The short story The Alienist was written by Machado de Assis and published between 1881 and 1882. The story has as its protagonist Simão Bacamarte, an alienist, who may be the precursor of the psychiatrist. Bacamarte occupies a prominent place in the village of Itaguaí, in Rio de Janeiro, after returning from his studies in Europe. He installed the Casa de Orates or Casa Verde, an asylum to treat the mental health of those considered alienated. With the support of councilors and the local population, he was successful, but he became obsessed and ended up interning almost all of the residents. The bibliographic review methodology was used, which aims to survey materials related to the study topic. Thus, this article aims to analyze Machado's work in its critique of sanity and madness, reflecting on the role and authority of the psychiatrist, in addition to thinking about the model of hospitalization in asylums and hospices.

El cuento El alienista fue escrito por Machado de Assis y publicado entre 1881 y 1882. La historia tiene como protagonista a Simão Bacamarte, un alienista, quien puede ser el precursor del psiquiatra. Bacamarte ocupa un lugar destacado en la aldea de Itaguaí, en Río de Janeiro, luego de regresar de sus estudios en Europa. Instaló la casa Orates o Casa Verde, un asilo para tratar la salud mental de aquellos considerados alienados. Con el apoyo de los concejales y de la población local, tuvo éxito, pero se obsesionó y acabó internando a casi todos los vecinos. Se utilizó la metodología de revisión bibliográfica, que tiene como objetivo relevar materiales relacionados con el tema de estudio. Así, este artículo tiene como objetivo analizar la obra de Machado en su crítica a la cordura y la locura, reflexionando sobre el papel y la autoridad del psiquiatra, además de pensar sobre el modelo de hospitalización en asilos y hospicios.

O conto O Alienista foi escrito por Machado de Assis e publicado entre 1881 e 1882. A história tem como protagonista Simão Bacamarte, alienista, que pode ser o precursor do psiquiatra. Bacamarte ocupa lugar de destaque na vila de Itaguaí, no Rio de Janeiro, após voltar de seus estudos na Europa. Instalou a casa de Orates ou Casa Verde, um asilo para tratar da saúde mental dos considerados alienados. Com o apoio dos vereadores e da população local, logrou êxito, mas se tornou obcecado e acabou internando quase todos os moradores. Utilizou-se a metodologia de revisão bibliográfica que tem por objetivo o levantamento de materiais relacionados ao tema do estudo. Assim, este artigo tem por objetivo analisar a obra machadiana em sua crítica sobre a sanidade e a loucura, refletindo sobre o papel e autoridade do médico psiquiatra, além de pensar o modelo de internação em asilos e hospícios.

RESUMO Objetivo: Revisar sistematicamente a literatura em busca das intervenções e indicações nutricionais mais adequadas e eficazes para o tratamento nutricional de crianças e adolescentes com paralisia cerebral (PC). Fontes de dados: Esta revisão foi conduzida de acordo com as diretrizes Preferred Reporting Items for Systematic Reviews and Meta-Analyses — PRISMA. Os artigos foram selecionados em sete bases de dados (Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde — Lilacs, Embase, United States National Library of Medicine — PubMed, Scientific Electronic Library Online — SciELO, Scopus, and Web of Science). Foram incluídos estudos de um grupo pediátrico (zero a 18 anos) com diagnóstico de PC e a estratégia de busca incluiu os descritores: “children” OR “childhood” AND “nutritional therapy” OR “nutritional intervention” OR “nutrition” OR “nutritional support” OR “diet” AND “cerebral palsy” OR “cerebral injury”. A qualidade metodológica foi avaliada utilizando a lista de verificação para estudos transversais analíticos, escala Newcastle-Ottawa ou ferramenta da Cochrane Collaboration, para ensaios clínicos. Síntese dos dados: Quinze estudos (n=658) publicados de 1990 a 2020 preencheram os critérios de inclusão. Todos tiveram baixo risco de viés. Os dados mostraram que crianças e adolescentes com PC apresentam pior estado nutricional do que os normalmente desenvolvidos. Aqueles que receberam suplementação nutricional hipercalórica e hiperproteica beneficiaram-se de seu uso. Estudos demonstram que a nutrição enteral deve ser considerada quando as necessidades nutricionais não são supridas pela dieta oral, principalmente nos casos em que as funções oromotoras estão prejudicadas. Além disso, houve relação direta entre a consistência dos alimentos, o nível de função motora e o estado nutricional. Conclusões: Crianças e adolescentes com PC têm maior risco de desnutrição. O uso de suplementação nutricional pode auxiliar no ganho de peso desses pacientes. Além disso, a nutrição enteral e a modificação da textura dos alimentos têm sido artifícios utilizados para a melhora do estado nutricional neste grupo. Objetivo PC. . (PC) MetaAnalyses Meta Analyses PRISMA Cochrane, (Cochrane LatinoAmericana Latino Americana Lilacs Embase PubMed SciELO Scopus Science. Science Science) zero 1 anos descritores children “children childhood “childhood nutritional therapy intervention nutrition “nutrition support diet “diet palsy injury. injury injury” analíticos NewcastleOttawa Newcastle Ottawa Collaboration clínicos n=658 n658 n 658 (n=658 199 202 inclusão viés desenvolvidos beneficiaramse beneficiaram se oral prejudicadas disso Conclusões desnutrição pacientes (PC n=65 n65 65 (n=65 19 20 n=6 n6 6 (n=6 2 n= (n= (n

ABSTRACT Objective: To systematically review the literature in search of the most suitable and effective nutritional interventions and indications for the nutritional treatment of children and adolescents with cerebral palsy (CP). Data source: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The articles were selected from seven databases (Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde — Lilacs, Embase, United States National Library of Medicine — PubMed, Scientific Electronic Library Online — SciELO, Scopus, and Web of Science). Studies from a pediatric group (0 to 18 years old) diagnosed with CP were included and the search strategy included the descriptors: “children” OR “childhood” AND “nutritional therapy” OR “nutritional intervention” OR “nutrition” OR “nutritional support” OR “diet” AND “cerebral palsy” OR “cerebral injury”. Methodological quality was assessed using the checklist for cross-sectional analytical studies, the Newcastle-Ottawa scale or the Cochrane Collaboration tool for clinical trials. Data synthesis: Fifteen studies (n=658) published from 1990 to 2020 met the inclusion criteria. All of them had a low risk of bias. The data showed that children and adolescents with CP have worse nutritional status than those normally developed. Those who received hypercaloric and hyperprotein nutritional supplementation benefited from its use. Studies indicate that enteral nutrition should be considered when nutritional needs are not met by the oral diet, especially in cases where oral motor functions are impaired. In addition, there was a direct relationship between the consistency of food, the level of motor function and nutritional status. Conclusions: Children and adolescents with CP have a greater risk of malnutrition. The use of nutritional supplementation may help with weight gain. In addition, enteral nutrition and modification of food texture have been used to improve the nutritional status of this group. Objective CP. . (CP) source MetaAnalyses Meta Analyses PRISMA (PRISMA guidelines Cochrane, (Cochrane LatinoAmericana Latino Americana Lilacs Embase PubMed SciELO Scopus Science. Science Science) 0 ( 1 old descriptors “children childhood “childhood therapy intervention “nutrition support diet “diet injury. injury injury” crosssectional cross sectional NewcastleOttawa Newcastle Ottawa trials synthesis n=658 n658 n 658 (n=658 199 202 criteria bias developed impaired addition Conclusions malnutrition gain (CP n=65 n65 65 (n=65 19 20 n=6 n6 6 (n=6 2 n= (n= (n

RESUMO Contexto: Nas últimas décadas, a ecoendoscopia evoluiu de uma ferramenta diagnóstica para uma plataforma para diversas intervenções terapêuticas. Vários avanços tecnológicos surgiram desde o último Consenso Brasileiro, demandando uma revisão e atualização das recomendações baseadas nas melhores evidências científicas. Métodos: Um grupo de 32 ecoendoscopistas renomados selecionou oito tópicos relevantes para serem discutidos a fim de gerar questões clínicas. Em seguida, foi realizada uma revisão da literatura para responder a essas perguntas com base nas evidências mais atualizadas. Resultados: Trinta e três tópicos foram formulados e votados pelos especialistas para alcançar um consenso. O Sistema de Oxford foi utilizado para classificar o nível de evidência. Conclusão: Há evidências moderadas para sustentar que a forma da agulha, calibre ou técnica de aspiração não influenciam no rendimento da amostragem tecidual guiada por ultrassom endoscópico (USE) de lesões sólidas pancreáticas. Há evidências moderadas para sustentar o uso da biópsia transcutânea guiada por USE da parede cística para diferenciar entre neoplasias císticas mucinosas e não mucinosas. Existem poucas evidências para apoiar o tratamento guiado por USE de varizes gástricas. Há um alto nível de evidência para sustentar que a drenagem biliar guiada por USE e a CPRE apresentam resultados semelhantes em pacientes com obstrução biliar maligna distal. Há um alto nível de evidência para o uso da USE no diagnóstico de cistos pancreáticos neoplásicos e na detecção de necrose antes de indicar a drenagem. Há evidências moderadas para sustentar a preferência pela gastroenterostomia guiada por USE em relação ao stent duodenal para obstrução maligna da saída gástrica em pacientes com expectativa de vida superior a 2 meses. Há um alto nível de evidência para sustentar o uso da ablação por radiofrequência no tratamento de ambos os tipos, funcionantes e não funcionantes, de tumores neuroendócrinos. Contexto décadas terapêuticas Brasileiro científicas Métodos 3 clínicas seguida atualizadas Resultados consenso Conclusão agulha (USE pancreáticas gástricas distal meses tipos neuroendócrinos

ABSTRACT Background: In the past decades, endoscopic ultrasound has developed from a diagnostic tool to a platform for many therapeutic interventions. Various technological advancements have emerged since the last Brazilian Consensus, demanding a review and update of the recommendations based on the best scientific evidence. Methods: A group of 32 renowned echoendoscopists selected eight relevant topics to be discussed to generate clinical questions. After that, a literature review was conducted to answer these questions based on the most updated evidence. Results: Thirty-three statements were formulated and voted on by the experts to reach a consensus. The Oxford System was used to grade the level of evidence. Conclusion: There is moderate evidence to support that the needle shape, gauge, or aspiration technique does not influence the yield of endoscopic ultrasound (EUS)-guided tissue sampling of pancreatic solid lesions. There is moderate evidence to support using EUS-TTNB of the cyst wall to differentiate between mucinous and non-mucinous cystic neoplasms. There is little evidence to support the EUS-guided treatment of gastric varices. There is a high level of evidence to support that EUS-guided biliary drainage and ERCP present similar outcomes in patients with distal malignant biliary obstruction. There is a high level of evidence for using EUS to diagnose neoplastic pancreatic cysts and detect necrosis before indicating drainage. There is moderate evidence to support EUS-GE over duodenal stent for malignant gastric outlet obstruction in patients with a life expectancy higher than 2 months. There is a high level of evidence to support the use of RFA in treating both functioning and non-functioning types of NET. Background decades interventions Consensus Methods 3 Results Thirtythree Thirty three consensus Conclusion shape gauge EUSguided guided lesions EUSTTNB TTNB nonmucinous non neoplasms varices EUSGE GE months nonfunctioning NET

Abstract Recent discoveries of funerary depositions at the Uruguay 1 site provide new elements on the mortuary behavior related to the Guarani archaeological unit. Five burials including one urn deposition and at least four directly in the ground were discovered. This last behavior had not yet been documented for the upper Uruguay river. The Guarani occupation of this site dates from the first half of the 15th century to the 18th century (510 ± 20 and 240 ± 30 years 14C AP). This site is inserted in the context of the archaeological area of Foz do Chapecó, which has been studied in the last two decades and in which at least seven other burials in urns have already been documented. In this article we present new field and laboratory findings on depositions from the Uruguai 1 site, as well as new radiocarbon dates for the level analyzed. The data contribute not only to regional archaeology, but also provide new elements for the understanding of the mortuary behavior of this archaeological unit along the De La Plata basin. discovered river th 510 (51 2 24 3 C AP. AP . AP) Chapecó analyzed archaeology basin 51 (5 5 (

Resumo Descobertas recentes de deposições funerárias no sítio Uruguai 1 contribuem com novos elementos sobre o comportamento mortuário relativos à unidade arqueológica Guarani. Tratam-se de cinco sepultamentos que incluem uma deposição em urna e ao menos quatro diretamente no solo, sendo a primeira vez que se documenta este último tipo de deposição para o alto vale do rio Uruguai. A ocupação Guarani desse sítio se situa da primeira metade do século XV até o século XVIII (510 ± 20 e 240 ± 30 anos 14C AP). Esse sítio está inserido no contexto da área arqueológica da Foz do Chapecó, que vem sendo estudada nas últimas duas décadas e na qual já foram documentadas pelo menos outras sete deposições funerárias, todas em urna. Neste artigo, apresentamos os achados de campo e laboratório sobre as deposições do sítio Uruguai 1, assim como novas datações radiocarbônicas para o nível analisado. Os dados não apenas contribuem para a arqueologia regional, mas trazem novos elementos para o entendimento do comportamento mortuário dessa unidade arqueológica na bacia do Prata. Tratamse Tratam solo 510 (51 2 24 3 C AP. AP . AP) Chapecó artigo analisado regional Prata 51 (5 5 (

RESUMO RACIONAL: O câncer colorretal é o terceiro tipo de câncer mais comum no Brasil apesar dos métodos de rastreamento que reduzem seu risco. A colonoscopia é o único método com possibilidade terapêutica. O adequado rastreio por colonoscopia está relacionado à qualidade dos exames, avaliados de acordo com critérios de qualidade recomendados por diversas instituições. Dentre os fatores, o mais utilizado é a Taxa de Detecção de Adenoma, que deve ser de pelo menos 25% na população geral. OBJETIVOS: Avaliar a qualidade das colonoscopias de rastreamento do câncer colorretal realizadas em um centro brasileiro. MÉTODOS: Estudo retrospectivo avaliando os indicadores de qualidade em colonoscopias de rastreio nos pacientes assintomáticos com mais de 45 anos. O desfecho primário foi a Taxa de Detecção de Adenoma, e os secundários incluíram a taxa de detecção de pólipos e a segurança do procedimento. Subanálises incluíram a correlação dos achados endoscópicos com sexo e idade e a evolução das taxas de detecção de adenoma ao longo dos anos. RESULTADOS: Foram incluídos 2.144 pacientes, com media de idade de 60.54 anos. Pólipos foram diagnosticados em 68,6% dos procedimentos. A taxa de detecção de adenoma foi de 46,8%, aumentando ao longo dos anos, principalmente em homens. A taxa de efeitos adversos foi de 0.23%, sem necessidade de intervenção cirúrgica ou registro de óbitos. CONCLUSÕES: Este estudo demonstra que é possível realizar colonoscopias com qualidade para o rastreio do câncer colorretal quando efetuadas por médicos experientes e enfermeiras treinadas em hospitais com infraestrutura adequada. RACIONAL risco terapêutica exames instituições fatores Adenoma 25 geral OBJETIVOS brasileiro MÉTODOS 4 anos procedimento RESULTADOS 2144 2 144 2.14 6054 60 54 60.5 686 68 6 68,6 procedimentos 468 46 8 46,8% homens 023 0 23 0.23% óbitos CONCLUSÕES adequada 214 14 2.1 605 5 60. 68, 46,8 02 0.23 21 1 2. 46, 0.2 0.

ABSTRACT BACKGROUND: Colorectal cancer is the third most common type of cancer in Brazil, despite the availability of screening methods that reduce its risk. Colonoscopy is the only screening method that also allows therapeutic procedures. The proper screening through colonoscopy is linked to the quality of the exam, which can be evaluated according to quality criteria recommended by various institutions. Among the factors, the most used is the Adenoma Detection Rate, which should be at least 25% for general population. AIMS: To evaluate the quality of the screening colonoscopies performed in a quarternary private Brazilian hospital. METHODS: This is a retrospective study evaluating the quality indicators of colonoscopies performed at a private center since its inauguration. Only asymptomatic patients aged over 45 years who underwent screening colonoscopy were included. The primary outcome was the Adenoma Detection Rate, and secondary outcomes included polyps detection rate and safety profile. Subanalyses evaluated the correlation of endoscopic findings with gender and age and the evolution of detection rates over the years. RESULTS: A total of 2,144 patients were include with a mean age of 60.54 years-old. Polyps were diagnosed in 68.6% of the procedures. Adenoma detection rate was 46.8%, with an increasing rate over the years, mainly in males. A low rate of adverse events was reported in 0.23% of the cases, with no need for surgical intervention and no deaths. CONCLUSIONS: This study shows that high quality screening colonoscopy is possible when performed by experienced endoscopists and trained nurses, under an adequate infrastructure. BACKGROUND Brazil risk procedures exam institutions factors Rate 25 population AIMS hospital METHODS inauguration 4 profile RESULTS 2144 2 144 2,14 6054 60 54 60.5 yearsold. yearsold old. old years-old 686 68 6 68.6 468 46 8 46.8% males 023 0 23 0.23 cases deaths CONCLUSIONS nurses infrastructure 214 14 2,1 605 5 60. 68. 46.8 02 0.2 21 1 2, 46. 0.

ABSTRACT This study analyzes the operational efficiency of Brazil’s 30 largest airports from 2014 to 2018, using a two-stage model. Operational efficiency is defined as an airport’s capacity to effectively utilize resources, such as facilities, staff, and technology, to cater to air traffic and passenger needs. The first stage involved measuring operational efficiency through data envelopment analysis. The second stage used a three-level hierarchical linear model to identify influencing variables. Key findings reveal that location significantly impacts airport efficiency, which generally declined during the study period. The interest rate, the only notable economic factor, had a negative effect on efficiency. Factors like the number of aircraft parking positions, years of airport operation, and the number of airlines positively influenced efficiency. Conversely, governance structure, airport size, commercial establishment count, and vehicle parking lot numbers didn’t notably affect efficiency variation. This methodological approach provided more accurate predictions than traditional regression models. Brazils Brazil s 3 201 2018 twostage two resources facilities staff technology needs analysis threelevel three level variables period rate factor positions operation Conversely structure size count didnt didn t variation models 20 2

ABSTRACT The purpose of this paper is to prioritize which waste should be treated by Lean Healthcare in a medical clinic of a middle-sized Brazilian hospital, using the multicriteria decision support method THOR 2. It focusses on structuring the problem, establishing alternatives through the study hospital and Lean interventions already made in it, and determining the criteria and parameters of THOR 2 with the help of Value Focus Thinking (VFT) and the hospital directors. THOR 2 was able to identify, taking into account its preference relationships in S2, that establishing a Kanban within the hospital’s medical clinic is the preferred and the main contribution and novelty to the literature is the way that multicriteria methods can help in Lean Healthcare decision making. As conclusions, it was possible to establish a prioritization order, maintaining the concept of continuous improvement, arising from Lean Healthcare, while respecting the limits and restrictions of the hospital. middlesized middle sized problem VFT (VFT directors identify S2 S hospitals s making conclusions order improvement

ABSTRACT Post-acute COVID-19 syndrome, or long COVID, presents with persistent symptoms, including cough, dyspnea, and fatigue, extending beyond one month after SARS-CoV-2 infection. Cardiac complications such as chest pain and arrhythmias have raised concerns, with chronotropic incompetence (CI), an inadequate heart rate increase during exercise, emerging as a significant condition contributing to diminished exercise tolerance and quality of life. This study estimated the prevalence of CI and explored its association with aerobic capacity and physical activity levels in long COVID patients. A cross-sectional study was conducted at a private hospital in Sergipe, Brazil, involving 93 patients over 18 years old with persistent post-COVID-19 symptoms after confirmed SARS-CoV-2 infections. Exclusion criteria included beta-blocker use, inadequate respiratory exchange ratio, and inability to complete cardiopulmonary exercise testing (CPET). Clinical histories, CPET results, and chronotropic index calculation were used to identify CI, with logistic regression analyzing associated factors. Of the participants (mean age 45 years; average duration since COVID-19 diagnosis 120 days), 20.4% were diagnosed with CI. Logistic regression identified a strong association between CI and sedentary behavior (OR 11.80; 95% CI 2.54 to 54.78; p=0.001). Patients with CI showed lower predicted peak heart rates and maximal oxygen uptake. The prevalence of CI among long COVID patients in this study was approximately 20%, associated with decreased aerobic capacity and increased sedentary behavior. These findings highlight the need for timely diagnosis and therapeutic interventions, including cardiopulmonary rehabilitation, to enhance the quality of life in post-COVID patients with CI. The study’s cross-sectional design and its specific context have limited causality inference and generalizability, underscoring the importance of further research in diverse settings. Postacute Post acute COVID19 19 COVID-1 syndrome cough dyspnea fatigue SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- infection concerns , (CI) crosssectional cross sectional Sergipe Brazil 9 1 postCOVID19 postCOVID post post-COVID-1 infections betablocker beta blocker use ratio CPET. . (CPET) histories results factors mean 4 12 days, days days) 204 20 20.4 OR 11.80 1180 11 80 95 254 54 2.5 54.78 5478 78 p=0.001. p0001 p p=0.001 0 001 p=0.001) uptake 20% interventions rehabilitation studys s generalizability settings COVID1 COVID- SARS-CoV (CI postCOVID1 post-COVID- (CPET 20. 11.8 118 8 25 5 2. 54.7 547 7 p000 p=0.00 00 11. 54. p00 p=0.0 p0 p=0. p=0 p=

ABSTRACT Introduction: sedation and analgesia are fundamental procedures for children undergoing invasive interventions, and complications must be avoided during their implementation. In situ simulation allows, in turn, training in real practice environments to improve the technical and non-technical skills of professionals for such procedures. Although it is a very useful tool, it is often not used due to lack of preparation for its planning and application. Objective: develop and validate an in situ simulation scenario in pediatric emergency care using sedation to perform an invasive procedure. Method: descriptive study of construction and content validation of an in situ simulation scenario, using the Delphi method, following the following steps: 1) definition of the problem and selection of experts; 2) development of the initial document; 3) rounds for validation with analysis of responses and feedback (until consensus is reached by the Content Validation Index); 4) final report. Results: The experts indicated suggestions that were duly used and the scenario obtained, in all items, a CVI greater than 80.0%, demonstrating its high validity and reliability. By using experts to validate the scenario, their insights guarantee greater precision and reliability in scenario construction engineering. Conclusion: It is expected that this study will allow the replication of the scenario in different training contexts, facilitating and encouraging professional training based on a scenario model based on best evidence and practices. Introduction interventions implementation allows turn nontechnical non tool application Objective procedure Method method steps 1 2 document 3 until Index Index) 4 report Results obtained items 800 80 0 80.0% engineering Conclusion contexts practices 8 80.0 80.

RESUMO Introdução: a sedação e analgesia são procedimentos fundamentais para crianças submetidas a intervenções invasivas, devendo-se evitar complicações durante sua realização. A simulação in situ permite, por sua vez, capacitações nos ambientes reais de prática para aprimorar as competências técnicas e não técnicas dos profissionais para tais procedimentos. Embora seja uma ferramenta de grande utilidade, muitas vezes não é aproveitada pelo despreparo para seu planejamento e aplicação. Objetivo: elaborar e validar um cenário de simulação in situ no atendimento de urgências pediátricas com uso de sedação para realização de procedimento invasivo. Método: estudo descritivo de construção e validação de conteúdo de um cenário de simulação in situ, por meio do método Delphi, seguindo os seguintes passos: 1) definição do problema e seleção de especialistas; 2) desenvolvimento do documento inicial; 3) rodadas para validação com análise das respostas e feedback (até obtenção do consenso pelo Índice de Validação de Conteúdo); 4) relatório final. Resultados: Os especialistas indicaram sugestões devidamente aproveitadas e o cenário obteve, em todos os itens, um IVC maior que 80,0% demonstrando sua alta validade e confiabilidade. Ao usar especialistas para validar o cenário, seus insights garatem maior precisão e confiabilidade à engenharia de construção dos cenários. Conclusão: espera-se, que este estudo permita a replicação do cenário em diferentes contextos de formação facilitando e incentivando a capacitação profissional a partir de um modelo de cenário baseado em melhores evidências e práticas. Introdução invasivas devendose devendo se permite vez utilidade aplicação Objetivo invasivo Método Delphi passos 1 2 inicial 3 até Conteúdo Conteúdo) 4 final Resultados obteve itens 800 80 0 80,0 cenários Conclusão esperase, esperase espera se, espera-se práticas 8 80,

ABSTRACT The selection process for instructors at the Brazilian Air Force Officers Improvement School (EAOAR) needs improvement to provide clearer guidance to the Commandant. This article aims to streamline and enhance the process by making it more efficient, less subjective, and more reliable. Researchers employed the Analytic Hierarchy Process (AHP) to determine criteria weights and the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) to rank candidates. They used Three Decision Methods (3DM) Software Web (v.1) for efficient calculations. Results showed that candidates closer to the Positive Ideal Solution (PIS) received favorable indications, while those closer to the Negative Ideal Solution (NIS) faced rejections. The AHP-TOPSIS hybrid approach successfully ranked candidates and expedited the process. Moreover, this approach has broader applications, including assessing candidates for international missions in the Brazilian Navy and Army, and evaluating employee performance in any organization. Future research could explore classification methods like the ELECTRE-TRI. EAOAR (EAOAR Commandant subjective reliable AHP (AHP TOPSIS (TOPSIS 3DM DM (3DM v.1 v1 v 1 (v.1 calculations PIS (PIS indications NIS (NIS rejections AHPTOPSIS Moreover applications Army organization ELECTRETRI. ELECTRETRI ELECTRE TRI. TRI ELECTRE-TRI v. (v. (v

Abstract This study evaluated the effects of broiler age (A) and levels of replacement (L) of control diet (CD) on the utilization of energy and nutrients of whole corn germ. 720 one-day-old broilers (b) were allocated at completely randomized design to six treatments and six replicates, in three assays: pre-starter (1-8 days, 10 b/cage), starter (15-22 days, 6 b/cage), and grower (28-35 days, 4 b/cage) phases. The treatments were: CD and four test diets (L): 100, 150, 200, 250, or 300 g kg-1 of the CD replaced by WCG levels. The data were adjusted to the response surface model. The stationary points for apparent energy metabolizable (AME) and AME corrected for nitrogen balance (AMEn) were: 4173 and 3591 kcal kg-1, respectively, and coefficients of gross energy (AMCGE), crude protein (AMCCP), dry matter (AMCDM), and ether extract (AMCEE) were: 49.3, 40.4, 72.6, and 61.3%, respectively; and Ileal digestibility coefficient of crude protein (IDCCP), dry matter (IDCDM), digestibility crude protein values (DCP), and digestibility dry matter value (DDM) were: 78.0, 57.96, 8.50, and 56.17%, respectively. The EP for AMEn was at 18 days of age, 28 g kg-1 WCG. There was a correlation between A and L on digestibility and metabolisability of nutrient’s WCG. (A (L (CD germ 72 onedayold one day old b (b replicates assays prestarter pre 1 8 (1- b/cage, bcage b/cage , cage 1522 15 22 (15-2 2835 35 (28-3 phases 100 150 200 250 30 kg1 kg kg- model (AME (AMEn 417 359 kg1, 1, respectively AMCGE, AMCGE (AMCGE) AMCCP, AMCCP (AMCCP) AMCDM, AMCDM (AMCDM) AMCEE (AMCEE 493 49 3 49.3 404 40 40.4 726 72.6 613 61 61.3% IDCCP, IDCCP (IDCCP) IDCDM, IDCDM (IDCDM) DCP, DCP (DCP) DDM (DDM 780 78 0 78.0 5796 57 96 57.96 850 50 8.50 5617 56 17 56.17% 2 nutrient s 7 (1 152 (15- 283 (28- 20 25 41 (AMCGE (AMCCP (AMCDM 49. 40. 72. 61.3 (IDCCP (IDCDM (DCP 78. 579 5 9 57.9 85 8.5 561 56.17 ( (15 (28 61. 57. 8. 56.1 (2 56.

ABSTRACT Objective: describe the process of translation and cross-cultural adaptation of the Mayo High Performance Team Scale into Brazilian Portuguese. Method: descriptive study of validation and cross-cultural adaptation of the scale, carried out virtually, following assumptions proposed by Beaton and collaborators. It had a sample of 40 experts, and carried out two rounds, one for validation and one for final assessment. Results: after following all translation steps, the scale was presented to the committee of experts who reached a consensus (IVC between 0.9 and 1.0) that there was no discrepancy, after evaluating the semantic, idiomatic, experiential and conceptual equivalences between the original scale and the translated version. Conclusion: The Brazilian Portuguese version of the MHPTS was adequately translated and validated, revealing excellent potential for use in clinical simulation contexts for multidisciplinary scenarios. Objective crosscultural cross cultural Method virtually collaborators 4 rounds assessment Results steps IVC 09 0 9 0. 1.0 10 1 discrepancy semantic idiomatic Conclusion validated scenarios 1.

RESUMO Objetivo: descrever o processo de tradução e adaptação transcultural da escala Mayo High Performance Team Scale para o português brasileiro. Método: estudo descritivo de validação e adaptação transcultural da escala, realizado de maneira virtual, seguindo pressupostos propostos por Beaton e colaboradores. Contou com uma amostra de 40 especialistas, e realizou duas rodadas, sendo uma de validação e uma de apreciação final. Resultados: após seguir todas as etapas de tradução a escala foi apresentada ao comitê de especialistas que chegou a um consenso (IVC entre 0,9 e 1,0) sobre não haver qualquer discrepância, após avaliação das equivalências semântica, idiomática, experiencial e conceitual entre a escala original e a versão traduzida. Conclusão: A versão em português brasileiro da MHPTS foi adequadamente traduzida e validada, revelando excelente potencial de utilização em contextos de simulação clínica para cenários multiprofissionais. Objetivo Método virtual colaboradores 4 rodadas final Resultados IVC 09 0 9 0, 1,0 10 1 discrepância semântica idiomática Conclusão validada multiprofissionais 1,

Chagas disease is a tropical neglected disease that affects millions of people worldwide, still demanding a more effective and safer therapy, especially in its chronic phase which lacks a treatment that promotes substantial parasitological cure. The technical note of Romanha and collaborators published in 2010 aimed establish a guideline with the set of minimum criteria and decision gates for the development of new agents against Trypanosoma cruzi with the focus on developing new antichagasic drugs. In this sense, the present review aims to update this technical note, bringing the state of the art and new advances on this topic in recent years. worldwide therapy cure 201 drugs sense years 20 2

Abstract In childhood and adolescence, cardiomyopathies have their own characteristics and are an important cause of heart failure, arrhythmias, sudden death, and indication for heart transplantation. Diagnosis is a challenge in daily practice due to its varied clinical presentation, heterogeneous etiologies, and limited knowledge of tools related to clinical and molecular genetics. However, it is essential to recognize the different phenotypes and prioritize the search for the etiology. Recent advances in precision medicine have made molecular diagnosis accessible, which makes it possible to individualize therapeutic approaches, stratify the prognosis, and identify individuals in the family who are at risk of developing the disease. The objective of this review is to emphasize the particularities of cardiomyopathies in pediatrics and how the individualized approach impacts the therapy and prognosis of the patient. Through a systematized approach, the five-stage protocol used in our service is presented. These stages bring together clinical evaluation for determining the morphofunctional phenotype, identification of etiology, classification, establishment of prognosis, and the search for personalized therapies. adolescence failure arrhythmias death transplantation presentation etiologies genetics However etiology accessible approaches disease patient fivestage five stage presented phenotype classification therapies

Resumo Na infância e adolescência, as miocardiopatias apresentam características próprias e são uma importante causa de insuficiência cardíaca, arritmias, morte súbita e indicação de transplante cardíaco. O diagnóstico é um desafio na prática diária devido à sua apresentação clínica variada, etiologias heterogêneas e conhecimento limitado das ferramentas de genética clínica e molecular. Entretanto, é fundamental reconhecer os diferentes fenótipos e priorizar a busca pela etiologia. Os avanços recentes na medicina de precisão tornaram o diagnóstico molecular mais acessível, permitindo individualizar condutas terapêuticas, estratificar o prognóstico e identificar indivíduos da família que estejam em risco de desenvolver doença. O objetivo desta revisão é enfatizar as particularidades das miocardiopatias na pediatria e como o enfoque individualizado influencia a terapêutica e o prognóstico do paciente. Através de uma abordagem sistematizada, o protocolo é apresentado em cinco etapas em nosso serviço. Estas etapas incluem a avaliação clínica para determinação do fenótipo morfofuncional, identificação da etiologia, classificação, estabelecimento do prognóstico e busca por terapias personalizadas. adolescência cardíaca arritmias cardíaco variada Entretanto etiologia acessível terapêuticas doença paciente sistematizada serviço morfofuncional classificação personalizadas

RESUMO Objetivo Investigar a associação entre indicadores da qualidade do sono e o consumo de alimentos ultraprocessados em adolescentes. Métodos Foi realizada uma revisão do tipo integrativa, estruturada com base nos critérios do Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A estratégia de busca foi realizada utilizando os descritores “adolescent”, “ultra-processed foods” e “sleep” nas bases de dados MedLine, SciELO, Scopus, Lilacs e PubMed, considerando estudos originais, nos idiomas inglês, português e espanhol, publicados sem limite temporal de ano, relacionados à temática estudada. A qualidade metodológica foi avaliada por meio do Checklist for Analytical Cross Sectional Studies of the Joanna Briggs Institute. Inicialmente foram encontrados 79 artigos. Após a leitura dos títulos e resumos 17 estudos foram selecionados. Em seguida estes artigos foram lidos na íntregra e os critérios de exclusão aplicados. Apenas 09 artigos atenderam aos critérios de elegibilidade e foram selecionados para compor esta revisão. Resultados Três estudos descreveram associações entre o maior consumo de alimentos ultraprocessados e menor duração do sono em adolescentes; um estudo apresentou associação entre o consumo de alimentos ultraprocessados e a má qualidade do sono em adolescentes; um estudo descreveu a associação de maiores chances de insônia com o maior consumo de alimentos ultraprocessados. Quatro estudos não relataram resultados significativos quanto ao questionamento principal que conduz a presente revisão. Conclusão Identificou-se associação entre o consumo de alimentos ultraprocessados e modificações em aspectos relacionados à qualidade e duração do sono, bem como à capacidade de adormecer e manter um sono contínuo em adolescentes. adolescentes integrativa MetaAnalyses. MetaAnalyses Meta Analyses. Analyses Meta-Analyses adolescent, adolescent , “adolescent” ultraprocessed ultra processed foods sleep “sleep MedLine SciELO Scopus PubMed originais inglês espanhol ano estudada Institute 7 1 aplicados 0 Identificouse Identificou se “adolescent

ABSTRACT Objective To investigate the association between sleep quality indicators and the consumption of ultra-processed foods in adolescents. Methods An integrative review was carried out, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. The search strategy was carried out using the descriptors “adolescent”, “ultra-processed foods” and “sleep” in the MedLine, SciELO, Scopus, Lilacs and PubMed databases, considering original studies on the investigation topic published in English, Portuguese and Spanish, without any date restriction. Methodological quality was assessed using the Checklist for Analytical Cross-Sectional Studies of the Joanna Briggs Institute. Initially, 79 articles were found. After reviewing the titles and abstracts, 17 papers were selected. Following a complete review the exclusion criteria were applied. Only 09 articles met the eligibility criteria. Results Three studies described associations between greater consumption of ultra-processed foods and shorter sleep duration in adolescents; one study showed an association between the consumption of ultra-processed foods and poor sleep quality in adolescents; one study described the association of greater chances of insomnia with greater consumption of ultra-processed foods. Four studies did not report significant results regarding the main question of our survey. Conclusion An association was identified between the consumption of ultra-processed foods and adolescent changes in the quality and duration of sleep, as well as in the ability to fall asleep and maintain continuous sleep. ultraprocessed ultra processed adolescents MetaAnalyses Meta Analyses adolescent, , “adolescent” “sleep MedLine SciELO Scopus databases English Spanish restriction CrossSectional Cross Sectional Institute Initially 7 found abstracts 1 selected applied 0 survey “adolescent