Do Methodological Differences in Experiments with Stream Shredders Imply Variability in Outputs? A Microcosm Approach.

Experiments are useful scientific tools for testing hypotheses by manipulating variables of interest while controlling for other factors that can bias or confuse the results and their interpretation. To ensures accuracy and reproducibility, experiments must have transparent and repeatable methodologies. Due to the importance of shredder invertebrates in organic matter processing, carbon cycling, and nutrient cycling, we tested experimentally the effect of different methodological approaches in microcosm experiments on the consumption and survival of shredders. We found that the shredder species, the presence or absence of the case, and the use or non-use of air-pumps in the microcosms did not affect shredder performance (i.e., consumption and survival). Furthermore, the type of water (stream or bottled) did not affect shredder performance. On the other hand, the amount of light had a negative effect on shredder performance, with constant light (i.e., 24 h) reducing shredder consumption and survival. Our results demonstrate that the use of different methodologies does not always result in changes in outcomes, thus ensuring comparability. However, luminosity is a critical factor that deserves attention when conducting microcosm experiments. Our findings provide valuable insights that can assist researchers in designing experiments with shredders from neotropical streams and conducting systematic reviews and meta-analyses.

G6PDH as a key immunometabolic and redox trigger in arthropods.

The enzyme glucose-6-phosphate dehydrogenase (G6PDH) plays crucial roles in glucose homeostasis and the pentose phosphate pathway (PPP), being also involved in redox metabolism. The PPP is an important metabolic pathway that produces ribose and nicotinamide adenine dinucleotide phosphate (NADPH), which are essential for several physiologic and biochemical processes, such as the synthesis of fatty acids and nucleic acids. As a rate-limiting step in PPP, G6PDH is a highly conserved enzyme and its deficiency can lead to severe consequences for the organism, in particular for cell growth. Insufficient G6PDH activity can lead to cell growth arrest, impaired embryonic development, as well as a reduction in insulin sensitivity, inflammation, diabetes, and hypertension. While research on G6PDH and PPP has historically focused on mammalian models, particularly human disorders, recent studies have shed light on the regulation of this enzyme in arthropods, where new functions were discovered. This review will discuss the role of arthropod G6PDH in regulating redox homeostasis and immunometabolism and explore potential avenues for further research on this enzyme in various metabolic adaptations.

Seasonal distribution of Calliphoridae and Mesenbrinellidae (Diptera) associated with the decomposition of a clothed animal model in a forest reserve in the Central Amazon.

We evaluated the effects of seasonality on the richness and abundance of dipterans of the families Calliphoridae and Mesembrinellidae associated with the decomposition of a clothed Large White swine Sus scrofa domesticus(Artiodactyla: Suidae) carcass. Experiments were carried out in less rainy, rainy, and intermediate periods between 2010 and 2011 at Reserva Florestal Ducke, Manaus, Amazonas. Two pig carcasses, each weighing approximately 40 kg, were used in each period. A total of 63,872 individuals of 18 species of Calliphoridae and Mesembrinellidae were collected. The abundance and richness of these dipteran families were influenced by the interaction between period and decomposition stage. The compositions of the Calliphoridae and Mesembrinellidae assemblages differed among periods, with the fauna of the less rainy period being less similar to those of the intermediate and rainy periods than they were to each other. Three species were selected as indicators for the less rainy period, namely Paralucilia pseudolyrcea (Mello, 1969) (Diptera, Calliphoridae), Paralucilia nigrofacialis (Mello, 1969) (Diptera, Calliphoridae), and Eumesembrinella randa (Walker, 1849) (Diptera,Mesembrinellidae) while Chloroprocta idioidea (Robineau-Desvoidy, 1830) (Dipetra, Calliphoridae) was selected as an indicator species for the rainy period; no taxon was selected as an indicator of the intermediate period. Among decomposition stages, only fermentation and black putrefaction had indicator taxa, with Hemilucilia souzalopesi Mello, 1972 (Diptera, Calliphoridae and Chysomya putoria(Wiedemann, 1830) (Diptera, Calliphoridae), respectively. Clothes did not prevent the laying of eggs and became a kind of protection for immature stages. The clothed model presented a delay in decomposition compared to other studies developed in the Amazon region.

An alternative approach for the surgical correction of unilateral crossbite.

This case report aims to describe a modified surgically assisted rapid palatal expansion technique to treat an asymmetrical posterior crossbite with no mandibular shift without causing an interincisal diastema. A clinical patient with an asymmetrical crossbite, large tooth-size-arch length, and Bolton discrepancy is used to illustrate the modified technique. Instead of traditional osteotomies, in this technique, the osteotomy is done between the maxillary right canine and lateral incisor (connecting the piriform aperture to the alveolar process) along with a unilateral LeFort I osteotomy. The expansion forces are produced by the activation of a conventional hyrax appliance. The skeletal unilateral crossbite was corrected without major changes to the opposite side and without causing an anesthetic diastema between the maxillary central incisors. A mandibular incisor extraction produced the space needed to treat the tooth size-arch length and corrected the Bolton discrepancy. This allowed a successful treatment of the problems initially presented by the patient.

Signatures of functional bacteriome structure in a tropical direct-developing amphibian species.

BACKGROUND: Host microbiomes may differ under the same environmental conditions and these differences may influence susceptibility to infection. Amphibians are ideal for comparing microbiomes in the context of disease defense because hundreds of species face infection with the skin-invading microbe Batrachochytrium dendrobatidis (Bd), and species richness of host communities, including their skin bacteria (bacteriome), may be exceptionally high. We conducted a landscape-scale Bd survey of six co-occurring amphibian species in Brazil's Atlantic Forest. To test the bacteriome as a driver of differential Bd prevalence, we compared bacteriome composition and co-occurrence network structure among the six focal host species. RESULTS: Intensive sampling yielded divergent Bd prevalence in two ecologically similar terrestrial-breeding species, a group with historically low Bd resistance. Specifically, we detected the highest Bd prevalence in Ischnocnema henselii but no Bd detections in Haddadus binotatus. Haddadus binotatus carried the highest bacteriome alpha and common core diversity, and a modular network partitioned by negative co-occurrences, characteristics associated with community stability and competitive interactions that could inhibit Bd colonization. CONCLUSIONS: Our findings suggest that community structure of the bacteriome might drive Bd resistance in H. binotatus, which could guide microbiome manipulation as a conservation strategy to protect diverse radiations of direct-developing species from Bd-induced population collapses.

Loads of continuous mechanics for uprighting the second molar on the second molar and premolar.

INTRODUCTION: This paper aims to evaluate the effect of tube height on uprighting a mandibular second molar with a continuous arch, specifically the main effects on the molar tube and the side effects on the second premolar bracket. METHODS: Slot brackets (0.18-in) and tubes were passively bonded from the left second molar to the right second premolar of the patient's cast and fixed to an orthodontic force tester. A mesially tipped second molar along with its tube was positioned at 5 different heights in relation to the bracket slots of the remaining appliance: 2 mm below (group -2), 1 mm below (group -1), leveled (group 0), 1 mm above (group 1) and 2 mm above (group 2). Each group had 10 different 0.016 × 0.022-in superelastic nickel-titanium wires tied one at a time to the appliance to register the vertical forces (Fz) and tipping moments (Mx) produced at the molar tube and the premolar bracket, statistically. Analysis of variance was used to identify differences of load among the groups for wire response to the position of the tube in relation to the other brackets' slots. RESULTS: As the molar tube was positioned more occlusally, Fz and Mx decreased at the molar tube from 1.31 N to 0.75 N and 13.98 N.mm to 11.84 N.mm, respectively, whereas at the premolar bracket, Fz and Mx decreased from 1.52 N to 0.88 N and 8.77 N.mm to 1.05 N.mm, respectively. CONCLUSIONS: In all groups, the load system at the molar tube (the main effects) registered a distal tipping moment and an extrusive force, whereas at the premolar bracket, the load system (side effects) included a distal tipping moment and an intrusive force. As the tube moved occlusally, the extrusive force and the uprighting moment decreased, along with the side effects at the premolar bracket. Attempting to bond the molar tube more occlusally (within reasonable intraoral dimensions) when trying to upright a molar does not appear to be sufficient to keep a molar from extruding.

Evaluation of Protocols of Controlled Ovarian Stimulation in Obtaining Mature Oocytes (MII): Retrospective Study on Assisted Reproductive Technology Procedures.

OBJECTIVE: To understand which of the controlled ovarian stimulation (COS) protocols used in different patients are associated with greater amounts of oocytes retrieved. METHODS: The study population was divided into three groups, considering AMH and AFC to obtain the Ovarian Response Predictor Index (ORPI); they were grouped into: G1-Low Reserve (ORPI <0.5); G2-Normal Reserve (ORPI:0.5-0.9); and G3-High Reserve (ORPI≥0.9). 246 cycles were selected in which COS was used: recombinant FSH - follitropin alfa or beta (Protocol 1) or corifollitropin alfa (Protocol 2), both associated with urinary HMG and the GnRH antagonist, with the trigger performed using recombinant hCG or GnRH agonist. RESULTS: The number of oocytes obtained was higher in protocol 1 in all groups, with higher counts seen in G1 than in G2 or G3. The number of days required in COS for protocol 2 was greater than for protocol 1 in all groups. The total dose of recombinant FSH alfa or beta / urinary HMG used in protocol 1 was inversely proportional to the ovarian reserve. The lower the ORPI, the greater the average number of international units administered. In protocol 2, there was a need to supplement with higher doses of urinary HMG when compared to protocol 1. The dosage of the GnRH antagonist was dependent on the number of COS days until the trigger was used. In obtaining MII oocytes, the percentages were similar regardless of the trigger used. CONCLUSIONS: The use of follitropin leads to greater numbers of retrieved oocytes than corifollitropin alfa in all ORPIs. The dose of recombinant FSH used with urinary HMG increases inversely proportional to the ORPI value. The fixed dose of recombinant FSH deposit requires a sharp increase in the dose of urinary HMG.

Can we expect similar behavior among CuNiTi 35°C wires?

OBJECTIVE: This paper aims to verify the thermodynamic, mechanical and chemical properties of CuNiTi 35ºC commercial wires. METHODS: Forty pre-contoured copper-nickel-titanium thermodynamic 0.017 x 0.025-in archwires with an Af temperature of 35°C were used. Eight wires from five different manufacturers (American Orthodontics® [G1], Eurodonto® [G2], Morelli® [G3], Ormco® [G4] and Orthometric® [G5]) underwent cross-sectional dimension measurements, tensile tests, SEM-EDS and differential scanning calorimetry (DSC) tests. Parametric tests (One-way ANOVA and Tukey post-test) were used, with a significance level of 5%, and Pearson's correlation coefficient test was performed between the Af and chemical elements of the wires. All sample tests and statistical analyses were double-blinded. RESULTS: All wires presented standard dimensions (0.017 x 0.025-in) and superelastic behavior, with mean plateau forces of: G1 = 36.49N; G2 = 27.34N; G3 = 19.24 N; G4 = 37.54 N; and G5 = 17.87N. The Af means were: G1 = 29.40°C, G2 = 29.13°C and G3 = 31.43°C, with p>0.05 relative to each other. G4 (32.77°C) and G5 (35.17°C) presented statistically significant differences between each other and among the other groups. All samples presented Ni, Ti, Cu and Al in different concentrations. CONCLUSIONS: The chemical concentration of the elements that compose the alloy significantly influenced the thermodynamic and mechanical properties.

Ciclo de vida em laboratório de imaturos de Phylloicus elektoros e Phylloicus amazonas (Trichoptera: Calamoceratidae) de um igarapé da Amazônia Central / Immature life cycle of laboratory-reared Phylloicus elektoros and Phylloicus amazonas (Trichoptera: Calamoceratidae) from a central Amazonian stream

Nós criamos massas de ovos dos tricópteros Phylloicus amazonas (n = 2) e Phylloicus elektoros (n = 7) coletadas no campo até a fase adulta. A mediana do tempo de desenvolvimento do primeiro instar larval ao adulto foi de 229 dias para P. amazonas e 275 dias para P. elektoros, incluindo o tempo de desenvolvimento pupal (mediana de 13.5 e 16 dias, respectivamente). Fragmentadores têm sido frequentemente usados em estudos relacionados ao processamento de matéria orgânica em ecossistemas aquáticos. As informações biológicas fornecidas neste estudo podem ser úteis para o planejamento de estudos experimentais em campo ou em condições de laboratório.(AU)

Effect of essential oils against acaricide-susceptible and acaricide-resistant Rhipicephalus ticks.

The indiscriminate use of acaricides is a problem worldwide and has increased the selection of acaricide-resistant tick populations. The goal of this study was to evaluate the acaricide effects of two essential oils (from Schinus molle and Bulnesia sarmientoi) using the larval immersion test on three Rhipicephalus tick species. Rhipicephalus evertsi, Rhipicephalus appendiculatus and Rhipicephalus pulchelus ticks collected in Kenya, without history of acaricide exposure, were tested, as well as individuals from two populations of Rhipicephalus microplus (with or without history of acaricide exposure), for comparison. The sample most resistant to the treatments was a population of R. microplus with previous acaricide exposure, whereas the least tolerant sample was a strain of the same species that never had contact with acaricides (Porto Alegre strain). Interestingly, the field tick samples without previous acaricide exposure responded to essential oils with a mortality profile resembling that observed in the acaricide-resistant R. microplus field population, and not the susceptible Porto Alegre strain. The essential oil of B. sarmientoi and its two components tested (guaiol and bulnesol) caused the highest mortality rates in the tested species and are potential molecules for future studies on control methods against these species.

Immature life cycle of laboratory-reared Phylloicus elektoros and Phylloicus amazonas (Trichoptera: Calamoceratidae) from a central Amazonian stream / Ciclo de vida em laboratório de imaturos de Phylloicus elektoros e Phylloicus amazonas (Trichoptera: Calamoceratidae) de um igarapé da Amazônia Central

We reared field-collected egg masses of the caddisflies Phylloicus amazonas (n = 2) and Phylloicus elektoros (n = 7) to adulthood. First instar larvae of both species hatched up to five days after field collection. Median development time from first larval instar to adult was 229 days for P. amazonas and 275 for P. elektoros, including the pupal development time (median of 13.5 and 16 days, respectively). Shredder organisms have been used frequently in studies related to organic matter processing in freshwater ecosystems. The biological information reported in here may be useful for the design of experimental studies in the field or under laboratory conditions.(AU)

Nós criamos massas de ovos dos tricópteros Phylloicus amazonas (n = 2) e Phylloicus elektoros (n = 7) coletadas no campo até a fase adulta. A mediana do tempo de desenvolvimento do primeiro instar larval ao adulto foi de 229 dias para P. amazonas e 275 dias para P. elektoros, incluindo o tempo de desenvolvimento pupal (mediana de 13.5 e 16 dias, respectivamente). Fragmentadores têm sido frequentemente usados em estudos relacionados ao processamento de matéria orgânica em ecossistemas aquáticos. As informações biológicas fornecidas neste estudo podem ser úteis para o planejamento de estudos experimentais em campo ou em condições de laboratório.(AU)

Can we expect similar behavior among CuNiTi 35°C wires?

ABSTRACT Objective: This paper aims to verify the thermodynamic, mechanical and chemical properties of CuNiTi 35ºC commercial wires. Methods: Forty pre-contoured copper-nickel-titanium thermodynamic 0.017 x 0.025-in archwires with an Af temperature of 35°C were used. Eight wires from five different manufacturers (American Orthodontics® [G1], Eurodonto® [G2], Morelli® [G3], Ormco® [G4] and Orthometric® [G5]) underwent cross-sectional dimension measurements, tensile tests, SEM-EDS and differential scanning calorimetry (DSC) tests. Parametric tests (One-way ANOVA and Tukey post-test) were used, with a significance level of 5%, and Pearson's correlation coefficient test was performed between the Af and chemical elements of the wires. All sample tests and statistical analyses were double-blinded. Results: All wires presented standard dimensions (0.017 x 0.025-in) and superelastic behavior, with mean plateau forces of: G1 = 36.49N; G2 = 27.34N; G3 = 19.24 N; G4 = 37.54 N; and G5 = 17.87N. The Af means were: G1 = 29.40°C, G2 = 29.13°C and G3 = 31.43°C, with p>0.05 relative to each other. G4 (32.77°C) and G5 (35.17°C) presented statistically significant differences between each other and among the other groups. All samples presented Ni, Ti, Cu and Al in different concentrations. Conclusions: The chemical concentration of the elements that compose the alloy significantly influenced the thermodynamic and mechanical properties.

RESUMO Objetivo: O presente artigo teve como objetivo verificar as propriedades termodinâmicas, mecânicas e químicas de fios CuNiTi 35°C comerciais. Métodos: Foram utilizados 40 arcos termodinâmicos pré-contornados de cobre-níquel-titânio de 0,017" x 0,025" e temperatura Af de 35°C. Oito fios de cinco fabricantes diferentes (American Orthodontics® [G1], Eurodonto® [G2], Morelli® [G3], Ormco® [G4] e Orthometric® [G5]) foram submetidos a medições de suas secções transversais, testes de tração, MEV-EDS e calorimetria diferencial (DSC). Foram utilizados testes paramétricos (One-way ANOVA e pós-teste de Tukey), com nível de significância de 5%, e foi realizado o teste do coeficiente de correlação de Pearson entre a temperatura Af e os elementos químicos dos fios. Todos os testes das amostras e análises estatísticas foram duplo-cegos. Resultados: Todos os fios apresentavam dimensões padronizadas (0,017" x 0,025") e comportamento superelástico, com forças médias de platô de G1 = 36,49 N; G2 = 27,34 N; G3 = 19,24 N; G4 = 37,54 N; e G5 = 17,87 N. As médias de Af foram: G1 = 29,40°C, G2 = 29,13°C e G3 = 31,43°C, com p> 0,05 entre si. G4 (32,77°C) e G5 (35,17°C) apresentaram diferenças estatisticamente significativas entre si e entre os demais grupos. Todas as amostras apresentaram Ni, Ti, Cu e Al em diferentes concentrações. Conclusões: A concentração química dos elementos que compõem a liga influenciou significativamente as propriedades termodinâmicas e mecânicas.

Data-driven study of the COVID-19 pandemic via age-structured modelling and prediction of the health system failure in Brazil amid diverse intervention strategies.

In this work we propose a data-driven age-structured census-based SIRD-like epidemiological model capable of forecasting the spread of COVID-19 in Brazil. We model the current scenario of closed schools and universities, social distancing of people above sixty years old and voluntary home quarantine to show that it is still not enough to protect the health system by explicitly computing the demand for hospital intensive care units. We also show that an urgent intense quarantine might be the only solution to avoid the collapse of the health system and, consequently, to minimize the quantity of deaths. On the other hand, we demonstrate that the relaxation of the already imposed control measures in the next days would be catastrophic.

Expansion with transpalatal arch or continuous arch mechanics.

INTRODUCTION: This study aimed to compare the 3-dimensional force system produced by transpalatal arch (TPA) mechanics with that produced by a continuous arch (CA) on the expansion of maxillary first molars. METHODS: A patient's model with 2 molars in 4-mm crossbite had orthodontic appliances bonded to all teeth. The first and the second molars were connected to two 3-dimensional load cells to compare the forces in the transverse and anteroposterior planes (Fx and Fy) and the rotational moments (Mz) produced in both molars by the expanded TPA and by 0.016-in nickel-titanium CA. The data were evaluated using 6 independent t tests, and the net moment at the molar's center of resistance was also calculated. RESULTS: All forces and moments were different at both molars. At the first molar, CA produced Fx of 2.60 N, Fy of -0.08 N, Mz of -5.16 N·mm, and Net Mz of -5.68 N·mm, whereas the TPA produced Fx of 2.87 N, Fy of -0.60 N, Mz of -22.08 N·mm, and Net Mz of -25.09 N·mm. At the second molar, the TPA did not produce significant forces and moments, whereas the CA produced Fx of -1.00 N, Mz of 3.95 N·mm, Fy of -0.84 N, and Net Mz of -0.67 N·mm. CONCLUSIONS: Based on our findings in a clinical set up with the specific horseshoe TPA and archwire tested, with the TPA used only on the first molars and the CA used from one second molar to the other, the mechanics produced different expansion forces at the first molar. The TPA produced a larger rotational side effect on the first molar, whereas the CA produced side effects on the second molar.

Redescription of the tadpole of Leptodactylus flavopictus Lutz, 1926 (Anura: Leptodactylidae) from Pilar do Sul, São Paulo, Brazil.

Frogs of the subfamily Leptodactylinae Werner can be found from southern Texas (USA) to southern Brazil, including the northern Antilles (Frost 2019). This subfamily is composed of 98 recognized species and the genus Leptodactylus Fitzinger contains the largest number of species (74 sp.) (Frost 2019). A study conducted by de Sá et al. (2014) provided a phylogeny of Leptodactylus based on molecular analysis, adult and larval morphology, and behavioral data. Currently, four species groups are recognized within this genus: L. fuscus group, L. pentadactylus group, L. latrans group, and L. melanonotus group (de Sá et al. 2014).

Characterization of adverse drug events identified by trigger in Brazilian pediatric inpatients.

OBJECTIVE: To describe the frequency and characteristics of adverse drug events in pediatric inpatients in a Brazilian tertiary teaching hospital. METHODS: A cross-sectional study was conducted by retrospective and manual chart review of 240 pediatric admissions to identify adverse drug events using 17 triggers. When triggers were detected in the chart, reviewers investigated the chart in depth to decide whether an event occurred. Consensus about the occurrence of the event was obtained in meeting with a healthcare team. Events were classified by harm category and drugs were classified according to the Anatomical Therapeutic Chemical Classification. Patients who had suffered were compared to those who had not experienced events using the chi-squared test and the Mann-Whitney U test. RESULTS: A total of 62 adverse events were found, and 18.8% of the patients had at least one event. Adverse events rates were 25.83 per 100 admissions, 20.27 per 1000 patient-days, 25.94 per 1000 drugs, and 2.12 per 1000 drug doses. All events found were classified as temporary harm, and cardiovascular drugs were most frequently related to events. Groups of patients with and without event were segregated (p<0.05) by the length of stay, number of drugs, and drug doses. CONCLUSION: The use of triggers demonstrated its utility in a pediatric setting by identifying harm. Adverse events rates were found to be higher than those of previous studies, but the harm rate was lower than other studies. This study enables the measurement of adverse events in order to define strategies to mitigate or reduce harm.

The hallmarks of GSK-3 in morphogenesis and embryonic development metabolism in arthropods.

Several research groups around the world have studied diverse aspects of energy metabolism in arthropod disease vectors, with the aim of discovering potential control targets. As in all oviparous organisms, arthropod embryonic development is characterized by the mobilization of maternally-derived metabolites for the formation of new tissues and organs. Glycogen synthase kinase-3 (GSK-3) is a serine-threonine kinase described as an important regulator of metabolism and development in a wide range of organisms. GSK-3 was first identified based on its action upon glycogen synthase, a central enzyme in glycogen biosynthesis. Currently, it is recognized as a key component of multiple cellular processes such as glucose metabolism, apoptosis, cell proliferation, transcription, cell migration, and immune response. The present review will describe the current knowledge on GSK-3 activation and its role in morphogenesis and embryonic metabolism in arthropods. Altogether, the information discussed here can spark new approaches and strategies for further studies, enhancing our understanding of these important arthropod vectors and strengthening the resources in the search for novel control methods.

Protocolo clínico de desgastes interproximais no tratamento com alinhadores ortodônticos / Clinical protocol for interproximal reduction in treatment with orthodontic aligners

Resumo O tratamento com alinhadores ortodônticos já uma realidade na prática ortodôntica, em especial para casos de baixa complexidade. Em muitos desses casos, a falta de espaço, caracterizada pelo apinhamento, faz parte do problema. Assim, com intuito de prover espaços, dentre inúmeros recursos existentes, pode-se também considerar o desgaste interproximal, a depender de cada caso. Com a finalidade de reduzir o diâmetro mesiodistal dos dentes, os desgastes interproximais precisam ser feitos de forma criteriosa. O objetivo desse artigo é apresentar um protocolo seguro de desgastes interproximais considerando diferentes situações cínicas. (AU)

Abstract Treatment with orthodontic aligners is already a reality in orthodontic practice, especially for low complexity cases. In many of these patients, the lack of space, characterized by crowding, is part of the problem. Thus, in order to provide spaces, among numerous available resources, interproximal reduction may be considered, depending on each case. In order to shorten mesiodistal teeth width, interproximal reduction should be done carefully. This paper aims to present a reliable protocol for interproximal reduction considering different clinical situations. (AU)

The Brazilian Portuguese version of the Pediatric Trigger Toolkit is applicable to measure the occurrence of adverse drug events in Brazilian pediatric inpatients / A versão em Português-BR do Pediatric Trigger Toolkit é aplicável para mensurar eventos adversos a medicamentos em pacientes pediátricos internados em hospitais brasileiros

Abstract Objective: To describe the process of translation, adaptation, and validation of the Brazilian Portuguese version of the Pediatric Trigger Toolkit: Measuring Adverse Drug Events in the Children's Hospital. Methods: The validation process for the research instrument was carried out in five steps: (I) translation from English into Brazilian Portuguese by two independent translators; (II) synthesis of the translated versions; (III) adaptation of the triggers to the Brazilian context using a modified Delphi method carried out in two rounds; (IV) application of the research instrument in the review of 240 hospitalizations during 2014; and (V) back-translation from Brazilian Portuguese to English. Results: The translation step resulted in two versions, which were then synthesized to obtain equivalence within the Brazilian cultural context. The process of adapting the research instrument allowed the inclusion and adaptation of some triggers, as well as the exclusion of others, based on the consensus reached among experts during the Delphi step. The positive predictive value of the research instrument was 13.51%, and the antihistamine trigger presented the highest positive predictive value. Conclusion: The research instrument can be used to track the occurrence of adverse drug events in pediatric patients in Brazilian hospitals. Despite the adjustments made, triggers that were not identified or that had low positive predictive value can suggest the need for additional changes. However, more studies are needed before modifying or removing a trigger.

Resumo Objetivo: Descrever o processo de tradução, adaptação e validação para o português do Pediatric Trigger Toolkit: Measuring Adverse Drug Events in the Children's Hospital. Métodos: O processo de validação do instrumento de pesquisa foi realizado em 5 etapas: (I) tradução do inglês para o português por dois tradutores independentes; (II) síntese das versões traduzidas; (III) adaptação dos rastreadores para realidade brasileira por meio do método Delphi modificado, em duas rodadas; (IV) aplicação do instrumento de pesquisa na revisão de 240 internações de 2014; e (V) retrotradução do português para o inglês. Resultados: A etapa de tradução resultou em duas versões traduzidas, que foram sintetizadas de forma a obter equivalência ao contexto cultural brasileiro. O processo de adaptação do instrumento de pesquisa possibilitou a inclusão e adaptação dos rastreadores, bem como a exclusão de rastreadores segundo consenso obtido entre os especialistas na etapa Delphi. O valor preditivo positivo do instrumento de pesquisa foi de 13,51% e o rastreador anti-histamínico foi o que apresentou maior valor preditivo positivo. Conclusão: O instrumento de pesquisa pode ser utilizado para rastrear a ocorrência de eventos adversos a medicamentos em pacientes pediátricos nos hospitais brasileiros. Apesar das adaptações realizadas, rastreadores que não foram identificados ou com baixo valor preditivo positivo podem indicar, ainda, a necessidade de modificações. Entretanto, mais estudos são necessários antes de modificar ou excluir algum rastreador.