Resumo São inúmeros os benefícios comprovados do aleitamento materno, e a demanda por tal direito em saúde para as pessoas transfemininas é pouco abordada na literatura, reforçando as iniquidades em saúde. O artigo objetiva realizar uma revisão de escopo sobre a indução da lactação para pessoas transfemininas no contexto de assistência à saúde. Revisão sistemática da literatura em seis bases de dados selecionadas, buscando artigos com termos relacionados à lactação e pessoas transfemininas. Os dados foram extraídos e analisados, resumindo os principais resultados em tabelas. Foram encontrados 390 artigos. Após a exclusão dos duplicados, procedeu-se à seleção por título/resumo e posterior seleção pela leitura na íntegra, considerando os critérios de exclusão e inclusão. Foram incluídos 21 artigos, publicados entre 2018 e 2023. Entre eles, seis são relatos de casos com informações inéditas sobre o tema, e os demais são publicações em diversos formatos. A indução da lactação foi alcançada em todos os relatos de casos. Existe um corpo de evidências frágil e recente que afirma o sucesso da indução da lactação em mulheres trans. Há necessidade de respaldar essa demanda por parte dos profissionais e estudos robustos para otimizar as intervenções necessárias.

Abstract There are countless proven benefits of breastfeeding, and the demand for such a right in health for transfeminine people is rarely addressed in the literature, reinforcing inequities in health. The article aims to conduct a scoping review of lactation induction for transfeminine people in the health care context. Systematic literature review in six selected databases, looking for articles with terms related to lactation and transfeminine people. Data were extracted and analyzed, summarizing the main results in tables. Three hundred ninety articles were found. After the exclusion of the duplicates there was a selection by title/abstract and a following selection by the full reading of the remaining articles, considering the pre-determined exclusion and inclusion criteria. Twenty-one articles were included, published between 2018 and 2023. Among them, six are case reports with unprecedented information on the topic, and the others are publications in various formats. Lactation induction was achieved in all the case reports. There is a fragile and recent body of evidence affirming the success of lactation induction in transgender women. There is a necessity to support this demand by health professionals and robust studies to optimize necessary interventions.

ABSTRACT Patients undergoing hematopoietic stem cell transplantation (HSCT) might present acute and late toxicities and the oral tissues are frequently affected. With the survival increasing, patients show late and long-term morbidities, and there is an important association between the general and the oral health. The first and second parts of this Consensus have showed the importance of the adequacy of oral health in the pre-HSCT, and the main alterations and oral care during the period of admission for HSCT. This third part aims to review specific themes of post-HSCT dental care, such as graft-versus-host disease (GVHD) and the pediatric patient. It also aims to review pertinent subjects, both during the HSCT period and post-HSCT, concerning quality of life, pain, cost-effectiveness, and remote care. Based on this review, it is evident the importance of the work of the dental surgeon (DS) in the follow-up and treatment of the HSCT patient, always collaborating with the whole multidisciplinary team.

ABSTRACT During the state of immune vulnerability in hematopoietic stem cell transplantation (HSCT), the patient has an increased risk of developing a vast number of complications, including severe problems in the oral cavity. These situations require professional oral care to act in the diagnosis and treatment of these conditions, as well as to develop prevention protocols to minimize patient's complications. Oral mucositis, opportunistic infections, bleeding, specific microbiota, taste, and salivary alterations are complications that can occur during HSCT and interfere with various aspects, such as pain control, oral intake, nutrition, bacteremia and sepsis, days of hospitalization and morbidity. Several guidelines have been published to address the role of professional oral care during the HSCT, we describe a consensus regarding these recommendations.

ABSTRACT The oral involvement in the Hematopoietic Stem Cell Transplantation is well described in the literature. The goal of the dental treatment and management of the oral lesions related to the HSCT is to reduce the harm caused by preexisting oral infection or even the worsening of oral acute/chronic GVHD and late effects. The aim of this guideline was to discuss the dental management of patients subjected to HSCT, considering three phases of the HSCT: pre-HSCT, acute phase, and late phase. The literature published from 2010 to 2020 was reviewed in order to identify dental interventions in this patient population. The selected papers were divided into three groups: pre-HSCT, acute and late, and were reviewed by the SBTMO Dental Committee's members. When necessary, an expertise opinion was considered for better translating the guideline recommendations to our population dental characteristics. This manuscript focused on the pre-HSCT dental management. The objective of the pre-HSCT dental management is to identify possible dental situations that On behalf of the Dental Committee of the Brazilian Society of Gene Therapy and Bone Marrow Transplantation (SBTMO) can worsening during the acute phase after the HSCT. Each guideline recommendations were made considering the Dentistry Specialties. The clinical consensus on dental management prior to HSCT provides professional health caregivers with clinical setting-specific information to help with the management of dental problems in patients to be subjected to HSCT.

ABSTRACT The use of resistant cultivars is the main strategy to control Fusarium wilt on tomato, caused by Fusarium oxysporum f. sp. lycopersici . This study aimed to quantify the incidence and distribution of this disease in the region of Nova Friburgo, RJ, as well as the type of resistance of tomato cultivars to the three FOL races. Samples of healthy and wilted plants from 40 properties were evaluated for the presence of vascular discouloration. Seventeen tomato cultivars were evaluated for resistance to the three FOL races using a grading scale. Classification for resistance/susceptibility, incidence and percentage of infection of the vascular system, fresh weight accumulation and seedling length were determined. All the cultivars analysed behaved as similar to immune (SI) to race 1 of FOL and similar to immune or partial resistance to race 2. Only Aguamiel cultivar presented a SI reaction to FOL race 3. None of the cultivars presented a SI reaction to the three races. It can be concluded that failures on the control of the disease in this region can be attributed to the majority use of cultivars with incomplete resistance to the three FOL races. The seed packages also contain incomplete information about FOL resistance.

Abstract: Introduction: Physicians and medical students constitute groups at risk for suicide and suicidal behavior. Suicidal behaviors encompass phenomena ranging from thoughts, planning, and finally death by suicide. Little is known about suicidal behavior among Brazilian medical students. Objective: The aim of this study was to assess the prevalence of suicidal ideation, planning and suicide attempt in a sample of undergraduate medical students in Brazil, as well as to identify the sociodemographic, student life aspects and health factors most often associated with suicidal behavior. Method: A total of 722 medical students at Unicamp, during 2017 and 2018, voluntarily and anonymously answered a broad questionnaire, including sociodemographic data, aspects of academic life and suicidal behavior. A statistical analysis was performed using the chi-square test, Mann-Whitney test, and multivariate logistic regression. A statistical significance level of 95% was adopted. Results: The lifetime prevalence rates of suicidal thoughts, planning and attempts were respectively 196 (27.3%), 64 (8.9%), and 26 (3.6%). In the 30 days prior to the survey, 36 (5%) seriously thought about ending their own lives, and 11 (1.5%) concretely planned to end their own lives. Bullying, presence of mental disorder, seeking mental health care at the university, use of sedatives without a prescription, low socioeconomic level, living alone, religion (atheists, agnostics and spiritualists) and degree of religiousness are the factors that, together, best explain the chance of suicidal behavior. Conclusion: Medical students show important prevalence rates of suicidal behavior.

Resumo: Introdução: Médicos e alunos de Medicina são grupos de risco para o suicídio e comportamento suicida. Comportamentos suicidas abrangem fenômenos que vão desde pensamentos, planejamentos, tentativas e até a morte por suicídio. Sabe-se pouco sobre o comportamento suicida entre estudantes de Medicina brasileiros. Objetivo: Este estudo teve como objetivos avaliar a prevalência de ideação, planejamentos e tentativas suicidas em uma amostra de estudantes de graduação em Medicina do Brasil, e identificar os fatores sociodemográficos, de vida estudantil e de saúde mais associados a esses comportamentos. Método: Participaram do estudo 722 alunos do curso de Medicina da Unicamp, durante os anos de 2017 e 2018, que responderam de forma voluntária e anônima a um questionário amplo, que incluía dados sociodemográficos, de vida acadêmica e de comportamento suicida. A análise estatística foi realizada por meio do teste de qui-quadrado, do teste de Mann-Whitney e da regressão logística múltipla. Adotou-se o nível de significância estatística de 95%. Resultado: As prevalências de pensamentos, planejamento e tentativas de suicídio ao longa da vida foram respectivamente 196 (27,3%), 64 (8,9%) e 26 (3,6%). Nos 30 dias que antecederam a pesquisa, 36 (5%) pensaram seriamente em pôr fim à própria vida, e 11 (1,5%) planejaram concretamente colocar fim a própria vida. Bullying, presença de transtorno mental, procura de assistência em saúde mental na universidade, uso de calmante sem prescrição médica, baixo nível socioeconômico, morar sozinho, religião (ateus, agnósticos e espiritualistas) e grau de religiosidade são os fatores que, conjuntamente, melhor explicam a chance de comportamento suicida. Conclusão: Alunos de Medicina apresentam prevalências importantes de comportamento suicida.

ABSTRACT Introduction: Fournier’s gangrene is a polybacterial infection, usually caused by anaerobic and aerobic bacteria, characterized by scrotal and perineal necrotizing fasciitis. Its treatment is based on surgical intervention by excision of the necrotic area and early antibiotic therapy. There are several strategies to reconstruct the defect resulting from debridement, and it should be noted that tissue losses greater than 50% are usually reconstructed with flaps. Methods: Retrospective analysis of the series of cases of scrotal reconstruction after Fournier’s gangrene performed by the authors throughout 2020, totaling eight patients. Results: The most used flap was thigh fasciocutaneous flap, which presented a partial necrosis rate of 14.29%, without total necrosis. In one of the cases, it was possible to reconstruct a spongy urethra with gracilis muscle without fistulization, preventing the patient from undergoing a definitive urethrostomy. As for complications, the occurrence of minor complications that required simple revision procedures was common. The prevalence of 75% of diabetes mellitus in our series is highlighted, which may have negatively interfered with the healing process. Conclusion: Scrotal reconstruction with flaps is important to accelerate wound healing from Fournier gangrene debridement and to maintain the pouch aspect necessary for testicular thermoregulation. Our primary option was thigh fasciocutaneous flap, which proved to be safe. And minor complications were frequent in this series, without compromising the final result.

RESUMO Introdução: Gangrena de Fournier é uma infecção polibacteriana, geralmente causada por bactérias anaeróbias e aeróbias, sendo caracterizada por fasciite necrosante escrotal e perineal. Seu tratamento é embasado em intervenção cirúrgica com excisão da área necrótica e antibioticoterapia precoces. Diversas são as estratégias de reconstrução do defeito resultante do desbridamento, devendo ser salientado que perdas teciduais maiores do que 50% costumam ser reconstruídas com retalhos. Métodos: Análise retrospectiva da série de casos de reconstrução escrotal após gangrena de Fournier procedidos pelos autores ao longo de 2020, totalizando oito pacientes. Resultados: O retalho mais utilizado foi o fasciocutâneo de coxa, que apresentou taxa de necrose parcial de 14,29%, sem necrose total. Em um dos casos foi possível reconstruir uma uretra esponjosa com músculo grácil sem fistulização, evitando que o paciente fosse submetido a uma uretrostomia definitiva. Quanto às complicações, foi comum a ocorrência de intercorrências menores que necessitaram de procedimentos revisionais simples. Destaca-se a prevalência de 75% de diabetes mellitus em nossa casuística, o que pode ter interferido negativamente no processo cicatricial. Conclusão: A reconstrução escrotal com retalhos é importante para acelerar a cicatrização da ferida proveniente do desbridamento de gangrena de Fournier e para manter o aspecto de bolsa necessário para a termorregulação do testículo. Nossa opção primária foi o retalho fasciocutâneo de coxa, que se mostrou seguro. Pequenas intercorrências foram frequentes nesta série, sem comprometimento do resultado final.

ABSTRACT Objective: To create and validate a model for predicting septic or hypovolemic shock from easily obtainable variables collected from patients at admission to an intensive care unit. Methods: A predictive modeling study with concurrent cohort data was conducted in a hospital in the interior of northeastern Brazil. Patients aged 18 years or older who were not using vasoactive drugs on the day of admission and were hospitalized from November 2020 to July 2021 were included. The Decision Tree, Random Forest, AdaBoost, Gradient Boosting and XGBoost classification algorithms were tested for use in building the model. The validation method used was k-fold cross validation. The evaluation metrics used were recall, precision and area under the Receiver Operating Characteristic curve. Results: A total of 720 patients were used to create and validate the model. The models showed high predictive capacity with areas under the Receiver Operating Characteristic curve of 0.979; 0.999; 0.980; 0.998 and 1.00 for the Decision Tree, Random Forest, AdaBoost, Gradient Boosting and XGBoost algorithms, respectively. Conclusion: The predictive model created and validated showed a high ability to predict septic and hypovolemic shock from the time of admission of patients to the intensive care unit.

RESUMO Objetivo: Criar e validar um modelo de predição de choque séptico ou hipovolêmico a partir de variáveis de fácil obtenção coletadas na admissão de pacientes internados em uma unidade de terapia intensiva. Métodos: Estudo de modelagem preditiva com dados de coorte concorrente realizada em um hospital do interior do nordeste brasileiro. Foram incluídos pacientes com 18 anos ou mais sem uso de droga vasoativa no dia da admissão e que foram internados entre novembro de 2020 e julho de 2021. Foram testados os algoritmos de classificação do tipo Decision Tree, Random Forest, AdaBoost, Gradient Boosting e XGBoost para a construção do modelo. O método de validação utilizado foi o k-fold cross validation. As métricas de avaliação utilizadas foram recall, precisão e área sob a curva Receiver Operating Characteristic. Resultados: Foram utilizados 720 pacientes para criação e validação do modelo. Os modelos apresentaram alta capacidade preditiva com área sob a curva Receiver Operating Characteristic de 0,979; 0,999; 0,980; 0,998 e 1,00 para os algoritmos de Decision Tree, Random Forest, AdaBoost, Gradient Boosting e XGBoost, respectivamente. Conclusão: O modelo preditivo criado e validado apresentou elevada capacidade de predição do choque séptico e hipovolêmico desde o momento da admissão de pacientes na unidade de terapia intensiva.

Resumo O gênero Tibouchina apresenta aproximadamente 350 espécies, dentre elas, Tibouchina affinis fothergillae, Tibouchina heteromalla, Tibouchina moricandiana var. vinaceae e Tibouchina sellowiana. Por se tratarem de espécies nativas do Brasil, podem ser utilizadas para revegetação de áreas antropizadas, devido à característica pioneira. A presente pesquisa objetivou estudar a propagação vegetativa via miniestaquia, utilizando ácido indol butírico (AIB) e ácido fúlvico (AF), bem como realizar determinações bioquímicas e quantificar a produtividade de minicepas destas espécies. Os propágulos foram coletados de um minijardim clonal, nos meses de abril, junho, setembro e novembro/2017, confeccionados com 5+1 cm de comprimento, corte em bisel na base e reto no ápice, mantendo-se um par de folhas reduzidas à metade. As bases das miniestacas foram submetidas aos tratamentos: 0 mg L-1AIB/AF, 2000 mg L-1AIB, 2000 mg L-1AF e 2000 mg L-1AIB+AF. O experimento foi instalado utilizando-se tubetes de 53 cm³ com vermiculita, avaliados após 33 dias de permanência em casa de vegetação, considerando-se a porcentagem de enraizamento das miniestacas. O delineamento foi inteiramente casualizado, num esquema fatorial de 4x4 (quatro épocas de coleta x quatro tratamentos), conduzido individualmente/espécie. As espécies não responderam aos tratamentos com AIB/AF. Nas diferentes épocas de coleta dos propágulos, o enraizamento foi superior a 95% para todas as espécies em abril, setembro e novembro, exceto para Tibouchina sellowiana com 49% de enraizamento no mês de novembro, demonstrando o efeito direto das condições ambientais as quais as plantas matrizes estavam sujeitas, sob a rizogênese. Conclui-se que não há necessidade da aplicação de AIB/AF para a propagação vegetativa das diferentes espécies de Tibouchina, sendo viável o uso da técnica de miniestaquia. Visando a maior produtividade de miniestacas, recomenda-se coletar os propágulos em abril para Tibouchina affinis fothergillae e Tibouchina moricandiana var. vinaceae, em novembro para Tibouchina heteromalla e em junho para Tibouchina sellowiana.

Abstract Tibouchina gene showed approximately 350 species, among these, Tibouchina affinis fothergillae, Tibouchina heteromalla, Tibouchina moricandiana var. vinaceae, Tibouchina sellowiana, are native species of Brazil, were used for revegetation in anthropized areas, due to the pioneerinh chacacteristic. The present research aimed to study rhizogenic from the technique of plant propagation by minicutting with the use of indole-3-butyric acid (IBA) and fulvic acid (FA), biochemical determinations, in addition to the ministumps production. The minicuttings were sampled in april, june, september and november and prepared with 5+1 cm length, bevel cut at the base and straight in the apical portion, keeping two leaves reduced to half. The bases of the minicuttings were to put to different treatments: 0 mg L-1 IBA/FA, 2000 mg L-1 IBA, 2000 mg L-1 FA and 2000 mg L-1 IBA+FA. The installation was in tubes with 53 cm3 with vermiculite, evaluating after 33 days of stay in the greenhouse, analyzed the rooting percentage of minicutting. The experimental design was completely randomized in a factorial of 4x4 (4 sample x 4 treatments). Rooting was greater than 95% for all species in the samples held in april, september and november, except to Tibouchina sellowiana with 49% of rooting in the month of November, showing the direct effect of the environment under the rizogenic. Concluded was unnecessary supplementation with exogenous IBA and FA for technical minicutting of different Tibouchina species. The production of minicutting was viable in april for Tibouchina affinis fothergillae and Tibouchina moricandiana var. vinaceae, in november Tibouchina heteromalla and june Tibouchina sellowiana.

Abstract The scope of this article is to describe the distribution of Transplant Centers (TCs) and hematopoietic stem-cell transplants (HSCTs) in the Brazilian territory. It is a descriptive study, which brings together information on the distribution of TCs and the number of procedures performed between 2001 and 2020, based on the following data sources: the Brazilian Cell Therapy and Bone Marrow Transplant Society of (SBTMO); the Brazilian Organ Transplant Association (ABTO); the Hospital Information System of the Unified Health System (SIH/SUS); and the Ministry of Health (MS). A total of 86 TCs were identified, predominantly in the Southeastern region of the country (64%). There are no TCs in the Northern region. Throughout the period, there were more than 30,000 procedures, concentrated in the Southeastern and Southern regions. The allogeneic type of HSCT was prevalent. Differences were found between the numbers of transplants performed depending on the source consulted. Despite the increase in the number of procedures during the period studied, both the distribution of TCs and the number of HSCTs were concentrated in more developed regions. This heterogeneity may have led to inequities in the access of the population to treatment.

Resumo O objetivo deste artigo é descrever a distribuição de Centros Transplantadores (CTs) e transplantes de células-tronco hematopoiéticas (TCTH) no território brasileiro. Estudo descritivo, que reúne informações sobre a distribuição CTs e o número de procedimentos realizados entre 2001 e 2020, a partir das fontes dos dados: Sociedade Brasileira de Terapia celular e Transplantes de Medula Óssea (SBTMO); Associação Brasileira de Transplante de Órgãos (ABTO); Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS); e Ministério da Saúde (MS). Foram identificados 86 CTs, com predominância na região Sudeste do país (64%). A região Norte não possui CTs. No período contabilizaram-se mais de 30 mil procedimentos, concentrados nas regiões Sudeste e Sul. O TCTH do tipo alogênico foi prevalente. Constataram-se divergências entre os números de transplantes realizados a depender da fonte consultada. Apesar do crescimento do número de procedimentos no período do estudo, tanto a distribuição de CTs quanto o número de TCTHs se concentrou em regiões mais desenvolvidas. Essa heterogeneidade pode ter propiciado iniquidades no acesso ao tratamento pela população.

Resumo O objetivo deste artigo é descrever a distribuição de Centros Transplantadores (CTs) e transplantes de células-tronco hematopoiéticas (TCTH) no território brasileiro. Estudo descritivo, que reúne informações sobre a distribuição CTs e o número de procedimentos realizados entre 2001 e 2020, a partir das fontes dos dados: Sociedade Brasileira de Terapia celular e Transplantes de Medula Óssea (SBTMO); Associação Brasileira de Transplante de Órgãos (ABTO); Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS); e Ministério da Saúde (MS). Foram identificados 86 CTs, com predominância na região Sudeste do país (64%). A região Norte não possui CTs. No período contabilizaram-se mais de 30 mil procedimentos, concentrados nas regiões Sudeste e Sul. O TCTH do tipo alogênico foi prevalente. Constataram-se divergências entre os números de transplantes realizados a depender da fonte consultada. Apesar do crescimento do número de procedimentos no período do estudo, tanto a distribuição de CTs quanto o número de TCTHs se concentrou em regiões mais desenvolvidas. Essa heterogeneidade pode ter propiciado iniquidades no acesso ao tratamento pela população.

Abstract The scope of this article is to describe the distribution of Transplant Centers (TCs) and hematopoietic stem-cell transplants (HSCTs) in the Brazilian territory. It is a descriptive study, which brings together information on the distribution of TCs and the number of procedures performed between 2001 and 2020, based on the following data sources: the Brazilian Cell Therapy and Bone Marrow Transplant Society of (SBTMO); the Brazilian Organ Transplant Association (ABTO); the Hospital Information System of the Unified Health System (SIH/SUS); and the Ministry of Health (MS). A total of 86 TCs were identified, predominantly in the Southeastern region of the country (64%). There are no TCs in the Northern region. Throughout the period, there were more than 30,000 procedures, concentrated in the Southeastern and Southern regions. The allogeneic type of HSCT was prevalent. Differences were found between the numbers of transplants performed depending on the source consulted. Despite the increase in the number of procedures during the period studied, both the distribution of TCs and the number of HSCTs were concentrated in more developed regions. This heterogeneity may have led to inequities in the access of the population to treatment.

A literatura endossa o crescente papel central de coordenação do governo federal nas políticas de saúde. Porém, há poucos estudos sobre o papel dos entes subnacionais, em especial, dos estados. Assim, este artigo analisou o arranjo institucional de implementação do Projeto Mais Médicos para o Brasil (PMMB) no estado de Minas Gerais. O trabalho foi realizado com base em análise documental de 31 atas de reuniões da Comissão de Coordenação Estadual e oito entrevistas com atores-chave responsáveis por sua implementação. Os resultados evidenciaram a (i) centralidade decisória do projeto no âmbito federal, a (ii) pouca clareza do papel do governo estadual no arranjo de implementação, a (iii) crise orçamentária do governo mineiro e a (iv) instabilidade política, que resultaram em (v) trocas de governo estadual e federal. Tais fatores, em conjunto, impactaram na capacidade de implementação do projeto em Minas Gerais.

The literature evidences the growing central coordinating role played by the federal government in health policy. However, there is little research on the role of subnational entities, especially state governments. This article analyzes the institutional arrangement for the implementation of the More Doctors for Brazil Project in the state of Minas Gerais. The study drew on data from a documentary analysis of 31 minutes of meetings of the State Coordinating Commission and eight interviews with key actors responsible for the implementation of the project. The results highlight: (i) Centralized Project decision-making at federal level; (ii) Lack of clarity with regard to the role of the state government in the implementation arrangement; (iii) A state government funding crisis; and (iv) Political instability, which result in (v) Changes in the state and federal government. These combined factors had a negative impact on project implementation capacity in Minas Gerais.

La literatura endosa el creciente papel central de coordinación del gobierno federal en las políticas de salud. No obstante, hay pocos estudios sobre el papel de los entes subnacionales, en especial de los estados. Por lo tanto, este artículo analizó la organización institucional de implementación del proyecto Más Médicos para Brasil (PMMB) en el estado de Minas Gerais. El trabajo se realizó con base en el análisis documental de 31 actas de reuniones de la Comisión de Coordinación Estatal y ocho entrevistas con actores-clave responsables por su implementación. Los resultados pusieron en evidencia: (i) la centralidad de decisión del Proyecto en el ámbito federal; (ii) la poca claridad del papel del gobierno estatal en la organización de la implementación; (iii) la crisis presupuestaria del gobierno del Estado de Minas Gerais y (iv) la inestabilidad política, lo que resultó en (v) cambios de gobierno estatal y federal. Tales factores, en conjunto, tuvieron impacto sobre la capacidad de implementación del Proyecto en Minas Gerais.

The literature evidences the growing central coordinating role played by the federal government in health policy. However, there is little research on the role of subnational entities, especially state governments. This article analyzes the institutional arrangement for the implementation of the More Doctors for Brazil Project in the state of Minas Gerais. The study drew on data from a documentary analysis of 31 minutes of meetings of the State Coordinating Commission and eight interviews with key actors responsible for the implementation of the project. The results highlight: (i) Centralized Project decision-making at federal level; (ii) Lack of clarity with regard to the role of the state government in the implementation arrangement; (iii) A state government funding crisis; and (iv) Political instability, which result in (v) Changes in the state and federal government. These combined factors had a negative impact on project implementation capacity in Minas Gerais.

La literatura endosa el creciente papel central de coordinación del gobierno federal en las políticas de salud. No obstante, hay pocos estudios sobre el papel de los entes subnacionales, en especial de los estados. Por lo tanto, este artículo analizó la organización institucional de implementación del proyecto Más Médicos para Brasil (PMMB) en el estado de Minas Gerais. El trabajo se realizó con base en el análisis documental de 31 actas de reuniones de la Comisión de Coordinación Estatal y ocho entrevistas con actores-clave responsables por su implementación. Los resultados pusieron en evidencia: (i) la centralidad de decisión del Proyecto en el ámbito federal; (ii) la poca claridad del papel del gobierno estatal en la organización de la implementación; (iii) la crisis presupuestaria del gobierno del Estado de Minas Gerais y (iv) la inestabilidad política, lo que resultó en (v) cambios de gobierno estatal y federal. Tales factores, en conjunto, tuvieron impacto sobre la capacidad de implementación del Proyecto en Minas Gerais.

A literatura endossa o crescente papel central de coordenação do governo federal nas políticas de saúde. Porém, há poucos estudos sobre o papel dos entes subnacionais, em especial, dos estados. Assim, este artigo analisou o arranjo institucional de implementação do Projeto Mais Médicos para o Brasil (PMMB) no estado de Minas Gerais. O trabalho foi realizado com base em análise documental de 31 atas de reuniões da Comissão de Coordenação Estadual e oito entrevistas com atores-chave responsáveis por sua implementação. Os resultados evidenciaram a (i) centralidade decisória do projeto no âmbito federal, a (ii) pouca clareza do papel do governo estadual no arranjo de implementação, a (iii) crise orçamentária do governo mineiro e a (iv) instabilidade política, que resultaram em (v) trocas de governo estadual e federal. Tais fatores, em conjunto, impactaram na capacidade de implementação do projeto em Minas Gerais.

ABSTRACT. The physicochemical characteristics of the meat from lambs fed diets containing whole or disintegrated cottonseed, associated or not with calcium lignosulfonate (LignoCaSO3), were evaluated. Thirty non-castrated Dorper x Santa Inês lambs, with an average of 24.9 ± 3.6 kg and four months of age were confined for 60 days in collective stalls and distributed in a completely randomized design with six replications. After slaughter, by means of contrasts, the averages of the parameters of the semimembranous and semitendinosus muscles were analyzed. The cottonseed increased cooking loss and ash, and reduced muscle weight, water holding capacity and red intensity. The disintegration of the cottonseed reduced the shear force in diets without LignoCaSO3, increased the protein and the loss by cooking and reduced the pH in the diets with the additive. The luminosity values increased with the disintegration of the cottonseed in diets with and without LignoCaSO3. The addition of LignoCaSO3 increased the weight of the muscle, protein, ash, pH, shear strength and the intensity of red. Moisture, lipids and yellow intensity were not influenced by the diets. Even changing the physical-chemical characteristics, the cottonseed with or without LignoCaSO3 does not change the quality of the meat.

Abstract Our hypothesis was that different sources of unsaturated fatty acids from oilseeds (sunflower, soybeans, and cottonseed) could alter milk yield, fatty acid profile, and the amount of unsaturated fatty acids yielded in milk. It aimed to evaluate the effects of lipid sources on yield and composition and fatty acids in milk of primiparous Girolando cows. Five cows in lactation (35 ± 8 days), with 410 ± 7.15 kg BW were randomly distributed in a 5 x 5 Latin square. Five experimental diets, namely a control diet without an additional source of lipid and four diets with different lipid sources: cottonseed, sunflower seed, whole soybean, or soybean oil, as lipid source, to reach 70 g/kg of ethereal extract dry matter basis were used. Cottonseed and soybean oil addition reduced daily yield by 15 and 22%. Oilseed can alter fatty acid profile in milk. Whole soybean provided greater daily milk and fatty acids yields.