ABSTRACT Struvite (NH4MgPO4∙6H2O) is a slow-release fertilizer obtained through phosphorus and/or nitrogen recovery from wastewaters, usually by adding magnesium salts. In this sense, the aim was to evaluate the viability of replacing commercial magnesium sources with alternative ones in the struvite precipitation process regarding ammonium and phosphate removal and precipitated crystal quantification and characterization. Experiments were conducted on a bench scale in a completely randomized design at pH 9.5 by precipitation of synthetic wastewater solution with four magnesium sources: MgCl2∙6H2O, MgSO4∙7H2O, MgO, and magnesite (MgCO3). After pre-acidification, derived solutions from low-cost alternative sources of magnesium removed above 55 and 90% of ammonium nitrogen and phosphate in solution, respectively, and reached around 10 g L-1 of precipitated crystals. Results proximity obtained with solutions derived from commercial sources of magnesium (46ꟷ56% of ammonium nitrogen removal, 97% of phosphate removal, and more than 6 g L-1 of precipitate formed) indicated that alternative reagents could easily substitute commercial ones if submitted to the previous digestion process, making magnesium available in solution. Qualitative analysis by X-ray diffraction confirmed the presence of both struvite and newberyite in most precipitates. NH4MgPO4∙6H2O NH4MgPO46H2O NHMgPOHO NH4MgPO4 6H2O NH MgPO H O (NH4MgPO4∙6H2O slowrelease slow release andor or wastewaters salts sense characterization 95 9 5 9. MgCl26H2O MgClHO MgCl2 MgCl MgCl2∙6H2O MgSO47H2O MgSOHO MgSO4 7H2O MgSO MgSO4∙7H2O MgO MgCO3. MgCO3 MgCO . (MgCO3) preacidification, preacidification pre acidification, acidification pre-acidification lowcost low cost 90 respectively 1 L1 L L- crystals 46ꟷ56% 46ꟷ56 ꟷ (46ꟷ56 97 formed Xray X ray precipitates NHMgPO NH4MgPO HO (MgCO3 46ꟷ5 (46ꟷ5 (MgCO 46ꟷ (46ꟷ

RESUMO A estruvita (NH4MgPO4∙6H2O) é um fertilizante de liberação lenta obtido através da recuperação de fósforo e/ou nitrogênio de águas residuais geralmente pela adição de sais de magnésio. Neste sentido, objetivou-se avaliar a viabilidade da substituição de fontes comerciais de magnésio por fontes alternativas no processo de precipitação de estruvita, em termos de remoção de amônio e fosfato, e quantificação e caracterização do cristal precipitado. Os experimentos foram conduzidos em escala de bancada sob delineamento inteiramente casualizado a pH 9,5 através da precipitação de uma solução de efluente sintético com quatro diferentes fontes de magnésio: MgCl2∙6H2O, MgSO4∙7H2O, MgO e magnesita (MgCO3). Após pré-acidificação, soluções derivadas de fontes alternativas de baixo custo de magnésio removeram acima de 55 e 90% de nitrogênio amoniacal e fosfato em solução, respectivamente, e alcançaram por volta de 10 g L-1 de cristais precipitados. A proximidade dos resultados obtidos com soluções derivadas de fontes comerciais de magnésio (46ꟷ56% de remoção de nitrogênio amoniacal, 97% de remoção de fosfato, e mais de 6 g L-1 de precipitado formado) indicou que reagentes alternativos puderam facilmente substituir os comerciais se submetidos ao prévio processo de digestão, a fim de tornar o magnésio disponível em solução. A análise qualitativa por difratometria de raios-X confirmou a presença de estruvita e newberyita na maioria dos precipitados. NH4MgPO4∙6H2O NH4MgPO46H2O NHMgPOHO NH4MgPO4 6H2O NH MgPO H O (NH4MgPO4∙6H2O eou ou sentido objetivouse objetivou 95 9 5 9, MgCl26H2O MgClHO MgCl2 MgCl MgCl2∙6H2O MgSO47H2O MgSOHO MgSO4 7H2O MgSO MgSO4∙7H2O MgCO3. MgCO3 MgCO . (MgCO3) préacidificação, préacidificação pré acidificação, acidificação pré-acidificação 90 respectivamente 1 L1 L L- precipitados 46ꟷ56% 46ꟷ56 ꟷ (46ꟷ56 97 formado digestão raiosX raios X NHMgPO NH4MgPO HO (MgCO3 46ꟷ5 (46ꟷ5 (MgCO 46ꟷ (46ꟷ

Abstract Sanitary ware waste (RLS) is proposed as an ecologically environmental alternative, replacing fine aggregates and gravel, used in the production of self-compacting concrete (SCC). The environmental efficiency in energy life cycles and carbon dioxide emissions of SCC with different mixtures of RLS, were compared with the self-compacting concrete without RLS (CAA_REF). The Life Cycle Assessment (LCA) showed that the replacement of RLS aggregates in CAA_REF, can generate an absolute reduction of approximately 45.42 MJ/m³ and 2.67 kg of CO2/m³ respectively, which corresponds to reductions of 2.2% and 0.6%. It was also verified that the use of an indicator of eco-efficiency of the environmental behavior in relation to the parameter mechanical resistance to compression, can contribute and be adequate in projects of dosages of SCC. Thus, it was observed that the use of RLS can contribute to environmental sustainability, reducing the inadequate disposal of RLS in the environment and implementing an adequate reuse. (RLS alternative gravel selfcompacting self compacting . (SCC) CAA_REF. CAAREF CAA_REF CAA REF (CAA_REF) LCA (LCA 4542 45 42 45.4 MJm³ MJm MJ m³ m MJ/m 267 2 67 2.6 CO2m³ COm CO2 CO CO2/m respectively 22 2.2 06 0 6 0.6% ecoefficiency eco compression Thus sustainability reuse (SCC (CAA_REF 454 4 45. 26 2. CO2m 0.6 0.

Resumo O resíduo de louça sanitária (RLS) é alvitrado como uma alternativa ecologicamente ambiental, em substituição aos agregados finos e pedriscos, empregados na produção de concretos autoadensáveis (CAA). A eficiência ambiental nos ciclos de vida energético e das emissões de dióxido de carbono de CAA com diferentes misturas de RLS, foram comparadas com o concreto autoadensável sem RLS (CAA_REF). A Análise do Ciclo de Vida (ACV) evidenciou que a substituição de agregados de RLS em CAA_REF, pode gerar uma redução absoluta de aproximadamente 34,70 MJ/m³ e 2,07 kg de CO2/m³, respectivamente, o que corresponde a reduções de 1,5% e 0,5%. Verificou-se ainda que o uso de um indicador de ecoeficiência do comportamento ambiental em relação ao parâmetro resistência mecânica à compressão, pode contribuir e ser adequado em projetos de dosagens de CAA. Assim, observou-se que o uso de RLS, pode colaborar para a sustentabilidade ambiental, reduzindo a disposição inadequada dos RLS no meio ambiente e implementado um reuso adequado. (RLS pedriscos . (CAA) CAA_REF. CAAREF CAA_REF REF (CAA_REF) ACV (ACV 3470 34 70 34,7 MJm³ MJm MJ m³ m MJ/m 207 2 07 2,0 CO2m³ COm CO2 CO CO2/m³ respectivamente 15 1 5 1,5 05 0 0,5% Verificouse Verificou se compressão Assim observouse observou (CAA (CAA_REF 347 3 7 34, 20 2, CO2m CO2/m 1, 0,5 0,

Abstract The city of Parras de la Fuente, Coahuila is characterized by having criollo avocado trees with different morphological properties. However, very little information is available on their fruit nutritional and sensory characteristics. The objective of this work was to perform the bromatological, mineral, phytochemical and sensory characterization of 7 avocado landraces. The proximal analysis was carried out using standardized tests by the AOAC (2019), while the phytochemical content was determined using HPLC/MS equipment. Subsequently, the samples were evaluated using a hedonic test. The bromatological analysis showed significant differences in the total of the samples for the different response variables, which indicates the great genetic diversity among the sampled trees. The mineral that were determined in the highest concentration were Potassium, Magnesium and Calcium. Thirty-eight different phytochemical compounds were identified in the fruits, with a greater presence of flavones. While the sensory analysis showed a significant difference among the avocado landraces for the evaluated attributes. The flavor and texture attributes were the most important for the consumer preference. Different environmental factors (soil, climate, altitude, latitude, maturity) modify the nutritional composition of the avocado and its organoleptic characteristics. The results of this work may help propagation, fruit diversification and development of companies focused on this fruit in Parras de la Fuente, Coahuila.

Resumen La ciudad de Parras de la Fuente, Coahuila, se caracteriza por tener árboles de aguacate criollo con diferentes propiedades morfológicas. Sin embargo, es muy poca la información que se tiene sobre las características nutrimentales y sensoriales de los frutos de estos árboles. El objetivo del presente trabajo fue caracterizar bromatológica, mineral, fitoquímica y sensorial 7 aguacates criollos, obtenidos de diferentes árboles. El análisis proximal se realizó mediante pruebas estandarizadas por la AOAC (2019), mientras que el contenido de fitoquímicos se determinó en un equipo HPLC/MS. Posteriormente, las muestras se evaluaron mediante una prueba hedónica. El análisis bromatológico arrojó diferencias significativas en el total de las muestras para las diferentes variables de respuesta, lo que indica la gran diversidad genética entre los árboles muestreados. Los minerales que se determinaron en mayor concentración fueron Potasio, Magnesio y Calcio. Se identificaron 38 compuestos fitoquímicos diferentes en los frutos, con mayor presencia de flavonas, mientras que el análisis sensorial arrojó una diferencia significativa entre los criollos en las variables evaluadas. Los atributos de sabor y textura resultaron los más importantes para la preferencia del consumidor. Diferentes factores ambientales (suelo, clima, altitud, latitud, madurez) modifican la composición nutrimental del aguacate y sus características organolépticas. Los resultados de este trabajo pudieran ayudar a la propagación, diversificación frutícola y desarrollo de empresas enfocadas en este fruto en Parras de la Fuente, Coahuila.

Abstract To date, hydroxyurea is the only effective and safe drug that significantly reduces morbidity and mortality of individuals with Sickle cell disease. Twenty years of real-life experience has demonstrated that hydroxyurea reduces pain attacks, vaso-occlusive events, including acute chest syndrome, the number and duration of hospitalizations and the need for transfusion. The therapeutic success of hydroxyurea is directly linked to access to the drug, the dose used and adherence to treatment which, in part, is correlated to the availability of hydroxyurea. This consensus aims to reduce the number of mandatory exams needed to access the drug, prioritizing the requesting physician's report, without affecting patient safety. date disease reallife real life attacks vasoocclusive vaso occlusive events syndrome transfusion which part physicians physician s report safety

Abstract Introduction: This study provides unprecedented scientific evidence for the expansion of health literacy as a tool capable of increasing patient safety through effective communication between health care professionals and their patients, especially in primary health care. Objective: To map the evidence available regarding the impact of health literacy on care safety for adult patients in primary health care. Materials and methods: This is a scoping review in line with the Joanna Briggs Institute method, which covers care, techniques, protocols, or health literacy methods used to improve primary health care. The Medline (PubMed), Web of Science, Scientific Electronic Library Online (SciELO), Virtual Health Library, Scopus, Cinahl, and Google Scholar databases were used for the gray literature search. Original studies available in full and published until January 2023, in all languages covering the topic, were included. Two reviewers screened them by title and abstract, and three reviewers read the full texts and extracted data from the selected articles presented in flowcharts, tables, and descriptive narratives. Results: A total of 3749 studies were found, of which 23 were selected. From these, the following categories emerged: ‘The impact of health literacy on the engagement and health outcomes of primary health care users;’ ‘Interventions that contribute to health literacy in primary health care;’ and ‘Evaluation of users’ and professionals’ perspectives on health literacy.’ Conclusions: Health literacy interventions focused on primary care should be encouraged within health care services to promote care, prevent illnesses, and inspire the population’s transformation process, with a direct impact on patient safety.

Resumen Introducción: el estudio aporta evidencias científicas sin precedentes para la expansión de la alfabetización en salud como herramienta capaz de aumentar la seguridad del paciente a través de una comunicación eficaz entre los profesionales de la salud y sus pacientes, especialmente en atención primaria. Objetivo: mapear la evidencia sobre el impacto de la alfabetización en salud en la seguridad de la atención a pacientes adultos en atención primaria. Material y método: revisión exploratoria según el método del Instituto Joanna Briggs, en la que se contemplaron cuidados, técnicas, protocolos o métodos de alfabetización en salud utilizados para mejorar la atención primaria de salud. Se utilizaron las bases de datos Medline (PubMed), Web of Science, Scientific Electronic Library Online (SciELO), Virtual Health Library, Scopus, Cinahl y Google Scholar para la literatura gris. Se incluyeron los estudios originales disponibles en su totalidad, publicados hasta enero de 2023, en todos los idiomas que cubrían el tema. Dos pares seleccionaron por título y resumen, y tres pares leyeron los textos completos y extrajeron los datos de los artículos seleccionados, que se presentaron en flujogramas, tablas y narrativas descriptivas. Resultados: se encontraron 3749 estudios, de los que se seleccionaron 23. De ellos surgieron las siguientes categorías: “impacto de la alfabetización en salud sobre el compromiso y los resultados en salud de los usuarios de atención primaria”; “intervenciones que contribuyen a la alfabetización en salud en atención primaria” y “evaluación de las perspectivas de los usuarios y los profesionales sobre la alfabetización en salud”. Conclusiones: las intervenciones de alfabetización en salud centradas en la atención primaria deben fomentarse en los servicios de salud para promover la atención, prevenir enfermedades e inspirar el proceso de transformación de la población, lo que repercute directamente en la seguridad de los pacientes.

Resumo Introdução: este estudo traz evidências científicas inéditas para a ampliação do letramento em saúde, como uma ferramenta capaz de aumentar a segurança do paciente através da comunicação eficaz entre os profissionais de saúde e seus pacientes, em especial nos cuidados primários em saúde. Objetivo: mapear evidências sobre o impacto do letramento em saúde na segurança do cuidado de pacientes adultos da atenção primária à saúde. Materiais e método: revisão de escopo de acordo com o método do Instituto Joanna Briggs, em que foram contemplados cuidados, técnicas, protocolos ou métodos de letramento em saúde utilizados para melhorar a assistência primária à saúde. Utilizaram- se as bases Medline (PubMed), Web of Science, Scientific Electronic Library Online (SciELO), Biblioteca Virtual em Saúde, Scopus, Cinahl e Google Acadêmico na literatura cinzenta. Foram incluídos estudos originais disponíveis na íntegra, publicados até janeiro de 2023, em todos os idiomas que englobassem a temática. Dois revisores realizaram a triagem por título e resumo, e três revisores leram os textos completos e extraíram dados dos artigos selecionados, sendo apresentados através de fluxo, tabela e narrativa descritiva. Resultados: foram encontrados 3749 estudos, dos quais 23 foram selecionados. Destes, surgiram as seguintes categorias: “impacto do letramento em saúde no engajamento e desfechos de saúde de usuários da atenção primária à saúde”; “intervenções que contribuem para o letramento em saúde na atenção primária à saúde” e “avaliação das perspectivas de usuários e profissionais quanto ao letramento em saúde”. Conclusões: intervenções para o letramento em saúde com foco nos cuidados primários devem ser estimuladas dentro dos serviços de saúde a fim de promover o cuidado, prevenir agravos e inspirar o processo de transformação da população, impactando diretamente na segurança do paciente.

Abstract Background: Real-world, primary data on the treatment of psoriasis are scarce, especially concerning the role of soluble biomarkers as outcome predictors. Objective: The authors evaluated the utility of Th1/Th17 serum cytokines along with clinical characteristics as predictors of drug survival in the treatment of psoriasis. Methods: The authors consecutively included participants with moderate to severe psoriasis who were followed up for 6 years. Baseline interferon-α, tumor necrosis factor-α, and inter-leukin (IL)-2, IL-4, IL-6, IL-10, and IL-17A were measured using a cytometric bead array; clinical data were assessed. The authors calculated hazard ratios (HRs) for drug survival using a Cox proportional hazards model. Results: The authors included 262 patients, most of whom used systemic immunosuppressants or biologics. In the multivariate model, poor quality of life measured by the Dermatology Life Quality Index (HR = 1.04; 95% CI 1.01–1.07; p = 0.012) and elevated baseline IL-6 (HR = 1.99; 95% CI 1.29–3.08; p = 0.002) were associated with treatment interruption. Study limitations: The main limitation of any cohort study is the presence of confounders that could not be detected in clinical evaluation. Conclusions: Poor quality of life and elevated baseline serum IL-6 level predicted treatment interruption in patients with moderate to severe psoriasis. Although IL-6 is not the most important mediator of the inflammatory pathway in the skin environment, it is an interesting biomarker candidate for predicting psoriasis treatment response. Background Realworld, Realworld Real world, world Real-world scarce Objective Th1Th17 ThTh Th1 Th17 Th Th1/Th1 Methods years interferonα, interferonα interferon α, α interferon-α factorα, factorα factor factor-α interleukin inter leukin IL2, IL2 IL 2, 2 (IL)-2 IL4, IL4 4, 4 IL-4 IL6, IL6 6, IL10, IL10 10, 10 IL-10 IL17A ILA 17A A array assessed HRs (HRs model Results 26 biologics HR 1.04 104 1 04 95 1.01–1.07 101107 01 07 0.012 0012 0 012 IL- 1.99 199 99 1.29–3.08 129308 29 3 08 0.002 0002 002 limitations evaluation Conclusions environment response Th1Th1 Th1/Th (IL)- IL1 IL-1 1.0 9 1.01–1.0 10110 0.01 001 1.9 19 1.29–3.0 12930 0.00 000 00 Th1Th (IL) 1. 1.01–1. 1011 0.0 1.29–3. 1293 (IL 1.01–1 101 0. 1.29–3 129 1.01– 1.29– 12 1.01 1.29 1.2

ABSTRACT Introduction: Recent concerns about the safety of silicone implants have led many women to seek the removal of their implants, even without apparent breast complications. On the other hand, many surgeons do not feel comfortable performing the explant for fear that the patient will not like the aesthetic result after surgery. Magnetic resonance imaging (MRI) is a valuable resource for diagnostic evaluation of the breast and can be used in explant planning. The objective is to demonstrate how the systematic analysis of breast MRI images can assist in planning silicone explantation. Method: A detailed analysis of the axial and sagittal MRI sections was performed to assess the amount of tissue in each breast. These images were presented to patients during the preoperative consultation so that they could clearly understand how much the implant influences the size of their breasts. At the same time, post-operative photos of patients with similar characteristics were presented so that the patient could analyze, more objectively, whether or not she would be satisfied with the aesthetics of her breasts after explantation. Results: The patients demonstrated a high degree of understanding of the images presented and were satisfied with this detailed analysis of expected results. Conclusion: The comparison of breast MRI images and postoperative results images provides greater objectivity to the preoperative dialogue, favoring the understanding of the expected result and bringing greater clarity to the decision for explantation. Introduction complications hand surgery (MRI explantation Method time post operative analyze objectively Results Conclusion dialogue

RESUMO Introdução: A recente preocupação sobre a segurança dos implantes de silicone tem levado muitas mulheres a buscarem a retirada de seus implantes, mesmo sem aparente complicação nas mamas. Por outro lado, muitos cirurgiões não se sentem confortáveis em realizar o explante por receio de que a paciente não gostará do resultado estético após a cirurgia. A ressonância nuclear magnética (RNM) é um recurso valioso para avaliação diagnóstica das mamas e pode ser usada no planejamento do explante. O objetivo é demonstrar como a análise sistematizada das imagens da ressonância magnética das mamas pode auxiliar no planejamento do explante de silicone. Método: Uma análise detalhada dos cortes axial e sagital da RNM foi feita para avaliar a quantidade de tecido em cada mama. Essas imagens foram apresentadas às pacientes durante a consulta pré-operatória para que elas pudessem perceber, com clareza, o quanto o implante influencia no tamanho de suas mamas. No mesmo momento, foram apresentadas fotos de pós-operatório de pacientes com características semelhantes para que a paciente pudesse analisar, de forma mais objetiva, se ficaria satisfeita ou não com a estética das mamas após o explante. Resultados: As pacientes demonstraram alto grau de compreensão das imagens apresentadas e se mostraram satisfeitas com esta análise detalhada de expectativa de resultado. Conclusão: A comparação das imagens da RNM das mamas e das imagens de resultados de pós-operatório confere maior objetividade ao diálogo pré-operatório, favorecendo a compreensão do resultado esperado e trazendo maior clareza à decisão pelo explante. Introdução lado cirurgia (RNM Método mama préoperatória pré operatória perceber momento pósoperatório pós operatório analisar objetiva Resultados Conclusão préoperatório, préoperatório operatório, pré-operatório

ABSTRACT: The drying agroindustrial products is used to preserve the sensory and nutritional quality and to reduce the biological activity, preventing deterioration and loss of commercial value. The objective was to study the mathematical modeling Guava bark drying to obtain flour and to determine and evaluate the effective diffusion coefficient, get the activation energy and the thermodynamic properties in drying temperatures of 45, 55, 65 and 75 °C. The experiment was conducted Instituto Federal Goiano - Campus Rio Verde, the guava was purchased in local shops in the city of Rio Verde Goiás, in the commercial maturity. Among the analyzed models, Midilli was the best to represent the drying phenomenon. The effective diffusion coefficient increased with increasing temperature and the activation energy for liquid diffusion drying was 37,207kJ mol-1. The enthalpy and entropy increased with increasing drying temperature. While the Gibbs free energy increased with increasing drying temperature. ABSTRACT activity value 45 55 6 7 C °C Goiás maturity models phenomenon 37207kJ kJ 37 207kJ mol1. mol1 mol 1. 1 mol-1 4 5 3 mol-

RESUMO: A secagem de produtos agroindustriais é utilizada visando preservar as qualidades sensoriais e nutricionais, bem como reduzir a atividade biológica que impede a deterioração e a perda do valor comercial. Assim, objetivou-se neste trabalho estudar a modelagem matemática da secagem da casca de goiaba para obtenção de farinha, bem como determinar o coeficiente de difusão efetivo, a energia de ativação e as propriedades termodinâmicas nas temperaturas de secagem de 45, 55, 65 e 75 °C. O experimento foi realizado no Instituto Federal Goiano - Campus Rio Verde, e as goiabas foram adquiridas no comércio local do município de Rio Verde, GO, no estádio de maturação comercial. Dentre os modelos analisados, Midilli foi selecionado para representar a cinética de secagem da casca de goiaba. O coeficiente de difusão efetivo aumentou com a elevação da temperatura e a energia de ativação para a difusão líquida na secagem foi de 37,207 kJ mol-1. A entalpia e a entropia diminuíram com a elevação da temperatura de secagem, enquanto a energia livre de Gibbs aumentou com o incremento da temperatura de secagem. RESUMO nutricionais comercial Assim objetivouse objetivou se farinha 45 55 6 7 C °C Verde GO analisados 37207 37 207 37,20 mol1. mol1 mol 1. 1 mol-1 4 5 3720 3 20 37,2 mol- 372 2 37,

Abstract The demand for innovative eco-friendly ingredients is a current trend in the pharmaceutical and cosmetic fields. Starches can be a good alternative because their gelatinization property could increase the stability of emulsions. The objective of the present study was to develop a gel formulation based on tapioca and corn starch and to evaluate its stability, physical-mechanical and sensory properties according to the experimental design. A general full factorial experimental design with three levels was elaborated for each polysaccharide under study. The best formulation was evaluated in terms of rheological and sensorial properties. Only the formulation with tapioca and corn starch in combination was stable, showing a thixotropic behavior without changes in rheological parameters after 28 days. Sensorial analysis classified the formulation as soft, easy to spread and giving a hydration sensation. The nature of the polymers could be responsible for a synergistic effect on the spreadability parameter. According to the results obtained, the use of starches for the development of topical products can be suggested as a natural alternative to the polymers and silicones commonly used as rheological additives. The developed formulation could be a green alternative with proven physical-mechanical stability and excellent sensorial properties. ecofriendly eco friendly fields emulsions physicalmechanical physical mechanical stable 2 days soft sensation parameter obtained additives

Abstract This study evaluated factors associated with hospitalization related to the mental health of people undergoing follow-up in Psychosocial Care Centers (CAPS, in Portuguese) in the city of São Paulo, Brazil, referred from Primary Health Care (PHC). This was an evaluative study conducted with 297 individuals in 24 adult CAPS. This study analyzed the prevalence ratios (PR) and their respective 95% confidence intervals (95% CI), obtained through Poisson Regression with robust variance. A statistically significant association was found with hospitalization during follow-ups in CAPS: having health insurance and/or medical plan; waiting time between the diagnosis and the first consultation with a non-medical professional of more than seven days; not having received medical advice regarding how long to use medication; not having received a psychopharmaceutical prescription at PHC; and having a medical history of the hospitalization due to mental health. The results warn of the need to expand access to the more socially vulnerable population, in addition to a restructuring of the services in order to provide more interactive and inclusive practices geared toward the singularities of the users. followup follow up CAPS, CAPS (CAPS Portuguese Paulo Brazil PHC. PHC . (PHC) 29 2 PR (PR 95 (95 CI, CI , CI) variance followups ups andor or plan nonmedical non days medication population users (PHC 9 (9 (

Resumo Avaliaram-se os fatores associados à internação relacionadas à saúde mental de pessoas em acompanhamento nos Centros de Atenção Psicossocial (CAPS) do município de São Paulo, encaminhadas pela atenção primária (APS). Pesquisa avaliativa com 297 pessoas em 24 CAPS Adulto. Analisaram-se as razões de prevalência (RP) e seus respectivos intervalos de confiança de 95% (IC), obtidas por meio da regressão de Poisson com variância robusta. Mostraram associação estatisticamente significativa com a internação durante o acompanhamento no CAPS: ter plano de saúde/convênio médico; tempo de espera entre diagnóstico e primeiro atendimento com profissional não médico maior que sete dias; não ter sido orientado sobre o tempo de uso da medicação; não receber prescrição de psicofármaco na APS; e ter histórico de ocorrência de internação por saúde mental. Os resultados alertam para a necessidade de ampliação do acesso à população com maior vulnerabilidade social, além de uma reestruturação dos serviços para a oferta de prática mais articuladas e inclusivas, voltadas às singularidades dos usuários. Avaliaramse Avaliaram se (CAPS Paulo APS. APS . (APS) 29 2 Adulto Analisaramse Analisaram RP (RP 95 IC, IC , (IC) robusta saúdeconvênio convênio dias medicação social inclusivas usuários (APS 9 (IC

Abstract Muscular fatigue is associated with repeated muscle contraction exercises and with intense use of muscles with high intensity leading to a decline of performance and inability to continue with the same activity original intensity of activity. One of most promising interventions is the photobiomodulation therapy (PBMT). The objective was to analyze the results of the studies that investigated the effects of acute and long-term photobiomodulation in experimental animal models of muscle fatigue levels. The review was registered with PROSPERO (CRD42021274444). 10 studies were identified (n=366 animals). 77% used histological analysis and blood level of lactate measures to record changes in fatigue and were considered moderate evidence. Nine chose isotonic contractions and one study opted for isometric contraction to induce fatigue. 77% applied long term PBMT and 33% applied an acute form. Most of the studies used the infrared wavelength; the power output varied from 0.625mW to 300mW and energy per point varied from 0.105J to 12J. This review demonstrates that PBMT has positive effects in acute and long-term treatment decreasing the level of fatigue and accelerating exercise performance in different animal models, even with distinct PBMT parameters and number of therapy sessions PBMT. . (PBMT) longterm levels CRD42021274444. CRD42021274444 CRD (CRD42021274444) 1 n=366 n366 n 366 (n=36 animals. animals animals) 77 evidence 33 form wavelength 0625mW mW 0 625mW 0105J J 105J 12J (PBMT CRD4202127444 (CRD42021274444 n=36 n36 36 (n=3 7 3 CRD420212744 (CRD4202127444 n=3 n3 (n= CRD42021274 (CRD420212744 n= (n CRD4202127 (CRD42021274 CRD420212 (CRD4202127 CRD42021 (CRD420212 CRD4202 (CRD42021 CRD420 (CRD4202 CRD42 (CRD420 CRD4 (CRD42 (CRD4 (CRD

ABSTRACT Background The pathway that links good communication skills and better health outcomes is still unclear. However, it is known that the way that physicians and patients communicate with each other has direct consequences on more “proximal outcomes”, such as perceptions of physician empathy and patient satisfaction. However, which specific communication skills lead to those patient outcomes is still unknown. In this study, the authors aimed to analyze which specific patient and physician communication skills are correlated to patients’ satisfaction with care and patient-perceived physician empathy. Methods The authors classified and quantified verbal and nonverbal communication of second-year internal medicine residents and their patients through video recordings of their consultations. Patients also rated their satisfaction with care and the physician's empathy for them. Results Using a linear regression model, the authors identified that patients’ and physicians’ expressions of disapproval, physicians’ disruptions, and patients’ use of content questions negatively correlated to patients’ satisfaction and patient-perceived physician empathy. Conversely, patient affective behaviors and the physician's provision of advice/suggestion were positively correlated to at least one of the patient-measured outcomes. Conclusion Our findings point to the importance of physicians’ attentiveness to patients’ communication cues. Training physicians to interpret those cues could help develop more satisfactory and empathic therapeutic relationships. unclear However proximal outcomes, , outcomes” unknown study patientperceived perceived secondyear second year consultations s them model disapproval disruptions Conversely advicesuggestion advice suggestion patientmeasured measured relationships

ABSTRACT Objective: To evaluate a 0.5% sodium hypochlorite (SH) protocol in reducing Candida spp. levels in complete dentures (CD) and palate and denture stomatitis (DS) remission. Material and Methods: Twelve CD wearers diagnosed with Candida-associated denture stomatitis (CADS) had their initial situation (Candida spp. levels and DS score) recorded (baseline). Then, participants were instructed to soak dentures once a day (10 minutes) in 0.5% SH. Candida spp. levels and DS scores were reassessed after 15, 30, and 60 days of SH denture cleanness. Biofilms from the denture base and palate were seeded in CHROMagar Candida. After incubation, colony-forming units were calculated. The palate was photographed at each time point, and DS was assessed according to Newton's classification. Data of Candida spp. levels were analyzed by 2-way repeated measures ANOVA followed by the Holm-Sidak test, and DS scores data were accessed by Friedman's 2-way ANOVA by ranks (α=0.05). Results: 0.5% SH significantly reduced Candida spp. levels after treatment compared to baseline (p<0.001) for both sites. Although at baseline, Candida spp. counts were higher on the denture base (p<0.001), no significant differences were observed between the collected areas within the other time points (p<0.05). Also, 0.5% SH effectively reduced clinical signs of DS after treatment (p<0.05). Conclusion: The protocol tested effectively decreased Candida spp. levels on the denture base and palatal mucosa and effectively reduced the signs of DS. Objective 05 0 5 0.5 (SH spp (CD (DS remission Methods Candidaassociated associated CADS (CADS score baseline. . (baseline) Then 10 (1 minutes 15 30 6 cleanness incubation colonyforming colony forming calculated point Newtons Newton s classification 2way way 2 HolmSidak Holm Sidak test Friedmans Friedman α=0.05. α005 α α=0.05 (α=0.05) Results p<0.001 p0001 p 001 (p<0.001 sites p<0.001, , p<0.05. p005 p<0.05 (p<0.05) Also Conclusion 0. (baseline 1 ( 3 α00 α=0.0 (α=0.05 p<0.00 p000 00 (p<0.00 p00 p<0.0 (p<0.05 α0 α=0. (α=0.0 (p<0.0 p0 p<0. α=0 (α=0. (p<0. p<0 α= (α=0 (p<0 p< (α= (p< (α (p

Abstract Background Systemic sclerosis (SSc) is a rare chronic autoimmune disease with heterogeneous manifestations. In the last decade, several clinical trials have been conducted to evaluate new treatment options for SSc. The purpose of this work is to update the recommendations of the Brazilian Society of Rheumatology in light of the new evidence available for the pharmacological management of SSc. Methods A systematic review including randomized clinical trials (RCTs) for predefined questions that were elaborated according to the Patient/Population, Intervention, Comparison, and Outcomes (PICO) strategy was conducted. The rating of the available evidence was performed according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. To become a recommendation, at least 75% agreement of the voting panel was needed. Results Six recommendations were elaborated regarding the pharmacological treatment of Raynaud’s phenomenon, the treatment (healing) and prevention of digital ulcers, skin involvement, interstitial lung disease (ILD) and gastrointestinal involvement in SSc patients based on results available from RCTs. New drugs, such as rituximab, were included as therapeutic options for skin involvement, and rituximab, tocilizumab and nintedanib were included as therapeutic options for ILD. Recommendations for the pharmacological treatment of scleroderma renal crisis and musculoskeletal involvement were elaborated based on the expert opinion of the voting panel, as no placebo-controlled RCTs were found. Conclusion These guidelines updated and incorporated new treatment options for the management of SSc based on evidence from the literature and expert opinion regarding SSc, providing support for decision-making in clinical practice. (SSc manifestations decade (RCTs PatientPopulation Patient Population Patient/Population Intervention Comparison PICO (PICO Assessment GRADE (GRADE methodology recommendation 75 needed Raynauds Raynaud s phenomenon healing (healing ulcers ILD (ILD drugs rituximab placebocontrolled placebo controlled found decisionmaking decision making practice 7

Abstract This study evaluated factors associated with hospitalization related to the mental health of people undergoing follow-up in Psychosocial Care Centers (CAPS, in Portuguese) in the city of São Paulo, Brazil, referred from Primary Health Care (PHC). This was an evaluative study conducted with 297 individuals in 24 adult CAPS. This study analyzed the prevalence ratios (PR) and their respective 95% confidence intervals (95% CI), obtained through Poisson Regression with robust variance. A statistically significant association was found with hospitalization during follow-ups in CAPS: having health insurance and/or medical plan; waiting time between the diagnosis and the first consultation with a non-medical professional of more than seven days; not having received medical advice regarding how long to use medication; not having received a psychopharmaceutical prescription at PHC; and having a medical history of the hospitalization due to mental health. The results warn of the need to expand access to the more socially vulnerable population, in addition to a restructuring of the services in order to provide more interactive and inclusive practices geared toward the singularities of the users.

Resumo Avaliaram-se os fatores associados à internação relacionadas à saúde mental de pessoas em acompanhamento nos Centros de Atenção Psicossocial (CAPS) do município de São Paulo, encaminhadas pela atenção primária (APS). Pesquisa avaliativa com 297 pessoas em 24 CAPS Adulto. Analisaram-se as razões de prevalência (RP) e seus respectivos intervalos de confiança de 95% (IC), obtidas por meio da regressão de Poisson com variância robusta. Mostraram associação estatisticamente significativa com a internação durante o acompanhamento no CAPS: ter plano de saúde/convênio médico; tempo de espera entre diagnóstico e primeiro atendimento com profissional não médico maior que sete dias; não ter sido orientado sobre o tempo de uso da medicação; não receber prescrição de psicofármaco na APS; e ter histórico de ocorrência de internação por saúde mental. Os resultados alertam para a necessidade de ampliação do acesso à população com maior vulnerabilidade social, além de uma reestruturação dos serviços para a oferta de prática mais articuladas e inclusivas, voltadas às singularidades dos usuários.