Você está pensando, refletindo, analisando o que você vê e o que você faz o tempo todo: percepção de residentes de Medicina de Família e Comunidade sobre vídeo feedback / You are thinking, reflecting, analysing what you see and what you do all the time: perception of General Practice trainees about video feedback / Estás pensando, reflexionando, analizando lo que ves y lo que haces todo el tiempo: percepción de los residentes de Medicina Familiar y Comunitaria sobre vídeo feedback

Introdução: A comunicação é reconhecida como uma habilidade central por vários órgãos reguladores internacionais da educação médica. O ensino específico de habilidades de comunicação é fundamental para melhorar a comunicação dos médicos. As técnicas experienciais mostraram superioridade em comparação com os modelos tradicionais. A utilização de consultas reais ajuda os estudantes a visualizar melhor as suas competências de entrevista e a refletir sobre elas. Com os avanços da tecnologia, o uso de consultas médicas gravadas em vídeo tornou-se a abordagem padrão para o ensino da comunicação. No entanto, a eficácia dessa técnica depende do envolvimento ativo dos estudantes. As suas contribuições e comentários dos pares sobre a consulta gravada são essenciais para a aprendizagem. Contudo, a perspectiva do estudante sobre a utilidade dessa abordagem educativa recebeu pouca atenção. Objetivos: Compreender a percepção da aprendizagem dos residentes de medicina de família e comunidade resultante da atividade de vídeo feedback na sua formação profissional. Métodos: Estudo exploratório, qualitativo, realizado com residentes do primeiro ano de medicina de família e comunidade de um programa de residência estabelecido em São Paulo, Brasil. Os participantes foram entrevistados após as sessões educativas, que foram analisadas por meio de análise temática reflexiva. Resultados: A autopercepção de sua prática, o aprendizado de habilidades de comunicação e os ganhos afetivos foram identificados pelos participantes como pontos de aprendizado derivados da atividade de vídeo feedback. Além disso, sobre o aprendizado de habilidades específicas de comunicação, eles mencionaram comunicação não-verbal e verbal, conexões entre teoria e prática, estrutura de consulta e oportunidades para cristalizar conhecimentos. Os ganhos afetivos incluíram sentir-se parte de um grupo, melhora da autoestima, superação de inseguranças, percepção de consultas mais efetivas, reforço do gosto pelo trabalho e reconhecer a necessidade de mais aprendizado. Conclusões: Os ganhos de aprendizagem identificados em nosso estudo levaram a uma experiência de humanidade compartilhada, que permite aos participantes serem mais efetivos técnica e afetivamente com seus pacientes. Além disso, identificamos que a atividade educativa de vídeo feedback pode ser utilizada para outros possíveis fins educacionais além do ensino da comunicação.

Introduction: Communication is recognized as a central skill by various international medical education regulatory bodies. Specific teaching on communication skills is important to enhance doctors' communication. Experiential techniques appear to be superior compared to traditional models. Real-life consultation helps trainees visualize their interview skills and reflect on them. Upgraded by technology, the use of video-recorded medical visits became the standard approach for communication teaching. However, the effectiveness pf this technique relies on trainees' active involvement. Their inputs and peer feedback on the recorded consultation are essential to learning. Despite its importance, their perspective on the usefulness of video feedback in medical education has received limited attention. Objective: To understand the perception of learning among general practice trainees as a result of the video feedback activity in their vocational training. Methods: An exploratory, qualitative study, conducted with first-year general practice trainees from an established training program in São Paulo, Brazil. Participants were interviewed after educational session, which were analyzed using reflexive thematic analysis. Results: Self-perception of their practice, communication skills learning, and affective gains were identified by participants as learning points derived from the video feedback activity. Furthermore, for specific communication skills learning, they mentioned nonverbal and verbal communication, theory and practice connections, consultation structure and opportunities for crystallizing knowledge. Affective gains included feeling part of a group, improving self-esteem, overcoming insecurities, perception of more effective consultations, reinforcing fondness for their work, and need for more learning. Conclusions: The learning gains identified in our study led to an experience of common humanity, which allowed participants to be more technically and affectively effective with their patients. Also, we identified that the video feedback educational activity can be used for other possible educational purposes, beyond the teaching of communication.

Introducción: La comunicación es reconocida como una habilidad fundamental por varios organismos reguladores internacionales de educación médica. La enseñanza específica de habilidades de comunicación es importante para mejorar la comunicación de los médicos. Las técnicas experienciales parecen ser superiores a los modelos tradicionales. El uso de consultas reales ayuda a los estudiantes a visualizar y reflexionar mejor sobre sus habilidades de entrevista. Actualizado por la tecnología, el uso de consultas médicas grabadas en video se ha convertido en el enfoque estándar para la enseñanza de la comunicación. Sin embargo, para que la técnica funcione, la participación de los estudiantes es crucial. Sus contribuciones y comentarios de los compañeros sobre la consulta grabada son esenciales para el aprendizaje. Sin embargo, la perspectiva de los estudiantes sobre la utilidad de este enfoque educativo ha recibido poca atención. Objetivos: Comprender la percepción del aprendizaje por parte de los residentes de medicina de familia y comunitaria como resultado de la actividad de vídeo feedback en su formación profesional. Métodos: Estudio cualitativo exploratorio realizado con residentes de primer año de medicina familiar y comunitaria de un programa de residencia establecido en São Paulo, Brasil. Los participantes fueron entrevistados después de una sesión educativa, que fueron analizados mediante análisis temático reflexivo. Resultados: La autopercepción de su práctica, el aprendizaje de habilidades comunicativas y las ganancias afectivas fueron identificadas por los participantes como puntos de aprendizaje derivados de la actividad de vídeo feedback. Además, sobre el aprendizaje de habilidades comunicativas específicas, mencionaron la comunicación verbal y no verbal, las conexiones entre la teoría y la práctica, la estructura de consulta y las oportunidades para cristalizar conocimientos. En cuanto a las ganancias afectivas, relataron sentirse parte de un grupo, mejora de la autoestima, superación de las inseguridades, percepción de consultas más efectivas, refuerzo del gusto por el trabajo y necesidad de más aprendizaje. Conclusión: Los logros de aprendizaje identificados en nuestro estudio llevaron a una experiencia de humanidad compartida, que permite a los participantes ser técnica y afectivamente más efectivos con sus pacientes. Además, identificamos que la actividad educativa de vídeo feedback puede ser utilizada para otros posibles fines educativos, además de la enseñanza de la comunicación.

A recommendation for the use of electrical biosensing technology in neonatology.

Non-invasive cardiac output monitoring, via electrical biosensing technology (EBT), provides continuous, multi-parameter hemodynamic variable monitoring which may allow for timely identification of hemodynamic instability in some neonates, providing an opportunity for early intervention that may improve neonatal outcomes. EBT encompasses thoracic (TEBT) and whole body (WBEBT) methods. Despite the lack of relative accuracy of these technologies, as compared to transthoracic echocardiography, the use of these technologies in neonatology, both in the research and clinical arena, have increased dramatically over the last 30 years. The European Society of Pediatric Research Special Interest Group in Non-Invasive Cardiac Output Monitoring, a group of experienced neonatologists in the field of EBT, deemed it appropriate to provide recommendations for the use of TEBT and WBEBT in the field of neonatology. Although TEBT is not an accurate determinant of cardiac output or stroke volume, it may be useful for monitoring longitudinal changes of hemodynamic parameters. Few recommendations can be made for the use of TEBT in common neonatal clinical conditions. It is recommended not to use WBEBT to monitor cardiac output. The differences in technologies, study methodologies and data reporting should be addressed in ongoing research prior to introducing EBT into routine practice. IMPACT STATEMENT: TEBT is not recommended as an accurate determinant of cardiac output (CO) (or stroke volume (SV)). TEBT may be useful for monitoring longitudinal changes from baseline of hemodynamic parameters on an individual patient basis. TEBT-derived thoracic fluid content (TFC) longitudinal changes from baseline may be useful in monitoring progress in respiratory disorders and circulatory conditions affecting intrathoracic fluid volume. Currently there is insufficient evidence to make any recommendations regarding the use of WBEBT for CO monitoring in neonates. Further research is required in all areas prior to the implementation of these monitors into routine clinical practice.

Carvacrol prevents D-( +)-galactose-induced aging-associated erectile dysfunction by improving endothelial dysfunction and oxidative stress in rats.

Aging is one of the risk factors involved in the development of erectile dysfunction (ED). Growing evidence suggests that oxidative stress is the critical mediator of changes in endothelial function and penile vascular tone in the aging process. Thus, reducing reactive oxygen species (ROS) levels may preserve the bioactivity of the penile vasculature. Antioxidant compounds, such as carvacrol, limit the damage caused by ROS and, therefore, benefit the treatment of ED. Thus, this study aims to evaluate the effects of carvacrol on ED using the D-( +)-galactose aging model. The animals were divided into five groups: control, D-( +)-galactose 150 mg/kg, carvacrol 50 mg/kg or 100 mg/kg, and sildenafil 1.5 mg/kg treated daily for 8 weeks. The physiological, functional, and morphological characteristics of aging-associated ED were evaluated after treatment with carvacrol. Carvacrol prevented ED in a D-( +)-galactose-induced aging model by reducing hypercontractility, enhancing endothelial dysfunction in the rat corpus cavernosum, and improving endothelial health of rat cavernous endothelial cells. In addition, carvacrol prevented the destruction of erectile components essential for penile erection and promoted a reduction of penile tissue senescence, probably through mechanisms that involve the harmful modulation of oxidative stress. Carvacrol significantly improved the erectile function of rats in a D-( +)-galactose-induced aging model and has excellent potential as a new therapeutic alternative in treating erectile dysfunction.

New and emerging treatments for major depressive disorder.

Major depressive disorder (MDD) affects a substantial portion of the population; however, much is still unknown about the pathophysiology of this disorder. Treatment resistance highlights the heterogeneous nature of MDD and the need for treatments to target more than monoamine neurotransmission. This review summarizes research into the new and emerging targets of MDD. These include drugs such as psychedelics, antibiotics, opioid modulators, neuropeptides, and onabotulinumtoxin. Neuromodulatory treatments such as light based therapies and neuromodulation involving either magnetic or electrical stimulation are also discussed. Almost all interventions, pharmacological and neuromodulation, were trialed as adjunctive treatments to an antidepressant. Most research has been conducted on psychedelics, with trials suggesting rapid antidepressant and anti-suicidal effects. Trial findings, tolerability, study design limitations and quality of research have been considered throughout this review. There remains challenges in forming recommendations with the current research at present. With there being considerable interest into the research of new and emerging treatments-in particular, psychedelics-there may be scope in the future to form more robust recommendations.

Musculoskeletal embolization - endovascular treatment of adhesive capsulitis.

Adhesive capsulitis, commonly known as frozen shoulder, is a painful and restrictive condition that significantly impairs the quality of life for affected individuals. We present the successful endovascular treatment of adhesive capsulitis in the first-ever case performed in Portugal. A 6-month follow-up with objective results is presented, using the visual analog scale for pain and the Quick Dash questionnaire. Trans-arterial, musculoskeletal embolization, as a cutting-edge technique, offers a promising avenue for patients with adhesive capsulitis unresponsive to traditional management, opening new possibilities for improved outcomes and enhanced quality of life.

Drug screening and development cascade for Chagas disease: an update of in vitro and in vivo experimental models.

Chagas disease is a tropical neglected disease that affects millions of people worldwide, still demanding a more effective and safer therapy, especially in its chronic phase which lacks a treatment that promotes substantial parasitological cure. The technical note of Romanha and collaborators published in 2010 aimed establish a guideline with the set of minimum criteria and decision gates for the development of new agents against Trypanosoma cruzi with the focus on developing new antichagasic drugs. In this sense, the present review aims to update this technical note, bringing the state of the art and new advances on this topic in recent years.

Giant cell carcinoma of the urinary bladder : Clinicopathologic analysis and oncological outcomes.

We present the clinicopathological features of 23 cases of the giant cell subtype of urothelial carcinoma, a rare subtype of bladder cancer recognized in the current World Health Organization classification of urological tumors. Histologically, the architectural pattern of the tumor varied from infiltrating to the solid expansile pleomorphic tumor with giant, bizarre, anaplastic cells. Typical or atypical mitotic figures were frequently present in all cases. Between 10 and 30% of the tumor had a giant cell component. All cases were associated with conventional high-grade urothelial carcinoma, with areas of squamous cell divergent differentiation and micropapillary carcinoma present in six and two cases, respectively. In one case each had sarcomatoid, nested, small cell, or glandular divergent differentiation. At diagnosis, 35% of patients had advanced disease and 12% had distant metastases. When comparing giant cell urothelial carcinoma with conventional urothelial carcinoma in a matched analysis, differences in overall and cancer-specific survival were observed, particularly in the T1 stage category. Immunohistochemical staining showed a similar profile of urothelial lineage with frequent positive expression of uroplakin II, GATA3, CK20, CK7, and S100P in both giant cell and conventional urothelial carcinomas. High Ki67 proliferation (range, 60-90%; mean, 71%) and nuclear p53 accumulation (mutant profile; range, 50-90%; mean, 64%) were observed. Using the 22C3 assay, the expression of PD-L1 was found to be variable in two cases, and beta-HCG was negative. In conclusion, giant cell carcinoma is a subtype of urothelial carcinoma associated with advanced clinical stage and a trend to lower survival rates.

Seasonality of the incidence of bronchiolitis in infants - Brazil, 2016-2022: An interrupted time-series analysis.

OBJECTIVE: To evaluate the seasonality of acute bronchiolitis in Brazil during the 2020-2022 season and compare it with the previous seasons. METHODS: Data from the incidence of hospitalizations due to acute bronchiolitis in infants <1 year of age were obtained from the Department of Informatics of the Brazilian Public Health database for the period between 2016 and 2022. These data were also analyzed by macro-regions of Brazil (North, Northeast, Southeast, South, and Midwest). To describe seasonal and trend characteristics over time, we used the Seasonal Autoregressive Integrated Moving Averages Model. RESULTS: Compared to the pre-COVID-19 period, the incidence of hospitalizations related to acute bronchiolitis decreased by 97% during non-pharmacological interventions (March 2020 - August 2021) but increased by 95% after non-pharmacological interventions relaxation (September 2021 - December 2022), resulting in a 16% overall increase. During the pre-COVID-19 period, hospitalizations for acute bronchiolitis followed a seasonal pattern, which was disrupted in 2020-2021 but recovered in 2022, with a peak occurring in May, approximately 4% higher than the pre-COVID-19 peak. CONCLUSIONS: This study underscores the significant influence of COVID-19 interventions on acute bronchiolitis hospitalizations in Brazil. The restoration of a seasonal pattern in 2022 highlights the interplay between public health measures and respiratory illness dynamics in young children.

Post-cooling sperm processing can rescue sperm quality of cooled-stored stallion semen.

Poor sperm quality in cooled-shipped semen has been related to subpar fertility in horses. Therefore, this study aimed to evaluate the ability of post-cooling sperm processing to improve sperm parameters of cooled-stored stallion semen for artificial insemination. For all experiments, ejaculates were collected, processed, and diluted in skimmed milk-based (SM) medium and stored at 5 °C/24h. In all experiments an aliquot of unprocessed cooled semen was used as a control. In the first experiment (Exp 1.), cooled-stored semen from 16 stallions (n = 32) was processed by SpermFilter or centrifugation (600×g/10min) and resuspended in an egg yolk-based freezing medium containing permeating cryoprotectants (EY-C) for cryopreservation. Sperm recovery and motility parameters were immediately assessed after sperm resuspension in both groups and compared with unprocessed (Unp) samples. In Exp 2., cooled semen samples from six stallions (n = 18) were processed using SpermFilter and resuspended in SM or EY-C. Motility parameters and plasma membrane integrity were assessed in all groups (Unp, SM, and EY-C). In Exp 3, cooled semen from four stallions (n = 20) was processed by SpermFilter, resuspended in SM, EY-C, or egg yolk-based medium without cryoprotectants (EY-nC); and submitted to a thermoresistance test (37 °C/3h). Motility parameters, plasma membrane integrity and stability, mitochondrial membrane potential, mitochondrial superoxide generation, and DNA fragmentation index were evaluated in all groups. Finally, in Exp 4, 39 estrous cycles of 11 mares were inseminated with unprocessed (n = 6) cooled-stored semen or semen cooled at 5 °C/24h and then processed by SpermFilter and resuspended in SM (n = 5), EY-C (n = 11), EY-nC (n = 11), or centrifuged and resuspended in EY-C (n = 6). Overall, semen processing and resuspension in EY mediums (EY-C and EY-nC) improved sperm parameters compared with those of unprocessed semen (P < 0.05). Centrifugation (91 ± 5 %) recovered more sperm than SpermFilter (84 ± 9 %; P < 0.05). Sperm resuspended in EY-nC maintained better sperm parameters throughout the thermoresistance test than those in the other groups (P < 0.05). The fertility rates were similar between all groups (P > 0.05). In conclusion, processing and resuspension in EY medium can improve sperm parameters in post-cooled-stored stallion semen.

Optimization of HS-SPME/GC-MS Method for Determining Volatile Organic Compounds and Sensory Profile in Cocoa Honey from Different Cocoa Varieties (Theobroma cacao L.).

This study aimed to develop an analytical method using HS-SPME/GC-MS to determine the volatile organic compound (VOC) profiles and evaluate the sensory attributes of cocoa honey from four cocoa varieties (CCN51, PS1319, SJ02, and Parazinho). Using a multivariate factorial experimental design, the HS-SPME/GC-MS method was optimized to determine the VOC profiles. Twenty previously trained tasters participated in the ranking descriptive analysis, while 108 consumers participated in the acceptance and purchase intention tests. A total of 84 volatile organic compounds were identified from various chemical classes, including acids, alcohols, aldehydes, esters, ketones, monoterpenes, oxygenated monoterpenoids, sesquiterpenes, and oxygenated sesquiterpenoids. Palmitic acid was the compound found in the highest concentration in all varieties (5.13-13.10%). Multivariate analysis tools identified key compounds for differentiation and grouping of the samples. The results revealed that the variety significantly influenced both the VOCs' concentrations and sensory profiles. The CCN51, PS1319, and SJ02 varieties exhibited the highest diversity of VOCs and sensory attributes. Notably, the SJ02 and CCN51 varieties demonstrated superior acceptability and purchase intention, with means ranging from 7.21 and 7.08 to 3.71 and 3.56, respectively. These results indicate their potential as promising sources of cocoa honey for the food industry.

Assessing the Risk Stratification of Breast Cancer Polygenic Risk Scores in a Brazilian Cohort.

Polygenic risk scores (PRSs) for breast cancer have a clear clinical utility in risk prediction. PRS transferability across populations and ancestry groups is hampered by population-specific factors, ultimately leading to differences in variant effects, such as linkage disequilibrium and differences in variant frequency (allele frequency differences). Thus, locally sourced population-based phenotypic and genomic data sets are essential to assess the validity of PRSs derived from signals detected across populations. Here, we assess the transferability of a breast cancer PRS composed of 313 risk variants (313-PRS) in a Brazilian trihybrid admixed ancestries (European, African, and Native American) whole-genome sequenced cohort, the Rare Genomes Project. We computed 313-PRS in the Rare Genomes Project (n = 853) using the UK Biobank (UKBB; n = 264,307) as reference. We show that although the Brazilian cohorts have a high European ancestry (EA) component, with allele frequency differences and to a lesser extent linkage disequilibrium patterns similar to those found in EA populations, the 313-PRS distribution is inflated when compared with that of the UKBB, leading to potential overestimation of PRS-based risk if EA is taken as a standard. Interestingly, we find that case controls lead to equivalent predictive power when compared with UKBB-EA samples with area under the receiver operating characteristic curve values of 0.66 to 0.62 compared with 0.63 for UKBB.

Agronomic performance and technological quality of sugarcane submitted to different poultry litter dosages.

Sugarcane is a central crop for sugar and ethanol production. Investing in sustainable practices can enhance productivity, technological quality, mitigate impacts, and contribute to a cleaner energy future. Among the factors that help increase the productivity of sugarcane, the physical, chemical and biological parameters of the soil are amongst the most important. The use of poultry litter has been an important alternative for soil improvement, as it acts as a soil conditioner. Therefore, this work aimed to verify the best doses of poultry litter for the vegetative, reproductive and technological components of sugarcane. The experiment was carried out at Usina Denusa Destilaria Nova União S/A in the municipality of Jandaia, GO. The experimental design used was a complete randomized block design with four replications: 5 × 4, totaling 20 experimental units. The evaluated factor consisted of four doses of poultry litter plus the control (0 (control), 2, 4, 6 and 8 t ha-1). In this study, were evaluated the number of tillers, lower stem diameter, average stem diameter, upper stem diameter, plant height, stem weight and productivity. The technological variables of total recoverable sugar, recoverable sugar, Brix, fiber, purity and percentage of oligosaccharides were also evaluated. It was observed, within the conditions of this experiment, that the insertion of poultry litter did not interfere significantly in most biometric, productive and technological variables of the sugarcane. But it can also be inferred that there was a statistical trend toward better results when the sugarcane was cultivated with 4 t ha-1 of poultry litter.

Engaging primary care professionals in OECD's international PaRIS survey: a documentary analysis.

Healthcare professionals have first-hand experience with patients in clinical practice and the dynamics in the healthcare system, which can be of great value in the design, implementation, data analysis and dissemination of research study results. Primary care professionals are particularly important as they provide first contact, accessible, coordinated, comprehensive and continuous people-focused care. However, in-depth examination of the engagement of health professionals in health system research and planning activities-how professionals are engaged and how this varies across national contexts- is limited, particularly in international initiatives. There is a need to identify gaps in the planning of engagement activities to inform the design and successful implementation of future international efforts to improve the responsiveness of health systems to the changing needs of patients and professionals. The aim of this study was to explore how primary care professionals were engaged in the design and implementation plans of an international health policy study led by the Organisation for Economic Co-operation and Development (OECD). The OECD's international PaRIS survey measures and disseminates information on patient-reported outcome and experience measures (PROMs and PREMs) of people living with chronic conditions who are managed in primary care. A documentary analysis of 17 written national implementation plans (country roadmaps) was conducted between January and June 2023. Two reviewers independently performed the screening and data abstraction and resolved disagreements by discussion. We reported the intended target primary care professionals, phase of the study, channel of engagement, level of engagement, and purpose of engagement. All 17 countries aimed to engage primary care professionals in the execution plans for the international PaRIS survey. While organisations of primary care professionals, particularly of family doctors, were the most commonly targeted group, variation was found in the timing of engagement activities during the different phases of the study and in the level of engagement, ranging from co-development (half of the countries co-developed the survey together with primary care professionals) to one-off consultations with whom. International guidance facilitated the participation of primary care professionals. Continuous collaborative efforts at the international and national levels can foster a culture of engagement with primary care organisations and individual professionals and enhance meaningful engagement of primary care professionals.

The impact of preservation solutions for static cold storage on kidney transplantation outcomes: Results of a Brazilian nationwide multicenter study.

This study evaluated the current practices of selecting cold storage preservation solutions in Brazil and their impact on delayed graft function (DGF) incidence and 1-year outcomes in kidney transplant recipients. A retrospective cohort study was conducted, including 3,134 brain-dead deceased donor kidney transplants performed between 2014 and 2015 in 18 Brazilian centers. The most commonly used preservation solution was Euro-collins (EC, 55.4%), followed by Histidine-tryptophan-ketoglutarate (HTK, 30%) and Institut Georges Lopez (IGL-1, 14.6%). The incidence of DGF was 54.4%, with 11.7% of patients requiring dialysis for more than 14 days, indicating prolonged DGF. Upon adjusting for confounding variables, HTK demonstrated a significantly lower risk of DGF than EC (OR 0.7350.82500.926), as did IGL-1 (OR 0.6050.7120.837). Similar protective effects were observed for prolonged DGF when comparing HTK (OR 0.4780.5990.749) and IGL-1 (OR 0.4780.6810.749) against EC. No significant association was found between preservation solutions and 1-year death-censored graft survival. In conclusion, EC was the most frequently used cold storage perfusion solution, demonstrating a higher incidence and duration of DGF compared with HTK and IGL-1, but with no impact on 1-year graft survival.

Concepts for the development of person-centred, digitally-enabled, Artificial Intelligence-assisted ARIA care pathways (ARIA 2024).

The traditional healthcare model is focused on diseases (medicine and natural science) and does not acknowledge patients' resources and abilities to be experts in their own life based on their lived experiences. Improving healthcare safety, quality and coordination, as well as quality of life, are important aims in the care of patients with chronic conditions. Person-centred care needs to ensure that people's values and preferences guide clinical decisions. This paper reviews current knowledge to develop (i) digital care pathways for rhinitis and asthma multimorbidity and (ii) digitally-enabled person-centred care (1). It combines all relevant research evidence, including the so-called real-world evidence, with the ultimate goal to develop digitally-enabled, patient-centred care. The paper includes (i) Allergic Rhinitis and its Impact on Asthma (ARIA), a two-decade journey, (ii) Grading of Recommendations, Assessment, Development and Evaluation (GRADE), the evidence-based model of guidelines in airway diseases, (iii) mHealth impact on airway diseases, (iv) from guidelines to digital care pathways, (v) embedding Planetary Health, (vi) novel classification of rhinitis and asthma, (vi) embedding real-life data with population-based studies, (vii) the ARIA-EAACI strategy for the management of airway diseases using digital biomarkers, (viii) Artificial Intelligence, (ix) the development of digitally-enabled ARIA Person-Centred Care and (x) the political agenda. The ultimate goal is to propose ARIA 2024 guidelines centred around the patient in order to make them more applicable and sustainable.

Detection of Arsenophonus in Glycaspis brimblecombei (Hemiptera: Aphalaridae) populations in Brazil.

Eucalyptus is the most intensively managed tree genus in the world. Different factors, including damage by insect pests, affect its growth and productivity. Among these pests is Glycaspis brimblecombei Moore (Hemiptera: Aphalaridae), an exotic insect of Australian origin. The evolutionary success of this insect depends on symbiotic associations with microorganisms. The influence of these microorganisms on insect pests and their natural enemies is important for integrated management tactics. Within this context, this work aimed to detect Arsenophonus in populations of G. brimblecombei in Brazil. Eucalyptus branches infested with G. brimblecombei nymphs were collected in commercial eucalyptus plantations in six Brazilian states. Specimens of this pest were sampled soon after emergence and frozen for molecular analysis. The genomic DNA of G. brimblecombei adults from each population was extracted and used to detect the endosymbiont Arsenophonus by polymerase chain reaction (PCR) employing specific primers that target its 23 S rRNA gene. This endosymbiont was identified in all of the studied G. brimblecombei populations. This is the first report on the association between Arsenophonus and G. brimblecombei in Brazil.