Abstract Background The escalation of surgeries for high-risk patients in Low- and Middle-Income Countries (LMICs) lacks evidence on the positive impact of Intensive Care Unit (ICU) admission and lacks universal criteria for allocation. This study explores the link between postoperative ICU allocation and mortality in high-risk patients within a LMIC. Additionally, it assesses the Ex-Care risk model's utility in guiding postoperative allocation decisions. Methods A secondary analysis was conducted in a cohort of high-risk surgical patients from a 800-bed university-affiliated teaching hospital in Southern Brazil (July 2017 to January 2020). Inclusion criteria encompassed 1431 inpatients with Ex-Care Model-assessed all-cause postoperative 30-day mortality risk exceeding 5%. The study compared 30-day mortality outcomes between those allocated to the ICU and the Postanesthetic Care Unit (PACU). Outcomes were also assessed based on Ex-Care risk model classes. Results Among 1431 high-risk patients, 250 (17.47%) were directed to the ICU, resulting in 28% in-hospital 30-day mortality, compared to 8.9% in the PACU. However, ICU allocation showed no independent effect on mortality (RR = 0.91; 95% CI 0.68‒1.20). Patients in the highest Ex-Care risk class (Class IV) exhibited a substantial association with mortality (RR = 2.11; 95% CI 1.54-2.90) and were more frequently admitted to the ICU (23.3% vs. 13.1%). Conclusion Patients in the highest Ex-Care risk class and those with complications faced elevated mortality risk, irrespective of allocation. Addressing the unmet need for adaptable postoperative care for high-risk patients outside the ICU is crucial in LMICs. Further research is essential to refine criteria and elucidate the utility of risk assessment tools like the Ex-Care model in assisting allocation decisions. highrisk high Low MiddleIncome Middle Income LMICs (LMICs (ICU LMIC Additionally ExCare Ex models s decisions 800bed bed 800 universityaffiliated university affiliated July 201 2020. 2020 . 2020) 143 Modelassessed Model allcause all cause 30day day 30 5 5% PACU (PACU) classes 25 17.47% 1747 17 47 (17.47% 28 inhospital 89 8 9 8.9 However RR 0.91 091 0 91 95 0.68‒1.20. 068120 0.68‒1.20 68 1 20 0.68‒1.20) Class IV 2.11 211 2 11 1.542.90 154290 1.54 2.90 54 90 1.54-2.90 23.3% 233 23 3 (23.3 vs 13.1%. 131 13.1% 13 13.1%) 80 202 14 (PACU 17.47 174 4 (17.47 8. 0.9 09 06812 0.68‒1.2 6 2.1 21 542 1.542.9 15429 154 1.5 290 2.9 1.54-2.9 23.3 (23. 13.1 17.4 (17.4 0. 0681 0.68‒1. 2. 1.542. 1542 15 1. 29 1.54-2. 23. (23 13. 17. (17. 068 0.68‒1 1.542 1.54-2 (2 (17 06 0.68‒ 1.54- ( (1 0.68 0.6

ABSTRACT Objective: To describe the management of quality of care in nursing and patient safety. Methodology: The research is developed from the quantitative approach with a descriptive methodology with non-experimental design, which is supported by documentary and bibliographic analysis. A research process was organized in which the study population was based primarily on written documents such as theses and scientific articles. The analytical-synthetic aspect was based on mentally decomposing the subject studied into different elements in order to obtain new knowledge. In conclusion: Nursing is the professional who is at the center of the direct care of people, families and community, providing collaboration to the health team, from a dynamic and responsible action where human values stand out and provide welfare to the population with quality and constancy. From the mildest to the most critical patients, complying with the care protocols for their prompt recovery.

RESUMEN Objetivo: Describir la gestión de la calidad de cuidados en enfermería y la seguridad del paciente. Metodología: La investigación se desarrolla desde el enfoque cuantitativo con una metodología descriptiva con diseño no experimental, la cual se apoya en el análisis documental y bibliográfico. Se organizó un proceso investigativo en donde la población de estudio se basó, primordialmente, en documentos escritos como tesis y artículos científicos. Lo analítico-sintético, radicó en descomponer mentalmente el tema estudiado en diversos elementos para poder conseguir nuevos conocimientos. En conclusión: La enfermería es el profesional que está en el centro del cuidado directo de las personas, familias y comunidad, prestando la colaboración al equipo de salud, desde una acción dinámica y responsable, donde resaltan los valores humanos con la finalidad de brindar bienestar a la población con calidad y constancia, desde los pacientes leves hasta los más críticos, cumpliendo con los protocolos de cuidados para su pronta recuperación.

ABSTRACT The objectives of this work were to estimate the genetic parameters for the traits longevity (LG) and accumulated milk yield at 305 days (MY305) using a bitrait animal model and the single-step GBLUP method and estimate the genetic gain for LG through direct and indirect selection for MY305. We used 4,057 records of first lactations of Murrah dairy buffaloes, collected between 1987 and 2020, belonging to six Brazilian herds located in the states Ceará, Rio Grande do Norte, and São Paulo and 960 animals genotyped using the 90K Axiom Buffalo Genotyping (Thermo Fisher Scientific, Santa Clara, CA) to estimate the genetic parameters. The heritability estimate was 0.25 for MY305 and 0.13 for LG. The genetic gain for LG was 0.13 months under direct selection, and 0.14 months under indirect selection, which results in a relative selection efficiency of 11% under selection for MY305 compared with the direct selection. The genetic correlation between the two traits was 0.77, indicating that animals with genetic potential for high MY305 tend to live longer. The genetic trends for MY305 and LG were 0.22 kg/year and 5.20 days/year, respectively, indicating a positive response, which reaffirms its relationship with the high genetic correlation between the two traits. (LG 30 MY (MY305 singlestep single step 4057 4 057 4,05 buffaloes 198 2020 Ceará Norte 96 K Thermo Scientific Clara CA 025 0 25 0.2 MY30 013 13 0.1 014 14 11 077 77 0.77 longer 022 22 kgyear kg year 520 5 20 5.2 daysyear days/year respectively response 3 (MY30 405 05 4,0 19 202 9 02 2 0. MY3 01 1 07 7 0.7 52 5. (MY3 40 4, (MY

ABSTRACT The objective of this study was to evaluate whether the addition of the enzymes phytase and xylanase, isolated or associated, in the liquid form after feed pelletization could improve energy utilization and digestibility of calcium and phosphorus by broiler chickens. Three experiments were performed using 120 birds each, divided into five treatments with eight replicates per group (n = 3), identified as: experiment 1 (xylanase: control, 1000 IU, 1500 IU, 2000 IU, 2500 IU), experiment 2 (phytase: control, 500 FTU, 1000 FTU, 1500 FTU, 2000 FTU), experiment 3 (xylanase + phytase: control, 3000 IU + 500 FTU, 3000 IU + 1000 FTU, 3000 IU + 1500 FTU, 3000 IU + 2000 FTU). Samples for digestibility tests were collected at 14 to 21 days of age. Therefore, the inclusion of liquid phytase and liquid phytase + xylanase after pelletization in broiler diets has become a relevant way to reduce the inclusion of inorganic P, which can reduce the cost of feed and P excretion in the environment. Furthermore, it is an interesting strategy to avoid enzyme denaturation in the pelleting process. associated chickens 12 each n 3, , 3) as control 100 150 200 250 IU) (phytase 50 FTU FTU) 300 FTU. . age Therefore environment Furthermore process 10 15 20 25 5 30

Abstract Abstract: This study evaluated the effect of oregano essential oil added to the feed of commercial laying hens. This research was focused on the analysis of biochemical changes linked to hepatic function, and protein and lipid metabolism. It was used 240 laying hens (59 weeks-old) distributed in a completely randomized design of six treatments (five repetitions with eight birds each). The experiments were constituted by a control treatment (CT) with the inclusion of zinc bacitracin and five treatments of oregano essential oil (OEO: 0, 50, 100, 150, and 200 mg.kg-1), respectively. After 28 days of feeding, an increase on serum levels of total proteins and globulins was observed on groups T150 and T200, as well as an increase on albumin levels on group CT. After 84 days of feeding, a significant reduction on total proteins and albumin was observed on group T200, as well as an increase in serum triglycerides. OEO at 200 mg.kg-1 increased globulin levels on day 28, which may be considered an effect in the inflammatory response, which increases serum immunoglobulins and proteins.

Abstract: The aim of this study was to evaluate whether the use phytogenic as feed additive of Holstein calves could exert beneficial effects on animal health and performance. Thirty newborn calves were randomly divided into two groups (control and treated), and the treated consisted of 10 g of the phytogenic product diluted in milk once a day for 30 days. Blood and fecal samples were collected, and fecal score was performed daily in order to determine the occurrence of diarrhea. Treated calves showed higher hematocrit on days 45 and 60 of life. Serum levels of urea, total proteins, globulins and glucose were lower in the treated group on day 60 of life, while triglycerides were lower on days 15 and 60 of life. Serum glutathione S-transferase activity was higher in treated animals on day 60 of life. Fecal bacterial count was lower in treated animals on days 30 and 60 of life. The weight gain was higher in treated animals on days 60 and 210 of life. Based on these results, it is possible to conclude that the addition of phytogenic as feed additive for calves was able to minimize fecal bacterial infections and to increase body weight gain.

RESUMEN Objetivo. El objetivo evaluar la ocurrencia de protozoos gastrointestinales en terneros lecheros y de identificar posibles factores de riesgo para infección. Materiales y métodos. Se recogieron 243 muestras de heces de terneros de hasta 60 días de edad en 43 granjas lecheras ubicadas en la región del oeste del estado de Santa Catarina, Brasil. Las muestras fueron examinadas por la técnica de centrifugación-flotación. Resultados. Como resultado, Giardia estaba presente en 26.75% (65/243) de todas las muestras, Eimeria en 21.81% (53/243), y Cryptosporidium en 20.99% (51/243). Además, 46.50% (113/243) de las muestras fueron negativas para cualquier protozoos, mientras que 39.10% (95/243) y 14.40% (35/208) mostraron infecciones simples y mixtas, respectivamente. Hubo una mayor asociación entre Cryptosporidium y Giardia (6.99%) en los casos de infecciones mixtas. Sin embargo, la asociación de triple protozoos tenía la menor prevalencia de infecciones mixtas (2.06%). Epidemiológicamente, se aplicó un cuestionario para determinar los factores de riesgo para estas infecciones parasitarias. Se han identificado algunos factores de riesgo de infecciones por Cryptosporidium, destacando manejo de la alimentación, periodo de tiempo que los terneros permanecieron con sus madres (vacas), y el contacto con los perros; el riesgo de contraer Giardia incrementado en función de la fuente de la leche, mientras que el tipo de suelo de las camas, y la edad fueron nombrados como los riesgos de factores de Eimeria. Conclusiones. Es posible confirmar que Giardia, Cryptosporidium y Eimeria pueden infectar a terneros lecheros, y el conocimiento de algunos factores de riesgo asociados a la infección en terneros.

ABSTRACT Objective. This study aimed to evaluate the occurrence of gastrointestinal protozoa in dairy calves and to identify potential risk factors for this type of infection. Materials and methods. For this purpose, 243 fecal samples were collected from calves up to 60 days of age in 43 dairy farms located in the West region of Santa Catarina state, Brazil. Samples were examined by centrifugal-flotation technique. Results. As a result, Giardia was present in 26.75% (65/243) of all samples, Eimeria in 21.81% (53/243), and Cryptosporidium in 20.99% (51/243). Additionally, 46.50% (113/243) of the samples were negative for any protozoa, while 39.10% (95/243) and 14.40% (35/208) showed single and mixed infections, respectively. There was a higher association between Cryptosporidium and Giardia (6.99%) in cases of mixed infections. However, the triple protozoa association had the lowest prevalence in mixed infections (2.06%). Epidemiologically, a questionnaire was applied to determine risk factors for these parasitic infections. Based on the statistical model applied, some risk factors for Cryptosporidium infections were identified, highlighting feeding management, period of time that calves stayed with their mothers (cows), and contact with dogs; the risk of contracting Giardia increased according to the milk source, while the floor type bedding, and age were appointed as risks factors for Eimeria. Conclusions. Therefore, it is possible to confirm that Giardia, Cryptosporidium and Eimeria may infect dairy calves, and the knowledge of some risk factors associated to their infection in calves.

RESUMO Objetivo Investigar se o uso do biofeedback eletromiográfico na terapia voltada às funções orofaciais (expressão facial, mastigação, deglutição, fonação e fala) produz efeitos benéficos para os indivíduos com doenças neurológicas. Estratégia de pesquisa Foi realizada busca nas bases de dados MEDLINE, LILACS e SciELO, por meio dos descritores “electromyographic biofeedback”, “swallowing”, “speech” “chewing”, “phonation”, e “facial expression”. A busca nas bases de dados e a seleção dos artigos foram realizadas independentemente, por duas pesquisadoras e, nos casos de não concordância, houve discussão fundamentada nos critérios de inclusão e exclusão para que chegassem a um consenso. Critérios de seleção Foram incluídos estudos experimentais em seres humanos, em inglês e português, que descreveram e discutiram a utilização do biofeedback eletromiográfico no tratamento das alterações das funções orofaciais provenientes de doenças neurológicas. Resultados Foram encontrados 175 artigos, sendo que somente 10 se adequaram aos critérios de inclusão. A maioria dos trabalhos relacionou-se a estudo de caso, seguido por estudos de série de casos, caso controle e ensaio clínico randomizado. A maior parte dos artigos abordou a aplicação da terapia com biofeedback eletromiográfico na função da deglutição, seguida da função da fala e apenas um artigo utilizou esta modalidade de tratamento na terapia para melhora da expressão facial. Não foram encontrados estudos que abordassem o tratamento fonoaudiológico utilizando o biofeedback eletromiográfico em pacientes com doenças neurológicas, nas funções de fonação e mastigação. Conclusão O uso do biofeedback eletromiográfico na terapia voltada às funções orofaciais pode produzir efeitos benéficos para os indivíduos com doenças neurológicas, nas funções de deglutição, fala e expressão facial.

ABSTRACT Purpose To determine whether the use of electromyographic biofeedback in the therapy of orofacial functions (facial expression, chewing, swallowing, phonation and speech) will result in beneficial effects for individuals with neurological diseases. Research strategy A keyword search was conducted in the MEDLINE, LILACS and SciELO databases, using the terms “electromyographic biofeedback”, “swallowing”, “speech”, “chewing”, “phonation”, and “facial expression”. The database search and the selection of papers were conducted independently by two researchers. In case of any disagreement, there was a discussion based on the inclusion and exclusion criteria, so that they could reach a common ground. Selection criteria This work has included experimental studies in humans, in English and Portuguese, which described and discussed the use of electromyographic biofeedback in the treatment of orofacial function diseases resulting from neurological illness. Results A total of 175 papers were found, wherein only 10 fitted the inclusion criteria. Most works were case studies, followed by case series, case control, and only one randomized controlled trial. Most of studies addressed the therapy with electromyographic biofeedback in the swallowing function, followed by speech function, and only one study addressed the use of electromyographic biofeedback in therapy to improve facial expression. No studies addressing speech therapy using electromyographic biofeedback in patients with neurological diseases in the functions of phonation and chewing were found. Conclusion The use of electromyographic biofeedback in the therapy for orofacial functions can result in beneficial effects for individuals with neurological diseases in the swallowing, speech, and facial expression functions.

Objectives The aim of the study was to evaluate the outcome of a pediatric population with ventricular preexcitation pattern, supraventricular tachycardia, atrial fibrillation, cardiomyopathies, mortality and medical treatment. Methods From 1976 to 2011, a descriptive observational study was conducted on patients with ventricular preexcitation in the electrocardiogram. All patients underwent an echocardiogram, 101 (75.3%) Holter monitoring, and 69 (51.5%) an ergometric test. Radiofrequency ablation was performed in selected patients. Data were expressed as mean and standard deviation. Results The study population consisted of 134 patients, 80 (59.7%) of whom were male. Age at diagnosis ranged from 2 days to 18 years, with a mean of 6.5±5 years. Clinical follow-up lasted 1 month to 20 years, with a mean of 3.6±3.9 years. Thirty five patients (26.1%) consulted for supraventricular tachycardia, 16 (11.9%) for ventricular preexcitation, and the remaining 83 patients (61.9%) for other abnormalities. Seventy-six patients (56.7%) evidenced left conduction pathway and 3 patients a double conduction pathway. Sixteen patients (11.9%) presented supraventricular tachycardia during follow-up. Overall, 51 patients (38%) had orthodromic tachycardia at 6.3±5.8 years, 10 patients during the neonatal period. Thirty-eight patients (28.3%) received antiarrhythmic drugs. No atrial fibrillation was observed. Twenty-eight patients (20.9%) presented cardiomyopathy, 9 with supraventricular tachycardia. No association was found between supraventricular tachycardia and another variable. Forty-three patients (32.1%) underwent radiofrequency ablation. A patient suffered sudden death and another patient died during the postoperative period of corrective surgery. Conclusions 1) More than 60% of patients remained asymptomatic. 2) No atrial fibrillation was recorded. 3) Sudden death rate was 0.75%. 4) Patients with supraventricular tachycardia not submitted to ablation had a favorable outcome. 5) Supraventricular fibrillation was not associated with any variable. 6) Multiple conduction pathways always developed supraventricular tachycardia.

Objetivos Evaluar la evolución de una población pediátrica con patrón de preexcitación ventricular, presencia de taquicardia supraventricular, fibrilación auricular, cardiopatías, mortalidad e intervención médica. Material y métodos Estudio descriptivo observacional. Se registraron pacientes con preexcitación ventricular en el electrocardiograma desde 1976 a 2011. Todos tenían ecocardiograma, 101 pacientes Holter (75,3%) y 69 (51,5%) ergometría. En pacientes seleccionados se realizó ablación por radiofrecuencia. Los datos se expresaron como media y desviación estándar. Resultados Se incluyeron en el estudio 134 pacientes, 80 varones (59,7%). Edad al diagnóstico: 2 días a 18 años, media 6,5 ± 5 años. Seguimiento clínico: 1 mes a 20 años, media 3,6 ± 3,9 años. Consultaron por taquicardia supraventricular 35 pacientes (26,1%), por preexcitación ventricular 16 pacientes (11,9%) y por otras causas 83 pacientes (61,9%); 76 pacientes (56,7%) evidenciaron vía izquierda, 3 pacientes doble vía; 16 pacientes (11,9%) presentaron taquicardia supraventricular durante el seguimiento. En total, 51 pacientes (38%) tuvieron taquicardia ortodrómica a los 6,3 ± 5,8 años, 10 pacientes en el período neonatal; 38 pacientes (28,3%) recibieron antiarrítmicos. No se observó fibrilación auricular. Veintiocho pacientes (20,9%) presentaron cardiopatía, 9 con taquicardia supraventricular. No hubo variables vinculadas con taquicardia supraventricular. En 43 pacientes (32,1%) se realizó ablación por radiofrecuencia. Un paciente murió súbitamente. Otro paciente falleció en el posoperatorio de cardiopatía. Conclusiones 1) Más del 60% de los pacientes permanecieron asintomáticos. 2) No se registró fibrilación auricular. 3) La tasa de muerte súbita fue del 0,75%. 4) Los pacientes con taquicardia supraventricular no sometidos a ablación evolucionaron bien. 5) No se asociaron variables con taquicardia supraventricular. 6) Las vías múltiples siempre desarrollaron taquicardia supraventricular.