Background: The concept introduced by enhanced recovery after surgery protocols modifies perioperative traditional care in digestive surgery. The integration of these modern recommendations components during the perioperative period are highly important to ensure less postoperative complications, reduced length of hospital stay and decreased surgical costs. Aims: The aim of this position paper is to emphasize the most important points of a multimodal perioperative care protocol. Methods:  A careful analysis of each recommendation of both ERAS and ACERTO protocols is presented, justifying its inclusion in the recommended multimodal care of digestive surgery patients. Results: Enhanced recovery programs (ERPs) such as ERAS and ACERTO protocols are a cornerstone in modern perioperative care. Nutritional therapy is highly important in digestive surgery and thus both preoperative and postoperative nutrition care are key to ensure less postoperative complications and to reduce the length of hospital stay. The concept of prehabilitation is another key element in ERPs. Management of crystalloid fluids in a perfect balance in vital. Fluid overload may delay the recovery of patients and increase postoperative complications. Abbreviation of preoperative fast for 2h before anesthesia is now accepted by various guidelines of both surgical and anesthesiology societies. Combined with early postoperative refeeding, these prescriptions are not only safe but can also enhance recovery of patients undergoing digestive procedures. Conclusions: This Brazilian College of Digestive Surgery position paper strongly emphasizes that the implementation of ERPs in digestive surgery represents a paradigm shift in perioperative care, transcending traditional practices and embracing an intelligent approach to patient well-being.   Background: The concept introduced by enhanced recovery after surgery protocols modifies perioperative traditional care in digestive surgery. The integration of these modern recommendations components during the perioperative period are highly important to ensure less postoperative complications, reduced length of hospital stay and decreased surgical costs. Aims: The aim of this position paper is to emphasize the most important points of a multimodal perioperative care protocol. Methods:  A careful analysis of each recommendation of both ERAS and ACERTO protocols is presented, justifying its inclusion in the recommended multimodal care of digestive surgery patients. Results: Enhanced recovery programs (ERPs) such as ERAS and ACERTO protocols are a cornerstone in modern perioperative care. Nutritional therapy is highly important in digestive surgery and thus both preoperative and postoperative nutrition care are key to ensure less postoperative complications and to reduce the length of hospital stay. The concept of prehabilitation is another key element in ERPs. Management of crystalloid fluids in a perfect balance in vital. Fluid overload may delay the recovery of patients and increase postoperative complications. Abbreviation of preoperative fast for 2h before anesthesia is now accepted by various guidelines of both surgical and anesthesiology societies. Combined with early postoperative refeeding, these prescriptions are not only safe but can also enhance recovery of patients undergoing digestive procedures. Conclusions: This Brazilian College of Digestive Surgery position paper strongly emphasizes that the implementation of ERPs in digestive surgery represents a paradigm shift in perioperative care, transcending traditional practices and embracing an intelligent approach to patient well-being.

ABSTRACT BACKGROUND: The concept introduced by protocols of enhanced recovery after surgery modifies perioperative traditional care in digestive surgery. The integration of these modern recommendations components during the perioperative period is of great importance to ensure fewer postoperative complications, reduced length of hospital stay, and decreased surgical costs. AIMS: To emphasize the most important points of a multimodal perioperative care protocol. METHODS: Careful analysis of each recommendation of both ERAS and ACERTO protocols, justifying their inclusion in the multimodal care recommended for digestive surgery patients. RESULTS: Enhanced recovery programs (ERPs) such as ERAS and ACERTO protocols are a cornerstone in modern perioperative care. Nutritional therapy is fundamental in digestive surgery, and thus, both preoperative and postoperative nutrition care are key to ensuring fewer postoperative complications and reducing the length of hospital stay. The concept of prehabilitation is another key element in ERPs. The handling of crystalloid fluids in a perfect balance is vital. Fluid overload can delay the recovery of patients and increase postoperative complications. Abbreviation of preoperative fasting for two hours before anesthesia is now accepted by various guidelines of both surgical and anesthesiology societies. Combined with early postoperative refeeding, these prescriptions are not only safe but can also enhance the recovery of patients undergoing digestive procedures. CONCLUSIONS: This position paper from the Brazilian College of Digestive Surgery strongly emphasizes that the implementation of ERPs in digestive surgery represents a paradigm shift in perioperative care, transcending traditional practices and embracing an intelligent approach to patient well-being. BACKGROUND stay costs AIMS protocol METHODS RESULTS (ERPs thus vital societies refeeding procedures CONCLUSIONS wellbeing. wellbeing well being. being well-being

RESUMO RACIONAL: O conceito introduzido pelos protocolos de recuperação após a cirurgia modifica os cuidados perioperatórios tradicionais em cirurgia digestiva. A integração desses componentes modernos de recomendações, durante o período perioperatório, é de grande importância para garantir menos complicações pós-operatórias, redução do tempo de internação hospitalar e diminuição dos custos cirúrgicos. OBJETIVOS: Enfatizar os pontos mais importantes de um protocolo multimodal de cuidados perioperatórios. MÉTODOS: Análise criteriosa de cada recomendação dos protocolos ERAS e ACERTO, justificando sua inclusão no atendimento multimodal recomendado para pacientes de cirurgia digestiva. RESULTADOS: Os programas de recuperação avançada (PRAs), tais como os protocolos ERAS e ACERTO, são a base dos cuidados perioperatórios modernos. A terapia nutricional é de grande importância na cirurgia digestiva e, portanto, tanto os cuidados nutricionais pré-operatórios, quanto pós-operatórios são fundamentais para garantir menos complicações pós-operatórias e reduzir o tempo de internação hospitalar. O conceito de pré-habilitação é outro elemento-chave nos PRAs. O manuseio de fluidos cristalóides em perfeito equilíbrio é vital. A sobrecarga de fluidos pode atrasar a recuperação dos pacientes e aumentar as complicações pós-operatórias. A abreviação do jejum pré-operatório para duas horas antes da anestesia é agora aceita por diversas diretrizes das sociedades cirúrgicas e de anestesiologia. Combinadas com a realimentação pós-operatória precoce, essas prescrições não são apenas seguras, mas também podem melhorar a recuperação de pacientes submetidos a procedimentos digestivos. CONCLUSÕES: Este posicionamento do Colégio Brasileiro de Cirurgia Digestiva enfatiza fortemente que a implementação de PRAs em cirurgia digestive, representa uma mudança de paradigma no cuidado perioperatório, transcendendo as práticas tradicionais e adotando uma abordagem inteligente para o bem-estar do paciente. RACIONAL recomendações perioperatório pósoperatórias, pósoperatórias pós operatórias, operatórias cirúrgicos OBJETIVOS MÉTODOS ACERTO RESULTADOS PRAs, , (PRAs) portanto préoperatórios, préoperatórios pré operatórios, operatórios pré-operatórios pósoperatórios préhabilitação habilitação elementochave elemento chave vital pósoperatórias. operatórias. préoperatório operatório anestesiologia pósoperatória operatória precoce seguras digestivos CONCLUSÕES digestive bemestar bem estar paciente (PRAs

Objective: To report on suicide plans and attempts among Brazilian physicians and to investigate the associated risk factors. Methods: From January 2018 to January 2019, a nationwide online survey was conducted among Brazilian physicians using the Tool for Assessment of Suicide Risk and the Satisfaction with Life Scale. Multivariate exploratory associations of demographic, psychological, and work-related factors were performed on reports of suicide plans and attempts. Results: Of the 4,148 participants, 1,946 (53.5%) were male, 2,527 (60.9%) were 30 to 60 years old, 2,675 (64.5%) had two to four jobs, and 1,725 (41.6%) worked 40 to 60 hours a week. The overall prevalence of suicide plans was 8.8% (n=364), and suicide attempts were reported by 3.2% (n=133) of participants. Daily emotional exhaustion (ORadj = 7.857; 95%CI 2.282-27.051, p = 0.002), weekly emotional exhaustion (ORadj = 7.953; 95%CI 2.403-26.324, p = 0.001), daily frustration at work (ORadj = 3.093; 95%CI 1.711-5.588, p < 0.001), and bisexuality (ORadj = 5.083; 95%CI 2.544-10.158, p < 0.001) were significantly associated with higher odds of suicide. Extremely dissatisfied physicians reported suicide plans and attempts in 38.3% of cases, whereas extremely satisfied physicians reported suicide plans and attempts in only 2.8% of cases (p < 0.001). Conclusion: Brazilian physicians with a history of suicide plans and attempts express emotional exhaustion and frustration at work. There is an urgent need for actions to promote professional safeguards and resilience. Objective Methods 201 2019 Scale demographic psychological workrelated related Results 4148 4 148 4,14 participants 1946 1 946 1,94 53.5% 535 53 5 (53.5% male 2527 2 527 2,52 60.9% 609 9 (60.9% 3 6 old 2675 675 2,67 64.5% 645 64 (64.5% jobs 1725 725 1,72 41.6% 416 41 (41.6% week 88 8 8.8 n=364, n364 n n=364 , 364 (n=364) 32 3.2 n=133 n133 133 (n=133 ORadj 7.857 7857 7 857 95CI CI 95 2.28227.051, 228227051 2.282 27.051, 282 27 051 2.282-27.051 0.002, 0002 0.002 0 002 0.002) 7.953 7953 953 2.40326.324, 240326324 2.403 26.324, 403 26 324 2.403-26.324 0.001, 0001 0.001 001 3.093 3093 093 1.7115.588, 17115588 1.711 5.588, 711 588 1.711-5.588 5.083 5083 083 2.54410.158, 254410158 2.544 10.158, 544 10 158 2.544-10.158 383 38 38.3 28 2.8 0.001. . Conclusion resilience 20 414 14 4,1 194 94 1,9 53.5 (53.5 252 52 2,5 60.9 (60.9 267 67 2,6 64.5 (64.5 172 72 1,7 41.6 (41.6 8. n36 n=36 36 (n=364 3. n=13 n13 13 (n=13 7.85 785 85 28227 2.28227.051 22822705 2282 2.28 27051 27.051 05 2.282-27.05 000 0.00 00 7.95 795 40326 2.40326.324 24032632 2403 2.40 26324 26.324 2.403-26.32 3.09 309 09 7115 1.7115.588 1711558 1711 1.71 5588 5.588 71 58 1.711-5.58 5.08 508 08 54410 2.54410.158 25441015 2544 2.54 10158 10.158 54 15 2.544-10.15 38. 2. 4, 19 1, 53. (53. 25 2, 60. (60. 64. (64. 17 41. (41. n3 n=3 (n=36 n=1 n1 (n=1 7.8 78 2822 2.28227.05 2282270 228 2.2 2705 27.05 2.282-27.0 0.0 7.9 79 4032 2.40326.32 2403263 240 2.4 2632 26.32 2.403-26.3 3.0 1.7115.58 171155 171 1.7 558 5.58 1.711-5.5 5.0 50 5441 2.54410.15 2544101 254 2.5 1015 10.15 2.544-10.1 (53 (60 (64 (41 n= (n=3 (n= 7. 2.28227.0 228227 22 270 27.0 2.282-27. 0. 2.40326.3 240326 24 263 26.3 2.403-26. 1.7115.5 17115 1. 55 5.5 1.711-5. 5. 2.54410.1 254410 101 10.1 2.544-10. (5 (6 (4 (n 2.28227. 22822 27. 2.282-27 2.40326. 24032 26. 2.403-26 1.7115. 1.711-5 2.54410. 25441 10. 2.544-10 ( 2.28227 2.282-2 2.40326 2.403-2 1.7115 1.711- 2.54410 2.544-1 2.2822 2.282- 2.4032 2.403- 2.5441 2.544-

RESUMO Objetivos: Analisar as notificações de morte encefálica (ME) recebidas pela Central de Transplantes (CET) do estado de Roraima (RR) de 2017 a 2021. Métodos: Trata-se de estudo transversal, quantitativo e observacional no qual foram analisadas todas as notificações recebidas pela CET no período de 2017 a 2021, resultando em 120 pacientes, dos seguintes centros de saúde: Hospital Geral de Roraima (HGR), Hospital Confederação Nacional das Cooperativas Médicas (UNIMED), Hospital da Criança Santo Antônio (HCSA), Hospital das Clínicas (HC) e Hospital Lotty Íris (HLI). Os dados foram coletados do sistema de gerenciamento de dados da central e repassados para a ficha de coleta desenvolvida pela pesquisadora. Resultados: Este estudo analisou 119 notificações após a exclusão de uma devido a dados conflitantes. Houve predominância do sexo masculino (58%), com trauma cranioencefálico sendo a causa mais frequente de ME. Ao todo, foram realizadas seis captações de órgãos, todas no HGR. Este estudo não encontrou associações significativas entre a captação de órgãos e sexo, idade, local de internação e ano. Conclusão: Há grandes desafios em relação à doação de órgãos em RR, com uma taxa de captação baixa ao longo de 5 anos. Apenas o HGR obteve sucesso em realizar captações de órgãos, diferentemente de outros hospitais notificadores. São necessárias melhorias, destacando a importância de se realizarem mais estudos para uma análise mais aprofundada dos dados. Objetivos ME (ME (CET RR (RR 201 2021 Métodos Tratase Trata transversal 12 pacientes saúde HGR, , (HGR) UNIMED, UNIMED (UNIMED) HCSA, HCSA (HCSA) HC (HC HLI. HLI . (HLI) pesquisadora Resultados 11 conflitantes 58%, 58 58% (58%) todo idade ano Conclusão anos notificadores melhorias 20 202 1 (HGR (UNIMED (HCSA (HLI (58% 2 (58 (5 (

ABSTRACT Objectives: To analyze brain death (BD) notifications received by Central de Transplantes (CET) in the state of Roraima (RR) from 2017 to 2021. Methods: This is a cross-sectional, quantitative, and observational study, where all notifications received by CET from 2017 to 2021 were analyzed, resulting in 120 patients from health the following centers: Hospital Geral de Roraima (HGR), Hospital Confederação Nacional das Cooperativas Médicas (UNIMED), Hospital da Criança Santo Antônio (HCSA), Hospital das Clínicas (HC), and Hospital Lotty Íris (HLI). The data were collected from the center’s data management system and passed on to the collection form developed by the researcher. Results: This study analyzed 119 notifications after excluding one due to conflicting data. There was a predominance of males (58%), with traumatic brain injury being the most frequent cause of BD. Six organ harvestings were carried out, all at the HGR. This study found no significant associations between organ procurement and sex, age, place of hospitalization, and year. Conclusion: There are considerable challenges concerning organ donation in RR, with a low uptake rate over five years. Only the HGR successfully carried out organ harvesting, while other reporting hospitals were unsuccessful. Improvements are needed, highlighting the importance of more studies for a more in-depth data analysis. Objectives BD (BD (CET RR (RR 201 Methods crosssectional, crosssectional cross sectional, sectional cross-sectional quantitative 202 12 centers HGR, , (HGR) UNIMED, UNIMED (UNIMED) HCSA, HCSA (HCSA) HC, HC (HC) HLI. HLI . (HLI) center s researcher Results 11 58%, 58 58% (58%) sex age hospitalization year Conclusion years harvesting unsuccessful needed indepth depth analysis 20 1 (HGR (UNIMED (HCSA (HC (HLI 5 (58% 2 (58 (5 (

ABSTRACT Purpose: Bacterial cellulose (BC) has shown high capacity for the treatment of wounds and burns, providing a moisty environment. Calcium alginate can be associated with BC to create gels that aid in wound debridement and contribute to appropriate wound healing. This study is aimed at characterizing and evaluating the use of bacterial cellulose/alginate gel in skin burns in rats. Methods: Cellulose and cellulose/alginate gels were compared regarding the capacity of liquid absorption, moisture, viscosity, and potential cytotoxicity. The 2nd degree burns were produced using an aluminum metal plate (2.0cm) at 120ºC for 20s on the back of rats. The animals were divided into non-treated, CMC(Carboxymethylcellulose), Cellulose(CMC with bacterial cellulose), and Cellulose/alginate(CMC with bacterial cellulose and alginate). The animals received topical treatment 3 times/week. Biochemical (MPO, NAG and oxidative stress), histomorphometry and immunohistochemical assays (IL-1β IL-10 and VEGF) were conducted on the 14th, 21st, 28th, and 35th days. Results: Cellulose/Alginate gel showed higher absorption capacity and viscosity compared to Cellulose gel, with no cytotoxic effects. Cellulose/alginate presented lower MPO values, a higher percentage of IL-10, with greater and balanced oxidative stress profile. Conclusions: The use of cellulose/alginate gel reduced neutrophils and macrophage activation and showed greater anti-inflammatory response, which can contribute to healing chronic wounds and burns. Purpose (BC environment cellulosealginate rats Methods moisture cytotoxicity nd 2.0cm 20cm cm 2 0cm (2.0cm ºC s nontreated, nontreated non treated, treated non-treated CMCCarboxymethylcellulose, CMCCarboxymethylcellulose CMC Carboxymethylcellulose , CMC(Carboxymethylcellulose) CelluloseCMC cellulose, cellulose) Cellulose/alginateCMC CellulosealginateCMC alginate. . alginate) timesweek times week times/week MPO, (MPO stress, stress) IL1β ILβ IL 1β β IL10 10 IL-1 VEGF 14th th 21st st 28th days Results CelluloseAlginate Alginate effects Cellulosealginate values IL10, 10, profile Conclusions antiinflammatory anti inflammatory response CMC(Carboxymethylcellulose alginateCMC IL1 1 IL-

ABSTRACT Purpose: To evaluate primary intraocular lens implantation in the treatment of children’s aphakia in the Brazilian public health system and compare the outcomes among different age groups. Methods: Children aged 0-12 years old with unilateral or bilateral congenital/developmental cataracts and underwent primary intraocular lens implantation were included. Results: A total of 108 eyes from 68 children were evaluated, and the children were divided into four age groups (<7 months [mo]; 7 mo-2 years old [y/o]; 2-5 y/o, and >5 y/o) were evaluated. Nineteen eyes (17.59%) presented visual axis opacification as a postoperative complication, which was more frequently observed in the <7 mo age group (37.93%). The difference was significant between the <7 mo and >5 y/o age groups (p=0.002). Visual axis opacification was divided into two categories: pupillary membrane and lens cell proliferation. Eight eyes presented pupillary membrane, whereas 14 showed lens cell proliferation. Out of eight eyes with pupillary membrane, seven occurred in the <7 mo age group. The difference between the <7 mo age group and the 2-5 y/o or >5 y/o age group was significant (p=0.01). Lens cell proliferation was more frequent in the <7 mo and 2-5 y/o age groups, but the difference was significant only between the < 7 mo age group and >5 y/o age group (p=0.040). Glaucoma and glaucoma suspect cases were not observed during the follow-up period. Conclusions: The main complication found in the study was visual axis opacification, which had a higher incidence in children operated on or before the age of 7 months. Purpose childrens s Methods 012 0 12 0-1 congenitaldevelopmental congenital developmental included Results 10 6 evaluated (< [mo] mo2 2 mo- yo y o [y/o] 25 5 2- > 17.59% 1759 17 59 (17.59% 37.93%. 3793 37.93% . 37 93 (37.93%) p=0.002. p0002 p p=0.002 002 (p=0.002) categories 1 p=0.01. p001 p=0.01 01 (p=0.01) p=0.040. p0040 p=0.040 040 (p=0.040) followup follow up period Conclusions 0- ( [mo [y/o 17.59 175 (17.59 379 37.93 3 9 (37.93% p000 p=0.00 00 (p=0.002 p00 p=0.0 (p=0.01 p004 p=0.04 04 (p=0.040 17.5 (17.5 37.9 (37.93 (p=0.00 p0 p=0. (p=0.0 (p=0.04 17. (17. 37. (37.9 p=0 (p=0. (17 (37. p= (p=0 (1 (37 (p= (3 (p

RESUMO Objetivo: Avaliar o implante de lente intraocular primária para tratamento da afacia pediátrica no Sistema Único de Saúde (SUS) e comparar os resultados em diferentes faixas etárias. Métodos: Foram incluídas crianças com catarata congênita e do desenvolvimento unilateral ou bilateral de 0-12 anos de idade e submetidas a implante de lente intraocular primária. Resultados: Cento e oito olhos de 68 crianças divididas em quatro grupos de idade (<7m; 7m-2a; 2-5a e > 5a) foram avaliados. Dezenove olhos (17,59%) apresentaram opacificação do eixo visual como complicação pós-operatória. Essa complicação foi mais frequente na faixa etária <7 meses (37,93%). A diferença foi significativa entre os grupos de idade <7 meses e > 5 anos (p=0,002). A opacificação do eixo visual foi dividida em duas categorias: membrana pupilar e proliferação de células do cristalino. Oito olhos apresentaram membrana pupilar e 14 proliferação de células do cristalino. Dos oito olhos com membrana pupilar, sete ocorreram na faixa etária <7 meses. A diferença entre o grupo de idade <7 meses e os grupos de 2-5 anos e > 5 anos foi significativa (p=0,01). A proliferação de células do cristalino foi mais frequente nos grupos de idade <7 meses e 2-5 anos, mas significativa apenas quando comparados o grupo de idade <7 meses com o grupo> 5 anos de idade (p=0,040). Glaucoma e suspeitos de glaucoma não foram observados durante o acompanhamento. Conclusões: A principal complicação encontrada no estudo foi a opacificação do eixo visual. Sua incidência foi maior em crianças operadas antes dos 7 meses de idade. Objetivo SUS (SUS etárias Métodos 012 0 12 0-1 Resultados 6 <7m 7m m (<7m 7m2a ma 2a 7m-2a 25a 2 5a avaliados 17,59% 1759 17 59 (17,59% pósoperatória. pósoperatória pós operatória. operatória pós-operatória < 37,93%. 3793 37,93% . 37 93 (37,93%) p=0,002. p0002 p p=0,002 002 (p=0,002) categorias 1 25 2- p=0,01. p001 p=0,01 01 (p=0,01) p=0,040. p0040 p=0,040 040 (p=0,040) acompanhamento Conclusões 0- 17,59 175 (17,59 379 37,93 3 9 (37,93% p000 p=0,00 00 (p=0,002 p00 p=0,0 (p=0,01 p004 p=0,04 04 (p=0,040 17,5 (17,5 37,9 (37,93 (p=0,00 p0 p=0, (p=0,0 (p=0,04 17, (17, 37, (37,9 p=0 (p=0, (17 (37, p= (p=0 (1 (37 (p= ( (3 (p

Abstract Objective Given the divergence of opinions on the need for complementary tests such as ultrasonography (US) and electroneuromyography (ENMG) for the diagnosis of carpal tunnel syndrome (CTS), we aimed to elucidate which of them presents greater accuracy for the confirmation of the presence or not of this condition. Methods A total of 175 patients from a hand surgery outpatient clinic were clinically evaluated, and the results of clinical trials (Tinel, Phalen and Durkan), US (normal or altered), and ENMG (normal, mild, moderate and severe) were noted, crossed, and submitted to a statistical analysis to verify the agreement between them. Results with the sample had a mean age of 53 years, with a prevalence of female patients (159 cases). Of the patients with positive clinical test, 43.7% had normal US and 41.7% had no alterations on the ENMG. Negative results were found on the Tinel in 46.9%, on the Phalen in 47.4%, and on the Durkan in 39.7%. In the crossing between the results of the ENMG and those of the other diagnostic methods, there was little statistical agreement between them. Conclusion There was no agreement between the results of the clinical examinations, the US and the ENMG in the diagnosis of CTS, and there is no clinical or complementary examination for CTS that accurately determines the therapeutic approach. Level of Evidence IV, Case Series. (US (ENMG , (CTS) condition 17 evaluated Tinel, (Tinel Durkan, Durkan) altered, altered altered) normal, mild severe noted crossed 5 years 159 (15 cases. cases . cases) test 437 43 7 43.7 417 41 41.7 469 46 9 46.9% 474 47 4 47.4% 397 39 39.7% methods examinations approach IV Series (CTS 1 15 (1 43. 41. 46.9 47.4 3 39.7 ( 46. 47. 39.

Resumo Objetivo Diante da divergência sobre a necessidade de exames complementares, como ultrassonografia (US) e eletroneuromiografia (ENMG) para o diagnóstico da síndrome do túnel do carpo (STC), objetivamos elucidar qual deles apresenta maior precisão na confirmação da presença ou não desta afecção. Métodos Um total de 175 pacientes de um ambulatório de cirurgia da mão foram avaliados clinicamente, e os resultados dos testes clínicos (Tinel, Phalen e Durkan), da US (normal ou alterada) e da ENMG (normal, leve, moderada e grave) foram anotados, cruzados, e submetidos a análise estatística para verificar a concordância entre eles. Resultados A idade média da amostra era de 53 anos, sendo prevalente o sexo feminino (159 casos). Dos pacientes com teste clínico positivo, 43,7% apresentavam US normal, e 41,7%, ENMG sem alterações. Foram encontrados resultados negativos no Tinel em 46,9% no Phalen em 47,4%, e no Durkan em 39,7%. No cruzamento entre a ENMG e os demais métodos diagnósticos, houve pouca concordância estatística. Conclusão Não houve concordância entre os resultados dos exames clínicos, da US e da ENMG no diagnóstico da STC, e não há exame clínico ou complementar para STC que determine a conduta terapêutica com precisão. Nível de Evidência IV, Série de Casos. complementares (US (ENMG , (STC) afecção 17 clinicamente Tinel, (Tinel Durkan, Durkan) normal alterada leve grave anotados cruzados eles 5 anos 159 (15 casos. casos . casos) positivo 437 43 7 43,7 417 41 41,7% alterações 469 46 9 46,9 474 47 4 47,4% 397 39 39,7% diagnósticos IV Casos (STC 1 15 (1 43, 41,7 46, 47,4 3 39,7 ( 41, 47, 39,

This study aims to identify and analyze factors associated with Food Insecurity (FI), trends and spatial distributions for geographical strata. The hypothesis of worsening of the outcome of severe FI, measured by the Brazilian Food Insecurity Scale (EBIA), in households as an effect of the crisis and/or the austerity policy, was investigated. The article involves studies with cross-sectional design and mixed ecological of spatio-temporal trends, based on 4 national IBGE surveys. It was adopted a weight calibration procedure according to population distribution by gender and age group, as well as estimation and modeling methods that incorporate effects of the sample design. Poisson regression with robust estimation of variance was used to estimate prevalence ratios of severe FI at the etiological level. For the ecological level, two multilevel modeling approaches were employed for repeated measures of strata: multiple log-log regression for associations; and, modeling of splines for trend estimation. The findings point to impacts of the current austerity, with changes in trends in the Bolsa Família Program and reflections on the increase in severe FI. It is projected an increase in FI and distance from the achievement of the SDG nº 2 in 2030 by Brazil, despite the success obtained in 2014 for MDG nº 1.

Este estudio tiene como objetivo identificar y analizar los factores asociados a la Inseguridad Alimentaria (IF), tendencias y distribución espacial por estratos geográficos. Se investigó la hipótesis de empeoramiento del resultado de la IF severa, medida por la Escala Brasileña de Inseguridad Alimentaria (EBIA), en los hogares como efecto de la crisis y/o de la política de austeridad. El artículo trata de estudios con diseño transversal para análisis ecológicos transversales y mixtos de tendencias espacio-temporales, a partir de 4 encuestas nacionales del IBGE. Se adoptó un procedimiento de calibración de peso de acuerdo con la distribución por sexo y grupo de edad y métodos de estimación y modelado que incorporan efectos del diseño de la muestra. Se utilizó la regresión de Poisson con estimación robusta de la varianza para estimar los índices de prevalencia de la IA grave a nivel etiológico. Para el nivel ecológico, se emplearon dos enfoques de modelado multinivel para medidas repetidas de estratos: regresión logarítmica múltiple para asociaciones; y modelado de splines para la estimación de tendencias. Los hallazgos apuntan a impactos de la actual austeridad, con cambios de tendencia en el Programa Bolsa Família y reflejos sobre el aumento de la IF severa. Se proyecta un aumento de la IA y distancia de la consecución del objetivo nº 2 de los ODS en 2030 por parte de Brasil, a pesar del éxito obtenido en 2014 para el ODM nº 1.

Este estudo visa identificar e analisar fatores associados à Insegurança Alimentar (IA), tendências e distribuição espacial para estratos geográficos. Investigou-se a hipótese de piora do desfecho de IA grave, medido pela Escala Brasileira de Insegurança Alimentar (EBIA), nos domicílios como efeito da crise e/ou da política de austeridade. O artigo envolve estudos com desenho transversal para análises seccionais e ecológico misto de tendências espaço-temporais, a partir de 4 inquéritos nacionais do IBGE. Adotou-se procedimento de calibração dos pesos segundo distribuição por sexo e faixa etária e métodos de estimação e modelagem que incorporam efeitos do desenho amostral. A regressão de Poisson com estimação robusta de variância foi empregada para estimar razões de prevalências de IA grave em nível etiológico. Para o nível ecológico, empregou-se duas abordagens de modelagem multinível para medidas repetidas de estratos: regressão múltipla log-log para associações; e, modelagem de splines para estimação de tendências. Os achados apontam impactos da austeridade vigente, com mudanças de tendências no Programa Bolsa Família e reflexos sobre o aumento da IA grave. Projeta-se o aumento da IA e afastamento do alcance do objetivo nº 2 dos ODS em 2030 pelo Brasil, a despeito do sucesso obtido em 2014 para o ODM nº 1.

RESUMO Objetivo: Este estudo teve como objetivo analisar a distribuição espacial da hanseníase e as incapacidades em menores de 15 anos de idade em Cuiabá. Métodos: Estudo ecológico realizado na cidade de Cuiabá, Mato Grosso, Brasil. A população do estudo foi composta de casos de hanseníase em menores de 15 anos notificados no Sistema de Informações de Agravos de Notificação, entre os anos de 2008 e 2018. Com base nos endereços residenciais, os casos foram georreferenciados. Na análise da distribuição espacial dos casos, foi utilizada a estimativa da densidade de Kernel e, posteriormente, aplicada a estatística de varredura espacial, espaço-temporal e variação espacial nas tendências temporais. Resultados: Foram notificados 514 casos de hanseníase em menores de 15 anos em Cuiabá, com percentual de 10,1% de casos com grau de incapacidade física 1 e 2,3% com grau de incapacidade física 2 no momento do diagnóstico. Com as técnicas de varredura espacial e espaço-temporal, foram identificados aglomerados de risco para hanseníase nas regiões norte, oeste, leste e sul de Cuiabá, e com a técnica de variação espacial nas tendências temporais foi identificado um aglomerado na região oeste de Cuiabá. Conclusão: Em Cuiabá, os casos de hanseníase em menores de 15 anos com incapacidades estavam distribuídos em toda a extensão urbana da cidade, com maior densidade de casos nas regiões norte e oeste, seguida da região leste. Os aglomerados de maior risco relativo foram identificados nas regiões leste e oeste, caracterizadas por apresentar baixo e médio níveis de renda.

ABSTRACT Objective This study aimed to analyze the spatial distribution of leprosy and disabilities in children under 15 years of age in Cuiabá. Methods Ecological study carried out in the city of Cuiabá, Mato Grosso, Brazil. The study population consisted of leprosy cases in children under 15 years old notified in the Notifiable Diseases Information System, between 2008 and 2018. Based on residential addresses, cases were georeferenced. In the analysis of the spatial distribution of the cases, the estimation of the Kernel density was used and, later, the statistics of spatial, spatio-temporal and Spatial Variation in Temporal Trends were applied. Results 514 cases of leprosy were reported in children under 15 years of age in Cuiabá, with a percentage of 10.1% of cases with degree of physical disability 1 and 2.3% with degree of physical disability 2 at the time of diagnosis. With the techniques of spatial and spatio-temporal scanning, clusters of risk for leprosy were identified in the North, West, East and South regions of Cuiabá, and with the technique of Spatial Variation in Temporal Trends, a cluster was identified in the West region of Cuiabá. Conclusion In Cuiabá, cases of leprosy in children under 15 years of age with disabilities were distributed throughout the urban area of the city, with the highest density of cases in the North and West regions, followed by the East region. The clusters with the highest Relative Risk were identified in the East and West regions, characterized by having low and medium income levels

ABSTRACT Among the multi-trait models selected to study several traits and environments jointly, the Bayesian framework has been a preferred tool when constructing a more complex and biologically realistic model. In most cases, non-informative prior distributions are adopted in studies using the Bayesian approach. However, the Bayesian approach presents more accurate estimates when informative prior distributions are used. The present study was developed to evaluate the efficiency and applicability of multi-trait multi-environment (MTME) models within a Bayesian framework utilizing a strategy for eliciting informative prior distribution using previous data on rice. The study involved data pertaining to rice (Oryza sativa L.) genotypes in three environments and five crop seasons (2010/2011 until 2014/2015) for the following traits: grain yield (GY), flowering in days (FLOR) and plant height (PH). Variance components, genetic and non-genetic parameters were estimated using the Bayesian method. In general, the informative prior distribution in Bayesian MTME models provided higher estimates of individual narrow-sense heritability and variance components, as well as minor lengths for the highest probability density interval (HPD), compared to their respective non-informative prior distribution analyses. More informative prior distributions make it possible to detect genetic correlations between traits, which cannot be achieved with non-informative prior distributions. Therefore, this mechanism presented to update knowledge for an elicitation of an informative prior distribution can be efficiently applied in rice breeding programs.

ABSTRACT. The study of traits in crops enables breeders to guide strategies for selecting and accelerating the progress of genetic breeding. Although the simultaneous evaluation of characteristics in the plant breeding programme provides large quantities of information, identifying which phenotypic characteristic is the most important is a challenge facing breeders. Thus, this work aims to quantify the best approaches for prediction and establish a network of better predictive power in flood-irrigated rice via methodologies based on regression, artificial intelligence, and machine learning. Multiple regression, computational intelligence, and machine learning were used to predict the importance of the characteristics. Computational intelligence and machine learning were notable for their ability to extract nonlinear information from model inputs. Predicting the relative contribution of auxiliary characteristics in rice through computational intelligence and machine learning proved to be efficient in determining the relative importance of variables in flood-irrigated rice. The characteristics indicated to assist in decision making are flowering, number of grains filled by panicles and length of panicles for this study. The network with only one hidden layer with 15 neurons was observed to be efficient in determining the relative importance of variables in flooded rice. ABSTRACT Thus floodirrigated flood irrigated regression inputs flowering 1

ABSTRACT Variation in rainfall affects crops; therefore, agricultural practices become essential for forage production in semi-arid regions. This study aimed to evaluate the influence of different agricultural practices on phyllochron, structural characteristics of forage cactus and millet, and their relations with crop yield using the principal component analysis (PCA). The design was in randomized blocks, with six treatments: sole cropped cactus without straw mulching, sole cropped cactus with straw mulching, sole cropped millet without straw mulching, sole cropped millet with straw mulching, and cactus intercropping with millet, with and without straw mulching, each with four replicates. There were three cactus cycles and nine millet cycles (three cycles of cultivars BRS1501 and six of IPA Bulk-1-BF). Biometric parameters were evaluated monthly, while yield was determined after the crop harvest. Phyllochron was determined with the regression analysis. The PCA was applied to structural characteristics and yield. The systems adopted did not influence the structural characteristics of cactus and millet ( p > 0.05), except for cladode thickness, which increased with straw mulching. Phyllochron of the millet reduced when the crop was intercropped. The structural characteristics of cladode length, width, and thickness influenced crop yield, mainly in systems with straw mulching. Straw mulching and intercropping alter phyllochron of cactus and millet. The adoption of straw mulching has a more significant relationship with cactus yield, whereas biometric variables influence crop yield for millet, not the cropping system. crops therefore semiarid semi arid regions PCA. . (PCA) blocks treatments replicates BRS BRS150 Bulk1BF. Bulk1BF BulkBF Bulk 1 BF Bulk-1-BF) monthly harvest 0.05, 005 0.05 , 0 05 0.05) intercropped length width system (PCA BRS15 Bulk-1-BF 00 0.0 BRS1 0.

ABSTRACT Congenital and gestational syphilis are increasingly prevalent multisystemic infections in Brazil. This study aimed to present a case series of three children diagnosed with congenital syphilis even though their mother had unreactive treponemal tests. The VDRL (Venereal Disease Research Laboratory) titers of a 22-year-old mother with three pregnancies decreased after treatment. The mother did not have a reactive treponemal test, but all the three children were diagnosed with early congenital syphilis. This case series highlights the difficulty in diagnosing gestational and congenital syphilis in Brazil. Brazil tests Venereal Laboratory 22yearold yearold 22 year old treatment test 2

Abstract Healthcare workers present an increased risk of contagion for the SARS-CoV-2 virus due to their labor exposure. Here, we describe the clinical, laboratory, and immunological characteristics of healthcare workers, before vaccine application, exposed to SARS-CoV-2-infected patients. We collected sociodemographic, clinical, and laboratory information from 50 professionals who worked during the COVID-19 pandemic at the Clinical Hospital of the Northwest in Brazil. The results showed that most workers are women, over 50 years old, and worked as nursing technicians. Approximately 56% of workers were positive for a previous infection by RT-PCR and/or anti-SARS-CoV-2-immunoglobulin tests. Increased levels of hematocrit, neutrophils, NK lymphocytes, and fibrinogen, were found in positive healthcare workers, suggesting a light inflammatory status. The immunological findings showed an increase in IL-17 production and a Th2/Th17/Th22 profile followed by high serology for anti-SARS-CoV-2 IgM and IgG. Those data reveal the importance of studies with healthcare workers to investigate if the continuous exposition to the virus may result in chronic activation of the immune system and/or pulmonary inflammation in this target group. SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- exposure Here clinical application SARSCoV2infected SARSCoVinfected infected patients sociodemographic 5 COVID19 COVID 19 COVID-1 Brazil women old technicians 56 RTPCR RT PCR andor or antiSARSCoV2immunoglobulin antiSARSCoVimmunoglobulin anti immunoglobulin tests hematocrit neutrophils lymphocytes fibrinogen status IL17 IL 17 IL-1 Th2Th17Th22 ThThTh Th2 Th17 Th22 Th Th2/Th17/Th2 antiSARSCoV2 antiSARSCoV anti-SARS-CoV- IgG group SARS-CoV COVID1 1 COVID- IL1 IL- Th2Th17Th2 Th1 Th2/Th17/Th anti-SARS-CoV Th2Th17Th

Abstract This research shows that brackish water increases the unconfined compressive strength of swelling soil/sugarcane bagasse ash (SCBA)/lime blends. Therefore, brackish water may substitute tap water in soil stabilization. Sodium chloride (NaCl) has been used in lime-ashes-soil treatments. In northeast Brazil, swelling soils are usual and artesian wells sometimes provide brackish water containing NaCl. Northeast Brazil also has a strong sugar and ethanol industry producing sugarcane bagasse ash (SCBA) as a byproduct. Therefore, brackish water can be used in soil-SCBA-lime stabilization. Hence, this work aims to evaluate the use of brackish water as a substitute for tap water in swelling soil-SCBA-lime blends stabilization. Two series of unconfined compression tests were carried out: one with tap water and the other with brackish water. In each group, the lime content varied from 4% to 8%, and the dry density from 13 kN/m3 to 15 kN/m3. All tests were carried out with a swelling soil-SCBA proportion of 75/25 and a water content of 22%. Results have shown that increasing lime content or dry density or using brackish water allowed to increase unconfined compression strength of swelling soil-SCBA-lime blends. The porosity/volumetric content of lime index (η/Liv) was suitable to predict the unconfined compressive strength of swelling soil-SCBA-lime blends, no matter if tap or brackish water was used in the molding process. Thus, brackish can be a feasible substitute for tap water in swelling soil-SCBA-lime stabilization, increasing blends unconfined compression strength, and preserving tap water, a scarce asset in Northeast Brazil. soilsugarcane SCBA/lime SCBAlime SCBA /lime Therefore stabilization NaCl (NaCl limeashessoil ashes treatments (SCBA byproduct soilSCBAlime Hence group 4 8 8% 1 kNm3 kNm kN m3 m kN/m soilSCBA 7525 75 25 75/2 22 22% porosityvolumetric porosity volumetric η/Liv ηLiv η Liv (η/Liv process Thus 752 7 2 75/