Abstract The legal field is historically constituted by social norms that establish a body pattern (binary, cisgender, endosex), thus excluding bodies that do not fit this norm, as it is the case of intersexuality. Because of this, intersex people suffer discrimination and have their rights violated by early hormonal and cosmetic surgical procedures even in their childhood. This paper seeks to discuss how intersexuality strains the legal content of prohibited criterion of sex discrimination, contributing to its expansion. To this end, a bibliographic and national and international legislation review was carried out on the content of the discrimination prohibited criterion sex, considering the need for anti-discriminatory protection of intersex people. It is evaluated whether the categories that give content to the prohibited criterion of sex - sexual orientation and gender identity - are sufficient to protect intersex people from discrimination and the desbinarization of the law is proposed, through the inclusion of the category sexual characteristics, as a way of contemplating the discrimination experienced by intersex people, and also by other corporalities that are not inscribed in a binary pattern and that are not linearly related to identity.

Resumo O campo jurídico é historicamente constituído por normativas sociais que estabelecem um padrão corporal (binário, cisgênero, endossexo), excluindo, dessa forma, corpos que não se enquadram nessa norma, como é o caso da intersexualidade. Por conta disso, pessoas intersexo sofrem discriminação e têm os seus direitos violados por procedimentos cirúrgicos e hormonais precoces e cosméticos, ainda na infância. O presente artigo busca discutir como a intersexualidade tensiona o conteúdo jurídico do critério proibido de discriminação sexo, contribuindo para o seu alargamento. Para tanto, foi realizada revisão bibliográfica e de legislação nacional e internacional sobre o conteúdo do critério proibido de discriminação sexo, considerando a necessidade de proteção antidiscriminatória das pessoas intersexo. Avalia-se se as categorias que dão conteúdo ao critério proibido sexo - orientação sexual e identidade de gênero - são suficientes para proteger as pessoas intersexo da discriminação e propõe-se a desbinarização do direito, por meio da inclusão da categoria características sexuais, como forma de contemplar as discriminações experienciadas por pessoas intersexo, e também por outras corporalidades que não se inscrevem em um padrão binário e que não se relacionam de modo linear com a identidade.

Abstract Background Evidence indicates a strong link between Zika virus (ZikV) and neurological complications. Acute myelitis, optic neuritis, polyneuropathy, and encephalomyelitis that mimic inflammatory idiopathic demyelination disorders (HDD) after ZikV infection have been reported in Brazil. Objective The present study aims to investigate the possible occurrence of molecular mimicry between ZikV antigens and Multiple Sclerosis (MS) autoantigens, the most frequent HDD of the central nervous system (CNS). Methods A retrospective cohort study with 305 patients admitted due to suspected arbovirus infection in Rio de Janeiro was performed, all subjects were submitted to neurological examination, and a biological sample was collected for serologic and molecular diagnostic. Bioinformatics tools were used to analyze the peptides shared between ZikV antigens and MS autoantigens. Results Of 305 patients, twenty-six were positive for ZikV and 4 presented IDD patterns found in MS cases. Sequence homology comparisons by bioinformatics approach between NS5 ZikV and PLP MS protein revealed a homology of 5/6 consecutive amino acids (CSSVPV/CSAVPV) with 83% identity, deducing a molecular mimicry. Analysis of the 3D structures revealed a similar conformation with alpha helix presentation. Conclusions Molecular mimicry between NS5 Zika virus antigen and PLP MS autoantigens emerge as a possible mechanism for IDD spectrum in genetically susceptible individuals.

Resumo Antecedentes Evidências indicam uma forte ligação entre o vírus Zika (ZikV) e complicações neurológicas. Mielite aguda, neurite óptica, polineuropatia e encefalomielite que mimetizam distúrbios inflamatórios de desmielinização idiopáticos (DDII) após infecção por ZikV têm sido relatadas no Brasil. Obejtivo O presente estudo tem como objetivo investigar a possível ocorrência de mimetismo molecular entre antígenos do ZikV e autoantígenos da Esclerose Múltipla (EM), a DDII mais frequente do sistema nervoso central (SNC). Métodos Foi realizado um estudo de coorte retrospectivo com 305 pacientes internados por suspeita de infecção por arbovirus no Rio de Janeiro, todos os indivíduos foram submetidos a exame neurológico e coleta de amostra biológica para diagnóstico sorológico e molecular. Ferramentas de bioinformática foram usadas para analisar os peptídeos compartilhados entre antígenos do ZikV e autoantígenos da EM. Resultados Dos 305 pacientes, vinte e seis foram positivos para ZikV e 4 apresentaram padrão IDD encontrado em casos de EM. As comparações de homologia de sequência por abordagem de bioinformática entre a proteína NS5 ZikV e PLP EM revelaram uma homologia de 5/6 aminoácidos consecutivos (CSSVPV/CSAVPV) com 83% de identidade, deduzindo um mimetismo molecular. A análise das estruturas 3D revelou uma conformação semelhante com apresentação em alfa-hélice. Conclusões O mimetismo molecular entre o antígeno NS5 do vírus Zika e o autoantígeno PLP da EM surge como um possível mecanismo para o espectro IDD em indivíduos geneticamente suscetíveis.

Resumen Introducción: el incremento del consumo de alimentos procesados y ultraprocesados puede predisponer a alteraciones metabólicas. Objetivo: verificar la asociación del consumo de alimentos con el fenotipo metabólico en trabajadores de un hospital cuaternario de Rio de Janeiro, Brasil. Métodos: fueron elegibles trabajadores de ambos sexos de edad > 18 años. El cuestionario de frecuencia de alimentos y la clasificación NOVA se utilizaron en el análisis del consumo de alimentos. El fenotipo metabólico consideró la presencia de al menos una alteración metabólica (glucemia, lípidos séricos y presión arterial) combinada con el IMC (eutrófico o exceso de peso) de la siguiente manera: 1) eutrófico metabólicamente saludable (EHM); 2) eutróficos metabólicamente no saludables (MUE); 3) exceso de peso metabólicamente saludable (MHEW); 4) exceso de peso metabólicamente no saludable (MUEW). Resultados: de los 160 participantes incluidos (edad media: 45,2 ± 1,1 años, 59,5 % de mujeres), el 21,9 % refirieron hipertensión arterial y el 4,4 % diabetes. La mayoría presentaron exceso de peso (74,6 %), siendo aproximadamente un 40 % obesos. El fenotipo MUEW presentó mayor porcentaje de grasa corporal y adiposidad central representada por mayor CC y VFA en comparación con los otros fenotipos. La masa corporal magra fue similar entre los grupos. La mediana de alimentos ultraprocesados fue de 32,4 % para los eutróficos, 32,7 % para el sobrepeso y 34,3 % para los obesos. No se observaron asociaciones significativas entre el consumo de ultraprocesados y el fenotipo eutrófico metabólicamente no saludable (OR: 1,01; IC 95 %: 0,96-1,06), exceso de peso metabólicamente saludable (OR: 1,03; IC 95 %: 0,98-1,08) y exceso de peso metabólicamente no saludable (OR: 1,00; IC 95 %: 0,96-1,05) en comparación con los eutróficos metabólicamente sanos. Conclusión: el consumo de alimentos ultraprocesados fue elevado. En este análisis transversal, no se observó asociación de fenotipos metabólicos y consumo de grupos de alimentos según el grado de procesamiento de los alimentos.

Abstract Introduction: an increase in the consumption of processed and ultra-processed foods may predispose to metabolic abnormalities. Objective: to verify the association of food consumption with metabolic phenotype in workers from a quaternary hospital in Rio de Janeiro, Brazil. Methods: workers of both sexes aged > 18 years were eligible. A food frequency questionnaire and the NOVA classification were used in the food consumption analysis. Metabolic phenotype considered the presence of at least one metabolic alteration (blood glucose, serum lipids, and blood pressure) combined with BMI (eutrophic or excess weight) as follows: 1) metabolically healthy eutrophic (MHE); 2) metabolically unhealthy eutrophic (MUE); 3) metabolically healthy excess weight (MHEW); 4) metabolically unhealthy excess weight (MUEW). Results: from the included 160 participants (mean age, 45.2 ± 1.1 years; 59.4 %, women), 21.9 % self-reported arterial hypertension and 4.4 % diabetes. Most presented excess weight (74.6 %), with approximately 40 % being obese. The MUEW phenotype had higher body fat percentage and central adiposity represented by higher WC and VFA in comparison to the other phenotypes. The lean body mass was similar between the groups. The median of ultra-processed foods was 32.4 % for eutrophic, 32.7 % for overweight, and 34.3 % for obese subjects. No significant associations were observed between ultra-processed food consumption and metabolically unhealthy eutrophic (OR: 1.01; 95 % CI: 0.96-1.06), metabolically healthy excess weight (OR: 1.03; 95 % CI: 0.98-1.08), and metabolically unhealthy excess weight (OR: 1.00; 95 % CI: 0.96-1.05) in comparison to metabolically healthy eutrophic. Conclusion: consumption of ultra-processed food was high. In this cross-sectional analysis, no association of metabolic phenotypes with consumption of food groups according to degree of food processing were observed.

Abstract Disease in plants as a major limiting factor in agricultural production. In rice culture, it contributes to the reduction of production and grain quality, such as glumela stain caused by Curvularia lunata. As forms of control available to this pathogen, are being of high cost to most producers. Arbuscular mycorrhizal fungi (AMF) can help as plants tolerate pathogen attacks and resistance mechanisms. Therefore, this study aimed to evaluate the control of C. lunata in the rice culture inoculated with AMF, as well as its benefits in growth and factors of production. The experiment was carried out in a greenhouse with a completely randomized experimental design considering the treatments: T1 - Witness; T2 - Rhizophagus clarus; T3 - Claroideoglomus etunicatum; T4 - Gigaspora margarita; T5 - R. clarus + C. etunicatum; T6 - C. etunicatum + G. margarita; T7 - R. clarus + G. margarita and T8 - R. clarus + C. etunicatum + G. margarita. The parameters evaluated were disease severity, height of the aerial part (HAP), dry plant shoot mass (DSPM), grain quantity (full and dry grain), panicle length and mycorrhizal colonization. The DSPM only the T2 and T5 differed from the control and presented higher averages. For the factors of production, all parameters were significant, except for full grains. The AMF present potential in the control of C. lunata, but complementary research is needed on the mechanism of action of the pathogen, AMF and the host plant.

Resumo A doença em plantas é considerada como um dos principais fatores limitantes na produção agrícola como a mancha das glumelas causada por Curvularia lunata. Na cultura do arroz, ela contribui na redução da produção e na qualidade dos grãos. As formas de controle disponíveis para esse patógeno são de alto custo para a maioria dos produtores. Os fungos micorrízicos arbusculares (FMA) podem auxiliar as plantas a tolerarem ataques de patógenos e desenvolverem mecanismos de resistência. Diante disso, este estudo objetivou avaliar o controle de C. lunata na cultura do arroz inoculado com FMA, bem como seus benefícios no crescimento e fatores de produção. O experimento foi realizado em casa de vegetação com delineamento experimental inteiramente casualizado considerando os tratamentos: T1 - Testemunha; T2 - Solo + Rhizophagus clarus; T3 - Solo + Claroideoglomus etunicatum; T4 - Solo + Gigaspora margarita; T5 - Solo + R. clarus + C. etunicatum; T6 - Solo + C. etunicatum + G. margarita; T7 - Solo + R. clarus + G. margarita e T8 - Solo + R. clarus + C. etunicatum + G. margarita. Avaliaram-se os parâmetros severidade da doença, altura da parte aérea (ALT), massa seca da parte aérea (MSPA), quantidade de grãos (cheios e chochos), comprimento de panículas e colonização micorrízica. A MSPA apenas Solo + Rhizophagus clarus e Solo + R. clarus + C. etunicatum diferiram da testemunha e apresentaram maiores médias. Nos fatores de produção, todos os parâmetros foram significativos, exceto grãos cheios. Os FMA apresentam potencial na redução dos efeitos causados por C. lunata, porém é necessita de pesquisas complementares sobre o mecanismo de ação do patógeno, FMA e da planta hospedeira.

Mental disorders such as anxiety, depression, and memory loss have been described in patients with chronic Chagas disease (CD), a neglected tropical disease caused by the protozoan parasite Trypanosoma cruzi. Social, psychological, and biological stressors may take part in these processes. There is a consensus on the recognition of an acute nervous form of CD. In chronic CD patients, a neurological form is associated with immunosuppression and neurobehavioural changes as sequelae of stroke. The chronic nervous form of CD has been refuted, based on the absence of histopathological lesions and neuroinflammation; however, computed tomography shows brain atrophy. Overall, in preclinical models of chronic T. cruzi infection in the absence of neuroinflammation, behavioural disorders such as anxiety and depression, and memory loss are related to brain atrophy, parasite persistence, oxidative stress, and cytokine production in the central nervous system. Interferon-gamma (IFNγ)-bearing microglial cells are colocalised with astrocytes carrying T. cruzi amastigote forms. In vitro studies suggest that IFNγ fuels astrocyte infection by T. cruzi and implicate IFNγ-stimulated infected astrocytes as sources of TNF and nitric oxide, which may also contribute to parasite persistence in the brain tissue and promote behavioural and neurocognitive changes. Preclinical trials in chronically infected mice targeting the TNF pathway or the parasite opened paths for therapeutic approaches with a beneficial impact on depression and memory loss. Despite the path taken, replicating aspects of the chronic CD and testing therapeutic schemes in preclinical models, these findings may get lost in translation as the chronic nervous form of CD does not fulfil biomedical model requirements, as the presence of neuroinflammation, to be recognised. It is hoped that brain atrophy and behavioural and neurocognitive changes are sufficient traits to bring the attention of researchers to study the biological and molecular basis of the central nervous system commitment in chronic CD.

ABSTRACT Objective To analyze the karyotype test and myeloid panel with next-generation sequencing findings in patients with myelofibrosis, and to compare transplant characteristics in patients referred for bone marrow transplantation. Methods Retrospective, single-center study with patients diagnosed with myelofibrosis treated at Hospital Israelita Albert Einstein between 2010 and 2020. Results A total of 104 patients with myelofibrosis were examined. Patients who had not been submitted to tests in our service were excluded. The final sample comprised 69 patients. Of these 69, 56 were submitted to karyotyping and 22 to myeloid panel with next-generation sequencing. Karyotype was normal in 60% of the patients and altered in 40%. The prevalence of high-risk molecular mutations was higher in patients referred for bone marrow transplantation (100% versus 50%). The median follow-up of transplant patients was 2.4 years and the overall survival at 2 years was 80% (95%CI: 62-100%). Conclusion The molecular analysis enables estimating the patient’s risk and thus instituting more aggressive treatment such as bone marrow transplant for patients at higher risk, being a relevant tool to guide therapy. Given the significance of molecular analysis for therapeutic decision-making in myelofibrosis, collection and disclosure of data on the prevalence of cytogenetic changes and findings of next-generation sequencing in affected patients is important.

ABSTRACT The attempt to face the limitations of wood-based materials, especially concerning the relationship with water, is still a considerable gap in research on this subject. The present work proposes the accomplishment of thermal treatment in fiberboard-type hardboard, using different temperatures and times, to evaluate the effect on the physical-mechanical properties. The parameters of the heat treatment were temperatures of 120 and 160 °C and times of 20 and 40 min. The hardboards were individually heat treated in a kiln. The characterization was performed from physical tests such as bulk density, moisture content, water absorption (2 and 24 h), thickness swelling (2 and 24 h); and mechanical properties of flexural strength. The treatment with a temperature of 160 °C for 40 min showed the lowest values of water absorption in 24 h (34%). Thickness swelling was lower compared to control, for all the treatments applied. Regarding flexural strength, the treatment that adopted the 160 °C for 20 min showed the highest MOR value (26.3 MPa). In general, the performance of heat treatments positively influenced the physical and mechanical properties of the hardboards, being an interesting alternative in the development of products for applications in internal environments.

ABSTRACT Objective: The primary aim is to analyze the endoscopic endonasal surgical results in short-term and two-year follow-ups according to the 11th Acromegaly Consensus statement (2018). Indeed, prognostic factors and complications were analyzed. Subjects and methods: 40 patients who underwent endoscopic endonasal surgery by acromegaly between 2013 to 2020 was analyzed. Patients were considered in remission if an upper limit of normal (ULN) IGF-1 was less than 1.0 at the six-month and two-year follow-ups. Moreover, we assessed the Knosp grade, tumor volumetry, ULN, T2 signal in MRI, reoperation, and complications. Results: The mean age of admission was 46.7 years. Thirty-two patients were in remission after six months of surgery (80%), decreasing to 76.32% at the two-year follow-up. All microadenomas presented remission (n = 6). Regarding the complications, three patients had permanent panhypopituitarism (7.5%); postoperative cerebrospinal fluid (CSF) leaks did not occur in this series. The hyperintense signal on the T2 MRI and a higher tumor volumetry were the single predictor's factors of non-emission in a multivariate regression logistic analysis (p < 0.05). Preoperative hormone levels (GH and IGF-1) were not a prognostic factor for remission. The re-operated patients who presented hypersignal already had a high predictor of clinical-operative failure. Conclusion: The endoscopic endonasal surgery promotes high short-term and two-year remission rates in acromegaly; the tumor's volumetry and the T2 hypersignal were statistically significant prognostic factors in non-remission – the complications presented at similar rates in comparison to the literature. In invasive GH-secreting tumors, we should offer these patients a multi-disciplinary approach to improve acromegalic patients’ remission rates.

ABSTRACT 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.

Abstract The objective of this work was to evaluate the effect of three dehydration/rehydration cycles on the vegetative growth and shoot dry matter of citrus seedlings, as well as seedling acclimatization to this environmental stress. The five following water regimes were evaluated: WR1 (control), WR2, and WR3, with plants kept at 100, 75, and 50% of pot capacity during the three cycles, respectively; and WR4 and WR5, with plants kept at 75, 100, and 75% and 50, 100, and 50% of pot capacity during the first, second, and third cycles, respectively. Relative water content, plant height, length and diameter of the main and secondary branches, angle of leaf insertion in the branch, specific leaf area, leaf chlorophyll content, and dry matter were evaluated. Rehydration after a cycle with 50% of pot capacity did not improve plant growth or dry matter accumulation in relation to the well-hydrated plants of the control. However, after a cycle with 75% of pot capacity, rehydration restores water content, the diameter of the secondary branches, and the angle of leaf insertion. The exposure to successive events of dehydration/rehydration makes the citrus seedlings more resistant to future exposures to water stress.

Resumo O objetivo deste trabalho foi avaliar o efeito de três ciclos consecutivos de desidratação/reidratação no crescimento vegetativo e na matéria seca de mudas de citros, bem como a aclimatação dessas mudas a esse estresse ambiental. Foram avaliados os seguintes cinco regimes hídricos: WR1 (controle), WR2 e WR3, com plantas mantidas em 100, 75 e 50% da capacidade de vaso durante os três ciclos, respectivamente; e WR4 e WR5, com plantas mantidas em 75, 100 e 75% e 50, 100 e 50% da capacidade de vaso durante o primeiro, o segundo e o terceiro ciclo, respectivamente. Foram avaliados teor relativo de água, altura da planta, comprimento e diâmetro dos ramos principal e secundário, ângulo de inserção da folha no ramo, área foliar específica, teor de clorofila foliar e matéria seca. A reidratação após um ciclo com 50% da capacidade do vaso não aumentou o crescimento nem o acúmulo de matéria seca das plantas, em comparação às plantas bem hidratadas do controle. Porém, após um ciclo com 75% da capacidade do vaso, a reidratação repôs o teor de água, o diâmetro dos ramos secundários e o ângulo de inserção das folhas. A exposição a sucessivos eventos de desidratação/reidratação torna as mudas de citros mais resistentes a futuras exposições ao estresse hídrico.

Resumo O câncer de mama representa um problema de saúde pública por ser a neoplasia maligna de maior incidência em mulheres no mundo. A forma hereditária corresponde a cerca de 5% a 10% de todos os casos e está diretamente relacionada à herança de mutações genéticas, sendo as principais nos genes supressores de tumor BRCA1 e BRCA2. A identificação dessas mutações é de extrema importância pelo elevado risco de desenvolvimento de câncer de mama nessa população, permitindo estratégias de rastreamento diferenciado e adoção de medidas de redução de risco. Entretanto, é importante e necessário refletir sobre os aspectos éticos relacionados ao uso indiscriminado de testes genéticos. O objetivo deste trabalho foi avaliar o conhecimento e a opinião de médicos de um centro de referência oncológico sobre a indicação dos testes genéticos de suscetibilidade ao câncer de mama mediante dilemas éticos aos quais são submetidos na prática médica.

Abstract Breast cancer is a public health problem because it is the malignant neoplasm with the highest incidence in women worldwide. The hereditary form corresponds to about 5% to 10% of all cases and is directly related to the inheritance of genetic mutations. The main ones occur in the BRCA1 and BRCA2 tumor suppressor genes. The identification of these mutations is extremely important because of the high risk of breast cancer development in this population, allowing differentiated screening strategies and the adoption of risk reduction measures. However, reflections on the ethical aspects related to the indiscriminate use of genetic testing are important and necessary. The objective of this study was to evaluate the knowledge and opinion of physicians of an oncology reference center on the indication of genetic tests for susceptibility to breast cancer given the ethical dilemmas to which they are submitted in medical practice.

Resumen El cáncer de mama representa un problema de salud pública, ya que es la neoplasia maligna con mayor incidencia en las mujeres de todo el mundo. La forma hereditaria corresponde a entre el 5% y el 10% de todos los casos y está directamente relacionada con la herencia de mutaciones genéticas, y las principales se dan en los genes supresores de tumores BRCA1 y BRCA2. La identificación de estas mutaciones es extremadamente importante debido al elevado riesgo de esta población de desarrollar cáncer de mama, además de permitir estrategias de rastreo diferenciadas y la adopción de medidas de reducción del riesgo. Sin embargo, es importante y necesario reflexionar sobre los aspectos éticos relacionados con el uso indiscriminado de las pruebas genéticas. El objetivo de este estudio fue evaluar el conocimiento y la opinión de los médicos de un centro oncológico de referencia sobre la indicación de las pruebas genéticas de susceptibilidad al cáncer de mama mediante los dilemas éticos a los que se ven sometidos en la práctica médica.

Resumo O objetivo foi analisar a distribuição espacial do comportamento sedentário e do hábito alimentar não saudável e verificar a relação com o ambiente da vizinhança. Estudo transversal com dados do Sistema de Vigilância de fatores de risco e proteção para doenças crônicas, realizado em Belo Horizonte, Minas Gerais. Considerou-se comportamento sedentário o hábito de assistir televisão quatro ou mais horas por dia. O hábito alimentar não saudável foi avaliado pelo consumo regular de carne com excesso de gordura, refrigerante e carne vermelha e irregular de frutas e hortaliças. Informações georreferenciadas dos locais para a prática de atividade física, estabelecimentos com venda de alimentos, densidade populacional e residencial, taxa de homicídio, renda e índice de vulnerabilidade social foram inseridas na base do Vigitel. A área de abrangência da unidade básica de saúde foi usada como unidade geográfica da vizinhança. A análise espacial identificou cluster significativo de alta prevalência de comportamento sedentário e hábito alimentar não saudável, mesmo após ajuste. Os ambientes físico e social podem estar relacionados a cluster de alta prevalência de comportamento sedentário e hábito alimentar não saudável.

Abstract The study aimed to analyze the spatial distribution of sedentary behavior and unhealthy eating habits, and to assess its relationship with the neighborhood environment. Cross-sectional study with data of Surveillance System of Risk and Protective Factors for Chronic Diseases, carried out in Belo Horizonte, Minas Gerais. Watching television for four hours or more per day was identified as sedentary behavior. Unhealthy eating habits were defined based on regular consumption of sodas, excess fat meat, and red meat, and irregular consumption of fruits and vegetables. Georeferenced data of places for physical activity, food establishments, population and residential density, homicide rate, mean total income, and social vulnerability index were entered into the Vigitel database. The coverage area by basic health units was used as the geographical unit of neighborhood. SaTScan was used to analyze the spatial distribution. Spatial analysis identified a significant cluster of high prevalence of sedentary behavior and unhealthy eating habits, after adjusting for sociodemographic characteristics. The comparison of environmental characteristics inside and outside clusters showed significant differences in the physical and social environment. Physical and social environment might be related to clusters of high prevalence of sedentary behavior and unhealthy eating habits.

Resumo O objetivo foi analisar a distribuição espacial do comportamento sedentário e do hábito alimentar não saudável e verificar a relação com o ambiente da vizinhança. Estudo transversal com dados do Sistema de Vigilância de fatores de risco e proteção para doenças crônicas, realizado em Belo Horizonte, Minas Gerais. Considerou-se comportamento sedentário o hábito de assistir televisão quatro ou mais horas por dia. O hábito alimentar não saudável foi avaliado pelo consumo regular de carne com excesso de gordura, refrigerante e carne vermelha e irregular de frutas e hortaliças. Informações georreferenciadas dos locais para a prática de atividade física, estabelecimentos com venda de alimentos, densidade populacional e residencial, taxa de homicídio, renda e índice de vulnerabilidade social foram inseridas na base do Vigitel. A área de abrangência da unidade básica de saúde foi usada como unidade geográfica da vizinhança. A análise espacial identificou cluster significativo de alta prevalência de comportamento sedentário e hábito alimentar não saudável, mesmo após ajuste. Os ambientes físico e social podem estar relacionados a cluster de alta prevalência de comportamento sedentário e hábito alimentar não saudável.

Abstract The study aimed to analyze the spatial distribution of sedentary behavior and unhealthy eating habits, and to assess its relationship with the neighborhood environment. Cross-sectional study with data of Surveillance System of Risk and Protective Factors for Chronic Diseases, carried out in Belo Horizonte, Minas Gerais. Watching television for four hours or more per day was identified as sedentary behavior. Unhealthy eating habits were defined based on regular consumption of sodas, excess fat meat, and red meat, and irregular consumption of fruits and vegetables. Georeferenced data of places for physical activity, food establishments, population and residential density, homicide rate, mean total income, and social vulnerability index were entered into the Vigitel database. The coverage area by basic health units was used as the geographical unit of neighborhood. SaTScan was used to analyze the spatial distribution. Spatial analysis identified a significant cluster of high prevalence of sedentary behavior and unhealthy eating habits, after adjusting for sociodemographic characteristics. The comparison of environmental characteristics inside and outside clusters showed significant differences in the physical and social environment. Physical and social environment might be related to clusters of high prevalence of sedentary behavior and unhealthy eating habits.

Resumo Objetivo Analisar as estratégias, os desafios e os enfrentamentos dos profissionais de enfermagem que trabalhavam nas emergências obstétricas no contexto da pandemia de COVID-19. Método Estudo exploratório descritivo, qualitativo, realizado com nove profissionais de enfermagem de uma emergência obstétrica de alto risco, em Fortaleza-CE. Os dados foram coletados através da técnica grupo focal, em novembro de 2021, posteriormente foram organizados em temáticas e analisados de acordo com a literatura. Resultados A partir das experiências dos participantes emergiram três temas, a saber: 1) Estratégias de enfrentamento adotadas na pandemia por COVID-19; 2) Vivências experienciadas pelos profissionais de enfermagem durante suas atividades assistenciais na pandemia; 3) Desafios e reflexos experienciados pelos profissionais de enfermagem durante as atividades assistenciais. Os profissionais relataram condições inseguras e conflituosas em que os fluxos assistenciais sofreram mudanças inesperadas e dificuldades para agilizar um cuidado com segurança e empatia às usuárias do serviço. Considerações finais e implicações para a prática Percebeu-se ainda a fragilidade emocional e psicológica dos profissionais decorrente das extensas jornadas de trabalho, das constantes modificações dos fluxos e protocolos assistenciais, sobrecarga de trabalho, equipes insuficientes ocasionadas pelo afastamento de profissionais contaminados pelo vírus e por licença médica por desenvolver depressão ou outro distúrbio psicológico.

Abstract Objective To analyze the strategies, challenges, and coping mechanisms of nursing professionals who worked in obstetric emergencies in the context of the COVID-19 pandemic. Method This was a qualitative descriptive exploratory study with nine nursing professionals who worked at a high-risk obstetric emergency service in Fortaleza, Ceará, Brazil. Data were collected using a focus group carried out in November 2021. The data were organized into themes and analyzed according to the current literature. Results Based on the experiences of the participants, three themes emerged: 1) coping mechanisms adopted in the COVID-19 pandemic; 2) challenges experienced by nursing professionals in their care activities in the pandemic; and 3) challenges and repercussions experienced by nursing professionals in care activities. The professionals reported unsafe and conflicting conditions in which care flows suffered unexpected changes and which created challenges to provide users with safe and empathetic care. Final considerations and implications for practice The professionals presented emotional and psychological fragility because of long work periods, constant changes in care flows and protocols, work overload, understaffing due to professionals infected with COVID-19 or medical leaves of absence due to depression or other psychological disorders.

Resumen Objetivo Analizar estrategias, desafíos y enfrentamientos de profesionales de enfermería que actuaron en emergencias obstétricas en el contexto de la pandemia de COVID-19. Método Estudio exploratorio, descriptivo, cualitativo, realizado con nueve profesionales de enfermería de una emergencia obstétrica de alto riesgo en Fortaleza-CE. Datos recolectados a través de la técnica de grupos focales, en noviembre/2021, posteriormente organizados en temas y analizados según la literatura. Resultados De las experiencias, emergieron tres temas: 1) Estrategias de enfrentamiento adoptadas en la pandemia de COVID-19; 2) Experiencias vividas por profesionales de enfermería durante sus actividades de cuidado en la pandemia; 3) Desafíos y reflejos experimentados por profesionales de enfermería durante las actividades de cuidado. Los profesionales relataron condiciones inseguras y conflictivas en las que los flujos de atención sufrieron cambios inesperados y dificultades para agilizar la atención con seguridad y empatía para los usuarios del servicio. Consideraciones finales e implicaciones para la práctica También se percibió la fragilidad emocional y psicológica de los profesionales, resultante de la extensa jornada laboral, constantes cambios en los flujos y protocolos de atención, sobrecarga de trabajo, equipos insuficientes por la baja de contaminados por el virus y de licencia médica por enfermedad, como depresión u otro trastorno psicológico.

RESUMO O objetivo deste artigo foi verificar a influência da liquidez em caixa e das restrições financeiras no desempenho de mercado das empresas brasileiras. Conforme a Teoria do Pecking Order as organizações optam por lucros retidos sobre as dívidas ou por novas emissões de ações, o que pode estar atrelado a custos específicos. Entretanto, a Teoria do Trade-Off destaca que os impostos têm a proposição de que a política financeira e a dívida podem ser relevantes ao valor da empresa. Assim, esse estudo visa atribuir novos insights para essas temáticas e conhecimento para a investigação da liquidez em caixa e para as restrições financeiras no desempenho. A liquidez em caixa das organizações e as restrições financeiras são fenômenos importantes para o desempenho, haja vista que, no presente estudo, houve aumento no desempenho. Com os resultados, sugere-se que as organizações optem pelo subinvestimento no cenário e pela dificuldade em disposição de crédito. Dessa forma, fica evidente a necessidade de as organizações apresentarem liquidez para não perderem oportunidades de investimento. Apesar de financeiramente restritas, as organizações representam, de certa forma, uma boa opção de investimento, por preferirem o excesso em caixa à disponibilidade para novos investimentos. A população deste estudo é formada pelas empresas listadas na B3 S.A. - Brasil, Bolsa, Balcão. O período de análise correspondeu os anos de 2014 a 2018, sendo realizado cálculo do índice KZ para classificação das organizações quanto ao nível de restrição. Após, ocorreu o cálculo por meio de regressão linear múltipla, com controle de efeitos fixos para ano e setor. Há necessidade de as organizações apresentarem liquidez para atraírem novos investidores. Entretanto, empresas que se encontram financeiramente restritas também podem representar uma boa opção de investimento se optarem pelo excesso em caixa. No mercado, existem algumas resistências quanto a organizações financeiramente restritas, mas nessas pode haver liquidez considerável.

ABSTRACT This article aimed to verify the influence of cash liquidity and financial constraints on the market performance of Brazilian companies. According to pecking order theory, organizations choose retained earnings over debts or new share issuances, which may be linked to specific costs. However, trade-off theory highlights that taxes mean that financial policy and debt can be relevant to company value. Thus, this study aims to provide new insights on these topics and knowledge for investigating cash liquidity and financial constraints in relation to performance. The cash liquidity of organizations and financial constraints are important phenomena for performance, given that, in this study, there was an increase in performance. The results suggest that organizations choose to underinvest in the setting due to the difficulty of obtaining credit. Thus, there is an evident need for organizations to present liquidity so as not to lose investment opportunities. Despite the financial constraints, the organizations represent, to some extent, a good investment option, as they prefer excess cash to resources for new investments. The population of this study is formed of companies listed on the B3 S.A. -Brasil, Bolsa, Balcão. The analysis period corresponded to the years from 2014 to 2018 and the KZ index is calculated to classify the organizations regarding their level of constraint. Next, multiple linear regression was run, controlling for year and sector fixed effects. There is a need for organizations to present liquidity to attract new investors. However, companies that find themselves financially constrained can also represent a good investment option as they choose excess cash. In the market, there are some resistances regarding financially constrained organizations, but there may be considerable liquidity in them.