Abstract Introduction: Pediatric patients with chronic kidney disease (CKD) develop mineral and bone disorders (MBD). We do not have Brazilian data that evaluate these outcomes, which can be obtained through epidemiological records. Objective: To present the DOMINÓ study, which aims to describe CKD-MBD characteristics in Brazilian pediatric patients. Methods: Retrospective and prospective, multicenter, observational cohort. The retrospective study will analyze data from prevalent patients in 2024, and the prospective study will analyze data from 2025 onwards. Demographic, clinical, laboratory, imaging, and bone biopsy data will be collected from pediatric patients with CKD-MBD < 18 years old with CKD stage 3-5D and kidney transplant recipients. The Ethics Committees of the participating centers approved the study. Discussion/conclusion: The DOMINÓ study will provide information on the incidence, prevalence, morbidity, treatment results, and mortality of this pediatric disease in Brazil. Future analyses will allow us to identify predictors of response to treatment and improve the care for these patients. Introduction (CKD MBD. MBD . (MBD) outcomes records Objective CKDMBD Methods multicenter cohort 2024 202 onwards Demographic clinical laboratory imaging 1 35D D 3 5D recipients Discussion/conclusion Discussionconclusion Discussion conclusion incidence prevalence morbidity results Brazil (MBD 20 2

Resumo Introdução: Pacientes pediátricos com doença renal crônica (DRC) evoluem com distúrbios minerais e ósseos (DMO). Não dispomos de dados brasileiros que avaliem esses desfechos; que podem ser obtidos por meio de registros epidemiológicos. Objetivo: Apresentar o projeto DOMINÓ, cuja proposta é descrever as características da DMO-DRC em pacientes pediátricos brasileiros. Métodos: Coorte retrospectiva e prospectiva, multicêntrica, observacional. O estudo retrospectivo analisará os dados dos pacientes prevalentes em 2024 e o prospectivo, os dados a partir de 2025. Serão coletados dados demográficos, clínicos, laboratoriais, de imagem e da biópsia óssea de pacientes pediátricos com DMO-DRC < 18 anos com DRC estágios 3-5D e dos transplantados renais. Os Comitês de Ética dos centros participantes aprovaram o estudo. Discussão/conclusão: O estudo DOMINÓ permitirá conhecer a incidência, prevalência, morbidade, resultados dos tratamentos e mortalidade dessa doença pediátrica no Brasil. Análises futuras permitirão identificar preditores de resposta ao tratamento e melhorar os cuidados com esses pacientes. Introdução (DRC DMO. DMO . (DMO) desfechos epidemiológicos Objetivo DMODRC Métodos prospectiva multicêntrica observacional 202 prospectivo 2025 demográficos clínicos laboratoriais 1 35D D 3 5D renais Discussão/conclusão Discussãoconclusão Discussão conclusão incidência prevalência morbidade Brasil (DMO 20 2

ABSTRACT Respiratory syncytial virus (RSV) infections constitute a significant cause of morbidity, hospitalization, school and work absenteeism, as well as mortality worldwide, including in Paraguay. Currently, tools for RSV prevention are available. In 2012, Paraguay approved the use of palivizumab (MedImmune, USA), a monoclonal antibody produced through recombinant DNA technology. This antibody is administered in 5 doses, every 30 days and is indicated in infants born prematurely and those with cardiopulmonary disorders. Furthermore, a novel tool for RSV prevention has recently become available. Nirsevimab, a long-acting monoclonal antibody specific to the prefusion conformation of the F protein, has been approved by both the European Medicines Agency (EMA) and the Food and Drug Administration (FDA). This monoclonal antibody is indicated for the prevention of acute lower respiratory tract infections caused by RSV in newborns and infants born during or entering their first RSV season, as well as in premature infants and infants up to 24 months of age who remain vulnerable to severe RSV disease during their second RSV season. After analyzing the epidemiological situation of RSV in our country and evaluating the evidence of efficacy, efficiency, and effectiveness of this monoclonal antibody, academic institutions, scientific societies, and non-governmental and governmental organizations developed consensus guidelines on a new prevention alternative for the prevention of RSV infections, suggesting the incorporation of Nirsevimab in children under 12 months of age before their first RSV season and replacing Palivizumab. The new monoclonal has the potential to change the panorama of RSV infections in infants and produce an impact on the reduction of infant mortality and morbidity reducing the burden on the health system by decreasing hospital bed occupancy both in wards and in intensive care units, as well as the decrease in the burden on caregivers, physicians and health care providers.

RESUMEN Las infecciones por el VSR en constituyen una causa importante de morbilidad, hospitalización, ausentismo escolar y laboral, así como de mortalidad, en el mundo, así como en el Paraguay.En la actualidad, existen herramientas para la prevención del VSR. En el año 2012, el Paraguay, ha incorporado el palivizumab (MedImmune, EE. UU.), anticuerpo monoclonal, producido por tecnología de DNA recombinante. Este anticuerpo se administra en 5 dosis, cada 30 días y está indicado en lactantes nacidos prematuros y aquellos con trastornos cardiopulmonares. Por otro lado, actualmente se cuenta con una nueva herramienta para la prevención del VSR. El anticuerpo monoclonal de vida media prolongada Nirsevimab, específico para la conformación de prefusión de la proteína F, aprobado por EMA y FDA. Este monoclonal, está indicado para la prevención de las Infecciones respiratorias agudas bajas, causada por VSR en recién nacidos y lactantes nacidos durante o al ingresar a su primera temporada de VSR, en prematuros y lactantes hasta los 24 meses de edad que siguen siendo vulnerables a la enfermedad grave por VSR durante su segunda temporada de VSR. Luego de analizar la situación epidemiológica del VSR en el país así como la evidencia de eficacia, eficiencia y efectividad de este monoclonal; instituciones académicas, sociedades científicas, organizaciones no gubernamentales y gubernamentales se reunieron y elaboraron un consenso interinstitucional para la prevención de las infecciones por VSR, sugiriendo la incorporación del Nirsevimab, en menores de 12 meses de edad antes de su primera temporada de VSR y en reemplazo del Palivizumab, debido a que el nuevo monoclonal tiene el potencial de cambiar el panorama de las infecciones por VSR en el lactante y producir un impacto en la reducción la mortalidad y morbilidad infantil; reduciendo la carga al sistema de salud, en lo que se refiere a la disminución de la ocupación de camas hospitalarias tanto en sala como en unidades de cuidados intensivos, así como la disminución de la carga para los cuidadores, médicos y proveedores de atención médica y la mortalidad infantil.

Abstract Introduction: Autoimmune hepatitis (AIH) has a spectrum of symptoms ranging from asymptomatic disease to acute severe hepatitis, chronic hepatitis, and decompensated cirrhosis. The acute presentation is not rare and could represent genuine acute AIH (GAAIH) or acute exacerbation of chronic autoimmune hepatitis. We aimed to identify the prevalence, clinical features, and prognostic factors associated with GAAIH and compare these cases with acute exacerbation of chronic AIH. Methods: This cross-sectional observational study evaluated patients with acute AIH presentation, defined as total bilirubin >5 times the upper limit of normality (xULN) and/or alanine aminotransferase >10 xULN, and no prior history of liver disease. Histology findings of acute disease defined GAAIH. Bivariate analyses were performed to identify factors associated with the GAAIH, when compared with acute exacerbation of chronic AIH. Results: Seventy-two patients with acute presentation of AIH were included and six (8.3%) of them presented GAAIH. Comparative analysis between patients with GAAIH and patients with acute exacerbation of chronic AIH revealed that prothrombin activity (96% [74-100] vs. 61% [10-100]; p = 0.003) and albumin levels (3.9 ± 0.2 g/dL vs. 3.4 ± 0.5 g/dL; p < 0.001) were higher in patients with GAAIH. The International Autoimmune Hepatitis Group score was higher in patients with acute exacerbation of chronic AIH (18.5 [8-23] vs. 16.5 [15-17]; p = 0.010). Compared to 15.2% of acute exacerbation of chronic AIH, complete therapeutic response to treatment was achieved in 67.7% of cases with GAAIH (p = 0.018). Conclusions: GAAIH was rare (8.3%), and patients with this presentation exhibited more preserved liver function tests, suggesting that most cases presenting with loss of function are acute exacerbation of chronic AIH. Additionally, patients with GAAIH had a better complete therapeutic response, suggesting a more preserved liver function at presentation, and early diagnosis has a positive therapeutic implication.

Resumo Introdução: A hepatite autoimune (HAI) apresenta um espectro de sintomas que varia de doença assintomática a hepatite aguda grave, hepatite crónica e cirrose descompensada. A apresentação aguda não é rara e pode representar hepatite autoimune aguda genuína (HAIAG) ou exacerbação aguda de hepatite autoimune crónica (EAHAIC). O nosso objetivo foi identificar a prevalência, caraterísticas clínicas e fatores prognósticos associados à HAIAG, e comparar esses casos com EAHAIC. Métodos: Estudo observacional, transversal, incluindo doentes com apresentação aguda de HAI, definida como bilirrubina total > 5 vezes o limite superior da normalidade (xLSN) e/ou ALT > 10 xLSN, e sem história prévia de doença hepática. HAIAG foi definida pela presença de achados histológicos de doença aguda. Análises bivariadas foram realizadas para identificar fatores associados à HAIAG, quando comparado com o EAHAIC. Resultados: Foram incluídos setenta e dois doentes com apresentação agu-da de HAI, dos quais seis (8.3%) com HAIAG. A análise comparativa entre doentes com HAIAG e doentes com EAHAIC mostrou que a atividade de protrombina (96%(74-100) versus 61% (10-100; p=0.003) e os níveis de albumina (3,9 ± 0,2 g/dL vs. 3,4 ± 0,5 g/dL; p < 0,001) foram significativamente mais elevados em pacientes com HAIAG. O score do Grupo Internacional de Hepatite Autoimune foi mais elevado em doentes com EAHAIC (18.5 (8-23) versus 16.5 (15-17); p=0.010). A resposta terapêutica completa ao tratamento foi alcançada em 66.7% dos casos de HAIAG (vs. 15,2% na EAHAIC, p=0,018). Conclusões: A HAIAG é rara (8.3%), e os doentes com esta apresentação mostraram testes de função hepática mais preservados, sugerindo que a maioria dos casos com perda de função são EAHAIC. Além disso, os doentes com HAIAG tiveram maior taxa de resposta terapêutica completa, sugerindo que uma função hepática mais preservada na apresentação e o diagnóstico precoce tem uma implicação terapêutica positiva.

ABSTRACT Objective Sexually transmitted infections (STIs) disproportionately affect transgender women and travestis (TGW), who often lack access to healthcare due to stigma and discrimination. We describe the approach and methodology of a study investigating the prevalence of syphilis, HIV, hepatitis A, B, and C, Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), and human papillomavirus (HPV) among TGW, as well as their knowledge and perceptions regarding syphilis, to better inform policies to curb STIs among this vulnerable population. Methods: TransOdara was a multicentric, cross-sectional study conducted among TGW in five capital cities from major Brazilian regions between December 2019 and July 2021. Self-identified transgender women and travestis aged >18 years were recruited using respondent-driven sampling after a qualitative formative phase, completed an interviewer-led questionnaire, were offered a physical examination, and were also asked to provide samples from multiple sites to detect various STIs, starting vaccination and treatment when indicated. Results: A total of 1,317 participants were recruited from the five study locations: Campo Grande (n=181, 13.7%), Manaus (n=340, 25.8%), Porto Alegre (n=192, 14.6%), Salvador (n=201, 15.3%), and São Paulo (n=403, 30.6%). The recruitment period varied at each study location due to logistic constraints imposed by the COVID-19 pandemic. Conclusion: Despite the enormous challenges posed by the co-occurrence of the COVID-19 pandemic and field work targeting a vulnerable, elusive, and scattered population, the TransOdara project has been effectively implemented. Caveats did not preclude 1,300 TGW from being interviewed and tested, amid a significant epidemic that disrupted health services and research projects in Brazil and worldwide.

RESUMO Objetivo As infecções sexualmente transmissíveis (IST) afetam desproporcionalmente as mulheres trans e travestis (MTT), que muitas vezes não têm acesso a cuidados de saúde devido ao estigma e à discriminação. Descrevemos a abordagem e a metodologia de um estudo que investigou a prevalência de sífilis, HIV, hepatite A, B e C, Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT) e papilomavírus humano (HPV) entre as MTT, bem como seu conhecimento e percepção sobre a sífilis, para melhor as políticas para redução de IST nessa população vulnerável. Métodos: TransOdara foi um estudo multicêntrico, transversal, realizado em cinco capitais das principais regiões brasileiras entre dezembro de 2019 e julho de 2021. Mulheres autoidentificadas como mulheres trans ou travestis, com idade >18 anos, foram recrutadas usando respondent-driven sampling, após uma fase de pesquisa formativa. Responderam a um questionário conduzido por entrevistadoras. Foi oferecida consulta médica, com exame físico, e solicitou-se que fornecessem amostras de vários locais para detectar as IST citadas. Quando indicado e consentido, foram iniciadas a vacinação e o tratamento. Resultados: Foram recrutadas 1.317 participantes nos cinco locais de estudo: Campo Grande (n=181, 13,7%), Manaus (n=340, 25,8%), Porto Alegre (n=192, 14,6%), Salvador (n= =201, 15,3%) e São Paulo (n=403, 30,6%). O período de recrutamento variou em cada local em razão de restrições logísticas impostas pela pandemia de COVID-19. Conclusão: Apesar dos enormes desafios colocados pela ocorrência simultânea da pandemia da COVID-19 e do trabalho de campo dirigido a uma população vulnerabilizada e dispersa, o projeto TransOdara foi eficazmente implementado. As adversidades não impediram que mais de 1.300 mulheres trans e travestis tenham sido entrevistadas e testadas em meio a uma epidemia de tal magnitude que perturbou os serviços de saúde e os projetos de pesquisa no Brasil e no mundo.

ABSTRACT We measured the optical properties of aerosols with two photoacoustic spectrometers operating at 532 and 870 nm wavelengths and sampled PM2.5 to analyze the organic carbon (OC) and elemental carbon (EC) content. The measuring site was in the southwest corner of Mexico City. We sorted the data by OC/EC ratios and calculated four mass absorption efficiencies (MAEs) for each wavelength with linear regressions. The MAEs ranged from 2.27 to 19.75 and 2.03 to 15.26 m2 g-1 at 532 and 870 nm, respectively, with determination coefficients above 0.88, showing that the amount of OC modifies the absorption properties of particles, sometimes underestimating or overestimating the black carbon concentration. It is possible to choose the MAE based on the daily median O3 concentration when there is no information about the EC and OC composition.

RESUMEN Medimos las propiedades ópticas de aerosoles con dos espectrómetros fotoacústicos que operaban a longitudes de onda de 532 y 870 nm y tomamos muestras de PM2.5 para analizar el contenido de carbono orgánico (OC, por su sigla en inglés) y carbono elemental (EC). El sitio de medición estaba en la esquina suroeste de la Ciudad de México. Ordenamos los datos por cocientes OC/EC y calculamos cuatro eficiencias de absorción de masa (MAE) para cada longitud de onda. Los diferentes MAE variaron de 2.27 a 19.75 m2 g-1 a 532 nm y 2.03-15.26 m2 g-1 a 870 nm, con coeficientes de determinación superiores a 0.88, lo que demuestra que la cantidad de OC modifica las propiedades de absorción de las partículas, en ocasiones subestimando o sobreestimando la concentración de carbono negro. Se puede elegir un MAE con base en la concentración mediana diaria de O3 si no hay información sobre la composición de EC y OC de los aerosoles atmosféricos.

Abstract Anthropogenic interventions have had a compromising effect on environmental health, intensifying the degradation of ecosystems, and the quantity of chemical pollutants released into nature. Therefore, research areas within the scope of environmental assessments and monitoring such as ecotoxicology have contributed to the determination of the toxic potential of contaminants. A small cyprinid known as the zebrafish (Danio rerio), the use of which has exponentially grown, is an alternative vertebrate model for scientific research, mainly in the assessment of environmental risks. The species exhibits several advantages for breeding in a laboratory, in addition to presenting multi-biomarkers of environmental toxicity. Thus, this review aims to present the main characteristics and advantages of working with this species, as well as show studies related to ecotoxicology involving biomarkers of toxicity in zebrafish. The results show a progressive trend towards employing the species in environmental risk analyses, it is an increasingly recommended species in the assessment of the toxicity level of a range of chemical pollutants. The development of future technologies must contribute to scientific advancement, rendering the potential application of this model organism an even more widespread one, which will certainly help in bridging knowledge gaps in various areas of study. health ecosystems nature Therefore contaminants Danio rerio, rerio , rerio) grown risks laboratory multibiomarkers multi Thus analyses advancement one study

RESUMO Objetivo: Relatar as adaptações realizadas na Técnica de Grupo Nominal (TGN) original, permitindo sua aplicação ao formato virtual, preservando todos os seus elementos-chave. Método: Relato de experiência sobre as adaptações e adequações realizadas na TGN original ao formato virtual aplicando as Tecnologias da Informação e Comunicação (TIC), por meio de ferramentas digitais disponibilizadas gratuitamente ou de baixo custo e de fácil manejo. Resultados: A TGN foi realizada integralmente de forma virtual e sofreu adaptações em cada uma das suas quatro etapas através da incorporação de recursos digitais específicos. Foi possível apresentar as ideias mais votadas e obter a aprovação final dos participantes. Os participantes não apresentaram dificuldade para utilizar os recursos virtuais disponibilizados, e, partir da avaliação de reação, mostram-se satisfeitos com as ferramentas disponibilizadas. Conclusão: A TGN adaptada mostrou-se um método efetivo quando utilizada em cenário virtual, sendo capaz de produzir um significativo número de ideias e desenvolver consenso. A ferramenta adaptada pode ser usada por outros pesquisadores em países com recursos ou dimensões semelhantes ao Brasil. Objetivo (TGN elementoschave. elementoschave elementos chave. chave elementos-chave Método TIC, TIC , (TIC) manejo Resultados específicos disponibilizados reação mostramse mostram se Conclusão mostrouse mostrou consenso Brasil (TIC

ABSTRACT Objective: To report on the adaptations made to the original Nominal Group Technique (NGT), allowing it to be applied to the virtual format, preserving all its key elements. Method: An experience report on the adaptations and adjustments made to the original NGT to the virtual format using Information and Communication Technologies (ICT), using digital tools that are available free of charge or are low cost and easy to use. Results: The NGT was carried out entirely virtually and underwent adaptations in each of its four stages through the incorporation of specific digital resources. It was possible to present the most voted ideas and obtain final approval from the participants. The participants had no difficulty in using the virtual resources provided and, based on the reaction evaluation, they were satisfied with the tools provided. Conclusion: The adapted NGT proved to be an effective method when used in a virtual setting, capable of producing a significant number of ideas and developing consensus. The adapted tool can be used by other researchers in countries with similar resources or dimensions to Brazil. Objective NGT, , (NGT) elements Method ICT, ICT (ICT) use Results evaluation Conclusion setting consensus Brazil (NGT (ICT

RESUMEN Objetivo: Informar sobre las adaptaciones realizadas a la Técnica de Grupo Nominal (TGN) original, permitiendo su aplicación al formato virtual, preservando todos sus elementos clave. Método: Se trata de un informe de experiencia sobre las adaptaciones y ajustes realizados a la TGN original para el formato virtual mediante el uso de las Tecnologías de la Información y la Comunicación (TIC), utilizando herramientas digitales disponibles de forma gratuita o de bajo coste y fácil uso. Resultados: El TGN se realizó íntegramente de manera virtual y sufrió adaptaciones en cada una de sus cuatro etapas mediante la incorporación de recursos digitales específicos. Fue posible presentar las ideas más votadas y obtener la aprobación final de los participantes. Los participantes no tuvieron dificultades para utilizar los recursos virtuales proporcionados y, según los comentarios recibidos, se mostraron satisfechos con las herramientas facilitadas. Conclusión: El TGN adaptado demostró ser un método eficaz cuando se utiliza en un entorno virtual, capaz de producir un número significativo de ideas y desarrollar el consenso. La herramienta adaptada puede ser utilizada por otros investigadores en países con recursos o dimensiones similares a las de Brasil. Objetivo (TGN clave Método TIC, TIC , (TIC) Resultados específicos recibidos facilitadas Conclusión consenso Brasil (TIC

Abstract Mental Health Promotion initiatives in schools are described in the international literature as a model of proven efficiency. However, few Brazilian studies are dedicated to this subject, especially concerning multi-agency collaboration between CAPSi and the educational sector. This study assumes that one of the main barriers highlighted in this collaboration refers to the low apprehension, by the psychosocial care network, about the psychosocial challenges in schools. Therefore, through focus groups, this research investigated the main challenges and latent potentialities in the school environment to support the elaboration of health promotion initiatives in schools, according to professionals from a public school in Rio de Janeiro. The results indicate that violence and school conflicts are the main challenges. As a way of coping with such problems, we highlight the overcoming of contact barriers between the different cultures in the school, the increase and democratization of the participation of students and their families in the school routine, and the permanent multi-agency collaboration between the psychosocial network and the school network.

Resumo As práticas de Promoção de Saúde Mental em escolas são descritas na literatura internacional como modelo de comprovada eficiência. Entretanto, ainda são escassos os estudos brasileiros dedicados ao tema, sobretudo no âmbito da articulação intersetorial entre os CAPSi e o setor escolar. Neste estudo, parte-se do pressuposto de que um dos principais entraves evidenciados nesta articulação remete à baixa apreensão, por parte das redes de atenção psicossocial, sobre os desafios de ordem psicossocial presentes nas escolas. Portanto, esta pesquisa investigou, por meio de grupos focais, quais são, na percepção de profissionais de uma escola pública do Rio de Janeiro, os principais desafios e potencialidades latentes no ambiente escolar, com vistas a fundamentar a elaboração de iniciativas de promoção de saúde mental em escolas. Os resultados apontam que a violência e os conflitos escolares constituem os principais desafios a serem enfrentados. Como forma de enfrentá-los, destaca-se a superação das barreiras de contato entre as diferentes culturas presentes na escola, o incremento e a democratização da participação de alunos e familiares no cotidiano escolar, e a colaboração intersetorial permanente entre a rede psicossocial e a rede escolar.

Objective: To investigating the relationship between α-Klotho and FGF-23 with bone biochemical markers and bone density findings in extremely aged individuals. Methods: A total of 55 individuals with a mean age of 85.6 years were subjected to clinical, biochemical, and bone mineral density analyses and the enzyme-linked immunosorbent assay-based detection of α-Klotho and FGF-23. The mean, standard deviation, median, and interquartile ranges of the sample values were determined, and Spearman's test for association assessments was used for statistical analysis. Results: The study participants expressed median FGF-23 and α-Klotho levels of 69.81 RU/mL (51.43 RU/mL) and 733.43 pg/mL (360.83 pg/mL), respectively. The majority of the participants possessed osteopenia (54.5%) and a vitamin D deficiency (57%). The 25-hydroxyvitamin D concentrations ranged between 7.1 and 47.5ng/mL, with a median of 18.1ng/mL. Conclusion: No substantial associations were discovered between α-Klotho and FGF-23 levels and bone density in the study participants. Objective αKlotho α Klotho FGF23 FGF 23 FGF-2 Methods 5 856 85 6 85. clinical enzymelinked enzyme linked assaybased assay based FGF23. 23. deviation determined Spearmans Spearman s analysis Results 6981 69 81 69.8 RUmL RU mL 51.43 5143 51 43 (51.4 73343 733 733.4 pgmL pg 360.83 36083 360 83 (360.8 pg/mL, , pg/mL) respectively 54.5% 545 54 (54.5% 57%. 57 57% . (57%) 25hydroxyvitamin hydroxyvitamin 25 71 7 1 7. 475ngmL ngmL 47 5ng ng 47.5ng/mL 181ngmL 18 1ng 18.1ng/mL Conclusion FGF2 2 FGF- 8 698 69. 51.4 514 4 (51. 7334 73 733. 360.8 3608 36 (360. 54.5 (54.5 (57% 51. (51 360. 3 (360 54. (54. (57 (5 (36 (54 ( (3

RESUMO Objetivo As infecções sexualmente transmissíveis (IST) afetam desproporcionalmente as mulheres trans e travestis (MTT), que muitas vezes não têm acesso a cuidados de saúde devido ao estigma e à discriminação. Descrevemos a abordagem e a metodologia de um estudo que investigou a prevalência de sífilis, HIV, hepatite A, B e C, Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT) e papilomavírus humano (HPV) entre as MTT, bem como seu conhecimento e percepção sobre a sífilis, para melhor as políticas para redução de IST nessa população vulnerável. Métodos: TransOdara foi um estudo multicêntrico, transversal, realizado em cinco capitais das principais regiões brasileiras entre dezembro de 2019 e julho de 2021. Mulheres autoidentificadas como mulheres trans ou travestis, com idade >18 anos, foram recrutadas usando respondent-driven sampling, após uma fase de pesquisa formativa. Responderam a um questionário conduzido por entrevistadoras. Foi oferecida consulta médica, com exame físico, e solicitou-se que fornecessem amostras de vários locais para detectar as IST citadas. Quando indicado e consentido, foram iniciadas a vacinação e o tratamento. Resultados: Foram recrutadas 1.317 participantes nos cinco locais de estudo: Campo Grande (n=181, 13,7%), Manaus (n=340, 25,8%), Porto Alegre (n=192, 14,6%), Salvador (n= =201, 15,3%) e São Paulo (n=403, 30,6%). O período de recrutamento variou em cada local em razão de restrições logísticas impostas pela pandemia de COVID-19. Conclusão: Apesar dos enormes desafios colocados pela ocorrência simultânea da pandemia da COVID-19 e do trabalho de campo dirigido a uma população vulnerabilizada e dispersa, o projeto TransOdara foi eficazmente implementado. As adversidades não impediram que mais de 1.300 mulheres trans e travestis tenham sido entrevistadas e testadas em meio a uma epidemia de tal magnitude que perturbou os serviços de saúde e os projetos de pesquisa no Brasil e no mundo. (IST MTT , (MTT) discriminação sífilis HIV A C NG, NG (NG) CT (CT HPV (HPV vulnerável Métodos multicêntrico transversal 201 2021 18 >1 anos respondentdriven respondent driven sampling formativa entrevistadoras médica físico solicitouse solicitou se citadas consentido tratamento Resultados 1317 1 317 1.31 n=181, n181 n 181 (n=181 13,7%, 137 13,7% 13 7 13,7%) n=340, n340 340 (n=340 25,8%, 258 25,8% 25 8 25,8%) n=192, n192 192 (n=192 14,6%, 146 14,6% 14 6 14,6%) n= (n =201 15,3% 153 15 3 n=403, n403 403 (n=403 30,6%. 306 30,6% . 30 30,6%) COVID19. COVID19 COVID 19. 19 Conclusão COVID-1 dispersa implementado 1300 300 1.30 mundo (MTT (NG 20 202 > 131 31 1.3 n=181 n18 (n=18 13,7 n=340 n34 34 (n=34 25,8 2 n=192 n19 (n=19 14,6 =20 15,3 n=403 n40 40 (n=40 30,6 COVID1 COVID- 130 1. n=18 n1 (n=1 13, n=34 n3 (n=3 25, n=19 14, =2 15, n=40 n4 4 (n=4 30, n=1 n=3 = n=4

ABSTRACT Objective Sexually transmitted infections (STIs) disproportionately affect transgender women and travestis (TGW), who often lack access to healthcare due to stigma and discrimination. We describe the approach and methodology of a study investigating the prevalence of syphilis, HIV, hepatitis A, B, and C, Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), and human papillomavirus (HPV) among TGW, as well as their knowledge and perceptions regarding syphilis, to better inform policies to curb STIs among this vulnerable population. Methods: TransOdara was a multicentric, cross-sectional study conducted among TGW in five capital cities from major Brazilian regions between December 2019 and July 2021. Self-identified transgender women and travestis aged >18 years were recruited using respondent-driven sampling after a qualitative formative phase, completed an interviewer-led questionnaire, were offered a physical examination, and were also asked to provide samples from multiple sites to detect various STIs, starting vaccination and treatment when indicated. Results: A total of 1,317 participants were recruited from the five study locations: Campo Grande (n=181, 13.7%), Manaus (n=340, 25.8%), Porto Alegre (n=192, 14.6%), Salvador (n=201, 15.3%), and São Paulo (n=403, 30.6%). The recruitment period varied at each study location due to logistic constraints imposed by the COVID-19 pandemic. Conclusion: Despite the enormous challenges posed by the co-occurrence of the COVID-19 pandemic and field work targeting a vulnerable, elusive, and scattered population, the TransOdara project has been effectively implemented. Caveats did not preclude 1,300 TGW from being interviewed and tested, amid a significant epidemic that disrupted health services and research projects in Brazil and worldwide. (STIs , (TGW) discrimination syphilis HIV B C NG, NG (NG) CT, CT (CT) HPV (HPV population Methods multicentric crosssectional cross sectional 201 2021 Selfidentified Self identified 18 >1 respondentdriven respondent driven phase interviewerled interviewer led questionnaire examination indicated Results 1317 1 317 1,31 locations n=181, n181 n 181 (n=181 13.7%, 137 13.7% 13 7 13.7%) n=340, n340 340 (n=340 25.8%, 258 25.8% 25 8 25.8%) n=192, n192 192 (n=192 14.6%, 146 14.6% 14 6 14.6%) n=201, n201 (n=201 15.3%, 153 15.3% 15 3 15.3%) n=403, n403 403 (n=403 30.6%. 306 30.6% . 30 30.6%) COVID19 COVID 19 COVID-1 Conclusion cooccurrence co occurrence elusive implemented 1300 300 1,30 tested worldwide (TGW (NG (CT 20 202 > 131 31 1,3 n=181 n18 (n=18 13.7 n=340 n34 34 (n=34 25.8 2 n=192 n19 (n=19 14.6 n=201 n20 (n=20 15.3 n=403 n40 40 (n=40 30.6 COVID1 COVID- 130 1, n=18 n1 (n=1 13. n=34 n3 (n=3 25. n=19 14. n=20 n2 (n=2 15. n=40 n4 4 (n=4 30. n=1 (n= n=3 n=2 n=4 n= (n

Abstract Cardiac amyloidosis (CA) is an infiltrative cardiomyopathy that affects the heart mostly in two forms: immunoglobulin light chain amyloidosis (AL-CM) and transthyretin amyloidosis. Transthyretin amyloid cardiomyopathy (ATTR-CM) predominantly affects the elderly population, mainly men (about 70-80%), and usually manifests with symptoms of heart failure (HF). Despite technological advances in medicine, CA is still an underdiagnosed condition, especially in women, partly due to the known male predominance and high level of suspicion required for diagnosis. It is important to remember that amyloidosis is a systemic disease with a heterogeneous and non-specific presentation. It’s worth paying attention to the patient’s medical history and red flags in clinical and diagnostic tests (electrocardiogram [ECG], echocardiogram [ECHO], cardiac magnetic resonance [CMR]). Accurate and timely diagnosis is crucial for appropriate management and prognosis. So far, the under-representation of women in clinical trials may have also limited the evidence on sex-specific diagnosis, and outcomes. (CA forms ALCM AL CM (AL-CM ATTRCM ATTR (ATTR-CM population about 7080%, 7080 70 80% , 80 70-80%) HF. HF . (HF) medicine condition nonspecific non specific presentation Its s patients patient electrocardiogram ECG, ECG [ECG] ECHO, ECHO [ECHO] CMR. CMR [CMR]) prognosis far underrepresentation under representation sexspecific sex outcomes 7080% 708 7 8 70-80% (HF [ECG [ECHO [CMR] 70-80 [CMR 70-8 70-

RESUMO Objetivos: Avaliar carga de trabalho e gravidade dos pacientes na Unidade de Terapia Intensiva (UTI) com COVID-19. Método: Estudo transversal, analítico realizado na UTI em hospital privado. Incluídos todos os pacientes maiores de 18 anos, com diagnóstico de COVID-19 admitidos de setembro de 2020 a junho de 2021. Carga de trabalho avaliado pelo Nursing Activities Score (NAS), e gravidade pelo Sequential Organ Failure Assessment. Realizado análises descritiva e inferencial. Resultados: Incluídos 217 pacientes, maioria homens, média de idade 62,41 anos, brancos, obesos, não tabagistas e sedentários. A média do NAS foi 84,79. O dimensionamento de pessoal estava em concordância com legislação e NAS. O NAS não foi associado a gravidade. Houve associação da gravidade com maior idade, sexo, comorbidades, sedentarismo, tempo de ventilação mecânica, internação e óbito. Conclusão: A carga de trabalho foi alta e não associada a gravidade e desfechos. A gravidade foi associada às condições demográficas e clínicas. Este estudo mostra a importância do dimensionamento de pessoal, com vistas à promoção da segurança e qualidade assistencial. Objetivos (UTI COVID19. COVID19 COVID 19. 19 Método transversal privado 1 anos COVID-1 202 2021 NAS, , (NAS) Assessment inferencial Resultados 21 homens 6241 62 41 62,4 brancos obesos sedentários 8479 84 79 84,79 sexo comorbidades sedentarismo mecânica óbito Conclusão desfechos clínicas assistencial COVID1 COVID- 20 (NAS 2 624 6 4 62, 847 8 7 84,7 84,

ABSTRACT Objective: To evaluate the workload and severity of patients in the Intensive Care Unit (ICU) with COVID-19. Method: Cross-sectional, analytical study carried out in the ICU of a private hospital. All patients over the age of 18 with a diagnosis of COVID-19 admitted from September 2020 to June 2021 were included. Workload assessed by the Nursing Activities Score (NAS), and severity by the Sequential Organ Failure Assessment. Descriptive and inferential analyses were performed. Results: 217 patients were included, mostly men, mean age 62.41 years, white, obese, non-smokers and sedentary. The average NAS was 84.79. Staffing was in line with legislation and NAS. NAS was not associated with severity. Severity was associated with higher age, gender, comorbidities, sedentary lifestyle, time on mechanical ventilation, hospitalization and death. Conclusion: Workload was high and not associated with severity or outcomes. Severity was associated with demographic and clinical conditions. This study shows the importance of staff sizing, with a view to promoting safety and quality of care. Objective (ICU COVID19. COVID19 COVID 19. 19 Method Crosssectional, Crosssectional Cross sectional, sectional Cross-sectional hospital 1 COVID-1 202 included NAS, , (NAS) Assessment performed Results 21 men 6241 62 41 62.4 years white obese nonsmokers non smokers 8479 84 79 84.79 gender comorbidities lifestyle ventilation death Conclusion outcomes conditions sizing care COVID1 COVID- 20 (NAS 2 624 6 4 62. 847 8 7 84.7 84.

RESUMEN Objetivo: Evaluar la carga de trabajo y la gravedad de los pacientes de la Unidad de Cuidados Intensivos (UCI) con COVID-19. Método: Estudio transversal y analítico realizado en la UCI de un hospital privado. Se incluyeron todos los pacientes mayores de 18 años con diagnóstico de COVID-19 ingresados entre septiembre de 2020 y junio de 2021. Carga de trabajo evaluada mediante la Nursing Activities Score (NAS), y gravedad mediante la valoración secuencial de fallo orgánico. Se realizaron análisis descriptivos e inferenciales. Resultados: Se incluyeron 217 pacientes, en su mayoría hombres, edad media 62,41 años, raza blanca, obesos, no fumadores y sedentarios. El NAS medio era de 84,79. Los niveles de personal se ajustaban a la legislación y al NAS. El NAS no se asoció con la gravedad. La gravedad se asoció a mayor edad, sexo, comorbilidades, sedentarismo, tiempo de ventilación mecánica, hospitalización y muerte. Conclusión: La carga de trabajo fue elevada y no se asoció a la gravedad ni a los resultados. La gravedad se asoció a las condiciones demográficas y clínicas. Este estudio muestra la importancia del dimensionamiento del personal, con vistas a promover la seguridad y la calidad de los cuidados. Objetivo (UCI COVID19. COVID19 COVID 19. 19 Método privado 1 COVID-1 202 2021 NAS, , (NAS) orgánico inferenciales Resultados 21 hombres 6241 62 41 62,4 blanca obesos sedentarios 8479 84 79 84,79 sexo comorbilidades sedentarismo mecánica muerte Conclusión resultados clínicas cuidados COVID1 COVID- 20 (NAS 2 624 6 4 62, 847 8 7 84,7 84,

Resumo Hypostomus está distribuído por bacias da América Central e do Sul, com grande diversidade de espécies com conflitos taxonômicos. Desta forma, a integração de técnicas auxiliares contribui para a compreensão da sistemática e filogenia do grupo. Assim, este estudo teve como objetivo investigar Hypostomus cochliodon e H. boulengeri do riacho Onça (bacia do rio Paraguai) por meio de técnicas aloenzimáticas e citogenéticas. As análises citogenéticas em H. boulengeri mostraram número cromossômico igual a 2n = 68 (14m+14sm+18st+22a), sistema de NOR múltiplo revelado por Ag-NOR e 18S-FISH, um polimorfismo de heterocromatina em acrocêntricos e a presença de microcromossomos Bs. Hypostomus cochliodon mostrou um número diploide de 64 cromossomos (16m+26sm+14st+8a); apesar do sistema de NOR simples, alguns indivíduos apresentaram NOR em ambos os telômeros detectados por Ag-NOR e 18S-FISH. Uma isozima identificou dois loci diagnósticos (Idh-A and Gdh-A) entre as duas espécies e múltiplos loci com alelos únicos em H. boulengeri. A variabilidade genética indicada pela heterozigosidade média (He) foi de 0,2461 e 0,0309 em H. boulengeri e H. cochliodon, respectivamente. Assim, este estudo relata os primeiros dados citogenéticos para H. boulengeri e os primeiros dados isoenzimáticos para H. boulengeri e H. cochliodon. As duas espécies apresentaram evidentes diferenças citogenéticas e isoenzimáticas com a obtenção de marcadores genéticos exclusivos fornecendo suporte para futuros estudos evolutivos no grupo. Sul taxonômicos forma grupo Assim H bacia Paraguai n 6 14m+14sm+18st+22a, 14m14sm18st22a msmsta 14m+14sm+18st+22a , 14m 14sm 18st 22a m sm st (14m+14sm+18st+22a) AgNOR Ag 18SFISH, 18SFISH SFISH 18S FISH, FISH S 18S-FISH Bs 16m+26sm+14st+8a 16m26sm14st8a 16m 26sm 14st 8a (16m+26sm+14st+8a) simples 18SFISH. FISH. IdhA Idh GdhA Gdh Gdh-A He (He 02461 0 2461 0,246 00309 0309 0,030 respectivamente (14m+14sm+18st+22a (16m+26sm+14st+8a 0246 246 0,24 0030 030 0,03 024 24 0,2 003 03 0,0 02 2 0, 00

Abstract Hypostomus is distributed by Central and South America basins, with diverse species with taxonomic conflicts. This way, the integration of auxiliary techniques contributes to understanding the systematics and phylogeny of the group. Thus, this study aimed to investigate the Hypostomus cochliodon and H. boulengeri from the Onça stream (Paraguai River basin) by allozyme and cytogenetic techniques. Hypostomus boulengeri showed a diploid number of 68 chromosomes (14m+14sm+18st+22a), multiple NOR revealed by Ag-NOR and 18S rDNA FISH, a polymorphism of heterochromatin in acrocentrics and the presence of B microchromosome. Hypostomus cochliodon showed a diploid number of 64 chromosomes (16m+26sm+14st+8a); despite the single NOR, some individuals showed NOR in both telomeres detected by Ag-NOR and 18S rDNA FISH. Isozyme identified two diagnostic loci (Idh-A and Gdh-A) between the two species and multiple loci with unique alleles in H. boulengeri. The genetic variability indicated by the mean heterozygosity (He) was 0.2461 and 0.0309 in H. boulengeri and H. cochliodon,respectively.Thus, this study reports the first cytogenetic data for H. boulengeri and the first isozymatic data for H. boulengeri and H. cochliodon. The two species presented evident cytogenetic and isoenzymatic differences with the obtaining of exclusive genetic markers providing support for future evolutionary studies in the group. basins conflicts way group Thus H Paraguai basin 6 14m+14sm+18st+22a, 14m14sm18st22a msmsta 14m+14sm+18st+22a , 14m 14sm 18st 22a m sm st (14m+14sm+18st+22a) AgNOR Ag S FISH microchromosome 16m+26sm+14st+8a 16m26sm14st8a 16m 26sm 14st 8a (16m+26sm+14st+8a) IdhA Idh A GdhA Gdh Gdh-A He (He 02461 0 2461 0.246 00309 0309 0.030 cochliodonrespectivelyThus respectively cochliodon,respectively.Thus (14m+14sm+18st+22a (16m+26sm+14st+8a 0246 246 0.24 0030 030 0.03 024 24 0.2 003 03 0.0 02 2 0. 00

BACKGROUND Leishmania (Viannia) braziliensis Thor strain exhibits a heterogeneous composition comprised of subpopulations with varying levels of infectivity. Clonal subpopulations were previously obtained from the strain Thor by sorting single-parasites and proceeding cultivation. The subpopulations used in this study are named Thor03, Thor 10 and Thor22. OBJECTIVES Phenotypic characteristics of the parasite, specially focusing on virulence factors and resistance to the antimicrobial mechanisms of macrophages, were investigate in these subpopulations. METHODS Cellular and molecular biology, as well as biochemistry approaches were applied to obtain the data analysed in this study. FINDINGS Relative quantification of gene expression was measured for calpain, cysteine protease B (CPB), and subtilisin proteases but no significant differences in these genes’ expression among subpopulations was observed. However, subtilisin and CPB proteins were assessed as more abundant in Thor03 by fluorescence-labelled flow cytometry technique. Western Blotting assays, as semi-quantitative analysis in gel, showed higher concentrations of subtilisin (110 to 50 kDa) and CPB (40 to 18 kDa) in extract of intracellular amastigotes from subpopulations Thor03 and Thor10 and calpain (60 to 25 kDa) showed no significant differences among subpopulations. Complementary, higher trypanothione reductase activity was observed in Thor10 intracellular amastigotes and assays of susceptibility to hydrogen peroxide-inducing agents and nitric oxide donors conducted with promastigotes revealed greater resistance to in vitro oxidative stress induction for Thor10, followed by Thor03. MAIN CONCLUSIONS The data obtained for the virulence factors explored here suggest how multiple coexisting phenotypic-distinct subpopulations may contribute in adaptability of a single L. (V.) braziliensis strain during infection in the host cells. Viannia (Viannia infectivity singleparasites parasites cultivation 1 Thor22 parasite macrophages biology CPB, , (CPB) genes However Thor0 fluorescencelabelled fluorescence labelled technique semiquantitative semi quantitative gel 110 (11 5 kDa 40 (4 Thor1 60 (6 2 Complementary peroxideinducing peroxide inducing phenotypicdistinct phenotypic distinct L V. V (V. cells Thor2 (CPB 11 (1 4 ( 6 (V