Abstract Background: Duchenne Muscular Dystrophy (DMD) is a rare inherited neuromuscular disease. At first, cardiac involvement may be asymptomatic. Therefore, assessing patients using non-invasive methods can help detect any changes. Objectives: Analyze the electrocardiogram (ECG) test and heart rate variability (HRV) of the DMD group and compare the information with that of the age-matched control group. Methods: A prospective study with 27 male patients with DMD (11.9 years old), who underwent clinical evaluation, ECG, echocardiogram, and Holter monitoring. ECG (200% increase) was assessed by two independent observers. HRV was measured over time (24 h) and in the frequency domain, in the supine and sitting positions. The healthy group consisted of nine patients (11.0 years old). A value of p < 0.05 was considered statistically significant. Results: The mean ejection fraction (EF) was 60% (34 to 71%). The Kappa coefficient for ECG measurements ranged from 0.64 to 1.00. An increase in the R/S ratio in V1 was observed in 25.9% of the subjects, pathological Q wave in 29.6%, and fragmented QRS in 22.2% in inferior/high lateral regions, with a negative correlation with EF (p = 0.006). There was low HRV, without the influence of any variable, including treatment. With the change in position, there was an increase in HR (p = 0.004), but there was no change in HRV. The LF/HF ratio was 2.7 in the DMD group and 0.7 in the control group (p = 0.002). Conclusions: In DMD subjects, prominent R waves in V1 and changes in the inferior/high lateral regions occurred in almost 30% of the cases. Lower vagal tone was observed without the influence of the variables age, ejection fraction, QT dispersion, and treatment. Despite the increase in HR, there was no adequate HRV response to the change in position. Background (DMD disease first asymptomatic Therefore noninvasive non invasive Objectives (ECG (HRV agematched age matched Methods 2 11.9 119 11 9 (11. old, old , old) evaluation echocardiogram monitoring 200% 200 (200 observers 24 (2 h domain positions 11.0 110 0 old. . 005 05 0.0 significant Results (EF 60 34 (3 71%. 71 71% 71%) 064 64 0.6 100 1 00 1.00 RS S V 259 25 25.9 subjects 296 29 6 29.6% 222 22 22.2 inferiorhigh inferior high 0.006. 0006 0.006 006 0.006) variable treatment position 0.004, 0004 0.004 004 0.004) LFHF LF HF 7 2. 07 0. 0.002. 0002 0.002 002 0.002) Conclusions 30 cases dispersion 11. (11 20 (20 ( 3 06 10 1.0 25. 29.6 22. 000 0.00 (1 1. 29.

Resumo Fundamento: Distrofia Muscular de Duchenne (DMD) é uma doença neuromuscular hereditária rara. O acometimento cardíaco inicial pode ser assintomático. Portanto, a avaliação por métodos não invasivos pode auxiliar sua abordagem. Objetivos: Analisar o eletrocardiograma (ECG) e a variabilidade da frequência cardíaca (VFC) do grupo com DMD, e comparar com a do grupo controle pareado por idade. Métodos: Estudo prospectivo com 27 pacientes masculinos com DMD (idade de 11,9 anos) que foram submetidos à avaliação clínica, ECG, ecocardiograma e Holter. ECG (aumento de 200%) foi avaliado por dois observadores independentes. VFC foi feita no domínio do tempo (24 h) e da frequência na posição supina e sentada. O grupo saudável foi de nove pacientes (11,0 anos). Um valor de p < 0,05 foi considerado estatisticamente significante. Resultados: A média da fração de ejeção (FE) foi de 60% (34 a 71%). O coeficiente de Kappa para as medidas do ECG variou de 0,64 a 1,00. Foram verificados aumento da relação R/S em V1 em 25,9%, onda Q patológica em 29,6% e QRS fragmentado em 22,2% em regiões inferior/lateral alta, este com correlação negativa com FE (p = 0,006). Houve baixa VFC, sem influência de nenhuma variável, inclusive tratamento. Com a mudança da posição, houve aumento da FC (p = 0,004), porém não houve alteração da VFC. A relação LF/HF foi de 2,7 na DMD e de 0,7 no controle (p = 0,002). Conclusões: Nos participantes com DMD, as ondas R proeminentes em V1 e alterações nas regiões inferior/lateral alta ocorreram em quase 30% dos casos. Houve menor tônus vagal sem influência das variáveis idade, fração de ejeção, dispersão do QT e tratamento. Apesar do aumento da FC, não houve resposta adequada da VFC com a mudança de posição. Fundamento (DMD rara assintomático Portanto abordagem Objetivos (ECG (VFC idade Métodos 2 119 11 9 11, anos clínica Holter 200% 200 independentes 24 (2 h sentada 11,0 110 0 (11, anos. . 005 05 0,0 significante Resultados (FE 60 34 (3 71%. 71 71% 71%) 064 64 0,6 100 1 00 1,00 RS S V 259 25 25,9% 296 29 6 29,6 222 22 22,2 inferiorlateral inferior lateral 0,006. 0006 0,006 006 0,006) variável tratamento 0,004, 0004 0,004 , 004 0,004) LFHF LF HF 7 2, 07 0, 0,002. 0002 0,002 002 0,002) Conclusões 30 casos 20 ( (11 3 06 10 1,0 25,9 29, 22, 000 0,00 (1 1, 25,

Abstract Background: Vasovagal syncope (VVS) results in impaired quality of life (QoL). The response during the head-up tilt test (HUTT) influences QoL and recurrence. Objectives: To analyze the influence of the type of HUTT response on QoL in patients with VVS and recurrence of events after the exam. Methods: The SF-36 and Impact of Syncope on Quality of Life (ISQL) questionnaires were applied over 12 months after the HUTT. Unpaired Student's t test was used for differences between 2 groups of quantitative data with normal distribution. The recurrence of syncope episodes was analyzed using a Kaplan-Meier curve, and the log-rank test was applied to compare the curves regarding responses to the HUTT. Statistical significance was set at p value < 0.05. Results: We analyzed 82 patients (43.7 years old), 69% with previous recurrence (2.8 prior episodes). Cardioinhibitory response occurred in 46 patients; vasodepressor response occurred in 36, and 85.4% of patients received non-pharmacological treatment after the HUTT. During clinical follow-up, 43.9% had recurrence, mainly young patients (35.7 years; p = 0.002). On the SF-36, the best score was in functional capacity in men (p = 0.04) and patients without prior trauma (p = 0.001). There were lower limitations due to pain in patients without prior trauma (p = 0.003) and patients without prodromes (p = 0.009). On the ISQL, there were better mean scores in men (p = 0.002) and in patients without prior trauma (p = 0.02). Patients with cardioinhibitory response had better SF-36 and ISQL scores (p < 0.001). There was greater VVS recurrence in the cardioinhibitory response group (log-rank p = 0.011; hazard ratio: 8.48; 95% confidence interval: 7.59 to 9.3) from the second to the fourth month, with stabilization in the eighth month after the HUTT, when compared to patients with vasodepressor response. Conclusion: The majority of patients with VVS reproduced during the HUTT under non-pharmacological treatment did not report worsening of QoL during clinical follow-up. Worse QoL was observed in non-young patients and in patients with vasodepressor response, and it was not influenced by recurrence after the HUTT. Background (VVS QoL. . (QoL) headup head up (HUTT Objectives exam Methods SF36 SF 36 SF-3 (ISQL 1 Students Student s distribution KaplanMeier Kaplan Meier curve logrank log rank 005 0 05 0.05 Results 8 43.7 437 43 7 (43. old, old , old) 69 2.8 28 (2. episodes. episodes) 4 854 85 85.4 nonpharmacological non pharmacological followup, followup follow up, follow-up 439 9 43.9 35.7 357 35 (35. 0.002. 0002 0.002 002 SF36, 0.04 004 04 0.001. 0001 0.001 001 0.001) 0.003 0003 003 0.009. 0009 0.009 009 0.009) 0.02. 0.02 02 0.02) 0.011 0011 011 ratio 8.48 848 48 95 interval 759 59 7.5 9.3 93 3 Conclusion followup. up. nonyoung (QoL SF3 SF- 00 0.0 43. (43 6 2. (2 85. 35. (35 000 0.00 0.01 01 8.4 84 75 5 7. 9. 0. (4 ( (3 8.

ABSTRACT Introduction: Along with cardiopulmonary bypass time, aortic cross-clamping time is directly related to the risk of complications after heart surgery. The influence of the time difference between cardiopulmonary bypass and cross-clamping times (TDC-C) remains poorly understood. Objective: To assess the impact of cardiopulmonary bypass time in relation to cross-clamping time on immediate results after coronary artery bypass grafting in the Registro Paulista de Cirurgia Cardiovascular (REPLICCAR) II. Methods: Analysis of 3,090 patients included in REPLICCAR II database was performed. The Society of Thoracic Surgeons outcomes were evaluated (mortality, kidney failure, deep wound infection, reoperation, cerebrovascular accident, and prolonged ventilation time). A cutoff point was adopted, from which the increase of this difference would affect each outcome. Results: After a cutoff point determination, all patients were divided into Group 1 (cardiopulmonary bypass time < 140 min., TDC-C < 30 min.), Group 2 (cardiopulmonary bypass time < 140 min., TDC-C > 30 min.), Group 3 (cardiopulmonary bypass time > 140 min., TDC-C < 30 min.), and Group 4 (cardiopulmonary bypass time > 140 min., TDC-C > 30 min.). After univariate logistic regression, Group 2 showed significant association with reoperation (odds ratio: 1.64, 95% confidence interval: 1.01-2.66), stroke (odds ratio: 3.85, 95% confidence interval: 1.99-7.63), kidney failure (odds ratio: 1.90, 95% confidence interval: 1.32-2.74), and in-hospital mortality (odds ratio: 2.17, 95% confidence interval: 1.30-3.60). Conclusion: TDC-C serves as a predictive factor for complications following coronary artery bypass grafting. We strongly recommend that future studies incorporate this metric to improve the prediction of complications. Introduction crossclamping cross clamping surgery TDCC TDC C (TDC-C understood Objective (REPLICCAR Methods 3090 090 3,09 performed mortality, (mortality infection accident time. . time) adopted outcome Results determination 14 min min. , min.) min.. regression odds ratio 164 64 1.64 95 interval 1.012.66, 101266 1.01 2.66 01 66 1.01-2.66) 385 85 3.85 1.997.63, 199763 1.99 7.63 99 7 63 1.99-7.63) 190 90 1.90 1.322.74, 132274 1.32 2.74 32 74 1.32-2.74) inhospital hospital 217 17 2.17 1.303.60. 130360 1.30 3.60 60 1.30-3.60) Conclusion 309 09 3,0 16 6 1.6 9 012 1.012.66 10126 101 1.0 266 2.6 0 1.01-2.66 38 8 3.8 997 1.997.63 19976 199 1.9 763 7.6 1.99-7.63 19 322 1.322.74 13227 132 1.3 274 2.7 1.32-2.74 21 2.1 303 1.303.60 13036 130 360 3.6 1.30-3.60 3, 1. 1.012.6 1012 10 26 2. 1.01-2.6 3. 1.997.6 1997 76 7. 1.99-7.6 1.322.7 1322 13 27 1.32-2.7 1.303.6 1303 36 1.30-3.6 1.012. 1.01-2. 1.997. 1.99-7. 1.322. 1.32-2. 1.303. 1.30-3. 1.012 1.01-2 1.997 1.99-7 1.322 1.32-2 1.303 1.30-3 1.01- 1.99- 1.32- 1.30-

RESUMO: Objetivo: analisar a abordagem dos conteúdos relacionados ao empreendedorismo nas dimensões ético-políticas em documentos curriculares dos cursos de graduação em Enfermagem. Método: pesquisa documental, com abordagem mista e natureza descritiva, de junho de 2021 a agosto de 2022, com verificação no site do Ministério da Educação, das instituições que ofertam cursos em Enfermagem na região Nordeste do Brasil. Avaliação de conteúdo e quantitativa pelo teste-T. Resultados: a maioria das IES oferecia cursos presenciais (94,1%) e pertencia a instituições privadas (64,7%). As disciplinas abordavam principalmente temas teóricos (94,1%), destacando a importância do empreendedorismo na formação de enfermeiros. A análise lexicográfica e de similitude destacou a forte ligação entre as palavras “Empreendedor” e “Saúde”, evidenciando a relevância desses conceitos na formação dos enfermeiros. Conclusão: os documentos curriculares destacam a importância de formar enfermeiros em seu papel profissional e empreendedor com competência, levando em consideração os princípios da Bioética, Moral, Ciência e Filosofia. RESUMO Objetivo éticopolíticas ético políticas Método documental descritiva 202 2022 Educação Brasil testeT. testeT teste T. T teste-T Resultados 94,1% 941 94 1 (94,1% 64,7%. 647 64,7% . 64 7 (64,7%) 94,1%, , Empreendedor “Empreendedor Saúde, Saúde “Saúde” Conclusão competência Bioética Moral Filosofia 20 94,1 9 (94,1 64,7 6 (64,7% “Saúde 2 94, (94, 64, (64,7 (94 (64, (9 (64 ( (6

RESUMEN: Objetivo: analizar el abordaje de contenidos relacionados con el emprendimiento en dimensiones ético-políticas en documentos curriculares de cursos de graduación en Enfermería. Método: investigación documental, de enfoque mixto y de carácter descriptivo, de junio de 2021 a agosto de 2022, con verificación en el sitio web del Ministerio de Educación de las instituciones que ofrecen cursos de Enfermería en la región Noreste de Brasil. Evaluación de contenidos y cuantitativa mediante la prueba T. Resultados: la mayoría de las IES ofrecían carreras presenciales (94,1%) y pertenecían a instituciones privadas (64,7%). Los temas abordaron principalmente temas teóricos (94,1%), destacando la importancia del emprendimiento en la formación del enfermero. El análisis lexicográfico y de similitud destacó la fuerte conexión entre las palabras “Emprendedor” y “Salud”, destacando la relevancia de esos conceptos en la formación de enfermeros. Conclusión: los documentos curriculares resaltan la importancia de formar enfermeros en su rol profesional y empresarial con competencia, teniendo en cuenta los principios de la Bioética, la Moral, la Ciencia y la Filosofía. RESUMEN Objetivo éticopolíticas ético políticas Método documental descriptivo 202 2022 Brasil T Resultados 94,1% 941 94 1 (94,1% 64,7%. 647 64,7% . 64 7 (64,7%) 94,1%, , enfermero Emprendedor “Emprendedor Salud, Salud “Salud” Conclusión competencia Bioética Moral Filosofía 20 94,1 9 (94,1 64,7 6 (64,7% “Salud 2 94, (94, 64, (64,7 (94 (64, (9 (64 ( (6

ABSTRACT Objective: to analyze the approach to content related to entrepreneurship in the ethical-political dimensions in curricular documents of undergraduate nursing courses. Method: documentary research, with a mixed approach and descriptive nature, from June 2021 to August 2022, with inspection of the Ministry of Education’s website, of the institutions offering Nursing courses in the Northeast region of Brazil. Content and quantitative evaluation using the T-test. Results: the majority of HEIs offered face-to-face courses (94.1%) and belonged to private institutions (64.7%). The subjects mainly covered theoretical topics (94.1%), highlighting the importance of entrepreneurship in the training of nurses. The lexicographic and similarity analysis highlighted the strong link between the words “Entrepreneur” and “Health”, highlighting the relevance of these concepts in the training of nurses. Conclusion: The curriculum documents highlight the importance of training nurses in their professional and entrepreneurial roles with competence, taking into account the principles of Bioethics, Morals, Science, and Philosophy. Objective ethicalpolitical ethical political Method research nature 202 2022 Educations Education s website Brazil Ttest. Ttest T test. test T-test Results facetoface face 94.1% 941 94 1 (94.1% 64.7%. 647 64.7% . 64 7 (64.7%) 94.1%, , Entrepreneur “Entrepreneur Health, Health “Health” Conclusion competence Bioethics Morals Science Philosophy 20 94.1 9 (94.1 64.7 6 (64.7% “Health 2 94. (94. 64. (64.7 (94 (64. (9 (64 ( (6

RESUMO Contexto: O uso crônico e excessivo de álcool é um importante fator de risco para diversos problemas sociais e de saúde. Métodos: Foi realizado um estudo transversal, numa amostra representativa da população brasileira, para avaliar a frequência do consumo de bebidas alcoólicas e comportamentos relativos às doenças hepáticas. Participantes foram entrevistados, prospectivamente, com um questionário sobre consumo de álcool e ações voltadas à saúde do fígado. O estudo aceitou erro amostral máximo de ±2 pontos percentuais e considerou intervalo de confiança de 95%. Resultados: Foram entrevistados 1995 indivíduos (1.048 mulheres, média de idade de 44 anos) de todas as regiões brasileiras. A maioria dos brasileiros (63-87%) acredita que o abuso de álcool é a principal causa de cirrose e câncer de fígado, no entanto, a maioria dos participantes (56%) nunca havia sido examinado para avaliar danos hepáticos relacionados ao consumo excessivo de álcool. Um total de 55% dos brasileiros consomem bebidas alcoólicas. Entre os brasileiros que consomem bebidas alcoólicas, 44% consomem três ou mais doses por vez, 11% consomem mais de 10 doses por dia. Entre aqueles que consomem 1 a 2 doses por dia, as mulheres (42%) consomem mais que os homens (32%) e mais que a média nacional (37%). Conclusão: Há elevada frequência de consumo de álcool, principalmente entre jovens e indivíduos de classes sociais mais baixas, com consumo frequente entre mulheres. Apesar do conhecimento sobre o impacto adverso na saúde do fígado, menos da metade dos brasileiros foram avaliados, em pelo menos uma ocasião, para doença hepática. Estratégias de educação e prevenção precisam ser implementadas para reduzir o uso nocivo do álcool. Contexto Métodos transversal brasileira hepáticas prospectivamente fígado ± 95 95% Resultados 199 1.048 1048 048 (1.04 4 anos brasileiras 6387% 6387 63 87% 87 (63-87% entanto 56% 56 (56% 55 vez 11 dia 42% 42 (42% 32% 32 (32% 37%. 37 37% . (37%) Conclusão baixas avaliados ocasião hepática 9 19 1.04 104 04 (1.0 638 6 8 (63-87 5 (56 (42 3 (32 (37% 1.0 0 (1. (63-8 (5 (4 (3 (37 1. (1 (63- ( (63 (6

ABSTRACT Background: Chronic excessive use of alcohol is an important risk factor for several health and social conditions. Methods: A cross-sectional survey, in a sample representative of the Brazilian population,was conducted to evaluate the frequency of consumption of alcoholic beverages and behaviors concerning liver diseases. Participants were prospectively interviewed using a questionnaire regarding alcohol consumption and actions toward liver health. The study accepted at most one sampling error of ±2 percentage points and considered a 95% confidence interval. Results: One thousand nine hundred ninety-five subjects (1.048 women, mean age 44 years) from all Brazilian regions were interviewed. Most of the Brazilian subjects believe that alcohol abuse (63-87%) is the leading cause of cirrhosis and liver cancer, however, most responders (56%) had never been screened to assess liver damage related to alcohol consumption. A total of 55% of Brazilians drink alcoholic beverages. Among Brazilians who drink alcoholic beverages, 44% consume three or more drinks at a time, 11% consume more than 10 doses a day. Among those who consume 1 to 2 drinks a day, women (42%) consume more than men (32%) and more than the national average (37%). Conclusion: There is a high frequency of alcohol consumption, especially among young people, and individuals from lower social classes, with frequent consumption among women. Despite the knowledge of its adverse impact on liver health, less than half of the Brazilians have been evaluated at least once for liver disease. Education and prevention strategies need to be implemented to reduce theharmful use of alcohol. Background conditions Methods crosssectional cross sectional survey populationwas population was diseases ± 95 interval Results ninetyfive ninety five 1.048 1048 048 (1.04 4 years 6387% 6387 63 87% 87 (63-87% cancer however 56% 56 (56% 55 time 11 day 42% 42 (42% 32% 32 (32% 37%. 37 37% . (37%) Conclusion people classes disease 9 1.04 104 04 (1.0 638 6 8 (63-87 5 (56 (42 3 (32 (37% 1.0 0 (1. (63-8 (5 (4 (3 (37 1. (1 (63- ( (63 (6

Abstract Background: Phlebitis is a complication associated with peripheral intravenous catheters and an adverse event. Objective: To analyze peripheral intravenous catheter-associated phlebitis incidents associated and drug administration to adult inpatients and their consequences. Methodology: Quantitative, retrospective, descriptive, and cross-sectional study. Non-probabilistic convenience sampling technique was used, with 96 adult patients hospitalized in 2019 selected in the area of medicine at a Hospital Center in Lisbon. The type of phlebitis incident was characterized using the Visual Infusion Phlebitis scale adapted and translated to European Portuguese. Patient harm was categorized according to the International Classification for Patient Safety (ICPS). Results: Of the documented phlebitis incidents, 78% obtained a score 2 on the VIP PT-PT scale. According to the ICPS, 87.5% resulted in mild harm and 12.5% in moderate harm. Antibiotics were the most frequent therapeutic group. Conclusion: Phlebitis has an impact on patient safety. The importance of nursing care is reinforced, with a focus on surveillance and early detection of phlebitis to prevent complications.

Resumen Marco contextual: La flebitis es una complicación asociada al uso de catéteres venosos periféricos clasificada como acontecimiento adverso. Objetivos: Analizar los incidentes de flebitis asociada al empleo de catéteres venosos periféricos y a la administración de fármacos en pacientes adultos hospitalizados y sus consecuencias. Metodología: Estudio cuantitativo, retrospectivo, descriptivo y transversal. Técnica de muestreo no probabilístico por conveniencia, se seleccionaron 96 pacientes adultos ingresados en 2019 en el área médica de un centro hospitalario de Lisboa. El grado de flebitis se evaluó mediante la escala Visual Infusion Phlebitis Score Portugués Portugal (VIP PT-PT), traducida y adaptada al portugués europeo. El daño se categorizó según la Clasificación Internacional sobre Seguridad del Paciente (CISD). Resultados: De los incidentes de flebitis documentados, el 78% se clasificó con una puntuación de 2 según la escala VIP PT-PT. Por la CISD, el 87,5% resultó en daño leve y el 12,5% en moderado. Los antibióticos fueron el grupo terapéutico más frecuente. Conclusión: La flebitis repercute en la seguridad del paciente. Se refuerza la importancia de los cuidados de enfermería centrados en la vigilancia y la detección precoz de la flebitis.

Resumo Enquadramento: A flebite é uma complicação associada à utilização de cateter venoso periférico, classificada como evento adverso. Objetivos: Analisar os incidentes de flebite associada ao cateter venoso periférico e aos medicamentos administrados em doentes adultos internados e as suas consequências. Metodologia: Estudo quantitativo, retrospetivo, descritivo e transversal. Técnica de amostragem não probabilística por conveniência sendo selecionados 96 doentes adultos internados em 2019, na área da medicina de um Centro Hospitalar em Lisboa. O grau de flebite foi avaliado pela escala Visual Infusion Phlebitis Score Português Portugal (VIP PT-PT) traduzida e adaptada para Português Europeu. O dano foi categorizado de acordo com a classificação internacional sobre segurança do doente (CISD). Resultados: Dos incidentes de flebite documentados, 78% classificados com score 2 pela escala VIP PT-PT. Pela CISD, 87,5% resultaram em dano ligeiro e 12,5% em moderado. Os antibióticos foram o grupo terapêutico mais frequente. Conclusão: A flebite tem impacto na segurança do doente. Reforça-se a importância dos cuidados de enfermagem com enfoque na vigilância e deteção precoce de flebite.

ABSTRACT Inside the Brazilian semi-arid region (Caatinga biome) there are vegetation refuges from other biomes that are present mainly at greater elevations in ancient geological formations such as Chapada do Araripe. This study aimed to understand the structure, diversity and floristic similarity of a fragment of humid forest in order to support conservation strategies for this community in Chapada do Araripe, southern Ceará (708m Alt.), an area of relevant ecological, cultural and scenic value. In 13 parcels of 25x25m (0.8 ha) all individuals with DBH ≥ 5cm were inventoried, observing total height. Floristic similarity was observed using the Jaccard method, comparing it with seven other areas in different regions of the Brazil. Sixty-six species were found distributed in 34 families, in a total of 1,544 individuals with DA=1,997.30 ind.ha-1 and AB =32,618 m²ha-1. Fabaceae (25.75%) and Myrtaceae (6%) had the highest number of species and Brosimum gaudichaudii had the highest IVI. The Shannon index (H') was 3.13 and the Pielou equability (J') was 0.75. The beta diversity, compared with other areas of humid forest (core and disjunct), was considered high and the statistics showed greater similarity with the area of the mesoregion of Pernambuco forest. The results allow the characterization of the area as a vegetational refuge of humid forest, corroborating the Refuge Theory and showing strong penetration of savanna species (“Cerradão”, Cerrado, Caatinga/“Carrasco”), emphasizing the action of climatic impulses that occurred in the Quaternary and pointing to the need to conservation strategies due to accelerated anthropism. semiarid semi arid Caatinga biome Araripe structure 708m m Alt., Alt Alt. , Alt.) ecological value 1 xm x 0.8 08 0 8 (0. ha cm inventoried height method Brazil Sixtysix Sixty six 3 families 1544 544 1,54 DA199730 DA 997 30 DA=1,997.3 ind.ha1 indha1 indha ind.ha ind ind.ha- 32618 32 618 =32,61 m²ha1. m²ha1 mha m²ha 1. m²ha-1 25.75% 2575 25 75 (25.75% 6% 6 (6% IVI H (H' 313 3.1 J (J' 075 0.75 core disjunct, disjunct disjunct) Cerradão, Cerradão (“Cerradão” Cerrado Caatinga/Carrasco, CaatingaCarrasco Caatinga/ Carrasco Caatinga/“Carrasco”) anthropism 0. (0 154 54 1,5 DA19973 99 DA=1,997. ha1 3261 61 =32,6 m²ha- 25.75 257 2 7 (25.75 (6 (H 31 3. (J 07 0.7 (“Cerradão Caatinga/Carrasco Caatinga/“Carrasco” ( 15 5 1, DA1997 9 DA=1,997 326 =32, 25.7 (25.7 Caatinga/“Carrasco DA199 DA=1,99 =32 25. (25. DA19 DA=1,9 =3 (25 DA1 DA=1, = (2 DA=1 DA=

RESUMO No interior da região semiárida brasileira (bioma Caatinga), há ocorrência de refúgios de vegetação de outros biomas que se apresentam principalmente em topos de formações geológicas do período Pré-Cambriano, como a Chapada do Araripe. Este trabalho objetivou o conhecimento da estrutura, diversidade e similaridade florística de um fragmento de mata úmida na Chapada do Araripe, sul do Ceará (708m Alt.), visando subsidiar estratégias de conservação dessa comunidade, área de relevante valor ecológico, cultural e paisagístico. Em 13 parcelas de 25x25m (0,8 ha), foram inventariados todos os indivíduos com DAP ≥ 5cm, observando-se altura total. A similaridade florística foi observada pelo método de Jaccard a partir da comparação com outras sete áreas em diferentes regiões do Brasil. Foram encontradas 66 espécies distribuídas em 34 famílias, num total de 1.544 indivíduos com DA=1.997,30 ind.ha-1 e AB=32,618 m²ha-1. Fabaceae (25,75%) e Myrtaceae (6%) apresentaram maior número de espécies e Brosimum gaudichaudii apresentou maior IVI. O índice de Shannon (H’) foi 3,13 e a equabilidade de Pielou (J’) foi 0,75. A diversidade beta, comparada com outras áreas de mata úmida (core e disjuntas), foi considerada alta e a estatística apontou maior similaridade com área da mesorregião da mata pernambucana. Os resultados permitem caracterizar a área como refúgio vegetacional de mata úmida, corroborando com a teoria dos refúgios e evidenciam forte penetração de espécies savânicas (cerradão, cerrado, caatinga/carrasco) enfatizando a atuação de impulsos climáticos ocorridos no Quaternário e apontando para a necessidade de estratégias de conservação devido ao antropismo acelerado. bioma Caatinga, Caatinga , Caatinga) PréCambriano, PréCambriano Pré Cambriano, Cambriano Pré-Cambriano Araripe estrutura 708m m Alt., Alt Alt. Alt.) comunidade ecológico paisagístico 1 xm x 0,8 08 0 8 (0, ha, ha ha) 5cm cm observandose observando Brasil 6 3 famílias 1544 544 1.54 DA199730 DA 997 30 DA=1.997,3 ind.ha1 indha1 indha ind.ha ind ind.ha- AB32618 AB 32 618 AB=32,61 m²ha1. m²ha1 mha m²ha 1. m²ha-1 25,75% 2575 25 75 (25,75% 6% (6% IVI H (H’ 313 3,1 J (J’ 075 0,75 beta core disjuntas, disjuntas disjuntas) pernambucana cerradão, cerradão (cerradão cerrado caatinga/carrasco caatingacarrasco caatinga carrasco acelerado 0, (0 154 54 1.5 DA19973 99 DA=1.997, ha1 AB3261 61 AB=32,6 m²ha- 25,75 257 2 7 (25,75 (6 (H 31 3, (J 07 0,7 ( 15 5 DA1997 9 DA=1.997 AB326 AB=32, 25,7 (25,7 DA199 DA=1.99 AB32 AB=32 25, (25, DA19 DA=1.9 AB3 AB=3 (25 DA1 DA=1. AB= (2 DA=1 DA=

Abstract This article aims to analyse the COVID-19 coping strategies adopted by municipal health managers in two regions. A mixed method study of the sequential explanatory type was carried out with municipal health managers and primary care coordinators. The quantitative stage was developed with the application of an instrument to 42 managers to identify coping actions and associations with demographic and epidemiological data of COVID-19 in the municipalities. The results aimed at the definition of 15 participants and the collection of data in the qualitative stage, enabling approximation of the meta inferences of the study. Of the actions implemented, there were immediate actions to monitor cases, organize new care flows and encourage the population to adopt nonpharmacological measures. Regional articulation was the device that allowed for expansion and municipal autonomy for testing, reducing contamination and deaths among citizens. Municipal coping strategies that focused on the surveillance of cases and expansion of testing showed positive outcomes in terms of the number of infections and deaths from COVID-19. COVID19 COVID 19 COVID-1 regions coordinators 4 municipalities 1 implemented measures citizens COVID19. 19. COVID1 COVID-

Resumo O objetivo deste artigo é analisar as estratégias de enfrentamento da COVID-19 adotadas por gestores municipais de saúde em duas regiões. Estudo de método misto do tipo explanatório sequencial, realizado com gestores municipais de saúde e coordenadores da atenção primária. A etapa quantitativa foi desenvolvida com a aplicação de instrumento a 42 gestores, para identificação de ações de enfrentamento e associação com dados demográficos e epidemiológicos da COVID-19 nos municípios. Os resultados direcionaram à definição de 15 participantes e à coleta de dados na etapa qualitativa, possibilitando aproximação das metainferências do estudo. Das ações implantadas, foram unânimes as ações de monitoramento dos casos, organização de novos fluxos de atendimento e estímulo à adoção de medidas não farmacológicas pela população. A articulação regional foi o dispositivo que permitiu ampliação e autonomia municipal para a testagem, com redução de contaminação e óbitos nos munícipes. As estratégias municipais de enfrentamento que tiveram foco na vigilância dos casos e na ampliação da testagem apresentaram desfechos positivos no que se refere a número de óbitos por COVID-19. COVID19 COVID 19 COVID-1 regiões sequencial primária 4 municípios 1 qualitativa estudo implantadas população munícipes COVID19. 19. COVID1 COVID-

Resumo O objetivo deste artigo é analisar as estratégias de enfrentamento da COVID-19 adotadas por gestores municipais de saúde em duas regiões. Estudo de método misto do tipo explanatório sequencial, realizado com gestores municipais de saúde e coordenadores da atenção primária. A etapa quantitativa foi desenvolvida com a aplicação de instrumento a 42 gestores, para identificação de ações de enfrentamento e associação com dados demográficos e epidemiológicos da COVID-19 nos municípios. Os resultados direcionaram à definição de 15 participantes e à coleta de dados na etapa qualitativa, possibilitando aproximação das metainferências do estudo. Das ações implantadas, foram unânimes as ações de monitoramento dos casos, organização de novos fluxos de atendimento e estímulo à adoção de medidas não farmacológicas pela população. A articulação regional foi o dispositivo que permitiu ampliação e autonomia municipal para a testagem, com redução de contaminação e óbitos nos munícipes. As estratégias municipais de enfrentamento que tiveram foco na vigilância dos casos e na ampliação da testagem apresentaram desfechos positivos no que se refere a número de óbitos por COVID-19.

Abstract This article aims to analyse the COVID-19 coping strategies adopted by municipal health managers in two regions. A mixed method study of the sequential explanatory type was carried out with municipal health managers and primary care coordinators. The quantitative stage was developed with the application of an instrument to 42 managers to identify coping actions and associations with demographic and epidemiological data of COVID-19 in the municipalities. The results aimed at the definition of 15 participants and the collection of data in the qualitative stage, enabling approximation of the meta inferences of the study. Of the actions implemented, there were immediate actions to monitor cases, organize new care flows and encourage the population to adopt nonpharmacological measures. Regional articulation was the device that allowed for expansion and municipal autonomy for testing, reducing contamination and deaths among citizens. Municipal coping strategies that focused on the surveillance of cases and expansion of testing showed positive outcomes in terms of the number of infections and deaths from COVID-19.

Abstract Vaccines are considered one of the most important public health advancements of the modern age and the most cost-effective preventive method of curbing the spread of several diseases with high morbidity and lethality. However, vaccination coverage rates around the world have been threatened by the vaccine hesitancy phenomenon, considered by the World Health Organization (WHO) as one of the ten greatest menaces to public health in the world. Vaccine opposition is a mentality driven by various interests, as old as the vaccine itself, predominantly using the media and social networks, which have an enormous influence on people. They often spread false information about vaccines, frequently with no adequate scientific backing, negatively impacting vaccination rates. To understand the possible correlation between the information spread on social media and childhood vaccination rates, we performed a narrative review on the subject, with a qualitative approach, in original or review articles, indexed in national and international databases and/or journals, in Portuguese and English, published between 2011 and 2021, available in full and free of charge. One hundred and seventy-two articles were extracted from the literature, 49 of which were submitted to analysis. The use of content analysis in a narrative literature review made it possible to interpret the main publications that in the last decade point to the impact of social media as one of the main factors linked to vaccine hesitancy in children. The articles show that communication is presented as a determinant for adherence or vaccine hesitancy, and social media are a useful tool for disseminating information that can influence and mobilize the population, promoting its acceptance or having a negative impact on childhood vaccine coverage rates. Social Media has become fertile ground for the creation and spread of fake news, hence the importance of the health professional's engagement in strengthening the population's confidence in relation to immunization, minimizing vaccine hesitancy.

Abstract “Patient safety” is an important care factor for all patients and therefore indispensable in the training of all health professionals. Thus, there is a need to assess patient safety in undergraduate nursing in the context of in-person teaching and the curricular stages. Objective: This study proposes to analyze students’ perspective of patient safety at a university in Northeastern Brazil. Methodology: This is an instrumental exploratory single-case study with a qualitative approach. The sample consisted of twelve students selected by convenience. Data collection occurred via an online focus group. The data were processed in NVivo software, version 12.0. Results: The data illustrate the students’ perception of patient safety, divided into three categories: in-person teaching; curricular stages; and attributes for managing future nurses. Although the university does not offer a specific patient safety course, the topic is satisfactorily discussed from the onset of the course. Final considerations: The case study found that health professional training based on patient safety measures is one of the most crucial investments that a university can make, sharpening critical thinking in order to improve care and reduce hospital costs, and above all, preserve life.

Abstract Objective: To analyze aspects of sexual life and fertility desire among 46, XY DSD people, including those who changed their gender. Methods: It is a cross-sectional study including 127 adults (> 16 years of age) with 46, XY DSD (83 females; 44 males) from a Single Brazilian Tertiary-Care Medical Center. Results: Sexual fantasies and masturbation were more frequent in 46, XY DSD males, whereas orgasm and sexual life satisfaction were similar in both genders. More 46, XY DSD men than women had a long-term romantic relationship. 46, XY DSD women with prenatal androgen exposure reported more fear of being romantically rejected. External genitalia appearance at birth did not impact the sexuality of 46, XY DSD women after surgical genital treatment had been completed. Overall, the sexual life was similar between 46, XY men assigned as males and those who changed to the male gender. Regarding sexual orientation, most self-reported as heterosexual (91% and 92% of women and men, respectively). The desire for fertility had a similar prevalence in both genders, but more women than men considered infertility a barrier to a long-term romantic relationship. Twelve individuals (7 males) had children; 10 out of 12 have adopted children. Conclusion: Fertility desire was shared among 46, XY DSD people, regardless of gender. Prenatal androgen exposure reduced the desire for motherhood in 46, XY women. 46, XY DSD people who changed from female to male gender presented similar sexual parameters as those assigned as males. Among females, virilized genitalia at birth did not affect sexuality once the surgical treatment is completed. Objective 46 Methods crosssectional cross sectional > ( 1 age 83 (8 females 4 TertiaryCare Tertiary Care Center Results genders longterm long term relationship rejected completed Overall orientation selfreported self 91% 91 (91 92 respectively. respectively . respectively) 7 children Conclusion 8 9 (9

Abstract Background In the pediatric population, syncope is mainly from vasovagal (VVS) origin. Its evaluation must be done by clinical methods, and the tilt test (TT) can contribute to the diagnosis. Objectives To analyze the clinical profile, Calgary and modified Calgary scores, response to TT and heart rate variability (HRV) of patients aged ≤ 18 years with presumed VVS. To compare the variables between patients with positive and negative responses to TT. Method Observational and prospective study, with 73 patients aged between 6 and 18 years, submitted to clinical evaluation and calculation of scores without previous knowledge of the TT. It was done at 70º under monitoring for HRV analysis. P-value < 0.05 was the statistical significance criterion. Results Median age was 14.0 years; 52% of participants were female, 72 had Calgary ≥ -2 (mean 1.80), and 69 had modified Calgary ≥ -3 (mean 1.38). Prodromes were observed in 59 patients, recurrence in 50 and trauma in 19. The response to TT was positive in 54 participants (49 vasovagal, with 39 vasodepressor responses), with an increase in the low frequency (LF) component and a decrease in the high frequency (HF) component (p < 0,0001). In the supine position, LF was 33.6 in females and 47.4 in normalized units for males (p = 0.02). When applying the operating characteristic curve for positive TT, there was no statistical significance for HRV and scores. Conclusion Most children and adolescents with a presumed diagnosis of VVS presented a typical clinical scenario, with a Calgary score ≥ -2, and a predominant vasodepressor response to TT. Greater sympathetic activation was observed in the supine position in males. Calgary scores and sympathetic activation did not predict the response to TT. population (VVS origin methods (TT profile (HRV 1 study 7 º analysis Pvalue P value 005 0 05 0.0 criterion 140 14 14. 52 female 2 - mean 1.80, 180 1.80 , 80 1.80) 3 1.38. 138 1.38 . 38 1.38) 5 19 49 (4 responses, responses) (LF HF (HF p 0,0001. 00001 0,0001 0001 0,0001) 336 33 33. 474 47 4 47. 0.02. 002 0.02 02 0.02) scenario 2, 00 0. 1.8 8 13 1.3 ( 0000 0,000 000 1. 0,00 0,0 0,

Resumo Fundamento A síncope, na população pediátrica, tem como sua principal causa, a vasovagal (SVV). Sua avaliação deve ser feita por métodos clínicos e o teste de inclinação (TI) pode contribuir para seu diagnóstico. Objetivos Analisar o perfil clínico, os escores de Calgary e de Calgary modificado, a resposta ao TI e a variabilidade da frequência cardíaca (VFC) de pacientes ≤ 18 anos de idade, com presumida SVV. Comparar as variáveis entre pacientes com resposta positiva e negativa ao TI. Método Estudo observacional e prospectivo, com 73 pacientes com idades entre 6 e 18 anos, submetidos à avaliação clínica e ao cálculo dos escores, sem o conhecimento do TI. Este foi feito a 70º sob monitoramento para análise da VFC. Valor-p < 0,05 foi considerado como o critério de significância estatística. Resultados A mediana de idade foi de 14,0 anos, sendo que 52% eram no sexo feminino, 72 apresentaram Calgary ≥ -2 (média 1,80) e 69 com Calgary modificado ≥ -3 (média 1,38). Ocorreram pródromos em 59 pacientes, recorrência em 50 e trauma em 19. A resposta ao TI foi positiva em 54 (49 vasovagal, com 39 vasodepressora), com aumento do componente de baixa frequência (BF) e diminuição da alta frequência (AF) (p < 0,0001). Na posição supina, o BF foi de 33,6 no sexo feminino e 47,4 em unidades normalizadas no sexo masculino (p = 0,02). Aplicando-se a curva de operação característica para TI positivo, não houve significância estatística para VFC e os escores. Conclusões A maioria das crianças e adolescentes com diagnóstico presumido de SVV apresentaram um cenário clínico típico, com escore de Calgary ≥ -2, e resposta vasodepressora predominante ao TI. Verificou-se uma maior ativação simpática na posição supina no sexo masculino. Os escores de Calgary e a ativação simpática não permitiram predizer a resposta ao TI. síncope pediátrica causa . (SVV) (TI (VFC 1 prospectivo 7 º Valorp Valor p 005 0 05 0,0 140 14 14, 52 2 - média 1,80 180 80 3 1,38. 138 1,38 38 1,38) 5 19 49 (4 vasodepressora, , vasodepressora) (BF AF (AF 0,0001. 00001 0,0001 0001 0,0001) 336 33 33, 474 47 4 47, 0,02. 002 0,02 02 0,02) Aplicandose Aplicando se positivo típico 2, Verificouse Verificou (SVV 00 0, 1,8 8 13 1,3 ( 0000 0,000 000 1, 0,00

ABSTRACT Eucalyptus is a species of the most cultivated in the national scope, whose wood is widely used in the manufacture of furniture and other derived products. However, it is subjected to variations due to changes in moisture and other factors. To minimize such variations, some treatments were studied in a non-environmentally aggressive manner. This work analyzed the physical and chemical properties of wood of hybrid clones of Eucalyptus urograndis, “in natura” and thermally modified at temperatures of 140, 160, 180, 200 and 220°C, with 8.5 years of age, planted in Buri-SP, Brazil. The physical characterization was performed according to Brito, Garcia and Bortoletto (2006) and Brazilian Association of Technical Standards (1997), and the chemical characterization according to Technical Association of the Pulp and Paper Industry (1999). Through statistical analysis of factorial regression with significance of 5%, the clone factor did not cause interference in the analyzed properties; the variation that occurred was due to the temperature used; the hemicellulose was the main chemical property affected by the temperature; the most interesting treatments were those performed up to 180°C, since they did not compromise much the chemical properties of the wood and, consequently, would not affect so much their physical and mechanical properties. scope products However factors nonenvironmentally non environmentally manner urograndis natura 140 160 180 20 220C C 220 220°C 85 8 5 8. age BuriSP, BuriSP Buri SP, SP Buri-SP Brazil Brito 2006 (2006 1997, 1997 , (1997) 1999. 1999 . (1999) 5% 180C 180°C consequently 14 16 18 2 22 (200 199 (1997 (1999 1 (20 19 (199 (2 (19 ( (1

RESUMO O eucalipto é uma espécie das mais cultivadas no âmbito nacional, cuja madeira é amplamente utilizada na fabricação de móveis e outros produtos derivados. Entretanto, ela está sujeita a variações por conta de mudanças na umidade e outros fatores. Para minimizar tais variações, estudaram-se alguns tratamentos de forma pouco agressiva ao meio ambiente. Assim, este trabalho analisou as propriedades físicas e químicas da madeira de clones híbridos de Eucalyptus urograndis, in natura e termicamente modificada nas temperaturas de 140, 160, 180, 200 e 220°C, com 8,5 anos de idade, plantados em Buri-SP, Brasil. A caracterização física foi realizada segundo Brito, Garcia e Bortoletto (2006) e normas da Associação Brasileira de Normas Técnicas (1997), e a caracterização química segundo as normas Technical Association of the Pulp and Paper Industry (1999). Através de análises estatísticas de regressão fatorial com significância de 5%, o fator clone não causou interferência nas propriedades analisadas; a variação que ocorreu foi por conta da temperatura utilizada; a hemicelulose foi a principal propriedade química afetada por conta da temperatura; os tratamentos mais interessantes foram os realizados até 180 °C, uma vez que não comprometeram muito as propriedades químicas da madeira e, consequentemente, não afetariam tanto suas propriedades físicas e mecânicas. nacional derivados Entretanto fatores estudaramse estudaram se ambiente Assim urograndis 140 160 20 220C C 220 220°C 85 8 5 8, idade BuriSP, BuriSP Buri SP, SP Buri-SP Brasil Brito 2006 (2006 1997, 1997 , (1997) 1999. 1999 . (1999) 5% analisadas 18 °C consequentemente mecânicas 14 16 2 22 (200 199 (1997 (1999 1 (20 19 (199 (2 (19 ( (1

Abstract Objective: to analyze the perception of musculoskeletal symptoms and their repercussion in the activities of daily living reported by professional Brazilian sign language interpreters (LIBRAS). Methods: descritive-analytical qualitative research, using thematic categorical content analysis. We used a sociodemographic questionnaire and a semi-structured interview with 12 professional LIBRAS interpreters, working in the primary, secondary, and superior education in the municipality of Goiânia. They were invited via social media, in the first half of 2021. Results: we identified three thematic categories: pain perception, perception of tiredness, and activities of daily living. The professionals were working remotely due to the COVID-19 pandemic. This allowed flexibility in the work schedule, with online classes, events, lectures, and congresses participation from the worker’s home. Conclusion: the participants had negative perceptions in all aspects evaluated, evidencing an overload in acting as a sign language interpreter in educational activities. Objective LIBRAS. . (LIBRAS) Methods descritiveanalytical descritive analytical research analysis semistructured semi structured 1 primary secondary Goiânia media 2021 Results categories tiredness COVID19 COVID 19 COVID-1 pandemic schedule classes events lectures workers worker s home Conclusion evaluated (LIBRAS 202 COVID1 COVID- 20 2

Resumo Objetivo: analisar a percepção de sintomas osteomusculares e sua repercussão nas atividades de vida diária referidas por intérpretes da língua brasileira de sinais (libras). Métodos: pesquisa qualitativa de natureza descritiva-analítica, utilizando a análise de conteúdo categorial temática. Foi aplicado questionário sociodemográfico e realizada entrevista semiestruturada com 12 profissionais intérpretes de libras, atuantes nas redes de ensino nos níveis fundamental, médio e superior do município de Goiânia, convidados via redes sociais, no primeiro semestre de 2021. Resultados: foram identificadas três categorias temáticas: percepção álgica, percepção de cansaço e atividades de vida diária. Os profissionais estavam trabalhando remotamente devido à pandemia da doença COVID-19, cujo regime permitiu uma flexibilização do processo de trabalho com aulas on-line, eventos, palestras e congressos a partir do domicílio do trabalhador. Houve um aumento expressivo da demanda física e psicológica, devido ao aumento das atividades a serem cumpridas e por estarem ausentes os limites entre ambiente de “trabalho” e “casa”. Conclusão: os participantes apresentaram percepções negativas em todos os aspectos avaliados, evidenciando a existência de sobrecarga na atuação como intérprete de língua de sinais. Objetivo libras. libras . (libras) Métodos descritivaanalítica, descritivaanalítica descritiva analítica, analítica descritiva-analítica temática 1 fundamental Goiânia sociais 2021 Resultados temáticas álgica COVID19, COVID19 COVID 19, 19 COVID-19 online, online on line, line on-line eventos trabalhador psicológica “trabalho casa. casa “casa” Conclusão avaliados (libras 202 COVID1 COVID-1 “casa 20 COVID- 2