Abstract Background Tuberous sclerosis complex (TSC) is a multisystem neurocutaneous syndrome with variable phenotypes. Recent updates of TSC diagnostic criteria reaffirmed the defined genetic diagnostic criterion as the finding of a pathogenic DNA alteration in either TSC1 or TSC2 genes. It also slightly modified definite clinical diagnostic criteria. TSC-associated skin lesions in infancy are important clinical signs to select individuals with possible TSC for a closer clinical follow-up and genetic testing. Objective To raise awareness of the updated TSC diagnosis criteria; to assess the frequency of skin lesions in TSC patients as well as the first dermatological presentation; and to associate the findings with either TSC1 or TSC2 mutations. Methods Observational cross-sectional study. Clinical and genetic data were retrospectively collected from 37 TSC patients from a Brazilian University Hospital. Patients with skin signs were examined and prospectively assessed for 12 months. Results The earliest cutaneous lesions were hypomelanotic macules, which together with angiofibromas were the most frequent dermatological lesions. The total pathogenic DNA alteration ratio between TSC2 and TSC1 genes was 8:1. The frequency of a TSC2 pathogenic variant was 10-fold greater in the presence of ungual fibromas. Study limitations Small sample and a limited number of patients with TSC1 pathogenic variants. Conclusion Clinicians should be knowledgeable about TSC updated diagnostic criteria. Patients need to be followed up by a multidisciplinary team and treated accordingly. Early detection of cutaneous lesions is important for TSC diagnosis. A significant association between TSC2 gene pathogenic alterations and ungual fibromas is described. (TSC phenotypes TSCassociated associated followup follow testing presentation mutations crosssectional cross sectional study 3 Hospital 1 months macules 81. 81 8 1. 8:1 10fold fold 10 variants accordingly described 8:

Resumo O Acordo União Europeia-Mercado Comum do Sul, negociado desde o início de 2000, possui objetivos que vão além das relações comerciais. A cooperação proposta traz em seu conjunto a redução de barreiras tarifárias e não tarifárias, investimentos para o desenvolvimento de tecnologias, transporte, educação e, sobretudo, a promoção do desenvolvimento sustentável. Considerado como um dos maiores acordos inter-regionais, são grandes as perspectivas de uma próxima conclusão. Sopesando as questões que dificultam sua conclusão, o presente artigo tem como objetivo analisar, por meio de pesquisa bibliográfica e estudo documental, as implicações dos diversos cenários para a definitiva aprovação do Acordo. Para tanto, buscou-se estudar seu contexto histórico, desde a proposta inicial, passando pelas negociações e diversas interrupções ocorridas, para então avaliar o estado da arte e as perspectivas de concretização. A partir da análise realizada, concluiu-se que houve melhoria nas expectativas sobre a aprovação do Acordo, considerando a mudança recente no contexto político do Brasil e as diversas forças que têm sido realizadas nesse sentido. Contudo, as negociações são permeadas por influências políticas e cenários dinâmicos, que podem inviabilizar o consenso pretendido. A importância do presente estudo está relacionada às crescentes discussões sobre os efeitos do Acordo, principalmente no que tange à efetividade das cláusulas socioambientais negociadas, questão que pode ser analisada em trabalhos futuros, que avaliem a efetividade das cláusulas propostas e a possibilidade de harmonização das normas e políticas adotadas no âmbito das duas regiões.

Abstract The EU-Mercosur agreement, negotiated more than 20 years ago, has objectives that go beyond trade relations. The proposed cooperation includes the reduction of tariff and non-tariff barriers, investment in technology development, transportation, education, and, above all, the promotion of sustainable development. Considered as one of the largest interregional agreements, the prospects for its future conclusion are great. Considering the issues that make its conclusion difficult, this article aims to analyze, through bibliographical research and documentary study, the implications of the different scenarios for a definitive approval of the Agreement. To this end, its historical context has been studied, from the initial proposal, through the negotiations and the various interruptions that have occurred, to then evaluate the state of the art and the prospects for completion. From the analysis carried out, it was concluded that expectations regarding the approval of the agreement have improved, considering the recent changes in the Brazilian political context and the various forces that have been exerted in this regard. However, the negotiations are permeated by political influences and dynamic scenarios that make the intended consensus unfeasible. The importance of the present study is related to the growing discussions about the impact of the agreement, mainly regarding the effectiveness of the negotiated socio-environmental clauses, an issue that can be analyzed in future work, which evaluates the effectiveness of the proposed clauses and the possibility of harmonizing standards and policies adopted within the two regions.

Introdução: O ensino em cirurgia deve acompanhar a evolução das técnicas, procedimentos e tecnologia. Desde a década de 90 a videocirurgia vem se desenvolvendo e hoje é a primeira escolha para muitos procedimentos em cirugia geral. Com características diferentes da cirurgia convencional, os residentes treinaram em simuladores para adaptação. A literatura médica mundial já apresenta programas consagrados para treinamento entre eles os Fundamentos da Cirurgia Laparoscópica (FLS). A avaliação das habilidades técnicas cirúrgicas é uma ferramenta importante em programas de residência médica. Objetivo: Avaliar o impacto do treinamento através de aquisição de habilidades dos médicos residentes em cirurgia geral antes e após treinamento teórico-prático em videocirurgia utilizando um simulador de baixa fidelidade baseado em exercícios do FLS. Método: Estudar de modo prospectivo a aquisição de habilidades de médicos residentes em cirurgia geral de primeiro e segundo ano (R1 e R2), antes e após realização de treinamento teórico-prático pré-definido. Conclusão: Houve melhora significativa com o treinamento atingindo níveis de conhecimento e aprimoramento semelhantes aos trabalhos da literatura mundial. A melhoria no desempenho dos residentes foi evidente em ambos os grupos da amostra. Aqueles do primeiro ano atingiram a concentração de conhecimento após o treinamento semelhante ao desempenho dos residentes de segundo ano na avaliação inicial, destacando que o treinamento sequenciado realizado equivale a um ano de prática no programa de residência geral de cirurgia

Introduction: Teaching in surgery must follow the evolution of medical techniques, procedures and technology. Since the 90s videosurgery has been developing and nowadays is the gold standard for many procedures in general surgery. As there are different characteristics from conventional surgery, residents need to practice in order to adapt to simulators. The world medical literature has established many training programs among them the Fundaments of laparoscopic Surgery (FLS). Evaluation of surgical technical abilities is a major tool for the residency programs. Objectives: To assess the effect of training acquiring skills of residents at first and second postgraduated level year (PGY1 and PGY2) before and after practice using low fidelity simulator based on tasks from FLS. Methods: A prospective study was conducted to determinate skills acquisition of residents at first and second postgraduated level year l (PGY1 and PGY2) before and after standardized practice using low fidelity simulator. Conclusions: There was a significant improve of the technical abilities reaching levels of improvement. Resident’s performance was evident in the sample groups. First year residents (PGY1) achieved knowledge retention after training similar to the performance of second in the initial assessment, suggesting that the sequenced training carried out is equivalent to one year of practice in the general surgery residency program

Introdução: O ensino em cirurgia convencional foi tradicionalmente baseado no modelo halstediano do “see one, do one and teach one” (veja um, faça um e ensine um); porém, com a bem sucedida propagação da cirurgia videolaparoscópica precisou ser adaptado para um novo modelo do “do many, mentored always” (fazer vários, sempre supervisionado). A nova era da cirurgia demanda treinamento sequencial, com crescente complexidade e repetição supervisionada para adquirir habilidades especificas prévias ao primeiro ato operatório. Objetivo: Desenvolver modelo para ensino e treinamento em videocirurgia com plataforma de baixo custo, fácil execução e baixa fidelidade com tarefas que utilizam materiais sintéticos. Método: Construiu-se com materiais de baixo custo plataforma utilizando apenas placa de madeira, poucos materiais de ferragem (parafuso simples, parafuso com porca tipo borboleta, gancho com rosca), folha de EVA (etileno acetato de vinila), tinta branca para artesanato e caneta hidrográfica. A amostra-teste foi composta por 15 cirurgiões gerais com mais de 10 anos de experiência em videolaparoscopia. Iniciou-se a avaliação com um vídeo explicativo com duração de 20 min. A seguir, cada cirurgião executou 5 tarefas gravadas para posterior análise e pontuação. Mediu-se as habilidades de acordo com a pontuação. Resultados: A plataforma foi útil e eficaz em reproduzir as atividades utilizadas para replicação do programa comparativo do Fundaments of Laparoscopic Surgery. A amostra de cirurgiões atingiu o tempo alvo definido como padrão pelo programa. Conclusão: A plataforma elaborada com materiais de baixo custo é de fácil aquisição, mostrou-se modelo eficaz para treinamento em videocirurgia, de fácil replicabilidade e construção, adaptável a vários modelos de tarefas, e feita com materiais sintéticos.

Introduction: Teaching in conventional surgery has traditionally been based on the Halstedian model of “see one, do one, and teach one”. However, with the widespread success of videolaparoscopic surgery, the teaching method needed to be adapted to a novel “Do many, always mentored” model. The modern era of surgery demands sequential training with progressively increasing complexity and supervised repetition, in order to acquire specific skills prior to the first surgical procedure. Objective: To develop a new experimental teaching and training with low cost and low fidelity platform for laparoscopic surgery using synthetic materials, and simple manufacturing. Method: A platform was built using low-cost materials easily found in hardware stores, consisting of a wooden board and a few hardware materials (threaded bolt, wing nut and bolt, threaded hooks), EVA sheet (ethylene vinylacetat), white crafting paint, and felt-tip pen. The sample consisted of 15 general surgeons with more than 10 years of experience in videolaparoscopy. The evaluation began with an explanatory video lasting 20 min. Next, each surgeon performed 5 recorded tasks for later analysis and scoring. Skills were measured according to the stablished score. Results: The developed platform was useful and capable of reproducing the tasks performed based on the program of Fundaments of Laparoscopic Surgery. All the surgeons of the sample group achieved the target time proposed for the program. Conclusion: Was shown that the proposed platform can be built using easily obtainable and low-cost materials, and it proved to be an effective model for training in laparoscopic surgery, being easy to replicate and construct. Additionally, this platform can be easily adapted to various models of tasks using materials similar to those found in other training programs, that are widely practiced and have been globally validated.

Introduction Treatment of hemophilia A in Brazil is offered to all patients at no cost. However, several unmet medical needs exist. Method In this study, we applied the Delphi method to discuss with seven hemophilia A specialists the challenges that patients and the health system face regarding hemophilia A treatment and opportunities for improvement. Results A consensus was obtained regarding the number of weekly infusions and patient adherence to treatment. The bleeding profile, unfavourable pharmacokinetics (PKs), low adherence and high daily activity were patient profiles that would benefit from using the extended half-life (EHL) recombinant factor VIII (rFVIII). The advantages of treatment with the EHL rFVIII were the lower number of infusions per week, which could increase patient adherence and decrease the risk of bleeds, due to a more constant plasma level, a lower value. Additionally, the EHL rFVIII could improve quality of life, especially in patients with high daily activity, such as adolescents and young adults. The panelists mentioned that EHL rFVIII, if available, could be offered first to the priority group (adolescents between 12 and 19 years old), followed by adults (20 to 64 years old) and elderly people (over 65 years old). Conclusion In summary, the EHL rFVIII offers the optimal prophylaxis by decreasing the dose frequency, increasing the treatment adherence and improving the QoL, without compromising safety and efficacy. cost However exist study improvement profile PKs, PKs , (PKs) halflife half life (EHL rFVIII. . (rFVIII) week bleeds level value Additionally available 1 old, old 20 (2 6 over old. summary frequency QoL efficacy (PKs (rFVIII 2 (

Abstract The COVID-19 pandemic has shed light on the negative impact of intellectual property on health and has given new relevance to the Direct Action of Unconstitutionality 5529/DF, which was ruled by the Supreme Court in 2021, resulting in the extinction of automatic patent extensions in Brazil. This documentary case study analyzes the effects of the judicial decision on patent applications and patents of interest for Productive Development Partnerships (PDP), investigating the progress of 90 patent applications related to 15 PDPs drugs of interest until Decembre 31, 2020. Variables for comparing the drug patent scenario with that of the PDPs were researched on the websites of the National Institute of Industrial Property, the Ministry of Health, ANVISA, and the Brazilian Medicines Market Regulation Chamber. Of 88 valid applications, 28 patents were granted, 17 of which had been extended to more than 20 years (24 years and 09 months average). The court decision resulted in a loss of over 68 years of monopoly, potentially opening alternatives for generic production. This resumption of the PDP policy should incorporate strategies to overcome patent barriers.

Resumo A covid-19 jogou luz sobre o impacto negativo da propriedade intelectual na saúde e deu nova relevância à Ação Direta de Inconstitucionalidade 5529/DF, que, acatada pelo Supremo Tribunal Federal em 2021, culminou na extinção da extensão automática de patentes no Brasil. Este estudo busca analisar o efeito do julgamento histórico da ADI 5529/DF sobre pedidos de patente e as patentes de interesse das Parcerias para Desenvolvimento Produtivo (PDP). Trata-se de um estudo com base em uma pesquisa documental de análise do andamento, até 31 de dezembro de 2020, de 90 pedidos de patente relacionados a 15 medicamentos objetos de PDP. Nos sites do Instituto Nacional de Propriedade Industrial, do Ministério da Saúde, da Anvisa e da Câmara de Regulação do Mercado de Medicamentos, foram pesquisadas variáveis para comparar o cenário patentário dos medicamentos com o das PDP. De 88 pedidos válidos, 28 patentes foram concedidas, das quais dezessete foram estendidas para mais de vinte anos (média de 24 anos e nove meses). A decisão do STF resultou em mais de 68 anos de monopólio perdidos, potencialmente desanuviando alternativas para a produção de genéricos no país. Neste momento de retomada das PDP, estratégias para a superação de barreiras patentárias deveriam ser incorporadas à política.

Resumo Objetivos: identificar as evidências científicas sobre tuberculose excessivamente resistente e multidroga resistente em pacientes pediátricos. Métodos: trata-se de uma revisão de escopo da literatura, tendo como questão norteadora: “Quais as evidências científicas sobre tuberculose multidroga-resistente (TB-MDR) e tuberculose extensivamente resistente em pacientes pediátricos?” A pesquisa usou os descritores: “tuberculose extensivamente resistente a medicamentos” OR “tuberculose resistente a múltiplos medicamentos” AND “pediatria”. A pesquisa foi realizada de modo duplo-cego nas bases de dados Medical Literature Analysis and Retrieval System Online, Regional Office for the Western Pacific’s Institutional Repository for Information Sharing, Embase/Elsevier e International Clinical Trials Registry Platform, com um corte temporal de 2011 a 2021, sendo a amostra final sintetizada de 18 artigos, nos quais avaliou-se o conteúdo metodológico por meio do nível de evidência. Resultados: os resultados mostraram a escassez de pesquisas de alto nível de evidência relacionadas à TB-MDR em crianças, ausência de posologia adequada das drogas de segunda linha para o público pediátrico e a importância do teste de sensibilidade a drogas para o tratamento dos casos. Conclusões: identificou-se que os obstáculos do tratamento TB-MDR se concentraram na ausência de protocolos detalhados, de dosagens medicamentosas seguras e com menor efeito colateral, e, principalmente, nos determinantes sociais do processo saúde e doença que envolvem a TB-MDR. Objetivos pediátricos Métodos tratase trata literatura norteadora Quais multidrogaresistente TBMDR TB MDR (TB-MDR pediátricos? descritores medicamentos pediatria. pediatria . “pediatria” duplocego duplo cego Online Pacifics Pacific s Sharing EmbaseElsevier Embase Elsevier Platform 201 2021 1 artigos avaliouse avaliou Resultados crianças casos Conclusões identificouse identificou detalhados colateral principalmente TBMDR. MDR. “pediatria 20 202 2

Abstract Objectives: to identify the scientific evidence on excessively resistant and multidrug resistant tuberculosis in pediatric patients. Methods: this is a scope review of the literature, with a guiding question: “What is the scientific evidence on multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis in pediatric patients?”. The research used the descriptors: “extensively drug-resistant tuberculosis” OR “multidrug-resistant tuberculosis” AND “pediatrics”. The research was carried out in a double-blind manner in the following databases of the Medical Literature Analysis and Retrieval System Online, Regional Office for the Western Pacific’s Institutional Repository for Information Sharing, Embase/Elsevier and International Clinical Trials Registry Platform, with a temporal cut-off from 2011 to 2021, sending a final synthesized sample of 18 articles, which evaluated the methodological content through the level of evidence. Results: the results show the lack of research with a high level of evidence related to MDR-TB in children, the lack of adequate dosage of second-line drugs for the pediatric population and the importance of drug sensitivity testing for the cases of treatment Conclusions: it was identified that the obstacles to MDR-TB treatment were concentrated in the lack of detailed protocols, safe drug dosages with a low side effect, and mainly in the social health determinants and disease process involving MDR-TB. Objectives patients Methods literature question What multidrugresistant MDRTB MDR TB (MDR-TB drugresistant . patients?” descriptors pediatrics. pediatrics “pediatrics” doubleblind double blind Online Pacifics Pacific s Sharing EmbaseElsevier Embase Elsevier Platform cutoff cut off 201 2021 1 articles Results children secondline second line Conclusions protocols effect MDRTB. TB. patients? “pediatrics 20 202 2

Resumo A covid-19 jogou luz sobre o impacto negativo da propriedade intelectual na saúde e deu nova relevância à Ação Direta de Inconstitucionalidade 5529/DF, que, acatada pelo Supremo Tribunal Federal em 2021, culminou na extinção da extensão automática de patentes no Brasil. Este estudo busca analisar o efeito do julgamento histórico da ADI 5529/DF sobre pedidos de patente e as patentes de interesse das Parcerias para Desenvolvimento Produtivo (PDP). Trata-se de um estudo com base em uma pesquisa documental de análise do andamento, até 31 de dezembro de 2020, de 90 pedidos de patente relacionados a 15 medicamentos objetos de PDP. Nos sites do Instituto Nacional de Propriedade Industrial, do Ministério da Saúde, da Anvisa e da Câmara de Regulação do Mercado de Medicamentos, foram pesquisadas variáveis para comparar o cenário patentário dos medicamentos com o das PDP. De 88 pedidos válidos, 28 patentes foram concedidas, das quais dezessete foram estendidas para mais de vinte anos (média de 24 anos e nove meses). A decisão do STF resultou em mais de 68 anos de monopólio perdidos, potencialmente desanuviando alternativas para a produção de genéricos no país. Neste momento de retomada das PDP, estratégias para a superação de barreiras patentárias deveriam ser incorporadas à política. covid19 covid 19 covid-1 5529DF DF 5529 que 2021 Brasil PDP . (PDP) Tratase Trata se andamento 3 2020 9 1 Industrial Saúde Medicamentos 8 válidos 2 concedidas média meses. meses meses) 6 perdidos país política covid1 covid- 552 202 (PDP 55 20 5

Abstract The COVID-19 pandemic has shed light on the negative impact of intellectual property on health and has given new relevance to the Direct Action of Unconstitutionality 5529/DF, which was ruled by the Supreme Court in 2021, resulting in the extinction of automatic patent extensions in Brazil. This documentary case study analyzes the effects of the judicial decision on patent applications and patents of interest for Productive Development Partnerships (PDP), investigating the progress of 90 patent applications related to 15 PDPs drugs of interest until Decembre 31, 2020. Variables for comparing the drug patent scenario with that of the PDPs were researched on the websites of the National Institute of Industrial Property, the Ministry of Health, ANVISA, and the Brazilian Medicines Market Regulation Chamber. Of 88 valid applications, 28 patents were granted, 17 of which had been extended to more than 20 years (24 years and 09 months average). The court decision resulted in a loss of over 68 years of monopoly, potentially opening alternatives for generic production. This resumption of the PDP policy should incorporate strategies to overcome patent barriers. COVID19 COVID 19 COVID-1 5529DF DF 5529 5529/DF 2021 Brazil PDP, , (PDP) 9 1 31 2020 Property Health ANVISA Chamber 8 2 granted 24 (2 0 average. average . average) 6 monopoly production barriers COVID1 COVID- 552 202 (PDP 3 ( 55 5

RESUMO O presente artigo tem como foco a reflexão e a discussão dos atravessamentos intersecionais de deficiência, gênero, classe social, trabalho e raça em processos de ensino da leitura e da escrita para estudantes surdos(as), à luz das teorias pós-críticas do currículo. O texto problematiza relatos e situações de sala de aula, realizados em uma escola pública da Educação de Jovens e Adultos na cidade de Belo Horizonte/MG. Metodologicamente, foram realizadas rodas de conversa com docentes e a observação participante no cotidiano de uma turma da referida escola, no ano de 2021. A partir das práticas curriculares docentes observadas, foi escolhido o conto “Circuito Fechado” de Ricardo Ramos, para problematização teórica pela perspectiva interseccional. A investigação apontou desafios no fazer docente durante o ensino da Língua Brasileira de Sinais e da Língua Portuguesa, como segunda língua. Os resultados indicaram a relevância em considerar o contexto de vida discente e o conhecimento prévio de cada estudante nos processos do aprender. Por fim, o estudo revelou como diferentes marcadores sociais podem atravessar práticas curriculares, oportunizando outras composições e outras leituras de mundo. deficiência gênero social surdosas, surdosas surdos as , surdos(as) póscríticas pós críticas currículo aula HorizonteMG Horizonte MG Horizonte/MG Metodologicamente 2021 observadas Circuito Fechado Ramos interseccional Portuguesa língua aprender fim mundo surdos(as 202 20 2

ABSTRACT This article focuses on reflecting on and discussing the intersections of disability, gender, social class, work, and race in processes of teaching reading and writing to deaf students, in the light of post-critical theories of curriculum. The text questions classroom reports and situations, carried out in a public school for Youth and Adult Education in the city of Belo Horizonte - MG. Methodologically, we held discussions with teachers and participant observation in the daily life of a class at the school in 2021. Based on curricular teaching practices observed, the short story Circuito Fechado (Closed Circuit) by Ricardo Ramos was chosen for theoretical questioning from an intersectional perspective. The investigation revealed challenges in teaching Brazilian Sign Language and Portuguese as a second language. The results indicate the importance of considering the context of the student’s life and the prior knowledge of each student in learning processes. Finally, the study reveals how different social markers can cross curricular practices, providing opportunities for other compositions and other readings of the world. disability gender work students postcritical post critical curriculum situations MG Methodologically 2021 observed Closed Circuit perspective language s Finally world 202 20 2

RESUMO Objetivo: Analisar o bem-estar espiritual de profissionais de enfermagem com distúrbio osteomuscular relacionado ao trabalho. Método: Estudo de corte transversal, realizado com profissionais de enfermagem de um hospital universitário público da Bahia, Brasil, de março a junho de 2023. Dados coletados em entrevista face-a-face na qual foram extraídos dados sociodemográficos, clínicos e ocupacionais, além da aplicação da Escala de Bem-Estar Espiritual. Procedeu-se à análise estatística descritiva e analítica. Resultados: entre profissionais de enfermagem (n=48), predominaram mulheres (89,6%), idade média 44,3 (±5,4), pretas e pardas (85,5%), casadas (31,3%), técnicas de enfermagem (83,3%), com mais que 10 anos na profissão (87,5%). A maioria das participantes tinha religião (60,4%), sendo 43,8% católicas, com escores positivos para bem-estar espiritual (77,1%), bem-estar religioso (87,5%) e bem-estar existencial (54,2%). Tempo na profissão, ter religião e ter prática espiritual/religiosa relacionou-se a escores mais altos de bem-estar espiritual. Técnicos de enfermagem apresentaram elevado bem-estar religioso e não houve significância na comparação das variáveis estudadas com o bem-estar existencial. Conclusão: Predomina entre os profissionais de enfermagem com distúrbios osteomusculares um alto nível de bem-estar espiritual e bem-estar religioso, com pouca diferença entre o resultado moderado e alto do bem-estar existencial. Objetivo bemestar bem estar trabalho Método transversal Bahia Brasil 2023 faceaface face sociodemográficos ocupacionais BemEstar Bem Estar Espiritual Procedeuse Procedeu se analítica Resultados n=48, n48 n n=48 , 48 (n=48) 89,6%, 896 89,6% 89 6 (89,6%) 443 44 3 44, ±5,4, 54 ±5,4 5 4 (±5,4) 85,5%, 855 85,5% 85 (85,5%) 31,3%, 313 31,3% 31 (31,3%) 83,3%, 833 83,3% 83 (83,3%) 1 87,5%. 875 87,5% . 87 60,4%, 604 60,4% 60 (60,4%) 438 43 8 43,8 católicas 77,1%, 771 77,1% 77 (77,1%) (87,5% 54,2%. 542 54,2% 2 (54,2%) espiritualreligiosa religiosa relacionouse relacionou Conclusão 202 n4 n=4 (n=48 89,6 (89,6% ±5, (±5,4 85,5 (85,5% 31,3 (31,3% 83,3 (83,3% 87,5 60,4 (60,4% 43, 77,1 7 (77,1% (87,5 54,2 (54,2% 20 n= (n=4 89, (89,6 ±5 (±5, 85, (85,5 31, (31,3 83, (83,3 87, 60, (60,4 77, (77,1 (87, 54, (54,2 (n= (89, ± (±5 (85, (31, (83, (60, (77, (87 (54, (n (89 (± (85 (31 (83 (60 (77 (8 (54 ( (3 (6 (7 (5

ABSTRACT Objective: To analyze the spiritual well-being of nursing professionals with work-related musculoskeletal disorders. Method: Cross-sectional observational study, carried out with nursing professionals from a public university hospital in Bahia, Brazil, from March to June 2023. Data was collected in a face-to-face interview in which sociodemographic, clinical and occupational data were extracted, in addition to the Spiritual Well-Being Scale application. Descriptive and analytical statistical analysis was carried out. Results: Most nursing professionals (n=48) were women (89.6%), mean age 44.3(±5.4), black and brown (85.5%), married (31.3%), nursing technicians (83.3%), more than 10 years in the profession (87.5%). The majority of participants had a religion (60.4%), 43.8% were Catholic, with positive scores for spiritual well-being (77.1%), religious well-being (87.5%) and existential well-being (54.2%). Having worked in the field for more than 10 years, having a religion, and having spiritual/religious practices were related to higher spiritual well-being scores. Nursing technicians showed high levels of religious well-being and there was no significant results when comparing the variables studied with existential well-being. Conclusion: Most nursing workers with musculoskeletal disorders presented a high level of spiritual well-being and religious well-being. In addition, there was little difference between the moderate and high results of existential well-being. Objective wellbeing well being workrelated work Method Crosssectional Cross sectional study Bahia Brazil 2023 facetoface face sociodemographic extracted WellBeing Well Being application Results n=48 n48 n 48 (n=48 89.6%, 896 89.6% , 89 6 (89.6%) 44.3±5.4, 44354 44.3 ±5.4 44 3 5 4 44.3(±5.4) 85.5%, 855 85.5% 85 (85.5%) 31.3%, 313 31.3% 31 (31.3%) 83.3%, 833 83.3% 83 (83.3%) 1 87.5%. 875 87.5% . 87 60.4%, 604 60.4% 60 (60.4%) 438 43 8 43.8 Catholic 77.1%, 771 77.1% 77 (77.1%) (87.5% 54.2%. 542 54.2% 54 2 (54.2%) spiritualreligious wellbeing. being. Conclusion 202 n=4 n4 (n=4 89.6 (89.6% 44.3±5.4 4435 443 44. ±5. 44.3(±5.4 85.5 (85.5% 31.3 (31.3% 83.3 (83.3% 87.5 60.4 (60.4% 43. 77.1 7 (77.1% (87.5 54.2 (54.2% 20 n= (n= 89. (89.6 44.3±5. ±5 44.3(±5. 85. (85.5 31. (31.3 83. (83.3 87. 60. (60.4 77. (77.1 (87. 54. (54.2 (n (89. 44.3±5 ± 44.3(±5 (85. (31. (83. (60. (77. (87 (54. (89 44.3± 44.3(± (85 (31 (83 (60 (77 (8 (54 44.3( (3 (6 (7 ( (5

RESUMEN Objetivo: Analizar el bienestar espiritual de los profesionales de enfermería con trastornos musculoesqueléticos relacionados al trabajo. Método: Estudio observacional transversal con profesionales de enfermería de un hospital público universitario de Bahía, Brasil, de marzo a junio de 2023. Datos recogidos en entrevista presenciales en que se extrajeron datos sociodemográficos, clínicos y ocupacionales, además de la aplicación de la Escala de Bienestar Espiritual. Se realizó un análisis estadístico descriptivo y analítico. Resultados: La mayoría de los profesionales de enfermería (n=48) eran mujeres (89,6%), edad media 44,3 (±5,4%), color negra o marrón (85,5%), casada (31,3%), técnicas de enfermería (83,3%), con más de 10 años en la profesión (87,5%). La mayoría de los participantes tenían religión (60,4%), el 43,8% eran católicos, con puntuaciones positivas en bienestar espiritual (77,1%), bienestar religioso (87,5%) y bienestar existencial (54,2%). El tiempo en la profesión, tener una religión y tener prácticas espirituales/religiosas se relacionaron con puntuaciones más altas de bienestar espiritual. Los técnicos de enfermería mostraron alto bienestar religioso y no hubo significancia al comparar las variables estudiadas con el bienestar existencial. Conclusión: Predomina un alto nivel de bienestar espiritual y bienestar religioso entre los profesionales de enfermería, con trastornos musculoesqueléticos Además, hubo poca diferencia entre los resultados moderados y altos de bienestar existencial. Objetivo trabajo Método Bahía Brasil 2023 sociodemográficos ocupacionales Espiritual analítico Resultados n=48 n48 n 48 (n=48 89,6%, 896 89,6% , 89 6 (89,6%) 443 44 3 44, ±5,4%, 54 ±5,4% 5 4 (±5,4%) 85,5%, 855 85,5% 85 (85,5%) 31,3%, 313 31,3% 31 (31,3%) 83,3%, 833 83,3% 83 (83,3%) 1 87,5%. 875 87,5% . 87 60,4%, 604 60,4% 60 (60,4%) 438 43 8 43,8 católicos 77,1%, 771 77,1% 77 (77,1%) (87,5% 54,2%. 542 54,2% 2 (54,2%) espiritualesreligiosas espirituales religiosas Conclusión Además 202 n=4 n4 (n=4 89,6 (89,6% ±5,4 (±5,4% 85,5 (85,5% 31,3 (31,3% 83,3 (83,3% 87,5 60,4 (60,4% 43, 77,1 7 (77,1% (87,5 54,2 (54,2% 20 n= (n= 89, (89,6 ±5, (±5,4 85, (85,5 31, (31,3 83, (83,3 87, 60, (60,4 77, (77,1 (87, 54, (54,2 (n (89, ±5 (±5, (85, (31, (83, (60, (77, (87 (54, (89 ± (±5 (85 (31 (83 (60 (77 (8 (54 (± (3 (6 (7 ( (5

RESUMO Objetivo: avaliar o conhecimento sobre transtornos de aprendizagem entre professores da educação básica e estudantes de estágio docente em escolas públicas e privadas brasileiras. Métodos: dois questionários foram administrados a professores de diversas instituições educacionais brasileiras, selecionados por amostragem aleatória. O primeiro questionário coletou dados sociodemográficos, enquanto o segundo avaliou o conhecimento sobre transtornos de aprendizagem. Para a investigação dos fatores associados ao conhecimento dos transtornos de aprendizagem, utilizou-se o Teste Qui-quadrado com nível de significância de 5%. Resultados: dos 158 professores inscritos, 51 responderam ao questionário e concluíram as etapas da pesquisa. A maioria era do sexo feminino (90,2%) com tempo médio de profissão de 13,6 anos. Das 1020 respostas obtidas no questionário sobre os transtornos da aprendizagem, 757 (74%) foram adequadas e 263 (26%) incorretas. Observou-se relação estatisticamente significante entre o maior conhecimento dos transtornos de aprendizagem e a realização anterior de palestras/cursos sobre o tema (p = 0,02). Conclusão: o treinamento de professores aumenta significativamente o conhecimento sobre transtornos de aprendizagem, sugerindo a necessidade de mais programas de desenvolvimento profissional focados nesse tema. Compreender o conhecimento dos professores sobre transtornos de aprendizagem é crucial para desenvolver intervenções educacionais eficazes e apoiar estudantes com dificuldades de aprendizagem. Objetivo brasileiras Métodos aleatória sociodemográficos utilizouse utilizou se Quiquadrado Qui quadrado 5 5% Resultados 15 inscritos pesquisa 90,2% 902 90 2 (90,2% 136 13 6 13, anos 102 75 74% 74 (74% 26 26% (26% incorretas Observouse Observou palestrascursos palestras cursos p 0,02. 002 0,02 . 0 02 0,02) Conclusão 1 90,2 9 (90,2 10 7 (74 (26 00 0,0 90, (90, (7 (2 0, (90 ( (9

ABSTRACT Purpose: to assess knowledge about learning disorders among basic education teachers and intern teachers in Brazilian public and private schools. Methods: two questionnaires administered to teachers from several Brazilian schools, selected by random sampling. The first questionnaire collected sociodemographic data, and the second assessed knowledge about learning disorders. The chi-square test investigated factors regarding knowledge about learning disorders, with a 5% significance level. Results: 51 of the 158 registered teachers responded to the questionnaire and completed the research stages. They were mostly females (90.2%) with a mean length of service of 13.6 years. The questionnaire on learning disorders obtained 1,020 responses, of which 757 (74%) were adequate, and 263 (26%) were incorrect. Greater knowledge of learning disorders was statistically significantly related to previous lectures/courses on the topic (p = 0.02). Conclusion: teacher training significantly increases knowledge about learning disorders, suggesting the need for more professional development programs focused on this topic. Understanding teachers' knowledge on learning disorders is crucial to developing effective educational interventions and supporting students with such difficulties. Purpose schools Methods sampling data chisquare chi square 5 level Results 15 stages 90.2% 902 90 2 (90.2% 136 13 6 13. years 1020 1 020 1,02 responses 75 74% 74 (74% adequate 26 26% (26% incorrect lecturescourses lectures courses p 0.02. 002 0.02 . 0 02 0.02) Conclusion difficulties 90.2 9 (90.2 102 1,0 7 (74 (26 00 0.0 90. (90. 10 1, (7 (2 0. (90 ( (9

Abstract Objective To conduct a systematic review of external validation studies on the use of different Artificial Intelligence algorithms in breast cancer screening with mammography. Data source Our systematic review was conducted and reported following the PRISMA statement, using the PubMed, EMBASE, and Cochrane databases with the search terms “Artificial Intelligence,” “Mammography,” and their respective MeSH terms. We filtered publications from the past ten years (2014 – 2024) and in English. Study selection A total of 1,878 articles were found in the databases used in the research. After removing duplicates (373) and excluding those that did not address our PICO question (1,475), 30 studies were included in this work. Data collection The data from the studies were collected independently by five authors, and it was subsequently synthesized based on sample data, location, year, and their main results in terms of AUC, sensitivity, and specificity. Data synthesis It was demonstrated that the Area Under the ROC Curve (AUC) and sensitivity were similar to those of radiologists when using independent Artificial Intelligence. When used in conjunction with radiologists, statistically higher accuracy in mammogram evaluation was reported compared to the assessment by radiologists alone. Conclusion AI algorithms have emerged as a means to complement and enhance the performance and accuracy of radiologists. They also assist less experienced professionals in detecting possible lesions. Furthermore, this tool can be used to complement and improve the analyses conducted by medical professionals. mammography statement PubMed EMBASE Intelligence, Mammography, Mammography “Mammography, 2014 (201 2024 English 1878 1 878 1,87 research 373 (373 1,475, 1475 1,475 , 475 (1,475) 3 work authors location year AUC specificity (AUC alone lesions Furthermore “Mammography 201 (20 202 187 87 1,8 37 (37 147 1,47 47 (1,475 20 (2 18 8 1, (3 14 1,4 4 (1,47 2 ( (1,4 (1, (1

ABSTRACT Objective Determining the etiology of hyperprolactinemia is fundamental for selecting the most appropriate treatment strategy. The aim of this study was to evaluate the usefulness and accuracy of prolactin levels in predicting the etiology of nonphysiological hyperprolactinemia. Subjects and methods In this retrospective study, we reviewed medical records of patients with nonphysiological hyperprolactinemia seen at two neuroendocrine reference centers located in Recife, Brazil, from January 2000 to December 2019. Results The study included 770 patients aged 12-73 years (65% female). The three most frequent etiologies of hyperprolactinemia were prolactinomas (n = 263; 34.2%), drug-induced hyperprolactinemia (n = 160; 20.8%), and macroprolactinemia (n = 120; 15.6%). The highest mean prolactin levels were observed in cases of prolactinomas and idiopathic hyperprolactinemia. Most patients with hyperprolactinemia due to other etiologies had prolactin levels < 100 ng/mL, but these levels were also found in 16.5% of patients with microproplactinomas and in 20% of those with idiopathic hyperprolactinemia. Likewise, prolactin levels largely overlapped among patients with microprolactinomas, macroprolactinemia, and drug-induced hyperprolactinemia. Notably, prolactin levels > 250 ng/mL enabled a clear distinction between the etiologies of macroprolactinoma and nonfunctioning pituitary adenoma. Moreover, prolactin levels > 500 ng/mL were highly suggestive of macroprolactinomas, although they were also found in very few patients (<2%) with microprolactinomas or drug-induced hyperprolactinemia. Conclusion Despite considerable overlap in prolactin levels among the different etiologies of hyperprolactinemia, values > 250 ng/mL allowed a clear distinction between macroprolactinomas and nonfunctioning pituitary adenomas. Furthermore, prolactin levels > 500 ng/mL were almost exclusively found in patients with prolactinomas. strategy Recife Brazil 200 2019 77 1273 12 73 12-7 65% 65 (65 female. female . female) n 263 34.2%, 342 34.2% , 34 2 34.2%) druginduced drug induced 160 20.8%, 208 20.8% 20 8 20.8%) 120 15.6%. 156 15.6% 15 6 15.6%) 10 ngmL ng mL 165 16 5 16.5 Likewise Notably 25 adenoma Moreover 50 <2% (<2% adenomas Furthermore 201 7 127 1 12- (6 26 34.2 3 20.8 15.6 16. <2 (<2 ( 34. 20. 15. (<

ABSTRACT. This study aimed to evaluate the effect of silicon and acibenzolar-S-methyl sources on the development of yellow melon (Cucumis melo L.) in the field and the occurrence of diseases in different years. The treatments consisted ofthe silicon sources Agrosilício® (3 g L−1), Rocksil® (3 g L−1), and Chelal® Si (2 L 100 L−1), the additional treatments acibenzolar-S-methyl (ASM) (2 mM) and the fungicide thiabendazole (400 mL 100 L−1), and a control (sterile distilled water). The following characteristics were evaluated: natural incidence of diseases; gas exchange: CO2 assimilation rate, transpiration, stomatal conductance, internal CO2 concentration, water use efficiency, instantaneous water use efficiency, and carboxylation; postharvest aspects: fruit weight, pulp thickness, pulp firmness, titratable acidity, pH, soluble solids, and vitamin C content; productivity; and the enzymatic activity of peroxidases, polyphenol oxidases, and phenylalanine ammonia-lyase. No significant response was observed for naturally occurring diseases. Treatments with Chelal®Si, Rocksil®, and Thiabendazole® increased photosynthetic and transpiration rates in the yellow melon. The silicon and ASM sources did not influence the physicochemical characteristics or the enzymatic activity of fruits. No effect was observed on the biometric characteristics, productivity, and chemical quality of fruits in both years of cultivation. Si sources increased photosynthetic rate and transpiration. However, no diseases were observed during the experimental period. Leaf spraying with silicon and acibenzolar-S-methyl sources did not influence the biometric characteristics and fruit production of yellow melon. The silicon and acibenzolar-S-methyl sources did not induce an increase in the enzymatic activity of peroxidases, polyphenol oxidase, and phenylalanine ammonia-lyase. Fruit production was higher in 2020. ABSTRACT acibenzolarSmethyl acibenzolar S methyl Cucumis L. Agrosilício 3 ( L−1, L1 L−1 , 1 L−1) Rocksil Chelal 2 10 (ASM mM 400 (40 sterile water. . water) evaluated exchange CO conductance concentration efficiency carboxylation aspects weight thickness firmness acidity pH solids content productivity peroxidases oxidases ammonialyase. ammonialyase ammonia lyase. lyase ammonia-lyase ChelalSi Chelal®Si Thiabendazole cultivation However period oxidase 2020 L− 40 (4 202 4 20