RESUMO A permanencia de material obturador após o retratamento pode abrigar bactérias e tecidos orgánicos que podem influenciar o resultado da terapia. Objetivo O objetivo deste estudo foi avaliar, por micro-CT, a quantidade de material obturador remanescente no canal radicular após a desobturagdo com WaveOne Gold e ProDesign RT. Material e Método Quarenta caninos inferiores humanos foram instrumentados com o sistema ProTaper Next até o instrumento X2 (25.06) e obturados com cones de guta-percha e AHPlus. Os dentes foram divididos em dois grupos (n=20): WaveOne Gold 25.07 (WOG) e ProDesign RT 25.08 (PRT) e escaneados em micro-CT para quantificagdo do volume de material obturador remanescente. Os dados foram submetidos á transformando log10, o teste t de Student foi realizado para contabilizar múltiplas observagoes por amostra, a significáncia foi fixada em 5%. Resultados O teste t de Student mostrou que ndo houve diferenga no volume de material obturador remanescente entre os dois sistemas nos tergos: apical (p = 0,392), médio (p = 0,065) ou cervical (p = 0,918). Conclusao O material obturador remanescente estavapresente em todos os grupos e ambos os sistemas foram semelhantes na remogdo do material obturador radicular nos caninos inferiores.

ABSTRACT The remaining filling material after retreatment can harbor bacteria and organic tissues that can influence the outcome of the therapy. Aim The aim of this study was to evalúate, by micro-CT, the amount of filling material remaining in the root canal after its removal using WaveOne Gold or ProDesign RT. Material and Method Forty human mandibular canines were instrumented with the ProTaper Next system up to the X2 instrument (25.06) and filled with gutta-percha cones and AHPlus. Teeth were divided into 2 groups (n=20): WaveOne Gold 25.07 (WOG) and ProDesign RT 25.08 (PRT) for filling removal, after which they were scanned in a micro-CT device to quantify the volume of remaining filling material. The data were subjected to log 10 transformation, Student ’s t-test was performed to account for multiple observationsper sample, significance was set at 5%. Results Student ’s t-test showed that there was no difference between the two systems regarding the volume of remaining filling material in the thirds: apical (p = 0.392), middle (p = 0.065), or cervical (p = 0.918). Conclusión Remaining filling material was present in all groups and both systems were similar in removing root filling material in mandibular canines.

ABSTRACT: This study assessed the efficacy of an intra-articular injection of allogeneic adipose tissue-derived from mesenchymal stem cells (AD-MSCs) for the treatment of hip dysplasia in dogs. The study group included 12 otherwise healthy dogs of different breeds, ages, weights, and degrees of hip dysplasia diagnosed using radiography. An orthopedic assessment was performed on all dogs before and at 30, 60, and 90 days after infusion of AD-MSCs(2 × 106cells). On the same days, each dog’s owner answered a questionnaire based on theHelsinkiChronic Pain Index. The data were converted to ordinal data based on the score for each variable, and the Friedman test for multiple comparisons was used to verify the results. Compared with the corresponding values on day 0, orthopedic and gait assessments and owners’ reported pain indexes improved over the 90-day observation period. These results suggested that treatment with allogeneic AD-MSCs significantly reduced the clinical signs associated with hip dysplasia during the study period. However, long-term studies are needed to determine the optimal therapeutic protocol for routine clinical use of AD-MSCs in hip dysplasia. ABSTRACT intraarticular intra articular tissuederived tissue derived ADMSCs AD MSCs (AD-MSCs 1 breeds ages weights radiography 30 60 9 ADMSCs2 2 AD-MSCs( 106cells. 106cells . 106cells) dog s Index variable 0 owners 90day period However longterm long term 3 6

RESUMO: O objetivo deste estudo foi avaliar a eficácia clínica da aplicação intra-articular de células-tronco mesenquimais alógenas derivadas do tecido adiposo (AD-CTM) no tratamento de cães portadores de osteoartrite secundária a displasia do coxofemoral (DCF). Doze cães de ambos os sexos, diferentes raças, idades e peso, portadores de graus variados de DCF comprovada em radiografia e livres de quaisquer outras alterações clínicas ou ortopédicas, foram utilizados no estudo. Todos os cães foram submetidos a avaliação ortopédica nos dias 0, 30, 60 e 90 após aplicação de AD-CTM na dose de 2 x 106. Além disso, os tutores preencheram a um questionário, baseado no Índice de dor crônica de Helsinque (IDCH) nos mesmos intervalos. Em comparação com o dia 0, observou-se melhora significativa na avalição em locomoção e físico-ortopédica assim como na avaliação dos tutores pelo IDCH ao longo dos 90 dias. Os resultados permitem inferir que as AD-CTM alógenas contribuíram significativamente para a redução dos sinais clínicos comumente associados a DCF durante o período de estudo. Entretanto, há necessidade de estudos de longo prazo para melhor determinação de protocolos terapêuticos baseados no uso de AD-CTM na rotina clínica. RESUMO intraarticular intra articular célulastronco células tronco ADCTM AD CTM (AD-CTM DCF. . (DCF) sexos raças peso ortopédicas 0 30 6 9 106 disso questionário (IDCH intervalos observouse observou se físicoortopédica físico Entretanto (DCF 3 10 1

Abstract Background Congenital heart diseases (CHD) are one of the most prevalent malformations, and the screening tests to identify critical congenital heart disease (CCHD) is the pulse oximetry test, with subsequent investigation and treatment. Objective To quantify positive pulse oximetry tests and verify the prevalence of CCHD detected by it in asymptomatic newborns, ≥35 gestational weeks, in a Brazilian maternity hospital. Methodology This is an observational, retrospective, quantitative, analytical and cross-sectional study, conducted from October 2020 to May 2022, in a maternity hospital in southern Brazil, through the collection of records of positive oximetry pulse tests, following the norms of screening CCHD test of the Brazilian Society of Pediatrics (SBP), after they were evaluated with echocardiography for confirmation or exclusion of CHD. Results A total of 5,667 newborns were evaluated in this study, according to the inclusion criteria; 0.17% (n = 10) had a positive pulse oximetry test. Regarding the results of the echocardiography of the neonates with a positive test, two were normal, seven were cases of patent foramen ovale (PFO), and one was a case (0,017%) with interatrial communication (IAC) diagnosis. In the same period, five neonates with CCHD were born, symptomatic, diagnosed by physical examination, and referred to neonatal intensive care units (NICU) before taking the neonatal cardiac screening (< 24 hours of life). Conclusion The prevalence of positive pulse oximetry tests was 0.17% and none CCHD was detected. Five cases of CCHD were born in this period, but they were diagnosed before the recommend time to perform the screening test. CHD (CHD malformations (CCHD treatment 35 ≥3 weeks observational retrospective quantitative crosssectional cross sectional study 202 2022 Brazil SBP, SBP , (SBP) 5667 5 667 5,66 criteria 017 0 17 0.17 n 10 normal PFO, PFO (PFO) 0,017% 0017 (0,017% IAC (IAC diagnosis period symptomatic examination NICU (NICU < ( 2 life. life . life) 3 ≥ 20 (SBP 566 66 5,6 01 1 0.1 (PFO 0,017 001 (0,017 56 6 5, 0. 0,01 00 (0,01 0,0 (0,0 0, (0, (0

Abstract Growth and carcass traits are essential selection criteria for beef cattle breeding programs. However, it is necessary to combine these measurements with body composition traits to meet the demand of the consumer market. This study aimed to estimate the genetic parameters for visual scores, growth (pre and post-weaning weights), and carcass (rib eye area (REA), back and rump fat thickness) traits in Nellore cattle using Bayesian inference. Data from 12,060 animals belonging to the HoRa Hofig Ramos herd were used. Morphological traits were evaluated by the MERCOS methodology. The heritability estimates obtained ranged from low to high magnitude, from 0.15 to 0.28 for visual scores, 0.13 to 0.44 for growth, and from 0.42 to 0.46 for carcass traits. Genetic correlations between visual scores and growth traits were generally of moderate to high magnitudes, however, visual scores showed low correlations with carcass traits, except between sacral bone and structure and REA. Selection for visual score traits can lead to favorable responses in body weight and vice versa, but the same is not true for carcass traits. Morphological categorical traits can be used as complementary tools that add value to selection. programs However market pre postweaning post weaning weights, weights , weights) rib REA, REA (REA) thickness inference 12060 12 060 12,06 methodology magnitude 015 0 15 0.1 028 28 0.2 013 13 044 44 0.4 042 42 046 46 magnitudes however versa (REA 1206 1 06 12,0 01 0. 02 2 04 4 120 12,

ABSTRACT Objective: To report on the experience and impressions of the Brazilian orthopedic trauma surgeons attending the Leadership Development Program (LDP) hosted by the Sociedade Brasileira do Trauma Ortopédico (SBTO) in Sao Paulo, Brazil on November 4, 2022. Methods: Forty-eight orthopedic trauma surgeons from five different regions throughout Brazil were provided a link to complete The Big Five Test, a validated online personality assessment. The questionnaire was available in Portuguese and was intended to provide a background on individual personality traits and their influence on interpersonal interactions. The LDP integrated content from literature reviews specific to Latin America, established leadership programs from leading business schools, and various subject matter experts. Prior to the start of the LDP, participants received a pre-course survey evaluating demographic information, a needs assessment, and the prioritization of leadership topics utilizing a 5-point Likert-scale. Attendees participated in the one-day, interactive LDP focusing on the fundamental principles of leadership development, communication, personal development, emotional intelligence and negotiation. Following the LDP, a post-course evaluation was administered to determine the participants’ overall experience, and suggestions for LDP improvement. Results: Forty-one of the forty-eight course participants completed the pre-course evaluation, whereas forty-six of the forty-eight participants completed the post-course evaluations. Overwhelmingly, the lack of opportunity was most prevalently reported as the main obstacle to attending a leadership course, as cited by 56% of respondents. Conclusion: Expanding the accessibility, diversity, and customizability of leadership programs can facilitate the development of personal tools needed to move healthcare forward. Critical topics include emotional intelligence and other differentiating leadership qualities that distinguish true transformational and servant leaders. Advancing leadership skills can stimulate networking, expose learners to experiential learning styles, inspire others to create positive change, and engender creative solutions for systematic improvements and health outcomes. Level of Evidence III; Individual Case-Control Studies. Objective (LDP SBTO (SBTO Paulo 4 2022 Methods Fortyeight Forty eight Test assessment interactions America schools experts precourse pre information 5point point 5 Likertscale. Likertscale Likert scale. scale Likert-scale oneday, oneday one day, day one-day communication negotiation postcourse post improvement Results Fortyone fortyeight forty fortysix six evaluations Overwhelmingly 56 respondents Conclusion accessibility diversity forward leaders networking styles change outcomes III CaseControl Case Control Studies 202 20 2

RESUMO Objetivo: Relatar a experiência e as impressões de cirurgiões de trauma ortopédico brasileiros participantes do Programa de Desenvolvimento de Liderança (PDL), organizado pela Sociedade Brasileira do Trauma Ortopédico (SBTO), em São Paulo, Brasil, em 4 de novembro de 2022. Métodos: Quarenta e oito cirurgiões de trauma ortopédico de cinco regiões diferentes do Brasil receberam um link para preencher o The Big Five Test, uma avaliação de personalidade on-line validada. O questionário estava disponível em português e pretendia fornecer informações básicas sobre traços de personalidade individuais e sua influência nas interações interpessoais. O PDL integrou conteúdo de análises de literatura específicas da América Latina, e programas de liderança estabelecidos pelas principais escolas de negócios e por vários especialistas no assunto. Antes do início do PDL, os participantes receberam uma pesquisa pré-curso solicitando informações demográficas, uma avaliação de necessidades e a priorização de tópicos de liderança utilizando uma escala Likert de 5 pontos. Os participantes participaram do PDL interativo de um dia com foco nos princípios fundamentais de desenvolvimento de liderança, comunicação, desenvolvimento pessoal, inteligência emocional e negociação. Após o PDL, foi realizada uma avaliação pós-curso para determinar a experiência geral dos participantes e sugestões para melhoria do PDL. Resultados: Quarenta e um dos quarenta e oito participantes do curso concluíram a avaliação pré-curso, enquanto quarenta e seis dos quarenta e oito participantes concluíram a avaliação pós-curso. A falta de oportunidade foi relatada com maior prevalência como o principal obstáculo para frequentar um curso de liderança, conforme citado por 56% dos entrevistados. Conclusão: Expandir a acessibilidade, a diversidade e a personalização dos programas de liderança podem facilitar o desenvolvimento de ferramentas pessoais necessárias para fazer avançar os cuidados de saúde. Os tópicos críticos incluem inteligência emocional e outras qualidades de liderança diferenciadas, que distinguem verdadeiros líderes transformacionais e servidores O avanço das competências de liderança pode estimular o networking, expor os alunos a estilos de aprendizagem experiencial, inspirar outros a criar mudanças positivas e gerar soluções criativas para melhorias sistemáticas dos resultados na saúde. Nível de Evidência III; Estudos de caso-controle individuais. Objetivo , (PDL) SBTO, SBTO (SBTO) Paulo 2022 Métodos Test online on line validada interpessoais Latina assunto précurso pré demográficas pontos comunicação pessoal negociação póscurso pós Resultados précurso, curso, póscurso. curso. 56 entrevistados Conclusão acessibilidade saúde diferenciadas networking experiencial III casocontrole caso controle (PDL (SBTO 202 20 2

ABSTRACT BACKGROUND: The human telomerase reverse transcriptase (hTERT) enzyme, encoded by the hTERT gene, synthesizes protective telomeric sequences on chromosomes and plays a fundamental role in cancer formation. Methylation of the hTERT gene has an upregulatory effect, increasing hTERT enzyme synthesis and allowing continuous tumor cell division. OBJECTIVE: In a group of patients with breast cancer, we aimed to analyze the methylation status of hTERT in the tumor, surrounding tissue, and circulating free deoxyribonucleic acid (cfDNA) of blood collected on the day of mastectomy and then approximately one year later. DESIGN AND SETTING: A prospective study was conducted at a university hospital in Rio de Janeiro, Brazil. METHODS: Samples were collected from 15 women with breast cancer on the day of mastectomy and approximately one year postoperatively. cfDNA was analyzed by sodium bisulfite conversion, followed by polymerase chain reaction, electrophoresis, and silver nitrate staining. RESULTS: Methylation of hTERT was detected in the tumors and surrounding tissues of all 15 patients. Five patients displayed hTERT methylation in the cfDNA from the blood of the first collection. Of the ten patients who returned for the second collection, three showed methylation. Two patients with methylation in the first collection did not display methylation in the second collection. One patient with no methylation in the first collection displayed methylation in the second collection, and one patient had a diminished level of methylation in the second collection. CONCLUSION: Only one-third of patients displayed methylation in their cfDNA, which may be related to the success of chemotherapy. BACKGROUND (hTERT formation effect division OBJECTIVE tissue (cfDNA later SETTING Janeiro Brazil METHODS 1 postoperatively conversion reaction electrophoresis staining RESULTS CONCLUSION onethird third chemotherapy

Abstract Groupers (Epinephelidae and Serranidae) have attracted special attention to fish farming, and their species offer good opportunities for successful hybridizations. Cytogenetic data allow a better understanding of the role of karyotypic diversification in the acquisition of post-zygotic reproductive isolation (RI). Thus, chromosomal analyses were performed on E. striatus (Caribbean Sea), E. coioides and E. tauvina (Indo-Pacific Region), using standard procedures and mapping of six repetitive DNA classes by the in situ hybridization. The three species have 2n=48 chromosomes. The karyotypes of E. coioides and E. striatus are composed only of acrocentric chromosomes (FN=48), while E. tauvina has 8 submetacentric chromosomes (FN=56). Heterochromatin has a preferential centromeric distribution, and the microsatellite repeats are dispersed throughout the chromosomes of all species. The 18S and 5S rDNA sites are unique but show a colocalization arrangement in E. tauvina and E. striatus. The chromosomal organization suggests that the three species still maintain a significant amount of syntenic regions. The range of the karyotype divergence and the RI levels showed low, but goes turn proportionally greater in relation to the divergence time between the parental species. The slow acquisition of postzygotic RI is consistent with the high karyotype homogeneity presented by Epinephelidae family. Serranidae farming hybridizations post zygotic RI. . (RI) Thus E Caribbean Sea, Sea , Sea) IndoPacific Indo Pacific Region, Region Region) hybridization 2n48 n 2n 48 2n=4 FN=48, FN48 FN FN=48 (FN=48) FN=56. FN56 FN=56 56 (FN=56) distribution S regions low family (RI 2n4 4 2n= FN4 FN=4 (FN=48 FN5 FN=5 5 (FN=56 FN= (FN=4 (FN=5 (FN= (FN

ABSTRACT Objective: To examine the physical function and respiratory muscle strength of patients - who recovered from critical COVID-19 – after intensive care unit discharge to the ward on Days one (D1) and seven (D7), and to investigate variables associated with functional impairment. Methods: This was a prospective cohort study of adult patients with COVID-19 who needed invasive mechanical ventilation, non-invasive ventilation or high-flow nasal cannula and were discharged from the intensive care unit to the ward. Participants were submitted to Medical Research Council sum-score, handgrip strength, maximal inspiratory pressure, maximal expiratory pressure, and short physical performance battery tests. Participants were grouped into two groups according to their need for invasive ventilation: the Invasive Mechanical Ventilation Group (IMV Group) and the Non-Invasive Mechanical Ventilation Group (Non-IMV Group). Results: Patients in the IMV Group (n = 31) were younger and had higher Sequential Organ Failure Assessment scores than those in the Non-IMV Group (n = 33). The short physical performance battery scores (range 0 - 12) on D1 and D7 were 6.1 ± 4.3 and 7.3 ± 3.8, respectively for the Non-Invasive Mechanical Ventilation Group, and 1.3 ± 2.5 and 2.6 ± 3.7, respectively for the IMV Group. The prevalence of intensive care unit-acquired weakness on D7 was 13% for the Non-IMV Group and 72% for the IMV Group. The maximal inspiratory pressure, maximal expiratory pressure, and handgrip strength increased on D7 in both groups, but the maximal expiratory pressure and handgrip strength were still weak. Only maximal inspiratory pressure was recovered (i.e., > 80% of the predicted value) in the Non-IMV Group. Female sex, and the need and duration of invasive mechanical were independently and negatively associated with the short physical performance battery score and handgrip strength. Conclusion: Patients who recovered from critical COVID-19 and who received invasive mechanical ventilation presented greater disability than those who were not invasively ventilated. However, they both showed marginal functional improvement during early recovery, regardless of the need for invasive mechanical ventilation. This might highlight the severity of disability caused by SARS-CoV-2. Objective COVID19 COVID 19 COVID-1 D (D1 D7, , (D7) impairment Methods noninvasive non highflow high flow sumscore, sumscore sum score, sum-score tests NonInvasive Non NonIMV . Results n 31 33. 33 33) range 12 61 6 1 6. 43 4 3 4. 73 7 7. 38 8 3.8 13 1. 25 2 5 2. 26 37 3.7 unitacquired acquired 72 weak i.e., ie i e (i.e. 80 value sex Conclusion ventilated However recovery SARSCoV2. SARSCoV2 SARSCoV SARS CoV SARS-CoV-2 COVID1 COVID- (D (D7 3. i.e. (i.e SARS-CoV- i.e SARS-CoV

RESUMO Objetivo: Examinar a função física e a força muscular respiratória de pacientes que se recuperaram da COVID-19 grave após a alta da unidade de terapia intensiva para a enfermaria nos Dias 1 e 7 e investigar as variáveis associadas ao comprometimento funcional. Métodos: Trata-se de estudo de coorte prospectivo de pacientes adultos com COVID-19 que necessitaram de ventilação mecânica invasiva, ventilação mecânica não invasiva ou cânula nasal de alto fluxo e tiveram alta da unidade de terapia intensiva para a enfermaria. Os participantes foram submetidos aos testes Medical Research Council sum-score, força de preensão manual, pressão inspiratória máxima, pressão expiratória máxima e short physical performance battery. Os participantes foram agrupados em dois grupos conforme a necessidade de ventilação mecânica invasiva: o Grupo Ventilação Mecânica Invasiva (Grupo VMI) e o Grupo Não Ventilação Mecânica Invasiva (Grupo Não VMI). Resultados: Os pacientes do Grupo VMI (n = 31) eram mais jovens e tinham pontuações do Sequential Organ Failure Assessment mais altas do que os do Grupo VMI (n = 33). As pontuações do short physical performance battery (intervalo de zero a 12) nos Dias 1 e 7 foram 6,1 ± 4,3 e 7,3 ± 3,8, respectivamente para o Grupo Não VMI, e 1,3 ± 2,5 e 2,6 ± 3,7, respectivamente para o Grupo VMI. A prevalência de fraqueza adquirida na unidade de terapia intensiva no Dia 7 foi de 13% para o Grupo Não VMI e de 72% para o Grupo VMI. A pressão inspiratória máxima, a pressão expiratória máxima e a força de preensão manual aumentaram no Dia 7 em ambos os grupos, porém a pressão expiratória máxima e a força de preensão manual ainda eram fracas. Apenas a pressão inspiratória máxima foi recuperada (ou seja, > 80% do valor previsto) no Grupo Não VMI. As variáveis sexo feminino, e necessidade e duração da ventilação mecânica invasiva foram associadas de forma independente e negativa à pontuação do short physical performance battery e à força de preensão manual. Conclusão: Os pacientes que se recuperaram da COVID-19 grave e receberam ventilação mecânica invasiva apresentaram maior incapacidade do que aqueles que não foram ventilados invasivamente. No entanto, os dois grupos de pacientes apresentaram melhora funcional marginal durante a fase inicial de recuperação, independentemente da necessidade de ventilação mecânica invasiva. Esse resultado pode evidenciar a gravidade da incapacidade causada pelo SARS-CoV-2. Objetivo COVID19 COVID 19 COVID-1 Métodos Tratase Trata sumscore, sumscore sum score, score sum-score . Resultados n 31 33. 33 33) intervalo 12 61 6 6, 43 4 3 4, 73 7, 38 8 3,8 13 1, 25 2 5 2, 26 37 3,7 72 fracas seja 80 previsto feminino Conclusão invasivamente entanto recuperação SARSCoV2. SARSCoV2 SARSCoV SARS CoV 2. SARS-CoV-2 COVID1 COVID- 3, SARS-CoV- SARS-CoV

SUMMARY OBJECTIVE: This prospective study aimed to provide a comprehensive analysis of the methylation status of two pivotal genes, CDKN2A/p16INK4A (cyclin-dependent kinase inhibitor 2A) and RB1 (retinoblastoma transcriptional corepressor 1), in breast cancer patients. METHODS: Samples were obtained from 15 women diagnosed with breast cancer and who underwent a total mastectomy. DNA was extracted from the tumor, non-tumor tissue, and peripheral blood (circulating cell-free DNA). The methylation pattern of cell-free DNA extracted from blood collected on the day of mastectomy was compared with the methylation pattern of cell-free DNA from blood collected 1 year post-surgery. The methylation analysis was carried out by sodium bisulfite conversion and polymerase chain reaction, followed by electrophoresis. RESULTS: Methylation of CDKN2A/p16INK4A was identified in 13 tumor samples and 12 non-tumor tissue samples. Two patients exhibited CDKN2A/p16INK4A methylation in the cell-free DNA of the first blood collection, while another showed methylation only in the cell-free DNA of the subsequent blood collection. Regarding RB1, 11 tumors and 8 non-tumor tissue samples presented methylation of the gene. CONCLUSION: This study presents a novel approach for monitoring breast cancer patients through the analysis of cell-free DNA methylation. This analysis can detect changes in methylation patterns before any visible sign of cancer appears in breast tissue and could help predict the recurrence of malignant breast tumors. OBJECTIVE genes CDKN2Ap16INK4A CDKNApINKA CDKN2A p16INK4A CDKN A p INK cyclindependent cyclin dependent 2A RB retinoblastoma 1, , 1) METHODS nontumor non circulating cellfree cell free DNA. . DNA) postsurgery. postsurgery post surgery. surgery post-surgery reaction electrophoresis RESULTS collection gene CONCLUSION Ap CDKNA pINKA

ABSTRACT Objective: To assess the accuracy of general practitioners in recognizing diabetic retinopathy through color retinal retinography, with a two-hour training course, by comparing the capacity of screening and classifying diabetic retinopathy. Methods: In the first arm of the study, of 142 diabetic patients included, 274 eyes were evaluated, and these patients were examined with an indirect binocular ophthalmoscope and classified according to the degree of diabetic retinopathy. In the second arm of the study, 14 physicians who are not specialists in ophthalmology received two-hour training to diagnose diabetic retinopathy with color retinography, and the accuracy of these professionals in screening for diabetic retinopathy before and after the training course was measured using the photographic images obtained on the first front of the study. Results: There was a significant increase in sensitivity (82% to 99%) and specificity (44% to 83%) in detecting diabetic retinopathy by general practitioners, after attending the training. Conclusion: Qualified general practitioners can assess diabetic retinopathy through color retinography, and the screening program for this diabetes complication is a viable and beneficial proposal for the country. Objective retinography twohour two hour Methods study included 27 evaluated 1 Results 82% 82 (82 99% 99 44% 44 (44 83% 83 Conclusion country 2 8 (8 9 4 (4 (

RESUMO Objetivo: Avaliar a acurácia de médicos generalistas em reconhecer a retinopatia diabética por meio da retinografia colorida, com um curso de capacitação com duração de 2 horas, comparando a capacidade de rastrear e classificar a retinopatia diabética em relação ao exame presencial com oftalmologista. Métodos: No primeiro braço do estudo, de 142 pacientes diabéticos incluídos, avaliaram-se 274 olhos, em que esses pacientes foram examinados com oftalmoscópio binocular indireto e classificados quanto ao grau da retinopatia diabética. No segundo braço do estudo, 14 médicos não especialistas em oftalmologia receberam um treinamento de 2 horas para o diagnóstico de retinopatia diabética com a retinografia colorida e se aferiu a acurácia desses profissionais em rastrear a retinopatia diabética antes e depois do curso de capacitação, utilizando as retinografias obtidas na primeira frente do estudo. Resultados: Verificou-se aumento significativo da sensibilidade (82% para 99%) e da especificidade (44% para 83%) na detecção da retinopatia diabética pelos médicos generalistas, com o curso de capacitação. Conclusão: O médico generalista capacitado pode avaliar a retinopatia diabética por meio da retinografia colorida, sendo o programa de rastreamento dessa complicação do diabetes uma proposta viável e benéfica ao país. Objetivo oftalmologista Métodos estudo incluídos avaliaramse avaliaram 27 olhos 1 Resultados Verificouse Verificou 82% 82 (82 99% 99 44% 44 (44 83% 83 Conclusão país 8 (8 9 4 (4 (

Abstract This study evaluated the mechanical properties and the chemical and thermal characteristics of low-density polyethylene (LDPE) nanocomposites reinforced with graphene oxide for manufacturing via 3D printing. LDPE nanocomposites with different graphene oxide (GO) loadings (0.5% and 1.5%) were processed by a single-screw extruder. To characterize the pre-injected material, Fourier transform infrared spectroscopy (FTIR) and thermal characterization with thermogravimetry (TGA) were used. The injected material was also characterized with mechanical impact and traction tests. The results showed that incorporating GO into the polymeric matrix added hydroxyl groups to the matrix structure, with a 39.13% increase in Young's modulus for LDPE-1.5%wtGO samples. Mechanical tests of 3D printed samples showed that, with an increase in the amount of GO in the polymer matrix, the composite loses ductility, enabling its use in 3D printing technologies and thus encouraging new studies on printed materials for various applications. lowdensity low density (LDPE D (GO 0.5% 05 0 5 (0.5 1.5% 15 1 singlescrew single screw extruder preinjected pre FTIR (FTIR TGA (TGA used structure 3913 39 13 39.13 Youngs Young s LDPE1.5%wtGO LDPE15wtGO LDPEwtGO 1.5%wtGO wtGO ductility applications 0.5 (0. 1.5 391 3 39.1 LDPE1 15wtGO 0. (0 1. 39. (

Abstract: The influenza-like illness (ILI) sentinel surveillance operates in Brazil to identify respiratory viruses of public health relevance circulating in the country and was first implemented in 2000. Recently, the COVID-19 pandemic reinforced the importance of early detection of the circulation of new viruses in Brazil. Therefore, an analysis of the design of the ILI sentinel surveillance is timely. To this end, we simulated a sentinel surveillance network, identifying the municipalities that would be part of the network according to the criteria defined in the design of the ILI sentinel surveillance and, based on data from tested cases of severe acute respiratory illness (SARI) from 2014 to 2019, we drew samples for each sentinel municipality per epidemiological week. The draw was performed 1,000 times, obtaining the median and 95% quantile interval (95%QI) of virus positivity by Federative Unit and epidemiological week. According to the ILI sentinel surveillance design criteria, sentinel units would be in 64 municipalities, distributed mainly in capitals and their metropolitan areas, recommending 690 weekly samples. The design showed good sensitivity (91.65% considering the 95%QI) for qualitatively detecting respiratory viruses, even those with low circulation. However, there was important uncertainty in the quantitative estimate of positivity, reaching at least 20% in 11.34% of estimates. The results presented here aim to assist in evaluating and updating the ILI sentinel surveillance design. Strategies to reduce uncertainty in positivity estimates need to be evaluated, as does the need for greater spatial coverage. Abstract influenzalike influenza like (ILI 2000 Recently COVID19 COVID 19 COVID-1 Therefore timely end SARI (SARI 201 2019 week 1000 1 000 1,00 times 95 95%QI 95QI QI (95%QI 6 areas 69 91.65% 9165 91 65 (91.65 However 20 1134 11 34 11.34 evaluated coverage 200 COVID1 COVID- 100 00 1,0 9 91.65 916 (91.6 2 113 3 11.3 10 0 1, 91.6 (91. 11. 91. (91 (9 (

Resumen: La vigilancia centinela de la enfermedad tipo infuenza (ETI) funciona en Brasil para identificar los virus respiratorios de importancia para la salud pública que circulan en el país y comenzó a ser implementada en 2000. Recientemente, la pandemia de COVID-19 ha reforzado la importancia de la detección temprana de la circulación de nuevos virus en el territorio brasileño. Así, se hace oportuno un análisis del diseño de la vigilancia centinela de la ETI. Para ello, simulamos una red centinela identificando los municipios que formarían parte de la red según los criterios definidos en el diseño de la vigilancia centinela de la ETI y, a partir de los datos de casos testados de infección respiratoria aguda grave (IRAG) de 2014 a 2019, se extrajeron muestras para cada municipio centinela por semana epidemiológica. El sorteo se repitió 1.000 veces y se obtuvo la mediana y el intervalo cuantílico del 95% (IC95%) de la positividad por virus, por Unidad Federativa y semana epidemiológica. Según los criterios del diseño de la vigilancia centinela de la ETI, unidades centinelas estarían en 64 municipios, distribuidas principalmente en capitales y zonas metropolitanas de las capitales, preconizando 690 muestras semanales. El diseño presentó una buena sensibilidad (total de 91,65% considerando el IC95%) para la detección cualitativa de los virus respiratorios, incluso los de baja circulación. Sin embargo, hubo una importante incertidumbre en la estimación cuantitativa de la positividad, alcanzando al menos el 20% en el 11,34% de las estimaciones. Los resultados presentados aquí tienen como objetivo ayudar en la evaluación y actualización del diseño de la red centinela. Es necesario evaluar las estrategias para reducir la incertidumbre en las estimaciones de positividad, al igual que la necesidad de una mayor cobertura espacial. Resumen (ETI 2000 Recientemente COVID19 COVID 19 COVID-1 brasileño Así ello IRAG (IRAG 201 2019 epidemiológica 1000 1 000 1.00 95 IC95% IC95 IC (IC95% 6 69 semanales total 9165 91 65 91,65 embargo 20 1134 11 34 11,34 espacial 200 COVID1 COVID- 100 00 1.0 9 IC9 (IC95 916 91,6 2 113 3 11,3 10 0 1. (IC9 91, 11, (IC

Resumo: A vigilância sentinela de síndrome gripal atua no Brasil identificando os vírus respiratórios de importância para a saúde pública circulantes no país, e começou a ser implementada em 2000. Recentemente, a pandemia de COVID-19 reforçou a importância da detecção precoce de novos vírus em circulação no território brasileiro. Assim, se faz oportuna uma análise do desenho da vigilância sentinela de síndrome gripal. Para tal, simulamos uma rede sentinela, identificando os municípios que fariam parte da rede segundo os critérios definidos no desenho da vigilância sentinela de síndrome gripal, e, a partir dos dados de casos testados de síndrome respiratória aguda grave (SRAG) de 2014 a 2019, sorteamos amostras para cada município sentinela por semana epidemiológica. O sorteio foi repetido mil vezes, obtendo-se a mediana e intervalo quantílico de 95% (IQ95%) da positividade para cada vírus por Unidade Federativa e semana epidemiológica. Segundo os critérios do desenho da vigilância sentinela de síndrome gripal, unidades sentinelas estariam em 64 municípios, distribuídas principalmente em capitais e suas zonas metropolitanas, o que preconizou 690 amostras semanais. O desenho apresentou boa sensibilidade (total de 91,65%, considerando o IQ95%) para a detecção qualitativa dos vírus respiratórios, mesmo os de baixa circulação. Porém, houve importante incerteza na estimativa quantitativa de positividade, chegando a, pelo menos, 20% em 11,34% das estimativas. Os resultados aqui apresentados visam auxiliar a avaliação e a atualização do desenho da rede sentinela. Estratégias para reduzir a incerteza nas estimativas de positividade precisam ser avaliadas, assim como a necessidade de maior cobertura espacial. Resumo país 2000 Recentemente COVID19 COVID 19 COVID-1 brasileiro Assim tal SRAG (SRAG 201 2019 epidemiológica vezes obtendose obtendo 95 IQ95% IQ95 IQ (IQ95% 6 metropolitanas 69 semanais total 9165 91 65 91,65% Porém menos 20 1134 11 34 11,34 avaliadas espacial 200 COVID1 1 COVID- 9 IQ9 (IQ95 916 91,65 2 113 3 11,3 (IQ9 91,6 11, (IQ 91,

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 ± (±

Resumen: La luxación traumática atlanto-occipital (LTAO) es una lesión grave, poco frecuente y con una elevada tasa de mortalidad. En este artículo presentamos el caso de un paciente politraumatizado de 28 años que sufrió una LTAO asociada a luxación rotatoria en C1-C2, a la avulsión de cóndilos y traumatismo craneoencefálico como consecuencia de un accidente de tráfico, con parada cardiorrespiratoria en el lugar del accidente. El paciente presentaba déficits motores y sensoriales y sufrió otras complicaciones clínicas graves durante su hospitalización. Luego de dos años de tratamiento quirúrgico, el paciente evoluciona favorablemente con recuperación completa de las alteraciones neuromotoras y sensitivas. El caso presentado demuestra que la recuperación neurológica con mínimas secuelas es posible, incluso después de un pronóstico desfavorable debido a una lesión grave y al alto riesgo de muerte derivado de este tipo de traumatismos. Es esencial que los profesionales sanitarios sean capaces de identificar y tratar la LTAO, garantizando mejores resultados clínicos, una reducción de la mortalidad y la morbilidad, y una mejor calidad de vida para los pacientes afectados. Nivel de Evidencia IV; Series de casos. Resumen atlantooccipital atlanto occipital (LTAO 2 C1C2, C1C2 CC C1 C2, C2 C C1-C2 tráfico hospitalización quirúrgico sensitivas posible traumatismos clínicos morbilidad afectados IV casos C1C C1-C

ABSTRACT Traumatic atlanto-occipital dislocation is a rare, severe, and usually fatal injury. In this paper, we report the case of a 28-year-old patient with multiple trauma, who suffered an atlanto-occipital dislocation (AOD) associated with rotatory dislocation at C1-C2, condyle fracture and traumatic brain injury resulting from a car accident, with a cardiopulmonary arrest at the accident site. The patient had motor and sensory deficits, suffering other complications of clinical severity during hospitalization. After two years of surgical treatment follow-up, the patient had a complete recovery of neuromotor and sensory functions. This case demonstrates that neurological recovery with minimal sequelae is possible, even after an unfavorable prognosis resulting from a severe injury with a high risk of death as this kind of trauma. It is essential for health professionals to have the ability to identify and treat AOD, ensuring improved clinical outcomes, reducing mortality and morbidity, and providing a better life to affected patients. Level of Evidence IV; Cases Series. atlantooccipital atlanto occipital rare paper 28yearold yearold 28 year old trauma AOD (AOD C1C2, C1C2 CC C1 C2, C2 C C1-C2 site deficits hospitalization followup, followup follow up, up follow-up functions possible outcomes morbidity patients IV Series 2 C1C C1-C

Resumo: A luxação traumática atlanto-occipital (LTAO) é uma lesão rara, grave e com alto índice de mortalidade. Neste artigo relatamos o caso de um paciente de 28 anos, politraumatizado, que sofreu uma LTAO associada à luxação rotatória em C1-C2, à avulsão de côndilo e ao traumatismo crânio encefálico decorrente de acidente automobilístico, com relato de uma parada cardiorrespiratória no local do acidente. O paciente deu entrada no serviço com déficit motor e sensitivo, sofrendo outras intercorrências de gravidade clínica durante a internação. Após dois anos do tratamento cirúrgico, o paciente evoluiu favoravelmente com completa recuperação das alterações neuromotoras e sensitivas. O caso apresentado demonstra que é possível a recuperação neurológica com sequelas mínimas, mesmo após um prognóstico desfavorável decorrente de uma lesão grave e o elevado risco de morte decorrente desse tipo de trauma. É essencial que os profissionais de saúde estejam aptos a identificar e tratar a LTAO, garantindo uma melhorar dos resultados clínicos, redução da mortalidade e morbidade, além de proporcionar uma melhor qualidade de vida aos pacientes afetados. Nível de Evidência IV; Série de casos. Resumo atlantooccipital atlanto occipital (LTAO rara 2 politraumatizado C1C2, C1C2 CC C1 C2, C2 C C1-C2 automobilístico sensitivo internação cirúrgico sensitivas mínimas trauma clínicos morbidade afetados IV casos C1C C1-C

ABSTRACT Objective: This study aimed to describe the clinical characteristics of the pediatric population with COVID-19 in an Emergency Department (ED) of a Brazilian general hospital. Methods: Epidemiological and clinical data of patients younger than 20 years old were collected from patients’ medical records from February 2020 to July 2021. Most of the epidemiological data described pertains to hospitalized patients. We also reviewed coinfections, treatment, and outcomes and compared the first and second waves of COVID-19. Results: We identified a total of 1303 episodes of SARS-CoV-2 infection. The median time from symptom onset to diagnosis was three days. Symptoms were present in 92.3% of the patients. The most common symptoms were fever (45.2%), nasal congestion/discharge (44.2%), and cough (39.4%). Chest radiography and tomography were performed in 7.7 and 3.3% of cases, with abnormal findings in 29.7 and 53.4%, respectively. Hospital admissions occurred in 3.5% of patients, mainly in the presence of comorbidities, in children under five years old and in those who presented to the ED during the first wave of COVID-19. Coinfection with a viral agent was identified in 20% of the 71 cases tested in this study, and a positive rapid test for Streptococcus pyogenes was found in 8% of the 174 cases tested, with no impact of these coinfections on hospitalization. Conclusions: We found that COVID-19 was a mild disease in most children in our study population, with most hospitalizations and readmissions occurring during the first wave of COVID-19. Objective COVID19 COVID 19 COVID-1 (ED hospital Methods 2 202 2021 treatment COVID19. 19. Results 130 SARSCoV2 SARSCoV SARS CoV SARS-CoV- infection days 923 92 3 92.3 45.2%, 452 45.2% , 45 (45.2%) congestiondischarge congestion discharge 44.2%, 442 44.2% 44 (44.2%) 39.4%. 394 39.4% . 39 4 (39.4%) 77 7 7. 33 3.3 297 29 29. 534 53 53.4% respectively 35 5 3.5 comorbidities 8 17 hospitalization Conclusions COVID1 1 COVID- 13 SARS-CoV 9 92. 45.2 (45.2% 44.2 (44.2% 39.4 (39.4% 3. 53.4 45. (45.2 44. (44.2 39. (39.4 53. (45. (44. (39. (45 (44 (39 (4 (3 (

RESUMO Objetivo: Este estudo teve como objetivo descrever as características clínicas da população pediátrica com COVID-19 no setor de emergência de um hospital geral brasileiro. Métodos: Os dados epidemiológicos e clínicos de pacientes idade inferior a 20 anos foram coletados dos prontuários dos pacientes de fevereiro de 2020 a julho de 2021. A maior parte dos dados epidemiológicos descritos refere-se a pacientes hospitalizados. Também foram revisados as coinfecções, o tratamento e os desfechos de internação e comparadas a primeira e a segunda ondas de COVID-19. Resultados: Foi identificado o total de 1.303 episódios de infecção por SARS-CoV-2. A mediana de tempo desde o início dos sintomas até o diagnóstico foi de três dias. Os sintomas estiveram presentes em 92,3% dos pacientes. Os sintomas mais comuns foram febre (45,2%), congestão/secreção nasal (44,2%) e tosse (39,4%). Radiografia e tomografia de tórax foram realizadas em 7,7 e 3,3% dos casos, com achados anormais em 29,7 e 53,4%, respectivamente. As internações hospitalares ocorreram em 3,5% dos pacientes, principalmente na presença de comorbidades, em crianças menores de cinco anos e naqueles que se apresentaram no pronto-socorro durante a primeira onda de COVID-19. Foi identificada coinfecção viral em 20% dos 71 casos testados e teste rápido positivo para Streptococcus pyogenes em 8% dos 174 casos testados, não havendo impacto dessas coinfecções quanto à internação hospitalar. Conclusões: Observamos que a COVID-19 foi uma doença leve na maioria das crianças de nossa população, com a maior parte das hospitalizações e readmissões ocorrendo durante a primeira onda de COVID-19. Objetivo COVID19 COVID 19 COVID-1 brasileiro Métodos 2 202 2021 referese refere hospitalizados COVID19. 19. Resultados 1303 1 303 1.30 SARSCoV2. SARSCoV2 SARSCoV SARS CoV 2. SARS-CoV-2 dias 923 92 3 92,3 45,2%, 452 45,2% , 45 (45,2%) congestãosecreção congestão secreção 44,2% 442 44 (44,2% 39,4%. 394 39,4% . 39 4 (39,4%) 77 7 7, 33 3,3 297 29 29, 534 53 53,4% respectivamente 35 5 3,5 comorbidades prontosocorro pronto socorro 8 17 hospitalar Conclusões COVID1 COVID- 130 30 1.3 SARS-CoV- 9 92, 45,2 (45,2% 44,2 (44,2 39,4 (39,4% 3, 53,4 13 1. SARS-CoV 45, (45,2 44, (44, 39, (39,4 53, (45, (44 (39, (45 (4 (39 ( (3