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Simultaneous en bloc replacement of the ascending aorta and aortic valve by a composite valve graft, as first described by Bentall and De Bono in 1968 and with later modifications, has become the standard surgical technique in the treatment of aneurysms of the aortic root associated with severe aortic valve dysfunction. Despite the good surgical results overall, it is still associated with considerable perioperative mortality and with dire complications in the long run. We report a case of a giant aortic pseudoaneurysm compressing the right heart chambers and communicating with the right ventricle presenting as rapidly progressing heart failure a few months after a Bentall operation. [ABSTRACT FROM AUTHOR]

Introduction: Otoacoustic emissions can be an alternative for cochlear evaluation in noise induced hearing loss (NIHL). Objective: To investigate the correlation between the findings of audiometry results and distortion product otoacoustic emissions (DPOAE) in the military police. Method: from cross-sectional and retrospective study, 200 military police officers were submitted to audiological evaluation - pure tone audiometry and DPOAE. Results: considering the provisions of Ordinance 19 of the Labour Department, the results were suggestive of induced hearing loss by high sound pressure levels in 58 individuals, distributed as follows: 28 (48.3%) bilateral cases and 30 (51.7%) unilateral cases, and 15 (25.85%) in each ear. The correlation between the audiometric and DPOAE showed statistical significance in most of the frequencies tested in both ears, confirming that the greater the degree of hearing loss, the smaller the DPOAE amplitudes. In addition, there was observed significant difference between the DPOAEs amplitudes of normal subjects and listeners with hearing loss, confirming the lowering of responses in the group with hearing loss. Conclusion: considering that the correlation between pure tone audiometry and DPOAE, we conclude that otoacoustic emissions can be a complementary tool for the detection and control of NIHL in military police.

Objective: To analyze self-care conditioning factors in women and men with urinary incontinence symptoms living with the Human T-Lymphotropic Virus Type 1., Method: Qualitative study, based on the pragmatic phase of Praxis Model for Technology Development. Twelve women and five adult men living with Human T-Lymphotropic Virus Type 1, residing in Bahia, Brazil, participated in the study. A structured instrument and focus group were applied to collect data. The empirical material was subjected to Thematic Content Analysis, using the software WebQDA and the Self-Care/Self-Care Deficit Theory was used., Results: Facilitating conditioning factors were used by women and men as strategies for performing self-care, and hindering conditioning factors prevented or disturbed, but opened paths to direct the nurse's performance to address self-care deficits., Conclusion: Self-care requirements were impacted by the hindering conditioning factors; the facilitating ones allowed self-care, providing technology in nursing/health.

Aims: To map interventions in the sexuality of men with stomas., Design: Scoping review, following JBI and PRISMA-ScR guidelines to report results., Methods: Databases consulted were PubMed, via National Library of Medicine, Latin American and Caribbean Health Sciences Literature, Web of Science, Scopus, Embase, Scientific Electronic Library Online, Brazilian Electronic Library of Thesis and Dissertations, CAPES Catalogue of Thesis and Dissertations and Open Access Scientific Repository of Portugal. Texts were read by independent reviewers, with no time or language restrictions., Results: The final sample included 10 studies. Data were synthesised and grouped for its similarity to approach models, preoperative orientations, self-care promotion, collecting pouch hygiene and safety, sexual health discussion and education, construction of bonds and sexual function evaluation., Conclusion: Interventions in the sexuality of men with stomas included adherence to models for approaching sexuality, focusing on the permission and coparticipation of the patient, open conversations on the topic, self-care promotion, collecting pouch hygiene and safety, encouragement to the creation of bonds, sexual function evaluation in pre- and postoperative periods and individual and/or collective sexual health education., Implications for the Profession And/or Patient Care: This study contributes to the sexuality of men with stomas. It identified recommendations to approach and conduct the topic at hand, addressing the rehabilitation process since the surgery to place the stoma is considered., Impact (addressing): This study addressed scientific literature on the sexuality of men with stomas. Most were from Europe and results demonstrated a gap in knowledge. This research will impact the stoma therapy research, affecting teams involved in the care to men with stomas, encouraging reflections on the sexuality of these patients., Reporting Method: This study complies with the PRISMA-ScR., Patient or Public Contribution: There was no patient or public contribution., Protocol Registration: The protocol of this scoping review was registered in the Open Science Framework, registered under DOI 10.17605/OSF.IO/X9DSC. It can be accessed through the following link: https://osf.io/x9dsc/?view_only=a9c62ef6c11f44499f7b2bfe1fe379f9., (© 2025 John Wiley & Sons Ltd.)

Objective: to understand the meanings and experiences of pregnancy among trans men in light of the Theory of Social Representations., Methods: this is a qualitative, descriptive and exploratory study, carried out with trans men selected for convenience and availability. Data production took place from September to October 2021, via the Google Meet® platform, based on interviews with a semi-structured script. Interview lexicographic textual analysis was performed using the Reinert method and instrumented by IRAMUTEQ version 7.0., Results: social representations of pregnancy involved a wide field of meanings, in which efforts were articulated to accept opportune and solitary pregnancy, fear of the parturition process and influence of physical and emotional changes., Final Considerations: the study reinforces the importance of advanced nursing practice in assisting the pregnancy-puerperal cycle, based on the perspective of comprehensive care, equity in access to services and respect for differences.

Limatus Durhamii: has wild habits with ecological plasticity in anthropized environments. We report the occurrence of this species in several types of artificial containers in 2 fragments of the Atlantic Forest in the city of São Paulo, Brazil. A total of 1,428 larvae were collected, in which plastic containers had the highest abundance of immature forms of Li. durhamii, with 579 (40.5%) specimens collected, followed by glass bottles with 464 (32.5%) and metal cans with 223 (15.6%). The high abundance of Li. durhamii in artificial containers points to an adaptation process to impacted environments. Therefore, studies that investigate the feeding habits and vectorial capacity of this species are essential to understanding its epidemiological role in the environment., (Copyright © 2024 by The American Mosquito Control Association, Inc.)

The study aims to explain the discourse of the collective subject of adult and elderly men about the experience of long COVID. Qualitative research, derived from a national multicenter clinical-virtual observatory involving 92 adult men, between 2022 and 2023 in Brazil. IRaMuTeQ software was used (data processing), the Collective Subject Discourse technique (analysis) and socio-anthropological references of the disease experience (interpretation). The results showed that the long COVID experience was marked by the prolongation of respiratory symptoms characteristic of COVID-19; systemic symptomatology in the physical-psychic body; and severe clinical complications. The experience of the long COVID-19 disease was shaped by gender relations and masculinities, constructed notions of health-disease, imaginaries about the capacity of the disease in the context of vaccination, the systemic character of syndromic events understood as sequelae left by the disease, resonating the sense of incapacity and stigmatization.

Background: PRO measures of symptoms in clinical trials have historically utilized visual and numerical scales but verbal descriptors may make it easier for patients to clearly differentiate between response options. This study assessed content validity and meaningful change in five verbal response scales (VRSs) used to assess chronic rhinosinusitis with nasal polyp (CRSwNP) symptom severity., Methodology: This qualitative, semi-structured interview study recruited adults from the US, Germany, and China with confirmed moderate-to-severe CRSwNP. Interviews included a concept elicitation section, where participants were asked about their experience of living with CRSwNP including symptoms and health-related quality-of-life impacts, and a cognitive debriefing section, where participants were debriefed and participant understanding and real-life relevance of the CRSwNP symptom VRS content were assessed. Interview transcripts were qualitatively analyzed using thematic analysis methods., Results: Among the 24 participants interviewed, the most frequently reported CRSwNP symptoms were nasal obstruction, runny nose, mucus in the throat, loss of smell and facial pain/pressure. Participants demonstrated good understanding of the CRSwNP symptom VRS instructions, items, recall period, and response options. The five CRSwNP symptom VRS items were relevant to the majority of participants' experience of CRSwNP. At the item level, a one-category within-person improvement was the level most frequently reported by participants to be a meaningful change., Conclusion: The CRSwNP symptom VRSs assess relevant and bothersome symptoms experienced by patients with moderate-to-severe CRSwNP, supporting content validity of this measure. The findings of this study provided preliminary insights into meaningful change in the VRS. Further quantitative assessment of meaningful change is needed, and psychometric evaluation of the CRSwNP symptom VRSs will be required to evaluate their appropriateness for assessment of clinical trial endpoints in patients with CRSwNP., Competing Interests: Declarations. Ethics approval and consent to participate: The study was conducted according to the principles outlined in the Declaration of Helsinki, and according to guidelines published by the US Food and Drug Administration (FDA) and European Medicines Agency (EMA). Additionally, all data was handled in accordance with the European General Data Protection Regulation (GDPR), and data from China was handled in accordance with the PIPL and Data Security Law (DSL). Ethical approval was obtained from Salus Institutional Review Board (IRB), a centralized IRB that provides ethical oversight to research conducted globally for multi-country studies, prior to the collection or processing of participant data (Salus IRB: C218108 GK9381A). Each participant provided written and verbal consent via the informed consent form before their interview was conducted. Consent for publication: Not applicable. Competing interests: TK, NG, WA, RA-C and ARS are employed by GSK and hold financial equities in GSK; KF, RS, SW and AG are employees of Adelphi Values, a consulting company that received funds from GSK to conduct this study but did not receive payment for manuscript development., (© 2024. The Author(s).)

Sand flies are a group of insects (Diptera, Psychodidae, Phlebotominae) in which some species may transmit agents of leishmaniasis. This study aimed to analyze the sand fly fauna in urban parks in Rio Branco, capital of Acre state, addressing its diversity, infection by Leishmania, and food sources in sand fly females. The sand flies were collected with CDC-type automatic light traps installed in three urban parks in Rio Branco: Captain Ciríaco, Horto Florestal and Chico Mendes. For comparison analysis of species richness and diversity between the parks, we analyzed rarefaction and prediction curves. For detection of Leishmania spp., molecular tests were performed by polymerase chain reaction (PCR) using ITS1 as a marker, followed by genetic sequencing. Identification of the blood meal source in engorged females was performed by PCR using a fragment of the cytochrome b gene (cyt b), followed by sequencing and phylogenetic analysis. A total of 2,672 specimens were collected, distributed in 14 genera and 35 species. Of these, Nyssomyia antunesi and Evandromyia walkeri predominated, and important proven and suspected vectors were also found. Horto Florestal was the park with the greatest diversity, richness, and evenness of species, while the Captain Ciríaco presented the lowest diversity and richness. A female of Ny. antunesi was PCR-positive for Leishmania guyanensis. Human blood was the most frequent food source detected, mainly in Ev. walkeri and Ny. antunesi. This research showed that the studied parks of Rio Branco can act as foci for the maintenance of Leishmania, and people who frequent these urban areas may be in risk for contracting leishmaniasis., (© 2024. EcoHealth Alliance.)

The Capivari-Monos Environmental Protection Area (EPA) is located in the southern part of the São Paulo city Green Belt. Since the 1950s, this region has been affected by uncontrolled urban sprawl, resulting in a change in the ecological habits of some vector mosquitoes. Over the last two decades, cases of autochthonous bromeliad malaria associated with the presence of anopheline mosquitoes in the EPA have been recorded. Anopheles cruzii, the primary vector of plasmodia in the region, is abundant and found naturally infected with both Plasmodium vivax and Plasmodium malariae. In light of this, the present study sought to update the catalog of mosquito fauna in this EPA, analyze mosquito diversity among sites with different degrees of conservation and compare species using different collection techniques. Field collections were carried out from March, 2015 to April, 2017. A total of 20,755 specimens were collected, distributed in 106 different taxa representing 16 genera. Analysis of the diversity among the sites based on the Shannon and Simpson indices showed that the most preserved of them had the lowest indices because of the dominance of An. cruzii . The results highlight the increase in the number of different taxa collected as different mosquito collection techniques were included, confirming the importance of using several strategies to ensure adequate sampling of a local mosquito fauna when exploring a greater number of ecotopes. Furthermore, the survey produced the most recent and complete list of mosquito species in the Capivari-Monos EPA, a refuge and shelter for native and introduced mosquito species where new biocenoses, including pathogens, vertebrate hosts, and vectors can form, allowing zoonotic outbreaks in the local human population to occur.

to unveil the experiences of transsexual men during childbirth and postpartum in the light of the Theory of Diversity and Universality of Cultural Care., a qualitative and descriptive study using the multiple case study method. Data was collected using an intentional sample of five transsexual men, selected on the basis of convenience and availability. The interviews were transcribed in full and the results were organized and adapted to the Sunrise Model., the majority of the participants were «primiparous» and had given birth by cesarean section. In adapting the Sunrise Model, we observed the encouragement of medicalization and mechanistic management of childbirth; fear of natural childbirth; violence perpetrated against transsexual men resulting from the difficulty of access to information by the pregnant man, and obstetric care not qualified to meet the needs of the public, resulting in fragile care, with dissatisfaction with the health service., the experiences of transsexual men during childbirth and the postpartum period are a mixture of experiences that generate damage, especially when linked to situations of transphobic violence and violation of rights.

There are two main complementary feeding (CF) approaches: traditional spoon-feeding (TSF) and baby-led weaning (BLW). Many parents and healthcare professionals have concerns about the risk of choking associated with BLW. Since asphyxia is one of infants' main causes of death, this study aims to understand the influence of the CF approach adopted by caregivers on infants' risk of choking. A systematic review was performed. The search was conducted through PubMed, Scopus, and Web of Science databases. We included randomized controlled trials or observational studies published between January 2010 and November 2023, with a clear definition of the intervention and directly assessing the risk of choking. After the selection procedure, 7 of the 165 studies initially identified were included. No study reported statistically significant differences in the risk of choking between babies following BLW, baby-led introduction to solids (BLISS), and TSF. In five studies, although not statistically significant, infants in the TSF group had more choking episodes than those in the BLW or BLISS groups. The risk of choking does not seem to be associated with the CF approach. Instead, it may be related to the familiarity of the baby with each texture and the parent's understanding of the information about how to minimize the risk of choking. Recall bias may be present in all included studies. Advice on how to modify foods to make them safer needs to be clearer and reinforced to all parents., (© 2024 European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)

Discrimination and stigma are significant barriers to healthcare for the LGBTQIAPN+ community, necessitating a deeper analysis of their sociocultural causes. There is a notable gap in the literature regarding the understanding of socio-discursive representations and their impact on the stigmatization and pathologization of sexual minorities in the context of communicable diseases. This study aims to discuss the understanding of the sociodiscursive aspects of the health-disease process, particularly in stigmatized infectious diseases affecting the LGBTQIAPN+ community. The focus is on examining how news articles, or the set of analyzed texts (corpus), shape these perceptions. We conducted documentary research with a qualitative and discursive approach using news articles retrieved from Google News Ⓡ about diseases affecting the LGBTQIAPN+ population from 2011 to 2022. The analysis was based on critical discourse analysis, processed using MAXQDA and IRAMUTEQ software. The identified representations predominantly align with biomedical ideology, manifesting in a discourse that normalizes and medicalizes (normative-curative discourse), and notable for its pathologizing and stigmatizing nature. Six classes were found: Ethical professional dilemmas facing stigma, infection and contamination of the LGBT+ population, prejudice and discrimination in the form of information, stigma related to sexual behavior/orientation, Vulnerability and stigma related to infectious diseases, and strategies for minimizing health risk/stigma for the LGBT+ public. The most relevant analytical categories were related to infectious diseases and sexual identity. These themes were identified, indicating that media representations reinforce stigma and maintain unequal health practices (verticalization) for the LGBT+ community. Understanding these patterns within a broader historical context is crucial for promoting health education and strategies that challenge internalized prejudice. The need to reformulate cultural norms and develop health information and education policies is urgent. These policies should be led by professionals with a comprehensive and humanized vision, addressing the diverse needs of the LGBT+ population., Competing Interests: Declarations. Conflict of interest: No potential conflict of interest was reported by the authors. Ethical Approval: As these are public data under a shared domain, the study was not submitted for ethical approval., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Effective hospital discharge planning is crucial, particularly in educating caregivers on handling medical devices. This education helps manage the patient's signs and symptoms, prevents post-discharge complications, and reduces early readmissions. This study aimed to understand aspects involved in the acquisition of mastery by home caregivers, in handling care of a patient who just underwent gastrostomy, after educational intervention during hospitalization and telemonitoring upon return home., Methods: Qualitative descriptive study. It followed 15 caregivers of people with percutaneous endoscopic gastrostomy. The intervention took place between November 2022 and July 2023 in the neuromusculoskeletal unit of a Brazilian university hospital., Results: The educational intervention had four stages. In stage 1, caregivers felt confused and uncertain about managing PEG. By stage 2, they expressed a desire to be capable of handling care, especially in the event of potential complications, and showed increased awareness and engagement. Stage 3 highlighted the effectiveness of hands-on training with feedback from professionals. In stage 4, during monitoring, several complications were noted, including granuloma formation in the stoma, tube obstruction, and accidental tube loss. However, caregivers demonstrated the ability to handle these situations, indicating the effectiveness of the training and telemonitoring interventions., Conclusions: Nursing professionals should consider various factors when training caregivers in a hospital setting, including providing adequate space, allocating sufficient time for educational interventions, offering both theoretical and practical demonstrations, ensuring effective communication, and taking into account the caregivers' context, as they play a direct role in acquiring a safe and effective skill set.

Background: Mpox is a viral zoonosis that has gained increased attention due to a global outbreak in 2022, significantly impacting men who have sex with men (MSM). Vaccination for this disease poses a public health challenge; because it carries a strong stigma, there may be greater hesitancy in vulnerable groups., Objectives: This study aimed to determine the prevalence and factors associated with Mpox vaccine hesitancy among Brazilian MSM., Methods: A cross-sectional study was conducted between September and December 2022 using an online survey targeted at MSM. Recruitment was carried out through social media and dating apps. The sample consisted of 1449 participants and the analysis involved bivariate logistic regression., Results: The prevalence of Mpox vaccine hesitancy was 7.57%. The significant factors associated with hesitancy were primarily related to sexual practices and attitudes towards Mpox exposure and diagnosis, such as not using "glory holes" (aOR: 19.82; 95% CI: 1.60-245.69), reluctance to undergo pre- and post-exposure testing for Mpox (aOR: 9.54; 95% CI: 5.52-16.48), and not knowing close contacts diagnosed with Mpox (aOR: 4.09; 95% CI: 1.72-9.73). Participants who would not take precautions after diagnosis (aOR: 3.00; 95% CI: 1.27-7.07) and those who would not disclose their serological status (aOR: 1.93; 95% CI: 1.13-3.30) also showed a higher likelihood of vaccine hesitancy., Conclusion: Public health strategies should address these factors to expand knowledge about vaccination barriers, plan educational campaigns with targeted messaging for the MSM population, and provide inclusive healthcare environments to increase vaccine acceptance and reduce Mpox transmission in vulnerable groups.

Objective: To analyze the experiences and meanings attributed by trans men to the breastfeeding process in light of the Theory of Social Representations., Method: A qualitative, descriptive and exploratory study, carried out nationwide, with an intentional sample of five trans men who experienced breastfeeding and aged 18 or over. A semi-structured interview script was applied as a data collection instrument, using the Google Meet® platform, from September to October 2021. The data were described, integrating them with content analysis, resulting in two analytical categories., Results: Trans men in labor were willing to breastfeed their child, anchoring their representations of breastfeeding in the idea that it is a phenomenon performed exclusively by women and also recognizing this phenomenon as an event that constitutes their masculinity, in addition to describing it as a pedagogical and learning experience with the objective of guaranteeing the healthy development of children., Conclusions: This study may promote reflections for changing nursing and health practices in different care settings, especially during prenatal care, childbirth and the postpartum period.

Background: This randomised, double-blind, placebo-controlled, parallel-group, 52-week Phase III study (MERIT; NCT04607005) assessed mepolizumab efficacy and safety in patients with chronic rhinosinusitis with nasal polyps (CRSwNP)/eosinophilic CRS (ECRS) in Japan, Russia, and China, for which data are limited., Methodology: Eligible patients (enrolled at 60 centres) had blood eosinophil count >2%, endoscopic bilateral NP score ≥5, nasal obstruction visual analogue scale (VAS) score >5, ≥2 sinonasal symptoms, and either previous sinus surgery or systemic corticosteroid use/intolerance. Patients were randomised (1:1) to receive mepolizumab 100 mg subcutaneously or placebo every 4 weeks, plus standard of care. Co-primary endpoints: change from baseline in total endoscopic NP score (ENPS) (Week 52) and nasal obstruction VAS score (Weeks 49-52). Post hoc analyses conducted in a modified intent-to-treat (mITT) population excluded patients from two study sites, related to Good Clinical Practice violations by the Site Management Organisation overseeing these sites. These were considered the primary efficacy analyses., Results: In the mITT population, mepolizumab (n=80) versus placebo (n=83) significantly improved nasal obstruction VAS score from baseline to Week 49-52 and was associated with a trend of total ENPS improvements at Week 52. Mepolizumab/placebo on-treatment adverse events (AEs) occurred in 68/84 and 65/85 patients in the safety population (treatment-related AEs: 2/84 and 5/85, respectively), and on-treatment serious AEs in 0/84 and 4/85 patients, respectively (no fatalities reported)., Conclusions: Mepolizumab was effective and well-tolerated in patients with CRSwNP/ECRS from Japan, Russia, and China.

Purpose: To evaluate the visual outcomes and changes in the retinal microcirculation in patients with primary rhegmatogenous retinal detachment (RRD) following successful pars plana vitrectomy (PPV)., Methods: Nine macula-on RRD and 23 macula-off RRD eyes were retrospectively evaluated. Clinical data was collected at admission and 3 months after PPV. Optical coherence tomography angiography (OCTA) was performed 3 months after PPV. Superficial vascular plexus data obtained with OCTA was compared between affected and fellow eyes and according to macular involvement. Quantitative measurements of the superficial retinal capillary associated with the preoperative and intraoperative factors were analyzed., Results: Overall RRD inner vessel densities (IVD), full vessel densities (FVD), inner perfusion densities (IPD) and full perfusion densities (FPD) were significantly and positively correlated with best corrected visual acuity (BCVA)(p = 0.002, p = 0.006, p = 0.009, p = 0.023, respectively). In the macula-off RRD, IVD and FVD were significantly decreased compared with macula-on RRD (p = 0.014 and p = 0.034, respectively) and significantly correlated with a longer duration and larger extension of detachment. Higher differences of IVD and FVD between the fellow and affected eyes were significantly correlated with worse BCVA in the macula-off subgroup., Conclusion: Macula-off RRD presented worse OCTA superficial vascular parameters compared with the macula-on group and fellow eyes, which were correlated with a poorer visual outcome and exacerbated by a longer duration and larger extension of the detachment. Macula-off RRD causes not only retinal structural damage but also a reduction in retinal perfusion despite successful anatomical repair., (© 2024. The Author(s).)

Purpose: Asthma is a clinical syndrome with various underlying pathomechanisms and clinical phenotypes. Genetic, ethnic, and geographic factors may influence the differences in clinical presentation, severity, and prognosis. We compared the characteristics of asthma based on the geographical background by analyzing representative cohorts from the United States, Europe, South America, and Asia using the Severe Asthma Research Program (SARP), Unbiased Biomarkers for the Prediction of Respiratory Disease Outcomes (U-BIOPRED), Program for Control of Asthma in Bahia (ProAR), and Cohort for Reality and Evolution of Adult Asthma in Korea (COREA), respectively., Methods: The clinical characteristics and medications for the SARP (n = 669), U-BIOPRED (n = 509), ProAR (n = 996), and COREA (n = 3,748) were analyzed. Subgroup analysis was performed for severe asthma., Results: The mean age was highest and lowest in the COREA and SARP, respectively. The asthma onset age was lowest in the ProAR. The mean body mass index was highest and lowest in the SARP and COREA, respectively. Baseline pulmonary function was lowest and highest in the U-BIOPRED and COREA, respectively. The number of patients with acute exacerbation in the previous year was highest in U-BIOPRED. The mean blood eosinophil count was highest in COREA. The total immunoglobulin E was highest in the ProAR. The frequency of atopy was highest in the SARP. The principal component analysis plot revealed differences among all cohorts., Conclusions: The cohorts from 4 different continents exhibited different clinical and physiological characteristics, probably resulting from the interplay between genetic susceptibility and geographical factors., Competing Interests: There are no financial or other issues that might lead to conflict of interest., (Copyright © 2024 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease.)

The stimulation of mesenchymal stromal cells (MSCs) with inflammatory molecules is often used to boost their therapeutic effect. Prolonged exposure to inflammatory molecules has been explored to improve their action because MSCs therapies seem to be improved transiently with such stimuli. However, the possibility of cyclically stimulating MSCs to recover their optimized therapeutic potential is still to be elucidated, although the efficacy of cell-based therapies may be dependent on the ability to readapt to the relapse pathological conditions. Here, the response of MSCs, encapsulated in alginate hydrogels and cultured for 22 d, is explored using three different regimes: single, continuous, and intermittent stimulation with IFNγ. Exposure to IFNγ leads to a decrease in the secretion of IL-10, which is cyclically countered by IFNγ weaning. Conditioned media collected at different stages of pulsatile stimulation show an immunomodulatory potential toward macrophages, which directly correlates with IL-10 concentration in media. To understand whether the correlation between cyclic stimulation of MSCs and other biological actions can be observed, the effect on endothelial cells is studied, showcasing an overall modest influence on tube formation. Overall, the results describe the response of encapsulated MSCs to unusual pulsatile simulation regimens, exploring encapsulated MSCs as a living on-demand release system of tailored secretomes with recoverable immunomodulatory action., (© 2024 The Authors. Advanced Healthcare Materials published by Wiley‐VCH GmbH.)

Therapeutic cells are usually administered as living agents, despite the risks of undesired cell migration and acquisition of unpredictable phenotypes. Additionally, most cell-based therapies rely on the administration of single cells, often associated with rapid in vivo clearance. 3D cellular materials may be useful to prolong the effect of cellular therapies and offer the possibility of creating structural volumetric constructs. Here, the manufacturing of shape-versatile fixed cell-based materials with immunomodulatory properties is reported. Living cell aggregates with different shapes (spheres and centimeter-long fibers) are fixed using a method compatible with maintenance of structural integrity, robustness, and flexibility of 3D constructs. The biological properties of living cells can be modulated before fixation, rendering an in vitro anti-inflammatory effect toward human macrophages, in line with a decreased activation of the nuclear factor kappa B (NF-κB) pathway that preponderantly correlated with the surface area of the materials. These findings are further corroborated in vivo in mouse skin wounds. Contact with fixed materials also reduces the proliferation of activated primary T lymphocytes, while promoting regulatory populations. The fixation of cellular constructs is proposed as a versatile phenotypic stabilization method that can be easily implemented to prepare immunomodulatory materials with therapeutic potential., (© 2024 Wiley‐VCH GmbH.)

Our goal was to explore self-care practices among men who have sex with men in the context of Mpox in Brazil. This study used qualitative research methods, including interviews and thematic analysis, to collect and analyze data from male participants across the Brazilian territory. The narratives unveil men's perspectives on self-care, risk reduction, and health beliefs during the Mpox pandemic. Our findings highlight a multifaceted approach to self-care among men, encompassing hygiene, physical contact management, mask usage, skin lesion vigilance, and adherence to official guidelines. Men's attitudes toward sexual behaviors emphasize the importance of reducing sexual partners, practicing safe sex, and combating misinformation through accurate information dissemination. The development of these behaviors and self-care practices can be facilitated by nurses guided by Dorothea Orem's Self-Care Theory, supported by patient-centered care, with strategies to address and confront the stigma associated with the disease and provide emotional support. Thus, the study underscores the pivotal role of self-care in mitigating infection risks, especially in the context of emerging infectious diseases. It acknowledges the impact of socio-cultural factors and healthcare policies on men's preventive measures. However, it also recognizes limitations, such as potential bias due to stigma concerns and a nonrepresentative sample. Ultimately, the research advocates for tailored education, promotion of gender equity, and healthcare empowerment to effectively manage health risks in such contexts., (© 2024 The Authors. Nursing Inquiry published by John Wiley & Sons Ltd.)

This study aimed to analyze the challenges in demand creation for participation in an HIV pre-exposure prophylaxis (PrEP) project in two Brazilian capitals. This qualitative study was conducted with men who have sex with men and transgender women aged 15 to 19 years who lived in two Brazilian state capitals. For this analysis, 27 semi-structured interviews carried out from 2019 to 2020 were evaluated by reflexive thematic content analysis. For participants, PrEP demand creation was essential for their interaction, mediation, bonding, and attachment and proved effective for PrEP acceptability and adherence. Adolescents' narratives showed that the strategies promoted HIV combination prevention, opened up opportunities for recruitment meetings, helped to negotiate with and convince individuals to use PrEP, strengthened peer education, and evoked a feeling of "being with" and "walking together" despite the challenges. Face-to-face or online interactions using social technologies played a crucial role in recruiting adolescents for the project, expanding knowledge on PrEP and other combination prevention strategies and access to health services and self-care.

The aim of this article is to analyze the serophobic content explicit in the publications published in Digital Social Networks in the context of HIV and AIDS in Brazil. This is a qualitative study of the descriptive exploratory type, based on documents. The data obtained were evaluated using the methodology of documentary analysis through Thematic Content Analysis with the aid of NVivo®12 Plus (Windows). A total of 187 codes were generated, subsequently grouped according to the semantics of the words, originating five thematic categories: #LivingWithHIV, #WeNeedtoTalkAboutIt, #WhatISSEROPHOBIA, #SerophobiaIsACrime, and #NoSerophobia. The results showed the main manifestations of HIV and AIDS-related serophobia on social networks. The shared content discussed the difficulties of living with a disease that has social dimensions; the relevance of talking and disseminating content about HIV and AIDS; the elements that make up the stigmatization process and, consequently, structure serophobia in society; the social and civil rights of people living with HIV; measures to combat serophobia in health institutions; and the implications of serophobia in the field of public health.

Objective: To understand the factors associated with the practice of chemsex among MSM in Brazil, especially during the Mpox health crisis, and to design effective prevention and intervention strategies specifically for this population., Design: A cross-sectional and analytical study using an electronic survey, conducted from September to December 2022, during the peak of the Mpox outbreak in Brazil., Sample: A total of 1452 MSM aged 18 and older., Measurements: Data were collected via the REDCap platform through a survey with 46 questions. These addressed demographic data, sexual affiliations, practices, experiences with Mpox, healthcare service usage, and stigma or fear related to Mpox., Results: The prevalence of chemsex was 19.42% (n = 282). Multivariate Poisson modeling indicated a high incidence of chemsex among those diagnosed with Mpox and those involved in high-risk behaviors. The practice of chemsex was six times higher among those diagnosed with Mpox (95% CI: 4.73-9.10). MSM who engage in bugchasing had a prevalence twice that of the main outcome (95% CI: 1.31-3.16)., Conclusion: There is a significant need for targeted interventions for MSM in Brazil, especially given the Mpox outbreak. This study highlights the strong relationships between chemsex, experiences with Mpox, and various sexual behaviors, underscoring the importance of effective public health initiatives., (© 2024 The Authors. Public Health Nursing published by Wiley Periodicals LLC.)

This study aims to analyze the experiences of a transgender man during the gestational-puerperal period and the perspective of obstetric nurses in training based on the dynamics and organization of obstetric healthcare in a hospital setting. This qualitative study is based on a case study approach, employing interviews and direct observations to collect data. The analysis was based on the theoretical and normative framework of the Nursing Process, the Theory of Caring, and the theoretical/critical perspective of transfeminism. The results are organized into six categories: Transgender man in the context of pregnancy, childbirth, and postpartum; partnership and parental dimensions; dilemmas faced by the pregnant couple; impressions recorded by the nursing professional; understanding of the case through a theoretical and epistemological lens; implications for healthcare professionals. We underscore the need to promote spaces for continuing education among healthcare professionals and to reformulate legislation in a way that enables the development of public policies based on respect for diversity and equitable care, recognizing the transgender population's specificities in the contexts of pregnancy, childbirth, and postpartum.

Background: Men's health is influenced by a complex interplay of social, economic, and cultural determinants. Understanding how these aspects affect the health of adult cisgender men in medium and high-complexity healthcare settings is essential for improving healthcare services and promoting better health outcomes., Objective: This study aimed to analyze the health status of adult cisgender men in medium and high-complexity healthcare settings based on social determinants and conditioners., Methods: This study employed a qualitative design involving 45 adult cisgender men receiving care in medium/high complexity services in Bahia, Brazil. Semi-structured interviews were conducted from July 2019 to February 2020, and data were interpreted based on Dahlgren and Whitehead's Model of Social Determinants of Health using deductive thematic analysis., Results: Proximal determinants included biological aspects, preventive behaviors, lifestyle/social life, and aging processes. Intermediate factors included work conditions, access/utilization of healthcare services/medications, and psychosocial factors. Macro determinants involved income distribution, power dynamics, resource allocation, health inequalities/iniquities, morbidity, culture, political decisions, environmental factors, and structural elements., Conclusion: The health status of men in medium/high complexity care was profoundly influenced by structural social determinants. These determinants impacted healthcare attention, service organization, cultural influences, the reproduction of hegemonic masculinity patterns, lifestyle, social support, and socioeconomic conditions necessary to realize the right to health. Nursing practices should conduct comprehensive assessments that extend beyond physical health indicators., Competing Interests: The authors declared no conflict of interest in this study., (© The Author(s) 2024.)

Transformative capacity (TC) is key for addressing climate change impacts. It refers to urban areas' ability for profound and intentional change to address current challenges and move towards a more desirable and resilient state. However, its varied applications across disciplines can lead to misunderstandings and implementation challenges. Thus, this Semi-Systematic Literature Review (SSLR) on TC within urban studies from 2016 to 2022 aims to overview and synthesise TC literature and its gaps to inform ongoing debates, intersecting it with climate-related research. The results show an increasing interest in TC within two fields of knowledge: resilience studies and transformative research. The review found TC as a catalyst for transformative actions, promoting sustainable pathways, enhancing resilience, and driving fundamental changes in urban climate adaptation. Finally, the prevailing literature gaps concern the TC concept's fragmentation, excessive research on governance features, and lack of joint research about TC and innovation., (© 2023. The Author(s).)