Abstract Objectives To investigate the associations between caregivers’ burden, family quality of life (QoL), and siblings’ QoL in Brazilian families of children with cerebral palsy, and to analyze siblings’ QoL using as a parameter the QoL of typically developed Brazilian children. Methods It was a cross-sectional study. The 212 families, 212 caregivers and 131 siblings completed the Family Quality of Life Scale, Burden Interview, and KIDSCREEN-27 Child and Adolescent Version and Parents Version questionnaires at a neurorehabilitation center in southeast Brazil. Univariable and multivariable models were used. Results Family QoL significantly worsened as caregivers’ burden increased (95 % CI -0.66 to -0.38). Caregivers’ burden was significantly lower with increasing family QoL scores (95 % CI -0.52 to -0.30). Self-reported siblings’ QoL was significantly worse than that of their typically developed peers (95 % CI -7.6 to -3.6). Self-reported siblings’ QoL was significantly lower as siblings’ age (95 % CI -2.52 to -0.59) and caregivers’ burden (95 % CI -0.35 to -0.05) increased. Parent-reported siblings’ QoL was significantly lower with increasing caregivers’ burden (95 % CI -0.45 to -0.16) and higher as family QoL increased (95 % CI 0.09 to 0.37). Conclusions The cross-sectional nature of these data precludes any statement of causality. Family QoL worsened with higher caregivers’ burden levels. Lower caregivers’ burden scores were associated with a higher family QoL. Siblings’ QoL was impaired as compared to typically developed peers, worse among older siblings, and as caregivers’ burden increased and better with higher family QoL levels. Future multicenter studies may validate the generalizability of the present findings. QoL, , (QoL) palsy crosssectional cross sectional study 21 13 Scale Interview KIDSCREEN27 KIDSCREEN 27 KIDSCREEN-2 Brazil used 95 (9 0.66 066 0 66 -0.6 0.38. 038 0.38 . 38 -0.38) Caregivers 0.52 052 52 -0.5 0.30. 030 0.30 30 -0.30) Selfreported Self reported 7.6 76 7 6 -7. 3.6. 36 3.6 3 -3.6) 2.52 252 2 -2.5 0.59 059 59 -0.59 0.35 035 35 -0.3 0.05 005 05 -0.05 Parentreported Parent 0.45 045 45 -0.4 0.16 016 16 -0.16 009 09 0.0 0.37. 037 0.37 37 0.37) causality levels Siblings findings (QoL 1 KIDSCREEN2 KIDSCREEN- 9 ( 0.6 06 -0. 03 0.3 -0.38 0.5 5 -0.30 7. -7 3. -3.6 2.5 25 -2. 00 -0.0 0.4 04 4 0.1 01 -0.1 0. -0 - -3. 2. -2 -3

Abstract The objective of this work was to identify the most adapted and stable genotypes for dry mass and seed yield using the genotype plus environment interaction (GGE) biplot technique. The experiment was conducted in the municipality of Frederico Westphalen, in the state of Rio Grande do Sul, Brazil, in 2018, 2019, 2020, and 2021, using five lines and two cultivars of black oat, in a randomized complete block experimental design, with three replicates. The adaptability and stability of the genotypes, as well as their behavior in the environments, were evaluated using the GGE biplot. The seed yield of black oat genotypes is highly influenced by the environmental conditions over the four studied cultivation years. The UFSMFW 2-07 genotype stands out, but shows instability. The UFSMFW 2-07 and 'UPFA 21-Moreninha' genotypes show adaptability in specific years. Mega environments are formed for the dry mass trait in 2018 and 2021 and seed yield in 2018, 2020, and 2021, whereas, 2019 is considered the year for genotype discrimination. (GGE technique Westphalen Sul Brazil 2020 design replicates years 207 2 07 2-0 out instability UPFA 21Moreninha Moreninha 21 21-Moreninha 201 202 whereas discrimination 20 0 2-

Resumo O objetivo deste trabalho foi identificar os genótipos mais adaptados e estáveis para massa seca e produtividade de sementes, com uso da técnica genótipo + interação genótipo-ambinete (GGE) biplot. O experimento foi conduzido no município de Frederico Westphalen, no estado do Rio Grande do Sul, Brasil, em 2018, 2019, 2020 e 2021, tendo-se utilizado cinco linhagens e duas cultivares de aveia-preta, em delineamento experimental de blocos ao acaso, com três repetições. A adaptabilidade e a estabilidade dos genótipos, bem como seu comportamento nos ambientes, foram avaliados pelo GGE biplot. A produtividade de sementes de genótipos de aveia-preta é altamente influenciada pelas condições ambientais ao longo dos quatro anos de cultivo estudados. O genótipo UFSMFW 2-07 destaca-se, mas apresenta instabilidade. Já os genótipos UFSMFW 2-07 e 'UPFA 21-Moreninha' apresentam adaptabilidade para produção de massa seca em anos específicos. São formados mega-ambientes para o traço massa seca em 2008 e 2021 e para produtividade de sementes em 2018, 2020 e 2021, enquanto 2019 é considerado o ano para discriminação de genótipos. genótipoambinete ambinete (GGE biplot Westphalen Sul Brasil 2018 202 tendose tendo se aveiapreta, aveiapreta aveia preta, preta acaso repetições ambientes estudados 207 2 07 2-0 destacase, destacase destaca se, destaca-se instabilidade UPFA 21Moreninha Moreninha 21 21-Moreninha específicos megaambientes mega 200 201 20 0 2-

ABSTRACT Background: We assessed the distribution of triatomines in an endemic area for Chagas disease. Methods: This retrospective study used secondary data extracted from the Official System of the National Chagas Disease Control Program (Sistema Oficial do Programa Nacional de Controle da Doença de Chagas - SisPCDCh). Results: A total of 7,257 (725.7 ± 221.7 per year) specimens were collected from 2013 to 2022. Most of them (6,792; 93.6%) were collected in the intradomicile and 465 (6.4%) in the peridomicile. A total of 513 (7.1%) triatomines tested positive for the presence of trypomastigote forms, similar to Trypanosoma cruzi. Conclusions: The spatial analysis revealed a heterogeneous distribution of triatomines across different municipalities. Background disease Methods Sistema SisPCDCh. SisPCDCh . SisPCDCh) Results 7257 7 257 7,25 725.7 725 (725. 2217 221 221. year 201 2022 6,792 6792 6 792 (6,792 93.6% 936 93 46 6.4% 64 4 (6.4% peridomicile 51 7.1% 71 1 (7.1% forms cruzi Conclusions municipalities 25 7,2 725. 72 (725 22 20 202 6,79 679 79 (6,79 93.6 9 6.4 (6.4 5 7.1 (7.1 2 7, (72 6,7 67 (6,7 93. 6. (6. 7. (7. (7 6, (6, (6 (

RESUMO Introdução: a obesidade é definida pelo acúmulo excessivo de gordura em diferentes regiões corporais, condição que acarreta prejuízos à saúde e constitui fator de risco para diversas comorbidades. A cirurgia bariátrica é a opção terapêutica com melhores resultados para o seu tratamento. Métodos: estudo retrospectivo descritivo realizado com dados obtidos de prontuários médicos do período de janeiro/2018 a dezembro/2020, relacionados a pacientes submetidos à cirurgia bariátrica. As análises estatísticas realizadas adotaram nível de significância p<0,05. Resultados: foram incluídos 178 prontuários, sendo 77,5% de mulheres. A média de idade foi de 35,7 anos (± 9,5), 63,8% dos pacientes eram procedentes de Imperatriz, 98,3% relataram sedentarismo, 38,7% consumo regular de álcool e 13% tabagismo. A prevalência de obesidade grau III (IMC≥40 kg/m²) foi de 53,3%. As comorbidades mais relacionadas foram esteatose hepática (64,6%), diabetes mellitus tipo 2 (DM2) (40,5%) e hipertensão arterial (38,7%). O principal tipo de cirurgia realizada foi o by-pass gástrico em Y de Roux (BGYR) (89,3%). Observou-se associação entre a mediana de IMC e o sexo (p=0,008), com as mulheres apresentando maiores valores [43,4 (IIQ 39,1 - 48,8)]. A média de IMC dos pacientes submetidos ao BGYR foi significativamente maior comparado aos que realizaram gastrectomia vertical (GV) (p=0,009). Houve associação estatística entre o DM2 (p=0,033) e a depressão (p=0,018) com o tipo de cirurgia realizada. Conclusão: o perfil clínico-epidemiológico encontrado evidenciou maior prevalência do sexo feminino e de indivíduos com obesidade grau III. O BGYR foi o procedimento mais realizado, estabelecendo associação com IMC e algumas comorbidades apresentadas pelos pacientes. Introdução corporais tratamento Métodos janeiro2018 janeiro 2018 janeiro/201 dezembro2020 dezembro 2020 dezembro/2020 p005 p 0 05 p<0,05 Resultados 17 775 77 5 77,5 357 35 7 35, ± ( 9,5, 95 9,5 , 9 9,5) 638 63 8 63,8 Imperatriz 983 98 3 98,3 sedentarismo 387 38 38,7 13 tabagismo IMC≥40 IMC40 40 (IMC≥4 kg/m² kgm² kgm kg m² m 533 53 53,3% 64,6%, 646 64,6% 64 6 (64,6%) DM (DM2 40,5% 405 (40,5% 38,7%. . (38,7%) bypass by pass (BGYR 89,3%. 893 89,3% 89 (89,3%) Observouse Observou se p=0,008, p0008 p=0,008 008 (p=0,008) 43,4 434 43 4 [43, IIQ 391 39 1 39, 48,8. 488 48,8 48 48,8)] GV (GV p=0,009. p0009 p=0,009 009 (p=0,009) p=0,033 p0033 033 (p=0,033 p=0,018 p0018 018 (p=0,018 Conclusão clínicoepidemiológico clínico epidemiológico janeiro201 201 janeiro/20 dezembro202 202 dezembro/202 p00 p<0,0 77, 9, 63, 98, 38, IMC≥4 IMC4 (IMC≥ kg/m 53,3 64,6 (64,6% (DM 40,5 (40,5 (38,7% 89,3 (89,3% p000 p=0,00 00 (p=0,008 43, [43 48, 48,8) (p=0,009 p=0,03 p003 03 (p=0,03 p=0,01 p001 01 (p=0,01 janeiro20 20 janeiro/2 dezembro20 dezembro/20 p0 p<0, IMC≥ (IMC 53, 64, (64,6 40, (40, (38,7 89, (89,3 p=0,0 (p=0,00 [4 (p=0,0 janeiro2 janeiro/ dezembro2 dezembro/2 p<0 (64, (40 (38, (89, p=0, [ (p=0, dezembro/ p< (64 (4 (38 (89 p=0 (p=0 (6 (3 (8 p= (p= (p

ABSTRACT Introduction: the obesity is defined as the excessive accumulation of fat in different areas of the body, a condition that causes damage to health and is a critical risk factor for various comorbidities. Bariatric surgery is the therapeutic option with the best results. Methods: this is a retrospective descriptive study using data obtained from medical records from January 2018 to December 2020 on patients undergoing bariatric surgery. Statistical analysis used a significance level of p<0.05. Results: 178 medical records were included, 77.5% of which were women. The average age was 35.7 years (± 9.5), 63.8% of the patients were from Imperatriz, 98.3% reported a sedentary lifestyle, 38.7% regular alcohol consumption and 13% smoking. The prevalence of Class III obesity (BMI≥40 kg/m²) was 53.3%. The most common comorbidities were hepatic steatosis (64.6%), type 2 diabetes mellitus (DM2) (40.5%) and hypertension (38.7%). The main type of surgery performed was Roux-en-Y gastric bypass (RYGB) (89.3%). There was an association between median BMI and gender (p=0.008), with women showing higher values [43.4 (IQR 39.1 - 48.8)]. The mean BMI of patients who underwent RYGB was significantly higher compared to those who underwent vertical gastrectomy (VG) (p=0.009). There was a statistical association between DM2 (p=0.033) and depression (p=0.018) and the type of surgery performed. Conclusion: the clinical and epidemiological profile found showed a higher prevalence of females and individuals with Class III obesity. RYGB was the most commonly performed procedure, establishing an association with BMI and some of the patients’ comorbidities. Introduction body results Methods 201 202 p005 p 0 05 p<0.05 Results 17 included 775 77 5 77.5 357 35 7 35. ± ( 9.5, 95 9.5 , 9 9.5) 638 63 8 63.8 Imperatriz 983 98 3 98.3 lifestyle 387 38 38.7 13 smoking BMI≥40 BMI40 40 (BMI≥4 kg/m² kgm² kgm kg m² m 533 53 53.3% 64.6%, 646 64.6% 64 6 (64.6%) DM (DM2 40.5% 405 (40.5% 38.7%. . (38.7%) RouxenY Roux en Y (RYGB 89.3%. 893 89.3% 89 (89.3%) p=0.008, p0008 p=0.008 008 (p=0.008) 43.4 434 43 4 [43. IQR 391 39 1 39. 48.8. 488 48.8 48 48.8)] VG (VG p=0.009. p0009 p=0.009 009 (p=0.009) p=0.033 p0033 033 (p=0.033 p=0.018 p0018 018 (p=0.018 Conclusion procedure 20 p00 p<0.0 77. 9. 63. 98. 38. BMI≥4 BMI4 (BMI≥ kg/m 53.3 64.6 (64.6% (DM 40.5 (40.5 (38.7% 89.3 (89.3% p000 p=0.00 00 (p=0.008 43. [43 48. 48.8) (p=0.009 p=0.03 p003 03 (p=0.03 p=0.01 p001 01 (p=0.01 p0 p<0. BMI≥ (BMI 53. 64. (64.6 40. (40. (38.7 89. (89.3 p=0.0 (p=0.00 [4 (p=0.0 p<0 (64. (40 (38. (89. p=0. [ (p=0. p< (64 (4 (38 (89 p=0 (p=0 (6 (3 (8 p= (p= (p

ABSTRACT. Twenty-four lambs between four and five months of age were divided into sex classes: uncastrated males, castrated males and females, eight for each treatment, with an average body weight of 27.00 ± 3.13 kg. dry matter and water intakes were higher for uncastrated males (p < 0.001). final body weight, body weight at slaughter, average daily gain and cold carcass weight were greater for uncastrated, intermediate for castrated and lower for females (p < 0.05). hot and cold carcass yields were higher for castrated males and females, respectively. (p < 0.05). based on principal component analysis, twenty-five variables were selected out of thirty-two, in some of the seven principal components generated, summarizing 21.87% data dimension. Discriminant analysis identified greater discrimination power for body weight at slaughter, thorax width, thorax depth, fatness, dry matter intake and hot carcass weight. All lambs were classified into their respective sex classes. Therefore, uncastrated males have performed better than castrated ones and both showed higher performance than females. Females and castrated males showed higher carcass yield. Discriminant analysis indicated heterogeneity between sex classes. ABSTRACT Twentyfour Twenty classes treatment 2700 27 00 27.0 313 3 13 3.1 kg p 0.001. 0001 0.001 . 0 001 0.001) slaughter 0.05. 005 0.05 05 0.05) respectively twentyfive twenty thirtytwo, thirtytwo thirty two, two thirty-two generated 2187 21 87 21.87 dimension width depth fatness Therefore yield 270 2 27. 31 1 3. 000 0.00 0.0 218 8 21.8 0. 21.

Abstract: Background: Having a glioblastoma is still a synonym of a very poor prognosis. In this population, end-of-life signs and symptoms differ from the rest of the cancer population. Objective: To identify the main signs and symptoms that occur in patients with glioblastoma in their last seven days of life in a neuro-oncology ward. Methods: Descriptive and retrospective study. Sample composed of people with glioblastoma in the last seven days of life, hospitalized in the neurology ward, with medical and nursing records. Admission in the institution through neuro-oncology consultation between 2019/2020. Data collection was performed through patient’s clinical records analysis. Results: The sample has 17 people. The most prevalent signs and symptoms were: “decreased level of consciousness” (94%); “rare and unexpected events” (94%); “respiratory dysfunction” (88%) and “loss of ability to swallow” (76%). Conclusions: The study allowed responding to the research objective. The results underline the importance of carrying out studies with more representative samples, given that most studies are found to be focused on the cancer population in general.

Resumo: Introdução: O diagnóstico de glioblastoma continua a ser associado a um prognóstico reservado. Os sinais e sintomas de fim de vida destas pessoas diferem da restante população oncológica. Objetivo: Identificar os principais sinais e sintomas presentes nos últimos sete dias de vida do doente com glioblastoma num serviço de neurologia oncológica. Métodos: Estudo descritivo e retrospetivo. A amostra inclui pessoas com diagnóstico de glioblastoma com registo médico e de enfermagem nos últimos sete dias de vida, internados no serviço de Neurologia e admitidos na instituição pela consulta de neuro-oncologia entre 2019/2020. A colheita de dados foi realizada através da análise dos processos. Resultados: A amostra é composta por 17 pessoas. Os principais sinais e sintomas presentes nos últimos sete dias de vida foram: “diminuição do nível de consciência” (94%); “acontecimentos raros e inesperados” (94%); “disfunção respiratória” (88%) e “perda da capacidade de engolir” (76%). Conclusões: O estudo realizado permitiu dar resposta ao objetivo definido. Contudo, considera-se importante a realização de estudos nesta população com amostras mais representativas, uma vez que a maioria da literatura se encontra centrada na população oncológica em geral.

RESUMO A soja está sujeita à ocorrência de patógenos transmitidos por sementes, necessitando de tratamento fitossanitário, porém, este pode ser tóxico ao homem e ao ambiente. Objetivou-se avaliar o efeito dos óleos essenciais de alecrim (Rosmarinus officinalis) e eucalipto (Corymbia citriodora) no tratamento contra fungos fitopatogênicos em sementes de soja armazenadas. O experimento foi em delineamento inteiramente casualizado em arranjo fatorial 2 × 5, para sementes com e sem inoculação de fungos (Aspergillus flavus e Penicillium rubens) e cinco tratamentos de sementes (três óleos essenciais, controle positivo e controle negativo), com quatro repetições. Os óleos essenciais de alecrim, eucalipto e a combinação destes foram aplicados na dose de 4 mL kg-1 de sementes de soja, na concentração de 700 µL mL-1. Como controle negativo (testemunha) utilizou-se água destilada com Tween® 80 a 2% e como controle positivo o fungicida comercial Vitavax-Thiram® 200SC, conforme dosagem do fabricante. O óleo essencial de R. officinalis foi eficiente no controle de Penicillium sp. nas sementes de soja armazenadas e apresentou efeito semelhante ao controle positivo. O óleo essencial de C. citriodora reduziu a incidência de Aspergillus sp. Portanto, estes óleos essenciais têm potencial para serem utilizados no controle alternativo de patógenos de sementes de soja.

ABSTRACT Soybean is subject to occurrences of pathogens transmitted by seeds, requiring phytosanitary treatment, however, it can be toxic to humans and the environment. The objective of this study was to evaluate the effect of essential oils of rosemary (Rosmarinus officinalis) and eucalyptus (Corymbia citriodora) on the control of phytopathogenic fungi in stored soybean seeds. The experiment was carried out in a completely randomized design, using a 2 × 5 factorial arrangement consisted of seeds with and without fungal inoculation (Aspergillus flavus and Penicillium rubens) and five seed treatments (three essential oils, positive control, and negative control), with four replicates. Rosemary and eucalyptus essential oils and their combination were applied to soybean seeds at the rate of 4 mL kg-1, at a concentration of 700 µL mL-1. Distilled water with 2% Tween® 80 was used as negative control, and the commercial fungicide Vitavax-Thiram® 200SC was used as positive control, according to the manufacturers’ recommendations. The R. officinalis essential oil was efficient in the control of Penicillium sp. in stored soybean seeds and showed a similar effect to the positive control. The C. citriodora essential oil reduced the incidence of Aspergillus sp. Therefore, these essential oils have potential to be used as an alternative control of soybean seed pathogens.

ABSTRACT The use of echocardiography by physicians who are not echocardiographers has become common throughout the world across highly diverse settings where the care of acutely ill patients is provided. Echocardiographic evaluation performed in a point-of-care manner can provide relevant information regarding the mechanism of causes of shock, for example, increasing the rates of correct diagnosis and allowing for faster informed decision-making than through evaluation methods. Considering that the accurate diagnosis of life-threatening situations is essential for professionals working with acutely ill patients, several international associations recommend that physicians responsible for critically ill patients acquire and develop the ability to perform bedside ultrasound examinations, including echocardiographic examinations. However, there is no consensus in the literature regarding which specific applications should be included in the list of skills for nonechocardiographer physicians. Taking into account the multiplicity of applications of echocardiography in different scenarios related to acutely ill patients; the differences in the published protocols, with regard to both the teaching methodology and competence verification; and the heterogeneity of training among highly diverse specialties responsible for their care at different levels, this consensus document aimed to reflect the position of representatives of related Brazilian medical societies on the subject and may thus serve as a starting point both for standardization among different specialties and for the transmission of knowledge and verification of the corresponding competencies. provided pointofcare shock example decisionmaking decision making methods lifethreatening life threatening examinations However protocols levels competencies

RESUMO O emprego da ecocardiografia por médicos não ecocardiografistas tem se tornado comum em todo o mundo nos mais diversos ambientes em que se dá o cuidado do paciente agudamente doente. A avaliação ecocardiográfica realizada de forma point-of-care pode fornecer informações pertinentes em relação ao mecanismo das causas de choque, por exemplo, incrementando as taxas de diagnóstico correto e possibilitando a tomada de decisão fundamentada de forma mais rápida do que por meio dos métodos tradicionais de avaliação. Considerando que o diagnóstico preciso de situações ameaçadoras à vida é indispensável a profissionais atuando junto a pacientes agudamente enfermos, diversas entidades associativas internacionais recomendam que médicos responsáveis por pacientes gravemente doentes devam adquirir e desenvolver a habilidade para realizar exames ultrassonográficos à beira do leito, inclusive ecocardiográficos. Entretanto, não há consenso na literatura acerca de quais aplicações específicas devam compor o rol de habilidades do médico não ecocardiografista. Levando-se em consideração a multiplicidade de aplicações da ecocardiografia em diversos cenários relativos ao paciente agudamente enfermo; as diferenças nos protocolos publicados, tanto no que diz respeito à metodologia de ensino como de verificação de competências, bem como a heterogeneidade da formação entre as mais diversas especialidades responsáveis pelo seu cuidado em diferentes níveis, este documento de consenso teve o objetivo de refletir o posicionamento de representantes de sociedades médicas brasileiras afins acerca do tema, podendo, assim, servir de ponto de partida para a uniformização entre diferentes especialidades, bem como para a transmissão de conhecimento e a verificação das competências correspondentes. doente pointofcare point of care choque exemplo enfermos leito ecocardiográficos Entretanto ecocardiografista Levandose Levando enfermo publicados níveis tema podendo assim correspondentes

Abstract Objective: To assess the predictive value of selected growth phenotypes for neonatal morbidity and mortality in preterm infants < 30 weeks and to compare them with INTERGROWTH-21st (IG21). Methods: Retrospective analysis of data from the Brazilian Neonatal Research Network (BNRN) database for very low birth weight (VLBW) at 20 public tertiary-care university hospitals. Outcome: the composite neonatal morbidity and mortality (CNMM) consisted of in-hospital death, oxygen use at 36 weeks, intraventricular hemorrhage grade 3 or 4, and Bell stage 2 or 3 necrotizing enterocolitis. Selected growth phenotypes: small-for-gestational-age (SGA) defined as being < 3rd (SGA3) or 10th (SGA10) percentiles of BW, and large-for-gestational-age (LGA) as being > 97th percentile of BW. Stunting as being < 3rd percentile of the length and wasting as being < 3rd percentile of BMI. Single and multiple log-binomial regression models were fitted to estimate the relative risks of CNMM, comparing them to IG21. Results: 4,072 infants were included. The adjusted relative risks of CNMM associated with selected growth phenotypes were (BNRN/IG21): 1.45 (0.92–2.31)/1.60 (1.27–2.02) for SGA; 0.90 (0.55–1.47)/1.05 (0.55–1.99) for LGA; 1.65 (1.08–2.51)/1.58 (1.28–1.96) for stunting; and 1.48 (1.02–2.17) for wasting. Agreement between the two references was variable. The growth phenotypes had good specificity (>95%) and positive predictive value (70-90%), with poor sensitivity and low negative predictive value. Conclusion: The BNRN phenotypes at birth differed markedly from the IG21 standard and showed poor accuracy in predicting adverse neonatal outcomes. Objective INTERGROWTH21st INTERGROWTHst INTERGROWTH 21st st IG . (IG21) Methods (BNRN VLBW (VLBW tertiarycare tertiary care hospitals Outcome (CNMM inhospital hospital death 4 enterocolitis smallforgestationalage small gestational age SGA (SGA rd SGA3 (SGA3 th SGA10 (SGA10 BW largeforgestationalage large LGA (LGA BMI logbinomial log binomial Results 4072 072 4,07 included BNRN/IG21 BNRNIG21 BNRNIG (BNRN/IG21) 145 1 45 1.4 0.92–2.31/1.60 092231160 0.92–2.31 /1.60 0 92 31 60 (0.92–2.31)/1.6 1.27–2.02 127202 27 02 (1.27–2.02 090 90 0.9 0.55–1.47/1.05 055147105 0.55–1.47 /1.05 55 47 05 (0.55–1.47)/1.0 0.55–1.99 055199 99 (0.55–1.99 165 65 1.6 1.08–2.51/1.58 108251158 1.08–2.51 /1.58 08 51 58 (1.08–2.51)/1.5 1.28–1.96 128196 28 96 (1.28–1.96 stunting 148 48 1.02–2.17 102217 17 (1.02–2.17 variable >95% 95 (>95% 7090%, 7090 70 90% , (70-90%) Conclusion IG2 outcomes (IG21 SGA1 (SGA1 407 07 4,0 BNRN/IG2 BNRNIG2 (BNRN/IG21 14 1. 0.92–2.31/1.6 09223116 092231 0.92–2.3 160 /1.6 9 6 (0.92–2.31)/1. 1.27–2.0 12720 (1.27–2.0 09 0. 0.55–1.47/1.0 05514710 055147 0.55–1.4 105 /1.0 5 (0.55–1.47)/1. 0.55–1.9 05519 (0.55–1.9 16 1.08–2.51/1.5 10825115 108251 1.08–2.5 158 /1.5 (1.08–2.51)/1. 1.28–1.9 12819 (1.28–1.9 1.02–2.1 10221 (1.02–2.1 >95 (>95 7090% 709 7 (70-90% (IG2 40 BNRN/IG (BNRN/IG2 0.92–2.31/1. 0922311 09223 0.92–2. /1. (0.92–2.31)/1 1.27–2. 1272 (1.27–2. 0.55–1.47/1. 0551471 05514 0.55–1. 10 (0.55–1.47)/1 0551 (0.55–1. 1.08–2.51/1. 1082511 10825 1.08–2. 15 (1.08–2.51)/1 1.28–1. 1281 (1.28–1. 1.02–2. 1022 (1.02–2. >9 (>9 (70-90 (IG (BNRN/IG 0.92–2.31/1 0922 0.92–2 /1 (0.92–2.31)/ 1.27–2 127 (1.27–2 0.55–1.47/1 0.55–1 (0.55–1.47)/ 055 (0.55–1 1.08–2.51/1 1082 1.08–2 (1.08–2.51)/ 1.28–1 128 (1.28–1 1.02–2 102 (1.02–2 (> (70-9 0.92–2.31/ 092 0.92– / (0.92–2.31) 1.27– 12 (1.27– 0.55–1.47/ 0.55– (0.55–1.47) (0.55– 1.08–2.51/ 108 1.08– (1.08–2.51) 1.28– (1.28– 1.02– (1.02– ( (70- 0.92 (0.92–2.31 1.27 (1.27 0.55 (0.55–1.47 (0.55 1.08 (1.08–2.51 1.28 (1.28 1.02 (1.02 (70 (0.92–2.3 1.2 (1.2 0.5 (0.55–1.4 (0.5 1.0 (1.08–2.5 (1.0 (7 (0.92–2. (1. (0. (1.08–2. (0.92–2 (1 (0 (1.08–2 (0.92– (1.08– (0.92 (1.08 (0.9

Abstract There is a gap between high-income countries and others in terms of access to medical cardiac devices, such as pacemakers and implantable cardioverter defibrillators. Costs are one of the main barriers to the use of cardiac devices in these countries. There are international initiatives that aim to reduce the gap. The reuse of pacemakers has been discussed as a possible alternative to this problem. The concept of reusing pacemakers is not new; however, recent studies have proven to be safe, ethical, and effective for those who need cardiac implantable electronic devices and cannot afford them. Part of the Portuguese-speaking countries, especially in Africa, need an immediate response that benefits their countless patients who suffer from treatable arrhythmias. highincome high income defibrillators problem new however safe ethical them Portuguesespeaking Portuguese speaking Africa arrhythmias

Resumo Há uma enorme disparidade entre os países de alta renda e outros em termos de acesso a dispositivos médicos cardíacos, como marca-passos e desfibriladores implantáveis. Os custos são uma das principais barreiras ao uso de dispositivos cardíacos nesses países. Existem iniciativas internacionais que visam reduzir essa disparidade, e o reuso de marca-passos tem sido discutido como uma possível alternativa. O conceito de reutilização de marca-passos não é novo; entretanto, estudos recentes têm se mostrado seguros, éticos e eficazes para aqueles que precisam de dispositivos eletrônicos cardíacos implantáveis e não tem como adquiri-los. Parte dos países de língua portuguesa, especialmente na África, precisam de uma resposta imediata que beneficie seus inúmeros pacientes que sofrem de arritmias tratáveis. marcapassos marca passos alternativa novo entretanto seguros adquirilos. adquirilos adquiri los. los adquiri-los portuguesa África tratáveis

ABSTRACT Regional development in the state of Pará (Brazil) continues to be limited by lack of access to energy. This is a problem that is widespread in several rural communities and agricultural regions. Therefore, this study aimed to analyze the potential use of palm oil and cocoa processing waste biomass, which are abundant in the state and whose energy capacities can be used to generate electricity in biomass gasification plants. To do so, a literature review on elementary and calorific value analysis of palm oil (empty fruit bunches, fibers, kernel shell and cake, trunks, and others) and cocoa (pod husks) were conducted. The findings have shown that both waste biomass materials have satisfactory energetic characteristics for use in gasification plants. Thus, palm oil and cocoa processing waste biomasses are alternative energy sources for producers of these fruits in upstate Pará, enabling the development of the region. Brazil (Brazil regions Therefore plants so empty bunches fibers cake trunks others pod husks conducted Thus region

Developing biomaterials for tissue regeneration is a promising alternative for the recovery of various tissues, including bone. Atorvastatin (ATV) has a series of beneficial effects which includes bone anabolism, vasodilating, and anti-inflammatory actions. The main objective of this work was to produce and characterize polycaprolactone (PCL) matrices incorporated with ATV. Samples were prepared by the solvent casting technique. Scanning electron microscopy (SEM), X-Ray diffraction (XRD), Fourier transform infrared spectrometry (FTIR), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC) and in vitro release studies were performed. FTIR analysis showed that no chemical bonds were formed between PCL and ATV. SEM analysis showed that the amount of ATV affects sample morphology. According to XRD and thermal analysis, the main ATV characteristics were maintained. The studies showed that PCL/ATV samples release the drug in a prolonged way since its release reaches around 50% after 15000 minutes of analysis and the model that showed the best fit for the studied matrices was the Higuchi model, with a correlation coefficient above 0.95. tissues (ATV anabolism vasodilating antiinflammatory anti inflammatory actions (PCL technique SEM, , (SEM) XRay X Ray XRD, (XRD) FTIR, (FTIR) TGA, TGA (TGA) DSC (DSC performed morphology maintained PCLATV 50 1500 095 0 95 0.95 (SEM (XRD (FTIR (TGA 5 150 09 9 0.9 15 0. 1

Resumen Algunas investigaciones sobre la esclavitud moderna han evidenciado cómo este fenómeno prospera y persiste pese a las presiones institucionales contra las prácticas inhumanas en la vida social. Para analizar este fenómeno desde una perspectiva institucional y responder a la pregunta de cuáles son los principales factores en el campo institucional que sostienen la esclavitud moderna, se recopilaron datos cualitativos en el contexto brasileño, ya que el país es ampliamente reconocido por sus acciones significativas contra las prácticas de esclavitud. Este estudio se basa en datos primarios y secundarios, recopilados por medio de entrevistas en profundidad y observación participante en conferencias sobre el tema, así como documentos cuyo contenido se analizó utilizando el software NVivo. El estudio sugiere que ciertas condiciones contextuales legitiman las prácticas organizacionales de las empresas formales e informales, lo que se denomina deflexión institucional. Como aporte a los patrones de gestión de la esclavitud moderna, este artículo presenta la “Rueda de la esclavitud moderna” a partir de los resultados de un ciclo dinámico que incorpora y sistematiza los elementos que sustentan el fenómeno. Los mecanismos de la rueda, tales como las condiciones favorables, la recurrencia, la incitación y el “sistema de trueque” (truck-system) contribuyen a las prácticas modernas de esclavitud y su manutención a lo largo del tiempo. Además, sugerimos que estos mismos componentes también pueden ser la salida para romper con el ciclo vicioso de la rueda de la esclavitud moderna. social brasileño secundarios tema NVivo informales Rueda favorables recurrencia sistema trueque trucksystem truck system (truck-system tiempo Además

Abstract A few research papers on modern slavery have outlined how this phenomenon flourishes and persists despite institutional pressures against inhumane practices. In order to analyze slavery from an institutional perspective and answer the question of the main factors in the institutional field that sustain modern slavery, qualitative data were collected in the Brazilian context, where the country is widely recognized for its significant actions against modern slavery practices. This study draws on primary and secondary data collected through in-depth interviews and participant observation at conferences, as well as content analysis of documents using NVivo software. The study suggests that certain contextual conditions legitimize organizational practices of formal and informal firms, called institutional deflection. As a contribution to modern slavery management patterns, this article presents the “modern slavery wheel” based on the results of a dynamic cycle that incorporates and systematizes the elements that support the phenomenon. Wheel mechanisms such as favorite conditioning, recurrence, enticement, and truck system seem to contribute to modern slavery practices and their maintenance over time. Moreover, we suggest that these same components may also contribute to breaking the modern slavery wheel context indepth depth conferences software firms deflection patterns conditioning recurrence enticement time Moreover

Resumo Algumas pesquisas sobre a escravidão moderna mostraram como esse fenômeno prospera e persiste, apesar das pressões institucionais contra práticas desumanas na vida social. Para analisar esse fenômeno do ponto de vista institucional e responder à pergunta sobre quais são os principais fatores no campo institucional que sustentam a escravidão moderna, foram coletados dados qualitativos no contexto brasileiro, já que o país é amplamente reconhecido por suas ações significativas contra práticas de escravidão. Este estudo é baseado em dados primários e secundários, coletados por meio de entrevistas em profundidade e observação participante em conferências sobre o tema, bem como documentos cujos conteúdos foram analisados usando o software NVivo. O estudo sugere que certas condições contextuais legitimam as práticas organizacionais de empresas formais e informais, o que é chamado de deflexão institucional. Como contribuição aos padrões de gestão da escravidão moderna, este artigo apresenta a “Roda da Escravidão Moderna” a partir dos resultados, definida como um ciclo dinâmico que incorpora e sistematiza os elementos que sustentam o fenômeno. Os mecanismos da roda, quais sejam as condições favoráveis, a recorrência, o aliciamento e o “sistema de barracão” (truck system) contribuem para as práticas de escravidão moderna e sua manutenção ao longo do tempo. Além disso, sugerimos que esses mesmos mecanismos também podem ser a solução para romper o círculo vicioso da Roda da Escravidão Moderna. persiste social brasileiro secundários tema NVivo informais Moderna resultados roda favoráveis recorrência sistema barracão truck system tempo disso

Abstract Chronic kidney disease is a worldwide public health problem, and end-stage renal disease requires dialysis. Most patients requiring renal replacement therapy have to undergo hemodialysis. Therefore, vascular access is extremely important for the dialysis population, directly affecting the quality of life and the morbidity and mortality of this patient population. Since making, managing and salvaging of vascular accesses falls within the purview of the vascular surgeon, developing guideline to help specialists better manage vascular accesses for hemodialysis if of great importance. Thus, the objective of this guideline is to present a set of recommendations to guide decisions involved in the referral, evaluation, choice, surveillance and management of complications of vascular accesses for hemodialysis. problem endstage end stage Therefore population making surgeon importance Thus referral evaluation choice

Resumo A doença renal crônica é um problema de saúde pública global e em seu estágio terminal está associada à necessidade de terapia dialítica. A grande maioria dos pacientes que necessitam realizar a terapia renal substitutiva, a fazem através da hemodiálise. Portanto, o acesso vascular é de extrema importância para a população dialítica, implicando diretamente na qualidade de vida e na morbimortalidade deste grupo de pacientes. Sendo a confecção, gerenciamento e resgate dos acessos vasculares uma das áreas de atuação do cirurgião vascular, é de grande importância a elaboração de uma diretriz que oriente o especialista no manejo mais adequado do acesso vascular para hemodiálise. Assim, o objetivo desta diretriz é apresentar um conjunto de recomendações para guiar as decisões na referenciação, avaliação, escolha, vigilância e gestão das complicações do acesso vascular para hemodiálise. dialítica substitutiva hemodiálise Portanto confecção Assim referenciação avaliação escolha

ABSTRACT Echocardiography in critically ill patients has become essential in the evaluation of patients in different settings, such as the hospital. However, unlike for other matters related to the care of these patients, there are still no recommendations from national medical societies on the subject. The objective of this document was to organize and make available expert consensus opinions that may help to better incorporate echocardiography in the evaluation of critically ill patients. Thus, the Associação de Medicina Intensiva Brasileira, the Associação Brasileira de Medicina de Emergência, and the Sociedade Brasileira de Medicina Hospitalar formed a group of 17 physicians to formulate questions relevant to the topic and discuss the possibility of consensus for each of them. All questions were prepared using a five-point Likert scale. Consensus was defined a priori as at least 80% of the responses between one and two or between four and five. The consideration of the issues involved two rounds of voting and debate among all participants. The 27 questions prepared make up the present document and are divided into 4 major assessment areas: left ventricular function, right ventricular function, diagnosis of shock, and hemodynamics. At the end of the process, there were 17 positive (agreement) and 3 negative (disagreement) consensuses; another 7 questions remained without consensus. Although areas of uncertainty persist, this document brings together consensus opinions on several issues related to echocardiography in critically ill patients and may enhance its development in the national scenario. settings hospital However subject Thus Emergência 1 them fivepoint five point scale 80 participants 2 function shock hemodynamics process agreement (agreement disagreement (disagreement consensuses persist scenario 8

RESUMO A ecocardiografia do paciente grave tem se tornado fundamental na avaliação de pacientes em diferentes cenários e ambientes hospitalares. Entretanto, ao contrário de outras áreas relativas ao cuidado com esses pacientes, ainda não existem recomendações de sociedades médicas nacionais acerca do assunto. O objetivo deste documento foi organizar e disponibilizar opiniões de consenso de especialistas que possam auxiliar a melhor incorporação dessa técnica na avaliação de pacientes graves. Dessa forma, a Associação de Medicina Intensiva Brasileira, a Associação Brasileira de Medicina de Emergência e a Sociedade Brasileira de Medicina Hospitalar compuseram um grupo de 17 médicos para formular questões pertinentes ao tópico e debater a possibilidade de consenso de especialistas para cada uma delas. Todas as questões foram elaboradas no formato de escala Likert de cinco pontos. Consenso foi definido, a priori, como um somatório de, ao menos, 80% das respostas entre um e dois ou entre quatro e cinco. A apreciação das questões envolveu dois ciclos de votação e debate entre todos os participantes. As 27 questões elaboradas compõem o presente documento e estão divididas em 4 grandes áreas de avaliação: da função ventricular esquerda; da função ventricular direita; diagnóstica dos choques e hemodinâmica. Ao fim do processo, houve 17 consensos positivos (concordância) e 3 negativos (discordância); outras 7 questões persistiram sem consenso. Embora persistam áreas de incerteza, este documento reúne opiniões de consenso para diversas questões relativas à ecocardiografia do paciente grave e pode potencializar seu desenvolvimento no cenário nacional. hospitalares Entretanto assunto graves forma 1 delas pontos definido priori menos 80 participantes 2 esquerda direita hemodinâmica processo concordância (concordância discordância (discordância) incerteza nacional 8 (discordância