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Pulp and paper industries are very important for developing the Brazilian economy. During production processes, many effluents are generated with high polluting potential. The objective of this study is to conduct an extensive literature review on the characteristics of effluents and treatment forms adopted by Brazilian mills in this industrial sector. Most consulted studies address raw (without treatment) and secondary (after biological treatment) effluents, considering their main characteristics like pH, chemical and biochemical oxygen demands (COD and BOD, respectively), color, solids, organochlorines, toxicity, estrogenic activity, and phenols. Raw effluents differ considerably in composition, depending on the type of paper produced, the pulping process employed, and other steps, like pulp bleaching. Raw effluent characteristics indicate that this effluent cannot be directly disposed of into water bodies, because it does not comply with federal and state disposal standards. Secondary effluents normally comply with Brazilian legislations, although some studies have reported COD and total phenol concentrations higher than disposal standards, suggesting that additional treatments are necessary. Treated effluent reuse was verified in some Brazilian mills, while its disposal in eucalyptus plantations has been considered a promising alternative for irrigation purposes.

Gastro-oesophageal reflux (GOR) and food allergy (FA) are common conditions, especially during the first 12 months of life. When GOR leads to troublesome symptoms, that affect the daily functioning of the infant and family, it is referred to as GOR disease (GORD). The role of food allergens as a cause of GORD remains controversial. This European Academy of Allergy and Clinical Immunology (EAACI) position paper aims to review the evidence for FA-associated GORD in young children and translate this into clinical practice that guides healthcare professionals through the diagnosis of suspected FA-associated GORD and medical and dietary management. The task force (TF) on non-IgE mediated allergy consists of EAACI experts in paediatric gastroenterology, allergy, dietetics and psychology from Europe, United Kingdom, United States, Turkey and Brazil. Six clinical questions were formulated, amended and approved by the TF to guide this publication. A systematic literature search using PubMed, Cochrane and EMBASE databases (until June 2021) using predefined inclusion criteria based on the 6 questions was used. The TF also gained access to the database from the European Society of Paediatric Gastroenterology and Hepatology working group, who published guidelines on GORD and ensured that all publications used within that position paper were included. For each of the 6 questions, practice points were formulated, followed by a modified Delphi method consisting of anonymous web-based voting that was repeated with modified practice points where required, until at least 80% consensus for each practice point was achieved. This TF position paper shares the process, the discussion and consensus on all practice points on FA-associated GORD.

This paper reports the use of paper spray mass spectrometry (PS-MS) combined with chemometric models to analyze seized samples of anabolic steroids. Because many forensic laboratories typically demand high-throughput analysis for this type of sample, we developed a quicker and simpler alternative analytical method for routine analysis with minimal sample preparation. Oily samples (n = 39) resulting from seizures carried out by Brazilian Federal and State Police units were selected for this study. These samples were analyzed by PS-MS in the positive ion mode and full scan (50-1000 m/z), providing spectra containing patterns of the respective active ingredients present in each product. A principal component analysis (PCA) model was built, which discriminated samples mainly according to their active ingredients and allowed to detect and characterize some cases of product counterfeiting. The variable selection method ordered predictors selection was employed jointly with PCA to improve sample cluster separation and to provide model simplification. The final PCA model was built with three principal components and using only 28 spectral variables. This model accounted for 69.82% of the variance and discriminated samples according to their specific active ingredients.

Pulp and paper mill wastewater (PPMWW) contains high concentrations of recalcitrant compounds that cause toxicity to organisms. Advanced oxidation processes (AOPs) have the ability to degrade these compounds and reduce overall toxicity. Physicochemical characterization and Lactuca sativa toxicity test were conducted to compare the effectiveness of two post-treatments: UV/H

The purpose of this review was to identify and analyze the main characteristics of the 100 most-cited papers in the field of endodontic therapy in primary teeth. A search for the most-cited articles was conducted in the Clarivate Analytics Web of Science ‘Core-Collection’ (WoS-CC) database up to December 2020. Papers were ranked in descending order, by number of citations, and each paper was matched with the citation count on Scopus and Google Scholar. Two independent reviewers selected the most-cited papers and analyzed it according to the number and density of citations, year and journal of publication, authors, countries and contributing institutions, study design, topic of the paper, and keywords. Spearman’s correlation and Poisson regression were used to determine associations between the number of citations and study characteristics. The citation count varied from 15 to 135 (WoS-CC), 8 to 141 (Scopus), and 14 to 317 (Google Scholar). Of the 306 contributing authors, most paper contributions were from Sakai VT, Oliveira TM, and Machado MAAM (5 each). Most of the papers originated from the USA (n=21) and Brazil (n=18). Randomized trials were the most common study design (n=32), and “pulpotomy” was the most frequently used keyword (n=35). Poisson regression showed that the number of citations decreased by 1.5% each year, and increased by 9.7% for each unit of impact factor. This bibliometric analysis highlighted papers, authors, and institutions that have contributed to endodontic therapy in primary teeth. Common terms of interest in this research area was also identified, representing the first bibliometric analysis on this subject.

The scientific publication landscape is changing quickly, with an enormous increase in options and models. Articles can be published in a complex variety of journals that differ in their presentation format (online-only or in-print), editorial organizations that maintain them (commercial and/or society-based), editorial handling (academic or professional editors), editorial board composition (academic or professional), payment options to cover editorial costs (open access or pay-to-read), indexation, visibility, branding, and other aspects. Additionally, online submissions of non-revised versions of manuscripts prior to seeking publication in a peer-reviewed journal (a practice known as pre-printing) are a growing trend in biological sciences. In this changing landscape, researchers in biochemistry and molecular biology must re-think their priorities in terms of scientific output dissemination. The evaluation processes and institutional funding for scientific publications should also be revised accordingly. This article presents the results of discussions within the Department of Biochemistry, University of Sao Paulo, on this subject.

Bisphenol A (BPA) is a high-production-volume chemical with endocrine disrupting properties commonly used as color developer in thermal paper. Concerns about the potential hazards of human BPA exposure have led to the increasing utilization of alternatives such as bisphenol S (BPS) and bisphenol F (BPF). This study was designed to assess: (i) BPA, BPS, and BPF concentrations in 112 thermal paper receipts from Brazil, France, and Spain by liquid chromatography coupled to mass spectrometry (LC-MS); and (ii) hormone-like activities of these receipts using two receptor-specific bioassays, the E-Screen for (anti-)estrogenicity and PALM luciferase assay for (anti-)androgenicity. BPA was present in 95.3% of receipts from Spain, 90.9% of those from Brazil, and 51.1% of those from France at concentrations up to 20.27 mg/g of paper. Only two samples from Brazil, two from Spain, and ten from France had a BPS concentration ranging from 6.46 to 13.29 mg/g; no BPA or BPS was detected in 27.7% of French samples. No BPF was detected in any receipt. Estrogenic activity was observed in all samples from Brazil and Spain and in 74.5% of those from France. Anti-androgenic activity was observed in > 90% of samples from Brazil and Spain and in 53.2% of those from France. Only 25.5% of French samples were negative for both estrogenic and anti-androgenic activity. Estrogenic and anti-androgenic activities per gram of paper were up to 1.411 µM estradiol (E2) equivalent units (E2eq) and up to 359.5 mM procymidone equivalent units (Proceq), respectively. BPA but not BPS concentrations were positively correlated with both estrogenic and anti-androgenic activities. BPA still dominates the thermal paper market in Brazil and Spain, and BPS appears to be one of the main alternatives in France. There is an urgent need to evaluate the safety of alternatives proposed to replace BPA as developer in thermal printing. The large proportion of samples with hormonal activity calls for the adoption of preventive measures.

Synthetic cannabinoid receptor agonists (SCRAs) are a class of varied compounds that mimic the effects of natural cannabinoids found in cannabis. Because they have a wide range of diverse structures, they vary widely in their potency. The abuse of new psychoactive substances (NPS) in prisons was reported in many European countries and in the USA. In the present study, we have described the identification of SCRAs in 56 infused paper sheet samples, seized mainly in Brazilian prisons between 2016 and 2020.The materials were seized by local or federal law enforcement and analyzed by São Paulo State Police or Brazilian Federal Police using gas chromatography-mass spectrometry, attenuated total reflection-Fourier transform infrared spectroscopy, liquid chromatography-high-resolution mass spectrometry or nuclear magnetic resonance spectrometry.Most of these samples (87.5%) were seized in 2019-2020; seven different SCRAs were identified in samples, and the most frequently identified substances were MDMB-4en-PINACA (23.6%) and 5F-MDMB-PICA (36.4%), the newest SCRAs emerging recently.As observed in Europe and the USA, Brazil also shows the prevalence of indazole-3-carboxamides and indole-3-carboxamides among SCRAs seizures in the prison system. This phenomenon is spreading all over the world at this moment. These data on the prevalence could help to alert judicial authorities to shutting down the introduction of NPS, including SCRAs, into prisons to ensure safety and security for avoiding health risks of prisoners and staff, leading to positive effects in this population. To our knowledge, this is the first demonstration of SCRAs smuggling into prisons in Latin America.

Introduction: Malnutrition in hospitalized patients is not evaluated frequently. However, it is a critical issue given that it has been related to a high rate of infectious complications and increased mortality rates. There is a high prevalence of patients with nutritional impairment in the home environment, which favors their clinical worsening, the increase of re-hospitalizations and, consequently, the increase in public health expenditures. Objective: Nutrition experts have thoroughly discussed and written this positioning paper on hospital and homecare malnutrition to describe the prevalence of malnutrition in Brazil. Best practice recommendations for nutrition therapy of patients in hospital and homecare, in particular the use of oral nutritional supplements (ONS), to those who are at risk of malnutrition or malnourished were evaluated, and the impact on clinical and economic data were assessed. In addition, they emphasize that investments in oral nutritional supplementation are also important in the homecare environment (home or nursing homes). Materials and methods: Selected scientific articles on disease-related malnutrition, especially those carried out in Brazil, were assessed. Data on prevalence, clinical outcomes, and economic burdens were reviewed. Results and conclusion: Several studies have shown the importance of in-hospital nutritional assessment for early detection of malnutrition and early intervention with nutrition therapy, in particular with oral nutritional therapy. Unfortunately, hospital malnutrition remains high in Brazil, with severe consequences for patients. The implementation of universal nutritional screening and diagnosis as well as the therapeutic approach of malnutrition, particularly with the use, when possible, of oral nutrition supplements as the first step to address this condition is still low, and demands the investment in educational resources to change practices. Routine use of nutritional therapy in hospital and homecare settings improves clinical outcomes, is cost effective, and would be expected to help reduce healthcare costs.

The use of mind maps as a method of building knowledge, planning, organizing activities and ideas can be seen in the literature related to ergonomics. The results of such use are relevant and its use in academic area found. However, regarding to its use in industrial environments, studies can't not be found. With this scenario, and based on the perception of the ergonomist about the importance of using methods such as mind maps in support of human cognition, it seems pertinent to its use in industry sectors whose cognitive demand requires. Given these assumptions, this study aimed to apply the method of Mind Maps in Productive Maintenance sector of a Brazilian paper. The Productive Maintenance sector in the Paper Industry has an important contribution to operational performance. With practical Predictive Maintenance, Preventive Maintenance and Corrective Maintenance, the industry advocates to make the machines to produce paper is not to stop producing when they are programmed to do so. Among the practices cited, the Preventive Maintenance is one that leads to pre-determined intervals in order to reduce the possibility of placing the equipment in a condition below the required level of acceptance. Therefore, this article aims to propose using the tool "mental maps" in order to collaborate in planning and implementation of preventive maintenance activities in the sector of mechanical maintenance of a pulp and paper industry in southern Brazil. The study investigated the maintenance sector through its employees, who went through training about the tool and then use it and ergonomists company.

INTRODUCTION: Human serofrequency of antibodies against Taenia solium antigens was determined and risk factors for cysticercosis transmission were identified. METHODS: Individuals (n=878) from periurban and rural locations of Lages, SC, were interviewed to gather demographic, sanitary and health information. Interviews and blood sample collections by finger prick on Whatman filter paper were performed from August 2004 to May 2005. Observation determined that 850 samples were suitable for analysis and were tested by ELISA using vesicular fluid of Taenia crassiceps heterologous antigen. To ensure the reliability of the results, 77 samples of the dried blood were matched with sera. The reactive samples were submitted to a serum confirmatory immunoblot (IB) test using purified Taenia crassiceps glycoproteins. RESULTS: The ELISA results for the dried blood and serum samples were statistically consistent. ELISA was positive in 186 (21.9%) out of 850 individuals. A group of 213 individuals were asked to collect vein blood for IB (186 with positive result in ELISA and 27 with inappropriate whole blood samples) and 130 attended the request. The IB was positive in 29 (3.4%) out of 850 individuals. A significant correlation (p = 0.0364) was determined among individuals who tested positive in the IB assay who practiced both pig rearing and kitchen gardening. CONCLUSIONS: ELISA with dried blood eluted from filter paper was suitable for cysticercosis population surveys. In Lages, human infection was associated with pig rearing and kitchen gardening. The prevalence index was compatible with other Latin American endemic areas. INTRODUÇÃO: O primeiro levantamento sobre cisticercose humana e identificação dos fatores de risco associados à transmissão, foram realizados em Lages, SC. MÉTODOS: Oitocentos e setenta e sete voluntários de regiões periurbana e rural foram entrevistados e forneceram informações demográficas e condições sanitárias e de saúde. Amostras de sangue foram coletadas por meio de punção digital em papel filtro entre agosto 2004 e maio 2005. Verificou-se que 850 amostras estavam adequadas para análise. No ELISA, utilizou-se o antígeno heterólogo liquido vesicular de Taenia crassiceps. Para assegurar a confiabilidade dos resultados de ELISA, foram pareadas 77 amostras de soro e sangue eluido do papel filtro. A confirmação do diagnóstico sorológico foi feita por immunoblot (IB) com glicoproteínas purificadas de Taenia crassiceps. RESULTADOS: A reatividade de IgG eluída de sangue em papel filtro mostrou-se compatível com a dos soros correspondentes. A triagem por ELISA de 850 indivíduos revelou 186 (21,9%) positivos. De 213 pessoas convidadas a colher soro para IB (186 ELISA positivo e 27 com amostras de sangue total inadequadas), compareceram 130. O IB foi positivo em 29 (3,4%) de 850 amostras. Houve correlação significativa entre IB positivo e a prática de criação de suínos e de horta caseira (p = 0,0364). CONCLUSÕES: ELISA com sangue total em papel filtro mostrou-se adequado para inquéritos populacionais para cisticercose. A transmissão da cisticercose humana na área estudada mostrou correlação com criação suína domestica e horta caseira. A prevalência obtida foi semelhante à relatada em áreas endêmicas da América Latina.

Bisphenol A (BPA) is an endocrine and metabolic disruptor commonly employed as a color developer in thermal papers. Consequently, BPA derived from thermal papers has been considered an important source of exposure for humans, since this chemical may migrate from paper to skin upon contact. Further, due to recent restrictions on BPA use in some countries, it has been replaced by a new analogue, bisphenol S (BPS). The aim of the present study was to determine levels of BPA and BPS in 190 different thermal receipts, randomly collected from different locations in Sao Paulo State, Brazil, including receipts from supermarkets, general and fast-food restaurants, gas stations, bus and airplane tickets, and credit card and bank accounts. BPA and/or BPS were detected in 98% of samples at concentrations ranging from below the quantification limit to 4.3% (mg/100 mg paper). The obtained values were higher than amounts previously reported in other countries. The estimated daily intake through dermal absorption from handling of thermal receipt papers was estimated on the basis of concentrations and frequencies of handling of papers by humans in both the general population and occupationally exposed individuals. Fifth percentile, median, and 95th percentile daily intakes by the general population were 0.44, 1.42, and 2 μg/d, respectively, whereas the corresponding values for occupationally exposed population are 21.8, 71 and 101 μg/d. The potential adverse consequences of elevated occupational exposure are currently being examined.

OBJECTIVE: To contrast how Brazil’s and Canada’s different jurisdictional and judicial realities have led to different types of telemedicine and how further scale and improvement can be achieved. COMPOSITION OF THE COMMITTEE: A subgroup of the Besrour Centre of the College of Family Physicians of Canada and Canadian telemedicine experts developed connections with colleagues in Porto Alegre, Brazil, and collaborated to undertake a between-country comparison of their respective telemedicine programs. METHODS: Following a literature review, the authors collectively reflected on their experiences in an attempt to explore the past and current state of telemedicine in Canada and Brazil. REPORT: Both Brazil and Canada share expansive geographies, creating substantial barriers to health for rural patients. Telemedicine is an important part of a universal health system. Both countries have achieved telemedicine programs that have scaled up across large regions and are showing important effects on health care costs and outcomes. However, each system is unique in design and implementation and faces unique challenges for further scale and improvement. Addressing regional differences, the normalization of telemedicine, and potential alignment of telemedicine and artificial intelligence technologies for health care are seen as promising approaches to scaling up and improving telemedicine in both countries.

OBJECTIVE: To develop an ethical framework for collaboration in international academic partnerships in family medicine. COMPOSITION OF THE COMMITTEE: A subgroup of the Besrour Centre of the College of Family Physicians of Canada including family medicine and bioethics experts began to collaborate in 2014 to undertake the development of an ethical framework and tools for the establishment of ethically sound international academic partnerships. METHODS: Following 2 consultative workshops and a wider consultation process with the Besrour Centre global community, the authors developed an ethical framework and tools for approval by the Besrour Centre leadership in November 2017. REPORT: Partnerships are essential to family practice and to the field of international development. The flawed nature of many North-South research partnerships underlines the importance of and need for delineating core principles for ethically sound partnerships, of which 10 have been identified in this process: accountability, cost and efficiencies, excellence, equity, humility, justice, leadership, reciprocity, respect for self-determination, and transparency. Based on these principles, a decision-making framework was created to translate these values into actions and to promote a cohesive and transparent structure for discussions. Fostering fairness, transparency, and consistency in decision making reduces the potential for inequity in a partnership, leading to lasting relationships that endure beyond the scope of a partnership agreement.

The authors examined the potential of pulp mill effluent from pulp-producing countries (Canada, Brazil, New Zealand) to affect fish reproduction. Specifically, the estrogenic effects in juvenile rainbow trout (Oncorhynchus mykiss) pulse-exposed to 11 different mill effluent extracts (intraperitoneal injections of solid-phase extraction-dichloromethane nonpolar fraction). The results indicated that effluent extracts were estrogenic in juvenile trout irrespective of the gender, as reflected by increasing level of plasma vitellogenin (VTG; Brazil New Zealand Canada). Despite the high variability observed among mills, differences in VTG levels were related to the type of mill process (kraft elementary chlorine-free kraft thermomechanical pulping). Moreover, effluent treatments did not appear to significantly decrease VTG induction. A consistent estrogenic effect was observed in those mills that process a combination of feedstocks (softwood and hardwood), with the highest increase in VTG related to eucalyptus feedstock. The results demonstrate significant estrogenic effects of pulp mill effluents on chronically exposed juvenile trout, suggesting that in vivo metabolic activation of precursors is necessary to cause the observed increases in VTG levels. This molecular estrogenic response provides a useful starting point for predicting population-level impacts through the adverse outcome pathway methodology. Environ Toxicol Chem 2017;36:1547-1555. © 2016 SETAC.

Background The most-cited papers help to better understand important characteristics of this specific science field. Objective To analyse the 100 most-cited papers in the field of Paediatric Dentistry. Design A search of the most-cited papers in Paediatric Dentistry journals was performed using journals included in the category of 'Dentistry, Oral Surgery & Medicine' in the Thompson Reuters Web of Science citation indexing database up to December 2018. Two researchers performed the data extraction, which included: number of citations, title, authors, country, year, journals, study design, and thematic area. Results The number of citations of each paper included in the top 100 most-cited ranged from 42 to 182 (mean: 64.51). Seven papers were cited more than 100 times. Most of the papers were published in the International Journal of Paediatric Dentistry (36%), between 2006 and 2015 (55%), with a cross-sectional design (39%). Twenty-six authors participated in two or more papers. The countries with the highest number of most-cited papers were the United States (25%), Australia (11%), and Brazil (9%). Cariology was the most studied thematic area. Conclusion The evaluation of the top 100 most-cited papers in Paediatric Dentistry journals allowed for a better understanding of the world scenario regarding this research field.

Social wasps from temperate zones have clear annual colony cycles, and the young queens hibernate during winter. In the subtropics, the only previously reported evidence for the existence of "hibernation" is the facultative winter aggregations of females during harsh climate conditions. As in temperate-zone species analyzed so far, we show in this study that in the paper wasp, Polistes versicolor, a subtropical species, body size increases as an unfavorable season approaches. Our morphological studies indicate that larger females come from winter aggregations--that is, they are new queens. Multivariate analyses indicate that size is the only variable analyzed that shows a relationship to the differences. Given the absence of a harsh climate, we suggest that the occurrence of winter aggregations in tropical P. versicolor functions to allow some females to wait for better environmental conditions to start a new nest, rather than all being obliged to start a new nest as soon as they emerge.

The usefulness of filter paper for preservation of bacterial cells was shown by mixed-linker DNA fingerprint analysis of Mycobacterium tuberculosis isolates from 77 Brazilian patients. DNA fingerprints of samples spotted onto filter paper and conventional culture material were identical. Thus, filter paper specimens analyzed by an amplification-based typing method provide a new resource for epidemiological studies of infectious diseases.

This chapter discusses the evolution of the South American pulp and paper industry (PPI), emphasising Brazil, Chile and Uruguay. The analysis is mainly based on secondary sources and demonstrates how the industry has evolved from its establishment to its present organization, the development of mechanisms and institutions to support innovation and the political, economic and legal regulations, including environmental regulation and social responsibility. This analysis is justified because of the importance the region has gained in the scenario of PPI worldwide, following a trend of reorganization and expansion of the PPI.

Arterial blood pressure (BP) is a very useful variable in clinical practice. Its measurement is simple, inexpensive and easy; it is worth noting that BP should be accurately obtained, following the recommendations of the VI Brazilian Guidelines on Hypertension (DBH VI)1. Office BP measurement is the central parameter for the diagnosis, treatment and follow-up of systemic arterial hypertension (SAH), being directly, continuously and independently related to the risk of fatal and non-fatal cardiovascular (CV) events1-3. Thus, the consideration of BP values closer to the upper limits of normality, the so-called prehypertension (PH)2, and intervention on those values have been emphasized over the last decade, because PH represents an important opportunity to prevent established SAH, contributing to reduce the associated CV risk. Repeated BP measurement at the office allows the diagnosis of hypertension and normotension. To better assess BP behavior, there are methods that analyze BP by using a higher number of measurements, minimizing interferences of the environment, situation and observer. Those alternatives are as follows: 24-hour ambulatory BP monitoring (ABPM); and dwelling BP measurement [home BP monitoring (HBPM) and BP self-measurement (BPSM)]. Based on those methods, two other BP classifications were adopted: white coat hypertension (WCH) and masked hypertension (MH)1,3-5 (Figure 1). Figure 1 Classification of blood pressure behavior considering office BP, ABPM and home BP measurements1. ABPM: ambulatory blood pressure monitoring; BP: blood pressure. Epidemiological and clinical studies on those conditions are still limited; however, they deserve attention because of their higher CV risk as compared with normotension6,7. This document represents the position of the Brazilian Society of Cardiology Arterial Hypertension Department (DHA/SBC) on the diagnosis and non-drug and drug therapy for PH, WCH and MH, aiming at contributing to a better clinical practice.

Background: A better understanding of how multicomponent school-based interventions work and their effects on health and education outcomes are needed. This paper described the methods of the Movimente Program, a school-based intervention that aims to increase physical activity (PA) and decrease sedentary behavior (SB) among Brazilian students. Methods: This is a cluster randomized controlled trial with adolescents from 7th to 9th grade in public schools from Florianopolis, Southern Brazil. After agreement, 6 schools were randomly selected to intervention or control groups (3 schools each), and all eligible students were invited to the study. The Movimente intervention program was performed during a school year and included 3 main components: Teacher training (including face-to-face meeting, social media platform, and handbook with lesson plans); improvements in the PA environment in school; and educational strategies. Control schools continued with their traditional schedule. Baseline (March/April 2017), postintervention (November/December 2017), and maintenance (June/July 2018) evaluations included PA and SB as primary outcomes (assessed by self-report and accelerometry). Secondary outcomes included psychosocial factors related to PA and SB (e.g., social support and self-efficacy), as well as health (e.g., quality of life and nutritional status) and education (e.g., academic achievement) outcomes. A program evaluation was performed based on the RE-AIM framework. Participants, intervention staffs, and evaluators were not blinded to group assignment, but a standardized evaluation protocol was applied independently of the trial allocation. Results: Statistical analyses will include a multilevel approach for repeated measurements and mediation analysis. Any side effects of the intervention will be recorded. The sample size close to that expected (n = 1090) was reached (n = 999). The results of this trial will involve valuable information about the effect and the evaluation of a multicomponent intervention carried out in a middle-income country. Conclusion: By creating opportunities for adolescents to be active at school using multicomponent strategies, the Movimente program has the potential to enhance students health and academic performance which may encourage the school community (e.g., teachers, principals) to adopt the program. Also, this trial will provide evidence for practitioners, policy makers, and researchers on how multicomponent program may be implemented in a school setting. Trial registration: The trial is registered at the Clinical Trial Registry (Trial ID: NCT02944318; date of registration: 18 October 2016).

This study investigates factors affecting reproduction in fish exposed to pulp and paper mill effluents by comparing effluents from countries with varying levels of documented effects. To explore the hypothesis of wood as a common source of endocrine disrupting compounds, feedstocks from each country were analyzed. Analyses included in vitro assays for androgenic activity (binding to goldfish testis androgen receptors), estrogenic activity (yeast estrogen screen), and neurotransmitter enzyme inhibition (monoamine oxidase and glutamic acid decarboxylase). Chemical analyses included conventional extractives, known androgens, and gas chromatograph index (GCI) profiles. All effluents and wood contained androgenic activity, particularly in nonpolar fractions, although known androgens were undetected. Effluents with low suspended solids, having undergone conventional biotreatment had lower androgenic activities. Estrogenic activity was only associated with Brazilian effluents and undetected in wood. All effluents and wood inhibited neurotransmitter enzymes, predominantly in polar fractions. Kraft elemental chlorine free mills were associated with the greatest neurotransmitter inhibition. Effluent and wood GCI profiles were correlated with androgenic activity and neurotransmitter enzyme inhibition. Differences in feedstock bioactivities were not reflected in effluents, implying mill factors mitigate bioactive wood components. No differences in bioactivities could be discerned on the basis of country of origin, thus we predict effluents in regions lacking monitoring would affect fish reproduction and therefore recommend implementing such programs.

This Selected Issues paper examines infrastructure investment in Brazil. Brazil has inferior overall infrastructure quality relative to almost all its export competitors. Brazil’s infrastructure endowment ranks low by international standards, and its low quality affects productivity, market efficiency, and competitiveness. Areas in which Brazil’s competitiveness has lagged include, but are not limited to, education, innovation, governance, and justice. Brazil’s infrastructure gap has become a major obstacle to growth and filling this gap will entail increasing investment and also stepping up other reforms.

Cellulose and paper pulp factories utilize a large amount of water generating several undesirable contaminants. The present work is a preliminary investigation that associates the electrocoagulation–flotation (EC) method followed by photocatalysis to treat such wastewater. For EC, the experiment with aluminium and iron electrodes showed similar efficiency. Iron electrodes (anode and cathode) were chosen. By applying 30 min of EC/Fe 0 , 153 A m −2 and pH 6.0, the COD values, UV–vis absorbance and turbidity underwent an intense decrease. For the subsequent UV photocatalysis (mercury lamps) TiO 2 was employed and the favourable operational conditions found were 0.25 g L −1 of the catalyst and solution pH 3.0. The addition of hydrogen peroxide (50 mmol L −1 ) highly increased the photo-process performance. By employing the UV/TiO 2 /H 2 O 2 system, the COD reduction was 88% compared to pre-treated effluents and complete sample photobleaching was verified. The salt concentration on EC (iron electrodes) showed that the electrolysis duration can be reduced from 30 to 10 min by the addition of 5.0 g L −1 of NaCl. The biodegradability index (BOD/COD) increased from 0.15 (pre-treated) to 0.48 (after EC) and to 0.89 (after EC/photocatalysis irradiated for 6 h), showing that the employed sequence is very helpful to improve the water quality. This result was confirmed by biotoxicity tests performed with microcrustaceous Artemia salina .

To explore the development of family medicine postgraduate training in countries with varying levels of resources at different stages of development of the discipline.Since 2012, the College of Family Physicians of Canada has hosted the Besrour Conferences to reflect on its role in advancing the discipline of family medicine globally. The Besrour Narrative Working Group was conceived in 2012 at the first Besrour Conference. Their mandate was to use narrative and appreciative inquiry to gather stories of family medicine worldwide. The working group comprised members of various academic departments of family medicine in Canada and abroad who attended the conferences.A consultation process with our partners from lower-middle-income countries was undertaken from 2012 to 2014. Stories were sought from each global partner institute with ties to Canadian family medicine departments. An appreciative inquiry approach was chosen to elicit narratives. Thematic analysis was used to search for common threads and important elements of success that could serve to inform other initiatives in other nations and, in turn, offer hope for greater effect.Sixteen narrative stories have been collected so far. These stories highlight insightful solutions, foresight, perseverance, and ultimately a steadfast belief that family medicine will improve the health system and the care provided to the citizens of each nation. Seventeen themes were elucidated by 3 independent Canadian readers. At a subsequent workshop, these themes were validated by Besrour Centre members from Canada and elsewhere. The linkage between the thematic analysis and the experiences of various schools helps to illustrate both the robustness and the usefulness of the narratives in exploring generalizable observations and the features supporting success in each institute.If we are to understand, and contribute to, the development of family medicine throughout the world (a key objective of the Besrour Centre), we must begin to hear each others' stories and search for ways in which our collective story can advance the discipline.

The validity of blood spotted on to filter-paper (BSOFP) eluates for the detection of antibodies against hepatitis A virus (HAV) was investigated in 718 individuals (children and adults) during a field study in a small area in Rio de Janeiro State, Brazil. Serum samples were considered the ‘gold standard’. BSOFP eluates were analysed by 2 different techniques: microplate competitive enzyme-linked immunosorbent assay (ELISA) of the whole study group and microparticle enzyme immune assay (MEIA) of a subsample of 59 individuals. For BSOFP eluates by ELISA, sensitivity and specificity were 89·6% (95% CI: 84·7–93·1) and 97·5% (95% CI: 95·6–98·7), respectively. For a seroprevalence of anti-HAV antibodies of 32%, the positive predictive value was 94·5% (95% CI: 90·3–97·0) and the negative predictive value was 95·2% (95% CI: 92·8–96·8). The test efficiency was 95·0% (95% CI: 93·1–96·4). Similar results were found for BSOFP eluates by MEIA. Agreement between the 2 techniques used for BSOFP (ELISA and MEIA) was also high (κ = 0·93). These results encourage the more widespread application of BSOFP as a means of surveillance for large-scale epidemiological studies for hepatitis A.

OBJECTIVES: To identify the most cited articles in general surgery published by Brazilian authors. INTRODUCTION: There are several ways for the international community to recognize the quality of a scientific article. Although controversial, the most widely used and reliable methodology to identify the importance of an article is citation analysis. METHODS: A search using the Institute for Scientific Information citation database (Science Citation Index Expanded) was performed to identify highly cited Brazilian papers published in twenty-six highly cited general surgery journals, selected based on their elevated impact factors, from 1970 to 2009. Further analysis was done on the 65 most-cited papers. RESULTS: We identified 1,713 Brazilian articles, from which nine papers emerged as classics (more than 100 citations received). For the Brazilian contributions, a total increase of about 21-fold was evident between 1970 and 2009. Although several topics were covered, articles covering trauma, oncology and organ transplantation were the most cited. The majority of classic studies were done with international cooperation. CONCLUSIONS: This study identified the most influential Brazilian articles published in internationally renowned general surgery journals.

Made available in DSpace on 2015-08-06T16:13:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2015 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Online data collection is becoming increasingly common and has some advantages compared to traditional paper-and-pencil formats, such as reducing loss of data, increasing participants' privacy, and decreasing the effect of social desirability. However, the validity and reliability of this administration format must be established before results can be considered acceptable. The aim of this study was to evaluate the validity, reliability, and equivalence of paper-and-pencil and online versions of the Weight Concerns Scale (WCS) when applied to Brazilian university students. A crossover design was used, and the Portuguese version of the WCS (in both paper-and-pencil and online formats) was completed by 100 college students. The results indicated adequate fit in both formats. The simultaneous fit of data for both groups was excellent, with strong invariance between models. Adequate convergent validity, internal consistency, and mean score equivalence of the WCS in both formats were observed. Thus, the WCS presented adequate reliability and validity in both administration formats, with equivalence/stability between answers. Universidade Estadual Paulista Júlio de Mesquita Filho, Departamento de Odontologia Social, Faculdade de Odontologia de Araraquara, Araraquara, Rua Humaitá 1680, Centro, CEP 14801-385, SP, Brasil Universidade Estadual Paulista Júlio de Mesquita Filho, Departamento de Odontologia Social, Faculdade de Odontologia de Araraquara, Araraquara, Rua Humaitá 1680, Centro, CEP 14801-385, SP, Brasil FAPESP: 2010/18279-3

The phlebotomine sand fly Lutzomyia longipalpis takes blood from a variety of wild and domestic animals and transmits Leishmania (Leishmania) infantum chagasi, etiological agent of American visceral leishmaniasis. Blood meal identification in sand flies has depended largely on serological methods but a new protocol described here uses filter-based technology to stabilise and store blood meal DNA, allowing subsequent PCR identification of blood meal sources, as well as parasite detection, in blood-fed sand flies. This technique revealed that 53.6% of field-collected sand flies captured in the back yards of houses in Teresina (Brazil) had fed on chickens. The potential applications of this technique in epidemiological studies and strategic planning for leishmaniasis control programmes are discussed.

In recent decades, the influence of Brazil, the Russian Federation, India, China and South Africa (BRICS) within the international arena has increased enormously.1 These countries represent around 25% of the world’s gross national income, more than 40% of the world’s population and about 30% of the world’s land area.2 Although much attention has been paid to their economic performance, less widely noted is the fact that these countries are uniquely positioned to exert a decisive influence on health at the global level. Within BRICS countries, hundreds of millions of people have been lifted out of poverty. This has resulted in marked improvements in health outcomes and in substantial progress towards achieving the Millennium Development Goals.3,4 BRICS countries are also gravitating towards universal health coverage, although not at an even pace. They are leaders in the manufacture of low-cost medicines and vaccines.5 Their experiences in reducing poverty and strengthening health systems, together with their booming economies and large populations, explain why they exert such an enormous influence on health worldwide. Besides, in only a few years they have amassed a wealth of experience and knowledge from which other low- and middle-income countries can draw valuable examples. Despite their many assets, however, BRICS countries face important health problems. India has the highest number of maternal and infant deaths of any country in the world. South Africa has the greatest number of people with human immunodeficiency virus infection. Alcohol abuse is a major public health concern in the Russian Federation. In addition, BRICS countries’ strong economic growth has created a new set of problems that need to be addressed. Over the last decade, inequities in health and in the socioeconomic sphere have become accentuated in most of these countries.6 Although life expectancy has improved substantially in Brazil, China and India, BRICS countries as a whole still account for about 40% of the global burden of disease.7 They also face a “double” disease burden resulting from the coupling of infectious diseases with the emergence of new health problems triggered by environmental factors and to an increase in road traffic injuries and noncommunicable diseases. Tackling the social determinants of health continues to be a priority for BRICS countries. Globally, BRICS countries are becoming increasingly important partners in international development cooperation.8 They are helping to reshape the landscape of aid effectiveness. According to the final declaration of the Fourth High Level Forum on Aid Effectiveness, held in 2011 in Busan, the Republic of Korea, the nature, modalities and responsibilities that apply to South–South cooperation differ from those that apply to North–South cooperation.9 Although the development cooperation coming from BRICS countries has increased substantially in recent years, estimates vary because of differences in the approaches and methods used to report development cooperation for countries not represented in the Development Assistance Committee.10,11 Through “South–South” health cooperation, BRICS countries are able to reach populations beyond their own borders. These countries can engage in cooperation of this type either individually through bilateral agreements or collectively. Inter-BRICS cooperation is gaining momentum, as highlighted in the recent meeting of ministers of health held on 10–11 January 2013 in New Delhi.12 Moreover, the establishment of the BRICS development bank, agreed upon by BRICS leaders on 27 March 2013 in Durban, South Africa, will also contribute to the advancement of health in BRICS countries and beyond. The Bulletin plans to publish a theme issue on BRICS and global health to enhance people’s understanding of the dynamics of health and development in BRICS countries and of how these countries contribute to global health, both by improving health outcomes in their own territories and by engaging in mutual cooperation. This issue will cover these countries’ key health policy achievements and their most important health challenges, as well as their rising influence on international health cooperation. We welcome papers for all sections of the Bulletin and encourage authors to consider contributions on any of the following topics as they pertain to BRICS countries: universal health coverage; universal access to medicines or vaccines; emerging and existing public health challenges, notably health inequities and the double burden of disease; South–South cooperation and inter-BRICS cooperation. The deadline for submissions is October 2013. Manuscripts should be prepared in accordance with the Bulletin’s Guidelines for contributors and authors should mention this call for papers in a covering letter. All submissions will go through the Bulletin’s peer review process. Please submit to: http://submit.bwho.org.

Brazil has been presenting in the last years a scientific production well-recognized in the international scenario, in several areas of knowledge, according to the impact of their publications in important events and especially in indexed journals of wide circulation. On the other hand, the country does not seem to be in the same direction regarding to the technological production and wealth creation from the established scientific development, and particularly from the applied research. The present paper covers such issue and discloses the main similarities and differences between a scientific paper and a patent application, in order to contribute to a better understanding of both types of documents and help the researchers to chose and select the results with technological potential, decide what is appropriated for industrial protection, as well as foster new business opportunities for each technology which has been created.

To assess the proportion of papers presented at the XXI Panamerican Congress of Trauma, VIII Congress of the Brazilian Society of Integrated Assistance to the Traumatized (SBAIT) and X Brazilian Congress of Trauma Leagues (CoLT) that were published in full.In the events cited, based in Campinas in 2008, 347 papers abstracts of were presented and published. To evaluate the proportion of complete published works a retrospective observational study was conducted, reviewing the biomedical databases PubMed and SciELO, with support from Google, from the title of the abstracts and list of authors.Of 347 papers considered, 25 (7.3%) were from foreign services and 322 (92.7%) national. Ten (2.9%) papers were published, of which six (1.7%) of nursing and four (1.2%) medical. Among these, four thesis publications were identified and only one international work has been published.Despite a large number of papers presented at trauma conferences in Brazil, the publications in this area are rare. The academy and the societies of surgery need to encourage the submission of scientific papers even before the presentation in Congresses in order for them to be evaluated for publication in indexed journals.

THE CHALLENGE OF ETHNICITY/RACE/SKIN COLOR AND HEALTH OUTCOMES Despite the consensus that age, sex, parental history, hypertension, dyslipidemia, smoking and diabetes are risk factors for cardiovascular diseases,1 race, ethnicity or skin color always bring an anthropological debate into biology.2 First, there are different views about the meaning of race according to culture and country. Second, the potential influence of genetic background is blurred by differential distribution of the proportions of formal education and income according to race/ethnicity/skin color. Third, considering that the foundation of racially admixed societies, such as most of the countries in the Americas, was based on subjugation of the indigenous populations and imported slavery of Africans, the presence of racism and discrimination cannot be neglected as one point in the causal pathway of cardiovascular diseases according to race/ethnicity/skin color. Fortunately, the emergence of molecular biology and genomics is opening up a new road towards understanding the influence of race on several diseases. Although the terms “race” and “skin color” are very popular, we will prefer “ethnicity” because it encompasses biology, culture, language and religion, thereby revealing health behavior and beliefs.3

The dissemination of the practice of collaborative authorship (coauthorship) in Brazil and in the international scientific community has been accompanied by an increasing occurrence of frauds, manipulations and other deviations in the assignment of responsibility for a scientific paper. This article discusses the criteria for authorship attribution, the reasons for the growing indices of coauthorship and the challenges to determine authorship in electronic journals. Through literature review and case study (bibliographic search in scientific database), it shows ways to avoid that "misbehaviors" related to the authorship attribution affect the credibility of science.

The article examines the idea of Europe conceived by Stefan Zweig and Hermann Ullmann in the similarly titled books about Brazil written in the late 1930s and early 1940s. In the political context between the great wars marked by the rise of Nazism, the question is posed regarding to what extent Europe continues to serve as a model of civilization and what the critical dimension is that is expressed in concepts reversing the roles of Europe and Brazil. One detects a partial rupture with dichotomous and hierarchical viewpoints about the relationship between the Old World and the New World, and new forms of relationship between these regions within the worldwide context are suggested.

This review covers recent publications on the motor system (orthopedics and movement) in Brazilian journals recently admitted to the ISI-Thomson Journal of Citations Index. Two of these are still pleading for admission into PubMed which will eventually enhance their global visibility. We offer this contribution to experts on these areas who are regular readers of Revista da Associação Médica Brasileira. Full free copies of all of them are available at www.scielo.br. The main areas covered are orthopedics of limb articulations, fractures, movement, posture, gait, exercise and animal models Esta revisão abrange publicações recentes sobre o sistema locomotor (ortopedia e movimento) em periódicos brasileiros recentemente incluídos na plataforma de citações ISI-Thomson. Dois destes periódicos ainda estão pleiteando inclusão no PubMed o que aumentará sua visibilidade. Oferecemos esta contribuição para especialistas nestas áreas de interesse e que são leitores regulares da Revista da Associação Médica Brasileira. Cópias integrais dos artigos citados estão disponíveis gratuitamente no site www.scielo.br. Os principais temas cobertos são ortopedia e articulações dos membros, fraturas, movimento, postura, marcha e modelos animais

A recent assessment of 4400 postgraduate courses in Brazil by CAPES (a federal government agency dedicated to the improvement of the quality of and research at the postgraduate level) stimulated a large amount of manifestations in the press, scientific journals and scientific congresses. This gigantic effort to classify 16,400 scientific journals in order to provide indicators for assessment proved to be puzzling and methodologically erroneous in terms of gauging the institutions from a metric point of view. A simple algorithm is proposed here to weigh the scientometric indicators that should be considered in the assessment of a scientific institution. I conclude here that the simple gauge of the total number of citations accounts for both the productivity of scientists and the impact of articles. The effort spent in this exercise is relatively small, and the sources of information are fully accessible. As an exercise to estimate the value of the methodology, 12 institutions of physics (10 from Brazil, one from the USA and one from Italy) have been evaluated.