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Platonia insignis is a fruit tree native to Brazil of increasing economic importance, with its pulp trading among the highest market values. This study aimed to evaluate the structure and genomic diversity of P. insignis (bacurizeiro) accessions from six locations in the Brazilian States of Roraima, Amazonas, Pará (Amazon biome), and Maranhão (Cerrado biome). A total of 2031 SNP markers were obtained using genotyping-by-sequencing (GBS), from which 625 outlier SNPs were identified. High genetic structure was observed, with most of the genetic variability (59%) concentrated among locations, mainly between biomes (Amazon and Cerrado). A positive and significant correlation (r = 0.85; p < 0.005) was detected between genetic and geographic distances, indicating isolation by distance. The highest genetic diversity was observed for the location in the Cerrado biome (HE = 0.1746; HO = 0.2078). The locations in the Amazon biome showed low genetic diversity indexes with significant levels of inbreeding. The advance of urban areas, events of burning, and expansion of agricultural activities are most probably the main factors for the genetic diversity reduction of P. insignis. Approaches to functional analysis showed that most of the outlier loci found may be related to genes involved in cellular and metabolic processes.

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Introduction Noise obscures speech signal, causing auditory masking. The effects of this masking can be observed through the cortical auditory evoked potentials (CAEPs). White noise, in turn, has an effect on the auditory cortex, interfering, for example, with lexical decision making. Objective To analyze the effect of simultaneous masking by contralateral white noise on CAEPs elicited by speech stimuli. Methods Cross-sectional observational analytical study carried out with 15 participants of both sexes, who were submitted to CAEPs in two conditions: 1) without noise; 2) with white noise at 100 dBSPL intensity, contralaterally and simultaneously. To compare these conditions, the Student t test or the Wilcoxon test were used, depending on the sample normality. Differences with p values < 0.05 were considered significant. Results : When white noise was presented contralaterally and simultaneously to the CAEPs with speech stimulus, an increase in P1, N1 and P2 wave latencies was observed. P1 and P2 amplitudes and N1-P2 peak to peak amplitude also increased, unlike N1 amplitude, which decreased. The differences were significant for P1 and P2 wave latencies and for P2 wave amplitude. Conclusion The simultaneous masking effect was observed from the morphological alterations of the CAEPs with speech stimulus when white noise was presented in the contralateral ear. There was a significant increase in P1 and P2 wave latencies, as well as in P2 wave amplitude.

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PURPOSE: Drug-resistant epilepsy affects a substantial proportion (30-40 %) of patients with epilepsy, often necessitating video-electroencephalography (video-EEG) monitoring. In 2016, Sauro et al. introduced a set of measures aimed at improving the quality and safety indicators reported in video-EEG evaluations. This study aims to report our experience with the implementation of these measures. METHODS: We analyzed video-EEG data regarding quality and safty from a period spanning January 2016 to January 2018, involving a total of 101 patients monitored in our video-EEG unit. RESULTS: Among the patients included in the study, a definitive diagnosis was attainable for 92.1 %, with 36.6 % experiencing a change in diagnosis and 65.3 % undergoing a change in treatment as a result of the video-EEG evaluation. Additionally, the referral question was fully addressed in 60.4 % of admissions, and video-EEG was considered to be very useful or extremely useful in 66.4 % of cases. Adverse events were observed in 26.7 % of patients, with the most common being the progression of focal seizures to bilateral tonic-clonic seizures (11.9 %) and the occurrence of seizure clusters (5.9 %). CONCLUSION: Our findings support the implementation of Sauro et al.'s set of measures, as they provide valuable criteria for improving the reporting of video-EEG quality and safety indicators. However, challenges may arise due to variations in terminology across studies and the lack of standardized criteria for defining essential questions in video-EEG evaluations. Further research utilizing these measures is necessary to enhance their effectiveness and encourage consistent reporting of results from epilepsy monitoring units.

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Recent progress in synthesizing and integrating surface-supported metal-organic frameworks (SURMOFs) has highlighted their potential in developing hybrid electronic devices with exceptional mechanical flexibility, film processability, and cost-effectiveness. However, the low electrical conductivity of SURMOFs has limited their use in devices. To address this, researchers have utilized the porosity of SURMOFs to enhance electrical conductivity by incorporating conductive materials. This study introduces a method to improve the electrical conductivity of HKUST-1 templates by in situ polymerization of conductive polypyrrole (PPy) chains within the SURMOF pores (named as PPy@HKUST-1). Nanomembrane-origami technology is employed for integration, allowing a rolled-up metallic nanomembrane to contact the HKUST-1 films without causing damage. After a 24 h loading period, the electrical conductivity at room temperature reaches approximately 5.10-6 S m-1 . The nanomembrane-based contact enables reliable electrical characterization even at low temperatures. Key parameters of PPy@HKUST-1 films, such as trap barrier height, dielectric constant, and tunneling barrier height, are determined using established conduction mechanisms. These findings represent a significant advancement in real-time control of SURMOF conductivity, opening pathways for innovative electronic-optoelectronic device development. This study demonstrates the potential of SURMOFs to revolutionize hybrid electronic devices by enhancing electrical conductivity through intelligent integration strategies.

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Abstract Introduction Noise obscures speech signal, causing auditory masking. The effects of this masking can be observed through the cortical auditory evoked potentials (CAEPs). White noise, in turn, has an effect on the auditory cortex, interfering, for example, with lexical decision making. Objective To analyze the effect of simultaneous masking by contralateral white noise on CAEPs elicited by speech stimuli. Methods Cross-sectional observational analytical study carried out with 15 participants of both sexes, who were submitted to CAEPs in two conditions: 1) without noise; 2) with white noise at 100 dBSPL intensity, contralaterally and simultaneously. To compare these conditions, the Student t test or the Wilcoxon test were used, depending on the sample normality. Differences with p values < 0.05 were considered significant. Results: When white noise was presented contralaterally and simultaneously to the CAEPs with speech stimulus, an increase in P1, N1 and P2 wave latencies was observed. P1 and P2 amplitudes and N1-P2 peak to peak amplitude also increased, unlike N1 amplitude, which decreased. The differences were significant for P1 and P2 wave latencies and for P2 wave amplitude. Conclusion The simultaneous masking effect was observed from the morphological alterations of the CAEPs with speech stimulus when white noise was presented in the contralateral ear. There was a significant increase in P1 and P2 wave latencies, as well as in P2 wave amplitude.

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Introducción: La hipertensión arterial constituye un problema de salud pública en casi todo el mundo. Entre los factores de riesgo vinculados a ella se destaca la acumulación de grasa, que puede, a su vez, establecer los riesgos, las comorbilidades y la mortalidad asociados a esta entidad nosológica. Objetivo: Determinar las variaciones de los valores del perímetro abdominal y el índice cintura-cadera en pacientes con hipertensión arterial, según variables epidemiológicas y clínicas seleccionadas. Métodos: Se realizó un estudio descriptivo, prospectivo y transversal de 221 pacientes con hipertensión arterial, pertenecientes al Consultorio 19 del Policlínico Docente Josué País García del municipio de Santiago de Cuba, desde junio del 2019 hasta diciembre del 2020. Resultados: Predominó el sexo femenino y el grupo etario de 65-74 años (28,5 %). Los indicadores antropométricos perímetro abdominal e índice cintura-cadera tuvieron valores que superaron los parámetros normales establecidos para ambos sexos. El cálculo del perímetro abdominal reveló un predominio de la obesidad en el sexo femenino, en tanto se clasificó como aumentado en el sexo masculino. Conclusiones: Los valores del índice cintura-cadera y del perímetro abdominal en ambos sexos estuvieron por encima de los clasificados por la Organización Mundial de la Salud como de alto riesgo de presentar la enfermedad.

Introduction: Hypertension constitutes a problem of public health in almost all over the world. Among the risk factors associated with it, the accumulation of fat is notable, which can, in turn, establish risks and determine comorbidities and mortality associated with this nosological entity. Objective: To determine the variations in the values of the abdominal perimeter and waist-hip ratio in patients with hypertension, according to selected epidemiological and clinical variables. Methods: A descriptive, prospective and cross-sectional study was carried out on 221 patients with hypertension, belonging to doctor's office 19 of Josué País García Teaching Polyclinic in Santiago de Cuba municipality, from June, 2019 to December, 2020. Results: There was a prevalence of the female sex and the 65-74 age group (28.5%). The anthropometric indicators, abdominal perimeter and waist-hip ratio, had values that exceeded the established normal parameters for both sexes. The calculation of the abdominal perimeter revealed a predominance of obesity in the female sex, while it was classified as increased in the male sex. Conclusions: The values of the waist-hip ratio and abdominal perimeter exceeded those classified by the World Health Organization as high risk of presenting the disease in both sexes.

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The fall armyworm (FAW), Spodoptera frugiperda, is a significant pest of many crops in the world and it is native to the Americas, where the species has shown the ability to rapidly evolve resistance to insecticides and transgenic plants. Despite the importance of this species, there is a gap in the knowledge regarding the genetic structure of FAW in South America. Here, we examined the genetic diversity of FAW populations across a wide agricultural area of Brazil and Argentina using a Genotyping-by-Sequencing (GBS) approach. We also characterized samples by their host strain based on mitochondrial and Z-linked genetic markers. The GBS methodology enabled us to discover 3309 SNPs, including neutral and outlier markers. Data showed significant genetic structure between Brazil and Argentina populations, and also among the Argentinian ecoregions. Populations inside Brazil showed little genetic differentiation indicating high gene flow among locations and confirming that structure is related to the presence of corn and rice strains. Outlier analysis indicated 456 loci putatively under selection, including genes possibly related to resistance evolution. This study provides clarification of the population genetic structure of FAW in South America and highlights the importance of genomic research to understand the risks of spread of resistance genes.

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The Neotropical brown stink bug, Euschistus heros, is a major pest of soybean in South America. The importance of E. heros as a pest has grown significantly in recent times due to increases in its abundance and range, and the evolution of insecticide resistance. Recent work has begun to examine the genetic diversity, population structure, and genetic mechanisms of insecticide resistance in E. heros. However, to date, investigation of these topics has been hampered by a lack of genomic resources for this species. Here we address this need by assembling a high-quality draft genome for E. heros. We used a combination of short and long read sequencing to assemble an E. heros genome of 1.4 Gb comprising 906 contigs with a contig N50 of 3.5 MB. We leveraged this new genomic resource, in combination with genotyping by sequencing, to explore genetic diversity in populations of this species in Brazil and identify genetic loci in the genome which are under selection. Our genome-wide analyses, confirm that there are two populations of E. heros co-occurring in different geographical regions in Brazil, and that, in certain regions of the country these populations are hybridizing. We identify several regions of the genome as under selection, including markers associated with putative insecticide resistance genes. Taken together, the new genomic resources generated in this study will accelerate research into fundamental aspects of stinkbug biology and applied aspects relating to the sustainable control of a highly damaging crop pest.

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OBJECTIVE: This study aimed to characterize teleconsultations in neurology executed by Regula+Brasil project in Recife, a capital city in northeastern Brazil. METHODS: A descriptive study carried out by four private hospitals, in a partnership with the Ministry of Health in Brazil. Teleconsultation was performed preferably in the video modality. Conditions eligible for teleconsultation were headache, epilepsy, and cerebrovascular disorders. Period of analysis was May to September 2020. RESULTS: A total of 243 teleconsultations were analyzed, of which 76.95% was a first appointment. In 48.97% of cases, the teleconsultation represented the first opportunity for the patient to be consulted with the specialist. Among cases of first appointment, 20.16% were further referred to a face-to-face consultation and 21.81% could be redirected to primary health care. Headache disorders were the most predominant clinical conditions. CONCLUSIONS: The implementation and development of telemedicine by Regula+Brasil during the COVID-19 pandemic represented an opportunity to assess the value of having teleconsultations added along the line of care from primary care to a medical specialty, promoting the coordination of care across different levels of complexity of care in the health system and improving access to specialized care.

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Copernicia prunifera (Miller) H. E. Moore is a palm tree native to Brazil. The products obtained from its leaf extracts are a source of income for local families and the agroindustry. Owing to the reduction of natural habitats and the absence of a sustainable management plan, the maintenance of the natural populations of this palm tree has been compromised. Therefore, this study aimed to evaluate the diversity and genetic structure of 14 C. prunifera populations using single nucleotide polymorphisms (SNPs) identified through genotyping-by-sequencing (GBS) to provide information that contributes to the conservation of this species. A total of 1,013 SNP markers were identified, of which 84 loci showed outlier behavior and may reflect responses to natural selection. Overall, the level of genomic diversity was compatible with the biological aspects of this species. The inbreeding coefficient (f) was negative for all populations, indicating excess heterozygotes. Most genetic variations occurred within populations (77.26%), and a positive correlation existed between genetic and geographic distances. The population structure evaluated through discriminant analysis of principal components (DAPC) revealed low genetic differentiation between populations. The results highlight the need for efforts to conserve C. prunifera as well as its distribution range to preserve its global genetic diversity and evolutionary potential.

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SUMMARY OBJECTIVE: This study aimed to characterize teleconsultations in neurology executed by Regula+Brasil project in Recife, a capital city in northeastern Brazil. METHODS: A descriptive study carried out by four private hospitals, in a partnership with the Ministry of Health in Brazil. Teleconsultation was performed preferably in the video modality. Conditions eligible for teleconsultation were headache, epilepsy, and cerebrovascular disorders. Period of analysis was May to September 2020. RESULTS: A total of 243 teleconsultations were analyzed, of which 76.95% was a first appointment. In 48.97% of cases, the teleconsultation represented the first opportunity for the patient to be consulted with the specialist. Among cases of first appointment, 20.16% were further referred to a face-to-face consultation and 21.81% could be redirected to primary health care. Headache disorders were the most predominant clinical conditions. CONCLUSIONS: The implementation and development of telemedicine by Regula+Brasil during the COVID-19 pandemic represented an opportunity to assess the value of having teleconsultations added along the line of care from primary care to a medical specialty, promoting the coordination of care across different levels of complexity of care in the health system and improving access to specialized care.

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The degree of weed interference in an agricultural crop is influenced by edaphoclimatic characteristics, the management used in the environment and the period of coexistence between the weeds and the crop of interest. This study aimed to determine periods of weed interference in cowpea (Vigna unguiculata-Fabaceae) var. BRS Potengi in the semiarid of northern Minas Gerais, Brazil. Treatments consisted of periods of control and coexistence of cowpea with weeds under irrigated cultivation (0, 7, 14, 21, 28, 35, 42, 49, 56, 63, and 77 days after crop emergence). At the end of each period of coexistence and harvest time, weeds were quantified and identified, and dry matter was determined. Stem diameter, number of pods per plant, and grain yield were obtained for cowpea. The main weeds found were Cenchrus echinatus, Panicum maximum, Eleusine indica (Poaceae), and Amaranthus retroflexus (Amaranthaceae). The period before interference (PBI) occurred up to 9 days after emergence, the total period of interference prevention (TPIP) occurred up to 23days after emergence, and critical period of interference prevention (CPIP) was observed between 9 and 23days after emergence. Weed interference during the entire cowpea cycle reduced yield by 37% when compared to the control treatment.

O grau de interferência de plantas daninhas em uma cultura agrícola é influenciado pelas características edafoclimáticas, pelo manejo utilizado no ambiente e pelo período de convivência entre as plantas daninhas e a cultura de interesse. Este trabalho teve como objetivo determinar períodos de interferência de plantas daninhas em feijão-caupi (Vigna unguiculata-Fabaceae) var. BRS Potengi no semiárido do norte de Minas Gerais, Brasil. Os tratamentos consistiram em períodos de controle e convivência do feijão-caupi com plantas daninhas sob cultivo irrigado (0, 7, 14, 21, 28, 35, 42, 49, 56, 63 e 77 dias após a emergência da cultura). Ao final de cada período de convivência e época de colheita, as plantas daninhas foram quantificadas e identificadas, e a matéria seca foi determinada. O diâmetro do caule, número de vagens por planta e produtividade de grãos foram obtidos para o feijão-caupi. As principais plantas daninhas encontradas foram Cenchrus echinatus, Panicum maximum, Eleusine indica (Poaceae) e Amaranthus retroflexus (Amaranthaceae). O Período Anterior à Interferência (PAI) ocorreu até 9 dias após a emergência, o Período Total de Prevenção à interferência (PTPI) ocorreu até 23 dias após a emergência e o Período Crítico de Prevenção à Interferência (PCPI) foi observado entre 9 e 23 dias após a emergência. A interferência de plantas daninhas durante todo o ciclo do feijão-caupi reduziu a produtividade em 37% quando comparado ao tratamento controle.

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Forestry pest management includes biological and chemical methods of pest control. Using insecticides and natural enemies can be compatible in forest pest management programs. The compatibility of the predatory stink bug Podisus distinctus with the insecticide indoxacarb, used in forestry, needs to be evaluated in Brazil. This study investigated the mortality, survival, respiration, preference, prey consumption, and locomotor activity of P. distinctus adults exposed to indoxacarb. In concentration-mortality bioassays, the lethality of indoxacarb (LC50 = 2.62 g L-1 and LC90 = 6.11 g L-1) was confirmed in P. distinctus adults. The survival rate was 100% in predator insects not exposed to indoxacarb, declining to 40.7% in predator insects exposed to 2.62 g L-1 and 0.1% in predators treated with 6.11 g L-1. Indoxacarb reduced the respiration of P. distinctus from 18.45 to 14.41 µL CO2 h-1 at 2.62 g L-1 for up to 3 h after insecticide exposure, inhibiting food consumption and displaying hyperexcitation. The harmful effects of indoxacarb to the natural enemy suggest that it should be better assessed for use with P. distinctus for pest management in forestry.

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Introduction: The coronavirus disease 2019 (COVID-19) pandemic led to the suspension or postponement of care for non-urgent conditions worldwide. Regula Mais Brasil is an initiative of the Unified Health System (SUS) in Brazil to optimize the management of referrals to specialized care by using telehealth. Objectives: To report the expansion of telehealth activities of Regula Mais Brasil in response to COVID-19 and to assess qualification of referrals in primary health care (PHC) units as well as the added value of teleconsultation in qualifying referral cases. Methods: Descriptive study of the teleconsultations carried out as an additional strategy to the remotely operated referral management system, responsible for navigating cases from PHC units to specialized care in Recife, Brazil, between May 6, 2020 and September 30, 2020. Teleconsultation was implemented as a tool for reducing delays in the access to health care due to COVID-19 and ultimately allowed for reclassification of the referral adequacy and priority. Changes in referral priority ratings and referral decisions after teleconsultation were analyzed. Results: A total of 622 referral cases were analyzed. Approved referrals represented 51.9% of cases. The main reason for approved referrals was the need for diagnostic resources. There was a reduction in priority ratings in 449 cases (72.2%) after teleconsultation. There was a statistically significant association between the change of priority ratings and the decision on referral (Pearson's χ2, p-value <0.0001). Results show that telemedicine had an impact on the prioritization and qualification of cases referred to specialized services. Conclusions: A need was detected to rapidly adapt tools available for telemedicine in Brazil. Our results demonstrate that teleconsultation as an additional strategy to the remotely operated referral management system has contributed toward improving equitable access to specialized services.

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Intermolecular electron-transfer reactions are key processes in physics, chemistry, and biology. The electron-transfer rates depend primarily on the system reorganization energy, that is, the energetic cost to rearrange each reactant and its surrounding environment when a charge is transferred. Despite the evident impact of electron-transfer reactions on charge-carrier hopping, well-controlled electronic transport measurements using monolithically integrated electrochemical devices have not successfully measured the reorganization energies to this date. Here, it is shown that self-rolling nanomembrane devices with strain-engineered mechanical properties, on-a-chip monolithic integration, and multi-environment operation features can overcome this challenge. The ongoing advances in nanomembrane-origami technology allow to manufacture the nCap, a nanocapacitor platform, to perform molecular-level charge transport characterization. Thereby, employing nCap, the copper-phthalocyanine (CuPc) reorganization energy is probed, ≈0.93 eV, from temperature-dependent measurements of CuPc nanometer-thick films. Supporting the experimental findings, density functional theory calculations provide the atomistic picture of the measured CuPc charge-transfer reaction. The experimental strategy demonstrated here is a consistent route towards determining the reorganization energy of a system formed by molecules monolithically integrated into electrochemical nanodevices.

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OBJECTIVE: The present study aimed to compare the force of aesthetic wires and their non-aesthetic equivalents from two commercial brands at different displacement points, during the unloading phase at 36°C. MATERIALS AND METHODS: Forty samples (n=10) were assessed, which were presented in two groups of aesthetic wires and two groups of non-aesthetic wires from the brands GAC® (Dentsply GAC® International, NY, USA) and Aditek®(Cravinhos, SP, Brazil), with 0.016-inch gauge. The orthodontic wires were maintained at a temperature of 36°C throughout the experiment and they were subjected to the three-point bending test at a speed of 1mm/min. The unloading values were recorded as 0.5, 1.5, and 2.5mm of displacement. The data were subjected to Student's t-test and unequal variance t test, at 5% significance level. RESULTS: During the unloading phase, the mean force was significantly higher for aesthetic wires than non-aesthetic ones, in the deflection of 2.5mm, presenting values means of 2.25N (P=.0213). In deflections of 0.5mm and 1.5mm, the orthodontic archwires did not show significant differences in force between the thermally activated wires with aesthetic coating and their non-aesthetic equivalents (P≥0.05). CONCLUSION: It is concluded that during the unloading phase at a temperature of 36°C, the orthodontic archwires analyzed did not show significant difference in force between thermally activated wires with aesthetic coating and their non-aesthetic equivalents at most displacement points analysed, except for the deflection of 2.5mm, which showed higher values.

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Background and Purpose- The increasing demand and shortage of experts to evaluate and treat acute stroke patients has led to the development of remote communication tools to aid stroke management. We aimed to evaluate the JOIN App smartphone system-a low-cost tool for rapid clinical and neuroimaging data sharing to expedite decision-making in stroke. Methods- Consecutive acute ischemic stroke patients treated at a University Hospital in Brazil from December 2014 to December 2015 were evaluated. The analysis included all patients presenting with acute ischemic stroke who underwent initial evaluation by neurology residents followed by JOIN teleconsultation with a stroke neurologist on call for management decisions. An expert panel of stroke neurologists and neuroradiologists revised all cases using a standard Picture Archiving and Communication System imaging workstation within 24 hours and analyzed the decision made with remote assistance during the emergency setting. Results- A total of 720 stroke codes were evaluated with 442 acute ischemic stroke qualifying. Seventy-eight (18%) patients were treated with intravenous thrombolysis. The main reasons for tPA (tissue-type plasminogen activator) exclusion were symptom onset >4.5 hours (n=295; 67%) and hypodense middle cerebral artery territory area >1/3 (n=31; 7%). The agreement rates between Picture Archiving and Communication System versus JOIN-based thrombolysis decisions were 100% for the stroke (unblinded) and 99.3% for the neuroradiologist (blinded) experts. The use of the application resulted in a significant reduction in the door-to-needle times across the pre- versus postimplementation periods (median, 90 [interquartile range, 75-106] versus 63 [interquartile range, 61-117] minutes; P=0.03). The rates of 90-day excellent outcomes (modified Rankin Scale, 0-1) were 51.3%; 90-day mortality, 2.6%; and symptomatic intracranial hemorrhage, 3.8%. Conclusions- The JOIN smartphone system allows rapid sharing of clinical and imaging data to facilitate decisions for stroke treatment. The remote application-based decisions seem to be as accurate as the physical presence of stroke experts and might lead to faster times to treatment. This system represents an easily implementable low-cost telemedicine solution for centers that cannot afford the full-time presence of stroke specialists.

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Abstract Background: The Gini coefficient is a statistical tool generally used by economists to quantify income inequality. However, it can be applied to any kind of data with unequal distribution, including heart rate variability (HRV). Objectives: To assess the application of the Gini coefficient to measure inequality in power spectral density of RR intervals, and to use this application as a psychophysiological indicator of mental stress. Methods: Thirteen healthy subjects (19 ± 1.5 years) participated in this study, and their RR intervals were obtained by electrocardiogram during rest (five minutes) and during mental stress (arithmetic challenge; five minutes). These RR intervals were used to obtain the estimates of power spectral densities (PSD). The limits for the PSD bands were defined from 0.15 to 0.40 Hz for high frequency band (HF), from 0.04 to 0.15 Hz for low frequency band (LF), from 0.04 to 0.085 Hz for first low frequency sub-band (LF1) and from 0.085 to 0.15 Hz for second low frequency sub-band (LF2). The spectral Gini coefficient (SpG) was proposed to measure the inequality in the power distribution of the RR intervals in each of above-mentioned HRV bands. SpG from each band was compared with its respective traditional index of HRV during the conditions of rest and mental stress. All the differences were considered statistically significant for p < 0.05. Results: There was a significant decrease in HF power (p = 0.046), as well as significant increases in heart rate (p = 0.004), LF power (p = 0.033), LF2 power (p = 0.019) and LF/HF (p = 0.002) during mental stress. There was also a significant increase in SpG(LF) (p = 0.009) and SpG(LF2) (p = 0.033) during mental stress. Coefficient of variation showed SpG has more homogeneity compared to the traditional index of HRV during mental stress. Conclusions: This pilot study suggested that spectral inequality of Heart Rate Variability analyzed using the Gini coefficient seems to be an independent and homogeneous psychophysiological indicator of mental stress. Also, HR, LF/HF, SpG(LF) of HRV are possibly important, reliable and valid indicators of mental stress.

Resumo Fundamento: O coeficiente de Gini é um instrumento estatístico geralmente usado por economistas para quantificar a desigualdade de renda. No entanto, ele pode ser aplicado a qualquer tipo de dados com distribuição desigual, incluindo a variabilidade da frequência cardíaca (VFC). Objetivos: Avaliar a aplicação do coeficiente de Gini para medir a desigualdade na densidade espectral de potência de intervalos RR, e usar esta aplicação como um indicador psicofisiológico do estresse mental. Métodos: Treze indivíduos saudáveis (19 ± 1,5 anos) participaram deste estudo, e seus intervalos RR foram obtidos por eletrocardiograma durante repouso (cinco minutos) e durante estresse mental (desafio aritmético; cinco minutos). Esses intervalos RR foram utilizados para obter as estimativas de densidades espectrais de potência (PSD). Os limites para as bandas PSD foram definidos de 0,15 a 0,40 Hz para banda de alta frequência (HF), de 0,04 a 0,15 Hz para banda de baixa frequência (LF), de 0,04 a 0,085 Hz para a primeira sub-banda de baixa frequência (LF1) e de 0,085 a 0,15 Hz para a segunda sub-banda de baixa frequência (LF2). O coeficiente de Gini espectral (SpG) foi proposto para medir a desigualdade na distribuição de potência dos intervalos RR em cada uma das bandas de VFC mencionadas acima. O SpG de cada banda foi comparado com seu respectivo índice tradicional de VFC durante as condições de repouso e de estresse mental. Todas as diferenças foram consideradas estatisticamente significativas para p < 0,05. Resultados: Houve uma diminuição significativa no poder de FC (p=0,046), bem como aumentos significativos na frequência cardíaca (p = 0,004), potência da LF (p = 0,033), potência da LF2 (p = 0,019) e LF/HF (p = 0,002) durante estresse mental. Houve também um aumento significativo de SpG(LF) (p = 0,009) e SpG(LF2) (p = 0,033) durante estresse mental. O coeficiente de variação mostrou que o SpG tem mais homogeneidade em comparação com o índice tradicional de VFC durante o estresse mental. Conclusões: Este estudo piloto sugeriu que a desigualdade espectral da VFC analisada pelo coeficiente de Gini parece ser um indicador psicofisiológico independente e homogêneo de estresse mental. Além disso, FC, LF/HF, SpG(LF) da VFC são possivelmente indicadores importantes, confiáveis e válidos de estresse mental.

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BACKGROUND: The Gini coefficient is a statistical tool generally used by economists to quantify income inequality. However, it can be applied to any kind of data with unequal distribution, including heart rate variability (HRV). OBJECTIVES: To assess the application of the Gini coefficient to measure inequality in power spectral density of RR intervals, and to use this application as a psychophysiological indicator of mental stress. METHODS: Thirteen healthy subjects (19 ± 1.5 years) participated in this study, and their RR intervals were obtained by electrocardiogram during rest (five minutes) and during mental stress (arithmetic challenge; five minutes). These RR intervals were used to obtain the estimates of power spectral densities (PSD). The limits for the PSD bands were defined from 0.15 to 0.40 Hz for high frequency band (HF), from 0.04 to 0.15 Hz for low frequency band (LF), from 0.04 to 0.085 Hz for first low frequency sub-band (LF1) and from 0.085 to 0.15 Hz for second low frequency sub-band (LF2). The spectral Gini coefficient (SpG) was proposed to measure the inequality in the power distribution of the RR intervals in each of above-mentioned HRV bands. SpG from each band was compared with its respective traditional index of HRV during the conditions of rest and mental stress. All the differences were considered statistically significant for p < 0.05. RESULTS: There was a significant decrease in HF power (p = 0.046), as well as significant increases in heart rate (p = 0.004), LF power (p = 0.033), LF2 power (p = 0.019) and LF/HF (p = 0.002) during mental stress. There was also a significant increase in SpG(LF) (p = 0.009) and SpG(LF2) (p = 0.033) during mental stress. Coefficient of variation showed SpG has more homogeneity compared to the traditional index of HRV during mental stress. CONCLUSIONS: This pilot study suggested that spectral inequality of Heart Rate Variability analyzed using the Gini coefficient seems to be an independent and homogeneous psychophysiological indicator of mental stress. Also, HR, LF/HF, SpG(LF) of HRV are possibly important, reliable and valid indicators of mental stress.

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RESUMEN Introducción: El resultado estético de la reconstrucción mamaria depende de varios factores difíciles de evaluar, la aplicación de la lipotransferencia ofrece alternativas para lograr mejores resultados estéticos y mayor satisfacción de las pacientes. Objetivo: Introducir la técnica de lipotransferencia en el instituto nacional de oncología de Cuba Métodos: Se realizó un estudio descriptivo, prospectivo, de corte longitudinal, en 10 pacientes a las que se les practicó técnica de lipotransferencia para reconstrucción mamaria por cáncer, que fueron operadas en el Instituto Nacional de Oncología y Radiobiología (INOR), en el período comprendido entre noviembre de 2016 y noviembre de 2018. Resultados: La técnica fue aplicada con mejores resultados estéticos en pacientes reconstruidas con expansión tisular. Se logró mejorar la disponibilidad de tejidos y amortiguar los daños de la radioterapia. La cantidad de grasa infiltrada fue hasta 400 ml, lo que propició mejorar la calidad de los tejidos y el contorno de la mama reconstruida. Obteniéndose con ello mejor simetría. Conclusiones: La aplicación de esta técnica complementaria, permite obtener mejores resultados estéticos y de esta mejor simetría en pacientes reconstruidas por cáncer de mama(AU)

ABSTRACT Introduction: The aesthetic result of breast reconstruction depends on several factors that are difficult to evaluate. The application of lipotransference offers alternatives to achieve better aesthetic results and greater patient satisfaction. Objective: To introduce the lipotransference technique in the Cuban National Institute of Oncology Methods: A descriptive, prospective, longitudinal-section study was carried out in 10 patients who underwent lipotransfer technique for breast reconstruction due to cancer, who underwent surgery at the National Institute of Oncology and Radiobiology (INOR), in the period between November 2016 and November 2018. Results: The technique was applied with better aesthetic results in reconstructed patients with tissue expansion. Tissue availability was improved and the damage from radiation therapy was cushioned. The amount of fat infiltrated was up to 400 ml, which favored improving the quality of the tissues and the contour of the reconstructed breast. Thus obtaining better symmetry. Conclusions: The application of this complementary technique allows obtaining better aesthetic results and this better symmetry in patients reconstructed for breast cancer(AU)

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