ABSTRACT Background: To evaluate the relationship between the ratio of affected lymph nodes (LNR) and clinical and anatomopathological variables in patients with rectal adenocarcinoma submitted or not to neoadjuvant chemoradiotherapy. Methods: The LNR was determined by dividing the number of compromised LNR by the total number of LNR dissected in the surgical specimen. Patients were divided into two groups: with QRT and without QRT. In each group, the relationship between LNR and the following variables was evaluated: degree of cell differentiation, depth of invasion in the rectal wall, angiolymphatic /perineural invasion, degree of tumor regression and occurrence of metastases. The LNR was evaluated in patients with more than 1, LNR (LNR >12) or less (LNR<12) in the surgical specimen with overall survival (OS) and disease-free survival (DFS). The results were expressed as the mean with the respective standard deviation. Qualitative variables were analyzed using Fisher’s exact test, while quantitative variables were analyzed using the Kruskal -Wallis and Mann-Whitney tests. The significance level was 5%. Results: We evaluated 282 patients with QRT and 114 without QRT, between 1995-2011. In the QRT Group, LNR showed a significant association with mucinous tumors (P=0.007) and degree of tumor regression (P=0.003). In both groups, LNR was associated with poorly differentiated tumors (P=0.001, P=0.02), presence of angiolymphatic invasion (P<0.0001 and P=0.01), perineural (P=0.0007, P=0.02), degree of rectal wall invasion (T3>T2; P<0.0001, P=0.02); Compromised LNR (P<0.0001, P<0.01), metastases (P<0.0001, P<0.01). In patients with QRT, LNR<12 was associated with DFS (5.889; 95%CI1.935-19.687; P=0.018) and LNR>12 with DFS and OS (17.984; 95%CI5.931-54.351; P<0.001 and 10.286; 95%CI 2.654-39.854; P=0.007, respectively). Conclusion: LNR was associated with histological aspects of poor prognosis, regardless of the use of QRT. In the occurrence of less than 12 evaluated LNR, the LNR was associated only with the DFS. Background chemoradiotherapy Methods groups group differentiation 1 >12 LNR12 (LNR<12 (OS diseasefree disease free . (DFS) deviation Fishers Fisher s test Wallis MannWhitney Mann Whitney tests 5 5% Results 28 11 19952011. 19952011 1995 2011. 2011 1995-2011 Group P=0.007 P0007 P 0 007 (P=0.007 P=0.003. P0003 P=0.003 003 (P=0.003) P=0.001, P0001 001 (P=0.001 P=0.02, P002 P=0.02 , 02 P=0.02) P<0.0001 P00001 0001 (P<0.000 P=0.01, P001 P=0.01 01 P=0.01) P=0.0007, P00007 0007 (P=0.0007 T3>T2 T3T2 TT T3 T2 T (T3>T2 P<0.01, P<0.01 P<0.01) P<0.01. LNR<1 5.889 5889 889 (5.889 95%CI1.93519.687 95CI193519687 CI 95%CI1.935 19.687 95 CI1 935 19 687 95%CI1.935-19.687 P=0.018 P0018 018 LNR>1 17.984 17984 17 984 (17.984 95%CI5.93154.351 95CI593154351 95%CI5.931 54.351 CI5 931 54 351 95%CI5.931-54.351 P<0.00 10.286 10286 10 286 95CI 2.65439.854 265439854 2.654 39.854 2 654 39 854 2.654-39.854 respectively. respectively respectively) Conclusion prognosis >1 LNR1 (LNR<1 (DFS 1995201 199 201 1995-201 P=0.00 P000 00 (P=0.00 (P=0.003 P=0.001 P00 P=0.0 P<0.000 P0000 000 (P<0.00 P=0.0007 (P=0.000 T3>T T3T (T3>T P<0.0 LNR< 5.88 588 88 (5.88 93519 95%CI1.93519.68 95CI19351968 95CI1935 95%CI1.93 19687 19.68 9 93 68 95%CI1.935-19.68 LNR> 17.98 1798 98 (17.98 93154 95%CI5.93154.35 95CI59315435 95CI5931 95%CI5.93 54351 54.35 35 95%CI5.931-54.35 10.28 1028 65439 2.65439.85 26543985 2654 2.65 39854 39.85 65 3 85 2.654-39.85 > (LNR< 199520 20 1995-20 (P=0.0 P0 P=0. (P<0.0 P=0.000 P<0. 5.8 58 8 (5.8 9351 95%CI1.93519.6 95CI1935196 95CI193 95%CI1.9 1968 19.6 6 95%CI1.935-19.6 17.9 179 (17.9 9315 95%CI5.93154.3 95CI5931543 95CI593 95%CI5.9 5435 54.3 95%CI5.931-54.3 10.2 102 6543 2.65439.8 2654398 265 2.6 3985 39.8 2.654-39.8 19952 1995-2 (P=0. P=0 (P<0. P<0 5. (5. 95%CI1.93519. 95CI193519 95CI19 95%CI1. 196 19. 95%CI1.935-19. 17. (17. 95%CI5.93154. 95CI593154 95CI59 95%CI5. 543 54. 95%CI5.931-54. 10. 2.65439. 265439 26 2. 398 39. 2.654-39. 1995- (P=0 P= (P<0 P< (5 95%CI1.93519 95CI19351 95CI1 95%CI1 95%CI1.935-19 (17 95%CI5.93154 95CI59315 95CI5 95%CI5 95%CI5.931-54 2.65439 26543 2.654-39 (P= (P< ( 95%CI1.9351 95%CI1.935-1 (1 95%CI5.9315 95%CI5.931-5 2.6543 2.654-3 (P 95%CI1.935- 95%CI5.931- 2.654-

RESUMO Contexto: Avaliar a relação entre a razão de linfonodos (RLA) acometidos e variáveis clínicas e anatomopatológicas em portadores de adenocarcinoma de reto submetidos ou não à quimiorradioterapia neoadjuvante. Métodos: A RLA foi determinada dividindo-se o número total de linfonodos (LFNs) dissecados no espécime cirúrgico pelo número de comprometidos. Os doentes foram divididos em dois grupos: com QRT e sem QRT. Em cada grupo foi avaliada a relação entre a RLA e as seguintes variáveis: grau de diferenciação celular, profundidade de invasão na parede retal, invasão angiolinfática/perineural, grau de regressão tumoral e ocorrência de metástases. Avaliou-se a RLA em pacientes com mais do que 12 LFNs (RLA>12) ou menos (RLA<12) na peça cirúrgica com a sobrevida global (SG) e sobrevida livre de doença (SLD). Os resultados foram expressos pela média com o respectivo desvio padrão. As variáveis qualitativas foram analisadas utilizando-se o teste exato de Fisher, enquanto as quantitativas pelos testes de Kruskal-Wallis e Mann-Whitney. O nível de significância foi de 5%. Resultados: Foram avaliados 282 pacientes com QRT e 114 sem QRT, entre 1995-2011. No Grupo QRT, RLA mostrou associação significativa com os tumores mucinosos (P=0,007) e grau de regressão tumoral (P=0,003). Nos dois grupos, a RLA associou-se com tumores pouco diferenciados (P=0,001 e P=0,02), presença de invasão angiolinfática (P<0,0001 e P=0,01), perineural (P=0,0007 e P=0,02), grau de invasão da parede retal (T3>T2; P<0,0001 e P=0,02); LFNs comprometidos (P<0,0001 e P<0,01), metástases (P<0,0001 e P<0,01). Nos pacientes com QRT, a RLA <12 associou-se com a SLD (5,889; IC95%1,935-19,687; P=0,018) e a RLA >12 com SLD e SG (17,984; IC95%5,931-54,351; P<0,001 e 10,286; IC95%2,654-39,854; P=0,007, respectivamente). Conclusão: A RLA associou-se a aspectos histológicos de mau prognóstico, independentemente do emprego de QRT. Na ocorrência de menos de 12 LFNs avaliados, a RLA associou-se apenas com a SLD. Contexto (RLA neoadjuvante Métodos dividindose dividindo se (LFNs grupos celular angiolinfáticaperineural angiolinfática/perineural Avaliouse Avaliou 1 RLA>12 RLA12 (RLA>12 RLA<12 (RLA<12 (SG . (SLD) padrão utilizandose utilizando Fisher KruskalWallis Kruskal Wallis MannWhitney. MannWhitney Mann Whitney. Whitney Mann-Whitney 5 5% Resultados 28 11 19952011. 19952011 1995 2011. 2011 1995-2011 P=0,007 P0007 P 0 007 (P=0,007 P=0,003. P0003 P=0,003 003 (P=0,003) associouse associou P=0,001 P0001 001 (P=0,00 P=0,02, P002 P=0,02 , 02 P=0,02) P00001 0001 (P<0,000 P=0,01, P001 P=0,01 01 P=0,01) P=0,0007 P00007 0007 (P=0,000 T3>T2 T3T2 TT T3 T2 T (T3>T2 P<0,000 P<0,01, P<0,01 P<0,01) P<0,01. <1 5,889 5889 889 (5,889 IC95%1,93519,687 IC95193519687 IC IC95%1,935 19,687 IC95 935 19 687 IC95%1,935-19,687 P=0,018 P0018 018 >1 17,984 17984 17 984 (17,984 IC95%5,93154,351 IC95593154351 IC95%5,931 54,351 931 54 351 IC95%5,931-54,351 P<0,00 10,286 10286 10 286 IC95%2,65439,854 IC95265439854 IC95%2,654 39,854 2 654 39 854 IC95%2,654-39,854 respectivamente. respectivamente respectivamente) Conclusão prognóstico RLA>1 RLA1 (RLA>1 RLA<1 (RLA<1 (SLD 1995201 199 201 1995-201 P=0,00 P000 00 (P=0,003 (P=0,0 P00 P=0,0 P0000 000 (P<0,00 P=0,000 T3>T T3T (T3>T P<0,0 < 5,88 588 88 (5,88 93519 IC95%1,93519,68 IC9519351968 IC951935 IC95%1,93 19687 19,68 IC9 93 68 IC95%1,935-19,68 > 17,98 1798 98 (17,98 93154 IC95%5,93154,35 IC9559315435 IC955931 IC95%5,93 54351 54,35 35 IC95%5,931-54,35 10,28 1028 65439 IC95%2,65439,85 IC9526543985 IC952654 IC95%2,65 39854 39,85 65 3 85 IC95%2,654-39,85 RLA> (RLA> RLA< (RLA< 199520 20 1995-20 (P=0, P0 P=0, (P<0,0 P<0, 5,8 58 8 (5,8 9351 IC95%1,93519,6 IC951935196 IC95193 IC95%1,9 1968 19,6 9 6 IC95%1,935-19,6 17,9 179 (17,9 9315 IC95%5,93154,3 IC955931543 IC95593 IC95%5,9 5435 54,3 IC95%5,931-54,3 10,2 102 6543 IC95%2,65439,8 IC952654398 IC95265 IC95%2,6 3985 39,8 IC95%2,654-39,8 19952 1995-2 (P=0 P=0 (P<0, P<0 5, (5, IC95%1,93519, IC95193519 IC9519 IC95%1, 196 19, IC95%1,935-19, 17, (17, IC95%5,93154, IC95593154 IC9559 IC95%5, 543 54, IC95%5,931-54, 10, IC95%2,65439, IC95265439 IC9526 IC95%2, 398 39, IC95%2,654-39, 1995- (P= P= (P<0 P< (5 IC95%1,93519 IC9519351 IC951 IC95%1 IC95%1,935-19 (17 IC95%5,93154 IC9559315 IC955 IC95%5 IC95%5,931-54 IC95%2,65439 IC9526543 IC952 IC95%2 IC95%2,654-39 (P (P< ( IC95%1,9351 IC95% IC95%1,935-1 (1 IC95%5,9315 IC95%5,931-5 IC95%2,6543 IC95%2,654-3 IC95%1,935- IC95%5,931- IC95%2,654-

RESUMEN Objetivos: identificar las percepciones de las madres sobre el cuidado de los recién nacidos en un entorno domiciliario, bajo la perspectiva del pensamiento de la complejidad. Métodos: es una investigación cualitativa, de carácter exploratorio y descriptivo, realizada entre noviembre de 2022 y febrero de 2023. Los datos se recopilaron mediante entrevistas individuales a 21 madres del sur de Brasil que cuidaron de neonatos en entorno domiciliario y se estudiaron bajo la óptica de la técnica del análisis temático. Resultados: los cuatro ejes temáticos resultantes del análisis de los datos fueron: convivencia en medio del orden y del desorden; acogimiento de las singularidades; lucha entre lo cierto y lo incierto; red de apoyo en el proceso de (re)organización. La madre que cuida de un recién nacido en entorno doméstico experimenta un proceso adaptativo distinto y plural, que debe ser atendido y comprendido por los profesionales sanitarios que trabajan en el ámbito familiar. Consideraciones Finales: el cuidado de los recién nacidos en un entorno doméstico, según la percepción de las madres, requiere una atención diferenciada y una red de apoyo formal o informal que tenga en cuenta las especificidades únicas de cada mujer/madre en los ámbitos personal, familiar y social. Por consiguiente, además de la red de apoyo social, es importante replantearse los enfoques de intervención en la atención domiciliaria. Objetivos complejidad Métodos cualitativa descriptivo 202 2023 2 temático Resultados fueron desorden singularidades incierto reorganización. reorganización re organización. organización (re)organización plural Finales mujermadre mujer personal social consiguiente domiciliaria 20

ABSTRACT Objectives: to identify mothers’ perceptions about caring for newborns in the home environment, from the perspective of complexity thinking. Methods: qualitative, exploratory and descriptive research, carried out between November/2022 and February/2023. Data were collected through individual interviews with 21 mothers from southern Brazil who cared for newborns at home and analyzed using the thematic analysis technique. Results: the four thematic axes resulting from the data analysis: Living amidst order and disorder; embracing singularities; dealing with the certain and the uncertain; support network in the (re)organizing process demonstrate that the mother caring for a newborn in their home environment experiences a distinct and plural adaptive process, which must be welcomed and understood by health professionals who work within the family environment. Final Considerations: the care of newborns in a home environment, in the perception of mothers, requires differentiated attention and a formal or informal support network that considers the unique specificities of each woman/mother in the personal, family and social spheres. Therefore, in addition to the social support network, it is important to rethink home intervention approaches. Objectives thinking Methods qualitative research November2022 November 2022 November/202 February2023 February 2023 February/2023 2 technique Results disorder singularities uncertain reorganizing re organizing Considerations womanmother woman personal spheres Therefore approaches November202 202 November/20 February202 February/202 November20 20 November/2 February20 February/20 November2 November/ February2 February/2 February/

RESUMO Objetivos: identificar percepções de mães sobre o cuidado de recém-nascidos em ambiente domiciliar, na perspectiva do pensamento da complexidade. Métodos: pesquisa qualitativa, de caráter exploratório e descritivo, realizada entre novembro/2022 e fevereiro/2023. Os dados foram coletados por meio de entrevistas individuais com 21 mães do sul do Brasil que cuidaram de recém-nascidos em ambiente domiciliar e analisados pela técnica de análise temática. Resultados: os quatro eixos temáticos resultantes da análise dos dados: Convivendo em meio a ordem e desordem; acolhendo às singularidades; lidando entre o certo e o incerto; rede de apoio no processo (re)organizador demonstram, que a mãe cuidadora de um recém-nascido em ambiente domiciliar vivência um processo adaptativo distinto e plural, que deve ser acolhido e compreendido pelos profissionais de saúde que atuam em âmbito familiar. Considerações Finais: o cuidado de recém-nascidos em ambiente domiciliar, na percepção de mães, requer atenção diferenciada e uma rede de apoio formal ou informal que considere as especificidades singulares de cada mulher/mãe em âmbito pessoal, familiar e social. Assim, para além da rede de apoio social é importante que se repense as abordagens de intervenção domiciliar. Objetivos recémnascidos recém nascidos complexidade Métodos qualitativa descritivo novembro2022 novembro 2022 novembro/202 fevereiro2023 fevereiro 2023 fevereiro/2023 2 temática Resultados desordem singularidades incerto reorganizador re organizador demonstram recémnascido nascido plural Finais mulhermãe mulher pessoal Assim novembro202 202 novembro/20 fevereiro202 fevereiro/202 novembro20 20 novembro/2 fevereiro20 fevereiro/20 novembro2 novembro/ fevereiro2 fevereiro/2 fevereiro/

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 At low concentrations used for in-office bleaching gels, such as 6% HP, gingival barrier continues to be performed. If we take into account that, in the at-home bleaching technique, no barrier is indicated, it seems that the use of a gingival barrier fails to make much sense when bleaching gel in low concentration is used for in-office bleaching. Objective This double-blind, split-mouth, randomized clinical trial evaluated the gingival irritation (GI) of in-office bleaching using 6% hydrogen peroxide (HP) with and without a gingival barrier in adolescents, as well as color change and the impact of oral condition on quality of life. Methodology Overall, 60 participants were randomized into which side would or would not receive the gingival barrier. In-office bleaching was performed for 50 minutes with 6% HP in three sessions. The absolute risk and intensity of GI were assessed with a visual analogue scale. Color change was assessed using a digital spectrophotometer and color guides. The impact of oral condition on quality of life was assessed using the Brazilian version of the Oral Health Impact Profile (α=0.05). Results The proportion of patients who presented GI for the “with barrier” group was 31.6% and for the “without barrier” group, 30% (p=1.0). There is an equivalence for the evaluated groups regarding GI intensity (p<0.01). Color change was detected with no statistical differences (p>0.29). There was a significant impact of oral condition on quality of life after bleaching (p<0.001). Conclusions The use or not of the gingival barrier for in-office bleaching with 6% HP was equivalent for GI, as well as for bleaching efficacy, with improvement in the impact of oral condition on quality of life. inoffice office gels 6 athome at home technique indicated doubleblind, doubleblind double blind, blind double-blind splitmouth, splitmouth split mouth, mouth split-mouth (GI (HP adolescents Overall Inoffice In 5 sessions scale guides α=0.05. α005 α α=0.05 . 0 05 (α=0.05) 316 31 31.6 30 p=1.0. p10 p p=1.0 1 (p=1.0) p<0.01. p001 p<0.01 01 (p<0.01) p>0.29. p029 p>0.29 29 (p>0.29) p<0.001. p0001 p<0.001 001 (p<0.001) efficacy α00 α=0.0 (α=0.05 3 31. p1 p=1. (p=1.0 p00 p<0.0 (p<0.01 p02 p>0.2 2 (p>0.29 p000 p<0.00 00 (p<0.001 α0 α=0. (α=0.0 p=1 (p=1. p0 p<0. (p<0.0 p>0. (p>0.2 (p<0.00 α=0 (α=0. p= (p=1 p<0 (p<0. p>0 (p>0. α= (α=0 (p= p< (p<0 p> (p>0 (α= (p (p< (p> (α

ABSTRACT: Hops are grown mainly for the brewing market due to the rich chemical composition that gives beer aroma and bitterness. Brazil is one of the largest beer producers and consumers in the world and one of the largest hop importers. There is growing demand and interest in producing hops for domestic supply; however, as this crop originates from a temperate climate and the Northern Hemisphere, it is important to carry out research that describes the development of hops in a tropical climate to provide information on its cultivation in Brazil, as well as to determine its behavior in organic cultivation. A randomized block design was adopted, the treatments consisted of two cropping systems, conventional and organic, for Hallertau Mittelfrueh variety cultivation, with four blocks and three plants per plot. Gas exchange analyzes of plants under both cultivation systems were performed to obtain measurements of A, g s , Ci, E, WUE and A/Ci, morphometric and yield analyzes were also carried out. In comparison with the plants of the organic system, the plants of the conventional cultivation had greater photosynthetic efficiency; however, the practices adopted in the organic cultivation system provided the plants with greater productive capacity. ABSTRACT bitterness importers supply however Hemisphere plot Ci E ACi A/Ci efficiency capacity

RESUMO: O lúpulo é cultivado principalmente para o mercado cervejeiro devido à rica composição química que confere aroma e amargor à cerveja. O Brasil é um dos maiores produtores e consumidores de cerveja do mundo e um dos maiores importadores de lúpulo. Há crescente demanda e interesse na produção de lúpulo para abastecimento interno; porém, como essa cultura é originária de clima temperado e do Hemisfério Norte, é importante a realização de pesquisas que descrevam o desenvolvimento do lúpulo em clima tropical para fornecer informações sobre seu cultivo no Brasil, bem como determinar seu comportamento em cultivo orgânico cultivo. Adotou-se o delineamento em blocos ao acaso, e os tratamentos consistiram em dois sistemas de cultivo, convencional e orgânico, para a variedade Hallertau Mittelfrueh, com quatro blocos e três plantas por parcela. Análises de trocas gasosas de plantas sob ambos os sistemas de cultivo foram realizadas para obter medidas de A, gs, Ci, E, WUE e A/Ci, análises morfométricas e de produção também foram realizadas. Em comparação com as plantas do sistema orgânico, as plantas do cultivo convencional apresentaram maior eficiência fotossintética. No entanto, as práticas adotadas no sistema de cultivo orgânico proporcionaram maior capacidade produtiva às plantas. RESUMO interno porém Norte Adotouse Adotou se acaso Mittelfrueh parcela A gs Ci E ACi A/Ci fotossintética entanto

Abstract The total cost of processes that use lipases can be reduced by using the mycelium or not purified crude extract with lipolytic activity. These catalysts can be used without complex purification and can show desirable properties to emerging applications like hydrolysis and biotransformation of vegetable oils. To explore the potential of multiple forms of lipases (produced by the same filamentous fungus species), this work investigated intracellular and extracellular lipases produced by Trichoderma koningii (intracellular lipases were never studied), Penicillium spp. F02 (isolated from industrial grease trap) and Aspergillus niger. For this, batch fermentations were conducted for 96h using olive oil as a carbon source. The submerged culture was interrupted with vacuum filtration to isolate the mycelium and crude extract. The lipolytic activities were determined by the hydrolysis method of olive oil. The best results were obtained for intracellular activity with T. koningii (81.5 U/g of dry biomass) and for extracellular activity with A. niger (10.6 U/mL of crude extract). Both were attained in 96h of fermentation. T. koningii showed an accumulation of intracellular lipases and a depreciated extracellular activity in the initial 24 hours, which can be reasonable indications that there is strong retention of lipases in the mycelium. Statistical analysis within the range of 37°C to 44°C associated with pH from 7.8 to 8.0 favored the activity of lipases from T. koningii. All these findings are promising for future studies in the enzymatic synthesis of biodiesel with lipases (intracellular and extracellular) from T. koningii. oils species, species , species) studied, studied studied) spp F F0 isolated trap h source T 81.5 815 81 5 (81. Ug U g biomass A 10.6 106 10 6 (10. UmL mL . extract) fermentation 2 hours 37C C 37 44C 44 78 7 8 7. 80 0 8. 81. (81 10. 1 (10 3 4 (8 (1 (

Abstract Laterite gravels have been successfully adopted as pavement materials in the field. Despite that, they are often rejected in material selection processes because of its base on traditional gradation and consistency limits requirements. To allow a deeper evaluation of such material found abundantly in tropical countries, along to characterizing traditional parameters, repeated load triaxial tests were performed in a Laterite Gravel from Acre/Brazil to evaluate its elastic and plastic behavior through Resilient Modulus (RM) and Permanent Deformation (PD), respectively. In addition, a simulation was conducted in the MeDiNa software, based on the test results considering stress states that are usually applied in pavement layers. The material showed RM values higher than 500 MPa, which was considered high compared to materials such as Quartz and Granite. It was also observed low permanent deformation (below 1 mm for higher tensions applied) and accommodation of displacement (shakedown) for most specimens. The simulation results showed low rutting prediction for the Laterite Gravel applied in highway pavement layers. Thus, the results indicated that the lateritic gravel can be adopted in the composition of base or subbase layers of flexible pavements, even though some limits of the parameters specified by traditional specifications were violated, as expected. In addition, we also highlight the need for adoption of new material selection strategies that are based on key mechanical characteristics to avoid discarding potentially well performing materials. field requirements countries AcreBrazil Acre Brazil (RM PD, PD , (PD) respectively addition software 50 MPa Granite below shakedown (shakedown specimens Thus pavements violated expected (PD 5

ABSTRACT Rocky Mountain Spotted Fever is a rickettsial disease caused by the bacteria Rickettsia rickettsii. In Brazil, the disease is known as Brazilian spotted fever (BSF), being the most significant tick-borne disease in the country. Among the affected patients, only 5% of cases occur in children aged one to nine years. Typical symptoms of the disease are fever, rash, headache and digestive symptoms. Neurological manifestations such as seizures, aphasia and hemiparesis have been described in few patients. This study aimed to describe the case of an infant diagnosed with BSF who presented severe signs of neurological manifestation. rickettsii Brazil BSF, , (BSF) tickborne tick borne country patients 5 years rash seizures manifestation (BSF

Abstract: Seed treatments with chemical phytosanitary products can compromise mobilization of seed reserves for the seedlings under water deficit conditions. The aim of this study was to evaluate the physiological quality, the initial seedling development, and the mobilization of reserves in soybean seeds treated with phytosanitary products under water deficit. The trial was set up in a completely randomized design in a 4 × 4 factorial arrangement: chemical treatments (control, Thiamethoxam, Fludioxonil + Metalaxyl-M, and Fipronil + Pyraclostrobin + Tiophanate-methyl) × osmotic potentials (0, -0.1, -0.2, and -0.3 MPa). We analyzed the following variables: germination; hypocotyl length, root length, and total seedling length; seedling length vigor index; cotyledon dry matter weight; seedling dry matter yield; seed reserve reduction; relative dry matter yield; seed reserve reduction rate; and conversion efficiency of seed reserves into seedling dry matter. Seed quality and seedling development decline under water deficit conditions. The treatment with Fipronil + Pyraclostrobin + Thiophanate-methyl results in lower phytotoxicity. The estimated cotyledon dry matter (CDM) weight is an indicator of phytotoxicity and water deficit. Mobilization of reserves is compromised in seeds treated with insecticides, reducing the capacity of conversion of reserves into dry matter. There is an inversely proportional relationship between the reduction in conversion and the efficiency of conversion of reserves of treated soybean seeds under water deficit. Abstract conditions arrangement control, control (control Thiamethoxam MetalaxylM, MetalaxylM Metalaxyl M, M Metalaxyl-M Tiophanatemethyl Tiophanate methyl Tiophanate-methyl 0, 0 (0 0.1, 01 1 -0.1 0.2, 02 2 -0.2 0.3 03 3 -0. MPa. MPa . MPa) variables germination index yield rate Thiophanatemethyl Thiophanate CDM (CDM insecticides ( 0.1 0.2 0. -0 -

Resumo: O tratamento químico de sementes com produtos fitossanitários sob condições de déficit hídrico, podem comprometer a mobilização das reservas das sementes para as plântulas. Objetivou-se avaliar a qualidade fisiológica, o desenvolvimento inicial de plântulas e a mobilização de reservas em sementes de soja tratadas com produtos fitossanitários sob déficit hídrico. O ensaio foi instalado em delineamento inteiramente casualizado em esquema fatorial 4 x 4: tratamentos químicos (Controle; Thiametoxam; Fludioxonil + Metalaxil-M e Fipronil + Piraclostrobina + Tiofanato-metílico) x potenciais osmóticos (0; -0,1; -0,2 e -0,3 MPa). Foram analisadas as variáveis: germinação, comprimento do hipocótilo, da raiz e total das plântulas, índice de vigor do crescimento, peso de matéria seca de cotilédones, rendimento de massa seca de plântulas, redução de reservas, rendimento relativo de matéria seca, taxa de redução de reservas e eficiência de conversão das reservas de sementes em matéria seca de plântulas. Há redução da qualidade de sementes e desenvolvimento das plântulas em condições de déficit hídrico. No tratamento com Fipronil + Piraclostrobina + Tiofanato-metílico a fitotoxidez é menor. O peso de matéria seca estimada de cotilédones (CDM) é um indicativo para fitotoxidez e déficit hídrico. A mobilização das reservas é comprometida em sementes tratadas com inseticidas diminuindo a capacidade de convertê-las em massa seca. Há uma relação inversamente proporcional entre a redução e a eficiência de conversão das reservas em sementes de soja tratadas sob déficit hídrico. Resumo hídrico Objetivouse Objetivou se fisiológica Controle (Controle Thiametoxam MetalaxilM Metalaxil M Tiofanatometílico Tiofanato metílico 0 (0 0,1 01 1 -0,1 0,2 02 2 -0, 0,3 03 3 MPa. MPa . MPa) variáveis germinação hipocótilo crescimento menor CDM (CDM convertêlas convertê las ( 0, -0 -

Abstract Visceral Crisis (VC) in breast cancer is a critical scenario when the burden of metastatic disease results in rapid deterioration of organ functions. There are no widely accepted objective clinical criteria for the definition of VC, and different studies have reported diverse clinical conditions such as visceral crises. Diagnosis of VC is associated with a dismal prognosis and the management of this condition is currently based on limited retrospective evidence and expert opinions. International guidelines have recommended cytotoxic polychemotherapy in the management of VC, to achieve rapid symptomatic control and preserve organ function. Nevertheless, in the case of hormone receptor-positive breast cancer, the role of chemotherapy as the treatment of choice for VC has been recently questioned, since endocrine therapy plus CDK4/6 inhibitors yielded similar response rates, with better quality of life. For HER2-positive and triple-negative breast cancer, combined chemotherapy (plus HER2-directed therapy for HER2-positive) remains a standard option for VC, but novel effective drugs such as antibody-drug conjugates are emerging and their role in the VC context shall soon be elucidated. This review aims to critically discuss the definition, prognosis, management, and future directions regarding the visceral crisis in metastatic breast cancer. (VC functions crises opinions function Nevertheless receptorpositive receptor positive questioned CDK46 CDK CDK4 6 CDK4/ rates life HER2positive HERpositive HER2 HER triplenegative triple negative HER2directed HERdirected directed antibodydrug antibody drug elucidated

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

SUMMARY OBJECTIVE: The objective of this study was to assess the predictors of survival among patients with coronavirus disease 2019 who underwent tracheal intubation, as part of a hospital cohort study. METHODS: This retrospective cohort study in the Rio do Sul County Hospital, Santa Catarina, Brazil, from April 2020 to May 2021, focused on patients aged 18 years or older intubated for coronavirus disease 2019. We assessed the 90-day survival of intubated patients by estimating the hazard ratio using a Cox proportional hazards regression model. RESULTS: The study included 132 participants, with an average age of approximately 60 years. Tracheal intubation was successfully accomplished in 97% of cases within two attempts. The overall mortality rate was 62.9%. Notably, mortality rates were significantly higher in patients aged over 60 years (hazard ratio=2.57; 95%CI 1.54–4.29; p<0.001), those with blood oxygen saturation below 85% (hazard ratio=1.92; 95%CI 1.03–3.57; p=0.04), instances where tracheal intubation was carried out using a conventional laryngoscope (hazard ratio=2.59; 95%CI 1.22–5.48; p=0.013), and when performed by emergency physicians (hazard ratio=3.96; 95%CI 1.51–10.4; p=0.005). CONCLUSION: Our analysis unveiled that the risk of death in intubated coronavirus disease 2019 patients is four times higher when an emergency physician, as opposed to an anesthesiologist, leads the tracheal intubation team. OBJECTIVE 201 METHODS Hospital Catarina Brazil 202 2021 1 90day day 90 model RESULTS 13 participants 6 97 attempts 629 62 9 62.9% Notably ratio=2.57 ratio257 2 57 95CI CI 95 1.54–4.29 154429 54 4 29 p<0.001, p0001 p p<0.001 , 0 001 p<0.001) 85 ratio=1.92 ratio192 92 1.03–3.57 103357 03 3 p=0.04, p004 p=0.04 04 p=0.04) ratio=2.59 ratio259 59 1.22–5.48 122548 22 5 48 p=0.013, p0013 p=0.013 013 p=0.013) ratio=3.96 ratio396 96 1.51–10.4 151104 51 10 p=0.005. p0005 p=0.005 . 005 p=0.005) CONCLUSION physician anesthesiologist team 20 62.9 ratio=2.5 ratio25 1.54–4.2 15442 p000 p<0.00 00 8 ratio=1.9 ratio19 1.03–3.5 10335 p00 p=0.0 1.22–5.4 12254 p001 p=0.01 01 ratio=3.9 ratio39 1.51–10. 15110 p=0.00 62. ratio=2. ratio2 1.54–4. 1544 p<0.0 ratio=1. ratio1 1.03–3. 1033 p0 p=0. 1.22–5. 1225 ratio=3. ratio3 1.51–10 1511 ratio=2 1.54–4 154 p<0. ratio=1 1.03–3 103 p=0 1.22–5 122 ratio=3 1.51–1 151 ratio= 1.54– 15 p<0 1.03– p= 1.22– 12 1.51– 1.54 p< 1.03 1.22 1.51 1.5 1.0 1.2 1.

ABSTRACT Objective: To assess the impact of different vertical positions on lung aeration in patients receiving invasive mechanical ventilation. Methods: An open-label randomized crossover clinical trial was conducted between January and July 2020. Adults receiving invasive mechanical ventilation for > 24 hours and < 7 days with hemodynamic, respiratory and neurological stability were randomly assigned at a 1:1 ratio to the sitting position followed by passive orthostasis condition or the passive orthostasis followed by the sitting position condition. The primary outcome was lung aeration assessed using the lung ultrasound score (score ranges from 0 [better] to 36 [worse]). Results: A total of 186 subjects were screened; of these subjects, 19 were enrolled (57.8% male; mean age, 73.2 years). All participants were assigned to receive at least one verticalization protocol. Passive orthostasis resulted in mean lung ultrasound scores that did not differ significantly from the sitting position (11.0 versus 13.7; mean difference, -2.7; [95%CI -6.1 to 0.71; p = 0.11). Adverse events occurred in three subjects in the passive orthostasis group and in one in the sitting position group (p = 0.99). Conclusion: This analysis did not find significant differences in lung aeration between the sitting and passive orthostasis groups. A randomized crossover clinical trial assessing the impact of vertical positioning on lung aeration in patients receiving invasive mechanical ventilation is feasible. Unfortunately, the study was interrupted due to the need to treat COVID-19 patients. ClinicalTrials.gov registry: NCT04176445 Objective Methods openlabel open label 2020 2 hemodynamic 11 1 1: better [better 3 worse. worse . [worse]) Results 18 screened 57.8% 578 57 8 (57.8 male age 732 73 73. years. years years) protocol 11.0 110 (11. 13.7 137 13 difference 2.7 27 -2.7 95%CI 95CI CI 95 6.1 61 6 -6. 0.71 071 71 0.11. 011 0.11 0.11) 0.99. 099 0.99 99 0.99) Conclusion groups feasible Unfortunately COVID19 COVID COVID-1 ClinicalTrialsgov ClinicalTrials gov registry NCT NCT0417644 202 [worse] 57.8 5 (57. 11. (11 13. 2. -2. 9 6. -6 0.7 07 01 0.1 09 0.9 COVID1 COVID- NCT041764 20 [worse 57. (57 (1 -2 - 0. NCT04176 (5 ( NCT0417 NCT041 NCT04 NCT0

RESUMO Objetivo: Avaliar o impacto de diferentes posicionamentos verticais na aeração pulmonar em pacientes em ventilação mecânica invasiva. Métodos: Trata-se de ensaio clínico aberto, randomizado e transversal, realizado entre janeiro e julho de 2020. Adultos em ventilação mecânica invasiva por mais de 24 horas e menos de 7 dias com estabilidade hemodinâmica, respiratória e neurológica foram distribuídos aleatoriamente em uma proporção de 1:1 à postura sentada seguida da condição de ortostatismo passivo ou o ortostatismo passivo seguido de postura sentada. O desfecho primário foi a aeração pulmonar avaliada pelo lung ultrasound score. O escore varia de zero (melhor) a 36 (pior). Resultados: Foram selecionados 186 indivíduos; destes, 19 foram incluídos (57,8% do sexo masculino; média idade de 73,2 anos). Todos os participantes foram selecionados para receber pelo menos um protocolo de verticalização. O ortostatismo passivo resultou em escores médios de aeração pulmonar por ultrassonografia que não diferiram significativamente da postura sentada (11,0 versus 13,7; diferença média, -2,7; IC95% -6,1 a 0,71; p = 0,11). Ocorreram eventos adversos em três indivíduos no grupo ortostatismo passivo e em um no grupo postura sentada (p = 0,99). Conclusão: Esta análise não encontrou diferenças significativas na aeração pulmonar entre os grupos ortostatismo passivo e postura sentada. É factível conduzir um estudo clínico transversal randomizado para avaliar o impacto do posicionamento vertical na aeração pulmonar em pacientes em ventilação mecânica invasiva. Infelizmente, o estudo foi interrompido devido à necessidade de tratar pacientes com COVID-19. Registro ClinicalTrials.gov: NCT04176445 Objetivo Métodos Tratase Trata se aberto 2020 2 hemodinâmica 11 1 1: score melhor (melhor 3 pior. pior . (pior) Resultados 18 destes 57,8% 578 57 8 (57,8 masculino 732 73 73, anos. anos anos) verticalização 11,0 110 0 (11, 13,7 137 13 2,7 27 -2,7 IC95 IC 6,1 61 6 -6, 0,71 071 71 0,11. 011 0,11 0,11) 0,99. 099 0,99 99 0,99) Conclusão Infelizmente COVID19. COVID19 COVID 19. COVID-19 ClinicalTrials.gov ClinicalTrialsgov ClinicalTrials gov NCT NCT0417644 202 (pior 57,8 5 (57, 11, (11 13, 2, -2, IC9 6, -6 0,7 07 01 0,1 09 0,9 9 COVID1 COVID-1 NCT041764 20 57, (57 (1 -2 - 0, COVID- NCT04176 (5 ( NCT0417 NCT041 NCT04 NCT0

Com o aumento da expectativa de vida e a redução da taxa de natalidade, no Brasil, assim como no mundo todo, tem ocorrido um intenso processo de envelhecimento da população, sendo que as pessoas idosas são consideradas mais vulneráveis, devido a diminuição da autonomia, por ficarem expostas a mais fatores de risco, conflitos sociais, familiares e a violência. Sendo assim, a violência contra a pessoa idosa trata-se de um importante problema de saúde pública e carece de intervenções dos profissionais da saúde, os quais devem receber formação para tal abordagem. Objetivo: Interpretar as vivências de jovens universitários dos cursos de enfermagem e medicina, de uma instituição brasileira do interior paulista, sobre a violência contra pessoa idosa. Método: Trata-se de uma pesquisa qualitativa, que utilizou a Teoria Fundamentada nos Dados e como técnica de coleta de dados, entrevistas semiestruturadas com oito estudantes dos cursos de enfermagem e de medicina de uma instituição do interior do estado de São Paulo. Realizou-se análise dos dados no software NVIVO, seguindo as etapas propostas pelo referencial escolhido. Resultados e discussão: Os entrevistados percebem que a violência contra a pessoa idosa tem pouca visibilidade, relataram aproximações com a temática, além de citarem os tipos de violência que a pessoa idosa pode sofrer. Reconheceram as necessidades de saúde da pessoa idosa relacionando com a integralidade do cuidado, interligando com pensamentos sobre o envelhecimento como uma causa natural e propondo intervenções para diminuição deste agravo. Finalizando, expuseram suas ações caso vivenciem uma situação de violência e a possibilidade do tema violência contra a pessoa idosa ser introduzido na grade curricular formal. Conclusão: Evidenciou a pouca visibilidade da pessoa idosa, bem como a necessidade de ações e intervenções educativas para o reconhecimento deste agravo, sendo um passo possível e viável.

With the increase in life expectancy and the reduction in the birth rate, in Brazil, as well as in the whole world, there has been an intense process of aging of the population, and the elderly are considered more vulnerable, due to the decrease in the autonomy, as they are exposed to more risk factors, social and family conflicts and violence. Therefore, violence against the elderly is an important public health problem and requires interventions by health professionals, who must receive training for such an approach. Objective: To interpret the experiences of young university students of nursing and medicine courses, from a Brazilian institution in the interior of São Paulo, about violence against the elderly. Method: This is qualitative research, which used Grounded Theory and as a data collection technique, semi-structured interviews with eight students of nursing and medicine courses at an institution in the interior of the state of São Paulo. Data analysis was carried out in the NVIVO software, following the steps proposed by the chosen reference. Results and discussion: Respondents perceive that violence against the elderly has little visibility, reported approaches to the theme, in addition to mentioning the types of violence that the elderly can suffer. They recognized the health needs of the elderly in relation to comprehensive care, interconnecting with thoughts about aging as a natural cause and proposing interventions to reduce this problem. Finally, they exposed their actions if they experience a situation of violence and the possibility of introducing violence against the elderly into the formal curriculum. Conclusion: It showed the poor visibility of the elderly, as well as the need for educational actions and interventions to recognize this condition, being a possible and viable step.