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Use of granulocyte colony-stimulating factor in neonatal intensive care unit: case series study and literature review
No full textIntrodução: Recém-nascidos (RN) internados em UTI Neonatal (UTIN) podem apresentar neutropenia associada à sepse ou à condições não infecciosas. O uso do fator estimulador de colônia de granulócitos recombinante (rG-CSF) em RN neutropênicos é controverso pois há dúvidas se ele melhora a mortalidade. Objetivos: Investigar em RN neutropênicos o uso do rG-CSF e avaliar o desfecho morte. Métodos: Estudo longitudinal realizado na UTIN do HC FMB UNESP, entre janeiro de 2017 a dezembro de 2023, após aprovação do comitê de ética. Foram incluídos os RN pré-termos neutropênicos que receberam rG-CSF, independente do peso de nascimento (PN) e número (nº) de doses recebidas; excluídos aqueles sem controle hematológico durante o tratamento ou com malformações congênitas maiores. A amostra foi de conveniência totalizando 32 RN. Foram estudadas variáveis maternas, do parto, dos RN e aquelas relacionadas ao uso do rG-CSF (tempo de vida, nº doses, contagem de neutrófilos pré e pós medicação). Desfecho: óbito. Comparação entre grupos: terapêutico (sepse) vs profilático (causa não infecciosa). Estatística: descritiva e comparação entre grupos por teste t student, exato de Fisher, teste qui quadrado, binomial negativa e distribuição de Poisson com significância estatística de 5%. Resultados: Dos 2508 RN internados na UTI, 36 receberam rG-CSF (1,4%) e 32 RN foram incluídos. As médias de peso de nascimento e idade gestacional foram respectivamente 1088 gramas e 28,6 semanas; 23 RN (72%) receberam rG-CSF no grupo terapêutico (neutropenia associada à sepse) e 9 RN (28%) no profilático (associada à pré-eclâmpsia). A mortalidade foi de 35% no grupo terapêutico e 33% no profilático. No grupo profilático 45% apresentaram sepse tardia clínica. O uso do rG-CSF ocorreu entre 2º e 3° dias de vida, em RN com neutropenia grave (mediana 400/mm3) atingindo valores > 1500/mm3 após a segunda dose. Conclusão: O uso do rG-CSF foi baixo e ocorreu em RN muito prematuros e de muito baixo peso. A principal indicação foi de neutropenia associada à sepse. Houve aumento da contagem de neutrófilos, mas a mortalidade foi alta em ambos os grupos. No grupo profilático a incidência de sepse tardia clínica também foi elevada. Portanto, o uso de rotina do rG-CSF não é recomendado.Introduction: Neonatal infants admitted to the Neonatal Intensive Care Unit (NICU) may present with neutropenia associated with either sepsis or non-infectious conditions. The use of recombinant granulocyte colony-stimulating factor (rG-CSF) in neutropenic neonates is controversial, as there are uncertainties regarding its impact on mortality. Objectives: This study aimed to investigate the use of rG-CSF and analyze mortality outcomes associated with its use. Methods: A longitudinal study conducted in the NICU of the HC FMB UNESP from January 2017 to December 2023, after approval by the ethics committee. Preterm neutropenic neonates who received rG-CSF were included, regardless of birth weight (BW) and the number of doses received; those without hematological monitoring during treatment or with major congenital malformations were excluded. The sample was convenience-based, totaling 32 neonates. Maternal, birth, neonatal variables, and those related to the use of rG-CSF (life duration, number of doses, neutrophil count before and after medication) were studied. Outcome: death. Group comparison: therapeutic (sepsis) vs prophylactic (non-infectious cause). Statistics: descriptive and group comparison using Student’s t-test, Fisher’s exact test, chi-square test, negative binomial, and Poisson distribution with statistical significance set at 5%. Results: Of the 2508 neonates admitted to the NICU, 36 received rG-CSF (1.4%) and 32 were included. The mean birth weight and gestational age were 1088 grams and 28.6 weeks, respectively. Twenty-three neonates (72%) received rG-CSF in the therapeutic group (neutropenia associated with sepsis) and 9 (28%) in the prophylactic group (associated with preeclampsia). The mortality rate was 35% in the therapeutic group and 33% in the prophylactic group. In the prophylactic group, 45% presented late-onset clinical sepsis. rG-CSF was administered between the 2nd and 3rd days of life in newborns with severe neutropenia (median 400/mm³), reaching values >1500/mm³ after the second dose. Conclusion: The use of rG-CSF was limited and occurred in very preterm and very low birth weight neonates. The main indication was neutropenia associated with sepsis. There was an increase in neutrophil count, but mortality was high in both groups. In the prophylactic group, the incidence of late-onset clinical sepsis was also elevated. Therefore, routine use of rG-CSF is not recommended
[Efeitos do cocultivo com células estromais multipotentes do endométrio na produção in vitro de embriões bovinos]
No full textIn vitro embryo production (IVP) protocols generally use supplementation with fetal bovine serum (FBS) in its culture media. Although it contains essential nutrients and growth factors for the embryo, exposure to serum can affect embryonic morphology and biochemistry, in addition to being possibly related to increased fetal weight at birth. In this sense, multipotent stromal cells (MSCs), given the wide range of secreted factors, could help improve IVP protocols. This study verified whether cell proliferation factors secreted by multipotent stro-mal cells obtained from endometrial tissue (eMSCs) stimulate the development and production of better quality embryos. For that purpose, bovine embryos produced in vitro were co-cultured with eMSCs and evaluated for cleavage index and blastocyst formation, as well as total cell count, trophoblast cell count and apoptotic cell count. It is concluded that the production of bovine embryos associated with co-culture with eMSCs presented similar results to the use of traditional media, showing an improvement regarding the total number of cells, in which the embryos cultivated in the presence of eMSCs and absence of FBS presented a higher number of total cells than those cultured in the absence of eMSCs and FBS.Faculdade de Medicina Veterinária e Zootecnia Universidade Estadual Paulista, SP, UnespUniversidade Federal de São Carlos, SPFaculdade de Medicina Veterinária e Zootecnia Universidade Estadual Paulista, SP, Unes
Limit cycles and chaos in planar hybrid systems
No full textIn this paper we study the family of planar hybrid differential systems formed by two linear centers and a polynomial reset map of any degree. We study their limit cycles and also provide examples of these hybrid systems exhibiting chaotic dynamics.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Agència de Gestió d'Ajuts Universitaris i de RecercaAgencia Estatal de InvestigaciónDepartament de Matemàtiques Facultat de Ciències Universitat Autònoma de Barcelona, BellaterraIBILCE-UNESP, CEP 15054-000, S. J. Rio PretoIBILCE-UNESP, CEP 15054-000, S. J. Rio PretoFAPESP: 2019/10269-3FAPESP: 2021/01799-9Agència de Gestió d'Ajuts Universitaris i de Recerca: 2021SGR00113FAPESP: 2022/14353-1Agencia Estatal de Investigación: PID2022-136613NB-10
Youth and Adult Education in evening middle school: is there room for physical education?
No full textPensar sobre a Educação Física Escolar e seu papel na sociedade, nos leva a refletir sobre sua área de atuação e legitimidade dentro do ambiente escolar, em seus diferentes níveis e modalidades. Com isso, surge a necessidade em compreender como a Educação Física é possível na Educação de Jovens e Adultos (EJA), uma modalidade por vezes tão marginalizada na educação, principalmente no período noturno, considerando que quando acontece as aulas de Educação Física, essas são no contraturno, inviabilizando a participação da maior parte dos estudantes. Nesta perspectiva, esta pesquisa teve como objetivo compreender a concepção que os 14 professores que atuam na EJA, em uma escola do município de Campinas/SP, possuíam em relação à disciplina de Educação Física, bem como os desafios e possibilidades nessa modalidade acadêmica, buscando a compreensão do papel deste componente curricular no atual cenário educacional. Este estudo partiu da análise dos subsídios teóricos das legislações vigentes e das diretrizes municipais, estaduais e nacionais. A pesquisa foi conduzida por meio de entrevistas utilizando um roteiro semiestruturado de entrevista junto aos 14 professores, as quais foram gravadas e transcritas para a respectiva análise de conteúdo. Os resultados indicaram que, embora os docentes reconheçam a relevância da Educação Física e seu potencial para o desenvolvimento integral dos estudantes, persiste uma incompreensão sobre o formato das aulas no contraturno. As estratégias propostas pelos professores – como a inclusão da disciplina no horário regular, a implementação de projetos interdisciplinares e a adequação metodológica – ressaltam a necessidade de reformulações para mitigar os obstáculos identificados. Ao final, foi construído o Recurso Educacional no formato de uma Proposta Unidade Didática Transdisciplinar a ser oferecida aos professores, integrando às aulas de Educação Física nessa modalidade de ensino, como uma forma de contribuir com o trabalho docente e ampliar as possibilidades de acesso a esse componente por parte de todos os estudantes.Search about School Physical Education and its role in society leads us to reflect on its area of activity and legitimacy within the school environment, at its different levels and modalities. Thus, there is a need to understand how Physical Education is possible in Youth and Adult Education (EJA), a modality that is sometimes so marginalized in education, especially in the evening period, considering that when Physical Education classes take place, they are in the opposite shift, making it impossible for most students to participate. In this perspective, this research aimed to understand the conception that the 14 teachers who work in EJA, in a school in the city of Campinas/SP, had in relation to the Physical Education discipline, as well as the challenges and possibilities in this academic modality, seeking to understand the role of this curricular component in the current educational scenario. This study was based on the analysis of the theoretical frameworks of current legislation and municipal, state and national guidelines. The research was conducted through interviews using a semi-structured interview script with 14 teachers, which were recorded and transcribed for content analysis. The results indicated that, although teachers recognize the relevance of Physical Education and its potential for the integral development of students, there is still a lack of understanding about the format of after-school classes. The strategies proposed by the teachers – such as including the subject in the regular timetable, implementing interdisciplinary projects and adapting the method – highlight the need for reformulations to mitigate the obstacles identified. In the end, the Educational Resource was created in the form of a Proposed Transdisciplinary Teaching Unit to be offered to teachers, integrating it into Physical Education classes in this teaching modality, as a way of contributing to the teaching work and expanding the possibilities of access to this component by all students
Synthesis of an amphiphilic and thermosensitive diblock polymer: poly(AAm-co-AN)-POEGMA
No full textPolímeros termossensíveis anfifílicos têm despertado grande interesse pela sua capacidade de atuação como constituintes de sistemas de liberação de fármacos responsivos à temperatura. Devido a característica anfifílica, podem formar micelas em solução aquosa e assim carrear fármacos hidrofóbicos na região central dessas micelas. A termoresponsividade desses sistemas torna a entrega desses fármacos dependente da temperatura local, possibilitando carreamento e liberação do fármaco em regiões específicas do corpo humano. Os polímeros com propriedades térmicas possuem solubilidade dependente da temperatura, podendo ser classificados em dois tipos: LCST, que apresentam temperatura crítica inferior de solução, e UCST, que apresentam temperatura crítica superior de solução. Os polímeros UCST, como poli(acrilamida-co-acrilonitrila) (PAA), são menos explorados que os LCST em virtude das dificuldades no processo de síntese. A demonstração de rotas sintéticas mais simples e de fácil controle da termossensibilidade, nos últimos 10 anos, tornou os polímeros UCST atrativos na confecção de sistemas de liberação inteligentes. Neste trabalho, polímeros dibloco anfifílicos PAA-b-POEGMA com comportamento UCST foram sintetizados e caracterizados, a fim de avaliar a influência da incorporação do bloco hidrofílico poli[(oligo(etilenoglicol)-metil-éter-metacrilato)], POEGMA, na termossensibilidade do bloco PAA em tampão fosfato-salino (PBS, pH 7,4). O PAA-b-POEGMA foi obtido via polimerização RAFT (transferência reversível de cadeia por adição-fragmentação). Esse polímero foi caracterizado por espectroscopia vibracional na região do infravermelho com transformada de Fourier (FTIR), ressonância magnética nuclear (RMN) de 1H, calorimetria exploratória diferencial (DSC) e espectroscopia na região do ultravioleta-visível (UV-Vis). O aumento da proporção do monômero acrilonitrila no PAA aumentou a temperatura de clarificação (TCL). A incorporação do bloco POEGMA em PAA favoreceu as interações com o solvente e, portanto, diminuiu os valores de TCL. O método de polimerização RAFT se mostrou adequado nas sínteses dos polímeros em bloco com diferentes conteúdos de POEGMA.Amphiphilic thermosensitive polymers have attracted great interest due to their ability to act as components of temperature-responsive drug delivery systems. Due to their amphiphilic characteristic, they can form micelles in aqueous solutions and carry hydrophobic drugs in the central region of the micelles. The thermoresponsiveness of these systems makes drug delivery dependent on local temperature, enabling the transport and release of the drug in specific regions of the human body. Polymers with thermal properties have temperature-dependent solubility and can be classified into two types: LCST, which has a lower critical solution temperature, and UCST, which has an upper critical solution temperature. UCST polymers, such as poly(acrylamide-co-acrylonitrile) (PAA), are less explored than LCST polymers due to the difficulties in the synthesis process. The demonstration of simpler synthetic routes and easier control of thermosensitivity in the last 10 years has made UCST polymers attractive for the preparation of smart delivery systems. In this work, amphiphilic diblock polymers PAA-b-POEGMA with UCST behavior were synthesized and characterized in order to evaluate the influence of the incorporation of the hydrophilic block poly[(oligo(ethylene glycol)-methyl-ether-methacrylate)], POEGMA, on the thermosensitivity of the PAA block in phosphate-buffered saline (PBS, pH 7.4). PAA-b-POEGMA was obtained via RAFT (reversible addition-fragmentation chain transfer) polymerization. This polymer was characterized by Fourier transform infrared (FTIR) vibrational spectroscopy, 1H nuclear magnetic resonance (1H NMR), differential scanning calorimetry (DSC) and ultraviolet-visible (UV-Vis) spectroscopy. The increase in the proportion of acrylonitrile monomers in PAA increased the clarification temperature (TCL). The incorporation of the POEGMA block in PAA favored the interactions with the solvent and, therefore, decreased the TCL values. The RAFT polymerization method proved to be appropriate for the synthesis of block polymers with different POEGMA contents
Bioavailability of Al, Fe, Mn and Zn in a Decommissioned Mining Area Evaluated by Biomonitoring and Passive Samplers: Robustness, Efficiency and Relationships Between Biotic and Abiotic Monitoring Approaches
No full textIn situ assessment of metal bioavailability is crucial for evaluating the degree of contamination in aquatic systems. This study evaluated the bioavailability of Al, Fe, Mn and Zn in water from three sites in a decommissioned mining area near the city of Poços de Caldas (State of Minas Gerais, Brazil). A multi-tool approach was used, combining DGT, transplanted fish (Oreochromis niloticus) and water samples (total and dissolved metal concentration analyses). Samples were taken at 14, 28 and 42-day intervals. Livers, gills and muscles of transplanted fish were analyzed after acid digestion in microwaves and determined by ICP-OES. Significant increases in transplanted fish for Mn and Zn concentrations were observed in the gills. Total and dissolved concentrations showed large fluctuations, possibly influenced by factors such as the rainy season, pH changes, and varying effluent discharges at each sampling point. The concentration of the element measured by DGT devices, proved to be an effective indicator of temporal and spatial variations in the bioavailable levels of Al, Fe, Mn and Zn across all sites analyzed. However, the weak correlations between the different monitoring methods highlight their complementary nature, as each approach captures distinct aspects of metal bioavailability. This underscores the importance of integrating multiple methodologies to provide a more comprehensive understanding of metal dynamics in complex environmental scenarios.Environmental Studies Center São Paulo State University (Unesp)Institute of Geosciences and Exact Sciences São Paulo State University (Unesp)Environmental Studies Center São Paulo State University (Unesp)Institute of Geosciences and Exact Sciences São Paulo State University (Unesp
Learning to communicate science produced at the university: a design aimed at training undergraduate chemistry students
No full textEsta pesquisa investiga o desenvolvimento de estudantes de graduação para a realização de atividades de Divulgação Científica (DC), com ênfase na produção de materiais com caráter extensionista, que visam aproximar o conhecimento científico da sociedade em geral. Reconhecendo a importância da DC como um instrumento fundamental para a socialização do conhecimento produzido na universidade, o estudo propõe uma abordagem formativa que combina aulas teóricas, palestras e atividades práticas voltadas para o desenvolvimento de competências comunicativas, compreensão crítica da ciência e da sua função social, além da construção da identidade dos estudantes como capazes de divulgar a ciência. O foco principal da formação está na capacitação dos estudantes para elaborar Textos de Divulgação Científica (TDC), reconhecidos como ferramentas eficazes para tornar o conhecimento acessível e compreensível a diferentes públicos, especialmente aqueles fora do meio acadêmico. Os TDC produzidos no âmbito deste projeto têm como base uma pesquisa científica sobre processos de oxidação e redução desenvolvida no Instituto de Química da UNESP, evidenciando a articulação entre ensino, pesquisa e extensão por meio da tradução do conhecimento acadêmico em linguagem acessível. A produção dos TDC é concebida não apenas como uma atividade acadêmica, mas como uma prática pré-extensionista, sendo que, uma vez posto em contato com seu público-alvo, o texto apresenta capacidade de ampliar o alcance social do conhecimento científico e contribui para a democratização da ciência. Ao longo da pesquisa, é analisado o percurso formativo dos estudantes, identificando os avanços no desenvolvimento de habilidades comunicativas, tais como clareza, adequação da linguagem e estratégias de engajamento do público. Além disso, a pesquisa destaca a reflexão crítica dos estudantes sobre o papel social da DC, fortalecendo a percepção da importância de uma comunicação ética, responsável e alinhada às necessidades sociais. Os resultados indicam que a formação oferecida, aliada à prática da produção de materiais extensionistas como os TDC, tem potencial de futuramente fortalecer a relação entre universidade e sociedade, ampliando o acesso ao conhecimento científico e fomentando uma cultura científica mais inclusiva e participativa.This research investigates the engagement of undergraduate students for engaging in Science Communication (SC) activities, with an emphasis on producing outreachoriented materials aimed at bridging the gap between scientific knowledge and society at large. Recognizing the importance of SC as a fundamental tool for the socialization of knowledge produced at the university, the study proposes an educational approach that combines theoretical classes, lectures, and practical activities focused on developing communicative competencies, critical understanding of science and its social role, as well as fostering students’ identities as capable science communicators. The core focus of the training lies in preparing students to write science communication texts, recognized as effective tools for making scientific knowledge accessible and understandable to diverse audiences, especially those outside academia. The TDC produced in this project are based on a scientific research study on oxidation and reduction processes developed at the Institute of Chemistry of UNESP, illustrating the articulation between teaching, research, and outreach through the translation of academic knowledge into accessible language. The production of these texts is conceived not merely as an academic activity, but as a pre-extensionist practice; once shared with a target audience, these texts have the potential to broaden the social reach of scientific knowledge and contribute to the democratization of science. Throughout the research, the students’ formative journey is analyzed, identifying progress in the development of communicative skills such as clarity, appropriate language use, and audience engagement strategies. Additionally, the study highlights students’ critical reflection on the social role of SC, reinforcing the perception of its importance as an ethical, responsible, and socially aligned form of communication. The results indicate that the training provided—alongside the practice of producing outreach materials like SCTs—holds the potential to strengthen the relationship between university and society, broaden access to scientific knowledge, and foster a more inclusive and participatory scientific culture.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES
Hypertonic saline solution evokes cardiovascular recovery in hemorrhagic rats dependent on GABA A and β-adrenergic transmission in the subfornical organ
No full textBackground: Studies have reported the use of a hypertonic saline solution (HSS) for the treatment of hypotensive hemorrhage (HH). Despite the established role of central mechanisms in the cardiovascular recovery induced by HSS during HH, the involvement of the Subfornical Organ (SFO) in these responses remains to be elucidated. The present study evaluated the role of SFO and adrenergic neurotransmission in the nucleus in the cardiovascular responses to HSS infusion in hemorrhagic rats. Methods: Mean arterial pressure (MAP), heart rate (HR), and aortic vascular resistance (AVR) were recorded in Wistar rats. HH was performed through blood withdrawal until a MAP of 60 mmHg was attained. Nanoinjections of saline (NaCl; 0.15 M; control group; n = 7), muscimol (4 mM; GABAergic agonist; muscimol group; n = 7), or propranolol (10 mM; non-selective β-adrenergic blocker; propranolol group; n = 7) in SFO were performed 10 min after the onset of blood withdrawal, followed by HSS infusion (NaCl; 3 M; 1.8 ml∙kg−1) 20 min after the beginning of HH. Results: Hypotension, bradycardia, and aortic vasoconstriction were observed in all groups During HH. Sodium overload reestablished MAP and HR while maintaining aortic vasoconstriction in the control group. Activation of GABA A receptors or β-adrenergic receptor blockade in the SFO prevents HSS-induced recovery of MAP and HR. In addition, maintenance of aortic vasoconstriction induced by HSS infusion was abolished by SFO inhibition. Conclusions: The results suggest that the integrity of SFO neurons and β-adrenergic neurotransmission are essential for cardiovascular recovery promoted by sodium overload in hemorrhagic rats.Center for Neuroscience and Cardiovascular Research Federal University of Goias, Estrada do Campus, s/n, GODepartment of Physiological Science Biological Sciences Institute Federal University of GoiásDepartment of Physiology and Pathology School of Dentistry São Paulo State University (UNESP)Department of Physiology Biomedical Sciences Institute Federal University of Uberlandia, UberlandiaDepartment of Physiology and Pathology School of Dentistry São Paulo State University (UNESP
Implementation challenges of disaster risk management policies: The organizational capacities of municipal civil defense units
No full textThe Sendai Framework for Disaster Risk Reduction has provided recommendations for disaster risk management policies. Several studies have contributed to them, generating knowledge about hazards and vulnerabilities. However, only some studies have delved into the capacities of municipalities to implement these national policies. This article analyzes the needs and organizational capacities of municipal civil defense units in Brazil and discusses cocreated proposals to catalyze national policy implementation at the municipal scale. The problem-oriented research conducted between October 2020 and December 2021 adopted mixed methods, composed of an online survey with 1993 municipalities, interviews with 31 municipalities' representatives across five regions of Brazil, and ten virtual focus groups with 260 participants. The qualitative and quantitative data were analyzed and summarized in five main topics that oriented the coproduction of proposals to catalyze policy implementation at the municipal level. These five main topics were centered on i) the professionalization of civil defense services; ii) funding sources to catalyze the implementation of municipal civil defense actions; iii) improving permanent communication among the national, state, and municipal civil defense units; iv) creating capacity development activities that are tailored to regional and biomes’ specificities; and v) fostering social and cross-sectoral participation in the civil defense policy.United Nations Development ProgrammeFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)National Early Warning and Monitoring Center of Natural Hazards (Cemaden) Estrada Doutor Altino Bondesan, 500 - Distrito de Eugênio de MeloGraduate Program on Disasters São Paulo State UniversityRede Nacional de Comunidades Resilientes - RENACOR Belo HorizonteGraduate Program on Disasters São Paulo State UniversityFAPESP: 2018/06093-4FAPESP: 2022/02891-
Overcoming gaps in medical imaging in Latin America and the Caribbean: comprehensive assessment and proposal of a transdisciplinary AI-supported framework for early diagnosis of lung cancer
No full textAs projeções do aumento da incidência do câncer de pulmão na América Latina e no Caribe (ALC) exigem atenção, especialmente nos países de baixa e média renda, que apresentam recursos limitados e desigualdade no investimento em saúde pública. O objetivo desta tese foi desenvolver uma estrutura integrada (framework) combinando Inteligência Artificial (IA), telerradiologia, Tecnologias Digitais da Informação e Comunicação (TDIC), rastreamento por Tomografia Computadorizada de Baixa Dose (TCBD) e o princípio da regionalização em saúde, com o intuito de promover o diagnóstico precoce do câncer de pulmão, com ênfase nas regiões da ALC que apresentam deficiência estrutural e escassez de profissionais em diagnóstico por imagem. A tese abordou as desigualdades no acesso ao diagnóstico por imagem na ALC e mapeou o estado da arte da IA no diagnóstico oncológico com ênfase em Tomografia Computadorizada (TC) e Ressonância Magnética (RM). Para tanto, foram realizados: (i) um estudo transversal sobre a disponibilidade de recursos de imagem médica e médicos especialistas na ALC; (ii) uma análise bibliométrica da literatura sobre aplicações de IA, com ênfase em TC e RM em imagem oncológica; e (iii) a construção de um modelo conceitual-teórico transdisciplinar. Os resultados do estudo transversal mostraram uma distribuição desigual de recursos na ALC, com alta concentração em países de alta renda, indicando, ainda, a necessidade do desenvolvimento de um planejamento estratégico e de políticas públicas com foco na gestão em saúde. Por outro lado, a análise bibliométrica revelou que as tendências emergentes da IA em imagem oncológica incluem o uso de tecnologias como o deep learning (aprendizado profundo), que têm sido utilizadas na prática com resultados positivos na análise de imagens para identificar padrões característicos de tumores ou lesões, trazendo maior precisão e eficiência diagnóstica clínica. O uso de TDIC facilita a criação de canais focados em educação continuada, troca de informações e comunicação entre profissionais, pacientes e familiares, promovendo um ambiente colaborativo e maior envolvimento da comunidade, o que pode otimizar os resultados de saúde. As bases da transdisciplinaridade contribuíram para a aplicação de teorias e conceitos de forma articulada e coesa, resultando na inovação proposta pelo modelo. Conclui-se que o framework proposto nesta tese representa uma estratégia potencial para mitigar as desigualdades no acesso ao diagnóstico por imagem precoce, podendo contribuir diretamente para a melhoria da sobrevida de pacientes com risco de câncer de pulmão. Como próximo passo, sugere-se a validação do framework e sua implementação em uma cidade piloto da ALC, expandindo a cobertura para outras regiões geográficas (esfera macro) de forma progressiva e adaptativa, respeitando as características regionais.Projections of the increasing incidence of lung cancer in Latin America and the Caribbean (LAC) demand attention, especially in low- and middle-income countries, which present limited resources and significant inequality in public health investment. The objective of this thesis was to develop an integrated framework combining Artificial Intelligence (AI), teleradiology, Digital Information and Communication Technologies (DICT), Low-Dose Computed Tomography (LDCT) screening, and the principle of healthcare regionalization, with the purpose of promoting the early diagnosis of lung cancer, with emphasis on LAC regions characterized by structural deficiencies and a shortage of imaging diagnosis professionals. This thesis addressed the inequalities in access to imaging diagnosis in LAC and mapped the state of the art of AI in oncological diagnosis, with emphasis on Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). To this end, the following were carried out: (i) a cross-sectional study on the availability of medical imaging resources and medical specialists in LAC; (ii) a bibliometric analysis of the literature on AI applications, with emphasis on CT and MRI in oncological imaging; and (iii) the construction of a transdisciplinary conceptual-theoretical model. The results of the cross-sectional study showed an unequal distribution of resources in LAC, with a high concentration in high-income countries, also indicating the need for the development of strategic planning and public policies focused on health management. On the other hand, the bibliometric analysis revealed that the emerging trends in AI applied to oncological imaging include the use of technologies such as deep learning, which have been applied in practice with positive results in image analysis to identify characteristic patterns of tumors or lesions, bringing greater accuracy and clinical diagnostic efficiency. The use of DICT facilitates the creation of channels focused on continuing education, information exchange, and communication among professionals, patients, and families, fostering a collaborative environment and greater community engagement, which can optimize health outcomes. The foundations of transdisciplinarity contributed to the application of theories and concepts in an articulated and cohesive manner, resulting in the innovation proposed by the model. It is concluded that the framework proposed in this thesis represents a potential strategy to mitigate inequalities in access to early imaging diagnosis, with the possibility of directly contributing to improving the survival of patients at risk for lung cancer. As a next step, it is suggested to validate the framework and implement it in a pilot city in LAC, progressively and adaptively expanding its coverage to other geographic regions (macro level), respecting regional characteristics.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Capes:00