Abstract: This paper projects and analyzes the regional impacts of climate change on the agricultural productivity of family farming and large-scale agriculture in Brazil between 2021 and 2050, using the RCP 4.5 and RCP 8.5 scenarios. The methodology adopted consists of a cross-sectional estimation of a production function in which agricultural productivity is determined by climatic, geographic, and productive factors. The study contributes to the literature by disaggregating agricultural production into family farming and large-scale agriculture, indicating the magnitude and direction of impacts by crops and regions in Brazil, a country with a great territorial dimension and relevant and heterogeneous agricultural production. The results indicate that the agricultural productivity of family farming is more sensitive and therefore this type of producer could be more vulnerable to the phenomenon. On average, the effects will be negative in the North/Northeast regions and for cassava, maize, beans, and soybeans, with possible impacts on deforestation and on food supply. Productivity gains are expected in the southern region and for the cultivation of sugar cane and soybeans. Deterioration of food security of the vulnerable farmers and regional disparities may increase in Brazil.

Resumo: O artigo analisa os impactos regionais das mudanças climáticas sobre a produtividade agrícola por cultivo da agricultura familiar e patronal no Brasil, utilizando os cenários RCP 4.5 e RCP 8.5 (IPCC, 2014), entre os anos de 2021 e 2050. A estratégia metodológica consiste na estimação em cross section de uma função de produção em que os resultados em termos de produtividade agrícola são determinados por fatores climáticos, geográficos e produtivos. O estudo contribui para a literatura, ao desagregar a produção agrícola em familiar e patronal, indicando a magnitude e a direção dos impactos, por cultivo e por Unidade da Federação no Brasil, pais de grande dimensão territorial e relevante e heterogênea produção agrícola. Os resultados indicaram que a agricultura familiar apresentaria maior sensibilidade, e portanto, maior vulnerabilidade ao fenômeno. Em média, os efeitos seriam negativos nas regiões Norte/Nordeste e para mandioca, milho, feijão e soja, com possíveis impactos no desmatamento e na oferta de alimentos. Esperam-se ganhos de produtividade na região Sul e para o cultivo de cana-de-açúcar e soja. A deterioração da segurança alimentar dos agricultores vulneráveis e as disparidades regionais poderiam aumentar no Brasil.

ABSTRACT BACKGROUND: Precisely determining the aspects related to an instrument's validity and reliability measures allows for greater assurance of the quality of the results. OBJECTIVES: To analyze the psychometric properties of The Providers Survey in the Brazilian context of mental health services. DESIGN AND SETTING: The instrument validation study was conducted in Montes Claros, Minas Gerais, Brazil. METHODS: The validation study was conducted using the Consensus-based Standards for the Selection of Health Measurement Instruments checklist to analyze its validity and reliability. RESULTS: A committee of expert judges performed content validation after which the Content Validity Index was calculated. Construct validation took place through Exploratory Factor Analysis using the Kaiser-Meyer-Olkin Test criterion and Bartlett's Sphericity Test. Reliability was verified using test-retest reliability. The significance level adopted for the statistical tests was 5% (P < 0.05). The final instrument comprised 54 questions. The Content Validity Index was 97%. Exploratory Factor Analysis identified a Kaiser-Meyer-Olkin index of 0.901 and Bartlett's Sphericity Test with P < 0.001. We obtained a Cronbach's alpha coefficient of 0.95 and an intraclass correlation coefficient of 0.849. CONCLUSIONS: The Providers Survey, translated and adapted into Portuguese, was named the Work Assessment Instrument for the Recovery of Mental Health. It presented adequate psychometric properties for evaluating work-related practices for the recovery of psychosocial care network users.

ABSTRACT BACKGROUND: Nutritional status and growth curves can affect cognitive development, increase the risk of infection, and contribute to the development of chronic diseases. Its etiology is related to food, socioeconomic, and maternal conditions. However, to date, no data on these parameters exist in the state of Goiás, Brazil. OBJECTIVE: To compare the nutritional status and growth curves of children and adolescents in the city of Goiânia, Goiás, Brazil. DESIGN AND SETTING: This was a cross-sectional study. A total of 529 individuals were recruited from a primary health center in the municipality. METHODS: To assess nutritional status, the sample was divided into three categories: 3–4, 5–10, and 11–19 years, with z-score classification considering body mass index for age. The classification of growth curves was performed considering the median height values for age, assuming two references: (a) young Brazilian population and (b) one recommended for international use. The independent sample T-test was used to compare anthropometric variables. RESULTS: The results showed that the classification of eutrophics represents a predominant percentage between both sexes (men: 03–04 = 55.4%; 05–10 = 57.6%; 11–19 = 53.5 % and women: 03–04 = 53.5%; 05–10 = 63.9%; 11–19 = 56.9%), and growth curves showed differences in specific periods in both sexes. CONCLUSIONS: It can be concluded that children and adolescents from the city of Goiânia present as predominance the eutrophic nutritional status, followed by the risk of overweight, underweight, obesity, and malnutrition of both sexes.

Abstract After the interruption of the Territories of Citizenship (TC) Program by the Brazilian federal government, Bahia was one of the few Brazilian states that maintained the territorial approach, the “Territories of Identity”. The objective of this study is to evaluate the effect of territorial management for the TC-Bahia (treatment group) in comparison to TC-Brazil (control group). A Rural Development Index for Family Agriculture (RDI-FA) was developed for two time periods to calculate its evolution for each group. The results showed that the RDI-FA had a significantly higher evolution for TC-Bahia in relation to TC-Brazil (p-value < 0.01). In ten years, TC-Bahia index increased by 0.07 while the rest of TC-Brazil grew by 0.04. We concluded that institutionalization and improvements of Bahian territorial approach has benefited family farmers, especially in the institutional dimension of territorial heritage.

Resumo Após a paralisação do programa federal Territórios da Cidadania (TC), a Bahia foi um dos poucos estados brasileiros que manteve a abordagem territorial, por meio dos Territórios de Identidade. Assim, o objetivo do estudo é avaliar o efeito da gestão territorial para os TC do estado da Bahia (grupo tratamento) em comparação com os demais TC do Brasil (grupo controle). Para tanto, um Índice de Desenvolvimento Rural da Agricultura Familiar (IDR-AF) foi desenvolvido para dois períodos, permitindo calcular a sua evolução para os dois grupos. Os resultados evidenciaram uma evolução significativamente superior do IDR-AF nos TC da Bahia em comparação com os TC do Brasil (p-valor < 0,01). Em dez anos, o índice da Bahia cresceu em 0,07, enquanto que o restante do Brasil progrediu em 0,04. Concluiu-se que a institucionalização e os aprimoramentos da abordagem territorial baiana beneficiaram a agricultura familiar, especialmente na dimensão institucional do patrimônio territorial.

ABSTRACT Zinnia sp. and hairy beggartick (Bidens pilosa) plants exhibiting symptoms of possible virus infection were found in the municipality of Santa Bárbara d’Oeste, São Paulo State, Brazil. Flexuous filamentous particles and cytoplasmatic inclusions typical of potyvirus infection were observed by transmission electron microscopy, respectively, in leaf extracts and cells of symptomatic leaves. Infection of both plants with bidens mottle virus (BiMoV) was confirmed by RT-PCR using potyvirus universal primers, followed by nucleotide sequencing of the amplicons. The nearly complete genome sequence of the Brazilian isolate, named BiMoV-BR, is 9700 nucleotides long and shares 95.6 % identity with the corresponding nucleotide sequence of a BiMoV isolate from the United States. BiMoV-BR was mechanically transmitted and caused systemic infection on plants of Zinnia sp., hairy beggarstick, sunflower (Helianthus annuus), and lettuce (Lactuca sativa). Myzus persicae transmitted the virus to Zinnia sp. plants with efficacy of 8 % and 42 %, using one and ten aphids per plant, respectively. This is the first detection of BiMoV in Brazil. Further studies are necessary to evaluate the distribution of this potyvirus in the country.

ABSTRACT Neuroleptic malignant syndrome (NMS) is a neurologic emergency potentially fatal. This rare side effect is most commonly associated with first-generation antipsychotics and less frequently with atypical or second-generation antipsychotics. The diagnosis relies on both clinical and laboratory criteria, with other organic and psychiatric conditions being ruled out. CASE REPORT: A 39-year-old female patient, who is institutionalized and completely dependent, has a medical history of recurrent urinary infections and colonization by carbapenem-resistant Klebsiella pneumoniae. Her regular medication regimen included sertraline, valproic acid, quetiapine, risperidone, lorazepam, diazepam, haloperidol, baclofen, and fentanyl. The patient began experiencing dyspnea. Upon physical examination, she exhibited hypotension and a diminished vesicular murmur at the right base during pulmonary auscultation. Initially, after hospitalization, she developed high febrile peaks associated with hemodynamic instability, prompting the initiation of antibiotic treatment. Despite this, her fever persisted without an increase in blood inflammatory parameters, and she developed purulent sputum, necessitating antibiotherapy escalation. The seventh day of hospitalization showed no improvement in symptoms, suggesting NNMS as a differential diagnosis. All antipsychotic and sedative drugs, as well as antibiotherapy, were discontinued, after which the patient showed significant clinical improvement. CONCLUSION: Antipsychotic agents are commonly employed to manage behavioral changes linked to various disorders. However, their severe side effects necessitate a high degree of vigilance, the cessation of all medications, and the implementation of supportive care measures. A prompt and accurate diagnosis of NMS is crucial to alleviating the severe, prolonged morbidity and potential mortality associated with this syndrome.

ABSTRACT: Suboptimal LH surges can lead to delayed or absent ovulation during reproductive management programs in cattle. Several signaling pathways may enhance the LH signal, potentially including growth factors. In the present study, we determined whether Fibroblast growth factor 18 (FGF18), which mimics some actions of the LH surge on granulosa cells, may potentiate the action of a suboptimal dose of LH using an established bovine granulosa cell (GC) culture system. Addition of recombinant FGF18 increased the concentration of progesterone (P4) in the culture medium. A combination of LH and FGF18 in the culture medium increased the abundance of mRNA encoding EREG, EGR1 and EGR3, proteins that are early modulators of the LH-induced pre-ovulatory cascade. This study demonstrated that FGF18 may be a co-factor in the regulation of the pre-ovulatory cascade in bovine ovarian granulosa cells.

RESUMO: Os picos de LH abaixo do ideal podem bloquear ou retardar a ovulação durante programas de manejo reprodutivo em bovinos. Várias vias de sinalização podem aumentar o sinal de LH, incluindo em especial fatores de crescimento. No presente estudo, determinamos se o fator de crescimento de fibroblastos 18 (FGF18), que estimula algumas ações do pico de LH nas células da granulosa, pode potencializar a ação de uma dose sub fisiológica de LH em um sistema de cultivo de células da granulosa bovina (GC). A adição de FGF18 recombinante aumentou a concentração de progesterona (P4) no meio de cultura. A combinação de LH e FGF18 no meio de cultura aumentou a abundância de mRNA para EREG, EGR1 e EGR3, proteínas que são moduladoras precoces da cascata pré-ovulatória induzida por LH. Este estudo demonstrou que o FGF18 pode ser um cofator na regulação da cascata pré-ovulatória em células da granulosa bovina.

ABSTRACT Objective: To assess the impact of different vertical positions on lung aeration in patients receiving invasive mechanical ventilation. Methods: An open-label randomized crossover clinical trial was conducted between January and July 2020. Adults receiving invasive mechanical ventilation for > 24 hours and < 7 days with hemodynamic, respiratory and neurological stability were randomly assigned at a 1:1 ratio to the sitting position followed by passive orthostasis condition or the passive orthostasis followed by the sitting position condition. The primary outcome was lung aeration assessed using the lung ultrasound score (score ranges from 0 [better] to 36 [worse]). Results: A total of 186 subjects were screened; of these subjects, 19 were enrolled (57.8% male; mean age, 73.2 years). All participants were assigned to receive at least one verticalization protocol. Passive orthostasis resulted in mean lung ultrasound scores that did not differ significantly from the sitting position (11.0 versus 13.7; mean difference, -2.7; [95%CI -6.1 to 0.71; p = 0.11). Adverse events occurred in three subjects in the passive orthostasis group and in one in the sitting position group (p = 0.99). Conclusion: This analysis did not find significant differences in lung aeration between the sitting and passive orthostasis groups. A randomized crossover clinical trial assessing the impact of vertical positioning on lung aeration in patients receiving invasive mechanical ventilation is feasible. Unfortunately, the study was interrupted due to the need to treat COVID-19 patients. ClinicalTrials.gov registry: NCT04176445

RESUMO Objetivo: Avaliar o impacto de diferentes posicionamentos verticais na aeração pulmonar em pacientes em ventilação mecânica invasiva. Métodos: Trata-se de ensaio clínico aberto, randomizado e transversal, realizado entre janeiro e julho de 2020. Adultos em ventilação mecânica invasiva por mais de 24 horas e menos de 7 dias com estabilidade hemodinâmica, respiratória e neurológica foram distribuídos aleatoriamente em uma proporção de 1:1 à postura sentada seguida da condição de ortostatismo passivo ou o ortostatismo passivo seguido de postura sentada. O desfecho primário foi a aeração pulmonar avaliada pelo lung ultrasound score. O escore varia de zero (melhor) a 36 (pior). Resultados: Foram selecionados 186 indivíduos; destes, 19 foram incluídos (57,8% do sexo masculino; média idade de 73,2 anos). Todos os participantes foram selecionados para receber pelo menos um protocolo de verticalização. O ortostatismo passivo resultou em escores médios de aeração pulmonar por ultrassonografia que não diferiram significativamente da postura sentada (11,0 versus 13,7; diferença média, -2,7; IC95% -6,1 a 0,71; p = 0,11). Ocorreram eventos adversos em três indivíduos no grupo ortostatismo passivo e em um no grupo postura sentada (p = 0,99). Conclusão: Esta análise não encontrou diferenças significativas na aeração pulmonar entre os grupos ortostatismo passivo e postura sentada. É factível conduzir um estudo clínico transversal randomizado para avaliar o impacto do posicionamento vertical na aeração pulmonar em pacientes em ventilação mecânica invasiva. Infelizmente, o estudo foi interrompido devido à necessidade de tratar pacientes com COVID-19. Registro ClinicalTrials.gov: NCT04176445

Abstract Background: Falls in hospital settings are frequent adverse events, with medications contributing significantly. Objective: To analyze inpatient fall notifications and characterize fall risk with a focus on drug therapy by applying the Medication Fall Risk Score. Methodology: An observational, descriptive, and retrospective study was conducted in a Portuguese hospital center. The Medication Fall Risk Score was applied to a sample of 183 patient fall notifications in the first quarter of 2021. Results: The Medication Fall Risk Score identified 60.6% of patients with "yes" for high fall risk. Regarding fall risk assessment recorded in the notifications using another scale, 65.8% of patients were classified as "low risk" or "no risk." Of these, 53.9% were classified as "yes" for high risk using the Medication Fall Risk Score. Conclusion: The Medication Fall Risk Score may help to improve the detection of patients at "high risk" of falling, allowing safer medication practices for fall prevention.

Resumo Enquadramento: As quedas em contexto hospitalar são eventos adversos frequentes, sendo os medicamentos um importante fator contribuinte. Objetivo: Analisar notificações de queda de doentes internados e caracterizar o risco de queda com foco na terapia farmacológica, através da aplicação da Medication Fall Risk Score. Metodologia: Estudo observacional, descritivo e retrospetivo realizado num centro hospitalar português. Aplicada a Medication Fall Risk Score, numa amostra de 183 notificações de queda ocorridas no primeiro trimestre de 2021. Resultados: A Medication Fall Risk Score identificou 60,6% dos doentes com “sim” para o alto risco de queda. Relativamente à avaliação de risco de queda registada nas notificações com recurso a outra escala, identificou-se que 65,8% dos doentes foram classificados como "baixo risco" ou "sem risco". Desses, 53,9% foram classificados com "sim” para o alto risco através da Medication Fall Risk Score. Conclusão: A Medication Fall Risk Score poderá contribuir para melhorar a deteção de doentes com “alto risco” de queda, permitindo uma gestão mais segura dos medicamentos para a prevenção das quedas.

Resumen Marco contextual: Las caídas en los hospitales son eventos adversos frecuentes y la medicación es un factor importante. Objetivo: Analizar las notificaciones de caída de pacientes hospitalizados y caracterizar el riesgo de caída centrándose en el tratamiento farmacológico, mediante la aplicación de la Medication Fall Risk Score. Metodología: Estudio observacional, descriptivo y retrospectivo realizado en un centro hospitalario portugués. Aplicada la Medication Fall Risk Score en una muestra de 183 notificaciones de caída ocurridas en el primer trimestre de 2021. Resultados: La Medication Fall Risk Score identificó al 60,6% de los pacientes con un "sí" para riesgo de caída elevado. En cuanto a la evaluación del riesgo de caída registrada en las notificaciones mediante otra escala, el 65,8% de los pacientes fueron clasificados como de “riesgo bajo" o "sin riesgo". De ellos, el 53,9% se clasificaron con un "sí" para riesgo elevado a través de la Medication Fall Risk Score. Conclusión: La Medication Fall Risk Score podría ayudar a mejorar la detección de pacientes con “riesgo elevado" de caída, lo que permitiría una gestión más segura de los medicamentos para prevenirla.

Abstract Background: The Nursing School of Coimbra knows the importance of extension units in the articulation between teaching, research, and extension. For this reason, the School has a Service Provision and Community Extension Activities Coordination Unit (UPSCCAEC). Objective: To describe the work developed by the UPSCCAEC in 2019 and 2020, highlighting its adaptive capacity in the face of the COVID-19 pandemic. Main topics under analysis: The reports of activities carried out within the scope of the UPSCCAEC in 2019 and 2020 were used as a data source. A comparison was made with findings in the two years, discussed based on the available theoretical framework and considering the COVID-19 pandemic and its impact on Higher Education Institutions’ training, research, and extension processes. Conclusion: The UPSCCAEC’s activity in those years contributed to the institution’s excellence and academic development and successful response to the current societal challenges in a time of great instability due to the COVID-19 pandemic.

Resumo Enquadramento: A Escola Superior de Enfermagem de Coimbra, ciente do valor das unidades de extensão na articulação do tripé Ensino-Investigação-Extensão tem na sua estrutura a Unidade de Prestação de Serviços à Comunidade e Coordenação das Atividades de Extensão na Comunidade (UPSCCAEC). Objetivo: Descrever o trabalho desenvolvido pela UPSCCAEC em 2019 e 2020, destacando a sua capacidade adaptativa mediante a pandemia pela COVID-19. Principais tópicos em análise: Utilizaram-se como fonte de dados os relatórios de atividades realizadas no contexto da UPSCCAEC nos anos civis de 2019 e 2020, e realizou-se a comparação com achados nos dois anos, os quais foram discutidos à luz do referencial teórico disponível, considerando a pandemia COVID-19 e o impacte a nível das Instituições do Ensino Superior (IES) em seus processos formativos, de investigação e extensão. Conclusão: A atividade da UPSCCAEC nos referidos anos contribuiu para a afirmação da instituição, do desenvolvimento académico, e constituiu recurso de excelência na resposta aos atuais desafios da sociedade, particularmente num período caracterizado por enorme turbulência resultante da pandemia COVID-19.

Resumen Marco contextual: La Escuela Superior de Enfermería de Coímbra, consciente del valor de las unidades de extensión en la articulación del trípode Enseñanza-Investigación-Extensión, cuenta en su estructura con la Unidad de Prestación de Servicios a la Comunidad y Coordinación de Actividades de Extensión Comunitaria (UPSCCAEC). Objetivo: Describir el trabajo desarrollado por la UPSCCAEC en 2019 y 2020, y destacar su capacidad de adaptación frente a la pandemia por COVID-19. Principales temas en análisis: La fuente de datos utilizada fueron los informes de las actividades realizadas en el marco de la UPSCCAEC en los años civiles de 2019 y 2020, y se realizó una comparación con los hallazgos en ambos años, los cuales se discutieron considerando el marco teórico disponible, la pandemia del COVID-19 y el impacto en las Instituciones de Educación Superior (IES), en sus procesos de formación, investigación y extensión. Conclusión: La actividad de la UPSCCAEC en estos años contribuyó a la afirmación de la institución, al desarrollo académico y constituyó un recurso de excelencia para responder a los desafíos actuales de la sociedad, particularmente en un período caracterizado por enormes turbulencias derivadas de la pandemia del COVID-19.

ABSTRACT Zinc is an essential micronutrient for plant metabolism and has been studied in several crops of economic interest. However, there is no evidence of its use in coconut crops. The objective of this study was to evaluate the influence of foliar zinc fertilization with doses of zinc on dwarf green coconut seedlings based on their nutritional status, growth attributes, and gas exchange. The experimental design consisted of randomized blocks, and the treatments consisted of different zinc doses (0, 5, 10, 15, 20, and 25 g per plant) with five replicates. Seedlings were positively influenced by zinc dose, mainly in terms of growth variables and gas exchange. Zinc fertilization reduced iron and manganese content and increased zinc concentrations in the leaf tissue. Zinc fertilization promoted an increase in leaf area, height, shoot dry mass, and total dry mass. Furthermore, zinc fertilization improved photosynthesis, transpiration, stomatal conductance, internal CO2 concentration, instantaneous water use efficiency, and intrinsic water use efficiency. The improvement in these growth indices and gas exchange, in most variables, was up to an estimated dose of approximately 16 g of zinc per plant and decreased with increasing doses.

RESUMO O zinco é um micronutriente de importância essencial para o metabolismo vegetal, é estudado para diversas culturas de interesse econômico, porém sem evidências de estudo para a cultura do coqueiro. Objetivou-se com este estudo avaliar a influência da fertilização com doses de zinco via foliar em mudas de coqueiro anão verde, por meio do estado nutricional, atributos de crescimento e trocas gasosas. O delineamento experimental foi em blocos ao acaso, e os tratamentos foram constituídos por doses de zinco (0, 5, 10, 15, 20 e 25 g por planta), com cinco repetições. As mudas foram influenciadas positivamente pelas doses de zinco principalmente nas variáveis de crescimento e nas trocas gasosas. No estado nutricional afetou de maneira decrescente o ferro e o manganês e aumentou o zinco no tecido foliar. O zinco proporcionou incrementos na área foliar, altura de plantas, massa seca da parte aérea e massa seca total. Além disso, melhorou a fotossíntese, transpiração, condutância estomática, concentração interna de CO2, eficiência instantânea do uso da água e eficiência intrínseca do uso da água. A melhora nesses índices de crescimento e trocas gasosas, na maioria das variáveis, foi até a dose estimada de aproximadamente 16 g de zinco por planta e diminuiu com o aumento das doses.

Abstract Longitudinal monitoring of indicators of accidental falls can facilitate the planning of effective care and prevention actions. This article aims to analyze temporal trends in variables related to falls among older persons in Brazil and in the state of São Paulo during the period 2000-2020 and estimate the projected economic burden on the health system in 2025. We conducted a quantitative retrospective observational study using data from the Health Information System. The Joinpoint Regression Program version 4.7.0 and SPSS version 20.0 were used to perform linear regression and calculate the Average Annual Percent Change (AAPC), adopting a 95% confidence interval. There was an increase in mean and total admissions costs due to falls at national level in both intervals of the study period. There was an increase in total admissions costs and the total number of admissions due to falls in the state of São Paulo (AAPC of 8.5% and 4.3%, respectively). Projections for the year 2025 suggest that the total number of admissions due to falls in Brazil will be around 150,000, resulting in costs of approximately R$ 260 million. There was an increase in the variables analyzed by this study, revealing the importance of fall prevention programs associated with national public policies.

Resumo O acompanhamento longitudinal de indicadores, como os relacionados às quedas acidentais, pode facilitar o planejamento de ações mais eficazes de assistência e prevenção. O objetivo deste artigo é analisar a tendência temporal das variáveis relacionadas aos acidentes de quedas na população idosa no Brasil e no estado de São Paulo entre 2000 e 2020 e estimar o impacto econômico para o SUS em 2025. Este é um estudo observacional retrospectivo com abordagem quantitativa, com dados do Sistema de Informação em Saúde. Foram utilizados os softwares Joinpoint Regression Program versão 4.7.0 e SPSS versão 20.0 para a realização de regressões lineares, além da análise Average Annual Percent Change (AAPC), adotando um intervalo de confiança de 95%. No país, houve aumento das internações nos dois períodos analisados, assim como os gastos totais, em todos os segmentos analisados. Em concordância no estado de São Paulo, o valor total e as internações apresentaram aumento (AAPC, sendo 8,5% e 4,3% respectivamente). No ano de 2025, as internações por quedas no Brasil estarão próximas a 150 mil, gerando custos em torno de R$ 260 milhões. Houve o aumento das variáveis analisadas, mostrando a importância de programas de prevenção de quedas associados a políticas públicas nacionais.

Polymer gel systems find applications in diverse areas, ranging from contact lenses to agriculture and oil production. In general, polyacrylamide (PAM) gels are produced by reaction with metallic (low temperatures) and organic (high temperatures) crosslinking agents. In this paper, given crescent environmental concerns, polyethyleneimine (PEI), an organic reactant, was chosen as the crosslinker of PAM, at 65 ºC. The effects of using a solution of water/glycerol as the solvent for preparing the gels and the addition of diethylenetriamine (DETA), a n-alkylamine, on the gelation kinetics and gel stability were evaluated. The data presented in this paper indicate that the solvent mixture provided a more controlled gelling behavior by delaying the gelation time. Also, diethylenetriamine acted both as an efficient anti-syneresis agent, improving gel stability, and by delaying the progress of gel strength.

Resumo Os tumores do Sistema Nervoso Central (SNC) representam mais da metade das neoplasias infantis malignas que acometem crianças. Objetivou-se analisar o risco de exposição a agrotóxicos relacionado com o desenvolvimento de tumores do SNC em crianças. Realizou-se uma revisão sistemática da literatura nas bases de dados PubMed/MEDILINE, Embase, Web of Science, Scopus e CINAHL. Foram incluídos estudos de coorte e caso-controle sobre o desenvolvimento de tumores do SNC (todos os tipos histológicos do grupo III Classificação de Câncer Infantil) decorrentes da exposição a agrotóxicos em crianças de 0-14 anos. Na metanálise utilizou-se o modelo de efeito aleatório e o método estatístico de Mantel-Haenszel. A Razão de Chances (RC) ou Odds Ratio (OR) foi a medida de associação aplicada. A revisão foi registrada no International Prospective Register of Systematic Reviews (PROSPERO) sob o número CRD42021209354. A busca identificou 1.158 estudos, dos quais 14 compuseram a revisão. Verificou-se evidência de associação entre o desenvolvimento de astrocitomas e a exposição a todas as classes de pesticidas (OR 1,50; IC95% 1,15-1,96; p=0,03). A síntese dos resultados apontou para uma relação da exposição aos agrotóxicos com o desfecho de alguns tipos histológicos de tumores do SNC na infância.

Abstract Central Nervous System (CNS) tumors represent more than half of all childhood malignant neoplasms. The aim of this study was to determine the relationship between environmental exposure to pesticides and the development of CNS tumors in children. We conducted a systematic review of the literature in the PubMed/MEDILINE, Embase, Web of Science, Scopus, and CINAHL databases. The inclusion criteria were cohort and case-control studies investigating the association between exposure to pesticides and CNS tumors (all histological types included in group III of the WHO Classification of Childhood Cancer) in children aged 0-14 years. The meta-analysis was performed using a random effects model and the Mantel-Haenszel method. Strength of association was measured using odds ratios (OR). The review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under identification number CRD42021209354. The search identified 1,158 studies, 14 of which were included in the review. There was evidence of an association between the development of astrocytomas and exposure to all classes of pesticides (OR 1.50; 95%CI 1.15-1.96; p=0.03). The synthesis of the evidence pointed to a relationship between exposure to pesticides and some histological types of CNS tumors in childhood.

Resumo O herpes zoster (HZ), ou zona, é causado pela reativação do vírus varicela zoster latente. Trata-se de uma doença com elevada incidência, associada a grande morbilidade, que pode originar ou agravar uma situação de fragilidade do doente, o que realça a importância da vacinação. Entre os fatores de risco para HZ e nevralgia pós-herpética (NPH), a sua principal complicação, encontram-se a idade, a imunossupressão e a presença de doenças crónicas. A vacinação é uma estratégia eficaz na prevenção do HZ e da NPH. Em Portugal, estão disponíveis duas vacinas contra o HZ: a vacina viva atenuada e a vacina recombinante, a qual apresenta elevada eficácia contra o HZ e suas complicações, especialmente nas populações de maior risco, imunodeprimidas e com imunossenescência que têm contraindicação para a formulação viva atenuada. Contudo, a vacina contra o HZ não consta do Programa Nacional de Vacinação nem existem recomendações nacionais específicas para a imunização. Assim, a Sociedade Portuguesa de Medicina Interna e a As-sociação Portuguesa de Medicina Geral e Familiar elaboraram um documento de consenso que estabelece orientações para a vacinação contra o HZ. Recomenda-se a vacinação contra o HZ em todos os adultos com idade igual ou superior a 50 anos, assim como em adultos com idade entre 18 e 49 anos com risco elevado de zona, nomeadamente doentes com comorbilidades médicas ou imunossupressão. Os adultos imunocompetentes devem ser preferencialmente imunizados com a vacina recombinante, podendo receber a vacina viva atenuada em situações pontuais; os adultos imunocomprometidos só podem ser imunizados com a vacina recombinante. Recomenda-se a vacinação de indivíduos com antecedentes de zona e a imunização com a vacina recombinante de indivíduos previamente vacinados com a vacina viva atenuada. Salienta-se ainda a relevância da promoção da literacia do doente aquando do ato de prescrição da vacina contra o HZ, bem como o papel ativo do médico na sensibilização para a importância da vacinação contra esta patologia.

Abstract Herpes zoster (HZ), or shingles, is caused by the reactivation of the latent varicella zoster virus. It is a high-incidence disease, associated with great morbidity, which might create or worsen a patient’s frailty condition, thus reinforcing the importance of vaccination. Among the risk factors for HZ infection and postherpetic neuralgia (PHN), its major complication, are age, immunosuppression and the presence of chronic conditions. Vaccination is an efficacious strategy to prevent HZ and PHN. In Portugal, there are two available HZ vaccines: the live attenuated vaccine and the recombinant vaccine, which demonstrated a high efficacy against HZ and its complications, particularly in the populations with higher risk, immunosuppressed and with immunosenescence for whom live attenuated vaccine is contraindicated. No-twithstanding, the HZ vaccine is not included in the National Vaccination Program and there are not specific national recommendations for immunization. Hence, the Portuguese Society of Internal Medicine and the Portuguese Association of General and Family Medicine elaborated a consensus re-port establishing guidelines for HZ vaccination. Vaccination against HZ is recommended for all adults aged 50 years and over, as well as for adults aged between 18 and 49 years at high risk for HZ, namely patients with comorbidities or immunosuppression. Immunocompetent adults should be preferentially immunized with the recombinant vaccine, although they might receive the live attenuated vaccine in punctual situations; immunocompromised adults should only be immuni-zed with the recombinant vaccine. The vaccination of individuals with a previous HZ episode is recommended, and individuals with prior immunization with the live attenuated vaccine should receive the recombinant vaccine. Promoting patient’s literacy when prescribing HZ vaccine is highly relevant, and the physician should have an active role in raising awareness about the importance of shingles vaccination.