RESUMO: O estudo de adaptabilidade, estabilidade e produtividade é importante para selecionar e recomendar genótipos superiores. Esse fato é particularmente válido para a introdução de cultivares de feijão comum no Rio de Janeiro, Brasil, cuja produção é ínfima e não atende a demanda interna. Assim, este trabalho teve como objetivo estimar parâmetros genéticos e ganhos de seleção e realizar uma seleção simultânea para adaptabilidade, estabilidade e produtividade de genótipos de feijão preto através de modelos mistos. O estudo foi realizado em três municípios do estado do Rio de Janeiro e em três anos agrícolas. Os ensaios foram instalados em delineamento de blocos casualizados com 11 genótipos e três repetições. Observou-se alta herdabilidade média (81%), acurácia seletiva (90%) e boas perspectivas de seleção. Também foram observados ganhos satisfatórios para a característica entre 1,03 e 9,49%. A seleção simultânea foi eficiente e permitiu selecionar duas linhagens de feijão preto CNFP (15290 e 15361) como sendo as mais produtivas, adaptáveis e estáveis e, portanto, têm potencial para serem lançadas como novas cultivares de feijão preto para o estado do Rio de Janeiro. RESUMO adaptabilidade superiores Brasil interna Assim mistos agrícolas 1 repetições Observouse Observou se 81%, 81 81% , (81%) 90% 90 (90% 103 03 1,0 949 9 49 9,49% 15290 (1529 15361 produtivas portanto 8 (81% (90 10 0 1, 94 4 9,49 1529 (152 1536 (81 (9 9,4 152 (15 153 (8 ( 9, 15 (1

ABSTRACT: The study of adaptability, stability, and productivity is essential for selecting and recommending superior genotypes. This fact is particularly the case for the introduction of common bean cultivars in Rio de Janeiro, Brazil, whose production is negligible and does not meet the internal demand. Thus, this study estimated genetic parameters and selection gains and undertake a simultaneous selection for adaptability, stability, and productivity in black bean genotypes via mixed models. The investigation was carried out in three municipalities in the state of Rio de Janeiro during three crop years. The trials were set up in a randomized block design with 11 genotypes and three replications. High mean heritability (81%) and selection accuracy (90%), as well as good selection prospects, were observed. Gains between 1.03 and 9.49% were achieved for grain yield. Simultaneous selection was efficient, indicating two black bean lines (CNFP 15290 and CNFP 15361) as the most productive, adaptable, and stable. As such, these lines have the potential to be released as new black bean cultivars for the state of Rio de Janeiro. ABSTRACT adaptability stability Brazil demand Thus models years 1 replications 81% 81 (81% 90%, 90 90% , (90%) prospects observed 103 03 1.0 949 9 49 9.49 yield efficient 1529 15361 productive adaptable stable such 8 (81 (90% 10 0 1. 94 4 9.4 152 1536 (8 (90 9. 15 153 ( (9

Abstract The surging health and financial costs of diseases, disabilities, and disparities support the global acceleration of interests and investments in health AI for better, cheaper, faster, and fairer health solutions globally and locally. Yet there is no consensus on practically operationalizing responsible AI principles across diverse global sectors, states, and belief systems. This proof-of-concept study utilizes the global pluralistic ethical framework (the Personalist Social Contract) to therefore provide the first known Bayesian augmented AI-driven Computational Ethical (AiCE) and policy analysis integrating clinical, cost effectiveness, and healthcare disparity analyses with nationally representative data to estimate the global cost of healthcare disparities in colonoscopy (CS) and the savings from AI-enabled CS to reduce them. It suggests that reversing racial disparities particularly for Hispanics and Asians may save American healthcare systems $17.61 billion annually, with AI-augmented CS potentially contributing savings of $625.40 million for Hispanics and $289.00 million for Asians in particular (with similar cost savings for vulnerable communities in middle and low-income countries also). The above findings support the cost savings imperative for such strategic and capacity-building investment in these AI-driven measures to improve healthcare’s strategic aims of Sustainability, Effectiveness, Efficiency, and Equity (SEEE). Such empirical results inform the larger global bioethical argument from the twin dimensions of human dignity and human security (rooted in the personalist, multicultural, and metaphysical account of the person as a member of the global human family) to highlight the AI ethical imperative to optimize the performance of the global digital health ecosystem. Such an instrumental end is a critical means of advancing toward the ultimate end of the common good, in which the individual good of each person is safeguarded and in which it finds her/his fulfillment working toward.

Resumen El aumento de los costos sanitarios y financieros de las enfermedades, las discapacidades y las disparidades respalda la aceleración mundial de los intereses y las inversiones en IA (inteligencia artificial) sanitaria para lograr soluciones sanitarias mejores, más baratas, más rápidas y justas a escala mundial y local. Sin embargo, no existe un consenso sobre la aplicación práctica de los principios de la IA responsable en diversos sectores, estados y sistemas de creencias de todo el mundo. Este estudio de prueba de concepto utiliza el marco ético pluralista global (el Contrato Social Personalista) para proporcionar, por tanto, el primer análisis conocido de ética computacional (AiCE, por sus siglas en inglés) y política basado en IA aumentada bayesiana que integra análisis clínicos, de rentabilidad y de disparidades en la atención sanitaria con datos representativos a nivel nacional para estimar el costo global de las disparidades en la atención sanitaria en la colonoscopia (CS, por sus siglas en inglés) y el ahorro de la CS habilitada por IA para reducirlas. El estudio sugiere que revertir las disparidades raciales, en particular entre hispanos y asiáticos, puede ahorrar a los sistemas sanitarios estadounidenses 17.610 millones de dólares al año, con un ahorro potencial de 625,40 millones de dólares para los hispanos y 289 millones de dólares para los asiáticos en particular (con un ahorro similar para las comunidades vulnerables en países de ingresos medios y bajos). Los resultados anteriores respaldan el imperativo de ahorro de costos que supone la inversión estratégica y de capacitación en estas medidas impulsadas por la IA para mejorar los objetivos estratégicos de sostenibilidad, eficacia, eficiencia y equidad (SEEE) de la atención sanitaria. Estos resultados empíricos informan el argumento bioético global más amplio de las dimensiones gemelas de la dignidad y la seguridad humanas (arraigadas en el relato personalista, multicultural y metafísico de la persona como miembro de la familia humana global) para destacar el imperativo ético de la IA para optimizar el rendimiento del ecosistema sanitario digital global. Semejante fin instrumental es un medio decisivo para avanzar hacia el fin último del bien común, en el que se salvaguarda el bien individual de cada persona y en el que éste encuentra su realización trabajando hacia él.

Abstract Introduction Myringoplasty is a common otologic procedure to restore the integrity of the tympanic membrane in cases of traumatic or pathologic perforations. Many grafting materials have been used with different techniques. Objective In the present work, we evaluate the surgical and audiological outcomes of periosteal graft overlying the mastoid cortex through a retroauricular incision in a pediatric cohort. Methods A retrospective study was carried out involving all children aged ≤ 16 years who underwent periosteal graft myringoplasty for the treatment of chronic suppurative otitis media with dry central perforation in our hospital from April 2019 to April 2021. All patients were followed up for one year to assess the anatomical success and functional outcomes by comparing the preoperative and postoperative (after six months) results of pure tone audiometry (PTA). Results The sample was composed of 36 patients; 20 of them were female (55.6%) and 16 were male (44.4%) subjects, with ages ranging from 7 to 16 (mean: 12.7) years. Four patients underwent surgery in both ears (with an interval of 6 to 9 months). Out of 40 surgeries performed, 38 ears have shown anatomical success (95%). A highly significant improvement in hearing was obtained (the mean difference between the pre- and postoperative results of the PTA was of 14.6 ± 3.45 dB (p < 0.001). Conclusion We advocate the use of periosteal graft in the pediatric population as a good alternative for other types of grafts, with comparable and even better functional and anatomical outcomes. perforations techniques work cohort 1 201 2021 after months PTA. . (PTA) 3 2 55.6% 556 55 (55.6% 44.4% 444 44 4 (44.4% subjects (mean 12.7 127 12 months. performed 95%. 95 95% (95%) pre 146 14 14. 345 45 3.4 p 0.001. 0001 0.001 0 001 0.001) grafts 202 (PTA 55.6 5 (55.6 44.4 (44.4 12. (95% 34 3. 000 0.00 00 55. (55. 44. (44. (95 0.0 (55 (44 (9 0. (5 (4 (

RESUMEN La subluxación atlantoaxial es la lesión más frecuente en la columna cervical causada por la artritis reumatoidea. Se manifiesta por rigidez de nuca, dolor cervical y déficit neurológico. El diagnóstico se realiza con tomografía computarizada e imágenes de resonancia magnética. El intervalo atlanto dental anterior mayor a 5mm indica inestabilidad atlantoaxial, el intervalo atlanto dental posterior menor a 14mm advierte riesgo neurológico. Las indicaciones más frecuentes de cirugía son: dolor cervical severo, inestabilidad y síntomas de mielopatía. Cuando existe compresión medular es necesaria la descompresión cervical alta sea por vía posterior o por vía anterior (odontoidectomía endonasal versus transoral). La línea rinopalatina nos indicará la factibilidad de una odontoidectomía endonasal endoscópica (OEE). El objetivo de la presentación del presente caso es compartir nuestra experiencia con la primera odontoidectomía endonasal endoscópica realizada en nuestro país y fomentar la utilización de la técnica. La cirugía fue realizada en un paciente con cuadriparesia espástica por subluxación atlantoaxial por artritis reumatoidea y que presentó excelente evolución pos operatoria, con recuperación casi completa. La OEE es una técnica operatoria mínimamente invasiva, ideal para pacientes con múltiples comorbilidades y que ofrece de buenos a excelentes resultados.

ABSTRACT Atlantoaxial subluxation is the most common injury to the cervical spine caused by rheumatoid arthritis. It is manifested by neck stiffness, neck pain and neurological deficit. Diagnosis is made with computed tomography and magnetic resonance imaging. The anterior dental atlanto interval greater than 5mm indicates atlantoaxial instability, the posterior dental atlanto interval less than 14mm warns of neurological risk. The most frequent indications for surgery are: severe neck pain, instability and symptoms of myelopathy. When there is spinal cord compression, upper cervical decompression is necessary, either via a posterior or anterior approach (endonasal versus transoral odontoidectomy). The rhinopalatine line will indicate the feasibility of an endoscopic endonasal odontoidectomy (EEO). The objective of the presentation of this case is to share our experience with the first endoscopic endonasal odontoidectomy performed in our country and to promote the use of the technique. The surgery was performed on a patient with spastic quadriparesis due to atlantoaxial subluxation due to rheumatoid arthritis and who presented excellent postoperative evolution, with almost complete recovery. EEO is a minimally invasive surgical technique, ideal for patients with multiple comorbidities and offering good to excellent results.

Resumen Presentamos un paciente con una rara enfermedad autoinflamatoria sistémica (deficiencia de mevalonato quinasa -DMQ-) con la identificación de dos variantes heterocigotas (c.1129G>A y c.32C>T) en el gen Meval onato Quinasa, detectadas por secuenciación masiva en paralelo y una glomerulonefritis de alta prevalencia (nefropatía por IgA). El paciente presentó un cuadro de fiebre periódica recurrente mensual desde los 12 días de vida, acompañada de lesiones mucocutáneas (rash maculopapular en extremidades, estomatitis aftosa), compromiso articular (artralgias en tobillos, muñecas y rodillas), linfoideo (linfoadenopatía cervical, esplenome galia), gastrointestinal (diarrea, dolor abdominal) y renal (hematuria y proteinuria) con repetidas biospias most rando nefropatía por IgA alternando actividad y cronic idad. Durante el seguimiento, tuvo una pobre respuesta terapéutica a múltiples esquemas inmunosupresores utilizados durante 7 años (corticoides, azatrioprina, micofenolato, ciclofosfamida, rituximab y tocilizumab), y buena respuesta finalmente a canakinumab. Cuatro años posteriores al inicio de canakinumab, durante el curso de una infección por un absceso muscular, el cuadro clínico se complica con un evento microvascular renal grave (necrosis cortical renal -NCR-) con fallo renal agudo y necesidad de diálisis. Los episodios recurrentes de inflamación por la DMQ podrían actuar como gatil los para la reactivación de su glomerulonefritis (lo que explicaría la escasa respuesta a inmunosupresores y la progresión rápida a cronicidad histológica) y para gen erar un microambiente que predisponga el desarrollo de una NCR ante una infección no grave. En la DMQ se ha descripto un defecto en las moléculas de IgA, fenómeno también observado en la nefropatía por IgA. Esto plantea la desafiante hipótesis de un vínculo patogénico común entre todas las manifestaciones clínicas del paciente.

Abstract We present a patient with a rare systemic autoinflam matory disease (mevalonate kinase deficiency -MKD-) with the identification of two heterozygous variants (c.1129G>A and c.32C>T) in the Mevalonate Kinase gene, detected by next generation sequencing and a highly prevalent glomerulonephritis (IgA nephropathy). The patient presents clinically with a monthly recurrent periodic fever from 12 days of age, accompanied by mucocutaneous lesions (maculopapular rash in ex tremities, aphthous stomatitis), joint (arthralgias in ankles, wrists and knees), lymphoid (cervical lymph adenopathy, splenomegaly), gastrointestinal (diarrhea, abdominal pain) and kidney (hematuria and protei-nuria) with repeated biopsies showing IgA nephropathy alternating activity with chronicity. During follow-up. The patients presented a poor therapeutic response to multiple immunosuppressive regimens used for 7 years (corticosteroids, azathioprine, mycophenolate, cyclo phosphamide, rituximab and tocilizumab), and finally a good response to canakinumab. Four years after starting canakinumab, during the course of an infection due to a muscle abscess, the clinical presentation is complicated by a severe renal microvascular event (renal cortical necrosis -RCN-) with acute kidney injury and dialysis requirement. Therecurrent episodes of inflammation due to MKD could act as triggers for the reactivation of glomerulonephritis (which would explain the poor response to immunosuppressants and the rapid pro gression to histological chronicity) and to generate a microenvironment that predisposes the development of RCN in the face of a non-serious infection. A defect in IgA molecules has been described in MKD, a phenom enon also observed in IgA nephropathy. This raises the challenging hypothesis of a common pathogenetic link between all the patient’s clinical manifestations.

RESUMEN Introducción: Las complicaciones de diabetes son una causa frecuente de discapacidad e invalidez. Objetivo: Determinar la supervivencia de la población con dictamen de invalidez por complicaciones de diabetes en el período 2016-2018. Métodos: Estudio observacional retrospectivo en población asegurada que recibió un dictamen de invalidez por complicaciones de diabetes mellitus tipo 2. Las variables estudiadas fueron: diagnósticos de los dictámenes de invalidez por complicaciones de diabetes tipo 2, años de supervivencia posteriores a la emisión del dictamen y características sociodemográficas. Resultados: Fueron 51 derechohabientes que recibieron un dictamen de invalidez por complicaciones de diabetes mellitus. Predominaron el sexo masculino y la edad promedio de 55,21 ± 9,14 años. El 72,6 % habita en zona urbana con buenas condiciones. Las complicaciones de diabetes más frecuentes fueron las circulatorias (33,3 %). El tiempo promedio de supervivencia fue de 4,7 años. Conclusiones: Se observaron diferencias en los tiempos medios de supervivencia entre las complicaciones retinopatía diabética vs complicaciones múltiples de diabetes que llevan al estado de invalidez. Los factores como el sexo o la situación geográfica del trabajador no influyen en el tiempo de supervivencia.

ABSTRACT Introduction: Complications of diabetes are a common cause of disability and invalidity. Objective: Determine the survival of the population insured by the Mexican Social Security Institute that received a disability ruling due to complications of type 2 diabetes mellitus at the Gineco-Pediatrics Hospital with Family Medicine No. 31 Mexicali Baja California in the period 2016-2018. Methods: Retrospective study in an insured population that received a disability ruling due to complications of type 2 diabetes mellitus. The variables studied were: diagnoses of the disability rulings due to complications of type 2 diabetes, years of survival after the ruling was issued, and characteristics. sociodemographic. Results: There were 51 beneficiaries who received a disability ruling due to complications of diabetes mellitus. Male sex predominated and the average age was 55.21 ± 9.14 years. 72.6% live in urban areas with good conditions. The most common diabetes complications were circulatory complications (33.3%). Average survival time was 4.7 years. Conclusions: Differences were observed in the mean survival times between diabetic retinopathy complications vs. multiple diabetes complications leading to disability. Factors such as the worker's sex or geographical location do not influence survival time.

The present work reports on the isolation and characterisation of two novel antiviral ester compounds from dichloromethane leaf extracts of Spondias mombin (SM). The characterisation and structural elucidation were established from spectroscopic evidence of nuclear magnetic resonance, Fourier transform infrared and mass spectroscopy. The compounds identified were 6-methylheptyl pentadecanoate and 6-methylheptyl-15-(1,2,3,4,4a,8a-hexahydronaphthalen-1-yl)pentadecanoate. The novel isolated ester compounds were reported to have anti-rhino virus activity in silico against a known biological target (HsNMT1) that plays a key role in developing therapeutics against the common cold. Molecular docking analysis revealed the binding affinity across all targets within the range of -4.6 to -8.2 kcal/mol, whilst molecular dynamic simulation showed that systems attained good stability due to the maintenance of mean root-mean-square deviation values within the acceptable range of 1.5-2.5 Å. It can be concluded that the novel compounds are potential inhibitory candidates against rhinovirus protein target HsNMT1. However, in vitro and in vivo experiments are further required to validate the possible inhibitory candidates against rhinovirus disease (common cold). SIGNIFICANCE: The significance of this study contributes to the scientific rationale for using SM leaf extracts to treat viral diseases. Two novel compounds, 6-methylheptyl pentadecanoate and 6-methylheptyl-15-(1,2,3,4,4a,8a-hexahydronaphthalen-1-yl)pentadecanoate, were predicted through computer-aided techniques to possess anti-rhinovirus properties.

ABSTRACT Purpose To assess the incidence of the most common intra- and early postoperative complications following RIRS in a large series of patients with kidney stones. Methods We conducted a retrospective analysis of patients with kidney stones who underwent RIRS across 21 centers from January 2018 to August 2021, as part of the Global Multicenter Flexible Ureteroscopy Outcome (FLEXOR) Registry. Results Among 6669 patients undergoing RIRS, 4.5% experienced intraoperative pelvicalyceal system bleeding without necessitating blood transfusion. Only 0.1% of patients, required a blood transfusion. The second most frequent intraoperative complication was ureteric injury due to the ureteral access sheath requiring stenting (1.8% of patients). Postoperatively, the most prevalent early complications were fever/infections requiring antibiotics (6.3%), blood transfusions (5.5%), and sepsis necessitating intensive care unit admission (1.3%). In cases of ureteric injury, a notably higher percentage of patients exhibited multiple stones and stone(s) in the lower pole, and these cases were correlated with prolonged lasing and overall surgical time. Hematuria requiring a blood transfusion was associated with an increased prevalence of larger median maximum stone diameters, particularly among patients with stones exceeding 20 mm. Furthermore, these cases exhibited a significant prolongation in surgical time. Sepsis necessitating admission to the intensive care unit was more prevalent among the elderly, concomitant with a significantly larger median maximum stone diameter. Conclusions Our analysis showed that RIRS has a good safety profile but bleeding requiring transfusions, ureteric injury, fever, and sepsis are still the most common complications despite advancements in technology. intra 2 201 2021 FLEXOR (FLEXOR Registry 666 45 4 5 4.5 01 0 1 0.1 1.8% 18 8 (1.8 patients. . patients) Postoperatively feverinfections fever infections 6.3%, 63 6.3% , 6 3 (6.3%) 5.5%, 55 5.5% (5.5%) 1.3%. 13 1.3% (1.3%) s stone(s pole time diameters mm Furthermore elderly diameter technology 202 66 4. 0. 1.8 (1. 6.3 (6.3% 5.5 (5.5% 1.3 (1.3% 1. (1 6. (6.3 5. (5.5 (1.3 ( (6. (5. (6 (5

Abstract Introduction Floods are a common phenomenon in flat ecosystems with deficiencies in river drainage, impacting the local and regional economy. They can be identified and analyzed by remote sensing. Objective The aim of this study was to evaluate the performance of two normalized water indices during periods of maximum and minimum annual precipitation for the identification of flooding in the Salado River Basin, Argentina. Materials and methods The years with maximum and minimum annual precipitation in the period 2001-2020 were derived from satellite estimates of monthly precipitation provided by NASA through Google Earth Engine. Floods were identified using Landsat images, applying two normalized water indices (NDWI -Normalized Difference Water Index- and modified NDWI) to evaluate their performance in generating binary images that better represent the reality of the study area. Results and discussion Both indices showed good capability in identifying permanent or semi-permanent watercourses and water bodies; however, only the NDWI demonstrated higher effectiveness in identifying flooded areas with shallow depths (5 to 15 cm). The use of the Landsat mid-infrared band (1 566 - 1 651 µm) is less sensitive to water sediment load and can reflect subtle differences in it, providing a greater ability to delineate the water-soil boundary. Conclusion The use of NDWI showed a suitable behavior for the identification of flooded areas in very low slope ecosystems

Resumen Introducción Los anegamientos son fenómenos frecuentes en ecosistemas llanos con deficiencias en el drenaje fluvial que afectan la economía local y regional. Estos pueden ser identificados y analizados mediante teledetección. Objetivo Evaluar el desempeño de dos índices normalizados de agua, en épocas de precipitación anual máxima y mínima, para la identificación de anegamientos en la cuenca del río Salado, Argentina. Materiales y métodos Los años con precipitación anual máxima y mínima en el periodo 2001-2020 se obtuvieron de estimaciones satelitales de precipitación mensual provistas por la NASA a través de Google Earth Engine. Los anegamientos se identificaron con imágenes Landsat, a través de la aplicación de dos índices normalizados de agua (NDWI, por sus siglas en inglés -Normalized Difference Water Index- y NDWI modificado) con la finalidad de evaluar su desempeño en la obtención de imágenes binarizadas que representen mejor la realidad del área de estudio. Resultados y discusión Ambos índices tuvieron buena capacidad para la identificación de los cursos y cuerpos de agua permanente o semipermanente; sin embargo, solo el NDWI demostró mayor capacidad para la identificación de áreas anegadas con escasa profundidad (5 a 15 cm). El empleo de la banda del infrarrojo medio de Landsat (1 566 - 1 651 µm) es menos sensible a la carga de sedimentos del agua y es capaz de reflejar diferencias sutiles en ella, lo que proporciona una mayor capacidad para delinear el límite agua-suelo. Conclusión El empleo del NDWI demostró un comportamiento adecuado para la identificación de zonas anegadas en ecosistemas de muy baja pendiente.

In this study, the analysis of metals in tap, river, wastewater, and sludge samples was conducted using ICP-OES after hotplate- or microwave-assisted digestion. Both digestion methods produced a good degree of accuracy, indicating their suitability for the analysis of the studied metals in water samples. From method development studies, 100 mL of HNO3 was found to be the optimum sample volume and acid type for digestion. The average concentrations obtained ranged from 4.9-410.8 μg/L, 5.9-465.0 μg/L, 3.6-425.4 μg/L, 16.1-647 μg/L and 9.7-784 μg/L in tap water, river, influent, effluent, and sludge samples, respectively. All metals were below their maximum permissible limits, with the exception of Mn in all sludge samples and Pb in all tap water, Umhlathuzana River, and Northern Works influent samples. Comparable recoveries and metal concentrations were obtained by microwave and hotplate methods, suggesting that the cheaper hotplate method can be used as an effective digestion method for daily analysis. Common anion concentrations obtained ranged from 0.03-23.5 mg/L, 0.02-3 064.67 mg/L, and 0.32-175.67 mg/L for tap, river, and wastewater samples, respectively. The anion concentrations were found to be below the maximum acceptable limits indicating no negative health effect on human and aquatic life, with the exception of Cl- and SO4(2-) in Amanzimtoti and Northern River water, respectively.

ABSTRACT Introduction: Meningitis, encephalitis and meningoencephalitis are caused by several pathogens, but viral etiology is the most common. Diagnosis consists of clinical history, observation of the patient and isolation of the agent. The virus is often not identified and is associated with significant morbidity and mortality. The long-term prognosis is not yet widely discussed, but the most common sequelae include difficulty concentrating, behavioral and/or speech disorders and memory loss. Many of these patients do not return to work and a good number of those who do that require some readjustment in their tasks. Case Report: This is a case of a 47-year-old nurse working in an Internal Medicine service, in which two weeks after providing care to a patient with meningoencephalitis, a condition compatible with the same diagnosis began. Because it is considered to be related to the health care provided, it is reported as a suspected Occupational Disease, but it is not recognized. After four years of initial participation, she started complaining of difficulty with attention and memory, with progressive evolution, being evaluated by Neurology, without conclusive results. Over this time it was necessary to restrict some nursing tasks, essentially due to memory difficulties. Due to worsening of complaints, five years after the first neurology evaluation, the patient is evaluated one more time. It is again reported as a suspected Occupational Disease, being recognized with a permanent partial disability of 82.5%. Discussion/ Conclusion: As infections are transmitted in the provision of healthcare, it is important to take into account measures that reduce transmissibility and protect Healthcare Professionals, for which the Occupational Health Service is fundamental, participating in diagnosis and referral, but essentially contributing to adaptation initial position of the job, keeping the worker active for as long as possible. The delay in recognizing the Occupational Disease results from the fact that the consequences only appear several years later and are progressive in nature. This case emphasizes the heavy burden of the sequelae of meningoencephalitis, resulting in a high degree of disability, incompatible with the continuous exercise of the profession. It was possible to establish the association with professional activity, which reinforces the risk to which Healthcare Professionals are exposed.

RESUMO Introdução: As meningites, encefalites e meningoencefalites são causadas por vários agentes patogénicos, mas a etiologia vírica é a mais comum. O diagnóstico consiste na história clínica, observação do doente e no isolamento do agente (mas muitas das vezes o vírus não é identificado), encontrando-se associado a morbilidade e mortalidade significativas. O prognóstico a longo prazo ainda não é muito discutido, mas as sequelas mais frequentes incluem dificuldade de concentração, distúrbios do comportamento e/ou da fala e perda de memória. Muitos destes doentes não regressam ao trabalho e uma boa parte dos que o fazem necessitam de algum reajuste nas tarefas. Descrição do Caso: Trata-se de um caso de uma enfermeira de 47 anos a laborar num internamento de Medicina Interna, em que duas semanas após prestar cuidados a doente com meningoencefalite, inicia quadro compatível com o mesmo diagnóstico. Por se considerar relação com os cuidados de saúde prestados, é participado como suspeita de Doença Profissional, mas não sendo reconhecida. Após quatro anos da participação inicial, inicia queixas de dificuldade de atenção e memória, com evolução progressiva, sendo avaliada por Neurologia, sem resultados conclusivos. Ao longo deste tempo foi necessário restringir algumas tarefas de enfermagem, essencialmente por dificuldades de memória. Por agravamento das queixas, cindo anos após a primeira avaliação de neurologia, é avaliada novamente por agravamento significativo da semiologia. É novamente participada como suspeita de Doença Profissional, sendo reconhecida com uma incapacidade permanente parcial de 82.5%. Discussão/ Conclusão: Enquanto infeções transmitidas na prestação de cuidados de saúde, é importante ter em conta medidas que diminuem a transmissibilidade e protegem os Profissionais de Saúde, para o qual o Serviço de Saúde Ocupacional é fundamental, participando no diagnóstico e encaminhamento, mas essencialmente contribuindo para a adaptação inicial do posto de trabalho, mantendo o trabalhador no ativo o máximo de tempo possível. O atraso no reconhecimento da Doença Profissional resulta do facto de as sequelas só se manifestarem vários anos após e serem de caráter progressivo. Este caso enfatiza o pesado fardo das sequelas da meningoencefalite, resultando num elevado grau de incapacidade, incompatível com o exercício contínuo da profissão. Foi possível estabelecer a associação com a atividade profissional, o que reforça o risco a que os Profissionais de Saúde estão expostos.

Abstract Amidst the crisis of ideologies and traditional conceptions about the state, liberal communitarianism develops an original political approach. Its central proposition is that a good society requires a balance between State, community, and market, rejecting both the minimal state and state-centrism. The present text seeks to answer the question: what elements are central to liberal communitarian theory in approaching the role of the State and its relations with the community and the market in contemporary societies? According to the exposition, the aspects that distinguish the communitarian formulation are: (i) the empirical analysis of the State has as its ethical-political reference the concept of the good society; (ii) democracy requires a responsive State, sensitive to the voice of communities; (iii) conversely to the politics of neutrality, the State is committed to a limited set of core values; (iv) the State fulfills fundamental functions, but, either strong or weak, its functions are always limited; (v) the fulfillment of collective needs and the common good requires a balance between State, community and market; (vi) to ensure peace in international relations requires the perspective of basic security, with the global political community as a horizon. The communitarian theory, which presents itself politically as a third way, brings relevant contributions to understanding current State dilemmas and examining future perspectives. The research technique is bibliographic. approach statecentrism. statecentrism centrism. centrism state-centrism question societies exposition i (i ethicalpolitical ethical ii (ii communities iii (iii neutrality values iv (iv but weak v (v vi (vi security horizon way perspectives bibliographic

Resumo Em meio à crise das ideologias e concepções tradicionais sobre o Estado, o comunitarismo liberal desenvolve uma abordagem política original. Sua proposta central é que uma boa sociedade requer um equilíbrio entre Estado, comunidade e mercado, rejeitando tanto o Estado mínimo quanto o estado-centrismo. No trabalho do sociólogo Amitai Etzioni, encontra-se a formulação política mais sistemática do pensamento comunitário. O presente texto busca responder a questão: que elementos são centrais na teoria comunitarista liberal na abordagem do papel do Estado e suas relações com a comunidade e o mercado nas sociedades contemporâneas? Segundo se expõe, os aspectos que distinguem a formulação comunitarista são: (i) a análise empírica do Estado tem como referência ético-política o conceito de boa sociedade; (ii) a democracia requer um Estado responsivo, sensível à voz das comunidades; (iii) ao contrário da política de neutralidade, o Estado está comprometido com um conjunto limitado de valores nucleares; (iv) o Estado cumpre funções fundamentais, mas, seja forte ou fraco, suas funções são sempre limitadas; (v) a satisfação das necessidades coletivas e do bem comum requer um equilíbrio entre Estado, comunidade e mercado; (vi) garantir a paz nas relações internacionais demanda a perspectiva da segurança básica, tendo a comunidade política global como horizonte. A teoria comunitarista, que se apresenta politicamente como uma terceira via, traz contribuições relevantes para compreender os dilemas atuais do Estado e examinar as perspectivas futuras. A técnica de pesquisa é bibliográfica. original estadocentrismo. estadocentrismo estado centrismo. centrismo estado-centrismo Etzioni encontrase encontra comunitário questão contemporâneas expõe i (i éticopolítica ético ii (ii responsivo comunidades iii (iii neutralidade nucleares iv (iv fundamentais mas fraco limitadas v (v vi (vi básica horizonte via futuras bibliográfica

Resumen Uno de los mayores retos de una cooperativa es la supervivencia, para lo que implementa estrategias como el trabajo colaborativo que le permita acceder a recursos para la solución de problemas colectivos, aunque en la mayoría de los casos, las relaciones no perduran. Existen empresas longevas, tanto en lo individual como en las relaciones con los colectivos con los que se integra, que cumplen los objetivos sociales, ambientales, organizacionales y económicos que se plantean. Un ejemplo de permanencia es la Unión de Cooperativas Tosepan Titataniske de Cuetzalan, Puebla, México, por lo que se eligió para un estudio de caso que permitiera comprender las características que les ha fortalecido. Se utilizaron la observación, revisión documental, un diario de campo y entrevistas semiestructuradas, que fueron analizadas con apoyo del software NVivo 12 ®. Los resultados muestran que los principios de vida de los pueblos originarios se han trasladado a la filosofía organizacional y a las redes estratégicas de las que forma parte, por lo que el Yeknemilis o buen vivir orienta las actividades conjuntas, fortalece las relaciones entre diferentes organizaciones y favorece la solución de problemas a partir de la construcción de una identidad colectiva y la búsqueda del bien común.

Abstract One of the biggest challenges a community enterprise faces is survival. In order to deal with it, it implements strategies such as collaborative work with different organizations, trying to access resources that make it possible to solve collective problems. However, in most cases, relationships E do not last. It was identified that there are companies that endure, both individually and in their relations with the groups with which they are integrated, achieving the fulfillment of the social, environmental, organizational and economic objectives they set out. Therefore, a case study was carried out in the Unión de Cooperativas Tosepan Titataniske in Cuetzalan, Puebla, México, to understand what characteristics have strengthened them. Observation, documentary review, a field diary and semi-structured interviews were used and analyzed with the support of NVivo 12 ® software. The results show that the principles of life of the native peoples have been transferred to the organizational philosophy and to the strategic networks of which they form part, so that the Yeknemilis or good living guides joint activities, strengthens relationships between different organizations and favors the solution of problems based on the construction of a collective identity and the search for the common good.

Abstract The article approaches population aging and euthanasia from an ethical perspective based on the principles of ontologically grounded personalist bioethics. The principles of dignity of the person, respect for physical life, solidarity, subsidiarity, justice and the common good are highlighted and shown how they apply in both contexts. The importance of an honest dialogue on euthanasia is emphasized, avoiding manipulation of language. It is emphasized that any discussion of euthanasia must be supported by thorough ethical reflection and that the rights of the elderly must be always protected. The article approaches these complex issues from a perspective that values the dignity and rights of older people and promotes their well-being, while thoughtfully and responsibly discussing the ethical issues surrounding euthanasia.

Resumen El artículo aborda el envejecimiento poblacional y la eutanasia desde una perspectiva ética basada en los principios de la bioética personalista ontológicamente fundamentada. Se resaltan los principios de la dignidad de la persona, el respeto a la vida física, la solidaridad, la subsidiariedad, la justicia y el bien común y se muestra cómo se aplican en ambos contextos. Se enfatiza la importancia de un diálogo honesto sobre la eutanasia, evitando la manipulación del lenguaje. Se destaca que cualquier discusión sobre la eutanasia debe ser respaldada por una reflexión ética profunda y que los derechos de las personas mayores deben protegerse en todo momento. El artículo aborda estas cuestiones complejas desde una perspectiva que valore la dignidad y los derechos de las personas mayores y promueva su bienestar, al tiempo que se discuten de manera reflexiva y responsable las cuestiones éticas en torno a la eutanasia.

ABSTRACT Introduction: Urethral stricture is a common, albeit complex, condition that predominantly affects men. The aim of this study was to translate, culturally adapt, and validate the Patient-Reported Outcome Measure questionnaire for patients undergoing urethroplasty (USS-PROM) into Brazilian Portuguese using validated psychometric criteria. Materials and Methods: The process involved translating and culturally adapting the original USS-PROM into Brazilian Portuguese (USS-PROMbr), synthesizing, back-translating, cross-culturally adapting, and analyzing the pre-final version with experts from our committee. This pre-version was administered to 10 patients who had undergone urethroplasty by the Reconstructive Urology team at the Hospital de Clínicas de Porto Alegre for face validation, linguistic, and semantic adjustments, resulting in the final USS-PROMbr version. Subsequently, well-established psychometric criteria, including content validity, internal consistency, and test-retest reproducibility, were assessed after administering the questionnaire to a total of 56 patients, with 50 of them responding to the test and retest. Results: Evaluation of the pre-final version identified 15 questions as clear, and only one question was considered somewhat unclear necessitating modifications based on patient suggestions and subsequent reassessment by the research team. Psychometric criteria demonstrated good content validity, with a content validity index exceeding 0.80 for all questions; good internal consistency, Cronbach's alpha of 0.77, ranging from 0.70 to 0.78 with the exclusion of any item, and item-total correlations ranging from 0.33 to 0.67. The test-retest intraclass correlation coefficient was 0.74 for the lower urinary tract symptoms construct (Q1-Q6). Conclusion: The USS-PROMbr demonstrated acceptable cross-cultural adaptation and psychometric properties, making it a valid and useful tool for evaluating patients undergoing urethroplasty. Introduction common complex men translate adapt PatientReported Patient Reported USSPROM USS PROM (USS-PROM Methods USSPROMbr, USSPROMbr PROMbr , (USS-PROMbr) synthesizing backtranslating, backtranslating back translating, back-translating crossculturally cross prefinal pre committee preversion 1 validation linguistic adjustments Subsequently wellestablished well established consistency testretest retest reproducibility 5 Results clear 080 0 80 0.8 Cronbachs Cronbach s 077 77 0.77 070 70 0.7 078 78 item itemtotal 033 33 0.3 067 67 0.67 074 74 Q1Q6. Q1Q6 QQ Q1 Q6 . Q (Q1-Q6) Conclusion crosscultural cultural properties (USS-PROMbr 08 8 0. 07 7 03 3 06 6 0.6 Q1Q (Q1-Q6 (Q1-Q