Abstract Tityus serrulatus scorpion is responsible for a significant number of envenomings in Brazil, ranging from mild to severe, and in some cases, leading to fatalities. While supportive care is the primary treatment modality, moderate and severe cases require antivenom administration despite potential limitations and adverse effects. The remarkable proliferation of T. serrulatus scorpions, attributed to their biology and asexual reproduction, contributes to a high incidence of envenomation. T. serrulatus scorpion venom predominantly consists of short proteins acting as neurotoxins (α and β), that primarily target ion channels. Nevertheless, high molecular weight compounds, including metalloproteases, serine proteases, phospholipases, and hyaluronidases, are also present in the venom. These compounds play a crucial role in envenomation, influencing the severity of symptoms and the spread of venom. This review endeavors to comprehensively understand the T. serrulatus scorpion venom by elucidating the primary high molecular weight compounds and exploring their potential contributions to envenomation. Understanding these compounds' mechanisms of action can aid in developing more effective treatments and prevention strategies, ultimately mitigating the impact of scorpion envenomation on public health in Brazil.

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 Objective: To define a reference chart comparing pressure drop vs. flow generated by a set of arterial cannulae currently utilized in cardiopulmonary bypass conditions in pediatric surgery. Methods: Cannulae from two manufacturers were selected considering their design and outer and inner diameters. Cannula performance was evaluated in terms of pressure drop vs. flow during simulated cardiopulmonary bypass conditions. The experimental circuits consisted of a Jostra HL-20 roller pump, a Quadrox-i pediatric oxygenator (Maquet Cardiopulmonary AG, Rastatt, Germany), and a custom pediatric tubing set. The circuit was primed with lactated Ringer’s solution only (first condition) and with human packed red blood cells added (second condition) to achieve a hematocrit of 30%. Cannula sizes 8 to 16 Fr were inserted into the cardiopulmonary bypass circuit with a “Y” connector. The flow was adjusted in 100 ml/min increments within typical flow ranges for each cannula. Pre-cannula and post-cannula pressures were measured to calculate the pressure drop. Results: Utilizing a pressure drop limit of 100 mmHg, our results suggest a recommended flow limit of 500, 900, 1400, 2600, and 3100 mL/min for Braile arterial cannulae sizes 8, 10, 12, 14, and 16 Fr, respectively. For Medtronic DLP arterial cannulae sizes 8, 10, 12, 14, and 16 Fr, the recommended flow limit is 600, 1100, 1700, 2700, and 3300 mL/min, respectively. Conclusion: This study reinforces discrepancies in pressure drop between cannulae of the same diameter supplied by different manufacturers and the importance of independent translational research to evaluate components’ performance.

ABSTRACT The aim of this study was to assess how microclimate variables and irrigation affect the growth of sugarcane. The experiment was conducted using the VAT90-212 cultivar in the Semi-arid region of Brazil. The microclimate was monitored and by quantifying the irrigation depth. Nine campaigns were carried out in the field to collect morphological and biomass data. The data were subjected to descriptive statistics, so as to generate the mean values and/or sum between the campaigns. Using the correlation coefficient, the extent, sign and significance of the relationship between the response and explanatory variables were evaluated. The direct or indirect effects of the explanatory variables on the response variables were identified by path analysis. There was a significant correlation between microclimate variables and the morphological and biomass variables of the sugarcane, with a strong contribution from the intercepted fraction of the photosynthetically active radiation, the wind speed and soil temperature. The negative correlation with irrigation suggests that excess water impaired the growth dynamics of the crop. It is concluded that the growth of sugarcane is closely related to its capacity to intercept radiation, to the wind, thermal regime of the soil and irrigation management.

Abstract Purpose This paper aims to investigate how the extant literature on sustainable supply chain management (SSCM) empirically explores the perspective of emerging economy suppliers operating in global supply chains (GSCs). It thereby explains the role of emerging economy suppliers in determining the success of SSCM. Design/methodology/approach A systematic literature review of 41 empirical papers (published between 2007 and 2021) was conducted, involving both descriptive and thematic analyses. Findings The findings demonstrate that emerging economy suppliers have a key role in SSCM, given their use of positive feedback loops to proactively create remedies to surpass barriers using their collaboration mechanisms, and exploit authentic sustainability outcomes as reinforcements to drive further sustainability initiatives. The authors also demonstrate that suppliers are particularly focused on the cultural and institutional dimensions of sustainability. Finally, the authors provide an explanatory analytical framework to reduce the institutional distance between buyers and their global suppliers. Research limitations/implications This review identifies avenues for future research on the role of emerging economy suppliers in SSCM. Practical implications Recognising remedies to surpass barriers and reinforcements to drive new actions can aid SSCM in GSCs and improve understanding between buyers and suppliers. Social implications The valorisation of cultural and institutional issues can lead to more responsible supplier interactions and improved sustainability outcomes in emerging economies. Originality/value This review only analyses the viewpoint of emerging economy suppliers, whereas prior SSCM reviews have focused on the buyer perspective. Thus, the authors reduce supplier invisibility and institutional distance between GSC participants.

Abstract This article describes the use of a low-cost softwaredefined radio applied to an Electromagnetic Compatibility (EMC) test. The proposed system is indicated for cases when an autonomous instrument is better suited, i.e., when there is no need for external signal or power connections. As a proof of concept, a metallic cavity has its shielding parameter measured, and the obtained results illustrate the kind of outputs the instrument can provide. Details concerning the hardware and software utilized are mentioned, alongside observed pitfalls and trade-offs. It is an affordable and versatile method, which can replace the traditional use of spectrum analyzers and receivers, especially in precompliance tasks. lowcost low cost EMC (EMC test suited ie i e i.e. connections concept measured provide mentioned tradeoffs. tradeoffs trade offs. offs trade-offs method receivers tasks i.e

Abstract The objective of this research was to evaluate the effectiveness of using LPL (Low power laser) to reduce pain, edema, and trismus after impacted lower third molar extraction. A split-mouth randomized triple-blind clinical trial was conducted at the Federal University of Ceará. For inclusion criteria, it was necessary that the patient presented a clear indication for removal of both lower third molars, in addition to both molars being in similar positions. The third molars (38 and 48) were randomly allocated to the test group that received the LPL application protocol, and to the placebo group that received a simulation of the protocol, making a total sample of 44 surgeries. Patients in the test group used an average of 50% of the amount of analgesics that was used by the placebo group, however, there was a statistically significant difference only on days four and five. Regarding trismus, the test group presented wide mouth openings, both at 48 hours and at 7 days after surgery compared to the placebo group, but without a statistically significant difference. For edema, we noted an equilibrium between the test group and the placebo group, but no measurement obtained a statistically significant difference. The use of LPL presented better pain and trismus indicators after complex extractions. The use of LPL is thus indicated as a complementary therapy to reduce postoperative discomfort caused by complex tooth extractions.

Resumo O objetivo desta pesquisa é avaliar a eficácia do uso de LBP (laser de baixa potência) na redução da dor, edema e trismo após exodontia de terceiros molares inferiores impactados. Ensaio clínico randomizado triplo-cego do tipo boca dividida foi realizado na Universidade Federal do Ceará. Para os critérios de inclusão era necessário que o paciente apresentasse indicação clara para a remoção de ambos os terceiros molares inferiores, além da obrigatoriedade de que ambos os molares estivessem em posições semelhantes segundo Winter (1926) e Pell & Gregory (1933). Os terceiros molares (38 e 48) foram alocados aleatoriamente no grupo teste que recebeu o protocolo de aplicação dO LBP e no grupo placebo que recebeu a simulação do protocolo, perfazendo uma amostra total de 44 cirurgias. Os pacientes do grupo teste usaram em média 1/2 da quantidade de analgésicos do que os do grupo placebo, porém, apenas nos dias quatro e cinco houve diferença estatisticamente significativa. Em relação ao trismo, o grupo teste apresentou melhores indicadores tanto em 48 horas quanto em 7 dias após a cirurgia em relação ao grupo placebo, mas sem diferença estatisticamente significante. Em relação ao edema, houve medidas na amostra favoráveis ao grupo teste e medidas favoráveis ao grupo placebo, mas nenhuma das medidas obteve diferença estatisticamente significativa. O uso de LBP mostrou melhores indicadores de dor e trismo após extrações complexas. Portanto, o uso de LBP é indicado como terapia complementar para reduzir morbidades causadas por exodontias complexas.

Abstract Objective Describe the epidemiological profile and social-economic burden that hydrocephalus patients represent to the national public health system, using data available at the online database of the Brazilian Health Ministry (DataSUS). Methods This is a populational study based on descriptive statistics of all clinical and surgical appointments included in the DataSUS database. Data included herein were collected between 2015 and 2021 and subdivided into three main groups, related to hydrocephalus incidence and mortality, hospitalizations, and financial costs. Results In the study period, 3993 new cases of congenital hydrocephalus were diagnosed, with 6051 deaths overall. The mortality rate in the country was 1.5/100000 live births and the prevalence was 0.374/100000 inhabitants. The number of hospitalizations resulting from treatment procedures and complications of hydrocephalus was 137,880 and there was a reduction of up to 27.2% during the SARS-CoV-2 pandemics concerning previous years. Total costs for hydrocephalus management in the country amounted to 140,610,585.51 dollars. Conclusions Hydrocephalus has a significant impact on public health budgets and pediatric mortality rates; however, it is probably underestimated, due to the paucity of demographic data and epidemiological studies in Latin America and, specifically, in Brazil. The dataSUS also has several limitations in accessing certain data related to hydrocephalus, making it difficult to have a more assertive understanding of the disease in Brazil. The results of this study provide important guidance for future research projects in clinical and experimental hydrocephalus and also the creation of public policies for better governance and care of hydrocephalus patients.

Abstract Background: Mobile phones in hospital settings have been identified as an important source of cross-contamination because of the low frequency with which mobile phones are cleaned by health workers and cyclical contamination of the hands and face. The aim of this study was to investigate whether the mobile phones of the anesthesia team at a teaching hospital are potential reservoirs of nosocomial bacteria. In addition, differences in device sanitization and hand hygiene habits between attending and resident anesthesiologists were correlated with mobile phone colonization. Methods: A prevalence study was conducted over a 6-month period from 2017 to 2018 that involved the collection of samples from the mobile phones of the anesthesiology team and culturing for surveillance. A questionnaire was administered to assess the mobile phone sanitization and hand washing routines of the anesthesia team in specific situations. Results: Bacterial contamination was detected for 86 of the 128 mobile phones examined (67.2%). A greater presence of Micrococcus spp. on devices was correlated with a higher frequency of mobile phone use (p = 0.003) and a lower frequency of sanitization (p = 0.003). The presence of bacteria was increased on the mobile phones of professionals who did not perform handwashing after tracheal intubation (p = 0.003). Conclusion: Hand hygiene and device sanitization habits were more important than the use behavior, as a higher presence of bacteria correlated with poorer hygiene habits. Furthermore, handwashing is the best approach to prevent serious colonization of mobile devices and the possible transmission of pathogens to patients under the care of anesthesiologists.

Chagas disease, caused by the parasite Trypanosoma cruzi, occurs most commonly in Latin America. As the treatment is highly toxic and ineffective in the chronic phase of the disease, alternative treatments are needed. Through quantitative structure-activity relationship modeling (QSAR) analysis using ligand-based and structure-based virtual screening methods, we predicted the trypanocidal potential of 47 neolignans against three targets, the enzymes cruzain, trypanothione reductase, and sterol 14-alpha demethylase. A combined analysis allowed for the selection of potent inhibitors against Trypanosoma cruzi. Of these compounds, two were isolated and shown to inhibit the growth of epimastigotes at concentrations of 9.64 and 8.72 µM, and trypomastigote forms at 4.88 and 2.73 µM. Therefore, the compounds (2R, 3R)-2,3-dihydro-2 (4 methoxyphenyl)-3-methyl-5-(E)-propenylbenzofuran (46) and ottomentosa (47) may be a good option of growth inhibitors for the parasite stages and warrant additional study.

Abstract Numerical and experimental analysis of visible light communication (VLC) systems based on orthogonal chirp division multiplexing (OCDM) and orthogonal frequency division multiplexing (OFDM) are presented in this paper. Unlike most of the related publications, in this work we numerically compared OCDM and OFDM based VLC systems with the same equalization process, i.e., employing an one tap equalizer (OTE) in both systems. Simulation results in line-of-sight VLC channels show that both systems have the same performance when baseband multicarrier signals are used. The impact of the optical modulation index and the bias current of a previously characterized light-emitting diode were also evaluated. Nevertheless, the experimental demonstrations, in which bandpass signals were used due to the bandpass characteristic of the exploited setup, show that OFDM-based system outperforms the VLC links with OCDM signals, when the OTE equalizer is used in both systems. The performance of the OCDM-based system was improved by using a zero forcing frequency domain equalizer. (VLC (OCDM (OFDM paper publications process ie i e i.e. (OTE lineofsight line sight lightemitting emitting evaluated Nevertheless demonstrations setup OFDMbased OCDMbased i.e

In this study, xiquexique (Pilosocereus gounellei) native endemic cactus from the Brazilian semiarid was used for the first time as a natural carbon source (“green precursor”) for the synthesis of highly fluorescent carbon dots (CDs). These CDs were successfully used to develop a fast, low-cost, eco-friendly fluorescence method for the determination of tannins in teas. This method was automatized employing a flow-batch system coupled to an inexpensive ultraviolet light-emitting diode (UV-LED) used as an excitation source and a cheap handheld spectrometer used as a detector. CDs were characterized by transmission electron microscopy (TEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), UV-Vis, and fluorescence spectroscopy. The proposed method presented a linear range from 2.0-30.0 mg L-1, relative standard deviation (RSD) < 3.0%, limit of detection (LOD) = 0.102 mg L-1, and recovery rates from 90.5-109.1%. A paired t-test at a 95% confidence level indicated no statistically significant difference between the proposed and reference methods, revealing that it is a useful alternative for the determination of tannins.

ABSTRACT Objective: To assess whether the use of ELMO, a helmet for noninvasive ventilation created in Brazil, had a positive impact on the prognosis of patients with hypoxemic respiratory failure caused by severe COVID-19. Methods: This is a retrospective study of 50 critically ill COVID-19 patients. Epidemiological, clinical, and laboratory data were collected on ICU admission, as well as before, during, and after ELMO use. Patients were divided into two groups (success and failure) according to the outcome. Results: ELMO use improved oxygenation parameters such as Pao2, Fio2, and the Pao2/Fio2 ratio, and this contributed to a gradual reduction in Fio2, without an increase in CO2, as determined by arterial blood gas analysis. Patients in the success group had significantly longer survival (p < 0.001), as determined by the Kaplan-Meier analysis, less need for intubation (p < 0.001), fewer days of hospitalization, and a lower incidence of acute kidney injury in comparison with those in the failure group. Conclusions: The significant improvement in oxygenation parameters, the longer survival, as reflected by the reduced need for intubation and by the mortality rate, and the absence of acute kidney injury suggest that the ELMO CPAP system is a promising tool for treating ARDS and similar clinical conditions.

RESUMO Objetivo: Avaliar se o uso do ELMO, um capacete para ventilação não invasiva criado no Brasil, teve impacto positivo no prognóstico de pacientes com insuficiência respiratória hipoxêmica por COVID-19 grave. Métodos: Estudo retrospectivo com 50 pacientes críticos com COVID-19. Dados epidemiológicos, clínicos e laboratoriais foram coletados na admissão na UTI e antes, durante e após o uso do ELMO. Os pacientes foram divididos em dois grupos (sucesso e falha) de acordo com o desfecho. Resultados: O uso do ELMO melhorou parâmetros de oxigenação como Pao2, Fio2 e relação Pao2/Fio2, e isso contribuiu para uma redução gradual da Fio2, sem aumento do CO2, conforme determinado pela gasometria arterial. Os pacientes do grupo sucesso apresentaram sobrevida significativamente maior (p < 0,001), conforme determinado pela análise de Kaplan-Meier, menor necessidade de intubação (p < 0,001), menos dias de hospitalização e menor incidência de lesão renal aguda em comparação com os do grupo falha. Conclusões: A significativa melhora nos parâmetros de oxigenação, a maior sobrevida, refletida pela menor necessidade de intubação e pela taxa de mortalidade, e a ausência de lesão renal aguda sugerem que o sistema ELMO CPAP é uma ferramenta promissora para o tratamento da SDRA e de condições clínicas semelhantes.

Abstract Introduction: Cardiovascular disease is an important cause of death among patients with chronic kidney disease (CKD). Valve calcification is a predictor of cardiovascular mortality and coronary artery disease. Objective: To assess heart valve disease frequency, associated factors, and progression in CKD patients. Methods: We conducted a retrospective study on 291 CKD patients at Hospital das Clínicas de Pernambuco. Inclusion criteria were age ≥ 18 with CKD and valve disease, while those on conservative management or with missing data were excluded. Clinical and laboratory variables were compared, and patients were categorized by dialysis duration (<5 years; 5–10 years; >10 years). Statistical tests, including chi-square, Fisher’s exact, ANOVA, and Kruskal-Wallis, were employed as needed. Simple and multivariate binary regression models were used to analyze valve disease associations with dialysis duration. Significance was defined as p < 0.05. Results: Mitral valve disease was present in 82.5% (240) of patients, followed by aortic valve disease (65.6%; 86). Over time, 106 (36.4%) patients developed valve disease. No significant association was found between aortic, pulmonary, mitral, or tricuspid valve disease and dialysis duration. Secondary hyperparathyroidism was the sole statistically significant factor for mitral valve disease in the regression model (OR 2.59 [95% CI: 1.09–6.18]; p = 0.031). Conclusion: CKD patients on renal replacement therapy exhibit a high frequency of valve disease, particularly mitral and aortic valve disease. However, no link was established between dialysis duration and valve disease occurrence or progression.

Resumo Introdução: Doenças cardiovasculares são uma causa significativa de morte em pacientes com Doença Renal Crônica (DRC). A calcificação valvar é preditor de mortalidade cardiovascular e doença arterial coronariana. Objetivo: Avaliar a frequência, fatores associados e progressão de valvopatias em pacientes com DRC. Métodos: Coorte retrospectiva com 291 pacientes ambulatoriais no Hospital das Clínicas de Pernambuco. Inclusão: ≥18 anos com DRC e valvopatia; exclusão: tratamento conservador ou dados incompletos. Variáveis clínicas e laboratoriais foram comparadas e categorizadas por tempo de terapia dialítica (TTD): <5 anos, 5–10 anos, >10 anos. Foram aplicados os testes Qui-quadrado, exato de Fisher, ANOVA, Kruskal-Wallis. Associação entre valvopatia e TTD foi avaliada por regressão binária. Significância foi definida como p < 0,05. Resultados: A valvopatia mitral foi encontrada em 82,5% (240) dos casos, seguida da aórtica (65,6%; 86). Houve progressão da doença valvar em 106 (36,4%) pacientes. Não houve associação entre valvopatias aórtica, pulmonar, mitral ou tricúspide e TTD. Hiperparatireoidismo secundário foi a única variável explicativa significativa na regressão para valvopatia mitral (OR 2,59 [IC95%: 1,09–6,18]; p = 0,031). Conclusão: Encontramos alta frequência de valvopatias, especialmente mitral e aórtica, aem pacientes com DRC. Não houve associação entre TTD e valvopatia.

ABSTRACT Objective: In view of the current COVID-19 pandemic, the objective of this study was to determine, through a systematic review and meta-analysis, whether the use of N95/FFP2 masks during aerobic exercise has a significant impact on HR, RR, SpO2, and blood pressure (BP) in healthy individuals. Methods: We searched the MEDLINE database for studies published in English between 2005 and 2021. To reduce bias and increase reliability, only randomized controlled trials and randomized crossover clinical trials were considered for inclusion. The selected outcomes included HR, RR, SpO2, and BP, with perceived exertion being evaluated by means of the Borg scale. Results: Eight controlled trials were included in the meta-analysis. Seven evaluated HR (p > 0.05), five evaluated RR (p > 0.05), five evaluated SpO2 and BP (p > 0.05 for both), and six evaluated perceived exertion, presenting controversial results such as risk ratios that were grouped for each variable. Conclusions: This study suggests that N95 and FFP2 masks do not have significant effects on HR, RR, SpO2, and BP during aerobic exercise in healthy individuals.

RESUMO Objetivo: Diante da atual pandemia de COVID-19, o objetivo deste estudo foi determinar, por meio de uma revisão sistemática e meta-análise, se o uso de máscaras N95/PFF2 durante o exercício aeróbico tem impacto significativo na FC, FR, SpO2 e pressão arterial (PA) em indivíduos saudáveis. Métodos: Buscamos no banco de dados MEDLINE estudos publicados em inglês entre 2005 e 2021. Para reduzir o viés e aumentar a confiabilidade, foram considerados para inclusão no estudo somente ensaios clínicos controlados randomizados e ensaios clínicos cruzados randomizados. Os desfechos selecionados foram FC, FR, SpO2 e PA; a percepção de esforço foi avaliada por meio da escala de Borg. Resultados: Oito ensaios controlados foram incluídos na meta-análise. Sete avaliaram FC (p > 0,05), cinco avaliaram FR (p > 0,05), cinco avaliaram SpO2 e PA (p > 0,05 para ambas) e seis avaliaram a percepção de esforço, com resultados controversos (razões de risco agrupadas para cada variável, por exemplo). Conclusões: Este estudo sugere que as máscaras N95 e PFF2 não têm efeitos significativos na FC, FR, SpO2 e PA durante o exercício aeróbico em indivíduos saudáveis.