Methodological Procedures to Acquire and Analyze Ultrasound Images of Swallowing: A Scoping Review.

This scoping review aimed to identify methodological procedures for acquiring and analyzing ultrasound images related to swallowing in adults and older adults. The inclusion criteria were based on the PCC strategy (participants, concept, and context), as follows: population (adults and older adults), concept (ultrasound assessment), and context (swallowing assessment). The review included observational, experimental, descriptive, and analytical studies and excluded those that were not available in full, animal studies, in vitro studies, letters to the editor, errata, study protocols, and those that used ultrasound for purposes other than swallowing. There were no language and time restrictions. Two independent blinded professionals selected 81 articles that met the inclusion criteria from different databases. The most evaluated parameters included tongue morphology and movements, hyoid bone displacement, swallowing muscle area, and pharyngeal residue detection, such as pharyngeal wall mobility. They used convex and linear transducers (3 MHz to 8 MHz) positioned in the submental, laryngeal, and lateral regions of the neck. The subjects were seated and instructed to eat different food volumes and consistencies. The literature mapping showed that ultrasound is a promising diagnostic tool, helping clinicians understand swallowing disorders, as it provides static and dynamic images in different modes and positions. Also, patients receive real-time biofeedback of changes related to dysphagia.

Exploring the potential of a new thermotolerant xylanase from Rasamsonia composticola (XylRc): production using agro-residues, biochemical studies, and application to sugarcane bagasse saccharification.

Xylanases from thermophilic fungi have a wide range of commercial applications in the bioconversion of lignocellulosic materials and biobleaching in the pulp and paper industry. In this study, an endoxylanase from the thermophilic fungus Rasamsonia composticola (XylRc) was produced using waste wheat bran and pretreated sugarcane bagasse (PSB) in solid-state fermentation. The enzyme was purified, biochemically characterized, and used for the saccharification of sugarcane bagasse. XylRc was purified 30.6-fold with a 22% yield. The analysis using sodium dodecyl sulphate-polyacrylamide gel electrophoresis revealed a molecular weight of 53 kDa, with optimal temperature and pH values of 80 °C and 5.5, respectively. Thin-layer chromatography suggests that the enzyme is an endoxylanase and belongs to the glycoside hydrolase 10 family. The enzyme was stimulated by the presence of K+, Ca2+, Mg2+, and Co2+ and remained stable in the presence of the surfactant Triton X-100. XylRc was also stimulated by organic solvents butanol (113%), ethanol (175%), isopropanol (176%), and acetone (185%). The Km and Vmax values for oat spelt and birchwood xylan were 6.7 ± 0.7 mg/mL, 2.3 ± 0.59 mg/mL, 446.7 ± 12.7 µmol/min/mg, and 173.7 ± 6.5 µmol/min/mg, respectively. XylRc was unaffected by different phenolic compounds: ferulic, tannic, cinnamic, benzoic, and coumaric acids at concentrations of 2.5-10 mg/mL. The results of saccharification of PSB showed that supplementation of a commercial enzymatic cocktail (Cellic® CTec2) with XylRc (1:1 w/v) led to an increase in the degree of synergism (DS) in total reducing sugar (1.28) and glucose released (1.05) compared to the control (Cellic® HTec2). In summary, XylRc demonstrated significant potential for applications in lignocellulosic biomass hydrolysis, making it an attractive alternative for producing xylooligosaccharides and xylose, which can serve as precursors for biofuel production.

Platelet-activating factor and protease-activated receptor 2 cooperate to promote neutrophil recruitment and lung inflammation through nuclear factor-kappa B transactivation.

Although it is well established that platelet-activated receptor (PAF) and protease-activated receptor 2 (PAR2) play a pivotal role in the pathophysiology of lung and airway inflammatory diseases, a role for a PAR2-PAFR cooperation in lung inflammation has not been investigated. Here, we investigated the role of PAR2 in PAF-induced lung inflammation and neutrophil recruitment in lungs of BALB/c mice. Mice were pretreated with the PAR2 antagonist ENMD1068, PAF receptor (PAFR) antagonist WEB2086, or aprotinin prior to intranasal instillation of carbamyl-PAF (C-PAF) or the PAR2 agonist peptide SLIGRL-NH2 (PAR2-AP). Leukocyte infiltration in bronchoalveolar lavage fluid (BALF), C-X-C motif ligand 1 (CXCL)1 and CXCL2 chemokines, myeloperoxidase (MPO), and N-acetyl-glycosaminidase (NAG) levels in BALF, or lung inflammation were evaluated. Intracellular calcium signaling, PAFR/PAR2 physical interaction, and the expression of PAR2 and nuclear factor-kappa B (NF-КB, p65) transcription factor were investigated in RAW 264.7 cells stimulated with C-PAF in the presence or absence of ENMD1068. C-PAF- or PAR2-AP-induced neutrophil recruitment into lungs was inhibited in mice pretreated with ENMD1068 and aprotinin or WEB2086, respectively. PAR2 blockade impaired C-PAF-induced neutrophil rolling and adhesion, lung inflammation, and production of MPO, NAG, CXCL1, and CXCL2 production in lungs of mice. PAFR activation reduced PAR2 expression and physical interaction of PAR2 and PAFR; co-activation is required for PAFR/PAR2 physical interaction. PAR2 blockade impaired C-PAF-induced calcium signal and NF-κB p65 translocation in RAW 264.7 murine macrophages. This study provides the first evidence for a cooperation between PAFR and PAR2 mediating neutrophil recruitment, lung inflammation, and macrophage activation.

Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) na graduação em Fonoaudiologia no Brasil / International Classification of Functioning, Disability and Health (ICF) in undergraduate Speech, Language and Hearing Sciences programs in Brazil / Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud (CIF) en cursos de pregrado en logopedia en Brasil

Introdução: A formação em saúde, especialmente no Brasil, tem incorporado a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) de modo a desenvolver capacidades para lidar com a vida humana no modelo biopsicossocial. Objetivo: Descrever e analisar a inserção da CIF nos currículos de graduação em Fonoaudiologia no Brasil. Método: Estudo descritivo e transversal, aprovado pelo Comitê de Ética em Pesquisa, conduzido entre novembro de 2021 e julho de 2022. Um questionário, composto por 24 questões, abertas e de múltipla escolha, com aspectos referentes à presença da CIF na matriz curricular, foi disponibilizado via Google Forms. Foram incluídos os cursos de graduação em Fonoaudiologia do Brasil, e excluídos os cursos com educação à distância. Foi realizada análise quantitativa no programa SPSS. Resultados: Dos 78 cursos de Fonoaudiologia contactados, 28,2% responderam ao questionário. Dos respondentes, 50% estavam localizados na região sudeste, e 59,1% vinculados a instituições públicas. Nos cursos participantes, 27,3% incluíram a CIF no projeto pedagógico. Dentre os cursos em que a CIF está presente, 50% se concentram em disciplinas teóricas, 33,3% em disciplinas teóricas e práticas e 16,7% em disciplinas teóricas, práticas e atividades complementares. Conclusão: A CIF está de modo incipiente nos cursos de graduação em Fonoaudiologia brasileiros, predominantemente em componentes curriculares teóricos. Evidencia-se a necessidade de ampliação do debate acerca da formação do fonoaudiólogo no que tange a preceitos que são oportunizados pela CIF, visto que sua inclusão em unidades curriculares, teóricas e práticas, pode favorecer o desenvolvimento de competências, habilidades e atitudes focadas no modelo biopsicossocial. (AU)

Introduction: Health training, especially in Brazil, has incorporated the International Classification of Functioning, Disability and Health (ICF) in order to develop capacities to deal with human life in the biopsychosocial model. Purpose: Describe and analyze the inclusion of the ICF in undergraduate Speech, Language and Hearing Sciences curricula in Brazil. Methods: A descriptive, cross-sectional study, approved by the Research Ethics Committee, conducted between November 2021 and July 2022. A questionnaire comprising 24 open-ended, multiple-choice questions on aspects relating to the presence of the ICF in the curriculum was made available via Google Forms. Brazilian undergraduate courses in Speech, Language and Hearing Sciences were included, and distance learning courses were excluded. Quantitative analysis was carried out using the SPSS program. Results: Of the 78 Speech, Language and Hearing Sciences undergraduate courses contacted, 28.2% answered the questionnaire. Of the respondents, 50% were in the southeast region and 59.1% were linked to public institutions. Of the participating courses, 27.3% included the ICF in their pedagogical project. Among the courses in which the ICF is present, 50% focus on theoretical subjects, 33.3% on theoretical and practical subjects and 16.7% on theoretical, practical, and complementary activities. Conclusion: The ICF is incipient in Brazilian undergraduate courses in Speech, Language and Hearing Sciences, predominantly in theoretical curricular components. There is a need to broaden the debate about the training of speech therapists about the precepts provided by the ICF, since its inclusion in curricular units, both theoretical and practical, can favor the development of competencies, skills and attitudes focused on the biopsychosocial model. (AU)

Introducción: La formación sanitaria, especialmente en Brasil, ha incorporado la Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud (CIF) con el fin de desarrollar capacidades para abordar la vida humana en el modelo biopsicosocial. Objetivo: Describir y analizar la inclusión de la CIF en los planes de estudio de pregrado de logopedia en Brasil. Método: Se trató de un estudio descriptivo, transversal, aprobado por el Comité de Ética de la Investigación y realizado entre noviembre de 2021 y julio de 2022. A través de Google Forms se puso a disposición un cuestionario compuesto por 24 preguntas abiertas de opción múltiple sobre aspectos relacionados con la presencia de la CIF en el plan de estudios. Se incluyeron los cursos de pregrado en Fonoaudiología en Brasil y se excluyeron los cursos a distancia. El análisis cuantitativo se realizó con el programa SPSS. Resultados:De los 78 cursos de logopedia contactados, el 28,2% respondió al cuestionario. De los encuestados, el 50% estaban situados en el sureste y el 59,1% estaban vinculados a instituciones públicas. De los cursos participantes, el 27,3% incluía el ICF en su proyecto pedagógico. Entre los cursos en los que el ICF está presente, el 50% se concentra en asignaturas teóricas, el 33,3% en asignaturas teóricas y prácticas y el 16,7% en asignaturas teóricas, prácticas y actividades complementarias. Conclusión: La CIF es incipiente en los cursos de logopedia de pregrado brasileños, predominantemente en los componentes curriculares teóricos. Es necesario ampliar el debate sobre la formación de logopedas en relación con los preceptos proporcionados por la CIF, ya que su inclusión en unidades curriculares teóricas y prácticas puede favorecer el desarrollo de competencias, habilidades y actitudes centradas en el modelo biopsicosocial. (AU)

Characteristics of women diagnosed with mpox infection compared to men: A case series from Brazil.

BACKGROUND: Cisgender men were mostly affected during the 2022 mpox multinational outbreak, with few cases reported in women. This study compares the characteristics of individuals diagnosed with mpox infection according to gender in Rio de Janeiro. METHODS: We obtained surveillance data of mpox cases notified to Rio de Janeiro State Health Department (June 12 to December 15, 2022). We compared women (cisgender or transgender) to men (cisgender or transgender) using chi-squared, Fisher's exact, and Mood's median tests. RESULTS: A total of 1306 mpox cases were reported; 1188 (91.0%) men (99.8% cisgender, 0.2% transgender), 108 (8.3%) women (87.0% cisgender, 13.0% transgender), and 10 (0.8%) non-binary persons. Compared to men, women were more frequently older (40+years: 34.3% vs. 25.1%; p < 0.001), reported more frequent non-sexual contact with a potential mpox case (21.4% vs. 9.8%; p = 0.004), fewer sexual partnerships (10.9 vs. 54.8%; p < 0.001), less sexual contact with a potential mpox case (18.5% vs. 43.0%; p < 0.001), fewer genital lesions (31.8% vs. 57.9%; p < 0.001), fewer systemic mpox signs/symptoms (38.0% vs. 50.1%; p = 0.015) and had a lower HIV prevalence (8.3% vs. 46.3%; p < 0.001), with all cases among transgender women. Eight women were hospitalized; no deaths occurred. The highest number of cases among women were notified in epidemiological week 34, when the number of cases among men started to decrease. CONCLUSIONS: Women diagnosed with mpox presented differences in epidemiological, behavioral, and clinical characteristics compared to men. Health services should provide a comprehensive assessment that accounts for gender diversity.

Effects on communication due to face mask use: an integrative review.

OBJECTIVES: to integrate evidence from studies on auditory perceptual and speech production effects in communication situations with face mask use. METHODS: an integrative literature review, in MEDLINE, Cochrane Library and Embase databases. The guiding question was: what effects on communication (perceptual-auditory and speech production) occur with face mask use? RESULTS: searches in electronic databases resulted in 1,478 studies and filtering resulted in 29 final studies. CONCLUSIONS: mask use has effects on communication, both in perception and speech production, factors that are also related to quality of life, stress and socio-emotional factors. These data can impact on indicators and alerts in favor of adopting strategies to manage mask use, involving speech production and perception when wearing a mask in health services.

Biomineralization of calcium phosphates functionalized with hydroxyapatite-binding peptide.

Functionalization of calcium phosphates with biomimetic peptides is a promising strategy to increase cellular response for bone tissue repair. In this work, biphasic calcium phosphate pellets were functionalized with the hydroxyapatite-binding peptide pVTK by dropping a suspension of the peptide on the pellet surface. The bioactivity tests were performed in vitro by using McCoy culture medium. Cytotoxicity tests were also performed to assess cell viability. The material was characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy with field emission gun (FEG-SEM). The results showed that functionalization with the biomimetic peptide was most effective in inducing precipitation of bone-like apatite on the pellets surface, when compared to the control groups (two positive control groups and one negative control group). Cytotoxicity tests showed that all samples are biocompatible but the pellets with peptide showed the highest values of cell viability.

Patterns in Wing Morphology and Fluctuating Asymmetry in Eulaema nigrita along an Altitudinal Gradient in the Brazilian Rupestrian Grassland.

Mountain ecosystems experience abrupt abiotic changes that represent environmental filters for many organisms, shaping their phenotypic expressions. However, little is known about the morphological and symmetric adjustments of native bees along altitudinal gradients. We evaluated the changes on wing morphology, wing size, and vein fluctuating asymmetry (FA) of Eulaema nigrita Lepeletier (Apidae: Euglossini) associated with climatic variables along an altitudinal gradient in the rupestrian grassland (known also as campo rupestre or rupestrian field) of Serra do Cipó, Brazil. Seven sampling points along the altitudinal gradient were selected and distributed among 800 and 1400 m.a.s.l., and then, 40 individuals of E. nigrita were collected per each altitudinal point to determine the FA levels and the morphological changes using geometric morphometric techniques. We found that the wing size of E. nigrita decreased with increasing altitude. At the highest altitudes, the levels of FA of the wing veins were greater compared to bees from lower altitudes. We detected significant changes in wing morphology along the altitudinal gradient; bees of lower altitudes showed longer and wider wings than bees of higher altitudes, which had narrower and less elongated wings. Our results show a set of morphological adjustments and phenotypic expressions in E. nigrita associated with the variation in environmental conditions along the altitudinal gradient. We highlight the importance of environmental variables as insect-stressor factors, and that FA and geometric morphometric can be excellent tools for monitoring and evaluating environmental stresses.

Early breast cancer: concept and therapeutic review.

OBJECTIVE: Breast cancer treatment has evolved significantly over the years, both in terms of local and systemic approaches. Halsted's radical mastectomy gave way to modified mastectomies and to conservative surgeries, along with breast reconstruction and repair. Although the use of new drugs has directly increased the survival of patients submitted to adjuvant or neoadjuvant systemic therapies, the de-escalation of drugs may also be beneficial in numerous cases. Therefore, breast cancer treatment must be increasingly customized and assessed using a multidisciplinary approach. This study aimed to review the concept and therapy of early breast cancer. METHODS: A narrative review of the literature was carried out in the PubMed database in December 2022, where the keywords for the searches were as follows: early breast cancer, surgical treatment of breast cancer, systemic treatment of breast cancer, neoadjuvant chemotherapy in breast cancer, adjuvant treatment of luminal breast cancer, early triple negative tumor, and early positive Her-2 tumor. Articles that were historically important in the treatment of breast cancer and articles that impacted management with scientific relevance were selected for this review. DISCUSSION: As new evidence continues to update existing knowledge, breast cancer treatment is becoming increasingly personalized and must now take into account the different tumor variants and their clinical stages, the age of patients and relevant comorbidities, as well as personal expectations and desires. CONCLUSION: This literature review of current studies shows that the primary therapy for patients with early breast cancer continues to be surgery, although a customized and multidisciplinary approach is now required.

Physician Perceptions of and Barriers to Pediatric Palliative Care for Children With Cancer in Brazil.

PURPOSE: Early integration of pediatric palliative care (PPC) for children with cancer is critical to improving the quality of life of both the patient and family. Understanding physician perceptions of palliative care and perceived barriers to early integration is necessary to develop PPC in Brazil. METHODS: The Assessing Doctors' Attitudes on Palliative Treatment survey was modified for use in Brazil. The survey was open from January 2022 to June 2022 and distributed to physicians of all specialties from participating institutions who treat children with cancer. Statistical analysis was complemented by qualitative analysis of open-ended responses. RESULTS: A total of 272 respondents participated. Most respondents reported access to PPC experts for consultation (77.2%) and 34.5% indicated previous palliative care training. Physician knowledge of PPC was generally aligned with WHO guidance (median alignment, 93.0%; range, 80.5%-98.2%). However, about half (53.3%) felt comfortable addressing physical needs of patients receiving PPC, 35.3% addressing emotional needs, 25.8% addressing spiritual needs, and 33.5% addressing grief and bereavement needs. Most respondents (65.4%) felt palliative care should be involved from diagnosis, but only 10.3% stated that this occurred in their setting. The most important barriers identified were physician discomfort (89.0%), limited physician knowledge (88.6%), and lack of home-based services (83.8%). CONCLUSION: Despite a strong understanding of the role of palliative care, physicians in Brazil reported low confidence delivering PPC to children with cancer. Additionally, physicians generally believed that PPC should be integrated earlier in the disease trajectory of children with cancer. This work will direct educational and capacity building initiatives to ensure greater access to high-quality PPC for children with cancer in Brazil to address patient and family suffering.

Diagnostic procedures in infrared thermography for the human face: a scoping review protocol / Procedimentos diagnósticos em termografia infravermelha para a face humana: um protocolo de revisão de escopo

ABSTRACT Purpose: to present the scoping review protocol that will describe the diagnostic procedures used in infrared thermography to evaluate the human face. Methods: based on the Joanna Briggs Institute and PRISMA-ScR checklist, with the mnemonic: population (P) - human face, concept (C) - infrared thermography, and context (C) - diagnostic procedures in infrared thermography for the human face. The methodological structure will have six stages. The PubMed, LILACS, SciELO, BBO, Web of Science, EMBASE, Scopus, Cochrane Library, and Grey Literature Report databases will be searched, with no restriction on time or language. The review will include qualitative and quantitative studies. Two reviewers will independently select studies and extract data. Results will be analyzed using a variable approach. Conclusion: this scoping review protocol followed the methodological precepts and is apt to be carried out. It will serve as the basis for other scoping reviews. Conducting a scoping review is important and the prior publication of the scoping review protocol is essential to make the review process transparent.

RESUMO Objetivo: apresentar um protocolo de revisão de escopo para identificar os procedimentos diagnósticos utilizados na termografia infravermelha para a avaliação da face humana. Métodos: baseado no The Joanna Briggs Institute e no checklist PRISMA-ScR, com o mnemônico: população (P) - face humana, conceito (C) - termografia infravermelha e contexto (C) - procedimentos diagnósticos na termografia infravermelha para a região da face humana. A estrutura metodológica consistirá em seis etapas. As bases de dados consultadas serão o PubMed, LILACS, SciELO, BBO, Web of Science, Embase, Scopus, Cochrane Library e Grey Literature Report. A busca será realizada sem delimitação temporal ou restrição de idioma. A revisão incluirá estudos qualitativos e quantitativos. Dois revisores selecionarão os estudos independentemente e extrairão os dados. Os resultados serão analisados utilizando uma abordagem variável. Conclusão: este protocolo de revisão de escopo seguiu os preceitos metodológicos e se encontra em condições de execução, servindo também como base para outras revisões de escopo. A realização de uma revisão de escopo é importante e a prévia publicação do protocolo de revisão de escopo fundamental, pois tem a finalidade de trazer transparência ao processo a ser realizado.

Ultrasound assessment of swallowing: a scoping review protocol / Avaliação ultrassonográfica da deglutição: um protocolo de revisão de escopo

ABSTRACT Purpose: to conduct a scoping review to identify procedures to obtain and analyze ultrasound images related to swallowing in adults and older adults. Methods: the strategy (participants, concept, and context) was employed to determine inclusion criteria - population (adults and older adults), concept (ultrasound assessment), and context (assessment of swallowing). The review will analyze observational, experimental and/or quasi-experimental, descriptive, analytical, and qualitative studies, and opinion texts and articles. It will exclude studies unavailable in full text, in animals, or in vitro, letters to the editor, errata, study protocols, and studies using ultrasound with purposes other than swallowing. There will be no restriction on the language. Two independent professionals will select the studies in the databases (MEDLINE, EMBASE, LILACS, Web of Science, and Scopus). The review will analyze the year of publication, study design, sample, age, and procedures to assess swallowing with ultrasound. Data will be presented in diagrams, tables, and narrative. Final Considerations: the literature has described ultrasound as an assessment instrument to analyze biomechanical swallowing movements. This scoping review will describe methods to acquire ultrasound images to assess swallowing.

RESUMO Objetivo: realizar uma revisão de escopo para identificar os procedimentos de obtenção e análise de imagens ultrassonográficas relacionadas à deglutição de adultos e idosos. Métodos: a estratégia (participantes, conceito e contexto) foi empregada para determinar os critérios de inclusão - população (adultos e idosos), conceito (avaliação ultrassonográfica) e contexto (avaliação da deglutição). Serão analisados os estudos observacionais, experimentais e/ou quase experimentais, descritivos, analíticos, qualitativos, textos e artigos de opinião; e eliminados os que não estiverem disponíveis na íntegra, estudos em animais, in vitro, cartas ao editor, errata, protocolos de estudo e os que usaram a ultrassonografia para fins que não contemplam a deglutição. Não haverá restrições a idiomas. Os estudos serão escolhidos por dois profissionais, independentemente, a partir das bases de dados (MEDLINE, EMBASE, LILACS, Web of Science e Scopus). Serão analisados o ano do estudo, delineamento, amostra, idade e os procedimentos para avaliação ultrassonográfica da deglutição. Os dados serão expostos por meio de diagramas, narrativas e tabelas. Considerações Finais: a ultrassonografia vem sendo descrita na literatura como um instrumento de avaliação que permite a análise dos movimentos biomecânicos da deglutição. Esta revisão de escopo irá permitir a descrição dos métodos de aquisição da ultrassonografia na avaliação da deglutição.

Evaluation of sucking using ultrasonography in infants: a scoping review protocol / Avaliação da sucção por meio da ultrassonografia em lactentes: um protocolo de revisão de escopo

ABSTRACT Purpose: to identify studies related to ultrasound assessment of suction in infants. Methods: this research aims to investigate how the literature describes the use of ultrasound to assess suction in infants. It used the "Participants, Concept, and Context" strategy to define inclusion criteria, as follows: population, infants 1 to 180 days old; concept, assessment of suction; and context, ultrasound assessment. The search strategy will be used in the databases of MEDLINE (via PubMed), EMBASE, Web of Science, and Scopus, and studies will be selected based on the inclusion and exclusion criteria established, independently, by two trained professionals. The article analysis protocol will consider the study year and design, the number of infants assessed, their ages, the suction assessment method, the ultrasound suction image acquisition method, and the ultrasound suction analysis method. Data will be presented in charts, narratives, and tables. Final Considerations: ultrasound has been described in the literature as an assessment instrument that enables the analysis of tongue movements during suction. This scoping review will describe ultrasound acquisition methods to assess suction.

RESUMO Objetivo: identificar estudos relacionados à avaliação ultrassonográfica da função de sucção em lactentes. Métodos: esta pesquisa procura investigar como a literatura descreve o uso da ultrassonografia na avaliação da sucção dos lactentes. A estratégia Participantes, Conceito e Contexto foi utilizada para definir os critérios de inclusão, sendo a população avaliada de lactentes de um a 180 dias de vida; com o conceito investigado de avaliação da função de sucção; e o contexto investigado de avaliação ultrassonográfica. A estratégia de busca será realizada nas bases de dados eletrônicas MEDLINE (via PubMed), EMBASE, Web of Science e Scopus e os estudos serão selecionados com base nos critérios de inclusão e exclusão estabelecidos por dois profissionais treinados, independentemente. O protocolo de análise dos artigos irá considerar ano do estudo, delineamento do estudo, número de bebês avaliados, idade, metodologia para avaliação da sucção, metodologia de aquisição de imagens ultrassonográficas da sucção e metodologia de análise ultrassonográfica da sucção. Os dados serão apresentados por meio de diagramas, narrativas e tabelas. Considerações Finais: a ultrassonografia vem sendo descrita na literatura como um instrumento de avaliação que permite a análise dos movimentos da língua durante a sucção. Esta revisão de escopo irá permitir a descrição dos métodos de aquisição da ultrassonografia na avaliação da sucção.

Effects on communication due to face mask use: an integrative review / Efectos en la comunicación por el uso de cubrebocas: revisión integradora / Efeitos na comunicação em razão de uso de máscara facial: revisão integrativa

ABSTRACT Objectives: to integrate evidence from studies on auditory perceptual and speech production effects in communication situations with face mask use. Methods: an integrative literature review, in MEDLINE, Cochrane Library and Embase databases. The guiding question was: what effects on communication (perceptual-auditory and speech production) occur with face mask use? Results: searches in electronic databases resulted in 1,478 studies and filtering resulted in 29 final studies. Conclusions: mask use has effects on communication, both in perception and speech production, factors that are also related to quality of life, stress and socio-emotional factors. These data can impact on indicators and alerts in favor of adopting strategies to manage mask use, involving speech production and perception when wearing a mask in health services.

RESUMEN Objetivos: integrar evidencias de estudios sobre efectos perceptuales auditivos y de producción del habla en situaciones de comunicación con el uso de mascarilla facial. Métodos: revisión integrativa de la literatura, en las bases de datos MEDLINE, Cochrane Library y Embase. La pregunta orientadora fue: ¿qué efectos en la comunicación (perceptivo-auditiva y producción del habla) se producen con el uso de mascarillas? Resultados: las búsquedas en bases de datos electrónicas dieron como resultado 1.478 estudios y el filtrado dio como resultado 29 estudios finales. Conclusiones: el uso de mascarillas tiene efectos en la comunicación, tanto en la percepción como en la producción del habla, factores que también se relacionan con la calidad de vida, el estrés y factores socioemocionales. Estos datos pueden impactar en indicadores y alertas a favor de la adopción de estrategias para gestionar el uso de mascarillas, involucrando la producción y percepción del habla al usar mascarilla en los servicios de salud.

RESUMO Objetivos: integrar evidências de estudos sobre efeitos perceptivos auditivos e de produção de fala em situações de comunicação com o uso de máscara facial. Métodos: revisão integrativa da literatura, nas bases MEDLINE, Cochrane Library e Embase. O questionamento direcionador foi: quais efeitos na comunicação (perceptivo-auditivos e de produção de fala) ocorrem com o uso de máscaras faciais? Resultados: as buscas nas bases de dados eletrônicas resultaram em 1.478 estudos, e a filtragem culminou em 29 estudos finais. Conclusões: o uso de máscaras traz efeitos na comunicação, tanto na percepção quanto na produção da fala, fatores ademais relacionados à qualidade de vida, estresse e socioemocionais. Esses dados podem impactar em indicadores e alertas em prol da adoção de estratégias ao manejo de uso de máscaras, envolvendo a produção e percepção de fala em ocasião de uso de máscara nos serviços de saúde.

Early breast cancer: concept and therapeutic review

SUMMARY OBJECTIVE: Breast cancer treatment has evolved significantly over the years, both in terms of local and systemic approaches. Halsted's radical mastectomy gave way to modified mastectomies and to conservative surgeries, along with breast reconstruction and repair. Although the use of new drugs has directly increased the survival of patients submitted to adjuvant or neoadjuvant systemic therapies, the de-escalation of drugs may also be beneficial in numerous cases. Therefore, breast cancer treatment must be increasingly customized and assessed using a multidisciplinary approach. This study aimed to review the concept and therapy of early breast cancer. METHODS: A narrative review of the literature was carried out in the PubMed database in December 2022, where the keywords for the searches were as follows: early breast cancer, surgical treatment of breast cancer, systemic treatment of breast cancer, neoadjuvant chemotherapy in breast cancer, adjuvant treatment of luminal breast cancer, early triple negative tumor, and early positive Her-2 tumor. Articles that were historically important in the treatment of breast cancer and articles that impacted management with scientific relevance were selected for this review. DISCUSSION: As new evidence continues to update existing knowledge, breast cancer treatment is becoming increasingly personalized and must now take into account the different tumor variants and their clinical stages, the age of patients and relevant comorbidities, as well as personal expectations and desires. CONCLUSION: This literature review of current studies shows that the primary therapy for patients with early breast cancer continues to be surgery, although a customized and multidisciplinary approach is now required.

Implementation strategy for men's health actions: action-research potentialities and challenges / Estrategia de implementación de acciones en materia de salud masculina: potencialidades y desafíos de la investigación-acción / Estratégia de implementação de ações em saúde dos homens: potencialidades e desafios da pesquisa-ação

ABSTRACT Objective: to analyze the implementation strategies for adult men's health actions in Primary Care. Methods: action-research conducted with 12 adult men and 14 health professionals from a Family Health Unit in the municipality of Salvador, Bahia, Brazil. Multiple data production techniques were employed, namely: systematic observation, semi-structured interviews, field diaries and contextualized photography, across the action-research stages. Thematic Content Analysis and interpretation based on the axes of the National Policy for Comprehensive Men's Health Care were used. Results: three categories emerged from the conceptions of men and health professionals: health care for men, differentiated strategies, and lessons learned. Discussion: the culture of the strong, unyielding provider man who does not get sick and considers illness as a sign of weakness exacerbates toxic masculinity, requiring a transformation through acknowledging that men are not inherently averse to care but, rather, they are socially shaped. Conclusion: recognizing the institutional barriers became important for the discussion regarding access to health services. The action-research challenges and potentialities enabled the elaboration of an action agenda to enhance access and welcoming at the study health unit.

RESUMEN Objetivo: analizar las estrategias de implementación de acciones en materia de salud masculina para hombres adultos en Atención Primaria. Métodos: investigación-acción realizada con 12 hombres adultos y 14 profesionales de salud de una Unidad de Salud de la Familia en el municipio de Salvador, Bahía, Brasil. Se emplearon múltiples técnicas de producción de datos, a saber: observación sistemática; entrevista semiestructurada; diario de campo y fotografía, contextualizados entre las etapas de la investigación-acción. Se utilizó Análisis Temático de Contenido e interpretación basada en los ejes da Política Nacional de Atención Integral a la Salud Masculina. Resultados: surgieron tres categorías a partir de las concepciones de los hombres y los profesionales de salud: cuidados de salud para hombres; estrategias diferenciadas; lecciones aprendidas. Discusión: la cultura del hombre fuerte y proveedor que no se enferma y que categoriza a las enfermedades como una condición de debilidad potencia la masculinidad tóxica, con la debida necesidad de transformarla admitiendo que los hombres no son naturalmente reacios a cuidarse sino moldeados socialmente. Conclusión: haber reconocido las barreras institucionales revisitó importancia para debatir el acceso a los servicios de salud. Los desafíos y las potencialidades de la investigación-acción permitieron elaborar una agenda de acciones para expandir el acceso y la recepción en la unidad de salud del estudio.

RESUMO Objetivo: analisar as estratégias de implementação de ações em saúde para homens adultos na Atenção Primária. Métodos pesquisa-ação realizada com 12 homens adultos e 14 profissionais de saúde de uma Unidade de Saúde da Família no Município de Salvador, Bahia, Brasil. Empregou-se multitécnicas de produção de dados: observação sistemática; entrevista semiestruturada; diário de campo e fotografia, contextualizados, entre as etapas da pesquisa-ação. Utilizou-se a Análise de Conteúdo Temático e a interpretação baseada nos eixos da Política Nacional de Atenção Integral à Saúde do Homem. Resultados: das concepções dos homens e dos profissionais de saúde emergiu-se três categorias: cuidados em saúde para homens, estratégias diferenciadas e lições apreendidas. Discussão: a cultura do homem forte, provedor que não adoece e que coloca a doença na condição de fraqueza, potencializa a masculinidade tóxica, necessitando transformá-la pelo reconhecimento de que o homem não é naturalmente avesso ao cuidar e sim moldado socialmente. Conclusão: reconhecer as barreiras institucionais tornou-se importante para a discussão do acesso aos serviços de saúde. Os desafios e as potencialidades da pesquisa-ação possibilitaram a elaboração de uma agenda de ações para ampliação do acesso e acolhimento na unidade de saúde do estudo.

Thermography in complementary assessments of head and neck muscles: A scoping review.

INTRODUCTION: Infrared thermography has the potential to help assess human head and neck muscles, as thermal variation measurements due to muscle imbalance can contribute to the evaluation and therapeutic follow-up of various clinical conditions in the field of health. OBJECTIVE: This study investigated, with a scoping review, the use of infrared thermography in complementary assessments of human head and neck muscles to determine the extent of research on the topic, what methodologies are used in thermal assessment and thermographic analysis, what regions are assessed, and what results are expected in thermography. METHODS: LILACS, MEDLINE, SciELO, and Web of Science were the databases searched to identify articles published on the topic, with no restriction of language or time of publication. Descriptive, analytical, and experimental observational studies on the assessment of the human head and neck muscle surface temperature with infrared thermography were included. Case studies, case series, methodological accuracy, literature review, animal studies, studies that assessed patients with head and neck cancer, and studies that did not assess head and neck muscle temperature with thermography were excluded. The articles were analysed with a protocol developed by the authors, with data on author, year, country, type of study, sample characterisation, muscles assessed, outcomes investigated, thermal assessment methodology, thermographic analysis methodology and thermography measurements. RESULTS: This review identified and analysed 27 articles. The studies assessed thermal distribution in normal individuals and those with pathologies related to hyper- and hypofunctional head and neck muscle conditions for diagnosis or therapeutic follow-up. The masseter, temporal, digastric, anterior cervical region, orbicularis oris, frontalis, buccinator, suprahyoid, trapezius, sternocleidomastoid and levator scapulae muscles were assessed. Quantitative analyses with area selection tool predominated, considering absolute temperatures and temperature differences. The studies investigated temperature and its relationship with myogenic pain, quantitative assessment of muscle parameters and blood flow velocity. The mean temperature ranged from 32.97°C (±2.21) to 34.90°C, and hyper-radiant and/or asymmetric regions were observed in hyperfunctional conditions and normal subjects after muscle activation. CONCLUSION: Thermography is used in complementary assessments of head and neck muscles, identifying hyper-radiant regions and thermal asymmetry related to muscle tension and activation state. Papers are limited to specific clinical conditions and few muscle groups, besides having great methodological variability.

A Critical Analysis on the Sensitivity Enhancement of Surface Plasmon Resonance Sensors with Graphene.

The use of graphene in surface plasmon resonance sensors, covering a metallic (plasmonic) film, has a number of demonstrated advantages, such as protecting the film against corrosion/oxidation and facilitating the introduction of functional groups for selective sensing. Recently, a number of works have claimed that few-layer graphene can also increase the sensitivity of the sensor. However, graphene was treated as an isotropic thin film, with an out-of-plane refractive index that is identical to the in-plane index. Here, we critically examine the role of single and few layers of graphene in the sensitivity enhancement of surface plasmon resonance sensors. Graphene is introduced over the metallic film via three different descriptions: as an atomic-thick two-dimensional sheet, as a thin effective isotropic material (same conductivity in the three coordinate directions), and as an non-isotropic layer (different conductivity in the perpendicular direction to the two-dimensional plane). We find that only the isotropic layer model, which is known to be incorrect for the optical modeling of graphene, provides sizable sensitivity increases, while the other, more accurate, models lead to a negligible contribution to the sensitivity.

Effect of Vocal Therapy Associated With TENS in Women With Behavioral Dysphonia.

PURPOSE: This study aimed to investigate the effect of transcutaneous electrical nerve stimulation (TENS) associated with vocal therapy in women with behavioral dysphonia. METHOD: Seventeen women with behavioral dysphonia were divided into an experimental group (n = 8) and a placebo group (n = 9). All were submitted to six sessions of vocal therapy, according to the Comprehensive Voice Rehabilitation Program. In the experimental group, therapy was associated with TENS (30 minutes) and in the placebo group, the electrodes were placed and the equipment remained off. The vocal handicap, the voice through the acoustic and auditory perception evaluation, the electrical activity, and the superficial temperature of the suprahyoid and infrahyoid muscles were evaluated. Pre and post data were compared by parametric and nonparametric tests. RESULTS: There was a decreased in vocal handicap of the placebo group (P = 0.002) and a decreased in the percentage of electrical activity of the right (P = 0.036) and left (P = 0.017) infrahyoid muscles of the experimental group in vowel emission and sequential speech (P = 0.036). There was an increase in temperature in the right infrahyoid region in vowel emission (P = 0.027) and the temperature difference decreased quantitatively between the supra and infrahyoid regions in the experimental group. CONCLUSION: TENS associated with vocal therapy reduced the electrical activity of the infrahyoid muscles and balance the temperature between the supra- and infrahyoid regions in women with behavioral dysphonia.

Effect of Electrical Stimulation on the Treatment of Dysphonia: A Systematic Review.

OBJECTIVES: The aim of this study was to review systematically the literature and to investigate the effects of electrical stimulation in treating dysphonia. STUDY DESIGN: This is a systematic review. METHODS: The publications indexed on the MEDLINE, LILACS, PubMed, Web of Science, and SciELO databases were searched. Original articles with experimental, clinical trial and randomized studies involving a control group and approaching dysphonia treatment with electrical stimulation in humans, regardless of age, gender, or race were included. Those excluded were theses, editorials, comments and opinions, reflexive articles, case studies, experimental studies with animals, models, projects, reports and technical reports, and review articles, as well as articles approaching other alterations, not related to dysphonia. RESULTS: Eleven articles were found and it evaluated the effects of neuromuscular electrical stimulation (NMES) and transcutaneous electrical nerve stimulation on dysphonia caused by vocal fold paralysis, spasmodic dysphonia, behavioral dysphonia, and in patients with vocal fold nodules. The methodological analysis of the articles through the PEDro scale resulted in a mean score of 5.18; the studies were classified as either high quality (N = 3) or fair quality (N = 8). The results indicated that electrical stimulation had a therapeutic effect on various aspects of dysphonia. However, due to the high risk of bias and the heterogeneity of the studies, it is not possible to state the effectiveness of electrical stimulation in treating dysphonia. CONCLUSION: Using electrical stimulation as an evidence-based conventional rehabilitation therapy in the treatment of dysphonia cannot yet be done.