Resumo A Hipereosinofilia (HE) é definida como uma contagem de eosinófilos superior a 1500 células/microL no sangue periférico em dois exames, realizados com intervalo mínimo de um mês e/ou confirmação anatomopatológica de HE, com eosinófilos compreendendo mais de 20% de todas as células nucleadas da medula óssea. A Síndrome hipereosinofílica (SHE) indica a presença de HE com comprometimento de órgãos por ação eosinofílica, podendo ser classificada como primária (ou neoplásica), secundária (ou reativa) e idiopática. O comprometimento cardíaco ocorre em até 5% dos casos na fase aguda e em 20% na fase crônica da doença, variando de casos oligossintomáticos até miocardite aguda fulminante ou cardiomiopatia restritiva crônica (endomiocardite de Loeffler). No entanto, o grau de disfunção cardíaca não se correlaciona diretamente com o grau de eosinofilia. O envolvimento cardíaco na SHE ocorre em três fases: necrótica inicial, trombótica e necrótica final. Pode se manifestar como insuficiência cardíaca, arritmias e fenômenos tromboembólicos. O diagnóstico de cardiopatia é baseado em métodos de imagem multimodalidade, com ênfase na importância do ecocardiograma transtorácico (ETT). Em pacientes com janela acústica limitada, podem ser utilizados agentes de contraste ultrassonográfico, que permitem melhor visualização das bordas endocárdicas e da região ventricular apical. Técnicas para análise da deformação miocárdica podem evidenciar redução do strain em segmentos apicais e preservação nos demais segmentos (reverse apical sparing). A ressonância magnética cardíaca permite a caracterização do realce tardio subendocárdico de gadolínio, e a biópsia endomiocárdica é considerada o padrão ouro no diagnóstico de cardiopatia. O tratamento é baseado na etiologia da SHE. (HE 150 célulasmicroL microL exames eou 20 óssea (SHE eosinofílica neoplásica, neoplásica , neoplásica) reativa idiopática 5 doença endomiocardite Loeffler. Loeffler . Loeffler) entanto eosinofilia fases inicial final tromboembólicos multimodalidade ETT. ETT (ETT) limitada ultrassonográfico reverse sparing. sparing sparing) gadolínio 15 2 (ETT 1

Abstract Hypereosinophilia (HE) is defined as an eosinophil count exceeding 1500 cells/microL in peripheral blood in two tests, performed with an interval of at least one month and/or anatomopathological confirmation of HE, with eosinophils comprising more than 20% of all nucleated cells in the bone marrow. Hypereosinophilic syndrome (HES) indicates the presence of HE with organ involvement due to eosinophil action, which can be classified as primary (or neoplastic), secondary (or reactive), and idiopathic. Cardiac involvement occurs in up to 5% of cases in the acute phase and 20% of the chronic phase of the disease, ranging from oligosymptomatic cases to fulminant acute myocarditis or chronic restrictive cardiomyopathy (Loeffler endomyocarditis). However, the degree of cardiac dysfunction does not directly correlate with the degree of eosinophilia. The cardiac involvement of HES occurs in three phases: initial necrotic, thrombotic, and finally necrotic. It can manifest as heart failure, arrhythmias, and thromboembolic phenomena. The diagnosis of cardiopathy is based on multimodality imaging, with an emphasis on the importance of echocardiography (echo) as the primary examination. TTE with enhanced ultrasound agents can be used for better visualization, allowing greater accuracy in assessing ventricular apex, and myocardial deformation indices, such as longitudinal strain, may be reduced, especially in the ventricular apex (reverse apical sparing). Cardiac magnetic resonance imaging allows the characterization of subendocardial late gadolinium enhancement, and endomyocardial biopsy is considered the gold standard in diagnosing cardiopathy. Treatment is based on the etiology of HES. (HE 150 cellsmicroL microL tests andor 20 marrow (HES action neoplastic, neoplastic , neoplastic) reactive, reactive reactive) idiopathic 5 disease Loeffler endomyocarditis. endomyocarditis . endomyocarditis) However eosinophilia phases necrotic thrombotic failure arrhythmias phenomena echo (echo examination visualization indices strain reduced reverse sparing. sparing sparing) enhancement 15 2 1

Abstract The antiulcer mechanisms of the dry extract of T. erecta flowers (DETe) were studied here. The acute ulcers induced by acidified ethanol or indomethacin were reproduced in mice pretreated with DETe (3 - 300 mg/kg). The antiulcer activity of DETe was also verified in mice pretreated with NEM, L-NAME, indomethacin, or yohimbine. The antisecretory effect of DETe was verified in rats, and its anti-Helicobacter pylori activity was determined in vitro. DETe (300 mg/kg, p.o) reduced the ethanol- or indomethacin-induced ulcer by 49 and 93%, respectively. The pre-treatment with L-NAME, NEM or yohimbine abolished the gastroprotective effect of DETe. However, DETe did not change the volume, acidity, or peptic activity in rats and did not affect H. pylori. This study expands knowledge about the antiulcerogenic potential of DETe, evidencing the role of nitric oxide, non-protein sulfhydryl groups, α2 adrenergic receptors, and prostaglandins, but not antisecretory or anti-H. pylori properties. T (DETe here 3 ( 30 mg/kg. mgkg mg/kg . mg kg mg/kg) LNAME, LNAME L NAME, NAME L-NAME antiHelicobacter anti Helicobacter vitro (30 p.o po p o indomethacininduced 4 93 93% respectively pretreatment pre treatment However volume acidity H oxide nonprotein non protein groups α receptors prostaglandins antiH. antiH anti-H properties 9

ABSTRACT Introduction: Since the reduction of healthcare-associated infections has been a focus for quality patient care, this study aimed to evaluate the surgical site infection rate of children who underwent cardiovascular surgery after implementation of ozonized water system for hand and body hygiene allied to previously implemented preventive measures. Methods: Two uniformly comparable groups of pediatric patients underwent cardiovascular surgery. Group A (187) patients were operated prior to installation of ozonized water system (March 1 to August 31, 2019), and group B (214) patients were operated after installation of ozonized water system (October 1, 2019, to March 31, 2020). Ozonized water was used for professional hand hygiene and patient body hygiene. Results: There was statistical significance for surgical site infection reduction in group B (P=0.0289), with a relative risk of 0.560 (95% confidence interval = 0.298 to 0.920), inferring the risk of being diagnosed with surgical site infections in group B was 44% less than in group A. There was no statistical significance regarding mechanical ventilation time (P=0.1998) or mortality (P=0.4457). Conclusion: Ozonized water for professional hand hygiene and patient body hygiene was an adjuvant combined with traditional preventive methods to reduce the risk of surgical site infection, although no impact on hospital stay or mortality was observed. Introduction healthcareassociated healthcare associated care measures Methods 187 (187 31 2019 , 2019) 214 (214 October 2020. 2020 . 2020) Results P=0.0289, P00289 P P=0.0289 0 0289 (P=0.0289) 0560 560 0.56 95% 95 (95 0298 298 0.29 0.920, 0920 0.920 920 0.920) 44 P=0.1998 P01998 1998 (P=0.1998 P=0.4457. P04457 P=0.4457 4457 (P=0.4457) Conclusion observed 18 (18 3 201 21 (21 202 P0028 P=0.028 028 (P=0.0289 056 56 0.5 9 (9 029 29 0.2 092 0.92 92 4 P=0.199 P0199 199 (P=0.199 P0445 P=0.445 445 (P=0.4457 (1 20 2 (2 P002 P=0.02 02 (P=0.028 05 5 0. ( 09 0.9 P=0.19 P019 19 (P=0.19 P044 P=0.44 (P=0.445 P00 P=0.0 (P=0.02 P=0.1 P01 (P=0.1 P04 P=0.4 (P=0.44 P0 P=0. (P=0.0 (P=0. (P=0.4 P=0 (P=0 P= (P= (P

RESUMO Objetivo: Determinar a frequência de reabordagens cirúrgicas no tratamento de pacientes adultos com diagnóstico de artrite séptica do joelho, a média de desbridamentos necessários para o controle da infecção e a taxa de mortalidade, assim como avaliar os fatores associados à maior necessidade de reabordagem e mortalidade. Métodos: Estudo retrospectivo tipo coorte que avaliou 38 pacientes adultos com diagnóstico de artrite séptica submetidos à artrotomia por via parapatelar medial para limpeza e desbridamento da articulação. Foram analisadas variáveis demográficas, clínicas, cirúrgicas e microbiológicas dos casos, por revisão de prontuário médico, e realizados testes de igualdade de duas proporções, qui-quadrado e análise multivariada de regressão logística, sendo definido um nível de significância de 0,05, com 95% de confiança estatística. Resultados: 50% dos casos foram submetidos à reabordagem cirúrgica, sendo a média de desbridamentos necessários de 2,02 e a taxa de mortalidade de 10,5%. Pacientes com infecção causada por Staphylococcus aureus apresentaram mais chances de necessitar de reabordagem quando comparados aos pacientes com culturas positivas para outros agentes (OR 6,0). Conclusão: Em 50% dos casos foram necessários, em média, 2,02 desbridamentos e a taxa de mortalidade foi de 10,5%. A infecção por Staphylococcus aureus está associada com seis vezes mais chances de cirurgias adicionais. Nível de Evidência IV, Série de Casos. Objetivo joelho Métodos 3 articulação demográficas clínicas médico proporções quiquadrado qui quadrado logística 005 0 05 0,05 95 estatística Resultados 50 cirúrgica 202 2 02 2,0 105 10 5 10,5% OR 6,0. 60 6,0 . 6 6,0) Conclusão adicionais IV Casos 00 0,0 9 20 2, 1 10,5 6, 0, 10,

ABSTRACT Objective: To determine the frequency of reoperations in the treatment of adult patients diagnosed with septic arthritis of the knee, the average number of debridements needed to control the infection, the mortality rate, and to assess factors associated with a greater need for reoperation and mortality. Methods: Retrospective cohort study evaluating 38 adult patients diagnosed with septic arthritis who underwent arthrotomy via a medial parapatellar approach for joint cleaning and debridement. Demographic, clinical, surgical, and microbiological variables of the cases were analyzed by review of medical records. Tests for equality of two proportions, chi-square, and multivariate logistic regression analysis were performed, defining a significance level at 0.05, with 95% confidence interval. Results: A total of 50% of the cases underwent reoperation, with an average number of required debridement of 2.02 and a mortality rate of 10.5%. Patients with infection caused by Staphylococcus aureus were more likely to need a reoperation compared to patients with positive cultures for other agents (OR 6.0). Conclusion: In 50% of cases, an average of 2.02 debridements were necessary and the mortality rate was 10.5%. Staphylococcus aureus infection is associated with a 6 times greater chance of additional surgeries. /Level of Evidence IV, Case Series. Objective knee Methods 3 Demographic clinical surgical records proportions chisquare, chisquare chi square, square chi-square performed 005 0 05 0.05 95 interval Results 50 202 2 02 2.0 105 10 5 10.5% OR 6.0. 60 6.0 . 6.0) Conclusion surgeries Level IV Series 00 0.0 9 20 2. 1 10.5 6. 0. 10.

ABSTRACT Clinical data: Infant, nine months of age, female, diagnosed with congenital heart disease, with signs of heart failure associated with cyanosis and difficulty in gaining weight. Chest radiography: Cardiomegaly with prevalence of pulmonary vascular network. Electrocardiogram: Ectopic atrial rhythm with right ventricular overload and left anterosuperior divisional block. Echocardiogram: Single atrium with absent interatrial septum, atrioventricular connection with a single valve and two orifices, with increased pulmonary pressure and high Qp/Qs. Computed tomography: Absence of portal vein and intrahepatic segment of the inferior vena cava. Infrahepatic portion continuing with the azygos system at the level of the thoracic cavity, presence of mesenteric-caval communication associated with signs suggestive of hepatic peribiliary fibrosis. Diagnosis: Abernethy malformation is a rare condition and represents an extrahepatic portosystemic shunt that develops between the mesenteric-portal vasculature and the systemic veins. It may be associated with cardiac malformations and advance with pulmonary hypertension and even the need for liver transplantation. Persistent cyanosis after corrective surgery led to a deeper investigation and correct diagnosis of this malformation. Operation: Sternotomy with 68 minutes of cardiopulmonary bypass and nine minutes of total circulatory arrest. In the postoperative period, persistence of cyanosis was evident, even though there were no immediate complications. Patient was discharged on the 10th postoperative day. An abdominal computed tomography angiography confirmed the diagnosis of Abernethy type I malformation, and the patient was transferred for liver transplantation after congenital heart disease treatment. data Infant age female weight radiography network Electrocardiogram block Echocardiogram septum orifices QpQs Qp Qs Qp/Qs cava cavity mesentericcaval mesenteric caval fibrosis Diagnosis mesentericportal veins Operation 6 arrest period evident complications th day treatment

Abstract The process that involves the continuous monitoring and analysis of a structure's behavior and performance is known as Structural Health Monitoring (SHM). SHM typically involves the use of sensors and other monitoring devices to collect data, such as displacements, strains, accelerations, among others. These data are analyzed using advanced algorithms and machine learning techniques to identify any signs of abnormal behavior or deterioration. This paper presents a numerical and experimental study of a slender frame subjected to five levels of structural changes under impact loading. The dynamic responses were recorded by four accelerometers and used to build models based on Sparse Auto-Encoders (SAE). Such models can identify each of the five structural states in an unsupervised way. A new strategy to define the hyperparameters of the SAE is presented, which proved to be adequate in the experiments conducted. Finally, the experimental data set is made available to the scientific community to serve as a benchmark for validating SHM methodologies to identify structural changes from dynamic measurements. structures structure s SHM. . (SHM) displacements strains accelerations others deterioration loading AutoEncoders Auto Encoders SAE. (SAE) way presented conducted Finally measurements (SHM (SAE

ABSTRACT OBJECTIVE: To identify longitudinal patterns of maternal depression between three months and five years after child's birth, to examine predictor variables for these trajectories, and to evaluate whether distinct depression trajectories predict offspring mental health problems at age 5 years. METHODS: We used data from the Maternal and Child Health and Nutrition in Acre (MINA-Brazil) study, a population-based birth cohort in the Western Brazilian Amazon. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) at 3 and 6–8 months, and 1 and 2 years after delivery. Mental health problems in 5-year-old children were evaluated with the Strengths and Difficulties Questionnaire (SDQ) reported by parents. Trajectories of maternal depression were calculated using a group-based modelling approach. RESULTS: We identified four trajectories of maternal depressive symptoms: "low" (67.1%), "increasing" (11.5%), "decreasing" (17.4%), and "high-chronic" (4.0%). Women in the "high/chronic" trajectory were the poorest, least educated, and oldest compared with women in the other trajectory groups. Also, they were more frequently multiparous and reported smoking and having attended fewer prenatal consultations during pregnancy. In the adjusted analyses, the odds ratio of any SDQ disorder was 3.23 (95%CI: 2.00–5.22) and 2.87 (95%CI: 1.09–7.57) times higher among children of mothers belonging to the "increasing" and "high-chronic" trajectory groups, respectively, compared with those of mothers in the "low" depressive symptoms group. These differences were not explained by maternal and child characteristics included in multivariate analyses. CONCLUSIONS: We identified poorer mental health outcomes for children of mothers assigned to the "chronic/severe" and "increasing" depressive symptoms trajectories. Prevention and treatment initiatives to avoid the adverse short, medium, and long-term effects of maternal depression on offspring development should focus on women belonging to these groups.

RESUMO OBJETIVO: Identificar padrões longitudinais de depressão materna entre três meses e cinco anos após o nascimento de seus filhos, analisar variáveis preditoras dessas trajetórias e avaliar se trajetórias distintas de depressão predizem problemas de saúde mental infantil aos cinco anos de idade. MÉTODOS: Utilizou-se dados do estudo sobre saúde e nutrição materno infantil no Acre (MINA-Brasil), uma coorte de nascimentos de base populacional na Amazônia ocidental brasileira. Os sintomas depressivos maternos foram avaliados pela Escala de Depressão Pós-parto de Edimburgo (EPDS) aos 3 e 6–8 meses e 1 e 2 anos após o parto. Problemas de saúde mental em crianças com cinco anos de idade foram avaliados pelo Questionário de Capacidades e Dificuldades (SDQ– Strengths and Difficulties Questionnaire), respondido pelos pais. As trajetórias de depressão materna foram calculadas usando uma abordagem de modelagem baseada em grupos. RESULTADOS: Foram identificadas quatro trajetórias de sintomas depressivos maternos: "baixa" (67,1%), "crescente" (11,5%), "decrescente" (17,4%) e "alta-crônica" (4,0%). As mulheres na trajetória "alta/crônica" eram mais pobres, menos escolarizadas, mais velhas e multíparas e relataram tabagismo com maior frequência e menor número de consultas de pré-natal durante a gestação do que as demais. Nas análises ajustadas, a razão de chances de qualquer transtorno do SDQ foi 3,23 (IC95%:2,00–5,22) e 2,87 (IC95%: 1,09–7,57) vezes maior entre os filhos de mães nos grupos de trajetória "crescente" e "alta-crônica", respectivamente, do que de mães do grupo de sintomas depressivos "baixos". As características maternas e infantis incluídas nas análises multivariadas foram incapazes de explicar essas diferenças. CONCLUSÕES: Identificou-se piores desfechos de saúde mental para filhos de mães atribuídas às trajetórias "crônica/grave" e "crescente" de sintomas depressivos. Iniciativas de prevenção e tratamento para evitar os efeitos adversos a curto, médio e longo prazo da depressão materna sobre o desenvolvimento de seus filhos devem se concentrar principalmente nas mulheres nesses grupos.

RESUMO OBJETIVO: Identificar padrões longitudinais de depressão materna entre três meses e cinco anos após o nascimento de seus filhos, analisar variáveis preditoras dessas trajetórias e avaliar se trajetórias distintas de depressão predizem problemas de saúde mental infantil aos cinco anos de idade. MÉTODOS: Utilizou-se dados do estudo sobre saúde e nutrição materno infantil no Acre (MINA-Brasil), uma coorte de nascimentos de base populacional na Amazônia ocidental brasileira. Os sintomas depressivos maternos foram avaliados pela Escala de Depressão Pós-parto de Edimburgo (EPDS) aos 3 e 6–8 meses e 1 e 2 anos após o parto. Problemas de saúde mental em crianças com cinco anos de idade foram avaliados pelo Questionário de Capacidades e Dificuldades (SDQ– Strengths and Difficulties Questionnaire), respondido pelos pais. As trajetórias de depressão materna foram calculadas usando uma abordagem de modelagem baseada em grupos. RESULTADOS: Foram identificadas quatro trajetórias de sintomas depressivos maternos: "baixa" (67,1%), "crescente" (11,5%), "decrescente" (17,4%) e "alta-crônica" (4,0%). As mulheres na trajetória "alta/crônica" eram mais pobres, menos escolarizadas, mais velhas e multíparas e relataram tabagismo com maior frequência e menor número de consultas de pré-natal durante a gestação do que as demais. Nas análises ajustadas, a razão de chances de qualquer transtorno do SDQ foi 3,23 (IC95%:2,00–5,22) e 2,87 (IC95%: 1,09–7,57) vezes maior entre os filhos de mães nos grupos de trajetória "crescente" e "alta-crônica", respectivamente, do que de mães do grupo de sintomas depressivos "baixos". As características maternas e infantis incluídas nas análises multivariadas foram incapazes de explicar essas diferenças. CONCLUSÕES: Identificou-se piores desfechos de saúde mental para filhos de mães atribuídas às trajetórias "crônica/grave" e "crescente" de sintomas depressivos. Iniciativas de prevenção e tratamento para evitar os efeitos adversos a curto, médio e longo prazo da depressão materna sobre o desenvolvimento de seus filhos devem se concentrar principalmente nas mulheres nesses grupos. OBJETIVO MÉTODOS Utilizouse Utilizou MINABrasil, MINABrasil MINA Brasil , (MINA-Brasil) brasileira Pósparto Pós parto EPDS (EPDS 68 6 8 6– SDQ– (SDQ Questionnaire, Questionnaire Questionnaire) pais RESULTADOS baixa "baixa 67,1%, 671 67,1% 67 (67,1%) crescente "crescente 11,5%, 115 11,5% 11 5 (11,5%) decrescente "decrescente 17,4% 174 17 4 (17,4% altacrônica alta crônica "alta-crônica 4,0%. 40 4,0% . 0 (4,0%) alta/crônica "alta/crônica pobres escolarizadas prénatal pré natal demais ajustadas 323 23 3,2 IC95%2,00–5,22 IC95200522 IC IC95% 2,00–5,22 IC95 00 22 (IC95%:2,00–5,22 287 87 2,8 (IC95% 1,09–7,57 109757 09 7 57 altacrônica, respectivamente baixos. baixos "baixos" diferenças CONCLUSÕES Identificouse Identificou crônica/grave crônicagrave grave "crônica/grave curto (MINA-Brasil 67,1 (67,1% 11,5 (11,5% 17,4 (17,4 4,0 (4,0% 32 3, IC95%2,00–5,2 IC9520052 200522 2,00–5,2 IC9 (IC95%:2,00–5,2 28 2, (IC95 1,09–7,5 10975 "baixos 67, (67,1 11, (11,5 17, (17, 4, (4,0 IC95%2,00–5, IC952005 20052 2,00–5, (IC95%:2,00–5, (IC9 1,09–7, 1097 (67, (11, (17 (4, IC95%2,00–5 IC95200 2005 2,00–5 (IC95%:2,00–5 (IC 1,09–7 109 (67 (11 (1 (4 IC95%2,00– IC9520 200 2,00– (IC95%:2,00– 1,09– 10 (6 ( IC95%2,00 IC952 20 2,00 (IC95%:2,00 1,09 IC95%2,0 2,0 (IC95%:2,0 1,0 IC95%2, (IC95%:2, 1, IC95%2 (IC95%:2

ABSTRACT OBJECTIVE: To identify longitudinal patterns of maternal depression between three months and five years after child's birth, to examine predictor variables for these trajectories, and to evaluate whether distinct depression trajectories predict offspring mental health problems at age 5 years. METHODS: We used data from the Maternal and Child Health and Nutrition in Acre (MINA-Brazil) study, a population-based birth cohort in the Western Brazilian Amazon. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) at 3 and 6–8 months, and 1 and 2 years after delivery. Mental health problems in 5-year-old children were evaluated with the Strengths and Difficulties Questionnaire (SDQ) reported by parents. Trajectories of maternal depression were calculated using a group-based modelling approach. RESULTS: We identified four trajectories of maternal depressive symptoms: "low" (67.1%), "increasing" (11.5%), "decreasing" (17.4%), and "high-chronic" (4.0%). Women in the "high/chronic" trajectory were the poorest, least educated, and oldest compared with women in the other trajectory groups. Also, they were more frequently multiparous and reported smoking and having attended fewer prenatal consultations during pregnancy. In the adjusted analyses, the odds ratio of any SDQ disorder was 3.23 (95%CI: 2.00–5.22) and 2.87 (95%CI: 1.09–7.57) times higher among children of mothers belonging to the "increasing" and "high-chronic" trajectory groups, respectively, compared with those of mothers in the "low" depressive symptoms group. These differences were not explained by maternal and child characteristics included in multivariate analyses. CONCLUSIONS: We identified poorer mental health outcomes for children of mothers assigned to the "chronic/severe" and "increasing" depressive symptoms trajectories. Prevention and treatment initiatives to avoid the adverse short, medium, and long-term effects of maternal depression on offspring development should focus on women belonging to these groups. OBJECTIVE childs s METHODS MINABrazil MINA Brazil (MINA-Brazil study populationbased population based Amazon EPDS (EPDS 68 6 8 6– delivery 5yearold yearold year old (SDQ parents groupbased group approach RESULTS low "low 67.1%, 671 67.1% , 67 (67.1%) increasing "increasing 11.5%, 115 11.5% 11 (11.5%) decreasing "decreasing 17.4%, 174 17.4% 17 4 (17.4%) highchronic high chronic "high-chronic 4.0%. 40 4.0% . 0 (4.0%) high/chronic "high/chronic poorest educated groups Also pregnancy analyses 323 23 3.2 95%CI 95CI CI 95 (95%CI 2.00–5.22 200522 00 22 287 87 2.8 1.09–7.57 109757 09 7 57 respectively CONCLUSIONS chronic/severe chronicsevere severe "chronic/severe short medium longterm long term 67.1 (67.1% 11.5 (11.5% 17.4 (17.4% 4.0 (4.0% 32 3. 9 2.00–5.2 20052 28 2. 1.09–7.5 10975 67. (67.1 11. (11.5 17. (17.4 4. (4.0 2.00–5. 2005 1.09–7. 1097 (67. (11. (17. (4. 2.00–5 200 1.09–7 109 (67 (11 (17 (4 2.00– 20 1.09– 10 (6 (1 ( 2.00 1.09 2.0 1.0 1.

ABSTRACT Introduction: Pediatric heart transplantation is the definitive therapy for children with end-stage heart failure. This paper describes our initial experience in pediatric heart transplantation in a tertiary center in Brazil Methods: This is a historical prospective descriptive cohort study based on a review of the medical records of children undergoing heart transplantation at Hospital de Base and Hospital da Criança e Maternidade de São José do Rio Preto. Variables were displayed as frequency, mean, or median. Statistical analysis and Kaplan-Meier actuarial curve were obtained with the aid of Microsoft® Excel® 2019 and STATSDirect version 3.3.5. Results: Between January 2010 and December 2020, ten children underwent bicaval orthotopic heart transplantation, 30% of which were under one year of age. Nine patients had end-stage heart failure (International Society for Heart and Lung Transplantation-Heart Failure D) and 50% of the recipients were transplanted under conditions of progressive clinical deterioration (Interagency Registry for Mechanically Assisted Circulatory Support ≤ 2). Forty percent of the recipients had a panel-reactive antibody > 20% on virtual crossmatch. In the postoperative period, 80% of patients required high dose of inotropic support (vasoactive-inotropic score > 10) for > 48 hours. The death-free survival rate at 131 months was 77.1±14.4%. Most patients (88.9%) in late follow-up had an episode of active cytomegalovirus infection. Cellular rejection, with or without clinical repercussion, was present in 44.4% of the patients. Conclusion: Pediatric heart transplantation produces acceptable and feasible outcomes as definitive therapy for children with end-stage heart failure.

ABSTRACT Clinical data: Infant, nine months of age, female, diagnosed with congenital heart disease, with signs of heart failure associated with cyanosis and difficulty in gaining weight. Chest radiography: Cardiomegaly with prevalence of pulmonary vascular network. Electrocardiogram: Ectopic atrial rhythm with right ventricular overload and left anterosuperior divisional block. Echocardiogram: Single atrium with absent interatrial septum, atrioventricular connection with a single valve and two orifices, with increased pulmonary pressure and high Qp/Qs. Computed tomography: Absence of portal vein and intrahepatic segment of the inferior vena cava. Infrahepatic portion continuing with the azygos system at the level of the thoracic cavity, presence of mesenteric-caval communication associated with signs suggestive of hepatic peribiliary fibrosis. Diagnosis: Abernethy malformation is a rare condition and represents an extrahepatic portosystemic shunt that develops between the mesenteric-portal vasculature and the systemic veins. It may be associated with cardiac malformations and advance with pulmonary hypertension and even the need for liver transplantation. Persistent cyanosis after corrective surgery led to a deeper investigation and correct diagnosis of this malformation. Operation: Sternotomy with 68 minutes of cardiopulmonary bypass and nine minutes of total circulatory arrest. In the postoperative period, persistence of cyanosis was evident, even though there were no immediate complications. Patient was discharged on the 10th postoperative day. An abdominal computed tomography angiography confirmed the diagnosis of Abernethy type I malformation, and the patient was transferred for liver transplantation after congenital heart disease treatment.

Resumo A resistência à compressão do concreto é uma propriedade essencial para garantir a segurança de uma estrutura. No entanto, estimar este valor é atualmente um processo trabalhoso e impreciso, uma vez que o a dosagem é baseada em métodos empíricos e sua confirmação em laboratório demanda tempo e recursos. Nesse contexto, este trabalho tem como objetivo avaliar modelos de Aprendizado de Máquina (ML) para predizer a resistência à compressão do concreto a partir de seus componentes. Para tanto, um banco de dados da literatura foi utilizado como entrada para quatro modelos de ML: Extreme Gradient Boosting (XGBoost), Regressão de Vetor de Suporte (SVR), Redes Neurais Artificiais (ANN) e Processo Gaussiano de Regressão (GPR). A precisão dos modelos foi avaliada por meio de validação cruzada (10-fold) e medida com as métricas de R2, Erro Médio Absoluto (MAE) e a Raiz do Erro Quadrático Médio (RMSE). Posteriormente, um novo banco de dados foi montado com traços da literatura e utilizado para validar os modelos anteriores. Na etapa de criação do modelo, todos os algoritmos obtiveram resultados semelhantes e satisfatórios, com MAE entre 1,96-2,26 MPa e R2 variando de 0,79 a 0,83. No entanto, na etapa de validação, a precisão dos modelos caiu drasticamente, com o MAE crescendo para 3,04-4,04 MPa e o R2 diminuindo para 0,37-0,59. As ANN e o GPR mostraram os melhores resultados, enquanto a SVR teve as piores previsões. Este trabalho mostrou que as ferramentas de ML são técnicas promissoras para prever a resistência à compressão do concreto, porém, deve-se ter cuidado com os dados de entrada para garantir que os modelos não sejam sobreajustados (overfitted) a uma determinada região, conjunto de materiais ou tipo de concreto.

Abstract The compressive strength of concrete is an essential property to ensure the safety of a concrete structure. However, estimating this value is usually a laborious and uncertain process since the mix design is based on empirical methods and its confirmation in the laboratory demands time and resources. In this context, this work aims to evaluate Machine Learning (ML) models to predict the compressive strength of concrete from its constituents. For this purpose, a dataset from the literature was used as input to four ML models: Extreme Gradient Boosting (XGBoost), Support Vector Regression (SVR), Artificial Neural Networks (ANN) and Gaussian Process Regression (GPR). The accuracy of the models was evaluated through 10-fold cross-validation, and quantified by R2, Mean Absolute Error (MAE), and Root-Mean-Square Error (RMSE) metrics. Subsequently, a new dataset was put together with mixtures from the literature and used to validate the previous models. In the model creation step, all algorithms obtained similar and positive results, with MAE between 1.96-2.26 MPa and R2 varying from 0.79 to 0.83. However, in the validation step, the accuracy of the models dropped sharply, with MAE growing to 3.04-4.04 MPa and R2 decreasing to 0.37-0.59. ANN and GPR showed the best results, while SVR had the worst predictions. This work showed that ML tools are promising techniques to predict the compressive strength of concrete. However, care must be taken with the input data to guarantee that models are not overfitted to a given region, set of materials, or type of concrete.

A pesar de una controversia en cuanto a la eficacia, la homeopatía es un método terapéutico alternativo a la medicina convencional. La práctica de la homeopatía varía mucho entre países, y la evidencia existente es contradictoria cuanto a la relación entre los factores sociodemográficos y las condiciones de salud asociadas a ella. Se pretende estimar la prevalencia de la práctica de homeopatía y su asociación con la autopercepción del estado de salud, depresión y factores sociodemográficos. Se utilizaron datos de 90.846 participantes de la Encuesta Nacional de Salud de Brasil de 2019 (PNS 2019), estudio de base poblacional, con método de muestreo complejo y probabilístico. Se recogieron datos sociodemográficos, clínicos e información sobre la práctica de la homeopatía en los últimos 12 meses. El Cuestionario de Salud del Paciente-9 (PHQ-9) se utilizó para evaluar la depresión. Todas las variables fueron categorizadas. Se aplicaron modelos de regresión logística para obtener las razones de probabilidad (OR) crudas y ajustadas y los intervalos del 95% de confianza (IC95%). La prevalencia de la práctica de la homeopatía fue del 0,99% (IC95%: 0,98-1,00). En el análisis ajustado las siguientes variables se asociaron a un mayor empleo de la homeopatía: sexo femenino, tener más de 51 años, raza blanca, mayor nivel socioeconómico y educativo, residir en las regiones Sur/Sudeste del país, peor estado de salud autoidentificado y depresión. Hubo un aumento en Brasil en la prescripción de diferentes medicamentos complementarios, incluida la homeopatía. Sin embargo, la práctica del tratamiento de la homeopatía es muy baja y está asociada con un nivel socioeconómico más alto, peor estado de salud autoidentificado y depresión.

Despite the controversy about its efficacy, homeopathy is considered a medical practice alternative to the conventional medical model. Prevalence of homeopathy use varies greatly among countries and the literature has conflicting evidence about the relation between sociodemographic factors and health conditions associated with homeopathy use. We aim to estimate the prevalence of homeopathy use and its association with self-perceived health status, depression, and sociodemographic factors. We used data from 90,846 participants in the 2019 Brazilian National Survey of Health (PNS 2019), a population-based study with complex and probabilistic sampling. Sociodemographic and clinical data and information on homeopathy use during the last 12 months were collected. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depression. All variables were categorized. Logistic regression models were built to obtain crude and adjusted odds ratios (OR) and 95% confidence intervals (95%CI). The prevalence of homeopathy use was 0.99% (95%CI: 0.98-1.00). In the adjusted analysis, the following variables were associated with higher use of homeopathy: female gender, age above 51 years, white ethnicity, higher socioeconomic and educational attainment, residence in Southern/Southeastern Brazil, poorer self-reported health status, and depression. Brazil shows increased offer of complementary medicine, including homeopathy. Nevertheless, the use of homeopathy treatment is very low and clearly associated with a higher socioeconomic status, poorer self-reported health status, and depression.

Apesar da controvérsia sobre sua eficácia, a homeopatia é considerada uma prática médica alternativa ao modelo médico convencional. A prevalência de uso de homeopatia varia muito entre os países e há evidências conflitantes sobre a relação entre fatores sociodemográficos e condições de saúde associadas ao uso da homeopatia. Pretende-se estimar a prevalência de uso de homeopatia e sua associação com autopercepção de saúde, depressão de cada indivíduo e fatores sociodemográficos. Foram utilizados dados de 90.846 participantes da Pesquisa Nacional de Saúde de 2019 (PNS 2019), estudo de base populacional, com método amostral complexo e probabilístico. Foram coletados dados sociodemográficos, clínicos e informações sobre o uso da homeopatia nos últimos 12 meses. Para avaliar depressão, o Questionário de Saúde do Paciente-9 (PHQ-9) foi utilizado. Todas as variáveis foram categorizadas. Foram realizados modelos de regressão logística para obtenção de odds ratios (OR) brutos e ajustados e intervalos de 95% de confiança (IC95%). A prevalência de uso de homeopatia foi de 0,99% (IC95%: 0,98-1,00). Na análise ajustada, as seguintes variáveis estiveram associadas ao maior uso de homeopatia: mulheres, ter mais de 51 anos, ser branca, maior nível socioeconômico e educacional, residindo nas regiões Sul/Sudeste do país, pior estado de saúde autorreferido e depressão. No Brasil, houve um aumento na oferta de diferentes tipos de medicamentos complementares, incluindo a homeopatia. No entanto, o uso do tratamento da homeopatia é muito baixo e está claramente associado a um maior nível socioeconômico, pior estado de saúde autorreferido e depressão.

Apesar da controvérsia sobre sua eficácia, a homeopatia é considerada uma prática médica alternativa ao modelo médico convencional. A prevalência de uso de homeopatia varia muito entre os países e há evidências conflitantes sobre a relação entre fatores sociodemográficos e condições de saúde associadas ao uso da homeopatia. Pretende-se estimar a prevalência de uso de homeopatia e sua associação com autopercepção de saúde, depressão de cada indivíduo e fatores sociodemográficos. Foram utilizados dados de 90.846 participantes da Pesquisa Nacional de Saúde de 2019 (PNS 2019), estudo de base populacional, com método amostral complexo e probabilístico. Foram coletados dados sociodemográficos, clínicos e informações sobre o uso da homeopatia nos últimos 12 meses. Para avaliar depressão, o Questionário de Saúde do Paciente-9 (PHQ-9) foi utilizado. Todas as variáveis foram categorizadas. Foram realizados modelos de regressão logística para obtenção de odds ratios (OR) brutos e ajustados e intervalos de 95% de confiança (IC95%). A prevalência de uso de homeopatia foi de 0,99% (IC95%: 0,98-1,00). Na análise ajustada, as seguintes variáveis estiveram associadas ao maior uso de homeopatia: mulheres, ter mais de 51 anos, ser branca, maior nível socioeconômico e educacional, residindo nas regiões Sul/Sudeste do país, pior estado de saúde autorreferido e depressão. No Brasil, houve um aumento na oferta de diferentes tipos de medicamentos complementares, incluindo a homeopatia. No entanto, o uso do tratamento da homeopatia é muito baixo e está claramente associado a um maior nível socioeconômico, pior estado de saúde autorreferido e depressão.

Despite the controversy about its efficacy, homeopathy is considered a medical practice alternative to the conventional medical model. Prevalence of homeopathy use varies greatly among countries and the literature has conflicting evidence about the relation between sociodemographic factors and health conditions associated with homeopathy use. We aim to estimate the prevalence of homeopathy use and its association with self-perceived health status, depression, and sociodemographic factors. We used data from 90,846 participants in the 2019 Brazilian National Survey of Health (PNS 2019), a population-based study with complex and probabilistic sampling. Sociodemographic and clinical data and information on homeopathy use during the last 12 months were collected. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depression. All variables were categorized. Logistic regression models were built to obtain crude and adjusted odds ratios (OR) and 95% confidence intervals (95%CI). The prevalence of homeopathy use was 0.99% (95%CI: 0.98-1.00). In the adjusted analysis, the following variables were associated with higher use of homeopathy: female gender, age above 51 years, white ethnicity, higher socioeconomic and educational attainment, residence in Southern/Southeastern Brazil, poorer self-reported health status, and depression. Brazil shows increased offer of complementary medicine, including homeopathy. Nevertheless, the use of homeopathy treatment is very low and clearly associated with a higher socioeconomic status, poorer self-reported health status, and depression.

A pesar de una controversia en cuanto a la eficacia, la homeopatía es un método terapéutico alternativo a la medicina convencional. La práctica de la homeopatía varía mucho entre países, y la evidencia existente es contradictoria cuanto a la relación entre los factores sociodemográficos y las condiciones de salud asociadas a ella. Se pretende estimar la prevalencia de la práctica de homeopatía y su asociación con la autopercepción del estado de salud, depresión y factores sociodemográficos. Se utilizaron datos de 90.846 participantes de la Encuesta Nacional de Salud de Brasil de 2019 (PNS 2019), estudio de base poblacional, con método de muestreo complejo y probabilístico. Se recogieron datos sociodemográficos, clínicos e información sobre la práctica de la homeopatía en los últimos 12 meses. El Cuestionario de Salud del Paciente-9 (PHQ-9) se utilizó para evaluar la depresión. Todas las variables fueron categorizadas. Se aplicaron modelos de regresión logística para obtener las razones de probabilidad (OR) crudas y ajustadas y los intervalos del 95% de confianza (IC95%). La prevalencia de la práctica de la homeopatía fue del 0,99% (IC95%: 0,98-1,00). En el análisis ajustado las siguientes variables se asociaron a un mayor empleo de la homeopatía: sexo femenino, tener más de 51 años, raza blanca, mayor nivel socioeconómico y educativo, residir en las regiones Sur/Sudeste del país, peor estado de salud autoidentificado y depresión. Hubo un aumento en Brasil en la prescripción de diferentes medicamentos complementarios, incluida la homeopatía. Sin embargo, la práctica del tratamiento de la homeopatía es muy baja y está asociada con un nivel socioeconómico más alto, peor estado de salud autoidentificado y depresión.