A transmissão do vírus Oropouche (OROV) para novas regiões, juntamente com um aumento de casos e o surgimento de formas graves, anteriormente não suspeitas, expressas preocupações de saúde pública. Uma fazendeira grávida de 40 anos, com 30 semanas de gestação, desenvolvimento de febre, mialgia e dor de cabeça, com infecção por OROV confirmada por RT-qPCR. as avaliações maternas e fetais não foram inicialmente concluídas. No entanto, na semana seguinte, um paciente notou diminuição dos movimentos fetais, e o ultrassom confirmou a morte fetal. O diagnóstico molecular detectou o RNA do OROV em vários espécimes fetais. Este caso de transmissão vertical ressalta a necessidade urgente de proteger as mulheres grávidas, incorporar o OROV no diagnóstico diferencial de doenças febris e investigar mais profundamente os potenciais mecanismos patogênicos do vírus.

A transmissão do vírus Oropouche (OROV) para novas regiões, juntamente com um aumento de casos e o surgimento de formas graves, anteriormente não suspeitas, expressas preocupações de saúde pública. Uma fazendeira grávida de 40 anos, com 30 semanas de gestação, desenvolvimento de febre, mialgia e dor de cabeça, com infecção por OROV confirmada por RT-qPCR. as avaliações maternas e fetais não foram inicialmente concluídas. No entanto, na semana seguinte, um paciente notou diminuição dos movimentos fetais, e o ultrassom confirmou a morte fetal. O diagnóstico molecular detectou RNA do OROV em vários espécimes fetais. Este caso de transmissão vertical ressalta a necessidade urgente de proteger as mulheres grávidas, incorporar o OROV no diagnóstico diferencial de doenças febris e investigar mais profundamente os potenciais mecanismos patogênicos do vírus.

A propagação do vírus Oropouche (OROV) em novas regiões, junto com um aumento de casos e o aparecimento de formas graves não reconhecidas anteriormente, suscitou preocupações importantes de saúde pública. Uma granjera embarazada de 40 anos em 30 semanas de gestação apresentou febre, mialgia e dor de cabeça, e a infecção por OROV foi confirmada por RT-qPCR. As avaliações maternas e fetais não foram avaliadas inicialmente. No entanto, na semana seguinte, o paciente notou uma diminuição dos movimentos fetais e a ecografia confirmada a morte fetal. Os diagnósticos moleculares detectam ARN de OROV em múltiplas amostras fetais. Este caso de transmissão vertical justifica a necessidade urgente de proteger as mulheres embaraçadas, incorporar o OROV no diagnóstico diferencial de doenças febris e investigar mais o fundo dos possíveis mecanismos patogênicos do vírus.

Resumen Introducción: El sufrimiento psicológico entre adolescentes y estrategias para la promoción de la salud mental existe y es necesario. Objetivo: Caracterizar las demandas emocionales de adolescentes escolares y describir conocimientos sobre factores protectores de la salud mental. Métodos: Investigación sociopoética con 30 adolescentes. Resultados: Temas de análisis: “Cuestiones de interés sobre emociones y salud mental”; “Cómo afrontar el estrés y la ansiedad”; “Reflexiones sobre la resolución de conflictos y problemas enfrentados”; y “Conocimiento sobre factores protectores de la salud mental”. Conclusiones: Las actividades recreativas y artísticas son poderosas para la promoción de la salud mental de los adolescentes y pueden implementarse a través de la asociación escuela-servicio de salud.

Abstract Introduction: Psychological suffering among adolescents and strategies for the promotion of mental health exists and is necessary. Aim: To characterize the emotional demands of school adolescents and describe knowledge about protective factors of mental health. Methods: Sociopoetic research with 30 adolescents. Results/Analysis topics: “Questions of interest about emotions and mental health”; “Dealing with stress and anxiety”; “Reflections on conflict resolution and problems faced”; and “Knowledge about protective factors of mental health”. Conclusions: Recreational and artistic activities are powerful for the promotion of adolescent mental health, and can be implemented through the school-health service partnership.

Resumo Introdução: O sofrimento psicológico entre adolescentes e estratégias para a promoção da saúde mental existem e são necessários. Objetivo: Caracterizar as demandas emocionais de adolescentes escolares e descrever o conhecimento sobre fatores protetores da saúde mental. Métodos: Pesquisa sociopoética com 30 adolescentes. Resultados: Temas de análise: “Questões de interesse sobre emoções e saúde mental”; “Lidar com o stresse e a ansiedade”; “Reflexões sobre resolução de conflitos e problemas enfrentados”; e “Conhecimento sobre fatores de proteção da saúde mental”. Conclusões: As atividades recreativas e artísticas são potentes para a promoção da saúde mental dos adolescentes e podem ser implementadas através da parceria escola/serviço de saúde.

Abstract Familial chylomicronemia syndrome (FCS) is an autosomal recessive disorder, characterized by alterations in the catabolism of chylomicrons and by increased levels of plasma triglycerides. It has been shown that about 60-90% of FCS patients have biallelic mutations in the LPL gene and the remaining patients have mutations in genes encoding proteins closely related to LPL function. The objective of this manuscript is to illustrate the different clinical scenarios of FCS presentation, and to guide practitioners on the usefulness of genetic tests in each of them. To this end, several published papers about recommendations for the diagnosis of FCS are discussed briefly, in addition to the presentation of several hypothetical cases, highlighting different clinical presentations and possible associated genetic findings. These cases illustrate the multiplicity of potential aspects of family history, clinical manifestations, biochemical parameters, and patterns of genetic variants found in genomic analyses of FCS. (FCS disorder triglycerides 6090% 6090 60 90% 90 60-90 function them end briefly findings history manifestations parameters 609 6 9 60-9 60-

Abstract Background There is a remarkable variability in the frequency of HLA-B27 positivity in patients with spondyloarthritis (SpA), which may be associated with different clinical presentations worldwide. However, there is a lack of data considering ethnicity and sex on the evaluation of the main clinical and prognostic outcomes in mixed-race populations. The aim of this study was to evaluate the frequency of HLA-B27 and its correlation with disease parameters in a large population of patients from the Brazilian Registry of Spondyloarthritis (RBE). Methods The RBE is a multicenter, observational, prospective cohort that enrolled patients with SpA from 46 centers representing all five geographic regions of Brazil. The inclusion criteria were as follow: (1) diagnosis of axSpA by an expert rheumatologist; (2) age ≥18 years; (3) classification according to ASAS axial. The following data were collected via a standardized protocol: demographic data, disease parameters and treatment historical. Results A total of 1096 patients were included, with 73.4% HLA-B27 positivity and a mean age of 44.4 (±13.2) years. Positive HLA-B27 was significantly associated with male sex, earlier age at disease onset and diagnosis, uveitis, and family history of SpA. Conversely, negative HLA-B27 was associated with psoriasis, higher peripheral involvement and disease activity, worse quality of life and mobility. Conclusions Our data showed that HLA-B27 positivity was associated with a classic axSpA pattern quite similar to that of Caucasian axSpA patients around the world. Furthermore, its absence was associated with peripheral manifestations and worse outcomes, suggesting a relevant phenotypic difference in a highly miscegenated population. HLAB27 HLAB HLA B27 B HLA-B2 SpA, , (SpA) worldwide However mixedrace mixed race populations RBE. . (RBE) multicenter observational 4 Brazil follow 1 (1 rheumatologist 2 (2 18 ≥1 years 3 (3 axial protocol historical 109 included 734 73 73.4 444 44 44. ±13.2 132 13 (±13.2 uveitis Conversely psoriasis activity mobility world Furthermore HLAB2 B2 HLA-B (SpA (RBE ( ≥ 10 7 73. ±13. (±13. ±13 (±13 ±1 (±1 ± (±

Abstract The integration of emigrants into the labor market has effects on the person's migration trajectory and their interaction with the host society. It is often overcome by difficulties in adjusting human capital and professional skills to the needs of the labor market. Qualified migration illustrates with acuity the heterogeneity of these processes. The employability of qualified emigration is not uniform. Some emigrants, despite having a higher level of qualification, may find themselves working in unskilled professions - a situation of over-qualification. Based on two studies on Portuguese emigration, over-qualification rates were found in the order of 18.1% and 16.9%. Negative consequences of this over-qualification were identified: dissatisfaction with work and low wages. Factors associated with this over-qualification were also identified: young age, social and human sciences training, and residence in classic Portuguese emigration countries with a high proportion of low-skilled emigration. persons person s society processes uniform qualification overqualification. overqualification over qualification. 181 18 1 18.1 169 16 9 16.9% identified wages age training lowskilled skilled 18. 16.9 16.

Resumo A integração de emigrantes no mercado de trabalho tem efeitos na trajetória migratória da própria pessoa e na sua interação com a sociedade de acolhimento. É frequentemente trespassada por dificuldades de ajustamento do capital humano e das competências profissionais às necessidades do mercado de trabalho. A migração qualificada ilustra com particular acuidade a heterogeneidade destes processos. Com efeito, a empregabilidade da emigração qualificada não é uniforme. Alguns/mas emigrantes, embora com uma qualificação de nível superior, podem encontrar-se a desempenhar profissões não qualificadas - situação de sobre-qualificação. Com base em dois estudos sobre a emigração portuguesa, apuraram-se taxas de sobre-qualificação na ordem dos 18,1% e dos 16,9%. Identificaram-se consequências negativas desta sobre-qualificação: insatisfação com o trabalho e baixos salários. Identificaram-se também fatores associados a esta sobre-qualificação: a idade jovem, a formação em ciências sociais e humanas e a residência em países clássicos da emigração portuguesa com elevado peso de emigração pouco qualificada. acolhimento processos efeito uniforme Algunsmas Alguns mas superior encontrarse encontrar se sobrequalificação. sobrequalificação qualificação. apuraramse apuraram 181 18 1 18,1 169 16 9 16,9% Identificaramse Identificaram salários jovem 18, 16,9 16,

Abstract Research around the world has focused on developing ways to predict hydraulic parameters in water distribution systems. The application of these forecasts can contribute to the decision-making of water distribution systems managers, aiming to ensure that the demand is met, and even to reduce water losses. The present work sought, among two data prediction models (ARIMA and Multi-Layer Perceptron Artificial Neural Networks), to assess which one can perform best predictions of pressure and discharge rate data. To reach the stipulated goal, real data were obtained from a water supply network provided by NUMMARH - Nucleus of Modeling and Simulation in Environment and Water Resources and Systems of the Federal University of Itajubá, Brazil. These data initially underwent an adjustment so that it was possible to develop a computer program. The results showed that the best prediction model for the data in question was ARIMA, presenting a mean absolute percentage error (MAPE) of 8.54%. Thus, it is concluded that ARIMA models are easy to build and apply, being an advantageous tool to predict such hydraulic parameters. decisionmaking decision making managers met losses sought MultiLayer Multi Layer Networks, Networks , Networks) goal Itajubá Brazil program MAPE (MAPE 854 8 54 8.54% Thus apply 85 5 8.54 8.5 8.

Resumo Pesquisas ao redor do mundo vem se concentrando em desenvolver maneiras de prever parâmetros hidráulicos em sistemas de distribuição de água. A aplicação destas previsões pode contribuir para a tomada de decisão dos gestores dos sistemas de distribuição de água, visando a garantia do atendimento da demanda, e até mesmo a redução de perdas de água. O presente trabalho buscou, dentre os modelos ARIMA e Redes Neurais Artificiais do tipo “Perceptron” de múltiplas camadas, identificar qual é capaz de realizar a melhor previsão de dados de pressão e vazão. Primeiro foram obtidos dados reais de uma rede de abastecimento de água em região de topografia irregular, que foram coletados pelo grupo de pesquisa NUMMARH - Núcleo de Modelagem e Simulação em Meio Ambiente e Recursos e Sistemas Hídricos, e fornecidos para execução deste trabalho. Os resultados mostraram que o melhor modelo de previsão para os dados em questão foi o ARIMA, apresentando erro médio percentual absoluto (MAPE) de 8,54%. Como conclusão identificou-se que os modelos ARIMA são de fácil construção e aplicação, sendo assim uma vantagem para se prever tais parâmetros hidráulicos. demanda buscou Perceptron “Perceptron camadas vazão irregular Hídricos MAPE (MAPE 854 8 54 8,54% identificouse identificou 85 5 8,54 8,5 8,

Abstract Patient Blood Management (PBM) is a holistic approach to managing blood as a resource of each patient; it is a multimodal strategy that is implemented using a set of techniques that can be applied in individual cases. In fact, the overall result of the implementation of PBM cannot be fully appreciated or explained by simply summing up the effects of the individual strategies and techniques used, since they can only produce the expected ideal result if combined. Implementing a PBM program in healthcare offers several benefits including improved patient safety, better outcomes, cost savings, conservation of resources, evidence-based practice, transfusion alternatives, improved quality of care, compliance with accreditation standards, patient-centered care, and professional education and training. (PBM cases fact used combined safety outcomes savings resources evidencebased evidence based practice alternatives care standards patientcentered centered training

Abstract Managing the patient's blood and hematopoietic system is like managing any of the other organs and organ systems during patient care. Specialists control the heart, kidneys, endocrine system, etc. and the patient's blood requires similar clinical treatment. The hematopoietic system and its circulatory products are fundamental for the healthy functioning of the human body. In simple terms, Patient Blood Management (PBM) is an organized, patient-centered approach in which the entire healthcare team coordinates efforts to improve outcomes by managing and preserving the patient's own blood. By reducing dependence on blood transfusions, PBM seeks to improve clinical outcomes, reduce the risks and costs associated with transfusions, and improve the safety and quality of patient care. Essentially, the concept of PBM is about the holistic management and preservation of the patient's own blood in the medical and surgical context. patients s care heart kidneys etc treatment body terms (PBM organized patientcentered centered transfusions Essentially context

Abstract Patient Blood Management (PBM) is a multidimensional approach that seeks to optimize the use of blood and its components in patients. This matter emerged as a response to the need to reduce unnecessary exposure to blood transfusions and their potential risks. In the past, blood transfusion was often overused resulting in complications and high costs. The advent of Patient Blood Management has caused a paradigm shift, highlighting anemia prevention, bleeding control and maximizing the production of blood cells by the organism itself. Patient Blood Management guidelines include the early identification of anemia, strategies to minimize blood loss during surgery, intraoperative blood conservation techniques, preoperative hemoglobin optimization and evidence-based approaches to the rational use of blood transfusions. Aiming to improve clinical outcomes, decrease transfusion-related complications and reduce associated costs, this multidisciplinary approach counts on doctors, nurses, pharmacists and other healthcare professionals. Based on research and clinical evidence, Patient Blood Management continues to evolve thereby promoting safer, more effective patient-centered practices. Its implementation has proven beneficial in various medical contexts thereby contributing to improvements in the quality of care provided to patients. Our goal with this Consensus is to present readers with a broad and diverse view of Patient Blood Management so that they have the building blocks to implement this new technique. PBM (PBM patients risks past costs shift prevention itself surgery techniques evidencebased evidence based outcomes transfusionrelated related doctors nurses professionals safer patientcentered patient centered practices technique

Abstract Background Cutaneous melanoma is a neoplasm with a high mortality rate and risk of metastases to distant organs. The Breslow micrometric measurement is considered the most important factor for evaluating prognosis and management, measured from the granular layer to the deepest portion of the neoplasm. Despite its widespread use, the Breslow thickness measurement has some inaccuracies, such as not considering variations in the thickness of the epidermis in different body locations or when there is ulceration. Objective To evaluate the applicability of a modified Breslow measurement, measured from the basal membrane instead of from the granular layer, in an attempt to predict sentinel lymph node examination outcome and survival of patients with melanoma. Methods A retrospective and cross-sectional analysis was carried out based on the evaluation of slides stained with hematoxylin & eosin from 275 cases of melanoma that underwent sentinel lymph node biopsy from 2008 to 2021 at a reference center in Brazil. Results Analysis of the Cox model to evaluate the impact of the Breslow measurement and the modified Breslow measurement on survival showed that both methods are statistically significant. Logistic regression revealed a significant association between both measurements and the presence of metastasis in sentinel lymph nodes. Conclusion Measuring melanoma depth from the basal membrane (modified Breslow measurement) is capable of predicting survival time and sentinel lymph node outcome, as well as the conventional Breslow measurement. organs management use inaccuracies ulceration crosssectional cross sectional 27 200 202 Brazil nodes 2 20

ABSTRACT Euterpe precatória Mart. (açaí-do-amazonas) and Euterpe oleracea Mart. (açaí-do-pará) are palm trees of socioeconomic importance to Brazil, and fruit demand has increased due to its nutritional characteristics. This study aimed to evaluate the effect of global climate change on the current geographic distribution of E. precatória and E. oleracea and in future climate scenarios using the ecological niche modeling in the scope of Brazilian territories. The modelings used 28 environmental variables, including climatic and edaphic data. The current distribution was verified for the reference period (2009-2019) and future projections were evaluated in two scenarios (Shared Socioeconomic Pathways - SSP): SSP 245 (less pessimistic) and SSP 585 (more pessimistic), in the time interval of 2061-2080. All algorithms presented satisfactory evaluation indexes. Euterpe precatória has a predominant geographic distribution in the Amazon domain, while E. oleracea has potential occurrence in three Brazilian phytogeographic domains: Amazon, Cerrado and Atlantic Forest. Euterpe oleracea showed to be more sensitive to climate change in both scenarios, while E. precatoria was more resilient up to a certain level of temperature increase (SSP 245). Mart açaídoamazonas açaí do amazonas (açaí-do-amazonas açaídopará pará (açaí-do-pará Brazil characteristics E territories 2 variables data 20092019 2009 2019 (2009-2019 Shared SSP) 24 less pessimistic 58 pessimistic, , 20612080. 20612080 2061 2080. 2080 2061-2080 indexes domain domains Forest 245. . 245) 2009201 200 201 (2009-201 5 2061208 206 208 2061-208 200920 20 (2009-20 206120 2061-20 20092 (2009-2 20612 2061-2 (2009- 2061- (2009 (200 (20 (2 (

RESUMO Euterpe precatoria Mart. (açaí-do-amazonas) e Euterpe oleracea Mart. (açaí-do-pará) são palmeiras de importância socioeconômica para o Brasil, e a demanda por frutos vem aumentando devido às suas características nutricionais. Objetivou-se avaliar o efeito das mudanças climáticas globais na distribuição geográfica atual de E. precatoria e E. oleracea e em cenários climáticos futuros, por meio de modelagem de nicho ecológico, nos âmbitos dos territórios brasileiros. As modelagens foram realizadas utilizando-se 28 variáveis ambientais, incluindo dados climáticos e edáficos. A distribuição atual foi verificada para o período de referência (2009-2019) e as projeções futuras em dois cenários (Shared Socioeconomic Pathways - SSP): SSP 245 (menos pessimista) e SSP 585 (mais pessimista), no intervalo de tempo 2061-2080. Todos os algoritmos apresentaram índices de avaliação satisfatórios. Euterpe precatoria possui distribuição geográfica predominante no domínio Amazônia, enquanto E. oleracea possui ocorrência potencial em três domínios fitogeográficos brasileiros: Amazônia, Cerrado e Mata Atlântica. Euterpe oleracea se mostrou mais sensível às alterações climáticas nos dois cenários, enquanto E. precatoria foi mais resiliente até certo nível de aumento de temperatura (SSP 245). Mart açaídoamazonas açaí do amazonas (açaí-do-amazonas açaídopará pará (açaí-do-pará Brasil nutricionais Objetivouse Objetivou E futuros ecológico brasileiros utilizandose utilizando 2 ambientais edáficos 20092019 2009 2019 (2009-2019 Shared SSP) 24 menos pessimista 58 pessimista, , 20612080. 20612080 2061 2080. 2080 2061-2080 satisfatórios Amazônia Atlântica 245. . 245) 2009201 200 201 (2009-201 5 2061208 206 208 2061-208 200920 20 (2009-20 206120 2061-20 20092 (2009-2 20612 2061-2 (2009- 2061- (2009 (200 (20 (2 (

ABSTRACT Objective: compare the levels of cultural capital inherited from the family among quota and non-quota students from Brazilian federal universities and analyze its influence on the occupation and remuneration of graduates. Theoretical framework: the sociological literature points out that students from low-income families (such as quota holders) lack cultural capital inherited from the family and this can negatively affect their opportunities in the job market. Methods: we applied an electronic questionnaire to 11,458 graduates from 248 undergraduate courses and 18 Brazilian federal universities. We created the levels of cultural capital of graduates based on a factor analysis, carried out through a combination of variables such as parents’ education and frequency of consumption of cultural goods by students before entering university. We compared the averages obtained for cultural capital between quota and non-quota students through Student’s t-test, and through multinomial logistic regression, we analyzed the influence of this cultural capital on the occupation and remuneration of graduates. Results: the results suggest that quota student graduates have lower levels of cultural capital before entering the federal university than non-quota student graduates. However, the results suggest little influence of this cultural capital for occupational and salary gains in the labor market. Conclusions: the results highlight the relevance of the quota policy of federal universities for the sociocultural and socioeconomic inclusion of quota students. Objective nonquota non framework lowincome low income holders market Methods 11458 11 458 11,45 24 1 analysis parents Students Student s ttest, ttest t test, test t-test regression Results However Conclusions 1145 45 11,4 2 114 4 11,

RESUMO Objetivo: comparar os níveis de capital cultural herdado da família entre egressos cotistas e não cotistas das universidades federais brasileiras e analisar a sua influência sobre a ocupação e remuneração dos egressos. Marco teórico: a literatura sociológica destaca que estudantes de famílias de baixa renda (como os cotistas) carecem de capital cultural herdado da família e isso pode afetar negativamente suas oportunidades no mercado de trabalho. Métodos: aplicamos um questionário eletrônico a 11.458 egressos, de 248 cursos de graduação e de 18 universidades federais brasileiras. Criamos os níveis de capital cultural dos egressos a partir de uma análise fatorial, realizada através de uma combinação de variáveis como escolaridade dos pais e frequência de consumo de bens culturais pelos estudantes antes de eles entrarem na universidade. Comparamos as médias obtidas de capital cultural entre egressos cotistas e não cotistas através do teste t de Student, e por meio da regressão logística multinomial, analisamos a influência desse capital cultural sobre a ocupação e remuneração dos egressos. Resultados: os resultados sugerem que egressos cotistas possuem menores níveis de capital cultural antes de entrarem na universidade federal do que os egressos não cotistas. No entanto, os resultados sugerem pouca influência desse capital cultural para ganhos ocupacionais e salariais no mercado de trabalho. Conclusões: os resultados destacam a relevância da política de cotas das universidades federais para a inclusão sociocultural e socioeconômica dos estudantes cotistas. Objetivo teórico trabalho Métodos 11458 11 458 11.45 24 1 fatorial Student multinomial Resultados entanto Conclusões 1145 45 11.4 2 114 4 11.

Abstract The authors aim to study Religiosity/Spirituality (R/S) and Quality of Life (QoL) in patients with Crohn's disease and their correlation with the disease phenotypes. Methods Prospective cross-sectional cohort study with 151 consecutive patients enrolled from March 2021 to October 2021 at the Colorectal IBD Outpatient of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). Sociodemographic, Religiosity/Spirituality (Duke University Religion Index - Durel) questionnaires and QoL (Inflammatory Bowel Disease Questionnaire - Short IBDQ-S) were applied. When necessary, qualitative variables were evaluated using the chi-square or Fisher's exact test. The Mann-Whitney and Kruskall-Wallis tests were used to analyze quantitative variables and compare more than two groups, both non-parametric statistical techniques. Results The most frequent location was Ileocolonic followed by Ileal and colonic (41.1 %, 27.2 %, and 25.2 %); only 6.6 % of subjects had a perianal presentation. Inflammatory, stenosing, and penetrating behaviors showed 36.4 %, 19.1 %, and 44.4 % respectively. The majority of the population is Catholic, Evangelical, or Spiritualist (92.4 %). QoL score showed no significant difference in the phenotypes. The scores for DUREL domains were 61.4 % for organizational religiosity, 75 % for non-organizational religiosity, 98.6 %, 93.6 % and 89.3 % for intrinsic spirituality, with high results in all disease phenotypes. Conclusions The studied population presented homogeneous sociodemographic results and high religious and spiritual activity. R/S in a positive context were not associated with better QoL or phenotype. R/S is present in the patients’ lives and could be seen as an important tool for adherence to treatment and the professional relationship between doctor and patient. The homogeneity of the sample difficult for an appropriate evaluation, which leads us to suggest new studies with more heterogeneous groups. ReligiositySpirituality Religiosity Spirituality RS R S (R/S (QoL Crohns Crohn s phenotypes crosssectional cross sectional 15 202 HCFMUSP. HCFMUSP . (HCFMUSP) Sociodemographic Duke Durel Inflammatory IBDQS IBDQ IBDQ-S applied necessary chisquare chi square Fishers Fisher test MannWhitney Mann Whitney KruskallWallis Kruskall Wallis groups nonparametric non parametric techniques 41.1 411 41 1 (41. 272 27 2 27. 252 25 25. %) 66 6 6. presentation stenosing 364 36 4 36. 191 19 19. 444 44 44. respectively Catholic Evangelical 92.4 924 92 (92. %. 614 61 61. religiosity 7 nonorganizational 986 98 98. 936 93 93. 893 89 3 89. spirituality activity phenotype patient evaluation 20 (HCFMUSP 41. (41 92. 9 (92 8 (4 (9 (

Objective: To report on suicide plans and attempts among Brazilian physicians and to investigate the associated risk factors. Methods: From January 2018 to January 2019, a nationwide online survey was conducted among Brazilian physicians using the Tool for Assessment of Suicide Risk and the Satisfaction with Life Scale. Multivariate exploratory associations of demographic, psychological, and work-related factors were performed on reports of suicide plans and attempts. Results: Of the 4,148 participants, 1,946 (53.5%) were male, 2,527 (60.9%) were 30 to 60 years old, 2,675 (64.5%) had two to four jobs, and 1,725 (41.6%) worked 40 to 60 hours a week. The overall prevalence of suicide plans was 8.8% (n=364), and suicide attempts were reported by 3.2% (n=133) of participants. Daily emotional exhaustion (ORadj = 7.857; 95%CI 2.282-27.051, p = 0.002), weekly emotional exhaustion (ORadj = 7.953; 95%CI 2.403-26.324, p = 0.001), daily frustration at work (ORadj = 3.093; 95%CI 1.711-5.588, p < 0.001), and bisexuality (ORadj = 5.083; 95%CI 2.544-10.158, p < 0.001) were significantly associated with higher odds of suicide. Extremely dissatisfied physicians reported suicide plans and attempts in 38.3% of cases, whereas extremely satisfied physicians reported suicide plans and attempts in only 2.8% of cases (p < 0.001). Conclusion: Brazilian physicians with a history of suicide plans and attempts express emotional exhaustion and frustration at work. There is an urgent need for actions to promote professional safeguards and resilience. Objective Methods 201 2019 Scale demographic psychological workrelated related Results 4148 4 148 4,14 participants 1946 1 946 1,94 53.5% 535 53 5 (53.5% male 2527 2 527 2,52 60.9% 609 9 (60.9% 3 6 old 2675 675 2,67 64.5% 645 64 (64.5% jobs 1725 725 1,72 41.6% 416 41 (41.6% week 88 8 8.8 n=364, n364 n n=364 , 364 (n=364) 32 3.2 n=133 n133 133 (n=133 ORadj 7.857 7857 7 857 95CI CI 95 2.28227.051, 228227051 2.282 27.051, 282 27 051 2.282-27.051 0.002, 0002 0.002 0 002 0.002) 7.953 7953 953 2.40326.324, 240326324 2.403 26.324, 403 26 324 2.403-26.324 0.001, 0001 0.001 001 3.093 3093 093 1.7115.588, 17115588 1.711 5.588, 711 588 1.711-5.588 5.083 5083 083 2.54410.158, 254410158 2.544 10.158, 544 10 158 2.544-10.158 383 38 38.3 28 2.8 0.001. . Conclusion resilience 20 414 14 4,1 194 94 1,9 53.5 (53.5 252 52 2,5 60.9 (60.9 267 67 2,6 64.5 (64.5 172 72 1,7 41.6 (41.6 8. n36 n=36 36 (n=364 3. n=13 n13 13 (n=13 7.85 785 85 28227 2.28227.051 22822705 2282 2.28 27051 27.051 05 2.282-27.05 000 0.00 00 7.95 795 40326 2.40326.324 24032632 2403 2.40 26324 26.324 2.403-26.32 3.09 309 09 7115 1.7115.588 1711558 1711 1.71 5588 5.588 71 58 1.711-5.58 5.08 508 08 54410 2.54410.158 25441015 2544 2.54 10158 10.158 54 15 2.544-10.15 38. 2. 4, 19 1, 53. (53. 25 2, 60. (60. 64. (64. 17 41. (41. n3 n=3 (n=36 n=1 n1 (n=1 7.8 78 2822 2.28227.05 2282270 228 2.2 2705 27.05 2.282-27.0 0.0 7.9 79 4032 2.40326.32 2403263 240 2.4 2632 26.32 2.403-26.3 3.0 1.7115.58 171155 171 1.7 558 5.58 1.711-5.5 5.0 50 5441 2.54410.15 2544101 254 2.5 1015 10.15 2.544-10.1 (53 (60 (64 (41 n= (n=3 (n= 7. 2.28227.0 228227 22 270 27.0 2.282-27. 0. 2.40326.3 240326 24 263 26.3 2.403-26. 1.7115.5 17115 1. 55 5.5 1.711-5. 5. 2.54410.1 254410 101 10.1 2.544-10. (5 (6 (4 (n 2.28227. 22822 27. 2.282-27 2.40326. 24032 26. 2.403-26 1.7115. 1.711-5 2.54410. 25441 10. 2.544-10 ( 2.28227 2.282-2 2.40326 2.403-2 1.7115 1.711- 2.54410 2.544-1 2.2822 2.282- 2.4032 2.403- 2.5441 2.544-