ABSTRACT Purpose: To histologically quantify the different tissues that make up the porcine ureter, (epithelial, connective, and muscular tissue) in the three segments labelled: cranial, middle and caudal, in order to identify the segment most compatible for use as a vascular graft. Methods: Fifteen porcine ureters were collected, divided into the three segments, and the samples were stained with hematoxylin and eosin, picrosirius red and Weigert’s resorcin-fuchsin. The immunohistochemistry technique was applied for alpha-smooth muscle actin. Collagen fibers, muscle, epithelium, and elastic fibers tissue were quantified, in the entire ureter, and divided into hemispheres, comparing the different segments. Results: When comparing hemisphere segments, significant differences were observed (p < 0.01) for collagen and muscle tissue, with the cranial segment presenting the greatest amount of these components when compared to the middle and caudal. No significant difference was observed between the segments when comparing the entire ureters. Conclusions: After comparing the segments by hemisphere, the cranial segment presented a slight advantage for use as a vascular graft due to presenting greater collagen fiber content. Purpose ureter epithelial, epithelial (epithelial connective labelled caudal Methods collected eosin Weigerts Weigert s resorcinfuchsin. resorcinfuchsin resorcin fuchsin. fuchsin resorcin-fuchsin alphasmooth alpha smooth actin epithelium quantified hemispheres Results p 0.01 001 0 01 Conclusions content 0.0 00 0.

Abstract Anticancer therapy often leads to premature ovarian insufficiency (POI) and infertility due to the extreme sensitivity of the ovarian follicle reserve to the effects of chemotherapy. Withanolides are known for their cytotoxic effect on cancer cells and low cytotoxicity on non-malignant or healthy cells. Therefore, this study aimed to investigate the in vivo effects of three withanolides derivatives: 27-dehydroxy-24,25-epoxywithaferin A (WT1), 27-dehydroxywithaferin A (WT2), and withaferin A (WTA) on fertility, and the ovarian preantral follicles of young female mice. To achieve this, mice received 7 intraperitoneal doses of WT1, WT2, or WTA at a concentration of 2 mg/kg (Experiment I) and 5 or 10 mg/kg (Experiment II) over 15 alternate days. In experiment I, two days after administration of the last dose, half of the mice were mated to evaluate the effects of withanolides on fertility. The other half of the mice, as well as all mice from experiment II, were sacrificed for histological, inflammation, senescence, and immunohistochemical analyses of the follicles present in the ovary. Regardless of the administered withanolide, the concentration of 2 mg/kg did not show toxicity on the follicular morphology, ovarian function, or fertility of the mice. However, at concentrations of 5 and 10 mg/kg, the three derivatives (WT1, WT2, and WTA) increased follicular activation, cell proliferation, and ovarian senescence without affecting inflammatory cells. Furthermore, at a concentration of 10 mg/kg, the three withanolides showed intensified toxic effects, leading to DNA damage as evidenced by the labeling of γH2AX, activated Caspase 3, and TUNEL. We conclude that the cytotoxic effect of the tested withanolide derivatives (WT1, WT2, and WTA) in the concentration of 2 mg/kg did not show toxicity on the ovary. However, in higher concentrations, such as 10 mg/kg, toxic effects are potentiated, causing DNA damage. POI (POI chemotherapy nonmalignant non malignant Therefore 27dehydroxy24,25epoxywithaferin 27dehydroxy2425epoxywithaferin dehydroxyepoxywithaferin 27 dehydroxy 24,25 epoxywithaferin 24 25 WT1 WT , (WT1) 27dehydroxywithaferin dehydroxywithaferin WT2 (WT2) (WTA mgkg mg kg Experiment I 1 II dose histological inflammation ovary morphology function However (WT1 activation proliferation Furthermore γH2AX γHAX γH AX 3 TUNEL potentiated 27dehydroxy24 25epoxywithaferin 2425 24,2 (WT2 (WT 27dehydroxy2 242 24, 27dehydroxy

Abstract Oviduct fluid extracellular vesicles (oEV) are essential for periconceptional events. The presence of EV has already been identified in the oviduct fluid (OF) from mammalian species, except in caprine. Therefore, this study aimed to isolate and characterize the caprine oEV (coEV). Initially, in Experiment 1, coEV were isolated from the OF of either each animal individually or from a pool of three animals. In experiment 2, coEV were isolated during the follicular or luteal phases of the estrous cycle. The coEV were characterized by size distribution, polydispersity index (PDI), and zeta potential using dynamic light scattering (DLS) analysis, as well as, by transmission electron microscopy (TEM) and dot blotting (DB). Our results indicated that the physicochemical characteristics of the coEV were similar (P > 0.05), regardless of the isolation method (individual or pool). However, coEV collected during the luteal phase were larger (P < 0.05) than those during the follicular phase. The TEM showed spherical and cup-shaped particles, characteristic of exosomes. The DB revealed the presence of exosomal proteins involved in the biogenesis of coEV. In conclusion, it is possible to isolate and characterize coEV from a single caprine female and the estrous cycle phase influences the vesicles average size and PDI. (oEV events (OF species Therefore . (coEV) Initially 1 animals 2 distribution PDI, PDI , (PDI) DLS (DLS analysis (TEM DB. (DB) P 0.05, 005 0.05 0 05 individual pool. pool) However cupshaped cup shaped particles exosomes conclusion (coEV (PDI (DB 00 0.0 0.

RESUMEN Objetivo: traducir, adaptar culturalmente y validar el Multidimensional Individual and Interpersonal Resilience Measure para el portugués brasileño. Método: después de la traducción inicial, la versión pre-final pasó por rigurosos procedimientos de adaptación cultural. Como resultado, la versión final adaptada fue sometida a un estudio de validez. Resultados: los procedimientos de adaptación proporcionaron equivalencia entre las versiones pre-final y original en términos semánticos, idiomáticos, experienciales y conceptuales. Un total de 187 ancianos fueron incluidos en el estudio de validez. El análisis factorial exploratorio (AFE) generó un modelo de cinco factores ((RMSEA = 0,030; TLI = 0,959; X2 = 151,590 p> 0,05). La versión final mostró adecuada consistencia (α de Cronbach = 0,705) y confiabilidad prueba-reprueba (ICC=0,835). No se encontró correlación estadísticamente significativa entre la resiliencia y las variables sociodemográficas y epidemiológicas evaluadas en este estudio. Conclusión: EMRII-BR es un instrumento válido y confiable para medir la resiliencia en ancianos brasileños. Objetivo traducir brasileño Método inicial prefinal pre cultural resultado validez Resultados semánticos idiomáticos conceptuales 18 AFE (AFE RMSEA 0,030 0030 0 030 0,959 0959 959 X 151590 151 590 151,59 p 0,05. 005 0,05 . 05 0,05) α 0,705 0705 705 pruebareprueba prueba reprueba ICC=0,835. ICC0835 ICC ICC=0,835 835 (ICC=0,835) Conclusión EMRIIBR EMRII BR brasileños 1 0,03 003 03 0,95 095 95 15159 15 59 151,5 00 0,0 0,70 070 70 ICC083 ICC=0,83 83 (ICC=0,835 0,9 09 9 1515 5 151, 0, 0,7 07 7 ICC08 ICC=0,8 8 (ICC=0,83 ICC0 ICC=0, (ICC=0,8 ICC=0 (ICC=0, ICC= (ICC=0 (ICC= (ICC

RESUMO Objetivo: traduzir, adaptar culturalmente e validar o Multidimensional Individual and Interpersonal Resilience Measure para o português brasileiro. Método: após a tradução inicial, a versão pré-final passou por rigorosos procedimentos de adaptação cultural. Como resultado, a versão final adaptada foi submetida a um estudo de validade. Resultados: os procedimentos de adaptação proporcionaram equivalência entre as versões pré-final e original em termos semânticos, idiomáticos, experienciais e conceituais. Um total de 187 idosos foram incluídos no estudo de validade. A análise fatorial exploratória (AFE) gerou um modelo de cinco fatores ((RMSEA = 0,030; TLI = 0,959; X2 = 151,590 p> 0,05). A versão final apresentou consistência adequada (α de Cronbach = 0,705) e confiabilidade teste-reteste (ICC=0,835). Não foi encontrada correlação estatisticamente significativa entre a resiliência e as variáveis sociodemográficas e epidemiológicas avaliadas neste estudo. Conclusão: o EMRII-BR é um instrumento válido e confiável para mensurar a resiliência em idosos brasileiros. Objetivo traduzir brasileiro Método inicial préfinal pré cultural resultado validade Resultados semânticos idiomáticos conceituais 18 AFE (AFE RMSEA 0,030 0030 0 030 0,959 0959 959 X 151590 151 590 151,59 p 0,05. 005 0,05 . 05 0,05) α 0,705 0705 705 testereteste teste reteste ICC=0,835. ICC0835 ICC ICC=0,835 835 (ICC=0,835) Conclusão EMRIIBR EMRII BR brasileiros 1 0,03 003 03 0,95 095 95 15159 15 59 151,5 00 0,0 0,70 070 70 ICC083 ICC=0,83 83 (ICC=0,835 0,9 09 9 1515 5 151, 0, 0,7 07 7 ICC08 ICC=0,8 8 (ICC=0,83 ICC0 ICC=0, (ICC=0,8 ICC=0 (ICC=0, ICC= (ICC=0 (ICC= (ICC

ABSTRACT Objective: to translate, culturally adapt and validate the Multidimensional Individual and Interpersonal Resilience Measure to Brazilian Portuguese. Method: after initial translation, the pre-final version underwent rigorous cultural adaptation procedures. As a result, the final adapted version was submitted to a validity study. Results: adaptation procedures provided equivalence between the pre-final and the original versions in semantic, idiomatic, experiential and conceptual terms. A total of 187 older adults were included in the validity study. Exploratory factorial analysis (EFA) generated a model of five factors ((RMSEA = 0.030; TLI = 0.959; X2 = 151.590 p> 0.05). Final version showed adequate consistency (Cronbach’s α = 0.705) and test-retest reliability (ICC=0.835). No statistically significant correlation was found between resilience and sociodemographic and epidemiological variables assessed in this study. Conclusion: EMRII-BR is a valid and reliable instrument for measuring resilience in Brazilian older adults. Objective translate Portuguese Method translation prefinal pre result study Results semantic idiomatic terms 18 EFA (EFA RMSEA 0.030 0030 0 030 0.959 0959 959 X 151590 151 590 151.59 p 0.05. 005 0.05 . 05 0.05) Cronbachs Cronbach s 0.705 0705 705 testretest test retest ICC=0.835. ICC0835 ICC ICC=0.835 835 (ICC=0.835) Conclusion EMRIIBR EMRII BR 1 0.03 003 03 0.95 095 95 15159 15 59 151.5 00 0.0 0.70 070 70 ICC083 ICC=0.83 83 (ICC=0.835 0.9 09 9 1515 5 151. 0. 0.7 07 7 ICC08 ICC=0.8 8 (ICC=0.83 ICC0 ICC=0. (ICC=0.8 ICC=0 (ICC=0. ICC= (ICC=0 (ICC= (ICC

Abstract Introduction Coronavirus disease 2019 (COVID-19) has claimed millions of lives. Adequate protection of the professionals involved in patient care is essential in the battle against this disease. However, there is much uncertainty involving safety-relarted topics that are of particular interest to the rhinologist in the context of COVID-19. Objective To evaluate the current evidence regarding three safety-related topics: mask and respirator use, performance of nasal endoscopic procedures, and use of topical nasal and intranasal medications (saline irrigation and nasal corticosteroids). Methods A literature review was performed on the PubMed, Scopus, and Cochrane databases, with standardized search queries for each of the three topics of interest. Results In total, 13 articles on mask use, 6 articles on the safety of nasal corticosteroids, 6 articles on the safety of nasal endoscopic procedures, and 1 article on nasal irrigation with saline solution were included in the final analysis. Conclusion N95 respirators are essential for the adequate protection of otolaryngologists. If reuse is necessary, physical methods of sterilization must be employed. No evidence was found to contraindicate the use of nasal corticosteroids, whether acute (in the management of sinonasal inflammatory conditions) or continued (in patients who use them chronically). Nasal irrigation with saline solution apparently does not increase the risk in the context of COVID-19. Nasal endoscopic procedures should only be performed after testing the patient for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the surgical team must wear full personal protective equipment to prevent aerosol exposure.

ABSTRACT Fragmentation is one of the main causes of biodiversity loss in tropical forests through consequences on their different components. Beta diversity patterns across fragments have been studied across multiple spatial scales, but comparisons with intact landscapes and in a variety of vegetation types are scarce. In order to address this issue of anthropogenic landscape disturbance, we tested two hypotheses relating to fragmentation and beta diversity: 1. Floristic homogenization at patch-level scale and 2. Floristic differentiation at landscape-level scale. The study was conducted in the Espinhaço Range biosphere reserve, Brazil. Three landscapes encompassing a broad range of vegetation types were sampled in 115 plots. Two landscapes were fragmented due to mining activities (Sabará and Brumadinho) and one is protected (Parque Estadual Serra do Rola-Moça). Results showed high overall beta diversity both between landscapes (conserved and fragmented) and vegetation types (forest, Brazilian savanna “campos rupestres”, ecotone and ironstone “canga”) with high turnover and species losses, even in highly disturbed vegetation types. The conserved landscape was most diverse in terms of richness. Thus, fragmentation effects differed from the expected with a main role of differentiation processes, and we argue that high beta diversity is not always a good predictor of ecosystem health.

Resumo O objetivo é avaliar o estágio de conformidade das universidades federais brasileiras ao requisito da aquisição de produtos da agricultura familiar nos termos do Decreto nº 7.775/2012, delimitando alcances e dilemas para retroalimentar o Programa de Aquisição de Alimentos na modalidade Compra Institucional (PAA-CI). Trata-se de estudo qualitativo-descritivo, com análise de dados secundários (chamadas públicas e resultados) entre 2012 e 2019. A análise dos dados indicou que é limitada e heterogênea a execução do PAA-CI no abastecimento de alimentos para os restaurantes universitários via chamadas públicas, beneficiando um reduzido número de agricultores familiares. Há lacunas em termos de cobertura do Programa e falhas na elaboração das chamadas públicas, o que desestimula a participação dos agricultores familiares e das organizações da agricultura familiar, especialmente dos menos estruturados. Em virtude do caráter recente da legislação, devem ser fomentadas políticas públicas de assistência técnica e extensão rural para a agricultura familiar e ações de capacitação dos gestores públicos de modo a conduzir burocratas a interações com organizações locais, criando e aperfeiçoando fluxos de informações e conhecimentos e retroalimentando políticas públicas de desenvolvimento local integradas às atividades-fim das universidades, de ensino, pesquisa e extensão.

Abstract This study aims to assess the level of compliance of Brazilian federal universities with the requirement for the acquisition of products from family farming under Decree No. 7775/2012, delimiting scopes and dilemmas to provide feedback to the Food Acquisition Program in the Institutional Purchase modality (PAA-CI). This is a descriptive qualitative study, with an analysis of secondary data (calls and results) between 2012 and 2019. Data analysis indicated that the implementation of the PAA-CI in the supply of food to university restaurants via public calls is limited and heterogeneous, benefiting a small number of family farmers. There are gaps in terms of Program coverage and failures in the preparation of public notices, which discourages the participation of family farmers and family farming organizations, especially the less structured ones. Due to the recent nature of the legislation, public policies of technical assistance and rural extension for family farming and actions to train public managers must be promoted to lead bureaucrats to interactions with local organizations, creating and improving flows of information and knowledge and providing feedback public policies for local development integrated to the core activities of universities, teaching, research, and extension.

RESUMO Introdução: Devido aos limites anatômicos da mandíbula, a arcada dentária inferior geralmente serve como guia para determinar as alterações necessárias na dimensão transversal da maxila. O aparelho de Schwarz e o Lip Bumper são os aparelhos usados tradicionalmente para expansão da arcada inferior em pacientes com quantidades limítrofes de apinhamento e/ou discrepância transversal. No entanto, eles requerem a cooperação do paciente, o que pode ser uma preocupação para os ortodontistas na prática diária. Objetivos: O presente artigo ilustra uma alternativa diferente de aparelho fixo para se obter a expansão da arcada inferior em pacientes com discrepância moderada de tamanho dentário e/ou comprimento da arcada. Os quatro casos relatados referem-se a pacientes com 8 a 10 anos de idade, na dentição mista, com má oclusão de Classe I ou II de Angle, deficiência transversal em ambas as arcadas, apinhamento moderado e/ou mordida cruzada posterior, apresentando comprometimento da estética do sorriso. Os pacientes foram tratados com expansão rápida da maxila (ERM), usando aparelho expansor de Hass, e expansor Arnold modificado (EAM). Conclusão: O EAM, que é um aparelho de baixo custo e não depende da colaboração do paciente, promoveu uma descompensação dentoalveolar por meio da verticalização dos dentes posteriores, necessitando de mínimo ou nenhum ajuste durante o tratamento. Os resultados pretendidos foram alcançados em três a quatro meses e cumpriram todos os objetivos do tratamento, como aumento do perímetro e largura da arcada, assim como o melhor alinhamento dos dentes.

ABSTRACT Introduction: Due to the anatomical constraints of the mandible, mandibular dental arch usually serves as a guideline to determine the required changes in the maxillary transverse dimension. The Schwarz appliance and the Lip Bumper are the traditional orthodontic appliances for mandibular arch expansion in patients with borderline amounts of crowding, and/or transverse discrepancy. However, they often require patient cooperation, which may be a concern for orthodontists in daily practice. Objectives: This article illustrates a simple fixed orthodontic device as an alternative to achieve mandibular arch expansion in patients with moderate tooth-size/arch-length discrepancy. The four reported cases refer to 8 to 10-year-old patients in the mixed dentition, with an Angle Class I or Class II malocclusion, transverse deficiency in both arches, moderate crowding and/or posterior crossbite, combined with compromised smile aesthetics. The patients were treated with rapid maxillary expansion (RME) using Hass expander appliance and the modified Arnold expander (MAE). Conclusion: This low-cost compliance-free orthodontic appliance provided dentoalveolar decompensation by means of uprighting the posterior teeth, with minimal or no adjustments during treatment. The final results were achieved in only three to four months, and fulfilled all treatment objectives, such as an increase in the arch perimeter and width, and a better teeth alignment.

Abstract Purpose: The benefits of laparoscopic approaches to treat colorectal cancer (CRC) and colorectal liver metastases (CRLM) separately are well established. However, there is no consensus about the optimal timing to approach the primary tumor and CRLM, whether simultaneously or staged. The objective of this review with practical reports is to discuss technical aspects required for patient selection to perform simultaneous laparoscopic approaches for CRC and CRLM. Methods: Literature review of oncological factors associated with patient selection for surgical treatment of CRLM and the use of laparoscopy in those cases, and report of technical aspects for simultaneous CRC and CRLM approaches. Results: Simultaneous laparoscopic resection has been successful in many series of selected patients, although it seems to be safer to perform minor and major liver resection with non-extended colorectal resections, and to avoid two high-risk procedures at the same time. Conclusions: Simultaneous CRC and CRLM resections seem to be safe when patients are carefully selected, also considering the risk of recurrence concerning oncologic outcomes. The pre-planning of simultaneous resection is mandatory to plan trocar positioning, procedure sequencing, and patient position.

Resumo: A falta de implementação de políticas públicas voltadas para a conservação ambiental, tem resultado, em nível global, em impactos sobre a biodiversidade e o funcionamento dos ecossistemas e, consequentemente, na contribuição da natureza para as pessoas. A aplicação inadequada de importantes de leis ambientais no Brasil, como por exemplo, a “Lei da Mata Atlântica” (Lei nº 11.428 / 2006) e o “Código Florestal” (Lei nº 12.651 / 2012), podem comprometer a manutenção dos ecossistemas e dos serviços que eles fornecem. Neste estudo, nós desenvolvemos um mapa conceitual que busca identificar causas diretas e indiretas de mudanças - agentes de mudança - na biodiversidade e na provisão de serviços ecossistêmicos relacionados ao solo e à água, na Área de Proteção Ambiental (APA) Sistema Cantareira. A APA Sistema Cantareira, localizada no sudeste do Brasil, fornece água potável para 47% da Região Metropolitana de São Paulo. Além da abordagem conceitual, nós projetamos quatro cenários de mudança no uso da terra para o ano de 2050, a fim de analisar o impacto de diferentes níveis de aplicação de leis federais: o cenário “business-as-usual” (BAU), que pressupõe que as tendências na mudança de uso da terra observadas no passado continuarão no futuro, e três cenários alternativos, considerando a implementação da Lei da Mata Atlântica, a implementação parcial do Código Florestal e a implementação completa do Código Florestal. A partir dos mapas de uso da terra gerados, avaliamos os impactos de cada cenário na conservação da biodiversidade, na retenção de solos e na exportação de sedimentos para os corpos d’água. Nossos resultados mostraram que os três cenários alternativos podem aumentar a conservação da biodiversidade (em 7%; 12%; e 12%, respectivamente), reduzir a perda de solo (em 24,70%; 34,70%; e 38,12%, respectivamente) e reduzir a exportação de sedimentos para a água (em 27,47 %; 55,06%; e 59,28%, respectivamente), quando comparados ao cenário BAU. Este estudo destaca a importância da restauração e conservação da vegetação nativa para a manutenção da biodiversidade e melhoria na provisão de serviços ecossistêmicos relacionados ao solo e à água, em uma região estratégica para o abastecimento de água no Brasil.

Abstract: The lack of implementation of well-designed public policies aimed at the conservation of natural ecosystems has resulted, at a global level, in the decline of ecosystem functioning and, consequently, of the contributions they make to people. The poor enforcement of important environmental legislation in Brazil - for instance, the “Atlantic Forest Law” (Law n.11.428/2006) and the “Forest Code” (Law n.12.651/2012) - could compromise the overall maintenance of ecosystems and the services they provide. To explore the implications of different levels of federal laws’ enforcement within the Cantareira System Protected Area (PA) - a PA in southeastern Brazil that provides fresh water for 47% of the Sao Paulo Metropolitan Area -, we developed a conceptual framework to identify indirect and direct drives of biodiversity and ecosystem changes. We also projected four land-use scenarios to 2050 to test the effects of deforestation control and forest restoration practices on biodiversity and ecosystem services maintenance: the “business-as-usual” scenario (BAU), which assumes that all trends in land-use cover changes observed in the past will continue in the future, and three alternative exploratory scenarios considering the Atlantic Forest Law implementation, the partial implementation of the Forest Code and the full implementation of the Forest Code. Using the land-use maps generated for each scenario, we assessed the impacts of land-use changes on biodiversity conservation and soil retention. Our results revealed all alternative scenarios could increase biodiversity conservation (by 7%; 12%; and 12%, respectively), reduce soil loss (by 24.70%; 34.70%; and 38.12%, respectively) and sediment exportation to water (by 27.47%; 55.06%; and 59.28%, respectively), when compared to the BAU scenario. Our findings highlight the importance of restoring and conserving native vegetation for the maintenance and improvement of biodiversity conservation and for the provision of ecosystem services.

Resumo O Programa Mais Médicos (PMM), criado em 2013, estabeleceu novo marco regulatório para a graduação médica e a residência médica no Brasil, tendo a necessidade social como orientadora do processo. A presente reflexão pauta as políticas públicas e suas ações direcionadas à implementação de mudanças na formação médica no PMM e seus resultados até 2015, por meio de análise documental de fontes oficiais e literatura. Identificou-se: redução nas desigualdades regionais na distribuição de vagas de graduação; interiorização da formação; expansão de vagas de residência médica com enfoque na medicina de família e comunidade; expansão da qualificação da preceptoria; e criação do Cadastro Nacional de Especialistas. São apontados desafios enfrentados pelo PMM para alcançar efetivamente seus objetivos, a necessidade de comprometimento do Estado e as atuais ameaças a essa dimensão vital do programa, que busca a garantia do direito à saúde.

Abstract The More Doctors Program (PMM) was created in 2013. Guided by social needs, it set a new regulatory framework for medical education and residency in Brazil. This study is based on public policies and their actions aimed at implementing changes in medical education in PMM, as well as their results until 2015, by analyzing documents from official sources and the literature. The following results were identified: decrease in regional inequalities in the distribution of undergraduate course seats; education internalization; increase in medical residency seats specialized in Family and Community Medicine; expansion of preceptorship qualification; and creation of the National Registration of Specialists. The challenges faced by PMM to effectively achieve its goals, the need for State commitment and the current threats to this vital dimension of the program (ensure the right to health) are pointed out.

Resumen El Programa Más Médicos fue creado en 2013 y estableció un nuevo marco regulador para la formación y residencia médica en Brasil. En este artículo se han realizado análisis documentales, análisis de bases de datos oficiales y revisión de literatura, buscando estudiar los cambios en la formación médica y sus resultados hasta 2015. Se han identificado avances importantes en la distribución de plazas de graduación entre las diferentes regiones del país; en la interiorización de la formación; en la creación de cursos de medicina que sigan la regulación estatal; en la regulación de las plazas de residencia médica con enfoque en medicina de familia y comunidad; en la cualificación de la preceptoría; y en la creación del Catastro Nacional de Especialistas. En la conclusión se señalan los desafíos que ha enfrentado para alcanzar efectivamente sus objetivos.

Resumo O Programa Mais Médicos (PMM), criado em 2013, estabeleceu novo marco regulatório para a graduação médica e a residência médica no Brasil, tendo a necessidade social como orientadora do processo. A presente reflexão pauta as políticas públicas e suas ações direcionadas à implementação de mudanças na formação médica no PMM e seus resultados até 2015, por meio de análise documental de fontes oficiais e literatura. Identificou-se: redução nas desigualdades regionais na distribuição de vagas de graduação; interiorização da formação; expansão de vagas de residência médica com enfoque na medicina de família e comunidade; expansão da qualificação da preceptoria; e criação do Cadastro Nacional de Especialistas. São apontados desafios enfrentados pelo PMM para alcançar efetivamente seus objetivos, a necessidade de comprometimento do Estado e as atuais ameaças a essa dimensão vital do programa, que busca a garantia do direito à saúde.

Abstract The More Doctors Program (PMM) was created in 2013. Guided by social needs, it set a new regulatory framework for medical education and residency in Brazil. This study is based on public policies and their actions aimed at implementing changes in medical education in PMM, as well as their results until 2015, by analyzing documents from official sources and the literature. The following results were identified: decrease in regional inequalities in the distribution of undergraduate course seats; education internalization; increase in medical residency seats specialized in Family and Community Medicine; expansion of preceptorship qualification; and creation of the National Registration of Specialists. The challenges faced by PMM to effectively achieve its goals, the need for State commitment and the current threats to this vital dimension of the program (ensure the right to health) are pointed out.

Resumen El Programa Más Médicos fue creado en 2013 y estableció un nuevo marco regulador para la formación y residencia médica en Brasil. En este artículo se han realizado análisis documentales, análisis de bases de datos oficiales y revisión de literatura, buscando estudiar los cambios en la formación médica y sus resultados hasta 2015. Se han identificado avances importantes en la distribución de plazas de graduación entre las diferentes regiones del país; en la interiorización de la formación; en la creación de cursos de medicina que sigan la regulación estatal; en la regulación de las plazas de residencia médica con enfoque en medicina de familia y comunidad; en la cualificación de la preceptoría; y en la creación del Catastro Nacional de Especialistas. En la conclusión se señalan los desafíos que ha enfrentado para alcanzar efectivamente sus objetivos.

Resumo: A formulação e a implementação de políticas públicas e programas governamentais têm ganhado destaque no cenário da administração pública brasileira; porém, ainda são escassas e incipientes as iniciativas voltadas à avaliação de políticas. Neste trabalho, objetivou-se avaliar a eficácia do Programa de Aquisição de Alimentos (PAA), classificando os municípios brasileiros em relação ao nível de propensão à execução desta política pública. Para isso, foram elaborados dois indicadores compostos por sete variáveis que englobassem tanto a propensão de insegurança alimentar da população local quanto a necessidade de acesso ao mercado por parte da agricultura familiar local. Posteriormente, foi estimado o nível de cobertura do programa nas regiões brasileiras. Foram utilizadas as técnicas estatísticas multivariada Análise de Cluster para identificar agrupamentos e Análise de Discriminante para validá-los. Foi possível identificar quatro grupos de demanda do programa com características distintas significativamente validados pela Análise Discriminante. O grupo com maior demanda das ações do programa é formado por municípios com expressiva presença de agricultores familiares, baixo dinamismo econômico e alto risco de segurança alimentar, e estão localizados majoritariamente nas regiões Nordeste e Norte. Constatou-se que o PAA tem concentrado suas ações nestes municípios; porém, o nível de cobertura do programa ainda é incipiente. Demonstrou-se, também, que a taxa de cobertura por regiões ainda é desigual, indicando que algumas regiões têm sido preteridas, com destaque para o Norte e o Nordeste.

Abstract: Conception and the practice of public policies and government programs have been highlighted in the Brazilian public administration. However, the initiatives to evaluate policies are still rare and incipient. We aim to evaluate the efficiency of food acquisition Program (PAA), classifying the Brazilian municipalities according to the level of tendency to implement this public policy. In order to do this, two indicators with seven variables were elaborated that incorporates both the propensity to food insecurity from local population and local familiar agriculture access to the market. Moreover, we estimated the coverage level of the program in Brazilian regions. We used multivariate statistical techniques Cluster analysis to identify groups and Discriminant analysis to validate them. As result, it was possible to identify four groups of program demand with distinct characteristics significantly validated by discriminant analysis. The group with highest demand of program actions is formed by municipalities with significant presence of family farmers, low economic dynamism and high risk of food security. They are mostly located in the Northeastern and Northern areas. Interestingly, we noted that the PAA has focused its actions in these municipalities. However, the level of coverage of the program is still incipient. Finally, the coverage rate based on regions is still uneven, indicating that some regions have been rejected, especially in North and Northeast of Brazil.

OBJECTIVE: The passive cycle ergometer aims to prevent hypotrophy and improve muscle strength, with a consequent reduction in hospitalization time in the intensive care unit and functional improvement. However, its effects on oxidative stress and immune system parameters remain unknown. The aim of this study is to analyze the effects of a passive cycle ergometer on the immune system and oxidative stress in critical patients. METHODS: This paper describes a randomized controlled trial in a sample of 19 patients of both genders who were on mechanical ventilation and hospitalized in the intensive care unit of the Hospital Agamenom Magalhães. The patients were divided into two groups: one group underwent cycle ergometer passive exercise for 30 cycles/min on the lower limbs for 20 minutes; the other group did not undergo any therapeutic intervention during the study and served as the control group. A total of 20 ml of blood was analysed, in which nitric oxide levels and some specific inflammatory cytokines (tumour necrosis factor alpha (TNF-α), interferon gamma (IFN-γ) and interleukins 6 (IL-6) and 10 (IL-10)) were evaluated before and after the study protocol. RESULTS: Regarding the demographic and clinical variables, the groups were homogeneous in the early phases of the study. The nitric oxide analysis revealed a reduction in nitric oxide variation in stimulated cells (p=0.0021) and those stimulated (p=0.0076) after passive cycle ergometer use compared to the control group. No differences in the evaluated inflammatory cytokines were observed between the two groups. CONCLUSION: We can conclude that the passive cycle ergometer promoted reduced levels of nitric oxide, showing beneficial effects on oxidative stress reduction. As assessed by inflammatory cytokines, the treatment was not associated with changes in the immune system. However, further research in a larger population is necessary for more conclusive results.

Neste trabalho, objetivou-se, essencialmente, ajustar modelos para a construção de curvas de índice de sítio e modelos para estimar alturas nas diferentes idades para Eucalyptus grandis,na região dos Campos Gerais, no estado do Paraná. Os dados utilizados no ajuste dos modelos foram provenientes de parcelas permanentes, temporárias e de inventários pré-corte, englobando idades de 2,5 a 26,5 anos. Foram testados vários modelos para representar os sítios e a relação hipsométrica. Para o sítio, o modelo de Chapman-Richards apresentou as melhores estatísticas de ajuste e precisão, tendo-se construído 5 curvas de sítio (amplitude de 5 m) pelo método da curva-guia. Os quatro modelos hipsométricos testados apresentaram desempenhos satisfatórios e estatísticas similares, constatando-se que a inclusão da variável altura dominante ou do índice de sítio nos modelos não melhorou, substancialmente, as estatísticas de ajustes e precisão, mas os resíduos ficaram mais homogêneos e mais próximos de zero.

The study aimed to fit mathematical models for the construction of Site Index curves and to estimate heights at different ages for Eucalyptus grandis in the Campos Gerais region, Parana State. The data used to fit the models came from permanent, temporary plots and pre-harvesting inventory, covering ages from 2.5 to 26.5 years. Several models were tested to represent the sites and the hypsometric relationship. The Site Index curves were constructed by the guide-curve method. For the Site Index, the Chapman-Richards model showed the best fit and precision statistics, generating 5 Site Index curves (range of 5 m) with the Chapman-Richards model. The four hypsometric models tested showed satisfactory performance and similar statistics and the inclusion of the variables dominant height or site index did not substantially improve the goodness of fit statistics, but the residues were more homogeneous and closer to zero.