Smoking, mortality, access to diagnosis, and treatment of lung cancer in Brazil.

INTRODUCTION: Lung cancer (LC) is a relevant public health problem in Brazil and worldwide, given its high incidence and mortality. Thus, the objective of this study is to analyze the distribution of smoking and smoking status according to sociodemographic characteristics and disparities in access, treatment, and mortality due to LC in Brazil in 2013 and 2019. METHOD: Retrospective study of triangulation of national data sources: a) analysis of the distribution of smoking, based on the National Survey of Health (PNS); b) investigation of LC records via Hospital-based Cancer Registry (HCR); and c) distribution of mortality due to LC in the Mortality Information System (SIM). RESULTS: There was a decrease in the percentage of people who had never smoked from 2013 (68.5%) to 2019 (60.2%) and in smoking history (pack-years). This was observed to be greater in men, people of older age groups, and those with less education. Concerning patients registered in the HCR, entry into the healthcare service occurs at the age of 50, and only 19% have never smoked. While smokers in the population are mainly Mixed-race, patients in the HCR are primarily White. As for the initial stage (I and II), it is more common in White people and people who have never smoked. The mortality rate varied from 1.00 for people with higher education to 3.36 for people without education. Furthermore, White people have a mortality rate three times higher than that of Black and mixed-race people. CONCLUSION: This article highlighted relevant sociodemographic disparities in access to LC diagnosis, treatment, and mortality. Therefore, the recommendation is to strengthen the Population-Based Cancer Registry and develop and implement a nationwide LC screening strategy in Brazil since combined prevention and early diagnosis strategies work better in controlling mortality from the disease and continued investment in tobacco prevention and control policies.

Synthesis of lignin-based carbon/graphene oxide foam and its application as sensors for ammonia gas detection.

The present study highlights the integration of lignin with graphene oxide (GO) and its reduced form (rGO) as a significant advancement within the bio-based products industry. Lignin-phenol-formaldehyde (LPF) resin is used as a carbon source in polyurethane foams, with the addition of 1 %, 2 %, and 4 % of GO and rGO to produce carbon structures thus producing carbon foams (CFs). Two conversion routes are assessed: (i) direct addition with rGO solution, and (ii) GO reduction by heat treatment. Carbon foams are characterized by thermal, structural, and morphological analysis, alongside an assessment of their electrochemical behavior. The thermal decomposition of samples with GO is like those having rGO, indicating the effective removal of oxygen groups in GO by carbonization. The addition of GO and rGO significantly improved the electrochemical properties of CF, with the GO2% sensors displaying 39 % and 62 % larger electroactive area than control and rGO2% sensors, respectively. Furthermore, there is a significant electron transfer improvement in GO sensors, demonstrating a promising potential for ammonia detection. Detailed structural and performance analysis highlights the significant enhancement in electrochemical properties, paving the way for the development of advanced sensors for gas detection, particularly ammonia, with the prospective market demands for durable, simple, cost-effective, and efficient devices.

Challenging the Dogma: Stage migration or negative lymph nodes, which of them is the main player on gastric cancer prognosis?

Expanding loco-regional nodes harvesting is expected to increase survival. This improvement may be associated to stage migration (SM). However, the great bulk of harvested lymph nodes observed in large dissections is negative. M&M: 830 patients who received R0 gastrectomy for adenocarcinoma were included. pN+ patients with <26 nodes (n = 209) were included for a simulation to "offer 26 nodes" - SM (proportional and exponential based) was simulated and analysed through machine learning algorithms. Overall Survival (OS), in native and simulated stages, were compared. OS of extended lymphadenectomies (pN+, D ≥ 26, n = 273) was compared with the simulated curves. OS of patients in the following dissection intervals of negative nodes were compared: <16 (n = 233), 16-25 (n = 258), ≥26 (n = 339). RESULTS: After simulation to 26 nodes (pN+, D < 26 patients, n = 209), staging was recomputed. OS of native vs simulated early-stages (I-II) and advanced stages (III) were not different (p > 0.05). OS of patients with lymphadenectomy (≥26) was better than simulated for early and advanced stages (p = 0.008; p = 0.005). OS of patients included in distinct intervals of negative lymph nodes were different (p < 0.001). These intervals were an independent prognostic factor (multivariate analysis). CONCLUSIONS: The influence of Stage Migration was null in this set of simulations and Will Rogers phenomenon was not observed. Extended dissection performed better in OS. But the influence of the number of negative nodes, even in large dissections, was highlighted. By emphasizing the role of negative nodes, we aim to facilitate more informed decision-making in management of gastric cancer patients, ultimately leading to improved treatment outcomes and patient care.

Presenteeism and associated factors among women with menstrual symptoms.

PURPOSE: Menstrual characteristics can affect a woman's productivity at work and college, but studies in a general population of adult women are scarce. In addition, it is important to know which menstrual symptoms are most associated with presenteeism in women to promote specific health actions. The present study aimed to assess menstrual symptoms associated with presenteeism in adult women. METHODS: Online cross-sectional study in which menstrual characteristics, including menstrual flow, age of menarche, menstrual pain and cycle duration were assessed by a self-report questionnaire. The menstrual pain intensity was assessed by Numerical Rating Scale, and the presenteeism, by the Stanford Presenteeism Scale-6 (SPS-6). Women were divided in two groups, with and without presenteeism, based on the SPS-6 cutoff point. Data were analyzed by binary logistic regression and presented as odds ratios (OR). RESULTS: Among the 430 women who participated in the study, 44.2% were classified as with presenteeism. Women with severe menstrual flow were more likely to have presenteeism (OR = 2.12) compared with women with mild and moderate menstrual flow. The higher menstrual pain intensity the higher the chances of a woman presenting with presenteeism (OR = 1.29). CONCLUSIONS: These menstrual characteristics (intensity of menstrual flow and menstrual pain) seem to affect women's productivity at work and/or college, and should be assessed in research and clinical practice. Thus, public policies on women's health can be carried out based on these results.

Hepatogenic photosensitization in lambs supplemented with different levels of extruded urea in Brachiaria spp. pastures in the Brazilian Cerrado: Case report.

The aim was to report cases and risk factors for hepatogenous photosensitization in lambs kept on Brachiaria spp. pastures and supplemented with levels of extruded urea (EU). The herd consisted of 69 Texel crossbred lambs with known parentage (fathers and mothers adapted to the consumption of forage of the genus Brachiaria), randomly divided into 5 groups and distributed in individual paddocks for each group. The animals were supplemented with increasing levels of EU (Amireia® 200S): 0, 6, 12, 18, and 24 g of EU per 100 kg-1 of body weight (BW). The concentration of protodioscin was estimated in the mixed pastures of Brachiaria spp. (cv. Marandu and cv. Basilisk), structural components (leaf, stem, and dead material), samples of each cultivar, and in the months of December (2018), February, and April (2019). The animals were examined daily, and when behavioral changes were identified, they underwent clinical examinations and anamnesis. Weighing was performed every 14 days, followed by necropsy and serum biochemical analysis, including gamma-glutamyltransferase (GGT). The highest concentrations of protodioscin (p < 0.0001) were found in the pastures used by animals supplemented without extruded urea (7.07 ± 0.56), in the Basilisk cultivar (11.35 ± 0.06), in the leaf blade components (2.08 ± 0.05), and thatch (2.20 ± 0.00), and in the month of April (7.34 ± 0.29) (the month with the lowest rainfall), respectively. Fourteen (20.29%) cases of photosensitization were observed in lambs, of which six recovered, and eight died. Serum GGT levels ranged from 42.2 to 225 IU/L; however, in animals that died, values ranged from 209.4 to 225 IU/L. The use of levels 12 g and 18 g per 100 kg-1 of body weight of extruded urea may contribute to the lower occurrence of photosensitization, as the animals selected pastures with lower protodioscin content, presenting a smaller number of cases.

Prevalence, pain intensity and symptoms associated with primary dysmenorrhea: a cross-sectional study.

BACKGROUND: Primary dysmenorrhea (PD) is an etiological cyclic pelvic pain related to the menstrual period; it can negatively impact women's quality of life and productivity. The aim of the present study was to estimate the prevalence of PD and analyze associated symptoms in Brazilian women. METHODS: An online cross-sectional study was carried out in Brazil, with a structured questionnaire regarding dysmenorrhea and associated symptoms. PD intensity was measured with the Numerical Rating Scale for Pain and classified as mild (1-3), moderate (4-7) and severe (> 8). The association between qualitative variables was performed using Pearson's Chi-Square Test. The quantification of this association was measured using multinomial logistic regression models, with calculation of Odds Ratio and confidence interval. A significance level of 5% was considered. RESULTS: A total of 10,070 women were included. Most participants classified PD intensity as moderate (40.4%, 41.9% and 49.7%) and severe (21.2%, 24.8% and 28.4%) in the previous month, 3 months and 5 years, respectively. The most common symptoms associated with PD were irritability, abdominal distension sensation, anxiety and feeling more emotional. The increased of the risk (OR > 1.0) for moderate and severe PD-related pain intensity is related to age, nulliparity and presence PD since adolescence. CONCLUSION: There is a high prevalence of PD among Brazilian women, and the most common symptoms reported were irritability, abdominal distension sensation, anxiety and feeling more emotional.

Postlumpectomy imaging: is there a role for the study of the contralateral breast?-a retrospective cohort.

Background: Some patients with breast cancer submitted to breast-conserving surgery might benefit from a postlumpectomy imaging examination previously to radiation therapy. This aims to document the complete removal of cancer and might be accomplished using mammogram with breast and axillary ultrasonography. These modalities study not only the affected side but also the contralateral side. In fact, it is well-documented that women with breast cancer have an increased risk for contralateral breast cancer. Thus, we intended to evaluate the value of postlumpectomy imaging undertaken before adjuvant radiotherapy regarding the evaluation of the contralateral breast and axilla. Methods: In this retrospective study, medical records for patients with breast cancer submitted to breast-conserving surgery and referred to our radiotherapy unit between 2018 and 2019 were reviewed. All patients had to be submitted to bilateral mammogram with breast and axillary ultrasonography previously to radiotherapy. Patients with bilateral disease or with a history of breast cancer were excluded. Results: One thousand two hundred forty patients were analyzed. 19 (1.5%) had suspicious findings for contralateral breast disease, and 8 (0.6%) had a re-excision positive for residual malignancy. Higher age, invasive lobular carcinoma associated or not with lobular carcinoma in situ, and presence of lobular carcinoma in situ were associated with an increased risk for residual disease. Conclusion: Contralateral evaluation as part of postlumpectomy imaging revealed itself useful at detecting contralateral cancer, with some demographic and clinical features being associated with an increased risk for residual disease.

Development of collagenous scaffolds for wound healing: characterization and in vivo analysis.

The development of wound dressings from biomaterials has been the subject of research due to their unique structural and functional characteristics. Proteins from animal origin, such as collagen and chitosan, act as promising materials for applications in injuries and chronic wounds, functioning as a repairing agent. This study aims to evaluate in vitro effects of scaffolds with different formulations containing bioactive compounds such as collagen, chitosan, N-acetylcysteine (NAC) and ε-poly-lysine (ε-PL). We manufactured a scaffold made of a collagen hydrogel bioconjugated with chitosan by crosslinking and addition of NAC and ε-PL. Cell viability was verified by resazurin and live/dead assays and the ultrastructure of biomaterials was evaluated by SEM. Antimicrobial sensitivity was assessed by antibiogram. The healing potential of the biomaterial was evaluated in vivo, in a model of healing of excisional wounds in mice. On the 7th day after the injury, the wounds and surrounding skin were processed for evaluation of biochemical and histological parameters associated with the inflammatory process. The results showed great cell viability and increase in porosity after crosslinking while antimicrobial action was observed in scaffolds containing NAC and ε-PL. Chitosan scaffolds bioconjugated with NAC/ε-PL showed improvement in tissue healing, with reduced lesion size and reduced inflammation. It is concluded that scaffolds crosslinked with chitosan-NAC-ε-PL have the desirable characteristics for tissue repair at low cost and could be considered promising biomaterials in the practice of regenerative medicine.

Effects of organic and inorganic selenium supplementation on frozen-thawed ram semen at two cooling periods.

The aim of this study was to evaluate the effects of different selenium compounds on the sperm quality of cryopreserved ram semen. Ejaculates from four rams, collected using an artificial vagina heated to 38 °C, were individually evaluated. The approved ejaculates were pooled and diluted (1:1 v:v) in Tris-egg yolk extender (20%, v/v) and separated into two control groups, one cooled for 2 h and the other for 4 h. The pooled ejaculates at the two cooling periods were supplemented with two doses (0.5 and 1 µg/mL) of organic selenium (ORG), and inorganic selenium (SeNa), each. The samples were packed in 0.25 ml straws, at a concentration of 400 × 106 sperms/mL and stored in liquid nitrogen. The straws were thawed in a water bath at 37 °C for 20 s, and the samples were subjected to sperm kinetics evaluation by Computer Assisted Semen Analysis software. Sperm membrane integrity, acrosome morphology, and mitochondrial potential were assessed. In addition, oxidative stress markers reactive oxygen species (ROS), ferric reducing antioxidant power (FRAP), thiobarbituric acid reactive species (TBARS), and glutathione peroxidase (GPx) enzyme activity) were also evaluated. No significant improvement was observed in the ram semen quality at the two cooling times. Supplementation of the freezing extender with 0.5 µg/mL ORG, subjected to 4 h cooling period, increased the sperm motility when compared with the control group at the same cooling time. In addition, the 0.5 µg/mL SeNa group, under the 2 h cooling period, showed an increase in sperm motility when compared to the control group at the same cooling period. Considering the importance of sperm motility as a fertility parameter, our study indicates that supplementation with ORG and SeNa can help improve the total motility of the cryopreserved ram semen.

Mathematical models for predicting protodioscin in tropical forage grasses.

Protodioscin is a saponin present in grasses that can lead to losses in animal production. Our hypothesis was that mathematical models can accurately and precisely predict the protodioscin concentration in tropical grasses. We evaluated the ability of four mathematical models to describe the protodioscin concentration in Brachiaria and Panicum cultivars with different regrowth periods. Six cultivars of Panicum: Aruana, Massai, Mombaça, Tanzânia, Tamani, and Zuri; and five of Brachiaria-grass: Marandu, Paiaguás, Piatã, Xaraés and Basilisk. Protodioscin concentration evaluations were carried out at 51, 84, 110, and 111 days of age. Linear, Quadratic, Exponential, and Logarithmic models were evaluated, and the adequacy of the models was verified. The models were compared for accuracy and precision by pairwise mean squared error analysis and the delta Akaike information criterion. The models did not differ from each other in terms of accuracy and precision. The exponential model showed a high ability to explain the observed variability between protodioscin concentration and plant age for Brachiaria grasses. Panicum grasses have constant protodioscin concentration. Mathematical models are capable of predicting the protodioscin concentration in grasses of the genus Brachiaria based on plant age. We recommend Exponential model to predict the concentration of protodioscin in Brachiaria grasses.

Second primary cancers among females with a first primary breast cancer: a population-based study in Northern Portugal.

PURPOSE: To estimate the incidence rate of second primary cancers (SPCs) and the cumulative incidence of metachronous [diagnosed > 2 months after a first primary cancer (FPC)] SPCs in patients with a breast FPC, and to compare the incidence of SPC [overall, synchronous (≤ 2 months of the FPC) and metachronous] with that expected in the general female population. METHODS: A cohort of patients with a breast FPC from the North Region Cancer Registry of Portugal, diagnosed in 2000-2010 (n = 15,981), was followed to 31 December 2015 for synchronous and metachronous SPCs. Cumulative incidence of metachronous SPCs considering death as a competing event, and incidence rates and standardized incidence ratios of SPCs were estimated. RESULTS: The diagnosis of an SPC occurred in 1229 (7.7%) of patients with a breast FPC. SPCs occurred mainly in the breast, followed by digestive organs, lung, thyroid, and female genital organs. Globally, patients with a breast FPC had a higher incidence for all types of cancer compared to the general female population, and in particular for cancers of the breast, stomach, colon, lung, lymphoma, uterus, and ovary. The 10-year cumulative incidence of metachronous SPCs following a breast FPC was 6.6% and the corresponding 10-year cumulative mortality was 26.2%. CONCLUSION: In Portugal, patients with a breast FPC have a higher incidence of cancer compared to the general female population, highlighting important aspects of care, surveillance, and counselling among this growing number of patients.

Effects of health education on women with urinary incontinence: systematic review and meta-analysis.

INTRODUCTION AND HYPOTHESIS: The objective was to investigate the effects of health education (HE) on urinary symptoms and quality of life in women with urinary incontinence (UI). METHODS: A systematic review and meta-analysis of trials evaluating HE for women with UI. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials. RESULTS: The search identified 5,118 articles. Eighteen papers were considered eligible. The interventions investigated included health education (HE), combined intervention, self-management (SM), and structured training (ST). Outcomes included quality of life (QoL), UI frequency, UI severity, impression of improvement, incontinence symptoms, urine leakage, fear of leakage, urgency, and incontinence impact. Compared with the control group there was a significant improvement in the frequency, severity, and impact on the QoL for women with UI (assessed by the total score of the International Consultation on Incontinence Questionnaire Short Form (ICIQ SF); RR = -1.47, 95% CI [-2.07, -0.88]; two trials; low certainty of the evidence). CONCLUSIONS: This review shows that HE seems to be beneficial in the treatment of women with UI when compared with control women (no treatment or general health care), improving the frequency, severity, and impact on QoL assessed by the ICIQ SF total score. However, the certainty of this evidence is low.

Head and neck cancers survival in Europe, Taiwan, and Japan: results from RARECAREnet Asia based on a privacy-preserving federated infrastructure.

Background: The head and neck cancers (HNCs) incidence differs between Europe and East Asia. Our objective was to determine whether survival of HNC also differs between European and Asian countries. Methods: We used population-based cancer registry data to calculate 5-year relative survival (RS) for the oral cavity, hypopharynx, larynx, nasal cavity, and major salivary gland in Europe, Taiwan, and Japan. We modeled RS with a generalized linear model adjusting for time since diagnosis, sex, age, subsite, and histological grouping. Analyses were performed using federated learning, which enables analyses without sharing sensitive data. Findings: Five-year RS for HNC varied between geographical areas. For each HNC site, Europe had a lower RS than both Japan and Taiwan. HNC subsites and histologies distribution and survival differed between the three areas. Differences between Europe and both Asian countries persisted even after adjustments for all HNC sites but nasal cavity and paranasal sinuses, when comparing Europe and Taiwan. Interpretation: Survival differences can be attributed to different factors including different period of diagnosis, more advanced stage at diagnosis, or different availability/access of treatment. Cancer registries did not have stage and treatment information to further explore the reasons of the observed survival differences. Our analyses have confirmed federated learning as a feasible approach for data analyses that addresses the challenges of data sharing and urge for further collaborative studies including relevant prognostic factors.

The crosstalk between Stroke and Cancer: Incidence of cancer after a first-ever cerebrovascular event in a population-based study.

OBJECTIVES: To determine the cancer incidence after the first-ever cerebrovascular event (CVE) and compare it to the cancer incidence in the population from the same region. METHODS: We evaluated 1069 patients with a first-ever CVE (Ischaemic or haemorrhagic stroke and Transient Ischaemic Attack) from a prospective population registry of stroke and transient focal neurological attacks, diagnosed between 2009 and 2011. We conducted a structured search to identify cancer-related variables and case-fatality for a period of 8 years following CVE. Cancer incidence in CVE patients was compared to the North Region Cancer Registry (RORENO). RESULTS: We found that 90/1069 (8.4%) CVE patients developed cancer after a first-ever CVE. Overall cancer annual incidence rate was higher after a CVE (820/100,000, 95%CI: 619-1020) than in general population (513/100,000, 95%CI: 508-518). In the 45-54 age group cancer incidence post-CVE was 3.2-fold (RR, 95%CI: 1.6-6.4) higher compared to the general population, decreasing gradually in older age-groups. Median time between CVE and cancer was 3.2 years (IQR = 1.4-5.2). Lower respiratory tract and colorectal were the most frequent cancer types. In univariable models, male sex (sHR = 1.78, 95%CI: 1.17-2.72, p = 0.007), tobacco use (sHR = 2.04, 95%CI: 1.31-3.18, p = 0.002) and peripheral artery disease (sHR = 2.37, 95%CI: 1.10-5.13, p = 0.028) were associated to higher cancer risk after CVE. After adjustment, tobacco use (sHR = 1.84, 95%CI: 1.08-3.14, p = 0.026) remained associated to a higher risk of cancer. CONCLUSIONS: At the population level, patients presenting a first-ever CVE have higher cancer incidence, that is particularly prominent in younger age-groups. Higher cancer incidence, delayed cancer diagnosis and increased mortality post-CVE warrants further research on long-term cancer surveillance in first-ever CVE survivors.

Moringa oleifera Lam. Commercial Beverages: A Multifaceted Investigation of Consumer Perceptions, Sensory Analysis, and Bioactive Properties.

This study employs a multidisciplinary approach to evaluate consumers' perceptions and acceptance of Moringa oleifera Lam. beverages, examining sensory attributes, chemical composition, and bioactivities. High-performance liquid chromatography with diode array detection (HPLC-DAD) analyses revealed significant chemovariation in phenolic compositions among commercial moringa beverages. A soluble moringa powder drink exhibited the greatest concentrations of phenolic and flavonoid compounds, along with powerful antioxidant capacity powers assessed with ABTS•+, DPPH•, FRAP assays, •NO, and H2O2 scavenging activities. However, this sample was the least preferred and presented high Cd levels, exceeding WHO-acceptable values of 0.3 mg/kg. Sensory testing indicated that sweet and floral flavors contributed to beverages being liked, while green, grass, herbal flavors, sour, bitter, and precipitate presence were considered unfavorable sensory attributes. Health claims positively influenced acceptance, particularly among women. Consumers associated feelings of health, wellness, relaxation, and leisure with moringa beverages. During purchase, the most observed information included the ingredient list, health benefits, and type/flavor. These findings emphasize the importance of consumer awareness in reading labels, verifying product origins, and ensuring the absence of contaminants. By understanding consumer preferences and the impact of health claims, producers can better tailor M. oleifera beverages to meet consumer expectations while maintaining safety and quality standards.

Fatores de risco intrínsecos para quedas entre idosos institucionalizados / Intrinsic risk factors for falls among institutionalized older adults

Objetivo: Investigar os fatores de risco intrínsecos para queda entre idosos de duas Instituições de Longa Permanência (ILP) no interior de Minas Gerais/Brasil. Métodos: Foram avaliados 20 idosos com idade média de 79 anos (entre 60-100 anos). Foram aplicadas as escalas de Tinetti e Barthel para avaliação do equilíbrio corporal e independência funcional, respectivamente. A escala de Downton para análise do risco de quedas; a estesiometria, a dinamometria e o teste manual de força muscular para estimar respectivamente, a sensibilidade das mãos e pés, a força de preensão palmar e a força dos músculos de membros inferiores. A análise estatística utilizada foi o teste t-student, o teste de correlação de Pearson, a análise de variância (ANOVA-one way), considerando nível de significância de 5%. Resultados: A média geral do escore da escala de Dowton foi de 4,68 (p<0,05); a do equilíbrio corporal foi de 14,57 pontos (p<0,05), a escala de Barthel foi de 72,36 pontos (p<0,05); a força de preensão palmar foi de 2,73 kg/m² (±3,64) e a média de força em membros inferiores foi de 3,7 kg/m2 (p<0,05). Conclusão: Conclui-se que os idosos avaliados apresentam alto risco de quedas sendo os parâmetros mais comprometidos e responsáveis por este risco, a polifarmácia, desequilíbrio, fraqueza muscular, perda de sensibilidade e dependência funcional.

Objective: The objective of the study is to investigate the intrinsic risk factors for falls among elderly people from two Long Stay Institutions (ILP) in the countryside of Minas Gerais/Brazil. Methods: Twenty elderly people with a mean age of 79 years (between 60-100 years) were evaluated. Tinetti and Barthel scales were applied to assess body balance and functional independence, respectively. The Downton scale for the analysis of the risk of falls; esthesiometry, dynamometry and manual muscle strength test to estimate, respectively, the sensitivity of the hands and feet, the hand grip strength and the strength of the muscles of the lower limbs. The statistical analysis used was the t-student test, Pearson's correlation test, analysis of variance (ANOVA-one way), considering a significance level of 5%. Results: The general mean score on the Dowton scale was 4.68 (p<0.05); that of body balance was 14.57 points (p<0.05), the Barthel scale was 72.36 points (p<0.05); the handgrip strength was 2.73 kg/m² (±3.64) and the mean strength in the lower limbs was 3.7 kg/m2 (p<0.05). Conclusion: It is concluded that the evaluated elderly have a high risk of falls and the parameters most compromised and responsible for this risk are polypharmacy, imbalance, muscle weakness, loss of sensitivity and functional dependence.

How does my pain look like? Characterizing dysmenorrhea-related pain using the body map / Como se parece a minha dor? Caracterizando a dor relacionada à dismenorreia utilizando o mapa corporal da dor

ABSTRACT BACKGROUND AND OBJECTIVES: Primary dysmenorrhea (PD) is a common gynaecological disorder characterized by pain in the abdominal region without pelvic disease. Evidence suggests that PD-related pain may not be restricted to the pelvis region, hence body mapping could be helpful in assessing the subjective location, intensity, and distribution of pain areas in women with PD. The objective of this study was to characterize dysmenorrhea-related pain location and intensity using body map. METHODS: We conducted a web-based cross-sectional study for adult women to self-report menstrual pain during three menstrual cycles. Each participant was instructed through a messaging application to paint the body map after printing it and rank their pain according to the 11-point Numerical Rating Scale. RESULTS: Seventy-three women (24.1 ± 3.0 years) participated in the study. A considerable proportion of participants reported pain in the lower abdomen (90.4%) and other body areas, such as the lower back (82.1%), head (54.6%), breasts (32.9%), upper abdomen (31.5%), and legs (28.8%). CONCLUSION: Our findings revealed that women with PD also present pain outside the uterine referral area during their period. In this way, body maps can help healthcare professionals to record specific regions of pain and track changes or patterns in the location or intensity pain during menses, helping to determine treatment strategies appropriate to the individual needs of each woman with PD. Therefore, we strongly recommend the clinical use of the self-report body map to evaluate menstrual pain and help health providers to improve PD symptoms in this population.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dismenorreia primária (DP) é um distúrbio ginecológico comum caracterizado por dor na região abdominal sem doença pélvica. Evidências sugerem que a dor relacionada à DP pode não estar restrita à região da pelve, portanto, o mapeamento corporal pode ser útil para avaliar a localização subjetiva, a intensidade e a distribuição das áreas de dor em mulheres com DP. O objetivo deste estudo foi caracterizar a localização e a intensidade da dor relacionada à dismenorreia por meio do mapa corporal. MÉTODOS: Conduziu-se um estudo transversal baseado na web para mulheres adultas para autorrelato de dor menstrual durante três ciclos menstruais. Cada participante foi instruído por meio de um aplicativo de mensagens a pintar o mapa corporal após imprimi-lo e classificar sua dor de acordo com a Escala de Avaliação Numérica de 11 pontos. RESULTADOS: Setenta e três mulheres (24,1±3,0 anos) participaram do estudo. Uma proporção considerável de participantes relatou dor na parte inferior do abdômen (90,4%) e em outras áreas do corpo, como a parte inferior das costas (82,1%), cabeça (54,6%), mamas (32,9%), parte superior do abdômen (31,5%) e pernas (28,8%). CONCLUSÃO: Os presentes achados revelaram que mulheres com DP também apresentam dor fora da área de referência uterina durante o período menstrual. Dessa forma, os mapas corporais podem ajudar os profissionais de saúde a registrar regiões específicas de dor e rastrear mudanças ou padrões na localização ou intensidade da dor durante a menstruação, ajudando a determinar estratégias de tratamento adequadas às necessidades individuais de cada mulher com DP. Portanto, recomenda-se fortemente o uso clínico do mapa corporal de autorrelato para avaliar a dor menstrual e ajudar os profissionais de saúde a melhorar os sintomas de DP nessa população.

Development of an Educational Gamification Strategy to Enhance the Food Safety Practices of Family Farmers in Public Food Markets of Northeast Brazil: A Case Study.

This study aimed to develop an educational gamification strategy to enhance the food safety practices of family farmers in public food markets in a city in Northeastern Brazil (João Pessoa, PB, Brazil). A good manufacturing practices (GMP) checklist was used to verify hygienic-sanitary conditions in the food markets. Educational game tools addressing foodborne diseases and GMP with information about the prevention of foodborne diseases, good food handling practices, and safe food storage were developed. Pre- and post-training assessments were done to evaluate food handlers' knowledge and food safety practices. Microbiological parameters of food samples were analyzed before and two months after the training. Results indicated unsatisfactory hygiene conditions in the examined food markets. There was a very strong positive correlation between "implementation of GMP" and "production and process controls" (R = 0.95; p ≤ 0.05) and between "production and process controls" and "hygiene habits of handlers" (R = 0.92; p ≤0.05). There was no homogeneity between answers before and after the training for the knowledge of family farmers regarding "prevention of foodborne diseases" and "safe food handling". There were improvements in the measured microbiological parameters of foods sold by family farmers after the application of the developed educational gamification training. These results showed the developed educational game-based strategy as being effective in raising awareness of hygienic sanitary practices, helping to promote food safety, and reducing risks for the consumers of street foods at family farmers' markets.

Extruded urea levels in lamb supplementation in rainy tropical savanna conditions: the triad host-gastrointestinal nematodes-environment.

The objective of this study was to evaluate the influence of increasing levels of extruded urea (EU, Amireia®) in the diet of lambs naturally infected by gastrointestinal nematodes on the interactions in the host-pasture-soil components in edaphoclimatic conditions of the tropical rainy savanna. A total of 60 Texel lambs with a mean initial weight of 20.7 ± 0.87 and mean age of 2.5 ± 0.70 months were distributed in a completely randomized design, in five treatments consisting of different levels of EU supplementation viz., 0, 6, 12, 18, and 24 g 100 kg-1 live weight (LW). The performance of lambs, parasitological variables, gastrointestinal nematodes (NGIs), and larvae recovery in pasture and soil were evaluated. The highest animal performance was observed in animals that received 0 to 18 g kg-1 LW (146.0 g day-1) and the lowest in animals supplemented with 24 g kg-1 LW (81.0 g day-1) of EU. The body condition score (BCS) was similar in the animals (P > 0.05). Parasitic infection did not differ as a function of EU level (P > 0.05). Eggs of Haemonchus spp., Trichostrongylus spp., Cooperia spp., and Oesophagostomum spp. were found. The largest amount of larvae in the L1/L2 and L3 stages was recovered in the pastures occupied by the animals that received supplementation 0 g kg-1 LW of EU (750 larvae), the smallest in those that the animals received 6 g 100 kg-1 LW of EU (54 larvae). The presence of larvae in the L1/L2 stages changed significantly (P < 0.05) in the soil; in the other stages, it did not differ in the soil. Increasing levels of extruded urea do not influence the eggs per gram of feces (EPG) count. The 0 to 18 g 100 kg-1 LW level maintains animal performance, BCS and FAMACHA©. There is less dispersal of NGI larvae in pasture and soil when EU levels increase in the edaphoclimatic conditions of the rainy tropical savannah, which suggests that this supplement can be implemented in the diet of beef lambs, in addition to to be a lower cost nitrogen source.

Nutrient Intake, Performance, Carcass Characteristics, Meat Quality, and Cost Analysis of Sheep Submitted to Intermittent Supplementation on Masai Grass Pastures.

This study aimed to assess nutrient intake, performance, intake behavior, carcass characteristics, and meat quality of sheep managed on Masai grass pastures along with intermittent concentrate supplementation, in addition to the economic impacts of applying that strategy. A sample of 24 Santa Inês sheep (12 males and 12 females) was kept for 80 days on Panicum maximum cv. Massai pastures and was supplemented daily or every other day. The voluntary intake of dry matter and nutrients was estimated. Mean daily weight gain and total weight gain were calculated and intake behavior parameters were assessed. The males were slaughtered and the weight and yield of the carcasses and meat cuts were assessed. The meat was analyzed for cooking losses, shear force, and color. The gross margin of the system was estimated from the difference between total income and operational cost. No effect was seen of the interaction between supplementation frequency and sex for any parameter assessed (p > 0.05). Intermittent supplementation of Santa Inês sheep managed with Masai grass is recommended since the strategy does not impact nutrient intake, performance, intake behavior, carcass characteristics, or meat quality, but lowers the costs of producing 1 kg of meat by 15%.