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Abstract Background Aromatase inhibitors (AI) are frequently used to treat hormone-receptor-positive breast cancer, but they have multiple adverse effects (e.g., osteoporosis, arthralgia), resulting in premature therapy discontinuation/switch. Physical activity (PA) can attenuate these negative effects and improve quality of life (QoL). However, most cancer survivors fail to perform/sustain adequate PA levels, especially in the long-term. Theory-based interventions, using evidence-based behavior change techniques, aimed at promoting long-term behavior change in breast cancer survivors are effective, but remain scarce and fail to promote self-regulatory skills and better-quality motivations associated with sustained PA adoption. This paper describes the design of the PAC-WOMAN trial, which will test the long-term effectiveness and cost-effectiveness of two state of the art, group-based interventions encouraging sustained changes in PA, sedentary behavior, and QoL. Additional aims include examining the impact of both interventions on secondary outcomes (e.g., body composition, physical function), and key moderators/mediators of short and long-term changes in primary outcomes. Methods A 3-arm pragmatic randomized controlled trial, involving a 4-month intervention and a 12-month follow-up, will be implemented, in a real exercise setting, to compare: 1) brief PA counseling/motivational intervention; 2) structured exercise program vs. waiting-list control group. Study recruitment goal is 122 hormone-receptor-positive breast cancer survivors (stage I-III), on AI therapy (post-primary treatment completion) ≥ 1 month, ECOG 0–1. Outcome measures will be obtained at baseline, 4 months (i.e., post-intervention), 10 and 16 months. Process evaluation, analyzing implementation determinants, will also be conducted. Discussion PAC-WOMAN is expected to have a relevant impact on participants PA and QoL and provide insights for the improvement of interventions designed to promote sustained adherence to active lifestyle behaviors, facilitating its translation to community settings. Trial registration April 20, 2023 – NCT05860621. April 21, 2023 – https://doi.org/10.17605/OSF.IO/ZAQ9N April 27, 2023 – UMIN000050945.

Objective. To describe bacterial resistance and antimicrobial consumption ratio at the subnational level in Argentina during 2018, considering beta-lactams group as a case-study. Methods. Antimicrobial consumption was expressed as defined daily doses (DDD)/1000 inhabitants. Resistance of Escherichia coli, Streptococcus pneumoniae, Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus to beta-lactams was recorded. Resistance/consumption ratio was estimated calculating R for each region of Argentina, and this data was compared with other countries. Results. The most widely consumed beta-lactams in Argentina were amoxicillin (3.64) for the penicillin sub-group, cephalexin (0.786) for first generation cephalosporins, cefuroxime (0.022) for second generation; cefixime (0.043) for third generation and cefepime (0.0001) for the fourth generation group. Comparison between beta-lactams consumption and bacterial resistance demonstrated great disparities between the six regions of the country. Conclusions. The case-study of Argentina shows that antimicrobial consumption and resistance of the most common pathogens differed among regions, reflecting different realities within the same country. Because this situation might also be occurring in other countries, this data should be taken into account to target local efforts towards better antimicrobial use, to improve antimicrobial stewardship programs and to propose more suitable sales strategies in order to prevent and control antimicrobial resistance.

Background: Irrational antimicrobial consumption (AMC) became one of the main global health problems in recent decades. Objective: In order to understand AMC in Latin-American Region, we performed the present research in 6 countries. Methods: Antimicrobial consumption (J01, A07A, P01AB groups) was registered in Argentina, Chile, Colombia, Costa Rica, Paraguay, and Peru. Source of information, AMC type, DDD (Defined Daily Doses), DID (DDD/1000 inhabitants/day), population were variables explored. Data was analyzed using the Global Antimicrobial Resistance and Use Surveillance System (GLASS) tool. Results: Source of information included data from global, public, and private sectors. Total AMC was highly variable (range 1.91-36.26 DID). Penicillin was the most consumed group in all countries except in Paraguay, while macrolides and lincosamides were ranked second. In terms of type of AMC according to the WHO-AWaRe classification, it was found that for certain groups like “Reserve,” there are similarities among all countries. Conclusion and Relevance: This paper shows the progress that 6 Latin-American countries made toward AMC surveillance. The study provides a standardized approach for building a national surveillance system for AMC data analysis. These steps will contribute to the inclusion of Latin-America among the regions of the world that have periodic, regular, and quality data of AMC.

Background. Irrational use of antimicrobials (ATMs) triggers microbial resistance (AMR) which has severe consequences for human health. ATM consumption varies among countries and within each territory. These data should be known, in order to perform local policies towards AMR reduction. This work aimed to expose the association of the level of consumption of carbapenems and fluoroquinolones with their resistance rates in Pseudomonas aeruginosa in Argentina. Method. Consumption of antimicrobials was expressed by defined daily dose (DDD)/1000 inhabitants for each ATM during one year period, discriminating by each country region. Resistance of P. aeruginosa to carbapenems/fluoroquinolones groups was recorded. Consumption/resistance ratio “R” was calculated for each region of the country, comparing results with other countries. Results. P. aeruginosa resistance rate to fluoroquinolone (F) was 26.4% in blood samples and 29.7% in urine samples, whereas resistance rates to carbapenems (C) were 19.9 and 17.7% in blood and urine, respectively. Correlation between consumption and resistance was demonstrated for both antimicrobials (C : R = 0.58; p=0.003 and F : R = 0.77; p=0.0001). Great fluctuations of resistance levels were seen among regions within the country, always correlating resistance with areas in which a higher level of ATM consumption was detected. Conclusion. P. aeruginosa resistance to fluoroquinolone/carbapenems in Argentina directly correlated with antimicrobial consumption levels. A great heterogeneity in resistance profile was observed among areas where ATMs were widely used. Global data at the national level might mask local realities that require specific health policies in order to control the irrational use of ATMs.

Introduction: Bacterial antimicrobial resistance (AMR) to the antibiotics (ATB) has severe consequences for human health. The excess ATB consumption is one of the main causes of AMR. One of the World Health Organizations main objective in AMR control strategy is to limit the ATB irrational use, that is why, it proposed to classify the ATB in three groups: “Access”, “Watch”, and “Reserve”, being the latter two preserved for certain situations. The present work aims to know the level of ATB consumption and its correlation with the Gram-negative resistance in Argentina. Materials and Methods: Gram-negative bacteria resistance to “watch” the ATB groups (cephalosporins/carbapenem/fluoroquinolones) were explored for Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Antibiotic consumption was expressed by the defined daily dose/1000 inhabitants for each ATB for one year period (2018). Resistance/consumption ratio was obtained by calculating the “R” for each region of the country, comparing them with the other countries. Results: E. coli resistance to 3rd generation cephalosporines was 8.68% and 16.51% in urine (U) and blood (B) samples, respectively, while to carbapenems was 0.08% (U) and 0.36% (B). Resistance of K. pneumoniae to 3 GC was 39.78% (U) and 52.45% (B) while to carbapenem was 9.03% (U) and 17.46% (B). P. aeruginosa resistance to fluoroquinolone and to carbapenems was 29.7% (U)/26.4% (B) and 17.7% (U)/19.9% (B), respectively. The resistance/consumption ratio was heterogenous within the country. Most of the populated areas patterns had similarities with the one observed in the less developed countries (mild-high resistance/mild-high consumption), while the ratio found in less densely populated areas, mimicked countries with the most rational use of ATB. Conclusion: In Argentina, Gram-negative bacteria showed overall high/mild resistance levels against the “Watch” ATB groups, with a largely variations among each region.

O projeto “Assistência Técnica a Agricultores Familiares na Produção Leiteira na região Centro-Oeste do Paraná” teve como objetivo geral oferecer suporte de acompanhamento técnico e organizacional a agricultores familiares, produtores de leite integrantes do sistema de cooperativas, em dez municípios do Paraná com baixo índice de desenvolvimento humano (IDH). Foram discutidas experiências vividas por seus participantes, levantando os pontos positivos e negativos referentes ao cooperativismo nesses municípios.AbstractThe project “Technical Assistance for Family Farmers Dairy in the Midwest region of Parana” aims generally support for the technical and organizational to farmers dairy members of the cooperative system in ten localities of the state with low human development index (HDI). They discussed experiences of participants, raising the pros and cons relating to involved region.

OBJETIVO: analisar o perfil clínico e epidemiológico, o desfecho da gestação e a transmissão vertical de gestantes infectadas pelo vírus da imunodeficiência humana (HIV) atendidas no pré-natal do Hospital Universitário de Santa Maria (HUSM). MÉTODOS: foi realizado um estudo prospectivo na população de 139 gestantes portadoras do vírus HIV que foram atendidas no Ambulatório de Pré-natal de Alto Risco do HUSM durante o período de agosto de 2002 a agosto de 2007, e que tiveram pelo menos duas consultas de pré-natal neste serviço. A coleta de dados foi efetuada por meio de entrevista e preenchimento do protocolo de pesquisa durante a consulta de pré-natal. O protocolo era mantido anexado ao prontuário da paciente e mantido até o desfecho da gestação. Realizou-se análise descritiva das variáveis quantitativas utilizando-se o programa SPSS versão 15.0. RESULTADOS: dentre as 139 gestantes, a média de idade foi de 25,6 anos (±5,8), 79 (56,8%) eram brancas, 81 (58,5%) eram casadas ou viviam em união estável e 90 (65,0%) tinham menos de oito anos de escolaridade. Cinquenta e um por cento das gestantes já tinham dois ou mais filhos, apresentando número de filhos superior à média estadual. O diagnóstico da infecção foi realizado em gestação atual ou anterior em mais de 70,0% das vezes. Houve exposição sexual em 97,7% e, destas, o parceiro era sabidamente infectado em 59,6%. No período, dos casos adequadamente acompanhados, apenas um recém-nascido (0,7%) contraiu a infecção pelo HIV. CONCLUSÕES: mulheres jovens em situação socioeconômica de vulnerabilidade, com baixa escolaridade e multíparas constituem a maioria da população de gestantes HIV-positivo atendidas no serviço. Avaliações realizadas durante o pré-natal foram relevantes para o diagnóstico da infecção na maioria dos casos. O diagnóstico precoce, associado ao adequado acompanhamento clínico, obstétrico, psicológico e cuidados de enfermagem, são importantes para prover a apropriada adesão ao tratamento e a redução das taxas de transmissão vertical.PURPOSE: to analyze the clinical and epidemiological profile, the outcome of pregnancy and the vertical transmission of human immunodeficiency virus (HIV)-infected pregnant women receiving prenatal care at the University Hospital of Santa Maria (HUSM). METHODS: A prospective study was conducted on 139 HIV-infected pregnant women attended at the High-Risk Prenatal Care Outpatient Clinic of HUSM, during the period from August 2002 to August 2007, with at least two prenatal visits in this service. Data were collected by an interview and by filling out a research protocol during a prenatal visit. The protocol was attached to the medical records of the patient and kept until the outcome of gestation. Descriptive analysis of quantitative variables was performed using the SPSS software, version 15.0. RESULTS: The mean age of the 139 pregnant women studied was 25.6 years (±5.8), 79 (56.8%) were white, 81 (58.5%) were married or lived in a stable union, and 90 (65.0%) had less than eight years of schooling. Fifty-one percent of the pregnant women already had two or more children, with a number of children higher than the mean for the state. The infection was diagnosed during the present or a previous pregnancy in more than 70.0% cases. Sexual exposure occurred in 97.0%, and in 59.6% of cases the partner was known to be infected. During the study period, among the cases properly monitored, only one newborn (0.7%) was infected with HIV. CONCLUSIONS: Young women in a socioeconomic situation of vulnerability, with low schooling and multiparous represent the majority of HIV-positive pregnant women attended at the service. Evaluations performed during the prenatal period were relevant for the diagnosis of infection in most cases. An early diagnosis associated with proper clinical, obstetrical and psychological monitoring and with nursing care is important to provide appropriate treatment compliance and a reduction of the rates of vertical transmission.

Estudo transversal e descritivo realizado no hospital universitário de Santa Maria, de novembro de 2008 a janeiro de 2009, com o objetivo de avaliar a visão dos residentes quanto ao funcionamento da residência médica. A participação no estudo foi voluntária, confidencial e obteve a aprovação do Comitê de Ética em Pesquisa. Realizou-se análise descritiva dos dados através do software SPSS 15.0. Da população de 90 médicos residentes, 59 (65,5%) responderam o questionário. A qualificação e a competência dos preceptores foram consideradas satisfatórias por 79,7% dos participantes, 91,5% ressaltaram a importância da diversidade de doenças e do número de atendimentos realizados, enquanto 49,2% revelaram estar insatisfeitos com o incentivo e o desenvolvimento de trabalhos científicos durante a especialização. A jornada de trabalho foi considerada excessiva por 54,2% dos residentes e estressante por 80,0%, fato referido principalmente na residência de Cancerologia Clínica e Anestesiologia. A maioria relatou que suas vivências, no período da residência, foram condizentes com suas expectativas. Conclui-se que a residência médica, apesar das fragilidades evidenciadas, mantém-se como uma proposta satisfatória de formação de médicos especialistas.

Objective: To identify the clinical presentation of molar incisor hypomineralization (MIH) and hypomineralization of second primary molars (HSPM), including the distribution patterns of presence and severity of lesions, and to investigate the association of risk factors during the pre-and postnatal period with the presence of lesions. Material and Methods: This cross-sectional study was conducted with 160 individuals (72 with MIH/HSPM and 88 without lesions). The symmetry analysis regarding the presence and severity of MIH/HSPM was evaluated in pairs of homologous and opposite teeth. Sociodemographic and medical information was obtained using a detailed questionnaire. Data were analyzed by means of chi-square tests, Student’s t-test, and logistic regression (p

Abstract Background The social restrictions resulting from the COVID-19 pandemic had a great impact on the routine of children and adolescents, with important consequences such as sleep, eating, and psychological/psychiatric disorders. Even though there are no studies on the subject, it is possible that these changes in habit and routine have also affected arterial stiffness (AS) in this population, which is an important predictor of cardiovascular risk. This study aimed to assess possible changes in AS, anthropometry, and quality of life (QoL) resulting from the COVID-19 pandemic in children and adolescents. Methods A controlled observational cross-sectional study was performed with 193 children and adolescents aged 9 to 19 years, allocated into two groups: before the pandemic (BPG) and one year after the pandemic (APG), matched by age and sex. Cardiovascular parameters were measured non-invasively by brachial artery oscillometry with a portable device. The main AS indices evaluated were the augmentation index (AIx) and pulse wave velocity (PWV) derived from the aortic pulse wave. QoL was assessed using the Paediatric Quality of Life Inventory version 4.0 (PedsQL 4.0). Results Regarding QoL, the APG showed a worsening in emotional (p = 0.002) and school-related (p = 0.010) aspects. There was no statistically significant difference for most anthropometric parameters, except for the hip circumference, which was higher in the APG group (p

INTRODUÇÃO: Percebemos o advento do neoliberalismo na educação por meio de diversas políticas educacionais que buscam a formação acrítica da classe trabalhadora. Em vista disso, acreditamos na potencialidade e na necessidade de abordar temáticas da cultura corporal que valorizem a cultura negra. OBJETIVO: O estudo pretende apresentar um relato de experiência de um processo pedagógico com a temática Congadas, apresentando possibilidades de subversão às propostas educacionais alinhadas ao neoliberalismo. MÉTODOS: O presente estudo corresponde a uma pesquisa qualitativa e, como forma de coleta de dados, foi utilizado o diário de campo. Nesse sentido, apresentamos um relato de experiência de uma proposta pedagógica, contendo 13 aulas, realizada com duas turmas da segunda série do Ensino Médio. RESULTADOS: Reconhecemos a importância de se abordar temáticas advindas da cultura africana e afro-brasileira na escola, e o trabalho com as Congadas foi potencial para que os(as) estudantes valorizassem culturas que, muitas vezes, são marginalizadas e se compreendessem como parte do grupo que sofre com as explorações presentes na sociedade capitalista. CONCLUSÃO: Embora a temática e a abordagem tenham ocorrido com embasamento crítico, a realidade em que estamos inseridos(as) não segue tal perspectiva, pois o neoliberalismo vem avançando para a educação em busca da ampliação das formas de exploração da classe trabalhadora.

Abstract Background Childhood obesity is a major cardiovascular risk factor because it predisposes individuals to comorbidities that are implicated in an increased risk of cardiovascular events. Its origin may be related to poor eating habits, such as the intake of foods of low nutritional value or inadequate eating behaviours related to emotional factors. This work aims to evaluate the relationship between the total body mass of children and adolescents and its association with eating habits, quality of life (QoL), and possible changes in early markers of cardiovascular risk. Methods This was a cross-sectional observational study that evaluated anthropometric and cardiovascular parameters, QoL, and eating behaviour in 181 children and adolescents aged between 5 and 13 years. Participants were stratified according to BMI/age into three groups (Adequate Weight, Overweight, and Obesity). Anthropometry included weight, height, waist and hip circumferences, waist-hip ratio, and waist-height ratio. QoL was assessed using the Peds-QL 4.0 questionnaire, and eating behaviour was assessed using the Children’s Eating Behaviour Questionnaire (CEBQ). Cardiovascular parameters were assessed using the Mobil-O-Graph® device, which measures the pulse wave velocity (PWV) and augmentation index (AIx@75) to estimate arterial stiffness (AS), which is considered an early marker of cardiovascular disease. Results In addition to the increase in anthropometric measurements (p

A degradação e os impactos ambientais causados pela indústria da construção civil (ICC) são observados em todas as fases de seu processo produtivo. Nesse contexto, tem-se buscado alternativas para reduzir o consumo acelerado de recursos naturais, os danos ambientais, o alto consumo de energia na fabricação de materiais e os custos dos produtos finais, como o desenvolvimento de técnicas construtivas e materiais sustentáveis. Dentro desse contexto, destaca-se o reaproveitamento dos resíduos gerados pela própria indústria da construção civil, de agronegócio e outros setores. O resgaste da terra crua para produção de blocos de solo estabilizado é uma das possibilidades de reutilização desses materiais e desenvolvimento sustentável da ICC. Este estudo teve como objetivo verificar a viabilidade da incorporação de serragem de madeira em matriz de solo-cimento para a fabricação de tijolos de adobe, com enfoque em apresentar materiais de construção alternativos e de baixo impacto ambiental. Para isso, foram realizadas análises de resistência à compressão simples, capacidade de absorção de água e retração dos blocos para o período de cura de 7 dias. Os blocos fabricados com a adição de serragem de madeira apresentaram adequado desempenho no que se refere à retração.

Carrots (Daucus carota L.), a globally significant vegetable, lack extensive research on heterotic groups and diallel analysis to generate hybrid combinations. Thus, the objective of this study was to assess combining abilities and identify optimal carrot parents for producing hybrids suitable for tropical climates with elevated metabolite levels. Twenty carrot hybrids, ten parent plants, and three commercial cultivars were evaluated during the summers of 2020/2021 and 2021/2022. Agronomic evaluations were carried out and chlorophyll and carotenoid levels were determined, followed by a diallel analysis using Griffing’s Method III and GGE biplot analysis. There were significant general combining ability (GCA) effects for various agronomic traits, suggesting additive genetic effects. Based on GCA, cultivars 5, 4, and 2 were the most promising parents. Specific combining ability (SCA) revealed that hybrids 1 × 2 and 3 × 5 stood out in environment 1, whereas hybrids 1 × 5 and 5 × 3 performed well in environment 2. The GGE biplot analysis showed that hybrids 1 × 2 and 3 × 2 displayed larger average root diameters, belonged to the group with the best bolting percentages, and exhibited stability across environments. Moreover, hybrids 2 × 4, 3 × 1, 4 × 1, and 4 × 2 exhibited higher metabolite levels. These findings suggest the feasibility of obtaining superior hybrids tailored for the tropical carrot market.

The objective of this study was to verify the genetic dissimilarity and validate image phenotyping using RGB (red, green, and blue) sensors in tropical carrot germplasms. The experiment was conducted in the city of Carandaí-MG, Brazil, using 57 tropical carrot entries from Seminis and three commercial entries. The entries were evaluated agronomically and two flights with Remotely Piloted Aircraft (RPA) were conducted. Clustering was performed to validate the existence of genetic variability among the entries using an artificial neural network to produce a Kohonen’s self-organizing map. The genotype–ideotype distance index was used to verify the best entries. Genetic variability among the tropical carrot entries was evidenced by the formation of six groups. The Brightness Index (BI), Primary Colors Hue Index (HI), Overall Hue Index (HUE), Normalized Green Red Difference Index (NGRDI), Soil Color Index (SCI), and Visible Atmospherically Resistant Index (VARI), as well as the calculated areas of marketable, unmarketable, and total roots, were correlated with agronomic characters, including leaf blight severity and root yield. This indicates that tropical carrot materials can be indirectly evaluated via remote sensing. Ten entries were selected using the genotype–ideotype distance (2, 15, 16, 22, 34, 37, 39, 51, 52, and 53), confirming the superiority of the entries.

A perda da capacidade de abdução da laringe de forma unilateral ou bilateral durante a inspiração de origem adquirida ou congênita é definida como paralisia de laringe. Essa patogenia está normalmente associada a cães de meia idade, a idosos, machos e de grande porte. A ocorrência de paralisia de laringe secundária a intubação em cães é pouco comum, diferente do que ocorre em humanos. O presente trabalho teve como objetivo relatar o caso de um cão da raça Pug, macho, castrado, de oito anos de idade, atendido no Hospital Veterinário da Universidade Federal do Paraná. O paciente em questão foi submetido a procedimento cirúrgico sob intubação, e retornou ao hospital em torno de 30 dias depois, em atendimento de emergência devido à angústia respiratória e queixa de afonia e roncos mais intensos e frequentes com início uma semana após a intubação. Após estabilização do quadro na internação, o animal foi submetido a laringoscopia sob anestesia ambulatorial leve para avaliação de vias aéreas superiores, durante a qual foi possível constatar prolongamento de palato mole, eversão de sacos laríngeos, processos cuneiformes das aritenoides colapsando em direção ao lúmen laríngeo durante a inspiração, colapso laríngeo grau 2 e paralisia de laringe unilateral esquerda. Após estabilização, o cão recebeu alta da internação para tratamento de hemoparasitose previamente à rinoplastia e estafilectomia. Duas semanas após a alta, paciente retornou ao hospital em crise respiratória severa, sendo necessária realização de traqueostomia temporária e monitoramento em unidade de terapia intensiva para estabilização do quadro. Três dias depois após estabilização, foi então submetido a estafilectomia, rinoplastia e saculectomia, sendo constatado novamente o quadro de colapso de laringe de segundo grau e paralisia laríngea unilateral esquerda. Após dois dias internado para cuidados pós-operatórios, o tubo de traqueostomia temporária foi retirado e recebeu alta sob orientações de tratamento clínico e manejo. Uma semana após o retorno, o animal em questão veio a óbito em casa após um quadro de êmese seguido por angústia respiratória relatada pelo tutor. Suspeita-se que tenha ocorrido um quadro de broncoaspiração, sendo tal complicação bastante frequente nos casos de paralisia de laringe.

Objective: To evaluate a group of Brazilian dentists on their knowledge of Molar Incisor Hypomineralization (MIH) and Hypomineralized Second Primary Molars (HSPM) related to clinical aspects, consequences, and diagnostic criteria. Material and Methods: In this cross-sectional, the participants were invited by e-mail and Whatsapp® to answer a questionnaire about their knowledge of hypomineralization enamel defects (MIH/HSPM) on the Google Forms® platform. The questionnaire comprised eight questions about personal data and multiple-choice questions about their knowledge concerning clinical aspects, diagnostic criteria of MIH/HSPM and differential diagnosis through clinical images. Chi-square test was applied with the significance level set at 5%. Results: Most participants (n = 492; 91.1%) reported having knowledge about MIH/HSPM. The general dentists gave more incorrect answers (n = 40; 65.6 %;) about dental tissues affected by MIH/HSPM. Overall, 83.3% of the dentists gave the correct answer to which dentitions are associated with this condition. In addition, most dentists presented knowledge about the consequences related to possible fractures (n= 487; 90.2%) and about an increased risk of caries (n= 479; 88.9%) in the affected teeth. Regarding the differential diagnosis performed through clinical images, most participants gave incorrect answers (p≤0.001). Conclusion: The participants presented knowledge about the dentition associated with this condition and possible consequences related to the teeth affected by MIH/HSPM; however, they showed difficulties concerning clinical diagnostic criteria.