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This Systematic Review assesses the economic impact of Respiratory Syncytial Virus (RSV) in Latin America and the Caribbean (LAC) in relation to healthcare resource utilization and associated costs. We searched online databases from January 2012 to November 2022 to identify eligible publications. We identified 12 publications that reported direct costs, indirect costs, and resources associated with RSV and its complications. The primary direct medical resources reported were medical services, diagnostics tests and procedures, and length of stay (LOS). Direct total costs per patient ranged widely from $563 to $19,076. Direct costs are, on average, 98% higher than indirect costs. Brazil reported a higher total cost per patient than Colombia, El Salvador, México, Panamá, and Puerto Rico, while for indirect costs per patient, El Salvador and Panamá had higher costs than Brazil, Colombia, and Mexico. The mean LOS in the general ward due to RSV was 6.9 days (range 4 to 20 days) and the mean Intensive Care Unit LOS was 9.1 days (range 4 to 16 days). In many countries of the LAC region, RSV represents a considerable economic burden on health systems, but significant evidence gaps were identified in the region. More rigorous health economic studies are essential to better understand this burden and to promote effective healthcare through an informed decision-making process. Vaccination against RSV plays a critical role in mitigating this burden and should be a priority in public health strategies.

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The nervous system is rich in miRNAs, indicating an important role of these molecules in regulating processes associated with cognition, memory, and others. Therefore, qualitative and quantitative imbalances involving such miRNAs may be involved in dementia contexts, including Late-Onset Alzheimer's Disease (LOAD). To test the viability of circulating miRNAs (c-miRNAs) as biomarkers for LOAD, we proceed accordingly to the following reasoning. The first stage was to discover and identify profile of c-miRNAs by RNA sequencing (RNA-Seq). For this purpose, blood serum samples were used from LOAD patients (n = 5) and cognitively healthy elderly control group (CTRL_CH) (n = 5), all over 70 years old. We identified seven c-miRNAs differentially expressed (p ≤ 0.05) in the serum of LOAD patients compared to CTRL_CH (miR-10a-5p; miR-29b-2-5p; miR-125a-5p; miR-342-3p, miR-708-5p, miR-380-5p and miR-340-3p). Of these, five (p ≤ 0.01) were selected for in silico analysis (miR-10a-5p; miR-29b-2-5p; miR-125a-5p; miR-342-3p, miR-708-5p), for which 44 relevant target genes were found regulated by these c-miRNAs and related to LOAD. Through the analysis of these target genes in databases, it was possible to observe that they have functions related to the development and progress of LOAD, directly or indirectly connecting the different Alzheimer's pathways. Thus, this work found five promising serum c-miRNAs as options for biomarkers contributing to LOAD diagnosis. Our study shows the complex network between these molecules and LOAD, supporting the relevance of studies using c-miRNAs in dementia contexts.

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OBJECTIVE: To identify, synthesize, and analyze the scientific knowledge produced regarding the implications of using clinical simulation for undergraduate nursing or medical students' motivation for learning. METHODS: The search for articles was conducted between July 28 and August 3, 2022, on the PubMed/MEDLINE, Scopus, Web of Science, and SciELO databases. The following was used for the search: P - undergraduate students attending Nursing or Medicine courses; C - motivation for learning, and C - skills and clinical simulation laboratory. The following research question guided the study: "What are the implications of clinical simulation on the motivation for learning of undergraduate students of nursing and medicine?" Of the 1,783 articles found, 13 were included in the sample for analysis. All stages of the selection process were carried out by two independent evaluators. The results were presented as charts and a discursive report. RESULTS: The studies analyzed indicated the beneficial effects of clinical simulation on students' motivation, in addition to other gains such as competencies, technical and non-technical skills, knowledge, belonging, autonomy, clinical judgment, critical and reflective thinking, self-efficacy and decreased anxiety, self-management, and improvements in learning and learning climate. CONCLUSION: Clinical simulation provides a positive learning environment favorable to the development of technical and interpersonal skills and competencies, and raising the level of motivational qualities.

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Introduction: The aim of the present study was to evaluate the influence of acute transcranial direct current stimulation (tDCS) on physical and subjective responses in professional rowing during the 2,000-m time trial test. Methods: Seven rowers (age 20.86 ± 4.49 years; weight 71.66 ± 7.97 kg) participated in this randomized triple-blind trial with a crossover experimental design. The protocol consists of 2 days with different conditions (anodal and sham). The tDCS anodic stimulation conducted was 2 mA for 20 min in the left temporal cortex (2.5 cm from the F7 zone and 2.5 cm from the T3 zone), targeting the left insular cortex. In the sham moment, the participants experienced 30 s of stimulation. Afterward, they performed a standardized progressive warm-up for 15 min, following the Brazilian Rowing Confederation's assessment protocols, and rested for 3 min before the test started. All procedures were made on an indoor rowing machine, which allowed the capture of performance variables such as time performed, power in watts (W), pace (m/min), and stroke rate (strokes/min). The ratings of perceived exertion [Borg scale (CR-20)] were recorded in each 2-min during the test. Results: The results presented differences in power [Z: -2.371; p = 0.018; effect size (ES) = -0.896 (large)] and pace [Z: -2.371; p = 0.018; ES = -0.896 (large)] and time performance [Z: -1.612; p = 0.107; ES = -0.609 (large)] throughout the protocol for the anodal moment. Discussion: However, no differences for the other variables were found. According to the results, the current tDCS with the present protocol improved the physical performance at the 2,000-m time trial Test providing ergogenic aid.

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The search for increased performance and physical performance are linked to the use of ergogenic resources. The vertical jump is one of the measures commonly used to evaluate the performance of lower limbs in athletes. Transcranial direct current stimulation (tDCS) is a non-invasive, safe, economically viable technique that can modulate cortical excitability, which can influence the increase in the performance of athletes in general. This study aimed to investigate whether the use of tDCS on the primary motor cortex (M1) improves the performance of soccer players. A cross-sectional study was conducted. Twenty-seven players were randomized into three groups: Active tDCS group (n = 9), Sham group (n = 9), and control group (n = 9). Stimulation was applied at 2 mA for 15 min using a cephalic mount. Visual Pain Scale (VAS) and Subjective Recovery Scale (SRS) were monitored before and after tDCS. In addition, the participants performed the Countermovement Jump (CMJ) before and after the stimulation intercalated with Heart Rate (HR) and Rating of Perceived Exertion (RPE CR-10). No differences were found in any of the performance variables analyzed (p > 0.05) nor in the responses of HR (p > 0.05), RPE (p > 0.05), VAS (p > 0.05), and SRS (p > 0.05) between groups. The tDCS in M1 did not change the performance of the vertical jump, and there was no improvement in the subjective scales. New studies should also be developed with different stimulus intensities in different cortical areas and sports modalities.

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The aims of this study were to estimate the genetic parameters for fat-to-protein ratio (F:P) within the first 90 days of lactation and to examine their genetic associations with daily milk yield (MY), somatic cell score (SCS), and calving interval between the first and second calving (IFSC) and between the second and third calving (ISTC) during the first three lactations of Holstein cows. We utilized 200,626 production-related data officially recorded from 77,436 cows milked two or three times a day from 2012 to 2022, sourced from the Holstein Cattle Breeders Association of Paraná State, Brazil. The (co)variance components were estimated using animal models, adopting the restricted maximum likelihood (REML) method with single-trait analysis (for heritability and repeatability) and two-trait analysis (for genetic and phenotypic correlations), per lactation. Regardless of lactation number, heritability estimates were relatively low, ranging from 0.08 ± 0.005 to 0.10 ± 0.003 for F:P; 0.08 ± 0.01 to 0.18 ± 0.005 for MY; 0.04 ± 0.01 to 0.07 ± 0.004 for SCS; and 0.03 ± 0.01 for both IFSC and ISTC. Repeatability estimates within the same lactation were low for F:P (ranging from 0.17 ± 0.002 to 0.19 ± 0.03), high for MY (between 0.50 ± 0.003 and 0.53 ± 0.002), and moderate to high for SCS (between 0.39 ± 0.003 and 0.44 ± 0.004). Genetic correlations between F:P and MY ranged from -0.26 ± 0.03 to -0.15 ± 0.02; F:P and SCS, from -0.06 ± 0.03 to -0.03 ± 0.08; F:P and IFSC, 0.31 ± 0.01; F:P and ISTC, 0.20 ± 0.01; MY and IFSC, 0.24 ± 0.05; and MY and ISTC, 0.13 ± 0.08. The fat-to-protein ratio during early lactation showed low genetic variability, regardless of lactation number. Furthermore, it was genetically correlated with MY, IFSC, and ISTC, although there is an antagonistic and unfavorable correlation between traits that can limit genetic progress.

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BACKGROUND: Psoriasis is a chronic, systemic inflammatory disease with a worldwide prevalence of approximately 2%. Currently, despite the difficulties faced every day by patients and physicians in low-resource countries, literature describing the exact needs of psoriasis treatment in Latin America remains scarce. OBJECTIVE: To investigate the unmet needs in psoriasis treatment in Latin America. METHODS: The authors conducted a systematic review following PRISMA statements in PubMed, Embase, and LILACS of studies published from January 2011 to March 2021 addressing challenges in psoriasis treatment in Latin America. RESULTS: The search strategy identified 3,837 articles, of which 19 were included in the final analysis. Most were from Brazil (58%; n=11), all were observational, and most were cross-sectional (84%; n=16). Difficulties faced by psoriasis patients in Latin America included the high prevalence of opportunistic and endemic infections (42% of the studies addressed this matter; n=8), delay in diagnosis (5%; n=1), work productivity impairment (16%; n=3), limited access to medication/medical care (37%; n=7), poor adherence to treatment (5%; n=1) and poor adherence to guidelines (11%; n=2). STUDY LIMITATIONS: Number and quality of studies currently available on this subject. CONCLUSIONS: Current psoriasis guidelines do not always account for epidemiological, financial, and cultural characteristics. Most studies available are from Brazil, which might not accurately represent Latin America as a whole. In a region where neglected diseases and scarce resources remain a reality, it is imperative that dermatological training be offered to primary care providers, allowing for standardized conduct and earlier diagnosis.

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ABSTRACT Objective: To identify, synthesize, and analyze the scientific knowledge produced regarding the implications of using clinical simulation for undergraduate nursing or medical students' motivation for learning. Methods: The search for articles was conducted between July 28 and August 3, 2022, on the PubMed/MEDLINE, Scopus, Web of Science, and SciELO databases. The following was used for the search: P - undergraduate students attending Nursing or Medicine courses; C - motivation for learning, and C - skills and clinical simulation laboratory. The following research question guided the study: "What are the implications of clinical simulation on the motivation for learning of undergraduate students of nursing and medicine?" Of the 1,783 articles found, 13 were included in the sample for analysis. All stages of the selection process were carried out by two independent evaluators. The results were presented as charts and a discursive report. Results: The studies analyzed indicated the beneficial effects of clinical simulation on students' motivation, in addition to other gains such as competencies, technical and non-technical skills, knowledge, belonging, autonomy, clinical judgment, critical and reflective thinking, self-efficacy and decreased anxiety, self-management, and improvements in learning and learning climate. Conclusion: Clinical simulation provides a positive learning environment favorable to the development of technical and interpersonal skills and competencies, and raising the level of motivational qualities.

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Abstract Background Psoriasis is a chronic, systemic inflammatory disease with a worldwide prevalence of approximately 2%. Currently, despite the difficulties faced every day by patients and physicians in low-resource countries, literature describing the exact needs of psoriasis treatment in Latin America remains scarce. Objective To investigate the unmet needs in psoriasis treatment in Latin America. Methods The authors conducted a systematic review following PRISMA statements in PubMed, Embase, and LILACS of studies published from January 2011 to March 2021 addressing challenges in psoriasis treatment in Latin America. Results The search strategy identified 3,837 articles, of which 19 were included in the final analysis. Most were from Brazil (58%; n = 11), all were observational, and most were cross-sectional (84%; n = 16). Difficulties faced by psoriasis patients in Latin America included the high prevalence of opportunistic and endemic infections (42% of the studies addressed this matter; n = 8), delay in diagnosis (5%; n = 1), work productivity impairment (16%; n = 3), limited access to medication/medical care (37%; n = 7), poor adherence to treatment (5%; n = 1) and poor adherence to guidelines (11%; n = 2). Study limitations Number and quality of studies currently available on this subject. Conclusions Current psoriasis guidelines do not always account for epidemiological, financial, and cultural characteristics. Most studies available are from Brazil, which might not accurately represent Latin America as a whole. In a region where neglected diseases and scarce resources remain a reality, it is imperative that dermatological training be offered to primary care providers, allowing for standardized conduct and earlier diagnosis.

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OBJECTIVE: to identify evidence about the use and effects of clinical simulation for preparing caregivers for discharging patients with chronic conditions. METHODS: an integrative peer review in the Scopus, PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, ScienceDirect and Virtual Health Library databases, from July to September 2022. RESULTS: 3,218 studies were identified, with a final sample consisting of four national and two international articles. Using simulation as an educational technology contributed to caregiver preparation in home care. In most studies, using clinical simulation included using other strategies to complement training: expository dialogued class, conversation circle and audiovisual resources. FINAL CONSIDERATIONS: simulation proved to be efficient for training caregivers, with the active participation of family members and nurses in health education actions.

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OBJECTIVES: to map studies that analyze the audit process of nursing councils. METHODS: this is a scoping review, anchored in the JBI framework, with the guiding question: what is the evidence of the audit process of legal practice of nursing by class councils (COFEN/COREN system)? The searches were carried out in October and November 2022 without limitation of language and year. RESULTS: of the 9 selected studies, all are Brazilian and published from 2014 onwards. Among the topics addressed are the role, challenges, costs and difficulties in nurse auditors' daily work process, in addition to the contribution of the audit sector in Brazil. CONCLUSIONS: the studies gathered discuss aspects related to costs, challenges and difficulties, but there is no focus on corrective, disciplinary and educational activities as well as little is said about the audit process, its reporting, referral and outcomes.

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Background: Electroencephalography (EEG) has identified neural activity in specific brain regions as a potential indicator of the neural signature of chronic pain. This study compared the lagged coherence connectivity between regions of interest (ROIs) associated with the pain connectome in women with fibromyalgia (FM) and healthy women (HC). Methods: We evaluated 64 participants (49 FM and 15 HC) during resting-state EEG sessions under both eyes open (EO) and eyes closed (EC) conditions. In addition to EEG measurements, we assessed clinical and psychological symptoms and serum levels of brain-derived neurotrophic factor (BDNF). The connectivity between eight ROIs was computed across eight different EEG frequencies. Results: The FM group demonstrated increased connectivity between the left dorsolateral prefrontal cortex (DLPFC) and right anterior cingulate cortex (ACC), specifically in the beta-3 frequency band (t = 3.441, p = 0.044). When comparing the EO and EC conditions, FM patients exhibited heightened interhemispheric connectivity between insular areas (t = 3.372, p = 0.024) and between the left insula (INS) and right DLPFC (t = 3.695, p = 0.024) within the beta-3 frequency band. In the EC condition, there was a negative correlation between pain disability and connectivity in the beta-3 frequency band between the left ACC and the left primary somatosensory cortex (SI; r = -0.442, p = 0.043). In the EO condition, there was a negative correlation between central sensitization severity and lagged coherence connectivity in the alpha-2 frequency band between the right ACC and left SI (r = 0.428, p = 0.014). Moreover, in the EO-EC comparison, the lagged coherence connection between the left DLPFC and right INS, indexed by the gamma frequency band, showed a negative correlation with serum BDNF levels (r = -0.506, p = 0.012). Conclusion: These findings indicate that increased connectivity between different pain processing circuits, particularly in the beta-3 frequency band during rest, may serve as neural biomarkers for the chronic pain brain signature associated with neuroplasticity and the severity of FM symptoms.

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Objetivo: verificar las implicaciones de las actividades prácticas en el Laboratorio de Habilidad y Simulación relacionadas con la motivación y los sentimientos expresados por los estudiantes universitarios cuando regresan a las actividades presenciales luego del aislamiento social ocasionado por la pandemia del COVID-19. Método: estudio cuasiexperimental, con un solo grupo y del tipo pre y postest, realizado mediante una intervención educativa basada en el entrenamiento de habilidades en administración de medicamentos y venopunción, con estudiantes de medicina de una universidad pública brasileña. La muestra estuvo conformada por 47 estudiantes. Para la recolección de datos se utilizaron los instrumentos de caracterización y autopercepción de los individuos y la Escala de Motivación Situacional. Resultados: en la muestra, el 98% mencionó la falta de actividades prácticas durante la pandemia. El sentimiento descrito con mayor frecuencia fue la ansiedad. Después de realizar la actividad, hubo un cambio en la frecuencia de los sentimientos expresados, aunque no hubo un cambio significativo en los niveles de motivación. Regulación Externa (5,1 - 5,6), Regulación Identificada (6,1 - 6,4) y Motivación Intrínseca (5,6 - 6,0) presentaron resultados altos, demostrando similitud con los sentimientos relatados por los estudiantes. Conclusión: la motivación es fundamental para un aprendizaje efectivo y el uso de metodologías activas refuerza de manera efectiva las habilidades construidas en los estudiantes frente al proceso de aprendizaje.

Objective: to verify the implications of practical activities in the Skills and Simulation Laboratory on the motivation and feelings expressed by undergraduate students when returning to face-to-face activities after the social isolation caused by COVID-19 pandemic. Method: a quasi-experimental study, with a single group and of the pre- and post-test type, carried out through an educational intervention based on skills training on medication administration and venipuncture, with medical students from a Brazilian public university. The sample was comprised by 47 students. The instruments of students' characterization and self-perceived feelings and the Situational Motivation Scale were used for data collection. Results: in the sample, 98% mentioned the lack of practical activities during the pandemic. The most frequently described feeling was anxiety. After carrying out the activity, there was a change in the frequency of expressed feelings, although there was no significant change in motivational levels. External Regulation (5.1 - 5.6), Identified Regulation (6.1 - 6.4) and Intrinsic Motivation (5.6 - 6.0) presented high results, showing similarity to the feelings reported by the learners. Conclusion: motivation is essential for effective learning and the use of active methodologies reinforces skills built in an affective way in the students facing the learning process.

Objetivo: verificar as implicações das atividades práticas no Laboratório de Habilidade e Simulação relacionado à motivação e os sentimentos expressos pelos estudantes universitários quando regressam às atividades presenciais após o isolamento social causado pela pandemia da COVID-19. Método: estudo quase-experimental, com um único grupo, do tipo pré e pós-teste, realizado por meio de uma intervenção educacional baseada no treino de habilidades de administração de medicamentos e punção venosa, com estudantes de medicina de uma universidade pública brasileira. A amostra foi composta por 47 estudantes. Para a coleta de dados, foram utilizados os instrumentos de caracterização dos sujeitos e sentimentos autopercebidos pelos estudantes e a Escala de Motivação Situacional. Resultados: na amostra, 98% referiram falta de atividades práticas durante a pandemia. O sentimento mais frequentemente descrito foi a ansiedade. Após a realização da atividade, observou-se uma mudança na frequência dos sentimentos expressos, embora não se tenha verificado uma mudança significativa nos níveis motivacionais. A Regulação Externa (5,1 - 5,6), a Regulação (6,1 - 6,4) e a Motivação Intrínseca (5,6 - 6,0) apresentaram resultados elevados, demostrando semelhança com os sentimentos relatados pelos alunos. Conclusão: a motivação é essencial para uma aprendizagem eficaz e a utilização de metodologias ativas reforça as habilidades construídas de uma forma efetiva nos estudantes frente ao processo de aprendizagem.

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INTRODUÇÃO: A deficiência de Vitamina D (VD) é frequente na doença falciforme (DF) em decorrência do status inflamatório crônico, danos renais, endoteliais, hiperhemólise e melanodermia. Atualmente, a suplementação desse nutriente em falcêmicos tem se mostrado importante devido sua ação sistêmica e imunológica. OBJETIVOS: Analisar o impacto da VD em crianças com DF. MÉTODOS: Trata-se de uma revisão integrativa da literatura, onde foram analisados estudos, publicados originalmente em inglês e português, dos últimos dez anos, em humanos, tendo como referência as bases de dados MEDLINE, SciELO e LILACS. A busca foi efetuada mediante a consulta ao MeSH. Os descritores utilizados foram: "children"; "vitamin D"; "sickle cell anemia"; "supplementation". Foram identificados 32 artigos a partir da frase de pesquisa. Ao aplicar os critérios de inclusão, nove artigos foram eleitos para o estudo. RESULTADOS: A partir da análise dos artigos incluídos, 6 avaliaram a prevalência da deficiência de VD em crianças com anemia falciforme e os outros três artigos relataram sobre a suplementação de VD em crianças também com anemia falciforme. Todos os estudos mostraram que as crianças tratadas com reposição de VD tiveram uma diminuição de idas ao pronto-socorro e maior estabilidade hemodinâmica durante os tratamentos. CONCLUSÃO: Outros ensaios clínicos randomizados devem ser realizados para identificar o papel da DV na qualidade de vida e na redução da morbidade falciforme. A contribuição deste artigo é reconhecer que há evidências sobre a vitamina D fora dos ensaios clínicos randomizados.

INTRODUCTION: Vitamin D (VD) deficiency is frequent in sickle cell disease (SCD) due to chronic inflammatory status, kidney and endothelial damage, hyperhemolysis and melanoderma. Currently, the supplementation of this nutrient in sickle cell patients is important due to its systemic and immunological action. Objectives: To analyze the impact of VD in children with SCD. METHODS: This is an integrative literature review, which analyzed studies, originally published in English and Portuguese, in the last ten years, in humans, using the MedLine, SciELO and LILACS databases as References. The search was performed by consulting the MeSH. The descriptors used were: "children"; "vitamin D"; "sickle cell anemia"; "supplementation". 32 articles were identified from the search phrase. When applying the inclusion criteria, nine articles were chosen for the study. RESULTS: Among the included articles, six evaluated the prevalence of VD deficiency in children with sickle cell anemia, and the other three reported on VD supplementation in children with sickle cell anemia. All studies showed that children treated with VD replacement had a decrease in emergency room visits and greater hemodynamic stability during treatments. CONCLUSION: Further randomized controlled trials should be carried out to identify the role of VD in quality of life and in the reduction of sickle cell morbidity. The contribution of this paper is to recognize that there is evidence about vitamin D outside of randomized controlled trials.

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Corn grain particle size has the potential to influence the performance of lactating dairy cows and the overall profitability of a dairy farm. The objective of this study was to evaluate the productive performance of lactating cows fed diets containing finely or coarsely ground corn grain. Fifty lactating Holstein cows (n = 50; 10 primiparous and 40 multiparous), averaging (mean ± standard deviation, SD) 658 ± 64 kg of BW, 38.8 ± 7.3 kg of milk/d, and 155 ± 80 DIM, were fed diets with finely ground corn grain (FGC) or coarsely ground corn grain (CGC) in a randomized block design with a 28-d treatment period. Finely and coarsely ground corn grain had an average particle size of 660 and 915 µm, respectively. Dry matter intake (DMI) was reduced (p < 0.01) for cows fed FGC (22.1 vs. 21.2 kg d-1). Milk yield and efficiency were not affected by treatments (37.9 vs. 36.8 kg d-1; p = 0.12 and 1.78 vs. 1.79; p = 0.15). Concentrations of milk protein and fat, as well as other milk solids, were unaffected (p > 0.05) by treatments. Fecal starch (FS) concentrations were greater (p < 0.01) for cows fed CGC (7.0 vs. 4.9%), whereas plasma concentrations of D-lactate were greater (p < 0.05) for cows fed FGC (98.5 vs. 79.7 µM). Overall, feeding finely ground corn grain increased total-tract starch digestibility and reduced DMI while maintaining milk yield.

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The marine environment is a rich reservoir of diverse biological entities, many of which possess unique properties that are of immense value to biotechnological applications. One such example is the red fluorescent protein derived from the coral Discosoma sp. This protein, encoded by the DsRed gene, has been the subject of extensive research due to its potential applications in various fields. In the study, a variant of the red fluorescent protein was generated through random mutagenesis using the DsRed2 gene as a template. The process employed error-prone PCR (epPCR) to introduce random mutations, leading to the isolation of twelve gene variants. Among these, one variant stood out due to its unique spectral properties, exhibiting dual fluorescence emission at both 480 nm (green) and 550 nm (red). This novel variant was expressed in both Escherichia coli and zebrafish (Danio rerio) muscle, confirming the dual fluorescence emission in both model systems. One of the immediate applications of this novel protein variant is in ornamental aquaculture. The dual fluorescence can serve as a unique marker or trait, enhancing the aesthetic appeal of aquatic species in ornamental settings.

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OBJECTIVES: to adapt, validate the content and assess the reliability of the instrument National Aeronautics and Space Administration - Task Load Index, translated into Brazilian Portuguese. METHODS: a methodological study, divided into five steps: translation; synthesis; back-translation; assessment of the Portuguese version by an expert committee; pre-test and content validity of the final version by health professionals working in inpatient units. The Content Validity Index (CVI) (minimum 0.80) and Cronbach's alpha (minimum 0.70) were calculated. RESULTS: in the first round, in the agreement analysis of the translated version, three items did not reach the minimum CVI value. It was decided to remove the statement. The instrument title and items "performance" and "effort" were changed. There was consensus and approval of the final version in the pre-test step. CONCLUSIONS: the NASA Task Load Index instrument, adapted to Brazilian Portuguese, presents reliability and content validity evidence.

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BACKGROUND: Oral anticoagulation is the cornerstone treatment of several diseases. Its management is often challenging, and different telemedicine strategies have been implemented to support it. OBJECTIVE: The aim of the study is to systematically review the evidence on the impact of telemedicine-based oral anticoagulation management compared to usual care on thromboembolic and bleeding events. METHODS: Randomized controlled trials were searched in 5 databases from inception to September 2021. Two independent reviewers performed study selection and data extraction. Total thromboembolic events, major bleeding, mortality, and time in therapeutic range were assessed. Results were pooled using random effect models. RESULTS: In total, 25 randomized controlled trials were included (n=25,746 patients) and classified as moderate to high risk of bias by the Cochrane tool. Telemedicine resulted in lower rates of thromboembolic events, though not statistically significant (n=13 studies, relative risk [RR] 0.75, 95% CI 0.53-1.07; I2=42%), comparable rates of major bleeding (n=11 studies, RR 0.94, 95% CI 0.82-1.07; I2=0%) and mortality (n=12 studies, RR 0.96, 95% CI 0.78-1.20; I2=11%), and an improved time in therapeutic range (n=16 studies, mean difference 3.38, 95% CI 1.12-5.65; I2=90%). In the subgroup of the multitasking intervention, telemedicine resulted in an important reduction of thromboembolic events (RR 0.20, 95% CI 0.08-0.48). CONCLUSIONS: Telemedicine-based oral anticoagulation management resulted in similar rates of major bleeding and mortality, a trend for fewer thromboembolic events, and better anticoagulation quality compared to standard care. Given the potential benefits of telemedicine-based care, such as greater access to remote populations or people with ambulatory restrictions, these findings may encourage further implementation of eHealth strategies for anticoagulation management, particularly as part of multifaceted interventions for integrated care of chronic diseases. Meanwhile, researchers should develop higher-quality evidence focusing on hard clinical outcomes, cost-effectiveness, and quality of life. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42020159208; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=159208.

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Soccer is a team sport that requires players to process a significant amount of information quickly and respond with both speed and accuracy to the ever-changing demands of the game. As such, success in soccer depends not only on physical attributes but also on cognitive abilities such as perception and decision-making. The aim of the current study was to investigate the acute effects of caffeine ingestion on Stroop test performance before and after repeated small-sided games (SSG) in professional soccer players. Twelve professional male soccer players (29 ± 4.1 years; 78.1 ± 7.7 kg body mass) participated in this study. A randomized crossover double-blind placebo-controlled trial was used. Caffeine (5 mg.kg-1) or a placebo was ingested 45 min before a protocol consisting of five 5 min SSG with 1 min rest intervals. A computerized version of the colour Stroop test was completed immediately before and after the exercise protocol. During the Stroop test, words appeared on the computer screen in three different ways: (i) neutral words (neutral condition); (ii) correspondent colour (i.e., "red" painted in red; congruent condition), or; (iii) different colour (i.e., "red" painted in green; incongruent condition). The incongruent condition aimed to cause the interference effect, as the colour and the word did not match. Ratings of perceived exertion (RPE) were assessed after each SSG. RPE increased during the five sets of the SSG protocol (p < 0.001), without differences between the caffeine and placebo trials. The soccer-specific exercise protocol promoted a faster response during the Stroop test (two-way ANOVA main effect for SSG protocol: p < 0.05), with no differences in accuracy (p > 0.05). Caffeine ingestion resulted in slower reaction time during the Stroop test during the congruent and neutral trials but not during the incongruent trial (two-way ANOVA main effect for supplementation: p = 0.009, p = 0.045, and p = 0.071, respectively). Accuracy was lower in the caffeine trial in congruent and incongruent trials (p < 0.05 caffeine vs. placebo both on the pre- and post-SSG protocol). In conclusion, a soccer-specific exercise protocol improved the Stroop test performance in professional soccer players, but acute caffeine ingestion (5 mg.kg-1) was detrimental.

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RESUMO

OBJECTIVE: To construct and validate clinical simulation scenarios for emergency care for patients with chest pain. METHODS: A methodological study carried out in two stages: construction and validity. The construction took place through the survey of evidence from national and international literature. The validity stage took place through instrument assessment by judges, according to the Content Validity Index and application of a pilot test with the target audience. Fifteen judges with expertise in simulation, teaching and/or care participated in the research, in addition to 18 nursing students, in the pilot test. RESULTS: Two scenarios of clinical simulation were constructed, and all the assessed items obtained a value above 0.80, showing evidence of validity, being considered instruments suitable for application. CONCLUSION: The research contributed to the development and validity of instruments that can be applied for teaching, assessment and training in clinical simulation in emergency care for patients with chest pain.

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