Introdução : A obesidade tem sido associada ao aparecimento ou piora de doenças autoimunes. Objetivo : Revisar a presença de autoanticorpos em obesos submetidos à cirurgia bariátrica e verificar a possível alteração deste perfil após o procedimento cirúrgico. Método : Revisão narrativa da literatura efetuada no PubMed e Scielo. A busca utilizou as palavras-chave: “ obesidade, autoimunidade, fator antinuclear, cirurgia bariátrica” . Os critérios de inclusão compreenderam artigos de revisão, estudos experimentais, pesquisas pré-clínicas e clínicas, escritos em português e inglês e disponíveis em texto completo. Resultado : Foram incluídos 63 artigos. Conclusão : Existe alta prevalência de FAN positiva na população obesa e candidata à cirurgia bariátrica que diminui consideravelmente no pós-operatório. O mesmo não pode ser verificado com o fator reumatóide, anticorpos do perfil ENA e anti-ds DNA, anticorpos anticardiolipina IgG e IgM, e anticorpos anti-endomísio. Nenhuma variável clínica ou antropométrica pôde estar ligada à presença de autoanticorpos, salvo níveis de vitamina D que foram significativamente menores nos indivíduos no pré-operatório e FAN positivos.

Introdução : A obesidade tem sido associada ao aparecimento ou agravamento de doenças autoimunes. Objetivo : Rever a presença de autoanticorpos em pacientes obesos submetidos à cirurgia bariátrica e verificar a possível alteração deste perfil após o procedimento cirúrgico. Método : Revisão narrativa da literatura realizada no PubMed e Scielo. A busca utilizou as palavras-chave: “ obesidade, autoimunidade, fator antinuclear, cirurgia bariátrica ”. Os critérios de inclusão compreenderam artigos de revisão, estudos experimentais, pesquisas pré-clínicas e clínicas, escritos em português e inglês e disponíveis em texto completo. Resultado : foram incluídos 63 artigos. Conclusão : Existe alta prevalência de FAN positivo na população obesa e candidata à cirurgia bariátrica, que diminui consideravelmente no pós-operatório. O mesmo não pode ser verificado com fator reumatoide, anticorpos ENA e anti-ds DNA, anticorpos IgG e IgM anticardiolipina e anticorpos antiendomísio. Nenhuma variável clínica ou antropométrica pôde ser associada à presença de autoanticorpos, exceto os níveis de vitamina D, que foram significativamente mais baixos nos indivíduos pré-operatórios e ANA-positivos.

Abstract The study addresses the historical disparities in the distribution of the medium- and high-complexity health network and the limits to budget adjustments between the municipality of Rio de Janeiro and its neighboring municipalities of the Metropolitan region 1. An ecological study was conducted with data related to the municipality of Rio de Janeiro, chosen because it has a large assistance network, while located on the borders of vulnerable and underprivileged areas, characterizing a locus that is representative of the situations faced throughout the country. A decrease in the gross values of the programmed quotas in all municipalities of Rio de Janeiro was observed from 2016 onwards. The temporal trend of the programmed quotas remained stable for all municipalities in the Metropolitan Region 1, even with significant increases in the accomplished quotas for neighboring municipalities. The resulting overload in local expenditure prevents the increase of capacity to anticipate fluctuations in demand, both known and unexpected ones, compromising the responsiveness of the health system regarding its regular operation, as well as the ability to adjust to cope with extraordinary events, essential characteristics of resilience.

Resumo O estudo explora as históricas disparidades regionais na distribuição da rede de média e alta complexidade e os limites impostos para a o remanejamento dos tetos de financiamento entre o município do Rio de Janeiro e municípios limítrofes da Região Metropolitana 1. Foi realizado um estudo ecológico com dados referentes à cidade do Rio de Janeiro, escolhido por ter uma grande rede de assistência e limites com territórios vulneráveis e carentes de serviços de saúde, caracterizando um lócus representativo das situações enfrentadas em todo o país. Foi observado um decréscimo dos valores brutos das cotas programadas em todos os municípios do Rio de Janeiro a partir de 2016. A tendência temporal das cotas programadas se manteve estacionária para todos os municípios da Região Metropolitana 1, mesmo com aumentos significativos nas cotas para municípios limítrofes. A resultante sobrecarga no aporte local de recursos impede o aumento da capacidade para antecipar flutuações de demanda, tanto conhecidas quanto inesperadas, comprometendo a responsividade do sistema de saúde no que respeita seu funcionamento regular, bem como a capacidade de ajuste para lidar com eventos extraordinários, características essenciais da resiliência.

It is particularly important to investigate the mechanical performance of carbon fiber (CF) reinforced polyamide 6 (PA6) composites used for automotive and aerospace applications, where diffused moisture of the environment may potentially weaken the material over time. In this work, CF/PA6 composites were subjected to two different types of conditioning: distilled water at a temperature of 80 ºC and saline solution for 12 weeks. The volumetric fraction of CF, PA6 matrix, and the voids of the CF/PA6 composites were determined by acid digestion analysis. At the end of the environmental conditionings, the moisture absorption content and the diffusion coefficient (D) were determined. The mechanical performance of CF/PA6 composites unconditioned and conditioned was evaluated through tensile and interlaminar shear strength (ILSS) tests, and morphological characteristics of the fracture surface after the mechanical tensile test. CF/PA6 composites conditioned in saline solution showed a decrease of 53% (tensile sample) and 72% (ILSS sample) in the diffusion coefficient (D) and insignificant losses of mechanical properties when compared to CF/PA6 composites conditioned in distilled water at 80 ºC. This behavior is attributed to the salt molecules blocking the pores and consequently reducing the migration of water into the samples, maintaining the internal integrity of the specimens. CF (CF PA (PA6 applications time work CFPA6 CFPA CF/PA conditioning 8 1 weeks matrix analysis conditionings D (D ILSS tests test 53 sample 72 samples specimens (PA 5 7

RESUMO OBJETIVO Propor um método de detecção e análise do sub-registro e evidenciar o seu potencial efeito financeiro em face da implementação do Programa Previne Brasil. MÉTODOS Foi realizado um estudo ecológico de análise dos exames citopatológicos na área programática 3.1 do município do Rio de Janeiro. Os dados foram coletados do barramento do Datasus, incluindo as informações relativas aos relatórios dos laboratórios terceirizados dos exames citopatológicos e aquelas disponíveis no Sistema de Informação em Saúde para a Atenção Básica (Sisab) e Sistema de Informação do Câncer do Colo do Útero (Siscolo) do Datasus/Ministério da Saúde. RESULTADOS Os sub-registros estimados por unidade de saúde totalizaram 108.511 exames nos últimos dois anos na área programática 3.1, o que corresponde a um total estimado de R$ 435.129,00 que teriam sido deixados de receber, caso o Programa Previne Brasil já estivesse efetivado no período estudado. CONCLUSÃO A principal contribuição do artigo está na apresentação de evidência empírica dos potenciais efeitos do sub-registro para o financiamento da atenção primária à saúde. Além disso, há dois outros achados significativos – primeiro, evidencia fragilidades no processo de registro das informações de saúde inerentes a regiões vulneráveis; segundo, indica um círculo vicioso potencialmente alimentado pela alteração brusca dos condicionantes do financiamento da atenção primária à saúde, além de potenciais consequências para os demais níveis de atenção.

ABSTRACT OBJECTIVE To propose a method for detecting and analyzing under-registration and highlight its potential financial effect in view of the implementation of the Previne Brasil Program. METHODS An ecological study was carried out to analyze cytopathological exams in programmatic area 3.1 in the municipality of Rio de Janeiro. The data was collected from the Departamento de Informática do Sistema Único de Saúde (DATASUS - Department of Informatics of the Unified Health System) database, including information on reports from outsourced cytopathology laboratories and those available in the Sistema de Informação em Saúde para a Atenção Básica (SISAB - Health Information System for Primary Care) and the Sistema de Informação do Câncer do Colo do Útero (SISCOLO - Cervical Cancer Information System) of DATASUS/Ministry of Health. RESULTS The estimated under-registrations per health unit totaled 108,511 exams in the last two years in the programmatic area 3.1 area, which corresponds to an estimated total of R$ 435,129.00 that would have been foregone if the Previne Brasil Program had been in place during the period studied. CONCLUSION The article’s main contribution lies in the presentation of empirical evidence of the potential effects of under-registration on Primary Health Care financing. In addition, there are two other significant findings - firstly, it highlights weaknesses in the process of recording health information inherent to vulnerable regions; secondly, it indicates a vicious circle potentially fueled by sudden changes in Primary Health Care funding conditions, in addition to potential consequences for other levels of care.

Abstract Objective: This study aims to correlate the RAPID score with the 3-month survival and surgical results of patients undergoing lung decortication with stage III pleural empyema. Methods: This was a retrospective study with the population of patients with pleural empyema who underwent pulmonary decortication between January 2019 and June 2022. Data were collected from the institution’s database, and patients were classified as low, medium, and high risk according to the RAPID score. The primary outcome was 3-month mortality. Secondary outcomes were the length of hospital stay, readmission rate, and the need for pleural re-intervention. Results: Of the 34 patients with pleural empyema, according to the RAPID score, patients were stratified into low risk (23.5 %), medium risk (47.1 %), and high risk (29.4 %). The high-risk group had a 3-month mortality of 40 %, while the moderate-risk group hada 6.25 % and the low-risk group had no deaths within 90days, confirmingagood correlation with the RAPID score (p < 0.05). Sensitivity and specificity for the primary outcome in the high-risk score were 80.0 % and 79.3%, respectively. The secondary outcomes did not reach statistical significance. Conclusions: In this retrospective series, the RAPID score had a good correlation with 3-month mortality in patients undergoing lung decortication. The morbidity indicators did not reach statistical significance. The present data justifies further studies to explore the capacity of the RAPID score to be used as a selection tool for treatment modality in patients with stage III pleural empyema. Objective 3month month 3 Methods 201 2022 institutions institution s database stay rate reintervention. reintervention re intervention. intervention re-intervention Results 23.5 235 23 5 (23. , %) 47.1 471 47 1 (47. 29.4 294 29 4 (29. %. . highrisk moderaterisk moderate 625 6 25 6.2 lowrisk 90days days p 0.05. 005 0.05 0 05 0.05) 800 80 80. 793 79 79.3% respectively significance Conclusions series 20 202 23. 2 (23 47. (47 29. (29 62 6. 00 0.0 8 7 79.3 (2 (4 0. 79. (

Resumo O estudo explora as históricas disparidades regionais na distribuição da rede de média e alta complexidade e os limites impostos para a o remanejamento dos tetos de financiamento entre o município do Rio de Janeiro e municípios limítrofes da Região Metropolitana 1. Foi realizado um estudo ecológico com dados referentes à cidade do Rio de Janeiro, escolhido por ter uma grande rede de assistência e limites com territórios vulneráveis e carentes de serviços de saúde, caracterizando um lócus representativo das situações enfrentadas em todo o país. Foi observado um decréscimo dos valores brutos das cotas programadas em todos os municípios do Rio de Janeiro a partir de 2016. A tendência temporal das cotas programadas se manteve estacionária para todos os municípios da Região Metropolitana 1, mesmo com aumentos significativos nas cotas para municípios limítrofes. A resultante sobrecarga no aporte local de recursos impede o aumento da capacidade para antecipar flutuações de demanda, tanto conhecidas quanto inesperadas, comprometendo a responsividade do sistema de saúde no que respeita seu funcionamento regular, bem como a capacidade de ajuste para lidar com eventos extraordinários, características essenciais da resiliência. 1 país 2016 demanda inesperadas regular extraordinários resiliência 201 20 2

Abstract The study addresses the historical disparities in the distribution of the medium- and high-complexity health network and the limits to budget adjustments between the municipality of Rio de Janeiro and its neighboring municipalities of the Metropolitan region 1. An ecological study was conducted with data related to the municipality of Rio de Janeiro, chosen because it has a large assistance network, while located on the borders of vulnerable and underprivileged areas, characterizing a locus that is representative of the situations faced throughout the country. A decrease in the gross values of the programmed quotas in all municipalities of Rio de Janeiro was observed from 2016 onwards. The temporal trend of the programmed quotas remained stable for all municipalities in the Metropolitan Region 1, even with significant increases in the accomplished quotas for neighboring municipalities. The resulting overload in local expenditure prevents the increase of capacity to anticipate fluctuations in demand, both known and unexpected ones, compromising the responsiveness of the health system regarding its regular operation, as well as the ability to adjust to cope with extraordinary events, essential characteristics of resilience. medium highcomplexity high complexity 1 areas country 201 onwards demand ones operation events resilience 20 2

Resumo Objetivos: descrever a prevalência da má nutrição (baixo peso, baixa estatura e excesso de peso) em crianças de seis a 59 meses e sua distribuição espacial na cidade de Beira, Moçambique. Métodos: estudo transversal exploratório, realizado entre outubro e novembro de 2019, incluindo 407 crianças de seis a 59 meses. O cálculo da amostra foi baseado na prevalência do déficit estatura/idade. Os dados antropométricos foram analisados no Anthro e a prevalência de má nutrição apresentada por meio de mapas temáticos no Quantum Geographic Information System (QGIS). Resultados: os principais resultados mostram uma prevalência de 27,0% de baixa estatura/idade, 7,9% de baixo peso/estatura e 4,7% de excesso de peso. Conclusões: a distribuição espacial evidenciou que as áreas urbanas e periurbanas da cidade apresentavam prevalências similares das três formas de má nutrição. A prevalência da má nutrição em Beira é alta, embora o déficit estatura/idade seja a sua maior expressão, estando o excesso de peso difusamente distribuído. Objetivos 5 Moçambique Métodos exploratório 2019 40 estaturaidade idade QGIS. QGIS . (QGIS) Resultados 270 27 0 27,0 79 7 9 7,9 pesoestatura 47 4 4,7 Conclusões alta expressão distribuído 201 (QGIS 2 27, 7, 4, 20

Abstract Objectives: to describe the prevalence of malnutrition (underweight, low height, and overweight) in children aged six to 59 months and its spatial distribution in the city of Beira, Mozambique. Methods: an exploratory cross-sectional study was conducted between October and November 2019, involving 407 children aged six to 59 months. The sample size calculation was based on the prevalence of height-for-age deficit. Anthropometric data were analyzed using Anthro version and the prevalence of malnutrition was presented through thematic maps generated in Quantum Geographic Information System (QGIS). Results: the main findings revealed a prevalence of 27.0% for low height/age, 7.9% for underweight/height, and 4.7% for overweight. Conclusions: the spatial distribution highlighted that both urban and peri-urban areas of the city showed similar prevalence rates for the three forms of malnutrition. The prevalence of malnutrition in Beira is high, with deficit height/age being the most significant expression, while overweight is diffusely distributed. Objectives underweight, underweight (underweight height 5 Mozambique Methods crosssectional cross sectional 2019 40 heightforage age QGIS. QGIS . (QGIS) Results 270 27 0 27.0 heightage 79 7 9 7.9 underweightheight underweight/height 47 4 4.7 Conclusions periurban peri high expression distributed 201 (QGIS 2 27. 7. 4. 20

ABSTRACT Objective: This study aims to evaluate the role of TUSG in the postoperative period and the detection of early complications after surgical treatment, pulmonary resection, or decortication for infectious and inflammatory thoracic diseases, comparing with the standard method (Chest Radiography ‒ CXR). Methods: Prospective non-randomized self-controlled study. Twenty-one patients over 16 years of age have undergone surgical treatment of inflammatory and infectious lung diseases. These patients were followed up with CXR and TUSG (performed on the 1st and 3rd postoperative days and/or after the chest tube removal). Results: Both exams demonstrated similar results regarding their ability to safely predict the adequate moment for chest drain removal. TUSG allowed chest drain removal in 30% of cases and CXR in 34%. Statistical analysis demonstrates that both exams have similar capabilities in detecting postoperative changes in the pleural space. However, the authors report that TUSG is statistically more accurate in detecting subcutaneous emphysema than CXR (p = 0.037, Kappa [κ = 0.3068]). The analysis of other parameters showed no statistical difference. Conclusion: The authors conclude that TUSG in trained hands is equivalent to CXR in searching for postoperative complications regarding the surgical treatment of infectious and inflammatory thoracic diseases and can be used as a complement, and not a substitute, to CXR, when CCT is not feasible, or a more urgent diagnosis is needed. Objective resection Chest CXR. . CXR) Methods nonrandomized non randomized selfcontrolled self controlled Twentyone Twenty one 1 performed st rd andor removal) Results 30 34 34% space However p 0037 0 037 0.037 κ 0.3068. 03068 0.3068 3068 0.3068]) difference Conclusion complement substitute feasible needed 3 003 03 0.03 0306 0.306 306 0.3068] 00 0.0 030 0.30 0. 0.3

RESUMO OBJETIVO Propor um método de detecção e análise do sub-registro e evidenciar o seu potencial efeito financeiro em face da implementação do Programa Previne Brasil. MÉTODOS Foi realizado um estudo ecológico de análise dos exames citopatológicos na área programática 3.1 do município do Rio de Janeiro. Os dados foram coletados do barramento do Datasus, incluindo as informações relativas aos relatórios dos laboratórios terceirizados dos exames citopatológicos e aquelas disponíveis no Sistema de Informação em Saúde para a Atenção Básica (Sisab) e Sistema de Informação do Câncer do Colo do Útero (Siscolo) do Datasus/Ministério da Saúde. RESULTADOS Os sub-registros estimados por unidade de saúde totalizaram 108.511 exames nos últimos dois anos na área programática 3.1, o que corresponde a um total estimado de R$ 435.129,00 que teriam sido deixados de receber, caso o Programa Previne Brasil já estivesse efetivado no período estudado. CONCLUSÃO A principal contribuição do artigo está na apresentação de evidência empírica dos potenciais efeitos do sub-registro para o financiamento da atenção primária à saúde. Além disso, há dois outros achados significativos – primeiro, evidencia fragilidades no processo de registro das informações de saúde inerentes a regiões vulneráveis; segundo, indica um círculo vicioso potencialmente alimentado pela alteração brusca dos condicionantes do financiamento da atenção primária à saúde, além de potenciais consequências para os demais níveis de atenção. subregistro sub 31 3 1 3. Janeiro Datasus Sisab (Sisab Siscolo (Siscolo DatasusMinistério Ministério subregistros registros 108511 108 511 108.51 R 43512900 435 129 00 435.129,0 receber estudado disso primeiro vulneráveis segundo 10851 10 51 108.5 4351290 43 12 0 435.129, 1085 5 108. 435129 4 435.129 43512 435.12 4351 435.1 435.

ABSTRACT OBJECTIVE To propose a method for detecting and analyzing under-registration and highlight its potential financial effect in view of the implementation of the Previne Brasil Program. METHODS An ecological study was carried out to analyze cytopathological exams in programmatic area 3.1 in the municipality of Rio de Janeiro. The data was collected from the Departamento de Informática do Sistema Único de Saúde (DATASUS - Department of Informatics of the Unified Health System) database, including information on reports from outsourced cytopathology laboratories and those available in the Sistema de Informação em Saúde para a Atenção Básica (SISAB - Health Information System for Primary Care) and the Sistema de Informação do Câncer do Colo do Útero (SISCOLO - Cervical Cancer Information System) of DATASUS/Ministry of Health. RESULTS The estimated under-registrations per health unit totaled 108,511 exams in the last two years in the programmatic area 3.1 area, which corresponds to an estimated total of R$ 435,129.00 that would have been foregone if the Previne Brasil Program had been in place during the period studied. CONCLUSION The article’s main contribution lies in the presentation of empirical evidence of the potential effects of under-registration on Primary Health Care financing. In addition, there are two other significant findings - firstly, it highlights weaknesses in the process of recording health information inherent to vulnerable regions; secondly, it indicates a vicious circle potentially fueled by sudden changes in Primary Health Care funding conditions, in addition to potential consequences for other levels of care. underregistration under registration 31 3 1 3. Janeiro DATASUS database SISAB SISCOLO DATASUSMinistry Ministry underregistrations registrations 108511 108 511 108,51 R 43512900 435 129 00 435,129.0 studied articles article s financing firstly regions secondly conditions care 10851 10 51 108,5 4351290 43 12 0 435,129. 1085 5 108, 435129 4 435,129 43512 435,12 4351 435,1 435,

Resumo Introdução: Os acidentes por transporte terrestre estão entre as dez principais causas de morte no mundo, principalmente entre os jovens. Essas mortes refletem um importante impacto socioeconômico e precisam ser mensurados. Um dos recursos é o indicador Anos Potenciais de Vida Perdidos (APVP). Objetivo: Descrever aspectos sociodemográficos e estimar os APVPs devido a acidentes por motocicletas no Brasil. Método: Estudo descritivo de dados secundários oficiais, incluindo óbitos por acidentes com motocicletas em 2019. O indicador APVP e a taxa APVP foram calculados por sexo, faixa etária e regiões geográficas. Resultados: Em 2019, ocorreram 11.182 óbitos por acidentes com motocicleta, envolvendo principalmente homens, solteiros, pardos, de 20 a 39 anos e ensino médio completo, os quais sucederam-se principalmente no Nordeste. A taxa de APVP foi de 194,6 anos perdidos/100.000 habitantes e as taxas de mortalidade variaram de 3,4 a 8,4 mortes/100.000 habitantes. A proporção de fatalidades foi oito vezes maior em homens que em mulheres. Conclusões: Os achados deste estudo reforçam que esses acidentes são um problema considerável, com impacto socioeconômico prevenível e, com ações intersetoriais e medidas de fácil execução e baixo custo. Introdução mundo jovens mensurados APVP. . (APVP) Objetivo Brasil Método oficiais 2019 sexo geográficas Resultados 11182 11 182 11.18 motocicleta solteiros pardos 2 3 completo sucederamse sucederam se Nordeste 1946 194 6 194, perdidos100000 perdidos 100 000 perdidos/100.00 34 4 3, 84 8 8, mortes100000 mortes/100.00 mulheres Conclusões considerável custo (APVP 201 1118 1 18 11.1 19 perdidos10000 10 00 perdidos/100.0 mortes10000 mortes/100.0 111 11. perdidos1000 0 perdidos/100. mortes1000 mortes/100. perdidos100 perdidos/100 mortes100 mortes/100 perdidos10 perdidos/10 mortes10 mortes/10 perdidos1 perdidos/1 mortes1 mortes/1 perdidos/ mortes/

Abstract Introduction: Road traffic accidents are among the ten leading causes of death worldwide, especially among young people. These deaths have an important socio-economic impact and need to be measured. One resource is the Potential Years of Life Lost (PYLL) indicator. Objective: To describe sociodemographic aspects and estimate the PYLL due to motorcycle accidents in Brazil. Method: Descriptive study of official secondary data, including deaths from motorcycle accidents in 2019. PYLL indicator and PYLL rate were calculated by sex, age group and regions. Results: In 2019, there were 11,182 deaths from motorcycle accidents, involving mainly men, singles, browns, aged 20 to 39 and having completed high school, mainly in the Northeast. The PYLL rate was 194.6 years lost/100,000 inhabitants, and the mortality rates ranged from 3.4 to 8.4 deaths/100,000 inhabitants. The proportion of fatalities was eight times higher in men than in women. Conclusions: The findings of this study reinforce that these accidents are an important problem with a preventable socioeconomic impact by promoting intersectoral actions and measures that are easy to perform and low cost. Introduction worldwide people socio economic measured (PYLL Objective Brazil Method data 2019 sex regions Results 11182 11 182 11,18 singles browns 2 3 school Northeast 1946 194 6 194. lost100000 lost 100 000 lost/100,00 inhabitants 34 4 3. 84 8 8. deaths100000 deaths/100,00 women Conclusions cost 201 1118 1 18 11,1 19 lost10000 10 00 lost/100,0 deaths10000 deaths/100,0 111 11, lost1000 0 lost/100, deaths1000 deaths/100, lost100 lost/100 deaths100 deaths/100 lost10 lost/10 deaths10 deaths/10 lost1 lost/1 deaths1 deaths/1 lost/ deaths/

Abstract Background and objective This study aims to quantify bedside pleural procedures performed at a quaternary teaching hospital describing technical and epidemiological aspects. Materials and methods The authors retrospectively reviewed consecutive patients who underwent invasive thoracic bedside procedures between March 2022 and February 2023. Results 463 chest tube insertions and 200 thoracenteses were performed during the study period. Most procedures were conducted by 1st-year Thoracic Surgery residents, with Ultrasound Guidance (USG). There was a notable preference for small-bore pigtail catheters, with a low rate of immediate complications. Conclusion Bedside thoracic procedures are commonly performed in current medical practice and are significant in surgical resident training. The utilization of pigtail catheters and point-of-care ultrasonography by surgical residents in pleural procedures is increasingly prevalent and demonstrates high safety. aspects 202 2023 46 20 period 1styear styear 1st year st USG. USG . (USG) smallbore small bore complications training pointofcare point care safety 4 2 (USG

Abstract The sacred ayahuasca brew, utilized by indigenous communities in the Amazon and syncretic religious groups in Brazil, primarily consists of a decoction of two plants: (i) the Amazonian liana known as Mariri or Jagube (Banisteriopsis caapi), and (ii) the shrub referred as Chacrona or Rainha (Psychotria viridis). While Chacrona leaves are rich in N,N-Dimethyltryptamine (DMT), a potent psychedelic, the macerated vine of Mariri provides beta-carboline alkaloids acting as monoamine oxidase inhibitors, preventing DMT’s degradation. This study sequenced, assembled, and analyzed the complete genome of B. caapi’s mitochondrion, yielding a circular structure spanning 503,502 bp. Although the mtDNA encompasses most plant mitochondrial genes, it lacks some ribosomal genes, presents some atypical genes, and contains plastid pseudogenes, suggesting gene transfer between organelles. The presence of a 7-Kb repetitive segment containing copies of the rrnL and trnfM genes suggests mitogenome isomerization, supporting the hypothesis of dynamic mitogenome maintenance in plants. Phylogenetics and phylogenomics across 24 Malpighiales confirms the sample’s placement in the “Tucunacá” ethnovariety, aligning with morphological identification. This study spearheads efforts to decode the genome of this esteemed Malpighiaceae. brew Brazil plants i (i Banisteriopsis caapi, caapi , caapi) ii (ii Psychotria viridis. viridis . viridis) N,NDimethyltryptamine NNDimethyltryptamine N,N Dimethyltryptamine N DMT, DMT (DMT) psychedelic betacarboline beta carboline inhibitors DMTs s degradation sequenced assembled B caapis mitochondrion 503502 503 502 503,50 bp pseudogenes organelles 7Kb Kb 7 isomerization 2 samples sample Tucunacá “Tucunacá ethnovariety identification Malpighiaceae NDimethyltryptamine NN (DMT 50350 50 503,5 5035 5 503,

ABSTRACT Objective: The purpose of this study was to assess performance in the Brazilian Lung Cancer Registry Database by using the parsimonious EuroLung risk models for morbidity and mortality. Methods: The EuroLung1 and EuroLung2 models were tested and evaluated through calibration (calibration plot, Brier score, and the Hosmer-Lemeshow test) and discrimination (ROC AUCs), in a national multicenter registry of 1,031 patients undergoing anatomic lung resection. Results: The evaluation of performance in Brazilian health care facilities utilizing risk-adjustment models, specifically EuroLung1 and EuroLung2, revealed substantial miscalibration, as evidenced by calibration plots and Hosmer-Lemeshow tests in both models. In terms of calibration, EuroLung1 exhibited a calibration plot with overlapping points, characterized by a slope of 1.11 and a Brier score of 0.15; the Hosmer-Lemeshow test yielded a statistically significant p-value of 0.015; and the corresponding ROC AUC was 0.678 (95% CI: 0.636-0.721). The EuroLung2 model displayed better calibration, featuring fewer overlapping points in the calibration plot, with a slope of 1.22, with acceptable discrimination, as indicated by a ROC AUC of 0.756 (95% CI: 0.670-0.842). Both models failed to accurately predict morbidity and mortality outcomes in this specific health care context. Conclusions: Discrepancies between the EuroLung model predictions and outcomes in Brazil underscore the need for model refinement and for a probe into inefficiencies in the Brazilian health care system. Objective Methods HosmerLemeshow Hosmer Lemeshow AUCs, AUCs , AUCs) 1031 1 031 1,03 resection Results riskadjustment adjustment miscalibration 111 11 1.1 0.15 015 0 15 pvalue p value 0.015 0015 0678 678 0.67 95% 95 (95 CI 0.6360.721. 06360721 0.636 0.721 . 636 721 0.636-0.721) 122 22 1.22 0756 756 0.75 0.6700.842. 06700842 0.670 0.842 670 842 0.670-0.842) context Conclusions system 103 03 1,0 1. 0.1 01 0.01 001 067 67 0.6 9 (9 6360 0.6360.721 0636072 0636 0.63 0721 0.72 63 72 0.636-0.721 12 2 1.2 075 75 0.7 6700 0.6700.842 0670084 0670 0842 0.84 84 0.670-0.842 10 1, 0. 0.0 00 06 6 ( 0.6360.72 063607 063 072 7 0.636-0.72 07 0.6700.84 067008 084 0.8 8 0.670-0.84 0.6360.7 06360 0.636-0.7 0.6700.8 06700 08 0.670-0.8 0.6360. 0.636-0. 0.6700. 0.670-0. 0.6360 0.636-0 0.6700 0.670-0 0.636- 0.670-

ABSTRACT This research aimed to prospect the working conditions of the rescue teams of the Mobile Emergency Care Service (SAMU-192) at the fluvial areas of the Alto Solimoes region, trough the systemic analysis of the activities of the water ambulances service popularly called ‘ambulanchas’ during the peaks of COVID-19 in the state of Amazonas, when the health system functioned under stress caused by the pandemic. Data were obtained from an exploratory cross-sectional design, based on qualitative data collected through interviews and observation of the normal functioning of the system before the pandemic. From there, models of two scenarios were developed showing the functioning of the water ambulances service when coping with the COVID-19 pandemic and the impact on the working conditions of the interprofessional rescue teams. Remote interviews with workers after the pandemic indicated that the prospection of working conditions from the instances of the models corresponded to the real functioning of the system during the COVID-19 pandemic.

RESUMO Esta pesquisa teve como objetivo prospectar as condições de trabalho das equipes de socorro do Serviço de Atendimento Móvel de Urgência (Samu-192) fluvial das áreas ribeirinhas e costeiras da região do Alto-Solimões, a partir da análise sistêmica das atividades no serviço de embarcações popularmente chamadas de ‘ambulanchas’ durante os picos da Covid-19 no estado do Amazonas, quando o sistema de saúde funcionou sob o estresse provocado pela pandemia. Os dados foram obtidos a partir de um desenho transversal exploratório, baseado em dados qualitativos coletados por meio de entrevistas e observação do funcionamento normal do sistema antes da pandemia. A partir daí modelos de dois cenários foram elaborados mostrando o funcionamento do serviço de ambulanchas ao lidar com a pandemia de Covid-19 e o impacto nas condições de trabalho das equipes de socorro interprofissionais de socorro. Entrevistas remotas com trabalhadores das ambulanchas após a pandemia indicaram que a prospecção das condições de trabalho a partir das instâncias dos modelos corresponderam ao funcionamento real do sistema durante a pandemia de Covid-19.

RESUMO Esta pesquisa teve como objetivo prospectar as condições de trabalho das equipes de socorro do Serviço de Atendimento Móvel de Urgência (Samu-192) fluvial das áreas ribeirinhas e costeiras da região do Alto-Solimões, a partir da análise sistêmica das atividades no serviço de embarcações popularmente chamadas de ‘ambulanchas’ durante os picos da Covid-19 no estado do Amazonas, quando o sistema de saúde funcionou sob o estresse provocado pela pandemia. Os dados foram obtidos a partir de um desenho transversal exploratório, baseado em dados qualitativos coletados por meio de entrevistas e observação do funcionamento normal do sistema antes da pandemia. A partir daí modelos de dois cenários foram elaborados mostrando o funcionamento do serviço de ambulanchas ao lidar com a pandemia de Covid-19 e o impacto nas condições de trabalho das equipes de socorro interprofissionais de socorro. Entrevistas remotas com trabalhadores das ambulanchas após a pandemia indicaram que a prospecção das condições de trabalho a partir das instâncias dos modelos corresponderam ao funcionamento real do sistema durante a pandemia de Covid-19. Samu192 Samu 192 (Samu-192 AltoSolimões, AltoSolimões Alto Solimões, Solimões Alto-Solimões ‘ambulanchas Covid19 Covid 19 Covid-1 Amazonas exploratório Covid19. 19. Samu19 (Samu-19 Covid1 1 Covid- Samu1 (Samu-1 (Samu- (Samu

ABSTRACT This research aimed to prospect the working conditions of the rescue teams of the Mobile Emergency Care Service (SAMU-192) at the fluvial areas of the Alto Solimoes region, trough the systemic analysis of the activities of the water ambulances service popularly called ‘ambulanchas’ during the peaks of COVID-19 in the state of Amazonas, when the health system functioned under stress caused by the pandemic. Data were obtained from an exploratory cross-sectional design, based on qualitative data collected through interviews and observation of the normal functioning of the system before the pandemic. From there, models of two scenarios were developed showing the functioning of the water ambulances service when coping with the COVID-19 pandemic and the impact on the working conditions of the interprofessional rescue teams. Remote interviews with workers after the pandemic indicated that the prospection of working conditions from the instances of the models corresponded to the real functioning of the system during the COVID-19 pandemic. SAMU192 SAMU 192 (SAMU-192 region ‘ambulanchas ambulanchas COVID19 COVID 19 COVID-1 Amazonas crosssectional cross sectional design there SAMU19 (SAMU-19 COVID1 1 COVID- SAMU1 (SAMU-1 (SAMU- (SAMU