psychometric analyses.

Objective: to assess the prevalence of pharmacological adherence in patients with coronary artery disease and to identify factors associated with adherence., Method: a crosssectional, correlational study, including 198 patients with a previous diagnosis of coronary artery disease. Pharmacological adherence was assessed by the four-item Morisky Green test, and the factors that potentially interfere with adherence were considered independent variables. The association between the variables was determined by the Cox model, with a 5% significance level., Results: 43% of the patients adhered to the treatment. Fatigue and palpitation, never having consumed alcohol and being served by medical insurance were associated with adherence. Lack of adherence was associated with considering the treatment complex, consumption of alcohol and being served by the public health care system. In the multiple analysis, the patients with fatigue and palpitations had a prevalence of adherence around three times higher and alcohol consumption was associated with a 2.88 times greater chance of non-adherence., Conclusion: more than half of the patients were classified as non-adherent. Interventions can be directed to some factors associated with lack of adherence.

Background: Pulmonary hypertension is a progressive, and disabling disease, however, there is little knowledge about impaired sexual function in this population., Aim: To identify the prevalence of sexual dysfunction and the association between sexual dysfunction level and sociodemographic and clinical characteristics., Methods: A cross-sectional study with 71 women diagnosed with pulmonary hypertension without signs of clinical decompensation was carried out. Sexual function was assessed using the Female Sexual Function Index (FSFI) and functional capacity was assessed by 6-minute walk test. The relationships between sociodemographic and clinical characteristics with sexual function was performed using statistical tests. A p-value <0.05 was considered as significant., Results: 71.8% of patients self-reported sexual dysfunction as indicated as a score of <26.55 points on FSFI. Women with sexual dysfunction were older, higher average age of their last menstruation, had worse functional class, shorter distance covered and worse Borg score at the end of the 6-minute walk test., Conclusion: There is evident impairment of sexual function self-reported by women with pH and the association of this condition with a decline in functional capacity was identified., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objectives: The majority of available scores to assess mortality risk of coronavirus disease 2019 (COVID-19) patients in the emergency department have high risk of bias. Therefore, this cohort aimed to develop and validate a score at hospital admission for predicting in-hospital mortality in COVID-19 patients and to compare this score with other existing ones., Methods: Consecutive patients (≥ 18 years) with confirmed COVID-19 admitted to the participating hospitals were included. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients admitted between March-July, 2020. The model was validated in the 1054 patients admitted during August-September, as well as in an external cohort of 474 Spanish patients., Results: Median (25-75th percentile) age of the model-derivation cohort was 60 (48-72) years, and in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. Seven significant variables were included in the risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein, SpO 2 /FiO 2 ratio, platelet count, and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829-0.859), which was confirmed in the Brazilian (0.859 [95% CI 0.833-0.885]) and Spanish (0.894 [95% CI 0.870-0.919]) validation cohorts, and displayed better discrimination ability than other existing scores. It is implemented in a freely available online risk calculator (https://abc2sph.com/)., Conclusions: An easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation was designed and validated for early stratification of in-hospital mortality risk of patients with COVID-19., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Fish muscle growth is a complex process regulated by multiple pathways, resulting on the net accumulation of proteins and the activation of myogenic progenitor cells. Around 350-320 million years ago, teleost fish went through a specific whole genome duplication (WGD) that expanded the existent gene repertoire. Duplicated genes can be retained by different molecular mechanisms such as subfunctionalization, neofunctionalization or redundancy, each one with different functional implications. While the great majority of ohnolog genes have been identified in the teleost genomes, the effect of gene duplication in the fish physiology is still not well characterized. In the present study we studied the effect of WGD on the transcription of the duplicated components controlling muscle growth. We compared the expression of lineage-specific ohnologs related to myogenesis and protein balance in the fast-skeletal muscle of pacus (Piaractus mesopotamicus-Ostariophysi) and Nile tilapias (Oreochromis niloticus-Acanthopterygii) fasted for 4 days and refed for 3 days. We studied the expression of 20 ohnologs and found that in the great majority of cases, duplicated genes had similar expression profiles in response to fasting and refeeding, indicating that their functions during growth have been conserved during the period after the WGD. Our results suggest that redundancy might play a more important role in the retention of ohnologs of regulatory pathways than initially thought. Also, comparison to non-duplicated orthologs showed that it might not be uncommon for the duplicated genes to gain or loss new regulatory elements simultaneously. Overall, several of duplicated ohnologs have similar transcription profiles in response to pro-growth signals suggesting that evolution tends to conserve ohnolog regulation during muscle development and that in the majority of ohnologs related to muscle growth their functions might be very similar., Competing Interests: The authors have declared that no competing interests exist.

Objective: to assess sleep quality in menopausal women and its association with symptoms related to this period., Method: this is a cross-sectional, analytical and correlational study. Sleep was assessed using the Pittsburgh Sleep Quality Index; and climacteric symptoms, according to the Menopause Rating Scale. To compare the total score and each Menopause Rating Scale domain with the PSQI classification, the Mann-Whitney U non-parametric test was used. P<0.05 was considered significant., Results: 261 women (67.8%) were classified as bad sleepers. There was a positive and significant correlation between the sleep scale scores and the total menopause score and its domains. Women categorized as poor sleepers had worse scores on the menopause symptom scale., Conclusion: women with worse sleep quality revealed greater severity of symptoms related to menopause.

Aims: To evaluate the effect of postoperative forced-air warming (FAW) on the incidence of excessive bleeding (ExB), arrhythmia, acute myocardial infarction (AMI), and blood product transfusion in hypothermic patients following on-pump CABG and compare temperatures associated with the use of FAW and warming with a sheet and wool blanket., Methods and Results: A randomized clinical trial conducted with 200 patients undergoing isolated on-pump CABG from January to November 2018. Patients were randomly assigned into an Intervention Group (IG, FAW, n = 100) and Control Group (CG, sheet and blanket, n = 100). The tympanic temperature of all patients was measured over a 24-h period. ExB was the primary outcome, while arrhythmia, AMI, and blood product transfusion were secondary outcomes. The effect of the interventions on the outcomes was investigated through using bivariate logistic regression, with a level of significance of 5%. The IG was 79% less likely to experience bleeding than the CG [odds ratio (OR) = 0.21, confidence interval (CI) 95% 0.12-0.39, P < 0.001]; the occurrence of AMI in the IG was 94% lower than that experienced by the CG (OR = 0.06, CI 95% 0.01-0.48, P < 0.001); and the IG was also 77% less likely to experience arrhythmia than the CG (OR = 0.23, CI 95% 0.12-0.47, P < 0.001); no difference was found between groups in terms of blood product transfusion (P < 0.279)., Conclusions: These findings show that FAW can be used following CABG until patients reach normothermia to avoid undesirable clinical outcomes., Trial Registration: REBeC RBR-5t582g., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.)

Introduction: In heart transplantation (HT) recipients, several factors are critical to promptly adopting appropriate rehabilitation strategies and may be important to predict outcomes way after surgery. This study aimed to determine preoperative patient-related risk factors that could adversely affect the postoperative clinical course of patients undergoing HT., Methods: Twenty-one hospitalized patients with heart failure undergoing HT were evaluated according to respiratory muscle strength and functional capacity before HT. Mechanical ventilation (MV) time, reintubation rate, and intensive care unit (ICU) length of stay were recorded, and assessed postoperatively., Results: Inspiratory muscle strength as absolute and percentpredicted values were strongly correlated with MV time (r=-0.61 and r=-0.70, respectively, at P<0.001). Concerning ICU length of stay, only maximal inspiratory pressure (MIP) absolute and percent-predicted values were significantly associated. The absolute |MIP| was significantly negatively correlated with ICU length of stay (r=-0.58 at P=0.006) and the percent-predicted MIP was also significantly negatively correlated with ICU length of stay (r=-0.68 at P=0.0007). No associations were observed between preoperative functional capacity, age, sex, and clinical characteristics and MV time and ICU length of stay in the cohort included in this study. Patients with respiratory muscle weakness had a higher prevalence of prolonged MV, reintubation, and delayed ICU length of stay., Conclusion: An impairment of preoperative MIP was associated with poorer short-term outcomes following HT. As such, inspiratory muscle strength is an important clinical preoperative marker in patients undergoing HT.