Symmetric dimethylarginine correlates with the urea, creatinine, potassium, and clinical scores in feline urethral obstructions.

BACKGROUND: A urethral obstruction (UO) is an emergency commonly observed in male cats, which can result in significant clinical and laboratory alterations, leading to complications and death. OBJECTIVES: This study aimed to correlate symmetric dimethylarginine (SDMA) with the urea, creatinine, potassium, and bicarbonate levels in cats with UO. In addition, the correlation between clinical score and time of obstruction was evaluated. METHODS: Thirty male cats were selected and allocated into a control group (CG, n = 13) and an obstruction group (OG, n = 17). The laboratory analyses were conducted before treatment (M0) and at different times after treatment (12 h [M12], 24 h [M24], and 48 h [M48]). Correlations were established between SDMA and creatinine, urea, bicarbonate, potassium, time of obstruction, and the clinical score. RESULTS: A strong correlation (r > 0.6) was observed between SDMA and creatinine, urea, and potassium in the OG. Furthermore, there was substantial agreement (kappa value) between SDMA and creatinine at M24. A higher clinical score was associated with a longer time of obstruction. In the OG, at M48, the SDMA and creatinine levels were 50% and 41.2% higher, respectively. CONCLUSIONS: A correlation was observed between SDMA and creatinine in obstructed cats, and significant agreement between these values was observed 24 h after the unblocking treatment. A correlation among SDMA, urea, and potassium was observed. Approximately 9% more cats continued to have elevated SDMA levels after 48 h of treatment compared to creatinine. This suggests a slightly lower sensitivity of the latter biomarker but does not exclude the possibility of congruent and normalized values after a longer evaluation period.

Diaphragmatic and excursion thickness in newborns using diaphragmatic kinesiology ultrasound: an observational study / Espessura e excursão diafragmática em recém-nascidos usando ultrassonografia cinesiológica do diafragma: um estudo observacional

Abstract Introduction The study of the diaphragm muscle has aroused the interest of physiotherapists who work with kinesiological ultrasonography, but still little explored; however, its findings can contribute to the clinical practice of hospitalized patients in neonatal intensive care units. Objective To measure the excursion and thickening of the diaphragm and describe measurements among neonates, preterm, and full-term. Methods Diaphragmatic kinesiological ultrasonography was performed on hospitalized newborns, in Neonatal Unit Care Unit, placed in supine position in their own bed, on the sixth day of life. Three repeated measurements of the same respiratory cycle were made, both for excursion and for diaphragmatic thickening. Results 37 newborns participated in the study and 25 were premature. The mean weight at the time of collection was 2,307.0 ± 672.76 grams and the gestational age was 35.7 ± 3.3 weeks. Diaphragmatic excursion increased with increasing gestational age (p = 0.01, df = 0.21) in term infants (p = 0.17, df = 0.35). Conclusion There was a positive correlation between diaphragmatic excursion and gestational age. There was no statistically significant difference in the measurements of excursion and inspiratory diaphragm thickening between preterm and term newborns, although pointing to higher measurements in the latter group.

Resumo Introdução O estudo do músculo diafragma tem des-pertado o interesse dos fisioterapeutas que trabalham com ultrassonografia cinesiológica. Ainda pouco explo-rado, contudo, seus achados podem contribuir para a prática clínica dos pacientes internados em unidades de terapia intensiva neonatal (UTIN). Objetivo Mensurar a excursão e o espessamento diafragmático e descrever as medidas entre recém-nascidos prematuros e a termo. Métodos Realizou-se ultrassonografia cinesiológica diafragmática em recém-nascidos internados em UTIN, posicionados em supino em seu próprio leito, no sexto dia de vida. Foram realizadas três medidas repetidas do mesmo ciclo respiratório, tanto da excursão quanto do espessamento diafragmático. Resultados Participaram do estudo 37 recém-nascidos, dos quais 25 eram pre-maturos. O peso no momento da coleta foi de 2.307,0 ± 672,76 gramas e a idade gestacional foi de 35,7 ± 3,3 semanas. A excursão diafragmática aumentou de acordo com o aumento da idade gestacional (p = 0,01; df = 0,21). A espessura variou entre 0,10 e 0,16 cm durante a inspiração nos prematuros e entre 0,11 e 0,19 cm nos nascidos a termo (p = 0,17; df = 0,35). Conclusão Houve correlação positiva entre a excursão diafragmá-tica e a idade gestacional. Não observou-se diferença estatisticamente significativa das medidas de excursão e de espessamento diafragmático inspiratório entre recém-nascidos prematuros e recém-nascidos a termo, embora apontando para maiores medidas neste último grupo.

Reproductive autonomy associated with the use of contraceptive methods among reproductive aged women.

OBJECTIVE: To assess the sociodemographic aspects associated with reproductive autonomy among urban women, with special regard to the relationship with the use of contraceptive methods. METHOD: Cross-sectional study with 1252 women, conducted between April and June 2021, using the Brazilian version of the Reproductive Autonomy Scale. Data were analyzed using multiple linear regression. RESULTS: Mean scores for the subscales were 2.5 (SD=0.3) (Decision-making), 3.8 (SD=0.3) (Absence of Coercion) and 3.6 (SD=0.4) (Communication). Compared to women who reported no use of contraceptive methods, women using barrier or behavioral methods and those using LARC had higher level of reproductive autonomy on all dimensions of the Scale (p<0.001). Other aspects associated with reproductive autonomy were education, race/ethnicity, religion, socioeconomic status and cohabitation living with a partner, depending on each subscale. CONCLUSION: The type of contraceptive method used was statistically associated with reproductive autonomy in all subscales.

Effect of Spinal Correction Surgery on Lower Limb Strength in Idiopathic Adolescent Scoliosis.

Objectives To analyze the lower limb strength in both untreated and surgically treated adolescent idiopathic scoliosis (AIS) patients and examine its correlation with the distance covered in a six-minute walking test (6MWT). Methods A total of 88 participants (n = 30 pre-surgery AIS patients, n = 30 post-surgical AIS patients, and n = 28 control) underwent a 6MWT and a muscle strength assessment. The lower limb strength was measured at the knee joint using the knee extension (KE) and knee flexion (KF) peak torque (PT) measurements. Results The control group covered a greater distance in the TC6 compared to both the pre-surgical (534 ± 67 m) and post-surgical (541 ± 69 m) groups, with a distance of 612 ± 70 m (p < 0.001). No differences were observed in KE PT (pre: 2.1 ± 0.63, post: 2.1 ± 0.7, control: 2.2 ± 0.7 Nm.kg -1 , p = 0.67) or KF PT (pre: 1.0 ± 0.3, post: 1.1 ± 0.3, control: 1.1 ± 0.5 Nm.kg -1 , p = 0.46). A moderate positive correlation was observed between KE PT and 6MWT distance (r = 0.53, p < 0.001), as well as a low positive correlation for KF PT (r = 0.37, p = 0.003) with 6MWT distance. Conclusion This study highlights the importance of lower limb maximal strength in the functionality of AIS patients. Our findings suggest that exercise programs aimed at enhancing lower limb strength, especially the KE, could improve the walking capacity of AIS patients. These results provide useful information for designing purposeful exercise programs for AIS patients with walking deficits.

Magnesium supplementation alleviates drought damage during vegetative stage of soybean plants.

Our working hypothesis was that magnesium (Mg) supplementation modulates plant performance under low water availability and improves drought tolerance in soybean genotypes. Plants of Bônus 8579, M8808 and TMG1180 genotypes were grown under field conditions and subjected to three water stress treatments (control, moderate and severe stress) and three Mg levels [0.9 (low), 1.3 (adequate) and 1.7 cmolc dm-³ (supplementation)]. After 28 days of drought imposition, the growth parameters, osmotic potential, relative water content, leaf succulence, Mg content and photosynthetic pigments were assessed. In general, drought drastically decreased the growth in all genotypes, and the reductions were intensified from moderate to severe stress. Under adequate Mg supply, TMG1180 was the most drought-tolerant genotype among the soybean plants, but Mg supplementation did not improve its tolerance. Conversely, although the M8808 genotype displayed inexpressive responses to drought under adequate Mg, the Mg-supplemented plants were found to have surprisingly better growth performance under stress compared to Bônus 8579 and TMG1180, irrespective of drought regime. The improved growth of high Mg-treated M8808-stressed plants correlated with low osmotic potential and increased relative water content, as well as shoot Mg accumulation, resulting in increased photosynthetic pigments and culminating in the highest drought tolerance. The results clearly indicate that Mg supplementation is a potential tool for alleviating water stress in M8808 soybean plants. Our findings suggest that the enhanced Mg-induced plant acclimation resulted from increased water content in plant tissues and strategic regulation of Mg content and photosynthetic pigments.

Effects of Preoperative Sarcopenia-Related Parameters on Cardiac Autonomic Function in Women with Obesity Following Bariatric Surgery: A One-Year Prospective Study.

OBJECTIVES: Investigate changes in blood pressure (BP) and heart rate variability (HRV) in women with and without sarcopenia-related parameters who underwent bariatric surgery (BS) during a one-year follow-up. SUBJECTS AND METHODS: Women were separated into obesity (OB, n = 20) and women with obesity displaying sarcopenia-related parameters (SOP, n = 14) and evaluated before BS and 3, 6, and 12 months after BS. SOP was defined as low handgrip strength (HS) and/or low appendicular skeletal mass adjusted for weight (ASM/wt × 100, %) in the lowest quartile of the sample. ASM/wt × 100, % and HS were significantly lower in SOP than OB over a one-year follow-up of BS (p < 0.05). RESULTS: There was a reduction in diastolic BP, heart rate (HR), SDHR, LF, and the LF/HF ratio (p < 0.05) and an increase in the HF band in both groups during the follow-up period (p < 0.05). SOP women had reduced root mean square differences of successive RR intervals (RMSSD) and HF band and an increased LF band and SD2/SD1 ratio compared to the OB group during the one-year follow-up (p < 0.05). ASM/wt × 100, % was negatively associated with the LF band (r = -0.24, p = 0.00) and positively associated with the HF band (r = 0.22, p = 0.01). Conversely, HS had no association with LF (r = -0.14, p = 0.09) and HF (r = 0.11, p = 0.19). ASM/wt × 100, % and HS were negatively associated with the LF/HF ratio (p < 0.05). CONCLUSIONS: Women who underwent BS had an improved HRV over a one-year follow-up. However, the improvement in HRV variables was less pronounced in women with low muscle mass and/or HS during the follow-up period.

Oxidative stability of white striping chicken breasts: effect of cold storage and heat treatments.

This study aimed to investigate the level of lipid and protein oxidation in poultry breasts with severe white striping (WS; striation thickness > 1 mm) and nonaffected meats (N; normal breast) during storage under refrigeration (1°C for 14 d) and freezing (-18°C for 90 d). WS presented higher lipid content, although no difference in protein content was detected, compared to normal broiler breast (N). Regarding oxidative damages, a reduction in malondialdehyde and carbonyl protein, hexanal, octanal and nonanal levels, alongside the interaction of these compounds with other compounds in raw, roasted, and reheated breasts was observed under refrigerated storage (14 d). Freezing storage promotes an increase in carbonyls proteins, hexanal, octanal and nonanal levels at 45 d of storage in poultry meats and subsequent decrease, indicating the evolution of oxidative reactions. Regardless of the type of storage, in general, breasts with WS myopathy have higher levels of lipid and protein oxidation.

Promotion, protection, and support of breastfeeding at work, and achieving sustainable development: a scoping review. / Promoção, proteção e apoio à amamentação no trabalho e o alcance do desenvolvimento sustentável: uma revisão de escopo.

This article aims to map promotion, protection, and support strategies aimed at working women who breastfeed and their potential impact on achieving the Sustainable Development Goals (SDGs), in particular SDGs 5 (gender equality and women's empowerment) and 8 (decent work and economic growth). This study is a scoping review based on the Joanna Briggs Institute (JBI) framework, whose searches were performed in PubMed, Web of Science, Scopus, Social Science Research Network, and Open Knowledge Repository databases. This study's search obtained 576 publications, of which 33 were included in the study. The narrative synthesis was organized into three axes: 1) promotion; 2) protection, and 3) support for breastfeeding in the work context. Actions aimed at women who breastfeed at work have the potential to directly achieve SDGs 5 and 8, and indirectly achieve SDGs 1 and 10. Increased breastfeeding rates also help to achieve another four SDGs (2, 3, 4, 12). Actions aimed at working women who breastfeed can contribute directly and indirectly to the achievement of eight of the 17 SDGs, and should therefore be encouraged and reinforced.

O objetivo deste artigo é mapear estratégias de promoção, proteção e apoio direcionadas às mulheres trabalhadoras que amamentam e o seu potencial impacto para alcançar os Objetivos de Desenvolvimento Sustentável (ODS), em particular os ODS 5 (igualdade de gênero e empoderamento da mulher) e 8 (trabalho decente e crescimento econômico). Revisão de escopo baseada no referencial do JBI (Joanna Briggs Institute), cujas buscas foram realizadas nas bases de dados PubMed, Web of Science, Scopus, Social Science Research Network e Open Knowledge Repository. Obtiveram-se 576 publicações, destas, 33 foram incluídas no estudo. A síntese narrativa foi organizada em três eixos: 1) promoção; 2) proteção; e 3) apoio ao aleitamento materno no contexto do trabalho. As ações voltadas às mulheres que amamentam no trabalho têm potencial para atingir diretamente os ODS 5 e 8, e atingem indiretamente os ODS 1 e 10. O aumento das taxas de amamentação contribui para atingir outros quatro ODS (2,3,4,12). As ações voltadas às mulheres trabalhadoras que amamentam podem contribuir direta e indiretamente para o alcance de oito dos 17 ODS, devendo, portanto, ser incentivadas e reforçadas.

Promoção, proteção e apoio à amamentação no trabalho e o alcance do desenvolvimento sustentável: uma revisão de escopo / Promotion, protection, and support of breastfeeding at work, and achieving sustainable development: a scoping review

Resumo O objetivo deste artigo é mapear estratégias de promoção, proteção e apoio direcionadas às mulheres trabalhadoras que amamentam e o seu potencial impacto para alcançar os Objetivos de Desenvolvimento Sustentável (ODS), em particular os ODS 5 (igualdade de gênero e empoderamento da mulher) e 8 (trabalho decente e crescimento econômico). Revisão de escopo baseada no referencial do JBI (Joanna Briggs Institute), cujas buscas foram realizadas nas bases de dados PubMed, Web of Science, Scopus, Social Science Research Network e Open Knowledge Repository. Obtiveram-se 576 publicações, destas, 33 foram incluídas no estudo. A síntese narrativa foi organizada em três eixos: 1) promoção; 2) proteção; e 3) apoio ao aleitamento materno no contexto do trabalho. As ações voltadas às mulheres que amamentam no trabalho têm potencial para atingir diretamente os ODS 5 e 8, e atingem indiretamente os ODS 1 e 10. O aumento das taxas de amamentação contribui para atingir outros quatro ODS (2,3,4,12). As ações voltadas às mulheres trabalhadoras que amamentam podem contribuir direta e indiretamente para o alcance de oito dos 17 ODS, devendo, portanto, ser incentivadas e reforçadas.

Abstract This article aims to map promotion, protection, and support strategies aimed at working women who breastfeed and their potential impact on achieving the Sustainable Development Goals (SDGs), in particular SDGs 5 (gender equality and women's empowerment) and 8 (decent work and economic growth). This study is a scoping review based on the Joanna Briggs Institute (JBI) framework, whose searches were performed in PubMed, Web of Science, Scopus, Social Science Research Network, and Open Knowledge Repository databases. This study's search obtained 576 publications, of which 33 were included in the study. The narrative synthesis was organized into three axes: 1) promotion; 2) protection, and 3) support for breastfeeding in the work context. Actions aimed at women who breastfeed at work have the potential to directly achieve SDGs 5 and 8, and indirectly achieve SDGs 1 and 10. Increased breastfeeding rates also help to achieve another four SDGs (2, 3, 4, 12). Actions aimed at working women who breastfeed can contribute directly and indirectly to the achievement of eight of the 17 SDGs, and should therefore be encouraged and reinforced.

Design and development of orally disintegrating films: A platform based on hydroxypropyl methylcellulose and guar gum.

From a design of experiments (DOE) performed under four independent variables, with the filmogenicity conditions and shortest disintegration time as the answers, a new oral disintegrating film (ODF) based on hydroxypropyl methylcellulose (HPMC) and guar gum (GG) with the essential oil of Plectranthus amboinicus L. (EOPA) was developed. Sixteen formulations were tested for filmogenicity, homogeneity, and viability. The better selected ODF required 230.1 s for complete disintegration. The retention rate of the EOPA was quantified using the nuclear magnetic resonance hydrogen technique (H1 NMR), which identified the presence of 0.14 % carvacrol. The scanning electron microscopy showed a smooth and homogeneous surface with the presence of small white dots. Through the disk diffusion test, the EOPA was able to inhibit the growth of clinical strains of the Candida genus and gram-positive and gram-negative bacterial strains. This work opens new perspectives for the development of antimicrobial ODFS used in clinical practice.

Técnicas para prática de escultura dental / Techniques for the practice of dental sculpture / Técnicas para la práctica de la escultura dental

Objetivo: Caracterizar e diferenciar as técnicas de escultura dental, bem como descrever as etapas da ceroplastia de dentes. Revisão Bibliográfica: As principais técnicas encontradas foram: Técnica de escultura regressiva de dentes isolados em cera; técnica progressiva; técnica de ceroplastia em dentes articulados no manequim; enceramento progressivo em molde de gesso; enceramento progressivo com a oclusão dente-a-dente, cúspide-fossa; técnica de escultura de dentes articulados (restaurações unitárias); técnica de escultura de dentes articulados (restaurações múltiplas). No geral, o material e instrumental utilizados nas práticas de escultura são definidos pelo corpo docente do componente curricular Escultura Dental, e alguns desses diferem de uma universidade para outra, assim como o passo a passo seguido. Para o alcance da completa e correta escultura, faz-se necessário seguir a sequência evitando ultrapassar uma etapa sem antes haver cumprido com plena observância dos detalhes o passo imediatamente anterior. Considerações finais: Não houve uma técnica de escultura dental padrão a ser aplicada, entretanto acredita-se que a técnica de ceroplastia em dentes articulados no manequim destaca-se na prática laboratorial, pois os dentes a serem esculpidos precisaram respeitar o tamanho, a relação de oclusão, a relação interdental e o alinhamento, de forma a simular um procedimento clínico.

Objective: To characterize and differentiate dental carving techniques, as well as describe the stages of wax-up of teeth. Bibliographic Review: The main techniques found were: Technique of regressive sculpture of isolated teeth in wax; progressive technique; wax-up technique on articulated teeth on the dummy; progressive waxing in plaster mold; progressive waxing with tooth-to-tooth, cusp-fossa occlusion; articulated teeth sculpting technique (single restorations); articulated teeth sculpting technique (multiple restorations). In general, the material and instruments used in sculpting practices are defined by the faculty of the Dental Sculpture curricular component, and some of these differ from one university to another, as well as the step by step followed. In order to achieve a complete and correct sculpture, it is necessary to follow the sequence, avoiding going beyond a stage without first having completed the immediately preceding step in full observance of the details. Final considerations: There was no standard dental sculpting technique to be applied, however, it is believed that the wax-up technique on articulated teeth on the dummy stands out in laboratory practice, as the teeth to be sculpted needed to respect the size, the relationship of occlusion, interdental relationship and alignment, in order to simulate a clinical procedure.

Objetivo: Caracterizar y diferenciar las técnicas de tallado dental, así como describir las etapas del encerado de los dientes. Revisión Bibliográfica: Las principales técnicas encontradas fueron: Técnica de escultura regresiva de dientes aislados en cera; técnica progresiva; técnica de encerado en dientes articulados en el maniquí; encerado progresivo en molde de yeso; encerado progresivo con oclusión cúspide-fosa diente a diente; técnica de esculpido de dientes articulados (restauraciones individuales); Técnica de esculpido de dientes articulados (restauraciones múltiples). En general, los materiales e instrumentos utilizados en las prácticas de escultura son definidos por la facultad del componente curricular de Escultura Dental, y algunos de estos difieren de una universidad a otra, así como el paso a paso seguido. Para lograr una escultura completa y correcta, es necesario seguir la secuencia, evitando pasar de una etapa sin haber completado antes el paso inmediatamente anterior con total atención a los detalles. Consideraciones finales: No existía una técnica de esculpido dental estándar a aplicar, sin embargo, se cree que la técnica de encerado sobre dientes articulados sobre el maniquí se destaca en la práctica de laboratorio, ya que los dientes a esculpir debían respetar el tamaño, la relación de oclusión, relación interdental y alineación, con el fin de simular un procedimiento clínico. PALABRAS CLAVE: Corona del Diente; Escultura; Anatomía Artística.

Algoritmo de indicação de acesso venoso para recém-nascidos em unidade de terapia intensiva neonatal / Venous access indication algorithm for newborns in neonatal intensive care unit / Algoritmo de indicación de acceso venoso para recién nacidos en una unidad de cuidados intensivos neonatales

RESUMO: Objetivo: apresentar um algoritmo de indicação de acessos venosos para recém-nascidos em Unidade de Terapia Intensiva Neonatal. Desenvolvimento: estudo descritivo realizado na Unidade de Terapia Intensiva Neonatal no sul do Brasil, no período de 2017 a 2020 em duas etapas de idealização: desenho do algoritmo; e a adequação baseada na aplicação conforme observações realizadas pelos enfermeiros envolvidos. O algoritmo desenvolvido contemplou a previsão de acesso venoso para pacientes com indicação de cirurgia abdominal e outras cirurgias, prematuros estratificados em idade gestacional superior e inferior a 30 semanas, cardiopatias com dependência ou não de canal arterial e hipoglicemia neonatal persistente. De acordo com a rede venosa, número de terapias prescritas, jejum, antibioticoterapia e drogas vasoativas, há indicação inicial de um tipo de cateter que pode ser seguido de outro de acordo com a necessidade. Conclusão: a participação do enfermeiro na indicação de acesso venoso integra as práticas interprofissionais e incrementa a assistência neonatal.

ABSTRACT Objective: to present an algorithm for the indication of venous accesses for newborns in Neonatal Intensive Care Unit. Development: descriptive study conducted in a Neonatal Intensive Care Unit in southern Brazil, in the period from 2017 to 2020 in two stages of idealization: design of the algorithm; and the adequacy based on the application according to observations made by the nurses involved. The developed algorithm contemplated the prediction of venous access for patients with indication for abdominal and other surgeries, premature infants stratified in gestational age higher and lower than 30 weeks, heart diseases with dependence or not on arterial channel and persistent neonatal hypoglycemia. According to the venous network, number of prescribed therapies, fasting, antibiotic therapy and vasoactive drugs, there is an initial indication for one type of catheter that may be followed by another according to need. Conclusion: the participation of nurses in the indication of venous access integrates interprofessional practices and increases neonatal care.

RESUMEN Objetivo: presentar un algoritmo para la indicación de accesos venosos para recién nacidos en la Unidad de Cuidados Intensivos Neonatales. Desarrollo: estudio descriptivo realizado en una Unidad de Cuidados Intensivos Neonatales en el sur de Brasil, en el período de 2017 a 2020 en dos etapas de idealización: diseño del algoritmo; y la adecuación basada en la aplicación de acuerdo con las observaciones realizadas por las enfermeras involucradas. El algoritmo desarrollado contemplaba la predicción de acceso venoso para pacientes con indicación de cirugías abdominales y de otro tipo, prematuros estratificados en edad gestacional superior e inferior a 30 semanas, cardiopatías con dependencia o no de canal arterial e hipoglucemia neonatal persistente. En función de la red venosa, el número de terapias prescritas, el ayuno, la antibioticoterapia y los fármacos vasoactivos, existe una indicación inicial para un tipo de catéter que puede ir seguida de otra según las necesidades. Conclusión: la participación del enfermero en la indicación de acceso venoso integra las prácticas interprofesionales e incrementa la asistencia neonatal.

Diaphragm ultrasound after manual rib cage stabilization maneuver in premature newborns: clinical trial / Ultrassom diafragmático após manobra de estabilização costal manual em recém-nascidos prematuros: ensaio clínico

Abstract Introduction The manual rib cage stabilization maneu-ver (MRCSM) is a physical therapy intervention that promotes stabilization of the zone of apposition of the diaphragm, facilitating the contraction of this muscle and the work of breathing. Objective To evaluate by diaphragm ultrasound the diaphragmatic excursion in premature newborns before and after MRCSM. Methods Before-after clinical trial assessing by diaphragm ultra-sound the effectiveness of MRCSM in the amplitude of diaphragmatic excursions. Results The study sample consisted of 48 premature newborns born at a mean gestational age of 33.0 ± 2.8 weeks with a mean birth weight of 1,904.1 ± 708.9 grams. The newborns were classified in three groups: without respiratory distress syndrome (RDS; n = 26), with RDS (n = 15) and with apnea (n = 7) as a cause of admission to the neonatal intensive care unit (NICU). The measurements of diaphragmatic excursion and thickening were similar in newborns without or with RDS or apnea and there was a significant increase in the amplitude of diaphragmatic excursions after MRCSM (p < 0.001; effect size > 0.68) and less diaphragmatic thickening at exhalation in all of them. The diaphragm thickening fraction was 0.50 (0.33 - 0.72), and the diaphragm thickening rate was 0.04 (0.03 - 0.07). These measurements showed no significant variation with the presence or absence of RDS or apnea (p > 0.05). No significant variations in heart rate (p = 0.30), respiratory rate (p = 0.79), and peripheral oxygen saturation, consid-ering newborns in ambient air (p = 0.17) compared with baseline. Conclusion The MRCSM was effective, safe, and increased the amplitude of diaphragmatic excursion and thickness in premature newborns at one week of age, regardless of the presence or absence of RDS or apnea as a cause of admission to the NICU.

Resumo Introducão A manobra manual de estabilização da caixa torácica (MRCSM) é uma intervenção fisioterapêutica que promove a estabilização da zona de aposição do diafragma, facilitando a contração deste músculo e o trabalho respiratório. Objetivo Avaliar pela ultrassonografia do diafragma a excur-são diafragmática em recém-nascidos prematuros antes e após MRCSM. Métodos Ensaio clínico antes e depois avaliando por ultrassonografia do diafragma a eficácia do MRCSM na amplitude das excursões diafragmáticas. Resultados A amos-tra do estudo foi composta por 48 recém-nascidos prematuros nascidos com idade gestacional média de 33,0 ± 2,8 semanas e peso médio ao nascer de 1904,1 ± 708,9 gramas. Os recém-nascidos foram classificados em três grupos: sem síndrome do desconforto respiratório (SDR; n = 26), com SDR (n = 15) e com apneia (n = 7) como causa de internação na unidade de terapia intensiva neonatal (UTIN) . As medidas de excursão e espessamento diafragmático foram semelhantes em recém-nascidos sem ou com SDR ou apneia e houve aumento significativo na amplitude das excursões diafragmáticas após MRCSM (p < 0,001; tamanho de efeito > 0,68) e menor espes-samento diafragmático na expiração em todos eles. A fração de espessamento do diafragma foi de 0,50 (0,33 - 0,72) e a taxa de espessamento do diafragma foi de 0,04 (0,03 - 0,07). Essas medidas não apresentaram variação significativa com a presença ou ausência de SDR ou apneia (p > 0,05). Não houve variações significativas na frequência cardíaca (p = 0,30), frequência respiratória (p = 0,79), saturação periférica de oxigênio, considerando os recém-nascidos em ar ambiente (p = 0,17) em comparação com o valor basal. Conclusão O MRCSM foi eficaz, seguro e aumentou a amplitude da excursão e espessura diafragmática em recém-nascidos prematuros com uma semana de idade, independentemente da presença ou ausência de SDR ou apneia como causa de admissão na UTIN.

What the skin of 341 premature newborns says - a transversal study

Abstract Objectives: Determine the frequency of dermatological diagnoses in preterm newborns up to 28 days of life and associated perinatal factors. Method: a cross-sectional analytical study with a convenience sample and prospective data collection, was conducted between November 2017 and August 2019. Overall, 341 preterm newborns who had been admitted to a University hospital - including those admitted to the Neonatal Intensive Care Unit - were evaluated. Results: 61 (17.9%) had less than 32 weeks gestational age (GA), with a mean GA and birth weight of 33.9 ± 2.8 weeks and 2107.8 ± 679.8g (465 to 4230g), respectively. The median age at the time of evaluation was 2.9 days (4 h to 27 days). The frequency of dermatological diagnoses was 100% and 98.5% of the sample had two or more, with an average of 4.67 +1.53 dermatoses for each newborn. The 10 most frequent diagnoses were lanugo (85.9%), salmon patch (72.4%), sebaceous hyperplasia (68.6%), physiological desquamation (54.8%), dermal melanocytosis (38.7%), Epstein pearls (37.2%), milia (32.2%), traumatic skin lesions (24%), toxic erythema (16.7%), and contact dermatitis (5%). Those with GA< 28 weeks showed more traumatic injuries and abrasions, whereas those with ≥ 28 weeks had physiological changes more frequently, and those with GA between 34-366/7 weeks, had transient changes. Conclusion: Dermatological diagnoses were frequent in our sample and those with higher GA showed a higher frequency of physiological (lanugo and salmon patch) and transient changes (toxic erythema and miliaria). Traumatic lesions and contact dermatitis were among the 10 most frequent injuries, reinforcing the need to effectively implement neonatal skin care protocols, especially in preterm.

Modelo estrutural de cidadania deliberativa: adição e validação de indicadores de participação / Modelo estructural de ciudadanía deliberativa: adición y validación de indicadores de participación / Structural model of deliberative citizenship: addition and validation of participation indicators

Resumo O objetivo deste estudo é aprimorar o modelo estrutural de cidadania deliberativa (Costa & Pinto, 2021, 2023), que tem por base os estudos relativos à aplicação de critérios (Tenório, 2012) ao campo teórico da gestão social. Os dados foram analisados mediante modelagem de equações estruturais (Hair, Hult, Ringle, & Sarstedt, 2017; Hair et al., 2021). Responderam ao questionário eletrônico 213 pessoas de variados territórios brasileiros, convidadas em redes sociais, com destaque para o LinkedIn. Além de ratificar a qualidade estatística do modelo estrutural de cidadania deliberativa (Costa & Pinto, 2021, 2023), validaram-se dois indicadores propostos ao construto "participação" (Costa & Pinto, 2021, 2023). O construto "processo deliberativo" segue em fase exploratória, tendo uma proposição de teste com um indicador adicional relativo ao critério "espaços de transversalidade". A validação dos indicadores adicionais ao construto "participação" elevou sua qualidade acima da zona exploratória, pois suas cargas externas ficaram acima de 0,7. Dessa forma, o aprimoramento realizado amplia a compreensão teórica e estatística do modelo, apto a ser aplicado aos diversos órgãos colegiados na gestão pública.

Resumen El objetivo de este estudio es mejorar el modelo estructural de ciudadanía deliberativa (Costa & Pinto, 2021, 2023), que se basa en estudios relacionados con la aplicación de criterios (Tenório, 2012) al campo teórico de la gestión social. Los datos se analizaron mediante modelos de ecuaciones estructurales (Hair, Hult, Ringle, & Sarstedt, 2017; Hair et al., 20211). 213 personas de varios territorios brasileños respondieron el cuestionario electrónico, invitadas a través de las redes sociales, con énfasis en LinkedIn. Además de confirmar la calidad estadística del modelo estructural de ciudadanía deliberativa (Costa & Pinto, 2021, 2023), se validaron dos indicadores propuestos para el constructo participación (Costa & Pinto, 2021, 2023). El constructo proceso deliberativo aún se encuentra en fase exploratoria, con una propuesta de prueba con un indicador adicional relacionado con el criterio de espacios transversales. La validación de indicadores adicionales al constructo participación elevó su calidad por encima de la zona exploratoria, ya que sus cargas externas fueron superiores a 0,7. De esta forma, la mejora realizada amplía la comprensión teórica y estadística del modelo, pudiendo ser aplicado a los distintos órganos colegiados de la gestión pública.

Abstract This study aims to improve the structural model of deliberative citizenship (Costa & Pinto, 2021, 2023), which is based on studies related to the application of criteria (Tenório, 2012) to the theoretical field of social management. Data were analyzed using structural equation modeling (Hair, Hult, Ringle, & Sarstedt, 2017; Hair et al., 2021). A sample of 213 people from various regions of Brazil responded to an electronic questionnaire after being invited via social media, with emphasis on LinkedIn. In addition to confirming the statistical quality of the structural model of deliberative citizenship (Costa & Pinto, 2021, 2023), two indicators proposed for the "participation" construct (Costa & Pinto, 2021, 2023) were validated. The "deliberative process" construct is still in an exploratory phase, with a test proposition with an additional indicator related to the "cross-cutting spaces" criterion. The validation of additional indicators to the "participation" construct raised its quality above the exploratory zone, as its outer loadings were above 0.7. Therefore, the improvement carried out expands the theoretical and statistical understanding of the model, which can be applied to the various collegiate bodies in public management.

Exposição ao gás cloro e padrões evolutivos da síndrome da disfunção reativa das vias aéreas: uma revisão sistemática / Chlorine gas exposure and evolutive patterns of reactive airways dysfunction syndrome: a systematic review

Resumo Introdução: o cloro é o gás irritante a que as pessoas estão comumente expostas no cotidiano. Um dos seus efeitos tóxicos é a síndrome da disfunção reativa das vias aéreas (SDRA). Objetivo: resumir as principais evidências dos padrões evolutivos da SDRA. Métodos: Revisão sistemática da literatura de artigos publicados entre setembro de 1985 e julho de 2021 no repositório da Universidade de São Paulo (USP) e nas bases BVS/LILACS, PubMed/Medline e SciELO. Foram utilizados os descritores "cloro" e "asma ocupacional" associados à "síndrome da disfunção reativa das vias aéreas" ou "asma induzida por irritantes". Dois revisores independentes selecionaram e avaliaram a qualidade dos estudos, com apoio do checklist do Instituto Joanna Briggs. Resultados: selecionaram-se 22 estudos: 11 séries de casos, oito relatos de caso e três estudos transversais. Os estudos selecionados abrangeram 1.335 participantes de 11 países, e apenas 170 tiveram diagnóstico de SDRA com evolução documentada. Destes, 115 (65%) foram devido à exposição ocupacional. Os padrões evolutivos mais frequentes foram persistência prolongada dos sintomas, alterações espirométricas e/ou hiper-responsividade brônquica, principalmente no ambiente ocupacional. Observou-se falta de padronização no relato de informações adequadas. Conclusões: a cronicidade foi o padrão evolutivo da SDRA mais frequente. Houve falta de informação apropriada que impediu uma análise adequada dos resultados.

Abstract Introduction: chlorine is the most irritant gas to which people are commonly exposed to daily. One of its toxic effects is reactive airway dysfunction syndrome (RADS). Objective: this study aims to summarize the evidence from the evolutive patterns of RADS. Methods: this systematic review study was conducted using the databases of the University of São Paulo repository, BVS/LILACS, PubMed/Medline, and SciELO. Studies from September 1985 to July 2021 with "chlorine" and "occupational asthma" as descriptors, associated with "reactive airway dysfunction syndrome" or "irritant-induced asthma," were included. These articles were assessed by two independent reviewers. The study's quality was assessed using the Joanna Briggs checklist. Results: a total of 22 studies were retrieved, including 11 case series, 8 case reports, and 3 cross-sectional studies. The selected studies covered 1.335 participants from 11 countries, and only 170 had a diagnosis of RADS with documented evolution. Of these, 115 (65%) were due to occupational exposure. The most frequent RADS evolutive pattern was the long-term persistence of symptoms, spirometric alterations, and/or bronchial hyperresponsiveness, mainly in the occupational setting. A lack of standardization of adequate information reporting was found. Conclusions: chronicity was the most frequent RADS evolutive pattern.

Reproductive autonomy associated with the use of contraceptive methods among reproductive aged women / Autonomía reproductiva asociada al uso de métodos anticonceptivos en mujeres en edad reproductiva / Autonomia reprodutiva associada ao uso de métodos contraceptivos entre mulheres em idade reprodutiva

ABSTRACT Objective: To assess the sociodemographic aspects associated with reproductive autonomy among urban women, with special regard to the relationship with the use of contraceptive methods. Method: Cross-sectional study with 1252 women, conducted between April and June 2021, using the Brazilian version of the Reproductive Autonomy Scale. Data were analyzed using multiple linear regression. Results: Mean scores for the subscales were 2.5 (SD=0.3) (Decision-making), 3.8 (SD=0.3) (Absence of Coercion) and 3.6 (SD=0.4) (Communication). Compared to women who reported no use of contraceptive methods, women using barrier or behavioral methods and those using LARC had higher level of reproductive autonomy on all dimensions of the Scale (p<0.001). Other aspects associated with reproductive autonomy were education, race/ethnicity, religion, socioeconomic status and cohabitation living with a partner, depending on each subscale. Conclusion: The type of contraceptive method used was statistically associated with reproductive autonomy in all subscales.

RESUMEN Objetivo: Verificar los aspectos sociodemográficos asociados a la autonomía reproductiva entre mujeres urbanas, especialmente en relación al uso de métodos anticonceptivos. Método: Estudio transversal realizado con 1252 mujeres, entre abril y junio de 2021, utilizando la versión brasileña de la Escala de Autonomía Reproductiva. Los datos se analizaron mediante regresión lineal múltiple. Resultados: Las puntuaciones medias de las subescalas fueron 2,5 (DE=0,3) (Toma de decisiones), 3,8 (DE=0,3) (Ausencia de coerción) y 3,6 (DE=0,4) (Comunicación). En comparación con las mujeres que informaron no usar métodos anticonceptivos, las mujeres que usaron métodos de barrera o conductuales y las que usaron LARC mostraron un mayor nivel de autonomía reproductiva en todas las dimensiones de la Escala (p<0,001). Otros aspectos asociados a la autonomía reproductiva fueron la educación, la raza/color, la religión, el grupo socioeconómico y la convivencia, según cada subescala. Conclusión: El tipo de método anticonceptivo utilizado se asoció estadísticamente con la autonomía reproductiva en todas las subescalas.

RESUMO Objetivo: Verificar os aspectos sociodemográficos associados à autonomia reprodutiva entre mulheres urbanas, em especial na relação com o uso de métodos contraceptivos. Método: Estudo transversal realizado com 1252 mulheres, entre abril e junho de 2021, utilizando a versão brasileira da Escala de Autonomia Reprodutiva. Os dados foram analisados por meio de regressão linear múltipla. Resultados: Os escores médios das subesacalas foram 2,5 (dp=0,3) (Tomada de decisão), 3,8 (dp=0,3) (Ausência de Coerção) e 3,6 (dp=0,4) (Comunicação). Comparadas às mulheres que relataram não usar métodos contraceptivos, mulheres que usavam métodos de barreira ou comportamentais e as que usavam LARC mostraram maior nível de autonomia reprodutiva em todas as dimensões da Escala (p<0,001). Outros aspectos associados à autonomia reprodutiva foram a escolaridade, raça/cor, religião, grupo socioeconômico e morar com o parceiro,a depender de cada subescala. Conclusão: O tipo de método contraceptivo utilizado foi estatisticamente associado à autonomia reprodutiva em todas as subescalas.

Effect of Spinal Correction Surgery on Lower Limb Strength in Idiopathic Adolescent Scoliosis / Efeito da cirurgia de correção da coluna vertebral na força dos membros inferiores na escoliose idiopática do adolescente

Abstract Objectives To analyze the lower limb strength in both untreated and surgically treated adolescent idiopathic scoliosis (AIS) patients and examine its correlation with the distance covered in a six-minute walking test (6MWT). Methods A total of 88 participants (n = 30 pre-surgery AIS patients, n = 30 postsurgical AIS patients, and n = 28 control) underwent a 6MWT and a muscle strength assessment. The lower limb strength was measured at the knee joint using the knee extension (KE) and knee flexion (KF) peak torque (PT) measurements. Results The control group covered a greater distance in the TC6 compared to both the pre-surgical (534 ± 67 m) and post-surgical (541 ± 69 m) groups, with a distance of 612 ± 70 m (p < 0.001). No differences were observed in KE PT (pre: 2.1 ± 0.63, post: 2.1 ± 0.7, control: 2.2 ± 0.7 Nm.kg-1, p = 0.67) or KF PT (pre: 1.0 ± 0.3, post: 1.1 ± 0.3, control: 1.1 ± 0.5 Nm.kg-1, p = 0.46). A moderate positive correlation was observed between KE PT and 6MWT distance (r = 0.53, p < 0.001), as well as a low positive correlation for KF PT (r = 0.37, p = 0.003) with 6MWT distance. Conclusion This study highlights the importance of lower limb maximal strength in the functionality of AIS patients. Our findings suggest that exercise programs aimed at enhancing lower limb strength, especially the KE, could improve the walking capacity of AIS patients. These results provide useful information for designing purposeful exercise programs for AIS patients with walking deficits.

Resumo Objetivos Analisar a força dos membros inferiores em pacientes com escoliose idiopática do adolescente (EIA) submetidos ou não ao tratamento cirúrgico e examinar sua correlação com a distância percorrida em um teste de caminhada de seis minutos (TC6). Métodos Um total de 88 participantes (n = 30 pacientes com EIA pré-operatório, n = 30 pacientes com EIA pós-operatório e n = 28 controles) foram submetidos ao 6MWT e à avaliação da força muscular. A força dos membros inferiores foi medida na articulação do joelho usando os valores de pico de torque (PT) de extensão do joelho (EJ) e flexão do joelho (FJ). Resultados O grupo controle percorreu uma distância maior no TC6 em comparação aos grupos pré-operatório (534 ± 67 m) e pós-operatório (541 ± 69 m), com distância de 612 ± 70 m (p < 0,001). Não foram observadas diferenças em PT EJ (pré: 2,1 ± 0,63, pós: 2,1 ±0,7, controle: 2,2±0,7 Nm.kg-1, p = 0,67) ou PT FJ (pré: 1,0±0,3, pós: 1,1 ±0,3, controle: 1,1 ±0,5 Nm.kg-1, p = 0,46). Houve uma correlação positiva moderada entre PT EJ e a distância do TC6 (r = 0,53, p<0,001), assim como uma correlação positiva baixa entre PT FJ (r = 0,37, p = 0,003) e a distância do TC6. Conclusão Este estudo destaca a importância da força máxima dos membros inferiores na funcionalidade de pacientes com EIA. Nossos achados sugerem que programas de exercícios destinados a aumentar a força dos membros inferiores, especialmente de EJ, podem melhorar a capacidade de caminhada de pacientes com EIA. Esses resultados fornecem informações úteis para o projeto de programas de exercícios intencionais para pacientes com EIA e déficits de marcha.

Lung Inflammasome Activation in SARS-CoV-2 Post-Mortem Biopsies.

The inflammasome complex is a key part of chronic diseases and acute infections, being responsible for cytokine release and cell death mechanism regulation. The SARS-CoV-2 infection is characterized by a dysregulated cytokine release. In this context, the inflammasome complex analysis within SARS-CoV-2 infection may prove beneficial to understand the disease's mechanisms. Post-mortem minimally invasive autopsies were performed in patients who died from COVID-19 (n = 24), and lung samples were compared to a patient control group (n = 11) and an Influenza A virus H1N1 subtype group from the 2009 pandemics (n = 10). Histological analysis was performed using hematoxylin-eosin staining. Immunohistochemical (IHC) staining was performed using monoclonal antibodies against targets: ACE2, TLR4, NF-κB, NLRP-3 (or NALP), IL-1ß, IL-18, ASC, CASP1, CASP9, GSDMD, NOX4, TNF-α. Data obtained from digital analysis underwent appropriate statistical tests. IHC analysis showed biomarkers that indicate inflammasome activation (ACE2; NF-κB; NOX4; ASC) were significantly increased in the COVID-19 group (p < 0.05 for all) and biomarkers that indicate cell pyroptosis and inflammasome derived cytokines such as IL-18 (p < 0.005) and CASP1 were greatly increased (p < 0.0001) even when compared to the H1N1 group. We propose that the SARS-CoV-2 pathogenesis is connected to the inflammasome complex activation. Further studies are still warranted to elucidate the pathophysiology of the disease.