Abstract The present paper evaluated the potential application of the functionally graded material (FGM) concept to develop more durable concrete to carbonation, one of the main degradation mechanisms of reinforced concrete structures. Accelerated carbonation tests with controlled temperature (27 ( 2°C), CO2 concentration (3 ( 0.5%) and humidity (65 ( 5%) were carried out in homogeneous concretes and with functional gradation in which the porosity of the material was varied across the slices. For the manufacture of graded concrete specimens, concretes with water/cement ratios equal to 0.35, 0.45, and 0.55 were produced, with lower porosity (w/c = 0.35) close to the surface of the specimen. The advance of the carbonation front was evaluated after 8, 9, 10, 14, and 24 weeks of accelerated exposure, using the chemical indicator phenolphthalein. The results show that the functionally graded concrete had a carbonation coefficient (K) slightly higher than that of the concrete with a w/c ratio equal to 0.35 (1.71 and 1.54 mm.week-0.5, respectively) and much lower than concrete with water-cement ratio equal to 0.45 (2.31 mm.week-0.5) and 0.55 (3.78 mm.week-0.5). This demonstrates that functional grading can be an efficient method to increase the durability of concrete elements subject to carbonation.

Resumo O presente artigo avalia o potencial de aplicação do conceito de material com gradação funcional (MGF) ao desenvolvimento de concretos mais duráveis frente à carbonatação, um dos principais mecanismos de degradação das estruturas de concreto armado. Ensaios acelerados de carbonatação com temperatura (27 ( 2 °C), concentração de CO 2 (3 ( 0,5%) e umidade (65 ( 5%) controladas foram realizados em concretos homogêneos e com gradação funcional em que a porosidade do material foi variada ao longo dos corpos de prova. Para a confecção dos corpos de prova de concreto com gradação funcional foram utilizados concretos com relações água/cimento iguais a 0,35, 0,45 e 0,55 de forma que tivéssemos uma redução de porosidade à medida que nos aproximássemos da superfície da peça. O avanço da frente de carbonatação foi avaliado após 8, 9, 10, 14 e 24 semanas de exposição acelerada, empregando-se o indicador químico fenolftaleína. A partir dos resultados obtidos observou-se que os concretos com gradação funcional apresentaram coeficiente de carbonatação (K) ligeiramente superior ao do concreto com relação a/c igual a 0,35 (1,71 e 1,54 mm.semana -0,5 , respectivamente) e bastante inferior aos concretos com relação água cimento iguais a 0,45 (2,31 mm.semana -0,5 ) e 0,55 (3,78 mm.semana -0,5 ), evidenciando que a gradação funcional pode ser um método eficiente para proporcionar o aumento da durabilidade de elementos de concreto sujeitos à carbonatação.

Abstract Introduction: recent studies have suggested the use of neck circumference as a parameter capable of identifying risks of cardiometabolic complications and the accumulation of truncal fat caused by both antiretroviral therapy and the lifestyle of people with the human immunodeficiency virus (HIV). Objective: to investigate the relationship between neck circumference and anthropometric indicators and to assess cardiometabolic risk and truncal obesity through proposed cut-off points. Methods: cross-sectional study including 233 people with HIV. Demographic, socioeconomic, lifestyle and clinical data were collected using a structured questionnaire. The anthropometric evaluation included: weight, height, body mass index (BMI) measurements; waist (WC), neck (NC), arm and arm muscle circumferences; triceps and subscapular skinfolds and their sum. ROC curves were constructed to determine the accuracy of NC in predicting cardiometabolic risk in people living with HIV. Results: the sample was 57.5 % male, with a mean age of 38.4 years (95 % CI: 37.2-39.7 years). NC showed a positive and significant correlation with all anthropometric variables analyzed (p < 0.05), and a higher correlation strength with WC and BMI. The NC cut-off point selected as a predictor of risk of cardiac metabolic complications and truncal obesity in women was ≥ 32.4 cm, considering both WC and BMI. For men, the NC cut-off points were different when considering WC (≥ 39.6 cm) and BMI (≥ 38.1 cm) as a reference. It is worth noting that NC performed well in ROC curve analysis for men, while in women it was a poor performance. Conclusion: NC proved to be a promising indicator in the assessment of nutrition and health of people living with HIV, especially in men.

Resumen Introducción: estudios recientes han sugerido el uso de la circunferencia del cuello como parámetro capaz de identificar los riesgos de complicaciones cardiometabólicas y la acumulación de grasa troncal causados tanto por la terapia antirretroviral como por el estilo de vida de las personas con el virus de la inmunodeficiencia humana (VIH). Objetivo: investigar la relación entre la circunferencia del cuello y los indicadores antropométricos y evaluar el riesgo cardiometabólico y la obesidad troncal a través de los puntos de corte propuestos. Métodos: estudio transversal que incluyó a 233 personas con VIH. Se recogieron datos demográficos, socioeconómicos, de estilo de vida y clínicos mediante un cuestionario estructurado. La evaluación antropométrica incluyó: medidas de peso, altura, índice de masa corporal (IMC); circunferencias de cintura (CC), cuello (CN), brazo (CA) y músculo del brazo (MCB); pliegues cutáneos del tríceps y subescapular y su suma. Se construyeron curvas ROC para determinar la precisión de la CN en la predicción del riesgo cardiometabólico en personas que viven con el VIH. Resultados: el 57,5 % de la muestra eran varones, con una edad media de 38,4 años (IC 95 %: 37,2-39,7 años). La CN mostró una correlación positiva y significativa (p < 0,05) con todas las variables antropométricas analizadas, y una mayor fuerza de correlación con la CC y el IMC. El punto de corte de la CN seleccionado como predictor de riesgo de complicaciones metabólicas cardiacas y obesidad troncular en mujeres fue ≥ 32,4 cm, considerando tanto la CC como el IMC. En el caso de los hombres, los puntos de corte de la CN fueron diferentes al considerar como referencia la CC (≥ 39,6 cm) y el IMC (≥ 38,1 cm). Cabe destacar que la CN obtuvo buenos resultados en el análisis de la curva ROC en el caso de los hombres, mientras que en el de las mujeres fue deficiente. Conclusión: la CN demostró ser un indicador prometedor en la evaluación de la nutrición y la salud de las personas que viven con el VIH, especialmente en los hombres.

Este artigo analisa a execução do PMAQ-AB a partir de sua contextualização em um cenário político nacional de profundas transformações, desde o reformismo fraco que promoveu lenta extensão de direitos até o contrarreformismo forte da restauração neoliberal. Para debater os elementos relacionados ao trabalho e às disputas pela distribuição dos recursos públicos, foi realizado estudo de caso com trabalhadores, gestores e conselheiros de saúde em duas capitais do nordeste brasileiro. Os resultados evidenciam o acirramento do conflito distributivo e o resultado desfavorável aos trabalhadores no contexto pós-golpe parlamentar de 2016. As dinâmicas locais expõem processos de contração salarial e individualização das relações de trabalho e a reafirmação da meritocracia como justificativa ideológica da precarização. A isso, trabalhadores se contrapõem pela reafirmação de sua condição coletiva de classe, em favor de benefícios derivados do PMAQ, como recomposição salarial para todos.

This article analyzes the implementation of the Program for Improving Access and Quality of Primary Care (PMAQ-AB) in the context of a national political scenario of deep transformations, from the weak reformism that promoted slow extension of rights to the strong counter-reformism of neoliberal restoration. It is a case study with health workers, managers, and counselors in two capital cities in northeastern Brazil, discussing matters of work and distributive disputes of public resources. Results show the intensification of these conflicts in health and the unfavorable outcome for workers after the parliamentary coup in 2016 political context. Local dynamics expose the wage contraction and individualization of labor relations and the reassertion of meritocracy as an ideological ground for precariousness. Workers oppose this, reaffirming their collective class condition, favoring the benefit derived from PMAQ for fully regaining their group wages.

Este artículo analiza la realización del PMAQ-AB a partir de su contextualización en un escenario político nacional de profundas transformaciones, desde el reformismo débil que promovió una lenta extensión de derechos contra el reformismo fuerte de la restauración neoliberal. Para discutir los elementos relacionados al trabajo y a las disputas por la distribución en los recursos públicos se realizó un estudio de caso con trabajadores, gestores y consejeros de salud en dos capitales del nordeste brasileño. Los resultados ponen en evidencia el recrudecimiento del conflicto distributivo y el resultado desfavorable para los trabajadores en el contexto post-golpe parlamentario de 2016. Las dinámicas locales exponen procesos de contracción salarial e individualización de las relaciones de trabajo y la reafirmación de la meritocracia como justificativa ideológica de la precarización. A eso se contraponen los trabajadores por medio de la reafirmación de su condición colectiva de clase, en favor del beneficio derivado del PMAQ con la recomposición salarial para todos.

ABSTRACT BACKGROUND: Exposure to air pollutants and illness by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection can cause serious pulmonary impairment. OBJECTIVE: To identify a possible association between exposure to air pollutants and hospitalizations due to SARS-Cov-2. DESIGN AND SETTING: Ecological time-series study carried out in Taubaté, Tremembé, and Pindamonhangaba in 2020 and 2021. METHODS: Study with Sars-Cov-2 hospitalizations with information on hospitalization date, sex and age of the subjects, duration of hospitalization, type of discharge, and costs of these hospitalizations. Statistical analysis was performed through a negative binomial regression, with data on pollutant concentrations, temperature, air relative humidity, and hospitalization date. Coefficients obtained by the analysis were transformed into relative risk for hospitalization, which estimated hospitalizations excess according to an increase in pollutant concentrations. RESULTS: There were 1,300 hospitalizations and 368 deaths, with a predominance of men (61.7%). These data represent an incidence rate of 250.4 per 100,000 inhabitants and 28.4% hospital lethality. Significant exposure (P value < 0.05) occurred seven days before hospital admission (lag 7) for nitrogen dioxide (NO2) (relative risk, RR = 1.0124) and two days before hospital admission for PM2.5 (RR = 1.0216). A 10 μg/m3 in NO2 concentration would decrease by 320 hospitalizations and » US $ 240,000 in costs; a 5 μg/m3 in PM2.5 concentration would decrease by 278 hospitalizations and » US $ 190,000 in costs. CONCLUSION: An association between exposure to air pollutants and hospital admission due to Sars-Cov-2 was observed with excess hospitalization and costs for the Brazilian public health system.

This article analyzes the implementation of the Program for Improving Access and Quality of Primary Care (PMAQ-AB) in the context of a national political scenario of deep transformations, from the weak reformism that promoted slow extension of rights to the strong counter-reformism of neoliberal restoration. It is a case study with health workers, managers, and counselors in two capital cities in northeastern Brazil, discussing matters of work and distributive disputes of public resources. Results show the intensification of these conflicts in health and the unfavorable outcome for workers after the parliamentary coup in 2016 political context. Local dynamics expose the wage contraction and individualization of labor relations and the reassertion of meritocracy as an ideological ground for precariousness. Workers oppose this, reaffirming their collective class condition, favoring the benefit derived from PMAQ for fully regaining their group wages.

Este artículo analiza la realización del PMAQ-AB a partir de su contextualización en un escenario político nacional de profundas transformaciones, desde el reformismo débil que promovió una lenta extensión de derechos contra el reformismo fuerte de la restauración neoliberal. Para discutir los elementos relacionados al trabajo y a las disputas por la distribución en los recursos públicos se realizó un estudio de caso con trabajadores, gestores y consejeros de salud en dos capitales del nordeste brasileño. Los resultados ponen en evidencia el recrudecimiento del conflicto distributivo y el resultado desfavorable para los trabajadores en el contexto post-golpe parlamentario de 2016. Las dinámicas locales exponen procesos de contracción salarial e individualización de las relaciones de trabajo y la reafirmación de la meritocracia como justificativa ideológica de la precarización. A eso se contraponen los trabajadores por medio de la reafirmación de su condición colectiva de clase, en favor del beneficio derivado del PMAQ con la recomposición salarial para todos.

Este artigo analisa a execução do PMAQ-AB a partir de sua contextualização em um cenário político nacional de profundas transformações, desde o reformismo fraco que promoveu lenta extensão de direitos até o contrarreformismo forte da restauração neoliberal. Para debater os elementos relacionados ao trabalho e às disputas pela distribuição dos recursos públicos, foi realizado estudo de caso com trabalhadores, gestores e conselheiros de saúde em duas capitais do nordeste brasileiro. Os resultados evidenciam o acirramento do conflito distributivo e o resultado desfavorável aos trabalhadores no contexto pós-golpe parlamentar de 2016. As dinâmicas locais expõem processos de contração salarial e individualização das relações de trabalho e a reafirmação da meritocracia como justificativa ideológica da precarização. A isso, trabalhadores se contrapõem pela reafirmação de sua condição coletiva de classe, em favor de benefícios derivados do PMAQ, como recomposição salarial para todos.

ABSTRACT Currently, the titanium substrate is one of the most important metallic biomaterials with application in orthopedics, dentistry, fracture fixation and knee and hip arthroplasty. Despite all these attractive properties, its biological inertia and low bactericidal capacity ends up limiting its osseointegration. In this sense, TiO2 and TiO2(MgO) coatings are performed to improve titanium characteristics, such as corrosion resistance. The objectives of this study were to analyze the corrosion resistance of titanium oxide and titanium oxide with addition of magnesium, topographies, morphologies and crystallinity on a titanium substrate through electrodeposition with constant current. Electrodepositions were performed on a three-electrode system, with titanium working electrode, Ag/AgCl as reference electrode and a platinum counter electrode in a potentiostat, and constant currents of 1.0 mA/cm2 were used for all processes. Characterizations by scanning electron microscopy (SEM), atomic force microscopy (AFM), confocal microscopy, X-Ray diffraction (XRD) and potentiodynamic polarization were used. Topography and morphology analyze indicated a change in roughness (Ra) and all demonstrated a uniform surface. The XRD analyzes indicated only metallic titanium, but all of them had a difference in the FWHM, indicating possible amorphous phases or interstitial Mg, also causing a variation in the height of the peaks. Finally, the potentiodynamic polarization indicated that the coating with TiO2 there was an improvement of 37.90% and the TiO2 with addition of magnesium there was a loss of 13.43%. Therefore, the coatings caused changes in roughness, morphologies, crystalline networks and anticorrosive properties, thus enabling the modulation of the desired properties according to the oxidation environment used.

RESUMO Atualmente, o substrato de titânio é um dos mais importantes biomateriais metálicos com aplicação em ortopedia, odontologia, fixação de fraturas e artroplastia de joelho e quadril. Apesar de todas estas propriedades atrativas, sua inércia biológica e baixa capacidade bactericida acaba limitando sua osseointegração. Neste sentido, revestimentos de TiO2 e TiO2(MgO) são realizados para aprimorar as características do titânio, como a resistência à corrosão. Os objetivos deste estudo foram analisar a resistência à corrosão do óxido de titânio e óxido de titânio com adição de magnésio, topografias, morfologias e cristalinidade em um substrato de titânio através da eletrodeposição com corrente constante. As eletrodeposições foram realizadas em um sistema de três eletrodos, sendo o titânio eletrodo de trabalho, Ag/AgCl como eletrodo de referência e um contra eletrodo de platina em um potenciostato e foram utilizadas correntes constantes de 1,0 mA/cm2 para todos os processos. Foram utilizadas as caracterizações por microscopia eletrônica de varredura (MEV), microscopia de força atômica (MFA), microscopia confocal, difração de raios X (DRX) e polarização potenciodinâmica. As análises de topografia e morfologia indicaram uma alteração nas rugosidades (Ra) e todas demonstraram uma superfície uniforme. As análises de DRX indicaram apenas o titânio metálico, porém todas tiveram uma diferença no FWHM, indicando possíveis fases amorfas ou Mg intersticial, causando também uma variação na altura dos picos. Por fim, a polarização potenciodinâmica indicou que o revestimento com TiO2 houve uma melhora de 37,90% e o TiO2 com adição de magnésio houve uma perda de 13,43%. Portanto, os revestimentos causaram alterações nas rugosidades, morfologias, redes cristalinas e nas propriedades anticorrosivas, possibilitando assim a modulação das propriedades desejadas de acordo com o ambiente de oxidação utilizado.

ABSTRACT BACKGROUND: Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects multiple joints. It is associated with psoriasis and treated with synthetic and biologic drugs. OBJECTIVE: The objective of this study was to assess the outcomes of patients who received biologic therapy with tumor necrosis factor (TNF) inhibitors in terms of effectiveness, safety, functionality, and quality of life. DESIGN AND SETTING: A prospective observational study was performed at a single center in Belo Horizonte, Brazil. METHODS: Patients with PsA who received their first TNF inhibitor treatment were followed up for 12 months. Disease activity was measured using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Clinical Disease Activity Index (CDAI). Functionality was measured using the Health Questionnaire Assessment (HAQ), and quality of life was evaluated using the European Quality of Life Five Dimensions (EQ-5D). Multiple linear regression was used to identify predictors of the clinical response at 12 months. RESULTS: A total of 143 patients treated with adalimumab or etanercept were evaluated. Most of the clinical measures were significantly improved at 12 months. However, 31%–51% of the patients did not achieve good clinical control. No differences were observed between adalimumab and etanercept, except for poor functionality at 12 months among patients treated with etanercept. The main predictors of a worse clinical response were female sex, etanercept use, poor functionality, or lower quality of life at baseline. The main adverse reactions were alopecia, headache, injection site reaction, sinusitis, flu, dyslipidemia, and infections. CONCLUSION: TNF inhibitor therapy was effective and safe. However, despite improvements in clinical measures, most patients did not achieve satisfactory control of the disease.

ABSTRACT Objective: The optimal time for a neck ultrasound (US) in the follow-up of papillary thyroid cancer (PTC) after the first year is undetermined. We aimed to verify the utility of routine neck US in the surveillance of patients diagnosed with low- and intermediate-risk PTC with no evidence of disease at the one-year assessment. Materials and methods: We conducted a retrospective longitudinal study of patients with low- and intermediate-risk PTC with normal neck US, unstimulated serum thyroglobulin (Tg) < 1 ng/mL and negative anti-Tg antibodies at the one-year follow-up. Patients were divided into group 1 [undetectable Tg (<0.20 ng/mL)] and group 2 [detectable Tg but < 1 ng/mL]. The negative predictive value (NPV) of the one-year unstimulated Tg at the five-year and last follow-up visits was calculated. Results: We included n = 88 patients in group 1 and n = 8 patients in group 2. No patient from group 1 presented suspicious US findings at the five-year evaluation [NPV: 100.0% (95% confidence interval (CI): 95.5%-100.0%)], and at the last visit, only one patient had developed a lymph node classified as suspicious [NPV: 98.8% (95% CI: 93.2%-100.0%); mean follow-up: 6.7 years]. In group 2, two patients’ USs presented suspicious findings at the five-year evaluation [NPV: 75.0% (95% CI: 34.9%-96.8%)]. At the last visit, only one patient persisted with suspicious findings in the US [NPV: 87.5% (95% CI: 47.4%-99.7%); mean follow-up: 6.5 years]. Conclusion: Low- and intermediate-risk PTC with an excellent response to treatment at the one-year assessment can be safely monitored with regular unstimulated Tg assessments. Conclusions should not be drawn for Tg levels between 0.20-0.99 ng/mL.

Objective: To analyze the correlation between colorectal cancer (CRC) mortality rates and socioeconomic factors in the five mesoregions (North, Northeast, Southeast, Southwest and Center-South) of the state of Mato Grosso, from 2005 to 2016. Methods: Ecological study, which considered deaths from CRC (C18 to C21) of residents of the state. Mortality rates were standardized by the direct method, using the world standard population. For the analysis of socioeconomic factors, the Firjan Municipal Development Index (IFDM) and its components (Education, Income and employment; Health) were used. Means of mortality rates and socioeconomic factors between the mesoregions were tested using ANOVA, and Pearson's correlation coefficient was used to analyze the correlation between mortality rates due to CRC and these factors. Results: In the period from 2005 to 2016, 1,492 deaths from CRC were registered in the state of Mato Grosso. The mesoregion with the highest average of both the crude rate and the standardized rate of mortality from CRC was the Southwest (3.47 and 3.86 deaths/100 thousand inhab.). There was a significant correlation between mortality rates from the disease with the following indicators: General IFDM for the North, Southeast and Center-South mesoregions; Education for the North and Southeast mesoregions; Income and employment for the North and Center-South mesoregions and Health for the North, Southeast and Center-South mesoregions. Conclusion: There was correlation between the CRC mortality rates and better socioeconomic development in the state.

Objetivo: Analisar a correlação entre as taxas de mortalidade por câncer colorretal (CCR) e os fatores socioeconômicos nas cinco mesorregiões (Norte, Nordeste, Sudeste, Sudoeste e Centro-Sul) do estado de Mato Grosso, de 2005 a 2016. Métodos: Estudo ecológico, que considerou os óbitos por CCR (C18 a C21) de residentes do Estado. As taxas de mortalidade foram padronizadas pelo método direto, utilizando-se a população padrão mundial. Para a análise dos fatores socioeconômicos foi utilizado o Índice Firjan de Desenvolvimento Municipal Geral (IFDM) e seus componentes (Educação; Renda e emprego; Saúde). Foram testadas as médias das taxas de mortalidade e dos fatores socioeconômicos entre as mesorregiões por meio da ANOVA, e empregado o coeficiente de correlação de Pearson para análise da correlação entre as taxas de mortalidade por CCR e esses fatores. Resultados: No período de 2005 a 2016, foram registrados 1.492 óbitos por CCR no estado de Mato Grosso. A mesorregião com a maior média tanto da taxa bruta quanto da taxa padronizada de mortalidade por CCR foi a Sudoeste (3,47 e 3,86 óbitos/100 mil hab.). Houve correlação significante entre as taxas de mortalidade por CCR com os seguintes indicadores: IFDM Geral para as mesorregiões Norte, Sudeste e Centro-Sul; Educação para as mesorregiões Norte e Sudeste; Renda e emprego para as mesorregiões Norte e Centro-Sul e Saúde para as mesorregiões Norte, Sudeste e Centro-Sul. Conclusão: Houve correlação da taxa de mortalidade de CCR com melhor desenvolvimento socioeconômico no estado.

Objective: To analyze the temporal trend of incidence of colorectal cancer (CRC), according to sex and age, in Greater Cuiabá, Mato Grosso, Brazil, from 2000 to 2016. Methods: Ecological time series study, with cases of CRC (C18 to C21) diagnosed from 2000 to 2016, of residents of Greater Cuiabá (Cuiabá and Várzea Grande), in Mato Grosso. Information on the cases was obtained from the Population-Based Cancer Registry and population data from IBGE. Rates were adjusted by world population. The age groups from 30 to 39 years old, 40 to 49 years old, 50 to 59 years old, 60 to 69 years old, 70 to 79 years old and 80 years old or more were considered. To analyze the trend of incidence, the Joinpoint regression was used. Results: A total of 1,715 cases of CCR were registered with information on sex and age, with an adjusted rate of 16.4 new cases/100,000 men and 16.1 new cases/100,000 women. Men presented trend of increasing incidence rates in the age group of 70 to 79 years, with increase of 4.0% per year, while women presented trend of increase in the age group 50 to 59 years, with increase of 2.7% per year. Conclusion: Older men showed more significant trend towards an increase in the incidence of CRC, but in women this occurred in a younger age group, highlighting the importance of considering information about age in the analyzes of the occurrence of the disease in this population.

Objetivo: Analisar a tendência temporal da incidência do câncer colorretal (CCR), segundo sexo e faixa etária, na Grande Cuiabá, Mato Grosso (Brasil), de 2000 a 2016. Métodos: Estudo ecológico de séries temporais, com casos de CCR (C18 a C21) diagnosticados de 2000 a 2016, de residentes da Grande Cuiabá (Cuiabá e Várzea Grande), em Mato Grosso. As informações dos casos foram provenientes do Registro de Câncer de Base Populacional e os dados populacionais do IBGE. As taxas foram ajustadas pela população mundial. Considerou-se as faixas etárias de 30 a 39 anos, 40 a 49 anos, 50 a 59 anos, 60 a 69 anos, 70 a 79 anos e 80 anos ou mais. Para análise da tendência temporal da incidência, empregou-se a regressão por Joinpoint. Resultados: Foram registrados 1.715 casos de CCR com informação de sexo e idade, com taxa ajustada de 16,4 casos novos/100.000 homens e 16,1 casos novos/100.000 mulheres. Os homens apresentaram tendência temporal de aumento das taxas de incidência na faixa etária de 70 a 79 anos, com acréscimo de 4,0% ao ano, e as mulheres apresentaram tendência temporal de aumento na faixa etária de 50 a 59 anos, com acréscimo de 2,7% ao ano. Conclusão: Os homens mais velhos apresentaram tendência temporal de aumento da incidência de CCR de forma mais expressiva, porém nas mulheres isso ocorreu em faixa etária mais jovem, ressaltando a importância de considerar a informação sobre a idade nas análises sobre a ocorrência da doença nessa população.

Abstract Changes in land use and land cover (LULC) can result in significant changes in a hydrographic basin flow regime. Future projections about LULC and its interference with water availability help to identify extreme events in advance and help propose appropriate management measures. Thus, this study aimed to make the LULC projection for the year 2030 for the Alto Rio Grande (ARG) sub-basin, located in Southeastern Brazil. This region was chosen because of its intense water resources use and for having recently faced water scarcity as result of prolonged droughts and inadequate water resources management. To identify the LULC trend for the year 2030, the Land Change Modeler (LCM) was used, the map obtained was inserted in the Soil and Water Assessment Tool (SWAT) model previously calibrated and validated for the region’ environmental and climatic conditions. The ARG sub-basin was affected by heavy rains in 2011, which resulted in changes in the landscape due to landslides. This particularity of the region contributed to the projection of LULC for the year 2030 to present an increase in forest and pastures to the agricultural areas detriment. When evaluating the impacts of these changes in water availability, it was observed that the SWAT model presented, for the same rainfall conditions, a reduction in peak streamflows of up to 59% and a reduction in the average monthly flow of up to 63% in 2030 in relation to the LULC observed in 2017. Thus, this study provides an important contribution by identifying a considerable reduction in water availability. These results will help to formulate strategies for water resources management and the adoption of measures to promote water security in the region.

Resumen Los cambios en el uso y la cobertura del suelo pueden resultar en cambios significativos en el régimen del flujo de una cuenca hidrográfica. Los estudios predictivos sobre el uso del suelo y su interferencia con la disponibilidad del agua ayudan a identificar eventos extremos con anticipación a fin de proponer medidas de gestión adecuadas. De esta forma, este estudio tuvo como objetivo realizar la predicción del uso del suelo para el año 2030 para la subcuenca del Alto Río Grande (ARG), ubicada en el sureste de Brasil. Esta región fue elegida por el uso intenso de los recursos hídricos y por haber enfrentado, recientemente, escasez de agua como resultado de sequías prolongadas y una gestión inadecuada de los recursos hídricos. Para la predicción del uso del suelo en 2030 se utilizó el Land Change Modeler (LCM), el mapa obtenido se insertó en el modelo Soil and Water Assessment Tool (SWAT) previamente calibrado y validado para las condiciones ambientales y climáticas de la región. La subcuenca ARG fue afectada por fuertes lluvias en 2011 que resultaron en cambios en el paisaje debido a deslizamientos de tierra. Esta particularidad de la región contribuyó para que la predicción del uso del suelo para el año 2030 presente un aumento de bosques y pastos en detrimento de las áreas agrícolas. Al evaluar los impactos de estos cambios en la disponibilidad del agua, se observó que el modelo SWAT presentó, para las mismas condiciones de precipitación, una reducción en los caudales pico de hasta 59% y una reducción en el caudal promedio mensual de hasta 63% en 2030 en relación con el uso del suelo observado en 2017. Es decir, este estudio hace un aporte importante al identificar una reducción considerable en la disponibilidad del agua. Estos resultados ayudarán a formular estrategias para la gestión de los recursos hídricos y la adopción de medidas para promover la seguridad hídrica en la región.

RESUMO Objetivo: Descrever aspectos clínicos e epidemiológicos de crianças e adolescentes infectados pelo SARS-CoV-2 no município de Taubaté (SP) de março a novembro de 2020. Métodos: Estudo transversal com dados secundários obtidos no Setor de Vigilância Epidemiológica de casos confirmados em residentes do município e consulta de prontuários de pacientes que foram atendidos em hospitais de Taubaté, com idade entre 0 e 19 anos. Realizaram-se os testes de qui-quadrado, comparação de proporções e t de Student, sendo considerados nível de significância alfa <5%. Resultados: Notificaram-se 677 casos no período estudado, correspondendo a 10,1% do total de casos notificados no município. O teste rápido de anticorpos foi o teste mais utilizado, seguido de RT-PCR e sorologia. Sintomas foram descritos em 57,7% dos casos, sendo febre e tosse os mais frequentes. Diarreia apresentou associação com faixa etária < 4 anos, e febre, tosse, cefaleia, odinofagia, ageusia, anosmia, mialgia e dispneia tiveram associação com faixa etária de 10 a 19 anos. No período estudado, não ocorreu nenhum óbito por COVID-19 na faixa etária de 0 a 19 anos de residentes do município. Conclusões: O estudo conseguiu identificar a proporção de acometimento da COVID-19 em crianças e adolescentes no município, e a doença teve comportamento leve e boa evolução. Os principais sintomas foram febre e tosse, destacando-se diarreia nas crianças mais jovens e cefaleia, odinofagia, anosmia, ageusia e mialgia nos adolescentes.

Abstract Objective: To describe clinical and epidemiological aspects of children and adolescents infected with the SARS-CoV-2 in the Municipality of Taubaté, SP, from March to November 2020. Methods: Cross-sectional study with secondary data obtained from the Epidemiological Surveillance System about confirmed cases in city residents and from medical records of patients who were treated in hospitals in Taubaté, aged between 0 and 19 years. Chi-square and Student’s t tests were used for comparisons. Results: 677 cases in the studied age range were reported during the study period, corresponding to 10.1% of cases reported in the municipality. The rapid antibody test was the most used to confirm infection, followed by RT-PCR and serology. Symptoms were described in 57.7% of the cases, mainly fever and cough. Diarrhea was associated with age below 4 years, while fever, cough, headache, odynophagia, ageusia, anosmia, myalgia, and dyspnea were associated with an age ranging from 10 to 19 years. In the study period, there were no deaths from COVID-19 of residents of the municipality in the age group from 0 to 19 years. Conclusions: The study was able to identify the proportion of involvement of COVID-19 in children and adolescents in the city, and the disease had a mild evolution. The main symptoms were fever and cough, but mainly diarrhea in younger children, and headache, odynophagia, anosmia, ageusia, and myalgia in adolescents.

RESUMO: Objetivo: Analisar a correlação entre as taxas de mortalidade por câncer colorretal (CCR) e os fatores socioeconômicos nas cinco mesorregiões (norte, nordeste, sudeste, sudoeste e centro-sul) do estado de Mato Grosso, de 2005 a 2016. Métodos: Estudo ecológico que considerou os óbitos por CCR (C18 a C21) de residentes do estado. As taxas de mortalidade foram padronizadas pelo método direto, utilizando-se a população padrão mundial. Para a análise dos fatores socioeconômicos, foram usados o Índice Firjan de Desenvolvimento Municipal Geral (IFDM) e seus componentes (educação; renda e emprego; saúde). Foram testadas as médias das taxas de mortalidade e dos fatores socioeconômicos entre as mesorregiões por meio da análise de variância (ANOVA), e empregou-se o coeficiente de correlação de Pearson para análise da correlação entre as taxas de mortalidade por CCR e esses fatores. Resultados: No período de 2005 a 2016, foram registrados 1.492 óbitos por CCR no estado de Mato Grosso. A mesorregião com a maior média tanto da taxa bruta quanto da taxa padronizada de mortalidade por CCR foi a sudoeste (3,47 e 3,86 óbitos/100 mil habitantes). Houve correlação significante entre as taxas de mortalidade por CCR com os seguintes indicadores: IFDM geral para as mesorregiões norte, sudeste e centro-sul; educação para as mesorregiões norte e sudeste; renda e emprego para as mesorregiões norte e centro-sul; e saúde para as mesorregiões norte, sudeste e centro-sul. Conclusão: Houve correlação da taxa de mortalidade de CCR com melhor desenvolvimento socioeconômico no estado.

ABSTRACT: Objective: To analyze the correlation between colorectal cancer (CRC) mortality rates and socioeconomic factors in the five mesoregions (North, Northeast, Southeast, Southwest and Center-South) of the state of Mato Grosso, from 2005 to 2016. Methods: Ecological study that considered deaths from CRC (C18 to C21) of residents of the state. Mortality rates were standardized by the direct method, using the world standard population. For the analysis of socioeconomic factors, the Firjan Municipal Development Index (IFDM) and its components (education, income and employment and health) were used. Means of mortality rates and socioeconomic factors between the mesoregions were tested using ANOVA, and Pearson’s correlation coefficient was used to analyze the correlation between mortality rates due to CRC and these factors. Results: In the period from 2005 to 2016, 1,492 deaths from CRC were registered in the state of Mato Grosso. The Southwest mesoregion had the highest average for both the crude rate and standardized CRC mortality rates (3.47 and 3.86 deaths/100,000 inhabitants, respectively). There was a significant correlation between mortality rates from the disease with the following indicators: Overall IFDM for the North, Southeast and Center-South mesoregions; education for the North and Southeast mesoregions; income and employment for the North and Center-South mesoregions; and health for the North, Southeast and Center-South mesoregions. Conclusion: There was a correlation between CRC mortality rates and better socioeconomic development in the state.

RESUMO: Objetivo: Analisar a tendência temporal da incidência do câncer colorretal (CCR) segundo sexo e faixa etária, na Grande Cuiabá, Mato Grosso (Brasil), de 2000 a 2016. Métodos: Estudo ecológico de séries temporais, com casos de CCR (C18 a C21) diagnosticados de 2000 a 2016 em residentes da Grande Cuiabá (Cuiabá e Várzea Grande), em Mato Grosso. As informações dos casos foram provenientes do Registro de Câncer de Base Populacional e os dados populacionais do Instituto Brasileiro de Geografia e Estatística. As taxas foram ajustadas pela população mundial. Consideraram-se as faixas etárias de 30 a 39 anos, 40 a 49 anos, 50 a 59 anos, 60 a 69 anos, 70 a 79 anos e 80 anos ou mais. Para análise da tendência temporal da incidência, empregou-se a regressão por joinpoint. Resultados: Foram registrados 1.715 casos de CCR com informação de sexo e idade, com taxa ajustada de 16,4 casos novos/100 mil homens e 16,1 casos novos/100 mil mulheres. Os homens apresentaram tendência temporal de aumento das taxas de incidência na faixa etária de 70 a 79 anos, com acréscimo de 4,0% ao ano, e as mulheres apresentaram tendência temporal de aumento na faixa etária de 50 a 59 anos, com acréscimo de 2,7% ao ano. Conclusão: Os homens mais velhos apresentaram tendência temporal de aumento da incidência de CCR de forma mais expressiva, porém nas mulheres isso ocorreu em faixa etária mais jovem, ressaltando a importância de considerar a informação sobre a idade nas análises sobre a ocorrência da doença nessa população.

ABSTRACT: Objective: To analyze the temporal incidence trend of colorectal cancer (CRC), according to sex and age, in the Greater Cuiabá, Mato Grosso, Brazil, from 2000 to 2016. Methods: Ecological time series study, with cases of CRC (C18 to C21) diagnosed from 2000 to 2016, of residents of the Greater Cuiabá (Cuiabá and Várzea Grande), in Mato Grosso. The information on the cases was obtained from the Population-Based Cancer Registry and population data from the Brazilian Institute of Geography and Statistics (IBGE). The rates were adjusted by world population. The age groups considered ranged from 30 to 39 years, 40 to 49 years, 50 to 59 years, 60 to 69 years, 70 to 79 years and 80 years and older. Joinpoint regression was used to analyze the trend of incidence. Results: A total of 1,715 cases of CRC were registered with information on sex and age, with an adjusted rate of 16.4 new cases/100,000 men and 16.1 new cases/100,000 women. Men presented trend of increasing incidence rates in the age group of 70 to 79 years, with increase of 4.0% per year, while women presented trend of increase in the age group 50 to 59 years, with increase of 2.7% per year. Conclusion: Older men showed a more significant trend towards an increase in the incidence of CRC, but in women this occurred in a younger age group, highlighting the importance of considering age related information in the analyzes of occurrence of the disease in this population.

ABSTRACT BACKGROUND: Exposure to air pollutants and illness by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection can cause serious pulmonary impairment. OBJECTIVE: To identify a possible association between exposure to air pollutants and hospitalizations due to SARS-Cov-2. DESIGN AND SETTING: Ecological time-series study carried out in Taubaté, Tremembé, and Pindamonhangaba in 2020 and 2021. METHODS: Study with Sars-Cov-2 hospitalizations with information on hospitalization date, sex and age of the subjects, duration of hospitalization, type of discharge, and costs of these hospitalizations. Statistical analysis was performed through a negative binomial regression, with data on pollutant concentrations, temperature, air relative humidity, and hospitalization date. Coefficients obtained by the analysis were transformed into relative risk for hospitalization, which estimated hospitalizations excess according to an increase in pollutant concentrations. RESULTS: There were 1,300 hospitalizations and 368 deaths, with a predominance of men (61.7%). These data represent an incidence rate of 250.4 per 100,000 inhabitants and 28.4% hospital lethality. Significant exposure (P value < 0.05) occurred seven days before hospital admission (lag 7) for nitrogen dioxide (NO2) (relative risk, RR = 1.0124) and two days before hospital admission for PM2.5 (RR = 1.0216). A 10 μg/m3 in NO2 concentration would decrease by 320 hospitalizations and » US $ 240,000 in costs; a 5 μg/m3 in PM2.5 concentration would decrease by 278 hospitalizations and » US $ 190,000 in costs. CONCLUSION: An association between exposure to air pollutants and hospital admission due to Sars-Cov-2 was observed with excess hospitalization and costs for the Brazilian public health system.