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The development of polymeric biocomposites containing natural fibers has grown over the years due to the properties achieved and its eco-friendly nature. Thus, biocomposites involving a polymer from a renewable source (Biopolyethylene (BioPE)) and babassu fibers (BFs), compatibilized with polyethylene grafted with maleic anhydride (MA) and acrylic acid (AA) (PE-g-MA and PE-g-AA, respectively) were obtained using melt mixing and injection molded into tensile, impact, and HDT specimens. Babassu fiber was characterized with Fourier transform infrared spectroscopy (FTIR), thermogravimetry (TGA), and scanning electron microscopy (SEM). The biocomposites were characterized using torque rheometry, TGA, tensile strength, impact strength, thermomechanical properties, Shore D hardness, and SEM. The data indicate that the torque during the processing of compatibilized biocomposites was higher than that of BioPE/BF biocomposites, which was taken as an indication of a possible reaction between the functional groups. Compatibilization led to a substantial improvement in the elastic modulus, tensile strength, HDT, and VST and a decrease in Shore D hardness. These results were justified with SEM micrographs, which showed babassu fibers better adhered to the surface of the biopolyethylene matrix, as well as an encapsulation of these fibers. The system investigated is environmentally sustainable, and the results are promising for the technology of polymeric composites.

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Our study explored the patterns of bovine brucellosis dissemination in Minas Gerais state, Brazil, by examining data on passive surveillance of bovine brucellosis cases from the Instituto Mineiro de Agropecuaria (IMA) (Animal Health Authority), as well as cattle population and bovine brucellosis testing, from 2011 to 2018 by means of a spatiotemporal analysis. We plotted cases, populations and testing distributions and performed spatial autocorrelation (Moran's I test) and local indicators of spatial autocorrelation (LISA) analyses. Moreover, we assessed the correlation of the spatial distribution and the compiled data (brucellosis cases, cattle populations, and brucellosis testing) by Lee's test. Our results showed that bovine brucellosis cases occurred mainly in the Triângulo Mineiro, Alto Paranaíba and Northwest regions, which reported cases in all analyzed years (2011 to 2018). The cattle population of Minas Gerais was concentrated in the same regions as bovine brucellosis cases, and the performed tests through the analyzed years (2011 to 2018). Moran's I test results of the case data showed significant spatial autocorrelation in 2011, 2015 and 2018 (p value < 0.05), and from 2011 to 2018, the population and testing data were also significant in Moran's I test (p value < 0.01). The results of cluster analysis (LISA) of cases showed clusters mainly in the Triângulo Mineiro, Alto Paranaíba, Northwest and South regions in 2011, 2015 and 2018. The local clusters for cattle populations and brucellosis testing were also observed in the same regions as bovine brucellosis cases in all years (2011 to 2018). The correlation results between clusters (Lee's test) were 0.22 (p value < 0.01) in 2011, 0.15 (p value < 0.01) in 2015 and 0.43 (p value <0.01) in 2018 between cases and populations, and 0.25 (p value <0.01) in 2011, 0.14 (p value <0.01) in 2015 and 0.38 (p value < 0.01) in 2018 for testing and cases. Therefore, our results showed that brucellosis cases were distributed together with cattle populations and brucellosis testing data, indicating that brucellosis in cattle in Minas Gerais state is being identified where there are more animals and where more tests are performed.

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ABSTRACT Objective: to develop and validate the content of an algorithm for planning intravenous medication administration in infants. Method: this is a methodological study of technology development and validity. A scoping review was carried out, which supported the creation of an algorithm by the researchers and its subsequent validity by 13 expert nurses, which took place between November 2021 and March 2022. Items with a Content Validity Index ≥ 0.8 were considered acceptable. Results: thirty-one references were included in the scoping review, organized into five categories: "recommendation for intravenous access", "polypharmacy-related care", "care prior to intravenous medication administration", "venous catheter handling-related care" and "medication infusion-related care". This division supported the algorithm development, which was validated after three rounds, with an overall Content Validity Index of the instrument of 0.91. Conclusion: algorithm validity indicates reliability and accuracy of its content.

RESUMEN Objetivo: desarrollar y validar el contenido de un algoritmo para la planificación de la administración de medicamentos intravenosos en neonatos. Método: se trata de un estudio metodológico de desarrollo y validación de tecnología. Se realizó una revisión de alcance que apoyó la creación del algoritmo por parte de los investigadores y su posterior validación por 13 enfermeras especialistas, que se llevó a cabo entre noviembre de 2021 y marzo de 2022. Se consideraron aceptables los ítems con un Índice de Validez de Contenido ≥ 0,8. Resultados: se incluyeron 31 referencias en la revisión de alcance, organizadas en cinco categorías: "indicación de acceso intravenoso", "cuidados relacionados con la polifarmacia", "cuidados previos a la administración de medicamentos intravenosos", "cuidados relacionados con la manipulación del catéter venoso" y "cuidados relacionados con la infusión de medicamentos". Esta división apoyó el desarrollo del algoritmo, que fue validado después de tres rondas, con un Índice de Validez de Contenido global del instrumento de 0,91. Conclusión: la validación del algoritmo indica confiabilidad y precisión de su contenido.

RESUMO Objetivo: elaborar e validar o conteúdo de um algoritmo para o planejamento da administração de medicamentos intravenosos em neonatos. Método: estudo metodológico de elaboração e de validação de tecnologia. Foi realizada a revisão de escopo que subsidiou a elaboração do algoritmo pelas pesquisadoras e sua posterior validação por 13 enfermeiros especialistas, a qual ocorreu entre novembro de 2021 e março de 2022. Foram considerados aceitáveis os itens com Índice de Validade de Conteúdo ≥ 0,8. Resultados: foram incluídas 31 referências na revisão de escopo, organizadas em cinco categorias: "indicação de acesso intravenoso", "cuidados relacionados à polifarmácia", "cuidados prévios à administração de medicamentos intravenosos", "cuidados relacionados à manipulação do cateter venoso" e "cuidados relacionados à infusão de medicamentos". Essa divisão subsidiou a elaboração do algoritmo, que foi validado após três rodadas, com Índice de Validade de Conteúdo geral do instrumento de 0,91. Conclusão: a validação do algoritmo indica confiabilidade e precisão do seu conteúdo.

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In this work, blends based on poly (lactic acid) (PLA)/acrylonitrile-butadiene-styrene (ABS) compatibilized with maleic anhydride-grafted (SEBS-g-MA) were prepared in a co-rotational twin-screw extruder by varying the concentrations of the compatibilizing agent. The influence of the compatibilizing agent on the morphology, mechanical, thermal, thermomechanical, and rheological properties of the prepared materials was analyzed. The effect of annealing on the properties of the blends was also investigated using injection-molded samples. The X-ray diffraction (XRD) results proved that the increments in crystallinity were an effect of annealing in the PLA/ABS/SEBS-g-MA blends, resonating at higher heat deflection temperatures (HDTs). The impact strength of the PLA/ABS blends compatibilized with 10 wt% SEBS-g-MA was significantly increased when compared to the PLA/ABS blends. However, the hardness and elastic modulus of the blends decreased when compared to neat PLA. The refined morphology shown in the scanning electron microscopy (SEM) analyses corroborated the improved impact strength promoted by SEBS-g-MA. The torque rheometer degradation study also supported the increased compatibility between SEBS-g-MA, PLA, and ABS. The TGA results show that the PLA/ABS and PLA/ABS/SEBS-g-MA blends are more thermally stable than the neat PLA polymer at higher temperatures. The results showed that the ideal composition is the heat-treated PLA/ABS/SEBS-g-MA (60/30/10 wt%), given the high impact strength and HDT results. The results of this work in terms of mechanical improvement with the use of compatibilizers and annealing suggest that the PLA/ABS/SEBS-g-MA system can be used in the production of 3D-printing filaments.

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The aim of this study was to analyze the demographic, clinical, and hematological aspects of the population in a dog shelter located in the municipality of Lavras, Brazil. All animals were microchipped and evaluated by veterinarians. Whole blood samples were obtained from 329 dogs in the months of July-August 2019 and from 310 dogs in the months of January-February 2020. Most of the dogs were of mixed breed, received anti-rabies and polyvalent vaccines (100%), were dewormed (100%), and were spayed/neutered (98.59%), with a predominance of adult (86.51%), short-hair (67.51%), normal body condition (65.57%), medium-size (62.57%), and female (62.36%). The main clinical alterations detected were enlarged lymph nodes (38.69%), skin lesions (31.50%), overweight (23.32%), obesity (6.07%), elevated temperature (17.05%), and ear secretion (15.72%). Regarding hematological alterations, thrombocytopenia (36.31%), leukopenia (15.92%), anemia with decreased hemoglobin values (10.60%), hematocrit (9.70%), and red blood cells (5.14%) were observed. Most of the shelter dogs were apparently healthy, but specific measures for nutritional, dermatological, otological and disease management should be implemented once the health changes are verified, as they impact the general state of the population and adoptions.

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Introdução:Mulheres têm sido subjugadas pela violência em prol da identidade machista e domínio viril do homem. Objetivo: analisar os atendimentos de emergência em mulheres vítimas de violência na região de cabeça e pescoço. Metodologia:Análise de dados do inquérito de Vigilância e Acidentes em 25 capitais e no Distrito Federal no ano de 2011 por meio de amostra de 351 atendimentos de mulheres entre 15 e 49 anos em relação à ocorrência de violência na região de cabeça e pescoço. Resultados:A ocorrência da violência foi predominante em mulheres pretas (70,8%),jovens (68,3% 20-29 anos)e com pouca escolaridade (< 8 anos de estudo), sendo mais frequentes no domicílio (45,5%), cometida de forma intencional (86,9%) por um agressor do sexo masculino (77,4%), identificado como parceiro ou ex-parceiro íntimo (44,5%), sendo aface (87,0%) a região de cabeça/pescoço mais atingida. Conclusões:A violência contra a mulher perpassa a discussão das desigualdades de gênero, interseccionalidade e capital social. O importante não é o gênero em si, mas a junção do gênero, raça e classe socioeconômica. Isto requer políticas públicas intersetoriais e mobilização social em prol do capital social. Para tanto, o modelo de Redes de Atenção, com a consequente multiprofissionalidade, intersetorialidade e transdisciplinaridadeé fundamental. Isto pressupõe, inclusive, a maior inserção do cirurgião-dentista na identificação e acolhimento das vítimas para posteriores encaminhamentos (AU).

Introduction:Women have been subjugated by violence in favor of the male identity and virile dominance of men. Objective:to analyze emergency care for women victims of violence in the head and neck region. Methodology:Analysis of data from the Surveillance and Accident Survey in 25 state capitals and the Federal District in 2011 througha sample of 351 visits to women between 15 and 49 years old regarding the occurrence of violence in the head and neck region. Results:The occurrence of violence was predominant in black women (70.8%), young (68.3% 20-29 years) and with little schooling (< 8 years of study), being more frequent at home (45.5 %), committed intentionally (86.9%) by a male aggressor (77.4%), identified as a partner or former intimate partner (44.5%), with the face (87.0%) the most affected head/neck region. Conclusions:Violence against women permeates the discussion of gender inequalities, intersectionality and social capital. What is important is not gender per se, but the combination of gender, race and socioeconomic class. This requires intersectoral public policies and social mobilization in favor of social capital. Therefore, the model of Care Networks, with the consequent multiprofessionality, intersectoriality and transdisciplinarity is fundamental. This presupposes, including, greater involvement of the dental surgeon in the identification and reception of victims for subsequent referrals (AU).

Introducción:Las mujeres han sido subyugadas por la violencia a favor de la identidad masculina y el dominio viril de los hombres. Objetivo:analizar la atención de emergencia a mujeres víctimas de violencia en la región de cabeza y cuello. Metodología:Análisis de datos de la Encuesta de Vigilancia y Accidentalidad en 25 capitales de estado y Distrito Federal en 2011 a través de una muestra de 351 visitas a mujeres entre 15 y 49 años sobre la ocurrencia de violencia en la región de cabeza y cuello. Resultados: Predominó la ocurrencia de violencia en mujeres negras (70,8 %), jóvenes (68,3 % 20-29 años) y con poca educación(< 8 años de estudio), siendo más frecuente en el hogar (45,5 %), cometida intencionalmente (86,9%) por un agresor masculino (77,4%), identificado como pareja o ex pareja íntima (44,5%), siendo el rostro (87,0%) la región de cabeza/cuello más afectada. Conclusiones:La violencia contra las mujeres permea la discusión sobre las desigualdades de género, la interseccionalidad y el capital social. Lo importante no es el género per se, sino la combinación de género, raza y clase socioeconómica. Esto requiere políticas públicas intersectoriales y movilización social a favor del capital social. Por ello, es fundamental el modelo de Redes de Atención, con la consiguiente multiprofesionalidad, intersectorialidad y transdisciplinariedad. Esto presupone incluso una mayor inserción del cirujano dentista en la identificación y recepción de las víctimas para su posterior derivación (AU).

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Brucellosis in equines, including horses, donkeys, and mules, is characterized by abscesses in tendons, bursae, and joints. Reproductive disorders, which are common in other animals, are rare in both males and females. Joint breeding of horses, cattle, and pigs was found as the main risk factor for equine brucellosis, with the transmission from equines to cattle or among equines possible, although unlikely. Hence, evaluation of the disease in equines can be considered an indirect indicator of the effectiveness of brucellosis control measures employed for other domestic species. Generally, the disease in equines reflects disease status in the sympatric domestic species, mainly cattle. It is important to note that in equines, the disease has no validated diagnostic test, which limits the interpretation of available data. Finally, it is important to mention that equines also represent significant Brucella spp. infection sources for humans. Considering the zoonotic aspect of brucellosis, the significant losses due to infection, and the representativeness of horses, mules, and donkeys in the society, as well as the continuous efforts to control and eradicate the disease in livestock, in this review, we covered the various aspects of brucellosis in equines and compile the sparse and diffuse information on the subject.

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O presente estudo teve como objetivo estudar a associação entre a exposição ao glifosato e a ocorrência do Transtorno do Espectro Autista (TEA). Trata-se de um estudo documental com busca de dados acerca da prevalência do TEA (Centers of Disease Control and Prevention) e de um levantamento para verificar o princípio ativo do praguicida mais usado no Brasil (Instituto Brasileiro do Meio Ambiente e dos Recursos Naturais Renováveis) e no mundo (United States Evironmental Prevention Agency). Os resultados mostraram que a prevalência do TEA aumentou ao longo dos anos. Do mesmo modo, o uso e a compra de praguicidas também aumentaram, sendo o glifosato o princípio ativo mais usado. Ainda que os resultados apontem a existência de uma relação entre a exposição ao glifosato e a ocorrência de autismo, são necessários mais estudos para afirmar o potencial neurotóxico do glifosato e sua associação com o nascimento de crianças autistas.

The present study aimed to study the association between exposure to glyphosate and the occurrence of Autistic Spectrum Disorder (ASD). This is a documental study with search for data about the prevalence of ASD (Centers of Disease Control and Prevention) and a survey to verify the active principle of the most used pesticide in Brazil (Brazilian Institute of Environment and Renewable Natural Resources) and worldwide (United States Environmental Prevention Agency). The results showed that the prevalence of ASD increased over the years. Likewise, the use and purchase of pesticides have also increased, with glyphosate being the most widely used active ingredient in the world. Although the results point to the existence of a relationship between exposure to glyphosate and the occurrence of autism, further studies are needed to confirm the neurotoxic potential of glyphosate and its association with the birth of autistic children.

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We aimed to evaluate the characteristics, resource use and outcomes of critically ill patients with cancer according to appropriateness of ICU admission. This was a retrospective cohort study of patients with cancer admitted to ICU from January 2017 to December 2018. Patients were classified as appropriate, potentially inappropriate, or inappropriate for ICU admission according to the Society of Critical Care Medicine guidelines. The primary outcome was ICU length of stay (LOS). Secondary outcomes were one-year, ICU, and hospital mortality, hospital LOS and utilization of ICU organ support. We used logistic regression and competing risk models accounting for relevant confounders in primary outcome analyses. From 6700 admitted patients, 5803 (86.6%) were classified as appropriate, 683 (10.2%) as potentially inappropriate and 214 (3.2%) as inappropriate for ICU admission. Potentially inappropriate and inappropriate ICU admissions had lower likelihood of being discharged from the ICU than patients with appropriate ICU admission (sHR 0.55, 95% CI 0.49-0.61 and sHR 0.65, 95% CI 0.53-0.81, respectively), and were associated with higher 1-year mortality (OR 6.39, 95% CI 5.60-7.29 and OR 11.12, 95% CI 8.33-14.83, respectively). Among patients with appropriate, potentially inappropriate, and inappropriate ICU admissions, ICU mortality was 4.8%, 32.6% and 35.0%, and in-hospital mortality was 12.2%, 71.6% and 81.3%, respectively (p < 0.01). Use of organ support was more common and longer among patients with potentially inappropriate ICU admission. The findings of our study suggest that inappropriateness for ICU admission among patients with cancer was associated with higher resource use in ICU and higher one-year mortality among ICU survivors.

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Objetivo: identificar os desafios e as possibilidades de coparticipação das puérperas e dos acompanhantes no cuidado seguro na maternidade. Materiais e Métodos: estudo qualitativo realizado com 23 puérperas e 11 acompanhantes em uma maternidade de Belo Horizonte, entre março e julho de 2019. Os dados foram coletados por meio de entrevistas com roteiros semiestruturados e submetidos à análise de conteúdo temática, segundo o referencial teórico da segurança do paciente. Resultados: emergiram duas categorias: contribuição da puérpera e do acompanhante para o cuidado seguro; e desafios e contribuições para o alcance da coparticipação das puérperas e dos acompanhantes na segurança do paciente. Conclusões: acompanhantes e puérperas se reconhecem como coparticipantes na promoção da segurança do paciente, porém foi observada a falta de conhecimento e estímulo em relação à participação desses atores. Salienta-se a importância de utilizar tecnologias educativas para incluí-los como parceiros ativos na segurança do paciente.(AU)

Objective: to identify the challenges and possibilities of co-participation of puerperal women and companions in safe maternity care. Materials and Methods: qualitative study carried out with 23 mothers and 11 companions in a maternity hospital in Belo Horizonte, between March and July 2019. Data were collected through interviews with semi-structured scripts and submitted to thematic content analysis, according to the theoretical framework of patient safety. Results: two categories emerged: contribution of the puerperal woman and the companion for safe care; and challenges and contributions to achieving co-participation of puerperal women and companions in patient safety. Conclusions: companions and puerperal women recognize themselves as co-participants in promoting patient safety, however, a lack of knowledge and encouragement regarding the participation of these actors was observed. The importance of using educational technologies to include them as active partners in patient safety is highlighted.(AU)

Objetivo: identificar los desafíos y posibilidades de la coparticipación de puérperas y acompañantes en la atención a la maternidad segura. Materiales y Métodos: estudio cualitativo realizado con 23 puérperas y 11 acompañantes en una maternidad de Belo Horizonte, entre marzo y julio de 2019. Los datos fueron recogidos a través de entrevistas con guiones semiestructurados y sometidos a análisis de contenido temático de acuerdo con el marco teórico de la seguridad del paciente. Resultados: surgieron dos categorías: Contribución de la puérpera y del acompañante para el cuidado seguro; Desafíos y aportes para lograr la coparticipación de las puérperas y acompañantes en la seguridad del paciente. Conclusiones: los acompañantes y puérperas se reconocen como copartícipes en la promoción de la seguridad del paciente, pero falta conocimiento y estímulo en cuanto a la participación de estos actores. Se destaca la importancia de utilizar tecnologías educativas para incluirlos como socios activos en la seguridad del paciente.(AU)

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Resumo O acesso integral à saúde é um problema global. Estima-se, que um terço da população não tenha acesso regular aos medicamentos essenciais. A Pessoa Privada de Liberdade (PPL) é uma das que apresenta situações de iniquidades de acesso. Diante da singularidade do sistema penitenciário, esta pesquisa objetivou identificar os fatores determinantes no acesso aos medicamentos disponibilizados pelo Sistema Único de Saúde (SUS) para a PPL paraense. Trata-se de uma pesquisa aplicada, exploratória, qualitativa, realizada no período de agosto de 2019 a fevereiro de 2020, utilizando-se, também do framework APOTECA. Evidenciou-se na análise do framework APOTECA que fatores técnicos, políticos e administrativos são identificados como principais barreiras na garantia ao acesso equânime aos medicamentos disponibilizados pelo SUS para a PPL paraense. A privação de liberdade, vulnerabilidade social e outros fatores inerentes a realidade carcerária dificultam a efetivação do direito à saúde das PPL, sendo que diversos desafios devem ser superados quanto a garantia ao acesso equânime aos medicamentos.

Abstract Comprehensive access to health is a global issue. One-third of the population does not have regular access to essential medicines. People Deprived of Liberty (PDL) are one of those people in a situation of unequal access. Given the uniqueness of the penitentiary system, this research aimed to identify the determining factors in the access to medicines made available by the Brazilian Unified Health System (SUS) for the PDLs in Pará, Brazil. The applied, exploratory, qualitative research was conducted from August 2019 to February 2020 using the APOTECA framework. The APOTECA framework analysis revealed that technical, political, and administrative factors are the main hurdles to guaranteeing equal access to medicines made available by the SUS for the PDLs in Pará. The deprivation of liberty, social vulnerability, and other factors inherent to the prison reality hinder the implementation of PDLs' right to health, and several challenges must be overcome to secure equal access to medicines.

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Comprehensive access to health is a global issue. One-third of the population does not have regular access to essential medicines. People Deprived of Liberty (PDL) are one of those people in a situation of unequal access. Given the uniqueness of the penitentiary system, this research aimed to identify the determining factors in the access to medicines made available by the Brazilian Unified Health System (SUS) for the PDLs in Pará, Brazil. The applied, exploratory, qualitative research was conducted from August 2019 to February 2020 using the APOTECA framework. The APOTECA framework analysis revealed that technical, political, and administrative factors are the main hurdles to guaranteeing equal access to medicines made available by the SUS for the PDLs in Pará. The deprivation of liberty, social vulnerability, and other factors inherent to the prison reality hinder the implementation of PDLs' right to health, and several challenges must be overcome to secure equal access to medicines.

O acesso integral à saúde é um problema global. Estima-se, que um terço da população não tenha acesso regular aos medicamentos essenciais. A Pessoa Privada de Liberdade (PPL) é uma das que apresenta situações de iniquidades de acesso. Diante da singularidade do sistema penitenciário, esta pesquisa objetivou identificar os fatores determinantes no acesso aos medicamentos disponibilizados pelo Sistema Único de Saúde (SUS) para a PPL paraense. Trata-se de uma pesquisa aplicada, exploratória, qualitativa, realizada no período de agosto de 2019 a fevereiro de 2020, utilizando-se, também do framework APOTECA. Evidenciou-se na análise do framework APOTECA que fatores técnicos, políticos e administrativos são identificados como principais barreiras na garantia ao acesso equânime aos medicamentos disponibilizados pelo SUS para a PPL paraense. A privação de liberdade, vulnerabilidade social e outros fatores inerentes a realidade carcerária dificultam a efetivação do direito à saúde das PPL, sendo que diversos desafios devem ser superados quanto a garantia ao acesso equânime aos medicamentos.

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The aim of this systematic review was to investigate the prevalence of leptospirosis among stray and sheltered dogs worldwide. Six databases were searched, which resulted in the retrieval of 476 articles. Sixty articles were selected for analysis according to 10 quality criteria. Among the selected papers, 26 papers [43.4% (26/60)] met five of the 10 quality criteria established, 10 papers [16.7% (10/60)] met three criteria, nine papers [15.0% (9/60)] met four criteria, six papers [10.0% (6/60)] met six criteria, four papers [6.7% (4/60)] met eight criteria, and three papers [5.0% (3/60)] met nine of the 10 criteria, whereas two papers [1.7% (1/60)] met two and seven [1.7% (1/60)] criteria. Publications originated mainly from the Americas [45.0% (27/60)] and in the last 16 years (2003-2019) [81.7% (49/60)], and most of the sampled dogs were stray dogs [65.0% (39/60)]. The most commonly used diagnostic test for leptospirosis was the microscopic agglutination test [78.4% (47/60)] followed by polymerase chain reaction [21.7% (13/60)], and the most common serovars were Canicola [71.4% (35/49)], Icterohaemorrhagiae [65.3% (32/49)], Grippotyphosa [40.8% (20/49)], and Pomona [40.8% (20/49)]. In conclusion, our results showed that Leptospira spp. are present in unowned dogs worldwide; however, the low-methodological quality of the recovered cross-sectional studies precluded a meta-analysis.

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BACKGROUND: Polypharmacy is commonly related to poor drug adherence, decreased quality of life and inappropriate prescribing in eldery. Furthermore, this condition also leads to a higher utilization of health services resources, due to the increased risk of adverse drug events, length of stays in hospitals and readmissions rates after discharge. OBJECTIVE: This Systematic Review aimed to synthesize the current evidence that evaluates pharmaceutical services on polymedicated patients, from an economic perspective. METHODS: Systematic searches were conducted in MEDLINE, SCOPUS and Cochrane Library databases to identify studies that were published until January 2021. Experimental and observational studies were included in this review, using strict inclusion/exclusion criteria and were assessed for quality using the following tools: RoB and ROBINS-I. Two independent reviewers selected the articles and extracted the data. RESULTS: 3,662 articles were retrieved from the databases. After the screening, 18 studies were included: 9 experimental and 9 observational studies. The studies reported that the integration of the pharmacist as a member of the healthcare team provides an optimized use of pharmacotherapy to polymedicated patients and contributes to health promotion, providing reduction of spending on medication, reduction of expenses related to emergency care and hospitalizations and other medical expenses. The ECRs made cost-effectiveness or cost-benefit analysis, and most of the Non Randomized studies had statistically significant cost savings even considering the expenses of pharmaceutical assistance. Experimental studies reported a cost reduction varying between US$ 193 to US$ 4,966 per patient per year. Furthermore, observational studies estimated a cost reduction of varying from US$ 3 to US$ 2,505 per patient per year. The cost savings are related to decrease in emergency visits and hospitalizations, through pharmacist intervention (medication review and pharmacotherapy follow-up). CONCLUSIONS: Considering the set of studies included, pharmaceutical care services directed to polymedicated patients may cooperate to save financial resources. Most of the interventions showed positive economic trends and also contributed to improving clinical parameters and quality of life. However, due to the majority of the studies having exploratory or qualitative methodology, it is essential to carry out more robust studies, based on full economic evaluation.

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In this work, recycled poly(ethylene terephthalate) (PETR) was blended with virgin high-density polyethylene (HDPE) in an internal mixer in an attempt to obtain a material with improved properties. A compatibilizer (PE-g-MA) and a chain extender (Joncryl) were added to the PETR/HDPE blend and the rheological and thermal properties of the modified and unmodified blends as well as those of virgin PET with virgin HDPE (PETV/HDPE). All the blends were characterized by torque rheometry, differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA). The data obtained indicate that the incorporation of either the chain extender or the compatibilizer agent led to increases in torque (and hence in viscosity) of the blend compared to that of the neat polymers. The joint incorporation of the chain extender and compatibilizer further increased the viscosity of the systems. Their effect on the crystallinity parameters of HDPE was minimal, but they reduced the crystallinity and crystallization temperature of virgin and recycled PET in the blends. The thermal stability of the PETR/HDPE blend was similar to that of the PETV/HDPE blend, and it was not affected by the incorporation of the chain extender and/or compatibilizer.

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BACKGROUND: Medical adhesives are used to affix components to the skin. They are part of procedures performed by medical specialties because of their participation as constituents of different products, such as tapes, dressings, and electrodes. AIM: This study aims to assess the prevalence of, and factors associated with, the development of medical adhesive-related skin injuries (MARSIs) in patients treated with medical tapes in the neonatology department of a large teaching hospital in Brazil. STUDY DESIGN: Cohort study. METHODS: All premature newborns (gestational age from 28 to <37 weeks) admitted in the neonatal intensive care unit of a teaching hospital, from March to August 2019, were followed up. Neonate skin condition was assessed based on the Neonatal Skin Condition Scale (NSCS). Data analyses were conducted in R software. RESULTS: In total, 46 premature newborns were included in the study; 552 evaluations were performed-mean of 11.7 per patient. Most neonates (n = 41; 89.1%) used adhesive tapes, either paper tape (n = 37; 80.4%) or transparent film dressing (n = 34; 73.9%). Newborns' face and head were the most affected body regions (n = 125; 50.2%). Eight patients had MARSIs (19.5% of patients who used tape). NSCS scores (P value <.001) and the adopted warming system (P value = .01302) were associated with the occurrence of MARSIs. Incubators seem to be a protective factor for MARSI (OR = 0.048; IC95% = 0.0008-0.75; P value = .013). CONCLUSION: Adhesive tapes in premature newborns should be considered a risk factor for injuries. Although NSCS showed mild-to-moderate impairment and lesion severity was low, this event is relatively frequent in neonatal units. RELEVANCE TO CLINICAL PRACTICE: Awareness of the risk associated with adhesive tape application and removal in newborns allow health services to better address the problem by enforcing good practices, elaborating better protocols, qualifying the health care professionals, and potentially selecting softer tapes for neonates.

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BACKGROUND: Human leptospirosis is responsible for great losses and deaths, especially in developing countries, which can be mitigated by knowing the correct health indicators and climate influence on the disease. METHODS: Leptospirosis cases and deaths, population and precipitation were recovered from different databases (2007-2019). Annual incidence, mortality and case fatality rates (CFRs) of human leptospirosis and average precipitation were calculated for Brazil and its regions. Time series analysis using an moving average with external variable (ARMAX) model was used to analyse the monthly contribution and precipitation influence over leptospirosis cases for each Brazilian region and for the whole country. A forecast model to predict cases for 2020 was created for Brazil. RESULTS: Human leptospirosis exhibited heterogeneous distribution among Brazilian regions, with most cases occurring during the rainy season and precipitation influenced the disease occurrence in all regions but the South. The forecast model predicted 3276.99 cases for 2020 (mean absolute percentage error 14.680 and root mean square error 53.013). Considering the annual average for the period, the leptospirosis incidence was 1913 cases per 100 000 inhabitants, mortality was 0.168 deaths per 100 000 inhabitants and the CFR was 8.83%. CONCLUSIONS: The models built can be useful for planning leptospirosis surveillance and control actions for the whole country and its regions and, together with the health indicators, revealed no uniform epidemiological situation of leptospirosis in Brazil.

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Abstract Substance use disorder is one of the major social and public health problems in the world. The present study analyzed the pharmacoepidemiological profile of patients treated at the Psychosocial Treatment Center for Alcohol and Substance Use Disorders (CAPS-AD) for treatment of alcohol use disorders (AUD), cocaine use disorders (CUD) and concomitant alcohol and cocaine use disorders (A-CUD) in the city of Betim-MG. The study used quantitative and descriptive data and was based on the evaluation of medical records of patients attended from January to December 2016. After analyzing 295 medical records, the majority of study participants were male (83.7 %) with an average age of 46.26 for AUD, 28.88 for CUD and 34.29 for A-CUD. The most prescribed drugs for AUD were diazepam (54.1 %), thiamine (37 %), complex B vitamins (29.5 %), and disulfiram (2.7 %); for CUD, diazepam (26.9 %) and haloperidol (23.1 %). It should be noticed that although contraindicated by the guidelines, chlorpromazine (42.3 %, 25.3 %, 20.3 %) was prescribed for CUD, AUD, and A-CUD respectively. Knowing the pharmacoepidemiological profile of CAPS-AD patients is extremely important for making decisions regarding which medicines to make available to the population.

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