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Neste artigo, objetivamos analisar/descrever como estão constituídos os grupos de pesquisa em Resolução de Problemas atuantes no Brasil, evidenciando seus líderes, tempo de fundação, regiões geográficas, unidades da federação, Instituições de Ensino Superior, áreas predominantes, linhas de investigação e setores de aplicação. Os aportes teórico-metodológicos vinculam-se à literatura específica de Resolução de Problemas na Educação Matemática e à pesquisa descritiva survey com abordagem quanti-qualitativa. O banco de dados consultado foi o Diretório dos Grupos de Pesquisa no Brasil, na data de 22 de agosto de 2022, sob o comando de busca “Resolução de Problemas”. Dos 44 grupos resultantes, validamos um total de 24 na região de inquérito da Educação Matemática. Os resultados principais apontaram um acumulado de 44 líderes, predomínio de grupos com liderança coletiva (20 grupos) e média de fundação de 8,6 anos, tendo o mais longevo 30 anos de atuação e grande parte possuindo entre 2 e 5 anos (11 grupos), surgindo, principalmente, em 2019 (4 grupos). Os grupos estão alocados em 22 instituições, concentrados nas regiões Sudeste e Nordeste, com 10 e 6 grupos, respectivamente, e apresentam vínculo predominante na área das Ciências Humanas/Educação. Sobre as linhas de pesquisa, os grupos possuem uma, duas e/ou até três temáticas no cerne da Resolução de Problemas e atuam, sobretudo, na Educação Básica. Argumentamos pela necessidade desse coletivo de pesquisadores formarem redes de pesquisa no trato de consolidar a temática e vislumbrar a fundação de um Grupo de Trabalho no Seminário Internacional de Pesquisa em Educação Matemática.

Analisamos a constituição de grupos de/com pesquisa em Educação Matemática no Brasil. Os aportes teórico-metodológicos vinculam-se a literatura específica da Educação, Educação Matemática e da pesquisa descritiva de levantamento com abordagem quanti-qualitativa. A Fonte de dados consultada foi o Diretório dos Grupos de Pesquisa no Brasil do CNPq, sendo validado um total de 569 grupos de pesquisa a partir de alguns comandos específicos de busca. As variáveis analisadas foram as Grandes Áreas, Áreas e linhas de pesquisa. Os resultados apontaram que os grupos apresentam integralmente ou parcialmente linhas de pesquisa vinculadas a Educação Matemática e estão locados principalmente nas Grandes Áreas/Áreas Ciências Humanas/Educação e Ciências Exatas e da Terra/Matemática; agregam, em média, quatro linha de pesquisa, sendo as de maior interesse Ensino e Aprendizagem, Formação de Professores e Tecnologias. Por fim, realçamos uma agenda de investigação que possa privilegiar estudos vindouros em torno da nossa região investigativa.

We analyze the constitution of the research groups in Mathematics Education in Brazil, registered in the Directory of Research Groups in Brazil of CNPq. The theoretical and methodological contributions are linked to Education and Mathematics Education, the norms/resolutions of CNPq and the descriptive survey research in a quanti-qualitative approach. The results showed a total of 569 groups, with significant growth since 2002, a predominance with up to 12 years of activity, concentrated in the Southeast and Northeast regions, but predominant in the states of São Paulo, Paraná, Minas Gerais, Bahia, Rio de Janeiro and Pará and in the Public Institutions, especially UTFPR and UNESP. The groups concentrate 15,085 people among researchers, students, technicians, and collaborators. We argue about the emergence of a research agenda that can privilege future studies around our investigative region.

Este artigo tem como objetivo principal reconhecer as múltiplas facetas de sub-existência e/ou subsistência das experiências estéticas nos contextos de Educação Infantil, percebendo as possibilidades que as crianças encontram para a compreensão de si e do outro e para manifestar e compartilhar vivências, ideias e questionamentos. A pesquisa segue a abordagem qualitativa de cunho hermenêutico e crítico, tendo como instrumentos de coleta o diário de bordo e as experiências de observações. A argumentação considera a complexidade das infâncias e a necessária transgressão estética para a compreensão da riqueza e singularidade da linguagem expressiva que as crianças carregam. No cotidiano da Educação Infantil, as manifestações das crianças, ainda que não reconhecidas pela professora, persistem como detalhes que navegam à margem das expectativas de uma prática curricular sedimentada.

BACKGROUND: Immediate initiation of antiretroviral therapy (ART) regardless of CD4 cell count reduces risk for AIDS and non-AIDS-related events in asymptomatic, HIV-positive persons and is the standard of care. However, most HIV-positive persons initiate ART when their CD4 count decreases below 500 × 10 9 cells/L. Consequences of delayed ART on risk for non-AIDS-defining and AIDS-defining cancer, one of the most common reasons for death in HIV, are unclear. OBJECTIVE: To estimate the long-term risk difference for cancer with the immediate ART strategy.DESIGN: Multinational prospective cohort study.SETTING: The D:A:D (Data collection on Adverse events of anti-HIV Drugs) study, which included HIV-positive persons from Europe, Australia, and the United States.PARTICIPANTS: 8318 HIV-positive persons with at least 1 measurement each of CD4 cell count and viral load while ART-naive (study period, 2006 to 2016).MEASUREMENTS: The parametric g-formula was used, with adjustment for baseline and time-dependent confounders (CD4 cell count and viral load), to assess the 10-year risk for non-AIDS-defining and AIDS-defining cancer of immediate versus deferred (at CD4 counts RESULTS: During 64 021 person-years of follow-up, 231 cases of non-AIDS-defining cancer and 272 of AIDS-defining cancer occurred among HIV-positive persons with a median age of 36 years (interquartile range, 29 to 43 years). With immediate ART, the 10-year risk for non-AIDS-defining cancer was 2.97% (95% CI, 2.37% to 3.50%) and that for AIDS-defining cancer was 2.50% (CI, 2.37% to 3.38%). Compared with immediate ART initiation, the 10-year absolute risk differences when deferring ART to CD4 counts less than 500 × 10 9 cells/L and less than 350 × 10 9 cells/L were 0.12 percentage point (CI, -0.01 to 0.26 percentage point) and 0.29 percentage point (CI, -0.03 to 0.73 percentage point), respectively, for non-AIDS-defining cancer and 0.32 percentage point (CI, 0.21 to 0.44 percentage point) and 1.00 percentage point (CI, 0.67 to 1.44 percentage points), respectively, for AIDS-defining cancer. LIMITATION: Potential residual confounding due to observational study design.CONCLUSION: In this young cohort, effects of immediate ART on 10-year risk for cancer were small, and further supportive data are needed for non-AIDS-defining cancer.PRIMARY FUNDING SOURCE: Highly Active Antiretroviral Therapy Oversight Committee.

Apresentamos os resultados de uma investigação que objetivou conhecer e compreender o panorama das pesquisas desenvolvidas em âmbito nacional acerca da interdisciplinaridade na Educação Matemática, identificadas no Catálogo da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes) e no acervo da Biblioteca Digital Brasileira de Teses e Dissertações (BDTD), entre 2015 e 2020. Identificamos um conjunto de 34 trabalhos, sendo 13 do banco de dados da Capes (11 dissertações e 2 teses) e 21 na BDTD (16 dissertações e 5 teses). Os dados obtidos mostraram que os estudos são desenvolvidos em nível de mestrado (27; 79,4%); foram publicados, em sua maioria, em 2017 (11; 32,35%); são voltados, majoritariamente, à Educação Básica (26; 76,5%); são, em grande parte, de natureza teórica (14;41,2%) e pragmática (14; 41,2%); e com uma pluralidade de temáticas, teorias, metodologias, áreas de conhecimento e conteúdos. Evidenciamos a tímida quantidade de trabalhos com foco no Ensino Superior e nenhum centrado na Educação Infantil, indicando um terreno fértil para investigações futuras.

Desde o início da suspensão das atividades presenciais no ensino superior no Brasil, em razão da pandemia da covid 19, as atenções se voltaram, predominantemente, para a graduação. Diante da legitimidade dessa preocupação, os processos educacionais envolvendo a pós-graduação receberam atenção e cuidados apenas residuais. Com o discurso de submissão da pós-graduação Stricto sensu à dinâmica estabelecida pela Capes, a grande maioria das universidades acabou delegando as decisões à “autonomia” de cada programa. Nesse sentido, a partir deste relato de experiência, objetivamos refletir sobre as estratégias de resistência construídas pelo Programa de Mestrado em Comunicação da Universidade Estadual de Londrina na defesa da qualidade da formação educacional, por meio de um processo coletivo e democrático, garantindo a qualidade no ensino.

Apresentamos os resultados de uma investigação que analisou as percepções de um grupo de estudantes acerca das usinas nucleares e do resíduo radioativo. Trata-se de um recorte de um projeto maior, o qual culminou na produção de uma dissertação de mestrado do primeiro autor. As percepções dos estudantes estão associadas aos riscos de catástrofes que as instalações nucleares podem ocasionar e às consequências que a exposição à radioatividade pode causar ao corpo humano. Essas percepções podem estar associadas a informações obtidas por meio de notícias veiculadas na mídia impressa ou televisiva, programas televisivos, filmes, documentários e séries streaming que abordam a temática da energia nuclear. Tanto as notícias quanto as produções televisivas reforçam o estereótipo do medo em relação aos riscos da radiação e da radioatividade. Os resultados de nosso estudo podem ser utilizados por professores de física ou química quando do ensino das Radiações Ionizantes. Defendemos que discussões sobre as Radiações Ionizantes sejam levadas para a sala de aula, a fim de que concepções equivocadas sejam minimizadas e que os estudantes se apropriem das ideias e dos conceitos pertencentes a Física das radiações ionizantes.

Apresentamos os resultados de uma pesquisa que buscou exercer a vigilância epistemológica em manuais escolares de Física pertencentes ao PNLD de 2018-2020, no que diz respeito à Radioatividade, avaliando a presença de possíveis imagens deformadas do trabalho científico. Para tal, utilizamos a Teoria da Transposição Didática de Yves Chevallard, de maneira a confrontar o saber a ensinar para com o saber sábio, a fim de compreender as semelhanças e diferenças entre os saberes do ponto de vista histórico. Tivemos como foco principal os processos de descontextualização e despersonalização do saber, os quais ocorrem parcialmente nos manuais analisados, que optam majoritariamente por uma abordagem voltada às aplicações tecnológicas, em detrimento de conteúdos voltados para a história da ciência. Concluímos que algumas imagens deformadas do trabalho científico são encontradas nas obras, entre as quais as visões: “empírico indutivista e ateórica”, “rígida”, “aproblemática e ahistórica”, “acumulativa de crescimento linear” e “individualista e elitista”. Apontamos para a necessidade de atenção por parte dos professores, em meio ao processo de transposição interna, com vistas a olhar para discussões voltadas para a natureza e história da ciência.

OBJECTIVES Only few studies compared the surgical morbidity and mortality of thoracoscopic segmentectomy versus lobectomy for non-small-cell lung cancer, in particular, by relating the segmental resections with the corresponding anatomical lobes. METHODS We enrolled a total of 7487 patients who underwent VATS lobectomy (7269) or segmentectomy (218) from January 2014 to July 2019. A propensity score matching approach was used to account for potential confounding factors between the 2 groups. After matching, 349 lobectomies and 208 segmentectomies were included in the analysis. We analysed the operative and postoperative outcomes of video-assisted anatomical segmentectomy compared with video-assisted lobectomy and, in details, the results of segmentectomy with its corresponding lobectomy in a large cohort of patients from the Italian VATS Group Registry. RESULTS The overall conversion rate to thoracotomy was not statistically different between the groups (27 patients 8% vs 7 patients 3%, P = 0.1). The lobectomy group had a greater number of resected lymph nodes (median 11 vs 8, P = 0.006). No significant differences were detected in 30-day mortality (1.4%, 5 patients vs 0.9%, 2 patients), overall complications (18%, 62 patients vs 14%, 29 patients) and prolonged air leakage (31 patients, 9% vs 12 patients, 6%) between lobectomy and segmentectomy, respectively. No statistical differences were found regarding the median duration of drainage (3.2 days, P = 1) and the overall median length of hospital stay (6.4 days, P = 0.1) between the 2 groups. In the context of segmentectomy versus corresponding lobectomy, the right upper lobectomy compared with right upper segmentectomy showed a higher number of resected lymph nodes (P = 0.027). No statistical differences were reported in terms of conversion rate and postoperative complication and mortality. CONCLUSIONS Segmentectomy could be considered a safe procedure without significant differences compared to thoracoscopic lobectomy in terms of postoperative morbidity and mortality.

O objetivo deste artigo é abordar o problema da atenção a partir da análise do conteúdo publicitário presente no canal do YouTube de Luccas Neto. Busca-se investigar como a publicidade se configura dentro de um dos maiores canais brasileiros no segmento infantil. A metodologia adotada é a análise de conteúdo, com recorte temporal de outubro a dezembro de 2019. No universo analisado, formado por 82 vídeos, foi constatado que a publicidade se divide em dois tipos: separada da narrativa e inserida na narrativa, também chamada de product placement. O artigo conclui que, apesar de todas as formas de publicidade infantil serem abusivas, o grande problema está no product placement, que atrai a atenção da criança com recursos visuais, mas dificulta sua identificação como publicidade.

To analyze how nephrotic syndrome (NS) correlates to increased intracranial pressure (ICP), and to present a case of an adult patient whose initial manifestation of NS was cephalalgia, with the later identification of raised ICP.Data were retrospectively retrieved from the patient's record, and a literature search with the keywords "nephrotic syndrome", "intracranial hypertension" and "headache" was conducted in PubMed and Embase.This is a rare description of co-occurrence of NS and raised ICP in a 48-year-old man, in which ICP normalizes after NS remits. There is no known cause for the raised ICP of our patient. Ten reports (n = 13) of concomitant occurrence of increased ICP and NS were described in the literature, both in children and adults. Cerebral venous thrombosis (CVT) was the most likely underlying cause for the majority of them. For one patient, the underlying cause was meningoencephalitis. Finally, in one case, the cause is unknown, but CVT was not discarded.The early suspicion of elevated ICP is warranted in patients with new-onset headache and NS. It is possible that NS could both directly and indirectly lead to increased ICP through yet unknown mechanisms, although this direct causal relationship cannot be currently established.

Mediastinal teratoma rarely causes pericarditis. We report a case of a 22-year-old young female admitted to the emergency department for inspiratory chest pain and fever with severe pericardial effusion, unexepectable the cause of pericarditis was a mediastinal teratoma.

Objective This study aims to assess the factors associated with the success and failure rate of the external cephalic version (ECV) in breech fetuses. Secondary outcomes were fetal presentation in labor and mode of delivery. Methods This cross-sectional study examined the live birth certificates from 2003 through 2020 from US states and territories that implemented the 2003 revision. A total of 149,671 singleton pregnancies with information about ECV success or failure were included. The outcome was ECV success/failure, while the exposures were possible factors associated with the outcome. Results The successful ECV procedures were 96,137 (64.23%). Among the successful ECV procedures, the prevalence of spontaneous vaginal delivery was 71.63%. Among the failed ECV procedures, 24.74% had a cephalic presentation at delivery, but 63.11% of these pregnancies were delivered by cesarean section. Nulliparity, female sex, low fetal weight centile, high pre-pregnancy BMI, high BMI at delivery, and high maternal weight gain during pregnancy were associated with an increased ECV failure (p p 40 years) were significant protective factors against ECV failure (p Conclusions A high prevalence of successful ECV procedures and subsequent spontaneous vaginal delivery were found. The present results found nulliparity, maternal race, maternal age, female fetal sex, low fetal weight, and maternal anthropometric features correlated to ECV results. These findings can potentially improve the knowledge about the factors involved in ECV, allowing more informed counseling to the women undergoing this procedure.

Apresentamos os resultados da análise da política editorial de 32 periódicos brasileiros indexados da área de Educação em Ciências quanto aos princípios éticos a serem seguidos pelos autores de artigos. As políticas foram analisadas de acordo com os preceitos éticos contidos nas diretrizes aos autores; as maneiras pelas quais os aspectos éticos dos artigos devem ser informados aos editores; os procedimentos para casos de más condutas científicas; e as retratações para autores, editores e pareceristas. Os dados obtidos indicaram que: (a) 40,6% dos periódicos não citam qualquer preceito ético na política editorial; (b) 31,2% das revistas informam que os aspectos éticos devem ser incluídos no texto submetido aos editores, 3,1% por meio do envio de documento assinado, 25% mediante cópia de aprovação do Comitê de Ética em Pesquisa (CEP) da instituição e/ou do Termo de Consentimento Livre e Esclarecido (TCLE) aprovado, 12,5% deixa subtendido que o estudo foi realizado dentro das normas, padrões ou princípios éticos, sem a exigência de qualquer tipo de informação, e 43,8% não apresentam nenhuma referência aos autores; (c) 34,4% não inclui considerações sobre as más condutas científicas; e (d) apenas 15% das revistas apresentam algum tópico que explicita as retratações para os casos de má conduta. Argumentamos acerca da importância de os periódicos incluírem, em suas políticas editoriais, aspectos relativos às boas práticas científicas, o que inclui as investigações realizadas com a colaboração de seres humanos, bem como da ampliação do debate acerca das questões éticas nas instituições de ensino e pesquisa, com vistas a uma formação ética dos futuros profissionais e pesquisadores.

Purpose: The risk of malignancy (ROM) in FDG-avid thyroid incidentalomas varies between studies, which may be contributed by discordance between the anatomical localization depicted on 18FDG-PET/CT and by histopathological examination. The purpose was to ensure anatomical congruity between the index tumour identified by 18FDG-PET/CT and the histopathological examination, in order to assess the risk of malignancy (ROM) in PET-positive and PET-negative thyroid nodules. Further, preoperative characteristics indicative of thyroid malignancy were identified. Methods: Thirty-two patients referred to thyroid surgery were prospectively included. 18FDG-PET/CT, fine-needle aspiration biopsy and thyroid ultrasonography examination were performed in all participants. The exact anatomical localization of the index nodule was established by histopathological examination to ensure concordance with the 18FDG-PET/CT finding. Results: Forty thyroid nodules were included. Malignancy was identified in 10 of 28 PET-positive nodules and in 1 of 12 PET-negative nodules, resulting in a ROM of 36% and 8%, respectively. A Hurtle cell neoplasm was found in 50% of patients with a benign nodule and a PET-positive scan. One PET-negative nodule represented a papillary microcarcinoma. In PET-positive nodules, hypoechogenicity, irregular margins, and pathological lymph nodes on thyroid ultrasonography were characteristics associated with malignancy. Conclusions: In this study—ensuring anatomical congruity between PET-findings and the histopathological examination—the risk of malignancy in PET-positive thyroid nodules was 36%. A low ROM was seen in thyroid nodules without suspicious ultrasonographic findings, independent of the 18FDG-PET/CT result. Trial registration number: NCT02150772 registered 14th of April 2014.

As ferramentas de agricultura de precisão permitem interpretação das causas de variações da fertilidade do solo e, assim, realizar intervenções de maneira localizada por meio da aplicação de insumos em taxa variável. Objetivou-se analisar a dependência espacial da fertilidade do solo e sua correlação com a produtividade da soja Glycine max (L) em Dourados - MS. Foi realizado o mapeamento com GPS de navegação global demarcando a área de 50 hectares, para posterior geração da malha de amostragem de solo e de produtividade. A partir da distribuição dos pontos, foi realizada a coleta do solo na camada de 0,00-0,20 m a cada 1 hectare, sendo as amostras identificadas e submetidas às análises químicas em laboratório, nas quais foram avaliados: CTC, H+Al, Fósforo, Potássio, Cálcio, Magnésio, pH, V%, e Matéria Orgânica. Além de determinada a produtividade da cultura. Os dados foram submetidos à estatística descritiva, geoestatistica e correlação de Pearson. Todos os atributos químicos do solo encontraram-se em níveis adequados para produção da soja. Quanto à dependência espacial dos atributos químicos do solo e produtividade da soja, estes apresentaram forte dependência espacial, exceto Matéria Orgânica cuja dependência foi moderada. O semivariograma constatou que as variáveis pH e Matéria Orgânica foram ajustadas ao modelo esférico, Fósforo e H+Al ao modelo exponencial e os demais ao modelo gaussiano. Com base nos coeficientes de correlação entre produtividade de soja e atributos químicos do solo foi constatado significância positiva para Fósforo (0,30) e significância negativa para CTC (-0,30) e H+Al (-0,29).

The simultaneous determination of adhesion and deformability parameters of erythrocytes was carried out through a microfluidic device, which uses an inverted optical microscope with new image acquisition and analysis technologies. Also, an update of the models describing erythrocyte adhesion and deformation was proposed. Measurements were carried out with red blood cells suspended in saline solution with human serum albumin at different concentrations. Erythrocytes adhered to a glass surface were subjected to different low shear stress (from 0.04 to 0.25 Pa), causing cellular deformation and dissociation. The maximum value obtained of the erythrocyte deformability index was 0.3, and that of the adhesion energy per unit area was 1.1 × 10-6 Pa m, both according to previous works. The obtained images of RBCs adhered to glass reveal that the adhesion is stronger in a single point of the cell, suggesting a ligand migration that concentrates the adhesion in a "spike-like tip" in the cell. Moreover, adhesion energy results indicate that the energy required to separate erythrocytes in media with a lower albumin concentration is greater. Both results could be explained by the mobility of membrane receptors.

Kruppel-like factors (KLFs) are transcription factors with the ability to mediate cross-talk with signaling pathways involved in cell proliferation control, apoptosis, migration, and differentiation. They also appear to influence steroid hormone signaling through transcriptional networks involving steroid hormone receptors and members of the nuclear receptor family of transcription factors. Our study aims to evaluate the potential prognostic role of KLF5, KLF9, and KLF11 in endometrial cancer, and their correlation with hormonal receptor status and cellular proliferation. Retrospective observational study on cases of endometrioid endometrial adenocarcinoma collected in the period January 2000–December 2011 at the University of Udine. Formalin-fixed, paraffin-embedded tissue samples were all submitted to tissue microarray immunohistochemical study. A survival analysis was performed. One hundred forty seven patients were included in the study with a mean age at surgery of 65.6 years (±10.2). 80.3% of endometrial malignancies were classified as stage FIGO I (118/147). Radiation therapy and chemotherapy were administered in 62.3% (91/146) and 6.2% (9/145) of patients respectively. Five-year overall survival and disease-free survival resulted 85.4% (95% CI, 79.8–91.4%) and 79.4% (95% CI, 73.0–86.4%) respectively. A high Ki-67, cytoplasmatic KLF5 (HR 4.72, CI.95 1.61–13.89, p

Background and objectives There is concern regarding the lack of prevention of unnecessary transfusion of RhD negative red cells and unnecessary administration of Rh immunoglobulin (RhIG) to pregnant women. In this study, performance of ID RHD XT, a genotyping assay for identification of six RHD allelic variants and human platelet antigens HPA-1a/1b was assessed. Materials and methods Whole blood samples presenting weak, discrepant or inconclusive D phenotype results were genotyped with ID RHD XT and compared to reference molecular tests. Candidacy for RhIG prophylaxis was determined by analysing samples from pregnant women. Hands-on time to complete the procedures was measured. Results Overall, 167 samples were tested (55 donors, 56 patients, 52 pregnant women and four newborns). Agreement between ID RHD XT and the reference method was 100% (51% weak D type 1, 2 or 3; 35·5% weak D Types 1, 2 or 3 not detected; 4% RHD deletion; 1% RHD*Pseudogene; 1% RHD*DIIIa-CE(3-7)-D; and 4% no amplification variant detected for RHD genotype; and 64% HPA-1a/a; 30% HPA-1a/b; and 3% HPA-1b/b for HPA-1 genotype). Call rate was 98·2%. ID RHD XT identified 40% of the pregnant women that would not have required RhIG prophylaxis. Overall hands-on time was 25-45 min to process a batch of 24 samples, and four hours for total assay time. Conclusion ID RHD XT yielded reproducible results for RHD typing in serologically weak D phenotype individuals. ID RHD XT was proven useful for the correct management of patients with RhD serological discrepancies and the rational use of RhIG in pregnancy.

Background: ultraviolet radiation types A and B (UV) (400–315nm and 315–280nm respectively) are the main components present in sunlight known to cause skin injuries. Arnica montana is a plant that ...

Quantifying infiltration and surface runoff at the hillslope scale is indispensable for soil conservation studies. However, the spatial and temporal variability of infiltration imposes a major constraint on surface runoff estimation. Point infiltration values do not fully express the complexity of the surface runoff in the landscape. Considering the need to improve the estimation of runoff volume from infiltration data, this study aimed to measure the apparent infiltration at hillslope-scale and compare it with two methods of infiltration estimative derived from point information. The study was carried out in six hydrological monitoring units paired. A set of hyetographs and hydrographs allowed the determination of apparent infiltration [Formula: see text] to each monitoring unit as a function of precipitation rate P. The measured [Formula: see text] values were used: (1) to evaluate the efficiency of the different land management in increasing infiltration; and (2) to evaluate the efficiency of two methods of hillslope-scale infiltration estimation based on point data: (a) derived from concentric rings method ([Formula: see text]), and (b) derived from a physically-based modeling ([Formula: see text]). Regarding the differences in land managements, terraces proved to be the most efficient land management practice, followed by phytomass addition. Regarding the methods, for precipitation rates greater than 40 [Formula: see text] the point infiltration-based [Formula: see text] underestimates apparent infiltration [Formula: see text] with PBIAS ranging from [Formula: see text] to [Formula: see text]. Even so, [Formula: see text] proved efficient in representing [Formula: see text] at less intense rainfall events. Nonetheless, the point infiltration-based method [Formula: see text] properly represented [Formula: see text] to all rainfall intensities (Nash-Sutcliffe coefficient [Formula: see text]).

Parentification involves a role reversal phenomenon between family subsystems, including role distortions and hierarchy inversion. The purpose of this study was to adapt and search for validity evidence of the Parentification Questionnaire for the Brazilian context. After translation procedures, the authors applied the instrument in 868 adults of four geographic regions of Brazil, of which 55.4 percent were women. Exploratory and confirmatory factor analyses revealed the solution of three parentification factors (i.e., emotional parenting, instrumental parenting and perceived unfairness) as adequate, with satisfactory internal consistency rates, following the construct theory. As expected, the authors also found relations with other variables; for example, people who presented parentification indicators in their speeches displayed higher levels in the three factors of the construct; while women displayed higher levels of parentification than men. The Brazilian version of the instrument showed satisfactory validity evidence and appropriate reliability indicators. Resumo A parentalização compreende um fenômeno de reversão de papéis entre os subsistemas familiares, incluindo distorções de papéis e inversão de hierarquia. Este estudo teve como objetivos adaptar e buscar evidências de validade do Questionário sobre a Parentalização para o contexto brasileiro. Após procedimentos de tradução, o instrumento foi aplicado em 868 adultos de quatro regiões do Brasil, sendo 55,4% mulheres. Análises fatoriais exploratórias e confirmatórias revelaram a solução de três fatores para a parentalização (i.e., parentalização emocional, parentalização instrumental e percepção de injustiça) como adequada, com satisfatórios índices de consistência interna, consonante com a teoria sobre o construto. Também se encontraram relações com outras variáveis conforme esperado, por exemplo, as pessoas que apresentavam indicadores de parentalização no discurso mostraram maiores níveis nos três fatores do construto; já as mulheres mostraram maiores níveis de parentalização do que os homens. A versão brasileira do instrumento apresentou satisfatórias evidências de validade e indicadores adequados de fidedignidade. Resumen La parentalización comprende un fenómeno de reversión de roles entre los subsistemas familiares, incluyendo distorsiones de roles e inversión de jerarquía. Este estudio tuvo como objetivos adaptar y buscar evidencias de validez del Inventario sobre la Parentalización para el contexto brasileño. Después de procedimientos de traducción, el instrumento fue aplicado en 868 adultos de cuatro regiones de Brasil, siendo 55,4% mujeres. Análisis factoriales exploratorias y confirmatorias revelaron la solución de tres factores para la parentalización (i.e., parentalización emocional, parentalización instrumental y percepción de la injusticia) como adecuada, con índices de consistencia interna satisfactorios, consonante con la teoría sobre el constructo. Conforme esperado, también se encontraron relaciones con otras variables, por ejemplo: las personas que presentaban indicadores de parentalización en el discurso mostraron niveles más altos en los tres factores del constructo; ya mujeres mostraron niveles más altos de parentalización que los hombres. La versión brasileña del instrumento presentó satisfactorias evidencias de validez e indicadores adecuados de confiabilidad.

Amphibians have suffered population decline due to several factors, including exposure to pesticides. In the south of Brazil, rice cultivations use herbicides based on atrazine, glyphosate and quinclorac as the commercial formulations Primoleo®, Roundup® and Facet®, respectively. Rhinella icterica was chosen to evaluate oxidative balance markers and body condition after exposure to three concentrations of herbicides (10, 20 and 40 µg/L of atrazine and quinclorac; 100, 250 and 500 µg/L of glyphosate). These xenobiotics, regardless of the concentrations used, accelerated the development process of animals and seemed to act as modulators of development. We observed no significant variations for any of the oxidative balance markers studied (superoxide dismutase, catalase, TBARS and carbonylated proteins); however, we cannot rule out that other antioxidant system components prevent oxidative stress. In general, atrazine and glyphosate accelerated the development of tadpoles, and quinclorac retards this process, which could impact the survival of these animals.

This study aimed to evaluate the effectiveness of intrapartum acute tocolysis for nonreassuring fetal heart rate tracing in decreasing the incidence of cesarean delivery. Secondary outcomes included modes of delivery other than cesarean delivery, successful acute tocolysis, time-to-delivery interval, and short-term perinatal outcomes.Searches were performed in MEDLINE/PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials and Reviews, ClinicalTrials.gov, and the International Clinical Trials Registry Platform from the inception of each database until February 2022.Selection criteria included randomized controlled trials of laboring patients with singleton gestations randomized to receive intrapartum acute tocolysis for nonreassuring fetal heart rate tracing, as defined by the original trial.All analyses were done using an intention-to-treat approach, evaluating women according to the treatment group to which they were randomly allocated in the original trials. A frequentist network-meta-analysis was performed.Four randomized clinical trials were eligible, including 605 patients with nonreassuring fetal heart rate tracing and singleton gestations at gestational ages32 weeks. The cesarean delivery rate was similar among patients managed with different types of acute tocolysis. Acute tocolysis, compared with emergency delivery, was associated with improved neonatal acid-base status (notably decreasing the prevalence of base deficit12 mmol/L [beta-2 agonists odds ratio, 0.61; 95% confidence interval, 0.37-0.99] and the rate of neonatal intensive care unit admission [beta-2 agonists odds ratio, 0.42; 95% confidence interval, 0.22-0.78]) and with an increase in the time-to-delivery interval (beta-2 agonists mean difference, 17.62 minutes; 95% confidence interval, 15.66-19.58); there was no reduction of cesarean delivery rate, showing an increased rate with atosiban and beta-2 agonists.The cesarean delivery rate was not reduced by acute tocolysis when used for nonreassuring fetal heart rate tracing during labor. Acute tocolysis is associated with improved short-term fetal outcomes and safely increases the time-to-delivery interval.

The aim of this study was to assess the impact of BMI on perioperative outcomes in patients undergoing VATS lobectomy or segmentectomy. Data from 5088 patients undergoing VATS lobectomy or segmentectomy, included in the VATS Group Italian Registry, were collected. BMI (kg/m

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is experiencing pandemic diffusion. The experience of an Italian private health care structure was reviewed.We retrospectively collected data about services provided in a single medium complexity private health care structure. Furthermore, we classified specialties within 4 categories, based on the performance of urgent non-deferrable services and possible provision of services without a necessary contact with the patient.The structure canceled/postponed almost every deferrable service, providing only 3% of services that could be performed without direct contact with patients. Regarding non-deferrable services requiring the presence of the patient, about 42% of booked services have been autonomously canceled/postponed by patients for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) fear. The administrative services have been remotely performed by smart working as far as possible.Private health care structures may safely continue to provide non-deferrable services while respecting the restrictive measures imposed by the government, encouraging telehealth and smart working modalities.

This narrative review aims to clarify the role of breast and gynecological risk-reduction surgery in BRCA mutation carriers. We examine the indications, contraindications, complications, technical aspects, timing, economic impact, ethical issues, and prognostic benefits of the most common prophylactic surgical options from the perspectives of a breast surgeon and a gynecologist. A comprehensive literature review was conducted using the PubMed/Medline, Scopus, and EMBASE databases. The databases were explored from their inceptions to August 2022. Three independent reviewers screened the items and selected those most relevant to this review’s scope. BRCA1/2 mutation carriers are significantly more likely to develop breast, ovarian, and serous endometrial cancer. Because of the Angelina effect, there has been a significant increase in bilateral risk-reducing mastectomy (BRRM) since 2013. BRRM and risk-reducing salpingo-oophorectomy (RRSO) significantly reduce the risk of developing breast and ovarian cancer. RRSO has significant side effects, including an impact on fertility and early menopause (i.e., vasomotor symptoms, cardiovascular disease, osteoporosis, cognitive impairment, and sexual dysfunction). Hormonal therapy can help with these symptoms. Because of the lower risk of developing breast cancer in the residual mammary gland tissue after BRRM, estrogen-only treatments have an advantage over an estrogen/progesterone combined treatment. Risk-reducing hysterectomy allows for estrogen-only treatments and lowers the risk of endometrial cancer. Although prophylactic surgery reduces the cancer risk, it has disadvantages associated with early menopause. A multidisciplinary team must carefully inform the woman who chooses this path of the broad spectrum of implications, from cancer risk reduction to hormonal therapies.

This meta-analysis aimed to evaluate the success rate of trial of labor in monochorionic diamniotic pregnancies and the impact of delivery mode on neonatal outcomes.Searches were performed in MEDLINE/PubMed, Embase, Scopus, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and the International Clinical Trials Registry Platform from the inception of each database until April 2022.Selection criteria included observational studies analyzing the delivery mode among monochorionic diamniotic gestations.All analyses were carried out using an intention-to-treat approach, evaluating women according to the delivery mode to which they were assigned in the original studies.Seventeen studies met the eligibility criteria and were suitable for qualitative and quantitative analysis. In total, 4116 women were analyzed. This meta-analysis showed that trial of labor in monochorionic diamniotic pregnancies resulted in vaginal delivery of both twins in 75.5% of cases (95% confidence interval, 69.1-80.9). Failure to deliver the second twin vaginally occurred in 3.8% of cases (95% confidence interval, 2.5-5.7). In addition, the neonatal outcomes were comparable among women with monochorionic diamniotic pregnancy undergoing different planned delivery modes. Neonatal death occurred in 3.7 per 1000 cases in the planned cesarean delivery group and in 1.6 per 1000 cases in the planned vaginal delivery group. Perinatal death was observed in 7.5 per 1000 cases in the planned cesarean delivery group and in 5.8 per 1000 cases in the planned vaginal delivery group. Umbilical artery pH7.00 occurred in 0 per 1000 cases in the planned cesarean delivery and 4.6 per 1000 cases in the planned vaginal delivery group. Neonatal intensive care unit stay of72 hours had a prevalence of 59.7 per 1000 cases in the planned cesarean delivery and 42.8 per 1000 cases in the planned vaginal delivery group.This meta-analysis showed that trial of labor in monochorionic diamniotic pregnancies is successful in most cases and relatively safe, considering that neonatal and perinatal mortality and severe morbidity were comparable between the trial of labor and planned cesarean delivery groups. Therefore, the choice of planned delivery mode in twin gestations should not be made a priori.

Background New treatments are currently offering new opportunities and challenges in clinical management and research in the migraine field. There is the need of homogenous criteria to identify candidates for treatment escalation as well as of reliable criteria to identify refractoriness to treatment. To overcome those issues, the European Headache Federation (EHF) issued a Consensus document to propose criteria to approach difficult-to-treat migraine patients in a standardized way. The Consensus proposed well-defined criteria for resistant migraine (i.e., patients who do not respond to some treatment but who have residual therapeutic opportunities) and refractory migraine (i.e., patients who still have debilitating migraine despite maximal treatment efforts). The aim of this study was to better understand the perceived impact of resistant and refractory migraine and the attitude of physicians involved in migraine care toward those conditions. Methods We conducted a web-questionnaire-based cross-sectional international study involving physicians with interest in headache care. Results There were 277 questionnaires available for analysis. A relevant proportion of participants reported that patients with resistant and refractory migraine were frequently seen in their clinical practice (49.5% for resistant and 28.9% for refractory migraine); percentages were higher when considering only those working in specialized headache centers (75% and 46% respectively). However, many physicians reported low or moderate confidence in managing resistant (8.1% and 43.3%, respectively) and refractory (20.7% and 48.4%, respectively) migraine patients; confidence in treating resistant and refractory migraine patients was different according to the level of care and to the number of patients visited per week. Patients with resistant and refractory migraine were infrequently referred to more specialized centers (12% and 19%, respectively); also in this case, figures were different according to the level of care. Conclusions This report highlights the clinical relevance of difficult-to-treat migraine and the presence of unmet needs in this field. There is the need of more evidence regarding the management of those patients and clear guidance referring to the organization of care and available opportunities.

Background: Synovial sarcoma is a relatively chemosensitive type of soft tissue sarcoma and it often metastasizes to the lung. We investigated the role of adjuvant chemotherapy in patients with high-grade synovial sarcoma at their first lung metastasectomy (LMTS). Methods: Forty-six HGSS patients had their first LMTS at our institute (Rizzoli Orthopedic Hospital, Bologna, Italy) between 2000 and 2020. We divided them into two groups: (1) those undergoing adjuvant chemotherapy (n = 24) and (2) those not receiving adjuvant chemotherapy (n = 22). The primary outcome was a median survival at 32.5 (IQR 18.0–82.7) median follow-up. The disease-free interval was calculated at time zero (DFI0, interval between the diagnosis of the primary tumor and the first CT-diagnosed lung metastasis) and at any further lung relapse (DFI1–3). T0 was defined as the time at first LMTS and T1–T3 referred to the time of further metastasectomy. Results: Freedom from SS-specific mortality at 60 months was significantly higher in patients without chemotherapy (50.0% (33.0–76.0%) vs. 20.8% (9.55%–45.4%), p = 0.01). Chemotherapy was associated with a higher risk of SS-specific mortality at multivariable Cox regression (HR 2.8, p = 0.02). Furthermore, DFI0 ≤ 6 months, female sex, age > 40 years, and primary tumor > 10 cm increased the risk of death by about four, six, >three, and >five times, respectively. Conclusions. Adjuvant chemotherapy did not show any advantage in terms of freedom from SS-specific mortality in HGSS patients. Further larger studies are necessary to confirm our findings.

This study was performed to evaluate the systemic oxidative stress balance in women with either ovarian or deep infiltrating endometriosis (DIE) and any alterations of the same during hormone therapy. Free oxygen radicals (FORT) and free oxidant radical defense (FORD) were measured in the capillary blood of 24 women without endometriosis, 26 women with endometrioma, and 26 women with DIE with or without endometrioma. Endometriosis was diagnosed by clinical and ultrasound assessment. Dietary factors, lifestyle habits, and intake of any substances interfering with the oxidative status were recorded. Women were prescribed contraceptive hormones, and the baseline assessments were repeated at the 3rd month of use, revealing a higher oxidative stress balance (FORT/FORD) in women with endometriosis than in controls (4.75 ± 4.4 vs. 2.79 ± 2.2; p = 0.05). The highest values were found in women with DIE (5.34 ± 4.6; p = 0.028 vs. controls). Regression analysis revealed an independent link between FORT/FORD and endometrioma (b 2.874, 95% CI 0.345, 5.403; p = 0.027) and DIE (b 4.419, 95% CI 1.775, 7.064; p = 0.001) but a negative correlation with HDL-cholesterol (b −0.063, 95% CI −0.125, −0.002; p = 0.043). In controls, the hormone therapy increased FORT (p = 0.003), but also FORD (p = 0.012), with the FORT/FORD balance remaining stable (2.72 ± 2.2 vs. 2.73 ± 1.8; p = 0.810). In women with endometriosis, FORT remained unchanged, but FORD increased (p = 0.004), and the FORT/FORD ratio significantly decreased (4.75 ± 4.4 vs. 2.57 ± 1.76; p = 0.002) to values similar to the control levels. These data indicate that systemic oxidative stress balance increased in women with endometriosis, particularly in those with DIE. The hormonal therapy did not change the oxidative stress balance in control women but significantly improved it in women with endometriosis, particularly those suffering from DIE.

Objectives Vascular injuries are among the most severe causes of unplanned conversion during VATS lobectomies. The study aimed to analyse the incidence of vascular injuries and their risk factors during VATS lobectomy. Methods The Italian VATS lobectomy Registry was used to collect data from 66 Thoracic Surgery Units. From 2013 to October 2016 (out of more than 3,700 patients enrolled) only information from Units with an enrollment >100 VATS lobectomies were retrospectively analysed. Logistic regression analysis was performed on selected variables of the univariate analysis. Results Ten institutions contributed a total of 1,679 patients. Vascular injuries leading to conversion occurred in 44 (2.6%) patients. Years of experiences were inversely related to the risk of vascular injuries. Univariate analysis showed age, gender, surgical activity, Charlson Index Score and number of resected lymph nodes like significantly associated variables. Multivariate analysis revealed that number of resected lymph nodes, VATS experience ratio (number of VATS lobectomies/total lobectomies performed in the same year at same centre), and surgical activity of the centre were significantly associated with the risk of conversion. Unplanned thoracotomy was correlated with postoperative morbidity. Conclusion Vascular injuries in VATS lobectomies represented a rare complication which could directly affect the postoperative outcomes. The predictive factors for conversion were multifactorial and depended on characteristics of centres and surgeons’ seniority. Minimally invasive VATS lobectomy approaches did not influence the risk of vascular damages.

For years, the management of schizophrenia has represented a challenge for clinicians, with antipsychotic treatments usually resulting in relapses and new hospitalizations. Clozapine has been shown to be an effective medication for treatment-resistant schizophrenia (TRS), but is currently underused due to its potential side effects. Nevertheless, research has suggested that clozapine reduces future hospitalizations in patients with TRS. This study aims to verify the rates of hospitalizations in patients with TRS under long-term use of clozapine. We retrospectively analyzed clinical data from 52 individuals with TRS before and after the use of clozapine. The mean duration of treatment with and without clozapine was 6.6 (± 3.9) and 8.5 years (± 6.6), respectively. Patients had a median of 0.5 (0.74) hospitalizations per year before the use of clozapine and 0 (0.74) hospitalizations after it (p = 0.001). Therefore, the use of clozapine resulted in an expected reduction in the number of hospitalizations per year in individuals with TRS.

Objetivo: Relatar o processo de ensino aprendizagem de primeiros socorros na escola por meio da utilização do Arco de Maguerez. Método: Trata-se de um relato de experiência desenvolvido por uma estudante de enfermagem sobre o processo de ensino aprendizagem de primeiros socorros na escola, que utilizou para o seu desenvolvimento como base metodológica problematizadora o Método do Arco de Charlez Maguerez. Resultados: O uso da metodologia da problematização para o ensino de primeiros socorros se mostrou importante à medida que organizou o processo de ensino aprendizagem, e promoveu a constante reflexão, o pensamento crítico, a formação e autonomia das crianças envolvidas. Conclusão: O método desencadeou uma transformação da realidade social na escola, pois contribuiu para a ampliação significativa no conhecimento das crianças. E, as etapas propostas pelo método trouxeram como implicações na prática a transformação social.

OBJECTIVE To investigate the placental staining pattern of fibronectin, an extracellular matrix protein essential for trophoblastic invasion, in pre-eclampsia and fetal growth restriction. METHODS This was a retrospective study conducted at the University of Udine, including the placentas of women with pre-eclampsia and fetal growth restriction collected between January 1, 2001, and December 31, 2010. Fibronectin was evaluated in placental tissue micro-array by immunohistochemistry, describing localization and intensity of staining. RESULTS The study included the placentas of 36 women with early-onset (delivery

A presente pesquisa buscou compreender como os profissionais da área de Psicologia e Psiquiatria, com atuação na clínica infantil, entendem a presença do fenômeno do amigo imaginário na infância. Três psicólogos e dois psiquiatras, com 5 anos ou mais de experiência, foram entrevistados sobre suas práticas profissionais. Os participantes foram recrutados em clínicas de atendimento à criança em uma cidade do interior do Rio Grande do Sul. A análise de conteúdo indicou que os profissionais consideravam o fenômeno um acontecimento saudável do desenvolvimento e facilmente diferenciável da sintomatologia da psicose. Além disso, acreditavam que a fantasia pode servir como um recurso para o profissional investigar a realidade psíquica da criança, facilitando a comunicação nos atendimentos. A partir desses resultados, buscou-se contribuir com a literatura nacional acerca do tema, ainda escassa, e com a atuação e conhecimento dos profissionais da área de saúde infantil e todos aqueles que estão em constante contato com crianças (profissionais escolares, familiares, etc.).

BACKGROUND: Excessive sun exposure is the major risk factor for skin cancer. Thus, sun exposure behavior is the major focus for prevention of this disease, since it is potentially modifiable. Increasing the knowledge on sun related habits and other skin cancer risk factors is fundamental in the development of preventive programs, especially when directed to young people. OBJECTIVES: To assess the photoprotection habits and the knowledge about skin cancer in college students. METHODS: We conducted a cross-sectional study from Oct. 16 to Feb. 17, including 371 students from the Federal University of Santa Maria, RS, Brazil, through a self-administered questionnaire. RESULTS: The level of knowledge about skin cancer and photoprotection was unsatisfactory in more than 10% of the students. The occurrence of sunburn was extremely high among students, and 25% reported at least one episode of second degree sunburn. Proper use of sunscreen was referred by only 34% of individuals. Students who reported having received photo education in college were associated with a more consistent use of sunscreen. STUDY LIMITATIONS: health area represented a large part of the sample; instrument validated outside Brazil. CONCLUSIONS: Young people are unaware of basic information about sun protection and exposure. Even among those with proper knowledge, the use of photoprotective measures is very low. The sun exposure has shown to be excessive in most of the students, which makes this population an important target for photo-educational measures.

L’article aborde l’écoute clinique à partir d’une recherche-intervention participative et évaluative sur les pratiques de soins de santé mentale dans le réseau de soins de santé primaires de la région métropolitaine de l’État du Rio Grande do Sul au Brésil. Sur la base de la méthode cartographique, l’étude a été développée avec des groupes d’intérêts,, qui ont réuni des utilisateurs, des travailleurs et des directeurs du réseau de soins psychosociaux de chacune des six municipalités participantes. Les récits extraits des scènes quotidiennes de l’une des municipalités participantes sont présentés dans le but de mettre en évidence les difficultés rencontrées par les travailleurs et par la communauté pour accepter les troubles psychiques exprimées dans le discursivité psychotique. À la fin, il est souligné combien la clinique de réforme psychiatrique aurait à apprendre avec des expériences déviantes que la folie et la recherche participative peuvent offrir lorsqu’elles fonctionnent dans une éthique de la différence. O artigo reflete sobre a escuta clínica a partir de uma pesquisa-intervenção participativa e avaliativa das práticas de cuidado em saúde mental na rede de atenção básica, realizada na região metropolitana do estado do Rio Grande do Sul. Sustentado no método cartográfico, o estudo foi desenvolvido com grupos de interesse, stakeholders, que reuniram usuários, trabalhadores e gestores da rede de atenção psicossocial de cada um dos seis municípios participantes. As narrativas extraídas de cenas cotidianas de um dos municípios pesquisados são apresentadas com a finalidade de destacar as dificuldades que tanto os trabalhadores como a comunidade têm em acolher os sofrimentos psíquicos expressos na discursividade psicótica. Ao final, aponta-se o quanto a clínica da reforma psiquiátrica teria a aprender com as experimentações desviantes que a loucura e as pesquisas participativas podem ofertar quando operadas sob uma ética da diferença. The article reflects on clinical listening from a participatory and evaluative intervention research on mental health care practices in the primary health care network in the metropolitan region of the state of Rio Grande do Sul. Based on the cartographic method, the study was developed with stakeholders, who gathered users, workers and managers of the psychosocial care network of each of the six participating municipalities. The narratives extracted from daily scenes of one of the cities surveyed are presented with the purpose of highlighting the difficulties that both workers and the community have in accepting the psychic sufferings expressed in psychotic discursiveness. In the end, it is pointed out how much the clinic of psychiatric reform would have to learn from the deviant experiments that madness and participatory research can offer when operated under an ethic of difference. El trabajo se refiere a la escucha clínica a partir de una investigación-intervención participativa y evaluativa de las prácticas de cuidado en salud mental en la red de atención básica, realizada en la región metropolitana del estado del Rio Grande del Sur. Sujetado en el método cartográfico, el estudio fue desarrollado con grupos de interés, stakeholders, que reunieron usuarios, trabajadores y gestores de la red de atención psicosocial de cada unos de los pueblos participantes. Las narrativas extraídas de escenas cotidianas de uno de los pueblos investigados son presentadas con el objetivo de enfocar las dificultades que tanto los trabajadores cuanto la comunidad tienen en acoger los sufrimientos psíquicos expresos en la discursividad psicótica. Al final, se indica cuanto la clínica de la reforma psiquiátrica tendría a aprender con las experiencias desviadas que la locura y las investigaciones participativas pueden ofrecer cuando operadas bajo una ética de la diferencia.

INTRODUCTION: Psoriasis is a chronic, immune-mediated inflammatory disease characterized by sharply circumscribed erythematous plaques on the trunk and limbs. Reports are suggesting low sleep quality and increased risk of Obstructive Sleep Apnea Syndrome (OSAS) in psoriasis patients. METHODS: The present study aimed to investigate the array of OSAS in psoriasis based on the STOP-Bang questionnaire. The study was cross-sectional. The sample was sequential and for convenience. The association between categorical variables was verified with Pearson's chi-square and Fischer's exact tests, and Pearson and Spearman's correlations were used to evaluate the relationships between the continuous variables. P

The purpose of this study is to investigate the effect of hormone therapy (HT) on the oncological outcomes of endometrial cancer (EC) survivors. A systematic literature review was conducted in July 2021 to identify studies detailing the effect size for the relationship between HT use in EC and oncological outcomes (survival and disease recurrence). This included studies that evaluated the different recurrence rates among women treated for EC who subsequently underwent HT and those who did not. The collected studies were evaluated for quality, heterogeneity, and publication bias, and a pooled odds ratio (OR) or hazard ratio (HR) was calculated with a confidence interval of 95% (95% CI). In total, 5291 studies were collated, and after the review process, one randomized trial and seven observational studies were included, comprising 1801 EC survivors treated with HT and 6015 controls. The time-dependent analysis could be conducted for four studies, and considering the disease-free survival, the pooled HR of 0.90 (95% CI 0.28 to 2.87) showed no significant differences. However, among Black American women treated with continuous estrogen HT, the HR was 7.58 (95% CI 1.96 to 29.31), showing a significantly increased risk of recurrence for women in this ethnic group. Considering the pooled OR of all included studies 0.63 (95% CI 0.48 to 0.83), a significantly reduced risk of recurrence was found among EC survivors treated with HT. Considering the type of HT, the most risk-reducing was combined estrogen and progestin therapy and the cyclic regimen. Although supporting evidence is based mainly upon observational studies, evidence of no increased risk or even decreased risk was generally found, apart from in Black American women where a significantly increased recurrence risk was evident. The data are rather reassuring for the short-term administration of HT to symptomatic EC survivors. Future studies with a longer follow-up are necessary to better clarify the long-term effects of HT.

Quais são os critérios de sustentabilidade adotados nos processos de compras públicas, realizadas no contexto das Universidades Federais localizadas no Rio Grande do Sul (RS)? Com o objetivo de analisar os critérios de sustentabilidade adotados nos processos licitatórios das universidades selecionadas, desenvolveu-se uma pesquisa qualitativa e descritiva, por meio da análise bibliográfica e documental. Foram coletados os dados das compras públicas do ano de 2013 das universidades para análise teórico-comparativa com base nas normativas e estudos publicados acerca do tema no contexto brasileiro. Os resultados identificam que dos 911 editais, apenas 20 apresentam algum critério de sustentabilidade, o que ressalta a baixa adoção dos mesmos. Destaca-se a utilização de critérios na aquisição de equipamentos eletrônicos com redução de consumo de energia. Conclui-se que os gestores devem investir em Compras Sustentáveis para ajudar o meio ambiente e a sociedade, incentivando outras instituições na adoção de critérios de sustentabilidade.

Accuracy, sensitivity, simplicity, reproducibility, and low-cost are desirable requirements for genotoxicity assessment techniques. Here we describe a simple electrophoretic assay for genomic DNA lesions quantification (EAsy-GeL) based on subjecting DNA samples to rapid unwinding/renaturation treatments and neutral agarose gel electrophoresis. The experiments performed in this work involved different biological samples exposed to increasing environmental-simulated doses of ultraviolet-B (UVB) radiation, such as Escherichia coli, human leukocytes, and isolated human genomic DNA. DNA extraction was carried out using a universal and low-cost protocol, which takes about 4 h. Before electrophoresis migration, DNA samples were kept into a neutral buffer to detect double-strand breaks (DSBs) or subjected to a 5-min step of alkaline unwinding and neutral renaturation to detect single-strand breaks (SSBs) or incubated with the DNA repair enzyme T4-endonuclease V for the detection of cyclobutane pyrimidine dimers (CPDs) before the 5-min step of DNA unwinding/renaturation. Then, all DNA samples were separated by neutral agarose gel electrophoresis, the DNA average length of each lane was calculated through the use of free software, and the frequency of DNA breaks per kbp was determined by a simple rule of three. Dose-response experiments allowed the quantification of different levels of DNA damage per electrophoretic run, varying from a constant and low amount of DSBs/SSBs to high and dose-dependent levels of CPDs. Compared with other assays based on alkaline unwinding and gel electrophoresis, EAsy-GeL has important advantages for both environmental monitoring and laboratory testing purposes. The simplicity and applicability of this protocol to other types of DNA lesions, biological models, and agents make it ideal for genotoxicity, DNA repair studies, as well as for assessing exposure risks to ecosystems and human health.

To compare preoperative contrast-enhanced spectral mammography (CEM) versus digital mammography plus digital breast tomosynthesis (DM + DBT) in detecting breast cancer (BC) and assessing its size. We retrospectively included 78 patients with histological diagnosis of BC who underwent preoperative DM, DBT, and CEM over one year. Four readers, blinded to pathology and clinical information, independently evaluated DM + DBT versus CEM to detect BC and measure its size. Readers' experience ranged 3–10 years. We calculated the per-lesion cancer detection rate (CDR) and the complement of positive predictive value (1-PPV) of both methods, stratifying analysis on the total of lesions, index lesions, and additional lesions. The agreement in assessing cancer size versus pathology was assessed with Bland–Altman analysis. 100 invasive BCs (78 index lesions and 22 additional lesions) were analyzed. Compared to DM + DBT, CEM showed higher overall CDR in less experienced readers (range 0.85–0.90 vs. 0.95–0.96), and higher CDR for additional lesions, regardless of the reader (range 0.54–0.68 vs. 0.77–0.86). CEM increased the detection of additional disease in dense breasts in all readers and non-dense breasts in less experienced readers only. The 1-PPV of CEM (range 0.10–0.18) was comparable to that of DM + DBT (range 0.09–0.19). At Bland–Altman analysis, DM + DBT and CEM showed comparable mean differences and limits of agreement in respect of pathologic cancer size. Preoperative CEM improved the detection of additional cancer lesions compared to DM + DBT, particularly in dense breasts. CEM and DM + DBT achieved comparable performance in cancer size assessment.