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Introduction The influence of collateral circulation on outcomes in intracranial atherosclerotic stenosis‐related large vessel occlusion (ICAS‐LVO) treated with mechanical thrombectomy (MT) with or without rescue stenting is not well defined. We aimed to determine whether collateral status modifies the effect of stenting on angiographic and clinical outcomes. Methods We analyzed patients with ICAS‐LVO in the RESCUE‐ICAS registry who underwent MT alone or with rescue stenting in the anterior circulation. Collaterals were graded as good or bad based on ASITN/SIR score. Outcomes included functional independence (mRS 0‐2 at 90 days), mortality, successful recanalization, sICH, and 24‐hour DWI infarct volume. Regression models evaluated stenting and collateral status interaction, adjusted using inverse probability weighting for age, sex, race, diabetes, hypertension, atrial fibrillation, hyperlipidemia, prior stroke, smoking, pre‐stroke mRS, admission NIHSS, IV tPA, and baseline ASPECTS, with weights trimmed at ≤4. Results A total of 324 patients were included (MT alone, n=182; stent+MT, n=142). Median age was 67 years, 57% were male, and vascular comorbidities were frequent. Good collaterals were present in 27% of cases. Interaction analysis between stenting and collateral status showed no significant effect modification for functional independence (adjusted OR 0.78, 95% CI 0.33‐1.82, p =0.560), mortality (adjusted OR 1.56, 95% CI 0.52‐4.68, p =0.425), sICH (adjusted OR 0.22, 95% CI 0.04‐1.42, p =0.112), or infarct volume (β = ‐10.1 mL, 95% CI ‐32.9 to 12.7, p =0.656). A borderline interaction was observed for successful recanalization, with stenting in the setting of good collaterals associated with higher odds of reperfusion (adjusted OR 5.34, 95% CI 0.90‐31.7, p =0.065). Conclusions In patients with anterior circulation ICAS‐LVO, collateral status did not significantly modify the benefit of rescue stenting. These findings suggest that good collaterals alone do not obviate the need for stenting, and highlight the need for prospective studies to define optimal medical management strategies in this population. image image

Introduction: Clinical simulation is an innovative teaching methodology that is widely recognised in nursing training for its ability to promote technical, relational and critical skills in a safe environment. It allows students to apply theoretical knowledge, develop clinical reasoning and acquire self-confidence before entering real care contexts. Objectives: To map the available scientific evidence on the use of clinical simulation in teaching nursing students, identifying perceived benefits and barriers to its implementation. Methodology: Follows Joanna Briggs Institute methodology and PRISMA-ScR guidelines. The March 2025 search used "Students, Nursing", "Simulation Training" and "Education, Nursing" in MEDLINE® Complete (via PubMed); CINAHL® Complete, MedicLatina® and Cochrane Central Register of Controlled Trials® (via EBSCOhost®). Included free full-text studies in any language, selected by two independent reviewers, with a third reviewer in the event of disagreement. Results: Main benefits: increased self-efficacy and confidence; development of technical skills; reflection and critical thinking; satisfaction and efficiency in learning. Obstacles to implementation: emotional and psychological challenges; training and support for teachers/supervisors; limitations of physical, human and financial resources; logistical problems and poor curriculum integration; lack of realism and limitations of simulated scenarios; insufficient preparation of students; initial resistance; ethical and emotional demands. Conclusion: Clinical simulation is a valuable educational tool in nursing, improving readiness for complex clinical situations. Effective implementation requires institutional support, educator training, and emotional support. This review underscores the need for structured curriculum integration and further research into the long-term impact and effectiveness of simulation in real-world clinical practice.

Unemployment insurance claimants are entitled to have state unemployment programs administered in accordance with federal standards, which include the provision of prompt and fair hearings for claimants if their applications for benefits are denied. Violations of these rights are widespread, but the United States Department of Labor's Unemployment Insurance Service has never brought a formal proceeding to enforce the federal standards of administration. This Article explains why enforcement of the federal standards is needed and why it has not been provided and suggests methods by which advocates for claimants can seek to enforce federal standards in the face of this failure by the federal agency.

La transformación digital ha sido acertadamente descrita como un “hecho social total”. Es omnipresente, ubicua y asimétrica, moldeando objetos, relaciones e individuos. La dataficación, la mediación y la hipermediación tecnológica configuran nuevos entornos habitados por las personas, en los cuales surgen diversas formas de contaminación “digital” (como la incitación al odio, la desinformación, los contenidos inapropiados, la manipulación del comportamiento y la adicción). Enfocándose en el acceso de los niños a los servicios en línea, esta reflexión pretende desarrollar una idea de ciberciudadanía, cuya implementación podría ser útil para proteger la libertad y los derechos frente a su creciente compresión entre las políticas de mercado y de seguridad.

Background: Idiopathic Intracranial Hypertension is a condition that mostly affects obese women of childbearing age. It is characterized by symptoms and signs associated with increased intracranial pressure, elevated opening pressure with normal cerebrospinal fluid composition, and exclusion of secondary causes of intracranial hypertension through imaging. Objective: To present the case of a nurse with Idiopathic Intracranial Hypertension from an Occupational Medicine perspective, focusing on her return to work and necessary changes. Method: Case report of a 37-year-old nurse working in a general surgery ward diagnosed with Idiopathic Intracranial Hypertension, after a cerebral venous sinus thrombosis episode. Due to medical treatment refractoriness, a lumboperitoneal shunt was placed. Upon returning to work, she was transferred to the Day Hospital. Discussion: Considering the impact of increased intra-abdominal pressure on intracranial pressure, and the cardiovascular risk associated with shift work and occupational stress, it was necessary to restrict her from performing tasks that could increase intra-abdominal pressure and from shift work. Given her remaining functional capacity, a job change was required. Conclusion: Occupational Medicine intervention should promote the implementation of protective measures tailored to the individual's situation and the adaptation/change of the job position.

Mestrando do PPG-GIIA da FZEA/USP 2 Docente do PPG-GIIA/FZEA/USP Resumo: No período entre 2010 e 2022, quando foram realizados os dois últimos censos demográficos, a população brasileira aumentou, segundo o IBGE, de 190 para 203 milhões de habitantes, o que provocou uma demanda maior por alimentos, como as carnes bovina, suína e de frangos, que são fontes importantes de proteína na dieta humana. No final deste período, entre março de 2020 e maio de 2023, a pandemia da COVID-19 alterou muito tanto a oferta quanto a procura por estes alimentos. No presente trabalho buscouse descrever e relacionar o comportamento da renda média do brasileiro e do consumo de carnes bovina, suína e de frangos no período entre os dois últimos censos. Palavras-chave: carne bovina, carne suína, carne de frango.

Since 1955 the Olympic Charter (OC) declares that there must be no extraneous events within the Olympic Games (OG), in particular of a political nature. The so-called Rule 50 has banned the use of the Games to externalize one’s ideas. Its infringements were mostly due to symbolic behavior by athletes who were then punished despite demanding respect for fundamental human rights trampled on in many regions of the world. The first question this essay poses is: is the rule an unjustified impediment to acting for just cause? Recent international political events and in particular the Russian-Ukrainian armed conflict have sparked renewed interest in the declared apolitical and neutrality of the Olympic Movement (OM) and its effectiveness in promoting peace and achieving the goals of Olympism. The second question of this essay is: is this positioning always reconcilable with real events? It will be concluded that the current rule 50 adheres to the rules of international law while neutrality should be rethought and sacrificed if it makes the pursuit of the objectives of peace and justice less effective. The two issues are independent but can act in complementary ways to pursue legitimate objectives of the OM.