ABSTRACT Peanut (Arachis hypogaea) is an important agricultural crop in Brazil, considered one of the most important oilseed crops cultivated. The use of fertilizer-solubilizing bacteria can mitigate salt stress. The objective of this study was to evaluate the gas exchange, growth, and water use efficiency of the peanut crop irrigated with brackish water under phosphate fertilization and inoculated with bacteria of the genus Bacillus sp. The experimental design used in this study was completely randomized, in a 4 × 2 × 2 factorial scheme, with 5 replicates, referring to the forms of fertilization (F1 - 0% phosphorus, F2 - 50% phosphorus, F3 - 100% phosphorus, and F4 - bovine biofertilizer), presence and absence of the inoculant and two levels of electrical conductivity of the irrigation water (ECw - 0.3 and 4.0 dS m-1). Fertilization with organic fertilizer (100% biofertilizer) and mineral fertilizer (50 and 100% phosphorus) associated with Bacillus sp. mitigated the damage caused by salt stress and promoted greater water use efficiency, chlorophyll index, internal CO2 concentration and stem diameter. The control treatment (without phosphate fertilization and without salt stress) and the application of Bacillus sp. promoted greater performance in net photosynthesis, transpiration rate, stomatal conductance, and plant height in peanut plants. Arachis hypogaea Brazil cultivated fertilizersolubilizing solubilizing exchange growth sp randomized scheme replicates F1 F (F 0 phosphorus 50 100 biofertilizer, biofertilizer , ECw 03 3 0. 40 4. m1. m1 m 1 . m-1) (100 (5 index CO diameter photosynthesis rate conductance plants 10 m-1 (10 ( m- (1

RESUMO O amendoim (Arachis hypogaea) é uma importante cultura agrícola no Brasil, considerada uma das mais importantes oleaginosas cultivadas. O uso de bactérias solubilizadoras de fertilizantes pode mitigar o estresse salino. O objetivo deste estudo foi avaliar as trocas gasosas, o crescimento e a eficiência do uso da água da cultura do amendoim irrigado com água salobra sob adubação fosfatada e inoculada com bactérias do gênero Bacillus sp. O delineamento experimental utilizado neste estudo foi inteiramente casualizado, em esquema fatorial 4 × 2 × 2, com 5 repetições, referente às formas de adubação (F1 - 0% fósforo, F2 - 50% fósforo, F3 - 100% fósforo e F4 - bovino biofertilizante), presença e ausência do inoculante e dois níveis de condutividade elétrica da água de irrigação (CEa - 0.3 e 4.0 dS m-1). As adubações com fertilizante orgânico (100% de biofertilizante) e mineral (50 e 100% de fósforo) associada a Bacillus sp. mitigou os danos causados pelo estresse salino e proporcionou maior eficiência no uso da água, índice de clorofila, concentração interna de CO2 e diâmetro do caule. O tratamento controle (sem adubação fosfatada e sem estresse salino) e a aplicação de Bacillus sp., promoveu maior desempenho na fotossíntese líquida, taxa de transpiração, condutância estomática e altura das plantas em plantas de amendoim. Arachis hypogaea Brasil cultivadas gasosas sp casualizado repetições F1 F (F 0 50 100 biofertilizante, biofertilizante , CEa 03 3 0. 40 4. m1. m1 m 1 . m-1) (100 (5 clorofila CO caule líquida transpiração 10 m-1 (10 ( m- (1

ABSTRACT Salt stress hampers the growth and physiology of nasturtium (Tropaeolum majus), due to biochemical, physiological, and anatomical disruptions. The application of salicylic acid stands as an alternative to alleviate the detrimental effects of salt stress, but studies on nasturtium are scarce. Thus, the aim of present study was to assess the effects of foliar application of salicylic acid on nasturtium cultivated under salt stress. The experiment followed a completely randomized design in a 3 x 3 factorial scheme, with 0 (no stress), 50 (moderate salt stress), and 100 (severe salt stress) mM of NaCl, and application of 0, 0.5, and 1 mM of salicylic acid, each with six replications. Growth (plant height, stem diameter, and number of leaves), gas exchange (stomatal conductance, photosynthesis, transpiration, internal CO2 concentration, intrinsic water use efficiency, instantaneous water use efficiency, and intrinsic carboxylation efficiency), as well as chlorophyll indices and chlorophyll a fluorescence were evaluated. Salt stress affected the variables analyzed in this study. The application of salicylic acid had a positive effect on mitigating the effects of severe salt stress, resulting in a significant increase in the number of leaves. The most effective dose was 1 mM, also leading to notable improvements in water use efficiency and photochemical efficiency. However, other combinations of salinity and salicylic acid reduced growth and gas exchange in nasturtium plants. Tropaeolum majus, majus , majus) biochemical physiological disruptions scarce Thus scheme no 5 moderate 10 NaCl 05 0.5 replications plant height diameter leaves, leaves leaves) stomatal conductance photosynthesis transpiration CO concentration efficiency) evaluated However plants 0.

RESUMO O estresse salino limita o crescimento e a fisiologia da capuchinha (Tropaeolum majus), devido a distúrbios bioquímicos, fisiológicos e anatômicos. A aplicação de ácido salicílico é uma alternativa para mitigar os efeitos prejudiciais do estresse salino, no entanto, em capuchinha os estudos são escassos. Assim, objetivou-se avaliar os efeitos da aplicação de ácido salicílico via foliar em capuchinha cultivada sob estresse salino. O experimento foi realizado em delineamento inteiramente casualizado, em esquema fatorial 3 x 3, referente a 0 (sem estresse) 50 (estresse salino moderado) e 100 (estresse salino severo) mM de NaCl e aplicação de 0, 0,5 e 1 mM de ácido salicílico, com seis repetições. O crescimento (altura de planta, diâmetro do caule e número de folhas), trocas gasosas (condutância estomática, fotossíntese, transpiração, concentração interna de CO2, eficiência intrínseca do uso da água, eficiência instantânea do uso da água e eficiência intrínseca de carboxilação) e os índices de clorofila e fluorescência da clorofila a foram avaliados. O estresse salino afetou as variáveis analisadas neste estudo. A aplicação de ácido salicílico teve um efeito positivo na mitigação dos efeitos do estresse salino severo, resultando em um aumento significativo no número de folhas, sendo a dose mais eficaz a concentração de 1 mM, levando ainda, a melhorias notáveis na eficiência no uso da água e na eficiência fotoquímica. No entanto, as demais combinações de salinidade e ácido salicílico reduziram o crescimento e as trocas gasosas nas plantas de capuchinha. Tropaeolum majus, majus , majus) bioquímicos anatômicos entanto escassos Assim objetivouse objetivou se casualizado sem 5 moderado 10 severo 05 repetições altura planta folhas folhas) condutância estomática fotossíntese transpiração CO2 CO carboxilação avaliados estudo ainda fotoquímica

RESUMEN Objetivo: evaluar la necesidad de desarrollar una aplicación con información sobre la vacuna contra el sarampión para los indígenas Warao. Métodos: Estudio cuantitativo, realizado en el refugio de refugiados llamado Espacio de Acolhida Tapanã, en la ciudad de Belém, Pará, Brasil. La muestra del estudio fue por conveniencia. Los datos fueron analizados de forma descriptiva, mediante el software Bioestat 5.0. Resultados: se entrevistaron a 21 indígenas Warao. Se identificó que el 91% (n=20) perdieron su tarjeta de vacunación; el 91% (n=20) afirmó que perdió la tarjeta de vacunación más de 3 veces y el 91% afirmó que les gustaría una aplicación para guardar su información de vacunación. Conclusiones: La investigación proporcionó información importante para la construcción de una aplicación de salud llamada WaraoMedI (Warao Measles Diversity Indigenous), así como proporcionó a los profesionales de enfermería evidencia sobre las dificultades de los indígenas Warao refugiados para autogestionar información sobre vacunación Objetivo Métodos cuantitativo Tapanã Belém Pará Brasil conveniencia descriptiva 50 5 0 5.0 Resultados 2 91 n=20 n20 n 20 (n=20 Conclusiones Indigenous, Indigenous , Indigenous) 5. 9 n=2 n2 (n=2 n= (n= (n

ABSTRACT Objective: To evaluate the need to develop an application with information about the measles vaccine for Warao indigenous people. Methods: This was a quantitative study conducted at the Espaço de Acolhimento Tapanã refugee shelter in the city of Belém, Pará, Brazil. The study sample was selected for convenience. Data were analyzed descriptively using Bioestat 5.0 software. Results: Twenty-one Warao indigenous individuals were interviewed. It was identified that 91% (n=20) had lost their vaccination card; 91% (n=20) stated they had lost their vaccination card more than three times, and 91% expressed interest in an application to store their vaccination information. Conclusions: The research provided important information for the development of a health application named WaraoMedI (Warao Measles Diversity Indigenous), as well as offered nursing professionals evidence about the challenges Warao indigenous refugees face in self-managing their vaccination information. Objective people Methods Belém Pará Brazil convenience 50 5 0 5. software Results Twentyone Twenty one interviewed 91 n=20 n20 n 20 (n=20 times Conclusions Indigenous, Indigenous , Indigenous) selfmanaging self managing 9 n=2 n2 2 (n=2 n= (n= (n

RESUMO Objetivo: avaliar a necessidade de desenvolver um aplicativo com informações sobre a vacina antissarampo para indígenas Warao. Métodos: Estudo quantitativo, realizado no abrigo de refugiados chamado Espaço de Acolhimento Tapanã, na cidade de Belém, Pará, Brasil. Amostra do estudo foi por conveniência. Os dados foram analisados de forma descritiva, por meio do software Bioestat 5.0. Resultados: foram entrevistados 21 indígenas Warao. Identificou-se que 91% (n=20) perderam o cartão de vacina; 91% (n=20) afirmaram que perderam o cartão de vacina mais de 3 vezes e 91% afirmaram que gostariam de um aplicativo para guardar suas informações de vacina. Conclusões: A pesquisa ofereceu informações importantes para a construção de um aplicativo em saúde chamado WaraoMedI (Warao Mesles Diversity Indigenous), assim como disponibilizou aos profissionais de enfermagem evidências sobre as dificuldades de os indígenas Warao refugiados autogerenciarem informações sobre vacina. Objetivo Métodos quantitativo Tapanã Belém Pará Brasil conveniência descritiva 50 5 0 5.0 Resultados 2 Identificouse Identificou se 91 n=20 n20 n 20 (n=20 Conclusões Indigenous, Indigenous , Indigenous) 5. 9 n=2 n2 (n=2 n= (n= (n

Abstract Objective To analyze marital outcomes, divorce or separation, and its association with demographic, socioeconomic, and clinicopathological factors among breast cancer (BC) survivors after 2-years of diagnosis. Methods We performed a retrospective analysis of marital status at baseline and at years 1 and 2 of follow-up of women aged ≥ 18 years diagnosed with invasive BC participating in the AMAZONA III (GBECAM0115) study. The BC diagnosis occurred between January 2016 and March 2018 at 23 institutions in Brazil. Results Of the 2974 women enrolled in AMAZONA III, 599 were married or living under common law at baseline. Divorce or separation occurred in 35 (5.8%) patients at 2 years of follow-up. In the multivariate analysis, public health insurance coverage was associated with a higher risk of marital status change (8.25% vs. 2.79%, RR 3.09, 95% CI 1.39 - 7.03, p = 0.007). Women who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation (8.1% vs. 4.49%, RR 1.97, 95 CI 1.04 – 3.72, p = 0.0366) than those who underwent breast-conserving surgery. Conclusion Women covered by the public health system and those who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation. This evidence further supports the idea that long-term marital stability is associated with a complex interplay between socioeconomic conditions and stressors, such as BC diagnosis and treatment. ClinicalTrials Registration: NCT02663973. outcomes demographic (BC 2years followup follow up GBECAM0115 GBECAM (GBECAM0115 study 201 Brazil 297 59 3 5.8% 58 5 8 (5.8% followup. up. 8.25% 825 25 (8.25 vs 279 79 2.79% 309 09 3.09 139 39 1.3 703 7 03 7.03 0.007. 0007 0.007 . 0 007 0.007) skinsparing skin sparing 8.1% 81 (8.1 449 4 49 4.49% 197 97 1.97 9 104 04 1.0 372 72 3.72 0.0366 00366 0366 breastconserving conserving surgery longterm long term stressors treatment Registration NCT02663973 NCT GBECAM011 (GBECAM011 20 29 5.8 (5.8 8.25 82 (8.2 27 2.79 30 3.0 13 1. 70 7.0 000 0.00 00 8.1 (8. 44 4.49 19 1.9 10 37 3.7 0.036 0036 036 NCT0266397 GBECAM01 (GBECAM01 5. (5. 8.2 2.7 3. 7. 0.0 8. (8 4.4 0.03 003 NCT026639 GBECAM0 (GBECAM0 (5 2. 0. ( 4. NCT02663 (GBECAM NCT0266 NCT026 NCT02 NCT0

Abstract Introduction Treatment-free remission (TFR) is successful in half of the patients with chronic myeloid leukemia who discontinue Imatinib (IM) after sustained molecular response. Methods In a prospective trial, we used pioglitazone for 3 months before stopping IM in 30 patients. Percentages of peripheral blood lymphocyte subsets were assessed before and after treatment. The relation of these data with duration of IM treatment and TRF were examined. Results The median time of IM treatment was 117.6 months. After discontinuation, 11 patients had molecular recurrence after 5.2 months (2.4 - 30). The observation time for those remaining in TFR was 46 (26 - 56) months. The independent factors for the maintenance of TFR were the duration of IM treatment and the percentage of double-positive T cells at IM stop. Conclusion A longer treatment with imatinib was associated with a longer TFR after discontinuation. Pioglitazone could act as an immunomodulator, increasing DP T cells which may contribute to prevent relapse. Treatmentfree Treatment free (TFR (IM response trial examined 1176 117 6 117. discontinuation 1 52 5 2 5. 2.4 24 4 (2. 30. . 30) 26 (2 56 doublepositive double positive stop immunomodulator relapse 2. (

Abstract Objective To review key evidence-based recommendations for the diagnosis and treatment of peripheral facial palsy in children and adults. Methods Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on peripheral facial palsy were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results The topics were divided into 2 main parts: (1) Evaluation and diagnosis of facial palsy: electrophysiologic tests, idiopathic facial palsy, Ramsay Hunt syndrome, traumatic peripheral facial palsy, recurrent peripheral facial palsy, facial nerve tumors, and peripheral facial palsy in children; and (2) Rehabilitation procedures: surgical decompression of the facial nerve, facial nerve grafting, surgical treatment of long-term peripheral facial palsy, and non-surgical rehabilitation of the facial nerve. Conclusions Peripheral facial palsy is a condition of diverse etiology. Treatment should be individualized according to the cause of facial nerve dysfunction, but the literature presents better evidence-based recommendations for systemic corticosteroid therapy. evidencebased based adults methods search citations studies inclusion Physicians Associations Association s interventions parts 1 (1 tests syndrome tumors (2 procedures grafting longterm long term nonsurgical non etiology dysfunction therapy (

ABSTRACT This research sought to identify the ideal timeframe for replacing a Harvester, used in forest harvesting, employing a comparative evaluation of different economic methods. A John Deere 1270D harvester, equipped with a 270-model head was utilized in this study. The machine’s cost per hour worked was calculated by adding fixed costs with variable costs. The methods used to determine the machine’s optimal replacement time were: the Total Average Cost (TAC) and the Equivalent Annual Cost (EAC), which consider discrete functions, and the Terminal Cycle and Constant Chain Replacement, which consider continuous functions. The four methods differed in their indication of the optimal replacement time for the harvester. Although the TAC is a simple and well-known method, it did not yield an adequate result (2 years). This is because replacing a forest machine usually occurs over a longer period of use, with current preventive and predictive maintenance routines. This discrepancy arises from the high acquisition and operational costs, as well as the method’s failure to account for the variation of capital over time (interest rate) and the revenues or production of the harvester, which significantly affects the analysis. Utilizing the discount rate, the EAC proved to be more efficient than the TAC, yielding a result that is more aligned with the reality of the forest sector (6 years). Furthermore, it is the most widespread method in machine and equipment replacement studies due to its simplicity, ease of application, and efficiency. The Chain Replacement method provided an optimal replacement time between 7 and 8 years, also consistent with the reality of companies in the forest sector engaged in forest harvesting for an extended period. Therefore, this method can be considered in decision-making as it takes into account the cost and revenue variables of the machine. Determining the useful life of a machine used in forest harvesting from an economic perspective, or the period in which it performs its activities with the lowest operational cost, is directly related to its lowest production cost. In the present study, the most suitable methods to determine the optimal replacement time for the harvester were the EAC and the Chain Replacement method. Harvester D 270model model 270 study machines s (TAC EAC, , (EAC) functions wellknown known 2 ( years. years . years) use routines interest rate analysis 6 Furthermore simplicity application efficiency Therefore decisionmaking decision making perspective 27 (EAC

RESUMO O objetivo deste trabalho foi identificar o momento ótimo para substituição de um Harvester utilizado na colheita florestal, comparando diferentes métodos econômicos. A máquina florestal utilizada foi o Harvester John Deere modelo 1270D, com cabeçote modelo 270. O custo da máquina por hora trabalhada foi calculado pela soma dos custos fixos com os custos variáveis. Os métodos utilizados para determinação da substituição ótima da máquina foram o Custo Médio Total (CMT) e o Custo Anual Equivalente (CAE), que consideram funções discretas e o Ciclo Terminal e Cadeia de Substituição Constante, que consideram funções contínuas. Os quatro métodos utilizados diferiram entre si na indicação do momento ótimo de substituição do Harvester. O CMT, apesar de ser um método simples e conhecido, não conduziu a um resultado adequado (2 anos), pois, a substituição de uma máquina florestal é usualmente feita com um período maior de uso, com as atuais rotinas de manutenção preventivas e preditivas. Tal divergência é justificada devido aos elevados valores de aquisição e de custo operacional, além do método não considerar a variação do capital no tempo (a taxa de juros) e as receitas ou a produção do Harvester, o que impacta drasticamente a análise. O CAE, por utilizar a taxa de desconto, foi mais eficiente que o CMT e forneceu um resultado mais coerente com a realidade do setor florestal, sendo 6 anos. Além disso, é o método mais difundido nos estudos de substituição de máquinas e equipamentos, por ser simples, de fácil aplicação e eficiente. Já o método da Cadeia de Substituição forneceu um momento ótimo de substituição entre 7 e 8 anos, também coerente com a realidade das empresas do setor florestal que praticam a atividade de colheita florestal por um longo período. Portanto, este método pode ser considerado na tomada de decisão, por considerar as variáveis de custo e receita da máquina. A determinação da vida útil de uma máquina utilizada na colheita florestal, do ponto de vista econômico, ou o período em que ela executa suas atividades com menor custo operacional está diretamente relacionada com seu menor custo de produção, e no presente estudo, os métodos mais adequados para determinar o momento ótimo de substituição do Harvester foram o CAE e o método da Cadeia de Substituição. econômicos 1270D D 270 (CMT , (CAE) Constante contínuas conhecido 2 ( anos anos) pois uso preditivas juros análise desconto disso equipamentos Portanto decisão econômico estudo 27 (CAE

Abstract By an analytical-interpretative effort of re-reading the historical facts regarding the idea, proposal, movement, and process of the Brazilian Health Care Reform (HCR) in light of decolonial and Black Feminist theories and critics, this study aims to propose an epistemological and political turn toward a decolonial health praxis. In a first moment, it reflects about some points of incoherence of certain dimensions in the HCR proposal. The second part of this studyd (re)positions this analysis concerning the coloniality situation in Brazil regarding what lies at stake in the attempt of “life redemocratization” in this country. Finally, it highlights that despite much progress to be made, the Brazilian Health Reform is assuredly not a “denatured movement.” analyticalinterpretative analytical interpretative rereading re reading idea proposal movement (HCR critics praxis moment repositions positions life redemocratization country Finally made denatured movement.

Resumo Por meio de um esforço analítico-interpretativo de releitura dos fatos históricos apresentados acerca da ideia, da proposta, do movimento e do processo da Reforma Sanitária Brasileira (RSB), e à luz das teorias e críticas decolonial e feminista negra, este artigo de cunho ensaístico tem como objetivo propor um giro epistemológico e político para uma práxis sanitária decolonial. Em um primeiro momento, reflete acerca de alguns pontos de incoerência de certas dimensões da RSB que possivelmente contribuíram para que houvesse promessas não cumpridas em sua proposta. Na segunda parte do trabalho, (re)posiciona a analítica concernente à situação de colonialidade no Brasil com relação ao que está em jogo, na tentativa de “redemocratizar a vida” neste país. Finalmente, evidencia-se que, apesar de haver muito a avançar, asseguradamente a RSB não é um “movimento desnaturado”. analíticointerpretativo analítico interpretativo ideia proposta RSB, , (RSB) negra momento trabalho reposiciona re posiciona jogo redemocratizar vida país Finalmente evidenciase evidencia se avançar desnaturado. desnaturado . desnaturado” (RSB

Abstract By an analytical-interpretative effort of re-reading the historical facts regarding the idea, proposal, movement, and process of the Brazilian Health Care Reform (HCR) in light of decolonial and Black Feminist theories and critics, this study aims to propose an epistemological and political turn toward a decolonial health praxis. In a first moment, it reflects about some points of incoherence of certain dimensions in the HCR proposal. The second part of this studyd (re)positions this analysis concerning the coloniality situation in Brazil regarding what lies at stake in the attempt of “life redemocratization” in this country. Finally, it highlights that despite much progress to be made, the Brazilian Health Reform is assuredly not a “denatured movement.”

Resumo Por meio de um esforço analítico-interpretativo de releitura dos fatos históricos apresentados acerca da ideia, da proposta, do movimento e do processo da Reforma Sanitária Brasileira (RSB), e à luz das teorias e críticas decolonial e feminista negra, este artigo de cunho ensaístico tem como objetivo propor um giro epistemológico e político para uma práxis sanitária decolonial. Em um primeiro momento, reflete acerca de alguns pontos de incoerência de certas dimensões da RSB que possivelmente contribuíram para que houvesse promessas não cumpridas em sua proposta. Na segunda parte do trabalho, (re)posiciona a analítica concernente à situação de colonialidade no Brasil com relação ao que está em jogo, na tentativa de “redemocratizar a vida” neste país. Finalmente, evidencia-se que, apesar de haver muito a avançar, asseguradamente a RSB não é um “movimento desnaturado”.

Resumo Introdução: O diagnóstico por imagem da neoplasia pseudopapilar sólida do pâncreas (NPS) é difícil. O diagnóstico pré-operatório obtido pela endosonografia com punção aspirativa por agulha fina (USE-PAF) é possível e tem sido relatado na literatura em tumores do pâncreas. No entanto, sua indicação é controversa e merece discussão. O objetivo do estudo foi determinar a acurácia da USE-PAF no diagnóstico de pacientes com NPS, descrever os achados da tomografia computadorizada (TC), colangiopancreatografia por ressonância magnética (RM/CPRM) e USE, comparando os métodos de imagem isolados aos achados da microhistologia (McH) obtida pela USE-PAF. Material e Métodos: Revisamos retrospectivamente os prontuários de pacientes submetidos à USE-PAF com suspeita de NPS em exames de imagem de 5 hospitais brasileiros de alto volume (dois universitários e três privados). Foram anotados prospectivamente os dados demográficos, os achados da TC, RM/CPRM e USE e o re sultado da McH obtida pela USE-PAF. O diagnóstico final foi obtido após o anatomopatológico da peça operatória em todos os pacientes (padrão-ouro). Comparamos os resultados da TC, RM/CPRM, EUS isoladas e da McH obtida pela USE-PAF com o padrão-ouro. Resultados: Cinquenta e quatro pacientes foram incluídos no estudo, 49 (90.7%) eram mulheres com média de idade de 33.4 (11-78) anos. O sintoma mais frequente foi dor abdominal, presente em 35.2%. A NPS foi detectada acidentalmente em 32 (59%) pacientes. O tamanho médio da lesão foi de 3.8 cm (SD: 2.26). O achado mais comum à USE foi lesão sólida, sólida/cística e cística em 52.9%, 41.1% e 7.8%, respectivamente. O diagnóstico final foi NPS (51) e tumor neuroendócrino pancreático não funcionante [NF-NET] (3). O diagnóstico correto feito pela TC, RM, USE e USE-PAF foi feito em 21.9%, 28.9%, 64.7% e 88.2, respectivamente. A USE-PAF associada a TC e a RM aumentou o desempenho diagnóstico de 21.9% para 94.1% e de 28.8% para 94.1%, respectivamente. Conclusões: NPS são raras, identificadas de forma acidental na maioria dos casos e afetam principalmente mulheres jovens. O diagnóstico diferencial entre NPS, NF-NET e outros tipos de lesões com exames de imagem isolados pode ser difícil. A USE-PAF aumenta a chance do diagnóstico pré-operatório em caso de dúvida diagnóstica e deve ser usado sempre que necessário para descartar NF-NET ou outro tipo de lesão nodular sólida ou sólido/cística do pâncreas.

Abstract Introduction: Imaging diagnosis of pancreatic solid-pseudo-papillary neoplasms (SPNs) is difficult. Preoperative diagnosis by endosonography-guided fine-needle aspiration (EUS-FNA) is possible and has been reported in the literature in pancreatic tumors. However, its usefulness is still controversial. The aim of this study was to determine the accuracy of the EUS-FNA in the diagnosis of patients with SPN and describe the findings in computerized tomography (CT), magnetic resonance cholangiopancreatography imaging (MRI/ MRCP), and EUS therefore comparing the imaging methods alone to the findings of microhistology (McH) obtained by EUS-FNA. Materials and Methods: We retrospectively reviewed the medical records of patients undergoing EUS-FNA with suspected SPN in imaging studies in 5 Brazilian high-volume hospitals (two university hospitals and three private hos-pitals). The demographic data; findings in CT, MRI/MRCP, and EUS; and McH results obtained by EUS-FNA were noted prospectively. The final diagnosis was obtained after the anatomopathological examination of the surgical specimen in all patients (gold standard), and we compared the results of CT, MRI/MRCP, EUS, and the McH with the gold standard. Results: Fifty-four patients were included in the study, of which 49 (90.7%) were women with an average age of 33.4 (range 11-78) years. The most common symptom presented was abdominal pain, present in 35.2% patients. SPN was detected incidentally in 32 (59%) patients. The average size of the tumors was 3.8 cm (SD: 2.26). The most common finding at EUS was a solid, solid/cystic, and cystic lesion in 52.9%, 41.1%, and 7.8% patients, respectively. The final diagnosis was 51 patients with SPN and 3 with nonfunctioning pancreatic neuro-endocrine tumors (NF-NET). The correct diagnosis was made by CT, MRI/MRCP, EUS isolated, and EUS-FNA in 21.9%, 28.88%, 64.71%, and 88.24%, respectively. EUS-FNA associated with CT and MRI increased diagnostic performance from 22.72% to 94.11% and from 29.16% to 94.11%, respectively. Conclusions: SPN are rare, incidentally identified in most cases, and affect young women. Differential diagnosis between SPN, NF-NET, and other types of tumors with imaging tests can be difficult. EUS-FNA increases preoperative diagnosis in case of diagnostic doubt and should be used whenever necessary to rule out NF-NET or other type of solid/cystic nodular lesion of the pancreas.

Abstract Objectives: To review and provide evidence-based recommendations for the diagnosis and treatment of otosclerosis. Methods: Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on otosclerosis were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results: The topics were divided into 2 parts: 1) Diagnosis – audiologic and radiologic; 2) Treatment – hearing AIDS, pharmacological therapy, stapes surgery, and implantable devices - bone-anchored devices, active middle ear implants, and Cochlear Implants (CI). Conclusions: The pathophysiology of otosclerosis has not yet been fully elucidated, but environmental factors and unidentified genes are likely to play a significant role in it. Women with otosclerosis are not at increased risk of worsening clinical condition due to the use of contraceptives or during pregnancy. Drug treatment has shown little benefit. If the patient does not want to undergo stapedotomy, the use of hearing aids is well indicated. Implantable systems should be indicated only in rare cases, and the CI should be indicated in cases of profound deafness. Objectives evidencebased based Methods methods search citations studies inclusion Physicians Associations Association s interventions Results parts 1 radiologic AIDS therapy surgery boneanchored bone anchored implants CI. . (CI) Conclusions elucidated it pregnancy benefit stapedotomy deafness (CI

RESUMO O Transtorno do Espectro Autista (TEA) é um transtorno neurobiológico multifatorial do desenvolvimento; que compromete as áreas de interação e linguagem. As crianças com TEA apresentam um déficit no desenvolvimento motor e na aquisição das habilidades motoras quando comparadas com seus pares sem autismo. Outro aspecto marcante nesta população é a presença da hipotonia e a diminuição da força muscular. Pode-se observar que a redução da força muscular está intimamente ligada a níveis de condicionamento físico diminuídos, e nas crianças com TEA, este cenário é muito presente. Sendo assim, neste estudo, testou-se a viabilidade de oito semanas de um treinamento de força para uma criança com TEA, objetivando a melhora da força muscular, bem como no condicionamento físico geral. O presente estudo defende uma nova abordagem de intervenção para além dos aspectos motores, em crianças com esse transtorno. Um paciente do sexo masculino com TEA de 4 anos foi voluntário, com consentimento dos responsáveis, para uma intervenção de oito semanas de treinamento de força, onde realizou um programa de treinamento, três vezes por semana com duração média de 40 minutos. Os seguintes testes foram realizados antes e após a intervenção de oito semanas: salto horizontal, salto vertical (CMJ), arremesso com a medicine ball (2kg) e uma repetição máxima predita do levantamento terra. O exercício de levantamento terra apresentou um aumento de 32% em relação à carga inicial. Os outros exercícios também tiveram um resultado positivo quando comparados ao teste inicial (pré), tendo uma adição de 16,4% para o salto horizontal, 16% para o salto vertical e 14,7% para o arremesso com a medicine ball. Um total de oito semanas de Treinamento de força levou a melhorias no ganho de força e nos testes de condicionamento físico, sugerindo que este tipo de abordagem pode constituir uma alternativa promissora e prática aos métodos tradicionais de intervenção com crianças com TEA. O treinamento de força pode servir como uma abordagem viável para melhorar a força e o condicionamento físico geral de uma criança com TEA.

ABSTRACT Autism is a multifactorial developmental neurobiological disorder; that compromises the areas of interaction and language. Children with ASD present a deficit in motor development and in the acquisition of motor skills when compared to their peers without ASD. Another striking aspect in this population is the presence of hypotonia and decreased muscle strength. It can be seen that the decrease in muscle strength is closely linked to decreased levels of physical conditioning, and in children with ASD, this scenario is very present. Therefore, in this study, the feasibility of strength training for a child with ASD was tested, aiming to improve muscle strength and general physical conditioning. A 4-year-old male patient with ASD volunteered, with parental consent, for an 8-week strength training intervention, where he performed a training program 3 times a week with an average duration of 40 minutes. The following tests were performed before and after the 8-week intervention: horizontal jump, vertical jump (CMJ), medicine ball throw (2 kg) and a predicted maximum repetition of the deadlift. The deadlift exercise showed a 32% increase in relation to the initial load. The other exercises also had a positive result when compared to the initial test (pre), having an addition of 16.4% for the horizontal jump, 16% for the vertical jump, and 14.7% for the medicine ball throw. A total of 8 weeks of strength training led to improvements in strength gain and fitness tests, suggesting that this type of approach may constitute a promising and practical alternative to traditional methods of intervention with children with ASD. Strength training can serve as a viable approach to improving the strength and overall fitness of a child with ASD.

In this work, cellulose-based composite biofilms doped with silver nanoparticles (AgNPs) have been produced by eco-friendly process. The AgNPs were synthesized from Ilex paraguariensis with an average size of 45 nm, a characteristic plasmon band at 450 nm and zeta potential of -23 mV. The biofilm has been synthesized by casting method, using different volumes of AgNPs suspension with glycerol plasticizing agent (T6-T10) or not (T1-T5). The AgNPs were successfully incorporated into the biofilms, which was confirmed by scanning electron microscopy. The mechanical and optical structural and the antimicrobial properties of the biofilms have been determined. In the presence of AgNPs, the mechanical properties, thermal stability and water vapor barrier of the biofilms have not been altered. However, the addition of glycerol decreased the tensile strength and the modulus of elasticity, in addition to increasing the elongation of the biofilms and the water vapor barrier. The biofilm T10 showed a transmittance of ca. 10%, with high potential to be used as a UV light blocker. Finally, the biofilms doped with AgNPs showed activity against the bacterium Pseudomonas fluorescens. Given the above, this work presented a new biofilm with activity against the bacterium Pseudomonus fluorescens obtained by eco-friendly process. cellulosebased cellulose based (AgNPs ecofriendly eco friendly process 4 23 -2 mV method T6T10 TT T6 T (T6-T10 T1T5. T1T5 T1 T5 . (T1-T5) microscopy determined altered However elasticity ca 10 10% blocker Finally above 2 - T6T1 (T6-T1 T1T (T1-T5 1 T6T (T6-T (T1-T

ABSTRACT Objectives: To evaluate the factors associated with mortality in mechanically ventilated patients with acute respiratory distress syndrome due to COVID-19. Methods: This was a retrospective, multicenter cohort study that included 425 mechanically ventilated adult patients with COVID-19 admitted to 4 intensive care units. Clinical data comprising the SOFA score, laboratory data and mechanical characteristics of the respiratory system were collected in a standardized way immediately after the start of invasive mechanical ventilation. The risk factors for death were analyzed using Cox regression to estimate the risk ratios and their respective 95%CIs. Results: Body mass index (RR 1.17; 95%CI 1.11 - 1.20; p < 0.001), SOFA score (RR 1.39; 95%CI 1.31 - 1.49; p < 0.001) and driving pressure (RR 1.24; 95%CI 1.21 - 1.29; p < 0.001) were considered independent factors associated with mortality in mechanically ventilated patients with acute respiratory distress syndrome due to COVID-19. Respiratory system compliance (RR 0.92; 95%CI 0.90 - 0.93; p < 0.001) was associated with lower mortality. The comparative analysis of the survival curves indicated that patients with respiratory system compliance (< 30mL/cmH2O), a higher SOFA score (> 5 points) and higher driving pressure (> 14cmH2O) were more significantly associated with the outcome of death at 28 days and 60 days. Conclusion: Patients with a body mass index > 32kg/m2, respiratory system compliance < 30mL/cmH2O, driving pressure > 14cmH2O and SOFA score > 5.8 immediately after the initiation of invasive ventilatory support had worse outcomes, and independent risk factors were associated with higher mortality in this population. Objectives COVID19. COVID19 COVID 19. 19 Methods retrospective 42 COVID-1 units ventilation 95CIs CIs 95 95%CIs Results RR 1.17 117 1 17 95CI CI 111 11 1.1 1.20 120 20 0.001, 0001 0.001 , 0 001 1.39 139 39 131 31 1.3 1.49 149 49 1.24 124 24 121 21 1.2 1.29 129 29 0.92 092 92 090 90 0.9 0.93 093 93 ( 30mLcmH2O mLcmHO 30mL/cmH2O 30mL cmH2O mL cmH O 30mL/cmH2O) points cmHO 2 6 Conclusion 32kgm2 kgm 32kg m2 kg m 32kg/m2 58 8 5. outcomes population COVID1 COVID- 9 1. 12 000 0.00 00 13 3 1.4 14 09 0. mLcmH 32kgm 32kg/m 0.0

RESUMO Objetivos: Avaliar os fatores associados à mortalidade em pacientes ventilados mecanicamente com síndrome o desconforto respiratório agudo por evolução da COVID-19. Métodos: Estudo de coorte retrospectiva, multicêntrica, que incluiu 425 pacientes adultos com COVID-19, ventilados mecanicamente, internados em 4 unidades de terapia intensiva. Foram coletados dados clínicos que compõem o escore SOFA, dados laboratoriais e características mecânicas do sistema respiratório, de forma padronizada, imediatamente após o início da ventilação mecânica invasiva. Os fatores de risco para óbito foram analisados por meio da regressão de Cox, para estimar as razões de risco, e seus respectivos IC95%. Resultados: Índice de massa corporal (RR de 1,17; IC95% 1,11 - 1,20; p < 0,001), escore SOFA (RR de 1,39; IC95% 1,31 - 1,49; p < 0,001) e driving pressure (RR de 1,24; IC95% 1,21 - 1,29; p < 0,001) foram considerados fatores independentes associados à mortalidade em pacientes ventilados mecanicamente com síndrome do desconforto respiratório agudo por COVID-19. Já a complacência do sistema respiratório (RR de 0,92; IC95% 0,90 - 0,93; p < 0,001) foi associada à menor mortalidade. A análise comparativa das curvas de sobrevida demonstra que pacientes com complacência do sistema respiratório (< 30mL/cmH2O), maior SOFA escore (> 5 pontos) e maior driving pressure (> 14cmH2O) apresentaram maior associação ao desfecho morte em 28 dias e 60 dias. Conclusão: Pacientes com índice de massa corporal > 32kg/m2, complacência do sistema respiratório < 30mL/cmH2O, driving pressure > 14cmH2O e SOFA escore > 5,8, imediatamente após o início da assistência ventilatória invasiva, apresentam piores desfechos no segmento, sendo fatores de risco independentes associados à maior mortalidade nessa população. Objetivos COVID19. COVID19 COVID 19. 19 COVID-19 Métodos retrospectiva multicêntrica 42 COVID19, 19, intensiva padronizada invasiva Cox IC95 IC Resultados RR 1,17 117 1 17 111 11 1,1 1,20 120 20 0,001, 0001 0,001 , 0 001 1,39 139 39 131 31 1,3 1,49 149 49 1,24 124 24 121 21 1,2 1,29 129 29 0,92 092 92 090 90 0,9 0,93 093 93 ( 30mLcmH2O mLcmHO 30mL/cmH2O 30mL cmH2O mL cmH O 30mL/cmH2O) pontos cmHO 2 6 Conclusão 32kgm2 kgm 32kg m2 kg m 32kg/m2 58 8 5,8 segmento população COVID1 COVID-1 IC9 1, 12 000 0,00 00 13 3 1,4 14 09 9 0, mLcmH 32kgm 32kg/m 5, COVID- 0,0

Abstract Objectives: To provide an overview of the main evidence-based recommendations for the diagnosis of hearing loss in children and adolescents aged 0–18 years. Methods: Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on childhood hearing loss were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results: The topics were divided into 2 parts: (1) treatment of sensorineural hearing loss: individual hearing aids, bilateral cochlear implants, cochlear implants in young children, unilateral hearing loss, and auditory neuropathy spectrum disorder; and (2) treatment of conductive/mixed hearing loss: external/middle ear malformations, ventilation tube insertion, and tympanoplasty in children. Conclusions: In children with hearing loss, in addition to speech therapy, Hearing AIDS (HAs) or implantable systems may be indicated. Even in children with profound hearing loss, both the use of HAs and behavioral assessments while using the device are important. Objectives evidencebased based 018 0 18 0–1 years Methods methods search citations studies inclusion Physicians Associations Association s interventions Results parts 1 (1 aids disorder (2 conductivemixed conductive mixed externalmiddle external middle malformations insertion Conclusions therapy (HAs indicated important 01 0– (