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IntroductionThe presence of multiple chronic conditions, also referred to as multimorbidity, is a common finding in adults. Epidemiologic research can help identify groups of individuals with similar clinical profiles who could benefit from similar interventions. Many cross-sectional studies have revealed the existence of different multimorbidity patterns. Most of these studies were focused on the older population. However, multimorbidity patterns begin to form at a young age and can evolve over time following distinct multimorbidity trajectories with different impact on health. In this study, we aimed to identify multimorbidity patterns and trajectories in adults 18–65 years old.MethodsWe conducted a retrospective longitudinal epidemiologic study in the EpiChron Cohort, which includes all inhabitants of Aragón (Spain) registered as users of the Spanish National Health System, linking, at the patient level, information from electronic health records from both primary and specialised care. We included all 293,923 patients 18–65 years old with multimorbidity in 2011. We used cluster analysis at baseline (2011) and in 2015 and 2019 to identify multimorbidity patterns at four and eight years of follow-up, and we then created alluvial plots to visualise multimorbidity trajectories. We performed age- and sex-adjusted logistic regression analysis to study the association of each pattern with four- and eight-year mortality.ResultsWe identified three multimorbidity patterns at baseline, named dyslipidaemia & endocrine-metabolic, hypertension & obesity, and unspecific. The hypertension & obesity pattern, found in one out of every four patients was associated with a higher likelihood of four- and eight-year mortality (age- and sex-adjusted odds ratio 1.11 and 1.16, respectively) compared to the unspecific pattern. Baseline patterns evolved into different patterns during the follow-up.DiscussionWell-known preventable cardiovascular risk factors were key elements in most patterns, highlighting the role of hypertension and obesity as risk factors for higher mortality. Two out of every three patients had a cardiovascular profile with chronic conditions like diabetes and obesity that are linked to low-grade systemic chronic inflammation. More studies are encouraged to better characterise the relatively large portion of the population with an unspecific disease pattern and to help design and implement effective and comprehensive strategies towards healthier ageing.

Glycosylation is a critical post-translational modification that plays a pivotal role in several biological processes, such as the immune response. Alterations in glycosylation can modulate the course of various pathologies, such as the case of congenital disorders of glycosylation (CDG), a group of more than 160 rare and complex genetic diseases. Although the link between glycosylation and immune dysfunction has already been recognized, the immune involvement in most CDG remains largely unexplored and poorly understood. In this study, we provide an update on the immune dysfunction and clinical manifestations of the 12 CDG with major immune involvement, organized into 6 categories of inborn errors of immunity according to the International Union of Immunological Societies (IUIS). The immune involvement in phosphomannomutase 2 (PMM2)-CDG - the most frequent CDG - was comprehensively reviewed, highlighting a higher prevalence of immune issues during infancy and childhood and in R141H-bearing genotypes. Finally, using PMM2-CDG as a model, we point to links between abnormal glycosylation patterns in host cells and possibly favored interactions with microorganisms that may explain the higher susceptibility to infection. Further characterizing immunopathology and unusual host-pathogen adhesion in CDG can not only improve immunological standards of care but also pave the way for innovative preventive measures and targeted glycan-based therapies that may improve quality of life for people living with CDG.

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This research investigates the relationship between stablecoin usage and tax evasion. We present a model that includes variables related to transactions such as intensity, frequency, environment on-chain (P2P) vs. off-chain (IntraVasp), and company characteristics such as age, sector, and size. Our model was empirically tested using a logistic regression based on data from the Brazilian Federal Revenue Service (Receita Federal do Brasil (RFB)) in 2021. This novel approach aims to understand the tax behaviours associated with stablecoin use in corporate financial practices. Our results indicate that the intensity, frequency, environment of transactions (specifically IntraVasp and P2P transactions), age, sector, and size are factors significantly associated with tax evasion behaviour. However, we found no evidence to suggest that firms engaging in only P2P transactions have a higher propensity for tax evasion than those engaging only in IntraVasp transactions. Our findings reveal that younger and medium-sized companies with intensive use of stablecoin, with high stablecoin transaction frequency, engaging in IntraVasp and P2P transactions, and belonging to the service sector are more likely to evade tax. Therefore, our research provides a detailed understanding of how digital financial practices with crypto assets (blockchain-based technology) intersect with corporate tax strategies, which can offer valuable insights for regulators, industry practitioners, and policymakers. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivos: Avaliar a relação do desempenho físico de MMII com a força muscular respiratória e a capacidade funcional de idosas saudáveis da comunidade. Métodos: Foram avaliadas 24 idosas, com média de idade de 66,17 ± 4,22 anos. Para análise da avaliação da força muscular de MMSS, utilizou-se o teste de preensão manual e para avaliar o desempenho de membros inferiores o instrumento short physical performance battery (SPPB). A pressão respiratória máxima foi realizada por meio da manovacuometria, e a capacidade funcional por meio do teste de caminhada de seis minutos (TC6). Resultados: O IMC foi de 26, 51 ± 5,2 kg/m², a força de preensão manual 23,15 ± 5,57 kgf, a pontuação total média da SPPB encontrada foi de 10,58 ± 1,67 pontos, e a PImáx 57,29 ± 18,47 cmH2O e da PEmáx 74,59 ± 19,11 cmH2O. A distância percorrida no TC6 foi de 487,88 ± 88m. Encontramos correlações entre a distância percorrida no TC6, o SPPB (r = 0,43; p ≤ 0,05) e a PImáx (r = 0,43; p ≤ 0,05) e também entre o SPPB e a PEmáx (r = 0,51; p ≤ 0,05). Conclusão: Houve associação entre a capacidade funcional e desempenho físico de MMII e força respiratória de idosas da comunidade, sugerindo que esses músculos devem ser incluídos nos programas de reabilitação de idosos para melhora da capacidade funcional.

Objetivo:Comparar a prevalência da síndrome metabólica (SM) com diferentes critérios de classificação e perfil lipídico em idosos remanescentes dos quilombos. Métodos: Foram avaliados 110 idosos, 54 remanescentes dos quilombos (IRQ), média de idade 71,1 ± 9,6 anos. A classificação para SM ocorreu pela International Diabetes Federation (IDF) e National Cholesterol Education Program’s Adult Treatment Panel III (NCEP/ATPIII). Os IRQ foram pareados e comparados a um grupo controle de 56 idosos não remanescentes dos quilombos (INRQ) com idade média 68,8 ± 5,7 anos. Foram submetidos a uma entrevista, avaliação clínica, antropométrica e bioquímica. Resultados: A prevalência de SM entre os IRQ foi de 18,5% e 38,9%, e nos INRQ foi de 34% e 64,3%, pelos critérios do NCEP/ATPIII e da IDF. Pelo NCEP/ATPIII, o critério de SM mais prevalente foi baixo HDL-c. No perfil lipídico dos grupos, houve diferença de colesterol total (p ≤ 0,037), (VLDL p ≤ 0,001) e triglicerídeos (p ≤ 0,001). Os IRQ apresentaram redução na glicemia de jejum e triglicerídeos. Conclusão: Os IRQ apresentaram menor prevalência de SM em ambas as definições e valores significativamente menores de triglicerídeos, colesterol total e VLDL-c.

Summary: Background: Female homicides are a public health-relevant issue, and its spatial distribution may evidence socioeconomic vulnerabilities. This study aims to analyze the temporal and spatial trends of female homicides in Brazil and investigate socioeconomic-demographic factors associated with it. Methods: This is an ecological, descriptive, and analytical epidemiological study investigating the age-standardized female homicide rate in all Brazilian municipalities between 2000 and 2018, divided into three periods. Spatial and temporal analyses were conducted using the Global Moran's Index and LISA to identify clusters of high and low rates. Rates were also calculated by population size and means of violence across macro-regions. For the last period, a multivariable linear regression model analyzed the association of female homicide rates with social, economic, and geographic factors. Findings: Female homicide rates in Brazil remained high during the studied period, with differences in trends between regions. Among the potentially associated factors, it was observed that male homicide rate, the high percentage of violent deaths among black women and those with low levels of education, in addition to the low Gross Domestic Product (GDP) per capita, were positively associated with female homicide, whereas larger cities were negatively associated. Interpretation: These findings show that Brazil is a country with a high risk of female homicide. Nevertheless, the vulnerability of women is unequally distributed in the country. Female homicides are mostly caused by domestic conflicts but can also be influenced by changes in the urban and social contexts. Funding: This project is funded by the Bill & Melinda Gates Foundation.

Objetivo: identificar los cambios cognitivos y funcionales más frecuentes en personas mayores después de la fase aguda de COVID-19. Método: revisión integrativa de la literatura con búsqueda de artículos en las bases de datos LILACS, MEDLINE, PubMed y Scopus, entre junio y julio de 2024. La selección fue realizada independientemente por dos revisores y validada por un tercer revisor. Se incluyeron los estudios originales primarios que involucraron participantes con mayoría o mediana de edad superior a 60 años, con alteraciones cognitivas y funcionales post-COVID-19. Resultados: se observó la heterogeneidad en las muestras, con un amplio espectro de características clínicas, siendo las más prevalentes: disnea, fatiga, alteraciones en el patrón de sueño y déficit cognitivo. Conclusión: los resultados contribuyen a una mejor evaluación y conducta. Señalan la necesidad de crear protocolos específicos de atención para las personas mayores con síndrome post-COVID-19 y desarrollar intervenciones más adecuadas y dirigidas a la prevención, reducción o minimización de los síntomas persistentes.

Objetivo: identificar as alterações cognitivas e funcionais mais frequentes em pessoas idosas após a fase aguda da COVID-19. Método: revisão integrativa da literatura com busca de artigos nas bases de dados LILACS, MEDLINE, PubMed e Scopus, entre junho e julho de 2024. A seleção foi realizada independentemente por dois revisores e validada por um terceiro revisor. Foram incluídos os estudos originais primários que envolveram participantes com maioria ou mediana de idade superior a 60 anos, com alterações cognitivas e funcionais pós-COVID-19. Resultados: observou-se a heterogeneidade nas amostras, com vasto espectro de características clínicas, sendo as mais prevalentes: dispneia, fadiga, alterações no padrão de sono e déficit cognitivo. Conclusão: os resultados contribuem para uma melhor avaliação e conduta. Apontam a necessidade de criação de protocolos específicos de atendimento às pessoas idosas com síndrome pós-COVID-19 e desenvolvimento de intervenções mais adequadas e direcionadas à prevenção, redução ou minimização dos sintomas persistentes.

Objective: To identify the most frequent cognitive and functional changes in elderly people after the acute phase of COVID-19. Method: Integrative literature review with a search for articles in the LILACS, MEDLINE, PubMed, and Scopus databases, between June and July 2024. The selection was conducted independently by two reviewers and validated by a third reviewer. Original primary studies were included that involved participants with a majority or median age over 60 years, with post-COVID-19 cognitive and functional changes. Results: Heterogeneity was observed in the samples, with a wide range of clinical characteristics, the most prevalent being: dyspnea, fatigue, changes in sleep patterns, and cognitive deficit. Conclusion: The results contribute to a better assessment and conduct. They point to the need to create specific care protocols for elderly people with post-COVID-19 syndrome and to develop more appropriate and targeted interventions for the prevention, reduction, or minimization of persistent symptoms.

Objective: Multicomponent physical training, carried out via tele-exercise, can contribute to a healthier lifestyle in the elderly. The objective is to present the intervention protocol of the “Idoso Ativo” (Active Older Adult) program via tele-exercise, synchronously and asynchronously. Method: This is a randomized clinical trial with two groups performing tele-exercise. Participant recruitment will be done via digital platforms, social media pages and printed leaflets distributed in the different regions of Distrito Federal. Both groups will perform exercises three times a week, lasting 50 min, and the intervention period will be 12 weeks. Discussion: The hypothesis is that the multicomponent exercise program offered online will provide improvements in muscular strength, balance and mobility in both groups. A higher adherence rate is expected in relation to the asynchronous group, and it is believed that the positive effects on physical health, minimizing the negative outcomes caused by inactivity, are present in participants in both groups.

As intoxicações são um grave problema de saúde pública, pelo impacto na saúde individual e coletiva e pelos custos econômicos e sociais que acarretam. Os agrotóxicos são um dos principais químicos relacionados a esses eventos. Objetiva-se descrever o perfil dos casos e dos óbitos positivos para agrotóxicos que aportaram a um Laboratório de Toxicologia Forense. Trata-se de um estudo transversal com dados periciais criminais (toxicológicos e necroscópicos) entre 2002 e 2018; realização de análises descritivas e de testes de Mann-Whitney, qui-quadrado de Pearson e exato de Fisher para verificação de associações. A maior parte dos 1.606 casos foi proveniente da região central de Minas Gerais, relacionou-se aos inibidores de acetilcolinesterase e era composta de indivíduos do sexo masculino. Houve limitações técnicas laboratoriais para a detecção de agrotóxicos e redução do número de casos ao longo do tempo. Para 296 óbitos avaliados, homens, negros, com idade entre 30-49 anos foram a maior parte das vítimas. A suspeita de suicídio e o uso de inibidores de acetilcolinesterase foram as principais causas da morte. Não foram observados sinais necroscópicos específicos; edema agudo de pulmão e secreção espumosa nas vias aéreas foram as principais alterações observadas. Adultos jovens, do sexo masculino, que utilizaram inibidores de acetilcolinesterase em contexto de suicídio foram os mais prevalentes, podendo ser foco de políticas públicas. Ainda há limitação na detecção dos casos de intoxicações por agrotóxicos, especialmente fatais, o que torna o cruzamento de diferentes bancos de dados uma alternativa para melhorar a sub-captação.

ABSTRACT Objective: To perform an integrative literature review about effectiveness of high-power laser in the treatment of gingival melanin pigmentation. Methods: This research consists of an integrative review conducted from September 2021 to May 2022 seeking to answer the following question: “What is the clinical effectiveness of laser in the treatment of gingival melanin pigmentation?”. The articles were analyzed by two researchers and the information about these was collected with emphasis on the following data: authors, year of publication, study objectives, methodology, results and conclusion. Results: Of the 16 articles initially selected, 08 were excluded (3 literature reviews, 4 internship reports and 1 monography). Thus, 8 articles were selected. Conclusion: Among several types of lasers and techniques for its use, laser, especially diode laser, was the most used technique and presented better aesthetic results, less pain, faster healing, preference and patient satisfaction after treatment. More good quality randomized control trials are needed in different techniques currently used to generate conclusions with high scientific evidence.

This article aims to estimate the underreporting of violence against women (VAW) in the Notifiable Diseases Information System (SINAN), based on data from the National Survey of Health (NSH), in Brazil and subnational units (SU). This work was an ecological study using SINAN and NSH, both from 2019. In SINAN, reports of sexual, physical, and psychological VAW, aged 18 years or older, were selected. In the NSH, women of the same age group who reported psychological, physical, or sexual violence, and who had sought health care due to consequences of the violence were selected. SINAN underreporting was calculated in reference to the NSH's estimated population, for Brazil and each SU. Underreporting of VAW in Brazil was 98.5%, 75.9%, and 89.4% for psychological, physical, and sexual violence, respectively. The North and Northeast states presented the lowest reporting rates among the states. VAW in Brazil is highly underreported by the health sector, showing the need for adequate training of health professionals to recognize situations of violence and raise awareness of the importance of reporting.