ABSTRACT Objective: To determine the relationship between psoriasis, thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triodothyronine (FT3), thyroid peroxidase antibodies (TPOAb), and subclinical thyroid dysfunctions in middle-aged and older adults. Materials and methods: Cross-sectional analyses included a self-reported medical diagnosis of psoriasis and thyroid function from the 3rd visit (2017-2019) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). TSH, FT4, and FT3 levels were analyzed as continuous variables and quintiles, and TPOAb positivity and subclinical hypothyroidism as a yes/no variable. Logistic regression models were built as crude and adjusted by main confounders (age, sex, education level, race/ethnicity, and smoking). Results: From 9,649 participants (52.3% women; 59.2 ± 8.7 years old), the prevalence of psoriasis was 2.8% (n = 270). TSH, FT4, TPOAb positivity, and subclinical hypothyroidism were not associated with psoriasis in the main analyses. In the stratified analysis, our findings showed positive associations of the lowest (OR = 2.01; 95% CI 1.05-3.84; p = 0.036) and the highest (OR = 2.13; 95% CI 1.12-4.05; p = 0.022) quintiles of FT4 and a protective association of TPOAb positivity (OR = 0.43; 95% CI 0.19-0.98; p = 0.046) with prevalent psoriasis in women. In the logistic regression for FT3, participants in the 1st quintile showed a statistically significant association with psoriasis for the whole sample (OR = 1.66; 95% CI 1.11-2.46; p = 0.013) and for men (OR = 2.25; 95% CI 1.25-4.04; p = 0.007) in the sex-stratified analysis. Conclusions: The present study showed that the association of FT4 levels with psoriasis are different according to sex, with a possible U-shaped curve in women but not in men. Although there were some associations of FT3 with psoriasis, they may be a consequence of non-thyroidal illness syndrome. Further prospective data may clarify the association of thyroid function and psoriasis.

ABSTRACT Grazing intensity is a preponderant factor for the success of integrated crop-livestock systems (ICLS). Management of grazing intensity impacts soil organic matter (SOM) dynamics, soil reacidification process, and amount and quality of residues added to the ICLS. Consequently, the soil mineral nitrogen (N) forms may present different behavior throughout the pasture cycle, because they are directed linked to SOM and soil acidity dynamics. This study aimed to evaluate the impact of grazing intensities and liming in the temporal variation of acidity and mineral N forms in soil surface (0.00-0.20 m) and subsurface (0.20-0.40 m), throughout the pasture cycle of an ICLS under an Oxisol in the Brazilian subtropics. The study was performed 11 years after the beginning of the field experiment, characterized by the cattle grazing in a winter pasture of oat + ryegrass during the winter and soybean cropping during the summer. The experimental design is randomized block with three replicates, where the grazing intensities are in the plots and liming is the subplots. The grazing intensities were defined as grazing sward height management, being 0.10, 0.20-0.30, and 0.40 m defined as intensive (IG), moderate (MG) and light grazing (LG), respectively. We evaluated the soil ammonium (N-NH4+), nitrate (N-NO3-), mineral N and pH at 45, 70, 156 and 192 days after pasture sowing (DAPS). Our results showed that grazing intensities only affected the soil pH at the end of pasture cycle, with MG presenting higher pH than IG and LG, regardless of liming. A decrease of soil N mineral stocks was observed throughout the pasture cycle in all managements, due to the decrease of soil N-NO3- stocks in the surface and subsurface layers and of N-NH4+ only in the surface layer. The influence of grazing intensities was only observed for N mineral forms in limed areas before the beginning of grazing. At 45 DAPS, MG and LG presented the highest and the lowest N-NH4+, respectively. At 70 DAPS, the behavior was inverse, and LG presented the highest N-NO3- stock and the MG and IG the lowest N-NO3- stocks. With such results, it is possible to conclude that there is an influence of grazing intensity and liming in the temporal variation of soil pH and mineral N forms in ICLS and this may be utilized for improvements in N fertilizer management, mainly before the starting of winter grazing.

Abstract Objectives This analysis describes the protocol of a study with a case-cohort to design to prospectively evaluate the incidence of subclinical atherosclerosis and Cardiovascular Disease (CVD) in Chronic Inflammatory Disease (CID) participants compared to non-diseased ones. Methods A high-risk group for CID was defined based on data collected in all visits on self-reported medical diagnosis, use of medicines, and levels of high-sensitivity C-Reactive Protein >10 mg/L. The comparison group is the Aleatory Cohort Sample (ACS): a group with 10% of participants selected at baseline who represent the entire cohort. In both groups, specific biomarkers for DIC, markers of subclinical atherosclerosis, and CVD morbimortality will be tested using weighted Cox. Results The high-risk group (n = 2,949; aged 53.6 ± 9.2; 65.5% women) and the ACS (n=1543; 52.2±8.8; 54.1% women) were identified. Beyond being older and mostly women, participants in the high-risk group present low average income (29.1% vs. 24.8%, p < 0.0001), higher BMI (Kg/m2) (28.1 vs. 26.9, p < 0.0001), higher waist circumference (cm) (93.3 vs. 91, p < 0.0001), higher frequencies of hypertension (40.2% vs. 34.5%, p < 0.0001), diabetes (20.7% vs. 17%, p = 0.003) depression (5.8% vs. 3.9%, p = 0.007) and higher levels of GlycA a new inflammatory marker (p < 0.0001) compared to the ACS. Conclusions The high-risk group selected mostly women, older, lower-income/education, higher BMI, waist circumference, and of hypertension, diabetes, depression, and higher levels of GlycA when compared to the ACS. The strategy chosen to define the high-risk group seems adequate given that multiple sociodemographic and clinical characteristics are compatible with CID.

ABSTRACT Urinary tract infections related to indwelling urinary catheterization are among the most frequent in hospitais. There are many recommendations for the prevention of infections, but the need to use antiseptics for periurethral cleaning is still questioned. Objective: this study aimed to analyze the evidence on the theme in the literature. Method: a systematic review was performed using the following databases: Biblioteca Virtual em Saúde, Medline, Embase, Web of Science and Cumulative Index to Nursing & Allied Health Literature. Clinicai trials were included which assessed the infection rates of the urinary tract/bacteriuria and which used antiseptic solutions and water in the periurethral cleaning. Results: of 211 studies, three were considered as methodologically adequate according to the Jadad Scale. All of the studies showed that there is no significant difference in the rates of UTI/bacteriuria when compared to the use of water with antiseptic (chlorhexidine or povidone-iodine). Conclusion: it was concluded that the use of water in the periurethral cleaning seems not to augment the risk of acquiring infections/bacteriuria.

RESUMEN Las infecciones del tracto urinario relacionadas con el cateterismo urinario permanente se encuentran entre las infecciones hospitalarias más comunes. Existen recomendaciones para la prevención de infecciones, pero aún se cuestiona la necesidad de usar antisépticos para la limpieza periuretral. Objetivo: analizar la evidencia en la literatura sobre el tema. Método: se realizó una revisión sistemática utilizando las bases de datos de la Biblioteca Virtual de Salud, Medline, Embase, Web of Science y Cumulative Index to Nursing & Allied Health Literature. Se incluyeron ensayos clínicos que evaluaron las tasas de infección urinaria / bacteriuria y el uso de soluciones antisépticas y agua para la limpieza periuretral. Resultados: de 211 estudios, tres se consideraron metodológicamente adecuados según la escala de Jadad. Todos los estudios mostraron que no hay diferencias significativas en las tasas de infección urinaria / bacteriuria en comparación con el uso de agua antiséptica (clorhexidina o povidona yodada). Conclusión: el uso de agua para la limpieza periuretral no parece aumentar el riesgo de contraer infección / bacteriuria.

RESUMO As infecções do trato urinário relacionadas ao cateterismo urinário de demora estão entre as mais frequentes em hospitais. Existem várias recomendações para a prevenção de infecções, porém ainda se questiona a necessidade de utilizar antissépticos para a limpeza periuretral. Objetivo: este estudo objetivou analisar as evidências, na literatura, acerca do tema. Método: foi realizada revisão sistemática utilizando-se as bases de dados Biblioteca Virtual em Saúde, Medline, Embase, Web of Science e Cumulative Index to Nursing & Allied Health Literature. Foram incluídos ensaios clínicos que avaliaram as taxas de infecção do trato urinário/bacteriúria e que utilizaram soluções antissépticas e água na limpeza periuretral. Resultados: de 211 estudos, três foram considerados metodologicamente adequados de acordo com a Escala de Jadad. Todos os estudos mostraram que não há diferenças significativas nas taxas de ITU/ bacteriúria quando comparado o uso de água com antisséptico (clorexidina ou povidona-iodo). Conclusão: concluiu-se que o uso de água na limpeza periuretral parece não aumentar o risco de adquirir infecção/bacteriúria.

Resumo O ozônio tem sido usado, por muito tempo, na água como desinfetante, devido ao seu potencial oxidante. Visto que possui capacidade de se decompor rapidamente em oxigênio molecular, não deixando resíduo, apresenta vantagens importantes para uso. A decomposição do ozônio é afetada pela temperatura e pelo pH do meio, sendo que baixos níveis de pH e de temperatura aumentam sua meia-vida, o que pode levar a uma desinfecção mais eficiente. Com o objetivo de aumentar a eficiência da ozonização, este trabalho investigou o efeito da temperatura (8 ºC e 25 °C) e do pH (3,0 e 6,0) da água no tempo de saturação e na concentração do gás, empregando duas concentrações iniciais de gás (13,3 e 22,3 mg L-1). A concentração de saturação do ozônio aumentou conforme a temperatura e o pH do meio diminuíram, bem como com uma maior concentração inicial do gás (C0). As maiores concentrações de saturação 4,50 e 8,03 mg L-1 foram obtidas em pH 3,0 a 8 °C, com em C0 de 13,3 e 22,3 mg L-1, respectivamente. Este maior teor de ozônio pode resultar em maior eficiência de descontaminação dos produtos alimentícios, quando higienizados com água submetida a esse tratamento.

Abstract Ozone has been used for many years to disinfect water due to its oxidizing potential. Since it decomposes quickly into molecular oxygen, leaving no residue, it has important advantages for use. The decomposition of ozone is affected by the temperature and pH of the medium, low pH values and temperatures increasing its half-life, which can result in more efficient disinfection. With the objective of increasing the effectiveness of ozonation, this study investigated the effect of temperature (8 ºC and 25 °C) and pH (3.0 and 6.0) of the water on the saturation time and gas concentration, employing two initial gas concentrations (13.3 and 22.3 mg L-1). The concentration of ozone saturation increased as the temperature and pH of the medium decreased, as also with the higher initial gas concentration ( C0). The highest saturation concentrations were obtained at pH 3.0 and 8 °C (4.50 and 8.03 mg L-1 with C0 of 13.3 and 22.3 mg L-1, respectively). This higher ozone content could result in greater decontamination efficiency of the food products washed with this water.

Resumo Fundamento: As escolas tornaram-se essenciais para a promoção de saúde e de intervenções para obesidade, propiciando o desenvolvimento de consciência crítica para a construção e promoção de dieta saudável, atividade física e monitoramento do status nutricional na infância e adolescência. Objetivos: Descrever um protocolo de estudo para avaliar a eficiência de uma intervenção projetada para aprimorar o conhecimento sobre escolhas alimentares no ambiente escolar. Métodos: Estudo clínico randomizado em cluster, paralelo, de dois braços, conduzido em escolas públicas de ensino fundamental e médio no Brasil. Os participantes serão crianças e adolescentes entre 5 e 15 anos de idade, dos dois sexos. As intervenções se concentrarão em mudanças de estilo de vida, atividade física e educação nutricional. As atividades de intervenção ocorrerão mensalmente na sala de multimídia ou quadra de esportes das escolas. O grupo controle receberá as recomendações usuais através da escola. O desfecho primário será a mudança nas medidas antropométricas, como índice de massa corporal e os níveis de atividade física conforme o Questionário Internacional de Atividade Física. Resultados: Esperamos que, após o estudo, as crianças aumentem o consumo de alimentos frescos, reduzam o consumo excessivo de alimentos açucarados e processados, e reduzam as horas gastas em atividades sedentárias. Conclusão: O propósito de iniciar a intervenção dietética nessa fase da vida é desenvolver o conhecimento que permitirá escolhas saudáveis, propiciando oportunidades para um melhor futuro para essa população.

Abstract Background: Schools have become a key figure for the promotion of health and obesity interventions, bringing the development of critical awareness to the construction and promotion of a healthy diet, physical activity, and the monitoring of the nutritional status in childhood and adolescence. Objectives: To describe a study protocol to evaluate the effectiveness of an intervention designed to improve knowledge of food choices in the school environment. Methods: This is a cluster-randomized, parallel, two-arm study conducted in public elementary and middle schools in Brazil. Participants will be children and adolescents between the ages of 5 and 15 years, from both genders. The interventions will be focusing on changes in lifestyle, physical activities and nutritional education. Intervention activities will occur monthly in the school’s multimedia room or sports court. The control group arm will receive usual recommendations by the school. The primary outcome variable will be anthropometric measures, such as body mass index percentiles and levels of physical activity by the International Physical Activity Questionnaire. Results: We expect that after the study children will increase the ingestion of fresh food, reduce excessive consumption of sugary and processed foods, and reduce the hours of sedentary activities. Conclusion: The purpose of starting the dietary intervention at this stage of life is to develop a knowledge that will enable for healthy choices, providing opportunities for a better future for this population.

RESUMO A tomografia por impedância elétrica torácica constitui ferramenta de monitorização não invasiva, em tempo real, da distribuição regional da ventilação pulmonar. Sua utilização à beira do leito em pacientes com síndrome do desconforto respiratório agudo tem o potencial de auxiliar na condução de manobras de recrutamento alveolar, frequentemente necessárias em casos de hipoxemia refratária. Neste relato de caso, apresentamos os resultados e a interpretação da monitorização da tomografia por impedância elétrica torácica em um paciente com síndrome do desconforto respiratório agudo, durante manobras de recrutamento alveolar, com aplicação transitória de altas pressões alveolares e titulação da pressão positiva ao final da expiração ideal. Adicionalmente, apresentamos uma breve revisão da literatura a respeito do uso de manobras de recrutamento alveolar e monitorização com tomografia por impedância elétrica torácica em pacientes com síndrome do desconforto respiratório agudo.

ABSTRACT Thoracic electrical impedance tomography is a real-time, noninvasive monitoring tool of the regional pulmonary ventilation distribution. Its bedside use in patients with acute respiratory distress syndrome has the potential to aid in alveolar recruitment maneuvers, which are often necessary in cases of refractory hypoxemia. In this case report, we describe the monitoring results and interpretation of thoracic electrical impedance tomography used during alveolar recruitment maneuvers in a patient with acute respiratory distress syndrome, with transient application of high alveolar pressures and optimal positive end-expiratory pressure titration. Furthermore, we provide a brief literature review regarding the use of alveolar recruitment maneuvers and monitoring using thoracic electrical impedance tomography in patients with acute respiratory distress syndrome.

Teaching the first instances of arbitrary matching-to-sample to nonhumans can prove difficult and time consuming. Stimulus control relations may develop that differ from those intended by the experimenter-even when stimulus control shaping procedures are used. We present, in this study, efforts to identify sources of shaping program failure with a capuchin monkey. Procedures began with a baseline of identity matching. During subsequent shaping trials, compound comparison stimuli had two components-one identical to and another different from the sample. The identical component was eliminated gradually by removing portions across trials (i.e., subtracting stimulus elements). The monkey performed accurately throughout shaping. At a late stage in the program, probe tests were conducted: (1) arbitrary matching trials that had all elements of the identical comparison removed and (2) other trials that included residual elements. During the test, the monkey performed at low levels on the former trials and higher levels on the latter. These results suggested that higher accuracy was due merely to continued control by the residual elements: the target arbitrary matching relations had not been learned. Thus, it appears that procedures that gradually transform identity matching baselines into arbitrary matching can fail by inadvertently shaping restricted control by residual elements. Subsequent probes at the end of the shaping series showed a successful transfer of stimulus control from identity to arbitrary matching after further programming steps apparently overcame the restricted stimulus control.

O objetivo deste trabalho foi explorar a relação entre a riqueza de espécies arbóreas com as características morfológicas do relevo no Planalto de Ibiúna (SE, Brasil). Foram amostrados 61 blocos de 0,30 ha, sistematicamente estabelecidos em 20 fragmentos de floresta secundária (2-274 ha) e em três áreas de uma floresta secundária contínua, a Reserva do Morro Grande (9.400 ha). Em cada bloco, 100 árvores com diâmetro à altura do peito > 5 cm foram amostradas pelo método do quadrante centrado, e as riquezas total e por grupo de dispersão e sucessão foram obtidas. O relevo foi caracterizado pela média e variância da declividade, altitude, orientação e posição na vertente. Não houve relação significativa entre a heterogeneidade do relevo e a riqueza de espécies arbóreas. Os parâmetros do relevo afetaram pouco a riqueza da vegetação, mas a altitude foi particularmente importante, especialmente na floresta contínua. Apesar da pouca extensão na variação de altitude (150 m), a riqueza aumentou com este fator. As áreas mais altas também foram aquelas com as maiores coberturas florestais e os mais baixos graus de perturbação, o que deve contribuir para a maior riqueza dessas áreas. Nossos resultados indicam uma influência indireta do relevo, pelo fato das áreas mais altas serem também as menos desmatadas, e não uma influência direta de fatores abióticos relacionados ao gradiente de altitude.

The aim of this work was to explore the relationship between tree species richness and morphological characteristics of relief at the Ibiúna Plateau (SE Brazil). We sampled 61 plots of 0.30 ha, systematically established in 20 fragments of secondary forest (2-274 ha) and in three areas within a continuous secondary forest site, Morro Grande Reserve (9,400 ha). At each plot, 100 trees with diameter at breast height > 5 cm were sampled by the point centered quarter method, and total richness and richness per dispersal and succession class were obtained. The relief was characterized by the mean and variance of slope, elevation, aspect and slope location. There was no significant relationship between relief heterogeneity and tree species richness. Relief parameters generally did not affect tree richness, but elevation was particularly important especially in the continuous forest. Despite the limited range of altitudinal variation (150 m), species richness increases with elevation. The highest areas were also those with the largest forest cover and the lowest disturbance degree, which should contribute to the greater richness of those sites. Our results suggest an indirect influence of relief, due to the fact that deforestation is less intense in higher regions, rather than a direct influence of abiotic factors related to the altitudinal gradient.

A Reserva Florestal do Morro Grande (RFMG, 10.870 ha) é um dos maiores remanescentes florestais do Planalto Atlântico paulista, região que foi submetida a fortes pressões de desmatamento tanto para a agricultura quanto para a exploração da lenha e do carvão e, mais recentemente, para a expansão imobiliária. A RFMG situa-se sobre embasamento cristalino, justo acima da Serra de Paranapiacaba, em altitudes que variam de 860 a 1075 m, numa região de transição entre o clima pluvial tropical do litoral e da encosta Atlântica, com o clima estacional do interior do estado. Por conseguinte, suas florestas acabam tendo uma composição de espécies particular, com elementos das florestas ombrófila densa e mesófila semi-decidual. Apesar desta particularidade, não houve até recentemente praticamente nenhum estudo nas florestas do Morro Grande. Foi apenas a partir de 2000 que um grupo de pesquisadores, no contexto de um projeto temático vinculado ao programa BIOTA/FAPESP, procurou analisar de forma sistemática a composição de diferentes grupos taxonômicos, assim como caracterizar processos ecológicos associados com a regeneração florestal. Este artigo tem por objetivo introduzir uma série de nove artigos com os principais resultados dos levantamentos biológicos na RFMG, obtidos nos últimos quatro anos, assim como fazer uma caracterização do histórico e das condições abióticas na Reserva, em termos de embasamento geológico, pedológico, clima, hidrografia, e do uso e cobertura do território.

The Morro Grande Forest Reserve (10,870 ha) is one of the biggest forest areas in the Atlantic Plateau. This region was intensively deforested for agriculture, wood and charcoal production, and more recently by the expansion of urban areas. The Reserve is located in the cristalline Plateau of Ibiúna, just above the Paranapiacaba Mountain (860 1075 m above sea level), in a transition region between the rainy climate from the Atlantic coast, and the seasonal climate from inland São Paulo state. As a consequence, species composition in Morro Grande Reserve combines elements from the tropical rainforest and the semideciduous forest. Despite this particularity, few studies were carried out in the forests from Morro Grande. It is only in 2000 that a group of scientist related to the BIOTA/FAPESP program began a systematic analysis of the species composition of different taxonomic groups, as well as the analysis of ecological processes related with forest regeneration. The present manuscript introduces a series of nine articles with the biological data obtained in the Reserve these last four years, and aims also to present an historical and abiotic description of the Reserve, highlighting aspects of the relief, geologic and pedological conditions, climate, hydrography, land use and land cover.