Comprehensive analysis of morbidity and mortality patterns in familial partial lipodystrophy patients: insights from a population study.

Background: There is a lack of information on the clinical and molecular presentation of familial partial lipodystrophy (FPLD), a rare genetic disorder characterized by partial subcutaneous fat loss. Objective: This study aimed to provide a comprehensive assessment of the clinical, metabolic, and genetic features of FPLD in the Brazilian population. Methods: In a multicenter cross-sectional investigation we evaluated patients with FPLD across five Brazilian reference centers for lipodystrophies. Diagnosis of FPLD was made by clinical evaluation and genetic confirmation. Data on genetic, clinical, and metabolic characteristics were captured. Statistical analysis involved the utilization of the Kruskal-Wallis test to identify differences. Results: The study included 106 patients with genetic confirmation of FPLD. The mean age was 44 ± 15 years, and they were predominantly female (78.3%). LMNA pathogenic variants were identified in 85.8% of patients, PPARG in 10.4%, PLIN1 in 2.8%, and MFN2 in 0.9%. Diabetes mellitus (DM) was highly prevalent (57.5%), affecting 54 females (50.9%). Median triglycerides levels were 199 mg/dL (54-2724 mg/dL), severe hypertriglyceridemia (≥ 500 mg/dL) was found in 34.9% and pancreatitis in 8.5%. Metabolic-associated fatty liver disease (MAFLD) was observed in 56.6%, and cardiovascular disease in 10.4%. The overall mortality rate was 3.8%, due to cardiovascular events. Conclusion: This study presents an extensive cohort of Brazilian patients with FPLD, predominantly DM with several multisystem complications. A comprehensive characterization of lipodystrophy syndromes is crucial for effective patient management and care.

Maize yield prediction and condition monitoring at the sub-county scale in Kenya: synthesis of remote sensing information and crop modeling.

Agricultural production assessments are crucial for formulating strategies for closing yield gaps and enhancing production efficiencies. While in situ crop yield measurements can provide valuable and accurate information, such approaches are costly and lack scalability for large-scale assessments. Therefore, crop modeling and remote sensing (RS) technologies are essential for assessing crop conditions and predicting yields at larger scales. In this study, we combined RS and a crop growth model to assess phenology, evapotranspiration (ET), and yield dynamics at grid and sub-county scales in Kenya. We synthesized RS information from the Food and Agriculture Organization (FAO) Water Productivity Open-access portal (WaPOR) to retrieve sowing date information for driving the model simulations. The findings showed that grid-scale management information and progressive crop growth could be accurately derived, reducing the model output uncertainties. Performance assessment of the modeled phenology yielded satisfactory accuracies at the sub-county scale during two representative seasons. The agreement between the simulated ET and yield was improved with the combined RS-crop model approach relative to the crop model only, demonstrating the value of additional large-scale RS information. The proposed approach supports crop yield estimation in data-scarce environments and provides valuable insights for agricultural resource management enabling countermeasures, especially when shortages are perceived in advance, thus enhancing agricultural production.

Identifying clusters of precipitation for the Brazilian Legal Amazon based on magnitude of trends and its correlation with sea surface temperature.

Prioritizing watershed management interventions relies on delineating homogeneous precipitation regions. In this study, we identify these regions in the Brazilian Legal Amazon based on the magnitude of Sen's Slope trends using annual precipitation data from September to August, employing the Google Earth Engine platform. Utilizing the silhouette method, we determine four distinct clusters representing zones of homogeneous precipitation patterns. Cluster 0 exhibits a significant median increase in precipitation of 3.20 mm year-1 over the period from 1981 to 2020. Cluster 1 shows a notable increase of 8.13 mm year-1, while Clusters 2 and 3 demonstrate reductions in precipitation of - 1.61 mm year-1 and - 3.87 mm year-1, respectively, all statistically significant. Notably, the region known as the arc of deforestation falls within Cluster 2, indicating a concerning trend of reduced precipitation. Additionally, our analysis reveals significant correlations between Sea Surface Temperature (SST) in various oceanic regions and precipitation patterns over the Brazilian Legal Amazon. Particularly noteworthy is the strong positive correlation with SST in the South Atlantic, while negative correlations are observed with SST in the South Pacific and North Atlantic. These findings provide valuable insights for enhancing climate adaptation strategies in the Brazilian Legal Amazon region.

Persistent high mortality rates for Diabetes Mellitus and Hypertension after excluding deaths associated with COVID-19 in Brazil, 2020-2022.

INTRODUCTION: The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) posed a significant public health challenge globally, with Brazil being no exception. Excess mortality during this period reached alarming levels. Cardiovascular diseases (CVD), Systemic Hypertension (HTN), and Diabetes Mellitus (DM) were associated with increased mortality. However, the specific impact of DM and HTN on mortality during the pandemic remains poorly understood. METHODS: This study analyzed mortality data from Brazil's mortality system, covering the period from 2015 to 2022. Data included all causes of death as listed on death certificates, categorized by International Classification of Diseases 10th edition (ICD-10) codes. Population data were obtained from the Brazilian Census. Mortality ratios (MRs) were calculated by comparing death rates in 2020, 2021, and 2022 to the average rates from 2015 to 2019. Adjusted MRs were calculated using Poisson models. RESULTS: Between 2015 and 2022, Brazil recorded a total of 11,423,288 deaths. Death rates remained relatively stable until 2019 but experienced a sharp increase in 2020 and 2021. In 2022, although a decrease was observed, it did not return to pre-pandemic levels. This trend persisted even when analyzing records mentioning DM, HTN, or CVD. Excluding death certificates mentioning COVID-19 codes, the trends still showed increases from 2020 through 2022, though less pronounced. CONCLUSION: This study highlights the persistent high mortality rates for DM and HTN in Brazil during the years 2020-2022, even after excluding deaths associated with COVID-19. These findings emphasize the need for continued attention to managing and preventing DM and HTN as part of public health strategies, both during and beyond the COVID-19 pandemic. There are complex interactions between these conditions and the pandemic's impact on mortality rates.

Metabolic causes of liver disease among adults living with HIV from low- and middle-income countries: a cross-sectional study.

INTRODUCTION: Liver disease is a leading cause of morbidity and mortality among persons living with HIV (PLHIV). While chronic viral hepatitis has been extensively studied in low- and middle-income countries (LMICs), there is limited information about the burden of metabolic disorders on liver disease in PLHIV. METHODS: We conducted a cross-sectional analysis of baseline data collected between October 2020 and July 2022 from the IeDEA-Sentinel Research Network, a prospective cohort enrolling PLHIV ≥40 years on antiretroviral treatment (ART) for ≥6 months from eight clinics in Asia, Americas, and central, East, southern and West Africa. Clinical assessments, laboratory testing on fasting blood samples and liver stiffness measurement (LSM)/controlled attenuation parameter (CAP) by vibration-controlled transient elastography were performed. Multivariable logistic regression models assessed factors associated with liver fibrosis (LSM ≥7.1 kPa) and steatosis (CAP ≥248 dB/m). Population attributable fraction (PAF) of each variable associated with significant liver fibrosis was estimated using Levin's formula. RESULTS: Overall, 2120 PLHIV (56% female, median age 50 [interquartile range: 45-56] years) were included. The prevalence of obesity was 19%, 12% had type 2 diabetes mellitus (T2DM), 29% had hypertension and 53% had dyslipidaemia. The overall prevalence of liver fibrosis and steatosis was 7.6% (95% confidence interval [CI] 6.1-8.4) and 28.4% (95% CI 26.5-30.7), respectively, with regional variability. Male sex at birth (odds ratio [OR] 1.62, CI 1.10-2.40), overweight/obesity (OR = 2.50, 95% CI 1.69-3.75), T2DM (OR 2.26, 95% CI 1.46-3.47) and prolonged exposure to didanosine (OR 3.13, 95% CI 1.46-6.49) were associated with liver fibrosis. Overweight/obesity and T2DM accounted for 42% and 11% of the PAF for liver fibrosis, while HBsAg and anti-HCV accounted for 3% and 1%, respectively. Factors associated with steatosis included overweight/obesity (OR 4.25, 95% CI 3.29-5.51), T2DM (OR 2.06, 95% CI 1.47-2.88), prolonged exposure to stavudine (OR 1.69, 95% CI 1.27-2.26) and dyslipidaemia (OR 1.68, 95% CI 1.31-2.16). CONCLUSIONS: Metabolic disorders were significant risk factors for liver disease among PLHIV in LMICs. Early recognition of metabolic disorders risk factors might be helpful to guide clinical and lifestyle interventions. Further prospective studies are needed to determine the causative natures of these findings.

Gestational and neonatal outcomes of women with partial Dunnigan lipodystrophy.

Introduction: Lipodystrophies are a group of disorders characterized by selective and variable loss of adipose tissue, which can result in an increased risk of insulin resistance and its associated complications. Women with lipodystrophy often have a high frequency of polycystic ovary syndrome (PCOS) and may experience gynecological and obstetric complications. The objective of this study was to describe the gestational outcomes of patients with familial partial lipodystrophy type 2 (FPLD2) at a reference center with the aim of improving the understanding and management of pregnant women affected by this condition. Methods: This was a retrospective analysis of data obtained from questionnaires regarding past pregnancies and a review of medical records from the beginning of follow-up in outpatient clinics. Results: All women diagnosed with FPLD2 who had previously become pregnant were included in this study (n=8). The women in the study experienced pregnancies between the ages of 14 and 38 years, with an average of 1.75 children per woman. The pregnancies in question were either the result of successful conception within 12 months of attempting to conceive or unplanned pregnancies. During pregnancy, two women (25%) were diagnosed with gestational diabetes mellitus (GDM), one (12.5%) with gestational hypothyroidism, and one (12.5%) with preeclampsia. Among the 17 pregnancies, two miscarriages (11.8%) occurred, and five cases (29.4%) of macrosomia were observed. Four instances of premature birth and an equal number of neonatal hypoglycemia cases were recorded. The reported neonatal complications included an unspecified malformation, respiratory infection, and two neonatal deaths related to heart malformation and respiratory distress syndrome. Conclusion: Our data showed a high frequency of fetal complications in women with FPLD2. However, no instances of infertility or prolonged attempts to conceive have been reported, highlighting the significance of employing effective contraception strategies to plan pregnancies at optimal times for managing metabolic comorbidities.

Single-Molecule Investigation of the Binding Interface Stability of SARS-CoV-2 Variants with ACE2.

The SARS-CoV-2 pandemic spurred numerous research endeavors to comprehend the virus and mitigate its global severity. Understanding the binding interface between the virus and human receptors is pivotal to these efforts and paramount to curbing infection and transmission. Here we employ atomic force microscopy and steered molecular dynamics simulation to explore SARS-CoV-2 receptor binding domain (RBD) variants and angiotensin-converting enzyme 2 (ACE2), examining the impact of mutations at key residues upon binding affinity. Our results show that the Omicron and Delta variants possess strengthened binding affinity in comparison to the Mu variant. Further, using sera from individuals either vaccinated or with acquired immunity following Delta strain infection, we assess the impact of immunity upon variant RBD/ACE2 complex formation. Single-molecule force spectroscopy analysis suggests that vaccination before infection may provide stronger protection across variants. These results underscore the need to monitor antigenic changes in order to continue developing innovative and effective SARS-CoV-2 abrogation strategies.

Lateral spatial biases in naturalistic and simulated driving: Does pseudoneglect influence performance?

Whereas a rightward bump is more likely than a leftward bump when walking through a doorway, investigations into potential similar asymmetries for drivers are limited. The research presented here aims to determine the influence of innate lateral spatial biases when driving. Data from the Strategic Highway Research Program Naturalistic Driving Study (SHRP 2 NDS) and a driving simulation were used to address our research questions. Data points from SHRP 2 were aggregated within relevant variables (e.g., left/right obstacles). In the simulation, participants drove in ways that were consistent with their everyday driving in urban and rural environments. Collision frequency, collision severity and average lateral lane position were analyzed with rightward biases throughout both analyzes. SHRP 2 data indicated greater likelihoods of collisions when vehicles crossed the right line/edge of the road and when making a right turn. There were more collisions with obstacles on the right side, which were also more severe, and greater rightward lane deviations in the driving simulation, contrasted with more severe collisions on the left side in SHRP 2 data, possibly because of the presence of traffic. These findings suggest that previously observed rightward biases in distant space when walking are also present when driving.

Smoking Cessation Is Associated With Short-Term Improvement of Vascular Health in a Cohort of People Living With HIV in Rio de Janeiro, Brazil.

Smoking is highly prevalent in people living with HIV/AIDS (PLHA), leading to detrimental effects in different tissues. We examined the effects of nicotine replacement therapy (NRT) on smoking cessation and vascular health. From December 2019 to October 2021, we prospectively enrolled PLHA who were actively smoking. The primary outcome was endothelial function measured by brachial artery flow-mediated dilatation (FMD). We evaluated the percent change in FMD compared to the baseline measure (Δ%FMD) to detect improvements among participants who quit smoking. To confirm the results, we used linear regression models to account for classical cardiovascular (CV) confounders. We included 117 participants with median age of 45.5 years (IQR= 36.4-54.8); 22 (20.4%) had hypertension, 9 (8.3%) had diabetes, almost half were smoking 20+ cigarettes/day (41.7%). After 12 weeks 30.76% participants quit smoking. Comparison of Δ%FMD change from baseline to week 12 showed that among participants adherent to therapy, there has been an increase in Δ%FMD when compared to those who relapsed (1.17% [0.29-2.98] vs -0.19% [-1.95-0.91], p<0.001). After adjustment for CV factors, multiple linear regression showed that Δ%FMD in participants who quit smoking presented a 2.54 mean increase in comparison to those who continued smoking (p=0.007). In conclusion, this study provides evidence that a strategy of NRT and counseling is modestly effective for smoking cessation in PLHA and improves vascular health in a short period of time. This reinforces the importance of the widespread anti-tobacco programs in HIV clinics and the expected impact lowering the incidence of future cardiovascular events.

Brazilian evidence-based guideline for screening, diagnosis, treatment, and follow-up of metabolic dysfunction-associated steatotic liver disease (MASLD) in adult individuals with overweight or obesity: A joint position statement from the Brazilian Society of Endocrinology and Metabolism (SBEM), Brazilian Society of Hepatology (SBH), and Brazilian Association for the Study of Obesity and Metabolic Syndrome (Abeso).

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as Nonalcoholic fatty liver disease (NAFLD), is one of the most common hepatic diseases in individuals with overweight or obesity. In this context, a panel of experts from three medical societies was organized to develop an evidence-based guideline on the screening, diagnosis, treatment, and follow-up of MASLD. Material and methods: A MEDLINE search was performed to identify randomized clinical trials, meta-analyses, cohort studies, observational studies, and other relevant studies on NAFLD. In the absence of studies on a certain topic or when the quality of the study was not adequate, the opinion of experts was adopted. Classes of Recommendation and Levels of Evidence were determined using prespecified criteria. Results: Based on the literature review, 48 specific recommendations were elaborated, including 11 on screening and diagnosis, 9 on follow-up,14 on nonpharmacologic treatment, and 14 on pharmacologic and surgical treatment. Conclusion: A literature search allowed the development of evidence-based guidelines on the screening, diagnosis, treatment, and follow-up of MASLD in individuals with overweight or obesity.

Watermelon (Citrullus lanatus) rind flour: Development and characterization of a novel watermelon byproduct.

Watermelon (Citrullus lanatus) is a fruit widely consumed by the Brazilian population; however, its rind is usually discarded, despite its nutritional value. This work aimed to develop a watermelon rind flour (WRF) and a fiber-rich bread. The WRF was submitted to microbiological analysis, proximate composition, antioxidant activity, and a profile of phenolic compounds. Six types of bread were developed: three using WRF (20%, 30%, and 40% of wheat flour replacement) and three control samples (only wheat flour), which were submitted to the same analysis, in addition to colorimetric properties, instrumental texture profile, and sensory evaluation (check-all-that-apply, purchase intent, and acceptance test). A high fiber content was observed in WRF (27.15%). The total concentration of phenolic compounds was 2.38 ± 0.20 mg of gallic acid equivalent per g and benzoic acid was the main compound found (73.50 mg/100 g WRF). The results of the antioxidant capacity through the DPPH method indicated a 30% reduction. The WRF 40% bread had 3.06 g of insoluble fiber, characterizing itself as a source of fiber. In the instrumental texture analysis, it was observed that bread hardness increased significantly as the WRF content increased. The formulation of the bread containing WRF is an alternative for the use of waste, favoring the development of a fiber-source product, with a functional food claim.

Siglec 15 as a biomarker or a druggable molecule for non-small cell lung cancer.

Lung cancer has been the main cause of cancer mortality worldwide. Furthermore, lung cancer rates of new cases per year evidenced a large incidence of this neoplasm in both men and women. Because there is no biomarker for early detection, it is frequently detected late, at an advanced state. The introduction of multiple lines of tyrosine kinase inhibitors in patients with EGFR, ALK, ROS1, and NTRK mutations has modified the therapy of lung cancer. Immunotherapy advances have resulted in substantial improvements in overall survival and disease-free survival, making immune checkpoint inhibitors (ICIs) a potential option for lung cancer treatment. Current PD-1/PD-L1/CTLA-4 immunotherapies have resulted in important response and survival rates. However, existing medicines only function in around 20% of unselected, advanced NSCLC patients, and primary and acquired resistance remain unsolved obstacles. Therefore, precise predictive indicators must be identified to choose the best patients for ICI treatment. Thus, Sialic acid-binding immunoglobulin-like lectin 15 (Siglec-15) stands out as a potential tumor biomarker, with distinctive expression in normal tissues, in tumor immune involvement, and a high structural similarity to PD-L1. Understanding the tumor immune response and the search for new therapeutic targets leads to the improvement of therapeutic pathways directed at the tumor microenvironment. The present review aims to analyze Siglec-15 potential as a diagnostic, prognostic, and response biomarker in lung cancer, considering its results evidenced in the current literature.

Performance of ChatGPT-4 in answering questions from the Brazilian National Examination for Medical Degree Revalidation.

OBJECTIVE: The aim of this study was to evaluate the performance of ChatGPT-4.0 in answering the 2022 Brazilian National Examination for Medical Degree Revalidation (Revalida) and as a tool to provide feedback on the quality of the examination. METHODS: A total of two independent physicians entered all examination questions into ChatGPT-4.0. After comparing the outputs with the test solutions, they classified the large language model answers as adequate, inadequate, or indeterminate. In cases of disagreement, they adjudicated and achieved a consensus decision on the ChatGPT accuracy. The performance across medical themes and nullified questions was compared using chi-square statistical analysis. RESULTS: In the Revalida examination, ChatGPT-4.0 answered 71 (87.7%) questions correctly and 10 (12.3%) incorrectly. There was no statistically significant difference in the proportions of correct answers among different medical themes (p=0.4886). The artificial intelligence model had a lower accuracy of 71.4% in nullified questions, with no statistical difference (p=0.241) between non-nullified and nullified groups. CONCLUSION: ChatGPT-4.0 showed satisfactory performance for the 2022 Brazilian National Examination for Medical Degree Revalidation. The large language model exhibited worse performance on subjective questions and public healthcare themes. The results of this study suggested that the overall quality of the Revalida examination questions is satisfactory and corroborates the nullified questions.

Waist circumference is independently associated with liver steatosis and fibrosis in LMNA-related and unrelated Familial Partial Lipodystrophy women.

BACKGROUND: Lipodystrophies are a heterogeneous group of diseases characterized by the selective loss of subcutaneous adipose tissue and ectopic fat deposition in different organs, including the liver. This study aimed to determine the frequencies of liver steatosis (LS) and liver fibrosis (LF) in a sample of individuals with LMNA-related and unrelated Familial Partial Lipodystrophy. METHODS: This cross-sectional study included 17 women with LMNA-related FPLD and 15 women with unrelated FPLD. LS and LF were assessed using transient elastography (TE) with FibroScan®. Anthropometric and biochemical variables were included in a multiple linear regression analysis to identify the variables that were independently related to liver disease. RESULTS: Regarding the presence of LF, 22 (68.2%) women were classified as having non-significant fibrosis, and 10 (31.8%) were classified as having significant or severe fibrosis. Regarding LS, only six women (20.7%) were classified as having an absence of steatosis, and 23 (79.3%) had mild to severe steatosis. After multiple linear regression, waist circumference (but not age, body mass index, or waist-to-hip ratio) was found to be independently related to LS and LF. Among the biochemical variables, only triglyceride levels were independently related to LS but not LF. CONCLUSIONS: In women with FPLD, visceral fat accumulation appears to be the most important determinant of liver disease, including LF, rather than fat scarcity in the lower limbs.

2023 UPDATE: Luso-Brazilian evidence-based guideline for the management of antidiabetic therapy in type 2 diabetes.

BACKGROUND: The management of antidiabetic therapy in people with type 2 diabetes (T2D) has evolved beyond glycemic control. In this context, Brazil and Portugal defined a joint panel of four leading diabetes societies to update the guideline published in 2020. METHODS: The panelists searched MEDLINE (via PubMed) for the best evidence from clinical studies on treating T2D and its cardiorenal complications. The panel searched for evidence on antidiabetic therapy in people with T2D without cardiorenal disease and in patients with T2D and atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), or diabetic kidney disease (DKD). The degree of recommendation and the level of evidence were determined using predefined criteria. RESULTS AND CONCLUSIONS: All people with T2D need to have their cardiovascular (CV) risk status stratified and HbA1c, BMI, and eGFR assessed before defining therapy. An HbA1c target of less than 7% is adequate for most adults, and a more flexible target (up to 8%) should be considered in frail older people. Non-pharmacological approaches are recommended during all phases of treatment. In treatment naïve T2D individuals without cardiorenal complications, metformin is the agent of choice when HbA1c is 7.5% or below. When HbA1c is above 7.5% to 9%, starting with dual therapy is recommended, and triple therapy may be considered. When HbA1c is above 9%, starting with dual therapyt is recommended, and triple therapy should be considered. Antidiabetic drugs with proven CV benefit (AD1) are recommended to reduce CV events if the patient is at high or very high CV risk, and antidiabetic agents with proven efficacy in weight reduction should be considered when obesity is present. If HbA1c remains above target, intensification is recommended with triple, quadruple therapy, or even insulin-based therapy. In people with T2D and established ASCVD, AD1 agents (SGLT2 inhibitors or GLP-1 RA with proven CV benefit) are initially recommended to reduce CV outcomes, and metformin or a second AD1 may be necessary to improve glycemic control if HbA1c is above the target. In T2D with HF, SGLT2 inhibitors are recommended to reduce HF hospitalizations and mortality and to improve HbA1c. In patients with DKD, SGLT2 inhibitors in combination with metformin are recommended when eGFR is above 30 mL/min/1.73 m2. SGLT2 inhibitors can be continued until end-stage kidney disease.

Platinum and Palladium Organometallic Compounds: Disrupting the Ergosterol Pathway in Trypanosoma cruzi.

Current treatment for Chagas' disease is based on two drugs, Nifurtimox and Benznidazol, which have limitations that reduce the effectiveness and continuity of treatment. Thus, there is an urgent need to develop new, safe and effective drugs. In previous work, two new metal-based compounds with trypanocidal activity, Pd-dppf-mpo and Pt-dppf-mpo, were fully characterized. To unravel the mechanism of action of these two analogous metal-based drugs, high-throughput omics studies were performed. A multimodal mechanism of action was postulated with several candidates as molecular targets. In this work, we validated the ergosterol biosynthesis pathway as a target for these compounds through the determination of sterol levels by HPLC in treated parasites. To understand the molecular level at which these compounds participate, two enzymes that met eligibility criteria at different levels were selected for further studies: phosphomevalonate kinase (PMK) and lanosterol 14-α demethylase (CYP51). Molecular docking processes were carried out to search for potential sites of interaction for both enzymes. To validate these candidates, a gain-of-function strategy was used through the generation of overexpressing PMK and CYP51 parasites. Results here presented confirm that the mechanism of action of Pd-dppf-mpo and Pt-dppf-mpo compounds involves the inhibition of both enzymes.

Artisanal Goat Coalho Cheese with Cachaça as Flavoring Agent.

Cachaça is a traditional Brazilian drink that has the potential to offer a new sensory and technological strategy for artisanal cheesemaking, particularly for small-scale producers and family farming. This study aimed to investigate the effects of cachaça immersion on the physicochemical, microbiological, color, texture, and sensory parameters of artisanal goat coalho cheeses using three different varieties of cachaça immersion. The results showed that cachaça immersion did not affect the cheese's proximate composition or starter culture viability, indicating its suitability as a new method for artisanal cheese production. Additionally, gold cachaça aged in oak casks was the most effective variety for sensory acceptance and purchase intention, suggesting that it may be a valuable strategy for small-scale producers to add value and encourage the consumption of artisanal goat coalho cheeses without compromising their quality. Thus, this study provides important insights for small-scale producers and family farming to enhance their product offerings and increase their competitiveness in the market.

A Literature Survey on AI-Aided Beamforming and Beam Management for 5G and 6G Systems.

Modern wireless communication systems rely heavily on multiple antennas and their corresponding signal processing to achieve optimal performance. As 5G and 6G networks emerge, beamforming and beam management become increasingly complex due to factors such as user mobility, a higher number of antennas, and the adoption of elevated frequencies. Artificial intelligence, specifically machine learning, offers a valuable solution to mitigate this complexity and minimize the overhead associated with beam management and selection, all while maintaining system performance. Despite growing interest in AI-assisted beamforming, beam management, and selection, a comprehensive collection of datasets and benchmarks remains scarce. Furthermore, identifying the most-suitable algorithm for a given scenario remains an open question. This article aimed to provide an exhaustive survey of the subject, highlighting unresolved issues and potential directions for future developments. The discussion encompasses the architectural and signal processing aspects of contemporary beamforming, beam management, and selection. In addition, the article examines various communication challenges and their respective solutions, considering approaches such as centralized/decentralized, supervised/unsupervised, semi-supervised, active, federated, and reinforcement learning.

O papel do fisioterapeuta junto aos idosos na atenção primária em saúde / The role of the physiotherapist the elderly in primary health care

Objetivo ­ O estudo aqui apresentado abordou sobre um assunto que vem ganhando destaque na área da saúde pública, uma vez que se percebe o aumento considerável de pessoas com mais de 65 anos na sociedade brasileira: o atendimento que deve ser prestado pelo fisioterapeuta aos idosos através da Atenção Primária à Saúde (APS). Para isso, teve-se como objetivo: Demonstrar quais atividades podem ser realizadas pelo profissional de fisioterapia junto aos idosos na Atenção Primária à Saúde para melhorar a sua capacidade funcional, como forma de promover uma melhor qualidade de vida. Métodos ­ A metodologia escolhida foi a realização de uma revisão da literatura, tendo para isso realizado busca em sites especializados, tais como: BVS Saúde, Lilacs, Pubmed, Scielo, entre outros. Discussão ­ A discussão vem apresentar que o fisioterapeuta é um profissional capacitado para realizar um processo de reabilitação resolutiva de acordo com cada caso dos pacientes, respeitando sempre a individualidade, as peculiaridades e as limitações de cada idoso o posicionamento de outros autores sobre o assunto. Conclusão ­ Com base em tudo que foi apresentado nesse estudo, pode-se concluir que o processo reabilitação através da fisioterapia em um idoso dentro da APS é considerado como um desafio, além de ter grande relevância, tanto o atendimento nas unidades, como no domiciliar

Análise ergonômica do trabalho para mototaxista: uma avaliação qualitativa e relato de caso / Ergonomic work analysis for motorcicle taxi drive: a qualitive assessment and case report

Objetivo ­ Devido ao crescimento desenfreado das grandes metrópoles, o mundo do trabalho vem sofrendo com o forte desemprego, fazendo com que a população recorra a outras fontes de renda. Os mototaxistas estão fazendo cada dia mais parte do cotidiano dos brasileiros. Porém esses trabalhadores enfrentam riscos em meio ao trânsito caótico das cidades como acidentes de trânsito, a exposição excessiva aos fatores ambientais como a radiação solar, chuva, barulhos, ruídos, cansaço e estresse, além de queixas de dor em algumas regiões do corpo, principalmente na coluna. Com isso, a Ergonomia entra como uma boa ferramenta para melhorar as condições de trabalho e promover o aumento de produtividade trabalhista desses trabalhadores. Métodos ­ O presente artigo abordou o relato de caso de um mototaxista de Belém-PA. As ferramentas Whoqol-Bref, IDE'S, diagrama de Corlett-Manenica, REBA e o Termo-HigroDecibelímetro-Luxímetro-Anemômetro foram utilizados para a coleta de dados. Discussão ­ As avaliações de temperatura (28ºC33,3ºC), ruídos (77-83,1dB) e luminância (650-5.900lux) apresentam inconformidades de acordo com as normas ergonômicas estabelecidas pela NR-17. Conclusão ­ Os resultados levaram à conclusão que a temperatura, os ruídos e a luminosidade excessiva podem ser fatores ambientais de risco para a saúde do mototaxista, assim como a presença de algias e alterações biomecânicas nas regiões cervical, torácica e lombar. Sendo assim, a atividade de mototaxista foi classificada como alto risco ergonômico pelo método REBA. Descritores: Avali