Abstract: The use of imagem strategies in medical socieal networks is increasingly widespread, meeting the ethical limit established by the CEM. Knowing this, the present study sought to understand the problem of patient exposure in medical social networks. For this, a literature review was carried out from the Scientific Electronic Library Online (Scielo), Pubmed, UpToDate, LILACS databases, articles in English, Spanish and Portuguese published from 2018 onwards were included. Thus, a tendency was noticed in some cities to create laws to regulate this exposure, given that the use of images has become routine in medical advertising, as a way to demonstrate results. However, this practice is greatly accompanied by ethical failures as recommended by the CFM.

Resumen: El uso de estrategias de imagen en las redes sociales médicas está cada vez más extendido, cumpliendo el límite ético establecido por el CEM. Sabiendo esto, el presente estudio buscó comprender el problema de la exposición de los pacientes en las redes sociales médicas. Para ello, se realizó una revisión bibliográfica a partir de las bases Scientific Electronic Library Online (Scielo), PubMED, UpToDate, LILACS, incluyendo artículos en inglés, español y portugués publicados a partir de 2018. Así, se percibió en algunas ciudades la tendencia a crear leyes para regular esta exposición, dado que el uso de imágenes se ha vuelto rutinario en la publicidad médica, como una forma de demostrar resultados. Sin embargo, esta práctica está muy acompañada de faltas éticas como recomienda el CFM.

Resumo: A utilização das estratégias de imagem nas redes sociais médicas está cada vez mais disseminada, encontrando-se no limite ético estabelecido pelo CEM. Sabendo disso, o presente estudo buscou entender a problemática da exposição do paciente nas redes sociais médicas. Para isso, foi feita uma revisão da literatura a partir das bases Scientific Eletronic Library Online (Scielo), PubMED, UpToDate, LILACS, foram incluídos artigos em inglês, espanhol e português publicados a partir de 2018. Assim, percebeu-se em algumas cidades a tendência de criar leis para regular essa exposição, haja vista que a utilização de imagens tornou-se rotineira na propaganda médica, como forma demonstrar resultados. Todavia, tal prática vem acompanhada grandemente de falhas éticas segundo o preconizado pelo CFM.

Abstract: The concept of dignified death or a good death has been widespread among health professionals, who routinely deal with it and experience the ethical dilemma about what should really be done in the face of a terminally ill patient. Given this, the present study aims to show the concepts and how cases of terminally ill patients have been conducted within the Intensive Care Units (ICU). To argue about the application and functionality of euthanasia, orthothanasia and dysthanasia in ICUs, a literature review of 14 articles was carried out. It was concluded that the knowledge that the professional has in relation to these themes needs to be taken into account and to distinguish the specific theme that is addressed, not forgetting to emphasize the rights provided for in the constitution and the well-being of the paciente and his family.

Resumen: El concepto de “muerte digna” o “buena muerte” ha sido muy difundido entre los profesionales de la salud, que lo manejan de manera rutinaria y experimentan el dilema ético sobre lo que realmente se debe hacer ante un enfermo terminal. Ante esto, el presente estudio tiene como objetivo mostrar los conceptos y cómo los casos de pacientes terminales han sido tratados dentro de las Unidad de Cuidados Intensivos (UCI). Para argumentar respecto de la aplicación y funcionalidad de la eutanasia, la ortotanasia y la distanasia en las UCI, se realizó una revisión bibliográfica de 14 artículos. Se concluyó que se debe considerar el conocimiento del profesional con relación a estos temas y distinguir el tema específico que se aborda, sin olvidar enfatizar los derechos previstos en la Constitución y el bienestar del paciente y su familia.

Resumo: O conceito de morte digna ou boa morte tem sido difundido entre os profissionais de saúde, os quais lidam com isso rotineiramente e vivem o dilema ético sobre o que realmente deve ser feito diante de um paciente terminal. Visto isso, o presente estudo visa mostrar os conceito e como tem sido conduzido os casos de pacientes em fase terminal dentro das Unidades de Terapia Intensiva (UTI). Para argumentar sobre a aplicação e a funcionalidade da eutanasia, ortotanásia e distanásia nas UTIs foi realizada uma revisão bibliográfica de 14 artigos. Concluiu-se que precisa ser levado em consideração o conhecimento que o profissional tem em relação a esses temas e distinguir a temática específica que é tratado, não esquecendo de salientar os direitos previstos na constituição e o bem-estar do paciente e de sua família.

ABSTRACT Objective: To describe the distribution profile of thyroidectomies in Brazil from 2010 to 2020 from a macro-regional perspective. Materials and methods: This is a retrospective, detailed and descriptive study built on secondary data obtained from the Hospital Information System of the Unified Health System (SIH/SUS). We organized the data in tables and grouped them according to the federative unit, macro-region, type of procedure, mortality rate, and year of performance. We performed statistical analysis using the χ2 test to assess the association between the variables, observing a P value of < 0.05 and a confidence interval of 95%. Results: From 2010 to 2020, 160 219 thyroidectomy surgeries were performed, of which 77 812 (48.56%) were total, 38 064 (23.76%) partial and 41 191 (25.70%) oncological.The Southeast was responsible for the largest share of procedures, with 70 745 (44.15%), followed by the Northeast with 43 887 (27.39%). In 2020, the procedure was less performed, with 9226 (5.75%) surgeries. The total mortality rate was 0.16% during the study period. Conclusion: We found that thyroidectomies are carried out mainly in the Southeastern, Northeastern, and Southern regions, and showed a downward trend in 2020, which may be related to the COVID-19 pandemic. In addition, total thyroidectomy is the most performed surgery, and the Northern region had the highest mortality rate.

ABSTRACT Introduction To evaluate the possible effects of the coronavirus disease 2019 (COVID-19) pandemic on the oncologic results of patients with prostate cancer regarding clinical staging, presence of adverse pathological outcomes, and perioperative complications. Materials and methods This retrospective study included patients who underwent radical prostatectomy. The time between biopsy and surgery, staging tests, final histopathological evaluation after surgery, lymphadenectomy rate, postoperative complications, and prostatic specific antigen (PSA) levels (initial and 30 days after surgery) were analyzed and compared in a group of patients before and during the pandemic period. Results We included 226 patients: 88 in the pre-pandemic period and 138 during the pandemic period. There was no statistically significant difference in mean age, body mass index, ASA, pathological locally advanced disease, the proportion of patients who underwent lymphadenectomy, and ISUP grade in the biopsy between the groups. Positive surgical margins, prostatic extracapsular extension, and PSA levels at 30 days were also similar between the groups. The mean time between medical consultation and surgery was longer in the pandemic period than in the pre-pandemic (124 vs. 107 days, p<0.001), and the mean time between biopsy and medical consultation (69.5 days vs. 114 days, p<0.001) and between biopsy and surgery (198.5 days vs. 228 days, p=0.013) was shorter during the pandemic. The incidence of severe early and late perioperative complications was similar between the periods. Conclusions There was no delay between diagnosis and treatment at our institution during the COVID-19 pandemic period. No worsening of the prostate cancer features was observed.

Abstract: The cultural industry assumed greater relevance as a productive system and expanded its market share with different forms of reception, transmission, and communication with the public, increasingly using the so-called classification and recommendation algorithms and manipulation of mass processed data, which do not require cyber-physical systems for cataloging andconstant feedback from all parties involved for cataloging. In this regard, this paper proposes a methodology to support the classification and creation of corresponding groups, automatically, of cultural productions of certain segments through Robot Process Automation (RPA) techniques, to first extract public data created by fans of certain cultural segments, and Latent Dirichlet Allocation (LDA), for the clustering of these productions based on the data of the terms extracted by RPA. As a case study for this proposal, we specifically observed the anime market, defined as an originally Japanese cultural product with high fan engagement and high annual production scale, supported by data obtained from two public databases data: MyAnimeList and AniDB, built collaboratively by fans. The application of the methodology allowed the automatic classification of anime, grouping them into topics that allow the proposal of a new demography of products of this genre in relation to the current one, providing a greater level of detail and allowing to contemplate the expansion of new themes.

Resumen: La industria cultural asumió mayor relevancia como sistema productivo y amplió su cuota de mercado con distintas formas de recepción, transmisión y comunicación con el público, con un creciente uso de los llamados algoritmos de clasificación, recomendación y manipulación de datos procesados en masa, que no requieren sistemas ciber-físicos para la catalogación ni una retroalimentación constante de todas las partes involucradas. En este sentido, este trabajo propone una metodología para apoyar la clasificación y creación de grupos correspondientes de forma automática de obras y producciones culturales de determinados segmentos mediante técnicas de Robot Process Automation (RPA) para extraer, primeramente, datos públicos creados por fans de determinados segmentos culturales, y Latent Dirichlet Allocation (LDA), para la agrupación de estos trabajos a partir de los datos de los términos extraídos por RPA. Como caso de estudio para se observó específicamente el mercado de animes, definido como un producto cultural originariamente japonés con un fuerte compromiso y apoyo de los fans y alta escala de producción anual, sustentado en datos obtenidos de dos bases de datos de carácter público construidos en colaboración por fans: MyAnimeList y AniDB. La aplicación de la metodología propuesta permitió la clasificación automática de animes, agrupándolos en temas que permiten proponer una nueva demografía de obras de este género diferente de la actual, proporcionando un mayor nivel de detalle y permitiendo contemplar la expansión de temas nuevos.

Resumo: A indústria cultural adquiriu maior relevância como sistema produtivo e ampliou sua participação no mercado com diversas formas de recepção, transmissão e comunicação com o público, com utilização cada vez maior dos chamados algoritmos de classificação, recomendação e manipulação de dados processados em massa, os quais prescindem de sistemas ciber-físicos para catalogação e retroalimentação constante por todas as partes envolvidas. Neste sentido, o presente trabalho propõe uma metodologia de apoio à classificação e criação de grupos correspondentes, de forma automática, de obras e produções culturais de determinados segmentos através de técnicas de Robot Process Automation (RPA), para primeiramente extrair dados públicos criados por fãs de certos segmentos culturais, e de Latent Dirichlet Allocation (LDA), para a agrupação destas obras com base nos dados dos termos extraídos por RPA. Como caso de estudo, observou-se em específico o mercado de anime, sendo este definido como um produto cultural originalmente japonês com alto engajamento e apoio dos fãs e alta escala de produção anual, tendo como suporte de dados aqueles obtidos em duas bases de dados públicas, o MyAnimeList e o AniDB, construídos de forma colaborativa por fãs. A aplicação da metodologia proposta permitiu a classificação automática de animes, agrupando-os em tópicos que possibilitam a proposição de uma nova demografia de obras deste gênero diferente em relação à atual, provendo um nível de detalhamento maior e permitindo contemplar a expansão de temáticas novas.

Abstract Background The study of the correlation between social and oral health indicators can contribute to evaluating the impacts of health policies and actions. Objective To investigate the correlation between municipal development indicators and oral health indicators in the metropolitan region of Curitiba, Paraná, Brazil. Method Epidemiological study of the ecological type was carried out, using data from the Municipal Human Development Index (MHDI) of the year 2010, obtained from the Atlas Brasil portal; Ipardes Municipal Performance Index (IPDM) of the years 2015 and 2016, obtained from the Ipardes portal; and oral health indicators from 2015 to 2018, from SIA/SUS. Subsequently, the Spearman correlation test was used. Results There was a statistically significant positive correlation between municipal development indicators and indicators of the first programmatic dental consultation in 2017; a negative correlation between MHDI and tooth extractions, in the years 2015 and 2016; a positive correlation between IPDM and basic individual dental procedures from the years 2015 to 2018. Conclusion There was a significant correlation between the municipal development indicators and the oral health indicators. Municipalities with higher development rates provided greater access to oral health services and lower proportions of tooth extractions per inhabitant.

Resumo Introdução O estudo da relação entre indicadores sociais e indicadores de saúde bucal pode contribuir para a avaliação dos impactos das políticas e ações de saúde. Objetivo Investigar a correlação entre indicadores de desenvolvimento municipal e indicadores de saúde bucal dos municípios integrantes da mesorregião metropolitana de Curitiba, Paraná, Brasil. Método Estudo epidemiológico do tipo ecológico, por meio de dados referentes ao Índice de Desenvolvimento Humano Municipal (IDHM) do ano 2010, obtidos no portal Atlas Brasil; Índice Ipardes de Desempenho Municipal (IPDM) dos anos 2015 e 2016, obtidos no portal do Ipardes; e indicadores de saúde bucal dos anos 2015 a 2018, oriundos do SIA/SUS. Posteriormente, foi empregado o teste de correlação de Spearman. Resultados Verificou-se correlação positiva estatisticamente significativa entre indicadores de desenvolvimento municipal e indicadores de primeira consulta odontológica programática no ano de 2017; correlação negativa entre IDHMs e exodontias nos anos de 2015 e 2016; correlação positiva entre IPDMs e procedimentos odontológicos individuais básicos dos anos 2015 a 2018. Conclusão Houve correlação significativa entre os indicadores de desenvolvimento municipal e os indicadores de saúde bucal. Municípios com maiores índices de desenvolvimento proporcionaram maior acesso aos serviços de saúde bucal e menores proporções de exodontias por habitante.

Abstract Paper aims The first aim is methodological, by developing a conceptual model to describe the internal relationship environment (IRE), the critical factors that impact this environment, the characterization of the parties involved, and their relationships. The second is practical and instrumentalizes the model to measure the effect of differences perceived by internal customers. Originality Distinct works focus on the formulation of management systems, successful implementation, or external and market environmental factors, although there is a lack of studies that relate organizational performance to differences in perceived quality between the parties. Research method The methodology followed a flow of collection/analysis, of the informational data of the company, sketch of the model and flow of information, exploratory focus group, thematic analysis of content, and confirmatory focus group. Then, the procedure of operationalization of the model. Main findings The conceptual model and its instrumentalization describe the apparent relationships between the support team and the operations teams, the underlying relationships of the ERI with the company's management model, and organizational performance. Implications for theory and practice In practice, the proposed measurement instrument allows evaluation of the effects of differences in the perceived quality of internal customers.

ABSTRACT: The present study evaluated germination, production, and morphological composition of Urochloabrizantha intercropped with corn and sorghum; and silage fermentation losses and aerobic stability of intercrop silage using microbial inoculant. Twenty experimental parcels (5.0 × 3.6 m) were used in a blocked randomized design to evaluate four treatments obtained from a 2 × 2 factorial arrangements: I) crop material (corn vs. sorghum) and II) Brachiaria (U. brizantha) establishment (present vs. absent). Corn- and sorghum-brachiaria integrated systems showed similar brachiaria germination, forage yield, and morphological composition. There was no crop and brachiaria interaction effect on the variables related to corn and sorghum plants and the total productivity. Brachiaria decreased the stem diameter and increased the population of maize and sorghum plants. However, it did not affect systems productivity. Microbial inoculation did not affect corn silage effluent losses and reduced sorghum silage effluent losses. In corn silage, brachiaria did not affect gas losses, while in sorghum silage, brachiaria increased the gas losses. Total losses were higher in sorghum silage than in corn silage, which resulted in a lower DM recovery. The treatments did not affect the pH of the silage after aerobic exposure. However, brachiaria increased silage temperature evaluated at 32 and 40 hours after aerobic exposure. Thus, corn or sorghum consortium has similar brachiaria morphological composition and productivity. Moreover, in intercropped silage, brachiaria increases effluent losses and reduces silage aerobic stability.

RESUMO: O presente estudo tem por objetivo avaliar a germinação, produção e composição morfológica de Urochloabrizantha consorciada com milho e sorgo, perdas de fermentação da silagem e estabilidade aeróbia da silagem consorciada com inoculante microbiano. Vinte parcelas experimentais (5.0 × 3.6 m) foram usadas em um delineamento em blocos casualizados para avaliar quatro tratamentos em arranjo fatorial 2 x 2: I) Cultura (milho vs. sorgo) e II) Estabelecimento da Brachiaria (U. brizantha) (presente vs. ausente). Os sistemas integrados milho e sorgo-brachiaria apresentaram germinação, produção de forragem e composição morfológica semelhante. Não houve efeito da interação cultura e braquiária sobre as variáveis relacionadas às plantas de milho e sorgo e a produtividade total. A brachiaria diminuiu o diâmetro do caule e aumentou a população de plantas de milho e sorgo. No entanto, não afetou a produtividade dos sistemas. A inoculação microbiana não afetou as perdas de efluente da silagem de milho e reduziu as perdas de efluente da silagem de sorgo. Na silagem de milho, a brachiaria não afetou as perdas de gás, enquanto na silagem de sorgo, a brachiaria aumentou as perdas de gás. As perdas totais foram maiores na silagem de sorgo do que na silagem de milho, o que resultou em menor recuperação da MS. Os tratamentos não afetaram o pH da silagem pós exposição aeróbia. Contudo, a brachiaria aumentou a temperatura da silagem 32 e 40 horas após exposição aeróbia. Portanto, os consórcios milho e sorgo-brachiaria apresentam composição morfológica e produtividade semelhantes. Além disso, na silagem consorciada, a brachiaria aumenta as perdas por efluentes e reduz a estabilidade aeróbia.

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

Abstract Studying a watershed in the Amazon region requires understanding that this region has national and global relevance. The fact that the study area is located in the so-called arc of deforestation raises the need to understand its context, its vulnerabilities, and its physical, environmental, and anthropic components. This research assesses the environmental vulnerability of the Buriticupu River Watershed in Maranhão State, Brazil. The aim is to foster improvements that may contribute to environmental planning and, specifically, to water resource management. For this purpose, the authors used the Geographic Information System environment to work with Map Algebra, interrelating primary and secondary data on geology, relief, pedology, and land use and land cover to generate synthesis cartography. The results pointed to areas with predominantly medium vulnerability. However, the analyses highlight alluvial plains, which became the most fragile areas from an environmental point of view. This is mainly because these areas comprise water-saturated soils (gleysols), unconsolidated deposits of sand and silt (alluvial deposits), and extensive humid vegetation, characteristics of igapó and floodplain forests. This research generated a document that applies is applicable to the study area. It also provided, in a systemic and integrated way, a product that will help in planning, which is very important for the creation of a watershed committee, something necessary and still embryonic in Maranhão State, Brazil.

Resumo Pesquisar uma bacia hidrográfica na região Amazônica requer assimilar que esta apresenta uma relevância nacional e mundial, estando a área de estudo situada no chamado arco do desmatamento, eleva a necessidade de entender seu contexto, vulnerabilidades e componentes físicos, ambientais e antrópicos. Esta pesquisa objetivou avaliar a vulnerabilidade ambiental da Bacia Hidrográfica do rio Buriticupu/Maranhão, com vistas a fomentar melhorias que possam contribuir com o processo de planejamento ambiental e, especificamente, de recursos hídricos. Para tanto, utilizou-se o ambiente de Sistema de Informação Geográfica para trabalhar com a Álgebra de Mapas, interrelacionando dados primários e secundários sobre a geologia, relevo, pedologia e uso e cobertura da terra, para gerar uma cartografia de síntese. Os resultados apontaram áreas com predominância das classes médias de vulnerabilidade, entretanto, o destaque fica por conta das planícies aluviais, que se tornaram, nas análises, as áreas mais frágeis do ponto de vista ambiental, sobretudo por serem solos saturados em água (gleissolos), depósitos inconsolidados de areia e silte (depósitos aluvionares) e por exibirem extensas vegetações úmidas, características de matas de igapó e de várzea. Este estudo foi capaz de gerar um documento que seja aplicável à área de estudo, além de propiciar, de modo sistêmico e integrado, um produto que contribuirá para possíveis planejamentos, sobretudo para um futuro comitê de bacia hidrográfica, algo necessário e ainda embrionário do Maranhão..

ABSTRACT Purpose: To introduce a new low-cost simulation model for training basic surgical skills. Methods: The training model was made from a mixture of 20 g of acetic silicone with 11 g of maize starch. Validation consisted of serial training sessions, evaluating the mean pre- and post-training time and the mean final score according to the global rating scale. Results: A decrease in the time required to perform the sutures was observed, comparing the average post and pre-training time of each training day, with a significant correlation between the order of training and the time for performing the simulation. Conclusions: The presented model proved to be capable of simulating the basic suture training skills. It is easy to make, has low cost, and can be easily reproduced in educational institutions.

ABSTRACT Elephant grass stands out among lignocellulosic biomass plants utilized for second-generation biofuel production due to several advantageous characteristics compared to other raw materials. Its short production cycle and ability to thrive in adverse soil and climate conditions contribute to its appeal. Additionally, breeders seek genotypes with high productivity potential and adaptability to various favorable cultivation environments. This study aimed to estimate genetic parameters, predict genetic values using mixed models (REML/BLUP), and evaluate stability and adaptability for energy biomass production in elephant grass genotypes. The experiment was conducted in Campos dos Goytacazes, RJ, Brazil, utilizing a two-replicate experimental block design that included 40 elephant grass genotypes. Four harvest assessments were performed between 2016 and 2019. Genetic parameter estimation and selection of superior genotypes based on genetic value using the REML/BLUP procedure were performed using Selegen software. Stability and adaptability analyses were obtained through the harmonic mean of genotypic values (HMGV), enabling the identification of stable and highly productive genotypes. Genotypes 17, 18, 32, 16, 36, 6, 15, 31, and 34 exhibited outstanding performance in terms of HMGV, indicating enhanced stability, adaptability, and simultaneous productivity, thus ensuring robustness in cultivation. These selected genotypes hold potential for future breeding programs aimed at improving elephant grass yield for biomass production.

ABSTRACT Introduction: historically, surgical medical specialties are mostly male, a scenario which, in recent years, has undergone changes. In this sense, despite the relevance of the growth of female participation in the medical career, little is discussed about the distribution between genders of the main surgical medical specialties in the country. Objective: discuss the process of feminization in surgical specialties in Brazil over the last few years, tracing a distribution profile of these specialties. Methods: this is a retrospective and cross-sectional study with secondary data from the Censuses of Medical Demography in Brazil in the years 2011, 2013, 2015, 2018, 2020 and 2023, including the surgical specialties: Urology, Orthopedics and Traumatology, Thoracic Surgery, Neurosurgery, Digestive System Surgery, Cardiovascular Surgery, Hand Surgery, General Surgery, Head and Neck Surgery, Vascular Surgery, Plastic Surgery, Ophthalmology, Coloproctology, Otorhinolaryngology, Pediatric Surgery, and Gynecology and Obstetrics. Results: males prevails in numbers, among the surgical specialties, however, with a lower growth rate compared to females. Specialties such as urology, orthopedics and traumatology and neurosurgery are mostly male, while gynecology and obstetrics are female. Conclusion: it is evident that female participation in the surgical medical field has increased significantly over the last few years.

RESUMO Introdução: historicamente, as especialidades médicas cirúrgicas são, majoritariamente, masculinas, cenário o qual, nos últimos anos, passa por mudanças. Nesse sentido, apesar da relevância do crescimento da participação feminina na carreira médica, pouco se debate sobre a distribuição entre sexos das principais especialidades médicas cirúrgicas no país. Objetivo: discutir o processo de feminização nas especialidades cirúrgicas no Brasil ao longo dos últimos anos, traçando um perfil de distribuição dessas especialidades. Métodos: Trata-se de um estudo retrospectivo e transversal com dados secundários oriundos dos Censos de Demografia Médica no Brasil dos anos de 2011, 2013, 2015, 2018, 2020 e 2023, incluindo as especialidades cirúrgicas:Urologia, Ortopedia e Traumatologia, Cirurgia Torácica, Neurocirurgia, Cirurgia do Aparelho Digestivo, Cirurgia Cardiovascular, Cirurgia da Mão, Cirurgia Geral, Cirurgia de Cabeça e Pescoço, Cirurgia Vascular, Cirurgia Plástica, Oftalmologia, Coloproctologia, Otorrinolaringologia, Cirurgia Pediátrica e Ginecologia e Obstetrícia. Resultados: O sexo masculino prevalece em números, dentre as especialidades cirúrgicas, porém, com menor taxa de crescimento em comparação ao sexo feminino. Especialidades como a urologia, ortopedia e traumatologia e neurocirurgia são majoritariamente masculinas, enquanto a ginecologia e obstetrícia, feminina. Conclusão: evidencia-se que a participação feminina na área médica cirúrgica aumentou significativamente ao longo dos últimos anos.

ABSTRACT State parks are integral protection units created to protect ecosystems. However, anthropic activities may have been previously performed before their creation, forming transitional areas. Studies that evaluate the modifications of edaphic properties in these environments are scarce. The aim of this study was to evaluate the changes in soil properties and litter stock in areas of eucalyptus-forest ecotones. Litter stock (Stocklitter) and total soil organic carbon content and stock (TOCsoil), weighted mean diameter (MWD), origin of aggregates (biogenic or physicogenic) and respective content of total organic carbon (TOCBio and TOCPhy), total organic carbon (TOCAG), soil organic matter chemical fractions [fulvic acid (FAC), humic (HAC), and humin (HUMC)], and particulate, mineral-associated, free light and intra-aggregate light (POC, MAOC, FLFC, and ILFC) soil organic matter, fertility, and glomalin-related soil protein (GRSP) fractions were evaluated in aggregates (layer 0.00-0.10 m) in areas of eucalyptus-forest ecotone (Eco), preserved forest fragment (For), and eucalyptus plantation (Euc), in Nova Baden State Park, Lambari–MG. In the Euc and Eco areas, the highest Stocklitter content was found. Higher values of TOCsoil, TOCAG, GRSP, and MWD were observed in the Euc area. In the biogenic aggregates, the highest content of TOCBio, HAC, HUMC, POC, MAOC, FLFC, and ILFC was determined in detriment of the physicogenic ones. The dynamics of edaphic properties in the Eco area showed greater similarity with the For area than in the Euc area. In general, all vegetation covers contribute to the maintenance of soil quality.

■ ABSTRACT Introduction: Late breast cancer diagnosis increases the number of surgeries, resulting in high mortality and unsightly results. Therefore, the institution of breast reconstruction procedures is essential. Method: Descriptive, quantitative, and retrospective study on authorizations for hospital admission of patients undergoing breast surgical procedures in oncology from 2011 to 2020, whose data were obtained from the DATASUS platform. Results: 7,529 breast cancer surgeries and 1,949 reconstructive surgeries were performed in the North Region. There was an increase in the number of procedures throughout the decade. In all states, it is possible to notice the difference in the number of municipalities of residence compared to the municipalities of hospitalization. Conclusion: It is necessary to establish oncological reference centers, guaranteeing individualized treatment and breast reconstruction.

■ RESUMO Introdução: O diagnóstico tardio do câncer de mama eleva o número de cirurgias, resultando em alta mortalidade e resultado pouco estético. Assim, é fundamental a instituição de procedimentos de reconstrução mamária. Método: Estudo descritivo, quantitativo e retrospectivo sobre as autorizações de internação hospitalar de pacientes submetidos a procedimentos cirúrgicos de mama em oncologia, no período de 2011 a 2020, cujo dados foram obtidos na plataforma DATASUS. Resultados: 7.529 cirurgias de câncer de mama e 1.949 cirurgias reparadoras foram realizadas na Região Norte. Houve aumento do número de procedimentos ao longo da década. Em todos os estados é possível perceber a diferença no número de municípios de residência, comparado aos municípios de internação. Conclusão: Necessita-se instituir centros de referência oncológica, garantindo tratamento individualizado e a reconstrução mamária.