Rational Design of 7-Azaindole-Based Robust Microporous Hydrogen-Bonded Organic Framework for Gas Sorption.

7-Azaindole has been integrated as building block with complementary N-H···N hydrogen bonding sites for the synthesis of a tetrahedral molecular tecton, namely tetra(α-carbolin-6-yl)methane, TACM. The self-assembly of this molecule results in a 3D hydrogen-bonded organic framework (HOF). This supramolecular structure constitutes a crystalline microporous material with an extraordinary thermal and chemical robustness. Single crystal X-ray diffraction reveals how the five-fold catenation of diamonoid systems, stabilized by hydrogen bonds and π-π interactions, form an interpenetrated network with monodimensional channels. The structural features of the crystalline material are also observed by transmission electron microscopy (TEM). Additionally, the microporosity of the activated TACM-HOF is characterized by gas sorption (N2, CO2, CH4 and H2) experiments performed at different pressures. A selective adsorption is observed for CO2 uptake and TACM-HOF also presents a good adsorption capacity for H2 among supramolecular organic frameworks.

Vitamin B3 Intercalated in Layered Double Hydroxides: A Drug Delivery System for Metabolic Regulation.

The organic compound niacin or nicotinic acid, also known as vitamin B3 (VitB3), is essential for human nutrition and metabolic regulation. However, in high doses, it can provoke side effects, such as hyperglycemia, liver damage, and flushing. Development of a controlled release system that slowly releases VitB3 into the organism would avoid high dosing peaks, thus contributing to decrease the occurrence of side effects in nutritional supplementation. Here, we show that the slow and controlled release of VitB3 in an acid environment can be achieved via its intercalation in layered double hydroxides (LDHs). The synthesis of a ZnAl-VitB3 system is shown, in which VitB3 is intercalated in a ZnAl LDH. The presence of VitB3 in the ZnAl-VitB3 system was confirmed by elemental analysis, infrared (FTIR) and NMR spectroscopy, while successful intercalation in the LDHs was revealed by powder X-ray diffraction (PXRD). In vitro release tests were carried out in a concentrated HCl solution of pH 1.5, a pH similar to the human stomach environment. The results showed a steady release of VitB3 from the LDH host, with 90% of the vitamin liberated in the first 60 min after the suspension of the LDH in the acidic solution.

Switching Vancomycin Monitoring From Trough Concentration to Area Under the Curve Estimation by Bayesian Forecasting: A Short Communication on a Cost-Benefit Study in Resource-Limited Settings.

BACKGROUND: This study was conducted to evaluate the cost-benefit indicators of a vancomycin monitoring protocol based on area under the curve estimation using commercial Bayesian software. METHODS: This quasi-experimental study included patients who were aged >18 years with a vancomycin prescription for >24 hours. Patients who were terminally ill or those with acute kidney injury (AKI) ≤24 hours were excluded. During the preintervention period, doses were adjusted based on the trough concentration target of 15-20 mg/L, whereas the postintervention period target was 400-500 mg × h/L for the area under the curve. The medical team was responsible for deciding to stop the antimicrobial prescription without influence from the therapeutic drug monitoring team. The main outcomes were the incidence of AKI and length of stay. Cost-benefit simulation was performed after statistical analysis. RESULTS: There were 96 patients in the preintervention group and 110 in the postintervention group. The AKI rate decreased from 20% (n = 19) to 6% (n = 6; P = 0.003), whereas the number of vancomycin serum samples decreased from 5 (interquartile range: 2-7) to 2 (interquartile range: 1-3) examinations per patient (P < 0.001). The mean length of hospital stay for patients was 26.19 days after vancomycin prescription, compared with 17.13 days for those without AKI (P = 0.003). At our institution, the decrease in AKI rate and reduced length of stay boosted yearly savings of up to US$ 369,000 for 300 patients receiving vancomycin therapy. CONCLUSIONS: Even in resource-limited settings, a commercial Bayesian forecasting-based protocol for vancomycin is important for determining cost-benefit outcomes.

A dataset of new occurrence records of primates from the arc of deforestation, Brazil.

​​​​​​​The so-called arc of deforestation is a major agricultural and industrial frontier in southern Amazonia and northern Cerrado of Brazil. As arboreal mammals, the primates in this region are therefore threatened by forest loss and fragmentation. At the same time, knowledge about the taxonomic diversity and distribution ranges of these taxa is incomplete, which might hamper efficient conservation measurements. New species have been recently discovered in this region, and their ranges remain imprecise because only a few occurrence records are available for each species. Here we present 192 new records of 22 species and subspecies of Alouatta, Aotus, Ateles, Cebus, Chiropotes, Lagothrix, Leontocebus, Pithecia, Plecturocebus, Saimiri, and Sapajus, collected in 56 different localities during 10 field expeditions across the arc of deforestation between 2015 and 2018. Based on these new records, we extend the ranges of Alouatta puruensis, Ateles chamek, and Saimiri collinsi; identify potential hybridization zones between A. puruensis and A. discolor, and between At. chamek and At. marginatus; redefine the range of Plecturocebus moloch; and clarify the ranges of P. baptista and P. hoffmannsi. Moreover, these results and the dataset are valuable for further research on, for example, species distribution and habitat use modeling, for assessing species extinction risks, and for supporting efforts for the conservation of species increasingly threatened on a global deforestation frontier.

Soft skills in Orthodontics: an analysis in residents and experienced professionals.

INTRODUCTION: Soft skills represent a range of personal skills, attitudes and characteristics relevant to success and adequate work performance. OBJECTIVE: This study aimed to evaluate the knowledge and usage of soft skills in Orthodontics. METHODS: The participants answered a questionnaire containing 27 objective questions on awareness and frequency of soft skills in their professional activities. Participants were also asked to rank the soft skills in a crescent order of importance. The sample was divided into subgroups: A) residents in Orthodontics; B) orthodontists with less than 5 years of experience and C) orthodontists with more than 5 years of experience. Intergroup comparisons were performed using the Kruskal-Wallis test. Sexual differences were compared using Mann-Whitney test (p< 0.05). RESULTS: The sample of this observational study comprised 129 experienced orthodontists and residents in Orthodontics (92 women, 37 men) with mean age of 35.3 years. From the total sample, 54,6% of respondents reported no previous instructions on soft skills. All respondents reported using the analyzed soft skills with a similar frequency (median 4-5). Residents reported accessing reliable sources in bibliographic research less frequently (46%). Female orthodontists reported to seek help from teachers and other professionals more often than males. Ethics and communication were frequently ranked as the most important soft skills. Information management and leadership were frequently less ranked as important soft skills. CONCLUSION: Poor knowledge of soft skills was demonstrated by residents and orthodontists. Communication skill was highly used and frequently ranked as the most important soft skill.

Combined effect of SAR-endolysin LysKpV475 with polymyxin B and Salmonella bacteriophage phSE-5.

Endolysins are bacteriophage (or phage)-encoded enzymes that catalyse the peptidoglycan breakdown in the bacterial cell wall. The exogenous action of recombinant phage endolysins against Gram-positive organisms has been extensively studied. However, the outer membrane acts as a physical barrier when considering the use of recombinant endolysins to combat Gram-negative bacteria. This study aimed to evaluate the antimicrobial activity of the SAR-endolysin LysKpV475 against Gram-negative bacteria as single or combined therapies, using an outer membrane permeabilizer (polymyxin B) and a phage, free or immobilized in a pullulan matrix. In the first step, the endolysin LysKpV475 in solution, alone and combined with polymyxin B, was tested in vitro and in vivo against ten Gram-negative bacteria, including highly virulent strains and multidrug-resistant isolates. In the second step, the lyophilized LysKpV475 endolysin was combined with the phage phSE-5 and investigated, free or immobilized in a pullulan matrix, against Salmonella enterica subsp. enterica serovar Typhimurium ATCC 13311. The bacteriostatic action of purified LysKpV475 varied between 8.125 µg ml-1 against Pseudomonas aeruginosa ATCC 27853, 16.25 µg ml-1 against S. enterica Typhimurium ATCC 13311, and 32.50 µg ml-1 against Klebsiella pneumoniae ATCC BAA-2146 and Enterobacter cloacae P2224. LysKpV475 showed bactericidal activity only for P. aeruginosa ATCC 27853 (32.50 µg ml-1) and P. aeruginosa P2307 (65.00 µg ml-1) at the tested concentrations. The effect of the LysKpV475 combined with polymyxin B increased against K. pneumoniae ATCC BAA-2146 [fractional inhibitory concentration index (FICI) 0.34; a value lower than 1.0 indicates an additive/combined effect] and S. enterica Typhimurium ATCC 13311 (FICI 0.93). A synergistic effect against S. enterica Typhimurium was also observed when the lyophilized LysKpV475 at ⅔ MIC was combined with the phage phSE-5 (m.o.i. of 100). The lyophilized LysKpV475 immobilized in a pullulan matrix maintained a significant Salmonella reduction of 2 logs after 6 h of treatment. These results demonstrate the potential of SAR-endolysins, alone or in combination with other treatments, in the free form or immobilized in solid matrices, which paves the way for their application in different areas, such as in biocontrol at the food processing stage, biosanitation of food contact surfaces and biopreservation of processed food in active food packing.

Binding of carbon dioxide and acetylene to free carboxylic acid sites in a metal-organic framework.

The functionalisation of organic linkers in metal-organic frameworks (MOFs) to improve gas uptake is well-documented. Although the positive role of free carboxylic acid sites in MOFs for binding gas molecules has been proposed in computational studies, relatively little experimental evidence has been reported in support of this. Primarily this is because of the inherent synthetic difficulty to prepare MOF materials bearing free, accessible -COOH moieties which would normally bind to metal ions within the framework structure. Here, we describe the direct binding of CO2 and C2H2 molecules to the free -COOH sites within the pores of MFM-303(Al). MFM-303(Al) exhibits highly selective adsorption of CO2 and C2H2 with a high selectivity for C2H2 over C2H4. In situ synchrotron X-ray diffraction and inelastic neutron scattering, coupled with modelling, highlight the cooperative interactions of adsorbed CO2 and C2H2 molecules with free -COOH and -OH sites within MFM-303(Al), thus rationalising the observed high selectivity for gas separation.

Oxygen Migration Pathways in Layered LnBaCo2O6-δ (Ln = La - Y) Perovskites.

Layered LnBaCo2O6-δ perovskites are important mixed ionic-electronic conductors, exhibiting outstanding catalytic properties for the oxygen evolution/reduction reaction. These phases exhibit considerable structural complexity, in particular, near room temperature, where a number of oxygen vacancy ordered superstructures are found. This study uses bond valence site energy calculations to demonstrate the key underlying structural features that favor facile ionic migration. BVSE calculations show that the 1D vacancy ordering for Ln = Sm-Tb could be beneficial at low temperatures as new pathways with reduced barriers emerge. By contrast, the 2D vacancy ordering for Ln = Dy and Y is not beneficial for ionic transport with the basic layered parent material having lower migration barriers. Overall, the key criterion for low migration barriers is an expanded ab plane, supported by Ba, coupled to a small Ln size. Hence, Ln = Y should be the best composition, but this is stymied by the low temperature 2D vacancy ordering and moderate temperature stability. The evolution of the oxygen cycling capability of these materials is also reported.

The Mitochondrial Connection: The Nek Kinases' New Functional Axis in Mitochondrial Homeostasis.

Mitochondria provide energy for all cellular processes, including reactions associated with cell cycle progression, DNA damage repair, and cilia formation. Moreover, mitochondria participate in cell fate decisions between death and survival. Nek family members have already been implicated in DNA damage response, cilia formation, cell death, and cell cycle control. Here, we discuss the role of several Nek family members, namely Nek1, Nek4, Nek5, Nek6, and Nek10, which are not exclusively dedicated to cell cycle-related functions, in controlling mitochondrial functions. Specifically, we review the function of these Neks in mitochondrial respiration and dynamics, mtDNA maintenance, stress response, and cell death. Finally, we discuss the interplay of other cell cycle kinases in mitochondrial function and vice versa. Nek1, Nek5, and Nek6 are connected to the stress response, including ROS control, mtDNA repair, autophagy, and apoptosis. Nek4, in turn, seems to be related to mitochondrial dynamics, while Nek10 is involved with mitochondrial metabolism. Here, we propose that the participation of Neks in mitochondrial roles is a new functional axis for the Nek family.

A comprehensive review on DDX3X liquid phase condensation in health and neurodevelopmental disorders.

DEAD-box helicases are global regulators of liquid-liquid phase separation (LLPS), a process that assembles membraneless organelles inside cells. An outstanding member of the DEAD-box family is DDX3X, a multi-functional protein that plays critical roles in RNA metabolism, including RNA transcription, splicing, nucleocytoplasmic export, and translation. The diverse functions of DDX3X result from its ability to bind and remodel RNA in an ATP-dependent manner. This capacity enables the protein to act as an RNA chaperone and an RNA helicase, regulating ribonucleoprotein complex assembly. DDX3X and its orthologs from mouse, yeast (Ded1), and C. elegans (LAF-1) can undergo LLPS, driving the formation of neuronal granules, stress granules, processing bodies or P-granules. DDX3X has been related to several human conditions, including neurodevelopmental disorders, such as intellectual disability and autism spectrum disorder. Although the research into the pathogenesis of aberrant biomolecular condensation in neurodegenerative diseases is increasing rapidly, the role of LLPS in neurodevelopmental disorders is underexplored. This review summarizes current findings relevant for DDX3X phase separation in neurodevelopment and examines how disturbances in the LLPS process can be related to neurodevelopmental disorders.

Clinical features, etiologies, and outcomes of central nervous system infections in intensive care: A multicentric retrospective study in a large Brazilian metropolitan area.

PURPOSE: The goal of this study was to investigate severe central nervous system infections (CNSI) in adults admitted to the intensive care unit (ICU). We analyzed the clinical presentation, causes, and outcomes of these infections, while also identifying factors linked to higher in-hospital mortality rates. MATERIALS AND METHODS: We conducted a retrospective multicenter study in Rio de Janeiro, Brazil, from 2012 to 2019. Using a prediction tool, we selected ICU patients suspected of having CNSI and reviewed their medical records. Multivariate analyses identified variables associated with in-hospital mortality. RESULTS: In a cohort of 451 CNSI patients, 69 (15.3%) died after a median 11-day hospitalization (5-25 IQR). The distribution of cases was as follows: 29 (6.4%) had brain abscess, 161 (35.7%) had encephalitis, and 261 (57.8%) had meningitis. Characteristics: median age 41 years (27-53 IQR), 260 (58%) male, and 77 (17%) HIV positive. The independent mortality predictors for encephalitis were AIDS (OR = 4.3, p = 0.01), ECOG functional capacity limitation (OR = 4.0, p < 0.01), ICU admission from ward (OR = 4.0, p < 0.01), mechanical ventilation ≥10 days (OR = 6.1, p = 0.04), SAPS 3 ≥ 55 points (OR = 3.2, p = 0.02). Meningitis: Age > 60 years (OR = 234.2, p = 0.04), delay >3 days for treatment (OR = 2.9, p = 0.04), mechanical ventilation ≥10 days (OR = 254.3, p = 0.04), SOFA >3 points (OR = 2.7, p = 0.03). Brain abscess: No associated factors found in multivariate regression. CONCLUSIONS: Patients' overall health, prompt treatment, infection severity, and prolonged respiratory support in the ICU all significantly affect in-hospital mortality rates. Additionally, the implementation of CNSI surveillance with the used prediction tool could enhance public health policies.

Exceptional capture of methane at low pressure by an iron-based metal-organic framework.

The selective capture of methane (CH4) at low concentrations and its separation from N2 are extremely challenging owing to the weak host-guest interactions between CH4 molecules and any sorbent material. Here, we report the exceptional adsorption of CH4 at low pressure and the efficient separation of CH4/N2 by MFM-300(Fe). MFM-300(Fe) shows a very high uptake for CH4 of 0.85 mmol g-1 at 1 mbar and 298 K and a record CH4/N2 selectivity of 45 for porous solids, representing a new benchmark for CH4 capture and CH4/N2 separation. The excellent separation of CH4/N2 by MFM-300(Fe) has been confirmed by dynamic breakthrough experiments. In situ neutron powder diffraction, and solid-state nuclear magnetic resonance and diffuse reflectance infrared Fourier transform spectroscopies, coupled with modelling, reveal a unique and strong binding of CH4 molecules involving Fe-OH⋯CH4 and C⋯phenyl ring interactions within the pores of MFM-300(Fe), thus promoting the exceptional adsorption of CH4 at low pressure.

Soft skills in Orthodontics: an analysis in residents and experienced professionals

ABSTRACT Introduction: Soft skills represent a range of personal skills, attitudes and characteristics relevant to success and adequate work performance. Objective: This study aimed to evaluate the knowledge and usage of soft skills in Orthodontics. Methods: The participants answered a questionnaire containing 27 objective questions on awareness and frequency of soft skills in their professional activities. Participants were also asked to rank the soft skills in a crescent order of importance. The sample was divided into subgroups: A) residents in Orthodontics; B) orthodontists with less than 5 years of experience and C) orthodontists with more than 5 years of experience. Intergroup comparisons were performed using the Kruskal-Wallis test. Sexual differences were compared using Mann-Whitney test (p<0.05). Results: The sample of this observational study comprised 129 experienced orthodontists and residents in Orthodontics (92 women, 37 men) with mean age of 35.3 years. From the total sample, 54,6% of respondents reported no previous instructions on soft skills. All respondents reported using the analyzed soft skills with a similar frequency (median 4-5). Residents reported accessing reliable sources in bibliographic research less frequently (46%). Female orthodontists reported to seek help from teachers and other professionals more often than males. Ethics and communication were frequently ranked as the most important soft skills. Information management and leadership were frequently less ranked as important soft skills. Conclusion: Poor knowledge of soft skills was demonstrated by residents and orthodontists. Communication skill was highly used and frequently ranked as the most important soft skill.

RESUMO Introdução: As soft skills representam uma variedade de habilidades pessoais, atitudes e características relevantes para o sucesso e desempenho adequado no trabalho. Objetivo: Este estudo teve como objetivo avaliar o conhecimento e o uso das soft skills em ortodontistas. Métodos: Os participantes responderam a um questionário contendo 27 perguntas objetivas sobre conhecimento e frequência das soft skills em suas atividades profissionais. Os participantes também foram solicitados a classificar as soft skills em uma ordem crescente de importância. A amostra foi dividida em subgrupos: A) residentes em Ortodontia; B) ortodontistas com menos de 5 anos de experiência e C) ortodontistas com mais de 5 anos de experiência. As comparações intergrupos foram realizadas usando o teste de Kruskal-Wallis. Diferenças entre os sexos foram comparadas usando o teste de Mann-Whitney (p< 0,05). Resultados: A amostra deste estudo observacional compreendeu 129 ortodontistas experientes e residentes em Ortodontia (92 mulheres, 37 homens) com idade média de 35,3 anos. Entre os entrevistados, 54,6% relataram não ter recebido instruções prévias sobre as soft skills. Todos os entrevistados relataram usar as habilidades interpessoais analisadas com uma frequência semelhante (mediana 4-5). Os residentes relataram acessar com menos frequência (46%) fontes confiáveis de pesquisa bibliográfica. Ortodontistas do sexo feminino relataram buscar ajuda de professores e outros profissionais com mais frequência do que os do sexo masculino. Ética e comunicação foram frequentemente classificadas como as soft skills mais importantes. Com frequência, o gerenciamento de informações e a liderança foram classificados como soft skills menos importantes. Conclusão: Foi demonstrado pouco conhecimento sobre as soft skills por parte de residentes e ortodontistas. A habilidade de comunicação foi frequentemente utilizada e considerada a soft skill mais importante.

Epidemiological profile of COVID-19 in patients with prostate cancer undergoing androgen deprivation therapy at a Brazilian Cancer Center

ABSTRACT Objective To describe the epidemiological aspects of COVID-19 in patients with prostate cancer who received androgen deprivation therapy and those who did not. Methods We retrospectively analyzed the medical records of patients with prostate cancer undergoing androgen deprivation therapy and those who did not undergo androgen deprivation therapy. These patients were treated at the A.C.Camargo Cancer Center between March 2020 and March 2021. Results Of the 78 patients with prostate cancer and positive RT-PCR test results, 50% were undergoing androgen deprivation therapy, and 49% were experiencing a non-metastatic biochemical relapse. Of these, 80.6% were symptomatic on the day of examination compared to 97.2% in the Control Group. A total of 82.1% of the patients receiving androgen deprivation therapy required hospitalization, with 30.8% admitted to the intensive care unit compared to 21.6% in the Control Group. There was no statistically significant difference in the use of a high-flow oxygen cannula, the need for orotracheal intubation and mechanical ventilation, the need for dialysis, multiple organ failure, or death. A significant difference was found between the groups in terms of the average length of stay in the intensive care unit. Conclusion Androgen deprivation therapy was not associated with protective factors or potential treatments in patients with prostate cancer and COVID-19. Although the number of patients analyzed was limited, and there may have been a selection bias, this is a unique study that cannot be expanded or replicated in similar (unvaccinated) populations.

Assessment of The Addition of Epinephrine to Intra-articular Bupivacaine for the Control of Acute Pain in Patients underwent to Anterior Cruciate Ligament Reconstruction / Avaliação da adição da epinefrina à bupivacaína intra-articular no controle da dor aguda em pacientes submetidos a reconstrução do ligamento cruzado anterior

Abstract Objective To evaluate postoperative pain, using the visual analog scale (VAS), in patients undergoing anterior cruciate ligament reconstruction (ACLR) and receiving intra-articular anesthetic solutions. Methods The present is a randomized clinical trial with a sample of 48 patients divided into 4 groups: Group I (n » 12) - 20 mL of saline solution (control); Group II (n » 12) - 20 mL of 0.5% bupivacaine; Group III (n » 12) - 20 mL of 0.5% bupivacaine þ 0.1 mg of epinephrine; and Group IV (n » 12) - 20 mL of saline solution þ 0.1 mg of epinephrine. These solutions were injected into the knee at the end of the surgery. Pain was assessed using the VAS immediately and 6, 12, 24 and 48 hours after the procedure. Results The VAS scores were highly variable among the groups. A Kruskal-Wallis analysis of variance (ANOVA), considering a level of significance of 5%, revealed that all intra-articular anesthetic solutions influenced the assessment of pain (p » 0.003), and that Group-III subjects presented less postoperative pain. There was no evidence of a higher or lower use of supplemental analgesic agents, or of adverse effects resulting from these anesthetic solutions. Conclusion Bupivacaine combined with epinephrine was the most effective solution for pain control in patients undergoing ACLR, but with no statistically significant differences when compared to Group II (p » 0.547). There was no decrease or increase in the use of supplemental analgesics or in the occurrence of adverse systemic effects (p > 0.05).

Resumo Objetivo Avaliar primariamente a dor pós-operatória, por meio da escala visual analógica (EVA), nos pacientes submetidos a reconstrução do ligamento cruzado anterior (RLCA) que receberam soluções anestésicas intra-articulares (IAs). Métodos Ensaio clínico randomizado com uma amostra de 48 pacientes, divididos em 4 grupos: Grupo I (n » 12) - 20 ml de solução fisiológica (controle); Grupo II (n » 12) - 20 ml de bupivacaína a 0,5%; Grupo III (n » 12) - 20 ml de bupivacaína a 0,5% þ 0,1 mg de epinefrina; e Grupo IV (n » 12) - 20 ml de solução fisiológica þ 0,1 mg de epinefrina, injetados no joelho ao término da cirurgia. A dor foi avaliada pela EVA imediatamente e 6, 12, 24 e 48 horas após o procedimento. Resultados Observou-se grande variabilidade nos resultados da EVA entre os pacientes avaliados em cada grupo. Verificou-se, pela análise de variância (analysis of variance, ANOVA) de Kruskal-Wallis, considerando um nível de 5% de significância, que as soluções anestésicas IAs de cada grupo influenciaram na avaliação da dor desses pacientes (p » 0,003), sendo os do Grupo III os que apresentaram menor dor pósoperatória. Não se evidenciou um maior ou menor consumo de drogas analgésicas suplementares, ou efeitos adversos das decorrentes das soluções empregadas. Conclusão A solução combinada de bupivacaína e epinefrina foi a mais eficaz no controle da dor nos pacientes submetidos a RLCA, mas sem diferenças estatisticamente significativas com relação ao grupo II (p » 0,547). Não se observou diminuição ou aumento no consumo de analgésicos suplementares, ou o aparecimento de efeitos sistêmicos adversos (p > 0,05).

Percepção estética e desconforto de pacientes brasileiros em tratamento com bráquetes vestibulares metálicos e cerâmicos, linguais e alinhadores Invisaling® / Esthetic perception and discomfort of Brazilian patients undergoing treatment with metallic and ceramic vestibular brackets, lingual brackets and Invisaling® aligners

Resumo O tratamento ortodôntico experimenta evolução contínua em seus aparelhos, principalmente por questões estéticas e de conforto. Objetivo: avaliar a satisfação e desconforto relatados por pacientes submetidos ao tratamento ortodôntico com bráquetes vestibulares metálicos e cerâmicos, bráquetes linguais e alinhadores Invisalign®. Material e métodos: Aplicação de um questionário padronizado a 126 pacientes de ambos os sexos, em tratamento ortodôntico em consultórios particulares há pelo menos 90 dias, sem outro acessório ortodôntico. Os pacientes foram divididos em 4 grupos: grupo I (n=30) bráquetes vestibulares metálicos, grupo II (n=30) bráquetes estéticos vestibulares, grupo III (n=32) alinhadores Invisalign® e grupo IV (n=34) bráquetes fixos linguais. A comparação entre os grupos foi feita pelo teste do qui-quadrado e, quando este indicou diferença estatisticamente significativa, foram realizadas comparações múltiplas pelo teste de proporções. Resultados: Os bráquetes metálicos vestibulares foram mais percebidos pelos demais e trouxeram maior desconforto estético. Os bráquetes cerâmicos foram menos percebidos pelos demais do que os bráquetes vestibulares metálicos. Os alinhadores foram menos percebidos pelos outros do que os bráquetes vestibulares, causaram menos dificuldades na fala e na escovação, menos desconforto nas bochechas e menos dificuldades na fala. Os bráquetes linguais trouxeram menos desconforto estético, revelando também maior desconforto na língua e menos desconforto na bochecha. Conclusão: Os pacientes relataram maior desconforto estético com bráquetes vestibulares metálicos. Aparelhos linguais e alinhadores foram menos percebidos pelos demais e trouxeram menos desconforto estético aos pacientes. Todos os pacientes tratados com alinhadores o usariam novamente caso precisassem de um novo tratamento.(AU)

Abstract Orthodontic treatment experiences continuous evolution in its appliances, especially due to esthetic and comfort reasons. Objective: The aim of this study was to evaluate the satisfaction and discomfort reported by patients undergoing orthodontic treatment with metallic and ceramic vestibular brackets, lingual brackets and Invisalign® aligners. Material and methods: Application of a standardized questionnaire to 126 patients of both genders, undergoing orthodontic treatment in private orthodontic offices for at least 90 days, with no other orthodontic accessory. Patients were divided into 4 groups: group I (n=30) vestibular metallic brackets, group II (n=30) vestibular esthetic brackets, group III (n=32) Invisalign® aligners and group IV (n=34) lingual fixed brackets. Comparison between the appliances were made by the chi-square test, and when this indicated a statistically significant difference multiple comparisons were performed by the test of proportions. Results: Vestibular metallic brackets were more perceived by others and brought greater esthetic discomfort. Ceramic brackets were less perceived by others than metallic vestibular brackets. Aligners were less perceived by others than vestibular brackets, caused fewer speech and brushing difficulties, less discomfort on the cheeks and less speech difficulties. Lingual brackets brought less esthetic discomfort, revealing also more tongue discomfort and less cheek discomfort. Conclusion: Patients reported more aesthetic discomfort with metallic vestibular brackets. Lingual appliances and aligners were less perceived by others and brought less esthetic discomfort to patients. All aligners patients would use these appliances again if they needed new treatment.(AU)

Factors associated with bariatric surgery rates in federative units in Brazil / Fatores associados às taxas de cirurgias bariátricas nas Unidades Federativas do Brasil

ABSTRACT OBJECTIVE To analyze the socioeconomic, demographic and health management factors associated with bariatric surgery rates performed by the Brazilian Unified Health System (SUS) in the federative units in Brazil. METHODS Description and analysis of bariatric surgeries rates (per 100,000 inhabitants) performed by SUS in adults from 18 to 65 years old, in the 27 federative units of Brazil, between 2008 and 2018; thus, the econometric methodology of count panel with negative binomial distribution (population-averaged, fixed effects and random effects) was used. Socioeconomic and demographic factors were also investigated, considering the real gross domestic product per capita, the average years of study of adults and life expectancy at birth, and those of health management, given the primary health care coverage, the rate of digestive system surgeons and the rate of hospitals accredited in high complexity care to patients with obesity in the SUS. RESULTS In regional terms, the performance of public bariatric surgeries in Brazil over the period analyzed suffered a great disparity; the procedures happen mostly in the South and Southeast regions, and scarcely in the North region. Moreover, we found a positive relationship between the rate of bariatric surgeries and life expectancy, the rate of digestive system surgeons and the rate of hospitals accredited in high complexity care; however, the average number of years of adult study and coverage of primary health care is a negative association regarding real gross domestic product per capita. CONCLUSION In the period analyzed, the investigated factors explained the rate of bariatric surgeries. Therefore, to train specialized health professionals, the accreditation of hospitals according to the legal framework, preventive actions of primary care, and socioeconomic and demographic factors, conditioning for the offer of surgical treatment by the SUS were crucial. Thus, these are all relevant factors for the formulation of public policies in this area.

RESUMO OBJETIVO Analisar os fatores socioeconômicos, demográficos e de gestão em saúde associados às taxas de cirurgias bariátricas realizadas pelo Sistema Único de Saúde (SUS) nas unidades federativas (UF) do Brasil. MÉTODOS Descrição e análise da taxa de cirurgias bariátricas (por 100 mil habitantes) realizadas pelo SUS em adultos de 18 a 65 anos, nas 27 unidades federativas do Brasil, entre 2008 e 2018; para isso, utilizou-se a metodologia econométrica de painel de contagem com distribuição binomial negativa (population-averaged, efeitos fixos e efeitos aleatórios). Investigou-se, também, os fatores socioeconômicos e demográficos, considerando o produto interno bruto (PIB) real per capita, a média de anos de estudo de adultos e a expectativa de vida ao nascer, e os da gestão em saúde, tendo em vista a cobertura da atenção básica, a taxa de cirurgiões de aparelho digestivo e a taxa de hospitais credenciados na assistência de alta complexidade (AAC) ao indivíduo obeso no SUS. RESULTADOS Em termos regionais, verificou-se grande disparidade na realização de cirurgias bariátricas públicas no Brasil ao longo do período analisado: os procedimentos estão concentrados nas regiões Sul e Sudeste, sendo escassos na região Norte. Além disso, encontrou-se uma relação positiva entre a taxa de cirurgias bariátricas e a expectativa de vida, a taxa de cirurgiões de aparelho digestivo e a taxa de hospitais credenciados na assistência de alta complexidade; havendo, porém, uma associação negativa em relação ao PIB real per capita, a média de anos de estudo de adultos e a cobertura da atenção básica. CONCLUSÕES No período analisado, o índice de cirurgias bariátricas foi explicado pelos fatores investigados. Portanto, mostrou-se de fundamental importância a formação de profissionais de saúde especializados, o credenciamento de hospitais conforme o marco legal, as ações preventivas da atenção básica, e os fatores socioeconômicos e demográficos, condicionantes da oferta do tratamento cirúrgico pelo Sistema Único de Saúde. Sendo assim, todos fatores relevantes para a formulação de políticas públicas nessa área.

Centro de estudos em política e gestão do esporte e lazer: trajetória científica e perspectivas futuras / The center for studies in sports and leisure policy and management: scientific trajectory and future perspectives / El centro de estudios en política y gestión del deporte y el ocio: trayectoria científica y perspectivas de futuro

O Centro de Estudos em Política e Gestão do Esporte e Lazer se apresenta como um grupo de pesquisa vinculado a Universidade Estadual do Sudoeste da Bahia. A referida entidade tem como objetivo o desenvolvimento de pesquisas correlatas ao processo da formação da agenda para o Esporte, Lazer, Promoção da Saúde e Educação Física. Do ponto de vista epistemológico, o programa de pesquisa do referido grupo encontra-se alicerçado na Ciência Política. A produção do conhecimento encontra-se materializada em livros, capítulos de livros e artigos publicados em periódicos nacionais e internacionais. Diante do exposto, os estudos desenvolvidos pelo grupo tornam-se uma alternativa para a revisão teórica da literatura científica nacional com vistas ao processo de falseamento dos valores e crenças que permeiam o fazer científico da produção relacionada a política e gestão do esporte e lazer.

The Center for Studies in Sports and Leisure Policy and Management presents itself as a research group linked to the State University of Southwest Bahia. This entity aims to develop research related to the process of forming the agenda for Sport, Leisure, Health Promotion and Physical Education. From an epistemological point of view, the research program of that group is based on Political Science. The production of knowledge is materialized in books, book chapters and articles published in national and international journals. Given the above, the studies developed by the group become an alternative for the theoretical review of the national scientific literature with a view to the process of falsifying the values ​​and beliefs that permeate the scientific production of production related to the politics and management of sport and leisure.

El Centro de Estudios en Política y Gestión del Deporte y el Ocio se presenta como un grupo de investigación vinculado a la Universidad Estatal del Sudoeste de Bahía. Esta entidad tiene como objetivo desarrollar investigaciones relacionadas con el proceso de conformación de la agenda de Deporte, Ocio, Promoción de la Salud y Educación Física. Desde un punto de vista epistemológico, el programa de investigación de ese grupo se basa en la Ciencia Política. La producción de conocimiento se materializa en libros, capítulos de libros y artículos publicados en revistas nacionales e internacionales. Dado lo anterior, los estudios desarrollados por el grupo se convierten en una alternativa para la revisión teórica de la literatura científica nacional con miras al proceso de falsificación de los valores y creencias que permean la producción científica de producción relacionada con la política y gestión del deporte y el ocio.

Trombosis venosa portal extrahepática, manejo quirúrgico con derivación meso-Rex. Serie de 3 casos / Extrahepatic portal vein thrombosis, surgical management with meso-Rex shunt. Series of 3 cases

La vena porta es un conducto que drena el flujo esplácnico al hígado y se puede ocluir por diferentes patologías, variando su presentación clínica de acuerdo con la causa de la obstrucción. Es muy importante diferenciar la trombosis portal asociada o no a la cirrosis, ya que su tratamiento y pronóstico es diferente. La trombosis venosa portal extrahepática es una condición netamente de origen vascular, y es la principal causa de trombosis portal en niños y adultos. Presentamos tres casos tratados con derivación meso-Rex, con seguimiento a 6 meses

The portal vein is a conduit that drains splanchnic flow to the liver, it can be occluded by different pathologies and its clinical presentation varies according to the cause of the obstruction. It is very important to differentiate portal thrombosis associated or not with cirrhosis, since its treatment and prognosis is different. Extrahepatic portal vein thrombosis (PEVT) is a condition of purely vascular origin, being the main cause of portal thrombosis in children and adults. We present three cases with meso-Rex shunt, with a 6-month follow-up

Protocolo de cirurgia segura: análise da produção e execução em dois hospitais terciários / Surgical safety checklist: analysis of its elaboration and implementation in two tertiary hospitals / Protocolo de cirugía segura: análisis de producción y ejecución en dos hospitales terciarios

Objetivo: Analisar o processo de produção e execução do protocolo de cirurgia segura em dois hospitais terciários do município de Manaus. Método: Pesquisa guiada pelo design thinking, com ênfase na técnica do duplo diamante, realizada em dois hospitais públicos no município de Manaus, de julho de 2018 a março de 2019. Foi feita nas etapas: investigativa (observação e questionário) e interventiva (síntese, ideação e entrega). Resultados: Na primeira etapa, com 120 horas de observação, constatou-se que as três fases do protocolo não foram cumpridas; analisando-se as repostas a 63 questionários, reforçou-se a não adesão ao checklist. Com base nesses achados, na etapa de síntese, elegeu-se como foco a aplicação do checklist do protocolo; na etapa de ideação, realizou-se a proposição de solução e a testagem-piloto; a etapa de entrega da solução aos hospitais encerrou o ciclo. Conclusão: A análise do processo de execução do protocolo indicou seu descumprimento, o que sugere o comprometimento da segurança do paciente. A solução testada poderá, após entrega e implementação, contribuir para a execução efetiva do protocolo.

Objective: To analyze the process of elaboration and implementation of the surgical safety checklist in two tertiary hospitals in the city of Manaus. Method: This study was based on design thinking, focusing on the double diamond technique. It was conducted in two public hospitals in Manaus, from July 2018 to March 2019. The following stages were adopted for this research: investigation (observation and questionnaire) and intervention (synthesis, ideation, and delivery). Results: The first stage, consisting of 120 hours of observation, showed the non-fulfillment of the three phases of the process. After analyzing the answers to the 63 questionnaires, we confirmed the non-adherence to the checklist. Based on these findings, the synthesis phase focused on the use of the checklist; the ideation phase involved the proposal of solutions and the pilot testing; the delivery phase concluded the cycle by providing solutions to the hospitals. Conclusion: The analysis of the process of implementation of the checklist indicated non-compliance, suggesting risk to patient safety. After delivery and implementation, the tested solution may contribute to the effective execution of the checklist.

Objetivo: Analizar el proceso de producción y ejecución del Protocolo de Cirugía Segura en dos hospitales terciarios de la ciudad de Manaus. Método: Investigación guiada por Design Thinking, con énfasis en la técnica Double Diamond, llevada a cabo en dos hospitales públicos de la ciudad de Manaus, desde julio de 2018 hasta marzo de 2019. Se realizó por etapas: de investigación (observación y cuestionario) e intervencionista (síntesis, ideación y entrega). Resultados: En la primera etapa, con 120 horas de observación, se encontró que las tres fases del protocolo no se cumplieron; En base a las respuestas a 63 cuestionarios, se reforzó la no adhesión a la lista de verificación. Con base en estos hallazgos, en la etapa de síntesis, la aplicación de la lista de verificación del protocolo fue elegida como el foco; en la etapa de ideación, se llevaron a cabo la propuesta de solución y la prueba piloto;La etapa de entrega de la solución a los hospitales finalizó el ciclo. Conclusión: El análisis del proceso de ejecución del protocolo indicó incumplimiento, lo que sugiere comprometer la seguridad del paciente. La solución probada puede, después de la entrega y la implementación, contribuir a la ejecución efectiva del protocolo.