Abstract Introduction: Screen use among adolescents has increased, with excessive screen time associated with poor sleep. Isolation due to the COVID-19 pandemic may have exacerbated these problems. This study aimed to characterize adolescents’ sleep and screen use behaviors during the COVID-19 pandemic lockdown. Methods: This was a multicenter, cross-sectional, descriptive study of adolescents aged 10 to 18 years evaluated in an Adolescent Medicine outpatient visit of four hospitals in northern Portugal between January and March 2021. Adolescents completed a survey with questions about screen use and sleep and the Pediatric Daytime Sleepiness Scale (Portuguese version). Results: A total of 131 adolescents (66.4% female; median age 15 years) were enrolled during the study period. Participants reported a median sleep duration of nine hours on weekdays and 10 hours on weekends, with 25.9% sleeping less than eight hours on weekdays. Approximately 80% reported good or very good sleep quality. Onset insomnia was identified in 39.7% and excessive daytime sleepiness (EDS) in 13.7%. Most adolescents (74.0%) reported screen time of ≥6 hours/day. Screens were mainly used for attending classes and talking to friends. Smartphones were available in the bedroom at night for 83.2%, while 61.1% had televisions, 57.3% had computers, and 16.0% had gaming consoles in their bedrooms. Fifty-five percent used screens within an hour of bedtime every day. Screen time ≥6 hours/day and having a computer or smartphone in the bedroom at night were associated with shorter sleep duration on weekdays and EDS. Screen use within an hour of bedtime ≥4 times/week was associated with sleep-onset insomnia, shorter weekday sleep duration, and EDS. Discussion: Online classes during the COVID-19 lockdown may explain the use of devices ≥6 hours/day. Although most adolescents reported normal median sleep time and subjective good or very good sleep quality, screen use ≥6 hours/day and within one hour before bedtime was associated with sleep deprivation on weekdays and EDS. Conclusions: Excessive screen time during the pandemic appears to have had a negative impact on adolescents’ sleep. These findings underscore the importance of identifying and intervening in these issues when addressing adolescent global health.

Resumo Introdução: O uso de ecrãs tem vindo a aumentar entre os adolescentes, estando descrita a associação entre tempo excessivo de ecrã e menor quantidade e pior qualidade de sono. A pandemia de COVID-19 poderá ter agravado estes problemas. Este estudo pretendeu caracterizar o comportamento dos adolescentes relativamente ao sono e uso de ecrãs durante o confinamento imposto pela pandemia de COVID-19. Métodos: Estudo descritivo, transversal, multicêntrico de adolescentes dos 10 aos 18 anos avaliados numa consulta externa de Medicina do Adolescente de quatro hospitais do norte de Portugal entre janeiro e março de 2021. Os adolescentes preencheram um questionário com perguntas sobre o uso de ecrãs e o sono e a Pediatric Daytime Sleepiness Scale (versão portuguesa). Resultados: Foram incluídos 131 adolescentes (66,4% do género feminino; idade mediana de 15 anos) durante o período de estudo. Os participantes relataram uma mediana de duração do sono de 9 horas durante a semana e 10 horas ao fim-de-semana, com 25,9% a dormir menos do que oito horas diárias durante a semana. Cerca de 80% referiu ter um sono de boa ou muito boa qualidade. Foi identificada insónia inicial em 39,7% e sonolência diurna excessiva (SDE) em 13,7% dos participantes. A maioria (74,0%) referiu um tempo de ecrã ≥6 horas/dia. Os ecrãs foram usados maioritariamente para assistir a aulas e conversar com amigos. Um total de 83,2% dos adolescentes referiu dormir com o telemóvel no quarto e 61,1% referiu ter televisão, 57,3% computador e 16,0% consola de jogos no quarto. Cinquenta e cinco por cento usava ecrãs todos os dias na hora antes de dormir. Um tempo de ecrã ≥6 horas/dia e ter computador ou telemóvel no quarto durante a noite associou-se a uma menor duração do sono durante a semana e SDE. O uso de ecrãs na hora antes de dormir associou-se a insónia inicial, menor duração do sono durante a semana e SDE. Discussão: As aulas online poderão explicar o uso frequente de ecrãs (≥6 horas/dia). Embora a mediana de duração do sono tenha sido normal e a maioria dos adolescentes tenha referido ter um sono de boa ou muito boa qualidade, o uso de ecrãs ≥6 horas/dia e na hora antes de dormir associou-se a privação de sono durante a semana e SDE. Conclusão: O uso excessivo de ecrãs durante a pandemia parece ter tido um impacto negativo no sono dos adolescentes. Estes dados reforçam a necessidade de identificar e intervir nestes problemas durante a abordagem de saúde global do adolescente.

Abstract The Atlantic goliath grouper Epinephelus itajara is the largest grouper species in the Atlantic Ocean. Despite the conservation status being Vulnerable (VU) globally and Critically Endangered (CR) in Brazil, the species continues to face threats from overfishing throughout its range. We used DNA barcoding employing the mitochondrial Cytochrome c oxidase subunit I (COI) gene to identify the illegal commercialization of E. itajara in fish markets from the northern (NC) and southern (SC) Brazilian coasts. Sampling was conducted in fish markets and aimed to confirm the identification of mischaracterized fish sold as E. itajara in the NC, as well as identifying fish fillets sold as the Dusky grouper in the SC. DNA barcoding allowed the unambiguous identification of 22 (84.6%) of the 26 analyzed fish market samples. Both sampled areas had confirmation of E. itajara illegal commercialization and from the 22 analyzed samples, 17 (77.3%) were confirmed to be E. itajara. Here we report two crimes, the illegal sale of E. itajara and commercial fraud by species substitution. This study has highlighted that the existing legislation that protects E. itajara in Brazilian waters requires the adoption of better public policies for the conservation of the species. Ocean VU (VU CR (CR Brazil range COI (COI E NC (NC SC (SC coasts 2 84.6% 846 84 6 (84.6% samples 1 77.3% 773 77 3 (77.3% crimes substitution 84.6 8 (84.6 77.3 7 (77.3 84. (84. 77. (77. (84 (77 (8 (7 (

Resumo O mero do Atlântico Epinephelus itajara é a maior espécie de garoupa no Oceano Atlântico. Apesar do seu status de conservação Vulnerável (VU) globalmente e Criticamente em Perigo (CR) no Brasil, a espécie continua enfrentando ameaças da sobrepesca em toda a sua área de distribuição. Utilizamos o sequenciamento de DNA por código de barras, empregando o gene mitocondrial da Citocromo c oxidase subunidade I (COI), para identificar a comercialização ilegal de E. itajara em mercados de peixe nas costas norte (CN) e sul (CS) do Brasil. A coleta de amostras foi realizada em mercados de peixe e teve como objetivo confirmar a identificação de peixes descaracterizados e vendidos como E. itajara na CN, bem como identificar filés de peixe vendidos como garoupa verdadeira na CS. O sequenciamento de DNA por código de barras permitiu a identificação inequívoca de 22 (84,6%) das 26 amostras de mercado de peixe analisadas. Ambas as áreas amostradas tiveram confirmação da comercialização ilegal de E. itajara, e das 22 amostras analisadas, 17 (77,3%) foram confirmadas como E. itajara. Nós relatamos aqui dois crimes, a venda ilegal de E. itajara e a fraude comercial por substituição de espécies. Este estudo ressaltou que a legislação existente que protege E. itajara em águas brasileiras requer a adoção de melhores políticas públicas para a conservação da espécie. VU (VU CR (CR Brasil distribuição COI, COI , (COI) E CN (CN CS (CS 2 84,6% 846 84 6 (84,6% analisadas 1 77,3% 773 77 3 (77,3% crimes espécies (COI 84,6 8 (84,6 77,3 7 (77,3 84, (84, 77, (77, (84 (77 (8 (7 (

Abstract In Brazil, lima bean is mainly grown in the Northeast region, where it is widely consumed and is of major economic importance. We evaluated different Phaseolus lunatus accessions from the Northeast of Brazil using agromorphological markers and CMA/DAPI fluorochrome banding techniques. All the accessions showed CMA+ blocks of pericentromeric constitutive heterochromatin (CH). At least one pair of CMA++ terminal marks corresponds to the nucleolus organizer region (NORs). Characterization of the seeds suggests that the two Andean and Mesoamerican Phaseolus cultigroups are represented in the Brazilian germplasm analyzed. Most of them belong to the "Big Lima" group. Characterization studies of lima bean germplasm are important for increasing knowledge of the diversity and variability of the species and for generating useful information for breeding and conservation of this economically important legume. importance CMADAPI CMA DAPI techniques CH. CH . (CH) NORs. NORs (NORs) analyzed Big Lima group legume (CH (NORs

Abstract Background Increased malignancy frequency is well documented in adult-systemic lupus erythematosus (SLE), but with limited reports in childhood-onset SLE (cSLE) series. We explored the frequency of malignancy associated with cSLE, describing clinical and demographic characteristics, disease activity and cumulative damage, by the time of malignancy diagnosis. Method A retrospective case-notes review, in a nationwide cohort from 27 Pediatric Rheumatology centres, with descriptive biopsy-proven malignancy, disease activity/damage accrual, and immunosuppressive treatment were compiled in each participating centre, using a standard protocol. Results Of the 1757 cSLE cases in the updated cohort, 12 (0.7%) developed malignancy with median time 10 years after cSLE diagnosis. There were 91% females, median age at cSLE diagnosis 12 years, median age at malignancy diagnosis 23 years. Of all diagnosed malignancies, 11 were single-site, and a single case with concomitant multiple sites; four had haematological (0.22%) and 8 solid malignancy (0.45%). Median (min–max) SLEDAI-2 K scores were 9 (0–38), median (min–max) SLICC/ACR-DI (SDI) score were 1 (1–5) Histopathology defined 1 Hodgkin's lymphoma, 2 non-Hodgkin's lymphoma, 1 acute lymphoblastic leukaemia; 4 gastrointestinal carcinoma, 1 squamous cell carcinoma of the tongue and 1 anal carcinoma; 1 had sigmoid adenocarcinoma and 1 stomach carcinoid; 3 had genital malignancy, being 1 vulvae, 1 cervix and 1 vulvae and cervix carcinomas; 1 had central nervous system oligodendroglioma; and 1 testicle germ cell teratoma. Conclusion Estimated malignancy frequency of 0.7% was reported during cSLE follow up in a multicentric series. Median disease activity and cumulative damage scores, by the time of malignancy diagnoses, were high; considering that reported in adult series. adultsystemic systemic SLE, , (SLE) childhoodonset childhood onset (cSLE series characteristics casenotes notes review centres biopsyproven biopsy proven activitydamage accrual centre protocol 175 07 0 7 (0.7% 91 females malignancies singlesite, singlesite site, site single-site sites 0.22% 022 22 (0.22% 0.45%. 045 0.45% . 45 (0.45%) min–max minmax min max (min–max SLEDAI2 SLEDAI SLEDAI- 0–38, 038 0–38 38 (0–38) SLICC/ACRDI SLICCACRDI SLICC/ACR DI SLICC ACR SDI (SDI 1–5 15 5 (1–5 Hodgkins Hodgkin s lymphoma nonHodgkins non leukaemia carcinoid carcinomas oligodendroglioma teratoma 0.7 diagnoses high (SLE 17 (0.7 0.22 02 (0.22 04 0.45 (0.45% 03 0–3 (0–38 ACRDI SLICCACR 1– (1– 0. (0. 0.2 (0.2 0.4 (0.45 0– (0–3 (1 (0 (0.4 (0– (

ABSTRACT OBJECTIVE To present the results of a cost analysis of remote consultations (teleconsultations) compared to in-person consultations for patients with type 2 diabetes, in the Brazilian public healthcare system (SUS) in the city of Joinville, Santa Catarina (SC). In addition to the costs from the local manager’s perspective, the article also presents estimates from the patient’s perspective, based on the transportation costs associated with each type of consultation. METHOD Data were collected from 246 consultations, both remote and in-person, between 2021 and 2023, in the context of a randomized clinical trial on the impact of teleconsultation carried out in the city of Joinville, SC. Teleconsultations were carried out at Primary Health Units (PHU) and in-person consultations at the Specialized Health Center. The consultation costs were calculate by the method time and activity-based costing (TDABC), and for the estimate of transportation costs data was collected directly from the research participants . The mean costs and time required to carry out each type of consultation in different scenarios and perspectives were analyzed and compared descriptively. RESULTS Considering only the local SUS manager’s perspective, the costs for carrying out a teleconsultation were 4.5% higher than for an in-person consultation. However, when considering the transportation costs associated with each patient, the estimated value of the in-person consultation becomes 7.7% higher and, in the case of consultations in other municipalities, 15% higher than the teleconsultation. CONCLUSION The results demonstrate that the incorporation of teleconsultation within the SUS can bring economic advantages depending on the perspective and scenario considered, in addition to being a strategy with the potential to increase access to specialized care in the public network. teleconsultations (teleconsultations inperson person diabetes (SUS Joinville SC (SC) managers manager s patient 24 inperson, person, 202 2023 PHU (PHU Center activitybased activity TDABC, TDABC , (TDABC) descriptively 45 4 5 4.5 However 77 7 7.7 municipalities 15 considered network (SC 20 (TDABC 4. 7. 1

RESUMO OBJETIVO Apresentar os resultados da análise de custos para a modalidade de consulta remota (teleconsulta) em comparação à consulta presencial, em pacientes com diabetes do tipo 2, no Sistema Único de Saúde (SUS) brasileiro, na cidade Joinville, Santa Catarina. Para além dos custos, sob a perspectiva do gestor local, o artigo também apresenta estimativas sob perspectiva do paciente, a partir dos custos de transporte associados a cada modalidade de consulta. MÉTODO Foram coletados dados de 246 consultas, remotas e presenciais, entre 2021 e 2023, no contexto de um ensaio clínico randomizado sobre o impacto da teleconsulta realizado na cidade de Joinville, SC. As teleconsultas foram realizadas em Unidades Básicas de Saúde (UBS) e as consultas presenciais no Centro de Saúde Especializada. Para o cálculo dos custos, foi utilizado o método de custos baseado em tempo e atividade (TDABC) e, para o cálculo dos custos relativos aos transportes dos pacientes, foram coletados dados diretamente com os participantes da pesquisa. Foram analisados e comparados descritivamente os custos médios e o tempo de realização de cada modalidade de consulta em diferentes cenários e perspectivas. RESULTADOS Considerando apenas a perspectiva do gestor local do SUS, os custos para a realização da teleconsulta se mostraram 4,5% maiores do que para uma consulta presencial. Contudo, quando considerados os custos de transporte associados a cada paciente, o valor estimado da consulta presencial passa a ser 7,7% maior e, no caso de consultas em outros municípios, 15% maior do que a teleconsulta. CONCLUSÃO Os resultados demonstram que a incorporação da teleconsulta dentro do SUS pode trazer vantagens econômicas, a depender da perspectiva e do cenário considerado, além de ser uma estratégia com potencial para aumentar o acesso à atenção especializada na rede pública. (teleconsulta 2 (SUS brasileiro Joinville Catarina paciente 24 202 2023 SC UBS (UBS Especializada TDABC (TDABC pesquisa perspectivas 45 4 5 4,5 Contudo 77 7 7,7 municípios 15 econômicas considerado pública 20 4, 7, 1

Resumen: Aunque Brasil ha presentado avances en la atención obstétrica en hospitales públicos y privados, todavía hay puntos débiles que necesitan atención. El Ministerio de Salud, consciente de esta necesidad, financió la segunda versión de la encuesta Nacer en Brasil. Los objetivos generales son: evaluar la atención prenatal, el parto y el nacimiento, el puerperio y el aborto, comparando con los resultados del Nacer en Brasil I, y analizar los principales determinantes de la morbimortalidad perinatal; evaluar la estructura y los procesos de atención de los servicios de obstetricia y neonatología en las maternidades; analizar los conocimientos, prácticas y actitudes de los profesionales de la salud que brindan atención para el parto y el aborto; e identificar las principales barreras y facilitadores para esta atención en el país. Tiene un alcance nacional y muestra probabilística en dos etapas (1-hospitales y 2-mujeres), la cual se dividió en 59 estratos; y se seleccionaron 465 hospitales con un total planificado de aproximadamente 24.255 mujeres, de las cuales 2.205 tuvieron procedimientos por aborto y 22.050 por parto. Para la recolección de datos se aplicó seis instrumentos electrónicos, que se realizó durante la hospitalización por parto o aborto, con dos rondas de seguimiento, a los dos y cuatro meses. Con el fin de ampliar el número de casos de morbilidad materna grave, mortalidad materna y perinatal, se incorporaron tres estudios de casos y controles en Nacer en Brasil II. El trabajo de campo comenzó en noviembre de 2021 y finalizará en 2023. Los resultados nos permitirán evaluar la atención al parto y al nacimiento actual con lo que se retrató en la primera encuesta, de esta manera se podrá evaluar los avances alcanzados a lo largo de estos 10 años. Resumen privados Salud necesidad son prenatal I perinatal maternidades conocimientos país 1hospitales 1 2mujeres, 2mujeres mujeres 2 , 2-mujeres) 5 estratos 46 24255 24 255 24.25 2205 205 2.20 22050 22 050 22.05 electrónicos seguimiento meses grave II 202 2023 años 2-mujeres 4 2425 25 24.2 220 20 2.2 05 22.0 242 24. 2. 0 22.

Abstract: Brazil has made advances in obstetric care in public and private hospitals; however, weaknesses in this system still require attention. The Brazilian Ministry of Health, aware of this need, funded the second version of the Birth in Brazil survey. This study aimed to evaluate: prenatal, labor and birth, postpartum, and abortion care, comparing the results with those of Birth in Brazil I; and analyze the main determinants of perinatal morbidity and mortality; evaluate the care structure and processes of obstetrics and neonatology services in maternity hospitals; analyze the knowledge, practices, and attitudes of health professionals who provide birth and abortion care; and identify the main barriers and facilitators related to care of this nature in Brazil. With a national scope and a 2-stage probability sample: 1-hospitals and 2-women, stratified into 59 strata, 465 hospitals were selected with a total planned sample of around 24,255 women - 2,205 for abortion reasons and 22,050 for labor reasons. Data collection was conducted using six electronic instruments during hospital admission for labor or abortion, with two follow-up waves, at two and four months. In order to expand the number of cases of severe maternal morbidity, maternal and perinatal mortality, three case control studies were incorporated into Birth in Brazil II. The fieldwork began in November 2021 and is scheduled to end in 2023. It will allow a comparison between current labor and birth care results and those obtained in the first study and will evaluate the advances achieved in 10 years. Abstract however attention Health need survey prenatal postpartum I mortality knowledge practices 2stage stage 2 1hospitals 1 2women, 2women women, 2-women 5 strata 46 24255 24 255 24,25 2205 205 2,20 22050 22 050 22,05 followup follow up waves months II 202 2023 years 4 2425 25 24,2 220 20 2,2 05 22,0 242 24, 2, 0 22,

Resumo: Com o passar do tempo, o Brasil vem apresentando avanços na assistência obstétrica em hospitais públicos e privados; no entanto, ainda existem pontos frágeis que necessitam de atenção. O Ministério da Saúde, ciente dessa necessidade, financiou a segunda versão da pesquisa Nascer no Brasil. Os objetivos gerais são: avaliar a assistência pré-natal, ao parto e nascimento, ao puerpério e ao aborto, comparando com os resultados do Nascer no Brasil I, e analisar os principais determinantes da morbimortalidade perinatal; avaliar a estrutura e processos assistenciais dos serviços de obstetrícia e neonatologia das maternidades; analisar os conhecimentos, atitudes e práticas de profissionais de saúde que prestam assistência ao parto e ao aborto; e identificar as principais barreiras e facilitadores para essa assistência no país. Com escopo nacional e amostra probabilística em dois estágios (1-hospitais e 2-mulheres), dividida em 59 estratos, foram selecionados 465 hospitais com total planejado de, aproximadamente, 24.255 mulheres, 2.205 por motivo de aborto e 22.050 por motivo de parto. A coleta de dados, realizada por meio de seis instrumentos eletrônicos, ocorre durante a internação hospitalar para o parto ou aborto, com duas ondas de seguimento, aos dois e quatro meses. Com o intuito de expandir o número de casos de morbidade materna grave, mortalidade materna e perinatal, três estudos caso controle foram incorporados ao Nascer no Brasil II. O trabalho de campo foi iniciado em novembro de 2021 com término previsto para 2023. Os resultados permitirão comparar a atenção atual ao parto e ao nascimento com a retratada no primeiro inquérito e, com isso, avaliar os avanços alcançados no decorrer desses 10 anos. Resumo tempo privados entanto Saúde necessidade são prénatal, prénatal pré natal, natal pré-natal I perinatal maternidades conhecimentos país 1hospitais 1 2mulheres, 2mulheres mulheres 2 , 2-mulheres) 5 estratos 46 aproximadamente 24255 24 255 24.25 2205 205 2.20 22050 22 050 22.05 dados eletrônicos seguimento meses grave II 202 2023 isso anos 2-mulheres 4 2425 25 24.2 220 20 2.2 05 22.0 242 24. 2. 0 22.

Abstract Objective To analyze marital outcomes, divorce or separation, and its association with demographic, socioeconomic, and clinicopathological factors among breast cancer (BC) survivors after 2-years of diagnosis. Methods We performed a retrospective analysis of marital status at baseline and at years 1 and 2 of follow-up of women aged ≥ 18 years diagnosed with invasive BC participating in the AMAZONA III (GBECAM0115) study. The BC diagnosis occurred between January 2016 and March 2018 at 23 institutions in Brazil. Results Of the 2974 women enrolled in AMAZONA III, 599 were married or living under common law at baseline. Divorce or separation occurred in 35 (5.8%) patients at 2 years of follow-up. In the multivariate analysis, public health insurance coverage was associated with a higher risk of marital status change (8.25% vs. 2.79%, RR 3.09, 95% CI 1.39 - 7.03, p = 0.007). Women who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation (8.1% vs. 4.49%, RR 1.97, 95 CI 1.04 – 3.72, p = 0.0366) than those who underwent breast-conserving surgery. Conclusion Women covered by the public health system and those who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation. This evidence further supports the idea that long-term marital stability is associated with a complex interplay between socioeconomic conditions and stressors, such as BC diagnosis and treatment. ClinicalTrials Registration: NCT02663973. outcomes demographic (BC 2years followup follow up GBECAM0115 GBECAM (GBECAM0115 study 201 Brazil 297 59 3 5.8% 58 5 8 (5.8% followup. up. 8.25% 825 25 (8.25 vs 279 79 2.79% 309 09 3.09 139 39 1.3 703 7 03 7.03 0.007. 0007 0.007 . 0 007 0.007) skinsparing skin sparing 8.1% 81 (8.1 449 4 49 4.49% 197 97 1.97 9 104 04 1.0 372 72 3.72 0.0366 00366 0366 breastconserving conserving surgery longterm long term stressors treatment Registration NCT02663973 NCT GBECAM011 (GBECAM011 20 29 5.8 (5.8 8.25 82 (8.2 27 2.79 30 3.0 13 1. 70 7.0 000 0.00 00 8.1 (8. 44 4.49 19 1.9 10 37 3.7 0.036 0036 036 NCT0266397 GBECAM01 (GBECAM01 5. (5. 8.2 2.7 3. 7. 0.0 8. (8 4.4 0.03 003 NCT026639 GBECAM0 (GBECAM0 (5 2. 0. ( 4. NCT02663 (GBECAM NCT0266 NCT026 NCT02 NCT0

ABSTRACT The article aims to approach the theoretical-epistemological contribution of Objective Hermeneutics (OH) to research on textbooks. To this end, we analyzed a high school Portuguese language textbook approved by the national school textbook plan in 2018. Based on the principles of HO, qualitative analyses were developed with a multidisciplinary team from the field of Education. The results reveal that the use of the method is appropriate for research on textbooks, since it enables the identification of contradictions established between the textbook and its internal (Teacher’s Book and Answer keys) and external (official documents) referentials, as well as a better understanding of the role played by paratexts and iconographic elements. theoreticalepistemological theoretical epistemological OH (OH textbooks end 2018 HO Education Teachers Teacher s keys official documents referentials elements 201 20 2

RESUMO O objetivo do artigo é aproximar o aporte teórico-epistemológico da Hermenêutica Objetiva (HO) das análises de livros didáticos. Compõe o corpus de pesquisa uma coleção de Português do Ensino Médio aprovada pelo Programa Nacional do Livro Didático em 2018. Com base nos princípios da HO, foram desenvolvidas análises qualitativas junto a uma equipe multidisciplinar de pesquisadores da área de Educação. Os resultados indicam que o uso do método é adequado aos estudos sobre a materialidade textual dos livros escolares, visto que possibilita a identificação de contradições estabelecidas entre o livro didático e seus referenciais internos (Manual do Professor e gabaritos) e externos (documentos oficiais), assim como uma melhor compreensão do papel exercido por paratextos e elementos iconográficos. teóricoepistemológico teórico epistemológico HO (HO didáticos 2018 Educação escolares Manual gabaritos documentos oficiais, oficiais , oficiais) iconográficos 201 20 2

ABSTRACT The objective of this study was to examine the effect of the increasing levels of inclusion of palm kernel cake (PKC) in the diet on the performance of feedlot heifers. Forty-eight Nelore heifers with an initial weight of 274 ± 4.58 kg, at 24 months of age, were confined for 98 days in a feedlot. The animals were allocated to the four treatments in a completely randomized design. Treatments consisted of PKC levels of 0 (control), 10, 20, and 30% in the total dry matter of the diet. The roughage:concentrate ratio in the diets was 30:70. Ether extract intake increased, whereas the intakes of non-fiber carbohydrates and total digestible nutrients decreased with the inclusion of PKC. The apparent digestibility of all nutrients decreased, as well as the amounts of nitrogen digested and retained. Microbial protein synthesis and its efficiency also declined. The inclusion of up to 20% PKC increased feeding time and reduced rumination time of heifers. Intake and rumination efficiencies decreased with the inclusion of PKC in the diet. Final weight and average daily gain did not change, but feed efficiency increased with the inclusion of PKC. The inclusion of up to 30% PKC in the diet of feedlot heifers is recommended. (PKC Fortyeight Forty eight 27 458 4 58 4.5 kg 2 age 9 design control, control , (control) 10 20 30 roughageconcentrate roughage concentrate 3070. 3070 70. 70 30:70 nonfiber non fiber retained declined change recommended 45 5 4. (control 1 3 307 7 30:7 30:

Abstract Objective To develop and validate an educational material for the construction of a postpartum plan by women in the pregnancy-puerperal cycle, with or without health professionals. Methods Methodological study, organized in three stages. 1) Content analysis and selection, theoretical elaboration of the project and language adaptation; 2) Production of material, with preparation of graphic design and illustrative project; 3) Validation with seven judges in the areas of women’s health and health education. Data collection was carried out using a characterization questionnaire and the Suitability Assessment of Materials for evaluation of health-related information for adults (SAM). The analysis was carried out using descriptive statistics and Content Validity Index, with items that presented a value equal to or greater than 0.80 being considered approved. Results The care plan entitled “My postpartum plan” showed excellent acceptance and reliability, evidenced by an overall Content Validity Index of 0.98. The main suggestions presented were about adapting the writing to a simpler and more accessible language, which were accepted by the authors. Experts highlighted the importance and relevance of the postpartum plan for the target audience. Conclusion The material proved to be a valid and reliable instrument for use by women during the pregnancy and puerperal cycle, encouraging reflection on care and early preparation to face this period. pregnancypuerperal cycle professionals study stages 1 selection adaptation 2 3 womens s education healthrelated related SAM. SAM . (SAM) 080 0 80 0.8 approved My reliability 098 98 0.98 authors audience period (SAM 08 8 0. 09 9 0.9

Resumen Objetivo Elaborar y validar material educativo para la creación de un plan de posparto por la mujer durante el embarazo y el puerperio, con o sin profesionales de la salud. Métodos Estudio metodológico, organizado en tres etapas: 1) análisis y selección de contenido, elaboración teórica del proyecto y adaptación del lenguaje; 2) producción del material, con elaboración del diseño gráfico y proyecto ilustrativo, y 3) validación por siete jueces de áreas de la salud de la mujer y educación para la salud. La recopilación de datos se llevó a cabo mediante la aplicación de un cuestionario de caracterización y el Suitability Assessment of Materials for evaluation of health-related information for adults (SAM). El análisis se realizó con estadística descriptiva y con el Índice de Validez de Contenido, donde se consideraron aprobados los ítems que presentaron un valor igual o superior a 0,80. Resultados El plan de cuidado llamado “Mi plan de posparto” presentó una excelente aceptación y fiabilidad, demostradas con un Índice de Validez de Contenido global de 0,98. Las principales sugerencias propuestas fueron sobre adaptar la escritura a un lenguaje más simple y accesible, y las autoras las aceptaron. Los especialistas señalaron la importancia y la relevancia del plan de posparto para el público destinatario. Conclusión El material demostró ser un instrumento válido y confiable para que lo utilicen mujeres durante el embarazo y el puerperio, y así favorecer una reflexión sobre los cuidados y la preparación temprana para enfrentar este período. puerperio metodológico etapas 1 contenido 2 ilustrativo 3 healthrelated health related SAM. SAM . (SAM) 080 0 80 0,80 Mi fiabilidad 098 98 0,98 accesible aceptaron destinatario período (SAM 08 8 0,8 09 9 0,9 0,

Resumo Objetivo Desenvolver e validar material educativo para a construção de um plano de pós-parto pela mulher no ciclo gravídico-puerperal, com ou não profissionais da saúde. Métodos Estudo metodológico, organizado em três etapas. 1) Análise e seleção de conteúdo, elaboração teórica do projeto e adaptação na linguagem; 2) Produção do material, com elaboração do design gráfico e projeto ilustrativo; 3) Validação com sete juízes nas áreas de saúde da mulher e educação em saúde. A coleta de dados foi executada com a aplicação de um questionário de caracterização e o Suitability Assessment of Materials for evaluation of health-related information for adults (SAM). A análise se deu por estatística descritiva e Índice de Validade de Conteúdo, sendo considerados aprovados os itens que apresentassem valor igual ou superior a 0,80. Resultados O plano de cuidado intitulado “Meu plano de pós-parto” apresentou ótima aceitação e confiabilidade, evidenciado por um Índice de Validade de Conteúdo global de 0,98. As principais sugestões apresentadas foram a respeito da adaptação da escrita para uma linguagem mais simples e acessível, sendo estas aceitas pelas autoras. Os especialistas apontaram a importância e relevância do plano de pós-parto para o público-alvo. Conclusão O material demonstrou ser um instrumento válido e confiável para a utilização das mulheres durante o ciclo gravídico puerperal, favorecendo uma reflexão sobre os cuidados e preparo precoce para enfrentamento deste período. pósparto pós parto gravídicopuerperal, gravídicopuerperal puerperal gravídico-puerperal metodológico etapas 1 conteúdo 2 ilustrativo 3 healthrelated health related SAM. SAM . (SAM) 080 0 80 0,80 Meu confiabilidade 098 98 0,98 acessível autoras públicoalvo. públicoalvo público alvo. alvo público-alvo período (SAM 08 8 0,8 09 9 0,9 0,

Resumen: Aunque Brasil ha presentado avances en la atención obstétrica en hospitales públicos y privados, todavía hay puntos débiles que necesitan atención. El Ministerio de Salud, consciente de esta necesidad, financió la segunda versión de la encuesta Nacer en Brasil. Los objetivos generales son: evaluar la atención prenatal, el parto y el nacimiento, el puerperio y el aborto, comparando con los resultados del Nacer en Brasil I, y analizar los principales determinantes de la morbimortalidad perinatal; evaluar la estructura y los procesos de atención de los servicios de obstetricia y neonatología en las maternidades; analizar los conocimientos, prácticas y actitudes de los profesionales de la salud que brindan atención para el parto y el aborto; e identificar las principales barreras y facilitadores para esta atención en el país. Tiene un alcance nacional y muestra probabilística en dos etapas (1-hospitales y 2-mujeres), la cual se dividió en 59 estratos; y se seleccionaron 465 hospitales con un total planificado de aproximadamente 24.255 mujeres, de las cuales 2.205 tuvieron procedimientos por aborto y 22.050 por parto. Para la recolección de datos se aplicó seis instrumentos electrónicos, que se realizó durante la hospitalización por parto o aborto, con dos rondas de seguimiento, a los dos y cuatro meses. Con el fin de ampliar el número de casos de morbilidad materna grave, mortalidad materna y perinatal, se incorporaron tres estudios de casos y controles en Nacer en Brasil II. El trabajo de campo comenzó en noviembre de 2021 y finalizará en 2023. Los resultados nos permitirán evaluar la atención al parto y al nacimiento actual con lo que se retrató en la primera encuesta, de esta manera se podrá evaluar los avances alcanzados a lo largo de estos 10 años.

Resumo: Com o passar do tempo, o Brasil vem apresentando avanços na assistência obstétrica em hospitais públicos e privados; no entanto, ainda existem pontos frágeis que necessitam de atenção. O Ministério da Saúde, ciente dessa necessidade, financiou a segunda versão da pesquisa Nascer no Brasil. Os objetivos gerais são: avaliar a assistência pré-natal, ao parto e nascimento, ao puerpério e ao aborto, comparando com os resultados do Nascer no Brasil I, e analisar os principais determinantes da morbimortalidade perinatal; avaliar a estrutura e processos assistenciais dos serviços de obstetrícia e neonatologia das maternidades; analisar os conhecimentos, atitudes e práticas de profissionais de saúde que prestam assistência ao parto e ao aborto; e identificar as principais barreiras e facilitadores para essa assistência no país. Com escopo nacional e amostra probabilística em dois estágios (1-hospitais e 2-mulheres), dividida em 59 estratos, foram selecionados 465 hospitais com total planejado de, aproximadamente, 24.255 mulheres, 2.205 por motivo de aborto e 22.050 por motivo de parto. A coleta de dados, realizada por meio de seis instrumentos eletrônicos, ocorre durante a internação hospitalar para o parto ou aborto, com duas ondas de seguimento, aos dois e quatro meses. Com o intuito de expandir o número de casos de morbidade materna grave, mortalidade materna e perinatal, três estudos caso controle foram incorporados ao Nascer no Brasil II. O trabalho de campo foi iniciado em novembro de 2021 com término previsto para 2023. Os resultados permitirão comparar a atenção atual ao parto e ao nascimento com a retratada no primeiro inquérito e, com isso, avaliar os avanços alcançados no decorrer desses 10 anos.

Abstract: Brazil has made advances in obstetric care in public and private hospitals; however, weaknesses in this system still require attention. The Brazilian Ministry of Health, aware of this need, funded the second version of the Birth in Brazil survey. This study aimed to evaluate: prenatal, labor and birth, postpartum, and abortion care, comparing the results with those of Birth in Brazil I; and analyze the main determinants of perinatal morbidity and mortality; evaluate the care structure and processes of obstetrics and neonatology services in maternity hospitals; analyze the knowledge, practices, and attitudes of health professionals who provide birth and abortion care; and identify the main barriers and facilitators related to care of this nature in Brazil. With a national scope and a 2-stage probability sample: 1-hospitals and 2-women, stratified into 59 strata, 465 hospitals were selected with a total planned sample of around 24,255 women - 2,205 for abortion reasons and 22,050 for labor reasons. Data collection was conducted using six electronic instruments during hospital admission for labor or abortion, with two follow-up waves, at two and four months. In order to expand the number of cases of severe maternal morbidity, maternal and perinatal mortality, three case control studies were incorporated into Birth in Brazil II. The fieldwork began in November 2021 and is scheduled to end in 2023. It will allow a comparison between current labor and birth care results and those obtained in the first study and will evaluate the advances achieved in 10 years.

RESUMO OBJETIVO Apresentar os resultados da análise de custos para a modalidade de consulta remota (teleconsulta) em comparação à consulta presencial, em pacientes com diabetes do tipo 2, no Sistema Único de Saúde (SUS) brasileiro, na cidade Joinville, Santa Catarina. Para além dos custos, sob a perspectiva do gestor local, o artigo também apresenta estimativas sob perspectiva do paciente, a partir dos custos de transporte associados a cada modalidade de consulta. MÉTODO Foram coletados dados de 246 consultas, remotas e presenciais, entre 2021 e 2023, no contexto de um ensaio clínico randomizado sobre o impacto da teleconsulta realizado na cidade de Joinville, SC. As teleconsultas foram realizadas em Unidades Básicas de Saúde (UBS) e as consultas presenciais no Centro de Saúde Especializada. Para o cálculo dos custos, foi utilizado o método de custos baseado em tempo e atividade (TDABC) e, para o cálculo dos custos relativos aos transportes dos pacientes, foram coletados dados diretamente com os participantes da pesquisa. Foram analisados e comparados descritivamente os custos médios e o tempo de realização de cada modalidade de consulta em diferentes cenários e perspectivas. RESULTADOS Considerando apenas a perspectiva do gestor local do SUS, os custos para a realização da teleconsulta se mostraram 4,5% maiores do que para uma consulta presencial. Contudo, quando considerados os custos de transporte associados a cada paciente, o valor estimado da consulta presencial passa a ser 7,7% maior e, no caso de consultas em outros municípios, 15% maior do que a teleconsulta. CONCLUSÃO Os resultados demonstram que a incorporação da teleconsulta dentro do SUS pode trazer vantagens econômicas, a depender da perspectiva e do cenário considerado, além de ser uma estratégia com potencial para aumentar o acesso à atenção especializada na rede pública.

ABSTRACT OBJECTIVE To present the results of a cost analysis of remote consultations (teleconsultations) compared to in-person consultations for patients with type 2 diabetes, in the Brazilian public healthcare system (SUS) in the city of Joinville, Santa Catarina (SC). In addition to the costs from the local manager’s perspective, the article also presents estimates from the patient’s perspective, based on the transportation costs associated with each type of consultation. METHOD Data were collected from 246 consultations, both remote and in-person, between 2021 and 2023, in the context of a randomized clinical trial on the impact of teleconsultation carried out in the city of Joinville, SC. Teleconsultations were carried out at Primary Health Units (PHU) and in-person consultations at the Specialized Health Center. The consultation costs were calculate by the method time and activity-based costing (TDABC), and for the estimate of transportation costs data was collected directly from the research participants . The mean costs and time required to carry out each type of consultation in different scenarios and perspectives were analyzed and compared descriptively. RESULTS Considering only the local SUS manager’s perspective, the costs for carrying out a teleconsultation were 4.5% higher than for an in-person consultation. However, when considering the transportation costs associated with each patient, the estimated value of the in-person consultation becomes 7.7% higher and, in the case of consultations in other municipalities, 15% higher than the teleconsultation. CONCLUSION The results demonstrate that the incorporation of teleconsultation within the SUS can bring economic advantages depending on the perspective and scenario considered, in addition to being a strategy with the potential to increase access to specialized care in the public network.

With the increase in industrial production, there is a direct increase in waste generation. Milk processing industries are one of these cases that results in a complex effluent with a high organic load. If the effluent is discarded without proper treatment, it can compromise the survival of biota in water courses. Advanced oxidation processes (AOP) are one of the main technologies used in the treatment of effluents, especially the Photocatalysis-Self-Fenton System (PF) type. The present study aimed to evaluate the efficiency of the PF process and to optimize the parameters of dairy effluent treatment. The raw effluent was characterized considering the parameters: conductivity, pH, chemical oxygen demand (COD), solids, and oils and greases. Through an experimental design, the variation of the concentrations of Fe2+, H2O2 and the reaction time were optimized, and the influence of these three variables on the removal of COD was evaluated. Statistical analysis showed that all variables were statistically significant, and the model used had a coefficient of determination of 0.97, confirming that the model was well adjusted. The ideal conditions for COD removal, reaching 79%, were obtained in 60 min, 0.625 g L-1 of Fe2+ and 0.829 mL L-1 of H2O2. production generation load courses AOP (AOP effluents PhotocatalysisSelfFenton Photocatalysis Self Fenton (PF type conductivity pH COD, , (COD) solids greases design Fe2 Fe HO H O H2O optimized evaluated significant 097 0 97 0.97 adjusted 79 79% 6 min 0625 625 0.62 L1 L 1 L- 0829 829 0.82 (COD 09 9 0.9 7 062 62 0.6 082 82 0.8 0. 06 08 8

ABSTRACT Objective: To measure the costs of preventive and therapeutic protocols of Photobiomodulation (PBM) for oral mucositis (OM) and their budgetary impact on Brazil’s Ministry of Health (BMH). Material and Methods: A partial economic analysis was performed to estimate the costs using a bottom-up approach from a social perspective. Monetary values were assigned in Brazilian reais (BRL). The costs of the preventive protocol were calculated for five, 30, and 33 consecutive PBM sessions, depending on the antineoplastic treatment instituted. The costs of the therapeutic protocol were calculated for 5 or 10 sessions. The annual financial and budgetary impact was calculated considering the groups of oncologic patients with a higher risk of development of OM, such as those with head and neck and hematological cancer and pediatric patients. Results: The cost of a PBM session was estimated at BRL 23.75. The financial impact of providing one preventive protocol per year for all oncologic patients would be BRL 14,282,680.00, 0.030% of the estimated budget for hospital and outpatient care of the BMH in 2022. The financial and budgetary impacts of providing one treatment for OM for all patients in one year would be BRL 2,225,630.31 (0.005%, most optimistic scenario) and BRL 4,451,355.63 (0.009%, most pessimistic scenario). Conclusion: The budgetary impact of implementing PBM protocols in the Brazilian Healthcare System is small, even in a pessimistic scenario. Objective (PBM (OM Brazils Brazil s BMH. . (BMH) Methods bottomup bottom up perspective BRL. (BRL) five 30 3 sessions instituted 1 Results 2375 23 75 23.75 1428268000 14 282 680 00 14,282,680.00 0030 0 030 0.030 2022 222563031 2 225 630 31 2,225,630.3 0.005%, 0005 005 (0.005% scenario 445135563 4 451 355 63 4,451,355.6 0.009%, 0009 009 (0.009% Conclusion small (BMH (BRL 237 7 23.7 142826800 28 68 14,282,680.0 003 03 0.03 202 22256303 22 2,225,630. 0.005% 000 (0.005 44513556 45 35 6 4,451,355. 0.009% (0.009 23. 14282680 14,282,680. 0.0 20 2225630 2,225,630 0.005 (0.00 4451355 4,451,355 0.009 1428268 14,282,680 0. 222563 2,225,63 0.00 (0.0 445135 4,451,35 142826 14,282,68 22256 2,225,6 (0. 44513 4,451,3 14282 14,282,6 2225 2,225, (0 4451 4,451, 1428 14,282, 222 2,225 ( 445 4,451 142 14,282 2,22 44 4,45 14,28 2,2 4,4 14,2 2, 4, 14,

ABSTRACT This study used a pedigree analysis to monitor trends in the genetic structure of the Mangalarga breed and identify factors that could impact its genetic variability. For this, genealogical information was used from the Associação Brasileira dos Criadores de Cavalo da Raça Mangalarga, considering as total population (TP) the animals born between 1919 and 2018 (n = 206,426) and as reference population (RP) those born between 2009 and 2018 (n = 20,539), which is the most recent generation according to the average generation interval calculated for the breed of 9.37 years. We evaluated the number of male and female births per year, foals produced by Mangalarga breeding animals, using the ENDOG 4.8, generation interval, proportion of known ancestors per parental generation, number of equivalent generations known per animal, inbreeding coefficient, increase in inbreeding, average relatedness (AR), effective population size, effective number of founders, effective number of ancestors, and founder genome equivalent. The number of equivalent generations known per animal increased over time, reaching an average of 2.75 in TP and 4.88 in RP. The calculated F was 2.26% for TP and 5.57% for RP, while AR was 2.41% for TP and 4.10% for RP. The effective population size was 40.85 for TP and 38.89 for RP. The 206,426 registered Mangalarga horses (TP) were derived from the genetic contribution of 9,011 founders and 8,908 ancestors, whereas those registered in or after 2009 (RP) originated from 2,662 founders and 2,193 ancestors. The effective number of founders represented 1.11 and 1.35% of the total number of founders in TP and RP, respectively. For RP, 11 animals accounted for 29.21% of the genetic pool of the breed. The analysis of population parameters estimated in the present study indicates that the Mangalarga horse population was formed through uneven contributions from founders and ancestors; therefore, genetic management of the breed is required to restrict average inbreeding from increasing over generations. variability this (TP 191 201 n 206426 206 426 RP (RP 200 20,539, 20539 20,539 , 20 539 20,539) 937 9 37 9.3 years year 48 4 8 4.8 coefficient AR, (AR) time 275 2 75 2.7 488 88 226 26 2.26 557 5 57 5.57 241 41 2.41 410 10 4.10 4085 40 85 40.8 3889 38 89 38.8 206,42 9011 011 9,01 8908 908 8,90 2662 662 2,66 2193 193 2,19 111 1 1.1 135 35 1.35 respectively 2921 29 21 29.21 therefore 19 20642 42 2053 20,53 53 93 3 9. 4. (AR 27 7 2. 22 2.2 55 5.5 24 2.4 4.1 408 40. 388 38. 206,4 901 01 9,0 890 90 8,9 266 66 2,6 219 2,1 1. 13 1.3 292 29.2 2064 205 20,5 5. 206, 0 9, 8, 6 2, 29. 20,