Resumen Introducción: El dengue es uno de los arbovirus de mayor importancia clínica y epidemiológica a nivel mundial. En Guatemala, durante el 2023 se registró el número más alto de casos en los últimos 10 años y un incremento de 135% en el número de casos comparado con el 2022. Objetivo: Caracterización clínica de dengue con signos de alarma y dengue grave. Metodología: Estudio descriptivo transversal retrospectivo, incluyó registros de 206 pacientes con signos de alarma de dengue que acudieron a la Emergencia de Adultos del Hospital Roosevelt de Guatemala, del 26 de septiembre al 26 de noviembre del 2023. Resultados: Predominó el sexo femenino en 54,4% y el grupo etario de 12-22 años en 51,0%. El principal signo de alarma fue el sangrado en 63,6%. Las mayores complicaciones fueron hepatopatía en 9,2%, choque en 5,8% y alteración neurológica en 2,9%. Respecto a los parámetros hematológicos, predominaron la trombocitopenia en 93,2%, leucopenia en 53,9% y linfocitosis en 71,4%. Las transaminasas AST y ALT presentaron elevación en 97,0% (96/99) y 91,0% (142/156), respectivamente. Los tiempos de coagulación se mostraron prolongados en 55,9% (104/186) para TPT y en 22,6% (42/186) para TP. Hubo 78,7% de positividad (148/188) para dengue. El 8,3% (17/206) de los pacientes fue referido al área crítica por clasificación de dengue grave. Conclusión: Estos datos aportan una mejora en el reconocimiento y el manejo clínico adecuado de casos con signos de alarma y dengue grave, que pueden contribuir para disminuir la carga de morbimortalidad de esta enfermedad en el país.

Resumo Introdução: A dengue é uma das arboviroses de maior importância clínica e epidemiológica em todo o mundo. Na Guatemala, durante 2023 foi registrado o maior número de casos dos últimos 10 anos e um aumento de 135% no número de casos em relação a 2022. Objetivo: Caracterização clínica da dengue com sinais de alerta e dengue grave. Metodologia: Estudo descritivo transversal que incluiu registros de 206 pacientes com sinais de alerta de dengue atendidos na Emergência Adulto do Hospital Roosevelt, na Guatemala, no período de 26 de setembro a 26 de novembro de 2023. Resultados: O sexo feminino predominou em 54,4% e na faixa etária de 12 a 22 anos em 51,0%. O principal sinal de alerta foi sangramento em 63,6%. As principais complicações foram doença hepática em 9,2%, choque em 5,8% e alteração neurológica em 2,9%. Em relação aos parâmetros hematológicos, houve predomínio de trombocitopenia em 93,2%, leucopenia em 53,9% e linfocitose em 71,4%. As transaminases AST e ALT foram elevadas em 97,0% (96/99) e 91,0% (142/156), respectivamente. Os tempos de coagulação foram prolongados em 55,9% (104/186) para TPT e em 22,6% (42/186) para TP. Houve 78,7% de positividade (148/188) para dengue. 8,3% (17/206) dos pacientes foram encaminhados para a área crítica devido à classificação de dengue grave. Conclusão: Esses dados proporcionam uma melhoria no reconhecimento e manejo clínico adequado dos casos com sinais de alerta e dengue grave, o que pode contribuir para a redução da carga de morbidade e mortalidade dessa doença no país.

Abstract Introduction: Dengue is one of the most clinically and epidemiologically important arboviruses worldwide. In Guatemala, the highest number of cases in the last 10 years was recorded in 2023 and an increase of 135% in the number of cases compared to 2022. Objective: Clinical characterization of dengue with warning signs and severe dengue. Methodology: Retrospective cross-sectional descriptive study, included records of 206 patients with warning signs of dengue who attended the Adult Emergency of the Roosevelt Hospital in Guatemala, from September 26 to November 26, 2023. Results: The female sex predominated in 54,4% and the age group of 12-22 years in 51,0%. The main warning sign was bleeding in 63,6%. The major complications were liver disease in 9,2%, shock in 5,8% and neurological alterations in 2,9%. Regarding hematological parameters, thrombocytopenia predominated in 93,2%, leukopenia in 53,9% and lymphocytosis in 71,4%. The transaminases AST and ALT were elevated in 97,0% (96/99) and 91,0% (142/156), respectively. Coagulation times were prolonged in 55,9% (104/186) for TPT and in 22,6% (42/186) for TP. There was 78,7% positivity (148/188) for dengue. The 8,3% (17/206) of patients were referred to the critical area for classification of severe dengue. Conclusion: These data provide an improvement in the recognition and adequate clinical management of cases with warning signs and severe dengue, which can contribute to reducing the burden of morbidity and mortality from this disease in the country.

Resumo Introdução: a escassez de debates sobre o cuidado de enfermagem às gestantes com doença falciforme no país e a urgente necessidade de intervenção e melhorias na assistência de enfermagem prestada às essas mulheres, motivaram este estudo. Além disso, em instrumentos para uso em pesquisa e/ou na prática clínica, a validade é um atributo essencial. Objetivo: desenvolver e validar um instrumento para cuidados às gestantes com doença falciforme. Materiais e método: estudo metodológico, de validação de conteúdo com juízas(es) especialistas. O instrumento foi estruturado com 19 diagnósticos de enfermagem que abordaram as dimensões biológica, psíquica e social, e 126 intervenções de enfermagem. Utilizou-se a técnica Delphi, com participação de 18 juízas(es). Os resultados foram analisados por meio do índice de validade de conteúdo e nível de concordância acima de 0,80. Resultados: dos 145 itens analisados, 22 (15,17 %) apresentaram índice de validade de conteúdo < 0,80, e os ajustes sugeridos pelas(os) juízas(es) foram implementados. O índice de validade de conteúdo geral do instrumento foi calculado em 0,87. O instrumento alcançou parámetros aceitáveis de validade de conteúdo, segundo o critério utilizado. Conclusões: destaca-se o potencial do instrumento, que pode ser aprimorado a partir do seu uso, como recurso na orientação das práticas de enfermagem voltadas às mulheres grávidas com doença falciforme, nos âmbitos da atenção primária à saúde e da rede hospitalar.

Resumen Introducción: la escasez de debates sobre la atención de enfermería a gestantes con anemia de células falciformes en el país y la urgente necesidad de intervención y mejora de los cuidados de enfermería prestados a esas mujeres motivaron la realización de este estudio. Además, la validez es un atributo esencial en los instrumentos para uso en investigación y/o práctica clínica. Objetivo: elaborar y validar un instrumento de atención a gestantes con anemia de células falciformes. Material y método: estudio metodológico, de validación de contenido con jueces/as expertos/as. El instrumento se estructuró con 19 diagnósticos de enfermería que abordaban las dimensiones biológica, psicológica y social, y 126 intervenciones de enfermería. Se utilizó la técnica Delphi, con la participación de 18 jueces/as. Los resultados se analizaron utilizando el índice de validez de contenido y un nivel de acuerdo superior a 0,80. Resultados: de los 145 ítems analizados, 22 (15,17 %) tenían un índice de validez de contenido < 0,80, y se aplicaron los ajustes sugeridos por los/las jueces/as. El índice global de validez de contenido del instrumento se calculó en 0,87. El instrumento alcanzó parámetros de validez de contenido aceptables, según los criterios utilizados. Conclusiones: se destaca el potencial del instrumento, que puede ser perfeccionado a través de su utilización como recurso para orientar las prácticas de enfermería dirigidas a gestantes con anemia de células falciformes, tanto en la atención primaria de salud como en la red hospitalaria.

Abstract Introduction: The lack of discussions on nursing care for pregnant women with sickle cell disease in Brazil and the urgent need for intervention and improvements in the nursing care provided to these women sparked this study. In addition, validity is an essential attribute for instruments used in research and/or clinical practice. Objective: To develop and validate an instrument covering the care of pregnant women with sickle cell disease. Materials and methods: This is a methodological, content validation study conducted with specialist judges. The instrument was structured with 19 nursing diagnoses that addressed the biological, psychological, and social dimensions, as well as 126 nursing interventions. The Delphi technique was used with the participation of 18 judges. The results were analyzed using the content validity index and a level of agreement above 0.80. Results: Of the 145 items analyzed, 22 (15.17 %) scored a content validity index < 0.80, and the adjustments suggested by the judges were implemented. The instrument’s general content validity index was calculated at 0.87. The instrument reached acceptable content validity parameters, according to the criteria used. Conclusions: The instrument’s potential stands out, and it can be improved through its use as a resource for guiding nursing practices directed to pregnant women with sickle cell disease, both in primary health care and in hospital networks.

Abstract Massive sequencing platforms allow the identification of complex clinical phenotypes involving more than one autosomal recessive disorder. In this study, we report on an adult patient, born to a related couple (third degree cousins), referred for genetic evaluation due to ectopia lentis, deafness and previous diagnosis of juvenile idiopathic arthritis. He was biochemically diagnosed as having Classic Homocystinuria (HCU); Sanger sequencing of the CBS gene showed the genotype NM_000071.2(CBS):c.[833T>C];[833T>C], compatible with the diagnosis of pyridoxine-responsive HCU. As he also had symptoms not usually associated with HCU, exome sequencing was performed. In addition to the variants found in the Sanger sequencing, the following variants were identified: NM_001256317.1(TMPRSS3):c.[413C>A];[413C>A]; and the NM_005807.6(PRG4):c.[3756dup]:[3756dup], confirming the diagnosis of autosomal recessive nonsyndromic deafness and Camptodactyly-Arthropathy-Coxa Vara-Pericarditis Syndrome (CACP), respectively. Genomic analysis allowed the refinement of the diagnosis of a complex case and improvement of the patient’s treatment. disorder study patient third cousins, cousins , cousins) lentis arthritis HCU (HCU) NM_000071.2CBSc.833T>C833T>C, NM0000712CBSc833TC833TC NMCBScTCTC NM_000071.2 c. 833T>C NM 000071 2 c 833T C T NM_000071.2(CBS):c.[833T>C];[833T>C] pyridoxineresponsive pyridoxine responsive performed identified NM_001256317.1TMPRSS3c.413C>A413C>A NM0012563171TMPRSS3c413CA413CA NMTMPRSScCACA NM_001256317.1 TMPRSS3 413C>A 001256317 1 413C A TMPRSS NM_001256317.1(TMPRSS3):c.[413C>A];[413C>A] NM_005807.6PRG4c.3756dup3756dup, NM0058076PRG4c3756dup3756dup NMPRGcdupdup NM_005807.6 PRG4 3756dup 005807 6 PRG dup NM_005807.6(PRG4):c.[3756dup]:[3756dup] CamptodactylyArthropathyCoxa Camptodactyly Arthropathy Coxa VaraPericarditis Vara Pericarditis CACP, CACP (CACP) respectively patients s treatment (HCU 2CBSc C833T CBSc NM_000071.2CBSc.833T>C833T>C TC NM0000712 NM_000071. 833TC 00007 NM_000071.2(CBS):c.[833T>C];[833T>C 1TMPRSS3c A413C CA NM0012563171 NM_001256317. 413CA 00125631 NM_001256317.1(TMPRSS3):c.[413C>A];[413C>A 6PRG4c 3756dup3756dup NM_005807.6PRG4c.3756dup3756dup NM0058076 NM_005807. 00580 NM_005807.6(PRG4):c.[3756dup]:[3756dup (CACP CT NM000071 NM_000071 0000 TMPRSSc AC NM001256317 NM_001256317 0012563 PRGc dupdup NM005807 NM_005807 0058 NM00007 NM_00007 000 NM00125631 NM_00125631 001256 NM00580 NM_00580 005 NM0000 NM_0000 00 NM0012563 NM_0012563 00125 NM0058 NM_0058 NM000 NM_000 0 NM001256 NM_001256 0012 NM005 NM_005 NM00 NM_00 NM00125 NM_00125 001 NM0 NM_0 NM0012 NM_0012 NM_ NM001 NM_001

ABSTRACT Inactivated COVID-19 vaccines data in immunocompromised individuals are scarce. This trial assessed the immunogenicity of two CoronaVac doses and additional BNT162b2 mRNA vaccine doses in immunocompromised (IC) and immunocompetent (H) individuals. Adults with solid organ transplant (SOT), hematopoietic stem cell transplant, cancer, inborn immunity errors or rheumatic diseases were included in the IC group. Immunocompetent adults were used as control group for comparison. Participants received two CoronaVac doses within a 28-day interval. IC received two additional BNT162b2 doses and H received a third BNT162b2 dose (booster). Blood samples were collected at baseline, 28 days after each dose, pre-booster and at the trial end. We used three serological tests to detect antibodies to SARS-CoV-2 nucleocapsid (N), trimeric spike (S), and receptor binding domain (RBD). Outcomes included seroconversion rates (SCR), geometric mean titers (GMT) and GMT ratio (GMTR). A total of 241 IC and 100 H adults participated in the study. After two CoronaVac doses, IC had lower SCR than H: anti-N, 33.3% vs 79%; anti-S, 33.8% vs 86%, and anti-RBD, 48.5% vs 85%, respectively. IC also showed lower GMT than H: anti-N, 2.3 vs 15.1; anti-S, 58.8 vs 213.2 BAU/mL; and anti-RBD, 22.4 vs 168.0 U/mL, respectively. After the 3rd and 4th BNT162b2 doses, IC had significant anti-S and anti-RBD seroconversion, but still lower than H after the 3rd dose. After boosting, GMT increased in IC, but remained lower than in the H group. CoronaVac two-dose schedule immunogenicity was lower in IC than in H. BNT162b2 heterologous booster enhanced immune response in both groups. COVID19 COVID 19 COVID-1 scarce BNTb BNT b BNT162b (IC (H SOT, SOT , (SOT) cancer comparison 28day day interval booster. . (booster) baseline 2 prebooster pre end SARSCoV2 SARSCoV SARS CoV SARS-CoV- N, N (N) S, S (S) RBD. RBD (RBD) SCR, (SCR) (GMT GMTR. GMTR (GMTR) 24 10 study antiN, antiN anti anti-N 333 33 3 33.3 79% 79 antiS, antiS 338 8 33.8 86 86% antiRBD, antiRBD RBD, 485 48 5 48.5 85 85% respectively 23 2. 15.1 151 15 1 588 58 58. 2132 213 213. BAU/mL BAUmL BAU mL 224 22 4 22. 1680 168 0 168. UmL U U/mL rd th boosting twodose groups COVID1 COVID- (SOT (booster SARS-CoV (N (S (RBD (SCR (GMTR 33. 7 48. 15. 21 16

Objetivo: mapear a literatura científica referente ao uso do Chat Generative Pre-trained Transformer , ChatGPT, na escrita acadêmica em saúde. Método: tratou-se de uma revisão de escopo, seguindo o método do JBI. Foram incluídas bases de dados convencionais e literatura cinzenta. A seleção dos estudos foi realizada após a remoção de duplicatas e avaliação individual e em pares. Os dados foram extraídos com base em um roteiro elaborado, e apresentados de forma descritiva, tabular e gráfica. Resultados: a análise dos 49 artigos selecionados mostrou que o ChatGPT é uma ferramenta versátil, que contribui para a produção científica, descrição de procedimentos médicos e elaboração de resumos alinhados aos padrões das revistas científicas. Sua aplicação melhorou a clareza da redação e beneficia áreas como inovação e automação. Também foram observados riscos, como a possibilidade de falta de originalidade e questões éticas. Perspectivas futuras destacam a necessidade de regulamentação adequada, adaptação ágil e busca por um equilíbrio ético na incorporação do ChatGPT na escrita acadêmica. Conclusão: o ChatGPT apresenta um potencial transformador na escrita acadêmica na área da saúde. Contudo, sua adoção requer supervisão humana rigorosa, regulamentação sólida e diretrizes transparentes para garantir seu uso responsável e benéfico pela comunidade científica. Objetivo Pretrained Pre trained saúde Método tratouse tratou se escopo JBI cinzenta pares elaborado descritiva gráfica Resultados 4 versátil científicas automação riscos éticas adequada Conclusão Contudo rigorosa

Objetivo: mapear la literatura científica sobre el uso del Chat Generative Pre-trained Transformer , ChatGPT, en la escritura académica en salud. Método: se trató de una revisión de alcance, siguiendo la metodología del JBI. Se incluyeron bases de datos convencionales y literatura gris. La selección de los estudios se realizó previa eliminación de duplicados y evaluación individual y en pares. Los datos se extrajeron basándose en un guión elaborado y se presentaron en un formato descriptivo, tabular y gráfico. Resultados: el análisis de los 49 artículos seleccionados reveló que ChatGPT es una herramienta versátil, que contribuye a la producción científica, descripción de procedimientos médicos y elaboración de resúmenes alineados con los estándares de las revistas científicas. Se ha demostrado que su aplicación mejora la claridad de la redacción y beneficia áreas como la innovación y la automatización. También se observaron riesgos, como la posibilidad de falta de originalidad y cuestiones éticas. Las perspectivas futuras resaltan la necesidad de una regulación adecuada, adaptación ágil y búsqueda de un equilibrio ético en la incorporación del ChatGPT a la escritura académica. Conclusión: ChatGPT presenta un potencial transformador en la escritura académica en el área de la salud. Sin embargo, su adopción requiere una supervisión humana rigurosa, una regulación sólida y directrices transparentes para garantizar su uso responsable y beneficioso por parte de la comunidad científica. Objetivo Pretrained Pre trained salud Método alcance JBI gris pares descriptivo gráfico Resultados 4 versátil científicas automatización riesgos éticas adecuada Conclusión embargo rigurosa

Objective: to map the scientific literature regarding the use of the Chat Generative Pre-trained Transformer, ChatGPT, in academic writing in health. Method: this was a scoping review, following the JBI methodology. Conventional databases and gray literature were included. The selection of studies was applied after removing duplicates and individual and paired evaluation. Data were extracted based on an elaborate script, and presented in a descriptive, tabular and graphical format. Results: the analysis of the 49 selected articles revealed that ChatGPT is a versatile tool, contributing to scientific production, description of medical procedures and preparation of summaries aligned with the standards of scientific journals. Its application has been shown to improve the clarity of writing and benefits areas such as innovation and automation. Risks were also observed, such as the possibility of lack of originality and ethical issues. Future perspectives highlight the need for adequate regulation, agile adaptation and the search for an ethical balance in incorporating ChatGPT into academic writing. Conclusion: ChatGPT presents transformative potential in academic writing in health. However, its adoption requires rigorous human supervision, solid regulation, and transparent guidelines to ensure its responsible and beneficial use by the scientific community. Objective Pretrained Pre trained Transformer health Method review methodology included evaluation script descriptive format Results 4 tool production journals automation observed issues regulation Conclusion However supervision community

Abstract Background Patient management in rheumatoid arthritis (RA) has evolved to a “treat-to-target” (T2T) approach, which entails intensive treatment and regular follow-up with the goal of achieving low levels of disease activity or clinical remission. Even though a T2T approach is endorsed by professional organizations and yields superior outcomes, its implementation remains incomplete. EVEREST (EleVatE care in RhEumatoid arthritiS with Treat-to-target) is a quality-improvement initiative designed to improve the widespread implementation of a personalized T2T strategy and enable patients with RA to reach their full potential for remission. We describe the Brazilian results from the Global T2T Survey, first part of the EVEREST program. Methods Between June and September 2022, we conducted an online survey targeting rheumatologists in Brazil. Our objective was to evaluate the barriers and knowledge gaps hindering the effective implementation of T2T strategies. To achieve this, we employed a set of multiple-choice questions specifically crafted to elicit responses categorized in a structured order. Results 166 rheumatologists participated in the survey, 51% of them with more than 21 years of experience in rheumatology. Regarding the perceived challenges in the management of RA in clinical practice, the highest percentage of agreement/strong agreement among the participants was related to the contradictory results of disease activity measures (60%). In terms of the main barriers to assess the disease activity in clinical practice, the lack of adherence to treatment and contradictory assessments between patient-reported outcomes and composite measures were indicated by 75% and 59% of the participants, respectively, as a moderate/serious barrier. The most frequently knowledge and skill gaps related to the management of RA pointed out by the participants were on the difficulty to assess patients’ health literacy (54% stated to have no more than intermediate knowledge on standardized methods to assess it and 43% no more than intermediate skills on determining the level of health literacy of the patients). In general, the use of tools to support the management of RA patients in clinical practice was indicated to be unusual by the participants. Self-reflection questionnaires, patient education materials and treatment consideration checklists were pointed out as the least frequently used tools (85%, 64% and 62% of the participants stated to use them never, rarely, or only sometimes, respectively). Conclusions Our findings indicate a greater need for design, selection, and uptake of practical strategies to further improve communication between healthcare providers and patients with RA, as well as for promoting well-informed, collaborative decision-making in their care. (RA treattotarget treat target “treat-to-target TT T (T2T followup follow up remission incomplete EleVatE Treattotarget Treat Treat-to-target qualityimprovement quality improvement Survey program 2022 Brazil this multiplechoice multiple choice order 16 51 2 rheumatology agreementstrong strong 60%. 60 60% . (60%) patientreported reported 75 59 respectively moderateserious moderate serious barrier 54% 54 (54 43 patients. patients) general Selfreflection Self reflection questionnaires 85%, 85 (85% 64 62 never rarely sometimes respectively. respectively) design selection wellinformed, wellinformed informed, informed well-informed decisionmaking decision making 202 1 5 6 (60% 7 (5 4 85% 8 (85 20 (60 ( (8 (6

RESUMO Introdução: O CrossFit® é um método de treinamento físico que visa promover a aptidão física por meio do desenvolvimento de componentes como capacidade aeróbia, força e resistência muscular. Os dados sobre comportamentos de bruxismo em praticantes de CrossFit® são escassos, mas estudos prévios mostraram aumento do comportamento de apertamento dentário durante as práticas de levantamento de peso. Objetivo: O presente estudo teve como objetivo avaliar os sinais clínicos de bruxismo em praticantes de CrossFit®. Métodos: O estudo foi composto por uma amostra de conveniência de praticantes de CrossFit® (n=57), de ambos os sexos, com idade entre 19 e 58 anos, e as variáveis de desfecho foram: Lista de Verificação de Comportamento Oral, Questionário Internacional de Atividade Física e Ferramenta Padronizada para Avaliação do Bruxismo. Os dados foram expressos em termos de valores absolutos e percentuais. Para análise estatística, foram utilizados os testes de correlação de Spearman e exato de Fisher, e considerou-se nível de significância de 5%. Resultados: A média de idade foi de 32,82 anos, com maioria feminina (63,15%). Os praticantes de CrossFit® relataram frequentemente apertar os dentes durante a prática do treinamento (61,40%) e apresentaram linha alba (82,45%), impressão labial (54,38%), impressão de língua (26,31%), exostose óssea (19,29%), desgaste dentário (61,40%) e lesões cervicais não cariosas (35,09%). Conclusões: Não foi encontrada correlação entre sinais clínicos de bruxismo, comportamentos orais e intensidade da atividade física; no entanto, os resultados sugerem que indivíduos que praticam o treinamento CrossFit® apresentam comportamentos orais que podem causar alterações morfofuncionais no sistema estomatognático, principalmente o hábito de apertar os dentes durante o treinamento. Além disso, os dados enfatizam a necessidade de educação em saúde bucal entre os praticantes de CrossFit®, sendo necessários mais estudos com amostras representativas. Introdução CrossFit aeróbia muscular escassos peso Objetivo Métodos n=57, n57 n n=57 , 57 (n=57) sexos 1 5 anos Oral Bruxismo percentuais estatística Fisher considerouse considerou se 5% Resultados 3282 32 82 32,8 63,15%. 6315 63,15% . 63 15 (63,15%) 61,40% 6140 61 40 (61,40% 82,45%, 8245 82,45% 45 (82,45%) 54,38%, 5438 54,38% 54 38 (54,38%) 26,31%, 2631 26,31% 26 31 (26,31%) 19,29%, 1929 19,29% 29 (19,29%) 35,09%. 3509 35,09% 35 09 (35,09%) Conclusões entanto estomatognático disso representativas n5 n=5 (n=57 328 3 8 32, 631 63,15 6 (63,15% 61,40 614 4 (61,40 824 82,45 (82,45% 543 54,38 (54,38% 263 26,31 2 (26,31% 192 19,29 (19,29% 350 35,09 0 (35,09% n= (n=5 63,1 (63,15 61,4 (61,4 82,4 (82,45 54,3 (54,38 26,3 (26,31 19,2 (19,29 35,0 (35,09 (n= 63, (63,1 61, (61, 82, (82,4 54, (54,3 26, (26,3 19, (19,2 35, (35,0 (n (63, (61 (82, (54, (26, (19, (35, (63 (6 (82 (54 (26 (19 (35 ( (8 (5 (2 (1 (3

ABSTRACT Introduction: CrossFit® is a physical training method that aims to promote physical fitness through the development of components such as aerobic capacity, strength and muscular endurance. Data regarding bruxism behaviors in CrossFit® practitioners are scarce, but previous studies have shown increased dental clenching behavior during weightlifting practices. Objective: The present study aimed to evaluate clinical signs of bruxism in CrossFit® practitioners. Methods: The sample comprised a convenience sample of CrossFit® practitioners (n=57), of both genders, aged 19-58 years. Outcome variables were as follows: Oral Behavior Checklist, the International Physical Activity Questionnaire and the Standardized Tool for the Assessment of Bruxism. Data were expressed in terms of absolute values and percentages. Spearman’s correlation and Fisher exact tests were used for statistical analysis, and a significance level of 5% was considered. Results: The mean age was 32.82 years, with a female majority (63.15%). CrossFit® practitioners frequently reported clenching their teeth during training practice (61.40%) and presented linea alba (82.45%), lip impression (54.38%), tongue impression (26.31%), bone exostosis (19.29%), tooth wear (61.40%) and non-carious cervical lesions (35.09%). Conclusions: No correlation was found between clinical signs of bruxism, oral behaviors and physical activity intensity; however, the results suggest that individuals who practice CrossFit® training have oral behaviors that can cause morpho-functional changes in the stomatognathic system, especially the habit of clenching their teeth during training. In addition, data emphasize the need for dental health education among CrossFit® practitioners, and more studies with a representative sample are necessary. Introduction CrossFit capacity endurance scarce practices Objective Methods n=57, n57 n n=57 , 57 (n=57) genders 1958 19 58 19-5 years follows Checklist Bruxism percentages Spearmans Spearman s analysis 5 considered Results 3282 32 82 32.8 63.15%. 6315 63.15% . 63 15 (63.15%) 61.40% 6140 61 40 (61.40% 82.45%, 8245 82.45% 45 (82.45%) 54.38%, 5438 54.38% 54 38 (54.38%) 26.31%, 2631 26.31% 26 31 (26.31%) 19.29%, 1929 19.29% 29 (19.29%) noncarious non carious 35.09%. 3509 35.09% 35 09 (35.09%) Conclusions intensity however morphofunctional morpho functional system addition necessary n5 n=5 (n=57 195 1 19- 328 3 8 32. 631 63.15 6 (63.15% 61.40 614 4 (61.40 824 82.45 (82.45% 543 54.38 (54.38% 263 26.31 2 (26.31% 192 19.29 (19.29% 350 35.09 0 (35.09% n= (n=5 63.1 (63.15 61.4 (61.4 82.4 (82.45 54.3 (54.38 26.3 (26.31 19.2 (19.29 35.0 (35.09 (n= 63. (63.1 61. (61. 82. (82.4 54. (54.3 26. (26.3 19. (19.2 35. (35.0 (n (63. (61 (82. (54. (26. (19. (35. (63 (6 (82 (54 (26 (19 (35 ( (8 (5 (2 (1 (3

Abstract Sjogren’s disease (SjD) is an autoimmune disease that is characterized not only by the sicca symptoms it causes but also by its systemic nature, which is capable of several and not yet fully understood extraglandular manifestations. To gain a clearer understanding of these manifestations as well as a better practical approach, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of epidemiologic and clinical features of the extraglandular manifestations present in ESSDAI (EULAR Sjogren´s syndrome disease activity index), followed by a voting panel with recommendations for clinical practice. This publication is complementary to others already published and covers cutaneous and hematological manifestations, with prevalence data generated by a meta-analysis of 13 clinical or laboratory manifestations and 6 clinical management recommendations. Sjogrens Sjogren s SjD (SjD nature approach metaanalysis meta analysis EULAR index, index , index) practice 1

Abstract Both root canal sealer-based and supplementary protocols may influence removal of filling material during endodontic retreatment. Mesial root canals of extracted mandibular molars were prepared using HyFlex EDM 25/.08, and filled with a calcium silicate sealer (Bio-C Sealer), or an epoxy resin (AH Plus), using the single cone technique (n = 12). Retreatment was performed using ProDesign Logic (PDL) RT and PDL 35/.05. The specimens were randomly divided into two experimental groups (n = 12), and the sealers were distributed similarly. A supplementary protocol was performed with PDL 50/.01 or XP-endo Finisher. Root canal transportation and volume, in addition to the remaining filling material percentage were evaluated using high-resolution (5 µm voxel size) micro-CT. Statistical analysis was performed using t-tests (α = 0.05). Root canals filled with AH Plus presented high residual filling material (p < 0.05). Both protocols decreased residual volume of filling material in the apical third (p < 0.05). PDL 50/.01 increased the apical root canal volume (p < 0.05). No difference was observed between the systems regarding canal transportation (p > 0.05). In conclusion, AH Plus is more difficult to remove from the apical third than Bio-C Sealer. PDL 50/.01 and XP-endo Finisher enabled greater removal of filling materials in the apical third, in the retreatment of curved root canals, without promoting apical transport. sealerbased based 2508 25 08 25/.08 BioC Bio C Sealer, Sealer , Sealer) Plus, Plus) n 12. 12 . 12) (PDL 3505 35 05 35/.05 12, similarly 5001 50 01 50/.0 XPendo XP endo highresolution resolution 5 ( size microCT. microCT micro CT. CT micro-CT ttests t tests α 0.05. 005 0.05 0 0.05) p conclusion transport 250 2 25/.0 1 350 3 35/.0 500 50/. 00 0.0 25/. 35/. 50/ 0. 25/ 35/

Abstract This study evaluated the effect of ultrasonic agitation on the filling capacity of ready-to-use calcium silicate-based sealer Bio-C Sealer (BCS, Angelus, Paraná, Brazil) or powder-liquid BioRoot RCS (BR, Septodont, Saint-Maur-des-Fossés, France) using curved artificial canals by micro-computed tomography (micro-CT). Additionally, flow (mm) and flow area (mm2) were evaluated for both materials. Acrylic resin main canal (60° curvature and 5 mm radius, with 3 lateral canals in the cervical, middle, and apical thirds) were prepared up to size 40/.05 (Prodesign Logic, Brazil). The agitation method was used with ultrasonic tip (US, Irrisonic, Helse, Brazil): BCS, BCS/US, BR, and BR/US. All specimens were filled using the single-cone technique. The samples were scanned by micro-CT (8,74 µm) after obturation. The percentage of filling material and voids were calculated. Flow was evaluated based on ISO 6876/2012 standards (mm) and area (mm2). The data were statistically analyzed using ANOVA and Tukey tests (α = 0.05). BR/US showed lower percentage of filling material in the lateral canals than and, BCS/US (p<0.05). BR/US resulted in a higher percentage of voids than BR in the lateral apical third (p<0.05). BCS showed higher flow than BR (p<0.05). BCS and BR presented proper filling capacity in the simulated curved canals regardless of the use of ultrasonic agitation. However, BR/US showed more voids in the apical third. BCS demonstrates higher filling ability. readytouse ready silicatebased silicate BioC Bio C (BCS Angelus Paraná Brazil powderliquid powder liquid (BR Septodont SaintMaurdesFossés, SaintMaurdesFossés Saint Maur des Fossés, Fossés Saint-Maur-des-Fossés France microcomputed micro computed microCT. microCT CT . (micro-CT) Additionally (mm mm2 (mm2 materials 60° 60 (60 radius cervical middle thirds 4005 40 05 40/.0 Prodesign Logic Brazil. US, US (US Irrisonic Helse BCSUS BRUS singlecone single cone technique 8,74 874 8 74 (8,7 µm obturation calculated 68762012 6876 2012 6876/201 mm2. α 0.05. 005 0.05 0 0.05) p<0.05. p005 p p<0.05 (p<0.05) However ability (micro-CT 6 (6 400 4 40/. 8,7 87 7 (8, 6876201 687 201 6876/20 00 0.0 p00 p<0.0 (p<0.05 ( 40/ 8, (8 687620 68 20 6876/2 0. p0 p<0. (p<0.0 68762 2 6876/ p<0 (p<0. p< (p<0 (p< (p

Resumo Este estudo avaliou o efeito da agitação ultrassônica na capacidade de preenchimento de cimento pronto para uso à base de silicato de cálcio Bio-C Sealer (BCS, Angelus, Paraná, Brasil) ou pó-líquido BioRoot RCS (BR, Septodont, Saint-Maur -des-Fossés, França) utilizando canais artificiais curvos por microtomografia computadorizada (micro-CT). Adicionalmente, escoamento (mm) e área de escoamento (mm2) foram avaliados para ambos materiais. Please, replace the sentence highlighted in yellow to: O canal principal de resina acrílica (curvatura de 60° e raio de 5 mm, com 3 canais laterais nos terços cervical, médio e apical) foi preparado até o tamanho 40/.05 (Prodesign Logic, Brasil). O método de agitação foi utilizado com ponta ultrassônica (US, Irrisonic, Helse, Brasil): BCS, BCS/US, BR e BR/US. Todos os espécimes foram obturados usando a técnica de cone único. As amostras foram escaneadas por micro-CT (8,74 µm) após obturação. A porcentagem de material obturador e vazios foram calculados. O escoamento foi avaliado com base nas normas ISO 6876/2012 (mm) e área (mm2). Os dados foram analisados estatisticamente pelos testes ANOVA e Tukey (α = 0,05BR/US apresentou menor percentual de material obturador nos canais laterais que BCS e BCS/US (p<0,05). BR/US resultou em maior porcentagem de vazios que o BR no canal lateral do terço apical (p<0,05). BCS apresentou maior escoamento que BR (p<0,05)." BCS e BR apresentaram capacidade de preenchimento adequada nos canais curvos simulados independente do uso de agitação ultrassônica. No entanto, BR/US apresentou mais vazios no terço apical. BCS demonstra maior capacidade de preenchimento. BioC Bio C (BCS Angelus Paraná Brasil pólíquido pó líquido BR, (BR Septodont SaintMaur Saint Maur desFossés, desFossés des Fossés, Fossés -des-Fossés França microCT. microCT micro CT . (micro-CT) Adicionalmente mm (mm mm2 (mm2 materiais Please to curvatura 60 cervical 4005 40 05 40/.0 Prodesign Logic Brasil. US, US (US Irrisonic Helse BCSUS BRUS único 8,74 874 8 74 (8,7 µm obturação calculados 68762012 6876 2012 6876/201 mm2. α 005BRUS 0 05BR p<0,05. p005 p p<0,05 (p<0,05) entanto (micro-CT 6 400 4 40/. 8,7 87 7 (8, 6876201 687 201 6876/20 p00 p<0,0 (p<0,05 40/ 8, (8 687620 68 20 6876/2 p0 p<0, (p<0,0 ( 68762 2 6876/ p<0 (p<0, p< (p<0 (p< (p

RESUMO Objetivo: fornecer aos pesquisadores de enfermagem um quadro abrangente para a realização de revisões de escopo de alta qualidade e aprimorar o processo de cuidado baseado em evidências. Método: Com base na literatura existente, este artigo sintetiza as orientações existentes com foco na adaptação das informações para a comunidade de enfermagem. Além disso, apresenta uma proposta de um quadro de 10 etapas para a realização de revisões de escopo, específico para pesquisadores de enfermagem, amalgamando orientações de organizações renomadas de pesquisa em saúde, como o Instituto Joanna Briggs (JBI) e a extensão do PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) para Revisões de Escopo. Resultados: Em uma era marcada pelo dilúvio de informações, os pesquisadores de enfermagem desempenham um papel fundamental na condução de revisões de escopo para navegar pelo crescente cenário científico. O artigo enfatiza a importância de uma abordagem sistemática em 10 etapas, fornecendo uma estrutura que assegura confiabilidade, rigor e transparência. Conclusão: Ao aderir a protocolos robustos e diretrizes de relato, os pesquisadores de enfermagem podem contribuir efetivamente para práticas de saúde baseadas em evidências, orientar os formuladores de políticas e inspirar futuras pesquisas, fechando, em última análise, a lacuna na tradução do conhecimento. Objetivo evidências Método existente disso 1 JBI (JBI Preferred MetaAnalysis Meta Analysis Meta-Analysis Escopo Resultados científico confiabilidade transparência Conclusão relato pesquisas fechando análise conhecimento

RESUMEN Objetivo: proporcionar a los investigadores de enfermería un marco integral para llevar a cabo revisiones de alcance de alta calidad y mejorar el proceso de atención basado en evidencia. Método: Basado en la literatura existente, este artículo sintetiza las guías actuales con un enfoque en la adaptación de la información para la comunidad de enfermería. Además, presenta una propuesta de un marco de 10 pasos para la realización de revisiones de alcance, amalgamando orientaciones de organizaciones de investigación en salud reconocidas, como el Instituto Joanna Briggs (JBI) y la extensión PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) para Revisiones de Alcance. Resultados: En una era marcada por el diluvio de información, los investigadores de enfermería desempeñan un papel crucial en la conducción de revisiones de alcance para navegar por el creciente panorama científico. El artículo enfatiza la importancia de un enfoque sistemático en 10 pasos, proporcionando una estructura que asegura confiabilidad, rigor y transparencia. Conclusión: Al adherirse a protocolos sólidos y guías de informes, los investigadores de enfermería pueden contribuir efectivamente a prácticas de salud basadas en evidencia, orientar a los formuladores de políticas e inspirar futuras investigaciones, cerrando, en última instancia, la brecha en la traducción del conocimiento. Objetivo evidencia Método existente Además 1 reconocidas JBI (JBI Preferred MetaAnalysis Meta Analysis Meta-Analysis Alcance Resultados científico confiabilidad transparencia Conclusión informes investigaciones cerrando instancia conocimiento

ABSTRACT Objective: to provide nursing researchers with a comprehensive framework for conducting high-quality scoping reviews and enhance the process of evidence-based care. Method: Drawing upon existing literature, this paper synthesizes insights from existing guidance with a focus in adapting the information for the nursing community. Furthermore, it introduces a proposed 10-step framework for conducting scoping reviews, specific for nursing researchers, amalgamating guidance from reputable healthcare research organizations such as the Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) extension for Scoping Reviews. Results: In an era marked by the information deluge, nursing researchers hold a pivotal role in conducting scoping reviews to navigate the burgeoning scientific landscape. The paper emphasizes the significance of a systematic 10-step approach, providing a framework that ensures reliability, rigor, and transparency. Conclusion: By adhering to robust protocols and reporting guidelines, nursing researchers can effectively contribute to evidence-based healthcare practices, guide policymakers, and inspire future research, ultimately closing the knowledge translation gap. Objective highquality high quality evidencebased evidence based care Method literature community Furthermore 10step step 10 JBI (JBI MetaAnalysis Meta Analysis PRISMA (PRISMA Results deluge landscape approach reliability rigor transparency Conclusion guidelines practices policymakers gap 1

Abstract Gypsum is a widely used material in civil construction, but its use is restricted to areas with low humidity or water action. The study shows the influence of the application of a commercial water-repellent additive in production of gypsum pastes. The total immersion water absorption test defined the contents used for the characterization of fresh and hardened plasters. The water absorption decreased in 1.0% and returned to increase in 2.0%, revealing that the optimal content of the water repellent used must be between 0.3% and 1.0% According to the capillary water absorption test, the water repellent additive showed the best results when used the content of 1.0% and was classified as water-preventive. The compressive strength decreased by 3.6% and the surface hardness by up to 6.2% in the pastes, when compared to the reference ones. The additive caused a change in the properties of gypsum pastes in the fresh and hardened state. The waterproofing barrier was not verified, the use of higher levels of water repellent may be unfeasible due to the high cost of the additive. construction action waterrepellent plasters 10 1 0 1.0 20 2 2.0% 03 3 0.3 waterpreventive. waterpreventive preventive. preventive water-preventive 36 6 3.6 62 6.2 ones state verified 1. 2.0 0. 3. 6. 2.

Resumo Ogesso é um material largamente utilizado na construção civil, mas seu uso se restringe a áreas com pouca umidade ou ação da água. O estudo mostra a influência da aplicação de um aditivo hidrofugante comercial na produção de pastas de gesso. O ensaio de absorção de água por imersão total definiu os teores utilizados na caracterização das pastas no estado fresco e endurecido. A absorção de água diminuiu em 1,0% de adição e volta a crescer aos 2,0%, revelando que o teor ótimo do hidrofugante utilizado deve estar entre 0,3% e 1,0%. Na absorção de água por capilaridade, o aditivo apresentou melhor resultado quando utilizado em 1,0%, sendo a mistura classificada como preventiva à água. A resistência à compressão diminuiu em 3,6% e a dureza superficial em até 6,2% nas pastas, quando comparadas às de referência. O aditivo provocou a modificação das propriedades das pastas de gesso no estado fresco e endurecido. A formação da barreira impermeabilizante não foi verificada, e a utilização de maiores teores de hidrofugação poderá ser inviável devido ao elevado custo do aditivo. civil endurecido 10 1 0 1,0 20 2 2,0% 03 3 0,3 capilaridade 36 6 3,6 62 6,2 referência verificada 1, 2,0 0, 3, 6, 2,

Abstract This study aimed to evaluate the effect of apicoectomy performed with a bur or an ultrasonic tip on the adaptation of the filling material to root canal dentin. Twenty human mandibular incisors were selected and prepared with a ProDesign Logic system up to diameter 40/.05. The root canals were filled with Bio-C Sealer (Angelus, PR, Brazil) using the single cone technique and were stored at 37ºC and 95% relative humidity for 7 days. After this period, the apicoectomy of the 3 millimeters of the root apex was performed using Endo-Z bur (Dentsply Sirona) or Bladesonic ultrasonic tip (Helse Ultrasonic, Santa Rosa de Viterbo, Brazil) (n=10). The specimens were scanned by micro-computed tomography (micro-CT; SkyScan 1176) with a voxel size of 8.74 µm after obturation and after apicoectomy. The percentage of voids at the interface between the filling material and the root canal wall was evaluated in the apical 4 mm of the root after apicoectomy, besides the time cutting to both devices. The data obtained were submitted to paired and unpaired t-tests (α = 0.05). Endo-Z and Bladesonic increased the percentage of voids between the filling material and the dentin after apicectomy (p<0.05), and they were similar (p>0.05). Endo-Z has a shorter time to perform apicoectomy compared to Bladesonic (p<0.05). Apicectomies with Endo-Z or Bladesonic could harm the material/dentin interface, while the Endo-Z bur was faster than the Bladesonic ultrasonic tip. 4005 40 05 40/.05 BioC Bio C Angelus, Angelus (Angelus PR Brazil ºC 95 days period EndoZ Endo Z Dentsply Sirona Helse Ultrasonic Viterbo n=10. n10 n n=10 . 10 (n=10) microcomputed micro computed microCT CT (micro-CT 1176 874 8 74 8.7 devices ttests t tests α 0.05. 005 0.05 0 0.05) p<0.05, p005 p p<0.05 , (p<0.05) p>0.05. p>0.05 (p>0.05) p<0.05. materialdentin 400 40/.0 9 n1 n=1 1 (n=10 117 87 8. 00 0.0 p00 p<0.0 (p<0.05 p>0.0 (p>0.05 40/. n= (n=1 11 0. p0 p<0. (p<0.0 p>0. (p>0.0 40/ (n= p<0 (p<0. p>0 (p>0. (n p< (p<0 p> (p>0 (p< (p> (p

Resumo O objetivo deste estudo foi avaliar o efeito da apicectomia realizada com broca ou inserto ultrassônico na adaptação do material obturador á dentina do canal radicular. Vinte incisivos inferiores humanos extraídos foram selecionados e preparados com o sistema ProDesign Logic até o diâmetro 40/.05. Os canais radiculares foram obturados com Bio-C Sealer (Angelus, PR, Brasil) por meio da técnica de cone único e foram armazenados em estufa a 37ºC e umidade relativa de 95% por 7 dias. Após esse período, foi realizada apicectomia dos 3 milímetros apicais utilizando broca Endo-Z (Maillefer - Dentsply) ou inserto ultrassônico BladeSonic (Helse Ultrasonic, Santa Rosa de Viterbo, Brasil) (n=10). Os espécimes foram escaneados por meio de microtomografia computadorizada (micro-CT; SkyScan 1176) com tamanho de voxel de 8,74 µm após obturação e após apicectomia. Please, correct this sentece to O percentual de falhas na interface entre o material obturador e a parede dentinaria foi avaliado nos 4 mm apicais da raiz apos apicectomia, alem do tempo de corte para ambos dispositivos. Os dados obtidos foram submetidos aos testes t pareado e não pareado (α = 0,05). Endo-Z e Bladesonic aumentaram o percentual de vazios entre o material obturador e a parede da dentina após apicectomia (p<0.05), sendo semelhantes entre si (p>0.05). Endo-Z demonstrou menor tempo para realizar apicectomia em comparação com Bladesonic (p<0.05). Apicectomias com Endo-Z ou Bladesonic podem prejudicar a interface material obturador/dentina, sendo a broca Endo-Z mais rápida que a ponta ultrassônica Bladesonic. radicular 4005 40 05 40/.05 BioC Bio C Angelus, Angelus (Angelus PR Brasil ºC 95 dias período EndoZ Endo Z Maillefer Dentsply Helse Ultrasonic Viterbo n=10. n10 n n=10 . 10 (n=10) microCT micro CT (micro-CT 1176 874 8 74 8,7 Please dispositivos α 0,05. 005 0,05 0 0,05) p<0.05, p005 p p<0.05 , (p<0.05) p>0.05. p>0.05 (p>0.05) p<0.05. obturadordentina obturador/dentina 400 40/.0 9 n1 n=1 1 (n=10 117 87 8, 00 0,0 p00 p<0.0 (p<0.05 p>0.0 (p>0.05 40/. n= (n=1 11 0, p0 p<0. (p<0.0 p>0. (p>0.0 40/ (n= p<0 (p<0. p>0 (p>0. (n p< (p<0 p> (p>0 (p< (p> (p

ABSTRACT Baru tree (Dipteryx alata) is an arboreal, fruitful plant native to the Cerrado biome with an important socioeconomic impact. Populations of this species are a good model to study anthropogenic disturbances on the biome through the genetic information. In this study, we developed seven new polymorphic microsatellite markers for D. alata, using an enriched genomic library. We performed loci characterization in three populations, obtaining a total of 49 alleles, with an average of 5 to 5.57 alleles per locus. A significant content of polymorphic information was obtained, as indicated by the average expected heterozygosity (uHE), with a total average of 0.58 to 0.65 per locus. The average value of the observed heterozygosity (Ho) was also high, with a total average of 0.73 to 0.85 per locus. Some of the loci are in linkage disequilibrium, such as DalatG6 with DalatB3, DalatH3 and DalatB4. The estimate of the combined loci for the probability of paternity exclusion obtained an average value of 1.00 for all loci, and the average combined probability of identity, the values were (1.210^-5) to (4.410^-6). All markers are informative and suitable for studies on genetic diversity and population structure, aiming at the conservation and management of the species. Dipteryx alata arboreal impact D library populations 4 557 57 5.5 locus uHE, uHE , (uHE) 058 0 58 0.5 065 65 0.6 Ho (Ho high 073 73 0.7 085 85 0.8 disequilibrium DalatG DalatB3 DalatB DalatH DalatB4 100 1 00 1.0 identity 1.210^5 12105 1.210^ 210 (1.210^-5 4.410^6. 44106 4.410^ 6 . 410 (4.410^-6) structure 55 5. (uHE 05 0. 06 07 7 08 8 10 1. 1210 1.210 21 (1.210^- 4.410^6 4410 4.410 41 (4.410^-6 121 1.21 2 (1.210^ 441 4.41 (4.410^- 12 1.2 (1.210 44 4.4 (4.410^ (1.21 4. (4.410 (1.2 (4.41 (1. (4.4 (1 (4. ( (4