Abstract: Diabetic ketoacidosis (DKA) is one of the most serious complications of type 1 diabetes mellitus. Its treatment requires fluid and electrolyte replacement and insulin. Hypophosphatemia as a complication of treatment has been scarcely evaluated. Objectives: To estimate the incidence of hypophosphatemia in children with DKA, treated with subcutaneous regular insulin (IRS), and to explore factors associated with this complication. Patients and Method: Prospective, observational study. Patients diagnosed with DKA hospitalized in the general care ward were included. Data on phosphatemia, glycemia, acid-base status, and IRS amount (U/kg) received were recorded at baseline and after 24 h of treatment. Hypophosphatemia was defined as values below 2.5 mg/dl. The correlation between initial phosphate and at 24 h of treatment was evaluated; the incidence of hypophosphatemia at 24 h was expressed as a percentage of the total number of patients. Results: 30 patients were included, 15 were female, mean age 11.4 ± 3.2 years. At 24 h of treatment with IRS, 36.7% (95%CI 22-55%) presented hypophosphatemia, mean value 1.9 ± 1.5 mg/dl. Initial bicarbonate < 10 mmol/L acted as a predictor of hypophosphatemia (OR 7.5; 95%CI 1.4-39.8%; p = 0.01). No patient required intravenous phosphate correction, and no associated clinical complications were observed. Conclusion: In the group studied, the incidence of hypophosphatemia reached 36.7% at 24 hours of treatment. Initial bicarbonate lower than 10 mmol/L was significantly associated with hypophosphatemia. No complications associated with hypophosphatemia were observed.

Resumen: La cetoacidosis diabética (CAD) es una de las complicaciones más graves de la diabetes mellitus tipo 1. Su tratamiento requiere reposición hidroelectrolítica e insulina. La hipofosfatemia como complicación del tratamiento ha sido escasamente evaluada. Objetivos: Estimar la incidencia de hipofosfatemia en niños con cetoacidosis diabética, tratados con insulina regular Subcutánea (IRS), y explorar factores asociados con esta complicación. Pacientes y Método: Estudio observacional, prospectivo. Se incluyeron los pacientes con diagnóstico de CAD hospitalizados en sala de cuidados generales. Se registraron, al inicio y después de 24 h de tratamiento, fosfatemia, glucemia, estado ácido base y cantidad de IRS (U/kg) recibido. Se definió hipofosfatemia a valores inferiores a 2,5 mg/dl. Se evaluó la correlación entre fósforo inicial y a las 24 h de tratamiento; la incidencia de hipofosfatemia a las 24h se expresó en porcentaje del total de pacientes. Resultados: Se incluyeron 30 pacientes, 15 sexo femenino, edad promedio 11,4 ± 3,2 años. A las 24 h de tratamiento con IRS el 36,7%; IC95% (2255%) presentó hipofosfatemia, valor promedio 1,9 ± 1,5 mg/dl. El bicarbonato inicial < 10 mmol/L se comportó como predictor de hipofosfatemia (OR 7,5 IC95% 1,4-39,8% p = 0,01). Ningún paciente requirió corrección endovenosa de fosfato, ni se observaron complicaciones clínicas asociadas. Conclusión: En el grupo estudiado, la incidencia de hipofosfatemia alcanzó un 36,7% a las 24 h de tratamiento. El bicarbonato inicial menor a 10 mmol/L se asoció significativamente a hipofosfatemia. No se observaron complicaciones asociadas a hipofosfatemia.

Resumo Introdução: A trombocitemia essencial (TE) é uma condição pouco comum e assintomática na maioria dos casos. No entanto, podem surgir sintomas como cefaleias, síncope, vertigem, dor torácica, eritromelalgia e distúrbios visuais transitórios. Os eventos hemorrágicos e tromboembólicos são os grandes riscos desta patologia. O objetivo da partilha deste caso clínico é alertar para uma patologia rara que pode passar despercebida e causar eventos potencialmente graves. Descrição do caso: Sexo feminino, 43 anos, raça caucasiana, antecedentes de hepatite B crónica, sem antecedentes cirúrgicos nem medicação habitual, incluindo método contracetivo hormonal. Recorreu a consulta com queixas de enfartamento precoce, dispepsia e epigastralgia com três dias de evolução, negando alterações do trânsito intestinal, características das fezes, náuseas ou vómitos. Exame físico e endoscopia digestiva alta recente sem alterações de relevo. Foi consultado o estudo analítico que a utente realizava regularmente no hospital, verificando-se que o valor do número de plaquetas se encontrava consistentemente a rondar os 500.000/uL desde há três anos. Pediu-se ecografia abdominal que descrevia trombose parcial da veia porta e do seu ramo esquerdo. A doente foi medicada com enoxaparina 60 mg 12h/12 h. Foi realizado angio-TC abdominal, estudo pró-trombótico e estudo genético e iniciou varfarina 5 mg 1x/dia, inicialmente sobreposta com enoxaparina 60 mg 12/12h. O angio-TC viria a confirmar a trombose da veia porta e confirmou-se positiva a mutação JAK2 V617F. Assumido o diagnóstico de TE e iniciado tratamento citorredutor com hidroxiureia 500 mg em dias alternados. Comentário: Este caso chama a atenção pelo excesso de plaquetas secundário à TE, ainda que ligeiramente acima do valor de referência, ter originado uma trombose da veia porta. Pretende-se alertar os médicos de família para a importância de realizar um estudo atento, valorizando pequenas variações sustentadas fora dos intervalos da normalidade e fazer uma referenciação correta e atempada quando necessário.

Abstract Introduction: Essential thrombocythemia (ET) is an asymptomatic rare condition in most cases. Nonetheless, symptoms like headache, syncope, vertigo, thoracic pain, erythromelalgia, and transient visual disturbances may surge. The major concerns of this pathology are hemorrhagic and thromboembolic events. The aim of sharing this case report is to alert for the existence of this rare pathology that can go unnoticed and cause potentially serious events. Case description: Female, 43-year-old, Caucasian. Background of chronic B hepatitis, without surgical background nor usual medication, including the contraceptive pill. She appealed to a medical appointment with an early feeling of fullness when eating, dyspepsia, and epigastric pain in the last three days. She denied changes in intestinal habits, feces characteristics, nausea, or vomiting. Physical examination and recent upper endoscopic study were normal. The hospital medical record was examined, verifying that platelet levels were consistently rounding 500,000/uL for the past three years. An abdominal ultrasonography was requested, and it described a partial portal vein and left branch thrombosis. The patient started enoxaparin 60 mg every 12 hours. It was conducted an abdominal angiotomography, prothrombotic, and genetic study, including the JAK2 V617F mutation. The patient started warfarin 5 mg one time daily, initially overlaid with enoxaparin 60 mg 12h/12h. The abdominal angiotomography would confirm the portal vein thrombosis and the JAK2 V617F mutation study was positive. It was assumed the diagnosis of ET and was initiated cytoreductive therapy with hydroxyurea 500 mg on alternated days. Comment: This case report shows that the excessive platelet count, secondary to ET, even if slightly above the reference value, caused a portal vein thrombosis. We aim to alert family physicians to the importance of doing a careful study, valuing little sustained variations out of the normal intervals, and referring correctly and promptly when necessary.

In light of the need for social isolation caused by the pandemic, in-person classes were suspended, making way for emergency remote teaching (ERT). This abrupt transition allowed for no planning or preparation for the individuals involved in the teaching-learning process. In this context, it fell upon the educators to adapt to this new, atypical reality. The aim of this study was to describe the characteristics and challenges faced by teachers at IF Sudeste MG - Campus Rio Pomba during ERT and its impacts on the teaching-learning process. To achieve this, a structured questionnaire with the participation of 41 educators was used. Difficulties related to pedagogical training, use of technological tools and active teaching methodologies (ATM), and the adaptive process of educators were highlighted. Educators did not consider ERT capable of efficiently fulfilling the objectives of the disciplines, although they acknowledged the necessary institutional support. The self-assessment of teaching performance during ERT was predominantly positive. Prior to ERT, the use of ATM was lower, especially among educators above 40 years old and males; furthermore, difficulties in using ATM increased with age, with more males reporting not using them. The adaptation to ERT was considered moderate, and more educators aged 40 to 49 reported dissatisfaction with the work environment. Educators above 40 years old and females had a higher incidence of negative psychological symptoms during ERT. This study highlights the challenges educators faced during ERT, especially those over 40 years old and females.

Ante la necesidad de aislamiento social causada por la pandemia, las clases presenciales fueron suspendidas dando paso a la enseñanza remota de emergencia (ERE). Esta transición abrupta no permitió ningún tipo de planificación o preparación para los actores involucrados en el proceso de enseñanza-aprendizaje. En este contexto, a los docentes les correspondió el desafío de adaptarse a esta nueva realidad atípica. El objetivo de este estudio fue describir las características y desafíos enfrentados por los profesores del IF Sudeste MG - Campus Rio Pomba durante la ERE y sus impactos en el proceso de enseñanza-aprendizaje. Se aplicó un cuestionario estructurado con la participación de 41 docentes. Se evidenciaron dificultades relacionadas con la formación pedagógica, el uso de herramientas tecnológicas y de metodologías activas de enseñanza (MAE). Los docentes no consideraron que la ERE fuera capaz de cumplir eficientemente con los objetivos de las disciplinas, a pesar de reconocer el apoyo institucional necesario. La autoevaluación del desempeño docente durante la ERE fue predominantemente positiva. Antes de la ERE, el uso de MAE era menor, especialmente entre los docentes mayores de 40 años y los hombres; además, las dificultades en el uso de MAE aumentaron con la edad, siendo que más hombres informaron no utilizarlas. La adaptación a la ERE fue considerada moderada, y más docentes de 40 a 49 años informaron insatisfacción con el ambiente de trabajo. Los docentes mayores de 40 años y las mujeres tuvieron una incidencia de síntomas psicológicos negativos durante la ERE y enfrentaron mayores desafíos.

Diante da necessidade do isolamento social causada pela pandemia, as aulas presenciais foram suspensas dando lugar ao ensino remoto emergencial (ERE). Essa migração abrupta não permitiu nenhum planejamento ou preparação dos atores envolvidos no processo de ensino-aprendizagem. Nesse contexto, coube ao docente o desafio de adaptar-se a essa nova realidade atípica. Dessa forma, objetivou-se com o presente estudo, descrever as características e desafios enfrentados pelos professores do IF Sudeste MG - Campus Rio Pomba durante o ERE e seus impactos no processo de ensino-aprendizagem. Para isso, foi utilizado um questionário estruturado com participação de 41 docentes. Dificuldades relacionadas a formação pedagógica, uso de ferramentas tecnológicas e de metodologias ativas de ensino (MAE) e processo adaptativo dos docentes foram evidenciadas. Docentes não consideraram o ERE capaz de suprir eficientemente os objetivos das disciplinas, apesar de considerarem que houve apoio institucional necessário. A autoavaliação do desempenho docente durante o ERE foi predominantemente positiva. Antes do ERE, o uso de MAE era menor, especialmente entre os docentes acima de 40 anos e homens, além disso, as dificuldades do uso de MAE aumentaram com a idade, sendo que mais homens relataram não as utilizar. A adaptação ao ERE foi considerada mediana e, mais docentes de 40 a 49 anos relataram insatisfação com o ambiente de trabalho. Docentes acima de 40 anos e mulheres tiveram maior incidência de sintomas psicológicos negativos no ERE. Esse trabalho evidencia o desafio que os docentes passaram durante o ERE, especialmente para aqueles maiores de 40 anos e mulheres.

ABSTRACT Selenium (Se) is an antioxidant mineral and has been included in fish feed formulations in the organic form of hydroxy-selenomethionine (OH-SeMet). This study evaluated how different concentrations of this substance, supplemented in the diet, act on tambaqui (Colossoma macropomum) muscle before and after a stressor (transportation). Juvenile fishes were divided into five treatments receiving 0.0; 0.3; 0.6; 0.9; 1.2 mg kg-1 Se supplementation for 75 days. After that period, the fish were exposed to transportation for four hours. Sampling of muscle tissue for the measurement of biochemical parameters occurred on day 75, prior to transportation, and one week after transportation (day 83). The activity of enzymes superoxide dismutase and glutathione-S-transferase did not change. Supplementation with 1.2 mg kg-1 Se increased the level of reduced glutathione before transportation, and 0.9 and 1.2 mg kg-1 Se reduced the level of thiobarbituric acid reactive substances levels before and after transportation. After transportation, we observed reduced glutathione levels in fish treated with 0.3, 0.6 and 1.2 mg kg-1, reduced ascorbic acid level in fish fed 0.6 mg kg-1 Se, and reduced total protein concentration in fish fed 0.3 mg kg-1 Se, as compared to the levels before transportation. In conclusion, the presence of different concentrations of Se in the fish diet promoted different patterns of response to redox status, minimizing oxidative damage generated by the stressor event.

RESUMO O selênio (Se) é um mineral antioxidante e tem sido incluído em formulações de rações para peixes na forma orgânica de hidróxi-selenometionina (OH-SeMet). Este estudo avaliou como diferentes concentrações dessa substância, suplementada na dieta, atuam no músculo do tambaqui (Colossoma macropomum) antes e após um estressor (transporte). Os peixes juvenis foram divididos em cinco tratamentos recebendo a suplementação de 0,0; 0,3; 0,6; 0,9; 1,2 mg kg-1 de Se por 75 dias. Após esse período, os peixes ficaram expostos ao transporte por quatro horas. A amostragem de tecido muscular para medição dos parâmetros bioquímicos ocorreu no dia 75, antes do transporte, e uma semana após o transporte (dia 83). A atividade das enzimas superóxido dismutase e glutationa-S-transferase não se alterou. A suplementação com 1,2 mg kg-1 de Se aumentou o nível de glutationa reduzida antes do transporte, e 0,9 e 1,2 mg kg-1 de Se reduziram os níveis de substâncias reativas ao ácido tiobarbitúrico antes e após o transporte. Após o transporte, observamos redução nos níveis de glutationa reduzida nos peixes tratados com 0,3, 0,6 e 1,2 mg kg-1, redução nos níveis de ácido ascórbico nos peixes alimentados com 0,6 mg kg-1 de Se e redução na concentração de proteínas totais nos peixes alimentados com 0,3 mg kg-1 Se, em comparação com os níveis antes do transporte. Conclui-se que a presença de diferentes concentrações de Se na dieta dos peixes promoveu diferentes padrões de resposta ao estado redox, minimizando os danos oxidativos gerados pelo evento estressor.

Abstract We describe the toxicity of multiwalled carbon nanotubes (MWCNTs) in two aquatic species: Danio rerio and Artemia salina. Fish were exposed to 25 mg L-1, 50 mg L-1, and 100 mg L-1 MWCNTs for 7 days. After exposure, the gills from D. rerio showed lamellar fusion and epithelial lifting in the secondary lamellae, and vasodilation in the primary lamellae. In the gills, heat shock protein 70 and Bax (pro apoptotic member) were stained more intensely in the treated groups than in the control group. The nauplii of A. salina were exposed to 25 µg L-1, 50 µg L-1, and 100 µg L-1 MWCNTs for 96 h. After exposure, the nauplii from the control group presented 20 % mortality, whereas the 25 µg mL-1, 50 µg mL-1, and 100 µg L-1 groups had 46.7 %, 70 %, and 100 % mortality, respectively. The nauplii exposed to 25 µg mL1 and 50 µg mL1 MWCNTs had black aggregates in the intestine because of the uptake of nanomaterials. In addition, the 25 µg mL-1 and 50 µg mL-1 MWCNT groups had black aggregates attached onto the body surface, appendages of the second pair, and mandibles.The results revealed the toxic effects of MWCNTs on the two aquatic organisms, and both species showed great potential for toxicological evaluation of MWCNTs in aquatic environments.

Abstract We investigated the Biogran on bone repair and metabolism at several time-intervals upon grafting into rat tibia artificial defects. The biomaterial was thoroughly characterized in vitro, and its dissolution behavior upon immersion was assessed in simulated body fluid (SBF) solution for 1, 3, 7, 14, and 30 days. Biogran was also assessed by in vitro hydroxyapatite formation in SBF solution, which is a marker for bioactive behavior. In vivo, distal and proximal bone defects were performed in the Wistar rat's right tibia and filled according to the experimental groups: I) negative control, no filling; II) positive control, 10 mg of autogenous bone; and III) 10 mg of Biogran. Animals were euthanized at 1, 2, 3, 4, 7, and 10 weeks. Bone neoformation was analyzed using histomorphometry (proximal defect), and local levels of bone morphogenetic protein 2 (BMP-2) were measured using the ELISA assay (distal defect). In vitro, the Biogran sample showed a fast dissolution rate within the first 7 days, parallel to the formation of the hydroxyapatite layer. In vivo, the sample was progressively resorbed at a higher rate within the first month until it became almost absent at week 10th. The sample presented similar or higher bone neoformation concerning the autogenous bone. BMP-2 levels were sustained in the Biogran group (around 200 pg/mg) and detected until the last experimental time with a significant difference compared with the controls. Results suggest Biogran is a candidate for hard tissue engineering even in highly active bone remodeling sites.

Abstract: Diabetic ketoacidosis (DKA) is one of the most serious complications of type 1 diabetes mellitus. Its treatment requires fluid and electrolyte replacement and insulin. Hypophosphatemia as a complication of treatment has been scarcely evaluated. Objectives: To estimate the incidence of hypophosphatemia in children with DKA, treated with subcutaneous regular insulin (IRS), and to explore factors associated with this complication. Patients and Method: Prospective, observational study. Patients diagnosed with DKA hospitalized in the general care ward were included. Data on phosphatemia, glycemia, acid-base status, and IRS amount (U/kg) received were recorded at baseline and after 24 h of treatment. Hypophosphatemia was defined as values below 2.5 mg/dl. The correlation between initial phosphate and at 24 h of treatment was evaluated; the incidence of hypophosphatemia at 24 h was expressed as a percentage of the total number of patients. Results: 30 patients were included, 15 were female, mean age 11.4 ± 3.2 years. At 24 h of treatment with IRS, 36.7% (95%CI 22-55%) presented hypophosphatemia, mean value 1.9 ± 1.5 mg/dl. Initial bicarbonate < 10 mmol/L acted as a predictor of hypophosphatemia (OR 7.5; 95%CI 1.4-39.8%; p = 0.01). No patient required intravenous phosphate correction, and no associated clinical complications were observed. Conclusion: In the group studied, the incidence of hypophosphatemia reached 36.7% at 24 hours of treatment. Initial bicarbonate lower than 10 mmol/L was significantly associated with hypophosphatemia. No complications associated with hypophosphatemia were observed.

Resumen: La cetoacidosis diabética (CAD) es una de las complicaciones más graves de la diabetes mellitus tipo 1. Su tratamiento requiere reposición hidroelectrolítica e insulina. La hipofosfatemia como complicación del tratamiento ha sido escasamente evaluada. Objetivos: Estimar la incidencia de hipofosfatemia en niños con cetoacidosis diabética, tratados con insulina regular Subcutánea (IRS), y explorar factores asociados con esta complicación. Pacientes y Método: Estudio observacional, prospectivo. Se incluyeron los pacientes con diagnóstico de CAD hospitalizados en sala de cuidados generales. Se registraron, al inicio y después de 24 h de tratamiento, fosfatemia, glucemia, estado ácido base y cantidad de IRS (U/kg) recibido. Se definió hipofosfatemia a valores inferiores a 2,5 mg/dl. Se evaluó la correlación entre fósforo inicial y a las 24 h de tratamiento; la incidencia de hipofosfatemia a las 24h se expresó en porcentaje del total de pacientes. Resultados: Se incluyeron 30 pacientes, 15 sexo femenino, edad promedio 11,4 ± 3,2 años. A las 24 h de tratamiento con IRS el 36,7%; IC95% (2255%) presentó hipofosfatemia, valor promedio 1,9 ± 1,5 mg/dl. El bicarbonato inicial < 10 mmol/L se comportó como predictor de hipofosfatemia (OR 7,5 IC95% 1,4-39,8% p = 0,01). Ningún paciente requirió corrección endovenosa de fosfato, ni se observaron complicaciones clínicas asociadas. Conclusión: En el grupo estudiado, la incidencia de hipofosfatemia alcanzó un 36,7% a las 24 h de tratamiento. El bicarbonato inicial menor a 10 mmol/L se asoció significativamente a hipofosfatemia. No se observaron complicaciones asociadas a hipofosfatemia.

ABSTRACT: Purple-fleshed sweet potato is a tuber rich in anthocyanins, which are phenolic pigments that confer color and present bioactive capacity. Moreover, its incorporation into dairy products can bring technological and functional benefits. Thus, this article evaluated the impact of the addition of lyophilized purple-fleshed sweet potato powder- LP (0% - Control, 2%, and 4%) on the physical, chemical, and technological characteristics of Greek yogurt. LP showed in vitro antioxidant and bioactive capacity by DPPH (20.64 ± 1.61 μmol TE g-1), FRAP (112.93 ± 4.38 μmol TE g-1), total phenolic content (103.66 ± 3.35 mg GAE g-1), and total anthocyanin content (51.10 ± 1.87 mg cyanidin 3-glucoside 100 g-1). Additionally, the assays demonstrated that the LP has 16.82 ± 0.63% of resistant starch. The fortification of Greek yogurt with LP reduced the syneresis, indicating that LP increased the water retention capacity. LP also inhibited the post-acidification process, increasing apparent viscosity, hardness, and gumminess, and promoting a stable pink coloration throughout the storage (P < 0.05). At the 4% level, the yogurt was firmer and showed greater chewiness, which is highly desirable for Greek yogurt. Therefore, the results suggested that lyophilized purple-fleshed sweet potato powder is a potential multifunctional natural ingredient.

RESUMO: Batata-doce de polpa roxa é um tubérculo rico em antocianinas, as quais são pigmentos fenólicos que conferem cor e apresentam capacidade bioativa. Além disso, sua incorporação em produtos lácteos pode trazer benefícios tecnológicos e funcionais. Desta forma, este estudo teve como objetivo avaliar o impacto da adição de pó liofilizado de batata-doce de polpa roxa - LP (0% - Controle, 2% e 4%) nas características físicas, químicas e tecnológicas de iogurte tipo Grego. LP apresentou capacidade antioxidante e bioativa in vitro para DPPH (20.64 ± 1.61 μmol TE g-1), FRAP (112.93 ± 4.38 μmol TE g-1), teor de compostos fenólicos totais (103.66 ± 3.35 mg GAE g-1) e teor de antocianinas totais (51.10 ± 1.87 mg cyanidin 3-glucoside 100 g-1). Adicionalmente, os ensaios demonstraram que o LP possui 16,82 ± 0,63% de amido resistente. A fortificação do iogurte Grego com LP reduziu a sinérese, indicando que LP aumentou a capacidade de retenção de água, LP também inibiu o processo pós-acidificação, aumentando a viscosidade aparente, a dureza e a gomosidade, e promovendo uma coloração rosa estável durante todo o armazenamento (P < 0,05). No nível de 4%, o iogurte apresentou-se mais firme e com maior mastigabilidade, o que é altamente desejável para o iogurte tipo Grego. Assim, os resultados sugerem que o pó liofilizado de batata-doce de polpa roxa é um potencial ingrediente natural multifuncional.

ABSTRACT The use of carp pituitary extract (CPE) in fish reproduction may have drawbacks, whereas analogues of mammalian (aGnRHm) or salmon (aGnRHs) gonadotropins containing dopamine inhibitor (DI) may offer greater advantages. The objective of this study was to evaluate the effect of different hormone inducers on the reproduction of Prochilodus brevis males. A total of 44 specimens of P. brevis were divided into six groups, namely, CPE 4.0 mg; saline solution 1.0 mL; aGnRHm + DI 0.3 mg and 0.5 mg; and aGnRHs + DI 0.25 mL and 0.35 mL kg-1 of live weight. The number of ejaculates, seminal volume, curvilinear velocity (VCL), straight-line velocity (VSL), average path velocity (VAP), sperm morphology and concentration, and membrane and DNA integrity were determined. Sample normality was examined using the Shapiro-Wilk test, and homogeneity using the Levene test. Analysis of variance (ANOVA) was conducted, followed by Tukey's test to compare means, with statistical significance set at p < 0.05. Notably, all fish induced with CPE 4.0 and aGnRHm + DI demonstrated ejaculation, yielding a greater seminal volume. Sperm concentration under aGnRHs + DI 0.35 exceeded that with aGnRHm + DI 0.3 and CPE 4.0. Regarding velocity, aGnRHm + DI 0.3 outperformed aGnRHs + DI 0.35 in VCL, while aGnRHm + DI 0.3 and 0.5 and aGnRHs + DI 0.25 led to higher VSL than aGnRHs 0.35. Additionally, VAP was elevated under aGnRHm + DI 0.3 and CPE, in contrast to aGnRHs + DI 0.35. Improved sperm morphology was observed with aGnRHm + DI 0.5 and aGnRHs + DI 0.25 compared to aGnRHm + DI 0.3. The remaining parameters did not differ significantly.

[Objective] Our main objective was to evaluate Favolus rugulosus indoor production in different substrates and to analyze the proximal composition of cultivated basidiomata. [Methodology] The studied species was identified by morphological and phylogenetic analyses based on ITS markers. Domestication capability was evaluated in different easy-access substrates. Total phenolic content and antioxidant activities were quantified, and proximal content was analyzed on cultivated basidiomata. [Results] Eucalypts sawdust-straw mixture produced basidiomata in higher yields in an intermediate amount of time (45 days). The highest concentration of phenolic compounds (35.6 ± 2.6 mg GAE g-1) and antioxidants (13.6 ± 1.3 mg AAE g-1) were obtained in the ethyl acetate fraction. Regarding proximal composition, F. rugulosus is composed of 20 % proteins, 15,4 % carbohydrates, 25,2 % dietary fiber and 5,7 % fat. [Conclusions] Nutritional composition analyses on cultivated basidiomata revealed F. rugulosus to be high in protein, carbohydrates, dietary fiber and essential fatty acids.

[Objetivo] El objetivo del trabajo fue evaluar la producción indoor de Favolus rugulosus en distintos sustratos y realizar los análisis de composición proximal de los basidiomas cultivados. [Metodología] La especie en estudio fue identificada por análisis morfológicos y filogenéticos basados en el marcador ITS. Se evaluó la capacidad de domesticación de la especie mediante el cultivo en distintos sustratos de fácil acceso, se cuantificó el contenido de compuestos fenólicos totales, antioxidantes y se realizó el análisis proximal de los basidiomas obtenidos. [Resultados] La mezcla eucalipto-paja resultó ser el mejor sustrato para la producción de basidiomas, por producir rindes más altos en un tiempo intermedio (45 días); la mayor concentración de compuestos fenólicos (35.6 ± 2.6 mg GAE g-1) y antioxidantes (13.6 ± 1.3 mg AAE g-1) se obtuvo en la fracción de acetato de etilo; en cuanto la composición proximal, F. rugulosus contiene 20 % proteínas, 15,4 % carbohidratos, 25,2 % fibra alimentaria y 5,7 % de grasas. [Conclusiones] Los análisis de composición química y nutricional del basidioma cultivado revelan que F. rugulosus es una fuente rica en&nbsp; proteínas, carbohidratos, fibra alimentaria y ácidos grasos esenciales.&nbsp;

Abstract Background Several randomized clinical trials (RCTs) have shown that dual orexin receptor antagonists (DORAs) are effective in the treatment of chronic insomnia. However, the superiority of one particular DORA over the others remains unclear. Objective To perform a network meta-analysis to evaluate the efficacy of different DORAs in patients with chronic insomnia. Methods The Medline, Embase, and Cochrane Central databases were searched for RCTs that compared DORA with placebo in patients ≥ 18 years of age with a diagnosis of insomnia disorder. We pooled outcomes for wake time after sleep onset (WASO), latency to persistent sleep (LPS), total sleep time (TST), and adverse events (AEs). Results We included 10 RCTs with 7,806 patients, 4,849 of whom received DORAs as the intervention. Overall, we found that DORAs were associated with the improvement of all analyzed efficacy outcomes. Concerning TST, an apparent dose-dependent pattern was noticed, with higherdoses relating to a longerTST. Lemborexant 10mg provided the largest reduction in WASO (at month 1) in minutes (standardized mean difference [SMD] = −25.40; 95% confidence interval [95%CI] = −40.02– −10.78), followed by suvorexant 20/15mg (SMD = −25.29; 95%CI = −36.42– −14.15), which also appeared to provide the largest decrease in long-term WASO (SMD = −23.70; 95%CI = −35.89– −11.51). The most frequent AEs were somnolence, nasopharyngitis, and headache, with rates of up to 14.8%. Conclusion Our results suggest that DORAs are associated with greater efficacy when compared with placebo in the treatment of insomnia, a complex 24-hour sleep disorder. Additionally, dosing might play an important role in the management of chronic insomnia.

Resumo Antecedentes Inúmeros ensaios clínicos randomizados (ECRs) têm demonstrado que os antagonistas duais do receptor de orexina (dual orexin receptor antagonists, DORAs, em inglês) são eficazes no tratamento da insônia. Contudo, restam dúvidas quanto à superioridade de um DORA com relação aos outros. Objetivo Realizar uma meta-análise em rede para avaliar a eficácia de diferentes DORAs em pacientes com insônia. Métodos Foram feitas buscas nas bases de dados Medline, Embase e Cochrane Central por ECRs que comparassem DORAs e placebo em pacientes ≥ 18 anos de idade com diagnóstico de insônia. Os seguintes desfechos foram selecionados: tempo desperto após o início do sono (wake time after sleep onset, WASO, em inglês), latência para o sono persistente (latency to persistent sleep, LPS, em inglês), tempo total de sono (total sleep time, TST, em inglês), e efeitos adversos (EAs). Resultados Incluímos 10 ensaios clínicos com 7,806 pacientes, 4,849 dos quais receberam DORAs como intervenção. Os DORAs foram associados à melhoria de todos os desfechos de eficácia analisados. Em relação ao TST, um aparente padrão de dependência da dose foi identificado, com doses maiores se associando a um maior TST. Lemborexant 10 mg proporcionou a maior redução em WASO (no primeiro mês) em minutos (diferença padronizada das médias [standardized mean difference, [SMD], em inglês) = −25.40; intervalo de confiança de 95% [IC95%] = −40.02– −10.78), seguido de suvorexant 20/15mg (SMD = −25.29; IC95% = −36.42– −14.15), o qual também proporcionou a maior diminuição em WASO no longo prazo (SMD = −23.70; IC95% = −35.89– −11.51). Os EAs mais frequentes foram sonolência, nasofaringite e cefaleia, com taxas de até 14.8%. Conclusão Nossos resultados sugerem que os DORAs estão associados a uma maior eficácia quando comparados com placebo no tratamento da insónia, um complexo transtorno do sono de 24 horas. Além disso, a dosagem pode desempenhar um papel importante no manejo da insónia crônica.

Abstract This case aims to highlight the importance of not neglecting anamnesis through pandemic times and to recognize the symptoms of a probable antidepressant withdrawal. A 41-year-old woman with a history of depressive syndrome and hyperthyroidism. Medicated daily with paroxetine 20 mg, bisoprolol 2.5 mg and thiamazole 5 mg. By self-initiative, she abruptly suspended paroxetine, which she was taking for 3 years. After 3 days, she presented with dizziness, dyspnea, tiredness, abdominal pain and diarrhea. Given the contact with SARS-CoV-2 infection cases in the workplace, a laboratory test for SARS-CoV-2 was requested and the result was negative. In TraceCOVID-19 surveillance, the patient reported the suspension of paroxetine and was indicated immediate resumption, with consequent total complaints regression. The case described mimics the clinic of a COVID-19 infection, thus emphasizing the complexity of diagnosing paroxetine withdrawal syndrome.

Resumo Este caso pretende realçar a importância de não descurar a anamnese em tempos de pandemia e a familiarização com os sintomas sugestivos de abstinência de antidepressivos. Mulher, 41 anos, com antecedentes de síndrome depressiva e hipertiroidismo. Medicada diariamente com paroxetina 20 mg, bisoprolol 2,5 mg e tiamazol 5 mg. Por autoiniciativa, suspendeu de forma abrupta a paroxetina, que cumpria há 3 anos. Passados 3 dias, iniciou quadro de tonturas, dispneia, cansaço, dor abdominal e diarreia. Dado o contexto de casos de infeção por SARS-CoV-2 no local de trabalho, foi pedido o teste laboratorial para SARS-CoV-2 cujo resultado foi negativo. No âmbito da vigilância TraceCOVID-19, a utente referiu a suspensão da paroxetina tendo tido indicação para retoma imediata, com consequente regressão total das queixas. O caso descrito mimetiza a clínica de uma infeção COVID-19, enfatizando, assim, a complexidade do diagnóstico da síndrome de abstinência de paroxetina.

Abstract The present study aimed to evaluate the biomass production and mineral composition of sweetpotato plant cultivar ‘Lira’ produced in south-west Portugal, in order to obtain information for the fertilizer recommendations of this crop. The biomass and mineral contents of N, P, K, Ca, Mg, Fe, Mn, Zn, Cu and B were determined in plant fractions: vines, storage roots and absorbent roots. The production of storage roots was 542,1 g per plant. At harvest, 67 % of the dry matter was accumulated in storage roots, 27 % in vines, and 6 % in the absorbent roots. The decreasing order of nutrient accumulation by storage roots was K > N > P> Ca > Mg > Mn > Fe > Zn > B > Cu and by vines was K > N > Ca > Mg > P > Mn > Fe> Zn > B > Cu. The storage roots exported, per tonne of fresh weight, the following amounts of nutrients: 2.65 kg t-1 of N; 0.40 kg t-1 of P; 3.45 kg t-1 of K; 0.26 kg t- 1 of Ca, 0.24 kg t-1 of Mg, 4.42 g t-1 of Fe; 5.71 g t-1 of Mn; 2.70 g t-1 of Zn; 0.96 g t-1 of Cu and 1.33 g t-1 of B.

Resumo O presente estudo teve como objetivo avaliar a produção de biomassa e a composição mineral da planta de batata-doce ‘Lira’ produzida no sudoeste de Portugal, para obter informação para as recomendações de fertilização da cultura. Determinou-se a produção de biomassa e os teores minerais de N, P, K, Ca, Mg, Fe, Mn, Zn, Cu e B na parte aérea, raízes de reserva e raízes absorventes. A produção de raízes de reserva foi de 542,1 g por planta. À colheita, 67 % da matéria seca total da planta encontrava-se nas raízes de reserva, 27 % na parte aérea e 6 % nas raízes absorventes. Por ordem decrescente, a acumulação de nutrientes pelas raízes de reserva foi K > N > P > Ca > Mg > Mn > Fe > Zn > B > Cu e pela parte aérea K > N > Ca > Mg > P > Mn > Fe > Zn > B > Cu. As raízes de reserva exportaram, por tonelada de peso fresco, as quantidades de nutrientes seguintes: 2,65 kg t-1 de N; 0,40 kg t-1 de P; 3,45 kg t-1 de K; 0,26 kg t-1 de Ca, 0,24 kg t-1 de Mg, 4,42 g t-1 de Fe; 5,71 g t-1 de Mn; 2,70 g t-1 de Zn; 0,96 g t-1 de Cu e 1,33 g t-1 de B.

Abstract Objective To trace the sociodemographic profile of endemic disease combat agents (ACEs) in the municipalities that make up the health microregion of Itaúna, Minas Gerais; and apprehend the perception of entomological surveillance professionals about Chagas disease and health services. Methodology A semi-structured questionnaire was applied to the ACEs and a focus group was held with coordinators of endemic diseases and typists. Results Among the ACEs, the majority were female, between 21 and 40 years old, with high school education, with a temporary work contract for less than 5 years. It was possible to apprehend: the poor working conditions of the ACEs, highlighting the high turnover and wage gap; absence of health promotion actions related to Chagas disease; disarticulation between Primary Health Care (PHC) and Health Surveillance (HS); and criticism of disease control actions after the health decentralization process. Conclusions There is an urgent need to implement the legislation inherent to the labor nature and working conditions of the ACEs, as well as the joint planning of PHC and SV actions, guaranteeing comprehensive care through health promotion actions aimed at the population, focusing especially on Chagas disease, consolidating the SUS.

Resumo Objetivo Traçar o perfil sociodemográfico dos agentes de combate a endemias (ACEs) dos municípios que compõem a microrregional de saúde de Itaúna, Minas Gerais; e apreender a percepção dos profissionais da vigilância entomológica sobre a doença de Chagas e serviços de saúde. Metodologia Aplicou-se um questionário semiestruturado aos ACEs e foi realizado um grupo focal com os coordenadores de endemias e digitadores. Resultados Dentre os ACEs, a maioria era do sexo feminino, entre 21 e 40 anos, com ensino médio, possuindo contrato de trabalho temporário há menos de 5 anos. Foi possível apreender: as más condições de trabalho dos ACEs, destacando-se a alta rotatividade e defasagem salarial; ausência de ações de promoção à saúde relacionadas à doença de Chagas; desarticulação entre a Atenção Primária à Saúde (APS) e Vigilância à Saúde (VS); e críticas às ações de controle da doença pós-processo de descentralização da saúde. Conclusões Há urgência na concretização da legislação inerente à natureza trabalhista e às condições de trabalho dos ACEs, bem como ao planejamento conjunto das ações de APS e VS, garantindo a atenção integral por meio de ações de promoção à saúde voltadas à população, focando especialmente a doença de Chagas, consolidando o SUS.

Resumo: Este artigo trata do efeito da pandemia de Covid-19 sobre o acesso aos mercados por agricultores familiares em Mariana. A pesquisa se orientou teoricamente pela discussão sobre a construção social dos mercados acessados por agricultores familiares. Foi utilizada como modelo analítico uma tipologia de mercados desenvolvida por Schneider (2016) que diferencia os principais canais de comercialização acessados pelos agricultores familiares no Brasil de modo a avaliar possíveis alterações nas formas de comercialização durante a pandemia. Trata-se de um estudo exploratório e descritivo, contando com uma metodologia qualitativa, consistindo na realização de entrevistas semiestruturadas com os agricultores familiares de Mariana. Por meio da análise de conteúdo das entrevistas, foi possível identificar que não se alteraram os canais de comercialização disponíveis no contexto pandêmico, mas, devido às restrições de acesso, somando-se à ausência de incentivos e políticas públicas, os agricultores foram impactados, destacando-se a redução expressiva em sua renda.

Abstract: This paper addresses the effect of the COVID-19 pandemic on access to markets by family farmers in Mariana. The research was theoretically guided by the discussion on the social construction of markets accessed by family farmers. A typology of markets developed by Schneider (2016) was used as an analytical model - which differentiates the main market channels accessed by family farmers in Brazil in order to assess possible changes in the forms of marketing during the pandemic. This is an exploratory and descriptive study, with a qualitative methodology consisting of semi-structured interviews with family farmers in Mariana. Through the content analysis of the interviews, it was possible to identify that the marketing channels available in the pandemic context did not change, but, due to access restrictions, in addition to the absence of incentives and public policies, farmers were impacted, highlighting the significant reduction in their income.