Resumen Objetivo Validar el contenido del guion de un recurso audiovisual para personas que viven con el VIH Métodos Estudio metodológico con enfoque cuantitativo, norteado por el marco referencial teórico metodológico de la psicometría. La validación de contenido fue realizada por jueces especialistas en el área temática mediante el uso del método Delphi. La muestra estuvo compuesta por 22 jueces en el primer análisis de validación y siete jueces en el segundo análisis. Resultados Todos los dominios analizados presentaron coeficiente de validez de contenido (CVC) >0,80, con un CVC total (CVCt) de 0,96, consistencia interna casi perfecta, Alfa de Cronbach de 0,988, ICC de 0,982 [IC95 % 0,969-0,991] y p<0,005 significativo en la primera ronda de evaluación de los especialistas. En el segundo análisis, los criterios usados para la validación de contenido presentaron un CVCt de 0,97, con los criterios de objetividad, simplicidad, claridad, relevancia, precisión, variedad, credibilidad y equilibrio, con un 100 % de aprobación. Conclusión Se validó el guion en cuanto al contenido, lo que demuestra que es un instrumento representativo y pertinente para la elaboración del recurso audiovisual. Contribuye al avance del conocimiento científico ya que presenta resultados con rigor metodológico, con innovaciones en el campo de la educación para la salud para personas que viven con el VIH. cuantitativo psicometría Delphi 2 (CVC 080 0 80 >0,80 (CVCt 096 96 0,96 perfecta 0988 988 0,988 0982 982 0,98 IC95 IC [IC9 0,9690,991 09690991 0,969 0,991 969 991 0,969-0,991 p0005 p 005 p<0,00 097 97 0,97 objetividad simplicidad claridad relevancia precisión variedad equilibrio 10 aprobación 08 8 >0,8 09 9 0,9 098 98 IC9 [IC 9690 0,9690,99 0969099 0969 0991 0,99 99 0,969-0,99 p000 00 p<0,0 1 >0, 0, 0,9690,9 096909 099 0,969-0,9 p00 p<0, >0 0,9690, 09690 0,969-0, p0 p<0 > 0,9690 0,969-0 p< 0,969-

Abstract Objective The study aimed to validate the script content of an audiovisual resource for people living with HIV. Methods This methodological study had a quantitative approach and was guided by the methodological theoretical framework of psychometrics. Content validation was performed by expert judges in the thematic area using the Delphi technique. The sample consisted of 22 judges in the first validation analysis and seven judges in the second analysis. Results All domains analyzed had a content validity coefficient (CVC) >0.80, with a total CVC (CVCt) of 0.96, almost perfect internal consistency, Cronbach’s alpha of 0.988, ICC of 0.982 [95%CI 0.969-0.991], and p<0.005 which was significant in the first round of expert evaluation. In the second analysis, the criteria used for content validation showed a CVCt of 0.97, with the criteria of objectivity, simplicity, clarity, relevance, accuracy, variety, credibility, and balance achieving 100% approval. Conclusion The script was validated in terms of content, showing to be a representative and relevant instrument for building the audiovisual resource. It contributes to the advancement of scientific knowledge as it presents results with methodological accuracy and innovations in the field of health education for people living with HIV. HIV psychometrics technique 2 (CVC 080 0 80 >0.80 (CVCt 096 96 0.96 consistency Cronbachs Cronbach s 0988 988 0.988 0982 982 0.98 95%CI 95CI CI 95 0.9690.991, 09690991 0.969 0.991 , 969 991 0.969-0.991] p0005 p 005 p<0.00 evaluation 097 97 0.97 objectivity simplicity clarity relevance variety credibility 100 approval 08 8 >0.8 09 9 0.9 098 98 9690 0.9690.991 0969099 0969 0991 0.99 99 0.969-0.991 p000 00 p<0.0 10 >0. 0. 0.9690.99 096909 099 0.969-0.99 p00 p<0. 1 >0 0.9690.9 09690 0.969-0.9 p0 p<0 > 0.9690. 0.969-0. p< 0.9690 0.969-0 0.969-

Resumo Objetivo Validar o conteúdo do roteiro de um recurso audiovisual para pessoas vivendo com HIV. Métodos Estudo metodológico com abordagem quantitativa, norteado pelo referencial teórico metodológico da psicometria. A validação de conteúdo foi realizada por juízes especialistas na área temática usando a técnica Delphi. A amostra foi composta por 22 juízes na primeira análise de validação e sete juízes na segunda análise. Resultados Todos domínios analisados apresentaram coeficiente de validade de conteúdo (CVC) >0,80, com CVC total (CVCt) de 0,96, consistência interna quase perfeita, Alfa de Cronbach de 0,988, ICC de 0,982 [IC95% 0,969-0,991] e p<0,005 significativo na primeira rodada de avaliação dos especialistas. Na segunda análise, os critérios usados para validação de conteúdo apresentaram CVCt de 0,97, com os critérios de objetividade, simplicidade, clareza, relevância, precisão, variedade, credibilidade e equilíbrio, atingindo 100% de aprovação. Conclusão O roteiro foi validado quanto ao conteúdo, mostrando ser um instrumento representativo e pertinente para construção do recurso audiovisual. Ele contribui para o avanço do conhecimento científico pois apresenta resultados com rigor metodológico, com inovações no campo da educação em saúde para pessoas vivendo com HIV. HIV quantitativa psicometria Delphi 2 (CVC 080 0 80 >0,80 (CVCt 096 96 0,96 perfeita 0988 988 0,988 0982 982 0,98 IC95% IC95 IC [IC95 0,9690,991 09690991 0,969 0,991 969 991 0,969-0,991 p0005 p 005 p<0,00 097 97 0,97 objetividade simplicidade clareza relevância precisão variedade equilíbrio 100 aprovação 08 8 >0,8 09 9 0,9 098 98 IC9 [IC9 9690 0,9690,99 0969099 0969 0991 0,99 99 0,969-0,99 p000 00 p<0,0 10 >0, 0, [IC 0,9690,9 096909 099 0,969-0,9 p00 p<0, 1 >0 0,9690, 09690 0,969-0, p0 p<0 > 0,9690 0,969-0 p< 0,969-

Abstract Slabs with cast-in-place steel formwork are composite structural elements composed of concrete and steel. The horizontal shear failure mode is the most common in composite slabs based on numerous experimental studies. This failure mode consists of loss of adherence and mechanical contact at the interface of the composite system and often occurs before the system reaches its full bending capacity. Thus, the design of this constructive system is determined by the value of the longitudinal shear strength, which can be computed by the semi-empirical so-called traditional m-k method based on the four-point bending test proposed by several standards. One of the most known factors to influence the longitudinal shear strength is the geometry of embossments present in the steel work. Calibrated computational simulation using the finite element method can be an alternative way to simulate this type of test. The present work modified and adapted a methodology explicitly including the geometry of embossments in the analysis in order to use materials and products with characteristics available to structural engineers in Brazil and used this methodology to derive m-k coefficients. This is being made with the objective of numerically simulating the effect of relevant parameters for determining the longitudinal shear strength at the concrete-steel interface of composite slabs. Force versus slip, force versus displacement graphs were obtained and the m-k coefficient values found were compared with those of other authors in the literature. The simulations presented values consistent with the literature and in relation to the rupture mode by longitudinal shear, the numerical simulations performed presented ultimate strengths with goodness-of-fit measured by the conventional coefficient of determination, reaching a good value for the semi-empirical relation using the results of the finite element data. castinplace cast place studies capacity Thus semiempirical semi empirical socalled so called mk m k fourpoint four point standards coefficients concretesteel slip goodnessoffit goodness fit determination data

Resumo Lajes com fôrmas metálicas utilizadas durante a concretagem são um sistema estrutural misto composto de aço e concreto. O modo de falha por cisalhamento horizontal é o mais comum em lajes mistas com bases em numerosos estudos experimentais. Esta falha consiste na perda de aderência e contato mecânico do sistema misto e, frequentemente, ocorre antes do sistema atingir sua capacidade máxima à flexão plástica. Assim, o projeto deste sistema construtivo é determinado pela sua resistência ao cisalhamento longitudinal, que pode ser determinada pelo método semiempírico convencional m-k com base no ensaio de flexão de quatro pontos proposto por diversas normas. Um dos fatores conhecidos de maior influência na resistência ao cisalhamento longitudinal é a geometria das mossas presentes na fôrma metálica. Simulações computacionais por meio do método dos elementos finitos calibradas com base em resultados experimentais podem ser uma alternativa à realização deste tipo de ensaio. O presente trabalho modificou e adaptou uma metodologia que inclui explicitamente a geometria das mossas na análise de modo a usar materiais e produtos com características disponíveis para os engenheiros estruturais do Brasil e usou esta metodologia para derivar coeficientes m-k. Isto foi feito com o objetivo de simular numericamente o efeito de parâmetros relevantes para determinar a resistência ao cisalhamento longitudinal na interface aço-concreto de lajes mistas. Gráficos de força versus deslocamentos foram obtidos e os valores dos coeficientes m-k foram comparados com aqueles de outros autores na literatura. As simulações apresentaram valores consistentes com a literatura e, em relação ao modo de ruptura por cisalhamento longitudinal, as simulações numéricas realizadas apresentaram resistências últimas com bom ajuste medido pelo coeficiente de determinação convencional chegando a um valor bom para a relação semiempírica utilizando os resultados dos dados de elementos finitos. concreto frequentemente plástica Assim mk m k normas metálica mk. k. açoconcreto

Abstract Background The application of botulinum toxin (BoNT) in the treatment of blepharospasm and hemifacial spasm (HS) is a well-established practice. However, neurology residency programs often rely on real patients for training, which has limitations in terms of patient availability and skill acquisition. Objective Assess the efficacy of a new facial phantom model for acquiring motor skills in BoNT application. Methods An anthropomorphic facial phantom model was developed in collaboration with a medical training simulator start-up. A group of seven neurologists and one ophthalmologist with expertise in BoNT application evaluated the model using an adapted learning object review instrument (LORI). The instrument assessed aspects such as: content quality, alignment of learning objectives, feedback and adaptation, motivation, presentation design, and accessibility. Results The facial phantom model received high scores in the LORI evaluation, with the highest ratings given to alignment with learning objectives and motivation. The model also scored well in terms of accessibility, content quality, and presentation design. However, feedback and adaptation received a lower score due to the static nature of the model. Conclusion The facial phantom model shows promise as a valuable tool for teaching and developing competence in BoNT application for HS and blepharospasm. The model reduces the reliance on real patients for training, providing a broader and safer learning experience for neurology residents. It also provides a realistic learning experience and offers portability, cost-effectiveness, and ease of manufacturing for use in various medical training scenarios. It is an effective and accessible tool for teaching BoNT application. (BoNT (HS wellestablished established practice However acquisition startup. startup start up. up start-up LORI. . (LORI) quality motivation design accessibility evaluation residents portability costeffectiveness, costeffectiveness cost effectiveness, effectiveness cost-effectiveness scenarios (LORI

Resumo Antecedentes A aplicação de toxina botulínica (TxB) no tratamento do blefaroespasmo e do espasmo hemifacial (EH) é uma prática bem estabelecida. No entanto, os programas de residência em neurologia frequentemente dependem de pacientes reais para treinamento, o que apresenta limitações em termos de disponibilidade de pacientes e aquisição de habilidades. Objetivo Avaliar a eficácia de um novo modelo de manequim facial para aquisição de habilidades motoras na aplicação de TxB. Métodos Foi desenvolvido um modelo antropomórfico de manequim facial em coloboração com uma empresa de simuladores de treinamento médico. Um grupo constituído por sete neurologistas e um oftalmologista com experiência em aplicação de TxB avaliou o modelo utilizando um instrumento adaptado de revisão de objeto de aprendizagem (LORI). O instrumento analisou aspectos como: qualidade do conteúdo, alinhamento dos objetivos de aprendizagem, feedback e adaptação, motivação, concepção da apresentação e acessibilidade. Resultados O modelo de manequim facial obteve pontuações altas na avaliação do LORI com os maiores escores em alinhamento com os objetivos de aprendizagem e motivação. O modelo também obteve boas pontuações em termos de acessibilidade, qualidade do conteúdo e concepção da apresentação. No entanto, o item feedback e adaptação recebeu uma pontuação média mais baixa, devido à natureza estática. Conclusão O modelo manequim facial mostra-se promissor como uma EH e blefaroespasmo. O modelo reduz a dependência de pacientes reais para treinamento portátil, de baixo custo e de fácil fabricação para uso em diversos cenários de treinamento, proporcionando uma experiência de aprendizagem mais ampla e segura para residentes de neurologia. Além disso, fornece uma experiência de aprendizagem realista e oferece portabilidade, economia e facilidade de fabricação para uso em vários cenários de treinamento médico. É uma ferramenta eficaz e acessível para o ensino da aplicação de TxB. (TxB (EH estabelecida entanto médico LORI. . (LORI) motivação acessibilidade baixa estática mostrase mostra se portátil disso portabilidade (LORI

ABSTRACT BACKGROUND: During childhood and adolescence, there are significant increases in bone mineral content (BMC) and bone mineral density (BMD). OBJECTIVE: To investigate physical growth parameters associated with BMD and BMC among children and adolescents diagnosed with human immunodeficiency virus (HIV). DESIGN AND SETTING: Cross-sectional study conducted in Florianópolis, Brazil, among 63 children and adolescents (aged 8-15 years) diagnosed with HIV. METHOD: BMD, BMC and fat percentage z score were evaluated using dual X-ray absorptiometry. Age/height z score and body mass index (BMI)/age z score were obtained in accordance with international recommendations, and bone age was obtained through hand-wrist radiography. Sex, family income, information on HIV infection (T CD4+ lymphocyte count, viral load and type of antiretroviral therapy, moderate-vigorous physical activity and sedentary behavior) were used as adjustment variables in the analyses. Simple and multiple linear regression analyses were performed, with a significance level of P ≤ 0.05. RESULTS: Subtotal BMD (without the head region) was directly associated with bone age, BMI/age z score and fat percentage z score, even after adjusting for covariates. Subtotal BMC/height was directly associated with bone age, height/age z score, BMI/age z score and fat percentage z score, even after adjusting for covariates. CONCLUSION: Subtotal BMD and subtotal BMC/height were directly associated with physical growth indicators among children and adolescents diagnosed with HIV.

ABSTRACT BACKGROUND: Studies that test associations between anthropometric indicators and insulin resistance (IR) need to provide better evidence in the context of the pediatric population (children and adolescents) with human immunodeficiency virus (HIV), as anthropometric indicators present a better explanation of the distribution of body fat. OBJECTIVE: To test the associations between anthropometric indicators and insulin resistance (IR) among children and adolescents diagnosed with HIV. DESIGN AND SETTING: Cross-sectional study on 65 children and adolescents (8-15 years) infected with HIV through vertical transmission conducted at the Joana de Gusmão Children's Hospital, Florianópolis, Brazil. METHODS: The anthropometric indicators measured were the abdominal (ASF), triceps (TSF), subscapular (SSF) and calf (CSF) skinfolds. The relaxed arm (RAC), waist (WC) and neck (NC) circumferences were also measured. Body mass index (BMI) was calculated from the relationship between body mass and height. IR was calculated through the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR). Simple and multiple linear regression analyses were used. RESULTS: After adjustment for covariates (sex, bone age, CD4+ T lymphocytes, CD8+ T lymphocytes, viral load, and physical activity), associations between IR and models with SSF and CSF remained. Each of these explained 20% of IR variability. For females, in the adjusted analyses, direct associations between IR and models with ASF (R² = 0.26) and TSF (R² = 0.31) were observed. CONCLUSIONS: SSF and CSF in males and ASF and TSF in females were associated with IR in HIV-infected children and adolescents.

ABSTRACT Objective To stratify ultrasound samples in a pediatric population undergoing evaluation for acute appendicitis to examine the variability in cecal appendix diameter, in different age groups, and to determine whether there is a prevalent value for each age group. Methods A retrospective cross-sectional study with 196 children aged 0 to 15 years. Data were extracted from reports of ultrasound examinations carried out between 2008 and 2015. Children with sonographic diagnosis of appendicitis or other signs of periappendiceal inflammation were excluded. Results The evaluation of the anteroposterior measurement of the cecal appendix revealed a mean diameter of 4.14mm (standard deviation: 0.93mm; 95%CI: 3.86-4.14). Cecal appendix diameter did not differ significant between age groups. Conclusion Evaluation of the anteroposterior diameter of the cecal appendix in centimeters in a sample of 196 children aged 0 to15 years revealed a mean diameter of 4.14mm (standard deviation, 0.93mm. There were no significant differences in cecal appendix diameter following stratification by age. Results indicate a single value can be adopted for mean cecal appendix diameter in pediatric populations.

SUMMARY: Discrete thresholds of structural or functional decline of a vegetation type are not readily apparent, as a vegetation type can slowly decline leading to transformations in its species composition and weakened or altered functions. However, forest monitoring can be used to assess changes in ecological functions in community structure and functional and phylogenetic composition of species. This study evaluated the existence of temporal variations in the functional and phylogenetic composition of a tree community, the occurrence of heterogeneity in the behavior of phylogenetic and functional variations, and how this possible heterogeneity influences the functional and phylogenetic variations under the aspect of environmental variations and by demographic ecological processes. Results detected quantitative and qualitative changes throughout the community, such as colonization, local extinctions, in demography and biomass, and increased evolutionary distinction, lower wood density species and phylogenetic clustering. These results have shown us that the natural changes of a community should not be underestimated, because the disappearance of a community can not only occur by the direct elimination of vegetation, but can be incremental with gradual changes in its functional characteristics and species composition, transforming itself into a new community with a new combination of species and new functions.

RESUMEN: Los umbrales discretos de deterioro estructural o funcional de un tipo de vegetación no son fácilmente aparentes, ya que un tipo de vegetación puede disminuir lentamente, lo que lleva a transformaciones en la composición de sus especies y funciones debilitadas o alteradas. Sin embargo, las observaciones pueden usarse para evaluar los cambios en las funciones ecológicas antes de que esto ocurra a través de la estructura comunitaria y la composición funcional y filogenética de las especies. Este estudio evaluó la existencia de variaciones temporales en la composición funcional y filogenética de una comunidad arbórea; la ocurrencia de heterogeneidad en el comportamiento de variaciones filogenéticas y funcionales; y cómo esta posible heterogeneidad influye en las variaciones funcionales y filogenéticas bajo el aspecto de variaciones ambientales y por procesos demográficos ecológicos. Los resultados en la detección de cambios cuantitativos y cualitativos en toda la comunidad con la colonización y las extinciones locales en la comunidad, las diferencias demográficas y de biomasa, la distinción evolutiva aumentada, las especies de menor densidad de madera y el agrupamiento filogenético. Los resultados han demostrado que los cambios naturales de una comunidad no deben subestimarse, porque la desaparición de una comunidad no solo puede ocurrir por la eliminación directa de la vegetación, sino que puede ser incremental con cambios graduales en sus características funcionales y composición de especies, transformando en una nueva comunidad con una nueva combinación de especies y nuevas funciones.

RESUMO O objetivo deste estudo foi investigar as águas superficiais e os níveis foliares dos elementos-traço (Cu, Zn, Cd e Pb) da Avicennia schaueriana na área de proteção ambiental (APA) Tinharé-Boipeba, litoral sul da Bahia, com ênfase na relação entre a qualidade ambiental e o gerenciamento costeiro. Mensuraram-se in situ variáveis físico-químicas nas águas superficiais, e tomaram-se alíquotas para análises microbiológicas. Também foram coletadas folhas de árvores de mangue em nove estações amostrais. Realizou-se a leitura dos elementos-traço por espectrometria de absorção atômica com chama (F-AAS). As análises físico-químicas e microbiológicas das águas superficiais, ainda que preliminares, indicaram perda de qualidade e desafios ao saneamento, os quais merecem a atenção de autoridades sanitárias ou de saúde pública e consulta à comunidade para elaboração de soluções técnicas compatíveis com os usos da natureza e modos de vida tradicionais na APA. Os níveis foliares dos metais foram normais e não tóxicos, sendo menores do que em áreas costeiras impactadas. Os bosques de mangue encontram-se em bom estado de conservação e servem de área de referência, recomendando-se o monitoramento dos elementos-traço nas folhas ou sedimentos de mangue e qualidade da água. Esta pesquisa tem relevância à conservação dos manguezais, aos usos culturais da natureza e ao gerenciamento costeiro.

ABSTRACT The objective of this study was to investigate the surface waters and leaf levels of trace elements (Cu, Zn, Cd, and Pb) of the Avicennia schaueriana in the Tinharé-Boipeba Environmental Protection Area (APA), South Coast of Bahia, with emphasis to the relationship between environmental quality and coastal management. Physical-chemical variables were measured in situ in surface waters and aliquots were taken for microbiological analysis. Also, leaves of mangrove trees were collected at nine sampling stations. The trace element reading was performed by F-AAS. Physical-chemical and microbiological analyzes of surface water, although preliminary, indicated that there is a loss of quality and challenges to sanitation, which deserve the attention of sanitary authorities, and of public health, and consultation with the community to elaborate technical solutions compatible with the uses of nature and traditional lifestyles in APA. Leaf metal levels were normal and nontoxic, being lower than in impacted coastal areas. Mangrove forests are in good state of conservation and serve as a reference area, recommending the monitoring of trace elements in mangrove leaves or sediments and water quality. This research has relevance to the conservation of mangroves, cultural uses of nature and coastal management.

Abstract INTRODUCTION: The number of syphilis cases among pregnant women in Brazil has increased. This study aimed to analyze the temporal trend of syphilis indicators among pregnant women in Northeast Brazil. METHODS: A time-series study was performed. RESULTS: We observed an increase in the detection rate of syphilis among pregnant women, those aged 15-19 years, and those of brown ethnicity. A strong correlation was observed between the detection rate of syphilis and family health strategy coverage. CONCLUSIONS: Despite an increase in primary care coverage, The increase in cases of syphilis among pregnant women is still considered a challenge.

OBJECTIVES: To verify the association between suicidal behaviors (ideation, planning, and attempts) and sedentary behaviors among adolescents from four Latin American and Caribbean countries. METHODS: A cross-sectional epidemiological study was conducted in four countries in Latin America and the Caribbean (Bahamas, Curação, El Salvador, and Guatemala). The sample comprised 6,813 adolescents aged 11-18 years, of which, 3,559 were females. The three suicidal behaviors considered were ideation, planning, and attempts. Sedentary behavior was regarded as the time that adolescents spent sitting, excluding time at school. Crude and adjusted logistic regression were used to estimate the odds ratio (OR) and 95% confidence interval (CI). RESULTS: Suicidal ideation was present in 10.7% of males and 22.7% of females. Suicidal planning was present in 8.6% of males and 16.3% of females. Suicidal attempt was present in 9.3% of males and 16.3% of females. Sedentary behavior was present in 39.6% of males and 45.7% of females. It was identified that male adolescents who reported spending ≥3 hours/day in sedentary behavior were more likely to have suicidal ideation (OR: 1.42; 95% CI: 1.13-1.80), whereas female adolescents who reported spending ≥3 hours/day in sedentary behavior were more likely to have suicidal ideation (OR: 1.55; 95% CI: 1.30-1.83), planning (OR: 1.54; 95% CI: 1.28-1.86), and attempts (OR: 1.31; 95% CI: 1.09-1.57). CONCLUSION: Adolescents of both sexes who reported spending ≥3 hours/day in sedentary behaviors were more likely to have some suicidal behaviors than those who spent less time in sedentary behaviors.