The purpose of this study was to carry out a literature review on the effectiveness of the validation method (VM) in job satisfaction and motivation of care professionals working with older people in nursing homes. The review was carried out in specialised databases: Scopus, PsychINFO, PubMed, Web of Science (WOS), Google Scholar, Scielo, and Cochrane Database of Systematic Reviews. 9046 results were obtained, out of which a total of 14 studies met the inclusion criteria: five quantitative, four qualitative, one single case series, two quasi-experimental and two mixed methods studies. The results of the analysed studies report that the VM can be an effective tool that facilitates communication and interaction in care, reducing levels of stress and job dissatisfaction among care professionals. The VM facilitates communication between professionals and older people with dementia, and improves the management of complex situations that may arise in care, directly influencing a reduction in work stress and increasing job satisfaction. The increase in life expectancy and the higher prevalence of neurocognitive disorders means there is a need to improve and innovate non-pharmacological strategies in order to ensure the quality of life and well-being of older people and their caregivers ,2,3. As Care for people with dementia can cause difficulties for care professionals, increasing their levels of stress, discomfort and job dissatisfaction ,9,10,11.This methodology is linked to the need found in many residential centers to promote the development of professionals’ relational and socioemotional skills in order to improve positive and reciprocal relationships between them and the older people, which is a core aspect of care models like the well-known person-centred care model ,18,19,20In this regard, this review is necessary given the increase in interest to improve the quality of care, giving priority to humanisation and the implementation of the person-centred care model ,18,33,34A literature review was performed by peers of articles that included the effectiveness of VM in nursing home care professionals. The following databases were used for the review: Scopus, PsychINFO, PubMed, Web of Science (WOS), Google Scholar, Scielo and Cochrane Database of Systematic Reviews. The terms validation therapy, validation method, validation training, nursing, care, institutionalised, satisfaction, motivation and burnout were used. The search strategy used in the databases was: “ and (therapy OR method OR training) AND  AND (satisfaction OR motivation OR burnout)”. In the Google Scholar database the following search was used: “ and (therapy OR method OR training) AND  AND (satisfaction OR motivation) and (Feil)”.The bibliographic references of the selected articles were analysed manually, in order to find other studies that could potentially be included for the review. In addition, documents from grey literature were included, as well as scientific articles, systematic reviews (SR), metanalyses and book chapters that met the inclusion criteria .The initial selection and subsequent screening were carried out by the principal researcher based on the title and results summary. Subsequently, the final selection was carried out by peers in a team six reviewers: five experts accredited by the Validation Training Institute in VM , and oneFor the evaluation of each article, the following were taken into consideration: the year and country of the study, the type of study design , outcome measures, intervention group , type of intervention, evaluation of intervention and main effects on results in healthcare professionals.Initially, 9046 results were obtained, out of which a total of 14 studies met the inclusion criteria .With regards to the characteristics of older people that some studies included ,28,36,37In contrast, the characteristics of the professional participants in age, gender, sample size and professional profile in the studies are heterogeneous . Most ofRegarding professional profile, 12 studies (86%) included nursing staff, made up mostly of nurses and auxiliary nurses, in the training of the VM and/or in its implementation ,36,37,38These studies used different designs ranging from quantitative designs 5) ,33,36,37 ,33,36,3The trial structure of the included studies that did training in the VM or analysed the effect on its implementation was, in two studies (14%), a single-arm trial where training in the VM was carried out ,30; in fAlthough all the interventions were carried out in nursing homes, the duration and time of intervention varied. Most lasted between five and seven months ,26,27,30Regarding the variables of the professional studied, first, in the studies with quantitative measures, six studies 43%) quantified as outcome measures the effect of VM in three major areas ,33,36,37% quantifSecond, in the studies with qualitative measures, five studies (36%) quantified as an outcome measure the satisfaction with the relationship and communication between the professional and the residents and between the latter and their families which was assessed through observations of the interactions between the professional, the residents and their families or with Hecht’s Interpersonal Communication Satisfaction Inventory (ICSI) , the DemThird, two quasi-experimental studies (14%) and one case series study (7%), quantified as an outcome result the effect of VM on satisfaction with communication between the professional and the residents and between the latter and their families, its use in the positive management of problem behaviours and increasing understanding of the behaviours of the disoriented person with dementia evaluated through Hecht’s Interpersonal Communication Satisfaction Inventory (ICSI) , the DemFinally, despite the heterogeneity in the sample composition and in the structure and duration of the training and implementation, all the studies included in the review agree that training positively influences satisfaction, motivation, competence and self-efficacy of the care professional, improving their productivity and commitment to the organisation. Although there are only two randomised studies, the evidence suggests that training in and/or implementing VM can have a positive effect on healthcare professionals on a personal/professional, interpersonal and organisational level.In the professional sphere there is a reduction in stress levels ,33,36,37Regarding the interpersonal sphere, there is an improvement in communication skills between the professionals and the disoriented person, which facilitate the relationship and care ,27,30,38Finally, in the organisational sphere, there is a positive increase in the work climate ,37 and aThe purpose of this study was to analyse evidence on the efficacy of the VM on the job satisfaction and motivation of nursing home care professionals. Despite the limitations and methodological heterogeneity of the studies, most of the studies indicate that the VM provides benefits to care professionals, concluding that training and the correct use of the communication techniques that the VM provides are useful tools for relating and communicating with disoriented seniors, reducing burnout and negative work climate, and increasing their productivity and satisfaction, motivation and happiness at work ,29,30,33In the studies analysed, the variables most analysed in the professionals are burnout, job satisfaction, competence in the positive management of problematic situations that arise in care, as well as improvement of the relationship and communication between the professional and resident. Implementing and/or training in VM may have positive work effects that can be related to job satisfaction and motivation. Therefore, the communication tools, relationship, and theoretical framework provided by the VM is highlighted in this type of intervention since it provides tools for developing relational competencies, facilitating the relationship and communication between the disoriented senior and the care professional. As a result, it is necessary to extend research on non-pharmaceutical strategies that provide care professionals with tools, as well as the use of VM with other pharmaceutical interventions, as is being done, for example, with the Emotion-Oriented Care Model ,26,27,53The VM, which is in some ways congruent with the good practices that the person-centred care fosters, promotes a change in the culture of care where the abilities of the older person with dementia are valued and empowered, and where the professional moves from a role of being caregiver of a patient to being a caregiver of an expert in his/her own care ,34,54,55Finally, this review has a number of limitations: One is that there may exist a publication selection bias, since the initial screening of articles was not done by peers. Furthermore, the heterogeneity, lack of information on the sample composition or the type of intervention, samples under thirty participants in some studies, as well as methodological limitations, means that the results need to be taken with caution. In addition, there may be a general publication bias in the evidence analysed and a bias on the “negative” effects of the use of and/or training in VM. The authors of the review have found this publication bias difficult to control. With regard to its strengths, it should be noted that an extensive search on the VM was conducted, where any type of study that dealt with the effectiveness of VM on nursing home care professionals was included, both in terms of implementation of, and training in, the method.Training in and/or implementing VM provides professionals with techniques of relationship and communication with disoriented older people that enables and helps them to manage their care, improving their quality of life and acting as tools that protect them against burnout, given that stress and overwork are reduced. In addition, it leads to greater empathy and provides professionals with a greater understanding of the meaning of the residents’ behaviour, promoting good treatment focused on the real needs of the older person with dementia (or disoriented).More exploration of this method’s techniques is required, since it offers a field of communication and relationship that should not be underestimated and that, as the scientific evidence shows, generates positive effects on the satisfaction and motivation of care professionals. To do this, it is necessary to generate studies with standardised instruments, appropriate samples, and also include mixed methodology to complement the qualitative nuances that are generated in the relationship and communication between the professional and the person with dementia (or disoriented) with the quantitative data.


Dear Editor,Diffuse Normolipemic Plane Xanthoma (DNPX) is a rare acquired dermatosis, clinically characterized by patches and/or yellow-orange plaques symmetrically distributed. It is an uncommon type of non-Langerhans histiocytosis that occurs due to the deposition of lipids in the skin and, in almost half of cases, occur in the absence of hypercholesterolemia.A 61 year-old man with a history of onset of asymptomatic yellowish spots, 2 years ago, initially on the eyelids. In one year, the lesions also appeared in the armpits, in the inguinal, genital and gluteal regions. He had a recent diagnosis of Hepatitis C (HCV), without treatment. He denied other comorbidities and use of medications. On examination he had yellowish plaques with a symmetrical distribution in the periorbital region bilaterally , and plaDNPX is a rare type of non-Langerhans histiocytosis that usually appears initially with a palpebral xanthelasma, as is the case, with later appearance flesions usually in the neck, trunk, upper dorsum, cubital fossae, and extremities. These distribution of xanthomatous lesions in DNPX is unique, although it varies among cases.Hepatitis C is a systemic disease that can cause manifestations in various organs and systems. It is estimated that approximately 74% of patients experience at least one extra hepatic manifestation of the disease during their lifetime, with 17% of them having dermatological manifestations. The most commonly associated dermatoses are cryoglobulinemia, lichen planus, porphyria cutanea tarda and acral necrolytic erythema. It is believed that most of these diseases present as path physiology the formation and deposition of immune complexes in the tissues, although the mechanism of these diseases is not completely understood. Other dermatological diseases also have been shown to be associated with hepatitis C, but with less consistency, such as cutaneous B-cell lymphoma, erythema multiforme, leukocytoclastic vasculitis and urticaria.XPDN has been associated with hematologic disorders, particularly multiple myeloma and monoclonal gammopathy; however, leukemia, lymphoma and Castleman's disease have also been associated with the disease.None declared.Maria Carolina Casa Souza: Approval of the final version of the manuscript; conception and planning of the study; elaboration and writing of the manuscript; obtaining, analysis, and interpretation of the data; effective participation in research orientation; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied cases; review of the literature; critical review of the manuscript.Paulo Henrique Teixeira Martins: Statistic analysis; approval of the final version of the manuscript; conception and planning of the study; elaboration and writing of the manuscript; obtaining, analysis, and interpretation of the data; effective participation in research orientation; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied cases; review of the literature; critical review of the manuscript.Analú Vivian: Approval of the final version of the manuscript; conception and planning of the study; elaboration and writing of the manuscript; effective participation in research orientation; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied cases; review of the literature; critical review of the manuscript.Laura Luzzatto: Obtaining, analysis, and interpretation of the data; effective participation in research orientation.None declared.


Case Report. Patient E.M.S, 25 years old, male, leucoderma, referred to the Emergency Room of our institute. He reported being a victim of physical aggression, occlusal alteration, limitation of mouth opening, sensibility loss in the mentalis region, right infraorbital, and denied visual alteration. On physical examination, during the inspection and palpation, the crackling was observed in the right mandibular region and apical displacement of the maxillary alveolar process, corresponding to elements 13, 14, and 15.  This report aims at demonstrating the treatment of complex mandibular fracture functional reimplantation of the maxillary alveolar fragment (FRAF), denoting the possibility and feasibility of this reduction with an excellent prognosis.  The rigid fixation of the complex jaw fracture and alveolar maxilla process, through functional reduction, indicated satisfactory applicability, and favorable prognosis. The bones of the face are part of the complex stomatognathic apparatus, of which the mandible occupies the second position among the most affected in craniofacial traumas . Such prThe etiology of mandibular fractures is concentrated in cases of physical aggression and automobile accidents, although sports accidents and pathological or mechanical fractures are present as predisposing factors, either in the involvement of neoplasms or during the extraction of lower third molars , 2. CommFor diagnosis, a thorough clinical and radiographic examination should be performed, taking into account factors such as impact energy, direction, and location, as well as the resilience of the structures involved . The objPatient E.M.S, 25 years old, male, leucoderma, was referred to the Emergency Room of our institute. During a medical-dental questionnaire, the patient mentioned having been a victim of physical aggression, reporting occlusal alteration, limitation of the amplitude of buccal opening, and loss of sensibility in the mental and infraorbital region. He denied visual and respiratory changes, although there were signs of subconjunctival ecchymosis and epistaxis. On physical examination, during the inspection and palpation, crepitation was observed in the body region and right mandibular angle and apical displacement of the bone fragment in the premaxilla, corresponding to elements 13, 14, and 15, with an evident sign of alveolar tooth fracture . In all After systemic stabilization, the patient was taken to the Buccomaxillofacial Surgery and Traumatology Service, after 10 days of the first care. In the surgical center, in HDD, under general anesthesia, antisepsis was started with topical PVP-i and placement of the sterile fields, followed by subperiosteal infiltrative terminal anesthesia in the right maxilla region, aiming at facilitating the detachment of the muco-suspicious flap and promoting hemostasis; through the Newman Modified incision, the detachment of the flap continued, evidencing the dentoalveolar fracture. In order to eliminate the granulation tissue at the interface of the fragment and maxilla, which would certainly prevent good bone repair, the fragment was removed Figures –4. HowevIn the next step, through the Risdon incision in the mandible, the subcutaneous planes were approached, location and protection of the facial nerve and artery, and incision of the pterygomassetric band and detachment. With the separation of the fragments and evaluation of the lingual space, the reconstruction and anatomical repositioning of the fragments with transfixing screws and plates and screws of the 2.0 system Figures  and 8 weThe suture of the deep planes of the mandibular approach and oral cavity was performed with Vicryl 4.0 wire and on the skin was used Nylon 6.0.The patient was preoperatively treated with Dexamethasone 8 mg, Cephalotin 1 g, and intravenous dipyrone 500 mg. All medications were maintained in trans and postoperative and were adapted for use in tablets. Postoperatively, N-acetylcysteine 500 mg was added to the bucosinusal communication.The patient followed postoperative follow-up for 7, 14, 21, 35, and 64 days, presenting evolution within the norms of normality and cicatricial process compatible with the surgical procedure performed. There was an absence of secondary infections, occlusal restoration, and consolidation of the fragment in the maxilla. In respect to the regeneration of the nervous tissue, although it is known, by the literature, that the regeneration of the proximal stump occurs, in this specific case, it comes to an avulsion of fragment with involved teeth, which made the reasoning of this case to devolve in the same conditions and treatment of avulsioned teeth, that is, endodontic treatment after 14 days of the trauma. The patient was referred to the endodontic treatment of the elements 13 and 14, making it possible to maintain them in the oral cavity. A radiographic examination of the control was performed, in which titanium plates and screws were positioned, indicating a satisfactory reduction of the bone fragments Figures  and 11.Facial fractures generate discussions among students ever since Hippocrates was alive, especially regarding the origin of the trauma, diagnosis, and treatment. In agreement with the findings found in the literature, this report presents a patient who suffered physical aggression of high intensity, generating maxillomandibular trauma. Such an etiology ranks first among the most common causes attended in emergency services , 4.Among the anatomical subdivisions of the mandible, the body region corresponds to a significant percentage of the fractures, and the immediate reduction of the stumps is a determinant factor to obtain adequate occlusion , 5. In tThe treatment choice was based on the analysis of complete clinical and radiographic examination, considering the possible sequels, both aesthetic and functional, that could be caused. According to most of the cases found in the literature, even in the other mandibular regions, the functional reduction was obtained through occlusal adjustment and rigid internal fixation, considering the complexity and biases of the reduction of complex fractures or maxillo-mandibular fractures , 5–7. WhAccording to a study carried out by Melo and Oleveira (2013), dentoalveolar trauma resulting from physical aggression accounts for about 35.8% of the cases, a study carried out on 1459 patients showed that in only 1% of the cases there was an association of dentoalveolar trauma with mandible fracture [It is important to observe that the removal of the fragment for removal of granulation tissue was indispensable; its nutrition was safeguarded by the periosteum itself carefully detached in the step of dieresis . From itThe nonrigid attachment of the dental elements involved should be indicated, when necessary, to stabilize them –16. HoweWith the evolution of the case, we can conclude that the proposed treatment proved to be effective, reestablishing the patient functionally. The FRAF technique process and primary stabilization of the anterior mandibular complex fracture and reconstruction plate are feasible and demonstrate a favorable prognosis when correctly indicated, following the basic principles of reduction, stabilization, and fixation even if mediated.


The Lancet HIV, Oliver Ratmann and colleaguesPopulation mobility is an intrinsic human condition. People have always moved over space and time, and always will. Yet mobility can be hard to define and measure, and thus it is challenging to understand the effects of mobility on the spread of HIV. In As countries move toward the UNAIDS 90-90-90 treatment goals and beyond, we will need more studies like that of Ratmann and colleagues to identify and predict whether and how population mobility will influence (positively or negatively) HIV intervention effectiveness. Strategies to end the HIV epidemic, especially those that target geographical hotspots, will increasingly need to account for population mobility with special attention to time.Human mobility directly and indirectly affects HIV transmission dynamics over time, but the temporal scale has received less attention. For example, the importance of population mobility on intervention effectiveness in a community depends on the relative timing of the intervention and mobility in the population.Migrant populations are heterogeneous, and the relative importance of different types of mobile populations on HIV depends on the stage of the epidemic. At the start of the HIV epidemic in sub-Saharan Africa, the spread of HIV was closely tied to migrant flows,Migration can have non-linear and long-lasting effects on transmission dynamics, depending on the epidemic's stage, the frequency and context of migration, the relative timing of interventions, life-stage, and the sexual behaviour of migrants.


WHO statistics shows that drowning is one of the most important research areas in the world. Despite the extensive research on drowning in the past, scientometric approaches have not been used yet to evaluate these studies.In this descriptive cross-sectional study, which is based on scientometric method, the analysis was done using the words in the title, abstract and keywords. In addition to visualization of the universal cooperation between universities and researchers, the bibliographic and citation data of articles have been retrieved from Web of science, PubMed and Scopus in the period of 2007-2017. These documents were analyzed using HistCite12, 03, 1 and VOS viewer 6, 5, 1 software.2314 articles in Web of science, 4024 articles in Scopus and 98 articles in PubMed published in the past 10 years were found. The number of articles published by Iranian researchers in Web of Science, Scopus and PubMed were 19, 45 and 10, respectively. The findings showed that the number of articles about this topic had increased in Web of Science and Scopus over the last 10 years. According to the results of this study, important research areas were visualized in the three databases by extracting repeated words. The frequency pattern of words showed that the focus of the research has been on cardiovascular diseases, age-groups, resuscitation problems, forensic medicine, and suicide, among others. The language of more than 80% of the documents was English. American and English Universities, journals and researchers had the most contribution in this field. The result of this study will help researchers to develop, plan and increase the qualitative and quantitative levels of their research on drowning. Similar to developed countries, developing research can help improve the culture and general education to prevent drowning in developing countries.Drowning, Scientometrics, Scientific Productions, Article


Life cycle assessment (LCA) is conducive to the change in the wind power industry management model and is beneficial to the green design of products. Nowadays, none of the LCA systems are for wind turbines and the concept of Internet of Things (IoT) in LCA is quite a new idea. In this paper, a four-layer LCA platform of wind turbines based on IoT architecture is designed and discussed. In the data transmission layer, intelligent sensing of wind turbines can be achieved and their status and location can be monitored. In the data transmission layer, the LCA platform can be effectively integrated with enterprise information systems through the object name service (ONS) and directory service (DS). In the platform layer, a model based on IMPACT 2002+ is developed, and four management modules are designed. In the application layer, different from other systems, energy payback time (EPBT) is selected as an important evaluation index for wind turbines. Compared with the existing LCA systems, the proposed system is specifically for wind turbines and can collect data in real-time, leading to improved accuracy and response time. Wind energy is a type of important clean and renewable energy with abundant reserves. As a green and environmental protection power generation technology, wind turbines can effectively reduce environmental pollution. In recent years, due to the gradual maturity of wind power technology and the continuous decline in the cost of wind power generation, wind turbines have been widely used in the world. According to “BP Statistical Review of World Energy June 2019”, the annual growth rate of global wind farms in 2018 is 12.6%, and the power generation capacity is 1170.0 TWH. Additionally, the rated power of wind turbines has developed from dozens of kilowatts to megawatts . In the As a technology to evaluate the environmental factors related to products and their potential impacts, life cycle assessment (LCA) has been developed as an important tool to evaluate the energy and environmental performance of products in their life cycle. The LCA of wind turbines can not only help enterprises carry out green design or improvement of the key energy consumption parts but also help the wind power industry change from the terminal-oriented management mode to the full life cycle management mode. In order to minimize energy consumption and environmental emissions, it is necessary to optimize energy management and carry out green design through accurate LCA of wind turbines. Moreover, the resource and environmental costs and energy conservation and emission reduction potential can be obtained through quantifying energy consumption and pollutant emissions. On this basis, suggestions for green and low-carbon management strategies of the wind power industry can be put forward.The accuracy of LCA mainly depends on the accuracy of the life cycle inventory and the rationality of the environmental analysis process. In the current research, the inventory data come from investigation, literature, or the existing database, which are universal to a certain extent and can be used in different products. However, due to the effectiveness and regionality of inventory data, the input and output data of the same material will vary greatly in different regions with different process levels. Consequently, the difficulty mainly lies in the acquisition and accuracy of data, because of the polymorphism, time variability, and sensitivity of LCA data.The existing life cycle assessment process mainly relies on software system databases, which are from the average data of various industries, or manually collecting from literature or on site. The real time, dynamic, and accuracy of evaluation data are far from satisfactory. Therefore, the results of LCA are not accurate enough.The existing LCA software are commercial, and they are for many products. As a result, the process is not specifically for wind turbines.The existing LCA methods mainly include problem-oriented midpoint methods and damage-oriented endpoint methods, having their limitations.The existing LCA systems and enterprise information systems (EIS) are independent of each other and cannot be effectively integrated together, and the data of enterprise information systems cannot be effectively utilized.The existing problems in the life cycle assessment of wind turbines are as follows:As a new and rapidly developing technology, the Internet of Things (IoT) holds great promise in handling the abovementioned issues. IoT is a pervasive presence around us of a variety of things or objects (such as radio-frequency identification (RFID) tags, sensors, actuators, mobile phones, etc.), which can interact with each other and cooperate with their neighbors through unique addressing schemes ,5. IoT iThe IoT technology is applied to achieve the real-time, intelligent collection of energy consumption and environmental impact data in the entire life cycle of wind turbines. Therefore, the databases of the platform have the function of updating and expanding, which ensures the objectivity and accuracy of the assessment results. Additionally, the status and location of wind turbines and their components can be monitored with the support of IoT technology.A novel LCA architecture based on IoT is proposed, which achieves the energy consumption assessment and environmental impact assessment of wind turbine from parts to products, including the stages of design, raw material acquisition, production and manufacturing, transportation and installation, operation and maintenance, and recovery and disposal.An LCA model for wind turbines is proposed based on IMPACT 2002+ , which cBased on ONS and DS of IoT technology, the effective integration method between the proposed platform and the existing EIS is innovated, thereby constructing an open and extensible platform for life cycle assessment.In order to solve the above problems, based on IoT, this paper proposed a new LCA platform for wind turbines. Additionally, the main innovations are as follows:The remainder of the paper is organized as follows. Life cycle assessment (LCA) has made remarkable progress, since the first life-cycle-oriented methods were proposed in the 1960s. Currently, LCA is defined as a tool that assesses the potential environmental impacts and resource consumption in a product’s life cycle, i.e., from raw material acquisition, via production and use stages, to waste management ,11. It iCurrently, the research on LCA mainly focuses on the evaluation of the new energy system, product resource consumption, and environmental emission. Additionally, LCA has been widely used in various fields, including materials, energy sources, transportation and construction, etc. Boyden et al. compared the environmental impact of three management strategies for lithium-ion batteries in Australia ehydro-metallurgy, pyro-metallurgy, and landfill through LCA . Geng etThe methods of LCA mainly include problem-oriented midpoint methods and damage-oriented endpoint methods . AdditioIn recent years, in view of the continuous expansion and complexity of evaluation objects, LCA methods are also developed in new forms. Additionally, the combination of LCA methodology with other methods has become a common practice. Suhariyanto et al. proposed a multi-life cycle assessment perspective for assessing the environmental impacts on the multiple life cycle product system . Bai et LCA needs a large amount of data as the basis and a variety of models as tools. In order to improve the research efficiency, the software developed includes Simapro, Gabi, LCAiT, eBalance, PEMS, and so on.Simapro is developed by the University of Leiden, the Netherlands. It provides abundant databases and a variety of evaluation methods. The database in the manufacturing phase is the most detailed. It is also the most popular LCA software in the world.GaBi is developed by Institut fur Kunststoffprufung und Kunst—stoffkunde from Stuttgart, Germany. It has the latest wide-range comprehensive database and provides sensitivity analysis.LCAiT (LCA Inventory Tool) is developed by Chalmers Industrieknik in Göteborg, Sweden. Although it has fewer own databases, it can connect with external databases. It is suitable for people who understand the flow of material and energy.eBalance is developed by IKE Environmental Technology Co. Ltd. from Chengdu, China. It includes three databases: Chinese Life Cycle Database, European Reference Life Cycle Database, and Ecoinvent Database. It supports China’s localized evaluation of energy conservation and emission reduction.Pira Environmental Management System (PEMS) is developed by Pira International, UK. The parameters in the database are from Europe, which cannot be modified or edited.2, CO, SO2, Nox, COD, etc.) in each stage can be calculated.Based on the system boundary, the main input of the above software includes the consumption of various resources  and different types of energy . Based on the establishment of process flow and the database in the software, the energy consumption and environmental emissions  For enterprises, the improvement schemes are proposed for the stages or parts with large energy consumption/environmental impact, and improvement measures of green design of wind turbine will be provided. (2) For the government, the reference standard of the research object will be established through the LCA results of each stage, and the energy consumption and environmental emission standards of each stage will be established. (3) For the third-party testing and certification department, it is to carry out green certification for the wind turbine by comparing the evaluation results with the defined green index value of the wind turbine.The related research objects are mainly divided into three types: wind farm, wind turbine, and its main components. Wind farm refers to the place where wind energy is captured, converted into electric energy, and sent to the power grid through transmission lines, including wind turbines, power collection lines, substations, and roads. A wind turbine is mainly composed of a rotor, an engine room, a tower, and a foundation. For the main components, the rotor is mainly composed of blade, hub, nose cone, and bolt; the engine room is usually integrated by engine room frame, which covers generator, gearbox, transformer, electrical, and mechanical equipment; tower supports engine room and rotor, mainly made of steel, aluminum, copper, and plastic; foundation provides ground support for all the above parts, which is composed of concrete, steel, and iron.Usually, for enterprises, the research object is mainly wind turbine or its main parts; for the third-party testing and certification department, the research object is wind farm or wind turbine or its main components; for the government, the research object is usually wind farm or wind turbine. The complexity of LCA decreases in the order of wind farm, wind turbine, and its main components.The system boundary is determined according to the research objectives. The wider the research scope is, the more the relative workload will be. Nowadays, the system boundary of LCA pays more attention to evaluation efficiency instead of breadth and depth, which is excluding the stage not related to the research objectives from the system boundary after comprehensively considering the accuracy of the evaluation results and the complexity of the evaluation work, and determining the most efficient system boundary according to the needs of research objectives. For example, when enterprises intend to improve the green design of wind turbines, they only need to study the stages of raw material acquisition, manufacturing, recycling, and scrapping, while the transportation, on-site installation, operation, and maintenance stages have little impact on the research objectives can be ignored.For different users, the objectives, and scope of LCA of wind turbines are shown in The evaluation of the wind turbine is the most common in practical applications. Therefore, this system is mainly designed for wind turbines. Taking wind turbine as an example, the system boundary of LCA for wind turbines is shown in Through the analysis of the objectives and scope of LCA of wind turbines, the architecture of the LCA platform based on IoT technology is constructed. The data acquisition layer, data transmission layer, platform layer, and application layer are included. The architecture of the LCA platform for wind turbines is shown in Each layer of the platform is introduced as follows.In the data acquisition layer, intelligent identification, positioning, tracking, monitoring, and management can be achieved with the help of RFID devices, barcode identification equipment, global positioning systems, laser scanners, and other information sensing equipment. Consequently, all the input and output data involved in the life cycle of wind turbines will be obtained and preprocessed. There are three ways for collecting data: (1) By using RFID, wireless, mobile, and sensor equipment, real-time and intelligent collection of energy consumption and environmental emission data can be generated from different material units and manufacturing processes of wind turbines. (2) Bill of Materials can be acquired from the information management systems of enterprises. (3) For the data that cannot be collected through sensors or obtained by EIS, they can be collected by manual input, such as enterprise fundamental information, some parameters and specifications of wind turbines, etc. In the process of manual entry, it is necessary to ensure the authenticity and effectiveness of data and make sure there is evidence to follow for data output in the later stage.The data acquiring methods in each stage of wind turbines are as follows. In the design stage, the wind turbine and its main components are designed, and the three-dimensional models of them are established, and the structure is tested and analyzed. Because the design tools such as computers and other electronic equipment are mainly used in this stage, the energy consumption and environmental emission data are not generated directly. Therefore, the energy consumption is measured by smart meters, and other data can be obtained through EIS. All the design schemes have a great impact on the final results.Raw materials include parts, components, semi-manufactures, etc. Raw materials can be obtained in two ways: production in the factory and purchased from other factories. For the raw materials produced in the factory, which usually including internal and external blades and baffles of wind turbines, relief valve, brake, transmission shaft, rod, bearing, clutch, flying pendulum, cover, and so on, the relevant data can be obtained by integrating with EIS. For the purchased raw materials, which usually including tire coupling, permanent magnet synchronous generator, standard parts, etc., the relevant data are collected by reading barcodes or RFID tags attached to them.The elementary raw materials in the wind turbine include concrete, steel, iron, copper, glass fiber, epoxy resin, etc., as shown in In the production and manufacturing stage, the energy consumption data of water, electricity, and gas are collected by embedded systems and sensing equipment installed on manufacturing equipment, and environmental emission data can be obtained from intelligent sensors and environmental monitoring systems. At the same time, in order to improve the reliability of the data, the measurement calibration certificates of relevant monitoring equipment should be upload simultaneously to the enterprise information database in the platform layer. According to the material composition of each component and the energy consumption and environmental emissions of various main raw materials, the total energy consumption and environmental emissions of wind turbines can be calculated in this stage.In the transportation stage, the fuel consumption, weight of product transported, and transportation distance are collected by sensors on vehicles, and the total energy consumption and pollutant emission of the transportation process can be calculated based on the fuel consumption per kilometer. In the installation stage, which includes the installation of foundation construction, tower hoisting, and engine room, the data related to mechanical equipment can be obtained by sensors, and other data can be manually entered.In the operation stage, the environmental information  and its operation data  can be collected through sensors. In addition, equipment calibration records  need to be uploaded in time. Based on IoT technology, the wind turbine status can be continuously monitored, and detection automation can be achieved. In the maintenance stage, energy consumption is mainly generated by using various maintenance tools or component replacement. Additionally, its data can be collected by reading RFID tags or manually entering.This stage is the process of wind turbine disassembly, renovation, recycling, reuse, reassembly, or disposal. Recovery methods include direct recovery and recovery after solvent extraction. Scrapping methods of the wind turbine include open stacking, landfill, and incineration. Eighty-five to ninety percent of the foundation, tower, and engine room components of the wind turbine can be recycled. However, it is difficult to recover the blades, because the thermosetting materials cannot be degraded and the cost of recovering fiber materials is very high . NowadayThe data transmission layer can also be called the network layer, which transfers the data captured in the data acquisition to the servers in the platform layer through networking technologies including WSN, WIFI, Ethernet, and so on. In addition, this paper proposes to achieve effective integration with EIS through object name service (ONS) and directory service (DS). As the infrastructure of the network layer, the ONS and DS provide external services.The ONS is defined by GS1 EPCglobal, and it is the core technology of the Internet . In 2013The ONS mainly completes the network resource analysis pointing request of all kinds of IoT identification and can map the Code identification to the resource entrance. The ONS can be called by the applications that need to conduct the name service. The DS is mainly deployed to offer the index access to EIS, which is at the data acquisition layer. Each enterprise submits event indexes automatically to their representative DS server. Before adopting this integration scheme, enterprises need to register and maintain their domain names in the enterprise information database in the Database Management Module in advance.The process of integration with enterprise information systems is shown in As shown in The platform layer mainly carries out an inventory analysis of the life cycle of wind turbines. Inventory analysis is the process of collecting and objectifying the basic data of all relevant processes of wind turbines, which mainly includes the analysis of raw material consumption, production and manufacturing energy consumption, material and product transportation energy consumption, operation and maintenance energy consumption, and scrapping treatment environmental emissions. The integrity and accuracy of the data obtained by inventory analysis affect the accuracy of LCA results directly. The platform layer includes four modules: Unit Process Management Module, Flow Management Module, Database Management Module, and Inventory Data Processing Module.Unit process refers to the most basic unit in life cycle assessment. In this module, the decomposition of the research object and the identification of the process flow are completed. In the meantime, in order to quantitatively determine the input and output corresponding data, users need to input the unit process attribute data of the research object in this module, and manage all the unit processes on this basis.The structure of wind turbines is complex, and there are many kinds of components and materials. Decomposing the wind turbine and classifying the materials and its components play a crucial role in the process of inventory analysis, which will affect the accuracy of the evaluation results. In our system, the analytic hierarchy process (AHP)  is used An example of wind turbine decomposition is shown in LCA focuses on the full life cycle and goes deep into each process to analyze the input and output data. For this reason, it is also necessary to identify the key influencing factors of each stage of the process flow. On this basis, the data of each basic unit are input and output, and the data of each stage are classified and summarized. The main LCA influencing factors of wind turbines in each stage are shown in Material flow management and energy flow management are included in this module. Material flow and energy flow data are a vital link and are used to record the material/energy interaction between different unit processes. In this module, the material flow and energy flow information of each unit can be added, modified, deleted, and viewed by users, which provides support for inventory data processing of the wind turbine. The Database Management Module is an important module to support the completion of the life cycle assessment of wind turbines. It mainly includes the functions of data addition, data storage, and data calls. For users, the required data can be obtained from the database conveniently, timely, and accurately.LCA basic database: the existing mature database, including Ecoinvent, European Reference Life Cycle Database (ELCD), Chinese Life Cycle Database (CLCD), GaBi Databases, NREL-USLCI Database, etc. The resource consumption and environmental emission of unit mass materials in the raw material acquisition stage, unit power consumption in the production and manufacturing stage, unit oil consumption in the transportation stage, and materials with different disposal methods in the scrapping stage can be obtained from these databases.Material list database: mostly utilizing the name and unit of the International Reference Life Cycle Data System (ILCD), and adding the material list according to the characteristics of the wind turbine.Enterprise information database: storing the enterprise information involved in the life cycle of the wind turbine, including enterprise name, organization code, enterprise identification, identification rules, enterprise address, legal person information, responsible person information, enterprise website, and other fundamental data of the enterprise. The information of the database is obtained through enterprise registration and filing mainly.Product information database: storing the fundamental data, operation and maintenance data, and environmental emissions and energy consumption data in the life cycle of wind turbines. The fundamental data contain the structural information of all kinds of wind turbines and defines the structural relationship between the wind turbine and its components and between the components. In this database, the fundamental data are mainly obtained through integration with EIS, and the operation and maintenance data and environmental emissions and energy consumption data are obtained by real-time monitoring of IoT technology. Based on the database, the usability and real-time performance of LCA can be significantly improved.Four databases are included in this module, which are as follows:LCIA index management: it mainly stores the types of evaluation indicators, conversion coefficients between different types of indicators, and environmental impact assessment standards of relevant industries or regions. It supports the calculation of LCIA characteristic indicators, normalized indicators, and weighted comprehensive indicators. Consequently, it is an important module for data normalization and environmental impact factor unification.Online modeling: Based on linking all types of life cycle inventory results via 14 midpoint categories to four damage categories, a feasible approach combining midpoint and damage is proposed, which is the IMPACT2002+ methodology . Based oThe Inventory Data Processing Module is the core module of the LCA platform. Based on the data support of material flow, energy flow, unit process, and database module, the module can quantify and analyze the data between input and output of resources and environment in each stage through online modeling and the corresponding algorithm. In this module, life cycle impact assessment (LCIA) index management and online modeling are included, which are as follows:As shown in Since the previous data collection is aimed at each unit process, in order to ensure the accuracy and integrity of the evaluation results, it is necessary to determine a measurement reference of data before data processing, which is the function unit. In the raw material acquisition stage, the functional unit of the weight of various raw materials is kg. In the manufacturing stage, the functional unit of electrical energy consumption is kWh. In the transportation stage, the functional unit of the transportation distance and energy consumption are km and L separately. In the recovery and disposal stage, the functional unit of the weight of recycled or scrapped materials is kg.The main influencing factors and functional units of each resource and environment index are shown in After the inventory analysis, in order to evaluate the accuracy of the inventory data, the relative error can be obtained by comparing the total mass of the wind turbine with the summing of the material quality of all components.To sum up, the data processing of the proposed platform is shown in Based on the Unit Process Management Module, the decomposition of the wind turbine is completed. The quantity of various resource and energy consumption can be obtained from the Flow Management Module. Additionally, the total energy consumption and environmental emissions can be calculated, and all kinds of indicators can be characterized in the Inventory Data Processing Module, which is based on the parameters from the Database Management Module.LCIA is a process of quantitative or qualitative evaluation to obtain the performance of energy consumption and environmental emission after inventory analysis, and the inventory information will be translated into environmental impact scores. In terms of resource consumption of wind turbines, it mainly includes the evaluation of mineral energy consumption in the raw material acquisition stage, electric energy consumption in the production and manufacturing stage, and oil consumption in the transportation stage. For wind turbines, energy payback time (EPBT) is one of the key factors of evaluation, because it is one of the important indexes in the evaluation system of wind turbines generating capacity . iE is the total energy input of the wind turbine in its entire life cycle, and 0E is the annual power generation of the wind turbine, which is calculated byp(v) is the expression of wind turbines output power characteristic curve, and f(v) is the wind speed frequency distribution curve expression of wind turbines installation site.EPBT is the ratio of the total energy input of the wind turbine in the entire life cycle to the annual power generation during its operation , as show0E will be calculated. At the same time, Ei is obtained according to the Inventory Data Processing Module. Thus, the EPBT of the wind turbine will be calculated. On this basis, according to the design life of the wind turbine, the power generation without emission in its life cycle can be calculated.In this study, the real-time wind speed and the actual output power of the wind turbine are collected through IoT technology. After obtaining the power characteristic curve of wind turbines and the wind speed frequency distribution of the installation site, Besides, when the wind turbine parameters  and installation address are known, the EPBT can be estimated in advance. On this basis, it can be predicted whether the installation site of wind turbines is appropriate, to avoid the loss caused by the improper installation scheme.Improvement analysis is to analyze the results of the impact assessment, form a report, and provide practical improvement plans for different users. Enterprise users, government users, and third-party users are included in this system.For enterprise users, according to the LCA results, the stage, or the key components with large resource consumption, energy consumption and environmental emission of wind turbines will be identified. Consequently, better raw materials can be selected. Additionally, design optimization, production process optimization, transportation route and vehicle optimization, operation and maintenance optimization, and recycling optimization can be carried out. For example, energy consumption in peak hours or idle time can be reduced.For government users, through the results of impact assessment, the entire process of recycling can be monitored, the recovery rate of product components or materials can be improved, and the potential harm to the environment in the recycling can be reduced. Additionally, the suppliers of materials and components with the highest proportion of environmental emission can be list as the major concerns. Based on the evaluation results, relevant standards can be established, the corresponding evaluation mechanism can be improved, and the industrial structure will be optimized finally.For the third-party users, the green certification will be accomplished by comparing the evaluation results with the defined green index value of the wind turbine.Based on the proposed architecture, an LCA prototype system of the wind turbine has been developed. In this system, various users have different authority to manage data.The main process of the life cycle assessment by using this system is illustrated as follows:The enterprise registers in the system and inputs the information of name, identification, address, website, responsible person information, relevant qualifications, etc.The decomposition of the wind turbine studied is determined, and the process flow is identified through the Unit Process Management Module. Additionally, then, the relevant parameters and the main information of key components for life cycle assessment will be input. Then, the material flow and energy flow information of each unit can be added, modified, deleted, and viewed through the Flow Management Module.Based on the installation of various sensors, the relevant energy consumption and environmental emission data will be collected. Meanwhile, the operation data will be monitored, including wind speed, vibration, noise, engine speed, pitch angle, etc. According to these data, the output power characteristic curve is formed, which can be used to calculate the annual power generation of the wind turbine. Moreover, the real-time fault data and the fault rate curve of wind turbines are collected and formed. On this basis, the residual life prediction of the main components of wind turbines is carried out.In addition to the real-time monitoring data, the Bill of Materials is acquired by integrating with the information systems of enterprises. Additionally, other data are obtained by the Database Management Module in the system.Based on the online modeling and LCIA index management, the inventory data will be processed through the Inventory Data Processing Module. Based on inventory data, the energy consumption and environmental emission data at all stages of wind turbines are calculated systematically, and the evaluation results are analyzed visually. On this basis, the life cycle assessment report of wind turbines is formed.The workload of using LCA software include goal definition and scoping, data preprocessing, inventory analysis, and impact assessment. Compared with the existing software, the workload of data collection is greatly reduced, and most of the scoping of wind turbines has been established in detail in the proposed system.To compare the LCA workload between the proposed system and the existing software, we suppose the total workload of data preprocessing, goal definition and scoping, inventory analysis, and impact assessment of the existing software are all 100%, and the weights of them on the LCA workload are 30, 20, 40, and 10%, respectively. The comparison results are shown in As shown in At present, the data collected by existing systems are often intertwined and need to be distributed among multiple parts, which is greatly affected by subjective factors. Therefore, the accuracy of the inventory data is not high. The proposed system can increase the data accuracy through IoT technology and improve the integrity of the data processing model through the integration with EIS.6 × 100% = 134%As previously mentioned, the system boundary of LCA for wind turbines mainly includes six stages. In order to estimate the accuracy of the results, we assume that the accuracy of inventory analysis in each stage is increased by 5% on average. Consequently, the accuracy of the results is improved by (1 + 5%)The characteristics of the IoT-based life cycle assessment platform of wind turbines are summarized as follows:The platform is designed for wind turbines. In the process of the platform design, the corresponding system modules are established according to the life cycle process of the wind turbine. At the same time, according to the characteristics of the wind turbine, the LCA model based on the IMPACT2002+ is established. Additionally, the EPBT of wind turbines can be calculated accurately.To solve the lacking of information in the process of life cycle assessment, it can effectively integrate with the existing enterprise information systems through the ONS and DS based on IoT. Furthermore, the platform provides a standard application program interface and supports all kinds of users to develop and integrate various business applications on the platform. Therefore, it has the feature of extensibility. Based on the Internet of Things technology, real-time and dynamic data in the life cycle of wind turbines can be collected in the platform. Therefore, the databases of the platform have the function of updating and expanding, which ensures the objectivity and accuracy of the assessment results. Based on the big data technology, the platform can analyze the real-time data collected by sensors and obtained from EIS and has functions of intelligent monitoring, analysis, and prediction. Finally, it can serve the design and manufacturing enterprises of wind turbines, wind farm construction enterprises, and operation and maintenance enterprises, which include modeling service, evaluation service, simulation service, analysis service, and optimization service, etc. In the meantime, an open platform with controllable permissions can be provided through the construction of application components, so that the third party can participate in the application development and create business value.The platform supports centralized user management, unified authentication and authorization, and business collaborative processing. Additionally, it is designed on B/S architecture, which is more convenient to operate and easier to maintain.To sum up, the comparison between the proposed platform and several existing LCA systems is shown in In this paper, based on IoT technology, an LCA platform architecture for wind turbines is proposed. Additionally, object name service and directory service are used to provide external services in the network layer. In the meantime, an LCA model of wind turbines is established based on IMPACT 2002+. Therefore, the platform is wind-turbines-oriented and has good scalability and credibility.The application of this platform can achieve effective integration and sharing with the existing enterprise information system and accomplish the real-time, intelligent collection of the energy consumption and environmental emission data generated in some stages. Given that the inventory data can be updated, the objectivity and accuracy of the assessment results can be ensured. It is of great significance for the sustainable development of the wind power industry.In our future work, it is very important to deploy the LCA platform in more application scenarios. Additionally, combining the platform with blockchain technology to ensure the authenticity and credibility of data is also a key research direction. Besides, further research and exploration are needed to make the analysis results comparable with the existing systems.


The affiliation for the last author is incorrect. The correct affiliation for Morteza Naderi is Arak University.An additional affiliation is missing for the last author. Morteza Naderi is also affiliated with the Department of Molecular Biology and Genetics, Faculty of Sciences, Koc University, Istanbul, Turkey.


Thismakes infections more difficult to treat and increases the risk of pathogensspreading, leading to higher mortality. Although the term antimicrobial refers toantibiotics, antivirals, antifungals, and antiparasitics, this article focuses onissues related to the use of antibiotics in the Brazilian context.Acquired antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi, andparasites change over time and cease to respond to drugs to which they werepreviously susceptibleAMR is a threat to global health and its worsening is observed in the current contextof the SARS-CoV-2 pandemic. Added to the challenges of infection control and theprevalence of morbidity and mortality in the pandemic, viral and bacterialresistance are a global health emergency. In this regard, AMR becomes intrinsicallyrelated to the current health context, which may imply accelerated AMR patterns andgreater incidence in health services.These challenges, with health and political implications on a global scale, areespecially difficult in countries with medium and low economic income, as is thecase of Latin America. In this scenario, responses to AMR require coordinated andmultisectoral efforts involving clinical-biological, socioeconomic, and politicalperspectives at the global, national, and local levels.,3.In response to the global agenda for tackling AMR, the World Health Organization(WHO) proposes “a collaborative, multisectoral, and transdisciplinary approach –working at local, regional, and national levels – with the goal of achieving optimalhealth and well-being outcomes, recognizing the interconnection between people,animals, plants, and their shared environment”, designated One HealthThis article considers the potential ramifications of the One Health approach to AMRresearch. It adopts a theoretical-methodological perspective that articulates theOne Health approach and the social production of the AMR phenomenon, in three axes.The first refers to the practices of prescribing and dispensing antibiotics byprofessionals. The second one concerns the analysis of antibiotic use from the pointof view of health services users. The third one proposes a reflection on the processof construction of a political agenda to fight AMR in Brazil. This contributionpresents an analysis and appreciation of the diversity of practices, knowledge, andindividual perspectives of Primary Health Care (PHC) users, health professionals,and policy makers that aim to fill research and knowledge gaps in the Braziliancontext. Moreover, it aims to advance the global action agenda in Brazil, whilecontributing with reflections that can serve as a reference for the Latin Americanregion..Furthermore, the functioning of health services, the communication betweendifferent levels of health care, and the influence, or lack of clinicalrecommendations and evidence-based clinical protocols, particularly in PHC, posechallenges for the implementation of appropriate interventions at this level ofhealth care. Antibiotic prescription has been the subject of increasing monitoring in hospitalsettings in the last decade, even though great part of the problem relies onPHC. Studies point to several factors associated with the prescription ofantimicrobials: knowledge about AMR, critical clinical situations, riskperceptions and patients’ expectations, as well as professionals’ behaviors,values, and ideologies.Antibiotic prescription has been widely used as a preventive strategy inveterinary medicine and zootechnics. Antibiotics are offered on a large scale topromote the growth and development of animals for human food consumption,although little attention is paid to the impacts these practices have on thedevelopment of AMR. Thus,AMR tends to be analyzed, above all, in relation to human health or thedoctor-patient relationship, despite the fact that AMR extends into the web ofinteractions among humans, animals, and the environment, including the healthsystems themselves and the provision of networks of basic sanitation,7. There is little scientific production on therelationships among humans, animals, and food consumption, especially in theBrazilian context.However, the purchase, sale, handling and disposal of antibiotics in pharmaciesand pet supply stores continue to be addressed only superficially addressed andin a fragmented waykit-Covid, an arrangement of drugs considered“prophylactic”, the use of which was encouraged by the Federal Government to beprescribed and used with the slogan of “early treatment”. As a result,azithromycin, an antibiotic already used in health services, had greaterprescription rates and sales throughout 2020 in the country as one of thecomponents of the kit-Covid. Communication and negotiation between antibiotic prescribers and users, as wellas the challenges and facilities that professionals find in their clinicalpractices, cooperate to make the intrinsic dynamics of antibiotic prescriptioneven more complex. For instance, in Brazil, antibiotics were included in theso-called In Brazil, the analysis of access conditions to the services of the BrazilianPublic Health System (SUS), especially through the teams of the Family HealthStrategy (FHS), contributes to the knowledge of housing spaces and theunderstanding of the factors conditioning demand and the use of antibiotics. Italso reveals how the interactions between users and health professionals areimportant to guide informed attitudes towards the consumption of thesemedications. The family unit, the community, the relationships between humansand animals, and the sanitary conditions in which they live are aspects forunderstanding the problem. isidentified. The impact of disposing of antibiotics in household waste, sinks,and toilets, as well as its influence on the selective pressure of resistantagents, is not completely known, indicating the relevance of investigating theconditions of use, storage, and disposal of antibiotics among health systemusers. All these aspects are an urgent issue in the Brazilian context, given thehigh rate of prescription and consumption of these drugs since the beginning ofthe COVID-19 pandemic in the country.Thus, the centrality of the individual inserted in the environment in which theylive is strategic, with a focus on mapping attitudes and knowledge regardingthe use of antibiotics and AMR. Characteristics such as gender, generation,income, and housing are understood as prevalent factors for the different formsof antibiotic use. The individuals’ lack of knowledge about the complicationscaused by the use of these medications without a medical prescription andthrough self-medicationSuch elements demand a comprehensive understanding of the environment, as thecontext in which individuals and groups are inserted, with the notion of theenvironment being that of a shared space where networks encompassing individualsand groups, as well as the relationships they establish among themselves, arebuilt. In this regard, the integrated approach to the environment and health,both human and animal, advocated by the One Health, is pertinent. Therefore,dimensions of cohabitation and interaction between owners and animals arevisible, as both domestic animals and humans can develop and transmit multidrugresistant microorganisms. Consequently, veterinary care practices for domesticanimals, such as prescribing antibiotics, also affect the development ofAMR.. The PAN-BR was coordinated bythe Ministry of Health and included the participation of the Brazilian HealthRegulatory Agency (Anvisa), the Ministry of Agriculture, Livestock, and Supply(Mapa), and the Ministry of the Environment (MMA), among others. The PAN-BR bothmeets an internal need to build a more integrated and intersectoral politicalagenda, as well as responds to a call from the multilateral agenda to recognizethe problem of AMR as a priority issue. This initiative was led by the WHO inpartnership with the Food and Agriculture Organization of the United Nations(FAO) and the World Organization for Animal Health (OIE).Although specific AMR-related actions have been developed in previous years, theformalization of a national agenda was only materialized in 2018, with thepublication of the National Action Plan for the Prevention and Control ofAntimicrobial Resistance in the Scope of One Health (PAN-BR). The creation of mechanisms that allowdialogue between health and epidemiological surveillance, with data sharing, toallow the search for causal links related to AMR from the perspective of OneHealth is required. The formulation of the PAN-BR represents a step forward in recognizing the needfor a multidisciplinary and multisectoral approach to AMR. Its implementationdemands articulated relationships among different levels of governance, publicand private agencies, industries, as well as the society in general. Thisimplies different priorities and possible conflicting interests. Among the mainchallenges for its implementation, the following are highlighted: theinstitution of a sustainable policy; the decentralized execution of control,prevention, and monitoring activities; and investment in research, development,and innovation for the production of antimicrobials, diagnostic methods, andvaccines through universal and equitable accessThe context of the global SARS-CoV-2 pandemic highlighted important elements forthe AMR agenda, including the urgency of investment in infection prevention andcontrol programs, and the need for comprehensive risk communication strategies,as well as the dangers arising from technological dependence on health suppliesfor the guarantee of medicines, including antibiotics. The lessons learned canserve as a reference for planning AMR-related interventions in the post-pandemicscenario and for preventing future crisis.Research on the political agenda of AMR in Brazil implies understanding theframeworks in which AMR is inserted, as well as how the underlying processes ofdispute, negotiation, consensus and dissent are constructed based on theperspectives of the main interested actors. Understanding the extent to whichpolicy responses such as the PAN-BR incorporate views and demands from healthservice users and professionals who work in the prescription and dispensing ofantibiotics is essential to promote adequate and sustainable interventions.Danida – Ministry of Foreign Affairs of Denmark.


PLOS Pathogens strives to advance community-rooted adoption of practices that enable transparency, rapid communication, reproducibility, and trust in research, and help to transform research globally. A key vision of PLOS Pathogens is to facilitate widespread adoption of Open Science to accelerate and improve research that is rigorous and trustworthy and to ensure its meaningful impact on lives.The pathogens research community has driven, and benefited from, Open Science. As a leader in the field, Open Science—the public, unrestricted sharing of all components of research—can improve science in many ways and has benefits for a wide range of stakeholders. Some elements of Open Science, such as Open Access to publications, advance equity to ensure research findings can be accessed by everyone with a vested interest in the science. Other elements, such as resource and data sharing, enable researchers to reuse and build on existing science. What all elements have in common is the ability to increase trust, reproducibility, and transparency in science . These aPLOS Pathogens was founded with a philosophy based on open, high-quality, rigorous science, initially focusing on Open Access publication and diversifying the ways scientists communicate with the community and public  and morple, see . We haveple, see  and, oveple, see ,6). PLOSs Plan S  and the s Plan S , that wiPLOS Pathogens, we have recently seen the critical importance of Open Science practices including the sharing of preprints and the genomic sequencing data of SARS-CoV-2 to drive rapid innovation in research during the global response to the COVID-19 pandemic , an, anPLOS nity see —to incluPLOS Pathogens, and we hope the journal can continue to work with the community to advance Open Science for years to come.Open, high-quality, peer-reviewed science is, and has always been, core to the mission of


To evaluate the effectiveness of a collective intervention to encourage the consumption of fruits and vegetables on the nutrients intake for the prevention of chronic non-communicable diseases (NCDs), a randomized controlled community trial was conducted with a representative sample from the Health Academy Program. While the individuals in the control group (CG) participated in regular physical exercise, those in the intervention group (IG) also participated in a collective intervention. After 12 months, IG and CG showed a reduction in energy, omega 3 and sodium intake and an increase in the consumption of carbohydrates, fiber, vitamins, and minerals. Individuals from the CG showed an increase in phosphorus consumption and, in the IG, a reduction in the consumption of total, saturated, and polyunsaturated fats as well as an increase in the consumption of monounsaturated fats was seen. In both groups, there was an increase in the prevalence of adequate nutrients. Participation in the nutritional intervention was associated with lower consumption of energy and protein in the diet. The results pointed to the importance of individuals’ participation in the program, which, associated with nutritional intervention, promoted an improvement in the nutrient profile of the diet and the prevention and control of NCDs. Chronic non-communicable diseases (NCDs) are an important public health problem, accounting for more than 70% of all deaths worldwide . A healtIn view of this, different nations, including Brazil, have sought to encourage their populations to adopt adequate and healthy diets, in addition to other healthy lifestyle factors ,4,5,6. IThe PAS is a Brazilian primary health care (PHC) service which aims to contribute to the promotion and production of health care and healthy lifestyles for the population . It inclDespite the positive results presented by the nutritional interventions developed within the scope of the PAS, it is not known whether actions to encourage the consumption of FV can also bring positive changes in the nutrient profile of the diet, especially for those nutrients aimed at the prevention and control of NCDs . A systeTherefore, the objective of this study was to evaluate the effectiveness of a collective intervention to encourage the consumption of FV on the nutrients intake, especially the ones focused on the prevention and control of NCDs, in those who attend the Brazilian PHC health promotion service.This is a randomized controlled community trial, carried out between 2013 and 2015, with the objective of evaluating the impact of an intervention to encourage the consumption of FV in PAS users in the city of Belo Horizonte, Minas Gerais, Brazil . This muAccess to the PAS in Belo Horizonte occurs by spontaneous demand or by referral from a health professional . The proThe selection of PAS units participating in the community trial was based on simple cluster sampling, stratified by the nine administrative regions of the municipality. At the time of the sampling process 2012), there were 50 PAS units in operation, 42 of which were eligible because they operate in the morning and are located in areas with medium and high/very high IVS; they have the predominant characteristics of the health service in the municipality, and have not participated in a nutritional intervention study in the last two years , the weight was obtained via a single measurement on a Marte® brand digital scale, model PP 180, with a capacity of 180 kg and precision of 100 g. Height was also verified via a single measurement using a portable stadiometer, brand Alturexata®, with a capacity of 220 cm and accuracy of 0.5 cm. Individuals with a BMI ≥ 30 kg/m2 were classified as having obesity  and protein [RR: 0.978 ] . Analysis of the adequacy of the consumption of nutrients aiming at the prevention and control of NCDs showed that participants of both groups, after 12 months, reported an increase in the prevalence of adequacy of the consumption of total fat, saturated fats, fiber, and sodium, and reduced trans fats. Additionally, IG individuals showed an increase in the prevalence of adequacy of potassium intake. However, participation in the collective intervention to encourage the consumption of FV, after adjustment for possible confounding factors, was not associated with adequacy of nutrient intake for the prevention and control of NCDs . 1, B2, B3, B6, B12, C, D, and E, folate, calcium, magnesium, potassium, selenium, manganese, zinc, and iron. IG individuals also showed a reduction in the consumption of proteins, and total, saturated and polyunsaturated fats; and an increase in monounsaturated fats consumption; while those in the CG reported an increase in phosphorus consumption. Regarding the evolution of the adequacy of the consumption of nutrients for the prevention and control of NCDs, improvements were observed for total fat, saturated, fiber, and sodium in both groups, and in potassium for IG; trans fats in worsened in both groups, with no differences related to participation in the nutritional intervention. The collective intervention to encourage the consumption of FV was effective in reducing the consumption of energy and protein in the diet. In addition, after 12 months of follow-up, regardless of participation in the nutritional intervention, PAS participants showed a reduction in energy, omega 3, and sodium consumption, and an increase in the consumption of carbohydrates, fiber, vitamins A, BNutritional interventions are important tools to motivate and encourage healthy food choices, amplifying health service results. Systematic reviews that investigated the effect of nutritional interventions on the eating behavior of PHC users identified beneficial effects of interventions, such as increased consumption of FV and whole grains and reduced consumption of fatty foods, in addition to improving the nutrient profile of the diet ,38. HoweOne of the eating behaviors that should be the target of nutritional interventions developed in PHC is the high consumption of energy and total fat, as it is related to excessive weight gain and the development and aggravation of NCDs . This stRegarding protein consumption, the median values of protein consumption at baseline remained above the recommendations for the prevention and control of NCDs  . After 1It is essential to design and strengthen food and nutrition education actions within the scope of health services, such as the PAS, given its characteristics of health promotion and care. In addition, interventions aimed at improving the food environment around these health services are also necessary in order to support their clients in making healthier food choices. Actions developed in the health promotion services are strategic to promote adequate and healthy food choices. For example, longer participation in the PAS seems to be effective in improving the profile of food and nutrient consumption of its clients, as evidenced by a cross-sectional study that identified an increase in the consumption of home-prepared food and a reduction in UPF, as well as lower energy and fat consumption, and higher levels of carbohydrates, vitamin C, and calcium among those with longer time as participation in the health service . A previUnderstanding the role and importance of balanced consumption of nutrients for a healthy diet, and the prevention and control of NCDs, some parameters guide adequate nutrient consumption. It is noteworthy that our result which stated that a significant increase in fiber consumption and adequacy was observed for both groups (CG and IG) over the course of the study, is in line with the recommendation .As for nutrients, the preference for unsaturated fats over saturated and trans fats  and limiRegarding sodium, a consumption of less than 2 g per day is recommended, since its increased intake is associated with insufficient potassium consumption contributing to the development of arterial hypertension and increased risk of heart and cerebrovascular diseases . In thisThis study makes important contributions by demonstrating that health promotion service users tend to show improvement in the adequacy of nutrient consumption over time and that the collective intervention to encourage the consumption of FV, based on theories, potentiated these beneficial effects, further reducing total energy and protein consumption. It also showed greater adequacy in the consumption of nutrients, including those aimed at the prevention and control of NCDs, regardless of participation in the nutritional intervention, revealing the potential of the PAS to promote adequate and healthy eating. However, it is also vital that government strengthen public actions and policies that promote a healthy food environment consistent with the health recommendations offered by PAS. Among the limitations of this study is the possible information bias on food consumption, inherent to food surveys. To minimize their possible effects, the instruments were applied by a data collection team trained every six months and a home-measurement kit was used to help identify the portions of food consumed. Another limitation relates to the quality of the nutritional composition tables that contain restricted data in relation to the foods consumed by the population. To reduce this limitation, tables of the nutritional composition of foods commonly consumed in Brazil were used, developed from the Family Budget Surveys; food label information and/or recipe standardizations were added, when necessary. Additionally, not having investigated the intake of vitamin supplements and the fact that some study participants already had arterial hypertension or diabetes were some other limitations of the study, but adjustments were made to minimize this effect as well. The external validity of this study is limited, considering that the participants come from health promotion services, and may differ from the general population, including the motivation to make changes in health-related behaviors. However, its data are relevant for the Brazilian PHC and for the adequacy of public policies and educational actions developed within the scope of PAS, which includes, among its objectives, the prevention and control of NCDs. Finally, there was a loss of follow-up during the study; however, data imputation was performed to minimize possible interference from this loss. The strengths of this study are the sample size and the study design with a high level of scientific evidence, which allowed us to obtain reliable data on the effectiveness of nutritional intervention on the nutrient profile, including those aimed at the prevention and control of NCDs, gaps existing in the literature and identified by systematic reviews ,38. FurtResults of this study pointed to the practical importance of health promotion services for the positive development of the nutrient consumption profile, including those associated with the prevention and control of NCDs. Thus, this study has practical importance, which can guide the expansion of actions carried out within the scope of PAS, including in its routine actions to promote adequate and healthy food.


Therefore, more and more reflections on the impacts and applicability of studies have permeated the center of discussions at a global level, especially considering the growing increase in knowledge production. In this scenario, research translation (RT) has a notable importance insofar as the social commitment of research establishes that the knowledge arising from investigations must reverberate in fruitful and beneficial results for society, configuring a core premise of research. However, the weaknesses regarding transfer and application of knowledge from research in health services’ practice are still notoriousRT tunes in and correlates with the translation of knowledge, evoking, for its understanding, an imaginative variation that expresses a dynamic, interactive, multidirectional and participatory movement that involves several nuances related to health demands and characteristics of research designs, institutional actors, starting points and intersections. From this perspective, RT aims to use evidence and knowledge to close gaps and leverage transformations ethically, responsibly and effectively in health care practice., given that, often, the knowledge unveiled is not transferred and concretely implemented in health practices and in health management and training policies. In this regard, the incipient understanding and implication of RT presents itself as a complex challenge, especially considering the plurality of concepts and terminologies that touch RT as well as the gaps regarding the forms of implementation.Therefore, it is crucial to understand the tenuous distinction between knowledge translation and evidenceTherefore, RT presents itself as an area still under development and covered in complexity. This is due to the pressing need to overcome obstacles, such as the inclusion of a translational perspective in research planning, weaknesses in the researcher’s training path, resulting in unpreparedness and inexperience for RT, lack of dialogue between researchers and services, inaccessibility of evidence for services, managers and potential users of knowledge, restriction of knowledge to the academy, lack of resources and investments, in addition to the historical devaluation of qualitative research results..On the other hand, from the identification of challenges, perspectives and initiatives to overcome them are outlined, highlighting the recovery of research’s social commitment, development of networks for dissemination and transfer of the results obtained, use of methodologies and rigorous, reproducible, and transparent research designs that include translation, reflection on the understandability of findings, increased investments, and communication strategies. Such actions favor accessibility to research and encourage a break with traditional and conservative models that tend to perpetuate unidirectional and limited patterns, which do not guarantee the realization of the public utility of the study and the strengthening of health and research systemsThus, considering the aforementioned considerations as well as the spreading of knowledge disassociated from the effective incorporation of evidence in places where care is provided, which would have repercussions in advances in health care, the following reflections emerged: is there understanding, support and preparation for RT in Brazil? What paths and bridges do we need to build to ensure the effective implementation of research results? What is the future of RP? Where are we going?The discussions raised here converge to the pressing need to (re)think research, its applications and purposes, with the intention of orchestrating them under the aegis of knowledge translation and social commitment, making RT a priority issue and intending to build paths and perspectives that value reflexivity, dissemination of knowledge and collaborative work, promoting powerful, safe and assertive transformations in health care practice for the population.In summary, this editorial is expected to promote new reflections on the subject, contributing to re-signification of RT by reducing the distance between theory and practice, in addition to boosting engagement and concentration of efforts by researchers, research centers and services to improve transfer and use of knowledge obtained, with the aim of remodeling practices and providing subsidies to guide the decision-making process safely and reasonably, whether in clinical practice or in health policies.


The growth in our knowledge of the diversity of the herpetofauna of Mexico has occurred over the period of approximately 445 years from the work of Francisco Hernández to that of a broad multinational array of present-day herpetologists. The work of this huge group of people has established Mexico as one of the most significant centers of herpetofaunal biodiversity in the world. This status is the result of a complex orography, in addition to diverse habitats and environments and the biogeographic history of Mexico. The current herpetofauna consists of 1,421 native and introduced species, allocated to 220 genera, and 61 families. This figure is comprised of 1,405 native species and 16 non-native species (as of April 2023). The non-native species include two anurans, 13 squamates, and one turtle. The level of endemism is very high, presently lying at 63%, with this level expected to increase with time. Species richness varies among the 32 federal entities in the country, from a low of 50 in Tlaxcala to a high of 492 in Oaxaca. Amphibian species richness by state-level can be envisioned as comprising three levels of low, medium, and high, with the lowest levels occurring in the Peninsula of Baja California, a group of seven states in north-central and central Mexico, and a group of three states in the Yucatan Peninsula, with the highest levels occupying the southern states of Guerrero, Puebla, Veracruz, Oaxaca, and Chiapas, and the medium level in the remaining states of the country. Reptile species richness also can be allocated to three categories, with the lowest level occupying Baja California Sur, a group of central states, and the states of the Yucatan Peninsula, and the highest level found in a cluster of the states of Veracruz, Guerrero, Oaxaca, and Chiapas. Knowledge of the Mexican herpetofauna will continue to grow with additional studies on systematics, conservation, and the construction of checklists at various levels. Historically, our knowledge of the diversity of different biological groups in Mexico has increased through the accumulation of local, regional, state, and/or country level studies mammals: . In studThe contributions of Finally, between 1990 and 2000, a strong interest in biodiversity led to an assessment of the herpetofauna of Mexico at both the regional and state levels , b. SubsChiropterotritonaureus or C.nubilus  compiled by the authors, which were searched from 1940 to date;records obtained in specialized journals, such as Mesoamerican Herpetology, ZooKeys, Zootaxa, Revista Mexicana de Biodiversidad, Herpetological Review, and Amphibian & Reptile Conservation, as well as publications of newly described species for the country (until 30 April 2023);https://www.gob.mx/conabio); anddatabases generated from projects undertaken by the Comisión Nacional para el Conocimiento y Uso de la Biodiversidad (https://www.gbif.org/), and authenticated by geographic distribution records from previously published literature.records of amphibians and reptiles from Mexico obtained from the Global Biodiversity Information Facility (https://www.amnh.org), and for reptiles, based on the Reptile Database website (http://www.reptile-database.org/).All taxonomic changes and the identification of the species were based on the most recent taxonomic revisions . The sciOur results show that the current native herpetofauna of Mexico is comprised as follows: amphibians = 16 families, 58 genera, and 430 species  and 14 reptiles .Currently, 16 species of non-native or exotic amphibians and reptiles have been reported from Mexico , includiThe percentage of species endemism of the Mexican herpetofauna is very high at 63.1%  maintain the highest richness levels  to that of Chihuahua , of which the latter is 165.5 times larger than the former  are found in the two states of the Peninsula of Baja California, a north-central swath of states that include Coahuila, Nuevo León, Zacatecas, Aguascalientes, and Guanajuato, two small states in central Mexico, Ciudad de México, and Tlaxcala, and the Yucatan Peninsula states, Campeche, Yucatán, and Quintana Roo Fig. . The nexAccording to the number of species of reptiles by state the resulting categories are somewhat different than those for the amphibians, since the lowest rank (32–120) is occupied by the states of Baja California Sur, a smaller central Mexican swath that includes Zacatecas, Aguascalientes, Guanajuato, Querétaro, Estado de México, Ciudad de México, Tlaxcala, and Morelos, the state of Colima, and the states of the Yucatan Peninsula  Fig. . The medThe richness of amphibian and reptile species in Mexico has been the subject of study for several decades, generating various works listing the herpetofauna at the country level. In this study, we update the list of species to 1,421, of which 1,405 are native species, and 16 are non-native. The number of native species we record in this study is higher compared to that of recent works by The high species richness and endemism of both groups stands out compared to that of other groups of vertebrates in Mexico , since Jth century, the principal impulse that led to our current knowledge of the Mexican herpetofauna did not occur until the second half of the 19th century and was made possible through the contributions of th century the number of species in the country was ca. 219, but by the end of 20th century it had increased to 995 species (Fig. st century, the increased herpetofaunal species richness resulted from new state records (The brief historical review shown in the introduction of this work highlights the continuous study of the herpetofauna to date, since it began with the acknowledgement of the amphibian and reptile fauna by the Aztecs, which later increased with the Spanish conquest of the Americas . Althougies Fig.  and Ameries Fig. . At the  records  and the  records . All theBased on this number, the herpetofauna of Mexico has been analyzed by authors in other related fields, including conservation  and biogThe states in southeastern Mexico, including Oaxaca, Chiapas, and Veracruz, have shown the highest amount of species richness Figs , and theFuture studies on systematics , regiona


Emancipation andHealth: Decoloniality, Reparation, and Critical Reconstruction, the eventproposed a dialogue with previous editions and absorbed the discussions in the area,expressed in the Master Plan of the Commission of Social and Human Sciences in Healthdeveloped from 2020 to 2022. As it took place in a post-pandemic context, wheredemocratic institutions were being re-established and public policy investment cyclesstrengthened, the debates focused on diversity, the decolonial purpose, and the demandfor social reparation as guiding principles for both the production of public actionsand the production and sharing of knowledge.Another page in the history of Brazilian Public Health Association (Abrasco) was writtenfrom October 30 to November 3, 2023, during the 9th Brazilian Congress of Social andHuman Sciences in Health Decoloniality of Can-be-know-do: Challenges and Contributions ofSocial and Human Sciences in Health; Repairing HistoricalInjustices in the Field of Health: Ethos, Knowledge, Politics, and SocialAction; and Challenges for the Critical Reconstruction of Brazil:the Place and Contributions of Social and Human Sciences in Health. Threepanels were also held, guided by the preparatory discussions of the Congress, whichsought to address central themes in the area, such as The Distribution ofCapital and the Question of Visibility in the Field of Public Health;The Critical Vanguard of Human Sciences in Health and their Potential in theField of Public Health; and Training in (Public) Health in theExperience of Social and Human Sciences in Health.The dialogues and debates revolved around three major debates and 34 panel discussions ontopics such as The significant participation of the Social and Human Sciences in Health community wasevident and powerful, with almost 200 organizers and more than 2,300 participants at theCongress, 2,353 articles submitted and 1,770 presented in the 35 thematic meetings. Weinnovated methodologically by including representatives of the social movements on thescientific committee, who designed the activities with us and evaluated the articlessubmitted, and by holding meetings between generations of researchers and students and exchanges among researchers, students, andrepresentatives of the social movements (inter-knowledge snacks).The Congress brought many reflections on the role of Social and Human Sciences in Healthin the paradigmatic renewal movements in the field, on the protagonism and diversity ofepistemic subjects in a turn that affirms the plurality of rights, identities, andstruggles. It also points to the urgent need to review parameters for the inclusion