Abstract The study sought to investigate the association between having a chronic disease or condition and the prevalence of having recourse to Integrative and Complementary Practices (ICP) among the Brazilian adult population. Chronic diseases are a serious public health issue and there are limitations of Western medicine to offer effective answers. Thus, the demand for ICP has increased as they constitute a humanized treatment option, with low cost and ease of acquisition. A cross-sectional population-based study was carried out using data from the 2019 National Health Survey. The prevalence of ICP use was estimated by categories of the other variables (presence or absence of chronic conditions) and prevalence ratios (PR) were adjusted for sociodemographic variables. The prevalence of the use of a given ICP, in the last 12 months, by the adult Brazilian population (18 years of age and over) was 5.5% (95%CI: 5.2%-5.8%), and adults with a chronic condition had a higher prevalence of use (PR: 2.11; 95%CI: 1.89-2.36), even after adjusting for sociodemographic characteristics. Stroke, asthma, arthritis, work-related musculoskeletal disorders, depression and other mental illnesses, chronic obstructive pulmonary disease, cancer and heart disease such as hypertension were associated with a higher prevalence of ICP use.

Resumo O estudo investigou a associação entre ter alguma doença ou agravo crônicos e a prevalência de uso de práticas integrativas e complementares (PIC) na população adulta brasileira. As doenças crônicas constituem uma séria questão de saúde pública e há limitações de respostas satisfatórias pela medicina ocidental. Assim, tem aumentado a procura pelas PIC por serem uma alternativa humanizada, de menor custo e de fácil aquisição. Foi realizado um estudo transversal de base populacional utilizando dados da Pesquisa Nacional de Saúde de 2019. Foram estimadas as prevalências de uso das PIC por categorias das demais variáveis (presença ou não de agravos crônicos), além de razões de prevalência (RP) ajustadas por características sociodemográficas. A prevalência de uso de alguma PIC, nos últimos 12 meses, pela população brasileira (a partir de 18 anos) foi de 5,5% (IC95%: 5,2%-5,8%), e os adultos com algum agravo crônico tiveram maior prevalência de uso (RP: 2,11; IC95%: 1,89-2,36), mesmo após ajuste sociodemográfico. Acidente vascular cerebral, asma, artrite, doenças osteomusculares relacionadas ao trabalho, depressão e outras doenças mentais, doença pulmonar obstrutiva crônica, câncer e doenças cardíacas, como hipertensão arterial, tiveram associação com maior uso de PIC.

Resumo Objetivo: descrever a mortalidade e os anos de vida ajustados pela incapacidade disability-adjusted life years – DALYs) para câncer de laringe no Brasil atribuíveis a fatores de risco ocupacionais e comportamentais. Métodos: estudo ecológico com dados do estudo Global Burden of Disease 2019. Foram obtidas taxas de mortalidade e de DALYs para o câncer de laringe atribuíveis aos riscos ocupacionais (ácido sulfúrico e amianto) e comportamentais (tabaco e álcool), de 1990 e 2019. Resultados: no Brasil, em 2019, a taxa de mortalidade por câncer de laringe atribuível aos riscos ocupacionais (ácido sulfúrico e amianto) foi 0,28 (II95%: 0,17;0,43) no sexo masculino e 0,03 (II95%: 0,02;0,04) no feminino, e a de DALYs foi 7,33 (II95%: 4,28;11,44) e 0,64 (II95%: 0,35;0,03), respectivamente. O ácido sulfúrico foi o principal risco ocupacional para a doença. Houve redução das taxas atribuíveis ao tabaco (mortalidade:-45,83%; DALYs:-47,36%) e aos riscos ocupacionais (mortalidade:-23,20%; DALYs:-26,31%), no Brasil, com aumento em alguns estados das regiões Norte e Nordeste. Conclusão: houve redução na mortalidade e na carga do câncer de laringe atribuível aos fatores ocupacionais no período, porém menor em comparação ao tabagismo, reforçando a importância de ações para reduzir o impacto dos riscos ocupacionais, como as medidas regulatórias aplicadas ao tabaco. Objetivo disabilityadjusted disability adjusted Métodos 2019 amianto álcool, álcool , álcool) 199 Resultados 028 0 28 0,2 II95% II95 II (II95% 0,170,43 017043 0,17 0,43 17 43 0,17;0,43 003 03 0,0 0,020,04 002004 0,02 0,04 02 04 0,02;0,04 feminino 733 7 33 7,3 4,2811,44 4281144 4,28 11,44 4 11 44 4,28;11,44 064 64 0,6 0,350,03, 035003 0,35 35 0,35;0,03) respectivamente doença mortalidade45,83% mortalidade4583 45,83% 45 83 (mortalidade:-45,83% DALYs47,36% DALYs4736 47,36% 47 36 DALYs:-47,36% mortalidade23,20% mortalidade2320 23,20% 23 20 (mortalidade:-23,20% DALYs26,31%, DALYs2631 26,31% 26 31 DALYs:-26,31%) Nordeste Conclusão período tabagismo 201 19 2 0, II9 (II95 170 0,170,4 01704 017 0,1 043 0,4 1 0,17;0,4 00 020 0,020,0 00200 002 004 0,02;0,0 73 3 7, 2811 4,2811,4 428114 428 4,2 1144 11,4 4,28;11,4 06 6 350 0,350,03 03500 035 0,3 0,35;0,03 mortalidade45 mortalidade45,83 mortalidade458 4583 45,83 8 (mortalidade:-45,83 DALYs47 DALYs47,36 DALYs473 4736 47,36 DALYs:-47,36 mortalidade23 mortalidade23,20 mortalidade232 2320 23,20 (mortalidade:-23,20 DALYs26 DALYs26,31% DALYs263 2631 26,31 DALYs:-26,31% (II9 0,170, 0170 01 0,17;0, 0,020, 0020 0,02;0, 281 4,2811, 42811 42 4, 114 11, 4,28;11, 0,350,0 0350 0,35;0,0 mortalidade4 mortalidade45,8 458 45,8 (mortalidade:-45,8 DALYs4 DALYs47,3 473 47,3 DALYs:-47,3 mortalidade2 mortalidade23,2 232 23,2 (mortalidade:-23,2 DALYs2 DALYs26,31 263 26,3 DALYs:-26,31 (II 0,170 0,17;0 0,020 0,02;0 4,2811 4281 4,28;11 0,350, 0,35;0, mortalidade45, 45, (mortalidade:-45, DALYs47, 47, DALYs:-47, mortalidade23, 23, (mortalidade:-23, DALYs26,3 26, DALYs:-26,3 0,17; 0,02; 4,281 4,28;1 0,350 0,35;0 (mortalidade:-45 DALYs:-47 (mortalidade:-23 DALYs26, DALYs:-26, 4,28; 0,35; (mortalidade:-4 DALYs:-4 (mortalidade:-2 DALYs:-26 (mortalidade:- DALYs:- DALYs:-2 (mortalidade: DALYs: (mortalidade

Abstract Objective: to describe mortality and disability-adjusted life years (DALYs) due to laryngeal cancer attributable to occupational and behavioral risk factors in Brazil. Methods: this is an ecological study with data from the 2019 Global Burden of Disease. Mortality and DALY rates for laryngeal cancer attributable to occupational (sulfuric acid and asbestos) and behavioral (tobacco and alcohol) risks were obtained from 1990 and 2019. Results: in 2019, the mortality rate from laryngeal cancer attributable to occupational hazards (sulfuric acid and asbestos) totaled 0.28 (95%UI: 0.17; 0.43) and 0.03 (95%UI: 0.02; 0.04), whereas and DALY rates, 7.33 (95%UI: 4.28; 11.44) and 0.64 (95%UI: 0.35; 0.03) in men and women in Brazil, respectively. Sulfuric acid configured the main occupational risk for the disease. The rates attributable to tobacco (mortality: −45.83%; DALYs: −47.36%) and occupational hazards (mortality: −23.20%; DALYs: −26.31%) decreased in Brazil but increased in some Northern and Northeastern states. Conclusion: laryngeal cancer mortality and burden attributable to occupational factors decreased in the period (although less than that for smoking), reinforcing the importance of actions to reduce the impact of occupational risks, such as the regulatory measures applied to tobacco. Objective disabilityadjusted disability adjusted DALYs (DALYs Methods 201 Disease sulfuric asbestos alcohol 199 Results 028 0 28 0.2 95%UI 95UI UI 95 (95%UI 0.17 017 17 0.43 043 43 003 03 0.0 0.02 002 02 0.04, 004 0.04 , 04 0.04) 733 7 33 7.3 4.28 428 4 11.44 1144 11 44 064 64 0.6 0.35 035 35 respectively disease (mortality −45.83% 4583 45 83 −47.36% 4736 47 36 −23.20% 2320 23 20 −26.31% 2631 26 31 states Conclusion although smoking, smoking smoking) 19 2 0. 9 0.1 01 1 0.4 00 73 3 7. 4.2 42 11.4 114 06 6 0.3 −45.83 458 8 −47.36 473 −23.20 232 −26.31 263 4. 11. −45.8 −47.3 −23.2 −26.3 −45. −47. −23. −26. −45 −47 −23 −26 −4 −2 −

ABSTRACT Objective: This study aimed to estimate the direct costs of peripherally inserted central catheterization by nurses for hospitalized patients. Methods: A cost estimation study using a quantitative approach was conducted in a public teaching hospital in northern Paraná to calculate the direct costs of peripherally inserted central catheterization. The population included all medical records of patients between 15 and 99 years of age who were hospitalized and underwent peripherally inserted central catheterization by nurses between January 1, 2019, and December 31, 2021, totaling 664 insertions. The sample comprised 631 insertions. Results: The catheter kits (epicutaneous catheter + introducer + angulators) corresponded to the items with the highest unit costs and the greatest impact on the composition of costs. The cost of peripherally inserted central catheterization was US$ 217.14 (SD=75.21), with the cost of materials and staff's labor being US$ 195.39 (SD=74.15) and US$ 20.00 (SD=2.22), respectively. Conclusion: Materials represented the highest cost, which was explained by the high unit cost of catheters and kits used in echocardiography, followed by the staff's labor costs. The estimated average direct cost allowed for financial visibility of the inputs used. The key challenge is promoting lasting changes in the behavior of managers who carry out administrative functions in healthcare institutions, where proper budget management directly affects the allocative efficiency of resources and the quality of care. Objective Methods 1 9 2019 31 2021 66 insertions 63 Results epicutaneous angulators US 21714 217 14 217.1 SD=75.21, SD7521 SD SD=75.21 , 75 21 (SD=75.21) staffs staff s 19539 195 39 195.3 SD=74.15 SD7415 74 (SD=74.15 2000 20 00 20.0 SD=2.22, SD222 SD=2.22 2 22 (SD=2.22) respectively Conclusion echocardiography institutions care 201 3 202 6 2171 217. SD752 SD=75.2 7 (SD=75.21 1953 19 195. SD=74.1 SD741 (SD=74.1 200 0 20. SD22 SD=2.2 (SD=2.22 SD75 SD=75. (SD=75.2 SD=74. SD74 (SD=74. SD2 SD=2. (SD=2.2 SD7 SD=75 (SD=75. SD=74 (SD=74 SD=2 (SD=2. SD=7 (SD=75 (SD=7 SD= (SD=2 (SD= (SD

Resumo O estudo investigou a associação entre ter alguma doença ou agravo crônicos e a prevalência de uso de práticas integrativas e complementares (PIC) na população adulta brasileira. As doenças crônicas constituem uma séria questão de saúde pública e há limitações de respostas satisfatórias pela medicina ocidental. Assim, tem aumentado a procura pelas PIC por serem uma alternativa humanizada, de menor custo e de fácil aquisição. Foi realizado um estudo transversal de base populacional utilizando dados da Pesquisa Nacional de Saúde de 2019. Foram estimadas as prevalências de uso das PIC por categorias das demais variáveis (presença ou não de agravos crônicos), além de razões de prevalência (RP) ajustadas por características sociodemográficas. A prevalência de uso de alguma PIC, nos últimos 12 meses, pela população brasileira (a partir de 18 anos) foi de 5,5% (IC95%: 5,2%-5,8%), e os adultos com algum agravo crônico tiveram maior prevalência de uso (RP: 2,11; IC95%: 1,89-2,36), mesmo após ajuste sociodemográfico. Acidente vascular cerebral, asma, artrite, doenças osteomusculares relacionadas ao trabalho, depressão e outras doenças mentais, doença pulmonar obstrutiva crônica, câncer e doenças cardíacas, como hipertensão arterial, tiveram associação com maior uso de PIC. (PIC ocidental Assim humanizada aquisição 2019 presença crônicos, , crônicos) RP (RP sociodemográficas 1 meses anos 55 5 5,5 IC95% IC95 IC (IC95% 5,2%5,8%, 5258 5,2% 5,8% 2 8 5,2%-5,8%) 2,11 211 11 1,892,36, 189236 1,89 2,36 89 36 1,89-2,36) sociodemográfico cerebral asma artrite trabalho mentais crônica cardíacas arterial 201 5, IC9 (IC95 5,2%5,8% 525 52 5,2 58 5,8 5,2%-5,8% 2,1 21 892 1,892,36 18923 189 1,8 236 2,3 3 1,89-2,36 20 (IC9 5,2%5,8 5,2%-5,8 2, 1,892,3 1892 1, 23 1,89-2,3 (IC 5,2%5, 5,2%-5, 1,892, 1,89-2, 5,2%5 5,2%-5 1,892 1,89-2 5,2%- 1,89-

Abstract The study sought to investigate the association between having a chronic disease or condition and the prevalence of having recourse to Integrative and Complementary Practices (ICP) among the Brazilian adult population. Chronic diseases are a serious public health issue and there are limitations of Western medicine to offer effective answers. Thus, the demand for ICP has increased as they constitute a humanized treatment option, with low cost and ease of acquisition. A cross-sectional population-based study was carried out using data from the 2019 National Health Survey. The prevalence of ICP use was estimated by categories of the other variables (presence or absence of chronic conditions) and prevalence ratios (PR) were adjusted for sociodemographic variables. The prevalence of the use of a given ICP, in the last 12 months, by the adult Brazilian population (18 years of age and over) was 5.5% (95%CI: 5.2%-5.8%), and adults with a chronic condition had a higher prevalence of use (PR: 2.11; 95%CI: 1.89-2.36), even after adjusting for sociodemographic characteristics. Stroke, asthma, arthritis, work-related musculoskeletal disorders, depression and other mental illnesses, chronic obstructive pulmonary disease, cancer and heart disease such as hypertension were associated with a higher prevalence of ICP use. (ICP answers Thus option acquisition crosssectional cross sectional populationbased based 201 Survey presence conditions PR (PR 1 months 18 (1 over 55 5 5.5 95%CI 95CI CI 95 (95%CI 5.2%5.8%, 5258 5.2% 5.8% , 2 8 5.2%-5.8%) 2.11 211 11 1.892.36, 189236 1.89 2.36 89 36 1.89-2.36) characteristics Stroke asthma arthritis workrelated work related disorders illnesses 20 ( 5. 9 5.2%5.8% 525 52 5.2 58 5.8 5.2%-5.8% 2.1 21 892 1.892.36 18923 189 1.8 236 2.3 3 1.89-2.36 5.2%5.8 5.2%-5.8 2. 1.892.3 1892 1. 23 1.89-2.3 5.2%5. 5.2%-5. 1.892. 1.89-2. 5.2%5 5.2%-5 1.892 1.89-2 5.2%- 1.89-

Abstract In reproductive technologies, uncovering the molecular aspects of oocyte and embryo competence under different conditions is crucial for refining protocols and enhancing efficiency. RNA-seq generates high-throughput data and provides transcriptomes that can undergo additional computational analyses. This study presented the transcriptomic profiles of in vitro matured oocytes and blastocysts produced in vitro from buffalo crossbred (Bubalus bubalis), coupled with gene co-expression and module preservation analysis. Cumulus Oophorus Complexes, obtained from slaughterhouse-derived ovaries, were subjected to in vitro maturation to yield metaphase II oocytes (616) or followed in vitro fertilization and culture to yield blastocysts for sequencing (526). Oocyte maturation (72%, ±3.34 sd) and embryo development (21.3%, ±4.18 sd) rates were obtained from three in vitro embryo production routines following standard protocols. Sequencing of 410 metaphase II oocytes and 70 hatched blastocysts (grade 1 and 2) identified a total of 13,976 genes, with 62% being ubiquitously expressed (8,649). Among them, the differentially expressed genes (4,153) and the strongly variable genes with the higher expression (fold-change above 11) were highlighted in oocytes (BMP15, UCHL1, WEE1, NLRPs, KPNA7, ZP2, and ZP4) and blastocysts (APOA1, KRT18, ANXA2, S100A14, SLC34A2, PRSS8 and ANXA2) as representative indicators of molecular quality. Additionally, genes exclusively found in oocytes (224) and blastocysts (2,200) with specific biological functions were identified. Gene co-expression network and module preservation analysis revealed strong preservation of functional modules related to exosome components, steroid metabolism, cell proliferation, and morphogenesis. However, cell cycle and amino acid transport modules exhibited weak preservation, which may reflect differences in embryo development kinetics and the activation of cell signaling pathways between buffalo and bovine. This comprehensive transcriptomic profile serves as a valuable resource for assessing the molecular quality of buffalo oocytes and embryos in future in vitro embryo production assays. technologies efficiency RNAseq RNA seq highthroughput high throughput analyses Bubalus bubalis, bubalis , bubalis) coexpression co Complexes slaughterhousederived slaughterhouse derived ovaries 616 (616 526. 526 . (526) 72%, 72 (72% 334 3 34 ±3.3 sd 21.3%, 213 21 (21.3% 418 4 18 ±4.1 41 7 grade 2 13976 13 976 13,97 62 8,649. 8649 8,649 8 649 (8,649) them 4,153 4153 153 (4,153 foldchange fold change 11 BMP15, BMP15 BMP (BMP15 UCHL1 UCHL WEE1 WEE NLRPs KPNA7 KPNA ZP2 ZP ZP4 APOA1, APOA1 APOA (APOA1 KRT18 KRT ANXA2 ANXA S100A14 SA S A SLC34A2 SLCA SLC PRSS Additionally 224 (224 2,200 2200 200 (2,200 components metabolism proliferation morphogenesis However bovine assays 61 (61 52 (526 72% (72 33 ±3. 21.3% (21.3 ±4. 1397 97 13,9 6 864 8,64 64 (8,649 4,15 415 15 (4,15 BMP1 (BMP1 (APOA KRT1 S100A1 SLC34A 22 (22 2,20 220 20 (2,20 (6 5 (52 (7 ±3 21.3 (21. ±4 139 9 13, 86 8,6 (8,64 4,1 (4,1 (BMP S100A (2 2,2 (2,2 ( (5 ± 21. (21 8, (8,6 4, (4, 2, (2, (8, (4 (8

Abstract In the microregion of the Canastra/MG/Brazil, with the growth and recognition of artisanal cheeses, producers have gradually inserted in the market cheeses that differ from the traditional ones. This study aimed to map, identify, and characterize the production sites of the varieties of artisanal Minas cheeses of the Canastra microregion. Data were collected from Canastra cheese producers who were producing artisanal Canastra cheeses with modifications to the original recipe, which we characterize as new varieties of artisanal Canastra cheese. Geographic coordinates and primary property data were collected. Questionnaires were applied to cheese producers through semi-structured interviews and milk samples analysed. The new varieties of cheese were described and photographed. Regarding the diversity of cheeses produced, we found that moldy cheeses were produced in Medeiros (31.25%), São Roque (43.75%), Bambuí (6.25%), Delfinópolis (6.25%) and Tapiraí (12.5%). Medeiros and São Roque also produced the cheeses “Merendeirinho” and “Canastrão”, which differ from the traditional in size. In Medeiros and São Roque, we also found seasoned Merendeirinho cheese, other seasoned cheeses, and cheeses cured in wine and coffee. And only Medeiros produced a cheese cured in beer. We found that in São Roque, Delfinópolis, and Tapiraí, the production of these cheeses is continuous. In the geographical demarcation of artisanal Canastra cheese manufacturing, the cities of São Roque and Medeiros stand out, due to the diversity of varieties of traditional cheese and the number of producers. CanastraMGBrazil MG Brazil Canastra/MG/Brazil ones map identify recipe semistructured semi structured analysed photographed 31.25%, 3125 31.25% , 31 25 (31.25%) 43.75%, 4375 43.75% 43 75 (43.75%) 6.25%, 625 6.25% 6 (6.25% 12.5%. 125 12.5% . 12 5 (12.5%) “Merendeirinho Canastrão, Canastrão “Canastrão” size coffee beer continuous manufacturing out 312 31.25 3 2 (31.25% 437 43.75 4 7 (43.75% 62 6.25 (6.25 12.5 1 (12.5% “Canastrão 31.2 (31.25 43.7 (43.75 6.2 (6.2 12. (12.5 31. (31.2 43. (43.7 6. (6. (12. (31. (43. (6 (12 (31 (43 ( (1 (3 (4

Resumo É preocupante ver a frequência e intensidade crescentes de eventos climáticos extremos e seu impacto nos ecossistemas aquáticos e espécies de peixes. Este manuscrito relata e analisa dois eventos, um de seca em 2019 e de enchente em 2024 fornecendo insights valiosos sobre as consequências desses eventos. O resgate de 269 indivíduos de 19 espécies de peixes durante a seca de 2019 destaca o impacto significativo das condições extremas na ictiofauna. O aumento das temperaturas, o isolamento e a fragmentação do habitat devem ter representado desafios severos para as espécies de peixes durante esse período. Por outro lado, a observação de 53 indivíduos mortos de 5 espécies durante a enchente de 2024 indica os efeitos prejudiciais desse evento na população de peixes. A associação da mortalidade e dispersão de várias espécies com a barragem existente ressalta ainda mais a complexidade dos desafios enfrentados pelos peixes durante eventos extremos de enchentes. A correlação entre precipitação, regime fluvial e o impacto do uso e ocupação da terra fornece um contexto importante para a compreensão da dinâmica desses eventos extremos. A baixa precipitação durante a seca de 2019 e o aumento gradual da precipitação entre 2022 e 2024, levando à enchente, demonstram o papel significativo dos padrões de precipitação na formação dos resultados para as espécies de peixes. Além disso, a análise do uso e ocupação da terra, particularmente o aumento substancial da urbanização na bacia de drenagem nos últimos 30 anos, destaca os fatores induzidos pelo homem que contribuem para o estresse nos ecossistemas aquáticos. É evidente que tanto as enchentes quanto as secas extremas têm implicações significativas para as espécies de peixes. As enchentes extremas podem alterar os leitos dos rios, causar mortalidade direta e interromper populações isoladas, enquanto as secas extremas podem levar à morte de peixes, fragmentação do habitat e exacerbação de estressores ambientais. Esta análise enfatiza a necessidade urgente de medidas abrangentes para mitigar o impacto de eventos climáticos extremos nos ecossistemas aquáticos e nas espécies de peixes. Abordar fatores como uso e ocupação da terra, gestão da água e estratégias de adaptação às mudanças climáticas é crucial para promover a resiliência das populações de peixes diante dos desafios ambientais contínuos. 201 202 26 1 ictiofauna temperaturas período lado disso 3 anos rios isoladas contínuos 20 2

Abstract The increasing frequency and intensity of extreme weather events and their impact on aquatic ecosystems and fish species is concerning. This manuscript reports and analyzes two events, a drought in 2019 and a flood in 2024, providing valuable insights into the consequences of these events. The rescue of 269 individuals of 19 fish species during the 2019 drought highlights the significant impact of the extreme conditions on the ichthyofauna. Rising temperatures, isolation, and habitat fragmentation must have posed severe challenges for the fish species during this period. On the other hand, the observation of 53 dead individuals of 5 species during the 2024 flood indicates the detrimental effects of this event on the fish population. The association of mortality and dispersal of several species with the existing dam further underscores the complexity of the challenges faced by fish during extreme flood events. The correlation between rainfall, river regime, and the impact of land use and occupation provides an important context for understanding the dynamics of these extreme events. The low rainfall during the 2019 drought and the gradual increase in rainfall between 2022 and 2024 leading to the flood demonstrate the significant role of precipitation patterns in shaping the outcomes for fish species. Additionally, the analysis of land use and occupation, particularly the substantial increase in urbanization in the drainage basin over the last 30 years, highlights the human-induced factors contributing to the stress on aquatic ecosystems. Both extreme floods and droughts have significant implications for fish species. Extreme floods can alter riverbeds, cause direct mortality, and disrupt isolated populations, while extreme droughts can lead to fish kills, and habitat fragmentation, and exacerbate environmental stressors. This analysis emphasizes the urgent need for comprehensive measures to mitigate the impact of extreme weather events on aquatic ecosystems and fish species. Addressing factors such as land use and occupation, water management, and climate change adaptation strategies is crucial for promoting the resilience of fish populations in the face of ongoing environmental challenges. concerning 201 26 1 ichthyofauna temperatures isolation period hand 202 population regime Additionally 3 years humaninduced human induced riverbeds kills stressors management 20 2

RESUMO Este estudo buscou verificar os efeitos dos exercícios de dupla tarefa no equilíbrio, autonomia funcional e mobilidade dos idosos. Trata-se de um estudo longitudinal, quase experimental, descritivo e quantitativo, sendo selecionados nove idosos que se enquadravam nos critérios de inclusão e exclusão, após aplicação do Mini exame do estado mental. Participaram do estudo dois idosos do sexo masculino e sete do sexo feminino, durante oito semanas, com frequência de dois dias alternados. Foram avaliadas as seguintes variáveis: teste de equilíbrio de Tinetti, Grupo de Desenvolvimento Latino-Americano para a Maturidade (GDLAM), Timed Up & Go (TUG), TUG manual 1 e 2 e TUG cognitivo 1 a 6. O valor de p< 0,05 foi adotado para a significância estatística. Não houve redução significativa no Timed Up & Go, TUG manual 1 e 2 e TUG cognitivo 1 a 6. Ocorreu aumento significativo de 1,11 pontos pós intervenção (p= 0,007) do teste de equilíbrio de Tinetti e uma diminuição significativa (6,14 segundos) os exercícios de C10m (p= 0,001), LPS (5,67 segundos) (p= 0,004) e VTC (4,79 segundos) (p= 0,003). Nota-se também uma redução significativa (8,88 pontos) (p= 0,001) do escore IG. Conclui-se através dos resultados obtidos na presente pesquisa que houve melhora significativa no desempenho do equilíbrio e autonomia funcional dos idosos. Através desses achados infere-se que os idosos da pesquisa terão uma melhor autonomia e menor risco de quedas.

ABSTRACT This study sought to verify the effects of dual-task exercises on balance, functional autonomy and mobility of the elderly. This longitudinal, quasi-experimental, descriptive and quantitative study selected 9 elderly people who met the inclusion and exclusion criteria. After applying the Mini Mental State Examination, two males and seven females participated in the study for eight weeks, with a frequency of two alternate days. The following variables were evaluated: Tinetti balance test, Latin American Development Group for Maturity (GDLAM), Timed Up & Go (TUG), manual TUG 1 and 2 and cognitive TUG 1 to 6. The p< 0.05 was adopted for statistical significance. There was no significant reduction in Timed Up & Go, manual TUG 1 and 2 and cognitive TUG 1 to 6. There was a significant increase of 1.11 points post-intervention (p= 0.007) of the Tinetti balance test and a significant decrease (6.14 seconds) in the C10m exercises (p= 0.001), LPS (5.67 seconds) (p= 0.004) and VTC (4.79 seconds) (p= 0.003). There was also a significant reduction (8.88 points) (p= 0.001) in the IG score. It is concluded through the results obtained in this research that there was a significant improvement in the performance of balance and functional autonomy of the elderly. These findings show that the elderly in the present research will have better autonomy and a lower risk of falls.

ABSTRACT The increase in inflammatory markers associated with persistent chronic fibrosing myocarditis, a characteristic of chronic Chagas disease, can result in a reduction in inspiratory muscle strength (IMS) in Chagas cardiomyopathy (CC). However, literature in this field is still scarce. This review aimed to map and summarize the evidence regarding IMS in patients with CC. The inclusion criteria included reports with adult participants with a CC diagnosis, with or without heart failure (HF). The core concept examined was the maximum inspiratory pressure evaluated in the untrained and trained groups in the pre-training period. The context was open, including but not limited to hospitals and health centers. Two authors independently identified eligible studies and extracted the data. Descriptive synthesis was used as the primary strategy for analyzing the results. Nine studies (five clinical trials, three cross-sectional, and one cohort) were included. The CC classification differed among the studies, with no mention of HF in five and no CC staging specification in six. IMS was assessed using a manovacuometer, and only six studies analyzed and interpreted the data concerning the predicted values. The CC population with HF appeared to have impaired IMS. All studies involved only Brazilian volunteers. In conclusion, randomized clinical trials evaluating IMS and the effects of inspiratory muscle training need to be conducted to better understand the prevalence and risk of inspiratory muscle weakness in the CC population, as well as the effects of training. Such studies should be conducted at different stages of CC in different populations and countries. myocarditis disease (IMS . (CC) However scarce diagnosis HF. (HF) pretraining pre period open centers results crosssectional, crosssectional cross sectional, sectional cross-sectional cohort manovacuometer values volunteers conclusion countries (CC (HF

ABSTRACT Objective: The occurrence of partial remission (honeymoon phase) in type 1 diabetes (T1D) has been associated with a reduced risk of chronic microvascular complications of diabetes. We have published case reports showing that a combination therapy with the DPP-4 inhibitor sitagliptin plus vitamin D3 (VIDPP-4i) can prolong the honeymoon phase in patients with new-onset T1D. In the present case-control study, we investigated the frequency of occurrence of clinical remission (CR) in patients with new-onset T1D after VIDPP-4i treatment. Subjects and methods: In this case-control study, we collected data spanning 10 years from medical records of 46 patients (23 females) recently diagnosed with T1D. Overall, 27 participants with CR (insulin dose-adjusted glycated hemoglobin [IDAA1c] ≤ 9) at 12 or 24 months composed the case group, and 19 participants without CR served as the control group. Chi-square with Yates correction was used to analyze the association between VIDPP-4i use and CR, and odds ratio (OR) was used to determine the chance of CR due to VIDPP-4i treatment exposure. Results: In all, 37 patients (80.4%) experienced CR at some time over 24 months. The mean CR duration was 13.15 ± 9.91 months. Treatment with VIDPP-4i was significantly associated with CR. At 24 months, the OR of CR after VIDPP-4i exposure was 9.0 (95% confidence interval [CI] 2.21-30.18, p = 0.0036). Additionally, 9 (33.6%) and 4 (14.8%) patients in the VIDPP-4i group experienced insulin-free CR at 12 and 24 months, respectively. Conclusion: Therapy with VIDPP-4i was associated with a higher frequency and duration of the honeymoon phase. Randomized controlled trials are needed to confirm these findings. Objective TD T D (T1D DPP4 DPP DPP- VIDPP4i VIDPPi VIDPP 4i i (VIDPP-4i newonset new onset casecontrol study (CR methods 23 (2 females Overall 2 insulin doseadjusted dose adjusted IDAA1c IDAAc IDAA c [IDAA1c Chisquare Chi square (OR Results all 3 80.4% 804 80 (80.4% 1315 13 15 13.1 991 91 9.9 90 0 9. 95% 95 (95 CI [CI 2.2130.18, 2213018 2.21 30.18, 21 30 18 2.21-30.18 0.0036. 00036 0.0036 . 0036 0.0036) Additionally 33.6% 336 33 6 (33.6% 14.8% 148 14 8 (14.8% insulinfree free respectively Conclusion findings ( 80.4 (80.4 131 13. 99 (9 2130 2.2130.18 221301 221 2.2 3018 30.18 2.21-30.1 0003 0.003 003 33.6 (33.6 14.8 (14.8 80. (80. 213 2.2130.1 22130 22 2. 301 30.1 2.21-30. 000 0.00 00 33. (33. 14. (14. (80 2.2130. 2213 30. 2.21-30 0.0 (33 (14 (8 2.2130 2.21-3 0. (3 (1 2.213 2.21-

Resumen El amamantamiento se reconoce como práctica determinante en la promoción de la salud de la mujer y del niño. Protegerla es actuar en favor de la Seguridad Alimentaria y Nutricional. El objetivo de este trabajo es describir el proceso de creación de material educativo para promoción de la lactancia en el ambiente hospitalario. Se trata de un estudio cualitativo, con realización de entrevistas semiestructuradas, con 13 mujeres atendidas en un hospital maternidad de la red pública del municipio de Río de Janeiro, seguidas del desarrollo y evaluación del material educativo. El material se elaboró con base en principios de la educación alimentaria y nutricional, en las narrativas de las mujeres y en la comprensión de la lactancia como derecho humano. Se concluyó que la participación de personas que amamantan en la elaboración del material dio oportunidad al protagonismo y a la representación de vivencias concretas sobre esta práctica. niño Nutricional hospitalario cualitativo semiestructuradas 1 Janeiro nutricional humano

A amamentação é reconhecida como prática determinante na promoção da saúde da mulher e da criança. Protegê-la é atuar em favor da Segurança Alimentar e Nutricional. O objetivo deste trabalho é descrever o processo de criação de material educativo para promoção da amamentação no ambiente hospitalar. Trata-se de um estudo qualitativo, mediante a realização de entrevistas semiestruturadas com 13 mulheres atendidas em hospital maternidade da rede pública do município do Rio de Janeiro, seguido do desenvolvimento e da avaliação do material educativo. Este estudo foi elaborado com base em princípios da educação alimentar e nutricional por meio de narrativas das mulheres e compreensão da amamentação como direito humano. Concluiu-se que a participação de pessoas que amamentam na elaboração do material oportunizou o protagonismo e a representação de vivências concretas sobre essa prática. criança Protegêla Protegê la Nutricional hospitalar Tratase Trata se qualitativo 1 Janeiro humano Concluiuse Concluiu

Abstract Breastfeeding is recognized as a determining practice in the promotion of women’s and children’s health. To protect it is to act in guaranteeing Food and Nutrition Security. The aim of this study is to describe the process of creating educational material to promote breastfeeding in the hospital environment. This is a qualitative study, involving semi-structured interviews with 13 women assisted in a public maternity hospital in the city of Rio de Janeiro, followed by the development and evaluation of the resource. The material was created based on principles of food and nutrition education, on the women’s narratives and on the comprehension of breastfeeding as a human right. It was concluded that the participation of those who breastfeed in the preparation of the material provided the opportunity for protagonism and the representation of concrete experiences about this practice. womens s childrens children health Security environment semistructured semi structured 1 Janeiro resource education right

Resumo O Brasil está entre os países que mais utiliza agrotóxicos no mundo. Essas substâncias químicas provocam modificações indesejáveis nos ecossistemas, destacando a contaminação de espécies florestais nativas não alvo, através da deriva. Os transtornos causados pelos agrotóxicos extrapolam os danos ambientais, sendo considerados problema de saúde pública. O objetivo deste trabalho foi avaliar os efeitos do glifosato nas trocas gasosas foliares, pigmentos fotossintéticos e morfoanatomia de plântulas de Eugenia dysenterica. Foram analisadas a toxicidade visual, as características fisiológicas e morfoanatômicas de E. dysenterica, expostas a concentrações de 0, 550, 1110 e 2220 g a.e. ha-1 do glifosato. Os resultados apontam que o herbicida causou toxicidade nas folhas em todos os tratamentos. Redução da fotossíntese (A), condutância estomática (gs) e da transpiração (E) aos 47 DAA, também foram identificados. O glifosato causou danos às estruturas anatômicas das folhas de E. dysenterica. Diante dos dados analisados é possível afirmar que plantas de E. dysenterica são sensíveis a ação do glifosato. Sintomas visíveis como clorose e necrose na borda foliar são indicadores que podem ser utilizados pelas comunidades rurais como alerta do risco de contaminação. mundo ecossistemas alvo deriva ambientais pública foliares visual E 0 550 111 222 ae a.e ha1 ha 1 ha- tratamentos A, A , (A) gs (gs (E 4 DAA identificados 55 11 22 (A 5 2

Abstract Brazil is among the countries that most use pesticides in the world. These chemicals cause undesirable changes in ecosystems, particularly the contamination of non-target native forest species through drift. The nuisances caused by pesticides go beyond environmental damage and include public health problems. The objective of this work was to evaluate the effects of glyphosate on leaf gas exchange, photosynthetic pigments and morphoanatomy of seedlings of Eugenia dysenterica. The visual toxicity, physiological and morphoanatomical characteristics of E. dysenterica, when exposed to concentrations of 0, 550, 1110 and 2220 g a.e. ha-1 of glyphosate, were analyzed. The results indicate that the herbicide caused toxicity in the leaves in all treatments. Reductions in photosynthesis (A), stomatal conductance (gs), and transpiration (E) at 47 DAA, were also identified. Glyphosate caused damage to the anatomical structures of E. dysenterica leaves. From the data analyzed it is possible to affirm that plants of E. dysenterica are sensitive to the action of glyphosate. Visible symptoms such as chlorosis and necrosis in the leaf edge are indicators that can be used by rural communities as a warning of the risk of contamination. world ecosystems nontarget non target drift problems exchange E 0 550 111 222 ae e a.e ha1 ha 1 ha- treatments A, A , (A) gs, gs (gs) (E 4 DAA identified 55 11 22 (A (gs 5 2

Resumo Fundamento O Programa Boas Práticas em Cardiologia é uma iniciativa da Sociedade Brasileira de Cardiologia (SBC) destinada à melhoria do cuidado cardiovascular nos hospitais públicos brasileiros. Objetivos Descrever características dos pacientes internados com Síndrome Coronariana Aguda (SCA) e Insuficiência Cardíaca (IC) e avaliar os indicadores de desempenho alcançados nos braços (SCA e IC) em um hospital público terciário, com uma meta pré-estabelecida de 85% de aderência às recomendações da SBC. Métodos Estudo do tipo transversal descritivo realizado por meio da coleta de dados de pacientes que estiveram internados entre maio de 2016 e setembro de 2019. Resultados Foram incluídos 1036 pacientes, 273 pacientes no braço IC e 763 no braço SCA. A média de idade foi de 59,8 ± 12,0 anos na SCA e 57,0 ± 14,1 anos na IC, com predomínio do sexo masculino em ambos os grupos. Mais da metade dos pacientes não tinham ensino fundamental completo e mais de 90% declararam renda mensal inferior a cinco salários-mínimos. Na SCA, predominou o diagnóstico de SCA com supradesnivelamento do segmento ST (66,3%) e 2,9% dos pacientes foram a óbito. Na IC, a etiologia mais comum foi a Doença de Chagas (25,8%) e 17,9% dos pacientes foram a óbito. Na avaliação dos indicadores de desempenho, nove dos 12 indicadores tiveram taxas de aderência acima de 85%. Conclusão Programas de qualidade são essenciais à melhoria do cuidado e os indicadores de desempenho do hospital apontam para uma boa adesão às diretrizes assistenciais da SBC, particularmente no braço da SCA. SBC (SBC brasileiros (IC terciário préestabelecida pré estabelecida 85 201 2019 103 27 76 598 59 8 59, 120 0 12, 570 57 57, 141 14 1 14, grupos 90 saláriosmínimos. saláriosmínimos salários mínimos. mínimos salários-mínimos 66,3% 663 66 3 (66,3% 29 2 9 2,9 óbito 25,8% 258 25 (25,8% 179 17 17,9 20 10 7 5 66,3 6 (66,3 2, 25,8 (25,8 17, 66, (66, 25, (25, (66 (25 (6 (2 (

Abstract Background The Good Practices in Cardiology Program is an initiative created by the Brazilian Society of Cardiology (SBC) to improve the quality of care of cardiovascular disease patients in Brazilian public hospitals. Objectives To characterize patients admitted to a tertiary public hospital with diagnosis of acute coronary syndrome (ACS) or heart failure (HF) and to evaluate performance indicators in both ACS and HF arms, with a pre-established target of 85% adherence to the SBC recommendations. Methods This was a descriptive cross-sectional study through data collection of patients hospitalized between May 2016 and September 2019. Results A total of 1,036 patients were included, 273 in the HF arm and 763 in the ACS arm. Mean age was 59.8 ± 12.0 years in the ACS and 57.0 ± 14.1 years in the HF, with a predominance of male patients in both groups. More than half of patients had some primary education and more than 90% reported a monthly income of less than five minimum wages. In ACS, the diagnosis of ACS with ST segment elevation was predominant (66.3%), and 2.9% of patients died. In HF, the most common etiology was Chagas disease (25.8%), and 17.9% died. Analysis of the performance indicators revealed an adherence rate higher than 85% to nine of the 12 indicators. Conclusion Quality programs are essential for improvement of quality of care. Performance indicators pointed to a good adherence to the SBC guidelines, mainly in the ACS arm. (SBC hospitals (ACS (HF arms preestablished pre established 85 recommendations crosssectional cross sectional 201 2019 1036 1 036 1,03 included 27 76 598 59 8 59. 120 0 12. 570 57 57. 141 14 14. groups 90 wages 66.3%, 663 66.3% , 66 3 (66.3%) 29 2 9 2.9 died 25.8%, 258 25.8% 25 (25.8%) 179 17 17.9 guidelines 20 103 03 1,0 7 5 66.3 6 (66.3% 2. 25.8 (25.8% 17. 10 1, 66. (66.3 25. (25.8 (66. (25. (66 (25 (6 (2 (

ABSTRACT The precise pathogenesis of COVID-19-related multisystem inflammatory syndrome remains largely elusive, despite its rarity. The syndrome symptoms often overlap with those of other infections, posing challenges for prompt diagnosis. A male patient, 34 years old, was admitted with suspicion of severe dengue, rapidly progressing to multiple organ dysfunction. Dengue tests resulted negative, and he passed away after four days. This case occurred approximately four weeks after the initial onset of COVID-19 and met all diagnostic criteria as defined by the Centers for Disease Control and Prevention. This report presents the first documented case of fatal multisystem inflammatory syndrome in adult (MIS-A) in Brazil. Recognizing the significance of suspecting this syndrome and promptly initiating treatment at an early stage are essential for minimizing damage and mortality. COVID19related COVIDrelated COVID 19 related elusive rarity infections diagnosis patient 3 old dengue dysfunction negative days COVID19 COVID-1 Prevention MISA MIS (MIS-A Brazil mortality 1 COVID1 COVID-