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COVID-19 has overwhelmed health services globally. Oral antiviral therapies are licensed worldwide, but indications and efficacy rates vary. We aimed to evaluate the safety and efficacy of oral favipiravir in patients hospitalised with COVID-19.We conducted a multicentre, open-label, randomised controlled trial of oral favipiravir in adult patients who were newly admitted to hospital with proven or suspected COVID-19 across five sites in the UK (n=2), Brazil (n=2) and Mexico (n=1). Using a permuted block design, eligible and consenting participants were randomly assigned (1:1) to receive oral favipiravir (1800 mg twice daily for 1 day; 800 mg twice daily for 9 days) plus standard care, or standard care alone. All caregivers and patients were aware of allocation and those analysing data were aware of the treatment groups. The prespecified primary outcome was the time from randomisation to recovery, censored at 28 days, which was assessed using an intention-to-treat approach. Post-hoc analyses were used to assess the efficacy of favipiravir in patients aged younger than 60 years, and in patients aged 60 years and older. The trial was registered with clinicaltrials.gov, NCT04373733.Between May 5, 2020 and May 26, 2021, we assessed 503 patients for eligibility, of whom 499 were randomly assigned to favipiravir and standard care (n=251) or standard care alone (n=248). There was no significant difference between those who received favipiravir and standard care, relative to those who received standard care alone in time to recovery in the overall study population (hazard ratio [HR] 1·06 [95% CI 0·89-1·27]; n=499; p=0·52). Post-hoc analyses showed a faster rate of recovery in patients younger than 60 years who received favipiravir and standard care versus those who had standard care alone (HR 1·35 [1·06-1·72]; n=247; p=0·01). 36 serious adverse events were observed in 27 (11%) of 251 patients administered favipiravir and standard care, and 33 events were observed in 27 (11%) of 248 patients receiving standard care alone, with infectious, respiratory, and cardiovascular events being the most numerous. There was no significant between-group difference in serious adverse events per patient (p=0·87).Favipiravir does not improve clinical outcomes in all patients admitted to hospital with COVID-19, however, patients younger than 60 years might have a beneficial clinical response. The indiscriminate use of favipiravir globally should be cautioned, and further high-quality studies of antiviral agents, and their potential treatment combinations, are warranted in COVID-19.LifeArc and CW+.

The objective was to contribute to the formation of spin-offs in the biotechnology segment in the Amazon, in ICTs, involved with innovation, technology transfer to the market, derived from successful academic ventures. We opted for the exploratory methodology, bibliographic, documentary and with qualitative approach from the theory of innovation that identify the trajectory of the spin-offs, with competencies for the development of innovative products and processes in their market journey. Concluded that in biotechnological innovation in the Amazon, it is necessary to join efforts of the private sector, government, and spin-offs of ICTs. The latter can contribute to skilled professionals and laboratories for R&I, to respond to the needs of sustainable socioeconomic development, through opportunities for biotechnology spin-off as an instrument of technology transfer of ICTs aiming at implementing innovative technologies for market access.

Introducción. La nutrición y salud bucal son temas de interés en salud pública por su alto impacto en el bienestar y desarrollo de las personas. Existe una alta prevalencia e incidencia de caries y malnutrición en los primeros años de vida. Objetivo. Determinar la relación entre el índice de caries en dentición primaria y permanente e índice de masa corporal en niños de 5 a 11 años en las Unidades de Salud de San Miguel Tepezontes y Panchimalco en el año 2019.Metodología. Investigación cuantitativa con una muestra de 265 niños de 5 a 11 años. Se evaluó el índice de masa corporal y el índice de caries; se hizo un análisis estadístico descriptivo e inferencial, realizando la prueba estadística de correlación de Spearman. Resultados. Se encontró que el índice de caries es de 2,11 en dentición permanente con una prevalencia de 70,5 % y el índice de caries de 7,02 en dentición primaria con una prevalencia de un 94,98 %. El coeficiente de correlación de Spearman entre índice de masa corporal e índice de caries en dentición permanente fue de 0,226, que indica una correlación positiva baja y el índice de masa corporal e índice de caries en dentición primaria fue - 0,158, que indica una correlación negativa muy baja. Conclusión. Existe relación entre el índice de caries en ambas denticiones y el índice de masa corporal.

Mushroom cultivation is an economically viable process for the conversion of various lignocellulosic residues. Recently in order to increase the feasibility of mushroom production, research has been carried out to investigate the use of residues as substrates and the possibility of obtaining two or more products in a single bioprocess. The aim of this study wasto investigate the potential of biomass residues from street markets in the city of Manaus (Amazonas, Brazil) as a substrate for the production of oyster mushroom and laccase. Pleurotus ostreatus was cultivated in the following biomass residues: a) peel from the fruit of Astrocaryum aculeatum Meyer, b) peel from the fruit of Bactris gasipaes Kunth, c) fibers from the endocarp of the fruit of Euterpe oleracea Mart. and d) peel from the fruit of Theobroma grandiflorum Schumann. The peel from the fruit of Bactris gasipaes was the best substrate to produce oyster mushroom (4.8 % biological efficiency -ratio between the fresh weight of the mushroom and the dry weight of the compost), and the peel from the fruit of Astrocaryum aculeatum was the best substrate for laccase production (21,766 U/Kg). The present work is important since it allowed us to demonstrate that two biomass residues from Amazonian plants could be utilized to produce mushrooms and laccases.

In this chapter, the authors aim to offer practical guidelines for implementing culturally and linguistically responsive teaching (CLRT) practices for educators working with emergent bilinguals (EBs) with and without disabilities. This chapter begins by defining CLRT and contextualizing the need for CLRT practices through a review of current research at the interface of bilingual and special education. Then, the authors offer practical examples of how teachers can use CLRT to support EBs with or without disabilities. The chapter concludes with an articulation of the authors' vision for the potential of CLRT to support this population of students in dual language bilingual (DLB) classrooms.

Glucocorticoid (GC) therapy is a common treatment used in rheumatic and autoimmune diseases, owing to its anti-inflammatory and immunosuppressive effects. However, GC therapy can also induce a number of adverse effects, including muscle and bone loss, hypertension, metabolic perturbations and increased visceral adiposity. We review available evidence in this area and provide nutritional recommendations that might ameliorate these adverse effects. Briefly, optimizing calcium, vitamin D, sodium and protein intake and increasing consumption of unprocessed and minimally processed foods, while decreasing the consumption of ultra-processed foods, might counteract some of the specific challenges faced by these patients. Importantly, we identify a dearth of empirical data on how nutritional intervention might impact health-related outcomes in this population. Further research is required to investigate the clinical and therapeutic efficacy of these theory-based recommendations.

Objectives:Photo at Discharge (PaD) is a nurse-led discharge strategy for enhanced wound care information for patients and healthcare providers. The purpose of this study is to describe implementation of PaD in three English cardiac centres.Methods:A prospective, cross-sectional design was used to evaluate implementation fidelity and sustainability of PaD on various geographical settings.Results:Three out of four hospitals (75%) approached agreed to complete surveys on implementation fidelity. Implementing the IT component took an average of 16 months (range 11–21 months). Across the three sites, 474 nursing staff have received training on PaD. Since implementing, a combined total of 9007 patients have received PaD. A 1-month compliance snapshot indicated mean of 96% (range 92–100%).Conclusions:PaD requires collaborative working, a change in behaviour and a change to the service. Despite these challenges, fidelity and sustainability scores across the sites were high. The findings from this study may help to increase implementation quality and dissemination of PaD.

This paper describes how we, a group of 7 emerging teacher educators, took up a critical inquiry framework to collaboratively generate knowledge through dialogic reflection on practice acro...

Objetivo: Realizar un análisis sobre los componentes de la Prótesis Parcial Removible. Método: Se analizaron 10 artículos y libros relacionados al tema de investigación, protesis parcial removible, que se usan en odontología.Resultados y conclusiones: Se determinó una gran variedad de elementos que tienen características e indicaciones especiales y diferentes, se determinó que los ganchos predilectos son los circunferenciales de acker por su versatilidad, los conectores mayores dependen del caso de cada paciente; como conclusión se obtuvo que conociendo los elementos de la PPR sus indicaciones y características, se determinó que el profesional odontólogo tiene la responsabilidad y el criterio para discernir y escoger el aparato protésico adecuado para suplir las necesidades y requerimientos del paciente parcialmente edéntulo, elaborando indicaciones de confección al laboratorio dental cumpliendo con los requisitos biomecánicos, éticos y legales que conforman una PPR.

Objetivo: Conocer la aplicación e implementación de estos programas en los profesionales y estudiantes, identificar la relación que mantiene el diseño digital actualmente, y conocer si estos programas digitales cumplen los principios básicos de la prótesis. Método: Descriptivo documental con revisión bibliográfica en una población de 15 artículos ubicados en base de datos PubMed. Conclusión: La implementación de los programas digitales enfocados en la PPR, actualmente dan resultados significativos y grandes benéficos en la fabricación y diseño gracias a los nuevos materiales aplicados y al software que ayuda a un mejor precisión y adaptación, como también a asegurar una mejor estabilidad y retención del material protésico a comparación de las técnicas tradicionales.

BACKGROUND Black women in the United States disproportionately suffer adverse pregnancy and birth outcomes compared to White women. Economic adversity and implicit bias during clinical encounters may lead to physiological responses that place Black women at higher risk for adverse birth outcomes. The novel coronavirus disease of 2019 (COVID-19) further exacerbated this risk, as safety protocols increased social isolation in clinical settings, thereby limiting opportunities to advocate for unbiased care. Twitter, 1 of the most popular social networking sites, has been used to study a variety of issues of public interest, including health care. This study considers whether posts on Twitter accurately reflect public discourse during the COVID-19 pandemic and are being used in infodemiology studies by public health experts. OBJECTIVE This study aims to assess the feasibility of Twitter for identifying public discourse related to social determinants of health and advocacy that influence maternal health among Black women across the United States and to examine trends in sentiment between 2019 and 2020 in the context of the COVID-19 pandemic. METHODS Tweets were collected from March 1 to July 13, 2020, from 21 organizations and influencers and from 4 hashtags that focused on Black maternal health. Additionally, tweets from the same organizations and hashtags were collected from the year prior, from March 1 to July 13, 2019. Twint, a Python programming library, was used for data collection and analysis. We gathered the text of approximately 17,000 tweets, as well as all publicly available metadata. Topic modeling and k-means clustering were used to analyze the tweets. RESULTS A variety of trends were observed when comparing the 2020 data set to the 2019 data set from the same period. The percentages listed for each topic are probabilities of that topic occurring in our corpus. In our topic models, tweets on reproductive justice, maternal mortality crises, and patient care increased by 67.46% in 2020 versus 2019. Topics on community, advocacy, and health equity increased by over 30% in 2020 versus 2019. In contrast, tweet topics that decreased in 2020 versus 2019 were as follows: tweets on Medicaid and medical coverage decreased by 27.73%, and discussions about creating space for Black women decreased by just under 30%. CONCLUSIONS The results indicate that the COVID-19 pandemic may have spurred an increased focus on advocating for improved reproductive health and maternal health outcomes among Black women in the United States. Further analyses are needed to capture a longer time frame that encompasses more of the pandemic, as well as more diverse voices to confirm the robustness of the findings. We also concluded that Twitter is an effective source for providing a snapshot of relevant topics to guide Black maternal health advocacy efforts.

Background Black women in the United States disproportionately suffer adverse pregnancy and birth outcomes compared to White women. Economic adversity and implicit bias during clinical encounters may lead to physiological responses that place Black women at higher risk for adverse birth outcomes. The novel coronavirus disease of 2019 (COVID-19) further exacerbated this risk, as safety protocols increased social isolation in clinical settings, thereby limiting opportunities to advocate for unbiased care. Twitter, 1 of the most popular social networking sites, has been used to study a variety of issues of public interest, including health care. This study considers whether posts on Twitter accurately reflect public discourse during the COVID-19 pandemic and are being used in infodemiology studies by public health experts. Objective This study aims to assess the feasibility of Twitter for identifying public discourse related to social determinants of health and advocacy that influence maternal health among Black women across the United States and to examine trends in sentiment between 2019 and 2020 in the context of the COVID-19 pandemic. Methods Tweets were collected from March 1 to July 13, 2020, from 21 organizations and influencers and from 4 hashtags that focused on Black maternal health. Additionally, tweets from the same organizations and hashtags were collected from the year prior, from March 1 to July 13, 2019. Twint, a Python programming library, was used for data collection and analysis. We gathered the text of approximately 17,000 tweets, as well as all publicly available metadata. Topic modeling and k-means clustering were used to analyze the tweets. Results A variety of trends were observed when comparing the 2020 data set to the 2019 data set from the same period. The percentages listed for each topic are probabilities of that topic occurring in our corpus. In our topic models, tweets on reproductive justice, maternal mortality crises, and patient care increased by 67.46% in 2020 versus 2019. Topics on community, advocacy, and health equity increased by over 30% in 2020 versus 2019. In contrast, tweet topics that decreased in 2020 versus 2019 were as follows: tweets on Medicaid and medical coverage decreased by 27.73%, and discussions about creating space for Black women decreased by just under 30%. Conclusions The results indicate that the COVID-19 pandemic may have spurred an increased focus on advocating for improved reproductive health and maternal health outcomes among Black women in the United States. Further analyses are needed to capture a longer time frame that encompasses more of the pandemic, as well as more diverse voices to confirm the robustness of the findings. We also concluded that Twitter is an effective source for providing a snapshot of relevant topics to guide Black maternal health advocacy efforts.

Esta investigación tiene como finalidad dar a conocer los factores más importantes de la satisfacción laboral en los empleados de una empresa comercializadora de productos de cuidado personal en la zona mercantil de la bahía de Guayaquil. El diseño investigativo utilizado fue no experimental, tipo transversal. En su desarrollo, se utilizó el cuestionario de Satisfacción laboral S20/23 de Melía y Peiró; este, presentó un nivel de consistencia interna alta (α = 0.90). El estudio tuvo una muestra por conveniencia de 201 empleados; el proceso en general se llevó a cabo en el año 2018. Se encontró que la participación en la toma de decisiones, la remuneración y las condiciones físicas son factores de insatisfacción laboral. Una de las conclusiones predominantes es que el sistema de compensaciones y las condiciones de trabajo influyen en la satisfacción de los trabajadores.

Phyllopezus lutzae (Loveridge, 1941) is a bromelicolous lizard species that inhabits the Atlantic Forest in northeastern Brazil. In this work we report the first records of this species for Paraíba state, Brazil. The records extend the distribution of the species 47 km north, helping to fill a gap in its distribution in northeastern Brazil

Objectives: This article aims to describe how the personal values of members of specialized workgroups impact their intra-group relationships based on professional and personal trust. Originality/value: The contributions of this study are threefold: 1. the consolidation that the analysis of trust in work groups has different results in the instrumental (professional or reputation trust) and the experimental (personal or friendship trust) relationship when verifying difference in the predominance of personal values for each type relationship; 2. the use of the functionalist theory of human values and to the use of social network analysis techniques and in conjunction with classical quantitative techniques such as ANOVA and multiple regression; 3. the verification of personal values that contributes to the organization and how trust relationships are structured in the group. Design/methodology/approach: The present study is characterized as descriptive field research with a quantitative approach. A survey was conducted with 171 participants from the two tactical groups of the Brasília police, using the Basic Values Questionnaire (BVQ) questionnaire of functionalist values and a questionnaire with eight questions about the instrumental and expressive relationship. Confirmatory factor analysis was used to evidence the validity of the instrument, analysis of social networks (ASN) for trust relationships and ANOVA, and multiple regression for relationships between values and relationships. Findings: The tactical groups presented characteristics of more pragmatic personal values and with less appreciation of individualism, denoting characteristics of appreciation of execution and intragroup collectivism. The normative and supra-personal values were negatively related, respectively, to friendship and professional relationships, while the achievement value was positively related to both trust relationships.

APRESENTAÇÃO DO DOSSIÊ - LUTAS, RESISTÊNCIAS E SABERES POPULARES: A EDUCAÇÃO COMO CAMINHO PARA A EMANCIPAÇÃO

The genus Proceratophrys Miranda-Ribeiro, 1920, frogs from the family Odontophrynidae Lynch, currently contains 41 nominal species with poorly resolved phylogenetic relationships (Frost 2019; Mângia et al. 2018). Molecular data from 15 and 18 Proceratophrys species support the monophyletic hypothesis of the genus (Teixeira-Jr et al. 2012; Dias et al. 2013; respectively) but do not fully resolve the phylogenetic relationship among the species. Currently, there are advertisement call parameters provided for 31 species of Proceratophrys in the literature (Ferreira et al. 2016; Andrade et al. 2018; Mângia et al. 2018; Nascimento et al. 2019). The Proceratophrys advertisement call is composed of pulsed notes, amplitude modulation, short to medium duration calls (0.05–4 s) and only one note in almost all species (see Nascimento et al. 2019 for details). Considering the importance of bioacoustics for taxonomy (Köhler et al. 2017), further descriptions of advertisement calls for the genus could also improve our understanding of the species’ relationships.

Proceratophrys redacta Teixeira Jr, Amaro, Recoder, Vechio & Rodrigues, 2012 is a dwarf species of Proceratophrys characterized by its small size and by the presence of a row of small round tubercles on the eyelids (Teixeira Jr et al. 2012). This species is only known from the type locality and surroundings of the municipality of Morro do Chap��u (state of Bahia, Brazil) and inhabits areas of montane forests and adjacent open mesic areas (Teixeira Jr et al. 2012). To date, natural history data on P. redacta remain limited to that provided in its original description (see Texeira Jr et al. 2012), and its advertisement call remains undescribed. Here, for the first time, we describe the advertisement call of P. redacta, using sound recordings obtained ca. 25 airline km northwards from the species type locality, in the same mountain range. Furthermore, we compare the advertisement call of P. redacta with calls available in the literature for congeners. We recorded four calling males of P. redacta for at least five minutes using a Rodes NTG-2 directional microphone coupled to a Tascam DR-40 digital recorder on February 3, 2018. The microphone was 1 m from the recorded individual, and the recordings were built in an uncompressed wav format with a 24-bit resolution and a sampling rate of 44,100 Hz. After all the recordings, we measured the air temperature and air humidity using a Minipa MT-241 thermohygrometer (precision: 1��C and 10%). We collected individuals after the recordings and measured their snout-vent length (SVL) and body mass using an LEE tools analog caliper (0.02 mm of precision) and a digital pocket scale (0.01 g of precision), respectively. The collected individuals were identified by comparisons with the diagnose presented in Texeira Jr et al. (2012). The specimens are housed at the Museu de Hist��ria Natural da Universidade Federal da Bahia (MHNBA, vouchers numbers: UFBA 15771���15774), and the sound recordings are housed at the MHNBA���s Amphibian Sounds Library (SUFBA, voucher numbers: SUFBA 401���404). Preceding the acoustic analysis, we edited the recordings through a high pass filter of -18 dB at 150 Hz on Audacity software (Audacity Team 2017) and normalized the recordings in R software (R Core Team 2018) using the seewave package (Sueur et al. 2008). We analyzed the acoustic parameters of the advertisement calls with R software (R Core Team 2018) using warbleR (Araya-Salas & Smith-Vidaurre 2017), tuneR (Ligges et al. 2018) and seewave (Sueur et al. 2008) packages. Spectrograms were built in an Asus notebook with an Intel I5 processor using Hanning window, a fast Fourier transform window width of 256, overlap of 80%, and a dynamic range of -40���0 dB. We measured temporal parameters directly on the oscillogram, while spectral parameters were measured on the power spectrum. Our terminology followed the ���note centered��� approach described by K��hler et al. (2017). We measured call duration (s), call emissions rate (calls/s), number of notes per call, number of pulses per call, pulse emissions rate (pulses/s; calculated by [pulse number - 1]/time interval (s) between the beginning of the first pulse and the beginning of the last pulse), and dominant frequency (Hz). The measured parameters followed those in Nascimento et al. (2019). The description was compared with all other published call descriptions for the Proceratophrys genus (available at Ferreira et al. 2016; Andrade et al. 2018; M��ngia et al. 2018; Nascimento et al. 2019). Data are presented as the mean �� standard deviation (minimum���maximum). We observed P. redacta individuals calling on two nights after sunset (approximately 5: 40 p. m.). On January 27, only one individual was calling (recording was not useful), and on February 3, after a rainy day, we observed at least five individuals (only four recorded) calling near a water spring (11��22���07���S, 41��15���12���W, datum WGS84, 1,128 m a.s.l.) in the Parque Estadual Morro do Chap��u, municipality of Morro do Chap��u, state of Bahia, Brazil. The recorded individuals were close to the near calling male at approximately 0.7 to 1.8 m. They were vocalizing on leaf litter between ferns (UFBA 15771), on mud (UFBA 15772, UFBA 15774), and on moist moss (UFBA 15773). On February 3, we measured the air humidity at 87���89% and the air temperature at 19.5���20.1��C. We analyzed 61 calls from four individuals (12 calls from UFBA 15771, 10 from UFBA 15772, 13 from UFBA 15773, and 26 from UFBA 15774). The advertisement call of P. redacta is composed of one amplitude-modulated pulsionated note. The majority of the analyzed calls (62%) started with a rising modulation amplitude, and at approximately the middle portion of the call, they presented a maximum amplitude followed by a decreasing amplitude modulation until the end of the call (fig. 1D). The advertisement call of P. redacta can be characterized by the following: duration=0.57 �� 0.14 s (0.15��� 0.85 s); call rate=0.22 �� 0.23 calls/s (0.01���1.04 calls/s); number of pulses=51.02 �� 12.35 (13���74); pulse rate=89.86 �� 2.93 pulses/s (84.85���106.79 pulses/s); and dominant frequency=1,926 �� 145 Hz (1,658 ���2,142 Hz). The waveform, power spectrum and spectrogram of the call are shown in fig. 1, and the call parameters are detailed in table 1. Proceratophrys redacta calls can be easily distinguished from almost all congeners by their higher value of dominant frequency (P. redacta: 1,658 ���2,142 Hz; combined dominant frequencies of congeners: 200���1,590 Hz). Proceratophrys species whose dominant frequency overlaps with P. redacta are P. avelinoi Mercadal de Barrio & Barrio; P. minuta Napoli, Cruz, Abreu, and Del Grande; and P. schirchi (Miranda-Ribeiro). In relation to P. avelinoi (call described by Kwet & Baldo 2003) and P. minuta (call described by Nascimento et al. 2019), the P. redacta call is distinguished by its high pulse emissions rate (P. redacta =84.85���106.79 pulses/s; P. avelinoi =64���72 pulses/s; and P. minuta =66.8���73.8 pulses/s). Comparisons between P. redacta and P. schirchi (call parameters presented by Nascimento et al. 2019) demonstrated overlap for all measured parameters. Despite the overlap in dominant frequency and pulse emissions rate, overlap occurs only for the extreme values. The higher values of the P. schirchi dominant frequency (1,640 ���1,810 Hz) and pulse emissions rate (76.6���85.0 pulses/s) overlap with the lower values of the P. redacta dominant frequency (1,658 ���2,142 Hz) and pulse emissions rate (84.85���106.79 pulses/s). Nevertheless, these two species can be morphologically distinguished from each other (see Teixeira-Jr et al. 2012 for morphological comparisons). Two of the parameters that mainly distinguish the P. redacta advertisement call from that of its congeners (dominant frequency and pulse emissions rate) are recommended for use in taxonomy and are very important for mate recognition in anuran species (K��hler et al. 2017). Therefore, despite our results showing a small overlap between P. redacta and other Proceratophrys species, differences in dominant frequency and pulse emissions rates seem to be sufficient to allow distinguishing species vocally and can be usefull on taxonomy of the genus., Published as part of Sim��es, C��ssio Rachid M. A., Pontes, Bruna Elizabeth Silva De, Trevisan, Camila Costa, Abreu, Rafael Oliveira De, Junc��, Flora Acu��a, Sol��, Mirco, Ara��jo, Carlos Barros De & Napoli, Marcelo Felgueiras, 2020, The advertisement call of Proceratophrys redacta (Anura, Odontophrynidae), pp. 447-450 in Zootaxa 4750 (3) on pages 447-449, DOI: 10.11646/zootaxa.4750.3.14, http://zenodo.org/record/3974686, {"references":["Teixeira Jr, M., Amaro, R., Recoder, R., Dal Vechio, F. & Rodrigues, M. (2012) A new dwarf species of Proceratophrys Miranda-Ribeiro, 1920 (Anura, Cycloramphidae) from the highlands of Chapada Diamantina, Bahia, Brazil. Zootaxa, 3551 (4), 25 - 42. https: // doi. org / 10.11646 / zootaxa. 3551.1.2","Audacity Team (2017) Audacity (R): Free Audio Editor and Recorder [Computer application]. Available from: https: // www. audacityteam. org / (accessed 14 January 2020)","R Core Team (2018) R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing, Vienna. Available from: https: // www. R-project. org (accessed 12 January 2020)","Sueur, J., Aubin, T. & Simonis, C. (2008) Seewave: a free modular tool for sound analysis and synthesis. Bioacoustics, 18 (2), 213 - 226. https: // doi. org / 10.1080 / 09524622.2008.9753600","Araya-Salas, M. & Smith-Vidaurre, G. (2017) warbleR: an r package to streamline analysis of animal acoustic signals. Methods in Ecology and Evolution, 8 (2), 184 - 191. https: // doi. org / 10.1111 / 2041 - 210 X. 12624","Ligges, U., Krey, S., Mersmann, O. & Schnackenberg, S. (2018) tuneR: Analysis of music and speech. Available from: https: // cran. r-project. org / web / packages / tuneR / index. html (accessed 15 January 2020)","Kohler, J., Jansen, M., Rodriguez, A., Kok, P. J. R., Toledo, L. F., Emmrich, M., Glaw, F., Haddad, C. F. B., Rodel, M. O. & Vences, M. (2017) The use of bioacoustics in anuran taxonomy: theory, terminology, methods and recommendations for best practice. Zootaxa, 4251 (1), 001 - 124. https: // doi. org / 10.11646 / zootaxa. 4251.1.1","Nascimento, J. S., Abreu, R. O., Menezes, L., Trevisan, C. C., Sole, M., Junca, F. A. & Napoli, M. F. (2019) The advertisement call of Proceratophrys minuta Napoli, Cruz, Abreu & Del Grande, 2011 (Anura: Odontophrynidae), with comments on acoustic parameters in the genus. South American Journal of Herpetology, 14 (1), 24 - 36. https: // doi. org / 10.2994 / SAJH-D- 17 - 00021.1","Ferreira, C. M. M., Sugai, J. L. M. M., Souza, F. L., Andrade, S. P., Vaz-Silva, W., Bastos, R. P. & Morais, A. R. (2016) The adver- tisement call and geographic distribution of Proceratophrys dibernardoi Brandao, Caramaschi, Vaz-Silva & Campos 2013 (Anura, Odontophrynidae). Zootaxa, 4205 (5), 480 - 482. https: // doi. org / 10.11646 / zootaxa. 4205.5.6","Andrade, S. P. de, Rocha, C. F. & Vaz-Silva, W. (2018) The advertisement call of Proceratophrys branti Brandao, Caramaschi, Vaz- Silva & Campos, 2013 (Amphibia, Anura, Odontophrynidae). Zootaxa, 4379 (3), 445 - 447. https: // doi. org / 10.11646 / zootaxa. 4379.3.10","Mangia, S., Koroiva, R., Nunes, P. M. S., Roberto, I. J., Avila, R. W., Sant'Anna, A. C., Santana, D. J. & Garda, A. A. (2018) A new species of Proceratophrys (Amphibia: Anura: Odontophrynidae) from the Araripe Plateau, Ceara state, northeastern Brazil. Herpetologica, 74 (3), 255 - 268. https: // doi. org / 10.1655 / Herpetologica-D- 16 - 00084.1","Kwet, A. & Baldo, D. (2003) Advertisement call of the leptodactylid frog Proceratophrys avelinoi. 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Restaurant management requires customer responsiveness to deal with increasingly higher expectations and market competitiveness. This study proposes an approach to simplify the decision-making process of restaurant managers by combining both live social media customer feedback and historical sales data in a sales forecast model (based on TripAdvisor data and the Bass model). Our approach was validated with internal and external (i.e., online reviews) data gathered from six restaurants. The collected data was processed using data analytics for developing a dashboard that provides value for restauranteurs by taking advantage of online reviews and sales forecast. Such dashboard was evaluated by restaurant management experts, which provided positive feedback, highlighting in particular the time saved in the decision-making process. info:eu-repo/semantics/acceptedVersion

etodologia Lean Startup como forma de melhoria no processo de criação e desenvolvimento de novos produtos e serviços. Foi realizada uma revisão bibliográfica sobre Startup, Lean e Lean Startup. A pesquisa caracterizou-se como bibliográfica, trazendo um exemplo da utilização da metodologia Lean Startup

This paper described the implementation of a terminology server performed at a health institution in Uruguay, whose architecture is based on SNOMED CT using graph databases (NoSQL). The aim of this development was to create an intuitive terminological service, making the most of SNOMED CT's ontology, and which can be used from a clinical, statistical, management, decision support and research point of view, among others, with good performance.

Phyllopezus lutzae (Loveridge, 1941) is a bromelicolous lizard species that inhabits the Atlantic Forest in northeastern Brazil. In this work we report the first records of this species for Paraíba state, Brazil. The records extend the distribution of the species 47 km north, helping to fill a gap in its distribution in northeastern Brazil

BackgroundExperiencing a pandemic can be very unsettling and may have a negative impact on the mental health of frontline healthcare workers (HCWs). This may have serious consequences for the overall well-being of HCWs, which in turn may adversely affect patient safety and the productivity of the institution.AimsWe designed a study to assess the prevalence of generalised anxiety disorder (GAD), depression and work-related stress experienced by the National Health Service staff in a large tertiary London hospital treating patients with COVID-19 during the current active phase of the COVID-19 era.MethodsAn anonymous survey was designed with demographic data and three questionnaires. The Generalised Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 were used to assess anxiety and depression, respectively. The Health and Safety Executive Management Standards Indicator Tool was used to assess work-related stress. Staff from multiple specialties embracing cardiothoracic surgery, cardiology, respiratory medicine, endocrinology, oncology, imaging, anaesthesia and intensive care at our hospital were asked to complete the questionnaire between 25 May and 15 June 2020.ResultsA total of 302 staff members (106 males and 196 females) completed the survey. The overall prevalence of GAD and depression was 41.4% and 42.7%, respectively. The prevalence of GAD and depression was significantly higher in females than in males and was statistically significant. Nurses were four times more likely to report moderate to severe levels of anxiety and depression as compared with doctors. Work-related stress was also observed to be prevalent in our surveyed population with the following standards: relationships, role, control and change showing a need for improvement.ConclusionsOur study presents early evidence suggestive of a high prevalence of GAD, depression and work-related stress in HCWs. It is imperative that coherent strategies are implemented to improve the healthcare work environment during this pandemic and mitigate further injury to the mental health status of the healthcare population.

Objective: to evaluate the adherence to the checklist procedure in surgeries performed in a public teaching hospital and to identify the patient’s profile regarding its use. Method: a descriptive study methodology was performed, which was conducted at the surgical ward of the Hospital Universitario de Londrina-PR from August to December 2014. Four hundred perioperative verification instruments were analyzed. Results: there was a predominance of male patients (55.5%), aged 21–40 years, and the predominant medical specialty was orthopedics. After 5 years of implementation and a second reformulation of the checklist, there was a considerable decrease in the number of unfilled instruments (blank), but there was an increase in the number of incomplete instruments. Conclusion: the adherence to the checklist needs to be improved to contribute to the reduction of adverse events, which may affect surgical patients and is a challenge for institutions and their staff.

Reprocessing single-use devices to cut costs is a common practice in hospitals around the world. In Brazil, there are few studies of reprocessing hemodynamic catheters and thus, this study aimed to evaluate the effectiveness of reprocessing hemodynamic catheters before and after biofilm formation in vitro using a continuous flow model. We used a sterility test and Scanning Electron Microscopy (SEM) to assess the presence of microorganisms, residue and integrity of a New (NC) and Reprocessed (RC) hemodynamic catheter, before and after in vitro biofilm formation by a clinical isolate of Enterococcus faecium (strain 155). NC was considered the negative control. The sterility test did not show the presence of microorganisms in either catheters used as a negative control (NC and RC). On the other hand, changes in integrity were observed by SEM in the RC, with a large number of microcracks and recesses, indicating that this would get worse after reprocessing. After biofilm formation and subsequent sterilization by ethylene oxide, both catheters were examined by SEM and RC showed a dense array of exopolysaccharide and substantial organic waste material, which was not evident in NC, showing changes in surface integrity. Ethylene oxide sterilization is very efficient in the sterilization process but the reprocessed catheters after biofilm formation by strain 155, showed marked surface changes, which increases the adhesion of organic matter and compromises the cleaning process in reprocessing. The results can be used as a parameter for hospitals and companies that reprocess catheters, to develop protocols for standardized and systematic surveillance in reusing materials recommended for single use to prevent infections.

Considerando o contexto histórico da Educação Superior, este artigo tem o objetivo de mostrar a evolução do ingresso na Educação Superior no Brasil, com enfoque especial às universidades públicas federais, tendo como base a legislação sobre o ingresso a partir do período da Primeira República, comparando as políticas de acesso à Educação Superior ao longo dos anos. Os documentos e referências que tratam do tema mostram frequentes mudanças, tais como: a) o acesso direto concedido a egressos do Colégio Dom Pedro II e a aplicação de exames de admissão sem a exigência da formação secundarista oficial (Reforma Rivadávia Correa); b) Reforma Carlos Maximiniano, que introduz o exame vestibular em 1915, com poucas alterações durante o Século XX; c) LDB 9.394/96, a mudança do termo vestibular para processo seletivo dá abertura a novas e diferentes formas de seleção; d) ENEM e Sisu. Em análise às leis, aos decretos e a outros documentos pesquisados, é possível afirmar que a democratização da Educação Superior no Brasil está ligada aos planos de implementação de políticas públicas cujo objetivo principal é a expansão do acesso a essa modalidade de ensino.

BACKGROUND: Pressure ulcers represent a serious public health problem, serving as a quality indicator (negative) the assistance provided by the health services. The aim of this study was to identify the prevalence of pressure ulcers in the Intensive Care Unit of a University Hospital in Joao Pessoa-PB and check the associations between socio-demographic and clinical data of customers and risk factors for the development of these. METHODS: The study of the sectional, quantitative, carried out with 78 patients in the Intensive Care Unit of a University Hospital in Joao Pessoa. Data were collected from medical record information from January to December 2014. RESULTS: Ten patients had pressure ulcers, and 6 already admitted with injuries and the 4 developed during hospitalization in the studied sector. The prevalence of these lesions in the sample was 12.8%. Has been identified as risk factors associated with pressure ulcer (p

This protocol is part of the VERVE holiday drive to collect exotic off-the-shelf laboratory recipes. More detailshere. (Image: Frosty apple, Olga Filonenko, CC BY-SA)

O desenvolvimento de úlcera por pressão é um evento adverso indesejável com incidência alta e estável ao longo do tempo. A presença deste evento acarreta dor, desconforto e aumento de morbimortalidade para as pessoas portadoras desse tipo de lesão, além do custo elevado nos diferentes serviços de saúde envolvidos no tratamento do evento. Na presente pesquisa, o foco de investigação da problemática foi o paciente cirúrgico. Assim, o objetivo geral do estudo foi analisar o risco de desenvolvimento, fatores de risco e a incidência de úlcera por pressão em pacientes submetidos a cirurgias eletivas de porte II, III e IV. Para tal adotamos a abordagem metodológica quantitativa, delineamento de pesquisa não experimental, tipo de estudo correlacional, prospectivo. A amostra foi composta por 148 pacientes adultos, de ambos os sexos, submetidos a cirurgias ortopédicas, neurológicas, do aparelho digestivo, urológicas, cardiovasculares e de obesidade mórbida. Em relação ao risco de desenvolvimento de úlcera por pressão, o qual foi mensurado por meio da aplicação da Escala de Braden, os pacientes que não desenvolveram esse tipo de lesão apresentaram na primeira avaliação um escore total médio de 20,12, que decresceu na segunda avaliação para uma média de 16,16. Para esse grupo o escore total mais frequente foi de 22, na primeira avaliação, o que classifica esse grupo como sem risco para o desenvolvimento de UP no pré operatório. Para o grupo que desenvolveu as lesões, a média do escore total da Escala de Braden, na primeira avaliação, foi de 15,81, caindo para 11,73, na segunda avaliação, sendo que para este grupo o escore total mais frequente na primeira avaliação foi de 18. Assim este grupo pode ser classificado, no pré operatório, de baixo risco para o desenvolvimento de úlcera por pressão. Na amostra estudada, a incidência de úlcera por pressão foi de 25%; as áreas corporais mais acometidas pelas lesões foram a região sacro/glútea (68%), calcâneos (18%), região dorsal (9%) e o pavilhão auricular (5%). A maioria das lesões diagnosticadas foi de grau II (57%), seguida por lesões de grau I (41%) e grau III (2%). Na amostra investigada nenhuma lesão de grau IV foi detectada. No modelo de regressão linear binominal empregado, as variáveis preditoras para o desenvolvimento de úlcera por pressão foram o tempo de anestesia e o porte cirúrgico quando investigadas em associação com outras variáveis relacionadas ao procedimento anestésico cirúrgico. Em relação às variáveis clínicas do paciente estudadas, a classificação ASA e a presença de hipertensão arterial foram preditoras para o desenvolvimento de úlcera por pressão quando investigadas em associação com outras variáveis. No modelo de regressão logística binária, as variáveis preditoras para desenvolvimento de úlcera por pressão foram idade, sexo e o tempo de anestesia quando estudadas em associação com outras variáveis. A presente investigação buscou dar o primeiro passo para o desenvolvimento de uma proposta de organização da avaliação do desenvolvimento de úlcera por pressão no paciente cirúrgico, a qual é simples e fácil de ser aplicada pelo enfermeiro no perioperatório. The development of pressure ulcer (PU) is an adverse unwelcome event with high and stable incidence throughout time. The presence of such event results in pain, discomfort, and increase of morbi-mortality in people bearing this type of lesion, besides the high costs of different health services related to the event\'s treatment. In the present research, the investigation focus of the problematic was on the surgical patient, thus the general objective of the study was analyzing the risk of development, risk factors, and the incidence of pressure ulcer in patients submitted to elective surgeries of size II, III and IV. Having that in mind, it was adopted the quantitative methodological approach, non-experimental research outlining, a type of correlational, prospective study. The sample was composed of 148 adult patients, of both genders, submitted to orthopedic, neurological, of the digestive tract, urological, cardiovascular, and morbid obesity surgeries. Concerning the risk of pressure ulcer development, which was measured through the application of Braden Scale, the patients who did not develop such type of lesion exhibited, in their first evaluation, a total average score of 20.12 that decreased in the second evaluation to an average of 16.16. For that group, the most frequent total score was of 22, in their first evaluation, fact that classifies such group as a non-risk one for the development of PU in pre-operatory period. For the group that developed the lesions, Braden Scale\'s total average score, in the first evaluation, was of 15,81 falling to 11,73 in the second evaluation, whereas in this group the most frequent total score in the first evaluation was of 18. Therefore, this group could be classified, in pre-operatory period, as of low risk for the development of pressure ulcer. In the studied sample, the incidence of pressure ulcer was of 25%; the body areas mostly affected by lesions were the sacral/gluteal area (68%), calcaneus (18%), dorsal region (9%), and the auricular pavilion (5%). Most diagnosed lesions were of grade II (57%), followed by lesions of grade I (41%) and grade III (2%). In the investigated sample, no grade IV lesion was detected. Under the employed model of binominal linear regression, the predicting variables for the development of pressure ulcer were anesthesia time and the surgical size when investigated in association with other variables related to the surgical anesthetic procedure. Concerning the patient\'s clinical variables studied, the classification ASA and the presence of hypertension were predictors for the development of pressure ulcer when investigated in association with other variables. In the binary logistic regression model, the predicting variables form the development of pressure ulcer were age, gender, and the anesthesia time when studied in association with other variables. The present investigation sought to give the first step towards the development of a proposition for the organization of the pressure ulcer development evaluation in the surgical patient, which is simple and easy to be applied by the nurse during the perioperative period.

Translocations t(14;18)(q32;q21) and t(11;14)(q13;q32) are recurrent findings in follicular lymphoma (FL) and mantle cell lymphoma (MCL), respectively. However, the molecular counterparts of these translocations can only be detected in up to 75% of FL and 50% of MCL cases using routine techniques. To improve the efficiency of detection, we first devised a single-tube multiplex-polymerase chain reaction (PCR) assay with primers located within a conserved immunoglobulin heavy chain (IGH) sequence and 5' to the main breakpoint cluster regions of BCL2 and CCND1. Using this assay in 17 FL and 11 MCL diagnostic DNA samples, we readily identified a BCL2-IGH fusion in 65% of FL patients and a CCND1-IGH fusion in 55% of MCL patients. In the remaining cases, we used long distance inverse-PCR to detect BCL2-IGH and CCND1-IGH fusion genes with different BCL2 and CCND1 breakpoint locations. We found additional translocations in 3 patients (17%) with FL and in 4 patients (36%) with MCL. Taken together, we show that multiplex-PCR combined with long distance inverse-PCR detected a t(14;18) in 82% of FL patients and a t(11;14) in 91% of MCL patients, demonstrating that this 2-step protocol is an effective approach for molecular detection of t(11;14) and t(14;18) in B-cell lymphomas.

Proper management of information is not only essential but also critical in any organization's decision making process. Data integration and spacial visualization are the key features of georeferencial systems, which bring support to decision making in epidemiology as well as sanitary planning.This paper shows the development of a georeferential system that interacts with the data provided by the Health Care System.Thereby allowing creation of viable methods which will help to improve patient care, treatments, and interventions through building space-time relationships.

Introducción. La distribución y el almacenamiento del agua después de su potabilización, pueden originar cambios significativos en su calidad, por lo que es necesario conocer las características finales del agua domiciliaria que consumen los usuarios. Objetivo. Evaluar de forma preliminar las sustancias químicas tóxicas en el agua de tanques y grifos de viviendas abastecidas por el acueducto de Bogotá. Materiales y métodos. Se hizo un estudio descriptivo en 26 viviendas localizadas en Bogotá y Soacha. Se hicieron dos muestreos: uno en época de lluvias y otro en temporada seca, y en ambos se aplicó una encuesta y se recolectaron muestras de agua de los tanques de almacenamiento y los grifos. Las muestras se sometieron a ensayos fisicoquímicos básicos, a una prueba de tamización de sustancias orgánicas e inorgánicas, y a pruebas de determinación de metales pesados y de residuos de plaguicidas organofosforados y carbamatos. Resultados. La conductividad, el color y los nitratos presentaron valores permisibles; el pH y la turbiedad tuvieron una ligera tendencia a presentar niveles altos y, el cloro residual, niveles bajos. Hubo trazas de aluminio en el 94 % de las muestras. En el período seco, 8 % de las muestras presentó compuestos orgánicos y, en el período lluvioso, 66,7 %. Solo hubo un resultado positivo para las sustancias inorgánicas. En el 11,5 % de las viviendas, el nivel de riesgo fue medio, en el 61,5 %, bajo, y en el 27 % no se registró riesgo. Conclusiones. Se evidenció deterioro de la calidad del agua domiciliaria debido a la presencia de sustancias orgánicas en tanques y sobre todo en las redes, presumiblemente a causa de la formación de biopelículas o a la presencia de polímeros orgánicos. Los niveles de aluminio cercanos al máximo aceptable pueden explicarse por los remanentes de los coagulantes utilizados durante el tratamiento.

To compare the frequency of major clinical, biochemical and anthropometric cardiovascular risk factors between a rural community and an urban community from Tinaquillo, Venezuela.118 individuals older than 18 years (52 of the urban community and 66 of the rural community) were included; their weight, height, waist circumference, blood pressure, blood glucose and lipid profile were assessed. A survey to measure personal history of cardiovascular disease and lifestyle was applied.About 60 % of the individuals of the rural community were either obese or overweight; similar figures were obtained in the urban community with no statistically significant differences. Almost half of the participants had abdominal obesity, and also a significant frequency of individuals with low HDLc (greater than 70 %) was observed. It should be noted that although low percentages of hypertriglyceridemia were obtained, they were significantly higher in the rural community (chi-square=4.82, p=0.0281). The opposite occurs with the frequency of smoking, which is statistically higher in the urban community (chi-square=4.48, p=0.0342).The results show a high prevalence of cardiovascular risk factors in both communities. Consequently, health promotion programs should reach out to rural communities, as the risk of cardiovascular disease is similar to that of the urban community, who are equally prone to acquire unhealthy habits.Comparar la frecuencia de los principales factores clínicos, bioquímicos y antropométricos de riesgo cardiovascular entre una comunidad rural y una urbana de Tinaquillo, Venezuela.Se evaluaron 118 individuos mayores de 18 años (52 pertenecientes a la comunidad urbana y 66 a la comunidad rural) a los cuales se les determinó peso, talla, circunferencia abdominal, presión arterial, glicemia y perfil lipídico. Se aplicó una encuesta para medir antecedentes personales de enfermedad cardiovascular y estilo de vida.Se evidenció que alrededor del 60 % de los individuos de la comunidad rural presentaron entre obesidad y sobrepeso. Cifras similares fueron obtenidas en la comunidad urbana, no encontrándose diferencias estadísticamente significativas entre ambas. Casi la mitad de los participantes mostró obesidad abdominal, así como una frecuencia importante de individuos con HDLc bajo (mayor al 70 %). Cabe destacar que si bien, se obtuvieron bajos porcentajes de hipertrigliceridemia, los mismos fueron significativamente superiores en la comunidad rural (Chi-cuadrado=4,82; p=0,0281). Caso contrario ocurre con la frecuencia del hábito tabáquico, el cual es estadísticamente superior en la comunidad urbana (Chi-cuadrado=4,48; p=0,0342).Los resultados muestran una elevada frecuencia de factores de riesgo cardiovascular en ambas comunidades. En consecuencia, los programas de promoción en salud emergentes deben tener alcance hasta las comunidades rurales, pues el riesgo a padecer una enfermedad cardiovascular es similar al de la comunidad urbana, además de estar igualmente propensas a la adquisición de hábitos no saludables.