Resumo Introdução: Estratégias de autocolheita de DNA do papilomavírus humano (HPV) mostraram-se promissoras na deteção de doença; no entanto, não é clara a sua real potencialidade ou aceitabilidade pelas mulheres. Objetivos: Como objetivo principal pretendeu-se determinar a precisão da deteção, estudo de não inferioridade, de HPV em amostras de autocolheita, comparativamente às colhidas por profissional de saúde. Secundariamente, pretendeu-se avaliar a aceitabilidade pelas mulheres. Métodos: Realizou-se uma pesquisa sistemática maioritariamente em bases de dados eletrónicas (MEDLINE, CENTRAL e Scopus). Foram incluídos estudos que compararam os dois métodos de rastreio. A seleção dos estudos e extração de dados foi feita por dois autores de forma independente. Utilizou-se o QUADAS2 Tool e Cochrane Risk of Bias Tool para avaliar o risco de viés. A sensibilidade e a especificidade dos testes foram estimadas e elaboradas curvas SROC, utilizando o RevMan v. 5.4. e MetaDisc para a análise de dados. Foi também realizada uma análise de subgrupo e de sensibilidade. Resultados: Foram incluídos 67 artigos (precisão 47 e aceitabilidade 36) com uma amostra total de 18.615 mulheres, com idades entre 15-80 anos. Demonstrou-se uma sensibilidade de 86,4% e uma especificidade de 91.8% Na análise de subgrupos não foram detetadas diferenças significativas relativas ao tipo de teste, dispositivo de autocolheita e respetivo transporte ou prevalência de HPV. Relativamente à aceitabilidade, as mulheres consideram a autocolheita fácil, confortável, privada e não constrangedora. 62,8% prefere a autocolheita. Conclusão: Esta revisão sistemática e meta-análise demonstrou uma taxa de deteção de HPV não inferior à colheita por profissional de saúde e revelou ser um método com boa aceitabilidade pela maioria das mulheres. No entanto, ainda há poucas evidências sobre a sua viabilidade e aplicabilidade, pelo que futuramente a avaliação de custo-efetividade deste tipo de rastreio deve ser realizada a nível nacional e internacional.

Abstract Introduction: Self-sampling strategies have shown promising efficacy in detecting disease, but it is still unclear whether these strategies can be implemented independently of a clinical setting in a manner acceptable to women. Objectives: This review aimed to evaluate the accuracy - non-inferiority - of human papillomavirus (HPV) detection rates between clinician-collected samples and self-sampling, and secondarily to assess the acceptability of self-sampling for cervical cancer screening. Methods: A systematic search was performed mainly from electronic databases (MEDLINE, CENTRAL, and Scopus). Studies that compared both screening methods of and that contained data on their accuracy and acceptability were included. Two independent researchers performed study selection and data extraction. An assessment of the risk of bias was done using the QUADAS2 and Cochrane Risk of Bias Tool. The pooled sensitivity and specificity of tests were estimated and SROC curves were built. A subgroup and sensitivity analysis were performed. RevMan5.4. and Meta-DiSc® 1.4.7. were used. Results: Sixty-seven articles were included, 47 regarding accuracy and 36 regarding acceptability, with a total sample of 18,615 women aged between 15 and 80. This study showed that self-sampling, as a screening test, has a sensitivity of 87.4% and specificity of 91.2% to detect HPV. From subgroup analysis, no significant differences were detected regarding the type of test, transport-device, or HPV prevalence. Regarding acceptability, women consider self-sampling to be easy, comfortable, and non-embarrassing. 62.8% preferred collection by self-sampling. Conclusion: This way of self-sampling HPV screening proved not inferior to clinician-sampling and has good acceptability among women, making it a possible alternative or complement to conventional screening. Nevertheless, there is still low evidence regarding its feasibility and applicability, therefore the next step should focus on evaluating the cost-effectiveness of this type of screening at a national and international level.

Utilizando dados de um estudo de coorte de nascimento, foi avaliada a associação a longo prazo entre amamentação e fatores de risco cardiovascular metabólicos aos 30 anos de idade. Em 1982, foram examinados 5.914 bebês nascidos vivos em maternidades de Pelotas, Rio Grande do Sul, Brasil, e suas mães foram entrevistadas. Desde então, esses indivíduos têm sido continuamente acompanhados. Aos 30 anos de idade, os membros da coorte foram entrevistados e foram obtidas informações sobre pressão arterial, espessura da íntima-média da carótida, velocidade da onda de pulso, glicemia aleatória e lipídios sanguíneos. Foi utilizada regressão linear simples e múltipla. Nas análises bruta e ajustada, a duração da amamentação não apresentou nenhuma associação clara com a pressão arterial média, a espessura da íntima-média da carótida e a velocidade da onda de pulso. Da mesma forma, o colesterol total, o colesterol não-HDL e a glicemia não apresentaram relação com a alimentação infantil. Em relação ao colesterol HDL, houve uma associação positiva com a duração da amamentação predominante na análise bruta, mas a associação não persistiu após o controle das variáveis de confusão. Em suma, os nossos achados sugerem que não há associação entre a duração da amamentação e os fatores de risco cardiometabólicos na idade adulta. Apesar disso, a promoção e o apoio à amamentação devem ser reforçados devido aos seus benefícios bem conhecidos, como a redução da mortalidade infantil e o desenvolvimento do capital humano.

Utilizando datos de un estudio de cohorte de nacimiento, se evaluó la asociación a largo plazo entre la lactancia materna y los factores de riesgo cardiovascular metabólicos a los 30 años de edad. En 1982, se examinaron 5.914 bebés nacidos vivos en hospitales de maternidad en Pelotas, Rio Grande do Sul, Brasil, y se entrevistó a sus madres. Desde entonces, estos individuos pasaron por un seguimiento continuo. A los 30 años de edad, se entrevistó a los miembros de la cohorte y se obtuvo información sobre la presión arterial, el grosor íntima-media carotídeo, la velocidad de la onda del pulso, la glucosa en sangre aleatoria y los lípidos en sangre. Se utilizó regresión lineal simple y múltiple. En los análisis bruto y ajustado, la duración de la lactancia materna no mostró una asociación clara con la presión arterial media, el grosor íntima-media carotídeo y la velocidad de la onda del pulso. Del mismo modo, el colesterol total, el colesterol no HDL y la glucosa en sangre no estaban relacionados con la nutrición infantil. Con respecto al colesterol HDL, hubo una asociación positiva con la duración de la lactancia materna predominante en el análisis bruto, pero la asociación no persistió tras controladas las variables de confusión. Los hallazgos indican que no existe una asociación entre la duración de la lactancia materna y los factores de riesgo cardiometabólico en la edad adulta. A pesar de esto, la promoción y el apoyo a la lactancia materna deben fortalecerse debido a sus beneficios ya conocidos, como la reducción de la mortalidad infantil y el desarrollo del capital humano.

Using data from a birth cohort study, we evaluated the long-term association between breastfeeding and metabolic cardiovascular risk factors at 30 years old. In 1982, the 5,914 live births in maternity hospitals in Pelotas, Rio Grande do Sul State, Brazil, were examined and the mothers were interviewed. Since then, these participants have been prospectively followed. The cohort members were interviewed at 30 years old and information on blood pressure, carotid intima-media thickness, pulse wave velocity, random blood glucose, and blood lipids were obtained. Simple and multiple linear regressions were used. In the crude and adjusted analyses, duration of breastfeeding did not show any clear association with mean arterial pressure, carotid intima-media thickness, and pulse wave velocity. Likewise, total and non-HDL cholesterol and blood glucose were not related to infant feeding. Regarding HDL cholesterol, it was positively related to predominant breastfeeding duration in the crude analysis, but the association disappeared after controlling for confounding variables. Concisely, our findings suggest that there is no association between duration of breastfeeding and cardiometabolic risk factors in adulthood. Despite that, promotion and support of breastfeeding must be reinforced due to its well-known benefits, such as reduction of infant and child mortality and human capital development.

Resumo Objetivo: Identificar a literatura científica acerca das estratégias de regulação das tecnologias de informação aplicadas na área da saúde para proteção dos dados dos usuários. Metodologia: Foi conduzida uma revisão integrativa da literatura, consultando as bases de dados BVS, Scielo e Web of Science, utilizando descritores em português e inglês, delimitando os artigos com ênfase nas tecnologias e LGPD. Resultados: A revisão resultou na identificação de 658 artigos, e considerando os critérios de seleção, foram selecionados cinco artigos que se relacionam diretamente com a temática do estudo. As categorias foram sistematizadas e analisadas a partir de três perspectivas: incorporação de inteligência artificial e inovações em saúde; proteção de dados em saúde e seu entrelaçamento com a LGPD; e os aspectos operacionais e governança de informações em saúde. Conclusões: A implementação da saúde digital emerge como um desafio importante para a Saúde Coletiva, exigindo discussões sobre seu impacto nas políticas de saúde. A análise ressalta a importância da regulamentação abrangente das TICs na saúde e destaca desafios como a rápida evolução tecnológica, segurança de dados e políticas públicas. Regulamentações como a LGPD se mostram essenciais para proteger a privacidade e segurança dos usuários na saúde digital.

Abstract Objective: To identify scientific literature on regulatory strategies for information technologies applied in the health sector to protect user data. Methodology: An integrative literature review was conducted, consulting the databases BVS, Scielo, and Web of Science, using descriptors in Portuguese and English, focusing on articles related to technologies and LGPD. Results: The review identified 658 articles, and considering the selection criteria, 5 articles directly related to the study's theme were selected. Categories were systematized and analyzed from three perspectives: incorporation of artificial intelligence and innovations in health; protection of health data and its intertwining with LGPD; and operational aspects and governance of health information. Conclusions: The implementation of digital health emerges as a significant challenge for Public Health, requiring discussions about its impact on health policies. The analysis highlights the importance of comprehensive regulation of ICTs in health and underscores challenges such as rapid technological evolution, data security, and public policies. Regulations like LGPD are essential to protect the privacy and security of users in digital health.

O almoço é uma refeição importante no Brasil cujo padrão varia entre os seus grupos populacionais. Este estudo buscou determinar os padrões alimentares de adultos brasileiros durante o almoço e verificar sua associação com as características socioeconômicas e demográficas dessa população. Os dados da Pesquisa Nacional de Alimentação (que incluiu 28.901 adultos com idade entre 19 a 59 anos) foram utilizados (excluindo-se gestantes e lactantes). O consumo alimentar foi avaliado por recordatórios de 24 horas nos domicílios dos entrevistados. Foram registrados 1.832 alimentos, dos quais 1.120 foram consumidos no almoço. As variáveis socioeconômicas e demográficas foram obtidas por um questionário estruturado. Os padrões alimentares foram derivados por análise fatorial considerando-se a complexidade da amostra. A média e os intervalos de 95% de confiança dos escores para cada padrão alimentar foram estimados em todos os níveis de variáveis socioeconômicas e demográficas. Considerando a complexidade do desenho amostral, todas as análises foram realizadas pelo pacote estatístico SAS OnDemand for Academics. No total, 3,4% dos adultos brasileiros não reportaram almoçar. Três padrões explicaram 30,7% da variabilidade do almoço: tradicional brasileiro; saladas; e à base de proteínas com sobremesas e bebidas. Homens, indivíduos com menor escolaridade e menor renda e os residentes no Centro-oeste e Nordeste aderiram mais ao padrão tradicional brasileiro. As frutas não desempenharam um papel essencial em nenhum padrão. A adesão aos padrões alimentares varia de acordo com fatores socioeconômicos e demográficos.

Lunch is an important meal in Brazil, with varying standards among different population groups. This study aims to determine the lunch dietary patterns of Brazilian adults and verify their association with socioeconomic and demographic characteristics. Data from the Brazilian National Dietary Survey were used, comprising 28,901 adults aged 19 to 59 years (excluding pregnant and lactating women). Food consumption was assessed via 24-hour recalls at the interviewee’s home. A total of 1,832 food items were recorded, 1,120 of which were mentioned at lunch. Socioeconomic and demographic variables were obtained through a structured questionnaire. Dietary patterns were derived by factor analysis, considering the complexity of the sample. The mean scores and 95% confidence intervals for each dietary pattern were estimated across all levels of socioeconomic and demographic variables. Considering the complexity of the sampling design, all analyses were performed using the statistical package SAS OnDemand for Academics. In total, 3.4% of Brazilian adults reported not having lunch. In total, three patterns explained 30.7% of lunch variability: traditional Brazilian; salads; and protein-based meal with desserts and beverages. Men, individuals with less schooling, those with lower income, and residents of the Central-West and Northeast regions adhered more to the traditional pattern. Fruits did not play an essential role in any pattern. Adherence to dietary patterns varied according to socioeconomic and demographic factors.

El almuerzo es una comida importante en Brasil cuyo patrón varía entre los grupos poblacionales. Este estudio buscó determinar los patrones dietéticos de los adultos brasileños durante el almuerzo y verificar su asociación con las características socioeconómicas y demográficas de esta población. Se utilizaron datos de la Encuesta Nacional de Alimentación (que incluyó a 28.901 adultos de entre 19 y 59 años) -excluyendo a las mujeres embarazadas y lactantes. El consumo de alimentos se evaluó mediante recordatório alimentário de 24 horas en los hogares de los entrevistados. Se registraron 1.832 alimentos, de los cuales 1.120 se consumieron en el almuerzo. Las variables socioeconómicas y demográficas se obtuvieron mediante un cuestionario estructurado. Los patrones dietéticos se derivaron mediante análisis factorial teniendo en cuenta la complejidad de la muestra. La media y los intervalos de 95% de confianza de las puntuaciones para cada patrón dietético se estimaron en todos los niveles de variables socioeconómicas y demográficas. Teniendo en cuenta la complejidad del diseño de la muestra, todos los análisis se realizaron utilizando el paquete estadístico SAS OnDemand for Academics. En total, el 3,4% de los adultos brasileños declararon que no almorzaban. Además, tres patrones explicaron el 30,7% de la variabilidad del almuerzo: tradicional de Brasil; ensaladas; y a base de proteínas con postres y bebidas. Los hombres, las personas con menor nivel de estudios, con menores ingresos y los residentes en las regiones Centro-Oeste y Nordeste registraron más el patrón tradicional de Brasil. Las frutas no jugaron un papel esencial en ningún patrón. La adherencia a los patrones dietéticos varía según los factores socioeconómicos y demográficos.

Fusel oil, a byproduct of ethanol fermentation, mainly consists of isoamyl alcohol and isobutanol. These compounds negatively impact distillation by causing fouling and corrosion in rectification columns, increasing maintenance costs, and affecting ethanol quality and sensory properties. Despite these drawbacks, fusel oil has extensive applications in the fine chemical industry. Its quality and yield vary depending on raw materials and fermentation conditions. This research investigates the effects of pH, supplementation, and refrigeration on isoamyl alcohol and isobutanol formation during sugarcane molasses fermentation at a microdistillery. Fermentations were performed in fed-batches with molasses must at 25 °Brix and commercial dry yeast (25% v/v) for 10 h. A complete 23 factorial design analyzed the effects on fermentation efficiency (nf), process efficiency (np), ethanol productivity (P), substrate-to-cell conversion (YX/S), isoamyl alcohol production (A), isobutanol production (B), and the A/B ratio. Statistical analysis included analysis of variance (ANOVA) and Tukey’s test. Results showed significant interactions influencing isoamyl alcohol and isobutanol production and the A/B ratio. Fermentation at pH 3.5, without supplementation, and with refrigeration achieved the highest A/B ratio (2.26). Conversely, fermentation at pH 5.0, with supplementation, and without refrigeration, yielded the highest isoamyl alcohol (0.4372 g L-1) and isobutanol (0.2666 g L-1) concentrations, without selectively enhancing isoamyl alcohol.

Abstract Indole-thiosemicarbazones have different biological activities. The present study evaluated the preliminary interaction of these compounds with biomolecules, specifically human serum albumin (HSA) and DNA, using fluorescence techniques. The suppression results (Ksv) for HSA ranged from 3.5 x 104 to 4.6 x 105 L/mol, while for DNA, they ranged from 1.4 x 104 to 5.9 x 104 L/mol. The suppression was classified as weak to strong for HSA and moderate for DNA. The bimolecular suppression constant (Kq) showed values between 6.0 x 1012 and 8.2 x 1013 L/mol/s for HSA and from 1.4 x 1012 to 5.9 x 1012 L/mol/s for DNA, suggesting a static suppression mechanism. Compound PR09 stood out, presenting a binding constant (Ka) greater than 105 L/mol for HSA, indicating a strong interaction. Additionally, PR05, PR06, PR07, and PR09 demonstrated strong interactions with DNA. The values of the number of binding sites (n) indicated that PR01, PR02, and PR09 bind to multiple sites on HSA, while PR04, PR05, PR06, and PR09 interact with more than one site on DNA. All interactions were spontaneous, with ∆G negative. The distance between the compounds and tryptophan on HSA was less than 8 nm, suggesting high energy transfer efficiency. In molecular docking studies, PR05 showed the highest affinity for DNA (-11.15 kcal/mol), while PR09 had the highest affinity for HSA (-10.00 kcal/mol). PR07 exhibited the lowest binding energies for DNA (-8.21 kcal/mol) and for HSA (-7.38 kcal/mol). This study demonstrates that the evaluated compounds have potential as new drug candidates.

Utilizando dados de um estudo de coorte de nascimento, foi avaliada a associação a longo prazo entre amamentação e fatores de risco cardiovascular metabólicos aos 30 anos de idade. Em 1982, foram examinados 5.914 bebês nascidos vivos em maternidades de Pelotas, Rio Grande do Sul, Brasil, e suas mães foram entrevistadas. Desde então, esses indivíduos têm sido continuamente acompanhados. Aos 30 anos de idade, os membros da coorte foram entrevistados e foram obtidas informações sobre pressão arterial, espessura da íntima-média da carótida, velocidade da onda de pulso, glicemia aleatória e lipídios sanguíneos. Foi utilizada regressão linear simples e múltipla. Nas análises bruta e ajustada, a duração da amamentação não apresentou nenhuma associação clara com a pressão arterial média, a espessura da íntima-média da carótida e a velocidade da onda de pulso. Da mesma forma, o colesterol total, o colesterol não-HDL e a glicemia não apresentaram relação com a alimentação infantil. Em relação ao colesterol HDL, houve uma associação positiva com a duração da amamentação predominante na análise bruta, mas a associação não persistiu após o controle das variáveis de confusão. Em suma, os nossos achados sugerem que não há associação entre a duração da amamentação e os fatores de risco cardiometabólicos na idade adulta. Apesar disso, a promoção e o apoio à amamentação devem ser reforçados devido aos seus benefícios bem conhecidos, como a redução da mortalidade infantil e o desenvolvimento do capital humano.

Using data from a birth cohort study, we evaluated the long-term association between breastfeeding and metabolic cardiovascular risk factors at 30 years old. In 1982, the 5,914 live births in maternity hospitals in Pelotas, Rio Grande do Sul State, Brazil, were examined and the mothers were interviewed. Since then, these participants have been prospectively followed. The cohort members were interviewed at 30 years old and information on blood pressure, carotid intima-media thickness, pulse wave velocity, random blood glucose, and blood lipids were obtained. Simple and multiple linear regressions were used. In the crude and adjusted analyses, duration of breastfeeding did not show any clear association with mean arterial pressure, carotid intima-media thickness, and pulse wave velocity. Likewise, total and non-HDL cholesterol and blood glucose were not related to infant feeding. Regarding HDL cholesterol, it was positively related to predominant breastfeeding duration in the crude analysis, but the association disappeared after controlling for confounding variables. Concisely, our findings suggest that there is no association between duration of breastfeeding and cardiometabolic risk factors in adulthood. Despite that, promotion and support of breastfeeding must be reinforced due to its well-known benefits, such as reduction of infant and child mortality and human capital development.

Utilizando datos de un estudio de cohorte de nacimiento, se evaluó la asociación a largo plazo entre la lactancia materna y los factores de riesgo cardiovascular metabólicos a los 30 años de edad. En 1982, se examinaron 5.914 bebés nacidos vivos en hospitales de maternidad en Pelotas, Rio Grande do Sul, Brasil, y se entrevistó a sus madres. Desde entonces, estos individuos pasaron por un seguimiento continuo. A los 30 años de edad, se entrevistó a los miembros de la cohorte y se obtuvo información sobre la presión arterial, el grosor íntima-media carotídeo, la velocidad de la onda del pulso, la glucosa en sangre aleatoria y los lípidos en sangre. Se utilizó regresión lineal simple y múltiple. En los análisis bruto y ajustado, la duración de la lactancia materna no mostró una asociación clara con la presión arterial media, el grosor íntima-media carotídeo y la velocidad de la onda del pulso. Del mismo modo, el colesterol total, el colesterol no HDL y la glucosa en sangre no estaban relacionados con la nutrición infantil. Con respecto al colesterol HDL, hubo una asociación positiva con la duración de la lactancia materna predominante en el análisis bruto, pero la asociación no persistió tras controladas las variables de confusión. Los hallazgos indican que no existe una asociación entre la duración de la lactancia materna y los factores de riesgo cardiometabólico en la edad adulta. A pesar de esto, la promoción y el apoyo a la lactancia materna deben fortalecerse debido a sus beneficios ya conocidos, como la reducción de la mortalidad infantil y el desarrollo del capital humano.

Resumo Objetivo: Identificar a literatura científica acerca das estratégias de regulação das tecnologias de informação aplicadas na área da saúde para proteção dos dados dos usuários. Metodologia: Foi conduzida uma revisão integrativa da literatura, consultando as bases de dados BVS, Scielo e Web of Science, utilizando descritores em português e inglês, delimitando os artigos com ênfase nas tecnologias e LGPD. Resultados: A revisão resultou na identificação de 658 artigos, e considerando os critérios de seleção, foram selecionados cinco artigos que se relacionam diretamente com a temática do estudo. As categorias foram sistematizadas e analisadas a partir de três perspectivas: incorporação de inteligência artificial e inovações em saúde; proteção de dados em saúde e seu entrelaçamento com a LGPD; e os aspectos operacionais e governança de informações em saúde. Conclusões: A implementação da saúde digital emerge como um desafio importante para a Saúde Coletiva, exigindo discussões sobre seu impacto nas políticas de saúde. A análise ressalta a importância da regulamentação abrangente das TICs na saúde e destaca desafios como a rápida evolução tecnológica, segurança de dados e políticas públicas. Regulamentações como a LGPD se mostram essenciais para proteger a privacidade e segurança dos usuários na saúde digital.

Abstract Objective: To identify scientific literature on regulatory strategies for information technologies applied in the health sector to protect user data. Methodology: An integrative literature review was conducted, consulting the databases BVS, Scielo, and Web of Science, using descriptors in Portuguese and English, focusing on articles related to technologies and LGPD. Results: The review identified 658 articles, and considering the selection criteria, 5 articles directly related to the study's theme were selected. Categories were systematized and analyzed from three perspectives: incorporation of artificial intelligence and innovations in health; protection of health data and its intertwining with LGPD; and operational aspects and governance of health information. Conclusions: The implementation of digital health emerges as a significant challenge for Public Health, requiring discussions about its impact on health policies. The analysis highlights the importance of comprehensive regulation of ICTs in health and underscores challenges such as rapid technological evolution, data security, and public policies. Regulations like LGPD are essential to protect the privacy and security of users in digital health.

Abstract Objective: Preterm birth remains a significant contributor to neonatal morbidity and mortality. The use of cervical pessaries as an intervention for preventing preterm delivery in women with a short cervix has been a subject of interest. We evaluated the effectiveness of cervical pessary compared to standard care in preventing preterm delivery in women with a short cervix. Data source: Databases were systematically searched in PubMed, Cochrane, and Embase databases in December 2023. Study selection: Randomized clinical trials with the outcomes of interest were included. Data collect: We computed risk ratios for binary endpoints, with 95% confidence intervals. Heterogeneity was assessed using I2 statistics. Data were analyzed using R software (version 4.3.0). The primary outcomes of interest were preterm delivery before 37 weeks, and preterm delivery before 34 weeks. Data synthesis: Seventeen studies with 5,704 patients were included. The use of cervical pessary was associated with a decreased risk of preterm delivery before 37 (RR 0.88; 95% CI 0.81-0.96) and 34 weeks (RR 0.79; 95% CI 0.63-0.99) of gestation in twin pregnancies as compared to standard care without progesterone. There were no significant differences in preterm delivery in singleton pregnancy, neonatal outcomes, preterm premature rupture of the membranes or chorioamnionitis. Conclusion: The use of cervical pessary was associated with a significant reduction in preterm delivery at 34 and 37 weeks of gestation in twin pregnancies among patients with a short cervix compared to no treatment. No significant difference was found in singleton pregnancies or maternal outcomes.

Abstract Objective: Preterm birth is a leading global cause of neonatal mortality and morbidity, with oxidative stress playing a role in its pathogenesis. Vitamin C, a powerful antioxidant, may help reduce this risk. This study assessed the effectiveness of vitamin C supplementation, both alone and with vitamin E, in preventing preterm birth compared to a placebo. Data source: Databases were systematically searched in PubMed, Cochrane and Embase in December 2023 and updated in May 2024. Study Selection: Included RCTs evaluated vitamin C's effect on preterm birth and related neonatal outcomes. Data collect: Statistical analyses used a random-effects model for pooled risk ratios (RR) and 95% confidence intervals (CI). Heterogeneity was assessed with the I² statistic. Data synthesis: Seventeen RCTs (21,567 patients) were analyzed. Vitamin C supplementation showed no significant difference compared to placebo for preterm birth (RR 1.04; 95% CI 0.96, 1.14). No significant differences were observed for neonatal death (RR 0.77; 95% CI 0.55, 1.08), NICU admission (RR 1.03; 95% CI 0.95, 1.13), preterm PROM (RR 1.04; 95% CI 0.63, 1.71), or birth weight (MD 52.41; 95% CI −19.65, 124.47). A slight decrease in gestational age was observed (MD 0.26; 95% CI −0.02, 0.55). Conclusion: Vitamin C supplementation alone or in combination with vitamin E does not significantly prevent preterm birth or improve related neonatal outcomes.

RESUMO A determinação do número kappa no processo de branqueamento é, geralmente, realizada com uma quantidade de polpa absolutamente seca entre 3 e 4g e permite somente o cálculo de valores superiores a quatro. Entretanto, após o estágio de extração oxidativa com peróxido de hidrogênio, a polpa apresenta número kappa inferior a este valor. Deste modo, o presente trabalho propõe um novo método de determinação do número kappa, através da criação do índice Ventorim de branqueamento, que evita os inconvenientes gerados na análise do número Kappa. Para a realização do trabalho, foi utilizada uma polpa kraft industrial deslignificada com oxigênio. Foram realizadas quatro diferentes sequências de branqueamento ECF: OD(E+P) DD, OAD(E+P)DP, OADEDP e OAEDP e realizado a correlação do número kappa com o índice Ventorim de branqueamento. Tendo como resultado o índice Ventorim realizado nas quatro sequências de branqueamento livre de cloro molecular (ECF), sendo que todas as quatros sequências com alvura final de 90% ISO resultando uma correlação (R2) e uma regressão da reta muito semelhantes entre as mesmas. Concluindo assim, a possibilidade do uso de uma única equação referente a todos os dados, sendo a correlação representada pela equação Y= 0,7202x + 0,1464.

ABSTRACT The determination of the kappa number in the bleaching process is typically conducted with a pulp quantity between 3 and 4 grams, allowing for the calculation of values above four. However, after the oxidative extraction stage with hydrogen peroxide, the pulp presents a kappa number lower than this value. Therefore, the present study proposes a new method for determining the kappa number by creating the Ventorim bleaching index, which avoids the inconveniences associated with traditional kappa number analysis. For this study, industrial oxygen-delignified pulp was used. Four different ECF bleaching sequences were performed: OD(E+P)DD, OAD(E+P)DP, OADEDP, and OAEDP, along with the determination of the kappa number and the Ventorim bleaching index. The Ventorim index was based on the four chlorinefree bleaching sequences (ECF), all of which achieved a final brightness of 90% ISO, with very similar R2 values and linear regressions. Consequently, a single equation was generated using all the data: Y=0.7202x+0.1464. This unified approach simplifies the analysis and broadens the applicability of the Ventorim bleaching index in the pulp and paper industry.

Abstract Introduction Autism Spectrum Disorder (ASD) is a neurodevelopment spectrum characterized by persistent deficits in social communication and interpersonal interaction, along with restricted and repetitive patterns of behavior, interest, or activities. The appropriate screening and diagnosis must be realized to improve the children's prognosis. Moreover, appropriate treatments are necessary to promote better social integration and development. In this scenario, this systematic review aims to evaluate the impacts of behavioral therapies applied in healthcare settings for patients with ASD. Methods This systematic review followed the PRISMA guidelines. The databases MEDLINE, Embase, CENTRAL (Cochrane), and Lilacs were accessed, and gray and manual searches were performed. The search strategy was created with terms referring to autism and behavioral therapy. The studies were assessed qualitatively. Results Randomized clinical trials and observational studies demonstrated improvements in cognitive and verbal components of patients who received behavioral therapies in therapeutic settings. These results indicate a positive impact of both cognitive-behavioral therapy and ESDM on the development of patients’ skills. Among the cognitive-behavioral therapies, the one based on the MASSI protocol did not impact the reduction of anxious symptoms. As for cognitive-behavioral therapy, one study demonstrated that the Behavioral Intervention for Anxiety in Children with Autism (BIACA), when compared to the Coping Cat protocol, improves cognition and reduces anxiety symptoms. Despite these results, further randomized clinical trials comparing behavioral therapies with one another are needed. Conclusion In the context of behavioral therapy within a healthcare setting, the Early Start Denver Model (ESDM) showed improvements in the cognitive, verbal, and social aspects of the evaluated patients. Improvement in scores sometimes is achieved independently of the group and related to the time of interventions.

ABSTRACT Purpose: Although Brazil has a high prevalence of retinoblastoma, there is a lack of epidemiological data on the disease. Thus, in this study, we aimed to evaluate the epidemiological profile of patients diagnosed with retinoblastoma in the ophthalmology department of a pediatric tertiary referral hospital in Ceara, Brazil. Methods: A descriptive and cross-sectional study was conducted by retrospectively analyzing the clinical and socioeconomic data from the medical records of pediatric patients followed-up at the hospital between 2007 and 2021. Retinoblastoma was diagnosed on the basis of a fundoscopic or histopathologic examination. Results: The data of 105 patients were included in the study, and the mean patient age at the time of diagnosis was 1.7 years. Most of the patients were women (50.5%) and hailed from rural areas (57.4%), which was associated with a higher tumor stage. Of the 150 patients, 57.1% initially presented with leukocoria. Ocular hyperemia was associated with more advanced stages of retinoblastoma (p=0.004). Bilateral involvement was observed in 25.7% of the patients and at a significantly younger age (p=0.009). The presence of retinal detachment, vascularized lesions, and vitreous seeds significantly increased the likelihood of requiring enucleation. Discussion: This study presents an epidemiological description of retinoblastoma in Brazil, which highlights the significance of early detection. Delayed diagnosis is associated with a poorer visual prognosis and higher mortality rate, particularly in patients with unilateral disease. Risk factors for a more severe disease were retinal detachment, vascularized lesions, and vitreous seeds. The correlation between histopathological features and clinical outcomes was limited. Conclusion: Further studies are required to assess the influence of ocular hyperemia, fundoscopic assessment, and histopathologic findings on the prognosis of retinoblastoma. Moreover, it is critical to devise interventions to reduce the time-to-diagnosis in rural areas.