ABSTRACT Objective: To assess the impact of different vertical positions on lung aeration in patients receiving invasive mechanical ventilation. Methods: An open-label randomized crossover clinical trial was conducted between January and July 2020. Adults receiving invasive mechanical ventilation for > 24 hours and < 7 days with hemodynamic, respiratory and neurological stability were randomly assigned at a 1:1 ratio to the sitting position followed by passive orthostasis condition or the passive orthostasis followed by the sitting position condition. The primary outcome was lung aeration assessed using the lung ultrasound score (score ranges from 0 [better] to 36 [worse]). Results: A total of 186 subjects were screened; of these subjects, 19 were enrolled (57.8% male; mean age, 73.2 years). All participants were assigned to receive at least one verticalization protocol. Passive orthostasis resulted in mean lung ultrasound scores that did not differ significantly from the sitting position (11.0 versus 13.7; mean difference, -2.7; [95%CI -6.1 to 0.71; p = 0.11). Adverse events occurred in three subjects in the passive orthostasis group and in one in the sitting position group (p = 0.99). Conclusion: This analysis did not find significant differences in lung aeration between the sitting and passive orthostasis groups. A randomized crossover clinical trial assessing the impact of vertical positioning on lung aeration in patients receiving invasive mechanical ventilation is feasible. Unfortunately, the study was interrupted due to the need to treat COVID-19 patients. ClinicalTrials.gov registry: NCT04176445

RESUMO Objetivo: Avaliar o impacto de diferentes posicionamentos verticais na aeração pulmonar em pacientes em ventilação mecânica invasiva. Métodos: Trata-se de ensaio clínico aberto, randomizado e transversal, realizado entre janeiro e julho de 2020. Adultos em ventilação mecânica invasiva por mais de 24 horas e menos de 7 dias com estabilidade hemodinâmica, respiratória e neurológica foram distribuídos aleatoriamente em uma proporção de 1:1 à postura sentada seguida da condição de ortostatismo passivo ou o ortostatismo passivo seguido de postura sentada. O desfecho primário foi a aeração pulmonar avaliada pelo lung ultrasound score. O escore varia de zero (melhor) a 36 (pior). Resultados: Foram selecionados 186 indivíduos; destes, 19 foram incluídos (57,8% do sexo masculino; média idade de 73,2 anos). Todos os participantes foram selecionados para receber pelo menos um protocolo de verticalização. O ortostatismo passivo resultou em escores médios de aeração pulmonar por ultrassonografia que não diferiram significativamente da postura sentada (11,0 versus 13,7; diferença média, -2,7; IC95% -6,1 a 0,71; p = 0,11). Ocorreram eventos adversos em três indivíduos no grupo ortostatismo passivo e em um no grupo postura sentada (p = 0,99). Conclusão: Esta análise não encontrou diferenças significativas na aeração pulmonar entre os grupos ortostatismo passivo e postura sentada. É factível conduzir um estudo clínico transversal randomizado para avaliar o impacto do posicionamento vertical na aeração pulmonar em pacientes em ventilação mecânica invasiva. Infelizmente, o estudo foi interrompido devido à necessidade de tratar pacientes com COVID-19. Registro ClinicalTrials.gov: NCT04176445

ABSTRACT Plant species have different adaptation mechanisms regarding seed survival to desiccation, preventing cellular destruction during the water loss. The knowledge of these mechanisms is of great importance for the understanding of how the seed formation/maturation processes and the processes involved in germination occur. Thus, this study aimed to determine physiological and enzymatic changes during the maturation process of melon seeds of the cultivar BRS Anton, obtained from fruits at different maturation stages and subjected to post-harvest storage, by the action of total proteins and the enzymes catalase, peroxidase, and superoxide dismutase. Melon fruits were grown in a greenhouse at Embrapa Vegetables and harvested at five different times: 30, 45, 60, 75, and 90 days after anthesis (DAA). Thirty fruits were harvested in each season and 15 fruits had their seeds extracted immediately after harvest and the other 15 fruits were stored for 15 days. After processing and drying, the seeds were submitted to the following analyses: germination, first count, protein profile analysis, and activity of antioxidant enzymes (total proteins, peroxidase, catalase, and superoxide dismutase). The activity of the antioxidant enzymes from 60 DAA under storage showed a more orderly behavior, reaffirming the results of physiological tests. It shows that the seeds at this point of physiological maturation are well-formed and drying caused no damage to their cell membranes.

RESUMO As espécies vegetais apresentam diferentes mecanismos de adaptação no que diz respeito à sobrevivência das sementes à dessecação, prevenindo a destruição celular durante a perda de água. O conhecimento desses mecanismos é de grande importância para o entendimento de como ocorre os processos de formação/maturação de sementes e dos processos envolvidos na germinação. Dessa forma, o objetivo deste trabalho foi determinar as alterações fisiológicas e enzimáticas durante o processo de maturação das sementes de melão da cultivar “BRS Anton”, obtidas de frutos em diferentes estádios de maturação e submetidas ao armazenamento pós-colheita, por meio da ação das proteínas totais e das enzimas catalase, peroxidase e superóxido dismutase. Os frutos de melão foram cultivados em casa de vegetação na Embrapa Hortaliças e colhidos em cinco épocas distintas: aos 30, 45, 60, 75 e 90 dias após a antese (DAA). Em cada época, foram colhidos 30 frutos, sendo que 15 frutos tiveram suas sementes extraídas imediatamente após a colheita e 15 frutos foram armazenados por 15 dias. Após o beneficiamento e secagem, as sementes foram submetidas às seguintes análises: germinação, primeira contagem, análise do perfil de proteínas e atividade de enzimas antioxidantes (proteínas totais, peroxidase, catalase e superóxido dismutase). Observou-se que as atividades das enzimas antioxidativas a partir dos 60 DAA sob armazenamento, apresentou um comportamento mais ordenado reafirmando os resultados dos testes fisiológicos. Demostrando que as sementes neste ponto de maturação fisiológica, encontra-se bem formadas e que a secagem não provocou danos em suas membranas celulares.

O presente trabalho se baseia na pesquisa histórica sobre o grupo de pesquisas em raios cósmicos formado na Faculdade de Filosofia, Ciências e Letras, da Universidade de São Paulo, liderado por Gleb Wataghin. Nesse sentido, o trabalho busca entender como a formação da nova universidade no estado de São Paulo e a contratação de professores estrangeiros foi um fator que gerou reflexos nas pesquisas ali desenvolvidas. A partir da análise das correspondências trocadas entre os personagens desse episódio histórico, à luz do conceito da circulação de pessoas, ideias e técnicas, buscamos entender como foi possível que a ciência nacional obtivesse algum protagonismo no cenário internacional e também como foi possível o desenvolvimento e na consolidação da física nuclear brasileira. Essa circulação contribuiu intensamente para que esse grupo de pesquisa se estabelecesse e mantivesse contato com grandes centros de ciência mundial, impulsionando assim uma institucionalização da física nuclear no país. A partir desse episódio, buscamos entender também como a sua compreensão nos ajuda a entender a dimensão política da ciência e possíveis reflexos existentes até os dias de hoje. Filosofia Letras Wataghin sentido desenvolvidas histórico pessoas técnicas brasileira mundial país hoje

The present work is based on historical research on the formation of the cosmic ray research group at the Faculty of Philosophy, Science and Letters, in the University of São Paulo, led by Gleb Wataghin. In this sense, the work seeks to understand how the formation of the new university in the state of São Paulo and the hiring of foreign professors was a factor that generated reflections on the research carried out there. Based on the analysis of the correspondence exchanged between the characters of this historical episode, we also sought to understand how the process of circulation of people, ideas and techniques took place. This process contributed for this research group to establish itself and maintain contact with major centers of world science, thus allowing Brazilian science to have some prominence on the international scene in the post-war period and also boosted the institutionalization of nuclear physics in the country. Philosophy Letters Wataghin sense there episode people place postwar post war country

Abstract Objective: To investigate the prevalence and factors associated with no intention to exclusively breastfeed for the first 6 months of life in a sample of women in the first 24 h postpartum during the hospital stay. Methods: Cross-sectional study with data from screening phase of a birth cohort. The proportion of mothers who did not intend to breastfeed exclusively for 6 months (primary outcome) derived from a negative response to the question “Would you be willing to try to breastfeed exclusively for the first 6 months?”, in an interview conducted by previously trained interviewers. Crude and adjusted prevalence ratios (PR) with 95% confidence intervals were obtained by Poisson regression with robust variance. Results: A total of 2964 postpartum women were interviewed. The overall prevalence of mothers who did not intend to breastfeed exclusively for 6 months was 17.8% (16.4–19.1%). After adjusting for maternal age and type of pregnancy (singleton or multiple), no intention to exclusively breastfeed was higher in mothers with a monthly household income < 3 minimum wages (PR, 1.64; 1.35–1.98) and in those who intended to smoke 4–7 days/week after delivery (PR, 1.42; 1.11–1.83). The presence of significant newborn morbidity (PR, 0.32; 0.19–0.54) and intention to breastfeed up to 12 months (PR, 0.46; 0.38–0.55) had a protective effect against not intending to breastfeed exclusively for 6 months. Conclusions: Approximately 1 in every 5 mothers did not intend to breastfeed exclusively for 6 months. Strategies aimed at promoting exclusive breastfeeding should focus attention on mothers from lower economic strata and smokers.

RESUMO Os resíduos orgânicos disponíveis na região Oeste do Maranhão, Brasil, são abundantes, devido à atividade agropecuária. Estes podem ser utilizados na composição de substratos para produção de mudas de mogno africano, porém há necessidade de demonstrar a eficiência técnica de resíduos orgânicos com solos da região. O objetivo foi avaliar substratos compostos de proporções varáveis de terra de diferente textura e resíduos orgânicos, para a obtenção de mudas de mogno africano de boa qualidade. O experimento foi conduzido em duas etapas, uma em viveiro florestal e outra no campo, ambos localizados no bioma Cerrado, Oeste do Maranhão, região Nordeste do Brasil. O delineamento foi em blocos casualizados, com onze tratamentos e sete repetições. As variáveis morfológicas de crescimento e qualidade foram avaliadas por 105 dias no viveiro e 270 dias no campo. Os resultados demonstraram que todos os substratos produziram mudas com índice de robustez e índice de qualidade de Dickson adequados, e as mudas de mogno africano produzidas nos substratos com proporção que vária entre 70 a 30% de solo, 15 a 30% de esterco bovino curtido e 15 a 20% de casca de arroz carbonizada apresentaram melhor padrão de qualidade considerando-se os maiores valores de teor de nutrientes, características morfológicas e índice de qualidade de Dickson. No entanto, ao serem plantadas no campo, apenas as mudas que foram produzidas nos substratos com terra de subsolo de textura argilosa, com até 20% de casca de arroz carbonizada, apresentaram maior crescimento em altura, pois o substrato permaneceu aderido à raiz ao serem retirados do recipiente. Portanto, a aderência do substrato ao sistema radicular das mudas foi o fator preponderante para o maior crescimento das mudas em condições de campo.

ABSTRACT The organic residues can be used in the composition of substrates, but there is a need to demonstrate the technical efficiency of organic residues. The objective was to evaluate substrates composed of varying proportions of soil of different texture and organic residues, in order to obtain good quality African mahogany seedlings. The experiment was carried out in two stages, one in a forest nursery and the other in the field, both located in the Cerrado biome, Western Maranhão, Northeast region of Brazil. The design was in randomized blocks, with eleven treatments and seven replications. The morphological variables of growth and quality were evaluated for 105 days in the nursery and 270 days in the field. The results showed that all substrates produced seedlings with adequate robustness and Dickson quality index. The seedlings produced in substrates with proportions ranging from 70 to 30% of soil, 15 to 30% of tanned cattle manure and 15 to 20% of carbonized rice husks presented a better quality standard, considering the higher values of nutrient content, morphological characteristics and Dickson quality index. However, when planted in the field, only seedlings that were produced in substrates with clayey textured soil, with up to 20% of carbonized rice husk, showed greater growth in height, as the substrate remained adhered to the root when removed from the container. Therefore, the adherence of the substrate to the root system of the seedlings was the main factor for the greater growth of the seedlings under field conditions.

Resumo O objetivo deste trabalho foi avaliar o efeito do retardo de resfriamento de morangos ‘San Andreas’ sobre a manutenção da qualidade dos frutos, bem como sobre os compostos fenólicos totais (CFT) e a atividade antioxidante total (AAT), após o armazenamento refrigerado. Os tratamentos consistiram no resfriamento nos tempos de 0 (controle, resfriamento imediato), 3, 6, 9 e 12 horas (em temperatura ambiente), após a colheita. Após a aplicação dos tratamentos, os frutos foram armazenados sob refrigeração (4 ± 0,5 °C e 92 ± 2% de UR), durante 5, 6, 7 e 8 dias, seguidos por mais 2 dias de exposição, em condição ambiente (20 ± 2 °C e 65 ± 5% de UR). Os morangos com o maior retardo de resfriamento apresentaram maior perda de massa fresca, além de menor firmeza, a partir de 7 dias de armazenamento. De maneira geral, os menores valores de incidência e severidade de podridões foram observados nos frutos do tratamento com resfriamento imediato após a colheita, quando armazenados por 7 e 8 dias, seguidos por mais 2 dias em condições ambiente. O retardo do resfriamento por até 6 horas não causa aumento de podridões até 5 dias de armazenamento refrigerado, mais 2 dias em condições ambiente. Os valores de CFT e AAT apresentaram aumento com o retardo de até 6 horas do resfriamento dos frutos, aos 6 dias de armazenamento seguidos por mais 2 dias em condições ambiente, e a AAT aumentou com o aumento do atraso no resfriamento dos frutos em até 12 horas, após 8 dias de armazenamento mais 2 dias em condições ambiente. O atraso no resfriamento causa perdas na qualidade dos frutos de morango, de acordo com o tempo de armazenamento.

Abstract This work aimed to evaluate the effect of the cooling delay of 'San Andreas' strawberries on the maintenance of fruit quality, as well as on Total Phenolic Compounds (TPC) and Total Antioxidant Activity (TAA) after refrigerated storage. Treatments consisted of no cooling at times 0 (control, immediate cooling), 3, 6, 9 and 12 hours (at room temperature) after harvest. After application of the treatments, the fruits were stored under refrigeration (4 ± 0.5 ºC and 92 ± 2% RH) for 5, 6, 7 and 8 days, followed by a further 2 days of exposure in ambient conditions (20 ± 2 °C and 65 ± 5% RH). Strawberries with the greatest cooling delay added significant loss of fresh mass, in addition to less firmness after 7 days of storage. In general, the lowest values of rot incidence and severity were observed in the fruits of the treatment with immediate cooling after harvest, when stored for 7 and 8 days, followed by 2 more days in ambient conditions. Delaying cooling for up to 6 hours did not cause increased decay for up to 5 days of refrigerated storage, plus 2 days at ambient conditions. The values of TPC and TAA showed a dissipation with a delay of up to 6 hours of cooling of the fruits, at 6 days of storage followed by another 2 days in ambient conditions, and the TAA increased with the increase of the delay in the cooling of the fruits in up to 12 hours, after 8 days of storage plus 2 days at ambient conditions. The delay in cooling could cause losses in strawberry fruit quality, according to storage time.

Abstract The advancement of predictive models by Machine Learning Algorithms (ML) associated with environmental data enables the improvement of models of environmental fragility, which are essential tools for decision-making. This study aimed to derive a prediction of environmental fragility by testing ML associated with environmental covariates in the state of Minas Gerais. We use physical-environmental variables (soil, geology, climate, relief) with a weight of fragility for the attributes and calculation of the average to obtain a model of Potential Environmental Fragility (PEF). Subsequently, we extracted the PEF values to a 4,800-point grid, which was used to generate a new prediction by ML called PEFML. This prediction was based on testing five algorithms and a set of 105 environmental covariates. The results indicated that the best-performing PEFML prediction was the Random Forest model (R2 0.59 and RMSE 0.47), indicating a predominance of the low environmental fragility level. The PEF and PEFML models have strong correlations (0.7 Pearson); however, PEFML has stronger correlations with other environmental data. Therefore, the PEFML prediction is a robust model that captures information from covariates and has coherent spatial patterns.

Resumen El avance de los modelos predictivos mediante Machine Learning Algorithms (ML) asociados a datos ambientales permite mejorar los modelos de fragilidad ambiental, que son herramientas fundamentales para la toma de decisiones. Este estudio tuvo como objetivo derivar una predicción de la fragilidad ambiental mediante la prueba de ML asociado con covariables ambientales en el estado de Minas Gerais. Se utilizaron variables físico-ambientales (suelo, geología, clima, relieve) con peso de fragilidad para los atributos y cálculo de la media para obtener un modelo de Fragilidad Ambiental Potencial (PEF). Posteriormente, extrajimos los valores de PEF a una cuadrícula de 4800 puntos, que se utilizó para generar una nueva predicción de ML, llamada PEFML. Esta predicción se basó en la prueba de cinco algoritmos y un conjunto de 105 covariables ambientales. Los resultados indicaron que la predicción PEFML con mejor desempeño fue el modelo Random Forest (R2 0.59 y RMSE 0.47), indicando un predominio del bajo nivel de fragilidad ambiental. Los modelos PEF y PEFML muestran fuertes correlaciones (0,7 Pearson); sin embargo, PEFML tiene correlaciones más fuertes con otros datos ambientales. Por lo tanto, la predicción PEFML es un modelo robusto que captura información de covariables y tiene patrones espaciales coherentes.

Resumo O avanço de modelos preditivos por Algoritmos de Aprendizado de Máquina (ML) associados à dados ambientais possibilita aprimoramento de modelos de fragilidade ambiental, os quais são importantes ferramentas para tomada de decisão. O objetivo desse estudo foi derivar uma predição de fragilidade ambiental, testando ML associados a covariáveis ambientais no estado de Minas Gerais. Utilizamos variáveis físico-ambientais (solo, geologia, clima, relevo) com peso de fragilidade para os atributos e cálculo da média obtendo o modelo de Fragilidade Ambiental Potencial (PEF). Posteriormente, extraímos os valores de PEF para uma grade de 4.800 pontos e usadas para gerar uma nova predição por ML, denominada PEFML. A predição foi com teste de cinco algoritmos e conjunto de 105 covariáveis ambientais. Comparamos os dois modelos de fragilidade ambiental (PEF e PEFML), inclusive com outros dados de riscos/vulnerabilidade/fragilidade. Os resultados indicaram que a predição de PEFML de melhor desempenho foi o modelo Random Forest (R2 0.59 e RMSE 0.47), indicando predomínio do nível fragilidade baixa. Os modelos de fragilidade PEF e PEFML têm forte correlação (0.7 Pearson), porém, PEFML possui correlações mais fortes com outros dados ambientais. Portanto, a predição de PEFML é um modelo robusto que capta informações de covariáveis e possui padrões espaciais coerentes

ABSTRACT Objectives: To evaluate the impact of COVID-19 on clinical and surgical practice, educational activities, health and lifestyle behavior of Brazilian urology residents. Materials and Methods: A web-based survey was sent to 468 Brazilian urology residents from postgraduate years (PGY) 3 to 5 to collect data on clinical practice and training after 4 months of COVID-19. We also assessed health-related and behavior changes, rate of infection by SARS-CoV-2, deployment to the front line of COVID-19, residents’ concerns, and access to personal protective equipment (PPE). Results: Massive reductions in elective and emergency patient consultations, diagnostic procedures and surgeries were reported across the country, affecting PGY 3 to 5 alike. Most in-person educational activities were abolished. The median damage to the urological training expected for 2020 was 6.0 [3.4 – 7.7], on a scale from 0 to 10, with senior residents estimating a greater damage (P< 0.001). Educational interventions developed included online case-based discussions, subspeciality conferences and lectures, and grand rounds. Most senior residents favored extending residency to compensate for training loss and most younger residents favored no additional training (p< 0.001). Modifications in health and lifestyle included weight gain (43.8%), reduced physical activity (68.6%), increased alcoholic intake (44.9%) and cigarette consumption (53.6%), worsening of sexual life (25.2%) and feelings of sadness or depression (48,2%). Almost half were summoned to work on the COVID-19 front-line and 24.4% had COVID-19. Most residents had inadequate training to deal with COVID-19 patients and most reported a shortage of PPE. Residents’ concerns included the risk of contaminating family members, being away from residency program, developing severe COVID-19 and overloading colleagues. Conclusions: COVID-19 had a massive impact in Brazilian urology residents´ training, health and lifestyle behavior, which may reflect what happened in other medical specialties. Studies should confirm these findings to help developing strategies to mitigate residents’ losses.

Abstract Background Cardiovascular disease is the main cause of death worldwide. There is a lack of studies addressing this issue in women and its risk factors, such as hypertension. Objective To evaluate the clinical and therapeutic profile of women with hypertension and to determine which factors are related to treatment adherence and blood pressure control. Methods Cross-sectional study of 181 hypertensive women treated at an outpatient referral clinic. Data were obtained from medical records, face-to-face interviews, and physical examination, using a standardized form. Statistical analysis was performed with prevalence ratio, chi-square and Student’s t test. Significance was accepted at p<0.05. Results Most patients were mixed-race or black (91.7%) and the mean age was 66.09 years. Only 44.2% of patients had controlled blood pressure. The prevalence of stroke was 14.9%, whereas the prevalence of coronary artery disease was 19.3%. The mean number of oral antihypertensive drugs prescribed to each individual was 3.41. A history of stroke was more often found in patients with uncontrolled blood pressure (p=0.013) and in those using three or more antihypertensives (p=0.023). Eighty patients (44.2%) had high treatment adherence. Depression was more frequently reported by patients with poorer adherence to treatment (p=0.026). Conclusion Women with hypertension presented a high prevalence of cardiovascular risk factors and cardiovascular events, including a significantly higher prevalence of stroke in those with uncontrolled hypertension. Self-reported depression may help identify patients at risk of nonadherence to treatment.

Abstract Background Resistant hypertension (RH) is manifested by the presence of blood pressure values resistant to antihypertensive therapy. RH is highly prevalent among black individuals, increasing cardiovascular risk in this population and requiring effective control of this comorbidity. Objectives To investigate the medication profile and therapeutic adherence in black people with apparent RH. Methods This is a cross-sectional study, with a convenience sample of individuals with apparent RH. Data were obtained from medical records. Therapeutic adherence was assessed using the Morisky Therapeutic Adherence Scale of 8 items (MMAS-8) and statistical analysis was performed using the SPSS, version 23. Significance was set at p <0.05. Results Of the 120 individuals, 90 (75%) were women and 72 (60%) were black. Mean SBP was 153.09 (SD 25.59) mm Hg and mean DBP, 90.82 (SD 16.91) mm Hg, with a statistical difference in relation to the target pressure for SBP. Regarding the medication profile, 79.2% of the individuals used the recommended regimen for RH (ACEI / ARB + Diuretic + CCB), with the fourth most used drug being beta-blockers. The average score in MMAS-8 was 6.62 (SD 1.38) points, with 19.2%, 50.0%, and 30.8% showing low, medium, and high adherence, respectively. Conclusions It was evidenced that two-thirds of the individuals did not have high therapeutic adherence and not all used the ideal regimen for the management of RH, nor full doses. Thus, most individuals were probably affected by pseudoresistance, which was initially diagnosed as apparent RH. (Int J Cardiovasc Sci. 2021; [online].ahead print, PP.0-0)

Background Since the end of 2020, there has been a great deal of international concern about the variants of SARS-COV-2 B.1.1.7, identified in the United Kingdom; B.1.351 discovered in South Africa and P.1, originating from the Brazilian state of Amazonas. The three variants were associated with an increase in transmissibility and worsening of the epidemiological situation in the places where they expanded. The lineage B.1.1.7 was associated with the increase in case fatality rate in the United Kingdom. There are still no studies on the case fatality rate of the other two variants. The aim of this study was to analyze the mortality profile before and after the emergence of the P.1 strain in the Amazonas state. Methods We analyzed data from the Influenza Epidemiological Surveillance Information System, SIVEP-Gripe (Sistema de Informação de Vigilância Epidemiológica da Gripe), comparing two distinct epidemiological periods: during the peak of the first wave, between April and May 2020, and in January 2021 (the second wave), the month in which the new variant came to predominate. We calculated mortality rates, overall case fatality rate and case fatality rate among hospitalized patients; all rates were calculated by age and gender and 95% confidence intervals (95% CI) were determined. Findings We observed that in the second wave there were a higher incidence and an increase in the proportion of cases of COVID-19 in the younger age groups. There was also an increase in the proportion of women among Severe Acute Respiratory Infection (SARI) cases from 40% (2,709) in the first wave to 47% (2,898) in the second wave and in the proportion of deaths due to COVID-19 between the two periods varying from 34% (1,051) to 47% (1,724), respectively. In addition, the proportion of deaths among people between 20 and 59 years old has increased in both sexes. The case fatality rate among those hospitalized in the population between 20 and 39 years old during the second wave was 2.7 times the rate observed in the first wave (female rate ratio = 2.71; 95% CI: 1.9-3.9], p &lt;0.0001; male rate ratio = 2.70, 95%CI:2.0-3.7), and in the general population the rate ratios were 1.15 (95% CI: 1.1-1.2) in females and 0.78 (95% CI: 0.7-0.8) in males]. Interpretation Based on this prompt analysis of the epidemiological scenario in the Amazonas state, the observed changes in the pattern of mortality due to COVID-19 between age groups and gender simultaneously with the emergence of the P.1 strain suggest changes in the pathogenicity and virulence profile of this new variant. Further studies are needed to better understanding of SARS-CoV-2 variants profile and their impact for the health population.

Introdução Desde o final de 2020 tem havido grande preocupação internacional com as variantes do SARS-COV-2: B.1.1.7, identificada no Reino Unido; B.1.351, descoberta na África do Sul e P.1, que emergiu inicialmente estado brasileiro do Amazonas. As três variantes foram associadas a aumento na transmissibilidade e piora da situação epidemiológica nos locais onde se expandiram. A linhagem B.1.1.7 foi associada ao aumento da taxa de letalidade no Reino Unido. Ainda não existem estudos conclusivos sobre letalidade das outras duas variantes. O objetivo deste estudo foi analisar o perfil de mortalidade antes e depois da emergência da linhagem P.1 no Amazonas. Métodos Analisamos os dados do sistema nacional de vigilância epidemiológica, comparando dois momentos epidemiológicos distintos: durante o pico da primeira onda, entre abril e maio de 2020, e em janeiro de 2021, mês em que a nova variante passou a predominar. Calculamos as taxas de mortalidade, letalidade e letalidade entre pacientes internados, todas as taxas foram calculadas por idade e por sexo e determinados os intervalos de confiança de 95%. Achados Observamos que na segunda onda houve maior incidência e aumento na proporção de casos de COVID-19 nas faixas etárias mais jovens. Observou-se, também, um aumento na proporção de mulheres entre os casos de SARI de 40% (2.709) na primeira onda para 47% (2.898) na segunda onda e entre mortes por COVID-19 de 34% (1,051) para 47% (1.724), respectivamente. Além disso, a proporção de mortes entre 20 e 59 anos aumentou em ambos os sexos. A letalidade entre os hospitalizados na população entre 20 e 39 anos durante a segunda onda foi 2.7 vezes a primeira onda [razão de taxas sexo feminino=2,71; CI(95%)=1,9-3,9], p&lt;0.0001; razão de taxas sexo masculino=2.70(2.0-3.7)), na população geral as razões de taxa foram 1,15(1,1-1,2) no sexo feminino e 0,78(0,7-0,8) no sexo masculino. Interpretação Observamos mudanças no padrão de mortalidade por COVID-19 entre as faixas etárias e sexo simultaneamente à emergência da linhagem P.1, sugerindo mudanças nos perfis de patogenicidade e virulência, novos estudos são necessários para melhor compreensão das variantes do SARS-CoV-2 e suas consequências na saúde da população.

ABSTRACT The aim of this study was to verify if a growth reduction of yellow passion fruit seedlings’ growth morphophysiology and quality could be changed by paclobutrazol applied through seedling immersion. The experiment was conducted in a greenhouse, with seedlings grown in polyethylene tubes (290 cm3), with substrate. At 40 days after sowing, the seedlings were immersed in an aqueous solution of paclobutrazol at concentrations of 0, 50, 100, 150, and 200 mg L-1. The experiment was conducted in a randomized block design, with five treatments (paclobutrazol concentrations) and four replicates. At 15 and 30 days after treatment, growth characteristics were evaluated. At the end of the assay, destructive evaluations related to mass determination, total leaf area, and seedling quality index were performed. Paclobutrazol treatment induced restrictions in seedling growth, except for fresh and dry mass of root and total fresh mass. Based on these characteristics, the increase in values induced by paclobutrazol was verified. The seedling quality, defined by the major value of the Dickson quality index and a smaller robustness index, was higher when submitted to paclobutrazol treatment.

RESUMO Objetivos: Este estudo tem como objetivo avaliar a efetividade de protocolos de escleroterapia com diferentes diluições de oleato de etanolamina no tratamento de varizes orais. Métodos: Dados clínicos e imagens de 14 casos tratados com escleroterapia foram avaliados, sendo realizado análises descritivas. Resultados: As mulheres (58%) e a cor de pele branca (83%) prevaleceram na amostra. A idade variou entre 14 e 79 anos, com média de 47 anos (DP = 19 anos). As localizações anatômicas mais comuns foram a mucosa jugal e o lábio inferior. O volume final do agente esclerosante (Ethamolin®) variou de 0,4 a 4,3ml e a concentração variou de 5% a 100%. O número de sessões variou de 1 a 12 e o número de pontos por aplicação foi de 1 a 7 pontos. Dor e edema foram observados em 43% e 29% dos pacientes, respectivamente. Conclusão: A escleroterapia com oleato de monoetanolamina diluído em anestésico é uma opção segura e eficaz para o tratamento das varizes orais, independentemente da concentração. No entanto, edema e dor parecem estar diretamente associados ao aumento da concentração do medicamento.

ABSTRACT Objective: This study aim to evaluate the effectiveness of sclerotherapy protocols with different dilutions of ethanolamine oleate in the treatment of oral varicose veins. Methods: Clinical data and images of 14 cases treated with sclerotherapy were analyzed and descriptive analyses were performed. Results: Females (58%) and white skin color (83%) prevailed. Age varied between 14 and 79 years, with 47 years on mean (SD = 19 years). The most common anatomical locations were the buccal mucosa and lower lip. The final volume of the sclerosing agent (Ethamolin®) ranged from 0.4 to 4.3ml and the concentration ranged from 5% to 100%. The number of sessions ranged from 1 to 12 and the number of points per application was 1 to 7 points. Pain and edema were seen in 43% and 29% of patients, respectively. Conclusion: Sclerotherapy with monoethanolamine oleate diluted in anesthetic is a safe and effective option for the treatment of this lesion, regardless of concentration. However, edema and pain seem to be directly associated with increased drug concentration.