RESUMEN Latinoamérica presenta una alta prevalencia de infección por Helicobacter pylori (Hp). Entre 1996-2003 la prevalencia en Santiago de Chile fue del 70%; estudios recientes presentan una disminución en esta infección. Actualizar la frecuencia de Hp es fundamental debido a su impacto en la salud asociado. Objetivo: Nuestro objetivo fue describir la tendencia de la infección por Hp en pacientes que asisten a endoscopía digestiva alta (EDA) ambulatoria en una población chilena. Materiales y métodos: Se realizó un estudio observacional retrospectivo de pacientes mayores de 18 años que asistieron a una primera EDA con test rápido de ureasa entre 2010-2020. La tendencia en el tiempo fue descrita mediante análisis de series de tiempo. Se construyó un modelo Poisson para estimar el riesgo de infección, ajustado por edad y sexo. Resultados: Se incluyeron 11 355 pacientes [66,9% mujeres; edad media 52 años; Hp 41,6%]. El sexo masculino presentó una mayor frecuencia de infección por Hp [RR 1,13; (IC95%:1,08-1,18)]. La frecuencia de Hp disminuyó significativamente desde 45,1% en 2010 hasta 29% en 2020, con 36% menor probabilidad de presentar infección por Hp en 2020 con respecto al 2010 [RR 0,64; (IC95%:0,55-0,74)]. Se proyectó un descenso progresivo en la tendencia de infección por Hp hasta valores cercanos al 25% para el año 2025. Conclusión: Se observó una reducción significativa en la infección por Hp entre los años 2010-2020. Esta disminución pudiese ser explicada mediante la incorporación de políticas públicas de salud en la última década asociadas a cambios sociosanitarios.

ABSTRACT Latin America presents a high prevalence of Helicobacter pylori (Hp) infection. Between 1996-2003, the prevalence in Santiago, Chile, was 70%; recent studies indicate a decrease in this infection. Updating the frequency of Hp is crucial due to its associated health impact. Objective: Our objective was to describe the trend in Hp infection in patients undergoing ambulatory esophagogastroduodenoscopy (EGD) in a Chilean population. Materials and methods: A retrospective observational study was conducted on patients over 18 years old who attended a first EGD with a rapid urease test between 2010-2020. Time trends were described through time series analysis. A Poisson model was constructed to estimate the risk of infection, adjusted for age and gender. Results: 11,355 patients were included [66.9% females; mean age 52 years; Hp 41.6%]. Male gender presented a higher frequency of Hp infection [RR 1.13; (95% CI: 1.08-1.18)]. Hp frequency infection decreased significantly from 45.1% in 2010 to 29% in 2020, with a 36% lower probability of Hp infection in 2020 compared to 2010 [RR 0.64; (95% CI: 0.55-0.74)]. A progressive decline in Hp infection trend was projected, reaching values close to 25% by year 2025. Conclusion: A significant reduction in Hp infection was observed between 2010-2020. This decrease could be explained by the implementation of public health policies in the last decade associated with socio-sanitary changes.

ABSTRACT The physical and microbiological characteristics of the soil are indicators considered in the assessment of the conditions of anthropized areas and are tools to identify levels of degradation, define the best crops, and thus, propose actions that help the producer to choose the appropriate soil management. In this regard, the aim of this work was to analyze the physical and microbiological properties of the soil in different agricultural production systems and in a preserved area. The research was carried out at a property located in the municipality of Campo Novo do Parecis - MT, Cerrado`s Biome. For the physical analysis, samples at depths of 0-0.10 m, 0.10-0.20 m and 0.20-0.30 m in five locations were collected randomly, within each production system and in the forest fragment. To evaluate the microbial activity of the soil, soil samples were collected at the 0-0.10 m layer also in five locations. All uses showed changes in physical characteristics, when compared to natural conditions. In the microbiological analysis, the integrated systems did not present significant differences in relation to the organic matter and the basal respiration of the soil when compared with the conventional systems and the forest fragment. The carbon of the microbial biomass of the soil and the metabolic quotient showed a difference between the systems of use and the preserved area. degradation crops thus management regard area MT Cerrados Cerrado s Biome analysis 00.10 0010 0 0.10 10 0-0.1 0.100.20 010020 0.20 20 0.10-0.2 0.200.30 020030 0.30 30 0.20-0.3 randomly fragment 00 00.1 001 010 0.1 1 0-0. 100 0.100.2 01002 020 0.2 2 0.10-0. 200 0.200.3 02003 030 0.3 3 0.20-0. 00. 01 0. 0-0 0.100. 0100 02 0.10-0 0.200. 0200 03 0.20-0 0- 0.100 0.10- 0.200 0.20-

ABSTRACT. Climate change and the expansion of agricultural lands to low-fertility soils have prompted studies on the effects of water and nutritional stress on nutrient uptake and use. This study aimed to evaluate the efficiency of absorption, translocation, and use of N in coffee cultivars under water stress (WS) and different N doses. The experiment was performed hydroponically and arranged in a 4 × 2 × 4 factorial randomized block design with three replications. These factors consisted of four coffee varieties, two N doses, and four levels of WS. At the end of the experiment, the dry matter production, N concentration, and N accumulation of plants, as well as nutritional efficiency indices were evaluated. The data were subjected to analysis of variance and regression. The results showed that in plants previously well-supplied with N, N stress induces greater allocation of dry matter in roots, mitigating the effects of subsequent water deficits on shoot dry matter production. Young Mundo Novo plants subjected to N stress followed by increasing water stress maintained a high utilization efficiency (UE). Young Acauã plants well-supplied with N, maintained their N utilization efficiency up to -1.6 MPa of water stress; however, when they were N starved, they underwent a drastic reduction in UE at potentials below -0.22 MPa. ABSTRACT lowfertility low fertility absorption translocation WS (WS doses replications varieties production concentration evaluated regression wellsupplied supplied roots UE. . (UE) 1.6 16 1 6 -1. however starved 0.22 022 0 22 -0.2 (UE 1. -1 0.2 02 -0. - 0. -0

ABSTRACT COVID-19 is a multisystemic disease, with functional and late consequences still under study. Psychological and neurocognitive sequelae impact workers’ quality of life and may compromise the Work Ability (WA). The objective was to investigate the WA of people infected with SARS-CoV-2, correlating it with the assessment of sleepiness, anxiety, depression and fatigue. Cross-sectional study, involving workers diagnosed with COVID-19 under follow-up at the Department of Neurology of Universidade Estadual de Campinas (UNICAMP). Application of the Work Ability Index (WAI) analyzed with sociodemographic and occupational variables, as well the sleepiness, anxiety, depression and fatigue scales. Multiple logistic regression analysis was performed. 119 workers participated in the study and, among them, more than half had WA impairment (52.9%). Emotional disorders were the most frequent reported problem (31.9%). Multiple logistic regression showed that the interaction between anxiety and sleepiness was associated with WA impairment (OR=4.50, p=0.002). Anxiety and sleepiness were associated with previous COVID-19 and they were associated with WA impairment among workers. This study shows the WA evaluation should be provided for all workers with a previous history of COVID-19, when they return to work. This assessment can guide health promotion actions, functional rehabilitation and work adaptation to the sequelae presented by workers, singularly.

RESUMO A Covid-19 é uma doença multissistêmica e consequências funcionais e tardias estão em estudo. Sequelas psicológicas e neurocognitivas podem comprometer a Capacidade para o Trabalho (CT) dos trabalhadores. Objetivou-se investigar a CT de pessoas previamente infectadas pelo Sars-CoV-2, correlacionando-a com avaliação da sonolência, ansiedade, depressão e fadiga. Estudo transversal, com trabalhadores diagnosticados com Covid-19 e em acompanhamento no Serviço de Neurologia da Universidade Estadual de Campinas (Unicamp). Aplicou-se o instrumento Índice de Capacidade para o Trabalho (ICT), um formulário com dados sociodemográficos e ocupacionais, bem como escalas de sonolência, ansiedade, depressão e fadiga. Dos 119 trabalhadores que participaram do estudo, mais da metade apresentaram comprometimento da CT (52,9%). Distúrbio emocional foi o agravo relatado mais frequente (31,9%). A regressão logística múltipla mostrou que a interação entre ansiedade e sonolência esteve associada ao comprometimento da CT (OR=4,50 com p=0,002). Ansiedade e sonolência foram alterações tardias da Covid-19 e associadas ao comprometimento da CT dos trabalhadores avaliados. Este estudo demonstra a necessidade de que todos os trabalhadores com teste positivo por Covid-19 tenham sua CT avaliada por ocasião do retorno ao trabalho. Ações de promoção à saúde, reabilitação funcional e adaptação do trabalho de acordo com as sequelas apresentadas pelos trabalhadores.

ABSTRACT COVID-19 is a multisystemic disease, with functional and late consequences still under study. Psychological and neurocognitive sequelae impact workers’ quality of life and may compromise the Work Ability (WA). The objective was to investigate the WA of people infected with SARS-CoV-2, correlating it with the assessment of sleepiness, anxiety, depression and fatigue. Cross-sectional study, involving workers diagnosed with COVID-19 under follow-up at the Department of Neurology of Universidade Estadual de Campinas (UNICAMP). Application of the Work Ability Index (WAI) analyzed with sociodemographic and occupational variables, as well the sleepiness, anxiety, depression and fatigue scales. Multiple logistic regression analysis was performed. 119 workers participated in the study and, among them, more than half had WA impairment (52.9%). Emotional disorders were the most frequent reported problem (31.9%). Multiple logistic regression showed that the interaction between anxiety and sleepiness was associated with WA impairment (OR=4.50, p=0.002). Anxiety and sleepiness were associated with previous COVID-19 and they were associated with WA impairment among workers. This study shows the WA evaluation should be provided for all workers with a previous history of COVID-19, when they return to work. This assessment can guide health promotion actions, functional rehabilitation and work adaptation to the sequelae presented by workers, singularly. COVID19 COVID 19 COVID-1 disease WA. . (WA) SARSCoV2, SARSCoV2 SARSCoV SARS CoV 2, 2 SARS-CoV-2 Crosssectional Cross sectional followup follow up UNICAMP. UNICAMP (UNICAMP) WAI (WAI variables scales performed 11 them 52.9%. 529 52.9% 52 9 (52.9%) 31.9%. 319 31.9% 31 (31.9%) OR=4.50, OR450 OR 4 50 (OR=4.50 p=0.002. p0002 p p=0.002 0 002 p=0.002) COVID19, 19, actions singularly COVID1 1 COVID- (WA SARS-CoV- (UNICAMP 52.9 5 (52.9% 31.9 3 (31.9% OR=4.50 OR45 (OR=4.5 p000 p=0.00 00 SARS-CoV 52. (52.9 31. (31.9 OR=4.5 OR4 (OR=4. p00 p=0.0 (52. (31. OR=4. (OR=4 p0 p=0. (52 (31 OR=4 (OR= p=0 (5 (3 OR= (OR p= (

RESUMO A Covid-19 é uma doença multissistêmica e consequências funcionais e tardias estão em estudo. Sequelas psicológicas e neurocognitivas podem comprometer a Capacidade para o Trabalho (CT) dos trabalhadores. Objetivou-se investigar a CT de pessoas previamente infectadas pelo Sars-CoV-2, correlacionando-a com avaliação da sonolência, ansiedade, depressão e fadiga. Estudo transversal, com trabalhadores diagnosticados com Covid-19 e em acompanhamento no Serviço de Neurologia da Universidade Estadual de Campinas (Unicamp). Aplicou-se o instrumento Índice de Capacidade para o Trabalho (ICT), um formulário com dados sociodemográficos e ocupacionais, bem como escalas de sonolência, ansiedade, depressão e fadiga. Dos 119 trabalhadores que participaram do estudo, mais da metade apresentaram comprometimento da CT (52,9%). Distúrbio emocional foi o agravo relatado mais frequente (31,9%). A regressão logística múltipla mostrou que a interação entre ansiedade e sonolência esteve associada ao comprometimento da CT (OR=4,50 com p=0,002). Ansiedade e sonolência foram alterações tardias da Covid-19 e associadas ao comprometimento da CT dos trabalhadores avaliados. Este estudo demonstra a necessidade de que todos os trabalhadores com teste positivo por Covid-19 tenham sua CT avaliada por ocasião do retorno ao trabalho. Ações de promoção à saúde, reabilitação funcional e adaptação do trabalho de acordo com as sequelas apresentadas pelos trabalhadores. Covid19 Covid 19 Covid-1 (CT Objetivouse Objetivou se SarsCoV2, SarsCoV2 SarsCoV Sars CoV 2, 2 Sars-CoV-2 correlacionandoa correlacionando fadiga transversal Unicamp. Unicamp . (Unicamp) Aplicouse Aplicou ICT, ICT , (ICT) ocupacionais 11 52,9%. 529 52,9% 52 9 (52,9%) 31,9%. 319 31,9% 31 (31,9%) OR=4,50 OR450 OR 4 50 (OR=4,5 p=0,002. p0002 p p=0,002 0 002 p=0,002) avaliados saúde Covid1 1 Covid- Sars-CoV- (Unicamp (ICT 52,9 5 (52,9% 31,9 3 (31,9% OR=4,5 OR45 (OR=4, p000 p=0,00 00 Sars-CoV 52, (52,9 31, (31,9 OR=4, OR4 (OR=4 p00 p=0,0 (52, (31, OR=4 (OR= p0 p=0, (52 (31 OR= (OR p=0 (5 (3 p= (

RESUMEN El objetivo de este artículo es considerar los desafíos que se enfrentan en Colombia y Perú con respecto a la vacunación y el papel de las vacunas combinadas pediátricas para superar estos desafíos. Los obstáculos para incluir vacunas nuevas con más antígenos siguen siendo evidentes en algunos lugares de estos países, donde las enfermedades prevenibles por vacunación en menores de 1 año continúan siendo un grave problema. Entre los desafíos se incluye la heterogeneidad de la cobertura de vacunación en cada país y en los países vecinos, lo que puede contribuir con que se registren tasas bajas de cobertura de vacunación; el impacto adverso de la migración interna de personas no vacunadas, lo que ha favorecido la reaparición de enfermedades prevenibles por vacunación; la escasez de vacunas, y el impacto de la pandemia del coronavirus de tipo 2 causante del síndrome respiratorio agudo grave (SARS-CoV-2) y los consiguientes cambios en los recursos de atención médica. Para mejorar la cobertura de las vacunas pediátricas en Colombia y Perú será necesario integrar de manera generalizada en los calendarios de vacunación vacunas combinadas con antígenos de difteria, tétanos, tos ferina acelular, poliovirus inactivados, Haemophilus influenzae tipo b y hepatitis B con una serie primaria de tres dosis administradas a los 2, 4 y 6 meses de edad, seguida de un refuerzo a los 18 meses de edad. Esas vacunas desempeñan un papel esencial en la prevención de la difteria, el tétanos y la tos ferina; la erradicación de la polio; y el refuerzo contra H. influenzae tipo b.

RESUMO O objetivo deste artigo foi avaliar os desafios da vacinação na Colômbia e no Peru e o papel das vacinas pediátricas combinadas na superação de tais desafios. Os obstáculos para incluir novas vacinas com mais antígenos permanecem visíveis em partes desses países, onde doenças imunopreveníveis em lactentes continuam a ser um grande problema. Os desafios incluem a heterogeneidade da cobertura vacinal dentro de cada país e nos países vizinhos, o que pode contribuir para baixas taxas de cobertura vacinal; o impacto adverso da migração interna de pessoas não vacinadas, o que favoreceu o ressurgimento de doenças imunopreveníveis; a escassez de vacinas; e o impacto da pandemia de síndrome respiratória aguda grave do coronavírus 2 (SARS-CoV-2) e mudanças relacionadas nos recursos de atenção à saúde. Para melhorar a cobertura das vacinas pediátricas na Colômbia e no Peru, será necessário assegurar sua integração generalizada em esquemas de vacinas combinadas contendo antígenos de difteria, tétano, pertussis acelular, poliovírus inativado, Haemophilus influenzae tipo B e hepatite B, com uma série primária de três doses aplicadas aos 2, 4 e 6 meses de idade seguidas de um reforço aos 18 meses de idade. Tais vacinas desempenham papéis importantes na prevenção da difteria, tétano e coqueluche; na erradicação da poliomielite; e no reforço contra H. influenzae tipo b.

ABSTRACT The objective of this article was to consider the vaccination challenges in Colombia and Peru and the role of pediatric combination vaccines in overcoming these challenges. Barriers to including new vaccines with more antigens remain apparent in parts of these countries, where vaccine-preventable diseases in infants continue to be a major problem. The challenges include the heterogeneity of vaccine coverage within each country and in neighboring countries, which can contribute to poor rates of vaccination coverage; the adverse impact of the inward migration of unvaccinated individuals, which has favored the re-emergence of vaccine-preventable diseases; vaccine shortages; and the impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and the associated shifts in health care resources. To improve the coverage of pediatric vaccines in Colombia and Peru, it will be necessary to ensure the widespread integration into vaccine schedules of combination vaccines containing diphtheria, tetanus, acellular pertussis, inactivated poliovirus, Haemophilus influenzae type b and hepatitis B antigens with a three-dose primary series delivered at 2, 4 and 6 months of age followed by a booster at 18 months of age. Such vaccines play important roles in preventing diphtheria, tetanus and pertussis; eradicating polio; and providing boosting against H. influenzae type b.

ABSTRACT Paracoccidioidomycosis (PCM) is a systemic fungal infection caused by Paracoccidioides species. Chylothorax is a rare complication of PCM. A 16-year-old adolescent presented daily fever, lymphadenomegaly, sweating, weight loss, ventilatory-dependent pain, and dysphagia, which confirmed PCM. During treatment, the patient developed chylothorax and chylous ascites. Chronic inflammatory and fibrotic lymphadenopathy may obstruct lymphatic vessels, resulting in the extravasation of lymph into the abdomen or pleural cavities. Chylothorax is one of several complications of PCM and can lead to respiratory insufficiency, even in patients undergoing antifungal therapy. (PCM species 16yearold yearold 16 year old fever lymphadenomegaly sweating loss ventilatorydependent ventilatory dependent pain dysphagia treatment ascites vessels cavities insufficiency therapy 1

Abstract Background Ischemic stroke and acute myocardial infarction (AMI) are cardiovascular diseases with high morbidity and mortality rates in Brazil and worldwide. Their outcomes are influenced by public policies aimed at mitigating risk factors and by investments in infrastructure of emergency support and quality of hospital care. Objective To analyze the trend in the proportion of in-hospital deaths from ischemic stroke and AMI in Brazil as a way of evaluating the effectiveness of urgency and emergency services. Methods Ecological time series study using data from the Hospital Information System. The outcome was the proportion of in-hospital deaths from ischemic stroke and AMI with stratification by sex and state. Prais-Winsten regression was used to analyze the trend between 1998-2018 with α≤0,05. Results The proportion of deaths from AMI and ischemic stroke declined in the time series (p<0.001), decreasing annually by 0.17% and 0.25%, respectively. In 20 years, it reduced 43.76% (ischemic stroke) and 32.39% (AMI) in both sexes. However, the decline was more evident in the South and Southeast regions. Conclusion The reduction in hospital deaths from AMI and ischemic stroke was heterogeneous among Brazilian regions, which may be related to inequality in emergency services and hospital support. (AMI worldwide care inhospital System state PraisWinsten Prais Winsten 19982018 1998 2018 1998-201 α005 α 0 05 α≤0,05 p<0.001, p0001 p p<0.001 , 001 (p<0.001) 017 17 0.17 025 25 0.25% respectively 2 years 4376 43 76 43.76 3239 32 39 32.39 sexes However regions 1998201 199 201 1998-20 α00 α≤0,0 p000 p<0.00 00 (p<0.001 01 1 0.1 02 0.25 437 4 7 43.7 323 3 32.3 199820 19 1998-2 α0 α≤0, p00 p<0.0 (p<0.00 0. 0.2 43. 32. 19982 1998- α≤0 p0 p<0. (p<0.0 α≤ p<0 (p<0. p< (p<0 (p< (p

ABSTRACT Objective: We hypothesized that the use of mechanical insufflation-exsufflation can reduce the incidence of acute respiratory failure within the 48-hour post-extubation period in intensive care unit-acquired weakness patients. Methods: This was a prospective randomized controlled open-label trial. Patients diagnosed with intensive care unit-acquired weakness were consecutively enrolled based on a Medical Research Council score ≤ 48/60. The patients randomly received two daily sessions; in the control group, conventional chest physiotherapy was performed, while in the intervention group, chest physiotherapy was associated with mechanical insufflation-exsufflation. The incidence of acute respiratory failure within 48 hours of extubation was evaluated. Similarly, the reintubation rate, intensive care unit length of stay, mortality at 28 days, and survival probability at 90 days were assessed. The study was stopped after futility results in the interim analysis. Results: We included 122 consecutive patients (n = 61 per group). There was no significant difference in the incidence of acute respiratory failure between treatments (11.5% control group versus 16.4%, intervention group; p = 0.60), the need for reintubation (3.6% versus 10.7%; p = 0.27), mean length of stay (3 versus 4 days; p = 0.33), mortality at Day 28 (9.8% versus 15.0%; p = 0.42), or survival probability at Day 90 (21.3% versus 28.3%; p = 0.41). Conclusion: Mechanical insufflation-exsufflation combined with chest physiotherapy seems to have no impact in preventing postextubation acute respiratory failure in intensive care unit-acquired weakness patients. Similarly, mortality and survival probability were similar in both groups. Nevertheless, given the early termination of the trial, further clinical investigation is strongly recommended. Clinical Trials Register: NCT 01931228 Objective insufflationexsufflation insufflation exsufflation 48hour hour post unitacquired acquired Methods openlabel open label trial 4860 60 48/60 sessions performed insufflationexsufflation. exsufflation. evaluated Similarly rate 2 9 assessed analysis Results 12 n 6 group. . group) 11.5% 115 11 5 (11.5 164 16 16.4% 0.60, 060 0.60 , 0 0.60) 3.6% 36 3 (3.6 10.7% 107 10 7 0.27, 027 0.27 27 0.27) ( 0.33, 033 0.33 33 0.33) 9.8% 98 8 (9.8 15.0% 150 15 0.42, 042 0.42 42 0.42) 21.3% 213 21 (21.3 28.3% 283 0.41. 041 0.41 41 0.41) Conclusion groups Nevertheless recommended Register 0193122 486 48/6 1 11.5 (11. 16.4 06 0.6 3.6 (3. 10.7 02 0.2 03 0.3 9.8 (9. 15.0 04 0.4 21.3 (21. 28.3 019312 48/ 11. (11 16. 0. 3. 10. 9. (9 15. 21. (21 28. 01931 (1 (2 0193 019 01

RESUMO Objetivo: Verificar se o uso de insuflação-exsuflação mecânica pode reduzir a incidência da insuficiência respiratória aguda no período de 48 horas pós-extubação em pacientes com fraqueza adquirida em unidades de terapia intensiva. Métodos: Estudo prospectivo, randomizado, controlado e aberto. Os pacientes diagnosticados com fraqueza adquirida em unidade de terapia intensiva foram incluídos consecutivamente, com base em uma pontuação do Medical Research Council ≤ 48/60. Os pacientes receberam aleatoriamente duas sessões diárias; no grupo controle, realizou-se fisioterapia torácica convencional, enquanto no grupo intervenção, combinou-se fisioterapia torácica com insuflação-exsuflação mecânica. Avaliou-se a incidência de insuficiência respiratória aguda dentro de 48 horas após a extubação. Da mesma forma, avaliaram-se a taxa de reintubação, o tempo de permanência na unidade de terapia intensiva, a mortalidade aos 28 dias e a probabilidade de sobrevida aos 90 dias. O estudo foi interrompido após resultados de futilidade na análise intermediária. Resultados: Incluímos 122 pacientes consecutivos (n = 61 por grupo). Não houve diferença significativa na incidência de insuficiência respiratória aguda entre os tratamentos (11,5% no grupo controle versus 16,4% no grupo intervenção; p = 0,60), na necessidade de reintubação (3,6% versus 10,7%; p = 0,27), no tempo médio de internação (3 versus 4 dias; p = 0,33), na mortalidade aos 28 dias (9,8% versus 15,0%; p = 0,42) ou na probabilidade de sobrevida aos 90 dias (21,3% versus 28,3%; p = 0,41). Conclusão: A insuflação-exsuflação mecânica associada à fisioterapia torácica parece não ter impacto na prevenção da insuficiência respiratória aguda pós-extubação em pacientes com fraqueza adquirida na unidade de terapia intensiva. Da mesma forma, a mortalidade e a probabilidade de sobrevida foram semelhantes em ambos os grupos. No entanto, devido ao término precoce do estudo, recomenda-se enfaticamente uma investigação clínica mais aprofundada. Registro Clinical Trials: NCT 01931228 Objetivo insuflaçãoexsuflação insuflação exsuflação pósextubação pós extubação Métodos prospectivo randomizado aberto consecutivamente 4860 60 48/60 diárias realizouse realizou convencional intervenção combinouse combinou Avaliouse Avaliou forma avaliaramse avaliaram 2 9 intermediária Resultados 12 n 6 grupo. . grupo) 11,5% 115 11 5 (11,5 164 16 16,4 0,60, 060 0,60 , 0 0,60) 3,6% 36 3 (3,6 10,7% 107 10 7 0,27, 027 0,27 27 0,27) ( 0,33, 033 0,33 33 0,33) 9,8% 98 8 (9,8 15,0% 150 15 0,42 042 42 21,3% 213 21 (21,3 28,3% 283 0,41. 041 0,41 41 0,41) Conclusão grupos entanto recomendase recomenda aprofundada Trials 0193122 486 48/6 1 11,5 (11, 16, 06 0,6 3,6 (3, 10,7 02 0,2 03 0,3 9,8 (9, 15,0 0,4 04 21,3 (21, 28,3 019312 48/ 11, (11 0, 3, 10, 9, (9 15, 21, (21 28, 01931 (1 (2 0193 019 01

ABSTRACT Paracoccidioidomycosis is a systemic mycosis found mainly in South America and is the most prevalent endemic and systemic mycosis in Brazil. The purpose of this paper was to report the case of a male patient who developed peritonitis caused by Paracoccidioides spp. Fortyeight-year-old, male patient, with type I Diabetes mellitus and chronic kidney disease who was undergoing a Continuous Ambulatory Peritoneal Dialysis (CAPD) program. After eighteen months of peritoneal dialysis, the patient developed turbidity of the peritoneal fluid and was diagnosed with peritonitis. Direct mycological examination of the peritoneal fluid revealed yeasts with morphology suggestive of Paracoccidioides spp. The patient was treated with sulfamethoxazole-trimethoprim (1,600 mg/320 mg dose/day) for 61 days, but he died because a bacterial septic shock. The diagnosis of opportunistic PCM peritonitis was later confirmed by autopsy and Paracoccidioides spp. isolation. This is the first reported case of a patient on CAPD who experienced complications due peritonitis caused by opportunistic PCM. Brazil spp Fortyeightyearold, Fortyeightyearold Fortyeight year old, old Fortyeight-year-old (CAPD program dialysis sulfamethoxazoletrimethoprim sulfamethoxazole trimethoprim 1,600 1600 1 600 (1,60 mg320 320 mg/32 dose/day doseday dose day 6 days shock isolation 1,60 160 60 (1,6 mg32 32 mg/3 1,6 16 (1, mg3 3 mg/ 1, (1 (

Abstract In this paper, we present an attention classification method using Machine-Learning Algorithms. The EEG signals were recorded from ten engineering students with an EPOC+BCI using the electrodes F3, F4, P7, and P8 while solving some mathematical operations. The recording time for these activities is around 20 minutes. Next, a similar time EEG register is obtained while doing non-academic activities, such as chattering with the staff, checking cell phones, or playing a video game. With these EEG registers, we obtained a set of features to train and evaluate attention using Machine Learning algorithms. This research shows how engineering students interact with math topics in solving mental operations and complex reasoning by increasing brain domain and knowledge for mathematical reasoningrelated processes, such as sustained and shifting attention and logical constructions for object interaction during operations resolution. The Random Forest algorithm (RF) obtained the highest accuracy with 0.7392, an F1 Score of 0.7430, and the highest Specificity/Accuracy with 0.7261.

Resumen Se presenta un método de clasificación de la atención utilizando algoritmos de aprendizaje automático. Con las señales EEG de diez estudiantes de ingeniería adquiridas utilizando los electrodos F3, F4, P7 y P8 de una BCI EPOC+ mientras resuelven productos escalares, multiplicaciones algebraicas simples, simplificaciones e integrales por aproximadamente 20 minutos. Posteriormente, se obtiene un registro EEG de tiempo similar mientras se realizan actividades no académicas, como charlar con el personal, consultar el móvil o jugar a un videojuego. Se obtienen algunas características/parámetros, se entrenan y evalúan varios algoritmos de aprendizaje automático para la clasificación de la atención. Los resultados de esta investigación pueden mejorar la forma en que los estudiantes de ingeniería interactúan con los temas matemáticos en la resolución de operaciones mentales y razonamientos complejos, aumentando el dominio y el conocimiento cerebral para los procesos relacionados con el razonamiento matemático, como la atención sostenida y cambiante y las construcciones lógicas para la interacción con objetos durante la resolución de operaciones. El clasificador Random Forest obtuvo la mayor precisión con 0.7392, una puntuación F1 de 0.7430 y la mayor especificidad/precisión con 0.7261.

Abstract In countries with strong family traditions, scientific studies often associate living alone with feelings of loneliness, which have negative consequences for the well-being of older adults. In modern societies, the Internet plays an important role in communication. In view of this, the aim is to analyze the role of the Internet in the relationship between living alone and loneliness in southern European countries. This study focuses on a sample of 17,228 individuals aged 50+ living in Portugal, Spain, Italy and Greece who were interviewed in wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE). We conclude that older individuals who live alone and use the Internet have less frequent feelings of loneliness than their peers (individuals in the same age group). The results of this study therefore reinforce the importance of policies aimed at digital inclusion.

Resumo Em países com fortes tradições familialistas, os estudos científicos associam frequentemente a vida a solo, a sentimentos de solidão, que têm consequências negativas para o bem-estar de adultos mais velhos. Nas sociedades atuais, é inegável o papel desempenhado pela internet enquanto meio de comunicação. Tendo em conta este facto, visa-se analisar o papel que desempenha a internet na relação entre a vida a solo e a solidão, nos países do Sul da Europa. O presente estudo incide sobre uma amostra de 17228 indivíduos de 50+ anos, residentes em Portugal, Espanha, Itália e Grécia que foram inquiridos na vaga 6 do projeto Survey of Health, Ageing and Retirement in Europe (SHARE). Conclui-se que os indivíduos mais velhos que vivem sós e utilizam a internet manifestam, com menos frequência, sentimentos de solidão que os seus pares (indivíduos do mesmo escalão etário). Os resultados deste estudo reforçam, pois, a importância de políticas que visem a inclusão digital.

Resumo Este estudo avaliou a centralização da região de interesse (ROI) na aquisição das imagens de TCFC, quando a função scout-view (SV) posicionável livremente é aplicada. Adicionalmente, a dosimetria das imagens adquiridas foi avaliada isoladamente na presença da função SV, bem como após aquisição de imagem tomográfica completa em dois diferentes campos de visão (FOV) (50x50 e 78x150mm). Um dispositivo de três localizações foi criado para acomodar os dosímetros e os espécimes, na localização direita, central e esquerda, durante a aquisição das imagens. Para avaliação da dose, dosímetros termoluminescentes foram irradiados dentro dos campos de visão e analisados em leitor portátil. Para avaliação da ROI, três espécimes de guta percha foram colocados no mesmo aparelho e as tomografias foram adquiridas (CBCT OP 300 Maxio, 90kV, 13mA, 85 μm tamanho de voxel, FOV de 50X50mm), com e sem a SV, em três posições (3-9, 1-7 e 5-11 horas), simulando diferentes regiões da boca. Foram realizadas duas avaliações de imagem, uma objetiva e outra subjetiva. Houve um leve aumento percentual (1,36% para 1,40%) da dose de radiação com o uso de SV. As distâncias foram significativamente maiores nas imagens adquiridas sem SV (p < 0,05). Todas as imagens obtidas com SV foram classificadas como sendo do centro do FOV. Em conclusão, os resultados do presente estudo demonstraram que a função scout view é eficaz para centralizar a ROI no FOV, aumentando a precisão do escaneamento e evitando repetições devido a erros de posicionamento.

Abstract This study evaluated the centralization of the region of interest (ROI) in acquisition of the CBCT images, when the freely positionable scout-view (SV) function is applied. Additionally, the dosimetry of the acquired images was assessed in the SV function alone as well as in complete tomographic image in two different fields of view (FOV) (50x50 and 78x150mm). A three-location device was created to accommodate the dosimeters and the specimens, in the right, middle and left location during image acquisition. For dose assessment, thermoluminescent dosimeters were irradiated within the FOV and analyzed in a portable reader. For ROI evaluation, three specimens of gutta-percha stick were placed on the same device and the CT scans were acquired (CBCT OP 300 Maxio device, 90kV, 13mA, 85 µm voxel size, FOV of 50X50mm), with and without the SV, in three positions (3-9, 1-7 and 5-11 o’clock), simulating different regions of the mouth. Two image evaluations were performed, an objective and subjective. There was a slight percentage increase (1.36% to 1.40%) of the radiation dose with the use of SV. The distances were significantly greater in the images acquired without SV (p < 0.05). Every image obtained with SV was classified as being at the FOV’s center. In conclusion, the results demonstrated that SVs function is effective to centralize the ROI in the FOV, increasing the scan precision and avoiding repetitions due to positioning errors.

Resumo Um inversor multinível é um dispositivo eletrônico capaz de alterar a potência de corrente contínua para potência de corrente alternada com tensão e frequência definidas pelo usuário. Eles são ideais para conectar fontes de energia renovável à rede elétrica, usinas de energia e redes inteligentes. É necessário ter uma tensão balanceada e sincronizada com a rede para seu correto funcionamento. Este artigo demonstra a sincronização da saída de tensão do inversor com a rede elétrica usando um algoritmo de fase baseado em observador adaptativo. O algoritmo proposto pode trabalhar diante de incertezas da rede como ruídos e gerar um sinal de referência para a modulação utilizada pelo inversor. O algoritmo proposto é robusto e computacionalmente eficiente, pois pode ser implementado por meio de elementos básicos como amplificadores operacionais, resistores e capacitores, reduzindo a dificuldade de executá-lo em um sistema.

Resumen Un inversor multinivel es un dispositivo electrónico capaz de cambiar energía de corriente directa a energía de corriente alterna con voltaje y frecuencia establecidas por el usuario. Son ideales para conectar fuentes de energía renovables con la red eléctrica, plantas de energía y redes eléctricas inteligentes. Es necesario contar con el voltaje balanceado y sincronizado con la red para su correcto funcionamiento. Este artículo muestra la sincronización de la salida de voltaje del inversor con la red eléctrica utilizando un algoritmo de fijación de fase basado en un observador adaptable. El algoritmo propuesto puede funcionar ante incertidumbres de la red como el ruido y genera una señal de referencia para la modulación utilizada por el inversor. El algoritmo propuesto es robusto y computacionalmente eficiente, ya que puede ser implementado a través de elementos básicos como amplificadores operacionales, resistencias y capacitores, reduciendo la dificultad de ejecutarlo en un sistema.

Abstract A multilevel inverter is an electronic device capable of changing direct current energy to alternant current energy with a voltage and frequency established by the user. They are ideal for connecting renewable energy sources to the AC grid, energy plants, and smart grids. The voltage must be balanced and synchronized with the electrical network for adequate performance. This paper shows the voltage synchronization between an inverter output voltage and the AC grid using a phase-locked loop based on an adaptive observer. The proposed algorithm can perform under grid uncertainties such as noise and generates a reference signal for the modulation used in the inverter. The algorithm is robust and computationally efficient and can be implemented through basic elements such as operational amplifiers, resistors, and capacitors, reducing its difficulty in executing it in a system.