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Hábitos alimentares inadequados, sedentarismo e a maior expectativa de vida da população contribuem significativamente para a prevalência da síndrome metabólica. Essa doença predispõe uma pessoa a desenvolver diabetes mellitus tipo 2 e doenças cardiovasculares, as quais têm um amplo impacto na saúde pública, induzindo sobrecarga no sistema de saúde e reduzindo a qualidade de vida dos indivíduos afetados. A síndrome metabólica é uma doença multifatorial e está relacionada ao processo de envelhecimento, contudo, ainda há uma lacuna significativa, em termos de estudos, sobre a prevalência da condição em populações idosas. Nesse contexto, o presente estudo objetivou rastrear a prevalência da síndrome metabólica em participantes da Universidade Aberta da Terceira Idade (UNATI), localizada em Francisco Beltrão, Paraná. Os critérios diagnósticos de síndrome metabólica abordados nesta pesquisa incluem: circunferência abdominal ≥ 90 cm para homens e ≥ 80 cm para mulheres, triglicerídeos ≥ 150 mg/dL, HDL ≤ 40 mg/dL para homens e ≤ 50 mg/dL para mulheres, pressão arterial sistólica ≥ 130 mmHg e/ou pressão arterial diastólica ≥ 85 mmHg ou estar em farmacoterapia para hipertensão, além de glicemia de jejum ≥ 100 mg/dL ou estar em tratamento farmacológico para diabetes. Um total de 44 idosos foram avaliados, apresentando uma média de idade de 66,9 ± 7,1 anos, com uma predominância de mulheres (88%). Os resultados revelaram uma prevalência alarmante de síndrome metabólica, atingindo 36,4% da amostra estudada. Além disso, observou-se uma alta prevalência de condições associadas, como hipertensão arterial (67,2%), sobrepeso (58,6%) e obesidade visceral (31%). Esses achados ressaltam a importância da implementação de medidas preventivas direcionadas à promoção da qualidade de vida saudável e ao controle dos fatores de risco metabólicos.

Inadequate dietary habits, sedentary lifestyle, and increased life expectancy significantly contribute to the prevalence of metabolic syndrome. This condition predisposes an individual to develop type 2 diabetes mellitus and cardiovascular diseases, which have a broad impact on public health, inducing a burden on the healthcare system and reducing the quality of life of affected individuals. Metabolic syndrome is a multifactorial disease and is related to the aging process; however, there is still a significant gap in terms of studies on the prevalence of the condition in elderly populations. In this context, this study aimed to screen the prevalence of metabolic syndrome in participants of the Open University for the Third Age (UNATI), located in Francisco Beltrão, Paraná. The diagnostic criteria for metabolic syndrome addressed in this research include: abdominal circumference ≥ 90 cm for men and ≥ 80 cm for women, triglycerides ≥ 150 mg/dL, HDL ≤ 40 mg/dL for men and ≤ 50 mg/dL for women, systolic blood pressure ≥ 130 mmHg and/or diastolic blood pressure ≥ 85 mmHg or being on pharmacotherapy for hypertension, in addition to fasting glucose ≥ 100 mg/dL or being on pharmacological treatment for diabetes. A total of 44 elderly individuals were evaluated, with a mean age of 66.9 ± 7.1 years, predominantly women (88%). The results revealed an alarming prevalence of metabolic syndrome, affecting 36.4% of the studied sample. Furthermore, a high prevalence of associated conditions was observed, such as arterial hypertension (67.2%), overweight (58.6%), and visceral obesity (31%). These findings underscore the importance of implementing preventive measures aimed at promoting healthy lifestyles and controlling metabolic risk factors.

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Introduction: High blood pressure (HBP) is the leading cause of death from cardiovascular disease. Despite the advances, the percentage of undiagnosed and untreated hypertensive patients is 58.4%. The evaluation of cognitive damage in HBP focuses on preventing stroke, while functional damage is ignored. This inadequate management may be multifactorial. The objective was to analyze the opinions that doctors have about the relationship between high blood pressure and cognitive damage. Methodology: Observational, descriptive, cross-sectional study developed in the period between August 2020 and August 2023. Analysis of data obtained from a self-administered, anonymous and voluntary questionnaire. Revealing information on the professional profile, knowledge of HBP, its link with cognitive impairment (CD), diagnosis and treatment. Results: 222 professionals were included, 215 (96.8%) agree with the existence of a link between HBP and other cardiovascular risk factors in CD, and 218 (98.1%) acknowledge assisting patients at risk of suffering from CD. The CD evaluation is carried out in selected cases by 132 (59.4%) participants and 59 (26.7%) always do it. Of those who perform evaluation, 103 (54%) use the Mini Mental State Examination (MMSE), 10 (5.2%) use the Montreal Cognitive Assessment (MoCA) and 9 (4.7%) use the Clock Drawing Test. Regarding the decrease in blood pressure in elderly patients and the link with risk of CD: 54 (24.3%) do not recognize risk and 65 (29.2%) recognize a moderate-high risk. In reference to the implication of the treatment of cardiovascular disease and CD: 217 (97.7%) recognized a beneficial effect. Discussion: Given the recognition of the link between HBP and CD, it would be expected that CD would be investigated in the vast majority, however only 26.7% always evaluate it. There is no consensus on the method, the MMSE being the most used, with a low application of the MoCA test and/or Clock Drawing Test, the latter being the ones that evaluate executive function, mostly altered in CD linked to HBP. Although the treatment of cardiovascular disease is recognized as beneficial with respect to CD, the control of HBP in older adults is considered risky. A diagnosis is made of a situation where a disparity is evident between what one recognizes as knowing and what one claims to do. Conclusions: The role of vascular disease in functional brain damage is recognized, considering it necessary to know the cognitive status of patients, however there is a low application of screening tests that evaluate executive function. In this context, a gap between medical knowledge and practice is shown.

Introdução: A hipertensão arterial (HA) é a principal causa de morte por doenças cardiovasculares. Apesar dos avanços, o percentual de hipertensos não diagnosticados e não tratados é de 58,4%. A avaliação do dano cognitivo na hipertensão concentra-se na prevenção do acidente vascular cerebral, enquanto o dano funcional é ignorado. Esse manejo inadequado pode ser multifatorial. É objetivo fue analisar a opinião dos médicos sobre a relação entre hipertensão arterial e danos cognitivos. Metodologia: Estudo observacional, descritivo, transversal desenvolvido no período entre agosto de 2020 e agosto de 2023. Análise de dados obtidos a partir de questionário autoaplicável, anônimo e voluntário. Revelar informações sobre o perfil profissional, conhecimento sobre a HA, sua ligação com o comprometimento cognitivo (DC), diagnóstico e tratamento. Resultados: Foram incluídos 222 profissionais, 215 (96,8%) concordam com a existência de ligação entre hipertensão e outros fatores de risco cardiovascular na DC e 218 (98,1%) reconhecem ajudar pacientes com risco de sofrer de D.C. A avaliação da DC é realizada em casos selecionados por 132 (59,4%) participantes e 59 (26,7%) a fazem sempre. Dos que realizam avaliação, 103 (54%) utilizam o Mini Exame do Estado Mental (MEEM), 10 (5,2%) utilizam a Avaliação Cognitiva de Montreal (MoCA) e 9 (4,7%) utilizam o Clock Drawing Test. Em relação à diminuição da pressão arterial em pacientes idosos e a ligação com o risco de DC: 54 (24,3%) não reconhecem risco e 65 (29,2%) reconhecem risco moderado-alto. Em referência à implicação do tratamento de doenças cardiovasculares e DC: 217 (97,7%) reconheceram o efeito benéfico. Discussão: Dado o reconhecimento da ligação entre hipertensão e DC, seria de esperar que a DC fosse investigada na grande maioria, no entanto apenas 26,7% sempre a avaliam. Não há consenso sobre o método, sendo o MEEM o mais utilizado, com baixa aplicação do teste MoCA e/ou Clock Drawing Test, sendo estes últimos os que avaliam a função executiva, majoritariamente alterada nos DC vinculados à HA. Embora o tratamento das doenças cardiovasculares seja reconhecido como benéfico em relação à DC, o controle da HA em idosos é considerado arriscado. É feito um diagnóstico de uma situação em que é evidente uma disparidade entre o que se reconhece como saber e o que se afirma fazer. Conclusões: O papel da doença vascular no dano cerebral funcional é reconhecido, considerando-se necessário conhecer o estado cognitivo dos pacientes, porém há baixa aplicação de testes de triagem que avaliam a função executiva. Nesse contexto, evidencia-se uma lacuna entre o conhecimento e a prática médica.

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Introducción. El yodo desempeña un rol fundamental en el metabolismo, el crecimiento y el desarrollo humano. Durante el embarazo y la infancia, la demanda de este micronutriente aumenta considerablemente. La tirotropinemia neonatal (TSHn) aumentada, definida como TSHn ≥5 mUI/l, es un marcador que señala la deficiencia de yodo en una población cuando su prevalencia supera el 3 %. Objetivo. Determinar la prevalencia de TSHn ≥ 5 en La Pampa durante el período 2021-2022, analizar su correlación con diferentes variables y compararla con datos de una cohorte histórica. Población y métodos. Estudio transversal, de diseño descriptivo-analítico, sobre una población de neonatos nacidos en las cinco zonas sanitarias de la provincia de La Pampa durante los años 2021 y 2022. Resultados. De los 5778 neonatos evaluados, el 9,6 % presentó niveles de TSHn ≥5 mUI/l. El 70,4 % de estas mediciones fueron realizadas después del tercer día de vida. No se observaron diferencias significativas en la frecuencia de niveles elevados de TSHn según el año de nacimiento, peso al nacer o días hasta la extracción. Se registró una mayor prevalencia en el sexo masculino (10,6 % versus 8,5 %; p = 0,007) y entre los neonatos nacidos a término (9,8 % versus 6,6 %; p = 0,02). La prevalencia de hipertirotropinemia fue superior a la observada en una cohorte de 2001-2002. Conclusiones. La prevalencia de hipertirotropinemia neonatal en La Pampa durante los años 2021 y 2022 fue del 9,6 %, lo que indica un estado de deficiencia leve de yodo en la provincia, superior al reportado hace dos décadas.

Introduction. Iodine plays a key role in human metabolism, growth, and development. During pregnancy and childhood, the demand for this micronutrient increases notably. Increased neonatal thyroid stimulating hormone (nTSH) levels, defined as nTSH ≥ 5 mIUL, are a marker of iodine deficiency in a population if its prevalence is higher than 3%.Objective. To establish the prevalence of nTSH ≥ 5 in La Pampa in the 2021­2022 period, analyze its correlation with different variables, and compare it with data from a historical cohort.Population and methods. Cross-sectional, descriptive-analytical study in a population of newborn infants born in the 5 health regions of the province of La Pampa in 2021 and 2022. Results. Of  the  5778  assessed  newborn  infants,  9.6%  had  nTSH  levels  ≥  5  mIU/L. It was reported that 70.4% of these measurements were done after the third day of life. No significant differences were observed in the frequency of high nTSH levels by year of birth, birth weight, or days until samplecollection.A higher prevalence was observed among male infants (10.6% versus 8.5%; p = 0.007) and term infants (9.8% versus 6.6%; p = 0.02). The prevalence of high TSH levels was superior to that observed in the 2001­2002 cohort. Conclusions. The  prevalence of high nTSH levels in La Pampa during 2021 and 2022 was 9.6%, suggesting the presence of mild iodine deficiency in the population of this province, higher that what  had been reported 2 decades ago.

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INTRODUCTION: Tumors can be targeted by modulating the immune response of the patient. Programmed cell death protein 1 (PD-1) and programmed cell death ligand 1 (PD-L1) are critical immune checkpoints in cancer biology. The efficacy of certain cancer immunotherapies has been achieved by targeting these molecules using monoclonal antibodies. METHOD: Small-molecule drugs have also been developed as inhibitors of the PD-1/PD-L1 axis, with a mechanism of action that is distinct from that of antibodies: they induce the formation of PD-L1 homodimers, causing their stabilization, internalization, and subsequent degradation. Drug repurposing is a strategy in which new uses are sought after for approved drugs, expediting their clinical translation based on updated findings. In this study, we generated a pharmacophore model that was based on reported small molecules that targeted PD-L1 and used it to identify potential PD-L1 inhibitors among FDA-approved drugs. RESULTS: We identified 12 pharmacophore-matching compounds, but only 4 reproduced the binding mode of the reference inhibitors in docking experiments. Further characterization by molecular dynamics showed that pranlukast, an antagonist of leukotriene receptors that is used to treat asthma, generated stable and energyfavorable interactions with PD-L1 homodimers and induced homodimerization of recombinant PD-L1. CONCLUSION: Our results suggest that pranlukast inhibits the PD-1/PD-L1 axis, meriting its repurposing as an antitumor drug.

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Congenital heart diseases are the most common congenital malformations worldwide and represent one of the leading causes of neonatal death, in addition to the significant use of human and financial resources by health systems. The purpose of this document is to support the implementation of neonatal screening for critical congenital heart diseases using pulse oximetry according to the different geographical altitudes of Peru. This technology is widely used worldwide and has high sensitivity, specificity, and cost-effectiveness. At many latitudes, it has led to better survival in this group of patients and in the neonatal population in general since its use in the early detection of sepsis, pneumonia, and other conditions that affect the oxygenation of the newborn. Neonatal screening for critical congenital heart disease is applicable at all levels of healthcare at a national level, and its implementation must be a priority to improve neonatal health.

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Background/Objectives: The prevalence of metabolic syndrome (MetS) is increasing worldwide, and an increasing number of cases are diagnosed in younger age groups. This study aimed to propose predictive models based on demographic, anthropometric, and non-invasive clinical variables to predict MetS in adolescents. Methods: A total of 2064 adolescents aged 18-19 from São Luís-Maranhão, Brazil were enrolled. Demographic, anthropometric, and clinical variables were considered, and three criteria for diagnosing MetS were employed: Cook et al., De Ferranti et al. and the International Diabetes Federation (IDF). A feed-forward artificial neural network (ANN) was trained to predict MetS. Accuracy, sensitivity, and specificity were calculated to assess the ANN's performance. The ROC curve was constructed, and the area under the curve was analyzed to assess the discriminatory power of the networks. Results: The prevalence of MetS in adolescents ranged from 5.7% to 12.3%. The ANN that used the Cook et al. criterion performed best in predicting MetS. ANN 5, which included age, sex, waist circumference, weight, and systolic and diastolic blood pressure, showed the best performance and discriminatory power (sensitivity, 89.8%; accuracy, 86.8%). ANN 3 considered the same variables, except for weight, and exhibited good sensitivity (89.0%) and accuracy (87.0%). Conclusions: Using non-invasive measures allows for predicting MetS in adolescents, thereby guiding the flow of care in primary healthcare and optimizing the management of public resources.

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With the advent of the new diagnostic model for personality disorders in the 11th revision of the International Classification of Diseases (ICD-11), researchers and practitioners in World Health Organization signatory countries are urged to implement it. This study aims to develop a brief, reliable, and valid scale for assessing maladaptive personality traits according to the ICD-11 model, using the item pool of the Dimensional Clinical Personality Inventory (IDCP-2). Quantitative and qualitative criteria for item selection were applied to a sample of 251 Brazilian adults. As a result, the 25 items (five items per factor) were selected, demonstrating promising evidence of validity based on the internal structure with a database of 1,659 Brazilian adults. In addition, we found good evidence of validity based on relationships with external variables, particularly those related to personality pathology, in a sample of 617 Brazilian adults. The implications of these findings are discussed.

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Copper is a trace element in plants and animals whose importance can be understood due to its role in different essential metabolic processes. Anthropogenic activities such as agriculture and mining are potential sources of pollution due to the emission of copper into the environment. Brazilian legislation ties soil quality to guideline values, among which the Prevention Value indicates the critical environmental limit for trace elements. The aim of this study was to obtain PVs for copper for two subtropical soils (Cambisol and Nitisol), given that the pedological richness was not considered when deriving the PVs contained in the federal normative. Reproduction assays followed ISO guidelines with the earthworm species Eisenia andrei and Perionyx excavatus, the enchytraeids Enchytraeus crypticus and Enchytraeus bigeminus and the springtails Folsomia candida and Proisotoma minuta. Results showed that the sensitivity of the organisms was greater in Cambisol. The most sensitive species were the earthworms, especially Perionyx excavatus (EC50 = 67.83 in Cambisol; EC50 = 264.96 in Nitisol). The springtails, on the other hand, were the least sensitive to contamination. These findings reinforce the need to include organisms from different ecological groups in ecotoxicological assessments. It was also observed that the PV adopted in federal legislation (= 60 mg kg-1) is in fact protective for the species and soils we evaluated, since the PVs we obtained based on the EC50 were 346.74 mg kg-1 in Nitisol and 134.05 mg kg-1 in Cambisol. It is important to note that our results do not exclude the need for evaluations with other subtropical soils, given the influence of their properties on the toxicity and bioavailability of copper to soil organisms.

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OBJECTIVE: Investigate the association between the age of treatment onset and confirmatory TSH level (as an indicator of severity) with a greater risk of developmental delay in infants with congenital hypothyroidism (CH). METHOD: The authors conducted a cross-sectional, observational, unmatched case-control study at a Brazilian neonatal screening reference center. Seventy-seven infants with CH (mean age: 12 ± 6.4 months) were examined. The authors evaluated their performance using the Bayley-III Screening Test and categorized them as "LOWER RISK" (competent category) or "GREATER RISK" (combined at-risk + emergent categories) for developmental delay based on the 25th percentile cutoff. RESULTS: Infants with CH are at a higher risk of non-competent performance in cognition, receptive language, fine motor skills, and gross motor skills when compared to infants without CH. This risk is more pronounced in infants with more severe indications of CH (TSH > 30 µUI/L in the confirmatory test) for cognition (OR = 5.64; p = 0.01), receptive language (OR = 14.68; p = 0.000), fine motor skills (OR = 8.25; p = 0.000), and gross motor skills (OR = 5.00; p = 0.011). CONCLUSION: The level of TSH in the confirmatory test can be a good indicator for identifying infants with CH who are at a higher risk of non-competent performance in cognition, receptive language, and motor skills. Monitoring development, early detection of delays, and intervention programs are particularly important for infants with CH.

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PURPOSE: Our study aimed to develop a relatively accurate gastric cancer (GC) screening score system for urban residents and to validate the screening efficacy. METHODS: The present study included a derivation cohort (n = 3406) and a validation cohort (n = 868) of urban residents. Applying the full-stack engineering intelligent system platform of Hualian Health Big Data of Shandong University, the clinical physical examination data of subjects were collected. Univariate and multivariate analyses were used to identify risk factors for GC, and subsequently, an optimal prediction rule was established to create three distinct scoring systems. RESULTS: In the GC-risk scoring system I, age, plateletocrit (PCT), carcinoembryonic antigen (CEA), glucose, albumin, creatinine were independent risk factors of GC, with scores ranging from 0 to 28 and optimal cut-off was 15.5. The second scoring system consisted of age, PCT, RDW-CV, CEA, glucose, albumin, and creatinine, with scores ranging from 0 to 31. The optimal cut-off point was determined to be 15.5. The scoring system III comprise of age, sex, PCT, RDW CV, CEA, glucose, with scores ranging from 0 to 21 and optimal cut-off was 10.5. All three scoring systems demonstrated excellent discrimination for GC, achieving an AUC of 0.884, 0.89, and 0.876, respectively. In external validation, the AUC values were 0.654, 0.658, and 0.714. Notably, the GC-risk scoring system III exhibited the highest screening efficiency. CONCLUSIONS: Urban residents benefited from the effective and verified GC-risk scoring systems, which demonstrated excellent performance in identifying individuals with an elevated risk of GC.

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Objective: This study aims to create a new screening for preterm birth < 34 weeks after gestation with a cervical length (CL) ≤ 30 mm, based on clinical, demographic, and sonographic characteristics. Methods: This is a post hoc analysis of a randomized clinical trial (RCT), which included pregnancies, in middle-gestation, screened with transvaginal ultrasound. After observing inclusion criteria, the patient was invited to compare pessary plus progesterone (PP) versus progesterone only (P) (1:1). The objective was to determine which variables were associated with severe preterm birth using logistic regression (LR). The area under the curve (AUC), sensitivity, specificity, and positive predictive value (PPV) and negative predictive value (NPV) were calculated for both groups after applying LR, with a false positive rate (FPR) set at 10%. Results: The RCT included 936 patients, 475 in PP and 461 in P. The LR selected: ethnics white, absence of previous curettage, previous preterm birth, singleton gestation, precocious identification of short cervix, CL < 14.7 mm, CL in curve > 21.0 mm. The AUC (CI95%), sensitivity, specificity, PPV, and PNV, with 10% of FPR, were respectively 0.978 (0.961-0.995), 83.4%, 98.1%, 83.4% and 98.1% for PP < 34 weeks; and 0.765 (0.665-0.864), 38.7%, 92.1%, 26.1% and 95.4%, for P < 28 weeks. Conclusion: Logistic regression can be effective to screen preterm birth < 34 weeks in patients in the PP Group and all pregnancies with CL ≤ 30 mm.

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Objectives: The Brazilian Unified Health System (Sistema Único de Saúde-SUS) is the universal public healthcare system of Brazil that maintains a nationwide database of its patients. Our primary objective was to analyze regional and temporal trends, while our secondary goal was to establish correlations between states' health economy status and their prostate cancer (PCa) epidemiology. Methods: We analyzed Brazil's nationwide data on prostate cancer (PCa) incidence, mortality, and care gathered between 2013 and 2021 by the Information Technology Department of SUS (DATA-SUS), updated monthly using the International Classification of Diseases (ICD-10) code. Results: In the period, 273,933 new cases of PCa and 135,336 PCa deaths were reported in men aged 50 years or over in Brazil. The median annual PCa-specific incidence rate (PCSIR) ranged from 14.7 in the Southeast to 6.9 in the North region and the median annual PCa-specific mortality rate (PCSMR) ranged from 7.7 in the Northeast to 6.0 in the South region (per 10,000 men >50). The median annual mortality to incidence ratio (MIR) was highest in the North (0.88) and lowest in the Southeast region (0.44). There were significant regional differences in PCa treatment rates (per new cases); the Midwest region had the highest median annual surgery rate (0.63) while the North region had the highest median annual systemic therapy rate (0.75) and the lowest radiation therapy rate (0.06). Temporal analysis of the data showed significant change in annual rate trends after the year 2018 for PCSIR (coefficient [ß] = +3.66, p < 0.001), any treatment (ß = -0.06, p = 0.016), surgery ([SR] ß = +0.05, p = 0.017) radiation therapy ([RTR] ß = -0.06, p = 0.005) and systemic therapy ([STR] ß = -0.10, p = 0.002). After the 2020 pandemic, annual PCSIR decreased (ß = -2.15, p = 0.002) but annual PCSMR, MIR, and treatment rates remained stable. Correlation studies showed that the PCSIR was strongly negatively correlated with STR (p < 0.001) and positively correlated with RTR (p = 0.004). MIR was positively correlated with STR (p < 0.001) and negatively correlated with the number of robotic surgical systems per million population (p = 0.003). Conclusion: Our data shows that PCa care is dependent on the region and is likely influenced by access to treatment options. Furthermore, changes after the year 2018 underscore the influence of international guidelines on Brazilian clinicians' decision-making especially concerning population screening which in turn affected incidence and treatment rates. Limitation of our study includes limited patient-related information and data on private practices as well as an unknown impact of traveling patients.

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Background: Bladder cancer (BC) is an aggressive disease that begins in the cells lining the bladder, which grows abnormally due to mutations. One of the aggravating factors during treatment is the nutritional risk, contributing to increased morbidity and mortality. Nutritional screening can be extremely important for these patients since the nutritional condition can deteriorate during treatment and due to the progression of the disease. Objectives: This cross-sectional observational study aimed to compare the results of using the Mini Nutritional Assessment (MNA) nutritional screening tool obtained by urologists and nutritionists at our center. Methods: The target audience were adult patients diagnosed with BC. They were followed up at the urology outpatient clinic and were asked to answer the questions in the short version of MAN during a nutritional screening conducted by a medical team, and later answer the questions contained in the full version of the instrument during a nutritional consultation by nutritionists. The data were analyzed and organized by employing a RedCap database. Statistical analysis of data was performed using the SPSS software package. For comparison between continuous variables, the Mann-Whitney U-test and Student's t-test were utilized. For analyses of the categorical variables, the Wilcoxon Matched Pairs test and the Cohen Kappa test were used. A significance level of 5% (P ≤ 0.05) with a confidence level of 95% was set for all statistical tests. Results: A total of 46 patients were evaluated. The medical team identified 18 (39.1%) with normal nutritional status, while the nutrition team identified 13 (28.3%). In comparison, the use of the full version of the MNA administered by the nutrition team found that 32 (69.6%) patients were at nutritional risk. Individual questions of the short-version MNA were also compared between the two groups and the Wilcoxon Matched Pairs test was performed. The short-version MNA was found to be an excellent screening tool. When applied by a urologist, it yielded a sensitivity of 87.5% (P = 0.87) and a sensitivity of 93.7% (P = 0.76) when used by the nutritionist. A raw match rate was 71.7% achieved by both questionnaires, and the Cohen Kappa test showed that the agreement was moderate, with an agreement rate of 77.9% (k = 0.50). Conclusion: The application of short-version MNA has a high sensitivity. However, the full-version MNA is necessary for nutritional screening to improve the sensitivity of the assessment and to serve as a guide for nutritionists and the multidisciplinary care team.

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OBJECTIVES: To estimate the coverage of newborn pulse oximetry screening (POS) in Brazil, as well as identifies associated factors and the proportion of positive screening results. METHODS: Coverage was estimated based on the most recent National Health Survey (2019). Adjusted marginal prevalence ratios were estimated via poisson regression model with robust variance. RESULTS: The POS coverage was 66.3 % (95 %CI: 65.5-67.1; N = 3,140,023) and was higher in children born in privately funded hospitals (PFHs) than in the Unified Health System (SUS): 78.1 % (76.7-79.5) versus 61.1 % (60.2-62.1). In the North region, the POS coverage in PFHs (64.9 %, 59.7-70.1) was lower than that in the South (82.5 %, 79.4-85.6) and the Southeast (81.5 %, 79.3-83.6); it was even lower in SUS in the North (44.0 %; 42.4-45.6). After a federal ordinance providing financial resources to postscreening diagnostic, the screening coverage in SUS increased from 57.6 % (56.2-59.1) to 64.6 % (63.3-65.9). The proportion of positive screening tests was 9.2 % (8.9-9.5) in SUS and 7.8 % (7.3-8.3) in PFHs, of which 40.8 % (40.5-41.1) underwent complementary exams in SUS and 57.2 % (56.7-57.7) in PFHs. In the multivariate model, the main independent predictors of POS were the coverage of other newborn screening tests. CONCLUSIONS: Inequalities were found between major regions and healthcare systems. Government financial incentives have reduced this inequality, although the percentage of postscreening complementary exams remains insufficient and unequal. The main independent predictors of screening prevalence were those related to the organization of health services.

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Objectives. To describe the results of a 16-year experience of a state-coverage expanded newborn screening program (NBSP) in Northeast México. Methods. Between 2002 and 2017, dried blood spots of newborns were screened for congenital hypothyroidism (CH), congenital adrenal hyperplasia (CAH), biotinidase deficiency, galactosemia, cystic fibrosis, and glucose-6-phosphate dehydrogenase (G6PD) deficiency via immunofluorescence and amino and fatty acid disorders and organic acidemias using tandem mass spectrometry. Frequency rates were determined. Results. Overall, 192 487 samples were processed; 99.4% had negative results, and 598 were diagnosed. The frequency was 3.01/1000 newborns. G6PD deficiency, CH, amino acidemia, organic acidemia, cystic fibrosis, CAH, fatty acid oxidation disorder, galactosemia, and biotinidase deficiency cases were 1:773, 1:962, 1:4277, 1:4476, 1:11,322, 1:10,693, 1:10,693, 1:38,497, and 1:64,162, respectively. Conclusion. Using different technologies in NBSP increased the number of conditions detected, facilitating infant morbidity and mortality prevention. The frequency of disorders depends on the population's genetic background and diagnostic capacity.

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PURPOSE: Our study aimed to 1) investigate the differences of muscle parameters in relation to each SARC-F component/question; and 2) explore the relationship between SARC-F score with these muscle parameters using various landmarks derived from computed tomography (CT) scans of patients with cancer. METHODS: This study is a cross-sectional analysis of a cohort comprised of consecutive patients with cancer, displaying CT scans. SARC-F questionnaire was utilized as a proxy for muscle functionality, with a score ≥4 indicating a poor status. Muscle assessment via CT measurements was performed using single cross-sectional images at the level of the third lumbar vertebrae (L3) in the abdominal region, the thigh region, and the total gluteal region at the level of the second sacral vertebrae. Skeletal muscle (SM) cross-sectional area, SM index (normalized to height2), and SM radiodensity (SMD) were evaluated for all anatomical landmarks. RESULTS: A total of 128 patients were included in this analysis (53.1% females, 61.7% older adults). Patients with SARC-F scores ≥4 demonstrated significantly lower values of SMD across all landmarks assessed. Those reporting difficulties related to strength (P = 0.039), requiring assistance in walking (P = 0.033), and climbing stairs (P = 0.012) exhibited significantly lower SMD values at the L3 landmark. At gluteus and thigh levels, only patients experiencing difficulty climbing stairs (P = 0.012) showed significantly lower values of SMD. Only SMD at gluteus level was independently associated with SARC-F score (ßadjusted -0.09, 95% CI -0.16 to -0.02). CONCLUSIONS: Our findings suggest that individuals with poor muscle composition may experience a higher risk of sarcopenia/poor muscle functionality.

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Evaluating citrus rootstocks is of paramount importance in determining their suitability for a certain region and promoting resilience in orchards by increasing the genetic pool, thereby potentially contributing to a more strategic establishment of new plantings. This long-term field study (2000-2013) aimed to evaluate different rootstocks for 'Swatow' mandarin grown at two locations (Paranavaí and Londrina) in the Brazilian subtropics. Nine rootstocks were evaluated, including 'Rangpur' lime, 'Swingle' citrumelo, 'Volkamer' lemon, 'Caipira DAC' sweet orange, 'Cleopatra' and 'Sunki' mandarins, 'Trifoliate' orange, 'Carrizo', and 'Fepagro C-13' citranges. Trees were assessed for vegetative growth, yield, fruit quality, density, and yield estimates. The experimental design was a randomized block arranged in a 9 × 2 setting (rootstock × location) with 6 replicates and 4 trees per plot. 'Swatow' trees grew more vigorously in Londrina than Paranavaí, particularly for 'Cleopatra' and 'Sunki' pairings. Tree vigor was reduced with 'Trifoliate', resulting in higher tree density estimates and yield efficiency. This rootstock, along with 'Rangpur', 'Swingle', and 'Carrizo' provided superior yield to the scion. All tested rootstocks conferred good fruit quality. Fruits were larger and heavier in 'Sunki' pairings, showing higher soluble solids (SS) content, along with 'Caipira DAC', 'Trifoliate', 'Swingle', and 'Carrizo' at both locations. Our findings confirm the suitability of 'Trifoliate' orange, 'Carrizo' citrange, or 'Caipira DAC' orange rootstocks as promising candidates for 'Swatow' mandarin cultivation in humid subtropical and analogous regions. Further investigations are invoked to improve the horticultural performance of 'Swatow' mandarin trees grafted onto these rootstocks.

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INTRODUCTION: When mental disorders go undetected until later stages, they can result in poorer health outcomes for patients. Primary healthcare (PHC) stands as a strategic setting for the early identification and management of these mental disorders, given its role as the primary care environment for health service users. This scoping review has the objective of mapping and assessing screening instruments validated for mental disorders that are applicable in PHC, particularly regarding their measurement properties. METHODS AND ANALYSIS: This scoping review will include studies that have developed and validated screening instruments for mental disorders in the PHC context, irrespective of the age group. Searches will be conducted in MEDLINE, EMBASE, LILACS, CINAHL and PsycInfo without imposing restrictions on publication status, publication year or language. Additionally, we will scrutinise the references cited in the selected studies. Our inclusion criteria encompass studies examining any measurement property recommended by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) taxonomy. The selection process, data extraction and quality assessment of studies will be performed independently by pairs of reviewers. To evaluate the risk of bias within the selected studies, we will employ the COSMIN Risk of Bias 2 tools. The collected data will undergo analysis using descriptive statistics and will be presented in an evidence gap map format for each specific mental disorder. ETHICS AND DISSEMINATION: The findings from this review will be discussed through deliberative dialogue with stakeholders and disseminated through peer-reviewed publications and conference presentations. The project was approved by the Ethics Committee for Research at the University of Sorocaba (number: 66993323.9.0000.5500). TRIAL REGISTRATION NUMBER: Open Science Framework - 10.17605/OSF.IO/Z6T5M.

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OBJECTIVE: In Haiti, cervical cancer continues to cause high levels of mortality and morbidity due to lack of resources and political unrest. Haitian women employed in factories are especially vulnerable because they are unable to take time away from work to access health resources. We aimed to describe a low-cost intervention which successfully addressed this need. METHODS: We present a retrospective review of data gathered through a public-private partnership, in which women working in garment factories near Port-au-Prince, Haiti, were offered health education, clinical breast exam, and free human papillomavirus (HPV) self-swab testing at their place of employment. Women testing positive for HPV were subsequently tested using visual inspection with acetic acid (VIA) to inform treatment referrals, and treated with mobile thermocoagulation in factory infirmaries. Factory-employed healthcare workers were trained on cancer screening, including VIA and clinical breast exam. RESULTS: A total of 6843 out of 6983 (98%) female factory employees attended free reproductive health education sessions, and 4005 out of 4153 eligible women (97%) were screened using HPV self-swab testing; 5176 women received a clinical breast exam. Of the women screened for HPV, 1001 (25%) tested positive and 905 (90%) of HPV-positive women received VIA testing and thermocoagulation. The intervention had a total cost of US$76 000, over half of which was spent on an HPV testing machine. CONCLUSIONS: Innovative approaches to the prevention of cervical cancer are especially necessary in very low-resource, politically unstable environments like Haiti. Self-swab and screen-and-treat programs in the workplace were acceptable to employees and factory owners. This low-cost model was reached vulnerable women through a public-private partnership, and tracked them through screening and treatment. It could be implemented elsewhere or extended to include other health services.

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BACKGROUND: Telemedicine-based interventions show promise in addressing mental health issues among rural populations, yet evidence regarding their impact among the health care workforce in these contexts remains limited. OBJECTIVE: This study aimed to evaluate the characteristics and the responses and perceptions of recently graduated physicians who work in rural areas of Peru as part of the Servicio Rural Urbano Marginal en Salud (Rural-Urban Marginal Health Service [SERUMS], in Spanish) toward a telehealth intervention to provide remote orientation and accompaniment in mental health. METHODS: A mixed methods study was carried out involving physicians who graduated from the Universidad Nacional Mayor de San Marcos and participated in the Mental Health Accompaniment Program (MHAP) from August 2022 to February 2023. This program included the assessment of mental health conditions via online forms, the dissemination of informational materials through a website, and, for those with moderate or high levels of mental health issues, the provision of personalized follow-up by trained personnel. Quantitative analysis explored the mental health issues identified among physicians, while qualitative analysis, using semistructured interviews, examined their perceptions of the services provided. RESULTS: Of 75 physicians initially enrolled to the MHAP, 30 (41.6%) opted to undergo assessment and use the services. The average age of the participants was 26.8 (SD 1.9) years, with 17 (56.7%) being female. About 11 (36.7%) reported have current or previous mental health issues, 17 (56.7%) indicating some level of depression, 14 (46.7%) indicated some level of anxiety, 5 (16.6%) presenting a suicidal risk, and 2 (6.7%) attempted suicide during the program. Physicians who did not use the program services reported a lack of advertising and related information, reliance on personal mental health resources, or neglect of symptoms. Those who used the program expressed a positive perception regarding the services, including evaluation and follow-up, although some faced challenges accessing the website. CONCLUSIONS: The MHAP has been effective in identifying and managing mental health problems among SERUMS physicians in rural Peru, although it faced challenges related to access and participation. The importance of mental health interventions in this context is highlighted, with recommendations to improve accessibility and promote self-care among participants.

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