RESUMO: A mastite bovina é a doença mais impactante na indústria de laticínios e é caracterizada por uma complexidade de agentes causais, os quais têm revelado uma variação geográfica entre regiões e países. Os patógenos relacionados à mastite têm sido tradicionalmente classificados como contagiosos ou ambientais, com base na fonte de infecção ou origem e nas vias de transmissão. Além disso, a gravidade das infecções mamárias tem sido associada à virulência dos patógenos, e ao estado imunológico e nutricional dos animais. Considerando esse cenário, investigamos os agentes etiológicos, os escores de gravidade clínica e os dados de dias em lactação (DEL) em 4.273 casos clínicos de mastite bovina em dez fazendas de grande porte, quatro localizadas no sudoeste do estado de São Paulo e seis no sul do Estado de Minas Gerais, Brasil. Streptococcus dysgalactiae (283/4.273 = 6,6%), Escherichia coli (190/4.273 = 4,4%), Prototheca spp. (112/4.273 = 2,6%) e Streptococcus uberis (95/4.273 = 2,2%) foram os patógenos predominantes isolados. Entre os 4.273 casos clínicos, a pontuação de gravidade clínica estava disponível em 43,8% (1.871/4.273) dos animais. Desses, 69,8% (1.306/1.871), 27,3% (510/1.871) e 2,9% (55/1.871) foram classificados como leves, moderados e graves, respectivamente. Os patógenos foram observados principalmente em amostras obtidas durante os primeiros 100 dias em lactação, e a gravidade clínica foi principalmente classificada como leve. Nossos resultados contribuem para a identificação etiológica, a pontuação de gravidade clínica e os aspectos de ordenha de vacas com mastite em fazendas leiteiras com histórico de infecções mamárias clínicas. RESUMO causais países ambientais transmissão disso animais cenário etiológicos DEL (DEL 4273 4 273 4.27 porte Gerais Brasil 283/4.273 2834273 283 (283/4.27 6,6%, 66 6,6% , 6 6,6%) 190/4.273 1904273 190 (190/4.27 4,4%, 44 4,4% 4,4%) spp 112/4.273 1124273 112 (112/4.27 2,6% 26 2 95/4.273 954273 95 (95/4.27 2,2% 22 isolados 438 43 8 43,8 1.871/4.273 18714273 1 871 (1.871/4.273 Desses 698 69 69,8 1.306/1.871, 13061871 1.306/1.871 306 (1.306/1.871) 27 3 27,3 510/1.871 5101871 510 (510/1.871 29 9 2,9 55/1.871 551871 55 (55/1.871 leves graves respectivamente 10 leve etiológica clínicas 427 4.2 283/4.27 283427 28 (283/4.2 6,6 190/4.27 190427 19 (190/4.2 4,4 112/4.27 112427 11 (112/4.2 2,6 95/4.27 95427 (95/4.2 2,2 43, 1.871/4.27 1871427 87 (1.871/4.27 69, 1306187 1.306/1.87 30 (1.306/1.871 27, 510/1.87 510187 51 (510/1.87 2, 55/1.87 55187 5 (55/1.87 42 4. 283/4.2 28342 (283/4. 6, 190/4.2 19042 (190/4. 4, 112/4.2 11242 (112/4. 95/4.2 9542 (95/4. 1.871/4.2 187142 (1.871/4.2 130618 1.306/1.8 (1.306/1.87 510/1.8 51018 (510/1.8 55/1.8 5518 (55/1.8 283/4. 2834 (283/4 190/4. 1904 (190/4 112/4. 1124 (112/4 95/4. 954 (95/4 1.871/4. 18714 (1.871/4. 13061 1.306/1. (1.306/1.8 510/1. 5101 (510/1. 55/1. 551 (55/1. 283/4 (283/ 190/4 (190/ 112/4 (112/ 95/4 (95/ 1.871/4 1871 (1.871/4 1306 1.306/1 (1.306/1. 510/1 (510/1 55/1 (55/1 283/ (283 190/ (190 112/ (112 95/ (95 1.871/ 187 (1.871/ 130 1.306/ (1.306/1 510/ (510/ 55/ (55/ (28 (19 (11 (9 1.871 18 (1.871 13 1.306 (1.306/ (510 (55 (2 (1 ( 1.87 (1.87 1.30 (1.306 (51 (5 1.8 (1.8 1.3 (1.30 1. (1. (1.3

ABSTRACT: Bovine mastitis is the most impacting disease of dairy industry, and it is characterized by a complexity of causal agents, which have revealed a geographical variation among regions and countries. The mastitis-related pathogens have been traditionally classified as contagious or environmental, based on habits of the microorganisms and transmission routes. Besides, the severity of mammary infections has been associated with the virulence of the pathogens, and immune and nutritional status of the hosts. Considering this scenario, we investigated the etiological pattern, clinical severity scores, and days in milk (DIM) data in 4,273 clinical cases of bovine mastitis among ten large-dairy farms located in Brazil. Streptococcus dysgalactiae (283/4,273 = 6.6%), Escherichia coli (190/4,273 = 4.4%), Prototheca spp. (112/4,273 = 2.6%), and Streptococcus uberis (95/4,273 = 2.2%) were the predominant pathogens isolated. Among 4,273 clinical cases, clinical severity score was available in 43.8% (1,871/4,273) animals. From these, 69.8% (1,306/1,871), 27.3% (510/1,871), and 2.9% (55/1,871) were scored as mild, moderate, and severe, respectively. Pathogens were observed mainly in samples obtained during the first 100 days in milk, and clinical severity scored mainly as mild. Our results contributed to the etiological identification, clinical severity scoring, and milking aspects of mastitic cows in dairy farms with a history of clinical mammary infections. ABSTRACT industry agents countries mastitisrelated related environmental routes Besides hosts scenario pattern scores DIM (DIM 4273 4 273 4,27 largedairy large Brazil 283/4,273 2834273 283 (283/4,27 6.6%, 66 6.6% , 6 6.6%) 190/4,273 1904273 190 (190/4,27 4.4%, 44 4.4% 4.4%) spp 112/4,273 1124273 112 (112/4,27 2.6%, 26 2.6% 2 2.6%) 95/4,273 954273 95 (95/4,27 2.2% 22 isolated 438 43 8 43.8 1,871/4,273 18714273 1 871 (1,871/4,273 animals these 698 69 69.8 1,306/1,871, 13061871 1,306/1,871 306 (1,306/1,871) 27 3 27.3 510/1,871, 5101871 510/1,871 510 (510/1,871) 29 9 2.9 55/1,871 551871 55 (55/1,871 mild moderate severe respectively 10 identification scoring 427 4,2 283/4,27 283427 28 (283/4,2 6.6 190/4,27 190427 19 (190/4,2 4.4 112/4,27 112427 11 (112/4,2 2.6 95/4,27 95427 (95/4,2 2.2 43. 1,871/4,27 1871427 87 (1,871/4,27 69. 1306187 1,306/1,87 30 (1,306/1,871 27. 510187 510/1,87 51 (510/1,871 2. 55/1,87 55187 5 (55/1,87 42 4, 283/4,2 28342 (283/4, 6. 190/4,2 19042 (190/4, 4. 112/4,2 11242 (112/4, 95/4,2 9542 (95/4, 1,871/4,2 187142 (1,871/4,2 130618 1,306/1,8 (1,306/1,87 51018 510/1,8 (510/1,87 55/1,8 5518 (55/1,8 283/4, 2834 (283/4 190/4, 1904 (190/4 112/4, 1124 (112/4 95/4, 954 (95/4 1,871/4, 18714 (1,871/4, 13061 1,306/1, (1,306/1,8 5101 510/1, (510/1,8 55/1, 551 (55/1, 283/4 (283/ 190/4 (190/ 112/4 (112/ 95/4 (95/ 1,871/4 1871 (1,871/4 1306 1,306/1 (1,306/1, 510/1 (510/1, 55/1 (55/1 283/ (283 190/ (190 112/ (112 95/ (95 1,871/ 187 (1,871/ 130 1,306/ (1,306/1 510/ (510/1 55/ (55/ (28 (19 (11 (9 1,871 18 (1,871 13 1,306 (1,306/ (510/ (55 (2 (1 ( 1,87 (1,87 1,30 (1,306 (510 (5 1,8 (1,8 1,3 (1,30 (51 1, (1, (1,3

Abstract The surging health and financial costs of diseases, disabilities, and disparities support the global acceleration of interests and investments in health AI for better, cheaper, faster, and fairer health solutions globally and locally. Yet there is no consensus on practically operationalizing responsible AI principles across diverse global sectors, states, and belief systems. This proof-of-concept study utilizes the global pluralistic ethical framework (the Personalist Social Contract) to therefore provide the first known Bayesian augmented AI-driven Computational Ethical (AiCE) and policy analysis integrating clinical, cost effectiveness, and healthcare disparity analyses with nationally representative data to estimate the global cost of healthcare disparities in colonoscopy (CS) and the savings from AI-enabled CS to reduce them. It suggests that reversing racial disparities particularly for Hispanics and Asians may save American healthcare systems $17.61 billion annually, with AI-augmented CS potentially contributing savings of $625.40 million for Hispanics and $289.00 million for Asians in particular (with similar cost savings for vulnerable communities in middle and low-income countries also). The above findings support the cost savings imperative for such strategic and capacity-building investment in these AI-driven measures to improve healthcare’s strategic aims of Sustainability, Effectiveness, Efficiency, and Equity (SEEE). Such empirical results inform the larger global bioethical argument from the twin dimensions of human dignity and human security (rooted in the personalist, multicultural, and metaphysical account of the person as a member of the global human family) to highlight the AI ethical imperative to optimize the performance of the global digital health ecosystem. Such an instrumental end is a critical means of advancing toward the ultimate end of the common good, in which the individual good of each person is safeguarded and in which it finds her/his fulfillment working toward.

Resumen El aumento de los costos sanitarios y financieros de las enfermedades, las discapacidades y las disparidades respalda la aceleración mundial de los intereses y las inversiones en IA (inteligencia artificial) sanitaria para lograr soluciones sanitarias mejores, más baratas, más rápidas y justas a escala mundial y local. Sin embargo, no existe un consenso sobre la aplicación práctica de los principios de la IA responsable en diversos sectores, estados y sistemas de creencias de todo el mundo. Este estudio de prueba de concepto utiliza el marco ético pluralista global (el Contrato Social Personalista) para proporcionar, por tanto, el primer análisis conocido de ética computacional (AiCE, por sus siglas en inglés) y política basado en IA aumentada bayesiana que integra análisis clínicos, de rentabilidad y de disparidades en la atención sanitaria con datos representativos a nivel nacional para estimar el costo global de las disparidades en la atención sanitaria en la colonoscopia (CS, por sus siglas en inglés) y el ahorro de la CS habilitada por IA para reducirlas. El estudio sugiere que revertir las disparidades raciales, en particular entre hispanos y asiáticos, puede ahorrar a los sistemas sanitarios estadounidenses 17.610 millones de dólares al año, con un ahorro potencial de 625,40 millones de dólares para los hispanos y 289 millones de dólares para los asiáticos en particular (con un ahorro similar para las comunidades vulnerables en países de ingresos medios y bajos). Los resultados anteriores respaldan el imperativo de ahorro de costos que supone la inversión estratégica y de capacitación en estas medidas impulsadas por la IA para mejorar los objetivos estratégicos de sostenibilidad, eficacia, eficiencia y equidad (SEEE) de la atención sanitaria. Estos resultados empíricos informan el argumento bioético global más amplio de las dimensiones gemelas de la dignidad y la seguridad humanas (arraigadas en el relato personalista, multicultural y metafísico de la persona como miembro de la familia humana global) para destacar el imperativo ético de la IA para optimizar el rendimiento del ecosistema sanitario digital global. Semejante fin instrumental es un medio decisivo para avanzar hacia el fin último del bien común, en el que se salvaguarda el bien individual de cada persona y en el que éste encuentra su realización trabajando hacia él.

ABSTRACT Digital culture constitutes a set of practices, customs and forms of social interaction that are carried out from the resources of digital technologies such as the internet (Borges, 2019). Digital culture has transformed the forms of communication, jobs and artistic expressions. In the culture sector, this technological revolution has opened up endless opportunities for local artists, allowing them to transcend borders and bring their art to global audiences. However, not all nations have the same technological advances, nor development of skills for the use of ICT by their artists and people related to the culture sector. At present, nations such as Cuba, Dominica, Martinique and Haiti are working together in order to develop a training and professional education program in Digital Culture adapted to the characteristics of the Caribbean region. This program is called the “CL.AU.DI.A. - Antillean Digital Culture: Young artists are trained and promote digital culture in the Caribbean”. This paper aims to describe the CL.AU.DI.A project and its contribution to the internationalization of the training of artists in digital culture issues in the Caribbean region. In the paper, the management of the project is exposed in eight steps from its design to the future actions to be developed with it.

RESUMEN La cultura digital constituye un conjunto de prácticas, costumbres y formas de interacción social que se llevan a cabo a partir de los recursos de las tecnologías digitales como el internet. La cultura digital ha transformado las formas de comunicación, los empleos y las expresiones artísticas. En el sector de la cultura, esta revolución tecnológica ha abierto un sinfín de oportunidades para los artistas locales, permitiéndoles trascender fronteras y llevar su arte a audiencias globales. Sin embargo, no todas las naciones tienen los mismos adelantos tecnológicos, ni desarrollo de habilidades para el uso de las Tecnologías de la Información y las Telecomunicaciones por parte de sus artistas y personas relacionadas con el sector de la cultura. En la actualidad naciones como Cuba, Dominica, Martinica y Haití trabajan en conjunto con el fin de desarrollar un programa de formación y educación profesional en Cultura Digital adaptado a las características de la región del Caribe. Este programa se denomina proyecto “CL.AU.DI.A. - Cultura Digital Antillana: Jóvenes artistas se forman y promueven la cultura digital en el Caribe”. El presente artículo tiene como objetivo describir el proyecto CL.AU.DI.A y su contribución a la internacionalización de la formación de artistas en temas de cultura digital en la región del Caribe. En el artículo se expone en ocho pasos la gestión del proyecto desde su diseño hasta las acciones futuras a desarrollar con el mismo.

RESUMO Objetivo: Avaliar as doenças autoinflamatórias (DAI) de acordo com sexo e idade no momento do diagnóstico e a resposta terapêutica em uma grande população. Métodos: Este é um estudo observacional transversal de um registro latino-americano que usou um sistema de dados coletados entre 2015 e 2018. Quaisquer achados alterados ao longo do acompanhamento foram registrados. Os formulários foram traduzidos para os idiomas português e espanhol, incluindo características demográficas, clínicas, laboratoriais, genéticas e de tratamento. Resultados: Incluímos 152 pacientes, sendo 51,3% do sexo masculino e 75% da raça branca. A média de idade de início da doença foi de 2,1 anos (0–15,6 anos) e a média de idade de diagnóstico 6,9 anos (0–21,9 anos); 111 (73%) eram crianças (0–9 anos) e 41 (27%) adolescentes/adultos jovens (10–21 anos). A síndrome de febre periódica, estomatite aftosa, faringite e adenite (PFAPA) ocorreu em 46/152 (30%), osteomielite não bacteriana crônica (CNO) em 32/152 (21%) e febre familiar do Mediterrâneo (FMF) em 24/152 (15,7%). A PFAPA foi significativamente maior em crianças pequenas (38,7 vs. 7,3%, p<0,001), e a CNO, em adolescentes/adultos jovens (13,5 vs. 41,5%, p<0,001). A frequência do sexo feminino foi significativamente maior na CNO (28,4 vs. 14,1%, p=0,031) e menor na FMF (8,1 vs. 23,1%, p=0,011). Os medicamentos mais utilizados foram glicocorticoides, anti-inflamatórios não esteroidais (AINE) e colchicina. O tratamento com glicocorticoides e colchicina foi usado em todas as DAI com resposta boa a moderada. No entanto, as síndromes periódicas associadas à criopirina (CAPS) pareciam não responder aos glicocorticoides. AINE e metotrexato foram os principais medicamentos utilizados no tratamento da CNO. Conclusões: Diferenças de pacientes com DAI foram observadas na população latino-americana em pacientes agrupados por sexo e idade ao diagnóstico da doença. Objetivo (DAI Métodos latinoamericano latino americano 201 2018 registrados espanhol demográficas clínicas laboratoriais Resultados 15 513 51 3 51,3 75 branca 21 2 1 2, 0–15,6 0156 0 6 (0–15, 69 9 6, 0–21,9 0219 (0–21, 11 73% 73 (73% 0–9 09 (0– 4 27% 27 (27% adolescentesadultos adolescentes adultos 10–21 1021 10 (10–2 anos. . periódica aftosa (PFAPA 46152 46 46/15 30%, 30 30% , (30%) (CNO 32152 32 32/15 21% (21% (FMF 24152 24 24/15 15,7%. 157 15,7% 7 (15,7%) 38,7 387 38 (38, vs 7,3% p<0,001, p0001 p p<0,001 001 p<0,001) 13,5 135 13 5 (13, 415 41,5% p<0,001. 28,4 284 28 (28, 141 14 14,1% p=0,031 p0031 031 8,1 81 8 (8, 231 23 23,1% p=0,011. p0011 p=0,011 011 p=0,011) antiinflamatórios anti inflamatórios (AINE moderada entanto CAPS (CAPS Conclusões latinoamericana americana 20 51, 0–15, 015 (0–15 0–21, 021 (0–21 (73 0– (0 (27 10–2 102 (10– 4615 46/1 (30% 3215 32/1 (21 2415 24/1 15,7 (15,7% 38, (38 7,3 p000 p<0,00 00 13, (13 41,5 28, (28 14,1 p=0,03 p003 03 8, (8 23,1 p001 p=0,01 01 0–15 (0–1 0–21 02 (0–2 (7 ( (2 10– (10 461 46/ (30 321 32/ 241 24/ 15, (15,7 (3 7, p00 p<0,0 (1 41, 14, p=0,0 23, 0–1 0–2 (15, p0 p<0, p=0, (15 p<0 p=0 p< p=

ABSTRACT Objective: To evaluate autoinflammatory diseases (AID) according to age at diagnosis and sex, and response to therapy in a large population. Methods: This is a cross-sectional observational study of a Latin American registry using a designed web system for data storage, collected between 2015 and 2018. Any altered findings during follow-up were recorded. The forms were translated into Portuguese and Spanish, including demographic, clinical, laboratory, genetic and treatment characteristics. Results: We included 152 patients, 51.3% male and 75% Caucasian. The median age at disease onset was 2.1 years (0–15.6 years) and median age at diagnosis 6.9 years (0–21.9 years); 111 (73%) were children (0–9 years old), and 41 (27%) were adolescents and young adults (AYA) (10–21 years old). Periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome (PFAPA) occurred in 46/152 (30%), chronic non-bacterial osteomyelitis (CNO) in 32/152 (21%), and familial Mediterranean fever (FMF) in 24/152 (15.7%). PFAPA was significantly higher in young children than in AYA (38.7% vs. 7.3%, p<0.001), while CNO were lower (13.5% vs. 41.5%, p<0.001). The frequency of females was significantly higher in CNO (28.4% vs. 14.1%, p=0.031) and lower in FMF (8.1% vs. 23.1%, p=0.011). The most used drugs were glucocorticoids, non-steroidal anti-inflammatory drugs (NSAID), and colchicine. Glucocorticoids and colchicine treatment were used in all AID with good to moderate response. However, cryopyrin-associated periodic syndromes (CAPS) seemed unresponsive to glucocorticoids. NSAIDs and methotrexate were the main medications used to treat CNO. Conclusions: Differences among AID patients were observed in the LA population regarding sex and age at disease diagnosis. Objective (AID Methods crosssectional cross sectional storage 201 2018 followup follow up recorded Spanish demographic clinical laboratory characteristics Results 15 513 51 3 51.3 75 Caucasian 21 2 1 2. 0–15.6 0156 0 6 (0–15. 69 9 6. 0–21.9 0219 (0–21. 11 73% 73 (73% 0–9 09 (0– old, old , old) 4 27% 27 (27% (AYA 10–21 1021 10 (10–2 old. . stomatitis pharyngitis (PFAPA 46152 46 46/15 30%, 30 30% (30%) nonbacterial non bacterial (CNO 32152 32 32/15 21%, 21% (21%) (FMF 24152 24 24/15 15.7%. 157 15.7% 7 (15.7%) 38.7% 387 38 (38.7 vs 7.3% p<0.001, p0001 p p<0.001 001 p<0.001) 13.5% 135 13 5 (13.5 415 41.5% p<0.001. 28.4% 284 28 (28.4 141 14 14.1% p=0.031 p0031 031 8.1% 81 8 (8.1 231 23 23.1% p=0.011. p0011 p=0.011 011 p=0.011) glucocorticoids nonsteroidal steroidal antiinflammatory anti inflammatory NSAID, NSAID (NSAID) However cryopyrinassociated cryopyrin associated CAPS (CAPS Conclusions 20 51. 0–15. 015 (0–15 0–21. 021 (0–21 (73 0– (0 (27 10–2 102 (10– 4615 46/1 (30% 3215 32/1 (21% 2415 24/1 15.7 (15.7% 38.7 (38. 7.3 p000 p<0.00 00 13.5 (13. 41.5 28.4 (28. 14.1 p=0.03 p003 03 8.1 (8. 23.1 p001 p=0.01 01 (NSAID 0–15 (0–1 0–21 02 (0–2 (7 ( (2 10– (10 461 46/ (30 321 32/ (21 241 24/ 15. (15.7 38. (38 7. p00 p<0.0 13. (13 41. 28. (28 14. p=0.0 8. (8 23. 0–1 0–2 (1 (3 (15. p0 p<0. p=0. (15 p<0 p=0 p< p=

Abstract This paper presents the structuring dimensions of the CEP-Conep System in order to understand the actions promoted by the National Research Ethics Commission in response to demands for the processing and ethical analysis of research protocols related to COVID-19 in 2020. Based on CEP-Conep System public documents, an assessment of legislation, from 1988 to 2020, and its extension in terms of the number of Committees, users, and protocols, from 2012 to 2020 was presented. The minutes of Conep’s Ordinary Meetings (RO), for 2020, of a confidential nature, were analyzed, to verify adaptations to the pandemic. At the end of 2020, the System had 844 Committees, 854,741 users, and 701,791 analyzed protocols. The Commission centralized the analysis of COVID-19 protocols, in January 2020, and promoted three decentralizations, as more knowledge was generated, with vaccine protocols for COVID-19 remaining centralized. The history of the CEP-Conep System provided ballast for the adoption of management, educational and communication measures that accelerated the approval of protocols and made the process transparent. The absence of indicators made it impossible to evaluate the performance in 2020, which was apparently satisfactory.

Resumo O artigo apresenta dimensões estruturantes do Sistema CEP-Conep para compreender as ações promovidas pela Comissão Nacional de Ética em Pesquisa nas respostas às demandas de tramitação e análise ética de protocolos de pesquisa relativos à COVID-19 no ano de 2020. Foi elaborado estudo de caso a partir de documentos públicos do Sistema CEP-Conep, para evidenciar seu marco regulatório, de 1988 a 2020, e sua extensão em termos de quantidade de comitês, usuários e protocolos, de 2012 a 2020. Foram examinadas as atas das reuniões ordinárias (RO) da comissão, de 2020, de caráter sigiloso, para caracterizar as adaptações à pandemia. No final de 2020, o sistema contabilizava 844 comitês, 854.741 usuários, e 701.791 protocolos analisados. A comissão centralizou a análise de protocolos de COVID-19, em janeiro de 2020, e promoveu três descentralizações, à medida que mais conhecimento era gerado, permanecendo centralizados os protocolos de vacinas para COVID-19. O histórico do Sistema CEP-Conep proveu lastro para a adoção de medidas de gestão, educativas e de comunicação que aceleraram a apreciação de protocolos e deram transparência ao processo. A ausência de indicadores não permitiu avaliar a performance em 2020, aparentemente satisfatória.

Resumen: Los desastres provocan cambios en la morbilidad, mortalidad y en el uso de medicamentos. Brasil es líder en la producción de minerales con grandes costos ambientales. Los desechos mineros se almacenan en represas y las roturas de dichas represas han causado grandes desastres. Investigamos el consumo de medicamentos psicoactivos en municipios afectados por el desastre de la presa de Fundão, en Minas Gerais. Se realizó un estudio ecológico sobre el consumo de medicamentos, con base en datos de compras públicas y distribución en farmacias privadas minoristas de Minas Gerais. El consumo (en número de dosis diarias definidas/100.000 habitantes por día) se analizó descriptivamente en ocho municipios, estratificados según el nivel de consumo durante un período de 25 meses. Se realizaron seis comparaciones de los valores medios de consumo para los dos conjuntos de datos de los períodos anterior y posterior al desastre. Se calculó el consumo medio de medicamentos antes y después del evento y se añadieron las tendencias lineales. Los datos de compras públicas mostraron altos niveles de consumo. Solo el comercio minorista farmacéutico presentó diferencias significativas entre los estratos en el período anterior al desastre frente a dos períodos posteriores al desastre. Los municipios más pequeños presentaron un aumento en el consumo a partir del 15º mes después del desastre. El clonazepam lideró el consumo en el comercio minorista farmacéutico, seguido de la fluoxetina. Los medicamentos presentaron una tendencia al alza después del desastre. La elevada oferta pública puede haber afectado los patrones de consumo significativo de medicamentos psicoactivos; sin embargo, se observaron aumentos en el comercio privado, lo que sugiere cambios en los patrones de uso después del desastre. La disminución del consumo inmediatamente después del evento probablemente relacionada con un menor comportamiento de búsqueda de cuidados por parte de la población, y los aumentos significativos posteriores pueden reflejar las consecuencias económicas del desastre.

Abstract: Disasters cause changes in morbidity, mortality, and medicine use. Brazil is one of the main producers of mineral ores at great environmental cost. Mine tailings are stored in dams and ruptures have led to major disasters. We investigated the consumption of psychoactive medicines in the municipalities affected by the Fundão dam disaster in Minas Gerais State. An ecological study was carried out on drug consumption, estimated using public purchases in Minas Gerais and dispensing data from private retail pharmacies. Consumption (in number of defined daily doses/100,000 inhabitants per day) was analyzed descriptively in eight municipalities, stratified according to consumption level during a 25-month period. Six comparisons of mean consumption values for both data sets were done for pre- and post-disaster periods. The means of medicine consumption before and after the event were plotted and linear trends were added. Public purchase data evinced high consumption levels. Only pharmaceutical retail showed significant differences between the strata in the pre-disaster versus two post-disaster periods. Smaller municipalities showed an increase in consumption 15 months after the disaster. Clonazepam led the way in pharmaceutical retail consumption, followed by fluoxetine. Medicines showed an upward trend after the disaster. The high public provision may have stifled significant consumption patterns of psychoactive drugs; however, peak consumption were observed in private retail, suggesting a modification in use patterns after the disaster. The decrease in consumption immediately after the event was probably related to lower care-seeking behavior on the part of the population, and significant peaks after the disaster may reflect economic consequences of it.

Resumo: Os desastres provocam alterações na morbidade, mortalidade e no uso de medicamentos. O Brasil é líder na produção de minérios com grande custo ambiental. Os rejeitos de mineração são armazenados em barragens e as rupturas dessas barragens têm causados grandes desastres. Investigamos o consumo de medicamentos psicoativos em municípios atingidos pelo desastre da Barragem de Fundão, em Minas Gerais. Foi realizado um estudo ecológico sobre o consumo de medicamentos, com base em dados de compras públicas e distribuição de farmácias privadas do varejo de Minas Gerais. O consumo (em número de doses diárias definidas/100 mil habitantes por dia) foi analisado descritivamente em oito municípios, estratificados segundo o nível de consumo durante um período de 25 meses. Foram feitas seis comparações de valores médios de consumo para os dois conjuntos de dados dos períodos pré- e pós-desastre. Foram calculadas as médias de consumo de medicamentos antes e depois do evento e adicionadas tendências lineares. Os dados de compras públicas mostraram elevados níveis de consumo. Apenas o varejo farmacêutico apresentou diferenças significativas entre os estratos no período pré-desastre versus dois períodos pós-desastre. Municípios menores apresentaram aumento no consumo a partir do 15º mês após o desastre. Clonazepam liderou o consumo no varejo farmacêutico, seguido pela fluoxetina. Os medicamentos apresentaram tendência de alta após o desastre. A elevada oferta pública pode ter afetado os padrões de consumo significativo de medicamentos psicoativos; no entanto, foram observados aumentos no comércio privado, sugerindo alterações nos padrões de uso após o desastre. A diminuição do consumo imediatamente após o evento estava provavelmente relacionada a um menor comportamento de procura de cuidados por parte da população e os aumentos significativos posteriores podem refletir as consequências econômicas do desastre.

ABSTRACT Currently, there are some concerns about the situation and, in particular, about the future of the COVID-19 pandemic and the new emerging variants of SARS-CoV-2. Rodents are an example of synanthropic animals in urban environments that harbor important zoonoses. Although the molecular identification of SARS-CoV-2 in Rattus norvegicus from New York City had been reported, in other studies, urban wild rodents infected with this virus have not been found. This study aimed to molecularly identify the presence of SARS-CoV-2 in urban wild rodents from Mexico City, trapped along a water channel of a public park as part of a pest control program, at the beginning of the COVID-19 pandemic, during the fall and winter of 2020. Up to 33 Mus musculus and 52 R. norvegicus were captured and euthanized, large intestine samples with feces from the animals were obtained. RNAs were obtained and subjected to qRT-PCR for SARS-CoV-2 identification and threshold cycle (Ct) values were obtained. Four mice (12.1%) and three rats (5.8%) were positive, three rodents exhibited Ct<30. Our results on the frequency of SARS-CoV-2 in urban rats are in line with other previous reports. Thus, similar to other authors, we suggest that surveillance for the detection of SARS-CoV-2 in urban wild rodents, as sentinel animals, should be maintained. Currently particular COVID19 COVID 19 COVID-1 SARSCoV2. SARSCoV2 SARSCoV SARS CoV 2. 2 zoonoses SARS-CoV- reported studies found program 2020 3 5 R euthanized qRTPCR qRT PCR Ct (Ct 12.1% 121 12 1 (12.1% 5.8% 58 8 (5.8% positive Ct30 30 Ct<30 reports Thus authors maintained COVID1 COVID- SARS-CoV 202 12.1 (12.1 5.8 (5.8 Ct3 Ct<3 20 12. (12. 5. (5. Ct< (12 (5 (1 (

Abstract Difficult airway management in pediatrics during anesthesia represents a major challenge, requiring a careful approach, advanced technical expertise, and accurate protocols. The task force of the Brazilian Society of Anesthesiology (SBA) presents a report containing updated recommendations for the management of difficult airways in children and neonates. These recommendations have been developed based on the consensus of a panel of experts, with the objective of offering strategies to overcome challenges during airway management in pediatric patients. Grounded in evidence published in international guidelines and expert opinions, the report highlights crucial steps for the appropriate management of difficult airways in pediatrics, encompassing assessment, preparation, positioning, pre-oxygenation, minimizing trauma, and, paramountly, the maintenance of arterial oxygenation. The report also delves into additional strategies involving the use of advanced tools, such as video laryngoscopy, flexible intubating bronchoscopy, and supraglottic devices. Emphasis is placed on the simplicity of implementing the outlined recommendations, with a focus on the significance of continuous education, training through realistic simulations, and familiarity with the latest available technologies. These practices are deemed essential to ensure procedural safety and contribute to the enhancement of anesthesia outcomes in pediatrics. challenge approach expertise protocols SBA (SBA neonates experts patients opinions assessment preparation positioning preoxygenation, preoxygenation pre oxygenation, oxygenation pre-oxygenation trauma paramountly tools laryngoscopy bronchoscopy devices education simulations technologies

ABSTRACT This study aimed to analyze the economic viability of the implementation of a mechanized harvesting of broilers where the activity is carried out entirely manually. The viability indicators used were net present value (NPV), net future value (NFV), net uniform value (NUV), discounted payback (DP), and internal rate of return (IRR). Scenario analysis, sensitivity, and Monte Carlo simulation were performed in the present study. The results showed that the initial investment was US$ 1,868,302.76. The average price paid by the slaughterhouse to third-party manual harvesting companies was US$ 18.17 per thousand broilers, which was converted into revenue in the cash flow of the project. The cash flow result was positive at US$ 22,256.14 over the entire study period considering a daily catch of 144 thousand broilers. The results of the economic viability analysis were NPV of US$ 64,786.23, NFV of US$ 333,382.11, NUV of US$ 735.19, DP of 13.82 years, IRR of 0.965 monthly, and modified IRR of 0.933 monthly. These values prove the economic viability of implementing the project considering the market conditions at the time of the study. The analysis of scenarios showed great sensitivity to the exchange rate and the price of fuels. The Monte Carlo simulation highlighted a moderate risk of negative NPV, emphasizing the importance of considering this variable when making decisions. Despite these challenges, the potential benefits of mechanized harvesting, such as increased efficiency and reduced labor costs, make it a promising alternative to manual harvesting, even for small to medium-sized poultry industries. manually , (NPV) NFV, (NFV) NUV, (NUV) DP, (DP) IRR. . (IRR) US 186830276 1 868 302 76 1,868,302.76 thirdparty third party 1817 18 17 18.1 2225614 22 256 14 22,256.1 6478623 64 786 23 64,786.23 33338211 333 382 11 333,382.11 73519 735 19 735.19 1382 13 82 13.8 years 0965 0 965 0.96 monthly 0933 933 0.93 fuels decisions challenges costs mediumsized medium sized industries (NPV (NFV (NUV (DP (IRR 18683027 86 30 7 1,868,302.7 181 18. 222561 2 25 22,256. 647862 6 78 64,786.2 3333821 33 38 333,382.1 7351 73 735.1 138 8 13. 096 96 0.9 093 93 1868302 3 1,868,302. 22256 22,256 64786 64,786. 333382 333,382. 735. 09 9 0. 186830 1,868,302 2225 22,25 6478 64,786 33338 333,382 18683 1,868,30 222 22,2 647 64,78 3333 333,38 1868 1,868,3 22, 64,7 333,3 186 1,868, 64, 333, 1,868 1,86 1,8 1,

Abstract The aim of this study was to investigate the effect of acid challenge on the activation of matrix metalloproteinases (MMPs) in the Dentinoenamel junction of primary and permanent teeth submitted to radiotherapy. For this purpose, a total of 178 dental fragments obtained from molars were used, and randomly divided into 2 groups (primary and permanent teeth) / 4 experimental subgroups (irradiated and non-irradiated, demineralized and non-demineralized). The fragments were exposed to radiation, with a dose fraction of 2 Gy, for 5 consecutive days, until a total dose of 60 Gy was reached, with a total of 30 cycles, for 6 weeks. To determine the activity of MMPs on the dentinoenamel junction (DEJ), in situ zymography assays on 0.6mm dental fragments were performed. To assess whether MMP activity would be impacted by an acidic environment, the fragments were placed in a demineralizing solution (pH of 4.8). The finding was that irradiation activated MMPs in DEJ and these effects were more evident in permanent when compared with primary teeth. When the effect of an acid challenge on MMPs activity was investigated, demineralization was observed not to increase MMPs activity in non-irradiated teeth, but it did increase MMPs activity in irradiated teeth. In conclusion, an acid challenge was found to exacerbate activation of MMPs in DEJ of permanent teeth submitted to irradiation, but not in primary teeth. (MMPs radiotherapy purpose 17 used nonirradiated, nonirradiated non irradiated, nondemineralized. nondemineralized . non-demineralized) radiation days reached 3 cycles weeks DEJ, , (DEJ) 06mm mm 0 6mm performed environment pH 4.8. 48 4.8 8 4.8) investigated conclusion 1 non-demineralized (DEJ 4.

RESUMO Objetivo: Comparar a eficácia da posição prona consciente nos desfechos clínicos relevantes em pacientes com insuficiência respiratória aguda relacionada à COVID-19 que necessitaram de oxigênio nasal de alto fluxo em diferentes ondas da doença na Argentina. Métodos: Trata-se de estudo de coorte prospectivo e multicêntrico, que incluiu pacientes adultos com insuficiência respiratória aguda relacionada à COVID-19 que necessitaram de oxigênio nasal de alto fluxo. A principal posição de exposição foi a prona consciente (≥ 6 horas/dia) em comparação com a prona não consciente. O desfecho primário foi a intubação endotraqueal, e o secundário foi a mortalidade hospitalar. Utilizou-se o escore de propensão de ponderação pela probabilidade inversa para ajustar a probabilidade condicional de atribuição de tratamento. Em seguida, ajustamos as variáveis contextuais, que variaram ao longo do tempo e comparamos a eficácia entre a primeira e a segunda onda. Resultados: Ao todo, 728 pacientes foram incluídos: 360 durante a primeira onda e 368 durante a segunda onda, dos quais 195 (54%) e 227 (62%) permaneceram em prona consciente numa mediana (intervalo interquatil 25 - 75%) de 12 (10 - 16) e 14 (8 - 17) horas/dia, respectivamente (Grupo Prona Consciente). As razões de chance (intervalo de confiança de 95%) de intubação endotraqueal no grupo prona em vigília foram de 0,25 (0,13 - 0,46) e 0,19 (0,09 - 0,31) na primeira e segunda ondas, respectivamente (p = 0,41 comparativamente entre as ondas). As razões de chance de mortalidade intra-hospitalar na posição prona consciente foram de 0,35 (0,17 - 0,65) e 0,22 (0,12 - 0,43), respectivamente (p = 0,44 comparativamente entre as ondas). Conclusão: A posição prona consciente foi associada à redução no risco de intubação endotraqueal e mortalidade hospitalar. Esses efeitos foram independentes do contexto em que a intervenção foi aplicada e não foram observadas diferenças entre as diferentes ondas. Objetivo COVID19 COVID 19 COVID-1 Argentina Métodos Tratase Trata se multicêntrico ≥ ( horas/dia horasdia horas dia hospitalar Utilizouse Utilizou tratamento seguida contextuais Resultados todo 72 incluídos 36 54% 54 (54% 22 62% 62 (62% intervalo 2 75% 75 1 10 (1 16 8 17 Grupo Consciente. Consciente . Consciente) 95% 95 025 0 0,2 0,13 013 13 (0,1 0,46 046 46 019 0,1 0,09 009 09 (0,0 0,31 031 31 p 041 41 0,4 ondas) intrahospitalar intra 035 35 0,3 0,17 017 0,65 065 65 022 0,12 012 0,43, 043 0,43 , 43 0,43) 044 44 Conclusão COVID1 COVID- 7 3 5 (54 (62 9 02 0, 01 (0, 04 4 0,0 00 03 0,6 06 (5 (6 (0

ABSTRACT Objective: To compare the effectiveness of the awake-prone position on relevant clinical outcomes in patients with COVID-19-related acute respiratory failure requiring high-flow nasal oxygen between different waves in Argentina. Methods: This multicenter, prospective cohort study included adult patients with COVID-19-related acute respiratory failure requiring high-flow nasal oxygen. The main exposure position was the awake-prone position (≥ 6 hours/day) compared to the non-prone position. The primary outcome was endotracheal intubation, and the secondary outcome was in-hospital mortality. The inverse probability weighting–propensity score was used to adjust the conditional probability of treatment assignment. We then adjusted for contextual variables that varied over time and compared the effectiveness between the first and second waves. Results: A total of 728 patients were included: 360 during the first wave and 368 during the second wave, of whom 195 (54%) and 227 (62%) remained awake-prone for a median (p25 - 75) of 12 (10 - 16) and 14 (8 - 17) hours/day, respectively (Awake-Prone Position Group). The ORs (95%CIs) for endotracheal intubation in the Awake-Prone Position Group were 0.25 (0.13 - 0.46) and 0.19 (0.09 - 0.31) for the first and second waves, respectively (p = 0.41 for comparison between waves). The ORs for in-hospital mortality in the awake-prone position were 0.35 (0.17 - 0.65) and 0.22 (0.12 - 0.43), respectively (p = 0.44 for comparison between waves). Conclusion: The awake-prone position was associated with a reduction in the risk of endotracheal intubation and in-hospital mortality. These effects were independent of the context in which the intervention was applied, and no differences were observed between the different waves. Objective awakeprone awake prone COVID19related COVIDrelated COVID 19 related highflow high flow Argentina Methods multicenter ≥ ( hours/day hoursday hours day nonprone non inhospital hospital weightingpropensity weighting propensity assignment Results 72 36 54% 54 (54% 22 62% 62 (62% p25 p (p2 75 1 10 (1 16 8 17 AwakeProne Awake Prone Group. . Group) 95%CIs 95CIs CIs 95 (95%CIs 025 0 25 0.2 0.13 013 13 (0.1 0.46 046 46 019 0.1 0.09 009 09 (0.0 0.31 031 31 041 41 0.4 waves) 035 35 0.3 0.17 017 0.65 065 65 022 0.12 012 0.43, 043 0.43 , 43 0.43) 044 44 Conclusion applied 7 3 5 (54 2 (62 p2 9 02 0. 01 (0. 04 4 0.0 00 03 0.6 06 (5 (6 (0

BACKGROUND Strigomonas culicis is a monoxenic trypanosomatid parasite of insects that naturally contains an endosymbiotic bacterium. The aposymbiotic strain can be obtained, making this strain a model for evolutive research about organelle origins. In addition, S. culicis contains homologues of virulence factors of pathogenic trypanosomatids, which functions are waiting for further analysis. In this sense, the publication of S. culicis proteome makes feasible additional investigations regarding the differential expression of peptidases from the wild-type (WT) and the aposymbiotic (APO) strains. OBJECTIVES Here, we analysed two proteomic data from S. culicis WT and APO strains screening for peptidases differentially expressed and assessed the differential expression of cysteine and metallopeptidases. METHODS A comparative proteomic screening between WT and APO identified 43 modulated peptidases. FINDINGS Cysteine and metallopeptidases, such as calpains and GP63, were the major classes, highlighting their significance. GP63 exhibited an increased proteolysis in a specific metallopeptidase substrate, an up-modulation gene expression in RT-PCR, and a higher protein identification by flow cytometry in the aposymbiotic strain. Notwithstanding, the wild-type strain showed enhanced cysteine peptidase activity. MAIN CONCLUSION Our study highlighted the endosymbiont influence in S. culicis peptidase expression, with GP63 expression and activity raised in the aposymbiotic strain, whereas cysteine peptidase levels were reduced. bacterium obtained origins addition S trypanosomatids analysis sense wildtype wild type (WT (APO Here metallopeptidases 4 GP classes significance GP6 substrate upmodulation up modulation RTPCR, RTPCR RT PCR, PCR RT-PCR Notwithstanding reduced

Resumo O artigo apresenta dimensões estruturantes do Sistema CEP-Conep para compreender as ações promovidas pela Comissão Nacional de Ética em Pesquisa nas respostas às demandas de tramitação e análise ética de protocolos de pesquisa relativos à COVID-19 no ano de 2020. Foi elaborado estudo de caso a partir de documentos públicos do Sistema CEP-Conep, para evidenciar seu marco regulatório, de 1988 a 2020, e sua extensão em termos de quantidade de comitês, usuários e protocolos, de 2012 a 2020. Foram examinadas as atas das reuniões ordinárias (RO) da comissão, de 2020, de caráter sigiloso, para caracterizar as adaptações à pandemia. No final de 2020, o sistema contabilizava 844 comitês, 854.741 usuários, e 701.791 protocolos analisados. A comissão centralizou a análise de protocolos de COVID-19, em janeiro de 2020, e promoveu três descentralizações, à medida que mais conhecimento era gerado, permanecendo centralizados os protocolos de vacinas para COVID-19. O histórico do Sistema CEP-Conep proveu lastro para a adoção de medidas de gestão, educativas e de comunicação que aceleraram a apreciação de protocolos e deram transparência ao processo. A ausência de indicadores não permitiu avaliar a performance em 2020, aparentemente satisfatória. CEPConep CEP Conep COVID19 COVID 19 COVID-1 2020 CEPConep, Conep, regulatório 198 comitês 201 RO (RO sigiloso pandemia 84 854741 854 741 854.74 701791 701 791 701.79 analisados COVID19, 19, descentralizações gerado COVID19. 19. gestão processo satisfatória COVID1 1 COVID- 202 20 8 85474 85 74 854.7 70179 70 79 701.7 2 8547 7 854. 7017 701.

Abstract This paper presents the structuring dimensions of the CEP-Conep System in order to understand the actions promoted by the National Research Ethics Commission in response to demands for the processing and ethical analysis of research protocols related to COVID-19 in 2020. Based on CEP-Conep System public documents, an assessment of legislation, from 1988 to 2020, and its extension in terms of the number of Committees, users, and protocols, from 2012 to 2020 was presented. The minutes of Conep’s Ordinary Meetings (RO), for 2020, of a confidential nature, were analyzed, to verify adaptations to the pandemic. At the end of 2020, the System had 844 Committees, 854,741 users, and 701,791 analyzed protocols. The Commission centralized the analysis of COVID-19 protocols, in January 2020, and promoted three decentralizations, as more knowledge was generated, with vaccine protocols for COVID-19 remaining centralized. The history of the CEP-Conep System provided ballast for the adoption of management, educational and communication measures that accelerated the approval of protocols and made the process transparent. The absence of indicators made it impossible to evaluate the performance in 2020, which was apparently satisfactory. CEPConep CEP Conep COVID19 COVID 19 COVID-1 documents legislation 198 Committees users 201 202 presented Coneps s RO, RO , (RO) nature pandemic 84 854741 854 741 854,74 701791 701 791 701,79 decentralizations generated management transparent satisfactory COVID1 1 COVID- 20 (RO 8 85474 85 74 854,7 70179 70 79 701,7 2 8547 7 854, 7017 701,

Abstract Objective To adapt the Scale of Perception of Respect for and Maintenance of the Dignity of the Inpatient (CuPDPH) to the Brazilian language and culture and to assess its psychometric properties. Results The scale was evaluated by 15 experts, and 239 patients from three tertiary hospitals in Rio de Janeiro. All participants signed a consent form. Data have shown adequacy of the model (KMO=0.839, Bartlett's test of sphericity: χ2(171) = 2241.3, p = 0.000010), good adjusted content validity (CVCa ≥ 0.90), internal consistency and reliability, such as α = 0.927. Discussion CuPDPH is a rating scale on observable professional attitudes. Illnesses change lives and impose adaptation to a new situation, perceived as depersonalization, leading patients to try to regain control of their lives. Patients expressed “ill will” to fill out the scale. Psychiatric patients’ scale filling time was higher than others. A sample from three Rio de Janeiro third-level hospitals may not reflect the country's population; also, this adaptation may not comprise all linguistic variations of Brazilian Portuguese and Portuguese-speaking countries. Conclusion The Portuguese version of the Scale of Perception of Respect for and Maintenance of the Dignity of the Inpatient (CuPDPH), a 19-item, six-component version is a reliable instrument to measure the perception of internal medicine, surgical, and psychiatric patients on the maintenance of their dignity in Rio de Janeiro, Brazil. This knowledge could be used in advancing research on patients’ perception of dignity, as well as professional ethical competencies, staff-patient relationship skills, and leadership development in medical and other healthcare professional education. (CuPDPH properties 1 experts 23 form KMO=0.839, KMO0839 KMO 0 839 (KMO=0.839 Bartletts Bartlett s sphericity χ2171 χ χ2 171 χ2(171 22413 2241 3 2241.3 0.000010, 0000010 0.000010 , 000010 0.000010) CVCa 0.90, 090 0.90 90 0.90) reliability 0927 927 0.927 attitudes situation depersonalization ill will others thirdlevel third level countrys country population also Portuguesespeaking speaking countries CuPDPH, 19item, 19item item 19 item, 19-item sixcomponent six component medicine surgical Brazil competencies staffpatient staff patient skills education 2 KMO=0.839 KMO083 83 (KMO=0.83 χ217 17 χ2(17 224 2241. 000001 0.00001 00001 09 0.9 9 092 92 0.92 KMO=0.83 KMO08 8 (KMO=0.8 χ21 χ2(1 22 00000 0.0000 0000 0. KMO=0.8 KMO0 (KMO=0. χ2( 0.000 000 KMO=0. (KMO=0 0.00 00 KMO=0 (KMO= 0.0 KMO= (KMO