RESUMO JUSTIFICATIVA E OBJETIVOS: Das abordagens inerentes ao tratamento conservador, o laser de baixa intensidade (LBI) é um dos recursos mais utilizados no tratamento da dor miofascial. Esta pesquisa buscou avaliar na literatura as evidências disponíveis sobre o tratamento da síndrome da dor miofascial com o LBI para analisar os efeitos reportados dessa intervenção. CONTEÚDO: Foram utilizadas as bases de dados Medline/Pubmed, SCOPUS, Web of Science, Registro Central Cochrane de Ensaios Controlados (CENTRAL) e Cumulative Index to Nursing and Allied Health Literature (CINAHL), da Ebsco, para busca de artigos de ensaios clínicos randomizados que relacionassem síndrome da dor miofascial com LBI. Os estudos foram selecionados sistematicamente por dois revisores, independentemente, por meio do título, resumo e, posteriormente, texto completo. Dez artigos que se adequaram aos critérios foram incluídos nessa revisão sistemática. Em seis destes artigos, foi apresentada a melhora da dor comparada ao grupo placebo logo após a sessão de LBI, embora esses resultados não tenham permanecido nos acompanhamentos dos estudos que realizaram follow-ups. CONCLUSÃO: O LBI parece ser um recurso que diminui a dor em pacientes com síndrome da dor miofascial. Apesar dos resultados positivos na diminuição da dor com o uso do LBI em alguns estudos, esta análise admite a heterogeneidade dos estudos com resultados conflitantes relacionados à efetividade do LBI. Pesquisas que definam os parâmetros e dosagens terapêuticas adequadas são necessárias para um melhor entendimento sobre os reais efeitos do LBI sobre essa condição clínica.

ABSTRACT BACKGROUND AND OBJECTIVES: Among the approaches inherent to conservative treatment, the low-level laser therapy (LLLT) is one of the most used resources in the treatment of myofascial pain. This research sought to search the literature for the available evidence on the treatment of myofascial pain syndrome with LLLT in order to analyze the reported effects of this intervention. CONTENTS: Medline/PubMed, SCOPUS, Web of Science, Cochrane Central Registry of Controlled Trials (CENTRAL) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) by Ebsco was used to search for articles on randomized clinical trials that related myofascial pain syndrome with LLLT. Studies were systematically selected by two reviewers independently, through title, abstract and, later, full text. Ten articles that met the criteria were included in this integrative review. In six of these articles, the improvement in pain compared to placebo group was presented right after LLLT session, although these results did not remain in the follow-ups of the studies that performed follow ups. CONCLUSION: LLLT seems to be a resource that decreases pain in patients with myofascial pain syndrome. Despite the positive results in reducing pain with the use of LLLT in some studies, this review admits the heterogeneity of studies with conficting results related to the effectiveness of LLLT. Research that defines the parameters and adequate therapeutic dosages are necessary for a better understanding of the real effects of LLLT on this clinical condition.

Abstract A numerical model based on the finite-difference time-domain (FDTD) method is developed for calculating discharge currents and fields produced due air ionization between two electrodes. Electric conductivity σ of the ionized channel between two electrodes is calculated using non-linear equations, i.e., σ is obtained using functions of time. The functions for calculating σ are adapted and proposed in this work for each stage of the plasma formation and disrupting processes. The proposed numerical model is validated by making comparisons among the obtained FDTD results and experimental data published in literature. In order to perform the validation procedures, an experimental setup from literature is numerically reproduced using the proposed FDTD methodology.

Abstract Brazil experienced the opening-up and democratization of its foreign policymaking in the last decades, but since 2016 a wave of bureaucratic reforms sought to reverse that process. This paper contributes to understanding this phenomenon by looking at the agri-food dimension of Brazilian foreign policy. Through the analysis of official documental and discursive data, we discuss successive symbolic-discursive, as well as policy-institutional governmental efforts to close-off foreign policymaking to peasant family farmers and their interests. The study reveals changing patterns in state-society interfaces, and contributes to bridging the fields of Foreign Policy Analysis, Policy Dismantling and Social Participation.

A BRIEF OVERVIEW ON SINGLE-ATOM CATALYSIS: CONCEPTS AND APPLICATIONS. Catalytic processes became extremely important for the development of our society, especially after the second industrial revolution. Thus, the research for more efficient catalysts is an obstacle to overcome to achieve cheaper processes, higher yields, and selectivity of desired products. In this context, single-atom catalysis emerges as a promising alternative to unite the advantages of traditional homogeneous and heterogeneous catalysis. Catalysis by single-atoms is a bridge that unites in a single catalyst the ease of recovery and reuse (from heterogeneous catalysis) with the high exposure and uniformity of sites (from homogeneous catalysis). Thus, single-atom catalysts (SACs) and single-atom alloys (SAAs) have already found several applications in the literature, such as in hydrogenation, oxidation, conversion of biomass derivatives, electrocatalysis, and photocatalysis. However, it is essential to emphasize that it is still a field that is expanding and relatively new, with several opportunities and many barriers to surpass. In this review, concepts of homogeneous, enzymatic, and heterogeneous catalysis will be addressed, as well as fundamental aspects of single-atom catalysis, preparation methods, characterization, and current challenges.

Abstract The Amazon region has high lightning occurrence rates, with many lightning hot spots. Different rivers cross the Amazon rainforests and the people that live there use these rivers as roads to go from one place to another. Every year, lightning deaths are reported in the Brazilian Amazon region. In 2018, a lightning discharge struck a small riverboat, which killed 4 people and injured 5 in the North region of Brazil. In this study, we investigate lightning fatalities in Amazon rivers and compute electric field distribution in a small riverboat due to a lightning strike using the finite-difference time-domain (FDTD) method. The results show that the electric field produced inside the boat is large enough to cause air breakdown. Additionally, we propose a cost-effective method to improve lightning safety for people that use small boats in the Amazon region.

RESUMO Com o objetivo de analisar a atuação das equipes multiprofissionais conformadas nos Núcleos Ampliados de Apoio à Família e Atenção Básica, frente às dimensões clínico-assistencial e técnico-pedagógica no contexto da Atenção Primária à Saúde no Brasil, delineou-se estudo multicêntrico, de natureza qualitativa, realizado no período de 2018 a 2020, em três municípios no estado do Ceará. A coleta de dados ocorreu através de observação e grupo focal com as equipes multiprofissionais. Os registros das observações e dos discursos dos grupos focais foram tabulados no software Interface de R pour L Analyses Multidimensionnelles de Textes L de Questionnaires (IRAMUTEQ®). Na Classificação Hierárquica Descendente, obteve-se um aproveitamento de 75,46% do corpus textual, formando cinco classes, cujos vocábulos têm associação estatisticamente relevante (p<0,0001). Os resultados evidenciam avanços na atuação das equipes multiprofissionais na produção do cuidado integral dos indivíduos e coletivos, a partir de ações de planejamento e tomada de decisões partilhadas com vistas à melhoria da qualidade de vida destes. Outrossim, identifica-se uma ênfase na dimensão clínico- -assistencial do cuidado, o que torna a dimensão técnico-pedagógica um desafio. Contudo, reconhece-se o potencial indutor da atuação das equipes para um trabalho colaborativo e orientado pela interprofissionalidade, corroborando o fortalecimento da Atenção Primária à Saúde.

ABSTRACT In order to analyze the performance of the multiprofessional teamwork at the Family Primary Health Care Expanded Support Centers, regarding the clinical-assistance and technical-pedagogical dimensions in Brazilian Primary Health Care, a multicentered study was outlined. This study is qualitative and descriptive in nature, and it was carried out between 2018 and 2020 in three northeast Brazilian towns. Data were collected through observation and focus groups with multiprofessional teams which worked in Primary Health Care. Observations were made during the baseline phase, follow-ups one and two. Documentation of observations and focal group’s speech were tabulated using the Interface de R pour L Analyses Multidimensionnelles de Textes L de Questionnaires (IRAMUTEQ®) software. 106 text units were identified in the Descending Hierarchical Classification, with 807 follow-ups, 28.304 occurrences, 1.809 active forms with average frequency ≥3:737, chi2≥57,64, and 75.46% use of textual statistics, which formed five classes of statistically relevant words (p<0,0001). The results show advances in the work done by the multiprofessional teams on the production of comprehensive care of both individuals and collectivity, due to action plans and collaborative decision seeking improvements in the quality of life of individuals and collectivity. It is also possible to identify emphasis on the clinical-assistance dimension of care and that makes the technical-pedagogical dimension a challenge. However, we highlight the teams’ collaborative driving force that was guided by the interprofessionality, corroborating, thus, the strengthening of Primary Health Care.

RESUMO Com o objetivo de analisar a atuação das equipes multiprofissionais conformadas nos Núcleos Ampliados de Apoio à Família e Atenção Básica, frente às dimensões clínico-assistencial e técnico-pedagógica no contexto da Atenção Primária à Saúde no Brasil, delineou-se estudo multicêntrico, de natureza qualitativa, realizado no período de 2018 a 2020, em três municípios no estado do Ceará. A coleta de dados ocorreu através de observação e grupo focal com as equipes multiprofissionais. Os registros das observações e dos discursos dos grupos focais foram tabulados no software Interface de R pour L Analyses Multidimensionnelles de Textes L de Questionnaires (IRAMUTEQ®). Na Classificação Hierárquica Descendente, obteve-se um aproveitamento de 75,46% do corpus textual, formando cinco classes, cujos vocábulos têm associação estatisticamente relevante (p<0,0001). Os resultados evidenciam avanços na atuação das equipes multiprofissionais na produção do cuidado integral dos indivíduos e coletivos, a partir de ações de planejamento e tomada de decisões partilhadas com vistas à melhoria da qualidade de vida destes. Outrossim, identifica-se uma ênfase na dimensão clínico- -assistencial do cuidado, o que torna a dimensão técnico-pedagógica um desafio. Contudo, reconhece-se o potencial indutor da atuação das equipes para um trabalho colaborativo e orientado pela interprofissionalidade, corroborando o fortalecimento da Atenção Primária à Saúde.

ABSTRACT In order to analyze the performance of the multiprofessional teamwork at the Family Primary Health Care Expanded Support Centers, regarding the clinical-assistance and technical-pedagogical dimensions in Brazilian Primary Health Care, a multicentered study was outlined. This study is qualitative and descriptive in nature, and it was carried out between 2018 and 2020 in three northeast Brazilian towns. Data were collected through observation and focus groups with multiprofessional teams which worked in Primary Health Care. Observations were made during the baseline phase, follow-ups one and two. Documentation of observations and focal group’s speech were tabulated using the Interface de R pour L Analyses Multidimensionnelles de Textes L de Questionnaires (IRAMUTEQ®) software. 106 text units were identified in the Descending Hierarchical Classification, with 807 follow-ups, 28.304 occurrences, 1.809 active forms with average frequency ≥3:737, chi2≥57,64, and 75.46% use of textual statistics, which formed five classes of statistically relevant words (p<0,0001). The results show advances in the work done by the multiprofessional teams on the production of comprehensive care of both individuals and collectivity, due to action plans and collaborative decision seeking improvements in the quality of life of individuals and collectivity. It is also possible to identify emphasis on the clinical-assistance dimension of care and that makes the technical-pedagogical dimension a challenge. However, we highlight the teams’ collaborative driving force that was guided by the interprofessionality, corroborating, thus, the strengthening of Primary Health Care.

Abstract Brazil became one of the world’s largest food donors after the WFP went through a reform process. The reform allowed non-traditional donors to donate food provided that other partners paid for logistical costs. We analyzed the reform process through documental analysis and interviews to understand Brazil’s role in this. The results show that both actors had complementary interests. However, whilst Brazil had ambitions of prominence in this area, it adopted a rule-taker position. The WFP’s Secretariat was the main driving force in the process and, to some extent, co-opted Brazil.

Abstract The current study focuses on the evaluation of culture parameters on the enzymatic hydrolysis of Ipomoea batatas (L.) Lam flour by Candida homilentoma strains. A 2-factor-5-level CCRD was used to evaluate the effect of pH and temperature on the hydrolysis process. For the S-47 strain, pH and both studied parameters were significant at 48 h and 96 h, respectively. Regarding S-81 strain, temperature was the only factor affecting the process, at 96 hours. The regression models were significant, and no lack of fit was observed for them.

Resumo O objetivo do estudo foi comparar o consumo máximo de oxigênio (VO2máx), frequência cardíaca (FC) máxima velocidade associada ao VO2máx, tempo até a exaustão e limiares ventilatórios entre dois protocolos de teste máximo (escalonado vs. rampa) com demanda metabólica equalizada em jovens adultos aparentemente saudáveis. Vinte e sete sujeitos de ambos os sexos foram analisados e submetidos à dois testes máximos: 1) escalonado com 1,2 km•h-1 a cada 2 min; 2) rampa com 0,1 km•h-1 a cada 0,18 min; ambos com 1% de inclinação e duração total máxima prevista de vinte minutos. As trocas respiratórias foram analisadas diretamente, e os limiares ventilatórios determinados por inspeção visual. Medidas de tendência central e dispersão foram adotadas, assim como um teste t pareado e tamanho do efeito. A análise de Bland-Altman verificou a concordância entre as variáveis. A única variável a apresentar diferença estatística (p < 0,01) foi a velocidade máxima (escalonado = 14,0 ± 1,9 km•h-1) e (rampa = 14,6 ± 2,3 km∙h-1). Mesmo com baixos valores de BIAS, é possível verificar uma tendência negativa assim como altos limites de concordância. Apesar da não diferença apresentada para as variáveis, exceto para a velocidade máxima, é possível afirmar que o teste escalonado é capaz de determinar as variáveis analisadas de modo semelhante ao teste rampa considerando as mesmas condições do presente estudo.

Abstract The aim of the study was to compare maximum oxygen uptake, maximum heart rate, speed corresponding to VO2max, time to exhaustion, and ventilatory thresholds between two maximal test protocols (scaled vs ramp) with equalized metabolic demand in apparently healthy young adults. Twenty-seven subjects of both sexes were analyzed and submitted to two maximum tests: 1) scaled test with 1.2 km∙h-1 every 2 min; 2) ramp test with 0.1 km∙h-1 every 0.18 min; both with 1% slope and maximum total duration of twenty minutes. Respiratory gas exchanges were directly analyzed, and ventilatory thresholds determined through visual inspection. Central tendency and dispersion measures were adopted, as well as paired t-test and effect size. Bland-Altman analysis verified the agreement among variables. Maximum speed showed significance difference (p < 0.01) for the scaled test (14.0 ± 1.9 km∙h-1) and ramp test (14.6 ± 2.3 km∙h-1). Even with small BIAS values, negative trend and high limits of agreement could be observed. Despite the non-difference presented for variables, except for maximum speed, it could be concluded that the scaled test is able to determine the analyzed variables similar to the ramp test, considering the same conditions of the present study.

ABSTRACT Purpose The 2018 American Urological Association guidelines on the Evaluation and Management of Testosterone Deficiency recommended that 300 ng/dL be used as the threshold for prescribing testosterone replacement therapy (TRT). However, it is not uncommon for men to present with signs and symptoms of testosterone deficiency, despite having testosterone levels greater than 300 ng/dL. There exists scant literature regarding the use of hCG monotherapy for the treatment of hypogonadism in men not interested in fertility. We sought to evaluate serum testosterone response and duration of therapy of hCG monotherapy for men with symptoms of hypogonadism, but total testosterone levels > 300 ng/dL. Materials and Methods We performed a multi-institutional retrospective case series of men receiving hCG monotherapy for symptomatic hypogonadism. We evaluated patient age, treatment indication, hCG dosage, past medical history, physical exam findings and serum testosterone and gonadotropins before and after therapy. Descriptive analysis was performed and Mann Whitney U Test was utilized for statistical analysis. Results Of the 20 men included in the study, treatment indications included low libido (45%), lack of energy (50%), and erectile dysfunction (45%). Mean testosterone improved by 49.9% from a baseline of 362 ng/dL (SD 158) to 519.8 ng/dL (SD 265.6), (p=0.006). Median duration of therapy was 8 months (SD 5 months). Fifty percent of patients reported symptom improvement. Conclusions Treatment of hypogonadal symptoms with hCG for men who have a baseline testosterone level > 300 ng/dL appears to be safe and efficacious with no adverse events.

Abstract INTRODUCTION: Trypanosoma cruzi is the etiological agent of Chagas disease (CD), a zoonotic infection transmitted by triatomine bug vectors to human beings. Although the story of this parasitic infection was born in Brazil and here this has made major step forward information, the same cannot be said about the actual distribution of the triatomine vector in several areas of this country. The aim of this study was to assess the occurrence of triatomine species in an endemic region for CD in Northeastern Brazil. METHODS: A retrospective study was performed using data obtained from 2008 to 2017. All information was provided by the V Gerência Regional de Saúde of the state of Pernambuco. The spatial distribution of triatomine species was analyzed by drawing a map using the Quantum geographic information system. RESULTS: A total of 4,694 triatomine specimens (469.4 ± 221.2 per year) were collected during the period 2008-2017, with 94.5% (4,434/4,694) at the intradomicile and 5.5% (260/4,694) at peridomicile environment. Of all arthropods collected, 92.5% (4,340/4,694) and 7.5% (354/4,694) were adults and nymphs, respectively. The species most frequently detected were Panstrongylus lutzi (30.36%), Triatoma brasiliensis (26.12%), Triatoma pseudomaculata (22.43%), and Panstrongylus megistus (20.54%). CONCLUSIONS: These data contribute to a better understanding of the distribution of T. cruzi infection in the Northeastern region of Brazil. Preventive measures based on vector control should be implemented in the study area in order to reduce the burden this neglected tropical disease.

Abstract The objective of this study was to assess the influence of chlorhexidine (liquid and gel) and zinc oxide in calcium hydroxide (CH) pastes on root pH in simulated external resorption. One hundred human anterior teeth with a single root canal were selected. After decoronation and root canal instrumentation, the specimens were divided into 4 experimental groups and 1 control group (without intracanal paste): CH + saline (CH+S), CH + 2% chlorhexidine liquid (CH+ CHX), CH + 2% chlorhexidine gel (CH+ CHXg), and CH + 2% chlorhexidine gel + zinc oxide (CH+ CHXg+ZnO). pH was measured using a microelectrode at 3 and 24 h, and 1, 2, 3, and 4 weeks after inserting intracanal pastes. Data were analyzed statistically using an ANOVA and Tukey’s test (p < 0.05). The CH+CHXg+ZnO group had the highest pH values throughout (p<0.05). The CH+S and CH+ CHX groups had the highest pH values after 1 week and the CH+ CHXg group after 2 weeks. CH+ CHXg maintained the highest pH until the fourth week compared with CH+ CHX (p < 0.05). The control group remained at a neutral pH at all evaluated times. It can be concluded that chlorhexidine solution or gel maintained the alkaline pH of CH, and chlorhexidine gel allowed a slower decrease in pH over time. CH+ CHXg+ZnO showed the highest pH values and was an effective intracanal medication for maintaining alkaline root pH in the area of resorption.

ABSTRACT Purpose: The baseline PSA has been proposed as a possible marker for prostate cancer. The PSA determination before 40 years seems interesting because it not suffers yet the drawbacks related to more advanced ages. Considering the scarcity of data on this topic, an analysis of PSA kinetics in this period seems interesting. Materials and Methods: A retrospective assay in a database of a private diagnostic center was performed from 2003 to 2016. All subjects with a PSA before 40 years were included. Results: 92995 patients performed PSA between the ages of 21 – 39. The mean value ranged from 0.66 ng / mL (at age 22) to 0.76 ng / mL (at age 39) and the overall mean was 0.73 ng / mL. As for outliers, 3783 individuals presented a baseline PSA > 1.6 ng / mL (p95). A linear regression model showed that each year there is a PSA increase of 0.0055 ng / mL (β = 0.0055; r2 = 0.0020; p < 0.001). A plateau in PSA between 23 and 32 years was found and there were only minimal variations among the ages regardless of the evaluated percentile. Conclusion: It was demonstrated that PSA kinetics before 40 years is a very slow and progressive phenomenon regardless of the assessed percentile. Considering our results, it could be suggested that any PSA performed in this period could represent the baseline value without significant distortions.

RESUMO O pé plano flexível é condição frequente na criança pequena e apresenta forte tendência para correção espontânea, ou tornar-se moderado ou leve no adulto, o que não causará problemas futuros. Entretanto, em uma pequena proporção de casos a deformidade é mais grave, não melhora, o que pode levar ao comprometimento do desempenho mecânico, deformidade e, eventualmente, dor. Nestes casos o tratamento cirúrgico deve ser considerado. O objetivo desta revisão sistemática foi avaliar os resultados da literatura no tratamento do pé plano flexível sintomático da criança ou adolescente por um procedimento bastante frequente que é a osteotomia de alongamento da coluna lateral do calcâneo. Foi realizada busca sistemática eletrônica nas bases de dados PubMed, Web of Science, Cochrane, CINAHL, SciELO, SCOPUS e LILACS por artigos publicados entre março de 1975 e setembro de 2016. Após aplicação dos critérios de elegibilidade, os artigos selecionados foram avaliados quanto aos resultados clínicos, radiográficos e complicações. Dos 341 artigos encontrados nas bases de dados, apenas oito estudos foram selecionados, segundo os critérios de inclusão e exclusão, com um total de 105 pacientes e 167 pés tratados. Somente três autores realizaram estudo prospectivo, mas sem caso controle ou aleatorização. A maioria das publicações no período avaliado é composta por estudos descritivos ou série de casos (nível de evidência III ou IV), com grandes variações metodológicas, mas com alto índice de satisfação dos pacientes e cirurgiões, em relação aos resultados. Entretanto, são necessárias pesquisas com desenho prospectivo, aleatorizado, grupo controle adequado e critérios de avaliação validados.

ABSTRACT Flexible flatfoot is a common condition in small children, which shows a strong tendency to spontaneously correct with their growth or to become moderate or mild in adults, which will not cause future problems. However, in a small number of cases, this condition is more severe, does not improve spontaneously, which may cause mechanical impairment, deformity, and, eventually, pain. In such cases, surgical treatment should be considered. The aim of this systematic review was to evaluate the literature results on the treatment of the symptomatic flexible flatfoot in children or adolescents through a very frequent procedure: calcaneal lateral column lengthening osteotomy, A systematic electronic search in PubMed, Web of Science, Cochrane, CINAHL, SciELO, SCOPUS and LILACS databases was performed. We searched articles published between March 1975 and September 2016. After applying the eligibility criteria, the selected publications were evaluated in relation to their clinical and radiographic results and complications. We found 341 articles in the mentioned databases, but selected only eight studies, according to the inclusion and exclusion criteria. These studies included a total of 105 patients and 167 treated feet. Only three authors performed prospective studies, but without case-control or randomization. The majority of publications were descriptive studies or case series (level of evidence III or IV), with great methodological variations, but with a high satisfaction rate on the part of both patients and surgeons in relation to the results. However, more prospective and randomized studies are required, with adequate control groups and validated evaluation criteria.