RESUMO Objetivo: Reconhecer e abordar a síndrome de Patau, apesar de sua raridade e da baixa expectativa de vida associada, por meio da apresentação de um estudo de caso de uma paciente de dois anos que recebe cuidados em casa por intermédio de serviços de home care. Descrição do caso: Apresentamos uma paciente do sexo feminino que desafiou as probabilidades, com sobrevivência prolongada devida, possivelmente, ao home care. Ela nasceu por cesariana, com 31 semanas + 4 dias, em razão da restrição do crescimento uterino. A mãe, de 36 anos, recebeu cuidados pré-natais adequados e gozava de boa saúde. O diagnóstico da síndrome de Patau foi confirmado por meio de cariótipo após o nascimento. Apesar da gravidade clínica do caso, a paciente, hoje com dois anos, recebe atendimento domiciliar especializado, apoiado por traqueostomia e gastrostomia. Um técnico de enfermagem dedicado 24 horas garante acompanhamento contínuo, e a paciente beneficia-se de check-ups médicos regulares, fisioterapia cinco vezes por semana, sessões semanais de fonoaudiologia, consultas mensais com nutricionista e apoio psicológico contínuo aos familiares. Comentários: Esta abordagem multidisciplinar resultou em melhora motora discreta, destacando o impacto positivo do cuidado integral no seu bem-estar geral. A existência de uma rede robusta de apoio às famílias que enfrentam desafios semelhantes é crucial, e um cuidado multidisciplinar pode prevenir eficazmente as complicações associadas a esta impactante síndrome. Objetivo associada care probabilidades devida possivelmente cesariana 3 dias uterino mãe prénatais pré natais saúde nascimento especializado gastrostomia 2 beneficiase beneficia se checkups check ups regulares semana fonoaudiologia familiares Comentários discreta bemestar bem estar geral crucial

ABSTRACT Objective: To recognize and address Patau’s syndrome, despite its rarity and associated low life expectancy, through the presentation of a case study of a 2-year-old patient receiving Home Care services. Case description: We present a female patient who defied the odds with a prolonged survival, possible due to Home Care. She was delivered via cesarean section at 31 weeks + 4 days due to restricted uterine growth. The mother, aged 36, had received proper prenatal care and was in good health. The diagnosis of Patau’s syndrome was confirmed through karyotyping after birth. Despite the severe clinical nature of the case, the patient, now with two years old, receives specialized home-based care, supported by a tracheostomy and gastrostomy. A dedicated 24-hour nursing technician ensures continuous monitoring, and the patient benefits from regular medical check-ups, physiotherapy five times a week, weekly speech therapy sessions, monthly consultations with a nutritionist, and ongoing psychological support for her family members. Comments: This multidisciplinary approach has resulted in a slight motor response, highlighting the positive impact of comprehensive care on her overall well-being. The existence of a robust support network for families facing similar challenges is crucial, and a multidisciplinary care can effectively prevent complications associated with this impactful syndrome. Objective Pataus Patau s expectancy 2yearold yearold 2 year old services description survival 3 growth mother 36 health birth homebased home based gastrostomy 24hour hour 24 monitoring checkups, checkups check ups, ups check-ups week sessions nutritionist members Comments response wellbeing. wellbeing well being. being well-being crucial

Abstract Introduction: The River Tambo basin is one of the main hydrographic systems of the Peruvian western watershed, being a source of development for agriculture, agroindustry, livestock, and domestic use in the Tambo Valley and Arequipa City. Objective: To analyze the structure of macroinvertebrates in River Tambo, Perú and assess the water quality through this community. Methods: Five sampling events were conducted between December 2018 and November 2019 in 12 stations, using a Surber net (500 μm). Macroinvertebrates were identified at a family level. To assess community structure, richness, Simpson’s dominance index (D), Pielou’s evenness (J’), and true diversity of order 1 were determined. A nMDS based on the Bray-Curtis index was used to evaluate dissimilarity. To check for differences in community structure, ANOSIM and two-way MANOVA were used. SIMPER was used to establish family contribution to sample similarity. Relations between physicochemical and biological variables were determined by CCA. ABI index was applied to assess ecological quality. Results: 32 families were recognized, being the most abundant: Baetidae, Chironomidae, Leptohyphidae, Simuliidae, Hydroptilidae, and Elmidae. The middle and low zones of the basin showed the highest and lowest diversity respectively. There were significant differences (P < 0.05) in the community structure indices among the 12 stations differed. There was a higher similarity among the 12 stations in December. ABI scores increased from the low to the middle part of the river, which showed the highest ecological quality. Conclusion: Macroinvertebrate communities from River Tambo reflect ecosystem conditions. Environments impacted by human activities show lower diversity and ecological quality, due to the structure, habitat, and water quality of the river being altered.

Resumen Introducción: La cuenca del rio Tambo es uno de los principales sistemas hidrográficos de la vertiente occidental del Perú y fuente de desarrollo para la agricultura, agroindustria, ganadería y consumo doméstico en el valle de Tambo y la ciudad de Arequipa. Objetivo: Analizar la estructura de macroinvertebrados en el río Tambo, Perú y evaluar la calidad del agua a través de esta comunidad. Métodos: Entre diciembre del 2018 y noviembre del 2019 se realizaron cinco muestreos en 12 estaciones, empleando una red Surber (500 μm). Los macroinvertebrados se identificaron a nivel de familia. Se registró la riqueza, dominancia de Simpson, equidad de Pielou, y diversidad verdadera de orden 1, para evaluar la estructura de la comunidad. Para estimar la similitud, se utilizó nMDS (índice de Bray-Curtis). Para verificar si existen diferencias en la estructura comunitaria, se empleó MANOVA de dos vías y ANOSIM. Para establecer la contribución de las familias a la similitud entre muestras, se utilizó SIMPER. La relación entre variables fisicoquímicas y biológicas se determinó con ACC. Se aplicó el índice ABI para evaluar la calidad ecológica. Resultados: se reconocieron 32 familias, siendo las más abundantes: Baetidae, Chironomidae, Leptohyphidae, Simuliidae, Hydroptilidae y Elmidae. La mayor y menor diversidad se presentó en la parte media y baja de la cuenca respectivamente. Existieron diferencias significativas (P < 0.05) de los índices de estructura comunitaria entre las 12 estaciones. Se evidenció mayor similitud entre las 12 estaciones en diciembre. Los puntajes del índice ABI se incrementan de la parte baja del río a la media, que se presentó la mejor calidad ecológica. Conclusión: Las comunidades de macroinvertebrados del río Tambo reflejan el estado del ecosistema. Los ambientes con impacto por actividad humana registran menor diversidad y calidad ecológica, ya que se altera la estructura, hábitat y calidad de agua del río.

SUMMARY OBJECTIVE: The objective of this study was to analyze the genetic alterations of tumors within the scope of the homologous recombination deficiency gene panel in patients diagnosed with synchronous endometrial ovarian cancer who have been followed for over 5 years using next-generation sequencing. METHODS: DNA was isolated from the patient’s formalin-fixed, paraffin-embedded tissue blocks. Next-generation sequencing was performed using the Illumina capture-based sequencing method. Samples were sequenced using the Sophia HR Solution DNA Kit. RESULTS: Seven patients were included in this study. The ratios of likely pathogenic (LP)/pathogenic (P) somatic mutations in ATM (serine/threonine kinase or Ataxia-telangiectasia mutated gene), BRCA2 (breast cancer type 2 susceptibility gene), BARD1 (BRCA1 associated RING domain 1), TP53 (tumor protein p53), BIRP1 (BRCA1-interacting helicase 1 gene), PALB2 (partner and localizer of BRCA2), and CHECK2 were 21 (48.8%), 8 (18.6%), 5 (11.6%), 3 (6.9%), 2 (4.6%), 2 (4.6%), and 2 (4.6%), respectively, in endometrium, and the ratios of somatic mutations in ATM, BRCA2, TP53, BARD1, RAD54L (DNA repair/recombination protein like), BIRP1, and RAD51D (RAD51 recombinase paralog D) were 24 (60%), 6 (15%), 5 (12.5%), 2 (5%), 2 (5%), 1 (2.5%), and 1 (2.5%), respectively, in ovary. In endometrioid-synchronous endometrial ovarian cancer cases, P/LP mutations were observed in ATM and CHECK2 genes in endometrium and ATM, BRCA2, and TP53 genes in ovary. In two non-endometrioid-synchronous endometrial ovarian cancer cases, CHEK2 (checkpoint kinase 2) mutations were observed in endometrium and ATM and TP53 mutations in ovary, whereas in one case, P/LP mutations in ATM and TP53 genes were common in both tissues. CONCLUSION: Pathogenic variations confirming the diagnosis of synchronous endometrial ovarian cancer with genetic alterations were identified in all but one case. ATM gene mutation emerged as the most common alteration and has a potential association with a favorable prognosis. OBJECTIVE nextgeneration next generation METHODS patient s formalinfixed, formalinfixed formalin fixed, fixed formalin-fixed paraffinembedded paraffin embedded blocks Nextgeneration Next capturebased capture based method Kit RESULTS LP/pathogenic LPpathogenic LP /pathogenic P (P serine/threonine serinethreonine serine threonine Ataxiatelangiectasia Ataxia telangiectasia gene, , gene) BRCA breast BARD BRCA1 (BRCA 1, 1) TP TP5 tumor p53, p53 p p53) BIRP BRCA1interacting BRCAinteracting interacting PALB partner BRCA2) CHECK 48.8%, 488 48.8% 48 (48.8%) 18.6%, 186 18.6% 18 (18.6%) 11.6%, 116 11.6% 11 (11.6%) 6.9%, 69 6.9% 9 (6.9%) 4.6%, 46 4.6% 4 (4.6%) respectively RADL RAD L repairrecombination repair like, like like) RADD D RAD51 (RAD5 60%, 60 60% (60%) 15%, 15 15% (15%) 12.5%, 125 12.5% 12 (12.5%) 5%, 5% (5%) 2.5%, 25 2.5% (2.5%) ovary endometrioidsynchronous endometrioid cases PLP nonendometrioidsynchronous non CHEK checkpoint case tissues CONCLUSION prognosis p5 48.8 (48.8% 18.6 (18.6% 11.6 (11.6% 6.9 (6.9% 4.6 (4.6% RAD5 (RAD (60% (15% 12.5 (12.5% (5% 2.5 (2.5% 48. (48.8 18. (18.6 11. (11.6 6. (6.9 4. (4.6 (60 (15 12. (12.5 (5 2. (2.5 (48. (18. (11. (6. (4. (6 (1 (12. ( (2. (48 (18 (11 (4 (12 (2

ABSTRACT. Oreochromis niloticus is the most important aquacultural species worldwide. Several countries are interested in repopulating natural or artificial reservoirs with the fry of tilapia (Oreochromis sp.) to develop new fisheries or to enhance the existing ones. However, as tilapia is considered an invasive species, it is essential to check the existence of the species in the place before releasing any fry. Characterization of tilapia species with meristic is unreliable because of existing morphological similarities among species. In this work, the composition of the tilapia species of Laguna El Mastranzo (LEM), Nayarit, Mexico, was explored for the first time through a molecular method using the mitochondrial DNA control region. Three tilapia species (Oreochromis niloticus, O. aureus, and O. urolepis) were found in LEM, and it was confirmed that the two commercial strains (Aquamol and Spring) intended for repopulation were O. niloticus. Seven haplotypes of mitochondrial DNA control region sequences were obtained: three in LEM, three in Aquamol, and one in Spring strains. Before repopulating any reservoir, a molecular verification strategy is recommended to avoid spreading the species. The results of this work represent a glimpse into the genetic material of LEM, Nayarit, Mexico.

Resumen La desnutrición infantil constituye un desafío de gran importancia en el ámbito de la salud pública. El objetivo de la investigación fue evaluar la influencia de los factores sociales y culturales en el estado nutricional en niños menores ecuatorianos de 2 años, en la ciudad de Portoviejo, Provincia de Manabí, durante el año 2023. Se realizó una investigación prospectiva, descriptiva, transversal y observacional. La población pediátrica incluyó 169 menores de dos años, cuyas madres proporcionaron los datos pertinentes. Los factores sociales predominantes fue el nivel educativo del cuidador del niño comprendida entre 7 a 12 años de estudios con la presencia de casos de desnutrición crónica en un 83,9%; además, la limitada contribución financiera del progenitor para la alimentación del infante con casos de desnutrición aguda en un 88,6%. Dentro de los factores culturales, se encontró que los niños con esquema de vacunación incompleto presentaban desnutrición crónica con un 88,7%, la falta de los controles prenatales, al igual que la inasistencia al primer control prenatal antes del quinto mes con casos de desnutrición aguda en un 95,5%; además, se evidenció que la estimulación para la ingesta de alimentos y la falta de práctica de la lactancia materna exclusiva con la presencia de desnutrición crónica en los menores, con un 98,4% y un 96,8%, respectivamente. En este entorno, el estado nutricional de mayor tendencia fue la desnutrición crónica con un 34,3%. Además, se identificó una asociación significativa de relación de dependencia (p<0,05) entre los factores sociales, culturales y el estado nutricional.

Abstract Child malnutrition constitutes a challenge of great importance in the field of public health. The objective of the research was to evaluate the influence of social and cultural factors on the nutritional status in Ecuadorian children under 2 years of age in the city of Portoviejo, Province of Manabí, during the year 2023. A prospective, descriptive, crooss-sectional and observational research was carried. The pediatric population included 169 children under two years of age, whose mothers provided the relevant data. The predominant social factors were the educational level of the child's caregiver, ranging from 7 to 12 years of education, with the presence of cases of chronic malnutrition in 83.9%; in addition, the limited financial contribution of the parent to feeding the infant with cases of acute malnutrition in 88.6%. Within the cultural factors, it was found that children with an incomplete vaccination presented chronic malnutrition with 88.7%, the lack of prenatal check-ups, as well as non-attendance at the first prenatal check-up before the fifth month with cases of malnutrition acute in 95.5%; Furthermore, it was evidenced that the stimulation of food intake and the lack of practice of exclusive breastfeeding with the presence of chronic malnutrition in minors, with 98.4% and 96.8%, respectively. In this environment, the most trending nutritional status was chronic malnutrition with 34.3%. In addition, a significant association of dependency relationship (p<0.05) was identified between social and cultural factors and nutritional status.

ABSTRACT Globalization and increasing demands on specialists determined the need to learn a foreign language in the modern world. Consequently, higher education institutions (HEIs) need to improve the educational programme for the preparation of future specialists for professional activities. The aim of this research was to determine the effectiveness of the use of modern digital technologies during the study of a foreign language by medical students and to identify the students’ personal attitude during the experiment. The research employed the methods of expert evaluation, pre- and post-testing (Common European Framework of Reference for Languages (CEFR)), a survey with the inclusion of a technology perception model. Cronbach’s alpha was used to check the reliability of the used questionnaires. Cohen’s kappa coefficient and Pearson’s chi-squared test were used for statistical processing of the results. The study found that students of the experimental group (EG) who studied using different digital technologies showed significant success in improving foreign language skills after the final test than students of the control group (CG). It is also worth noting that EG students were more motivated to use digital technologies after the experiment.The novelty of this study is that the study of English by medical students was carried out using digital technologies that were chosen according to the age, profession and foreign language proficiency level of the experimental sample of students. Prospects for further research may be to determine the effectiveness of artificial intelligence during foreign language learning by medical students.

RESUMEN La globalización y las crecientes exigencias a los especialistas determinaron la necesidad de aprender una lengua extranjera en el mundo moderno. En consecuencia, las instituciones de educación superior (IES) necesitan mejorar el programa educativo para la preparación de futuros especialistas para actividades profesionales. El objetivo de esta investigación fue determinar la efectividad del uso de tecnologías digitales modernas durante el estudio de una lengua extranjera por parte de estudiantes de medicina e identificar la actitud personal de los estudiantes durante el experimento. La investigación empleó los métodos de evaluación de expertos, pruebas previas y posteriores (Marco Común Europeo de Referencia para las Lenguas (MCER)), una encuesta con la inclusión de un modelo de percepción tecnológica. Se utilizó el alfa de Cronbach para comprobar la fiabilidad de los cuestionarios utilizados. Para el procesamiento estadístico de los resultados se utilizó el coeficiente kappa de Cohen y la prueba chi-cuadrado de Pearson. El estudio encontró que los estudiantes del grupo experimental (EG) que estudiaron utilizando diferentes tecnologías digitales mostraron un éxito significativo en mejorar sus habilidades en lenguas extranjeras después de la prueba final que los estudiantes del grupo de control (CG). También vale la pena señalar que los estudiantes de GE estaban más motivados para utilizar tecnologías digitales después del experimento. La novedad de este estudio es que el estudio del inglés por parte de estudiantes de medicina se realizó mediante tecnologías digitales que fueron elegidas según la edad, profesión y nivel de dominio de lengua extranjera de la muestra experimental de estudiantes. Las perspectivas para futuras investigaciones pueden ser determinar la efectividad de la inteligencia artificial durante el aprendizaje de lenguas extranjeras por parte de estudiantes de medicina.

ABSTRACT This paper analyzes the institutional legacy of the Bolsonaro government on Brazilian democracy, with effects on 2023 and beyond. Focusing on the rebalance of the power of the executive branch vis-a-vis other powers, we argue that Bolsonaro’s botched coup attempt exposed the limitations of existing regime safeguards. First, the activation of the military brought the shadow of raw power to the political table. Second, the increased leverage Congress now exercises over the executive has ambiguous effects on its willingness to check authoritarian overreaches from the President. Finally, we consider how the conflict between the past President and the Supreme Court has made the court more politicized, potentially affecting its public standing and making it a more likely target for future attacks within the political system. We suggest that, while democracy has resisted, it is not immune to backsliding. We briefly discuss how this reshuffling will shape the scenario for Lula’s presidency and the Worker's Party in the coming years.

RESUMEN Este artículo analiza el legado institucional del gobierno de Bolsonaro sobre la democracia brasileña, con efectos en 2023 y más allá. Enfocándose en el reequilibrio del poder del ejecutivo en relación con otros poderes, argumentamos que el fallido intento de golpe de Bolsonaro expuso las limitaciones de las salvaguardias del régimen existente. Primero, la activación de los militares trajo la sombra del poder bruto a la mesa política. Segundo, el mayor apalancamiento que el Congreso ahora ejerce sobre el ejecutivo tiene efectos ambiguos en su disposición para controlar los excesos autoritarios del Presidente. Finalmente, consideramos cómo el conflicto entre el expresidente y la Corte Suprema ha politizado más a la corte, afectando potencialmente su reputación pública y haciéndola un objetivo más probable para futuros ataques dentro del sistema político. Sugerimos que, aunque la democracia ha resistido, no es inmune a retrocesos. Discutimos brevemente cómo este reordenamiento dará forma al escenario para la presidencia de Lula y el Partido de los Trabajadores en los próximos años.

RESUMEN En un contexto local de estudios estrictamente tipológicos y con ausencia de manuales para el estudio de la cerámica relacionada con la cultura arqueológica Puruhá, Sierra Central del Ecuador, verificamos la posibilidad de asociar la cuestión teórica y metodológica con la práctica arqueológica, resultando en la ubicación de la producción cerámica como un subsistema intrínseco a la comprensión de los sistemas socioculturales que definen una cultura. Con esta premisa, este manuscrito presenta una propuesta de clasificación en arqueología basada en el análisis de la cultura material cerámica contextualizada o no contextualizada mediante la aplicación de los conceptos de antropología de técnicas y cadenas operativas asociadas a los análisis tecnotipológicos con el estudio de caso de la producción alfarera Puruhá. Teniendo como marco metodológico el método empírico inductivo, con un enfoque cualitativo que mezcla revisión de la literatura, inserción conceptual, técnica y análisis, con un alcance exploratorio y no experimental como diseño de investigación. La propuesta de clasificación en arqueología permitió verificar la factibilidad y potencial de su uso en un contexto Puruhá, así como su correlación con otros sitios, resultando en una lectura que permite hacer inferencias sobre continuidades y cambios culturales.

ABSTRACT In a local context of strictly typological studies and with the absence of manuals for the study of ceramics related to the Puruhá archaeological culture, Sierra Central do Ecuador, we verified the possibility of associating the theoretical and methodological issue with archaeological practice, resulting in the location of ceramic production as an intrinsic subsystem understanding the sociocultural systems that define a cultural. With this premise, this manuscript presents a proposal for classification in archeology based on the analysis of contextualized or non-contextualized ceramic material culture through the application of the concepts of anthropology of techniques and operational chains associated with techno-typological analyzes with the case study of production Puruhá potter. Having as a methodological framework the inductive empirical method, with a qualitative approach that mixes literature review, conceptual insertion, technique and analysis, with an exploratory and non-experimental scope as a research design. The proposed archeological classification allowed us to check the feasibility and potential of its usage in a Puruhá setting, as well as its linkage with other sites, yielding a reading that allows us to draw conclusions regarding cultural continuities and changes.

RESUMO Em um contexto local de estudos estritamente tipológicos e com a ausência manuais para o estudo da cerâmica relacionada a cultura arqueológica Puruhá, Serra Central do Equador, verificamos a possibilidade associar a questão teórica e metodológica à prática arqueológica, resultando na localização da produção ceramista como um subsistema intrínseco a compreensão dos sistemas socioculturais que definem uma cultural. Com esta premissa, este manuscrito apresenta uma proposta de classificação em arqueologia com fulcro na análise da cultura material cerâmica contextualizada ou não contextualizada por intermédio da aplicação dos conceitos de antropologia das técnicas e das cadeias operatórias associada às análises tecnotipológicas com o estudo de caso da produção ceramista Puruhá. Tendo como marco metodológico o método empírico indutivo, com enfoque qualitativo que mescla a revisão de literatura, inserção conceitual, técnica e análises, de alcance exploratório e não experimental enquanto desenho de investigação. A proposta de classificação em arqueologia possibilitou verificar a factibilidade e potencial de sua utilização em um contexto Puruhá, assim como sua correlação entre outros sítios, resultando em uma leitura que permite realizar inferências sobre continuidades e mudanças culturais.

Abstract This study aims to identify the differences between green marketing initiatives and greenwashing, as well as their implications for companies’ social and environmental development practices. It relies on data from Banco do Brasil S.A. and Natura & Co. A qualitative, descriptive and multiple case study was employed, involving an analysis of documents such as annual reports and other publicly available information on the companies’ websites. The documentary analysis was guided by the checklist developed from the theoretical review. The research findings indicate that both organisations analysed adhere to ethical principles when communicating their sustainability efforts in environmental and social dimensions, thus aligning with the green marketing model advocated in scientific literature and distancing them from the representation of greenwashing. Banco do Brasil and Natura & Co., as evidenced in reports available on their websites, demonstrate genuine actions and support projects in both social and environmental domains. Communication with the market and stakeholders includes verifiable details, sources, and documents, establishing credibility and affirming that the reported actions were indeed implemented. Consequently, it is possible to infer that the practices observed align with green marketing rather than greenwashing.

Resumo Este estudo tem como objetivo identificar as diferenças entre as ações de marketing verde e de tendência ao greenwashing, bem como suas implicações para as práticas de desenvolvimento socioambiental das empresas, com base em dados do Banco do Brasil S.A. e Natura & Co. Utilizou-se uma pesquisa qualitativa, descritiva e estudo de caso múltiplo, realizado com análise de documentos, como relatórios anuais, além de outras informações disponíveis aos consumidores pelas duas empresas em seus sites. A análise documental foi orientada pela check-list construída a partir da revisão teórica. A pesquisa evidenciou que as duas organizações analisadas seguem princípios éticos na publicização de suas ações no âmbito da sustentabilidade, nas dimensões ambiental e social, configurando desta forma o modelo de marketing verde, preconizado na literatura científica, distanciando-se da tipificação de greenwashing. Tanto o Banco do Brasil como a Natura & Co. demonstram, por meio de relatórios disponibilizados em seus sites, a realização de ações e apoio a projetos, tanto sociais, como ambientais, que, ao serem objeto de comunicação ao mercado e stakeholders, evidenciam características de veracidade, com indicação de fontes e documentos que comprovam a efetiva execução de ações citadas. Destarte, é possível inferir que se trata de marketing verde e não greenwashing.

Abstract Introduction: Chronic kidney disease is usually asymptomatic, and its diagnosis depends on laboratory tests, with emphasis on serum creatinine and proteinuria. Objective: To assess knowledge on the role of serum creatinine as a biomarker of kidney function in a sample of the Brazilian population. Method: Cross-sectional observational study conducted in São Paulo (SP, Brazil), in which a random adult population was interviewed. Results: A total of 1138 subjects were interviewed, with a median age of 36 years old (27–52); 55.1% were female. Regarding the “creatinine” biomarker, 40.6% stated they had never performed such a test. When asked about their knowledge on the usefulness of this exam, only 19.6% knew its function. The other responses were “I don’t know” (71.6%), evaluating heart function (0.9%) and liver function (7.8%). Of those who reported they had already taken a creatinine test, only 29.4% correctly identified the role of creatinine. When dividing the groups into “knows” and “does not know” the function of creatinine, a statistically significant difference (p < 0.05) was observed regarding level of education, female sex, being a healthcare student/worker, having ever measured creatinine, knowing someone with kidney disease and older age. In the multivariate analysis, the main variable related to knowing the creatinine role was having previously taken the test (OR 5.16; 95% CI 3.16–8.43, p < 0.001). Conclusion: There is a significant lack of knowledge about creatinine and its use in checkups. The results indicate that greater efforts are needed from healthcare professionals to raise awareness on the role of serum creatinine. Introduction asymptomatic tests proteinuria Objective Method Crosssectional Cross sectional SP, SP (SP Brazil, Brazil , Brazil) interviewed Results 113 3 27–52 2752 27 52 (27–52) 551 55 1 55.1 “creatinine 406 40 6 40.6 exam 196 19 19.6 I dont don t know 71.6%, 716 71.6% 71 (71.6%) 0.9% 09 0 9 (0.9% 7.8%. 78 7.8% . 7 8 (7.8%) 294 29 4 29.4 knows “knows does 0.05 005 05 education sex studentworker student worker student/worker analysis OR 5.16 516 5 16 95 316843 43 3.16–8.43 0.001. 0001 0.001 001 0.001) Conclusion checkups 11 27–5 275 2 (27–52 55. 40. 19. 71.6 (71.6% 0.9 (0.9 7.8 (7.8% 29. 0.0 00 5.1 51 31684 3.16–8.4 000 0.00 27– (27–5 71. (71.6 0. (0. 7. (7.8 5. 3168 3.16–8. (27– (71. (0 (7. 316 3.16–8 (27 (71 ( (7 31 3.16– (2 3.16 3.1 3.

Resumo Introdução: A doença renal crônica costuma ser assintomática e seu diagnóstico depende da realização de exames laboratoriais, com destaque para a creatinina sérica e pesquisa de proteinúria. Objetivo: Avaliar em uma amostra da população brasileira o conhecimento sobre o papel da creatinina sérica como marcador de função renal. Método: Estudo observacional transversal realizado na cidade de São Paulo (SP, Brasil), em que foi entrevistada uma população adulta aleatória. Resultados: Foram entrevistados 1138 indivíduos, com idade mediana de 36 anos (27–52); 55,1% do sexo feminino. Com relação ao marcador “creatinina”, 40,6% afirmaram que nunca realizaram tal dosagem. Quando questionados quanto ao conhecimento sobre a utilidade desse exame, somente 19,6% sabiam a sua função. As outras respostas foram “não sei” (71,6%), avaliar o funcionamento do coração (0,9%) e fígado (7,8%). Dos que afirmaram já terem realizado o exame de creatinina, somente 29,4% acertaram a função da creatinina. Ao dividir os grupos em “sabe” e “não sabe” a função da creatinina, percebeu-se diferença estatisticamente significante (p < 0,05) em relação ao grau de escolaridade, sexo feminino, ser aluno/trabalhador da saúde, ter dosado creatinina alguma vez, conhecer alguém com doença renal e maior idade. Na análise multivariada, a principal variável relacionada com conhecer a função da creatinina foi ter realizado o exame anteriormente (OR 5,16; IC 95% 3,16–8,43, p < 0,001). Conclusão: Há grande desconhecimento sobre a creatinina e seu uso em check-ups. Os resultados indicam que é necessário maior esforço por parte dos profissionais de saúde para divulgar o papel da creatinina sérica. Introdução laboratoriais proteinúria Objetivo Método SP, SP (SP Brasil, Brasil , Brasil) aleatória Resultados 113 indivíduos 3 27–52 2752 27 52 (27–52) 551 55 1 55,1 feminino “creatinina” 406 40 6 40,6 dosagem 196 19 19,6 não sei 71,6%, 716 71,6% 71 (71,6%) 0,9% 09 0 9 (0,9% 7,8%. 78 7,8% . 7 8 (7,8%) 294 29 4 29,4 sabe “sabe percebeuse percebeu se 0,05 005 05 escolaridade alunotrabalhador aluno trabalhador vez multivariada OR 5,16 516 5 16 95 316843 43 3,16–8,43 0,001. 0001 0,001 001 0,001) Conclusão checkups. checkups check ups. ups check-ups 11 27–5 275 2 (27–52 55, “creatinina 40, 19, 71,6 (71,6% 0,9 (0,9 7,8 (7,8% 29, 0,0 00 5,1 51 31684 3,16–8,4 000 0,00 27– (27–5 71, (71,6 0, (0, 7, (7,8 5, 3168 3,16–8, (27– (71, (0 (7, 316 3,16–8 (27 (71 ( (7 31 3,16– (2 3,16 3,1 3,

INTRODUCTION: The bone marrow is responsible for haemopoiesis, but when it fails, oral mucosal lesions may be seen due to reduced platelets, white blood cells, or red blood cells. AIMS AND OBJECTIVES: This study aims to report on three patients who presented with leukaemia, aplastic anaemia and neutropenia, respectively, with spontaneous bleeding, ulceration and mucosal pallor. DESIGN/METHODS: The oral mucosal features of three patients who presented at the University of Pretoria Oral Health Centre, with varying degrees of bone marrow failure, were recorded. Special investigations were performed to check their bone marrow function. The patients were managed collaboratively with their respective physicians. RESULTS: These cases demonstrate that dentists should be cognisant of disorders of bone marrow failure so that patients are a) diagnosed timely and appropriately, b) referred back to their treating clinician due to relapse of a known disease, or c) managed in collaboration with their treating clinician to confirm a suspected diagnosis. CONCLUSIONS: Dentists play a pivotal role in diagnosing haematological disease that results from bone marrow failure. Bleeding, ulceration and mucosal pallor are important diagnostic indicators of reduced platelet, neutrophil and red blood cell counts.

Abstract Scaptotrigona mexicana honey is characterized by its nutritional and antioxidant properties, but it has a high moisture content that affects its stability during storage. The objective of this work was to evaluate the physicochemical and antioxidant properties by UV-Visible spectroscopy, profile of phenolic compounds by ultra-high performance liquid chromatography coupled to mass spectrometry and fatty acids and volatile compounds by gas chromatography coupled to mass spectrometry, minerals by microwave plasma atomic emission spectroscopy, from honey stored in different containers that, along with traditional methods, are commonly used to increase its stability. Most physicochemical and antioxidant properties were not significantly different from those of freshly harvested honey. The results suggest that the packaging with an exhaust check valve has a significant effect on the decrease in moisture content and water activity, but not on the physicochemical and antioxidant properties for at least 2 yr of storage. These results suggest that the type of container should be considered when storing honey as it significantly (P<0.05) affects its properties and quality.

Resumen La miel de Scaptotrigona mexicana se caracteriza por sus propiedades nutricionales y antioxidantes, pero tiene un alto contenido de humedad que afecta su estabilidad durante el almacenamiento. El objetivo de este trabajo fue evaluar las propiedades fisicoquímicas y antioxidantes mediante espectroscopía UV-Visible, perfil de compuestos fenólicos por cromatografía líquida de ultra alta resolución acoplada a espectrometría de masas y ácidos grasos y compuestos volátiles mediante cromatografía de gases acoplada a espectrometría de masas, minerales por espectroscopía de emisión atómica de plasma de microondas, a partir de miel almacenada en diferentes recipientes que, junto con los métodos tradicionales, se utilizan comúnmente para aumentar su estabilidad. La mayoría de las propiedades fisicoquímicas y antioxidantes no fueron significativamente diferentes de las de la miel recién cosechada. Los resultados sugieren que el envase con válvula de retención de escape tiene un efecto significativo en la disminución del contenido de humedad y la actividad del agua, pero no en las propiedades fisicoquímicas y antioxidantes durante al menos 2 años de almacenamiento. Estos resultados sugieren que el tipo de recipiente debe considerarse al momento de almacenar la miel, ya que afecta significativamente (P<0.05) sus propiedades y calidad.

Abstract What kind of gestures were used in ancient comedy? Iconography gives us an idea of the body and costume of the comic actor. But beyond the fixity of images, how were gestures successively performed on stage? To answer this question, we need to consider the material context in which the plays were produced: the costumes, the masks, the rectangular orchestra, and the large audience. We must remember that gesture is above all a medium adapted to the space and to technical needs. In this article, I'd like to check whether the method I've applied so far to analyze kinesics in tragedy also works in the case of comedy. I study a scene from Aristophanes' Acharnians characterized by intense moves. I show that different types of gestures can be identified in the text: praxis gestures, modal gestures, mimetic gestures, and iconic gestures. Taken together, they allow us to better understand what the Athenian spectators had "in front of their eyes".

Résumé Comment nous représenter le type de gestualité mise en œuvre par la comédie ancienne ? L’iconographie nous offre une idée du corps et du costume de l’acteur comique. Mais la fixité des images (sans parler de leur origine et de leur datation différente) laisse en suspens la question de la réalisation scénique des gestes, et de leur succession. Pour répondre à cette question, il importe de prendre en compte le contexte matériel dans lequel étaient produites les pièces : les costumes, les masques, mais aussi le gradin élevé, l’orchêstra rectangulaire, le public nombreux. Il faut, pour reconstituer la gestualité antique, se rappeler qu’elle est avant tout un medium adapté à cet espace et répondant, par-delà les codes esthétiques, à des besoins techniques particuliers. Dans cet article, je souhaite observer si la méthode que j’ai appliquée jusqu’ici à la gestualité tragique fonctionne également dans le cas de la comédie. J’étudie une scène des Acharniens d’Aristophane caractérisée par son intense gestualité. Je montre qu’on peut identifier dans le texte différents types de gestes : gestes praxiques, modalisateurs, mimétiques, iconiques. Mis bout à bout, ils permettent de comprendre un peu mieux ce que le public athénien avait "devant les yeux".

Abstract American television fiction has constructed a stereotypical representation of women journalists. However, in recent decades, and partly thanks to the incorporation of women into the creation and executive production of the series, these models have been updated, giving greater prominence, complexity and dramatic richness to the female characters. The present study analyzes three American television fictions set in the world of journalism and created by women, Murphy Brown (Diane English), Good Girls Revolt (Dana Calvo) and Inventing Anna (Shonda Rhimes), to check if there are differences with respect to stereotypes gender and journalist models that have cha- racterized this type of characters over decades. Among the conclusions, it should be noted that the women creators of the series analyzed tend to reduce the androcentric approach with a more respectful and realistic treatment of female characters.

Resumen La ficción televisiva estadounidense ha construido una representación estereotipada de las mujeres periodistas. Sin embargo, en las últimas décadas, y en parte gracias a la incorporación de mujeres a la creación y producción ejecutiva de las series, se han actualizado estos modelos dando mayor protagonismo, complejidad y riqueza dramática a los personajes femeninos. El presente estudio analiza tres ficciones televisivas estadounidenses ambientadas en el mundo del periodismo y creadas por mujeres, Murphy Brown (Diane English), Good Girls Revolt (Dana Calvo) e Inventing Anna (Shonda Rhimes), para comprobar si existen diferencias respecto a los estereotipos de género y modelos de periodistas que han caracterizado a este tipo de personajes a lo largo de décadas. Entre las conclusiones, cabe señalar que las mujeres creadoras de las series analizadas tienden a reducir el enfoque androcéntrico con un tratamiento más respetuoso y realista de los personajes femeninos.

ABSTRACT Introduction: Spinal cord injury is any injury to the structures contained in the spinal canal (medulla, conus medullaris and cauda equina), which can lead to motor, sensory, autonomic and psycho-affective changes that cause physical, psychological and social repercussions. Studies indicate a fragility in the health care provided to patients with this type of disabling injury, in the context of Primary Health Care and the need for ongoing education actions on the subject of rehabilitation for Nurses. Despite being the gateway to health services and the first level of care for users within their territory, within their homes, these users still experience difficulties such as professional disqualification for providing comprehensive care to patients with spinal cord injuries. The aim of the study is to develop a scoping review protocol that will seek to identify and synthesize the available scientific evidence on nursing interventions focused on autonomy for daily activities of people with spinal cord injury in Primary Health Care. Methodology: The method proposed by JBI (Joanna Briggs Institute) will be used and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) extension will be used to systematize the information through the PRISMA ScR (Extension for Scoping Reviews) checklist, ensuring greater transparency and methodological rigor. This protocol will be indexed on the Open Science Framework platform. Results: The search for texts will be carried out in nine databases and gray literature. Three reviewers will carry out the analysis and selection of studies, with the help of the PRISMA Flow Diagram manager. Discrepancies will be resolved by a fourth reviewer. The data will be extracted according to the systematized form for data collection regarding the Scope Review and organized in Excel software, and the conclusions of the studies will be analysed with the help of software. Discussion: The results will be presented in a tabular and narrative format, aiming to achieve the objective and review question of this protocol. Conclusion: It is expected that the study will strengthen rehabilitation in Nursing practices in Primary Health Care by elucidating the need for training Specialist Nurses in Rehabilitation Nursing (SNRN) in Health Education actions.

RESUMO Introdução: A lesão da medula espinal é toda injúria às estruturas contidas no canal medular (medula, cone medular e cauda equina), podendo levar a alterações motoras, sensitivas, autonômicas e psicoafetivas e que causam repercussões físicas, psíquicas e sociais. Estudos apontam uma fragilidade na assistência à saúde do paciente com este tipo de lesão incapacitante, no contexto da Atenção Primária à Saúde e a necessidade de ações de educação permanente sobre o tema de reabilitação aos Enfermeiros. Apesar de ser a porta de entrada aos serviços de saúde e o primeiro nível de atenção ao usuário inserido em seu território, dentro de sua residência, esses usuários ainda vivenciam dificuldades como a desqualificação profissional para o atendimento integral ao paciente com lesão da medula espinal. O objetivo do estudo é desenvolver um protocolo de revisão de escopo que buscará identificar e sintetizar as evidências científicas disponíveis sobre as intervenções de enfermagem focadas na autonomia para atividades cotidianas de pessoas com lesão medular na Atenção Básica de Saúde. Metodologia: Será utilizado o método proposto pelo JBI (Joanna Briggs Institute) e para sistematização das informações será utilizada a extensão PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) através do check list PRISMA ScR (Extension for Scoping Reviews), garantindo maior transparência e rigor metodológico. O presente protocolo será indexado na plataforma Open Science Framework. Resultados: A busca dos textos será efetuada em nove bases de dados e na literatura cinzenta. Três revisores efetuarão a análise e seleção dos estudos, com auxílio do gerenciador de Diagrama de Fluxo PRISMA. Divergências serão dirimidas por um quarto revisor. Os dados serão extraídos conforme Ficha sistematizada para coleta dos dados referente à Revisão de Escopo e organizados no software Excel, e as conclusões dos estudos serão analisadas com auxílio de software. Discussão: Os resultados serão apresentados de modo tabular e narrativo, visando alcançar objetivo e questão de revisão deste protocolo. Conclusão: Espera-se que o estudo fortaleça a reabilitação nas práticas de Enfermagem na Atenção Primária à Saúde elucidando a necessidade de formação de Enfermeiros Especialistas em Enfermagem de Reabilitação (EEER) nas ações de Educação em Saúde.

RESUMEN Introducción: La lesión medular es cualquier lesión de las estructuras contenidas en el canal raquídeo (médula, cono medular y cola de caballo), que puede provocar cambios motores, sensoriales, autonómicos y psicoafectivos que provocan repercusiones físicas, psicológicas y sociales. Estudios señalan fragilidad en la atención a la salud brindada a los pacientes con este tipo de lesión incapacitante, en el contexto de la Atención Primaria de Salud y la necesidad de acciones de educación continua en materia de rehabilitación del Enfermero. A pesar de ser la puerta de entrada a los servicios de salud y el primer nivel de atención para los usuarios dentro de su territorio, dentro de sus hogares, estos usuarios aún experimentan dificultades como la inhabilitación profesional para brindar atención integral a pacientes con lesiones medulares. El objetivo del estudio es desarrollar un protocolo de revisión de alcance que buscará identificar y sintetizar la evidencia científica disponible sobre intervenciones de enfermería centradas en la autonomía para las actividades diarias de personas con lesión medular en Atención Primaria de Salud. Metodología: Se utilizará el método propuesto por JBI (Joanna Briggs Institute) y se utilizará la extensión PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) para sistematizar la información a través de la lista de verificación PRISMA ScR (Extension for Scoping Reviews), garantizando una mayor transparencia y rigor metodológico. Este protocolo estará indexado en la plataforma Open Science Framework. Resultados: La búsqueda de textos se realizará en nueve bases de datos y literatura gris. Tres revisores realizarán el análisis y selección de estudios, con la ayuda del gestor del Diagrama de Flujo PRISMA. Las discrepancias serán resueltas por un cuarto revisor. Los datos serán extraídos según el formulario sistematizado de recolección de datos de la Revisión de Alcance y organizados en software Excel, y las conclusiones de los estudios serán analizadas con ayuda de software. Discusión: Los resultados se presentarán en formato tabular y narrativo, con el objetivo de lograr el objetivo y la pregunta de revisión de este protocolo. Conclusión: Se espera que el estudio fortalezca la rehabilitación en las prácticas de Enfermería en la Atención Primaria de Salud, al dilucidar la necesidad de formación de Enfermeros Especialistas en Enfermería de Rehabilitación (EEER) en acciones de Educación en Salud.