Long-Term Sustainability of Peri-Operative Infection Control Practices: Implementation of "Clean Cut," a Checklist-Based Quality Improvement Program in India.

Introduction: Surgical site infections (SSIs) are a substantial healthcare burden in low- and middle- income countries. "Clean Cut" is a checklist-based infection prevention and control (IPC) program intended to improve compliance to peri-operative IPC standards. We aim to study the short-term and long-term impact of its implementation in a tertiary care cancer referral center. Methods: This was a single institute, prospective interventional study. Patients undergoing elective head-neck surgical procedures were included. The "Clean Cut" program consisting of surveillance, audits, and IPC training was implemented for 6 months, after which there was no active oversight. Post-intervention (T2) and 1-year follow-up (T3) data regarding compliance to core IPC practices and SSI rates were compared with baseline (T1). Results: One hundred eighty six patients were included with 50 (26.9%), 86 (46.2%), and 50 (26.9%) patients at T1, T2, and T3, respectively. At baseline, teams complied with a mean of 3.56 of the six critical components of infection control processes which rose to 4.66 (p < 0.001) at T2, but decreased to 4.02 at T3 (p = 0.053). The SSI rate at baseline decreased significantly after Clean Cut implementation [16 (32%) vs. 12 (13.95%), p = 0.012], but returned to baseline levels after 1 year [17 (34%), p = 0.006]. Conclusion: Implementation of the "Clean Cut" program increases compliance to infection control processes and reduces SSI rates in the short term. Without continuing oversight, these rates return to baseline values after 1 year.

Acute kidney injury associated with anti-PD-1 and anti-PD-L1 drugs: a meta-analysis of randomized clinical trials.

BACKGROUND: Immune Checkpoint Inhibitors (ICI) have been widely used in treating different types of cancer. They increase survival in many oncologic patients and enable cancer-specific therapy. Acute Kidney Injury (AKI) is one of the adverse effects associated with using ICI, where knowledge of the prevalence and renal histological findings are still reasons for discussion. OBJECTIVE: Therefore, this meta-analysis evaluates the association between ICI use and AKI. METHODS: The search was performed in PubMed, Lilacs, and Cochrane platforms. Studies published up to December 1, 2022, were included. RESULTS: A total of 16 studies met the established PICOT criteria and were included in this review. Comparing the ICI plus chemotherapy against chemotherapy alone, the relative risk (RR) for AKI's development with ICI use was 2.89 (95%CI 1.37-6.10). In the analyses by class and drug type, programmed cell death 1 monoclonal antibody (anti-PD-1) showed an increased risk of 2.11 (95%CI 1.26-3.52), and pembrolizumab demonstrated a risk of AKI (RR= 2.77, 95%CI 1.46-5.26). Likewise, regarding the severity of AKI, AKI grade 3 or higher was more common in the ICI plus chemotherapy compared to the chemotherapy group: 3.66 (95%CI 1.19-11.30), while the subgroup analyses pooled studies comparing ICI alone versus chemotherapy alone in the control group did not demonstrate an association with AKI. CONCLUSIONS: These findings suggest that ICI use is associated with an increased risk of AKI and that anti-PD-1 use is associated with a higher incidence of renal adverse events than programmed cell death ligand 1 monoclonal antibody (anti-PD-L1). Studies with adequate power and well-defined criteria for acute interstitial nephritis, nowadays taken as a synonym for AKI related to ICI, are necessary.

Impact of quality and transparency in scientific writing on the reduction of animal usage in experimental protocols: a review based in pertinent literature.

The irreproducibility in scientific research has become a critical issue. Despite the essential role of rigorous methodology in constructing a scientific article, more than half of publications, on average, are considered non-reproducible. The implications of this irreproducibility extend to reliability problems, hindering progress in technological production and resulting in substantial financial losses. In the context of laboratory animal research, this work emphasizes the importance of choosing an appropriate experimental model within the 3R's principle (Refine, Reduce, Replace). This study specifically addresses a deficiency in data specification in scientific articles, revealing inadequacies in the description of crucial details, such as environmental conditions, diet, and experimental procedures. For this purpose, 124 articles from journals with relevant impact factors were analyzed, conducting a survey of data considered important for the reproducibility of studies. Important flaws in the presentation of data were identified in most of the articles evaluated. The results of this study highlight the need to improve the description of essential information, standardizing studies, and ensuring the reproducibility of experiments in areas such as metabolism, immunity, hormones, stress, among others, to enhance the reliability and reproduction of experimental results, aligning with international guidelines such as ARRIVE and PREPARE.

Perspectives of FTIR as Promising Tool for Pathogen Diagnosis, Sanitary and Welfare Monitoring in Animal Experimentation Models: A Review Based on Pertinent Literature.

Currently, there is a wide application in the literature of the use of the Fourier Transform Infrared Spectroscopy (FTIR) technique. This basic tool has also proven to be efficient for detecting molecules associated with hosts and pathogens in infections, as well as other molecules present in humans and animals' biological samples. However, there is a crisis in science data reproducibility. This crisis can also be observed in data from experimental animal models (EAMs). When it comes to rodents, a major challenge is to carry out sanitary monitoring, which is currently expensive and requires a large volume of biological samples, generating ethical, legal, and psychological conflicts for professionals and researchers. We carried out a survey of data from the relevant literature on the use of this technique in different diagnostic protocols and combined the data with the aim of presenting the technique as a promising tool for use in EAM. Since FTIR can detect molecules associated with different diseases and has advantages such as the low volume of samples required, low cost, sustainability, and provides diagnostic tests with high specificity and sensitivity, we believe that the technique is highly promising for the sanitary and stress and the detection of molecules of interest of infectious or non-infectious origin.

Alterações sistêmicas e bucais em pacientes usuários de cocaína: uma revisão integrativa da literatura / Cambios sistémicos y orales em pacientes consumidores de cocaína: una revisión bibliográfica integradora / Systemic and oral changes in cocaína-using patients: an integrative literature review

Introdução: A utilização de cocaína é bastante associada ao surgimento de algumas manifestações sistêmicas e também de algumas alterações orais. Objetivo: Identificaras alterações sistêmicas e bucais mais comuns a pacientes usuários de cocaína. Metodologia: Trata-se de uma revisão sistemática da literatura, considerando artigos com texto completo, com restrição de idioma em Português ou Inglês e que tenham sido publicados entre os anos de 2017 a 2022. Usou-se as bases de dados LiLaCS, MedLine e BBO, por via portal Biblioteca Virtual de Saúde, e SciELO. Os artigos excluídosf oram aqueles que não apresentaram relação explícita do uso de cocaína com alguma manifestação sistêmica e/ou bucal. Resultados: Após o processo de triagem,10 artigos foram salvos para serem analisados e 111 foram descartados por não atenderem aos critérios de inclusão. Dos 10 artigosselecionados,40% deles (n=4) trouxeram informações identificando possíveis riscos de desenvolvimento de doenças cardiovasculares sofridas pelos usuários de cocaína, 10%(n=1) identificou problemas cognitivos associados ao uso da cocaína,30% dos artigos (n=3) mostrou as alterações bucais associadas à utilização abusiva de cocaína. Conclusões: Houve a predominância de algumas manifestações sistêmicas e bucais nos indivíduos usuários de cocaína, como doenças cardiovasculares, xerostomia, perfurações no palato, etc. A partir disso, há algumas alterações sistêmicas e bucais provocadas por esse uso. Mediante o risco considerável, faz-se necessário que o Cirurgião-Dentista se atualize sobre essas alterações em pacientes usuários de cocaína visando promover um trabalho transdisciplinare multiprofissional para atender adequadamente às suas necessidades (AU).

Introduction: The use of cocaine is closely associated with the appearance of some systemic manifestations and also some oral alterations.Objective: To identify the most common systemic and oral alterations in cocaine-using patients.Methodology:This is a systematic review of the literature, considering full-text articles, with a language restriction of "Portuguese" or "English" and published between 2017 and 2022. We used the LiLaCS, MedLine and BBO databases, via the Virtual Health Library (VHL) portal, and SciELO.The articles excluded were those that did not explicitly relate cocaine use to some systemic and/or oral manifestation.Results: After the screening process, 10 articles were saved for analysis and 111 were discarded because they did not meet the inclusion criteria. Of the 10 articles selected, 40% (n=4) provided information identifying possible risks of developing cardiovascular diseases suffered by cocaine users, 10% (n=1)identified cognitive problems associated with cocaine use, 30% of the articles (n=3) showed oral alterations associated with cocaine abuse.Conclusions: There has been a predominance of some systemic and oral manifestations in cocaine users, such as cardiovascular diseases, xerostomia, perforations in the palate, etc. Based on this, there are some systemic and oral alterations caused by this use. Given the considerable risk, it is necessary for dentists to be up-to-date on these alterations in cocaine-using patients in order to promote transdisciplinary and multi-professional work to adequately meet their needs (AU).

Introducción: El consumo de cocaína está estrechamente asociado a la aparición de algunas manifestaciones sistémicas y también de algunas alteraciones orales. Objetivo:Identificar las alteraciones sistémicas y bucales más frecuentes en los consumidores de cocaína. Metodología: Se trata de una revisión sistemática de la literatura, considerando artículos a texto completo, con restricción de idioma en "portugués" o "inglés" y publicados entre 2017 y 2022. Se utilizaron las bases de datos LiLaCS, MedLine y BBO, a través del portal Biblioteca Virtual en Salud (BVS) y SciELO. Los artículos excluidos fueron aquellos que no mostraban una relación explícita entre el consumo de cocaína y alguna manifestación sistémica y/o oral. Resultados: Tras el proceso de cribado, se guardaron10 artículos para el análisis y se descartaron 111 por no cumplir los criterios de inclusión. De los 10 artículos seleccionados, el 40% (n=4) proporcionaba información que identificaba posibles riesgos de desarrollar enfermedades cardiovasculares sufridaspor consumidores de cocaína, el 10% (n=1) identificaba problemas cognitivos asociados al consumo de cocaína, el 30% de los artículos (n=3) mostraban alteraciones orales asociadas al abuso de cocaína.Conclusiones:Ha habido un predominio de algunas manifestaciones sistémicas y orales en los consumidores de cocaína, como enfermedades cardiovasculares, xerostomía, perforaciones en el paladar, etc. De acuerdo con esto, existen algunas alteraciones sistémicas y orales causadas por este uso. Dado el considerable riesgo, es necesario que los odontólogos estén al día sobre estas alteraciones en los pacientes consumidores de cocaína, con el fin de promover el trabajo transdisciplinar y multiprofesional para atender adecuadamente sus necesidades (AU).

Redirection of palatally ectopic maxillary canines: Case report and proposition of an interceptive sequential guideline.

The eruptive deviation of the permanent maxillary canine must be identified early, at the beginning of the second transitional period of the mixed dentition. Acting at this moment is fundamental for its spontaneous redirection and eruption. The aim of the paper is to present a case where the extraction of the deciduous canines was the choice for redirecting the maxillary permanent canines with eruptive palatal deviation, as well as to suggest a sequence of procedures for diagnosis and choice of treatment. The success of deciduous canine extraction in redirecting the ectopic permanent canines is discussed in this case, as well as aspects that might lead to failure. Still, it highlights the importance of computed tomography for choosing conservative treatment or traction, including it in the sequential guideline for acting in these cases.

A multi-level approach reveals key physiological and molecular traits in the response of two rice genotypes subjected to water deficit at the reproductive stage.

Rice is more vulnerable to drought than maize, wheat, and sorghum because its water requirements remain high throughout the rice life cycle. The effects of drought vary depending on the timing, intensity, and duration of the events, as well as on the rice genotype and developmental stage. It can affect all levels of organization, from genes to the cells, tissues, and/or organs. In this study, a moderate water deficit was applied to two contrasting rice genotypes, IAC 25 and CIRAD 409, during their reproductive stage. Multi-level transcriptomic, metabolomic, physiological, and morphological analyses were performed to investigate the complex traits involved in their response to drought. Weighted gene network correlation analysis was used to identify the specific molecular mechanisms regulated by each genotype, and the correlations between gene networks and phenotypic traits. A holistic analysis of all the data provided a deeper understanding of the specific mechanisms regulated by each genotype, and enabled the identification of gene markers. Under non-limiting water conditions, CIRAD 409 had a denser shoot, but shoot growth was slower despite better photosynthetic performance. Under water deficit, CIRAD 409 was weakly affected regardless of the plant level analyzed. In contrast, IAC 25 had reduced growth and reproductive development. It regulated transcriptomic and metabolic activities at a high level, and activated a complex gene regulatory network involved in growth-limiting processes. By comparing two contrasting genotypes, the present study identified the regulation of some fundamental processes and gene markers, that drive rice development, and influence its response to water deficit, in particular, the importance of the biosynthetic and regulatory pathways for cell wall metabolism. These key processes determine the biological and mechanical properties of the cell wall and thus influence plant development, organ expansion, and turgor maintenance under water deficit. Our results also question the genericity of the antagonism between morphogenesis and organogenesis observed in the two genotypes.

From capillaries to microchips, green electrophoretic features for enantiomeric separations: A decade review (2013-2022).

Enantioseparation by the electromigration-based method is well-established and widely discussed in the literature. Electrophoretic strategies have been used to baseline resolve complex enantiomeric mixtures, typically using a selector substance into the background electrolyte (BGE) from capillaries to microchips. Along with developing new materials/substances for enantioseparations, it is the concern about the green analytical chemistry (GAC) principles for method development and application. This review article brings a last decade's update on the publications involving enantioseparation by electrophoresis for capillary and microchip systems. It also brings a critical discussion on GAC principles and new green metrics in the context of developing an enantioseparation method. Chemical and green features of native and modified cyclodextrins are discussed. Still, given the employment of greener substances, ionic liquids and deep-eutectic solvents are highlighted, and some new selectors are proposed. For all the mentioned selectors, green features about their production, application, and disposal are considered. Sample preparation and BGE composition in GAC perspective, as well as greener derivatization possibilities, were also addressed. Therefore, one of the goals of this review is to aid the electrophoretic researchers to look where they have not.

Avaliação de condição de saúde bucal de idosos institucionalizados: revisão integrativa / Assessment of oral health conditions of institutionalized elderly: integrative review / Evaluaciónde las condiciones de salud bucal de ancianos institucionalizados: revisión integrativa

Com o aumento da expectativa de vida, é esperado que a população idosa se faça presente cada dia mais na sociedade. Por esse motivo, é importante reconhecer as necessidades de saúde desse grupo de pessoas que vivem institucionalizadas, para que a odontogeriatria atue de forma mais ativa e proceda de maneira mais efetiva, atendendo as demandas priorizando uma maior qualidade de vida.Objetivo:Identificar as principais alterações que acometem a cavidade oral de idosos institucionalizados. Metodologia:Fez-se uma revisão integrativa nas bases de dados LILACS, BBO, IBECS, SciELOe PubMed. Foram usados os descritores "Saúde do Idoso Institucionalizado", "idoso" e "odontologia" junto de seus sinônimos e variações em inglês, retirados do DeCS e MeSH. Os critérios de inclusão foram artigos originais, artigos nas línguas portuguesa, inglesa e espanhola, estudos que envolveram pessoas e sem restrição quanto ao ano de publicação. Foram excluídos estudos feitos em animais, revisões de literatura, capítulos de livros, teses e dissertações. Resultados:Foram identificados 555 registros. Desses, 15artigos foram selecionados para compor a revisão. Diversas alterações orais foram encontradas. As principais foram hiperplasia tecidual, estomatite e xerostomia, candidíase e halitose. Sendo os principais fatores causadores: má higiene oral, medicamentos utilizados e má adaptação de próteses dentárias. Conclusões:Considerando os resultados da análise dessa revisão integrativa, pode-se concluir que a hiperplasia tecidual, estomatite, xerostomia são as alterações mais predominantes nos idosos institucionalizados (AU).

With the increase in life expectancy, it is expected that the elderly population will become more and more present in society. For this reason, it is important to recognize the health needs of this group of people who live institutionalized, so that geriatric dentistry acts more actively and proceeds more effectively, meeting the demands prioritizing a better quality of life. Objective:To identify the main alterations that affect the oral cavity of institutionalized elderly.Methodology:An integrative review was carried out in the LILACS, BBO, IBECS, SciELO and PubMed databases. The descriptors were used "Saúde do Idoso Institucionalizado", "idoso" e "odontologia"together with its synonyms and variations in English, taken from DeCS and MeSH. The inclusion criteria were original articles, articles in Portuguese, English and Spanish, studies involving people and without restriction regarding the year of publication. Animal studies, book chapters,literature review,theses and dissertations were excluded. Results:555 records were identified. Of these, 15articles were selected to compose the review. Several oral alterations were found. The main ones were tissue hyperplasia, stomatitis and xerostomia, candidiasis and halitosis. The main causative factors being: poor oral hygiene, medications used and poor adaptation of dental prostheses.Conclusions:Considering the analysis results of this integrativereview, it can be concluded that tissue hyperplasia, stomatitis, xerostomia are the most predominant changes in institutionalized elderly (AU).

Con el aumento de la esperanza de vida, se espera que la población anciana estécada vez más presente en la sociedad. Por eso, es importante reconocer las necesidades de salud de este grupo de personas que viven institucionalizadas, para que la odontología geriátrica actúe más activamente y proceda con mayor eficacia, atendiendo las demandas priorizando una mejor calidad de vida.Objetivo: Identificar las principales alteraciones que afectan la cavidad oral de ancianos institucionalizados.Metodología: Se realizó una revisión integradora en las bases de datos LILACS, BBO, IBECS, SciELO y PubMed. Se usaron los descriptores"Saúde do Idoso Institucionalizado", "idoso" e "odontologia"Los criterios de inclusión fueron artículos originales, artículos en portugués, inglés y español, estudios involucrando personas y sin restricción en cuantoal año de publicación. Se excluyeron estudios en animales, revision de literatura, capítulos de libros, tesis y disertaciones.Resultados: Se identificaron 555 registros. De estos, 15artículos fueron seleccionados para componer la revisión. Se encontraron varias alteraciones orales. Los principales fueron hiperplasia tisular, estomatitis y xerostomía, candidiasis y halitosis. Siendo los principales factores causales: la mala higiene bucal, los medicamentos utilizados y la mala adaptación de las prótesis dentales.Conclusiones: Considerando los resultados del análisis de esta revisión integrativa, se puede concluir que la hiperplasia tisular, la estomatitis, la xerostomía son las alteraciones más predominantes en los ancianos institucionalizados (AU).

Antimicrobial photodynamic therapy for the treatment of oral mucositis-A comparative study.

OBJECTIVES: The aim was to evaluate the effectiveness of photobiomodulation and antimicrobial photodynamic therapy in the treatment of oral mucositis. BACKGROUND: Oral Mucositis is a frequent complication of oral cavity and oropharynx cancer. Considering the OM aggravation by microorganisms contamination, disinfection provide by antimicrobial photodynamic therapy could be an effective approach. MATERIAL AND METHODS: This comparative study included fourteen patients undergoing radiochemotherapy for oral cavity and oropharynx cancer treatment, who developed oral mucositis. CONTROL GROUP: photobiomodulation. Intervention group: photobiomodulation and antimicrobial photodynamic therapy. The lesion size, duration, pain, and identification of microorganisms were evaluated. RESULTS: The mean reduction in oral mucositis size in the intervention group was 0.70 cm² (±0.35) and 0.30 cm² (±1.10) for the control group. The mean duration of oral mucositis was 18.37 days (±12.12) for the intervention group and 23 days (±14.78) for the control group. The intervention group had a mean reduction of 3.40 points on the pain scale (±2.44), while the control group had 0.17 (±2.28). In the intervention group, the predominant isolated microbiota was featured as mixed culture (n = 4/ 50%), followed of Gram Positive (n = 3/ 37.50%), and Gram Negative (n = 1/ 12.55%). In the control group, mixed culture was also more frequent (n = 4 / 66%), followed by Gram Positive (n = 2 /34%). Gram Negative was not predominantly isolated in the control group. CONCLUSION: No statistical significance was found between PBM-T alone and PBM-T + PDT. However, the better outcomes reached by PBM-T + PDT group would suggest there could be a role for combined treatment in the management of OM lesions.

Eugenol attenuates ischemia-mediated oxidative stress in cardiomyocytes via acetylation of histone at H3K27.

Despite clinical advances, ischemia-induced cardiac diseases remain an underlying cause of death worldwide. Epigenetic modifications, especially alterations in the acetylation of histone proteins play a pivotal role in counteracting stressful conditions, including ischemia. In our study, we found that histone active mark H3K27ac was significantly reduced and histone repressive mark H3K27me3 was significantly upregulated in the cardiomyocytes exposed to the ischemic condition. Then, we performed a high throughput drug screening assay using rat ventricular cardiomyocytes during the ischemic condition and screened an antioxidant compound library comprising of 84 drugs for H3K27ac by fluorescence microscopy. Our data revealed that most of the phenolic compounds like eugenol, apigenin, resveratrol, bis-demethoxy curcumin, D-gamma-tocopherol, ambroxol, and non-phenolic compounds like l-Ergothioneine, ciclopirox ethanolamine, and Tanshinone IIA have a crucial role in maintaining the cellular H3K27ac histone marks during the ischemic condition. Further, we tested the role of eugenol on cellular protection during ischemia. Our study shows that ischemia significantly reduces cellular viability and increases total reactive oxygen species (ROS), and mitochondrial ROS in the cells. Interestingly, eugenol treatment significantly restores the cellular acetylation at H3K27, decreases cellular ROS, and improves cellular viability. To explore the mechanism of eugenol-medicated inhibition of deacetylation, we performed a RNAseq experiment. Analysis of transcriptome data using IPA indicated that eugenol regulates several cellular functions associated with cardiovascular diseases, and metabolic processes. Further, we found that eugenol regulates the expression of HMGN1, CD151 and Ppp2ca genes during ischemia. Furthermore, we found that eugenol might protect the cells from ischemia through modulation of HMGN1 protein expression, which plays an active role in regulation of histone acetylation and cellular protection during stress. Thus, our study indicated that eugenol can be exploited as an agent to protect the ischemic cells and also could be used to develop a novel drug for treating cardiac disease.

Morphological variations of the labial frenum, type of attachment and presence of diastemas: integrative review / Variações morfológicas do freio labial, tipo de inserção e presença de diastemas: revisão integrativa

ABSTRACT Objective: The aim of the present literature review was to compile data on the frequency of morphological and attachment types of the upper and lower labial frenum in different populations and investigate the association between the attachment level of the upper labial frenum and the occurrence of diastemas. Methods: Searches were conducted between May and June 2021 in the Medline (via Ovid), Google Scholar and CAPES databases. Thirty-eight studies that evaluated frenum morphology, frenum morphology and attachment or frenum morphology, attachment and the occurrence of diastemas were selected for the extraction of data. Results: Based on the data compiled in this review, the most common morphological and attachment types were labial frenum normale and mucosal attachment. The papillary and papilla penetrating types of attachment were more associated with the occurrence of diastemas. Conclusion: Longitudinal studies are needed to investigate this correlation in children and adults.

RESUMO Objetivo: O objetivo dessa revisão de literatura é compilar dados referentes a frequência de tipos morfológicos e de inserção do freio labial superior ou inferior, em diferentes populações, além de avaliar a relação entre o nível de inserção do freio labial superior e a ocorrência de diastemas. Métodos: Foram consultadas as bases de dados Medline (via Ovid), o Google acadêmico e o portal periódicos CAPES. A pesquisa foi realizada no período compreendido entre os meses de maio e junho de 2021. Foram selecionados para a extração de dados 35 estudos, que avaliação a morfologia do freio ou morfologia e inserção ou morfologia, inserção e presença de diastemas. Resultados: A partir dos dados compilados por essa revisão, foi possível estabelecer que os tipos morfológicos e de inserção mais comuns foram freio labial simples e inserção em mucosa. Com relação ao tipo de inserção e a ocorrência de diastemas, os tipos papilar e papilar penetrante foram os mais associados à sua ocorrência. Conclusão: Há necessidade de estudos longitudinais que avaliem essa correlação em crianças e populações adultas.

O nível de ansiedade, a renda e o acompanhamento psicológico podem influenciar na recorrência de peso corporal em mulheres submetidas a cirurgia bariátrica / Anxiety level, income and psychological monitoring can influence the recurrence of body weight in women submitted to bariatric surgery

Introdução: A melhora nos sintomas de ansiedade após a cirurgia bariátrica pode não permanecer estável em longo prazo, favorecendo a adoção de comportamentos alimentares disfuncionais. Objetivo: Testar a correlação entre o nível de ansiedade e a recorrência de peso em mulheres no pós-operatório tardio de cirurgia bariátrica e metabólica. Métodos: Foram avaliadas 50 mulheres adultas com no mínimo 24 meses após a cirurgia bariátrica e metabólica. Foram coletados dados sociodemográficos (idade, renda e nível de escolaridade) e de acompanhamento psicológico. Foram aferidos dados antropométricos (peso e altura). Para avaliar o nível de sintomas de ansiedade, foi utilizado o Inventário de Beck. Resultados: Foi encontrada média de idade de 40,9±11,4 anos. Todas apresentavam sintomas de ansiedade moderados a graves. Aquelas que estavam sem acompanhamento psicológico apresentavam maior peso corporal (p=0,049) e maior recorrência de peso (p=0,040). Observou-se correlação positiva entre o escore de ansiedade e a recorrência de peso, e correlação negativa entre o escore de ansiedade e a renda familiar. No modelo de regressão linear, a correlação entre o escore de ansiedade com a recorrência de peso (B=0,276; IC 0,003;0,594; p=0,048) e a renda (B=-0,310; IC -0,004;0,000; p=0,027) permaneceu significativa. Contudo, ao adicionar a variável "tempo de cirurgia", observou-se perda de significância entre ansiedade e recorrência de peso (B=0,270; IC -0,040; -0,624; p=0,083), mas manteve-se a correlação com a renda (B=-0,310; IC -0,004;-0,000; p=0,029). Conclusões: Ressalta-se a importância de suporte financeiro no pós-operatório, pelos custos com o tratamento, além de manter o acompanhamento com a equipe multiprofissional em longo prazo.

Introduction: The improvement in anxiety symptoms after bariatric surgery may not remain stable in the long term, favoring the adoption of dysfunctional eating behaviors. Objective: To test the correlation between anxiety level and weight recurrence in women in the late postoperative period of bariatric and metabolic surgery. Methods: Fifty adult women with at least 24 months after bariatric and metabolic surgery were evaluated. Sociodemographic data (age, income and level of education) and psychological monitoring were collected. Anthropometric data (weight and height) were measured. To assess the level of anxiety symptoms, the Beck Anxiety Inventory was used. Results: A mean age of 40.9±11.4 years was found. All had moderate to severe anxiety symptoms. Those who were without psychological support had higher body weight (p=0.049) and greater recurrence of weight (p=0.040). There was a positive correlation between the anxiety score and body weight recurrence, and a negative correlation between the anxiety score and family income. In the linear regression model, the correlation between anxiety score and weight recurrence (B=0.276; CI 0.003; 0.594; p=0.048) and income (B=-0.310; CI -0.004; 0.000; p=0.027) remained significant. However, when adding the variable "surgery time", there was a loss of significance between anxiety and weight recurrence (B=0.270; CI -0.040; -0.624; p=0.083), but the correlation with income was maintained (B=-0.310; CI -0.004; -0.000; p=0.029). Conclusions: We emphasize the importance of financial support in the postoperative period, due to treatment costs, in addition to maintaining monitoring with the multidisciplinary team in the long term.

Acute effect of different loads on muscle performance and perceived exertion in young women / Efecto agudo de distintas cargas sobre el desempeño muscular y el esfuerzo percibido en mujeres jóvenes / Efeito agudo de diferentes cargas no desempenho muscular e esforço percebido em mulheres jovens

ABSTRACT Introduction: Load reduction using the repetition maximum (RM) method may be necessary to promote higher numbers of repetitions, and consequently, higher total volume, time under tension, and perceived exertion ratings. Objective: To compare the effects of different leg press exercise loads on number of repetitions, total volume, time under tension, and perceived exertion. Methods: Eighteen women university students (23.9 ± 3.8 years) performed two experimental sessions with 90% and 100% of 10-12 RM in a balanced crossover design. Results: The number of repetitions of the second and third sets, the total volume, and time under tension at 90% of 10-12 RM was statistically higher than at 100% of 10-12 RM ( p < 0.05). The perceived exertion of the first and second sets and the training load (perceived exertion x duration of sessions) were higher at 100% of the 10-12 RM session ( p < 0.05). Conclusion: A small reduction in load results in a greater number of repetitions, total volume, and time under tension. The session with the higher load appeared to induce higher perceived exertion and training load. Thus, scientists and coaches might consider lower loads to maximize the number of repetitions, total volume, and time under tension, which may cause greater long-term muscular adaptations. Level of evidence II; Comparative prospective study.

RESUMEN Introducción: La reducción de la carga por el método de las repeticiones máximas (RM) puede ser necesaria para promover un mayor número de repeticiones y, consecuentemente, un mayor volumen total, tiempo bajo tensión y calificaciones del esfuerzo percibido. Objetivo: Comparar los efectos de diferentes cargas del ejercicio de prensa de piernas sobre el número de repeticiones, volumen, tiempo bajo tensión y esfuerzo percibido. Métodos: Dieciocho estudiantes universitarios (23,9 ± 3,8 años) realizaron dos sesiones experimentales con el 90% y el 100% de 10-12 RM en un diseño trasversal equilibrado. Resultados: El número de repeticiones de la segunda y tercera serie, el volumen total y el tiempo bajo tensión al 90% de 10-12 RM fue estadísticamente mayor que al 100% de 10-12 RM (p < 0,05). El esfuerzo percibido de la primera y segunda serie y la carga de entrenamiento (esfuerzo percibido x duración de las sesiones) fueron superiores en la sesión realizada al 100% de 10-12 RM (p < 0,05). Conclusión: Una pequeña reducción de la carga da lugar a un mayor número de repeticiones, volumen total y tiempo bajo tensión. La sesión con mayor carga indujo un mayor esfuerzo percibido y carga de entrenamiento. Por lo tanto, los científicos y entrenadores pueden considerar cargas más bajas para maximizar el número de repeticiones, el volumen total y el tiempo bajo tensión, lo que puede causar mayores adaptaciones musculares a largo plazo. Nivel de evidencia II; Estudio prospectivo comparativo.

RESUMO Introdução: A redução da carga pelo método das repetições máximas (RM) pode ser necessária para promover maior número de repetições e, consequentemente, maior volume total, tempo sob tensão e classificações do esforço percebido. Objetivo: Comparar os efeitos de diferentes cargas do exercício leg press no número de repetições, volume total, tempo sob tensão e percepção de esforço. Métodos: Dezoito universitárias (23,9 ± 3,8 anos) realizaram duas sessões experimentais com 90% e 100% de 10-12 RM em desenho transversal balanceado. Resultados: O número de repetições da segunda e terceira séries, volume total e tempo sob tensão a 90% de 10-12 RM foi estatisticamente maior do que a 100% de 10-12 RM (p < 0,05). A percepção do esforço da primeira e segunda séries e a carga de treinamento (percepção do esforço x duração das sessões) foram maiores na sessão realizada com 100% de 10-12 RM (p < 0,05). Conclusão: Uma pequena redução da carga resulta em maior número de repetições, volume total e tempo sob tensão. A sessão com maior carga induziu maior percepção do esforço e carga de treinamento. Assim, cientistas e treinadores podem considerar cargas menores para maximizar o número de repetições, o volume total e o tempo sob tensão, o que pode causar maiores adaptações musculares a longo prazo. Nível de evidência II; Estudo prospectivo comparativo.

Construct Validity of the Brazilian Version of the Dyadic Adjustment Scale / Validação de Construto da Versão Brasileira da Dyadic Adjustment Scale

Abstract This study sought evidence of construct validity for the Brazilian versions of the Dyadic Adjustment Scale and Revised Dyadic Adjustment Scale. A total of 448 individuals participated in the research, 253 women and 195 men from several regions of Brazil who had been cohabiting with their marital partners for an average of 14.7 years. Several proposed models for the measure were tested in Structural Equation Modeling. In the Confirmatory Factor Analysis, the four-factor and hierarchical models of the Revised Dyadic Adjustment Scale showed good overall adjustments. Evidence of factor, convergent, and discriminant validity were also found. Composite reliability revealed adequate levels of internal consistency. The Multigroup Confirmatory Factor Analysis demonstrated a strong measurement invariance model for men and women.

Resumo Este estudo verificou evidências de validade de construto para as versões brasileiras da Dyadic Adjustment Scale e da Revised Dyadic Adjustment Scale. Participaram da pesquisa 448 indivíduos, 253 mulheres e 195 homens de diversas regiões nacionais que coabitavam com seus parceiros conjugais há 14,7 anos, em média. Na Análise Fatorial Confirmatória, foram testados seis modelos anteriormente propostos para a medida. Entre eles, quatro fatores correlacionados e hierárquico multidimensional da Revised Dyadic Adjustment Scale apresentaram os melhores ajustes gerais. Foram encontradas evidências de validades fatorial, convergente e discriminante e níveis adequados de consistência interna por meio da confiabilidade composta. Também foi demonstrada a invariância de medida forte do modelo da RDAS entre homens e mulheres.

Stormfires in La Palma, Chile: Shared Meanings Emerging from a Post-disaster Community Intervention / Tormenta de fuego en la palma (chile): significados compartidos surgidos de una intervención comunitaria postdesastre

RESUMEN Los desastres socioambientales afectan desigualmente a las zonas rurales en comparación con las urbanas. Esta realidad hace que la movilización de recursos comunitarios sea esencial para afrontar estos eventos. El objetivo de este trabajo fue analizar la construcción de significados derivados del proceso de intervención comunitaria posterior a un desastre (incendio forestal) entre la comunidad La Palma y el equipo de la Fundación Tierra de Esperanza, planteando como pregunta de investigación ¿Qué significados compartidos surgen del proceso de intervención vivenciado por la comunidad de La Palma y el equipo interventor? El estudio tuvo un diseño fenomenológico, utilizando análisis interpretativo del discurso. Los resultados muestran la emergencia de categorías vinculadas a procesos identitarios, ruralidad, y el despliegue de procesos psicosociales durante la experiencia de intervención vinculados con el afrontamiento comunitario, apoyo social, rol clave de liderazgos femeninos y aprendizajes de la comunidad. Se discute cómo la toma de conciencia de esta comunidad rural incrementó su capacidad de agencia ante eventos en los que cuentan con escaso apoyo gubernamental.

ABSTRACT Socio-environmental disasters affect rural areas unequally, compared to urban areas. This reality makes the mobilization of community resources essential when facing these events. The objective of this study was to analyze the construction of meanings derived from the process of community intervention after a disaster (forest fires) between the La Palma community and the Tierra de Esperanza Foundation team, posing as a research question: What shared meanings emerge from the intervention process experienced by the La Palma community and the intervention team? The study had a phenomenological design, using interpretative discourse analysis. The results show the emergence of categories linked to identity processes, rurality, and the unfolding of psychosocial processes during the intervention experience, linked to community coping, social support, the key role of female leadership, and community learning. It is discussed how the awareness of this rural community increased its capacity for agency in the face of events with little government support.

Burnout syndrome in healthcare workers during the COVID-19 pandemic: a systematic review.

There is evidence that harm to the mental health of healthcare workers has occurred during the pandemic caused by COVID-19. The burnout syndrome is a form of exhaustion that occurs in occupational settings and is a condition caused by long-term stress in the workplace. The objectives of this systematic review of observational studies were to present data from research into the prevalence of burnout syndrome in healthcare workers during the COVID-19 pandemic and observe its prevalence among frontline workers. The search was conducted on the MEDLINE, LILACS, and Embase databases from 2019 to May of 2021 and returned 538 publications, which underwent a two-stage process of selection by independent peers, resulting in selection of a sample of 29 articles. Data were then extracted and synthesized for presentation in narrative form. Cross-sectional designs were more prevalent (n = 26) than longitudinal studies (n = 3). The sample included research from 19 different countries, with one Brazilian study. A wide range of different instruments were administered by study authors to assess burnout syndrome, the most common of which was the Maslach Burnout Inventory (n = 13). The prevalence of burnout syndrome in the studies varied from 76 to 14.7%. Data on the relationship between development of burnout syndrome and working on the frontline were controversial. The lack of standardization of burnout syndrome assessment was a source of considerable difficulty, compromising comparability of the results, and should therefore be targeted for improvement by researchers. We suggest that more investigations should be conducted into prevalence and the associated factors of risk and protection.

Integrative and Multidisciplinary Care for People Living With Human T-Cell Lymphotropic Virus in Bahia, Brazil: 20 Years of Experience.

Brazil is home to the highest absolute number of human T-cell lymphotropic virus type-1 (HTLV-1)-infected individuals worldwide; the city of Salvador, Bahia, has the highest prevalence of HTLV-1 infection in Brazil. Due to the complex nature of several diseases associated with this retrovirus, a multidisciplinary health care approach is necessary to care for people living with HTLV-1. The Bahia School of Medicine and Public Health's Integrative Multidisciplinary HTLV Center (CHTLV) has been providing support to people living with HTLV and their families since 2002, striving to ensure physical and mental well-being by addressing biopsychosocial aspects, providing clinical care and follow-up, including to pregnant/postpartum women, as well as comprehensive laboratory diagnostics, psychological therapy, and counseling to family members. To date, CHTLV has served a total of 2,169 HTLV-infected patients. The average patient age is 49.8 (SD 15.9) years, 70.3% are female, most are considered low-income and have low levels of education. The majority (98.9%) are HTLV-1 cases, and approximately 10% have been diagnosed with tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM), while 2.2% have infective dermatitis and 1.1% have adult T-cell lymphoma. In all, 178 pregnant/postpartum women [mean age: 32.7 (±6.5) years] have received care at CHTLV. Regarding vertical transmission, 53% of breastfed infants screened for HTLV tested positive in their second year of life, nearly 18 times the rate found in non-breastfed infants. This article documents 20 years of experience in implementing an integrative and multidisciplinary care center for people living with HTLV in Bahia, Brazil. Still, significant challenges remain regarding infection control, and HTLV-infected individuals continue to struggle with the obtainment of equitable and efficient healthcare.

Efficacy of a dinotefuran, permethrin and pyriproxyfen combination product in the treatment of rabbits (Oryctolagus cuniculus) naturally infested by Psoroptes ovis.

The main of this study was to evaluate the efficacy of dinotefuran, pyriproxyfen and permethrin-combination (Vectra 3D-CEVA) in the topical treatment of rabbits naturally infested with P. ovis. Adult New Zealand rabbits (n = 18) with plaques of crust in both ears were divided into three groups (one control and two treated). On day 0, the animals belonging to the treated groups received a single dose of a commercial ectoparasiticide formulation, recommended for use in dogs. The control group (G1) (n = 6) received no treatment, the treated group (G2) (n = 6) received one drop in each ear, and the remaining volume was applied along the back of the animal in the dorsal midline with the commercial formulation. In the other treated group (G3) (n = 6), animals received the same product used in G2, but all the volumes of 0.5 mL were applied only to the back of the animal (dorsal midline). On days 0, +7, +14, +21, +28 and +35, lesion scores and mites per gram (MPG) of each ear scab were evaluated. Statistical analysis was performed using the statistical software Bioestat 5.01. As the Shapiro-Wilk test determined that the data were nonparametrically distributed, the Kruskal-Wallis test was performed, followed by the Student-Newman-Keuls test, to determine the significance levels among the mean values of mite counts per gram of crusts compared to the three experimental groups. The efficacies for remission of lesion scores were 19.87 % on day +7 to 83.44 % on day +35 for G2 and 70.67 % on day +7 to 92.20 % on day +35 for G3. The efficacies obtained by evaluation of MPG were 100 % on day +7 to 99.86 % on day +35 for G2 and from 93.05 % on day +7 to 99.89 on day +35 for G3. The topical administration of the combination of dinotefuran (4.95 %), pyriproxifen (0.44 %) and permethrin (36 %) on the ears and back or only on the back in rabbits was shown to be effective in naturally controlling mite infestations by P. ovis.

A Serious Game (Immunitates) About Immunization: Development and Validation Study.

BACKGROUND: Vaccination is a fundamental part of all levels-local to worldwide-of public health, and it can be considered one of humanity's greatest achievements in the control and elimination of infectious diseases. Teaching immunization and vaccination can be monotonous and tiring. It is necessary to develop new approaches for teaching these themes in nursing school. OBJECTIVE: We aimed to develop and validate a serious game about immunization and vaccination for Brazilian nursing students. METHODS: We developed a quiz-type game, Immunitates, using design and educational theoretical models and Brazilian National Health Guidelines. The game's heuristics and content were evaluated with 2 different instruments by a team of experts. A sample of nursing students evaluated the validity of the game's heuristics only. We calculated the content validity index (CVI) for each evaluation. RESULTS: The study included 49 experts and 15 nursing students. All evaluations demonstrated high internal consistency (Cronbach α≥.86). The game's heuristics (experts: CVI 0.75-1.0; students: CVI 0.67-1.0) and the game's contents demonstrated validity (experts: CVI 0.73-1.0). Participants identified some specific areas for improvement in the next version. CONCLUSIONS: The serious game appears to be valid. It is intended as a support tool for nursing students in the teaching-learning process and as a tool for continuing education for nurses.