ABSTRACT: This research evaluated different rice genotypes regarding physicochemical and instrumental parameters of grain quality and associated the data with sensory analysis to support the creation of rules for classification of the culinary quality of rice (texture), based on isolated or combined parameters. The combination of amylose content and gelatinization temperature was able to predict the rice quality. According to the sensorial panel, the instrumental stickiness was able to segregate rice with very low amylose content or waxy to the other ones. Regarding pasting properties, rice that presented high final viscosity (310-480 RVU), setback (165-245 RVU), and pasting temperature (78 - 88 °C), and low values for breakdown (15-120 RVU), associated with a high stickiness (>-5N) was desirable by the Brazilian consumers. The classification rules created through the relationship between the physicochemical parameters and the texture profile evaluated by the sensory panel will help to verify the culinary profile of the rice samples (through free software), which makes it easier to predict the probability of rice meeting the desired quality standards.

RESUMO: Este trabalho avaliou diferentes genótipos de arroz quanto a parâmetros físico-químicos e instrumentais de qualidade do grão e associou os dados à análise sensorial para subsidiar a criação de regras de classificação da qualidade culinária do arroz (textura), com base em parâmetros isolados ou combinados. A combinação do teor de amilose e temperatura de gelatinização foi capaz de predizer a qualidade do arroz. De acordo com o painel sensorial, a pegajosidade instrumental foi capaz de segregar arroz com baixo teor de amilose ou ceroso dos demais. Em relação às propriedades de pasta, o arroz que apresentou alta viscosidade final (310-480RVU), retrogradação (165-245RVU) e temperatura de pasta (78-88 °C) e baixos valores de quebra pasta (15-120RVU), associados a uma alta pegajosidade (> -5N) será desejável pelos consumidores brasileiros. As regras de classificação criadas por meio da relação entre os parâmetros físico-químicos e o perfil de textura avaliado pelo painel sensorial ajudarão a verificar o perfil culinário das amostras de arroz (por meio de um software livre), o que torna mais fácil prever a probabilidade de o arroz atender aos padrões de qualidade desejados.

ABSTRACT: Polioencephalomalacia (PEM) is a nervous disease that affects ruminants, has a worldwide distribution and causes significant economic losses. PEM is abundantly described and studied in cattle and small ruminants, but there is little information about the disease in buffaloes, especially in Brazil. The objective of this work is to describe the clinical and pathological aspects of an outbreak of PEM in buffaloes in a feedlot in the state of Pará, Brazil. The outbreak occurred in a flock of 76 Murrah buffaloes, with an average age of five months, in a feedlot. Twenty-eight of these buffaloes became ill, and thirteen showed neurological signs and died. Two buffaloes underwent necropsy. The brain and fragments of various abdominal and thoracic cavity organs were fixed in 10% formalin and sent for histopathological examination. In the frontal, parietal, and occipital telencephalic lobes, the convolutions were flattened and yellowish, and when cut, there was a clear line of demarcation between the superficial and deep layers. Histologically, the intermediate layers of the cerebral cortex showed mild to moderate vacuolization of the neuropil, moderate enlargement of the perivascular, perineuronal, and periastrocyte spaces, moderate swelling and edema of astrocytes, and a large number of necrotic neurons. The work demonstrates that, despite being poorly documented in Brazil, PEM should be considered in the differential diagnosis of neurological syndromes in buffaloes.

RESUMO: Polioencefalomalacia (PEM) é uma doença nervosa complexa que afeta ruminantes, tem distribuição mundial e causa perdas econômicas significativas. A PEM é abundantemente descrita e estudada em bovinos e pequenos ruminantes, porém há poucas informações sobre a doença em bubalinos, especialmente no Brasil. O objetivo deste trabalho é descrever os aspectos clínicos e patológicos de um surto de PEM em búfalos em um confinamento no estado do Pará, Brasil. O surto ocorreu em um lote de 76 búfalos da raça Murrah, com idade média de cinco meses, em um sistema de confinamento. Vinte e oito desses bubalinos adoeceram e treze apresentaram sinais neurológicos e morreram. Dois bubalinos foram submetidos à necropsia. O encéfalo e fragmentos de diversos órgãos da cavidade abdominal e torácica foram fixados em formol a 10% e enviados para exame histopatológico. Nos lobos frontal, parietal e occipital do telencéfalo as circunvoluções estavam achatadas e amareladas e ao corte havia uma clara linha de demarcação entre as camadas superficial e profunda. Na histologia as camadas intermediárias do córtex cerebral apresentavam vacuolização leve a moderada do neurópilo, aumento moderado dos espaços perivascular, perineuronal e periastrocitário, tumefação e edema moderados de astrócitos e grande número de neurônios necróticos. O trabalho demonstra que, apesar de pouco documentada no Brasil, a PEM deve ser considerada no diagnóstico diferencial das síndromes neurológicas em bubalinos.

Abstract In the county of Pedra Lavrada - PB, various mineral occurrences of pegmatite are observed with prominence at Alto Dois Irmãos - PB, where quartz, feldspar and mica are mined. The understanding of mineral constituents is fundamental to define their industrial employment and to implement improvements in the beneficiation process. The proposal of this research is the detailed characterization and proof of that part of the ore (quartz) considered waste, presenting low poisoning (Fe2O3) and high silica (SiO2) content, to enable its industrial use. Besides that, to minimize the environmental impact through the reuse of this waste, and to determine the correct utilization of the milling equipment. For the pegmatite characterization, done were density determination tests, mineralogical identification by X-ray diffraction (XRD), chemical analysis by fluorescents X-rays and morphological analysis by scanning electron microscopy (SEM/EDS). Then tests were done for the Work Index (WI) calculous and consequently the empirical determination of the dimensions (LxD) of the pebble mill. The sterile presented a medium density of 2.66g/cm³, majority chemical composition of silicon and oxygen and quartz as the main mineralogical stage, indicating that this material has high purity. The. The Work Index (WI) was 15.9 kwh/t showing that this material can be considered resistant to breaking in the grinding process. The necessary energy to the milling was defined in 11.52 kwh/st, that corresponds to 57.28 HP. This power allowed the mill selection with diammeter and length of 1.83m, that provides the production maximization and the energy saving.

Abstract This article presents a formulation for the optimization problem that minimizes the CO2 emission of pile caps with variations of geometry and pile position. The problem is defined by the design variables: concrete pile cap dimensions, rebar ratio, concrete compressive strength, the number of piles, the diameter, and length. The environmental impact was chosen as the objective function, taking CO2 emission as the main parameter. The design procedure was based on the ABNT NBR 6118:2014 (2014), and by the formulation proposed by Blévot & Frémy (1967). Also, the soil structure interaction between the cap and the piles was considered in the optimization problem. The problem was implemented using MATLAB (2016) and solved via a Genetic Algorithm native to the program. Results obtained from numerical examples were compared with structural designs solutions located in the Grande Vitória metropolitan area, Espírito Santo, Brazil and validated with a commercial software. The analyses indicate that design optimizations of pile caps considering the compressive strength of concrete, the diameter and length of piles and the optimal geometry of the pile caps may lead to significant reductions of material consumption, and consequently, a reduction of environmental impacts.

Abstract A continuous increase in levels of atmospheric pollution and emission restrictions has forced scientists and engineers to adopt new strategies to improve and develop internal combustion engines. One strategy is based on the development of new simulation methodologies using computational fluid dynamic (CFD) techniques, proposed in the present article. In this study,the dynamic loop methodology with ANSYS Fluent code is proposed to perform the numerical simulation ofa four-stroke spark ignition engine. The complexity of the real case was first simplified with three-dimensional CAD geometry, which was then discretized in ANSYS Meshing, whereby a hybrid mesh was created using prismatic and tetrahedral elements. Simulations for in-cylinder analyses were performed in cold flow and employing common flow parameters, such as swirl and tumble. The mesh quality results were classified as good or excellent, being higher than 0.79 for orthogonal quality criteria and lower than 0.36 for skewness criteria. Turbulent effects were introduced concerning the opening and closing of the valves. It was found that the turbulence increases during the intake stroke up to 90°, and during the power stroke, wherein the of the piston bowl, had a great contributionthat can be seen from the swirl and tumble profile for the engine cycle. In the case of the turbulence intensity, a sharp increase was registered during the admission step up to 90°, at which point the turbulence intensity was 4.0. It canbe concluded that this is an innovative approach, capable of simulating the engine motion profile in cold flow.

Introduction Muscle mass assessment of critically ill patients is essential to be part of the nutritional diagnosis in hospital care. Thus, the evaluation of more specific techniques for that purpose is needed. The present study aimed to investigate the association of quadriceps muscle thickness (QMT), measured by ultrasound (US), with the nutritional status of critically ill patients in a referral high-complexity trauma care hospital. Methods A cross-sectional observational study was conducted in the intensive care units (ICUs) in a tertiary hospital in Brazil. The sample comprised 30 critically ill trauma patients admitted between February and March 2022. The methodology involved evaluating muscle mass and comparing nutritional status through mid-upper arm circumference measurements and US assessments. Specifically, the QMT was quantified using US at a predefined site between the iliac crest and the proximal border of the patella. Results The Kruskal-Wallis test indicated variability in QMT between the nutritional status groups, with statistical significance reached after excluding the overweight group (H(2) = 7.532, p = 0.023). The moderate malnutrition group exhibited notably lower QMT. Sensitivity analyses using bootstrap and Monte Carlo methods showed moderate trends toward significance. A positive correlation was found between QMT and mid-upper arm circumference adequacy (p < 0.05), demonstrating fair to moderate correlation (rs = 0.531). Conclusion Significant changes in QMT were detected by ultrasound assessment in moderate malnutrition patients compared to patients of other nutritional statuses. Ultrasound may be a valuable technique for monitoring muscle integrity in critically ill patients.

Resumo Este estudo objetivou analisar as possíveis associações entre o Escore da Estrutura de Controle de Infecção (EECI), os serviços de saúde e características sociais dos municípios brasileiros. Foram analisados dados secundários do terceiro ciclo 2017-2018 do Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica (PMAQ). Seis variáveis independentes - Índice FIRJAN de Desenvolvimento Municipal, número de habitantes, número de Equipes de Saúde da Família que recebiam incentivo financeiro do governo federal, gasto com saúde per capita e número de Equipes de Saúde Bucal modalidades 1 e 2 - foram incluídas para avaliar a influência sobre o EECI, medido para cada município brasileiro. Para a análise dos dados, foi utilizado o modelo de Árvore de Classificação e Regressão no IBM SPSS 25. Foram incluídos 4.900 municípios, e o EECI médio foi de 0,905 (±0,092). Observou-se uma associação positiva entre o gasto com saúde per capita, o desenvolvimento municipal e o desfecho. Por outro lado, municípios com maior número de Equipes de Saúde da Família com incentivo financeiro do governo federal apresentaram menor média do EECI. Os achados sugerem que existem desigualdades nas estruturas de controle de infecções no país, relacionadas aos serviços de saúde e às características sociais dos municípios.

Abstract This study aimed to analyze possible associations between the Infection Control Structure Score (ICSS), health services, and social characteristics of the municipalities in Brazil. Secondary data from the third cycle 2017-2018 of the Brazilian National Program for Improving Primary Care Access and Quality (PMAQ) was analyzed. Six independent variables - FIRJAN Index of Municipal Development, number of inhabitants, number of family health teams receiving a financial incentive from the federal government, healthcare expenditure per capita, and number of Oral Health Teams modalities 1 and 2 - were included to assess their influence on ICSS, measured for each Brazilian town. Data analysis used the Classification and Regression Tree model performed with IBM SPSS 25. A total of 4,900 municipalities were included, and the mean ICSS was 0.905 (±0.092). A positive relationship was observed between healthcare expenditure per capita, municipal development, and the outcome. Conversely, towns with a higher number of family health teams receiving a financial incentive from the federal government showed lower mean ICSS. The findings suggest that inequalities in the infection control structures exist within the country, and they were related to the health services and social characteristics of the municipalities.

Abstract This study aimed to analyze possible associations between the Infection Control Structure Score (ICSS), health services, and social characteristics of the municipalities in Brazil. Secondary data from the third cycle 2017-2018 of the Brazilian National Program for Improving Primary Care Access and Quality (PMAQ) was analyzed. Six independent variables - FIRJAN Index of Municipal Development, number of inhabitants, number of family health teams receiving a financial incentive from the federal government, healthcare expenditure per capita, and number of Oral Health Teams modalities 1 and 2 - were included to assess their influence on ICSS, measured for each Brazilian town. Data analysis used the Classification and Regression Tree model performed with IBM SPSS 25. A total of 4,900 municipalities were included, and the mean ICSS was 0.905 (±0.092). A positive relationship was observed between healthcare expenditure per capita, municipal development, and the outcome. Conversely, towns with a higher number of family health teams receiving a financial incentive from the federal government showed lower mean ICSS. The findings suggest that inequalities in the infection control structures exist within the country, and they were related to the health services and social characteristics of the municipalities.

Resumo Este estudo objetivou analisar as possíveis associações entre o Escore da Estrutura de Controle de Infecção (EECI), os serviços de saúde e características sociais dos municípios brasileiros. Foram analisados dados secundários do terceiro ciclo 2017-2018 do Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica (PMAQ). Seis variáveis independentes - Índice FIRJAN de Desenvolvimento Municipal, número de habitantes, número de Equipes de Saúde da Família que recebiam incentivo financeiro do governo federal, gasto com saúde per capita e número de Equipes de Saúde Bucal modalidades 1 e 2 - foram incluídas para avaliar a influência sobre o EECI, medido para cada município brasileiro. Para a análise dos dados, foi utilizado o modelo de Árvore de Classificação e Regressão no IBM SPSS 25. Foram incluídos 4.900 municípios, e o EECI médio foi de 0,905 (±0,092). Observou-se uma associação positiva entre o gasto com saúde per capita, o desenvolvimento municipal e o desfecho. Por outro lado, municípios com maior número de Equipes de Saúde da Família com incentivo financeiro do governo federal apresentaram menor média do EECI. Os achados sugerem que existem desigualdades nas estruturas de controle de infecções no país, relacionadas aos serviços de saúde e às características sociais dos municípios.

Abstract Introduction: Sexual violence is a serious problem in Brazilian society whose repercussions on public health make it imperative to address this issue in the context of training in professions. Likewise, comprehensive care for people in situations of sexual violence requires the joint action of different professions, in addition to network integration and articulation of different social facilities. Objective: This study aimed to reflect which competencies - understood as the set of knowledge, skills and attitudes - are permitted for the development of comprehensive care for people in situations of sexual violence, according to the best standards of quality and health safety they. Method: A qualitative study of an exploratory and descriptive nature was carried out, which involved the application of a preliminary form on knowledge about skills, followed by the dynamics of the construction of the human figure, which consists of manufacturing a doll in which the knowledge would be represented by the head, by the skills of the members and by the attitudes of the body, in the creation of an office with 76 participants from different professions. Furthermore, a questionnaire was administered to 32 professionals with experience in the area of sexual violence and with practical experience in caring for people in this situation. Categorical thematic analysis was used. Result: Result: Challenges were identified to be overcome in the three dimensions that constitute competencies, with a clear lack of knowledge for working in a network aiming at the effectiveness and comprehensiveness of care. 15 competencies common to professionals who deal with violence were recognized, and the final product was represented in a radially arranged infographic with the organization of knowledge, skills and attitudes identified as necessary for the development of such competencies. Conclusion: Recognizing common competencies and identifying, separately, which knowledge, skills and attitudes constitute them represent strategies that promote a transversal approach to these contents in the training of professions, especially in health. Proposing a matrix of common competencies for interprofessional practice in care for people in situations of sexual violence can guide the qualification of this care and support interprofessionality in crucial scenarios of collective action to combat the blatant social injustice that sexual violence means.

Resumo Introdução: A violência sexual é um grave problema na sociedade brasileira cujas repercussões no âmbito da saúde pública tornam imperativa a abordagem dessa questão no contexto da formação das suas profissões. Igualmente, a integralidade do cuidado destinado às pessoas em situação de violência sexual requer a atuação conjunta de diversas profissões, além da integração em rede e articulação de diferentes equipamentos sociais. Objetivo: Este estudo teve como objetivo reconhecer quais competências - entendidas como o conjunto de conhecimentos, habilidades e atitudes - são necessárias para o desenvolvimento do cuidado integral destinado às pessoas em situação de violência sexual, segundo os melhores padrões de qualidade e segurança para a saúde delas. Método: Realizou-se um estudo qualitativo de caráter exploratório e descritivo que envolveu a aplicação de um formulário prévio sobre os conhecimentos acerca das competências, seguido da dinâmica da construção da figura humana, que consiste na confecção de um boneco no qual os conhecimentos estariam representados pela cabeça, as habilidades pelos membros e as atitudes pelo corpo, na realização de uma oficina com 76 participantes de diferentes profissões. Adicionalmente, aplicou-se um questionário a 32 profissionais com reconhecida expertise na área de violência sexual e com experiência prática no atendimento às pessoas nessa situação. Foi empregada a análise temática categorial. Resultado: Identificaram-se desafios a serem superados nas três dimensões constituintes das competências, com nítida deficiência de conhecimentos para a atuação em rede visando à efetividade e à integralidade do cuidado. Reconheceram-se 15 competências comuns aos profissionais que lidam com a violência, e o produto final foi representado num infográfico de disposição radial com a organização dos conhecimentos, das habilidades e das atitudes identificados como necessários para o desenvolvimento de tais competências. Conclusão: Reconhecer competências comuns e identificar, separadamente, quais conhecimentos, habilidades e atitudes as constituem representa estratégias promotoras da abordagem transversal desses conteúdos na formação das profissões, sobretudo da saúde. A proposição de uma matriz de competências comuns para prática interprofissional no cuidado destinado às pessoas em situação de violência sexual pode orientar a qualificação desse cuidado e alicerçar a interprofissionalidade em cenários cruciais de atuação coletiva para o enfrentamento da flagrante injustiça social que a violência sexual significa.

Abstract: Tomatoes are widely cultivated, both by family farmers and corporate producers. During the tomato growth cycle, several diseases can affect the plant. The identification of these diseases through short-range images is significant, and computer vision techniques are commonly used to identify diseases in plant leaves. In this paper, a hybrid model that combines a convolutional neural network (CNN) and a Random Forest (RF) decision tree is used for foliar spot detection in tomato leaves. High-level features learned and extracted from CNN are used as input for the RF classifier. To evaluate the proposed model’s performance for plant disease identification, a case study of 2480 low-cost digital RGB images collected in actual field conditions, under different intensities of light exposure, were used, including healthy tomato leaves and leaves with visible symptoms of powdery mildew fungus, which attacks the tomato leaf. The results were compared with six conventional machine learning classifiers: Logistic Regression (LR), Linear Discriminant Analysis (LDA), K- Nearest Neighbors (KNN), Naive Bayes (NB), Support Vector Machine (SVM) and Random Forest (RF). The results show that the proposed model outperformed conventional classifiers, reaching an accuracy of 98%. The results highlight the importance of fusing models to improve the detection plant´s diseases.

Abstract This study aimed to analyze possible associations between the Infection Control Structure Score (ICSS), health services, and social characteristics of the municipalities in Brazil. Secondary data from the third cycle 2017-2018 of the Brazilian National Program for Improving Primary Care Access and Quality (PMAQ) was analyzed. Six independent variables - FIRJAN Index of Municipal Development, number of inhabitants, number of family health teams receiving a financial incentive from the federal government, healthcare expenditure per capita, and number of Oral Health Teams modalities 1 and 2 - were included to assess their influence on ICSS, measured for each Brazilian town. Data analysis used the Classification and Regression Tree model performed with IBM SPSS 25. A total of 4,900 municipalities were included, and the mean ICSS was 0.905 (±0.092). A positive relationship was observed between healthcare expenditure per capita, municipal development, and the outcome. Conversely, towns with a higher number of family health teams receiving a financial incentive from the federal government showed lower mean ICSS. The findings suggest that inequalities in the infection control structures exist within the country, and they were related to the health services and social characteristics of the municipalities.

Resumo Este estudo objetivou analisar as possíveis associações entre o Escore da Estrutura de Controle de Infecção (EECI), os serviços de saúde e características sociais dos municípios brasileiros. Foram analisados dados secundários do terceiro ciclo 2017-2018 do Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica (PMAQ). Seis variáveis independentes - Índice FIRJAN de Desenvolvimento Municipal, número de habitantes, número de Equipes de Saúde da Família que recebiam incentivo financeiro do governo federal, gasto com saúde per capita e número de Equipes de Saúde Bucal modalidades 1 e 2 - foram incluídas para avaliar a influência sobre o EECI, medido para cada município brasileiro. Para a análise dos dados, foi utilizado o modelo de Árvore de Classificação e Regressão no IBM SPSS 25. Foram incluídos 4.900 municípios, e o EECI médio foi de 0,905 (±0,092). Observou-se uma associação positiva entre o gasto com saúde per capita, o desenvolvimento municipal e o desfecho. Por outro lado, municípios com maior número de Equipes de Saúde da Família com incentivo financeiro do governo federal apresentaram menor média do EECI. Os achados sugerem que existem desigualdades nas estruturas de controle de infecções no país, relacionadas aos serviços de saúde e às características sociais dos municípios.

Abstract Technological advancement has had a significant impact on written production, especially in Additional Languages (ALs). Although technology has brought new opportunities for AL teaching, it also poses challenges, including concerns about the complexity of writing and the authenticity of students’ work. One such tool is ChatGPT, an artificial intelligence (AI) platform that has been the subject of debate since its popularization in 2022. This study analyses a corpus consisting of six tasks produced by ChatGPT in five languages (German, Spanish, French, Italian, and Portuguese), considering the proficiency levels proposed by the Common European Framework of Reference for Languages (CEFR), totalling 2991 texts and 706,401 words. The data were generated by students in a computer lab at a British university from 100 different profiles on the ChatGPT platform, following the researchers’ instructions. Data analysis employs Systemic Functional Linguistics (SFL) and the concept of lexical density ( Halliday, 1985, 1987, 1993; Halliday; Matthiessen, 2014) to investigate the complexity of the produced texts, as lexical complexity is related to proficiency in writing, where more advanced texts proportionally use more “content words” (nouns, verbs, adjectives, and some adverbs of manner). The results reveal that ChatGPT does not adhere to task instructions regarding the requested word count, thereby impacting the calculation of lexical density, nor does it produce texts that show significant differences in lexical density among additional languages and proficiency levels.

Resumo O avanço tecnológico tem tido um grande impacto na produção escrita, especialmente em Línguas Adicionais (LAs). Embora a tecnologia tenha trazido novas oportunidades para o ensino de LAs, ela também apresenta desafios, incluindo preocupações sobre a complexidade da escrita e a autenticidade dos trabalhos dos alunos. Uma dessas ferramentas é o ChatGPT, plataforma de inteligência artificial (IA) que tem sido objeto de debates desde sua popularização em 2022. Este estudo analisa um corpus composto por seis tarefas produzidas pelo ChatGPT em cinco idiomas (alemão, espanhol, francês, italiano e português), considerando os níveis de proficiência propostos pelo Quadro Comum Europeu de Referência para Línguas (CEFR), que totalizou 2991 textos e 706,401 palavras. Os dados foram gerados por alunos em um laboratório de informática em uma universidade britânica a partir de 100 diferentes perfis na plataforma do ChatGPT, seguindo instruções dos pesquisadores. A análise dos dados utiliza a linguística sistêmico-funcional (LSF) e o conceito de densidade lexical ( Halliday, 1985, 1987, 1993; Halliday; Matthiessen, 2014) para investigar a complexidade dos textos produzidos, dado que a complexidade lexical está relacionada à proficiência na escrita, na qual textos mais avançados usam proporcionalmente mais “palavras de conteúdo” (nomes, verbos, adjetivos e alguns advérbios de modo). Os resultados revelam que o ChatGPT não segue as instruções das tarefas quanto ao número de palavras solicitadas, impactando, assim, no cálculo da densidade lexical, nem produz textos que mostram diferenças significativas da densidade lexical entre as línguas adicionais e níveis de proficiência.

Abstract Brazil has the second largest cesarean section rate in the world. Differences in rates exist between the public and private health sectors. This study used data on admissions of supplementary health plan holders aged between 10 and 49 years living in the state of São Paulo admitted between 2015 and 2021 to determine cesarean section rates and costs in the private health sector. We conducted a partial economic analysis in health from a supplementary health perspective focusing on the direct medical costs of admissions. A total of 757,307 admissions were analyzed with total costs amounting to R$7.701 billion. The cesarean section rate over the period was 80%. Rates were lowest in young women (69%) and highest in the oldest age group (86%), exceeding 67% across all groups. The rate was 71% higher than in public services. The proportion of admissions with use of the intensive care unit was higher among cesarian deliveries. The median cost of a cesarean was 15% higher than that of a normal delivery and twice as high in insurance companies than healthcare cooperatives. There is an opportunity to apply policies that are widely used in public services to the private sector with the aim of reducing cesarean rates in private services, direct costs of admission, and the cost of supplementary health plans.

Resumo O Brasil tem a segunda maior taxa de cesárea do mundo. Há diferença dessas taxas nos setores públicos e privados. Foram utilizados dados de internação de beneficiárias residentes no estado de São Paulo, internadas entre 2015 e 2021, com idades entre 10 e 49 anos, para verificar as taxas e custos das cesáreas no setor privado. Foi realizado estudo parcial de avaliação econômica em saúde na perspectiva da saúde suplementar considerando custos médicos diretos de internação. Foram analisadas 757.307 internações, com gasto total de R$ 7,701 bilhões. As taxas de cesáreas foram de 80% no período. São menores nas gestantes mais novas (69%) e maiores nas mais velhas (86%), e sempre superiores a 67%. Essa população tem taxas 71% maiores do que aquelas do SUS. Há maior proporção de internações com uso de unidade de terapia intensiva nas cesáreas. O custo mediano da cesárea é 15% maior do que o parto normal e são duas vezes maiores nas seguradoras do que nas cooperativas médicas. Há oportunidade de aplicação de políticas públicas de saúde amplamente utilizadas no Sistema Único de Saúde visando a redução das taxas, dos custos diretos da internação e dos planos de saúde.

Abstract Tilapia is one of the most important aquaculture species due to the desirable characteristics as easy reproduction and quick growth in several farming systems, including the recirculating aquaculture systems RAS. In this, the high flow of water to remove waste casually stimulates the fish to swim backset, and growth performance may be improved. Increasing the speed of swimming can improve performance within certain limits, in which however if exceeded can be harmful. Fish may be exhausted leading to impaired growth or even mortality. The objective of this work was to evaluate the growth performance of tilapia juveniles under sustained swimming exercise at different speeds. Additionally, the fish stocking density effect was tested in the sustained swimming exercise condition. In the first experiment, Nile tilapia juveniles were submitted in triplicates to sustained swimming exercise in speeds of control (not exercised), 1 BL/s (body length per second), 1.5 BL/s and 2 BL/s. In the second experiment, two fish stocking densities were tested in triplicates in sustained swimming exercise in speed of 2 BL/s and control not exercised. Fish growth performance was improved by sustained swimming exercise in speeds up to 2 BL/s. No expressive fish mortalities were observed in both experiments. The comparison between the two stocking densities does not allow us to safely say tilapia can be reared at stocking densities in order of 1,000 fish/m3, even under sustained swimming exercise. Other densities need to be tested.