Abstract The NBR 7190-3 (ABNT, 2022) presents various methods to determine the wood's modulus of elasticity, allowing for the adoption of equivalence between the modulus of elasticity in compression (Ec0) and tension (Et0). However, it does not provide a way to estimate the modulus of elasticity in bending (EM0), and such estimates do not consider the variation in anatomical structures among species. Faced with this gap, it is necessary to evaluate whether these equations are valid for different species. This article evaluated the elastic properties of three species: Cumaru (Dipteryx odorata), Marupá (Simarouba amara Aubl., Simaroubaceae) and Roxinho (Peltogyne spp., Leguminosae). For this purpose, a non-destructive flexural test was initially conducted, followed by compression and tension tests. Microscopic images were compared to understand the influence of anatomical structures on stiffness properties. The results confirmed the equivalence between Ec0 and Et0. The higher concentration of parenchyma cells in Cumaru and Roxinho is responsible for statistically lower values of EM0 compared to Ec0 and Et0. 71903 7190 3 7190- ABNT, ABNT (ABNT 2022 woods wood s Ec (Ec0 Et0 Et . (Et0) However EM0, EM , (EM0) species gap Dipteryx odorata, odorata odorata) Simarouba Aubl Aubl. Simaroubaceae Peltogyne spp spp. Leguminosae. Leguminosae Leguminosae) purpose nondestructive non destructive conducted tests 719 202 (Ec (Et0 (EM0 71 20 (Et (EM 7 2

Resumo A NBR 7190-3 (ABNT, 2022) apresenta diferentes métodos para determinar o módulo de elasticidade da madeira, permitindo a adoção de equivalência entre o módulo de elasticidade na compressão (Ec0) e na tração (Et0). Por outro lado, não apresenta uma forma de estimar o módulo de elasticidade na flexão (EM0), e tais estimativas não consideram a variação das estruturas anatômicas das espécies. Diante dessa lacuna, é necessário avaliar se essas equações são válidas para diferentes espécies. O presente artigo avaliou as propriedades elásticas de três espécies: Cumaru (Dipteryxodorata), Marupá (Simarouba amara Aubl., Simaroubaceae) e Roxinho (Peltogyne spp., Leguminosa). Para isso, realizou-se o ensaio não destrutivo de flexão, seguido de ensaios à compressão e à tração. Imagens microscópicas foram comparadas, para compreender a influência das estruturas anatômicas nas propriedades de rigidez. Os resultados confirmaram a equivalência entre Ec0 e Et0. A maior concentração de parênquimas no Cumaru e no Roxinho é responsável pelos valores estatisticamente inferiores de EM0 em relação ao Ec0 e Et0. 71903 7190 3 7190- ABNT, ABNT (ABNT 2022 madeira Ec (Ec0 Et0 Et . (Et0) lado EM0, EM , (EM0) espécies lacuna Dipteryxodorata, Dipteryxodorata (Dipteryxodorata) Simarouba Aubl Aubl. Simaroubaceae Peltogyne spp spp. Leguminosa. Leguminosa Leguminosa) isso realizouse realizou comparadas rigidez 719 202 (Ec (Et0 (EM0 (Dipteryxodorata 71 20 (Et (EM 7 2

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.

Resumo O estudo analisou a distribuição espacial e as desigualdades sociais na cobertura vacinal para COVID-19 entre crianças de 5 a 11 anos no Brasil. As coberturas vacinais foram calculadas para os municípios brasileiros e analisadas por região geográfica e decis com base no Índice de Desenvolvimento Humano (IDH-M) e expectativa de escolaridade aos 18 anos. Modelos multiníveis foram usados para determinar o coeficiente de partição da variância, e a estatística local bivariada de Moran I foi usada para avaliar a associação espacial. Os resultados mostraram diferenças significativas nas taxas de cobertura vacinal entre os municípios, com menor cobertura nas regiões Norte e Centro-Oeste. Municípios com menor IDH e anos de escolaridade esperados apresentaram menores taxas de cobertura vacinal. A análise de agrupamento bivariado identificou extensas concentrações de municípios nas regiões Norte e Nordeste com baixa cobertura vacinal e baixo desenvolvimento humano, enquanto alguns aglomerados de municípios nas regiões Sudeste e Sul com baixa cobertura localizavam-se em áreas com alto IDH-M. Essas descobertas destacam as desigualdades persistentes em nível municipal na cobertura vacinal entre crianças e a necessidade de intervenções para melhorar o acesso e a cobertura vacinal em áreas mais vulneráveis. COVID19 COVID 19 COVID-1 1 Brasil IDHM M (IDH-M variância CentroOeste. CentroOeste Centro Oeste. Oeste Centro-Oeste humano localizavamse localizavam se IDHM. M. IDH-M vulneráveis COVID1 COVID-

Abstract This study examined the spatial distribution and social inequalities in COVID-19 vaccine coverage among children aged 5-11 in Brazil. First and second dose vaccine coverage was calculated for all Brazilian municipalities and analyzed by geographic region and deciles based on human development index (HDI-M) and expected years of schooling at 18 years of age. Multilevel models were used to determine the variance partition coefficient, and bivariate local Moran’s I statistic was used to assess spatial association. Results showed significant differences in vaccine coverage rates among Brazilian municipalities, with lower coverage in the North and Midwest regions. Municipalities with lower HDI and expected years of schooling had consistently lower vaccine coverage rates. Bivariate clustering analysis identified extensive concentrations of municipalities in the Northern and Northeastern regions with low vaccine coverage and low human development, while some clusters of municipalities in the Southeast and South regions with low coverage were located in areas with high HDI-M. These findings highlight the persistent municipal-level inequalities in vaccine coverage among children in Brazil and the need for targeted interventions to improve vaccine access and coverage in underserved areas. COVID19 COVID 19 COVID-1 511 5 11 5-1 HDIM M (HDI-M 1 age coefficient Morans Moran s association HDIM. M. HDI-M municipallevel municipal level COVID1 COVID- 51 5-

Abstract Objective: To evaluate exclusive breastfeeding at discharge and hospital length-of-stay in pre-term infants undergoing or not the Kangaroo-Mother Care Method (KMC). Methods: A retrospective cohort study was conducted including preterm infants < 1800 g admitted to the neonatal unit of a KMC reference center. The infants were grouped into the KMC group and the non-KMC group. Multiple logistic and Poisson regressions were performed to evaluate the association between the KMC and two outcomes, exclusive breastfeeding at discharge, and hospital length-of-stay, adjusted for potential confounders. Results: 115 mother-infant dyads were included, 78 in the KMC group and 37 in the non-KMC group. In the bivariate analysis, the KMC group had a lower prevalence of maternal adverse conditions (6% vs. 32%, p < 0.001), a higher number of prenatal visits (median 6 vs. 3.5, p < 0.001), higher gestational ages (median 32 vs. 31 weeks, p < 0.05), higher birth weights (median 1530 vs. 1365 g, p < 0.01), a lower prevalence of necrotizing enterocolitis (3.8% vs. 16.2%, p < 0.05), parenteral nutrition (50% vs. 73%, p < 0.05), and deep vascular access (49.7% vs. 78.4%, p < 0.01), a higher prevalence of exclusive breastfeeding (65% vs. 8%, p < 0.001) and a shorter length of hospital stay (median 28 vs. 42 days, p < 0.001). In the multiple regression analysis, the KMC group was 23 times more likely to be exclusively breastfed at discharge (OR = 23.1; 95% CI = 4,85–109,93) and had a 19% reduction in the hospital length-of-stay (IDR = 0.81; 95% CI = 0.76–0.86) compared to the non-KMC group. Conclusions: The KMC is associated with better short-term neonatal outcomes and should be encouraged in all Brazilian maternity hospitals. Objective lengthofstay pre term KangarooMother Kangaroo Mother KMC. . (KMC) Methods 180 center nonKMC non lengthofstay, stay, confounders Results 11 motherinfant mother infant included 7 3 analysis 6% (6 vs 32% 0.001, 0001 0.001 , 0 001 median 35 5 3.5 weeks 0.05, 005 0.05 05 0.05) 153 136 0.01, 0.01 01 0.01) 3.8% 38 8 (3.8 162 16 2 16.2% 50% 50 (50 73 73% 49.7% 497 49 (49.7 784 4 78.4% 65% 65 (65 8% days 0.001. OR 23.1 231 1 95 4,85–109,93 48510993 85 109 93 19 IDR 0.81 081 81 0.76–0.86 076086 76 86 Conclusions shortterm short hospitals (KMC 18 ( 000 0.00 00 3. 0.0 15 13 3.8 (3. 16.2 (5 49.7 (49. 78.4 23. 9 4,85–109,9 4851099 10 0.8 08 0.76–0.8 07608 0. (3 16. 49. (49 78. 4,85–109, 485109 0.76–0. 0760 (4 4,85–109 48510 0.76–0 076 4,85–10 4851 0.76– 07 4,85–1 485 0.76 4,85– 48 0.7 4,85 4,8 4,

Abstract Objective: To evaluate the effect of high-fidelity simulation of pediatric emergencies compared to case-based discussion on the development of self-confidence, theoretical knowledge, clinical reasoning, communication, attitude, and leadership in undergraduate medical students. Methods: 33 medical students were allocated to two teaching methods: high-fidelity simulation (HFS, n = 18) or case-based discussion (CBD, n = 15). Self-confidence and knowledge tests were applied before and after the interventions and the effect of HFS on both outcomes was estimated with mixed-effect models. An Objective Structured Clinical Examination activity was conducted after the interventions, while two independent raters used specific simulation checklists to assess clinical reasoning, communication, attitude, and leadership. The effect of HFS on these outcomes was estimated with linear and logistic regressions. The effect size was estimated with the Hedge’sg. Results: Both groups had an increase in self-confidence (HFS 59.1 × 93.6, p < 0.001; CDB 50.5 × 88.2, p < 0.001) and knowledge scores over time (HFS 45.1 × 63.2, p = 0.001; CDB 43.5 × 56.7, p-value < 0.01), but no difference was observed between groups (group*time effect in the mixed effect models adjusted for the student ranking) for both tests (p = 0.6565 and p = 0.3331, respectively). The simulation checklist scores of the HFS group were higher than those of the CBD group, with large effect sizes in all domains (Hedges g 1.15 to 2.20). Conclusion: HFS performed better than CBD in developing clinical reasoning, communication, attitude, and leadership in undergraduate medical students in pediatric emergency care, but no significant difference was observed in self-confidence and theoretical knowledge. highfidelity high fidelity casebased case based selfconfidence, selfconfidence self confidence, confidence reasoning communication attitude Methods 3 methods HFS, 18 CBD, (CBD 15. 15 . 15) Selfconfidence Self mixedeffect regressions Hedgesg. Hedgesg Hedge sg. sg Hedge’sg Results 591 59 1 59. 936 93 6 93.6 0.001 0001 0 001 505 50 5 50. 882 88 2 88.2 451 45 45. 632 63 63.2 435 43 43. 567 56 7 56.7 pvalue value 0.01, 0.01 , 01 0.01) group*time grouptime ranking 06565 6565 0.656 03331 3331 0.3331 respectively. respectively respectively) Hedges 115 1.1 2.20. 220 2.20 20 2.20) Conclusion care 9 93. 0.00 000 00 8 88. 4 63. 56. 0.0 0656 656 0.65 0333 333 0.333 11 1. 22 2.2 0. 065 65 0.6 033 0.33 2. 06 03 0.3

ABSTRACT The canonical correlation is used to correlate groups of distinct variables. The objective of this study was to use canonical correlation analysis to evaluate the interaction between water quality attributes clogging-causing and the hydraulic performance of non-pressure compensating drippers operating with dilutions of aquaculture effluent in well water. The experiment was in a completely randomized design in a split-split-plot scheme with three replicates, with five dilutions in the plots (Dilution 1: 100% aquaculture effluent; Dilution 2: 75% aquaculture effluent + 25% well water; Dilution 3: 50% aquaculture effluent + 50% well water; Dilution 4: 25% aquaculture effluent + 75% well water; and Dilution 5: 100% well water), three emitters in the sub-plots (ST (1.6 L h-1), SL (1.6 L h-1) and NJ (1.7 L h-1)), and three operating times in the sub-subplots (0, 80 and 160 hours, in which 0 hours operating time means the start of evaluations). The statistical analyses performed were correlation matrix and canonical analysis. The canonical correlation analysis indicated that when the concentrations of attributes increase, the hydraulic performance of the drippers decreases. The interaction of this group of attributes indicates that the clogging of drippers operating with the five dilutions of aquaculture effluent in well water occurs by the combined action of physical, chemical, and biological agents. The ST dripper was the least sensitive to the group of quality attributes of the dilutions, whereas the most sensitive was the SL dripper. variables cloggingcausing causing nonpressure non pressure splitsplitplot split plot replicates 1 100 2 75 25 3 50 4 5 water, , water) subplots sub 1.6 16 6 (1. h1, h1 h h-1 1.7 17 7 h-1)) subsubplots 0, (0 8 evaluations. evaluations . evaluations) increase decreases physical chemical agents 10 1. (1 h- (

RESUMO A correlação canônica é usada para correlacionar grupos de variáveis distintas. O objetivo deste estudo foi utilizar análise de correlação canônica para avaliar a interação entre atributos de qualidade da água causadores de entupimento e o desempenho hidráulico de gotejadores não autocompensantes operando com diluições de efluente de aquicultura em água de poço. O experimento foi conduzido em delineamento inteiramente casualizado, em esquema de parcelas subsubdivididas, com três repetições, com cinco diluições nas parcelas (Diluição 1: 100% de efluente de aquicultura; Diluição 2: 75% de efluente de aquicultura + 25% de água de poço; Diluição 3 : 50% efluente de aquicultura + 50% água de poço; Diluição 4: 25% efluente de aquicultura + 75% água de poço; e Diluição 5: 100% água de poço), três emissores nas subparcelas (ST (1,6 L h-1) , SL (1,6 L h-1) e NJ (1,7 L h-1)), e três tempos de operação nas subsubparcelas (início do experimento, 80 e 160 horas, em que 0 horas de operação significa o início das avaliações). As análises estatísticas realizadas foram matriz de correlação e análise canônica. A análise de correlação canônica indicou que quando as concentrações dos atributos aumentam, o desempenho hidráulico dos gotejadores diminui. A interação desse grupo de atributos indica que o entupimento dos gotejadores que operam com as cinco diluições de efluente de aquicultura em água de poço ocorre pela ação combinada de agentes físicos, químicos e biológicos. O gotejador ST foi o menos sensível ao grupo de atributos de qualidade das diluições, enquanto o mais sensível foi o gotejador SL. distintas casualizado subsubdivididas repetições 1 100 2 75 25 50 4 5 poço, poço) 1,6 16 6 (1, h1 h h-1 1,7 17 7 h1, h-1)) 8 avaliações. avaliações . avaliações) aumentam diminui físicos biológicos 10 1, (1 h- (

Abstract Introduction: Syphilis is a notifiable infection, mostly sexually acquired, caused by the bacterium Treponema pallidum. Clinical manifestations vary on the stage of the disease: early syphilis, (primary and secondary disease) and late syphilis (latent or tertiary). The secondary disease is systemic and develops within weeks or a few months, in approximately 1/4 of individuals with untreated primary infection. At this stage, the illness may appear as constitutional symptoms, adenopathies, macular or papular rash including palms and soles, and hepatic, renal, or neurological manifestations, among others. Serologic testing provides a presumptive diagnosis, therefore nontreponemal and treponemal-specific tests are needed for the diagnosis of syphilis. The difficult interpretation of the serologic findings allied to a wide variety of signs and symptoms and an increasing incidence in the last years challenge the diagnosis of this disease. Case description: The authors describe a clinical case of an adult who appears with swollen lower limbs, fatigue, and the perception of abdominal distension. Objectively, exhibits erythematous maculopapular lesions, with peripheral desquamation, non-pruritic, on the palms and soles. After a complete clinical interview, the hypothesis of decompensation of liver disease in the context of secondary syphilis/syphilitic hepatitis is raised and the patient is sent to the Emergency Department, where the infection is confirmed. Comment: This case report demonstrates the challenge of diagnosing syphilis due to the wide variety of clinical manifestations. Once the diagnosis of syphilis, treatment is curable simply with an only-dose injection of penicillin, preventing severe consequences due to systemic disease. In summary, a family doctor must be capable of recognizing this infection and acquainted with the serologic tests that may be used and the recommended treatment.

Resumo Introdução: A sífilis é uma infeção de notificação obrigatória, maioritariamente transmitida por via sexual, causada pela bactéria Treponema pallidum. As manifestações clínicas variam conforme o estadio da doença: sífilis precoce (doença primária e secundária) e sífilis tardia (latente ou terciária). A doença secundária é sistémica e desenvolve-se, após semanas ou meses, em aproximadamente 1/4 dos indivíduos com infeção primária não tratada. Neste estadio, a doença pode manifestar-se através de sintomas constitucionais, adenopatias, erupções cutâneas maculopapulares palmoplantares, manifestações hepáticas, renais ou neurológicas, entre outras. A serologia fornece um diagnóstico presuntivo, sendo necessários testes não treponémicos e treponémicos para estabelecer o diagnóstico de sífilis. A difícil interpretação dos achados serológicos associada a uma grande variedade de manifestações clínicas e a uma incidência crescente nos últimos anos torna o seu diagnóstico um desafio. Descrição do caso: Os autores descrevem o caso clínico de um adulto que apresenta um quadro de edema inaugural dos membros inferiores, cansaço e noção de distensão abdominal. Objetivamente apresenta lesões maculopapulares eritematosas, com descamação periférica, não pruriginosas, nas palmas das mãos e plantas dos pés. Após entrevista clínica completa coloca-se a hipótese de descompensação de doença hepática em contexto de sífilis secundária/hepatite sifilítica e envia-se o doente ao serviço de urgência, onde é confirmada a infeção. Comentário: Este caso demonstra que a grande variedade de manifestações clínicas torna o diagnóstico de sífilis um desafio. Uma vez feito o diagnóstico deve ser instituído tratamento com dose única de penicilina intramuscular, evitando potenciais consequências graves decorrentes da doença sistémica. Em suma, um médico de família deve ser capaz de reconhecer esta infeção, interpretando corretamente os testes serológicos e instituindo o tratamento recomendado.

Abstract This article presents a formulation for the optimization problem that minimizes the CO2 emission of pile caps with variations of geometry and pile position. The problem is defined by the design variables: concrete pile cap dimensions, rebar ratio, concrete compressive strength, the number of piles, the diameter, and length. The environmental impact was chosen as the objective function, taking CO2 emission as the main parameter. The design procedure was based on the ABNT NBR 6118:2014 (2014), and by the formulation proposed by Blévot & Frémy (1967). Also, the soil structure interaction between the cap and the piles was considered in the optimization problem. The problem was implemented using MATLAB (2016) and solved via a Genetic Algorithm native to the program. Results obtained from numerical examples were compared with structural designs solutions located in the Grande Vitória metropolitan area, Espírito Santo, Brazil and validated with a commercial software. The analyses indicate that design optimizations of pile caps considering the compressive strength of concrete, the diameter and length of piles and the optimal geometry of the pile caps may lead to significant reductions of material consumption, and consequently, a reduction of environmental impacts. CO position variables dimensions ratio function parameter 61182014 6118 2014 6118:201 2014, , (2014) 1967. 1967 . (1967) Also 2016 (2016 program area Santo software consumption consequently impacts 6118201 611 201 6118:20 (2014 196 (1967 (201 611820 61 20 6118:2 19 (196 (20 61182 6 2 6118: 1 (19 (2 (1 (

Abstract Objective: Analysis of the results of mastoidectomy using the retrograde technique for removal of cholesteatomas in adults. Methods: Retrospective analysis of cases of mastoidectomy via retrograde technique performed at Centro Hospitalar Tondela-Viseu between January 2018 and December 2021 with collection of demographic data, type of surgery, reconstruction of the posterosuperior wall of the canal, type of tympanoplasty, recurrence, follow-up time and audiometric results. Results: 45 ears were included in the study, 73.3% of which corresponded to primary surgery. Reconstruction of the posterosuperior wall of the canal was performed in 37.8% and ossiculoplasty was done in 73.3%. The air-bone gap gain, in patients who underwent wall reconstruction was 9.66dB (vs. 1.91 dB without reconstruction). During follow-up, recurrence occurred in 13.3% of cases. Conclusions: In our series, this technique proved to be safe and effective in cholesteatoma excision. Reconstruction of the EAC wall allowed better audiometric results.

Resumo Objetivo: Análise de resultados de mastoidectomia via técnica retrógrada para extirpação de colesteatoma em adultos. Métodos: Estudo retrospetivo dos casos de mastoidectomia via técnica retrógrada realizados no Centro Hospitalar Tondela-Viseu entre Janeiro de 2018 e Dezembro de 2021 com recolha de dados demográficos, tipo de cirurgia, reconstrução da parede póstero-superior do canal, tipo de timpanoplastia, recidiva, tempo de follow-up e resultados audiométricos. Resultados: Foram incluídos no estudo 45 ouvidos, 73,3% dos quais correspondeu a cirurgia primária. Foi realizada reconstrução da parede póstero-superior do canal em 37,8% dos ouvidos operados e ossiculoplastia em 73,3%. O ganho no gap aero-ósseo nos doentes em que se realizou reconstrução da parede foi de 9,66dB (vs. 1,91 dB sem reconstrução). Durante o follow-up ocorreu recidiva em 13,3% dos casos. Conclusões: Na nossa série esta técnica mostrou ser segura e eficaz na exérese do colesteatoma. A reconstrução da parede do CAE permitiu melhores resultados audiométricos.

Abstract Objectives: To investigate whether computed tomography (CT) findings in patients with otosclerosis influence the audiometric prognosis after stapedial surgery. Study design: Retrospective. Material and methods: Patients undergoing stapes surgery, who had undergone prior ear CT and pre- and postoperative pure-tone audiometry (PTA), were included. The degree of otosclerosis on CT was classified according to the Symons and Fanning scale. Therapeutic success was defined as an air-bone gap ≤10 dB HL. Results: The surgical success rate was 91%, with an average improvement of 6.9 dB HL in bone conduction after stapes surgery. Similar results were found in patients with cochlear foci, grades 2-3, on CT (6.5 dB HL). Conclusion: The presence of cochlear otosclerosis foci on CT does not seem to influence postoperative audiometric outcomes.

Resumo Objetivos: Verificar se os achados na tomografia computadorizada (TC) em doentes com otosclerose influenciam o prognóstico audiométrico após cirurgia estapédica. Desenho do estudo: Retrospetivo. Material e métodos: Foram incluídos, doentes submetidos a cirurgia estapédica que realizaram TC de ouvido prévia e audiograma tonal simples (ATS) pré e pós-operatório. O grau de otosclerose na TC foi classificado de acordo a escala de Symons e Fanning. Foi determinado como sucesso terapêutico um hiato aero-ósseo no audiograma tonal simples ≤10 dB HL. Resultados: Verificou-se uma taxa de sucesso cirúrgico global de 91%, com uma melhoria da via óssea em média 6,9 dB HL após cirurgia estapédica, existindo um resultado semelhante nos doentes que apresentaram focos cocleares (graus 2-3) na TC (6,5 dB HL). Conclusão: A presença de focos de otosclerose coclear na TC não pareceu influenciar os resultados audiométricos pós-operatórios.

Introduction Muscle mass assessment of critically ill patients is essential to be part of the nutritional diagnosis in hospital care. Thus, the evaluation of more specific techniques for that purpose is needed. The present study aimed to investigate the association of quadriceps muscle thickness (QMT), measured by ultrasound (US), with the nutritional status of critically ill patients in a referral high-complexity trauma care hospital. Methods A cross-sectional observational study was conducted in the intensive care units (ICUs) in a tertiary hospital in Brazil. The sample comprised 30 critically ill trauma patients admitted between February and March 2022. The methodology involved evaluating muscle mass and comparing nutritional status through mid-upper arm circumference measurements and US assessments. Specifically, the QMT was quantified using US at a predefined site between the iliac crest and the proximal border of the patella. Results The Kruskal-Wallis test indicated variability in QMT between the nutritional status groups, with statistical significance reached after excluding the overweight group (H(2) = 7.532, p = 0.023). The moderate malnutrition group exhibited notably lower QMT. Sensitivity analyses using bootstrap and Monte Carlo methods showed moderate trends toward significance. A positive correlation was found between QMT and mid-upper arm circumference adequacy (p &lt; 0.05), demonstrating fair to moderate correlation (rs = 0.531). Conclusion Significant changes in QMT were detected by ultrasound assessment in moderate malnutrition patients compared to patients of other nutritional statuses. Ultrasound may be a valuable technique for monitoring muscle integrity in critically ill patients.

Abstract Background: One of the main adverse reactions of adjuvant radiotherapy for breast cancer is radiodermatitis. Objective: To assess the incidence of radiodermatitis in women with breast cancer, identify factors associated with its severity and determine the time at which this event occurs. Methods: Prospective cohort study in 113 women with breast cancer who were evaluated before radiotherapy and at every fifth session until the end of treatment. Logistic regression and Cox proportional regression model were used for the assessment of risk factors; P values < 0.05 were considered significant. Results: The incidence rate of radiodermatitis was 98.2% and it was demonstrated that for each additional point of the Body Mass Index (BMI), the chance of occurrence of grades II to IV radiodermatitis increases by 14% (OR = 1.14 [95% CI 1.04–1.26]; p = 0.004) and statin use increases the risk of more severe skin lesions by four-fold (OR = 4.27 [95% CI 1.11–16.42]; p = 0.035). The exclusive use of hydrogel for skin hydration was an independent factor in delaying the onset of radiodermatitis (HR = 0.55 [95% CI 0.36–0.82]; p = 0.004). Study limitations: The main limitation of this study was its external validity. The identified factors should be considered for services and populations similar to those in this study. Conclusions: There was a high incidence of radiodermatitis and its severity was related to higher BMI, statin use; there was a protective effect of hydrogel use. Background Objective occurs Methods 11 treatment 005 0 05 0.0 significant Results 982 98 2 98.2 BMI , (BMI) 14 OR 114 1 1.1 95% 95 [95 1.04–1.26 104126 04 26 1.04–1.26] 0.004 0004 004 fourfold four fold 427 4 27 4.2 1.11–16.42 1111642 16 42 1.11–16.42] 0.035. 0035 0.035 . 035 0.035) HR 055 55 0.5 0.36–0.82 036082 36 82 0.36–0.82] 0.004. limitations validity Conclusions 00 0. 9 98. (BMI 1. [9 1.04–1.2 10412 0.00 000 4. 1.11–16.4 111164 003 0.03 03 5 0.36–0.8 03608 3 8 [ 1.04–1. 1041 1.11–16. 11116 0.36–0. 0360 1.04–1 104 1.11–16 1111 0.36–0 036 1.04– 10 1.11–1 111 0.36– 1.04 1.11– 0.36 1.0 1.11 0.3

SUMMARY OBJECTIVE: The aim of this study was to evaluate the prevalence of early neonatal sepsis in pregnant women with a positive culture for group B beta-hemolytic Streptococcus in a middle-income city in Southeastern Brazil. METHODS: A retrospective cohort study was conducted, involving singleton low- and high-risk pregnancies in whom group B beta-hemolytic Streptococcus cultures were evaluated between 35 and 37 weeks of gestation using vaginal and anal swabs. A specific medium (Todd-Hewitt) was used for culturing. The pregnant women were divided into two groups based on positive (n==201) and negative (n==420) cultures for group B beta-hemolytic Streptococcus. RESULTS: The maternal colonization rate by group B beta-hemolytic Streptococcus was 32.3%. The prevalence of early neonatal sepsis was 1.0% (2/201) among patients with a positive group B beta-hemolytic Streptococcus culture and 1.9% (8/420) among patients with a negative culture. Among the patients who underwent adequate prophylaxis, crystalline penicillin G was used in 51.9% (54/104), followed by cefazolin in 43.3% (45/104), ampicillin in 3.8% (4/104), and clindamycin in 1.0% (1/104). A model that included prematurity (p==0.001) proved to be an independent risk predictor of early neonatal sepsis [χ2 (1)==15.0, odds ratio: 16.9, 95% confidence interval: 4.7–61.6, p<0.001, Nagelkerke R2==0.157]. CONCLUSION: The prevalence of a positive culture for group B beta-hemolytic Streptococcus was high. However, the prevalence of early neonatal sepsis was low in pregnant women with both positive and negative group B beta-hemolytic Streptococcus cultures and in pregnant women with a positive culture who underwent both adequate and inadequate antibiotic prophylaxis. Prematurity proved to be an independent predictor of early neonatal sepsis, considering the entire study population.

ABSTRACT Objective: To evaluate the agreement between body mass index (BMI) parameters applied to children aged six to ten years in the city of Montes Claros (MG), Brazil with national and international criteria, also calculating their sensitivity and specificity regarding excess weight screening. Methods: A sample comprising 4151 children aged six to ten years was assessed, with height and body mass determined for BMI calculation. The obtained values were classified according to cutoff points established by the World Health Organization (WHO), International Obesity Task Force (IOTF), Centers for Disease Control and Prevention (CDC), Conde & Monteiro, and a recent local proposal. The agreement index between the mentioned criteria was calculated and thereafter the sensitivity and specificity. Results: The local proposal was proven to be highly consistent in most combinations, especially concerning the excess weight criteria of the World Health Organization (WHO) (k=0.895). Regarding excess weight, the local proposal presented sensitivity and specificity values of 0.8680 and 0.9956, respectively, indicating high BMI discrimination power. Conclusions: The locally applied BMI parameters for children aged six to ten years represent a valid, highly viable and practical proposal for excess weight screening in this population group, improving professional decision-making in their follow-up. Objective (BMI MG, MG , (MG) Methods 415 assessed calculation WHO, WHO IOTF, IOTF (IOTF) CDC, CDC (CDC) Monteiro Results combinations (WHO k=0.895. k0895 k k=0.895 . 0 895 (k=0.895) 08680 8680 0.868 09956 9956 0.9956 respectively power Conclusions valid group decisionmaking decision making followup. followup follow up. up follow-up (MG 41 (IOTF (CDC k089 k=0.89 89 (k=0.895 0868 868 0.86 0995 995 0.995 4 k08 k=0.8 8 (k=0.89 086 86 0.8 099 99 0.99 k0 k=0. (k=0.8 08 0. 09 9 0.9 k=0 (k=0. k= (k=0 (k= (k

RESUMO Objetivo: Analisar a concordância dos parâmetros de índice de massa corporal (IMC) para crianças com idade de seis a dez anos da cidade de Montes Claros/MG com os demais critérios de abrangência nacional e internacional, bem como sua sensibilidade e especificidade no rastreio do excesso de peso. Métodos: Foi utilizada uma amostra de 4.151 crianças de seis a dez anos, sendo mensuradas estatura e massa corporal para a determinação do IMC. Os valores obtidos foram classificados de acordo com os pontos de corte da World Health Organization (WHO), International Obesity Task Force (IOTF), Centers for Disease Control and Prevention (CDC), Conde & Monteiro e uma recente proposta local. Calculou-se o índice de concordância entre os critérios mencionados e, em seguida, a sensibilidade e a especificidade. Resultados: A proposta local mostrou-se altamente concordante na maioria das combinações, principalmente para o excesso de peso com a WHO (k=0,895). Com relação ao excesso de peso, a proposta local apresentou valores de 0,8680 e 0,9956 para a sensibilidade e especificidade respectivamente, mostrando alto poder de discriminação do IMC. Conclusões: Conclui-se que os parâmetros locais de IMC para crianças de seis a dez anos representam uma proposta válida, altamente viável e utilizável para o rastreio do excesso de peso desse grupo populacional, melhorando a tomada de decisão profissional no acompanhamento de tais indivíduos. Objetivo (IMC ClarosMG Claros MG internacional Métodos 4151 4 151 4.15 WHO, , (WHO) IOTF, IOTF (IOTF) CDC, CDC (CDC) Calculouse Calculou se seguida Resultados mostrouse mostrou combinações k=0,895. k0895 k k=0,895 . 0 895 (k=0,895) 08680 8680 0,868 09956 9956 0,995 respectivamente Conclusões Concluise Conclui válida populacional indivíduos 415 15 4.1 (WHO (IOTF (CDC k089 k=0,89 89 (k=0,895 0868 868 0,86 0995 995 0,99 41 1 4. k08 k=0,8 8 (k=0,89 086 86 0,8 099 99 0,9 k0 k=0, (k=0,8 08 0, 09 9 k=0 (k=0, k= (k=0 (k= (k

ABSTRACT The knowledge of correlations between multiple characteristics in plant breeding leads to more effective selection strategies. The path analysis allows refining these correlations and partitioning them into direct and indirect effects on the main variable. The path analysis becomes more effective when based on predicted genotypic values rather than phenotypic values. The objective was to evaluate correlations between the main agronomic characteristics of grapevine cultivation and their direct and indirect effects on yield per plant to improve selection strategies to reach superior progenies. A randomized complete block design was installed using four cultivars and two rootstocks, five repetitions, and plots of four plants. Data from three crop seasons were analyzed from a mixed model and genetic correlations were subject to the path analysis. A high and positive significant correlation was found between average fruit production and the number of clusters per plant. On the other hand, the average production per plant showed a low correlation to cluster width and height per grapevine. Wider and higher berries tend to increase berry fresh mass and therefore increase the contents of soluble solids and reducing sugars. Among the features, the number of clusters per plant has the strongest direct effect on fruit production in grape cultivars. Berry fresh mass, berry length, and berry width were indirectly influenced by the number of clusters and showed high heritability compared to yield and number of clusters. These characteristics could be used in indirect selection. variable progenies rootstocks repetitions plants hand sugars features length