Objectives: To summarize evidence-based cognitive-behavioral therapy (CBT) treatment and propose clinical interventions for adult patients with obsessive-compulsive disorder (OCD). Methods: The literature on CBT interventions for adult OCD, including BT and exposure and response prevention, was systematically reviewed to develop updated clinical guidelines for clinicians, providing comprehensive details about the necessary procedures for the CBT protocol. We searched the literature from 2013-2020 in five databases (PubMed, Cochrane, Embase, PsycINFO, and Lilacs) regarding study design, primary outcome measures, publication type, and language. Selected articles were assessed for quality with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association. Results: We examined 44 new studies used to update the 2013 American Psychiatric Association guidelines. High-quality evidence supports CBT with exposure and response prevention techniques as a first-line treatment for OCD. Protocols for Internet-delivered CBT have also proven efficacious for adults with OCD. Conclusion: High-quality scientific evidence supports the use of CBT with exposure and response prevention to treat adults with OCD.

Objectives: To summarize evidence-based pharmacological treatments and provide guidance on clinical interventions for adult patients with obsessive-compulsive disorder (OCD). Methods: The American Psychiatric Association (APA) guidelines for the treatment of OCD (2013) were updated with a systematic review assessing the efficacy of pharmacological treatments for adult OCD, comprising monotherapy with selective serotonin reuptake inhibitors (SSRIs), clomipramine, serotonin and norepinephrine reuptake inhibitors (SNRIs), and augmentation strategies with clomipramine, antipsychotics, and glutamate-modulating agents. We searched for the literature published from 2013-2020 in five databases, considering the design of the study, primary outcome measures, types of publication, and language. Selected articles had their quality assessed with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association (ACC/AHA). Results: We examined 57 new studies to update the 2013 APA guidelines. High-quality evidence supports SSRIs for first-line pharmacological treatment of OCD. Moreover, augmentation of SSRIs with antipsychotics (risperidone, aripiprazole) is the most evidence-based pharmacological intervention for SSRI-resistant OCD. Conclusion: SSRIs, in the highest recommended or tolerable doses for 8-12 weeks, remain the first-line treatment for adult OCD. Optimal augmentation strategies for SSRI-resistant OCD include low doses of risperidone or aripiprazole. Pharmacological treatments considered ineffective or potentially harmful, such as monotherapy with antipsychotics or augmentation with ketamine, lamotrigine, or N-acetylcysteine, have also been detailed.

O setor agrícola está sujeito a adversidades provenientes de eventos climáticos, incidência de pragas, incêndios e variações de mercado, sendo, portanto, de suma importância a adoção de seguro rural para uma gestão adequada das atividades agrícolas. Entretanto, a existência de falhas de mercado inibe o desenvolvimento e a ampliação desse mercado, especialmente no Brasil. Nesse contexto, o principal objetivo desse artigo é propor uma metodologia inovadora que combina algoritmos de aprendizado de máquina com imagens de satélite ópticas e de radar para previsão de sinistros agrícolas que permita uma redução das assimetrias informacionais existentes no mercado brasileiro. Classificação JEL. Q00, Q10, C81. climáticos pragas sendo portanto Entretanto Brasil contexto brasileiro JEL Q00 Q Q10 C81 C Q0 Q1 C8

RESUMO O trabalho teve por objetivo avaliar a moderação de variáveis relacionadas com incentivos ao gerenciamento de resultados (endividamento, lucratividade e tamanho) no efeito da mudança de normas (contábil ou fiscal) sobre book-tax differences (BTD). O fim do Regime Tributário Transitório (RTT) permite avaliar a simetria entre o afastamento e a reaproximação das normas contábil e fiscal, ajudando a identificar o efeito moderador de características como tamanho, alavancagem e rentabilidade sobre o uso da discricionariedade permitido pelas International Financial Reporting Standards (IFRS). O estudo dos efeitos de mudanças nas normas contribui para o entendimento de como afetam a qualidade da informação contábil, particularmente quando observados movimentos simétricos de afastamento das normas contábil e fiscal, com a adoção das IFRS, e de reaproximação, com o fim do RTT. A análise realizada permite separar efeitos do distanciamento entre as normas fiscal e contábil, das inovações trazidas pelas IFRS. O entendimento do efeito da norma sobre a qualidade da informação contábil contribui para a qualidade do trabalho de analistas financeiros, das autoridades fiscais, e dos reguladores. São realizados estudos de eventos para avaliar o efeito da adoção das IFRS, bem como do fim do RTT, sobre BTD (proxy de gerenciamento de resultados), em seções transversais de empresas. São utilizadas variáveis explicativas relacionadas com incentivos para gerenciar resultados contábeis e tributários (endividamento, rentabilidade e tamanho), que poderiam explicar a ambiguidade dos resultados na literatura. O artigo mostra evidências de que endividamento e tamanho das empresas influem no efeito da adoção das IFRS, assim como do fim do RTT. Foi observada relação negativa de endividamento e tamanho com o impacto das mudanças de norma sobre diferenças entre resultados contábil e fiscal (BTD).

ABSTRACT This paper aimed to evaluate the moderation by variables related to incentives for earnings management (indebtedness, profitability, and size) over the effect of the change in standards (accounting or tax) on the book-tax differences (BTD). The end of the Transitional Tax Regime (RTT) enables us to evaluate the symmetry between the divergence and reconvergence of the accounting and tax standards, helping to identify the moderating effect of characteristics such as size, leverage, and profitability over the use of the discretion allowed by the International Financial Reporting Standards (IFRS). Studying the effects of changes in the standards contributes to understanding how they affect accounting information quality, particularly when we observe symmetrical movements of divergence of the accounting and tax standards, such as IFRS adoption, and of reconvergence, with the end of the RTT. The analysis conducted enables us to separate effects of divergence between the tax and accounting standards from the innovations introduced by the IFRS. An understanding of the effect of the standard over accounting information quality contributes to the quality of the work of financial analysts, tax authorities, and regulators. Event studies are conducted to evaluate the effect of IFRS adoption, as well as the end of the RTT, over the BTD (a proxy for earnings management), in cross sections of companies. We use explanatory variables related to incentives to manage book and taxable income (indebtedness, profitability, and size), which could explain the ambiguity of the results in the literature. The article provides evidence that the indebtedness and size of companies influence the effect of IFRS adoption, as well as of the end of the RTT. We observed a negative relationship of indebtedness and size with the impact of changes in standards over differences between book and taxable income (BTD).

RESUMO: A cana-de-açúcar se destaca como uma das fontes de energia renovável frente às estratégias para reduzir a emissão de gases causadores do efeito estufa. O nitrogênio é um dos mais significativos devido ao seu impacto no crescimento de folhas e colmos. Portanto, o monitoramento eficiente do nitrogênio aplicado é essencial e o sensoriamento remoto se apresenta como uma alternativa na melhoria do gerenciamento da adubação. O presente trabalho teve por objetivo selecionar comprimentos de onda a partir de dados hiperespectrais de dossel da cana-de-açúcar para geração de modelos na predição da concentração de Nitrogênio. O estudo foi realizado em experimentos de campo instalados nos municípios de Piracicaba, Jaú e Santa Maria da Serra, estado São Paulo, na safra 2013/2014. Cada experimento foi alocado em blocos ao acaso, com parcelas subdivididas e quatro repetições, com variedades de cana-de-açúcar na parcela (três variedades por local, sendo a SP 81-3250 comum à todos) e doses de nitrogênio (0, 50, 100 e 150 kg.ha-1) na subparcela. Na seleção dos comprimentos de onda que melhor se correlacionam com o TFN foi utilizada a metodologia sPLS. Posteriormente, foi realizada a combinação linear dos comprimentos de onda selecionados pela metodologia sPLS, por meio de Regressão Linear Múltipla por Stepwise (SMLR). Foram identificadas bandas importantes nas regiões do visível (700 a 705 nm), red-edge(710 a 720 nm), infravermelho próximo (725, 925, 955 e 980 nm) e infravermelho de ondas curtas (1355, 1420, 1595, 1600, 1605 e 1610 nm). O modelo de predição de TFN teve valores de R² de 0,50 e o RMSE de 1,67 g.kg-1. Os modelos gerados para Piracicaba, Jaú e Santa Maria obtiveram R² ajustados e RMSE, respectivamente, de 0,31 considerado não confiável (1,30 g.kg-1), 0,53 (1,96 g.kg-1) e 0,54 (1,46 g.kg-1). Os sensores hiperespectrais de dossel podem ser utilizados para predição do TFN e monitoramento de aplicação de nitrogênio em cana-de-açúcar.

ABSTRACT: Sugarcane is a good source of renewable energy and helps reduce the emission of greenhouse gases. Nitrogen has a critical role in plant growth; therefore,estimating nitrogen levels is essential, and remote sensing can improve fertilizer management. This field study selects wavelengths from hyperspectral data on a sugarcane canopy to generate models for estimating leaf nitrogen concentrations. The study was carried out in the municipalities of Piracicaba, Jaú, and Santa Maria da Serra, state of São Paulo, in the 2013/2014 growing season. The experiments were carried out using a completely randomized block design with split plots (three sugarcane varieties per plot [variety SP 81-3250 was common to all plots] and four nitrogen concentrations [0, 50, 100, and 150 kgha-1] per subplot) and four repetitions. The wavelengths that best correlated with leaf nitrogen were selected usingsparse partial least square regression. The wavelength regionswere combinedby stepwise multiple linear regression. Spectral bands in the visible (700-705 nm), red-edge (710-720 nm), near-infrared (725, 925, 955, and 980 nm), and short-wave infrared (1355, 1420, 1595, 1600, 1605, and 1610 nm) regions were identified. The R² and RMSE of the model were 0.50 and 1.67 g.kg-1, respectively. The adjusted R² and RMSE of the models for Piracicaba, Jaú, and Santa Maria were 0.31 (unreliable) and 1.30 g.kg-1, 0.53 and 1.96 g.kg-1, and 0.54 and 1.46 g.kg-1, respectively. Our results showed that canopy hyperspectral reflectance can estimate leaf nitrogen concentrations and manage nitrogen application in sugarcane.

Resumo: Introdução: Como o tromboembolismo venoso (TEV) é uma das principais causas de mortes evitáveis em pacientes hospitalizados, é importante a criação de medidas para sua prevenção e seu tratamento. Porém, para a profilaxia de qualidade, a educação e o envolvimento dos pacientes são necessários, e uma das ferramentas para facilitar as atividades educativas em saúde são as tecnologias educacionais. Objetivo: Este estudo teve como objetivos construir e validar um aplicativo móvel sobre orientações para prevenção de TEV em pacientes hospitalizados durante a internação e após a alta hospitalar. Método: Trata-se de um estudo metodológico composto por duas fases (construção e validação), divididas em nove etapas. A fase de validação foi realizada com 11 juízes especialistas e 30 representantes do público-alvo. Utilizaram-se quatro instrumentos de coletas de dados: Suitability Assessment of Materials (SAM), Instrumento de Validação de Conteúdo Educativo em Saúde (IVCES), Instrumento de Avaliação para o Público-alvo e System Usability Scale (SUS), todos interpretados mediante avaliação específica. Resultado: Entre os juízes especialistas, a média da pontuação do SAM foi 89,4%, e a do IVCES, 93,8%. Em relação à opinião do público-alvo, a média de concordância no primeiro instrumento de coleta de dados foi 95%, e a do SUS, 79,5 pontos. Conclusão: O aplicativo móvel foi considerado válido mediante a metodologia aplicada por juízes especialistas e público-alvo.

Abstract: Introduction: Venous thromboembolism (TEV) is one of the main causes of preventable deaths in hospitalized patients. Therefore, it is important to create methods for its prevention and treatment. However, for quality prophylaxis, it is necessary to educate and involve patients, and one of the tools to facilitate educational activities in health is educational technologies. Objective: To build and validate a mobile application on guidelines for preventing TEV in hospitalized patients during hospitalization and after discharge from hospital. Methods: Methodological study consisting of two phases (construction and validation), divided into nine steps. The validation phase was carried out with 11 expert judges and 30 representatives of the target audience. Four data collection instruments were used: Suitability Assessment of Materials (SAM), Health Educational Content Validation Instrument (IVCES), Target Audience Assessment Instrument and System Usability Scale (SUS), all interpreted by specific evaluation. Results: Among the expert judges, the average score for the SAM was 89.4% and for the IVCES, 93.8%. In relation to the opinion of the target audience, the average agreement score in the first data collection instrument was 95% and for the SUS, 79.5 points. Conclusion: The mobile application was considered valid according to the methodology applied by the expert judges and target audience.

ABSTRACT This article analyzes the differences between public and private health services regarding infrastructure and human resources at the state (subnational) and macro-regional levels in Brazil. The research collected monthly data on inpatient beds and the number of nurses, physiotherapists, and doctors from Brazilian states for 2020. Indicators were created following quarterly changes and comparing the actions of public and private healthcare entities. Variations were analyzed using temporal graphs based on means and standard deviation. The findings suggest: (1) exponential growth in health care infrastructure and human resources led by public sector investment in the second quarter, followed by a slowdown; (2) a more significant variation in the acceleration and deceleration of the public sector response in the North of Brazil and the states of Maranhão, Rio Grande do Norte, and the Federal District; (3) the public sector was the primary response mechanism to the pandemic considering the variations throughout the year. The study concludes that the government was the leading actor in response to the COVID-19 pandemic in Brazil in 2020, pointing out that responses were uneven in the states.

Resumo Este trabalho analisa a distribuição espacial do rebanho bovino nas microrregiões brasileiras entre 1995 e 2016, com enfoque especial na Amazônia Legal. A partir de uma análise espacial com dados em painel, a taxa de crescimento do rebanho se mostrou entre 5,6% a 15,68% mais elevada na Amazônia Legal, enquanto o crescimento da densidade bovina (rebanho por km²) foi superior em 11,11% a 21,47%, indicando uma possível intensificação da produção na região. Além disso, verificou-se uma desconcentração regional da pecuária brasileira, em especial devido à presença de externalidades espaciais positivas que auxiliaram no espraiamento do rebanho. O acesso ao crédito pecuário também se mostrou importante para explicar esse crescimento ao gerar forças de atração e propulsão para a produção. De maneira específica, a produtividade dos insumos utilizados na nutrição bovina (soja, milho e cana-de-açúcar) auxiliou no crescimento da densidade bovina, mas não do rebanho, corroborando sua relação com a intensificação da produção.

Abstract This paper analyses the spatial distribution of the bovine herd in the Brazilian micro-regions between 1995 and 2016, especially in the Legal Amazon. From a spatial analysis with panel data, the growth rate showed to be between 5.6% to 15.68% higher in the Legal Amazon, while the increase in bovine density (herd per km²) was higher in 11.11% to 21.47%, indicating a possible intensification of production in the region. In addition, there was a regional deconcentration of Brazilian livestock, especially due to positive spatial externalities that helped the spread of the herd. Credit for livestock also proved to be important to explain this growth by generating forces of attraction and propulsion for production. Specifically, the productivity of the inputs used in bovine nutrition (soybeans, corn and sugar cane) helped the growth of bovine density, but not in the herd, which corroborates its relationship with the intensification of production.

ABSTRACT. Nitrogen management in crops is a key activity for agricultural production. Methods that can determine the levels of this element in plants in a quick and non-invasive way are extremely important for improving production systems. Within several fronts of study on this subject, proximal and remote sensing methods are promising techniques. In this regard, this research sought to demonstrate the relationships between variations in leaf nitrogen content (LNC) and sugarcane spectral behaviour. The work was carried out in three experimental areas in São Paulo State, Brazil, with different soils, varieties and nitrogen rates during the 2012/13 and 2013/14 seasons. A significant correlation was observed between the LNC and variations in the sugarcane spectra. The green and red-edge spectral bands were the most consistent and stable predictors of LNC among the evaluated harvests. Stepwise multiple linear regression analysis (MSLR) generated better models for LNC estimation when calibrated with experimental area, independent of the variety. The present research demonstrates that specific wavelengths are associated with the variation in LNC in sugarcane, and these are reported in the green region (near 550 nm) and in the red-edge wavelengths (680 to 720 nm). These results may help in future research on the direct in situ application of nitrogen fertilizers.

ABSTRACT OBJECTIVE: To investigate how sociodemographic conditions, political factors, organizational confidence, and non-pharmaceutical interventions compliance affect the COVID-19 vaccine hesitancy in Brazil. METHODS: Data collection took place between November 25th, 2020 and January 11th, 2021 using a nationwide online survey. Subsequently, the researches performed a descriptive analysis on the main variables and used logistic regression models to investigate the factors associated with COVID-19 vaccine hesitancy. RESULTS: Less concern over vaccine side effects could improve the willingness to be vaccinated (probability changed by 7.7 pp; p < 0.10). The current vaccine distrust espoused by the Brazilian president is associated with vaccine hesitancy, among his voter base. Lower performance perception (“Very Bad” with 10.7 pp; p < 0.01) or higher political opposition (left-oriented) regarding the current presidency is associated with the willingness to be vaccinated. Higher compliance with non-pharmaceutical interventions (NPIs) is usually positively associated with the willingness to take the COVID-19 vaccine (+1 score to NPI compliance index is associated with higher willingness to be vaccinated by 1.4 pp, p < 0.05). CONCLUSION: Willingness to be vaccinated is strongly associated with political leaning, perceived federal government performance, vaccine side effects, and compliance with non-pharmaceutical interventions (NPIs).

ABSTRACT OBJECTIVE: To investigate how sociodemographic conditions, political factors, organizational confidence, and non-pharmaceutical interventions compliance affect the COVID-19 vaccine hesitancy in Brazil. METHODS: Data collection took place between November 25th, 2020 and January 11th, 2021 using a nationwide online survey. Subsequently, the researches performed a descriptive analysis on the main variables and used logistic regression models to investigate the factors associated with COVID-19 vaccine hesitancy. RESULTS: Less concern over vaccine side effects could improve the willingness to be vaccinated (probability changed by 7.7 pp; p < 0.10). The current vaccine distrust espoused by the Brazilian president is associated with vaccine hesitancy, among his voter base. Lower performance perception (“Very Bad” with 10.7 pp; p < 0.01) or higher political opposition (left-oriented) regarding the current presidency is associated with the willingness to be vaccinated. Higher compliance with non-pharmaceutical interventions (NPIs) is usually positively associated with the willingness to take the COVID-19 vaccine (+1 score to NPI compliance index is associated with higher willingness to be vaccinated by 1.4 pp, p < 0.05). CONCLUSION: Willingness to be vaccinated is strongly associated with political leaning, perceived federal government performance, vaccine side effects, and compliance with non-pharmaceutical interventions (NPIs).

Abstract This paper discusses the crisis in regional governance in South America from 2017 onwards by analyzing Unasur’s disintegration and the emergence of new arrangements (the Lima Group, Prosur, and the Leticia Pact), as well as the regional and global conditions that enabled them. We assessed their performance in responding to different crises in South America, concluding that the constraints and challenges they faced jeopardize their aim to prosper in the future. Special attention is given to changes in Brazilian foreign policy guidelines toward South America, which contributed to these outcomes.

Abstract This paper uses a theoretical motivation for an Expanded Knowledge Production Function (EKPF) that encompasses both path dependence and spatial spillovers to search for evidences in Brazil using a Dynamic Spatial Panel Data approach. The purpose is to identify the determinants of knowledge production in the 2005-2015 period as well as its temporal evolution, using innovation patents as proxies. Regarding its spatial distribution, we identified a North-South disparity for the knowledge production in Brazil, with Southeast and South producing a large part of the country's patents. Based on the EKPF, we confirmed the importance of path dependence and knowledge spillovers to explain the Brazilian innovation. In addition, population density, which generates Jacobian externalities and economies of agglomeration, is an important structural feature in the short run while the number of researchers in universities and an increased economic scale are essential to knowledge production in the long run.

Resumo A doença de Behçet é uma vasculite multissistémica rara, cuja apresentação inicial é habitualmente ulceração recorrente da mucosa oral; no entanto, pode apresentar-se com envolvimento de outros sistemas, dificultando o diagnóstico. Apresentamos um caso de um homem de 45 anos com queixas de desequilíbrio da marcha, vertigem, diminuição da força muscular/sensibilidade do membro superior esquerdo e hipovisão. Na ressonância magnética verificou-se lesão expansiva na fossa posterior adjacente ao pedúnculo cerebeloso médio. Ao exame oftalmológico, apresentava oclusão de ramo da veia temporal inferior. Após anamnese minuciosa, foi possível apurar história de ulceração aftosa recorrente da mucosa oral. Pela elevada suspeição de doença de Behçet com atingimento neurológico, decidido iniciar terapêutica com corticoterapia, com melhoria clínica, analítica e imagiológica. A doença de Behçet pode ser muito difícil de diagnosticar quando a manifestação inicial não inclui a tríade clínica clássica de aftas orais, úlceras genitais e lesão ocular.

Abstract Behçet’s disease is a rare multisystemic vasculitis that most commonly presents with recurrent episodes of oral ulceration. However, other system involvement may be the first sign. We report a case of a 45-year-old male who presented with walking instability, loss of motor/sensory function on the upper left arm, vertigo and poor visual acuity. The magnetic resonance imaging showed an expansive lesion in the posterior fossa adjacent to the middle cerebellar peduncle. On ophthalmic examination, he presented occlusion of the inferior temporal vein. After a complete anamnesis, it was possible to establish a history of recurrent aphthous ulceration in the oral mucosa. Due to high suspicion of Behçet’s disease with neurological involvement, the patient was started on corticosteroids, with clinical, analytical and imagiologic improvement. Behçet’s disease can be very difficult to diagnose when the initial manifestation does not include the classic clinical triade of oral aphthous ulceration, genital ulcers and ocular disease.