Towards the Future of Public Health: Roadmapping Trends and Scenarios in the Post-COVID Healthcare Era.

The COVID-19 pandemic, a transformative event in modern society, has disrupted routine, work, behavior, and human relationships. Organizations, amidst the chaos, have innovatively adapted to the evolving situation. However, many countries were unprepared for the magnitude of the challenge, revealing the fragility of health responses due to inadequate leadership, insufficient resources, and poor information system integration. Structural changes in health systems are imperative, particularly in leadership, governance, human resources, financing, information systems, technology, and health service provision. This research utilizes the Technological Roadmapping method to analyze the health sector, focusing on public health, drawing on articles from SCOPUS and PubMed databases, and creating a roadmap extending to 2050. The research presents three long-term scenarios based on the literature-derived roadmap and explores various alternatives, including integrated care, telemedicine, Big Data utilization, nanotechnology, and Big Tech's AI services. The results underscore the anticipation of post-pandemic public health with high expectations, emphasizing the importance of integrating health history access, encouraging self-care, and leveraging technology for streamlined treatment. Practical implications include insights for decision makers and stakeholders to inform strategic planning and adapt to evolving industry demands, recognizing the significance of preventive services and the humanizing potential of technology.

Donkey Skin Trade and Its Non-compliance With Legislative Framework.

Donkeys (Equus asinus) are facing a global crisis. Their welfare, and even survival, is being compromised as the demand for their skins increases. This demand is driven by the need to supply raw materials to produce ejiao, a Traditional Chinese Medicine made from collagen extracted from donkey skins. Since there is no productive chain for donkey skin production outside of China, the global trade is an entirely extractive industry that has resulted in the decimation of some local donkey populations. The donkey skin trade is demonstrably unsustainable, from the ethical issues associated with poor welfare, to the biosecurity and human health risks the trade poses; and it violates both legal frameworks and moral expectations at both a national and global level.

Selectivity of Metarhizium anisopliae and Beauveria bassiana to adults of Telenomus podisi (Hymenoptera: Scelionidae) / Seletividade de Metarhizium anisopliae e Beauveria bassiana para adultos de Telenomus podisi (Hymenoptera: Scelionidae)

The selectivity of entomopathogenic fungi to non-target organisms needs to be considered in Integrated Pest Management (IPM), because even though they are biological control agents, if used incorrectly, they can negatively alter the functioning of agroecosystems. Therefore, studies that assess the selectivity of these fungi to beneficial organisms are extremely important. The objective of this work was to evaluate the selectivity of Metarhizium anisopliae (Metarril®) and Beauveria bassiana (Boveril®) to adults of Telenomus podisi Ashmead (Hymenoptera: Scelionidae), under laboratory conditions. The products were evaluated on adult females of T. podisi, at the concentrations recommended by the manufacturer. To this, 0.2 mL of suspensions of each product and control (treatments) were applied to the inner surface of glass tubes, and then a female T. podisi was placed in it (≤ 48 h of emergence). After 24 h of contact, cards with 25 eggs of Euschistus heros Fabricius (Hemiptera: Pentatomidae) were offered for 24 h (COF24). After this period, the COF24 were withdrawn. After 72 h of contact of the female with the tube surface, new E. heros egg cards were made available (COF72) for 24 h for T. podisi ovipositioning. The mortality of T. podisi females was evaluated daily to determine longevity, percentage of parasitism and emergence, sex ratio, and egg-adult period of the T. podisi offspring. Metarril® and Boveril®, considered selective for adult females of T. podisi, did not negatively affect most of the parameters evaluated.(AU)

A seletividade de fungos entomopatogênicos a organismos não-alvo deve ser considerada no Manejo Integrado de Pragas (MIP), pois mesmo sendo agentes de controle biológico, se utilizados de forma incorreta, podem alterar negativamente o funcionamento dos agroecossistemas. Portanto, estudos que avaliam a seletividade desses fungos a organismos benéficos são extremamente importantes. O objetivo deste trabalho foi avaliar a seletividade de Metarhizium anisopliae (Metarril®) e Beauveria bassiana (Boveril®) a adultos de Telenomus podisi Ashmead (Hymenoptera: Scelionidae), em condições de laboratório. Os produtos foram avaliados em fêmeas adultas de T. podisi, nas concentrações recomendadas pelo fabricante. Para tanto, 0,2 mL das suspensões de cada produto e controle (tratamentos) foram aplicados na superfície interna dos tubos de vidro, sendo então colocada uma fêmea de T. podisi (≤ 48 h de emergência). Após 24 h de contato, cartões com 25 ovos de Euschistus heros Fabricius (Hemiptera: Pentatomidae) foram oferecidos por 24 h (COF24). Após esse período, o COF24 foi retirado. Após 72 h de contato da fêmea com a superfície do tubo, foram disponibilizadas novas cartelas de ovos de E. heros (COF72) por 24 h para oviposição de T. podisi. A mortalidade de fêmeas de T. podisi foi avaliada diariamente para determinar longevidade, porcentagem de parasitismo e emergência, proporção sexual e período de ovo-adulto da prole de T. podisi. Metarril® e Boveril® foram considerados seletivos para fêmeas adultas de T. podisi, não afetaram negativamente a maioria dos parâmetros avaliados.(AU)

Development of an Index for the Inspection of Aedes aegypti Breeding Sites in Brazil: Multi-criteria Analysis.

BACKGROUND: Aedes aegypti is a vector for the transmission of diseases such as dengue fever, chikungunya, Zika fever, and yellow fever. In 2016, over 1 million cases of these diseases were reported in Brazil, which is an alarming public health issue. One of the ways of controlling this disease is by inspecting and neutralizing the places where A. aegypti lays its eggs. The Ministry of Planning, Development, and Administration of Brazil maintains the inspection statistics. OBJECTIVE: We propose a multi-criteria analysis to create an index for A. aegypti inspections reported through the Ministry of Planning, Development, and Administration system of Brazil. METHODS: Based on the repository from urban cleaning services combined with data on inspections conducted by government agencies in several Brazilian cities and municipalities, we selected and combined metrics, which we further ranked using the analytic hierarchy process methodology. We also developed risk maps based on the analytic hierarchy process ranking of the A. aegypti breeding sites. RESULTS: Based on our analysis and the available data, the priority for inspections should consider the number of sick people (weight 0.350), medical evaluations (weight 0.239), inspections (weight 0.201), mosquito breeding sites (weight 0.126), and days of absence from work (weight 0.096). CONCLUSIONS: The proposed index could aid public health practitioners in preventing the appearance of new A. aegypti breeding sites. This information technology application can help solve such public health challenges.

Donkey skin trade: is it sustainable to slaughter donkeys for their skin? / Comércio de pele de jumentos: é sustentável abater jumentos para o uso de sua pele?

Donkeys (Equus asinus) face a global crisis. The health, welfare, and even survival of donkeys are being compromised as the demand for their skins increases. It is driven by the production of ejiao, a traditional Chinese remedy believed by some to have medicinal properties. It is estimated that the ejiao industry currently requires approximately 4.8 million donkey skins per year. Since there is no productive chain for donkey skin production outside of China, the activity is extractive and has resulted in the decimation of donkeys. Gestation is 12 months in donkeys, increasing the risk of extinction if such practices are not controlled. In this scenario, the donkeys are collected (purchased for low prices, stolen, and collected from the side of the roads) and are then often transported for long distances, usually without water, food, or rest. The trade, in Brazil, poses significant biosecurity risks, particularly because examinations are rarely conducted and therefore infectious diseases, such as glanders and infectious anemia, remain undetected. Furthermore, in chronic stress situations, the immune system is suppressed, increasing the biosecurity risk, especially because donkeys are a silent carrier of diseases. Rarely there is traceability with animals from different origins being put together in "fake farms", before being delivered to slaughterhouses. The opportunistic strategy of collecting animals, or buying for low prices, keeping them without access to food and veterinary assistance, is what makes this trade profitable. Our experience in donkey welfare and the global skin trade suggest that it will be enormously challenging and cost-prohibitive to run a trade at the standards required to be considered humane, sustainable, and safe. Although donkeys are being blamed for the involvement in road accidents, it is not an ethical solution to maintain this trade as an alternative. Moreover, the ecological role of donkeys in native ecosystems has not been elucidated, and some studies indicate they could even have a positive effect. Regardless of the future the donkeys will have; we must guarantee a life with the least dignity to the animals under our responsibility.(AU)

Os jumentos (Equus asinus) estão enfrentando uma crise global. A saúde, o bem-estar e até a sobrevivência dos jumentos estão sendo comprometidos à medida que a demanda por suas peles aumenta. A atividade é impulsionada pela produção de ejiao, um remédio tradicional chinês que algumas pessoas acreditam possuir propriedades medicinais. Estima-se que a indústria de ejiao demande atualmente cerca de 4,8 milhões de peles de jumento por ano. Uma vez que não existe uma cadeia produtiva fora da China, a atividade é extrativista e resultou na drástica redução das populações. A gestação dos jumentos é de 12 meses, aumentando o risco de extinção se tais práticas não forem controladas. Neste cenário, os jumentos são recolhidos (comprados a preços baixos, roubados e recolhidos à beira das estradas) e são frequentemente transportados para longas distâncias, normalmente sem água, comida ou descanso. O comércio no Brasil apresenta riscos significativos de biossegurança, principalmente porque os exames raramente são realizados e, portanto, doenças infecciosas, como mormo e anemia infecciosa equina, permanecem sem detecção. Além disso, em situações de estresse crônico, o sistema imunológico é suprimido, aumentando o risco de biossegurança, principalmente porque os jumentos são portadores silenciosos de doenças. Raramente há rastreabilidade, e os animais de diferentes origens acabam sendo colocados em "fazendas fantasma", antes de serem entregues aos abatedouros. A estratégia oportunista de coletar animais, ou comprar por preços irrisórios, mantendo-os sem acesso a alimentação e assistência veterinária, é o que torna esse comércio lucrativo. Nossa experiência em bem-estar de jumentos e no comércio global de peles sugere que será extremamente desafiador e com custo proibitivo administrar um comércio dentro dos padrões exigidos para ser considerado humano, sustentável e seguro. Embora os jumentos sejam responsabilizados pelo envolvimento em acidentes rodoviários, não é uma solução ética manter este comércio como uma alternativa. Além disso, o papel ecológico dos jumentos nos ecossistemas nativos não foi elucidado, e alguns estudos indicam que eles podem até ter um efeito positivo. Independentemente do futuro que os jumentos terão, devemos garantir uma vida com o mínimo de dignidade aos animais sob nossa responsabilidade.(AU)

The human-animal relationship and its influence in our culture: the case of donkeys / A relação homem-animal e sua influência em nossa cultura: o caso dos jumentos

Donkeys (Equus asinus) face a global crisis. Their health, welfare, and even their local survival are compromised as the demand for their skins increases. Such demand for donkey skins aims to supply the ejiao industry. Ejiao is a traditional remedy made from the collagen of donkey skins. Some people believe it has medicinal properties. It is estimated that the ejiao industry currently requires approximately 4.8 million donkey skins per year. Although the future of the donkeys is still uncertain, we must guarantee a life free from suffering to the animals under our responsibility. The trade of donkey skins also undermines the cultural role of donkeys. Donkeys have developed an essential role in Brazil, especially in the Northeast region of the country, carrying on their backs construction materials, water, and food, and, as a consequence, helping people build cities in the deepest hinterland. The close relationship between people and donkeys affords donkeys a unique place in the local culture. This central importance has been recognized by Brazilian artists throughout history. We have many examples of songs, books, "cordeis" (typical Brazilian literature), poems, documentaries, movies, woodcuts, paintings, and sculptures, created to honor this important actor. Here we describe some examples of this human-donkey relationship, and its influence on our culture.(AU)

Os jumentos (Equus asinus) estão enfrentando uma crise global. A saúde, o bem-estar e, principalmente, a sobrevivência dos jumentos está sendo comprometida à medida que a demanda por suas peles aumenta. Essa demanda por peles de jumento visa abastecer a indústria de ejiao. Ejiao é um remédio tradicional feito de colágeno de pele de jumento. Alguns acreditam que possui propriedades medicinais. Estima-se que o setor exija aproximadamente 4,8 milhões de peles de jumento por ano. Independentemente do futuro que os jumentos terão, devemos garantir uma vida com o mínimo de dignidade aos animais sob nossa responsabilidade. A preocupação ética também inclui o papel cultural dos jumentos. Os jumentos desenvolveram um papel essencial no Brasil, especialmente na Região Nordeste do país, carregando nas costas todo o tipo de material de construção, água e comida e, como consequência, ajudando o ser humano a construir as cidades no sertão. Devido à estreita relação com os seres humanos, os jumentos também estão participando da cultura. Essa importância central foi reconhecida por vários artistas brasileiros ao longo da história. Temos muitos exemplos de músicas, livros, "cordéis" (literatura típica brasileira), poemas, documentários, filmes, xilogravuras e esculturas feitos em homenagem a esse importante ator. Aqui descrevemos alguns exemplos dessa relação humano-jumento e sua influência em nossa cultura.(AU)

Donkey skin trade: is it sustainable to slaughter donkeys for their skin? / Comércio de pele de jumentos: é sustentável abater jumentos para o uso de sua pele?

Donkeys (Equus asinus) face a global crisis. The health, welfare, and even survival of donkeys are being compromised as the demand for their skins increases. It is driven by the production of ejiao, a traditional Chinese remedy believed by some to have medicinal properties. It is estimated that the ejiao industry currently requires approximately 4.8 million donkey skins per year. Since there is no productive chain for donkey skin production outside of China, the activity is extractive and has resulted in the decimation of donkeys. Gestation is 12 months in donkeys, increasing the risk of extinction if such practices are not controlled. In this scenario, the donkeys are collected (purchased for low prices, stolen, and collected from the side of the roads) and are then often transported for long distances, usually without water, food, or rest. The trade, in Brazil, poses significant biosecurity risks, particularly because examinations are rarely conducted and therefore infectious diseases, such as glanders and infectious anemia, remain undetected. Furthermore, in chronic stress situations, the immune system is suppressed, increasing the biosecurity risk, especially because donkeys are a silent carrier of diseases. Rarely there is traceability with animals from different origins being put together in "fake farms", before being delivered to slaughterhouses. The opportunistic strategy of collecting animals, or buying for low prices, keeping them without access to food and veterinary assistance, is what makes this trade profitable. Our experience in donkey welfare and the global skin trade suggest that it will be enormously challenging and cost-prohibitive to run a trade at the standards required to be considered humane, sustainable, and safe. Although donkeys are being blamed for the involvement in road accidents, it is not an ethical solution to maintain this trade as an alternative. Moreover, the ecological role of donkeys in native ecosystems has not been elucidated, and some studies indicate they could even have a positive effect. Regardless of the future the donkeys will have; we must guarantee a life with the least dignity to the animals under our responsibility.(AU)

Os jumentos (Equus asinus) estão enfrentando uma crise global. A saúde, o bem-estar e até a sobrevivência dos jumentos estão sendo comprometidos à medida que a demanda por suas peles aumenta. A atividade é impulsionada pela produção de ejiao, um remédio tradicional chinês que algumas pessoas acreditam possuir propriedades medicinais. Estima-se que a indústria de ejiao demande atualmente cerca de 4,8 milhões de peles de jumento por ano. Uma vez que não existe uma cadeia produtiva fora da China, a atividade é extrativista e resultou na drástica redução das populações. A gestação dos jumentos é de 12 meses, aumentando o risco de extinção se tais práticas não forem controladas. Neste cenário, os jumentos são recolhidos (comprados a preços baixos, roubados e recolhidos à beira das estradas) e são frequentemente transportados para longas distâncias, normalmente sem água, comida ou descanso. O comércio no Brasil apresenta riscos significativos de biossegurança, principalmente porque os exames raramente são realizados e, portanto, doenças infecciosas, como mormo e anemia infecciosa equina, permanecem sem detecção. Além disso, em situações de estresse crônico, o sistema imunológico é suprimido, aumentando o risco de biossegurança, principalmente porque os jumentos são portadores silenciosos de doenças. Raramente há rastreabilidade, e os animais de diferentes origens acabam sendo colocados em "fazendas fantasma", antes de serem entregues aos abatedouros. A estratégia oportunista de coletar animais, ou comprar por preços irrisórios, mantendo-os sem acesso a alimentação e assistência veterinária, é o que torna esse comércio lucrativo. Nossa experiência em bem-estar de jumentos e no comércio global de peles sugere que será extremamente desafiador e com custo proibitivo administrar um comércio dentro dos padrões exigidos para ser considerado humano, sustentável e seguro. Embora os jumentos sejam responsabilizados pelo envolvimento em acidentes rodoviários, não é uma solução ética manter este comércio como uma alternativa. Além disso, o papel ecológico dos jumentos nos ecossistemas nativos não foi elucidado, e alguns estudos indicam que eles podem até ter um efeito positivo. Independentemente do futuro que os jumentos terão, devemos garantir uma vida com o mínimo de dignidade aos animais sob nossa responsabilidade.(AU)

The human-animal relationship and its influence in our culture: the case of donkeys / A relação homem-animal e sua influência em nossa cultura: o caso dos jumentos

Donkeys (Equus asinus) face a global crisis. Their health, welfare, and even their local survival are compromised as the demand for their skins increases. Such demand for donkey skins aims to supply the ejiao industry. Ejiao is a traditional remedy made from the collagen of donkey skins. Some people believe it has medicinal properties. It is estimated that the ejiao industry currently requires approximately 4.8 million donkey skins per year. Although the future of the donkeys is still uncertain, we must guarantee a life free from suffering to the animals under our responsibility. The trade of donkey skins also undermines the cultural role of donkeys. Donkeys have developed an essential role in Brazil, especially in the Northeast region of the country, carrying on their backs construction materials, water, and food, and, as a consequence, helping people build cities in the deepest hinterland. The close relationship between people and donkeys affords donkeys a unique place in the local culture. This central importance has been recognized by Brazilian artists throughout history. We have many examples of songs, books, "cordeis" (typical Brazilian literature), poems, documentaries, movies, woodcuts, paintings, and sculptures, created to honor this important actor. Here we describe some examples of this human-donkey relationship, and its influence on our culture.(AU)

Os jumentos (Equus asinus) estão enfrentando uma crise global. A saúde, o bem-estar e, principalmente, a sobrevivência dos jumentos está sendo comprometida à medida que a demanda por suas peles aumenta. Essa demanda por peles de jumento visa abastecer a indústria de ejiao. Ejiao é um remédio tradicional feito de colágeno de pele de jumento. Alguns acreditam que possui propriedades medicinais. Estima-se que o setor exija aproximadamente 4,8 milhões de peles de jumento por ano. Independentemente do futuro que os jumentos terão, devemos garantir uma vida com o mínimo de dignidade aos animais sob nossa responsabilidade. A preocupação ética também inclui o papel cultural dos jumentos. Os jumentos desenvolveram um papel essencial no Brasil, especialmente na Região Nordeste do país, carregando nas costas todo o tipo de material de construção, água e comida e, como consequência, ajudando o ser humano a construir as cidades no sertão. Devido à estreita relação com os seres humanos, os jumentos também estão participando da cultura. Essa importância central foi reconhecida por vários artistas brasileiros ao longo da história. Temos muitos exemplos de músicas, livros, "cordéis" (literatura típica brasileira), poemas, documentários, filmes, xilogravuras e esculturas feitos em homenagem a esse importante ator. Aqui descrevemos alguns exemplos dessa relação humano-jumento e sua influência em nossa cultura.(AU)

Larvicide Activity on Aedes aegypti of Essential Oil Nanoemulsion from the Protium heptaphyllum Resin.

The aim of this work was to prepare a nanoemulsion containing the essential oil of Protium heptaphyllum resin and to evaluate the larvicidal activity and the residual larvicidal effect against Aedes aegypti. The essential oil was identified by gas chromatography coupled to a mass spectrometer, and the nanoemulsions were prepared using a low-energy method and characterized by photon correlation spectroscopy. The results indicated the major constituents as p-cimene (27.70%) and α-Pinene (22.31%). Nanoemulsions had kinetic stability and a monomodal distribution in a hydrophilic-lipophilic balance of 14 with particle diameters of 115.56 ± 1.68 nn and zeta potential of -29.63 ± 3.46 mV. The nanoemulsion showed larvicidal action with LC50 = 2.91 µg∙mL-1 and residual larvicidal effect for 72 h after application to A. aegypti larvae. Consequently, the nanobiotechnological product derived from the essential oil of P. heptaphyllum resin could be used against infectious disease vectors.

Side Effects of Organic Products on Telenomus podisi (Hymenoptera: Platygastridae).

Telenomus podisi Ashmead, 1893 is an important biocontrol agent, both in conventional and organic production systems. It can be used in association with other control strategies, such as natural botanical products and biological insecticides. Studies of selectivity and side effects are fundamental for proper management of insect control strategies because the interaction between different control strategies may negatively affect T. podisi. In this context, the present study evaluated the side effects of commercial natural products on T. podisi under laboratory conditions. Five natural products (insecticide, fungicide, and leaf fertilizer) allowed in organic farming were evaluated at concentrations recommended by the manufacturer in three bioassays. First bioassay (free-choice test), the preference of T. podisi parasitism between treated and non-treated E. heros eggs was assessed. In the second and third bioassay (no-choice tests) the treatments were applied to E. heros eggs, repectively before and after T. podisi parasitism (pre- and post-parasitism) and parasitism, emergence, offspring sex ratio, developmental time, and adult longevity were assessed. The products formulated with Metarhizium anisopliae (Metsch.) Sorok. (Hypocreales), Beauveria bassiana (Bals.) Vuill. (Hypocreales), orange oil fertilizer, and the fungicide copper oxychloride did not have side effects on T. podisi because they did not affect most of the evaluated characteristics. In contrast, azadirachtin A/B had a sublethal effect due to the reduced parasitism in all tests performed and, although it did not affect other aspects, this could compromise the performance of the parasitoid.

Growth and biomass production of prickly pear in the second cycle irrigated with treated domestic sewage / Crescimento e produção de biomassa da palma forrageira segundo ciclo irrigada com esgoto doméstico tratado

This study aimed to evaluate, in the second cycle, the growth and production of 'Orelha-de-elefante Mexicana' prickly pear (Opuntia sp.) under complementary irrigation with treated domestic sewage. The experiment was carried out in the Milagre Settlement, municipality of Apodi-RN, Brazil, from June 2016 to February 2017. Five treatments were evaluated, corresponding to four irrigation frequencies (2.3, 7.0, 14.0 and 21.0 days) to apply an effluent depth of 3.5 mm, and the control, rainfed cultivation (without irrigation). The experimental design was randomized blocks, with four replicates. After preliminary-primary treatment, the domestic sewage showed acceptable chemical and physical characteristics for fertigation under the conditions adopted in the prickly pear cultivation. 234 days after the 1st cut in the plants, the following morphometric characteristics were measured: plant height and length, width, perimeter, thickness and number of primary and secondary cladodes, and biomass accumulation. Complementary irrigation with treated domestic sewage effluent applied at intervals of 2.3, 7.0, 14.0 and 21.0 days allowed satisfactory growth and production of 'Orelha-de-elefante Mexicana' prickly pear; without irrigation, its development was substantially hampered during the dry period. Complementary irrigation with 3.5 mm of domestic sewage effluent applied at intervals of 2.3, 7.0 and 14.0 days led to highest growth and biomass accumulation in 'Orelha-de-elefante Mexicana' prickly pear.

Objetivou-se com esse trabalho avaliar, no segundo ciclo, o crescimento e a produção da palma forrageira orelha-de-elefante (Opuntia sp), conduzida sob irrigação complementar, com esgoto doméstico tratado. O experimento foi realizado no Assentamento Milagre, município de Apodi/RN, no período de junho/2016 a fevereiro/2017. Foram estudados cinco tratamentos, sendo quatro frequências de irrigação (2,3; 7; 14 e 21 dias), para aplicar uma lâmina de 3,5 mm de efluente, e a testemunha, cultivo em sequeiro (sem irrigação). Utilizou-se o delineamento de blocos casualizados com quatro repetições. A água de esgoto doméstico após passar pelo tratamento preliminar-primário apresentou características químicas e biológicas aceitáveis para a fertirrigação nas condições utilizadas no cultivo da palma. Após 234 dias do 1º corte realizado na palma, foram feitas medições das características morfométricas: altura de planta, comprimento, largura, perímetro, espessura e número de cladódios primário e secundário e acúmulo de biomassa. A complementação hídrica realizada por irrigação com intervalos de 2,3; 7,0; 14,0 e 21,0 dias, viabilizou satisfatoriamente o crescimento e a produção da palma forrageira orelha de elefante que, sem irrigação, teve seu desenvolvimento bastante comprometido no período seco. A complementação hídrica com 3,5 mm de água de esgoto doméstico tratado por irrigação, com intervalos de 2,3; 7,0 e 14,0 promovem o maior crescimento e acúmulo de biomassa da palma forrageira orelha de elefante.

Physiotherapy Questionnaires App to Deliver Main Musculoskeletal Assessment Questionnaires: Development and Validation Study.

BACKGROUND: Patient-reported outcomes (PROs) translate subjective outcomes into objective data that can be quantified and analyzed. Nevertheless, the use of PROs in their traditional paper format is not practical for clinical practice due to limitations associated with the analysis and management of the data. To address the need for a viable way to group and utilize the main functioning assessment tools in the field of musculoskeletal disorders, the Physiotherapy Questionnaires app was developed. OBJECTIVE: This study aims to explain the development of the app, to validate it using two questionnaires, and to analyze whether participants prefer to use the app or the paper version of the questionnaires. METHODS: In the first stage, the app for an Android operational system was developed. In the second stage, the aim was to select questionnaires that were most often used in musculoskeletal clinical practice and research. The Foot and Ankle Outcome Score (FAOS) and American Orthopaedic Foot and Ankle Society (AOFAS) questionnaire were selected to validate the app. In total, 50 participants completed the paper and app versions of the AOFAS and 50 completed the FAOS. The study's outcomes were the correlation of the data between the paper and app versions as well as the preference of the participants between the two versions. RESULTS: The app was approved by experts after the adaptations of the layout for mobile phones and a total of 18 questionnaires were included in the app. Moreover, the app allows the generation of PDF and Excel files with the patients' data. In regards to validity, the mean of the total scores of the FAOS were 91.54% (SD 8.86%) for the paper version and 91.74% (SD 9.20%) for the app. There was no statistically significant differences in the means of the total scores or the subscales (P=.11-.94). The mean total scores for the AOFAS were 93.94 (SD 8.47) for the paper version and 93.96 (SD 8.48) for the app. No statistically significant differences were found for the total scores for the AOFAS or the subscales (P>.99). The app showed excellent agreement with the paper version of the FAOS, with an ICC value of 0.98 for the total score (95% CI 0.98-0.99), which was also found for the AOFAS with the ICC for the total score of 0.99 (95% CI 0.98-0.99). For compliance, 72% (36/50) of the participants in the FAOS group and 94% (47/50) in the AOFAS group preferred the app version. CONCLUSIONS: The Physiotherapy Questionnaires app showed validity and high levels of compliance for the FAOS and AOFAS, which indicates it is not inferior to the paper version of these two questionnaires and confirms its viability and feasibility for use in clinical practice.

The association of ankle dorsiflexion and dynamic knee valgus: A systematic review and meta-analysis.

OBJECTIVE: The objective of this systematic review was to evaluate the association between ankle dorsiflexion (ADF) and dynamic knee valgus (DKV). METHODS: Electronic searches were conducted in MEDLINE, EMBASE, CINAHL and SPORTDiscus. A modified Downs and Black checklist was used for quality assessment and meta-analysis was performed to compare standardised mean differences (SMD) of ADF. RESULTS: Seventeen studies met the inclusion criteria. Meta-analysis showed that reduced ADF is associated with participants presenting with DKV compared to controls (SMD -0.65, 95% CI -0.88 to -0.41). Subgroup analysis showed consistent results regarding different forms of ADF measurement; restriction in ADF measured in weight-bearing position (SMD -1.25, 95% CI -2.24 to -0.25), non-weight-bearing with knee flexed (SMD -0.56, 95% CI -0.97 to -0.16) or non-weight-bearing with knee extended (SMD -0.54, 95% CI -0.80 to -0.28) was significantly associated with DKV. CONCLUSION: The meta-analysis results provide evidence that reduced ADF is correlated with DKV. The assessment of ADF in the clinical setting is important, as it may be related to harmful movement patterns of the lower limbs.

Determination of Aerobic Performance in Youth Soccer Players: Effect of Direct And Indirect Methods.

This study was conducted to correlate and compare values for variables determined in indirect tests with the values determined directly in youth soccer players. The study subjects were 27 youth soccer players (age 16.77 ± 0.75 years; body mass 63.29 ± 7.37 kg; body height 174.14 ± 8.46 cm) playing in the basic categories of a first division team at the regional level of Brazilian soccer. Each subject was evaluated with the following tests: a) a treadmill test to directly determine values of VO2max and Vamax (Treadmill); b) an indirect Shuttle Run Test (SRT); c) an indirect Carminatti's test (TCar). VO2max showed significantly different values in the Treadmill and the SRT (59.21 ± 5.88 and 50.67 ± 3.58 ml⋅kg-1⋅min-1, respectively). Similarly, values obtained for VPeak in the treadmill test and for Vamax in TCar were different from values for SRT VPeak (15.01 ± 1.10, 14.92 ± 0.87 and 12.64 ± 0.62 km⋅h-1, respectively). A correlation analysis showed a moderate relationship between values for VPeak TCar and VO2max determined on a treadmill (r = 0.46) and Vamax determined on a treadmill (r = 0.54). The analysis also showed a high correlation between values of VO2max determined on the treadmill and VO2max evaluated in the SRT (r = 0.69), as well as VPeak determined in the SRT and VO2max tested on the treadmill (r = 0.71), as well as between VPeak determined in the SRT and VO2max evaluated on the treadmill (r = 0.77). We concluded that the SRT underestimated values of VO2max and Vamax. Additionally, VPeak TCar showed no difference compared to Vamax, although it did show a low correlation with it. In addition the SRT, even with high correlations, did not seem to be a great predictor of aerobic fitness in youth soccer players.

BIOMECHANICAL DIFFERENCES IN BRAZILIAN JIU-JITSU ATHLETES: THE ROLE OF COMBAT STYLE.

BACKGROUND: Brazilian Jiu-Jitsu (BJJ) athletes can be divided into two combat styles: pass fighters (PFs) and guard fighters (GFs). Flexibility of the posterior chain muscles is highly necessary in these athletes, especially in GFs. On the other hand, isometric strength of the trunk extensors is required in PFs. Handgrip strength is important in holding the kimono of the opponent, and symmetrical lower-limb strength is important for the prevention of injuries due to the overload caused by training. PURPOSE: The aim of this study was to compare the biomechanical profiles of BJJ athletes with different combat styles using the following outcome measures: flexibility, trunk extensor isometric endurance, postural balance, handgrip isometric endurance and lower-limb muscle strength. METHODS: A cross-sectional study was conducted using 19 GFs and 19 PFs. The sit-and-reach test was used to evaluate the flexibility of the posterior chain muscles. The Biodex Balance System® was used to evaluate balance. A handgrip dynamometer and a dorsal dynamometer were used to evaluate handgrip and trunk extensor endurance, respectively. Quadriceps and hamstring strength were evaluated with an isokinetic dynamometer at 60 °/s. RESULTS: No differences were observed between groups in terms of flexibility, balance, handgrip isometric endurance or quadriceps and hamstring strength; however, PFs (81.33) showed more isometric trunk extension endurance than GFs (68.85) (p = 0.02). Both groups had low values for hamstring/quadriceps ratio. CONCLUSION: No significant biomechanical differences were observed between PFs and GFs. LEVEL OF EVIDENCE: 2b.

Germinação de 15 espécies vegetais do cerrado sob diferentes condições de luz / Germination of 15 cerrado plant species under different light conditions

A ausência de conhecimento sobre a germinação de plantas do Cerrado tem sido apontada como importante obstáculo à propagação dessas espécies e, consequentemente, à restauração da vegetação. Assim, o objetivo deste estudo foi investigar o comportamento de quinze espécies herbáceas, arbustivas e arbóreas do Cerrado, semeadas em diferentes condições de luz. Realizamos um experimento em viveiro, onde as sementes foram expostas a pleno sol e sob sombreamento a 75%, com cinco repetições por espécie e 10 tubetes por repetição, totalizando 1500 sementes. Acompanhamos a germinação diariamente durante nove meses. Das quinze espécies estudadas doze germinaram, sendo três apenas na sombra e quatro apenas a pleno sol. De modo geral, a germinação foi baixa, sendo que seis espécies tiveram no máximo 10% de sementes germinadas. Somente duas espécies apresentaram germinação superior a 50%. Três espécies apresentaram diferenças significativas entre os dois tratamentos para a germinação: Cyrtocymura scorpioides e Fimbristylis autumnalis, típicas de fisionomias campestres, cuja germinação foi maior a pleno sol, e Styrax pohlii, espécie de ambiente florestal, que germinou mais à sombra, características essas que podem explicar os resultados observados. Algumas espécies permaneceram viáveis no substrato por muito tempo e continuaram germinando mesmo cinco meses após a semeadura. Esses resultados confirmam que a luz pode influenciar diferentemente a germinação das plantas do Cerrado. As baixas taxas de germinação e a variabilidade no tempo para germinar são importantes desafios a serem superados pela ciência e pela tecnologia para a propagação das espécies do Cerrado, seja por meio da produção de mudas ou semeadura direta. Informações sobre as respostas das espécies a diferentes fatores abióticos são essenciais para aumentar as chances de sucesso dessas técnicas, permitindo ampliar o número de espécies a serem utilizados na restauração.

The lack of knowledge about germination of Brazilian Savanna species has been pointed out as an important constrain to their propagation and, as a consequence, to ecological restoration. The aim of this study was to assess the germination of fifteen herb, shrub and tree Savanna species under different light conditions. We carried out a nursery experiment, sowing the seeds under full sunlight and 75% shade. The experimental design comprised five replicates per species and 10 pots per replicate, in a total of 1500 seeds. We monitored germination daily during nine months. Twelve out of the fifteen species germinated, being three exclusively under 75% shade and four exclusively under full sun. The overall germination was low; six species showed no more than 10% of germination and only two species germinated more than 50%. Three species differed significantly between treatments: Cyrtocymura scorpioides and Fimbristylis autumnalis, which are frequent in open grassland savannas and showed higher germination under full sun, and Styrax pohlii, which is more common in wooded savannas and had higher germination under shade. The natural occurrence of those species in such environments might help to explain our results. Some species remained viable for a long time in the soil, and still germinated five months after sowing. Our results agree with other studies showing that light may differently affect germination of savanna species. The low germination rates and the variability in the time to germinate are important challenges to be overcome by science and technology for the propagation of the Cerrado species, either through the production of seedlings or direct sowing. Information on species response to different abiotic factors are essential to increase the chances of success of such techniques, and to increase the number of species to be used in restoration projects.

Resources and procedures in the treatment of heavy menstrual bleeding with the levonorgestrel-releasing intrauterine system (LNG-IUS) or hysterectomy in Brazil.

BACKGROUND: Heavy menstrual bleeding (HMB) is the most common complaint of women seeking gynecological care. Treatments included surgical or medical options including hysterectomy and the levonorgestrel-releasing intrauterine system (LNG-IUS) due to the profound suppression of endometrial growth that intrauterine LNG exerts which results in amenorrhea or in a reduction of blood loss. OBJECTIVE: The study was conducted to evaluate the resources and procedures involved in inserting an LNG-IUS compared to performing hysterectomy in women with HMB in a public sector hospital in Brazil. STUDY DESIGN: Two cohorts of women were studied: women who accepted an LNG-IUS (n=124) and matched women who underwent hysterectomy on the same day (n=122). We evaluate the number of procedures carried out in each group of women, including those performed before the decision was made to insert an LNG-IUS or to perform hysterectomy, the insertion of the device itself and the surgical procedure, in addition to the procedures and complications registered up to 1 year after LNG-IUS insertion or hysterectomy. RESULTS: Age and the duration of HMB were significantly lower in the LNG-IUS acceptors than women at the hysterectomy group. The numbers of gynecological consultations and Pap smears were similar in both groups; however, women in the hysterectomy group also underwent laboratory tests, ultrasonography, chest X-ray and electrocardiogram. In the hysterectomy group, the main complications were hemorrhage (six), bladder/bowel perforation (four), complications with anesthesia (one), ureteral reimplantation required (one) and abdominal pain (two). At 1 year, HMB was controlled in 83.1% of women in the LNG-IUS group, and 106 women continued with the device. CONCLUSIONS: Both treatments were effective in HMB control. Fewer resources and complications were observed in LNG-IUS acceptors when compared to hysterectomy. The LNG-IUS represents a good strategy for reducing the number of hysterectomies and the resources required for women with HMB.