Abstract Introduction: Iron (Fe) and manganese (Mn) are bioessential micronutrients for plants but can impair the energetic metabolism when present at high levels. Objective: To assess the photosynthetic performance and oxidative damages in Rhizophora mangle L. leaf tissues at low and high concentrations of Fe (74 and 195 mg kg-1; Feleaf) and Mn (65 and 414 mg kg-1; Mnleaf). Methods: Photosynthetic pigments, chlorophyll a fluorescence, leaf CO2 assimilation and gas exchange and DPPH• radical scavenging capacity were sampled in R. mangle growing in estuarine forests in the North region of Espírito Santo State and the extreme South of Bahia State (Brazil) showing low and high Feleaf and Mnleaf. Results: Effects of high Fe and Mn were not identified on pigment levels. The increase in Feleaf and Mnleaf at the levels observed in this assessment had a positive effect on the number of reaction centers and on the efficiency of the oxygen-evolving complex, evaluated as K-band, while no changes were found in the parameters related to the excitation trapping efficiency at the active center of photosystem II. Distinct interference patterns of Fe and Mn on the functional processes of photosynthesis were identified, especially on CO2 assimilation and reactive oxygen species metabolism, with major effects on CO2 assimilation and carboxylation efficiency of Rubisco at high Mnleaf. Conclusion: These findings demonstrate the efficiency of R. mangle in positively regulating the electron transport chain in response to high Fe and Mn, at least in terms of the preservation of structure and functionality of the plant photosynthetic apparatus. Moreover, interference of high Mnleaf in R. mangle occurs at non-stomatal and biochemical levels. There is an antagonistic interference of these trace elements with the physiology of R. mangle, which is a dominant species in Brazilian mangroves.

Resumen Introducción: El hierro (Fe) y el manganeso (Mn) son micronutrientes bioesenciales para las plantas, pero pueden afectar el metabolismo energético cuando están presentes en niveles altos. Objetivo: Evaluar el desempeño fotosintético y los daños oxidativos en tejidos foliares de Rhizophora mangle L. a bajas y altas concentraciones de Fe (74 y 195 mg kg-1; Feleaf) y Mn (65 y 414 mg kg-1; Mnleaf). Métodos: Se muestrearon pigmentos fotosintéticos, fluorescencia de clorofila a, asimilación e intercambio de gases de CO2 foliar y capacidad de eliminación de radicales DPPH• en R. mangle que crece en bosques de estuarios en la región Norte del estado de Espírito Santo y el extremo Sur del Estado de Bahía (Brasil) mostrando Feleaf y Mnleaf bajos y altos. Resultados: No se identificaron efectos de niveles elevados de Fe y Mn en los niveles de pigmento. El aumento de Feleaf y Mnleaf en los niveles observados en esta evaluación tuvo un efecto positivo en el número de centros de reacción y en la eficiencia del complejo generador de oxígeno, evaluado como banda K, mientras que no se encontraron cambios en los parámetros relacionados con la eficiencia de atrapamiento de excitación en el centro activo del fotosistema II. Se identificaron distintos patrones de interferencia de Fe y Mn en los procesos funcionales de la fotosíntesis, especialmente en la asimilación de CO2 y el metabolismo de las especies reactivas de oxígeno, con efectos importantes en la asimilación de CO2 y la eficiencia de carboxilación de Rubisco a niveles altos de Mnleaf. Conclusión: Los hallazgos demuestran la eficiencia de R. mangle en la regulación positiva de la cadena de transporte de electrones en respuesta a los altos niveles de Fe y Mn, al menos en términos de preservación de la estructura y funcionalidad del aparato fotosintético de la planta. Además, la interferencia de Mnleaf alto en R. mangle se presenta a niveles no estomáticos y bioquímicos. Hay interferencia antagónica de estos oligoelementos con la fisiología de R. mangle, que es una especie dominante en los manglares brasileños.

ABSTRACT The project ‘One Health in the Pantanal: society’s participation in the emergency surveillance of zoonoses emergency as a post-fire effect in the territory and the formation of integrated strategies’ aimed to integrate institutional representations and local society; expand the use of Wildlife Health Information System (SISS-Geo) for fauna monitoring; identify priority areas for zoonosis surveillance and build paths involving One Health (OH). A webinar was held, highlighting the need for broader events with the participation of leaders in each of the chosen territories. Seminars and workshops were held in the states of Mato Grosso do Sul (MS), with the participation of health service managers from the Province of Santa Cruz, Bolivia, and Mato Grosso. The representation of different segments at the events enabled the articulation of citizens and local managers. In traditional communities, it was possible to address the impacts of the fires and provide the opportunity for these people to express their health priorities and demands, before and after the fires. The Synthesis Workshop held in Corumbá, MS allowed the feedback of results and integration with representatives from different institutions in Brazil and Bolivia, and prospecting and prioritization of illnesses to be incorporated into the OH model for the Pantanal and western border of Brazil.

RESUMO O projeto ‘Saúde Única no Pantanal: participação da sociedade na vigilância de emergência de zoonoses como efeito pós-incêndios no território e formação de estratégias integradas’ objetivou integrar representações institucionais e da sociedade local; ampliar o uso do Sistema de Informação em Saúde Silvestre (SISS-Geo) para o monitoramento da fauna; identificar áreas prioritárias para vigilância de zoonoses e construir caminhos envolvendo a Saúde Única (SU). Realizou webinário, apontando a necessidade de eventos mais amplos com a participação de lideranças em cada um dos territórios escolhidos. Foram executados seminários e oficinas nos estados de Mato Grosso do Sul (MS), com a participação de gestores do serviço de saúde da Província de Santa Cruz, Bolívia, e de Mato Grosso. A representatividade dos diferentes segmentos nos eventos possibilitou a articulação de cidadãos e gestores locais. Nas comunidades tradicionais, foi possível abordar os impactos dos incêndios e dar oportunidade para que essas pessoas manifestassem suas prioridades e demandas de saúde, antes e depois dos incêndios. A Oficina Síntese realizada em Corumbá, MS possibilitou a devolutiva dos resultados e a integração com representantes de diferentes instituições do Brasil e da Bolívia, além da prospecção e priorização de enfermidades a serem incorporadas em modelo de SU para o Pantanal e fronteira oeste do Brasil.

Resumen OBJETIVO: Determinar la frecuencia de aceptación y los factores asociados con la anticoncepción moderna posaborto en pacientes atendidas en un hospital público de Perú. MATERIALES Y MÉTODOS: Estudio observacional y transversal efectuado en pacientes en el posaborto inmediato atendidas de junio a diciembre de 2022 en el servicio de Urgencias del Hospital San Juan de Lurigancho, Lima, Perú, seleccionadas por conveniencia. Se utilizó un cuestionario validado. Se aplicó la prueba χ2 de Pearson con un nivel de significación del 5%. RESULTADOS: Se estudiaron 166 pacientes en el posaborto inmediato de las que el 94% (n = 156) aceptó algún método anticonceptivo moderno; el más frecuente fue el inyectable mensual (44.0%) y el menos aceptado el dispositivo intrauterino (0.6%). Los factores personales asociados con la aceptación del método anticonceptivo moderno fueron: edad (p < 0.01), no tener pareja (p < 0.001) y ésta estuviera de acuerdo con el anticonceptivo elegido (p < 0.001). Los factores institucionales asociados fueron: tiempo de la consejería en planificación familiar (p = 0.047), privacidad-confidencialidad de la consejería (p < 0.001) y satisfacción con la atención ofrecida durante la orientación (p = 0.026). CONCLUSIONES: La edad, carecer de pareja y estar de acuerdo con ésta acerca de la elección del método anticonceptivo posaborto junto con los factores institucionales (tiempo de consejería en planificación familiar, importancia de la privacidad-confidencialidad y percepción de la atención en consejería en planificación familiar) se asociaron, significativamente, con la aceptación de algún método anticonceptivo moderno posaborto.

Abstract OBJECTIVE: To determine the frequency of acceptance and factors associated with modern postabortion contraception in patients attended at a public hospital in Peru. MATERIALS AND METHODS: Observational and cross-sectional study conducted in immediate postabortion patients attended from June to December 2022 at the Emergency Department of the Hospital San Juan de Lurigancho, Lima, Peru, selected by convenience. A validated questionnaire was used. Pearson&apos;s test c2 was used with a significance level of 5%. RESULTS: We studied 166 patients in the immediate postabortion period, of whom 94% (n = 156) accepted some modern contraceptive method; the most common was the monthly injectable (44.0%) and the least accepted was the intrauterine device (0.6%). Personal factors associated with modern contraceptive method acceptance were age (p < 0.01), no partner (p < 0.001), and partner&apos;s agreement with the chosen contraceptive method (p < 0.001). Associated institutional factors were agreeing with the time of family planning counseling (p = 0.047), considering the importance of privacy-confidentiality of counseling (p < 0.001), and agreeing with the care offered during counseling (p = 0.026). CONCLUSIONS: Age, lack of a partner, and agreeing with the partner about the choice of postabortion contraceptive method along with institutional factors (time of family planning counseling, importance of privacy-confidentiality, and perception of care in family planning counseling) were significantly associated with acceptance of some modern postabortion contraceptive method.

ABSTRACT OBJECTIVE To identify empirical patterns of multimorbidity and quantify their associations with socioeconomic, behavioral characteristics, and health outcomes in the megacity of São Paulo. METHODS This was a cross-sectional study conducted through household interviews with residents aged 20 years or older in urban areas (n = 3,184). Latent class analysis was used to identify patterns among the co-existence of 22 health conditions. Age-adjusted prevalence ratios were estimated using Poisson regression. RESULTS The analysis of latent classes showed 4 patterns of multimorbidity, whereas 58.6% of individuals were classified in the low disease probability group, followed by participants presenting cardiovascular conditions (15.9%), respiratory conditions (12.8%), and rheumatic, musculoskeletal, and emotional conditions (12.8%). Older individuals, with lower schooling and lower household income, presented higher multimorbidity prevalence in cardiovascular, respiratory, rheumatic, musculoskeletal, and emotional conditions patterns compared with the low disease probability pattern. CONCLUSION The results showed four distinct patterns of multimorbidity in the megacity population, and these patterns are clinically recognizable and theoretically plausible. The identification of trends between patterns would make it feasible to estimate the magnitude of the challenge for the organization of health care policies.

Resumo Introdução: Avaliação e manejo adequados da dor têm se tornado uma preocupação cada vez maior dos profissionais de saúde. Segundo a definição de cuidados paliativos da Organização Mundial da Saúde, são importantes a identificação precoce, a avaliação e o tratamento da dor. Objetivo: Este estudo teve como objetivos desenvolver e avaliar um aplicativo para dispositivos móveis voltado para o ensino de abordagem da dor em cuidados paliativos. Método: Foi desenvolvido um aplicativo móvel, seguido de sua utilização por médicos residentes e de avaliação qualiquantitativa prospectiva. Aplicou-se o teste de conhecimento. Obtiveram-se a usabilidade do aplicativo, por meio da System Usability Scale (SUS), e a satisfação, por meio do Net Promoter Score (NPS). Os dados foram tabulados no Microsoft Office Excel® e exportados para o software Statistical Package for the Social Sciences (SPSS) versão 20.0 (IBM): na realização das análises, adotou-se uma confiança de 95%. Para a análise qualitativa das avaliações, o conteúdo das respostas foi transcrito e organizado em nuvens de palavras para destacar as ideias centrais. O estudo foi aprovado pelo Comitê de Ética do Centro Universitário Christus. Resultado: Desenvolveu-se o PaliPain App, aplicativo constituído de casos clínicos de pacientes em cuidados paliativos com manifestações de dor, além de questões, vídeos e imagens, disponibilizado nas plataformas Android e iOS. Utilizaram o aplicativo 13 médicos residentes. A média de acertos de questões no pré-teste sobre dor em cuidados paliativos aumentou de 6,08 para 7,54 após manuseio do aplicativo. Na avaliação sobre a usabilidade do aplicativo, obtivemos na SUS uma média de 89,2, acima do nível considerado adequado de 70,0. Na avaliação de satisfação, 54% dos médicos responderam com pontuação 10 à pergunta: “Em uma escala de 0 a 10, quanto você recomendaria o aplicativo PaliPain a um amigo ou colega?”. Conclusão: O PaliPain App, desenvolvido e disponibilizado nas plataformas Android e iOS, foi bem avaliado pelos médicos residentes, apresentando ótimos escores de usabilidade e de satisfação. Identificamos que houve ganho de conhecimento, com pontuação média na resolução de questões aumentando de 6,08 para 7,54 após livre uso da aplicação. O PaliPain App pode ser uma ferramenta útil para ensino de abordagem de dor para médicos residentes. Introdução saúde Saúde precoce Objetivo Método móvel prospectiva Aplicouse Aplicou conhecimento Obtiveramse Obtiveram SUS, , (SUS) satisfação NPS. NPS . (NPS) Excel SPSS (SPSS 200 20 20. IBM (IBM) análises adotouse adotou 95 95% avaliações centrais Christus Resultado Desenvolveuse Desenvolveu imagens iOS 1 préteste pré 608 6 08 6,0 754 7 54 7,5 892 89 2 89,2 700 70 70,0 pergunta Em colega. colega colega?” Conclusão aplicação (SUS (NPS (IBM 9 60 6, 75 5 7, 8 89, 70, colega?

Abstract Introduction: Pain evaluation has become an increasingly relevant concern for healthcare workers. According to the World Health Organization’s definition of Palliative Care, early identification, evaluation, and treatment of pain are important. Objective: Developing and rating an app for mobile devices that focuses on teaching the subject of pain management in Palliative Care. Research Methodology: The app was developed as a learning tool and tested by resident physicians while undergoing a qualitative and quantitative prospective evaluation. Mock tests were taken. The usability of the app was rated through the System Usability Scale (SUS), and satisfaction with the app was rated through the Net Promoter Score (NPS). The data was charted by using Microsoft Office Excel ® and was exported to the Statistical Package for the Social Sciences (SPSS) version 20.0 (IBM) software: an analysis was run with a 95% confidence interval. As for the qualitative analysis of the resident physicians’ evaluations, all available content was transcribed and properly organized in word clouds in order to highlight the most important pieces of feedback that the physicians presented regarding the app. The study was approved by the Ethics Committee. Main Results: The PaliPain App was developed as a database filled with clinical cases of patients undergoing palliative care who were experiencing varying levels of pain, and also presents analysis of test questions, videos and images. It was made available for the Android and iOS platforms. The average correct answers in a mock test about pain management during palliative care rose from 6.08 to 7.54. Thirteen resident physicians made use of the app. In the evaluation of the app’s usability, the average SUS score was 89.2. In the evaluation of user satisfaction, 54% of the resident physicians answered the question “from a scale of 0 to 10, what is the likelihood of you recommending the PaliPan app to a friend or colleague?” with a score of 10. Conclusion: The PaliPain App, developed and available on Android and iOS platforms, was well evaluated by resident physicians, presenting excellent scores for both usability and satisfaction. We identified that there was a gain in knowledge, with an average score in the resolution of questions increasing from 6.08 to 7.54 after free use of the application. The PaliPan app could be a useful tool to teach the subject of pain to resident physicians. Introduction workers Organizations Organization s Care identification Objective Methodology taken SUS, , (SUS) NPS. NPS . (NPS) SPSS (SPSS 200 20 20. IBM (IBM software 95 interval evaluations Committee Results images platforms 608 6 08 6.0 754 7 54 apps 892 89 2 89.2 10 colleague colleague? Conclusion knowledge 7.5 application (SUS (NPS 9 60 6. 75 5 8 89. 1 7.

RESUMO O projeto ‘Saúde Única no Pantanal: participação da sociedade na vigilância de emergência de zoonoses como efeito pós-incêndios no território e formação de estratégias integradas’ objetivou integrar representações institucionais e da sociedade local; ampliar o uso do Sistema de Informação em Saúde Silvestre (SISS-Geo) para o monitoramento da fauna; identificar áreas prioritárias para vigilância de zoonoses e construir caminhos envolvendo a Saúde Única (SU). Realizou webinário, apontando a necessidade de eventos mais amplos com a participação de lideranças em cada um dos territórios escolhidos. Foram executados seminários e oficinas nos estados de Mato Grosso do Sul (MS), com a participação de gestores do serviço de saúde da Província de Santa Cruz, Bolívia, e de Mato Grosso. A representatividade dos diferentes segmentos nos eventos possibilitou a articulação de cidadãos e gestores locais. Nas comunidades tradicionais, foi possível abordar os impactos dos incêndios e dar oportunidade para que essas pessoas manifestassem suas prioridades e demandas de saúde, antes e depois dos incêndios. A Oficina Síntese realizada em Corumbá, MS possibilitou a devolutiva dos resultados e a integração com representantes de diferentes instituições do Brasil e da Bolívia, além da prospecção e priorização de enfermidades a serem incorporadas em modelo de SU para o Pantanal e fronteira oeste do Brasil. pósincêndios pós integradas local SISSGeo SISS Geo (SISS-Geo fauna SU. . (SU) webinário escolhidos MS, , (MS) Cruz Bolívia locais tradicionais Corumbá (SU (MS

ABSTRACT The project ‘One Health in the Pantanal: society’s participation in the emergency surveillance of zoonoses emergency as a post-fire effect in the territory and the formation of integrated strategies’ aimed to integrate institutional representations and local society; expand the use of Wildlife Health Information System (SISS-Geo) for fauna monitoring; identify priority areas for zoonosis surveillance and build paths involving One Health (OH). A webinar was held, highlighting the need for broader events with the participation of leaders in each of the chosen territories. Seminars and workshops were held in the states of Mato Grosso do Sul (MS), with the participation of health service managers from the Province of Santa Cruz, Bolivia, and Mato Grosso. The representation of different segments at the events enabled the articulation of citizens and local managers. In traditional communities, it was possible to address the impacts of the fires and provide the opportunity for these people to express their health priorities and demands, before and after the fires. The Synthesis Workshop held in Corumbá, MS allowed the feedback of results and integration with representatives from different institutions in Brazil and Bolivia, and prospecting and prioritization of illnesses to be incorporated into the OH model for the Pantanal and western border of Brazil. societys society s postfire post fire strategies SISSGeo SISS Geo (SISS-Geo monitoring OH. . (OH) territories MS, , (MS) Cruz Bolivia communities demands Corumbá (OH (MS

Resumo Introdução O fenótipo cintura hipertrigliceridêmica (CH) é caracterizado por obesidade abdominal e triglicerídeos elevados no sangue, indicando alto risco cardiovascular em pessoas idosas. Objetivo Identificar a prevalência e os fatores associados à CH em pessoas idosas. Método Estudo epidemiológico transversal realizado com 223 pessoas idosas (idade média de 71,80 ± 7,70 anos) residentes em Aiquara, Bahia, Brasil. A CH foi diagnosticada pela presença de circunferência da cintura elevada (mulheres: ≥ 88 cm; homens: ≥102 cm) em conjunto com hipertrigliceridemia (triglicerídeos ≥150 mg/dL). A regressão de Poisson com variância robusta foi utilizada para análise, com estimativas das Razões de Prevalência (RP) e seus respectivos Intervalos de Confiança (IC) de 95%. Resultados A prevalência de CH foi de 23,30%. O sexo feminino (RP: 2,50; IC 95%: 1,35–4,63), estado civil (separado ou divorciado) (RP: 2.30; IC95%: 1.33-3.96), colesterol não-HDL elevado (RP: 2,15; IC95%: 1,37–3,49) e colesterol HDL baixo (RP: 2,35; IC95%: 1,49–3,72) apresentaram maior probabilidade para a CH. Além disso, o baixo peso apresentou menor probabilidade para a CH (RP: 0,17; IC95%: 0,04–0,60). Conclusão Foi identificada uma alta prevalência de CH, com associações positivas com o sexo feminino, estado civil separado ou divorciado, colesterol não-HDL elevado e colesterol HDL baixo. Por outro lado, o baixo peso apresentou associação inversa com a CH. (CH sangue 22 idade 7180 71 80 71,8 770 7 70 7,7 anos Aiquara Bahia Brasil mulheres (mulheres 8 cm homens 102 ≥10 150 ≥15 mg/dL. mgdL mg/dL . mg dL mg/dL) análise RP (RP (IC 95 95% 2330 23 30 23,30% 2,50 250 2 50 1,35–4,63, 135463 1,35–4,63 , 1 35 4 63 1,35–4,63) divorciado 2.30 230 IC95% IC95 1.333.96, 133396 1.33 3.96 33 3 96 1.33-3.96) nãoHDL não 2,15 215 15 1,37–3,49 137349 37 49 2,35 235 1,49–3,72 149372 72 disso 0,17 017 0 17 0,04–0,60. 004060 0,04–0,60 04 60 0,04–0,60) lado 718 71, 77 7, 10 ≥1 9 233 23,30 2,5 25 5 13546 1,35–4,6 6 2.3 IC9 333 1.333.96 13339 133 1.3 396 3.9 1.33-3.96 2,1 21 1,37–3,4 13734 2,3 1,49–3,7 14937 0,1 01 00406 0,04–0,6 23,3 2, 1354 1,35–4, 2. 1.333.9 1333 13 1. 39 3. 1.33-3.9 1,37–3, 1373 1,49–3, 1493 0, 0040 0,04–0, 23, 135 1,35–4 1.333. 1.33-3. 1,37–3 137 1,49–3 149 004 0,04–0 1,35– 1.333 1.33-3 1,37– 1,49– 14 00 0,04– 1,35 1.33- 1,37 1,49 0,04 1,3 1,4 0,0 1,

Abstract Background The hypertriglyceridemic waist (HW) phenotype is characterized by abdominal obesity and elevated blood triglycerides, indicating high cardiovascular risk in older adults. Objective To identify the prevalence and factors associated with HW in older adults. Method A cross-sectional epidemiological study was conducted with 223 older adults (mean age 71.80 ± 7.70 years) residing in Aiquara, Bahia, Brazil. HW was diagnosed by the presence of elevated waist circumference (women: ≥ 88 cm; men: ≥ 102 cm) in conjunction with hypertriglyceridemia (triglycerides ≥ 150 mg/dL). Poisson regression with robust variance was used for analysis, along with estimates of Prevalence Ratios (PR) and their respective 95% Confidence Intervals (CI). Results The prevalence of HW was 23.30%. Female sex (PR: 2.50; 95% CI: 1.35–4.63), marital status (separated or divorced) (PR: 2.30; 95% CI: 1.33-3.96), elevated non-HDL cholesterol (PR: 2.15; 95% CI: 1.37–3.49), and low HDL cholesterol (PR: 2.35; 95% CI: 1.49–3.72) presented a greater probability of HW. Additionally, low weight presented a lower probability of HW (PR: 0.17; 95% CI: 0.04–0.60). Conclusion A high prevalence of HW was identified, with positive associations with female sex, separated or divorced marital status, elevated non-HDL cholesterol, and low HDL cholesterol. Conversely, low weight showed an inverse association with HW. (HW triglycerides crosssectional cross sectional 22 mean 7180 71 80 71.8 770 7 70 7.7 years Aiquara Bahia Brazil women (women 8 cm men 10 15 mg/dL. mgdL mg/dL . mg dL mg/dL) analysis PR (PR 95 CI. CI (CI) 2330 23 30 23.30% 2.50 250 2 50 1.35–4.63, 135463 1.35–4.63 , 1 35 4 63 1.35–4.63) 2.30 230 1.333.96, 133396 1.33 3.96 33 3 96 1.33-3.96) nonHDL non 2.15 215 1.37–3.49, 137349 1.37–3.49 37 49 1.37–3.49) 2.35 235 1.49–3.72 149372 72 Additionally 0.17 017 0 17 0.04–0.60. 004060 0.04–0.60 04 60 0.04–0.60) identified Conversely 718 71. 77 7. 9 (CI 233 23.30 2.5 25 5 13546 1.35–4.6 6 2.3 333 1.333.96 13339 133 1.3 396 3.9 1.33-3.96 2.1 21 13734 1.37–3.4 1.49–3.7 14937 0.1 01 00406 0.04–0.6 23.3 2. 1354 1.35–4. 1.333.9 1333 13 1. 39 3. 1.33-3.9 1373 1.37–3. 1.49–3. 1493 0. 0040 0.04–0. 23. 135 1.35–4 1.333. 1.33-3. 137 1.37–3 1.49–3 149 004 0.04–0 1.35– 1.333 1.33-3 1.37– 1.49– 14 00 0.04– 1.35 1.33- 1.37 1.49 0.04 1.4 0.0

ABSTRACT OBJECTIVE To identify empirical patterns of multimorbidity and quantify their associations with socioeconomic, behavioral characteristics, and health outcomes in the megacity of São Paulo. METHODS This was a cross-sectional study conducted through household interviews with residents aged 20 years or older in urban areas (n = 3,184). Latent class analysis was used to identify patterns among the co-existence of 22 health conditions. Age-adjusted prevalence ratios were estimated using Poisson regression. RESULTS The analysis of latent classes showed 4 patterns of multimorbidity, whereas 58.6% of individuals were classified in the low disease probability group, followed by participants presenting cardiovascular conditions (15.9%), respiratory conditions (12.8%), and rheumatic, musculoskeletal, and emotional conditions (12.8%). Older individuals, with lower schooling and lower household income, presented higher multimorbidity prevalence in cardiovascular, respiratory, rheumatic, musculoskeletal, and emotional conditions patterns compared with the low disease probability pattern. CONCLUSION The results showed four distinct patterns of multimorbidity in the megacity population, and these patterns are clinically recognizable and theoretically plausible. The identification of trends between patterns would make it feasible to estimate the magnitude of the challenge for the organization of health care policies. socioeconomic characteristics Paulo crosssectional cross sectional 2 n 3,184. 3184 3,184 . 3 184 3,184) coexistence co existence Ageadjusted Age adjusted regression 586 58 6 58.6 group 15.9%, 159 15.9% , 15 9 (15.9%) 12.8%, 128 12.8% 12 8 (12.8%) rheumatic musculoskeletal 12.8%. income pattern population plausible policies 318 3,18 18 5 58. 15.9 1 (15.9% 12.8 (12.8% 31 3,1 15. (15.9 12. (12.8 3, (15. (12. (15 (12 (1 (

RESUMO Objetivo Associar a ansiedade materna aos fatores sociodemográficos, pratica de aleitamento, hábitos bucais e ingresso da criança em creche entre mulheres surdas e ouvintes. Método Participaram deste estudo transversal retrospectivo comparativo, 116 mães (29 surdas e 87 ouvintes) de crianças na faixa etária entre dois e cinco anos. As mães surdas pertenciam a um centro de referência da cidade e as mães ouvintes foram contatadas em creches públicas, onde seus filhos estavam matriculados. As mães foram submetidas a entrevista sobre fatores socioeconômicos e relacionados ao desenvolvimento dos filhos, além de realizarem o preenchimento do Inventário Brasileiro de Ansiedade de Beck, nas versões para surdos e ouvintes, que foram instrumentos usados para avaliar a ansiedade. O teste de normalidade de Kolmogorov-Smirnov, os testes de Kruskal Wallis, Mann-Whitney e Regressão de Poisson foram utilizados para análises estatísticas (p &lt;0,05). Resultados Mães surdas apresentaram escore de ansiedade uma vez e meia maior que mães ouvintes. Além disso, mães de crianças com hábito de sucção de dedo apresentaram maior escore de ansiedade e mães cujos filhos começaram a frequentar a creche ainda bebês apresentaram menor escore de ansiedade, quando comparados a crianças sem o hábito e que não frequentavam a creche. Conclusão Mães surdas apresentaram maior ansiedade quando comparadas às ouvintes. Comportamento dos filhos com hábitos de sucção de dedo e o ingresso em creches no primeiro ano de vida influenciaram a ansiedade materna. sociodemográficos aleitamento comparativo 11 29 (2 8 anos públicas matriculados Beck KolmogorovSmirnov, KolmogorovSmirnov Kolmogorov Smirnov, Smirnov Kolmogorov-Smirnov Wallis MannWhitney Mann Whitney p &lt0,05. lt005 lt &lt 0,05 . 0 05 &lt;0,05) disso 1 2 ( lt0 &lt0,05 lt00 005 0,0 &lt;0,05 &lt0,0 00 0, &lt;0,0 &lt0, &lt;0, &lt0 &lt;0 &lt;

ABSTRACT Purpose To associate maternal anxiety with sociodemographic factors, breastfeeding practices, oral habits, and the child’s entry into daycare among deaf and hearing (non-deaf) mothers. Methods This retrospective comparative cross-sectional study included 116 mothers (29 deaf and 87 hearing) of children aged between two and five years. Deaf mothers belonged to a reference center in the city, while hearing mothers were contacted in public daycares where their children were enrolled. Mothers underwent interviews covering socio-economic factors and child development-related aspects. Additionally, they completed the Brazilian Beck Anxiety Inventory, adapted for both deaf and hearing individuals, serving as instruments to assess anxiety. The Kolmogorov-Smirnov normality test, Kruskal Wallis test, Mann-Whitney test, and Poisson Regression were employed for statistical analyses (p<0.05). Results Deaf mothers exhibited anxiety scores one and a half times higher than hearing mothers. Moreover, mothers of children with thumb-sucking habits showed higher anxiety scores, while mothers whose children started attending daycare as infants demonstrated lower anxiety scores compared to mothers of children without such habits and who did not attend daycare. Conclusion Deaf mothers displayed higher anxiety levels when compared to hearing mothers. Children’s behaviors, such as thumb-sucking habits, and early enrollment in daycare during the first year of life influenced maternal anxiety. practices childs s nondeaf non (non-deaf crosssectional cross sectional 11 29 (2 8 years city enrolled socioeconomic socio economic developmentrelated development related aspects Additionally Inventory individuals KolmogorovSmirnov Kolmogorov Smirnov test MannWhitney Mann Whitney p<0.05. p005 p p<0.05 . 0 05 (p<0.05) Moreover thumbsucking thumb sucking Childrens Children behaviors 1 2 ( p00 p<0.0 (p<0.05 p0 p<0. (p<0.0 p<0 (p<0. p< (p<0 (p< (p

Abstract Background During aging, physiological and behavioral changes occur that lead to the development of diabesity (diabetes + obesity). Hence, the hypothesis that behavioral and health aspects can increase the probability of this outcome is plausible. In this framework, it is essential to carry out health surveys to investigate the factors that increase the probability of diabesity, as this information could be used to help monitor this outcome in the older population more accurately. Objective To verify the factors associated with diabesity in older adults. Methods This is an epidemiological survey, with a cross-sectional design, conducted with 211 older adults (58.80% women) from Aiquara, Bahia, Brazil. To assess the outcome, body mass index (BMI > 27 kg/m2) and the concomitant presence of diabetes mellitus were used. In the inferential analyses, crude models and, subsequently, a multiple hierarchical explanatory model were constructed (level 1: socioeconomic variables; level 2: behavioral aspects; level 3: health conditions). This was performed using Poisson regression, with a robust estimator, calculations of prevalence ratios (PR) and their relevant 95% confidence intervals (CI). Results The prevalence of diabesity observed was around 9.50%. Furthermore, older adults who were insufficiently active (RP: 2.55; 95% CI: 1.20 to 6.36), those with arterial hypertension (PR: 5.32; 95% CI: 1.10 to 25.73), and those with hypercholesterolemia (PR: 2.80; 95% CI: 1.08 to 7.23) were more likely to have this outcome. Conclusion In the older population of Aiquara, Bahia, Brazil, the factors associated with diabesity were insufficient level of physical activity (PA), arterial hypertension, and hypercholesterolemia. aging obesity. obesity . obesity) Hence plausible framework accurately survey crosssectional cross sectional design 21 58.80% 5880 58 80 (58.80 women Aiquara Bahia Brazil BMI 2 kg/m2 kgm2 kgm kg m2 m analyses subsequently 1 variables 3 conditions. conditions conditions) regression estimator PR (PR 95 CI. CI (CI) 950 9 50 9.50% Furthermore RP (RP 2.55 255 55 120 20 1.2 6.36, 636 6.36 , 6 36 6.36) 5.32 532 5 32 110 10 1.1 25.73, 2573 25.73 25 73 25.73) 2.80 280 108 08 1.0 7.23 723 7 23 PA, PA (PA) 58.80 588 8 (58.8 kg/m (CI 9.50 2.5 12 1. 63 6.3 5.3 53 11 257 25.7 2.8 28 0 7.2 72 (PA 58.8 (58. 9.5 2. 6. 5. 25. 7. 58. (58 9. (5 (

Resumo Antecedentes A disfunção olfatória (DO) é uma manifestação frequente da doença do coronavírus 2019 (COVID-19). A apolipoproteína E (APOE) é uma proteína que interage com o receptor da enzima conversora de angiotensina, essencial para a entrada viral na célula. Publicações anteriores sugeriram um possível papel da APOE na gravidade da COVID-19. Até onde sabemos, nenhuma publicação encontrou associações significativas entre a gravidade dessa doença, DO e polimorfismos da APOE (E2, E3 e E4). Objetivo Analisar a epidemiologia da DO e sua relação com os polimorfismos do gene APOE em uma coorte de pacientes com COVID longa. Métodos Um estudo de coorte prospectiva com pacientes acompanhados em ambulatório neurológico pós-COVID, com DO sendo definida como uma redução subjetiva da função olfativa após a infecção e a DO persistente sendo definida quando a queixa durou mais de 3 meses após a resolução da infecção por COVID-19. Este estudo transversal é parte de uma pesquisa maior com dados anteriormente relatados, focando na performance cognitiva dos pacientes. Resultados Foram selecionados 221 pacientes para esse estudo, dos quais 186 haviam coletado amostras de sangue para genotipagem APOE. O grupo DO persistente foi mais jovem e apresentou menor taxa de internação na fase aguda da doença (p < 0,001). Além disso, a frequência do alelo E4 da APOE foi menor nesse grupo (p = 0,035). Este estudo avaliou a DO em uma população com COVID longa. Na literatura atual sobre essa doença, a anosmia está associada a melhores desfechos clínicos e o alelo E4 está associado a piores desfechos. Conclusão Nosso estudo acrescenta novas informações a essas correlações, sugerindo a APOE E4 como um fator de proteção para DO. (DO 201 COVID19. COVID19 19 . (COVID-19) (APOE angiotensina célula 19. COVID-19 sabemos E2, E2 (E2 E4. E4) longa pósCOVID, pósCOVID pós COVID, pós-COVID relatados 22 18 p 0,001. 0001 0,001 0 001 0,001) disso 0,035. 0035 0,035 035 0,035) correlações 20 COVID1 1 (COVID-19 COVID-1 (E 2 000 0,00 00 003 0,03 03 (COVID-1 COVID- 0,0 (COVID- 0, (COVID

Abstract Background Olfactory dysfunction (OD) represents a frequent manifestation of the coronavirus disease 2019 (COVID-19). Apolipoprotein E (APOE) is a protein that interacts with the angiotensin-converting enzyme receptor, essential for viral entry into the cell. Previous publications have suggested a possible role of APOE in COVID-19 severity. As far as we know, no publications found significant associations between this disease's severity, OD, and APOE polymorphisms (E2, E3, and E4). Objective To analyze the epidemiology of OD and its relationship with APOE polymorphisms in a cohort of Long-COVID patients. Methods We conducted a prospective cohort study with patients followed in a post-COVID neurological outpatient clinic, with OD being defined as a subjective reduction of olfactory function after infection, and persistent OD being defined when the complaint lasted more than 3 months after the COVID-19 infection resolution. This cross-sectional study is part of a large research with previously reported data focusing on the cognitive performance of our sample. Results The final sample comprised 221 patients, among whom 186 collected blood samples for APOE genotyping. The persistent OD group was younger and had a lower hospitalization rate during the acute phase of the disease (p < 0.001). Furthermore, the APOE variant E4 allele frequency was lower in this group (p = 0.035). This study evaluated OD in an outpatient population with COVID-19. In the current literature on this disease, anosmia is associated with better clinical outcomes and the E4 allele is associated with worse outcomes. Conclusion Our study provides new information to these correlations, suggesting APOE E4 as a protective factor for OD. (OD 201 COVID19. COVID19 COVID 19 . (COVID-19) (APOE angiotensinconverting angiotensin converting receptor cell COVID-1 severity know diseases s E2, E2 (E2 E3 E4. E4) LongCOVID Long postCOVID post clinic resolution crosssectional cross sectional 22 18 genotyping p 0.001. 0001 0.001 0 001 0.001) Furthermore 0.035. 0035 0.035 035 0.035) 19. correlations 20 COVID1 1 (COVID-19 COVID- (E 2 000 0.00 00 003 0.03 03 (COVID-1 0.0 (COVID- 0. (COVID

Abstract The objective of this manuscript was to investigate the influence of different Babassu Mesocarp Flour (BMF) contents (3, 5, 8, and 10% by weight) on the physical and surface properties of the Poly(Lactic Acid) (PLA) matrix. For this purpose, composite films were produced through flat-die extrusion processing. Visual analysis showed that the films were successfully produced by this processing method and exhibited good handling. The physical properties of the films varied as follows: width (16.41‒20.38 cm), thickness (0.14‒0.24 mm), apparent density (0.78‒1.07 g/cm3), and grammage (168.34‒255.31 g/m2). Through optical microscopy, good distribution and dispersion of the particles were observed despite the presence of some agglomerates. The film surface became rough due to the incorporated flour content, which influenced the contact angle result. The combination of PLA/BMF for producing composite films has technological potential, enabling the valorization of an industrial by-product and preserving the environment. BMF (BMF 3, 3 (3 5 8 10 weight PolyLactic Poly Lactic Acid PLA (PLA matrix purpose flatdie flat die handling follows 16.41‒20.38 16412038 16 41 20 38 (16.41‒20.3 cm, cm , cm) 0.14‒0.24 014024 0 14 24 (0.14‒0.2 mm, mm mm) 0.78‒1.07 078107 78 1 07 (0.78‒1.0 g/cm3, gcm3 gcm g/cm3 g cm3 g/cm3) 168.34‒255.31 1683425531 168 34 255 31 (168.34‒255.3 g/m2. gm2 gm g/m2 . m2 m g/m2) microscopy agglomerates content result PLABMF potential byproduct product environment ( 16.41‒20.3 1641203 4 2 (16.41‒20. 0.14‒0.2 01402 (0.14‒0. 0.78‒1.0 07810 7 (0.78‒1. g/cm 168.34‒255.3 168342553 25 (168.34‒255. g/m 16.41‒20. 164120 (16.41‒20 0.14‒0. 0140 (0.14‒0 0.78‒1. 0781 (0.78‒1 168.34‒255. 16834255 (168.34‒255 16.41‒20 16412 (16.41‒2 0.14‒0 014 (0.14‒ 0.78‒1 078 (0.78‒ 168.34‒255 1683425 (168.34‒25 16.41‒2 1641 (16.41‒ 0.14‒ 01 (0.14 0.78‒ (0.78 168.34‒25 168342 (168.34‒2 16.41‒ 164 (16.41 0.14 (0.1 0.78 (0.7 168.34‒2 16834 (168.34‒ 16.41 (16.4 0.1 (0. 0.7 168.34‒ 1683 (168.34 16.4 (16. 0. (0 168.34 (168.3 16. (16 168.3 (168. (1 168. (168