Abstract Objectives: To analyze bone mineral content (BMC) and area bone mineral density (aBMD) accrual in adolescent male footballers who started their first football season. Methods: 17 athletes (14.8 ± 0.4 years) were monitored across 15 weeks of football training. Participants were evaluated for somatic maturation (HPHV), BMC, and aBMD at three time points: before (M1) and after (M2) a preparatory phase, and at the end of the competitive phase (M3). BMC and aBMD were measured using DXA scans. Participants were divided into groups according to maturation status (circa-PHV and post-PHV), and the amount of accumulated training load (median split). Results: A significant effect (12.1 g/week, standard error (SE) = 2.6 g/week) was observed for lower limbs BMC across the three time points. There were no significant effects of time for upper limbs BMC. There was a significant effect of time for total body aBMD (0.007, SE = 0.003 g/cm2/week) across the three time points. Adolescents at post-PHV had a significant 245.6 g (SE = 56.1 g) higher BMC compared to adolescents at circa-PHV. No significant effects were observed for the accumulated training load. Conclusion: Systematic football training, even during the growth spurt, has a positive impact on adolescent bone markers despite the accumulated training load and maturation. Objectives (BMC (aBMD season Methods 1 14.8 148 14 8 (14. 04 0 4 0. years HPHV, HPHV , (HPHV) points M1 M (M1 M2 (M2 M3. M3 . (M3) scans circaPHV circa PHV postPHV, postPHV post post-PHV) median split. split split) Results 12.1 121 12 (12. gweek week g/week 26 2 6 2. 0.007, 0007 007 (0.007 0003 003 0.00 g/cm2/week gcm2week gcmweek cm2 cm 2456 245 245. 561 56 56. circaPHV. PHV. circa-PHV Conclusion spurt 14. (14 (HPHV (M (M3 12. (12 0.007 000 00 (0.00 0.0 gcm 24 5 (1 (0.0 ( (0. (0

Caves are ecosystems and natural heritage sites with magnificent biological diversity, from microorganisms to animals, despite their selective environment for development and survival. Until now, studies on cave microbiomes have included taxonomic classification through metagenomics analysis, demonstrating microbiological heterogeneity mainly composed of prokaryotic organisms or bacteria species. The generally oligotrophic environment, with limited energy input and dark zone, is the main feature differentiating the cave microorganisms from the other microbiomes and resulting in a unique habitat, which has unexplored regard to biology and chemical diversity. Multi-omics integration is a key strategy for scanning and integrating the macro and micromolecular universe, providing a better comprehension of processes and answers of the microbiome in natural cavities. Here, we highlight the strategies employed to study the cave microbiome, from the microbial genomes to their ability to secondary metabolites production, and also the multi-omics integration to explore the chemical and biological diversity in caves. animals survival now analysis species zone habitat Multiomics Multi omics universe cavities Here production multiomics multi caves

ABSTRACT Luis Tavares revolutionized cardiac surgery, always bringing the most modern instruments and equipment from his travels to England - surgical forceps, scissors, scalpels, etc. He always insisted that he was not just a thoracic surgeon, for his work extended over a wide field and created three important cardiac surgery centers which promoted a great development of cardiology. He carried out the first open heart surgery (atrial septal defect) employing extracorporeal circulation and closure of a ventricular septal defect with deep surface hypothermia of north and northeast Brazil. He promoted an intense scientific exchange program between Recife and England, resulting in significant advances in medicine, and participated directly in the creation of HEMOPE), leading to radical changes and improvements in blood therapy in the whole country. The PROCAPE, inaugurated in 2006, was the result of the cardiac center created by him in early 1970 at Hospital Oswaldo Cruz and can be considered the second largest public-university cardiology center in Brazil. He is thus widely regarded as an outstanding name in medicine in the 20th century and one of the fathers of modern cardiac surgery in Brazil. forceps scissors scalpels etc surgeon atrial Brazil HEMOPE, HEMOPE , HEMOPE) country PROCAPE 2006 197 publicuniversity public university th 200 19 20 1 2

Abstract Difficult airway management in pediatrics during anesthesia represents a major challenge, requiring a careful approach, advanced technical expertise, and accurate protocols. The task force of the Brazilian Society of Anesthesiology (SBA) presents a report containing updated recommendations for the management of difficult airways in children and neonates. These recommendations have been developed based on the consensus of a panel of experts, with the objective of offering strategies to overcome challenges during airway management in pediatric patients. Grounded in evidence published in international guidelines and expert opinions, the report highlights crucial steps for the appropriate management of difficult airways in pediatrics, encompassing assessment, preparation, positioning, pre-oxygenation, minimizing trauma, and, paramountly, the maintenance of arterial oxygenation. The report also delves into additional strategies involving the use of advanced tools, such as video laryngoscopy, flexible intubating bronchoscopy, and supraglottic devices. Emphasis is placed on the simplicity of implementing the outlined recommendations, with a focus on the significance of continuous education, training through realistic simulations, and familiarity with the latest available technologies. These practices are deemed essential to ensure procedural safety and contribute to the enhancement of anesthesia outcomes in pediatrics. challenge approach expertise protocols SBA (SBA neonates experts patients opinions assessment preparation positioning preoxygenation, preoxygenation pre oxygenation, oxygenation pre-oxygenation trauma paramountly tools laryngoscopy bronchoscopy devices education simulations technologies

Abstract Since the open-pit precedence-constrained production scheduling problem is an NP-hard problem, solving it is always a challenging task, especially from a long-term perspective because a mineral deposit containing millions of blocks would require several million precedence arcs as constraints, making the solution time grow exponentially and making a direct approach unfeasible. Therefore, different strategies have been employed since the 1960s to reduce the size of this problem, such as determining the ultimate pit limit, subdividing it into phases, segmenting the production scheduling problem into long-, mid-, and short-term plans, as well as aggregating blocks into clusters, thus significantly reducing the number of precedence arcs. Different modeling and clustering strategies have already been employed in an attempt to reduce the size of the mine sequencing problem, such as layer modeling, re-blocking, bench-phase clustering, or polygon (mining cut) clustering based on a similarity function. The mining cut clustering problem has been solved lately by machine learning and heuristics techniques, and this approach can also introduce operational constraints to the mine sequencing problem, such as equipment size, minimum pit width, and preferential mining direction. In this study, we propose a mining cut clustering model based on Mixed Integer Linear Programming (MILP). Then we solve it by an exact approach and by Constraint Programming (CP), analyzing the strengths and weaknesses of the Constraint Optimization Problem (COP) and Constraint Satisfaction Problem (CSP) techniques. Numerical experiments were carried out on the Bench 15 of the Newmanl dataset, demonstrating the superiority of the COP approach. openpit open precedenceconstrained constrained NPhard NP hard task longterm long term unfeasible Therefore s limit phases long, , long- mid, mid mid- shortterm short plans clusters reblocking, reblocking re blocking, blocking re-blocking benchphase bench phase function techniques width direction study MILP. MILP . (MILP) CP, CP (CP) (COP CSP (CSP 1 dataset (MILP (CP

RESUMO O câncer de pulmão (CP) é uma das neoplasias mais comuns e letais no Brasil, e apenas 15% dos pacientes são diagnosticados nos estágios iniciais. O tabagismo persiste como o responsável por mais de 85% de todos os casos. O rastreamento do CP (RCP) por meio da TC de baixa dosagem de radiação (TCBD) reduz a mortalidade do CP em 20%, e, quando combinado com a cessação do tabagismo, essa redução chega a 38%. Na última década, diversos países adotaram o RCP como recomendação de saúde populacional. No Brasil, embora ainda incipiente, a discussão sobre o tema é cada vez mais ampla e necessária. Com o intuito de aumentar o conhecimento e estimular o debate sobre o RCP, a Sociedade Brasileira de Cirurgia Torácica, a Sociedade Brasileira de Pneumologia e Tisiologia e o Colégio Brasileiro de Radiologia e Diagnóstico por Imagem constituíram um painel de especialistas para elaborar as recomendações para o RCP. As recomendações aqui apresentadas foram baseadas em revisão narrativa da literatura, com ênfase em grandes estudos populacionais, em revisões sistemáticas e em recomendações de diretrizes internacionais, sendo construídas após ampla discussão pelo grupo de especialistas. Os temas revisados foram os seguintes: porque rastrear, considerações gerais sobre tabagismo, epidemiologia do CP, critérios de elegibilidade, achados incidentais, lesões granulomatosas, modelos probabilísticos, requisitos mínimos da TCBD, aquisições volumétricas, riscos do rastreamento, estrutura mínima e papel da equipe multidisciplinar, conduta segundo o Lung CT Screening Reporting and Data System (Lung-RADS), custos vs. benefícios e perspectivas do rastreamento. (CP Brasil 15 iniciais 85 casos (RCP TCBD (TCBD 20 20% 38 38% década populacional incipiente necessária Torácica literatura populacionais internacionais seguintes rastrear elegibilidade incidentais granulomatosas probabilísticos volumétricas multidisciplinar LungRADS, LungRADS RADS , (Lung-RADS) vs 1 8 2 3 (Lung-RADS

ABSTRACT Although lung cancer (LC) is one of the most common and lethal tumors, only 15% of patients are diagnosed at an early stage. Smoking is still responsible for more than 85% of cases. Lung cancer screening (LCS) with low-dose CT (LDCT) reduces LC-related mortality by 20%, and that reduction reaches 38% when LCS by LDCT is combined with smoking cessation. In the last decade, a number of countries have adopted population-based LCS as a public health recommendation. Albeit still incipient, discussion on this topic in Brazil is becoming increasingly broad and necessary. With the aim of increasing knowledge and stimulating debate on LCS, the Brazilian Society of Thoracic Surgery, the Brazilian Thoracic Association, and the Brazilian College of Radiology and Diagnostic Imaging convened a panel of experts to prepare recommendations for LCS in Brazil. The recommendations presented here were based on a narrative review of the literature, with an emphasis on large population-based studies, systematic reviews, and the recommendations of international guidelines, and were developed after extensive discussion by the panel of experts. The following topics were reviewed: reasons for screening; general considerations about smoking; epidemiology of LC; eligibility criteria; incidental findings; granulomatous lesions; probabilistic models; minimum requirements for LDCT; volumetric acquisition; risks of screening; minimum structure and role of the multidisciplinary team; practice according to the Lung CT Screening Reporting and Data System; costs versus benefits of screening; and future perspectives for LCS. LC (LC tumors 15 stage 85 cases (LCS lowdose low dose (LDCT LCrelated related 20 20% 38 cessation decade populationbased population recommendation incipient necessary Surgery Association literature studies reviews guidelines reviewed criteria findings lesions models acquisition team System 1 8 2 3

ABSTRACT Objective: To review the pathological diagnosis of possible cases and/or hidden cases of malignant mesothelioma (MM) between 2000 and 2012 using the Hospital-Based Cancer Registry database in the state of São Paulo, Brazil. Methods: Possible cases were retrieved by assessing the database. Inclusion criteria were being older than 30 years of age and having ICD-O-3 topography and morphology codes related to MM. A board of expert pathologists reviewed the pathology reports and requested paraffin blocks in cases that demanded revision. After staining with calretinin, D2-40, WT-1 (as positive MM markers) and Ber-EP4 and MOC31 (as negative MM markers), cases were divided and studied independently by a pair of pathologists to confirm or discard the diagnosis of MM. Results: Our sample comprised 482 cases from 25 hospitals, and 130 needed further histological revision. We received 73 paraffin blocks with adequate material. After board analysis, there were 9 cases with a definitive diagnosis of MM, improving the diagnostic rate in 12%. Two cases of previously diagnosed MM were discarded by review. Conclusions: Our results confirm that part of MM underdiagnosis and underreporting in Brazil is due to incomplete or mistaken pathological diagnosis. Objective andor (MM 200 201 HospitalBased Hospital Based Paulo Methods 3 ICDO3 ICDO ICD O ICD-O- revision calretinin D240, D240 D D2 40, 40 D2-40 WT1 WT 1 WT- as markers BerEP4 BerEP Ber EP4 EP Ber-EP MOC MOC3 markers, , Results 48 2 hospitals 13 7 material analysis 12 12% Conclusions 20 ICD-O D24 4 D2-4 D2-

Resumo Este estudo avaliou a resistência de união (RU) de sistemas de pinos de fibra de vidro convencionais, anatomizados, ajustáveis e CAD/CAM. Quarenta raízes de caninos superiores foram enfraquecidas, tratadas endodonticamente e divididas em quatro grupos (n=10). Um slice de cada terço do canal radicular (cervical, média e apical) foi submetido ao teste de push-out e o padrão de falha foi analisado posteriormente. O slice mais apical foi submetido à análise da espessura da linha de cimentação por microscopia eletrônica de varredura (MEV). Os dados referentes à RU e espessura da linha de cimentação foram submetidos ao teste de normalidade de Shapiro-Wilk seguido dos testes de variância e Tukey. O padrão de falha foi expresso em porcentagem e submetido ao teste qui-quadrado. O pino convencional apresentou menor RU em comparação aos demais pinos de fibra de vidro (p<0,05). Todos os pinos de fibra de vidro apresentaram maior percentual de falhas adesivas à dentina. A MEV evidenciou linha de cimentação mais espessa para o pino convencional em relação aos demais grupos (p<0,05), além de lacunas e espaços vazios no material restaurador. Os pinos de fibra de vidro anatomizados, ajustáveis e fresados em CAD/CAM demonstraram RU superior e melhor adaptação à dentina radicular em comparação com o pino de fibra de vidro convencional. (RU convencionais anatomizados CADCAM CAD CAM enfraquecidas n=10. n10 n n=10 . 10 (n=10) cervical, cervical (cervical pushout push out posteriormente MEV. (MEV) ShapiroWilk Shapiro Wilk Tukey quiquadrado. quiquadrado qui quadrado. quadrado qui-quadrado p<0,05. p005 p p<0,05 0 05 (p<0,05) p<0,05, , restaurador n1 n=1 1 (n=10 (MEV p00 p<0,0 (p<0,05 n= (n=1 p0 p<0, (p<0,0 (n= p<0 (p<0, (n p< (p<0 (p< (p

Abstract This study evaluated the bond strength (BS) of conventional, anatomized, adjustable, and CAD/CAM fiberglass post systems. Forty maxillary canine roots were weakened, endodontically treated, and divided into four groups (n=10). A slice from each of the three sections (cervical, middle, apical) of the root canal was subjected to the push-out test and the failure pattern was subsequently analyzed. The most apical slice was subjected to analysis of the cementation line thickness by scanning electron microscopy (SEM). Data regarding the BS and cementation line thickness were subjected to the Shapiro-Wilk normality test followed by the variance and Tukey tests. Data failure patterns were expressed as a percentage and submitted to the chi-square test. Conventional fiberglass posts had the lowest BD compared to the other fiberglass posts (p<0.05). All fiberglass posts exhibited a higher percentage of adhesive failures to dentin. The SEM demonstrated a thicker cementation line for the conventional post compared to the other groups (p<0.05), as well as gaps and voids in the cementing material. The anatomized, adjustable, and CAD/CAM milled fiberglass post systems demonstrated a superior BS and adaptation to the root dentin compared to the conventional fiberglass post. (BS anatomized adjustable CADCAM CAD CAM weakened treated n=10. n10 n n=10 . 10 (n=10) cervical, cervical (cervical middle pushout push out analyzed SEM. (SEM) ShapiroWilk Shapiro Wilk tests chisquare chi square p<0.05. p005 p p<0.05 0 05 (p<0.05) p<0.05, , material n1 n=1 1 (n=10 (SEM p00 p<0.0 (p<0.05 n= (n=1 p0 p<0. (p<0.0 (n= p<0 (p<0. (n p< (p<0 (p< (p

Resumo O objetivo deste estudo foi analisar a provisão de retratamentos endodônticos não-cirúrgicos nos serviços odontológicos públicos do Brasil entre 2008 e 2022. Foi construída uma série temporal com esse propósito. Os números anuais de retratamentos endodônticos não-cirúrgicos foram obtidos do Sistema de Informações Ambulatoriais do Brasil e ajustados a cada 100.000 habitantes para obter a incidência entre 2008 e 2022. A comparação da incidência entre tipos de dentes, a estimativa da tendência temporal e a avaliação dos impactos relacionados à pandemia da COVID-19 foram realizadas com um nível de significância de 5%. Neste período, foram realizados 1.270.182 retratamentos endodônticos não-cirúrgicos. Foi observada uma incidência maior entre os dentes unirradiculares (328/100.000) quando comparados aos dentes birradiculares (183/100.000) e com três ou mais raízes (112/100.000) (p <0,05). As incidências anuais apresentaram uma tendência significativamente decrescente nos últimos 15 anos para todos os tipos de dentes (p <0,05), além de exibirem um padrão altamente correlacionado de variação temporal (p <0,05). Ademais, não houve influência nesse resultado ao remover o período entre 2020 e 2022 (todas as tendências temporais permaneceram decrescentes). No entanto, a incidência mensal foi significativamente menor no primeiro, segundo e terceiro ano após o início da pandemia de COVID-19 (p <0,05). A provisão de retratamentos endodônticos não-cirúrgicos nos serviços odontológicos públicos do Brasil experimentou uma queda dramática nos últimos 15 anos, incluindo após a pandemia da COVID-19. nãocirúrgicos cirúrgicos 200 propósito 100000 100 000 100.00 COVID19 COVID 19 COVID-1 5 5% 1270182 1 270 182 1.270.18 nãocirúrgicos. cirúrgicos. 328/100.000 328100000 328 (328/100.000 183/100.000 183100000 183 (183/100.000 112/100.000 112100000 112 (112/100.000 p <0,05. 005 <0,05 . 0 05 <0,05) <0,05, , Ademais 202 todas decrescentes. decrescentes decrescentes) entanto primeiro COVID19. 19. 20 10000 10 00 100.0 COVID1 COVID- 127018 27 18 1.270.1 328/100.00 32810000 32 (328/100.00 183/100.00 18310000 (183/100.00 112/100.00 11210000 11 (112/100.00 <0,0 2 1000 100. 12701 1.270. 328/100.0 3281000 3 (328/100.0 183/100.0 1831000 (183/100.0 112/100.0 1121000 (112/100.0 <0, 1270 1.270 328/100. 328100 (328/100. 183/100. 183100 (183/100. 112/100. 112100 (112/100. <0 127 1.27 328/100 32810 (328/100 183/100 18310 (183/100 112/100 11210 (112/100 < 12 1.2 328/10 3281 (328/10 183/10 1831 (183/10 112/10 1121 (112/10 1. 328/1 (328/1 183/1 (183/1 112/1 (112/1 328/ (328/ 183/ (183/ 112/ (112/ (328 (183 (112 (32 (18 (11 (3 (1 (

Abstract The objective of this study was to analyze the provision of non-surgical endodontic retreatments in Brazil's public dental services from 2008 to 2022. A time series was outlined for this purpose. The annual numbers of non-surgical endodontic retreatments were retrieved from the Brazilian National Outpatient Information System and adjusted per 100,000 inhabitants to obtain the incidence between 2008 and 2022. Comparison of the incidence between types of teeth, temporal trend estimation, and evaluation of the COVID-19 pandemic-related impacts were conducted with a significance level of 5%. In this timeframe, 1,270,182 non-surgical endodontic retreatments were carried out. A higher incidence was observed among single-rooted teeth (328/100,000) when compared to double-rooted (183/100,000) and multi-rooted teeth (112/100,000) (p <0.05). The annual incidences showed a significantly decreasing trend over the last 15 years for all types of teeth (p <0.05), as well as demonstrated a highly correlated pattern of temporal variation (p <0.05). In addition, there was no influence on this outcome when removing the period between 2020 and 2022 (all temporal trends remained decreasing). However, the monthly incidence was significantly lower in the first, second, and third years after the COVID-19 pandemic onset (p <0.05). The provision of non-surgical endodontic retreatments in Brazil's public dental services has experienced a dramatic decline over the past 15 years, including after the COVID-19 pandemic. nonsurgical non surgical Brazils Brazil s 200 purpose 100000 100 000 100,00 estimation COVID19 COVID 19 COVID-1 pandemicrelated related 5 5% timeframe 1270182 1 270 182 1,270,18 out singlerooted single rooted 328/100,000 328100000 328 (328/100,000 doublerooted double 183/100,000 183100000 183 (183/100,000 multirooted multi 112/100,000 112100000 112 (112/100,000 p <0.05. 005 <0.05 . 0 05 <0.05) <0.05, , addition 202 decreasing. decreasing) However first second 20 10000 10 00 100,0 COVID1 COVID- 127018 27 18 1,270,1 328/100,00 32810000 32 (328/100,00 183/100,00 18310000 (183/100,00 112/100,00 11210000 11 (112/100,00 <0.0 2 1000 100, 12701 1,270, 328/100,0 3281000 3 (328/100,0 183/100,0 1831000 (183/100,0 112/100,0 1121000 (112/100,0 <0. 1270 1,270 328/100, 328100 (328/100, 183/100, 183100 (183/100, 112/100, 112100 (112/100, <0 127 1,27 328/100 32810 (328/100 183/100 18310 (183/100 112/100 11210 (112/100 < 12 1,2 328/10 3281 (328/10 183/10 1831 (183/10 112/10 1121 (112/10 1, 328/1 (328/1 183/1 (183/1 112/1 (112/1 328/ (328/ 183/ (183/ 112/ (112/ (328 (183 (112 (32 (18 (11 (3 (1 (

ABSTRACT Objective: Thymidine-dependent small-colony variants (TD-SCVs) of Staphylococcus aureus are being isolated with increasing frequency from patients with cystic fibrosis (CF). The aim of this study was to evaluate the relationship between TD-SCV isolation and pulmonary function in patients with CF, as well as to determine whether the emergence of TD-SCVs was associated with trimethoprim-sulfamethoxazole (TMP-SMX) use and with coinfection with other microorganisms. Methods: This was a retrospective case-control study including patients with CF who visited the Clinical Hospital Complex of the Federal University of Paraná, in Curitiba, Brazil, between 2013 and 2022. Demographic, clinical, and spirometric data, as well as information on TD-SCVs and other isolated microorganisms, were collected from the medical records of patients with CF and TD-SCVs (TD-SCV group; n = 32) and compared with those of a matched group of patients with CF without TD-SCVs (control group; n = 64). Results: Isolation of TD-SCVs was positively associated with TMP-SMX use (p = 0.009), hospitalization (p < 0.001), and impaired pulmonary function (p = 0.04). Conclusions: The use of TMP-SMX seems to contribute to the emergence of TD-SCVs, the isolation of which was directly associated with worse pulmonary function in our sample. Objective Thymidinedependent Thymidine dependent smallcolony small colony TDSCVs TD SCVs (TD-SCVs CF. . (CF) TDSCV SCV trimethoprimsulfamethoxazole trimethoprim sulfamethoxazole TMPSMX TMP SMX (TMP-SMX microorganisms Methods casecontrol case control Paraná Curitiba Brazil 201 2022 Demographic clinical data 32 64. 64 64) Results p 0.009, 0009 0.009 , 0 009 0.009) 0.001, 0001 0.001 001 0.001) 0.04. 004 0.04 04 0.04) Conclusions TDSCVs, SCVs, sample (CF 20 202 3 6 000 0.00 00 0.0 2 0.

Resumo O primeiro caso de covid-19 foi detectado em dezembro de 2019, na China. A doença rapidamente evoluiu para uma pandemia e trouxe um fardo social e de saúde sem paralelo para a humanidade. As formas graves de covid-19 afetam principalmente adultos, especialmente idosos com comorbidades. Relatamos um caso grave de covid-19 em uma paciente de 12 anos de idade, previamente saudável, que deu entrada no pronto-socorro em 26/05/2020 com febre, dores abdominais, vômitos e diarreia. Durante a investigação, apresentou teste positivo para SARS-CoV-2 e evoluiu com falência múltipla de órgãos e eventos trombóticos catastróficos, resultando em amputação bilateral de pernas e quirodáctilos. Ela recebeu alta hospitalar para acompanhamento ambulatorial após 107 dias. No momento da redação deste relato, a paciente estava sendo submetida a protetização e recuperando marcha independente. covid19 covid 19 covid-1 2019 China humanidade adultos comorbidades 1 idade saudável prontosocorro pronto socorro 26052020 26 05 2020 26/05/202 febre abdominais diarreia investigação SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- catastróficos quirodáctilos 10 dias relato independente covid1 covid- 201 2605202 0 202 26/05/20 SARS-CoV 20 260520 26/05/2 26052 26/05/ 2605 26/05 260 26/0 26/

Abstract The first case of COVID-19 was detected in Dec 2019, in China. The disease shortly evolved into a pandemic and imposed an unparalleled health and social burden on mankind. Severe forms of COVID-19 mainly affect adults, especially the elderly and those with comorbidities. We report a severe case of COVID-19 in a previously healthy 12-year-old female who was admitted to the emergency room on May 26, 2020, with fever, abdominal pain, vomiting, and diarrhea. During the hospital stay, she tested positive for SARS-CoV-2 and developed multiple organ failure and catastrophic thrombotic events resulting in bilateral amputation of legs and fingers. She was discharged from the hospital for outpatient follow-up after 107 days. By the time this report was written, the patient was undergoing prosthesis prescription and training and regaining her independence to walk. COVID19 COVID 19 COVID-1 2019 China mankind adults comorbidities 12yearold yearold 12 year old 26 2020 fever pain vomiting diarrhea stay SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- fingers followup follow up 10 days written walk COVID1 1 COVID- 201 202 SARS-CoV 20

Resumo A Serra do Ibitipoca ocorre no sudeste do estado de Minas Gerais, sudeste do Brasil, e inclui um mosaico de diferentes tipos de vegetação, como parte do domínio da Mata Atlântica. Tal heterogeneidade é resultado da ocorrência de diversos ecótonos na região, considerados áreas de amortecimento essenciais para manutenção da biodiversidade e estrutura de ecossistemas adjacentes. Dada a importância destes ambientes para conservação da biodiversidade, inventários florísticos são importantes para catalogar a riqueza de plantas em áreas naturais, onde espécies e paisagens têm sido destruídas, especialmente nas últimas décadas. Para contribuir com o aumento do conhecimento sobre a Flora vascular na Serra do Ibitipoca, um inventário florístico foi conduzido em áreas privadas adjacentes ao Parque Estadual do Ibitipoca. As descobertas mais relevantes do presente estudo incluem: caracterização dos diferentes tipos de vegetação, 17 novos registros para a Flora de Minas Gerais, coleta de 288 espécies nunca registradas para o parque (80% de dissimilaridade – especialmente devido à ocorrência e tamanho de diferentes fitofisionomias entre as áreas) e presença de 31 espécies ameaçadas. Além disso, discussões sobre esforços para conservação e políticas públicas são apresentadas. Gerais Brasil vegetação Atlântica região naturais destruídas décadas incluem 1 28 80% 80 (80 3 ameaçadas disso apresentadas 2 8 (8 (

Abstract The Ibitipoca Mountains occur in southeastern Minas Gerais state, Southeast Brazil, and includes a mosaic of different vegetation types, as part of the Atlantic Forest domain. Such heterogeneity results in the occurrence of several ecotones in the region, considered essential buffer zones for maintaining biodiversity and structure among adjacent ecosystems. Given the importance of these environments for biodiversity conservation, floristic surveys are important to catalogue plant richness in natural areas, where species and landscapes have been destroyed, especially over the last decades. To contribute to increase the knowledge on the vascular Flora in the Ibitipoca Mountains, a floristic inventory was undertaken in private properties located in the boundaries of “Parque Estadual do Ibitipoca” (Ibitipoca State Park). Relevant findings of the present study include: characterization of the different vegetation types, 17 new records for the Flora of Minas Gerais, collection of 288 species never recorded in the state park (80% dissimilarity – especially due to the occurrence and size of different phytophysiognomies between these areas) and presence of 31 threatened species. In addition, discussions about conservation efforts and public policies are presented. Brazil types domain region ecosystems areas destroyed decades Parque Park. Park . Park) include 1 28 80% 80 (80 3 addition presented 2 8 (8 (

Generalized anxiety disorder is a highly prevalent mental disorder. Previous data indicate that more than 18 million Brazilians suffer from this condition. Traditionally, generalized anxiety disorder has been considered a mild mental health disorder, despite its links to lower life expectancy, cardiovascular disease, and suicide. The aim of this article is to combine elements of systematic and critical reviews to produce a synthesis of the best evidence about generalized anxiety disorder treatment. Systematic reviews, meta-analyses, and randomized controlled trials were included. The descriptor used in the search was “generalized anxiety disorder,” which resulted in 4,860 articles and seven other studies, of which 59 were selected. Antidepressants and benzodiazepines were indicated, as was pregabalin, and atypical antipsychotics, such as quetiapine, have been studied. Individual cognitive behavior therapy (third wave) has proven effective. There is extensive literature on many effective treatments for generalized anxiety disorder. The present review summarizes the therapeutic possibilities, emphasizing those available in Brazil. Further studies are needed to compare other available medications, assess psychotherapies and new treatments in greater depth, as well as to assess the ideal duration of therapy. Registration number: PROSPERO CRD42021288323. 1 condition Traditionally expectancy disease suicide treatment metaanalyses, metaanalyses meta analyses, analyses meta-analyses included 4860 4 860 4,86 5 selected indicated pregabalin antipsychotics quetiapine studied third wave possibilities Brazil medications depth number CRD42021288323 CRD 486 86 4,8 CRD4202128832 48 8 4, CRD420212883 CRD42021288 CRD4202128 CRD420212 CRD42021 CRD4202 CRD420 CRD42 CRD4