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João Marcelo Barreto Silva,1,2 Paulo Henrique De Souza Bermejo,3 Marina Figueiredo Moreira,3 David Nadler Prata,1 Daniela Mascarenhas de Queiroz Trevisan,1 Otávio Augusto dos Santos2 1Program in Governance and Digital Transformation, Federal University of Tocantins, Palmas, TO, Brazil; 2Department of Assistance Regulation and Control, Ministry of Health, Brasília, DF, Brazil; 3Administration Department, Faculty of Economics, Administration, Accounting and Public Policy Management of University of Brasília, Brasília, DF, BrazilCorrespondence: João Marcelo Barreto Silva, Department of Assistance Regulation and Control, Ministry of Health, St. de Adm. Federal Sul Q1-G, Sala 147B, Brasília, DF, 70058-900, Brasil, Email joao.marcelo@saude.gov.brBackground: Analyzing patients’ nonattendance at medical appointments helps address an issue impacting the management and sustainability of health systems globally, providing valuable insights for healthcare managers. This study aims to identify factors at both patient and health system levels that contribute to understanding missed appointments.Methods: The analysis was conducted using data from secondary care consultations within the Brazilian Unified Health System between April 2018 and March 2020. Primary care includes general medical consultations, while secondary care involves specialized services provided by doctors with advanced expertise. We examined demographic factors (age, sex, race/color, socioeconomic level) and health system practices (waiting time, hospitalization, distance to service, medical specialty, and severity of clinical condition) to assess their impact on patient attendance. A weighted analysis and receiver operating characteristic (ROC) analysis were applied to determine the relative risk of nonattendance.Findings: Of 5,003,159 consultations, 435,523 (8.7%) were missed. Nonattendance was highest among patients facing long distances to the service (13.3%, [RRR] 1.227), younger age (16– 30 years: 11.8%, [RRR] 1.041), and waiting times (> 30: 10.9%, [RRR] 1.738). Socially vulnerable patients were more likely to miss appointments (9.6%, [RRR] 1.055) compared to less vulnerable groups (8.6%). Practice-level factors had a slightly greater impact on nonattendance (ROC: 0.621) than patient-level factors (ROC: 0.5674). The overall predictive model achieved a C statistic of 0.6228, resulting in a fair predictive ability. However, the model showed only modest prediction of no-shows, indicating the need for more detailed data to improve accuracy. Gauging which group suffers the highest risk of nonattendance was a secondary goal of this analysis.Interpretation: Young, socially vulnerable patients with long commutes and extended waiting times are at higher risk of nonattendance. Effective management of these risk factors and targeted preventive actions are essential to reduce absenteeism and improve health system efficiency.Keywords: absenteeism, health policy, medical appointment, health management

Rebeca Cecília Souza,1 Emerson Tavares de Sousa,2 David Sousa,3 Marcelo Sales,4 Rudyard dos Santos Oliveira,5 Maria Helena Mariano,6 Eliézer Rushansky,7 Ana Cláudia Amorim Gomes,8 Emanuel Silva8 1Department of Oral Surgery, Dental School, Pernambuco University, Recife, Pernambuco, Brazil; 2Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; 3Center of Medical Sciences, Federal University of Paraiba, Joao Pessoa, Paraiba, Brazil; 4Department of Clinical and Community Dentistry, Dental School, Federal University of Paraiba, Joao Pessoa, Paraiba, Brazil; 5Department of Orthodontics, Sao Leopoldo Mandic School, Campinas, São Paulo, Brazil; 6Department of Rheumatology, Oswaldo Cruz University Hospital, Medical School, Pernambuco University, Recife, Pernambuco, Brazil; 7Brazilian Society of Rheumatology, Department of Rheumatology, Oswaldo Cruz University Hospital, Medical School, Pernambuco University, Recife, Pernambuco, Brazil; 8Department of Oral and Maxillofacial Surgery, Oswaldo Cruz University Hospital, Dental School, Pernambuco University, Recife, Pernambuco, BrazilCorrespondence: Emanuel SilvaUniversity of Pernambuco, School of Dentistry, Oswaldo Cruz University Hospital, Department of Oral and Maxillofacial Surgery, 310 Arnóbio Marquês Street, Recife, PE, 50100-130, BrazilTel +55 81-3184-1468Email residenciactbmf@upe.brBackground: This study sought to investigate which temporomandibular disorders (TMD) can be expected in patients with ankylosing spondylitis (AS) and to determine the combined impact of these conditions on the psychological status, chronic pain, and functional disability.Material and Methods: A cross-sectional study composed of 30 patients between 18 and 65 years with ankylosing spondylitis was performed. The research protocol considered the evaluation of outcomes related to the ankylosing spondylitis (HLA-B27 antigen, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI) and Health Assessment Questionnaire – Spondylitis (HAQ-S)) and temporomandibular disorders (axis I and II of the Research Diagnostic Criteria for Temporomandibular Disorders – RDC/TMD). Descriptive analyses were applied to express the results.Results: The sample presented both AS and TMD, most of them (24) were diagnosed with conventional AS (HLA-B27 positive). The BASDAI was scored as 7.70 (2.30) (high activity of AS disease). Functional disability represented by high scores of BASFI [7.00 (2.63)] and HAQ-S [1.79 (0.62)] demonstrates the severe impact of the disease on the daily routine and quality of life. According to RDC/TMD diagnostic criteria, 17 (57%) share the three groups of TMD, and 9 (30%) share two groups of TMD (Group I and III). Over 73% of the volunteers scored high levels of chronic pain (Grade III and IV) associated with a high depression scale score. The sample scored the somatization scale (with and without pain) as severe.Conclusion: Patients with ankylosing spondylitis presented a high prevalence of temporomandibular disorder, most of them having the degenerative forms of TMJ disease. AS and TMD cause moderate to severe chronic pain and a negative impact on psychological status and functional capacities.Keywords: spondyloarthritis, temporomandibular disorders, quality of life, chronic pain

In view of the need to obtain genetically superior eucalyptus clones that promote productivity coupled with quality, we used multivariate statistical techniques for the selection and evaluation of Eucalyptus spp. clones for wood production. The experiments were carried out in three environments in the districts of Eldorado do Sul, Butiá and São Gabriel. A clone of the commercial species Eucalyptus saligna was used as a common control in all trials. A total of 84 eucalyptus clones were used belonging to the breeding program in Rio Grande do Sul, Brazil, in a randomized block design, with 20 replicates and one plant per plot, spacing 3.50 x 2.14 m. Silvicultural practices were performed according to the particularities required by each environment. The clones were evaluated at 36 months for diameter at breast height, total height, total individual volume with bark and survival of clones. The datawere submitted to a joint analysis of variance, and the significance was interpreted by the F test at 5% probability. Interaction tests were performed and then multivariate models were used. Selection of clones from their values of genetic divergence and heterogeneity in relation to the others can be used to increase variability in breeding populations. Improvement strategies such as Intrapopulation Recurrent Selection can be "fed" from selections made based on these parameters, but also focusing on increasing productivity and improving wood technology. There wasa great difference in behavior of the clones for each environment, demonstrating the influence of genotype x environment interactions, which can be evaluated later in amplified clonal tests or in the observation plantings of these clones; these will serve for the future indication of genotypes for commercial plantations. [ABSTRACT FROM AUTHOR]

Mercury is a highly hazardous water contaminant; both organic and inorganic forms are cumulatively and extremely toxic. In this context, this study describes the application of TiO2 -based systems modified with 5, 8, 10 and 15 wt% Fe using the impregnation method for the photocatalytic reduction of Hg2+. Characterization of TiO2 and synthesized materials was performed by using Brunauer, Emmett and Taller area, pore diameter and pore volume, scanning electron microscopy, point zero charge, X-ray diffraction (XRD), Fourier transform infrared spectroscopy, photoacoustic and Mössbauer spectroscopy. The photocatalytic reduction of Hg2+ was performed in batch stirred tank reactor and compound parabolic collector solar photoreactor, in the presence of catalysts, under four different reaction conditions. The process of heterogeneous photocatalysis was studied in the treatment of synthetic wastewater containing mercury chloride (HgCl2 ) in different reaction conditions. In particular, the influence of oxygen and formic acid was analyzed. The results showed that an addition of 8% to the iron weight improved the performance of the photocatalytic titania in the reduction of Hg2+ (artificial radiation). In the presence of this catalyst, and reaction medium containing only mercuric chloride in an aqueous solution containing oxygen, Hg2+ was 100% reduced, after 3 h of reaction. However, under solar radiation, the reduction of Hg2+ obtained was 67%. [ABSTRACT FROM AUTHOR]

Several studies have focused on the removal and recovery of precious metal ions from industrial wastewater due to their environmental and economic importance. Adsorption on bentonite clays has been shown to possess a high removal potential for several metal ions. We herein investigated the dynamic adsorption of silver using a fixed-bed column and a calcined bentonite clay called Verde-lodo as an adsorbent. A fluid dynamic study was performed to evaluate the adsorption system's metal-ion removal capacity (qu and qt), the mass transfer zone and the percentage of total removal according to different effluent's flow. Adsorption-desorption cycles were carried out using nitric acid as an eluent to evaluate the useful lifetime of the column. The breakthrough curves were fitted to the Bohart-Adams model (quasichemical). Moreover, the zeta potential was analyzed to explain the difference between the removal capacity obtained for the static and dynamic systems. [ABSTRACT FROM AUTHOR]

Evellyn Claudia Wietzikoski Lovato,1 Patrícia Amaral Gurgel Velasquez,1 Cristiana dos Santos Oliveira,1 Camila Baruffi,1 Thais Anghinoni,1 Raquel Costa Machado,1 Francislaine Aparecida dos Reis Lívero,2 Samantha Wietzikoski Sato,1 Lisiane de Almeida Martins1 1Laboratory of Microbiology of Natural Products, Paranaense University, Umuarama, Brazil; 2Laboratory of Preclinical Research of Natural Products, Paranaense University, Umuarama, Brazil Background: The indiscriminate use of antibiotics has caused bacteria to develop mechanisms of resistance to antibacterial agents, limiting treatment options. Therefore, there is a great need for alternative methods to control infections, especially those related to skin. One of the alternative methods is the high frequency equipment (HFE), which is used on skin conditions as an analgesic, an anti-inflammatory, and mainly to accelerate cicatricial processes and have a bactericidal effect through the formation of ozone. This research investigated the antibacterial effect of HFE on standard cultures of bacteria.Materials and methods: Dilutions (104 colony forming unit mL−1) were performed for Enterobacter aerogenes and Staphylococcus aureus with 24-hour growth bacteria. Then, 1 μL of each dilution was pipetted into suitable medium and the HFE flashing technique was used at intensities of 6, 8 and 10 mA for 30, 60, 90, 120 and 180 seconds. The control group received no treatment. Plates were incubated at 37°C for 24 hours and then read.Results: The spark at intensity of 6 mA had no bactericidal effect on the E. aerogenes; however, a significant bacterial growth reduction occurred at intensity of 8 mA after 120 and 180 seconds, and at 10 mA, reduction in bacterial growth could already be verified at 30 seconds and total bacterial growth inhibition occurred in 180 seconds. For S. aureus, there was a strong bacterial growth inhibition at all intensities used; however, at 6 mA, absence of bacterium growth after 120 and 180 seconds was observed. By increasing the flashing intensity to 8 and 10 mA, it was observed that the bacterium growth was inhibited after only 30 seconds of irradiation.Conclusion: The HFE has time-dependent antibacterial effects against E. aerogenes and S. aureus bacteria that have several resistance mechanisms. Keywords: bactericidal, bacterial viability, gram negative bacteria, gram positive bacteria, Enterobacter aerogenes, Staphylococcus aureus

Abstract: Several benzofuran derivatives linked to a 3-indoletetrahydropyridine through an alkyl chain were prepared and evaluated for serotonin transporter and 5-HT1A receptor affinities. Their design, synthesis and structure–activity relationships are described. [Copyright &y& Elsevier]

Abstract Background In 2009, an outbreak of respiratory illness caused by influenza A H1N1 virus occurred worldwide. Some patients required Intensive Care Unit (ICU) admission. The use of non-invasive ventilation (NIV) in these patients is controversial, as the aerosol dispersion may contaminate the environment and health-care co-workers. Methods Describe the respiratory profile, the mortality rate, and the benefit of using NIV in patients with confirmed diagnosis of influenza AH1N1 who were admitted in the ICU during the year 2009. Results A total of 1, 401 cases of influenza A H1N1 were confirmed in our hospital by real-time RT-PCR in 2009, and 20 patients were admitted to the ICU. The patients' ages ranged from 18 to 74 years (median of 42). Acute Respiratory Failure (ARF) was present in 70% of patients. The median Acute Physiology and Chronic Health Evaluation II score was 7 (range 7 to 25). Of the 14 patients who developed ARF, 85.7% needed NIV and 14% needed invasive MV at admission. Our success rate (41.6%) with NIV was higher than that described by others. The hospital mortality rate was 2.1%. When influenza A H1N1 arrived in Brazil, the disease was already on endemic alert in other countries. The population was already aware of the symptoms and the health-care system of the treatment. This allowed patients to be properly and promptly treated for influenza A H1N1, while health-care workers took protective measures to avoid contamination. Conclusion In our study we found a high success and low mortality rates with non-invasive ventilation in patients with influenza A H1N1.

Abstract Background Dengue fever is one of the most common tropical diseases worldwide. Early detection of the disease, followed by intravenous fluid therapy in patients with dengue hemorrhagic fever (DHF) or with warning signs of dengue has a major impact on the prognosis. The purpose of this study is to describe the care provided in a hydration tent, including early detection, treatment, and serial follow-up of patients with dengue fever. Findings The analysis included all patients treated in the hydration tent from April 8 to May 9, 2008. The tent was set up inside the premises of the 2nd Military Firemen Group, located in Meier, a neighborhood in Rio de Janeiro, Brazil. The case form data were stored in a computerized database for subsequent assessment. Patients were referred to the tent from primary care units and from secondary city and state hospitals. The routine procedure consisted of an initial screening including vital signs (temperature, blood pressure, heart rate, and respiratory rate), tourniquet test and blood sampling for complete blood count. Over a 31-day period, 3,393 case recordings were seen at the hydration tent. The mean was 109 patients per day. A total of 2,102 initial visits and 1,291 return visits were conducted. Of the patients who returned to the hydration tent for reevaluation, 850 returned once, 230 returned twice, 114 returned three times, and 97 returned four times or more. Overall, 93 (5.3%) patients with DHF seen at the tent were transferred to a tertiary hospital. There were no deaths among these patients. Discussion As the epidemics were already widespread and there were no technical conditions for routine serology, all cases of suspected dengue fever were treated as such. Implementing hydration tents decrease the number of dengue fever hospitalizations.

Abstract The electrical conductivity σ has been calculated for p-doped GaAs/Al0.3Ga0.7As and cubic GaN/Al0.3Ga0.7N thin superlattices (SLs). The calculations are done within a self-consistent approach to the k → ⋅ p → theory by means of a full six-band Luttinger-Kohn Hamiltonian, together with the Poisson equation in a plane wave representation, including exchange correlation effects within the local density approximation. It was also assumed that transport in the SL occurs through extended minibands states for each carrier, and the conductivity is calculated at zero temperature and in low-field ohmic limits by the quasi-chemical Boltzmann kinetic equation. It was shown that the particular minibands structure of the p-doped SLs leads to a plateau-like behavior in the conductivity as a function of the donor concentration and/or the Fermi level energy. In addition, it is shown that the Coulomb and exchange-correlation effects play an important role in these systems, since they determine the bending potential.