Abstract Time series analysis is a useful tool for many practical water resource management applications, such as planning and anticipating conflict around water use. These analyses are also necessary for the use, design and operation of hydrotechnical works and for the protection of aquatic ecosystems. Basically, his review focuses on classic models such as Box and Jenkins. However, restrictive assumptions about data and residuals make its use difficult. As an alternative, non-parametric approaches are interesting due to their application versatility. One of the techniques that has been widely used in the analysis of flow time series is Singular Spectral Analysis (SSA). However, its application is concentrated as a pre-processor or in hybrid approaches and, because of this, many studies focus only on the model to be improved, leaving gaps in the process understanding that underlie the SSA. Within this context, and because of this, the objective of this study is to present the SSA technique in detail, through an application to a time series of monthly average flows with complex behavior (Jucu River, located in Southeast Brazil), in order to overcome gaps associated to a rigorous understanding of the procedures that make up the SSA. The Sequential SSA technique was used to decompose signal and noise components. The reconstructed series preserved the dynamics of the observed series, suggesting a strong influence of the signal component (trend and seasonality) on its behavior. It’s expected that the technique can be used with greater fluidity by specialists and contribute to the management of water resources. applications ecosystems Basically Jenkins However difficult alternative nonparametric non parametric versatility . (SSA) preprocessor pre processor improved context detail Jucu River Brazil, Brazil , Brazil) components trend seasonality Its It s resources (SSA

Resumo A análise de séries temporais é uma ferramenta útil para muitas aplicações práticas de gestão de recursos hídricos, como no planejamento e antecipação de conflitos em torno do uso d'água. Estas análises são também necessárias para a concepção e operação de obras hidrotécnicas e para a proteção de ecossistemas aquáticos. Basicamente, sua análise se concentra em modelos clássicos, como Box e Jenkins. No entanto, suposições restritivas sobre dados e resíduos dificultam seu uso. Como alternativa, abordagens não paramétricas são interessantes devido a sua versatilidade de aplicação. Uma das técnicas que têm sido amplamente utilizada na análise de séries temporais de vazão é a Análise Espectral Singular (SSA). No entanto, sua aplicação é concentrada como pré-processador ou em abordagens híbridas e por conta disso, muitos estudos se concentram apenas no modelo a ser aprimorado, deixando lacunas de entendimento dos processos que fundamentam a SSA. Dentro desse contexto, e por conta disso, o objetivo deste estudo é apresentar detalhadamente a técnica SSA, através de uma aplicação à uma série temporal de vazões médias mensais com comportamento complexo (rio Jucu, localizado no Sudeste do Brasil), a fim de superar lacunas associadas ao entendimento rigoroso dos procedimentos que compõem a SSA. A SSA Sequencial foi utilizada para decompor os componentes sinal e ruído. A série reconstruída preservou a dinâmica da série observada, sugerindo forte influência do sinal (tendência e sazonalidade) em seu comportamento. Espera-se que a técnica possa ser usada com maior fluidez pelos especialistas e contribuir na gestão dos recursos hídricos. hídricos dágua. dágua d água. água d'água aquáticos Basicamente clássicos Jenkins entanto alternativa . (SSA) préprocessador pré processador disso aprimorado contexto rio Jucu Brasil, Brasil , Brasil) ruído observada tendência sazonalidade Esperase Espera (SSA

ABSTRACT Accuracy in river flows forecasts is crucial for Hydrology, but is challenged by fluviometric data quality. This study investigates the impact of different missing data imputation methods on the Seasonal Autoregressive Integrated Moving Average (SARIMA) model performance. SARIMA (1,1,1)(0,1,1)12 was selected using semi-automated criteria, such as lowest AIC, significant parameters (p-value < 0.05) and residuals adequacy. This model was then compared with reconstructed series using different imputation methods such as Mean (AM), Median (M), Spline and Stinemann Interpolations, Regional Weighting (RW), Multiple Linear Regression (MLR), Multiple Imputation (MI) and Maximum Likelihood (ML). The data were analyzed considering scenarios of 5, 20 and 40% missing data, following random and block patterns, using data from the Doce River, in Southeast Brazil. Results obtained by the performance indicators and, their respective relative differences, indicated that, univariate (AM and M) and multivariate (PW and RLM) methods limited the model's performance, while univariate Spline and Stine and multivariate IM and ML methods didn't present significant limitations, except Spline for the block pattern. It is concluded that, future predictions accuracy depends, not only on a well-trained and validated model, but also on the appropriate use of missing data imputation methods. Hydrology quality (SARIMA 1,1,10,1,112 11101112 1,1,1 0,1,1 12 1 0 (1,1,1)(0,1,1)1 semiautomated semi automated criteria AIC pvalue p value 0.05 005 05 adequacy AM, AM , (AM) M, M (M) Interpolations RW, RW (RW) MLR, MLR (MLR) MI (MI ML. . (ML) 5 2 40 patterns River Brazil differences that PW RLM models s didnt didn t limitations pattern depends welltrained well trained 10 112 1,1,10,1,11 1110111 111 1,1, 011 0,1, (1,1,1)(0,1,1) 0.0 00 (M (RW (MLR (ML 4 11 1,1,10,1,1 111011 1,1 01 0,1 (1,1,1)(0,1,1 0. 1,1,10,1, 11101 1, 0, (1,1,1)(0,1, 1,1,10,1 1110 (1,1,1)(0,1 1,1,10, (1,1,1)(0, 1,1,10 (1,1,1)(0 (1,1,1)( (1,1,1) (1,1,1 (1,1, (1,1 (1, (1 (

RESUMO A precisão nas previsões de vazão dos rios é crucial para a Hidrologia, mas é desafiada pela qualidade dos dados fluviométricos. Este estudo investiga o impacto de diferentes métodos de imputação de dados faltantes no desempenho do modelo Autoregressivo Integrado de Médias Móveis Sazonal (SARIMA). O modelo SARIMA (1,1,1)(0,1,1)12 foi selecionado usando critérios semi-automatizados, como menor AIC, parâmetros significativos (p-valor < 0,05) e adequação dos resíduos. Este modelo foi então comparado com séries reconstruídas usando diferentes métodos de imputação, como Média (AM), Mediana (M), Interpolações Spline e Stinemann, Ponderação Regional (RW), Regressão Linear Múltipla (MLR), Imputação Múltipla (MI) e Máxima Verossimilhança (ML). Os dados foram analisados considerando cenários de 5, 20 e 40% de dados faltantes, seguindo padrões aleatórios e de blocos, utilizando dados do Rio Doce, no Sudeste do Brasil. Os resultados obtidos pelos indicadores de desempenho e suas respectivas diferenças relativas, indicaram que, métodos univariados (AM e M) e multivariados (PW e RLM) limitaram o desempenho do modelo, enquanto os métodos univariados Spline e Stine e multivariados IM e ML não apresentaram limitações significativas, exceto Spline para o padrão de blocos. Conclui-se que a precisão das previsões futuras depende, não apenas de um modelo bem treinado e validado, mas também, do uso adequado de métodos de imputação de dados faltantes. Hidrologia fluviométricos SARIMA. . (SARIMA) 1,1,10,1,112 11101112 1,1,1 0,1,1 12 1 0 (1,1,1)(0,1,1)1 semiautomatizados, semiautomatizados semi automatizados, automatizados semi-automatizados AIC pvalor p valor 0,05 005 05 resíduos AM, AM , (AM) M, M (M) Stinemann RW, RW (RW) MLR, MLR (MLR) MI (MI ML. (ML) 5 2 40 blocos Doce Brasil relativas PW RLM significativas Concluise Conclui se depende validado também (SARIMA 10 112 1,1,10,1,11 1110111 111 1,1, 011 0,1, (1,1,1)(0,1,1) 0,0 00 (M (RW (MLR (ML 4 11 1,1,10,1,1 111011 1,1 01 0,1 (1,1,1)(0,1,1 0, 1,1,10,1, 11101 1, (1,1,1)(0,1, 1,1,10,1 1110 (1,1,1)(0,1 1,1,10, (1,1,1)(0, 1,1,10 (1,1,1)(0 (1,1,1)( (1,1,1) (1,1,1 (1,1, (1,1 (1, (1 (

ABSTRACT Backgrounds: Fortunately, much has been studied about COVID-19 in patients with inflammatory bowel diseases (IBD). Evidence suggests that these patients do not appear to be at increased risk of severe COVID-19. However, there are still some uncertainties regarding the clinical manifestations of COVID-19 in patients with immune-mediated diseases. Objective: This study aimed to describe the main symptoms of COVID-19 and their frequency in IBD patients and evaluate the impact of the IBD therapeutic drugs on clinical presentation of COVID-19 and to determine factors associated with COVID-19 in this population. Methods: Adult patients with IBD from three tertiary-care public, teaching hospitals in Ceará, Northeastern Brazil, were evaluated during one scheduled appointment from March to December 2020. Patients with possible or confirmed COVID-19 were compared with patients without COVID-19. Furthermore, incidences of each symptom were evaluated based on the use of IBD therapeutic drugs. Results: A total of 515 patients with IBD were included in the study: 234 with CD, and 281 with UC. Of these, 174 patients (34%) had possible/confirmed COVID-19 of whom 156 (90%) were symptomatic. Main symptoms were fever (65%) and headache (65%); gastrointestinal symptoms occurred in one third of patients and were higher than COVID-19 in general population. The factors associated with having COVID-19 were female gender (OR 1.71, 95%CI: 1.17-2.50); contact at home (OR 5.07, 95%CI: 3.31-7.78) and outside the home (OR 3.14, 95%CI: 2.10-4.71) with a case of COVID-19; work outside of the home (OR 1.87, 95%CI: 1.26-2.78); family history of COVID-19 (OR 2.29, 95%CI 1.58-3.33) use of salicylate (OR 1.71, 95%CI: 1.17-4.28); and asthma (OR 7.10, 95%CI: 1.46-34.57). Conclusion: IBD patients at high risk of COVID-19 infection may need to avoid salicylate therapy but further studies are necessary to confirm this association. Backgrounds Fortunately COVID19 COVID 19 COVID-1 IBD. . (IBD) COVID19. 19. However immunemediated immune mediated Objective population Methods tertiarycare tertiary care public Ceará Brazil 2020 Furthermore Results 51 23 CD 28 UC 17 34% 34 (34% possibleconfirmed 15 90% 90 (90% symptomatic 65% 65 (65% OR 171 1 71 1.71 95CI CI 95 1.172.50 117250 1.17 2.50 2 50 1.17-2.50) 507 5 07 5.07 3.317.78 331778 3.31 7.78 3 31 7 78 3.31-7.78 314 14 3.14 2.104.71 210471 2.10 4.71 10 4 2.10-4.71 187 87 1.87 1.262.78 126278 1.26 2.78 26 1.26-2.78) 229 29 2.29 1.583.33 158333 1.58 3.33 58 33 1.58-3.33 1.174.28 117428 4.28 1.17-4.28) 710 7.10 1.4634.57. 1463457 1.46 34.57 46 57 1.46-34.57) Conclusion association COVID1 COVID- (IBD 202 (34 9 (90 6 (65 1.7 172 1.172.5 11725 117 1.1 250 2.5 1.17-2.50 0 5.0 317 3.317.7 33177 331 3.3 778 7.7 3.31-7.7 3.1 104 2.104.7 21047 210 2.1 471 4.7 2.10-4.7 18 8 1.8 262 1.262.7 12627 126 1.2 278 2.7 1.26-2.78 22 2.2 583 1.583.3 15833 158 1.5 333 1.58-3.3 1.174.2 11742 428 4.2 1.17-4.28 7.1 4634 1.4634.57 146345 146 1.4 3457 34.5 1.46-34.57 20 (3 (9 (6 1. 1.172. 1172 11 25 2. 1.17-2.5 5. 3.317. 3317 3. 77 7. 3.31-7. 2.104. 2104 21 47 4. 2.10-4. 1.262. 1262 12 27 1.26-2.7 1.583. 1583 1.58-3. 1.174. 1174 42 1.17-4.2 463 1.4634.5 14634 345 34. 1.46-34.5 ( 1.172 1.17-2. 3.317 3.31-7 2.104 2.10-4 1.262 1.26-2. 1.583 1.58-3 1.174 1.17-4. 1.4634. 1463 1.46-34. 1.17-2 3.31- 2.10- 1.26-2 1.58- 1.17-4 1.4634 1.46-34 1.17- 1.26- 1.463 1.46-3 1.46-

RESUMO Contexto: Felizmente, muito se tem estudado sobre a COVID-19 em pacientes com doenças inflamatórias intestinais (DII). As evidências sugerem que esses pacientes não parecem ter risco aumentado de COVID-19 grave. Mas ainda se tem algumas incertezas com relação às manifestações clínicas da COVID-19 em portadores de doenças imunomediadas. Objetivo: Este estudo teve como objetivo descrever os principais sintomas da COVID-19 e sua frequência em pacientes com DII e avaliar o impacto dos medicamentos utilizados no tratamento das DII na apresentação clínica da COVID-19. Métodos: Pacientes adultos com DII de três hospitais públicos terciários de ensino do Ceará, Nordeste do Brasil, foram avaliados em consulta ambulatorial no período de março a dezembro de 2020. Pacientes com COVID-19 possível ou confirmada foram comparados com pacientes sem COVID-19. Além disso, as incidências de cada sintoma foram avaliadas com base no uso de medicamentos utilizados para tratamento da DII. Resultados: Foram incluídos no estudo 515 pacientes com DII: 234 com DC e 281 com RCU. Destes, 174 pacientes (34%) tinham COVID-19 possível/confirmado, dos quais 156 (90%) eram sintomáticos. Os principais sintomas foram febre (65%) e dor de cabeça (65%); sintomas gastrointestinais ocorreram em um terço dos pacientes, sendo mais frequentes do que na população geral com COVID-19. Os fatores associados a ter COVID-19 foram sexo feminino (OR 1,71, IC95%: 1,17-2,50); ter contato com caso de COVID-19, tanto intradomiciliar (OR 5,07; IC95%: 3,31-7,78) como fora do domicílio (OR 3,14; IC95%: 2,10-4,71); trabalhar fora de casa (OR 1,87; IC95%: 1,26-2,78); história familiar de COVID-19 (OR 2,29, IC95% 1,58-3,33), uso de salicilato (OR 1,71, IC95%: 1,17-4,28) e asma (OR 7,10; IC95%: 1,46-34,57). Conclusão: Pacientes com DII com alto risco de infecção por COVID-19 podem precisar evitar a terapia com salicilatos, mas mais estudos são necessários para confirmar esta associação. Contexto Felizmente COVID19 COVID 19 COVID-1 . (DII) grave imunomediadas Objetivo COVID19. 19. Métodos Ceará Brasil 2020 disso Resultados 51 23 28 RCU Destes 17 34% 34 (34% possívelconfirmado confirmado possível/confirmado 15 90% 90 (90% sintomáticos 65% 65 (65% OR 171 1 71 1,71 IC95 IC 1,172,50 117250 1,17 2,50 2 50 1,17-2,50) COVID19, 19, 5,07 507 5 07 3,317,78 331778 3,31 7,78 3 31 7 78 3,31-7,78 3,14 314 14 2,104,71 210471 2,10 4,71 10 4 2,10-4,71) 1,87 187 87 1,262,78 126278 1,26 2,78 26 1,26-2,78) 229 29 2,29 1,583,33, 158333 1,58 3,33 , 58 33 1,58-3,33) 1,174,28 117428 4,28 1,17-4,28 7,10 710 1,4634,57. 1463457 1,46 34,57 46 57 1,46-34,57) Conclusão salicilatos associação COVID1 COVID- (DII 202 (34 9 (90 6 (65 1,7 IC9 172 1,172,5 11725 117 1,1 250 2,5 1,17-2,50 5,0 0 317 3,317,7 33177 331 3,3 778 7,7 3,31-7,7 3,1 104 2,104,7 21047 210 2,1 471 4,7 2,10-4,71 1,8 18 8 262 1,262,7 12627 126 1,2 278 2,7 1,26-2,78 22 2,2 583 1,583,33 15833 158 1,5 333 1,58-3,33 1,174,2 11742 428 4,2 1,17-4,2 7,1 4634 1,4634,57 146345 146 1,4 3457 34,5 1,46-34,57 20 (3 (9 (6 1, 1,172, 1172 11 25 2, 1,17-2,5 5, 3,317, 3317 3, 77 7, 3,31-7, 2,104, 2104 21 47 4, 2,10-4,7 1,262, 1262 12 27 1,26-2,7 1,583,3 1583 1,58-3,3 1,174, 1174 42 1,17-4, 463 1,4634,5 14634 345 34, 1,46-34,5 ( 1,172 1,17-2, 3,317 3,31-7 2,104 2,10-4, 1,262 1,26-2, 1,583, 1,58-3, 1,174 1,17-4 1,4634, 1463 1,46-34, 1,17-2 3,31- 2,10-4 1,26-2 1,583 1,58-3 1,17- 1,4634 1,46-34 2,10- 1,26- 1,58- 1,463 1,46-3 1,46-

ABSTRACT The ideal ventral hernia surgical repair is still in discussion1. The defect closure with a mesh-based repair is the base of surgical repair, in open or minimally invasive techniques2. The open methods lead to a higher surgical site infections incidence, meanwhile, the laparoscopic IPOM (intraperitoneal onlay mesh) increases the risk of intestinal lesions, adhesions, and bowel obstruction, in addition to requiring double mesh and fixation products which increase its costs and could worsen the post-operative pain3-5. The eTEP (extended/enhanced view totally intraperitoneal) technique has also arisen as a good option for this hernia repair. To avoid the disadvantages found in classic open and laparoscopic techniques, the MILOS (Endoscopically Assisted Mini or Less Open Sublay Repair) concept, created by W. Reinpold et al. in 2009, 3 years after eTEP conceptualization, allows the usage of bigger meshes through a small skin incision and laparoscopic retro-rectus space dissection, as the 2016 modification, avoiding an intraperitoneal mesh placement6,7. This new technique has been called E-MILOS (Endoscopic Mini or Less Open Sublay Repair)8. The aim of this paper is to report the E-MILOS techniques primary experience Brazil, in Santa Casa de Misericórdia de São Paulo. discussion1 discussion meshbased based techniques2 incidence meanwhile lesions adhesions obstruction postoperative post operative pain35. pain35 pain pain3 5. 5 pain3-5 extended/enhanced extendedenhanced extended enhanced Endoscopically Repair concept W al 2009 conceptualization retrorectus retro rectus dissection 201 modification placement67 placement placement6 7 placement6,7 EMILOS E Endoscopic Repair8. Repair8 8. 8 Repair)8 Brazil Paulo pain3- 200 20 placement6, 2

RESUMO O tratamento cirúrgico ideal para correção das hérnias ventrais ainda é motivo de grande discussão1. O fechamento do defeito associado a utilização de telas para reforço da parede abdominal são passos fundamentais da terapia cirúrgica, podendo ser realizados tanto pela via aberta quanto pelas técnicas minimamente invasivas2. A via aberta apresenta maiores taxas de infecção de sítio cirúrgico, enquanto o reparo laparoscópico IPOM (intraperitoneal onlay mesh) acarreta um risco aumentado de lesões intestinais, aderências e obstruções intestinais, além de requerer uso de telas de dupla face e dispositivos de fixação que encarecem o procedimento e não raro aumentam a dor no pós-operatório3-5. A técnica eTEP (extended/enhanced view totally extraperitoneal), tem ganhado importância, mostrando-se uma boa opção para a correção das hérnias ventrais também2. A fim de se evitar as desvantagens das técnicas abertas e laparoscópicas “clássicas” o conceito MILOS (Endoscopically Assisted Mini or Less Open Sublay Repair), desenvolvido por W. Reinpold et al. em 2009, 3 anos antes do advento do eTEP, possibilita ao cirurgião o uso de telas de grandes dimensões no plano retromuscular através de uma pequena incisão na pele e dissecção laparoscópica deste espaço, conforme modificação realizada em 2016, evitando a colocação de uma tela no espaço intraperitoneal6-7. Esta nova técnica passou a se chamar EMILOS (Endoscopic Mini or Less Open Sublay Repair)8 Este artigo tem como objetivo relatar nossa experiência inicial no emprego da técnica E-MILOS no Brasil, na Santa Casa de Misericórdia de São Paulo. discussão1 discussão cirúrgica invasivas2 invasivas intraperitoneal mesh intestinais pósoperatório35. pósoperatório35 pósoperatório pós operatório3 5. 5 operatório pós-operatório3-5 extended/enhanced extendedenhanced extended enhanced extraperitoneal, extraperitoneal , extraperitoneal) importância mostrandose mostrando também2 também clássicas “clássicas Endoscopically Repair, Repair Repair) W al 2009 2016 intraperitoneal67. intraperitoneal67 intraperitoneal6 7. 7 intraperitoneal6-7 Endoscopic Repair8 8 E Brasil Paulo pósoperatório3 pós-operatório3- 200 201 intraperitoneal6- pós-operatório3 20 pós-operatório 2

Abstract Objective To evaluate clinical characteristics and outcomes of COVID-19 patients infected with HIV, and to compare with a paired sample without HIV infection. Methods This is a substudy of a Brazilian multicentric cohort that comprised two periods (2020 and 2021). Data was obtained through the retrospective review of medical records. Primary outcomes were admission to the intensive care unit, invasive mechanical ventilation, and death. Patients with HIV and controls were matched for age, sex, number of comorbidities, and hospital of origin using the technique of propensity score matching (up to 4:1). They were compared using the Chi-Square or Fisher's Exact tests for categorical variables and the Wilcoxon for numerical variables. Results Throughout the study, 17,101 COVID-19 patients were hospitalized, and 130 (0.76%) of those were infected with HIV. The median age was 54 (IQR: 43.0;64.0) years in 2020 and 53 (IQR: 46.0;63.5) years in 2021, with a predominance of females in both periods. People Living with HIV (PLHIV) and their controls showed similar prevalence for admission to the ICU and invasive mechanical ventilation requirement in the two periods, with no significant differences. In 2020, in-hospital mortality was higher in the PLHIV compared to the controls (27.9% vs. 17.7%; p = 0.049), but there was no difference in mortality between groups in 2021 (25.0% vs. 25.1%; p > 0.999). Conclusions Our results reiterate that PLHIV were at higher risk of COVID-19 mortality in the early stages of the pandemic, however, this finding did not sustain in 2021, when the mortality rate is similar to the control group. COVID19 COVID 19 COVID-1 infection (202 2021. . 2021) records unit death sex comorbidities up 41. 41 4 1 4:1) ChiSquare Chi Square Fishers Fisher s study 17101 17 101 17,10 hospitalized 13 0.76% 076 0 76 (0.76% 5 IQR (IQR 43.064.0 430640 43.0 64.0 43 64 43.0;64.0 202 46.063.5 460635 46.0 63.5 46 63 46.0;63.5 (PLHIV differences inhospital 27.9% 279 27 9 (27.9 vs 17.7% 177 7 0.049, 0049 0.049 , 049 0.049) 25.0% 250 25 (25.0 25.1% 251 0.999. 0999 0.999 999 0.999) pandemic however group COVID1 COVID- (20 4:1 1710 10 17,1 0.76 07 (0.76 064 43.064. 43064 430 43. 640 64. 6 43.0;64. 20 063 46.063. 46063 460 46. 635 63. 46.0;63. 27.9 2 (27. 17.7 004 0.04 04 25.0 (25. 25.1 099 0.99 99 (2 4: 171 17, 0.7 (0.7 06 43.064 4306 43.0;64 46.063 4606 46.0;63 27. (27 17. 00 0.0 25. (25 09 0.9 ( 0. (0. 43.06 43.0;6 46.06 46.0;6 (0 43.0; 46.0;

ABSTRACT Several drugs are available for the treatment of osteoporosis in postmenopausal women. Over the last decades, most patients requiring pharmacological intervention were offered antiresorptive drugs as first-line therapy, while anabolic agents were considered a last resource for those with therapeutic failure. However, recent randomized trials in patients with severe osteoporosis have shown that anabolic agents reduce fractures to a greater extent than antiresorptive medications. Additionally, evidence indicates that increases in bone mineral density (BMD) are maximized when patients are treated with anabolic agents first, followed by antiresorptive therapy. This evidence is key, considering that greater increases in BMD during osteoporosis treatment are associated with a more pronounced reduction in fracture risk. Thus, international guidelines have recently proposed an individualized approach to osteoporosis treatment based on fracture risk stratification, in which the stratification risk has been refined to include a category of patients at very high risk of fracture who should be managed with anabolic agents as first-line therapy. In this document, the Brazilian Society of Endocrinology and Metabolism and the Brazilian Association of Bone Assessment and Metabolism propose the definition of very high risk of osteoporotic fracture in postmenopausal women, for whom anabolic agents should be considered as first-line therapy. This document also reviews the factors associated with increased fracture risk, trials comparing anabolic versus antiresorptive agents, efficacy of anabolic agents in patients who are treatment naïve versus those previously treated with antiresorptive agents, and safety of anabolic agents.

RESUMO Antecedentes: O Doppler transcraniano (DTC) é uma técnica não invasiva para a avaliação da hemodinâmica cerebral, porém existem controvérsias na literatura sobre sua aplicabilidade preditiva em situações de elevada pressão intracraniana (PIC). Objetivo: Investigar o fluxo sanguíneo cerebral pelo DTC e correlacioná-lo com as variações da PIC na fase aguda da hipertensão intracraniana em modelo animal. Métodos: Dois grupos de animais (suínos) foram submetidos a hipertensão intracraniana secundária à indução de diferentes volumes de hematoma, por meio da insuflação de balão intracraniano controlado com 4 e 7 mL de solução salina fisiológica (grupos A e B, respectivamente). Em seguida, administrou-se infusão venosa de solução salina hipertônica (SSH 3%). Foram coletados os valores dos parâmetros de PIC e DTC (velocidade sistólica [FVs], diastólica [FVd] e média [FVm] do fluxo sanguíneo cerebral), bem como o índice de pulsatilidade (IP). Comparações entre os parâmetros do DTC e o monitoramento da PIC foram realizadas. Resultados: Vinte porcos foram estudados, dez no grupo A e dez no grupo B. Correlação significativa entre IP e PIC foi obtida, principalmente logo após a elevação abrupta da PIC. Não houve correlação entre PIC e FVs, FVd ou FVm separadamente. Também não houve alteração significativa na PIC após a infusão de SSH. Conclusões: Esses resultados demonstram o potencial do IP como um bom parâmetro para a avaliação de pacientes com suspeita de elevação da PIC.

ABSTRACT Background: Transcranial Doppler has been tested in the evaluation of cerebral hemodynamics as a non-invasive assessment of intracranial pressure (ICP), but there is controversy in the literature about its actual benefit and usefulness in this situation. Objective: To investigate cerebral blood flow assessed by Doppler technique and correlate with the variations of the ICP in the acute phase of intracranial hypertension in an animal model. Methods: An experimental animal model of intracranial hypertension was used. The experiment consisted of two groups of animals in which intracranial balloons were implanted and inflated with 4 mL (A) and 7 mL (B) for controlled simulation of different volumes of hematoma. The values of ICP and Doppler parameters (systolic [FVs], diastolic [FVd], and mean [FVm] cerebral blood flow velocities and pulsatility index [PI]) were collected during the entire procedure (before and during hematoma simulations and venous hypertonic saline infusion intervention). Comparisons between Doppler parameters and ICP monitoring were performed. Results: Twenty pigs were studied, 10 in group A and 10 in group B. A significant correlation between PI and ICP was obtained, especially shortly after abrupt elevation of ICP. There was no correlation between ICP and FVs, FVd or FVm separately. There was also no significant change in ICP after intravenous infusion of hypertonic saline solution. Conclusions: These results demonstrate the potential of PI as a parameter for the evaluation of patients with suspected ICP elevation.

ABSTRACT BACKGROUND: We aimed to describe the clinical characteristics of coronavirus disease 2019 (COVID-19) among healthcare workers (HCWs) in Curitiba, Brazil. METHODS: Upper respiratory samples from 1077 HCWs were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using reverse transcription polymerase chain reaction from June 16, 2020 to December 9, 2020. RESULTS: Overall, 32.7% of HCWs were infected. The positivity rates in symptomatic and asymptomatic HCWs were 39.2% and 15.9%, respectively. Hospital departments categorized as high-risk for exposure had the highest number of infected HCWs. CONCLUSIONS: Early diagnosis and isolation of infected HCWs remain key in controlling SARS-CoV-2 transmission because HCWs in close contact with COVID-19 patients are more likely to be infected than those who are not.

ABSTRACT Purpose: To determine the normal optical nerve sheath (ONS) diameter ultrasonography (ONSUS) and evaluate the possible effects of drugs on ONS diameter during anesthetic induction in healthy pigs. Methods: Healthy piglets were divided into three groups: a control group, that received xylazine and ketamine (X/K); other that received xylazine, ketamine and propofol (X/K/P); and a third group that received xylazine, ketamine, and thiopental (X/K/T). The sheath diameter was assessed by ultrasonography calculating the average of three measurements of each eye from the left and right sides. Results: 118 animals were anesthetized (49 X/K 33 X/K/P and 39 X/K/T). Mean ONS sizes on both sides in each group were 0.394 ± 0.048 (X/K), 0.407 ± 0.029 (X/K/P) and 0.378 ± 0.042 cm (X/K/T) (medians of 0.400, 0.405 and 0.389, respectively). The ONS diameter varied from 0.287–0.512 cm (mean of 0.302 ± 0.039 cm). For group X/K, the mean diameter was 0.394 ± 0.048 cm. Significant differences in ONS sizes between the groups P and T (X/K/P > X/K/T, p = 0.003) were found. No statistically significant differences were detected when other groups were compared (X/K = X/K/P, p = 0.302; X/K = X/K/T, p = 0.294). Conclusions: Sedation with thiopental lead to significative ONS diameter reduction in comparison with propofol. ONSUS may be useful to evaluate responses to thiopental administration.

Abstract This study investigated the corrosion inhibition of polyeugenol on API P110 in 1 M HCl. Its monomer – eugenol – is obtained from clove and cinnamon, making the oligomer environmentally friendly. The influence of molecular weight and polymerization degree was evaluated by increasing the polymerization initiator/monomer ratio. This enabled the polymerization of three different oligomers (P10, P20 and P30), which were characterized by Fourier-transform infrared spectroscopy (FTIR), proton nuclear magnetic resonance (1H-NMR), thermogravimetric analysis (TGA/DTG), and size exclusion chromatography techniques. The inhibition performance of polyeugenol was determined by weight loss (WL) and electrochemical tests to assess the influence of structural differences. WL indicated that the oligomer with the lowest polymerization degree (P10) exhibited greater efficiency (82-84%) due to more uniform surface coverage. Electrochemical tests confirmed polyeugenol as a mixed inhibitor. Energy-dispersive X-ray spectroscopy (EDX) calculations indicated the presence of an organic layer covering the steel surface.

ABSTRACT The muscular performance of the lumbar spine is frequently assessed in studies that compare populations with and without low back pain. However, the gold standard equipment used to evaluate the strength of these muscles has a high cost. Therefore, rarely used in the clinical practice of health professionals, being the handheld dynamometer an accessible alternative for use in clinical practice. Therefore, this study aimed to determine the reliability of the handheld dynamometer in the measurement of maximum voluntary isometric contraction of trunk extensors in healthy adults. Twenty-six healthy adults of both sexes (21.53± 1.88 years old) performed the test and retest with a 1-week interval. The comparison between test-retest demonstrated high and very high intraclass correlation coefficient for peak strength (0.82; 0.60 to 0.92) and mean strength (0.90; 0.76 to 0.95), respectively. Also, the Bland-Altman analyses indicate an error of 5.10 kg for peak strength and 5.7 kg for mean strength. In addition, the minimum detectable change for peak strength was 6.03kg (16.18%) and 5.92 kg for mean strength (20.95%). In conclusion, the test presents high reliability for the extensor muscles of the trunk in healthy adults. Therefore, the use of the handheld dynamometer can be indicated for clinical practice.

Abstract INTRODUCTION We aimed to describe the sociodemographic, epidemiological, and clinical characteristics of patients with chronic Chagas disease (CD) at an infectious disease referral center. Changes in patient profiles over time were also evaluated. METHODS This retrospective study included patients with CD from November 1986-December 2019. All patients underwent an evaluation protocol that included sociodemographic profile; epidemiological history; anamnesis; and physical, cardiologic, and digestive examinations. Trend differences for each 5-year period from 1986 to 2019 were tested using a nonparametric trend test for continuous and generalized linear models with binomial distribution for categorical variables. RESULTS A total of 2,168 patients (52.2% women) were included, with a mean age of 47.8 years old. White patients with low levels of education predominated. The reported transmission mode was vectorial in 90.2% of cases. The majority came from areas with a high prevalence (52.2%) and morbidity (67.8%) of CD. The most common clinical presentation was the indeterminate form (44.9%). The number of patients referred gradually decreased and the age at admission increased during the study period, as did the patients’ levels of education. CONCLUSIONS The clinical profile of CD is characterized by a predominance of the indeterminate form of the disease. Regarding the patients who were followed up at the referral center, there was a progressive increase in the mean age and a concomitant decrease in the number of new patients. This reflects the successful control of vector and transfusion transmission in Brazil as well as the aging population of patients with CD.

RESUMO: O objetivo deste trabalho foi avaliar a contribuição da inoculação da estirpe de Azospirillum MAY12 no desenvolvimento de plantas de arroz da cultivar BRS Esmeralda. Foi realizado um experimento inteiramente casualizado em casa de vegetação, tendo oito tratamentos e seis repetições: inoculante comercial (IC) contendo as estirpes de Azospirillum brasilense AbV5 e AbV6 (T1), MAY12 (T2), testemunha nitrogenada com 50 mg de N ou dose cheia (T3), IC + 30% de N (percentual referente à dose cheia) (T4), IC + 60% de N (T5), MAY12 + 30% de N (T6), MAY12 + 60% de N (T7) e testemunha absoluta (T8). Houve aumento significativo da massa fresca e seca da parte aérea e de raízes, altura, volume de raízes e do número de perfilhos e de folhas das plantas com a inoculação de MAY12 (com e sem adição de N) em relação a T8. Os tratamentos contendo MAY12 + N aumentaram em torno de 920% a massa seca total em relação a T8, equiparando-se ao rendimento T3. A inoculação de MAY12, isoladamente, foi tão eficiente quanto a aplicação da dose cheia de N para o aumento em torno de 115% da altura e de 373% do volume de raízes das plantas em relação a T8. A estirpe MAY12 apresentou bom desempenho no desenvolvimento da cultivar equiparando-se com o IC nas variáveis testadas. Portanto, a inoculação com a estirpe MAY12 mostra-se promissora para a redução parcial de fertilizantes nitrogenados no cultivo de arroz de terras altas.

ABSTRACT: The purpose of this study was to evaluate the contribution of the inoculation of the strain Azospirillum MAY12 to the development of rice plants of the cultivar BRS Esmeralda. A completely randomized experiment was performed in a greenhouse, with 8 treatments and 6 repetitions, namely, commercial inoculant (CI) containing strains of Azospirillum brasilense ABV5 and ABV6 (T1), MAY12 (T2), nitrogen control with 50 mg of N or full dose (T3), CI + 30% of N (percentage referring to full dose) (T4), CI + 60% N (T5), MAY12 + 30% N (T6), MAY12 + 60% N (T7) and absolute control (T8). There was a significant increase in the fresh and dry mass of the shoot and roots, height, root volume, and the number of tillers and leaves of plants with the MAY12 inoculation (with and without N added) compared to T8. Treatments containing MAY12 + N increased the total dry mass by ~920% compared to T8, matching the T3 yield. The inoculation of MAY12 in isolation was as efficient as the application of the full dose of N, resulting in an increase of ~115% in height and 373% in root volume of the plants compared to T8. The MAY12 strain demonstrated good performance in the development of the cultivar, which was comparable to the CI in the variables tested. Therefore, inoculation with the MAY12 strain is promising for the partial reduction of nitrogen fertilizers in upland rice cultivation.

ABSTRACT Antiresorptive therapy is the main form of prevention of osteoporotic or fragility fractures. Medication-related osteonecrosis of the jaw (MRONJ) is a relatively rare but severe adverse reaction to antiresorptive and antiangiogenic drugs. Physicians and dentists caring for patients taking these drugs and requiring invasive procedures face a difficult decision because of the potential risk of MRONJ. The aim of this study was to discuss the risk factors for the development of MRONJ and prevention of this complication in patients with osteoporosis taking antiresorptive drugs and requiring invasive dental treatment. For this goal, a task force with representatives from three professional associations was appointed to review the pertinent literature and discuss systemic and local risk factors, prevention of MRONJ in patients with osteoporosis, and management of established MRONJ. Although scarce evidence links the use of antiresorptive agents in the context of osteoporosis to the development of MRONJ, these agents are considered a risk factor for this complication. Despite the rare reports of MRONJ in patients with osteoporosis, the severity of symptoms and impact of MRONJ in the patients' quality of life make it imperative for health care professionals to consider this complication when planning invasive dental procedures.

Resumo Em finais de 2019, entrevistamos por e-mail os professores Marcelo Neves e Aldo Mascareño, sugerindo-lhes um eixo comum de perguntas sobre suas trajetórias e sobre os principais desafios envolvidos na tarefa de aclimatar a teoria dos sistemas sociais de Niklas Luhmann ao contexto latino-americano. Além das duas entrevistas, fizemos uma sucinta apresentação do que denominamos cenário “pós-luhmanniano” e do potencial da recepção latino-americana para a renovação do legado sistêmico no presente, incluindo breve exploração bibliométrica de alguns padrões dessa recepção.

Abstract At the end of 2019, we interviewed by email Professors Marcelo Neves and Aldo Mascareño, presenting them with a similar list of questions on their intellectual trajectories and the principal challenges involved in the task of adapting Niklas Luhmann’s social systems theory to the Latin American context. As well as the two interviews, we provide a brief presentation of what we call the ‘post-Luhmannian’ scenario and the potential for its Latin American reception to renew the systemic legacy in the present, including a short bibliometric exploration of some of the patterns evident in this reception.