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Existem diversos indicadores de desempenho que monitoram as atividades do processo industrial para que uma empresa alcance suas metas operacionais (BELÉM & WANDERLEY, 2006). Este trabalho visa estruturar uma ferramenta automatizada baseada nos conceitos da metodologia Seis Sigma (DMAIC) suportada pelo método BWM (Best Worst Method), que retorna os principais indicadores críticos para monitoramento do desempenho dos ativos industriais de forma particularizada para cada tipo de processo operacional que compõem uma Unidade Geradora (UG). Esses indicadores representam a realidade operacional do sistema de geração de energia. Assim, o modelo desenvolvido permitirá a busca por possíveis aperfeiçoamentos nas atividades de manutenção e operação contemplando a otimização dos recursos humanos e materiais, com foco na confiabilidade e disponibilidade operacional de Unidades Geradoras (UGs). Ademais, também visa apresentar brevemente os indicadores de desempenho aplicados a hidrogeradores, seguido de uma descrição dos principais indicadores utilizados por agentes de geração, tendo como fontes principais o Submódulo 9.2 dos Procedimentos de Rede do Operador Nacional do Sistema (ONS), a Resolução Normativa Nº 614 da Agência Nacional de Energia Elétrica (ANEEL) e o Relatório de Análise Estatística de Desempenho de Equipamentos e Instalações elaborado pela Associação Brasileira das Empresas Geradoras de Energia Elétrica (ABRAGE), para disseminar conhecimento acerca da gestão de indicadores de desempenho da gestão do setor energético.

Objective: To observe risk factors that hypertensive patients present in the outpatient segment from the nursing perspective care. Method: Cross-sectional study where essential hypertensives of legal age belonging to the hypertension program of a municipality in Bahia were included. Those with cancer, hepatitis, HIV, lupus, arthritis, pregnant women, and chronic corticosteroid users were excluded. Collected patient demographic information and cardiovascular risk factors. Results: Included 61 patients with a mean age of 58±11, 56% women. A relationship was established between age/glucose; IL6/LDL; vitamin D/ferritin; waist circumference/BMI; BMI/CRP; smoking, age, blood pressure, LDL, and neutrophil/lymphocyte ratio. The statistical analysis evaluated predictive variables for developing hypertension and high cardiovascular risk. In the cardiovascular risk stratification, 09 patients had low chance; one was intermediate, 37 high risk, and 02 very high risk.

Ao contrário do que se constitui no imaginário popular acerca da “vida pacata”, o campo é espaço de contradições, lutas, conflitos. Embora as forças hegemonizadoras do capital tenham se firmado como principal agente ordenador do território, o capital não se consolida completamente, pois há os movimentos de enfrentamento político por parte daqueles que fogem à lógica do sistema capitalista de produção. Os camponeses e outros sujeitos que vivem do labor na terra, a partir da territorialização das empresas capitalistas, constroem as chamadas (Re)Existências, ou seja, (Re)Existem para continuar Existindo. Nessa perspectiva, compreendeu-se a relação entre a Educação desenvolvida nas escolas rurais em Piracanjuba enquanto (Re)Existências camponesas no Município. Especificamente, nesta pesquisa buscou-se analisar a relação entre a Escola Municipal de Educação Básica Urbano Pedro Guimarães e a Comunidade Areia, verificando a contribuição da educação no campo como instrumento de fortalecimento das famílias camponesas na terra.

Resumo Objetivo Descrever as preferências e práticas atuais de uma amostra de cirurgiões de joelho do Brasil quanto à forma de tromboprofilaxia na artroplastia total do joelho (ATJ). Método Na presente pesquisa realizada pela internet, cirurgiões associados à Sociedade Brasileira de Cirurgia do Joelho (SBCJ) foram convidados a responder voluntariamente a um questionário anônimo incluindo o tempo de experiência cirúrgica pessoal, percepções sobre as melhores opções de tromboprofilaxia e as reais práticas no ambiente onde trabalham. Resultados Entre dezembro de 2020 e janeiro de 2021, 243 participantes responderam ao questionário completo. Exceto por 3 (1,2%) participantes, todos declararam praticar tromboprofilaxia, a maioria (76%) combinando as formas farmacológica e mecânica. A droga mais prescrita é a enoxaparina (87%), com modificação para rivaroxabana (65%) após a alta. O momento de início da tromboprofilaxia variou conforme o tempo de formação do cirurgião de joelho (p ≤ 0,03) e as preferências e práticas variaram conforme a região do país (p Conclusão As preferências e práticas de tromboprofilaxia na ATJ são diversas nas regiões do Brasil e sistemas de saúde (público ou privado). Dada a inexistência de uma diretriz clínica nacional, a maior parte dos ortopedistas segue ou a diretriz de seu próprio hospital ou nenhuma. O método de profilaxia mecânica e a pouca utilização do ácido acetilsalicílico são os pontos que mais destoam das diretrizes e práticas internacionais.

Tissue engineering is an interdisciplinary field that applies the principles of engineering and the life sciences toward the development of biological substitutes that restore, maintain, or improve tissue function. The most studies are focused on the preparation of scaffolds, selection of the different cell sources and construction of engineered bone. The decrease in bone height in the sinus area after tooth loss is a major challenge in implantology, making the search for new materials a constant challenge. Faced with this, the aim of this review article is to discuss the tissue engineering techniques for maxillary sinus lifting in atrophic jaws.

Background: Technological advancement has also allowed dentistry to obtain new materials and techniques, as well as more predictable results in dental treatment. However, there are still many flaws related to the technique and choice of materials by dentists. Thus, the aim of this study was to evaluate through panoramic radiographs failures in dental treatment. Methods: 1250 panoramic radiographs were selected and evaluated by an experienced specialist, 609 of which had one or more iatrogenic Results: 48.72% of the radiographs analyzed showed some failure in dental treatment that focused on the age group of 31-50 years. Conclusion: Thus, it is necessary that dentists are attentive to the detection and correction of iatrogenesis, seeking a better quality of life for patients.

We researched governance from the perspective of Business Process Management – BPM. From the understanding of process management as a practice that aims to register organizational knowledge, BPM can be seen as a valuable tool for governance. The BPM uses methodologies of analysis and redesign of processes to represent and translate organizational objectives and strategies to add value to clients. This article presents a systematic mapping of scientific papers published between 2011 and 2021 through the data collected in Scopus and Web of Science databases. The co-occurrence of keywords allowed identifying research subareas such as the public sector, technology, and strategic management. The analysis of the evolution of the publications revealed that the theme is still growing; however, we did not find many articles contemplating the connection between the two constructs simultaneously. We concluded that despite the results found, the concepts of both constructs consider common elements as value generation, demonstrating that there is room for new approaches to analyze the evolution of the theme and possibilities of further research.

O presente artigo tem por objetivo analisar as questões jurídicas incidentes sobre a responsabilidade do advogado público. Serão estudados os fundamentos jurídicos da responsabilidade do advogado público no exercício da atividade consultiva, com enfoque nos posicionamentos externados pelo Supremo Tribunal Federal e pelo Tribunal de Contas da União. Nesse contexto há conclusão pela importância da concepção da autonomia técnica do advogado público como expressão do direito coletivo à boa administração, que irá permear os limites jurídicos existentes que caracterizam a responsabilidade do advogado público consultivo. Por fim, será concluído que em certas circunstâncias o advogado público parecerista somente responderá por dolo ou fraude na forma do art. 184 do CPC, afastando-se a culpa grave (erro grosseiro).

O território da Comunidade Tradicional do Iratapuru/Amapá foi impactado com a implantação da Usina Hidrelétrica de Santo Antônio, transformando não apenas estruturalmente as moradias, mas criando efeitos duradouros na identidade dos seus lares, que gerou a perda da identidade territorial. O presente estudo visa por meio dos olhares dos moradores - relatos vividos - elucidar a perspectiva do antes e o depois. Nesta perspectiva foram utilizados os preceitos metodológicos com base na revisão de literatura, ampliando a discussão da problemática em questão, e de modo qualitativo usar as entrevistas e conversas semiestruturadas para melhor compreender a realidade dos envolvidos. Diante da narrativa dialogada, apresentará quais alterações e dinâmicas foram diagnosticados, bem como o novo estilo de vida, com implicações sociais, as quais não apresentaram melhoras significativas na vida dos povos locais.

Neoplasmas primários do sistema urinário são incomuns em cães e gatos. Quando acometem os rins, o carcinoma é o mais comum nos cães e o linfoma nos gatos. Neoplasmas ureterais primários são raros nos cães e não existe relatos em gatos. O principal neoplasma vesical primário descrito em cães e gatos é o carcinoma de células de transição; porém, é mais frequente em cães. Neoplasmas uretrais ocorrem raramente e quando diagnosticados normalmente são amplificações de neoplasmas prostáticos ou de vesícula urinária. Com a finalidade de auxiliar no diagnóstico e na conduta médica para as duas espécies, esse trabalho tem o objetivo de apresentar uma revisão de literatura com os principais neoplasmas de ocorrência no sistema urinário que afetam cães e gatos. Apesar destas alterações serem infrequentes na rotina veterinária, é necessário um diagnóstico precoce para melhor prognóstico dos pacientes.

A Atenção Primária à Saúde (APS) é componente chave para o fortalecimento dos sistemas de saúde, que visam alcançar os princípios de integralidade e equidade. No Brasil, a organização da APS é norteada pela Estratégia de Saúde da Família (ESF), que utiliza como um dos principais instrumentos avaliativos o Primary Care Assessment Tool (PCAT). Esse instrumento mede a orientação da APS à luz dos atributos essenciais (acesso de primeiro contato, longitudinalidade, integralidade e coordenação do cuidado) e derivados (orientação familiar e comunitária e competência cultural). O objetivo deste estudo é analisar o desempenho de uma Equipe de Saúde da Família (EqSF) no município de Aracaju, SE, à luz do PCAT, a fim de se obter o grau de orientação da APS. Foram entrevistados 310 adultos cadastrados maiores de 20 anos. Destes, 254 (81,9%) mostraram-se afiliados à Unidade de Saúde, sendo essa amostra utilizada para o cálculo do grau de orientação. O escore geral obtido foi de 6,8, com o valor de 6,66 sendo considerado indicativo de uma boa orientação para APS. Apesar desse resultado, foi percebido que os atributos de acesso, integralidade e orientação comunitária precisam de ajustes para que a equipe possa ofertar um serviço mais resolutivo e de qualidade.

ObjectiveFor transgender women (TW) on oestrogen therapy, the effects of prior exposure to testosterone during puberty on their performance, mainly cardiopulmonary capacity (CPC), while exerting physical effort are unknown. Our objective was to evaluate CPC and muscle strength in TW undergoing long-term gender-affirming hormone therapy.MethodsA cross-sectional study was carried out with 15 non-athlete TW (34.2±5.2 years old), 14 cisgender men (CM) and 13 cisgender women (CW). The TW received hormone therapy for 14.4±3.5 years. Bioimpedance, the hand grip test and cardiopulmonary exercise testing on a treadmill with an incremental effort were performed.ResultsThe mean VO2peak (ml/min) was 2606±416.9 in TW, 2167±408.8 in CW and 3358±436.3 in CM (TW vs CW, p0.05; TW vs CM p>0.05; CW vs CM p>0.05). The O2 pulse in TW was between that in CW and CM (TW vs CW, p2among TW (r=0.7388; pConclusionAbsolute CPC in non-athlete TW showed an intermediate pattern between that in CW and CM; however, relative CPC adjusted for fat-free mass showed no difference between TW and CW or CM. Similarly, the mean strength in non-athlete TW was higher than those in non-athlete CW but not when adjusted for fat-free mass.

OBJECTIVE To describe the clinical characteristics of cutaneous adverse reactions and cross-sensitivity induced by antiseizure medications and compare the pattern of use of antiseizure medications in patients with epilepsy according to skin rash history. METHODS We analysed patients with a history of skin rash presenting for up to 12 weeks after initiating antiseizure medication. The history of skin rash was verified by medical charts, interviews, and identification of skin lesions by patients based on illustrative images. The minimum follow-up period was eight months. The control group comprised epilepsy patients with regular antiseizure medication use for at least 12 weeks without skin rash. We included 109 cases and 99 controls. RESULTS The median (interquartile range) period from the index rash was six years (2-11). Carbamazepine was the trigger medication in 48% of cases and induced skin rashes in all patients with cross-sensitivity and carbamazepine exposure. Stevens-Johnson syndrome, toxic epidermal necrolysis, or drug reactions with eosinophilia and systemic symptoms affected 36% of cases. Carbamazepine- or oxcarbazepine-induced maculopapular exanthema occurred earlier (median: one week) than that induced by other antiseizure medications (median: three weeks) (p=0.006). Cross-sensitivity was more common in patients with at least one episode of Stevens-Johnson syndrome (29%) and Stevens-Johnson/toxic epidermal necrolysis overlap (50%) than in patients with maculopapular exanthema (8%) (p=0.01). Although most cases were mild, the pattern of antiseizure medication use differed from that of controls, with a lower proportion of antiseizure medication typically associated with severe cutaneous adverse reactions (carbamazepine, phenytoin, phenobarbital, primidone, oxcarbazepine, and lamotrigine) (p

Compound odontoma is an odontogenic tumor of ectomesenchymal origin containing tooth-like structures. Occasionally, this lesion may trigger occlusal, phonetic, and aesthetic disorders. The aim is to report a case of a compound odontoma containing 23 denticles in the anterior region of the maxilla of an infant patient. A 12-year-old male patient was referred for orthodontic treatment at Ribeirão Preto School of Dentistry, University of São Paulo (Ribeirão Preto, Brazil) complaining of a large diastema between the upper central incisors. Panoramic radiograph revealed the presence of a radiopaque lesion with tooth-like structures surrounded by a radiolucent rim in the anterior region of the maxilla, associated with distal displacement of the left central incisor. Surgical approach under general anesthesia revealed and extracted 23 denticles. Post-operative Cone beam computed tomography (CBCT) confirmed removal of all denticles, and further orthodontic treatment could be planned. Multidisciplinary involvement of pediatric dentist, oral and maxillofacial surgeon, and orthodontist was essential to achieve full functional, aesthetic, and psychosocial success.

Biomaterials have been investigated as an alternative for the treatment of bone defects, such as chitosan/carbon nanotubes scaffolds, which allow cell proliferation. However, bone regeneration can be accelerated by electrotherapeutic resources that act on bone metabolism, such as low-level laser therapy (LLLT). Thus, this study evaluated the regeneration of bone lesions grafted with chitosan/carbon nanotubes scaffolds and associated with LLLT. For this, a defect (3 mm) was created in the femur of thirty rats, which were divided into 6 groups: Control (G1/Control), LLLT (G2/Laser), Chitosan/Carbon Nanotubes (G3/C+CNTs), Chitosan/Carbon Nanotubes with LLLT (G4/C+CNTs+L), Mineralized Chitosan/Carbon Nanotubes (G5/C+CNTsM) and Mineralized Chitosan/Carbon Nanotubes with LLLT (G6/C+CNTsM+L). After 5 weeks, the biocompatibility of the chitosan/carbon nanotubes scaffolds was observed, with the absence of inflammatory infiltrates and fibrotic tissue. Bone neoformation was denser, thicker and voluminous in G6/C+CNTsM+L. Histomorphometric analyses showed that the relative percentage and standard deviations (mean ± SD) of new bone formation in groups G1 to G6 were 59.93 ± 3.04a (G1/Control), 70.83 ± 1.21b (G2/Laser), 70.09 ± 4.31b (G3/C+CNTs), 81.6 ± 5.74c (G4/C+CNTs+L), 81.4 ± 4.57c (G5/C+CNTsM) and 91.3 ± 4.81d (G6/C+CNTsM+L), respectively, with G6 showing a significant difference in relation to the other groups (a ≠ b ≠ c ≠ d; p < 0.05). Immunohistochemistry also revealed good expression of osteocalcin (OC), osteopontin (OP) and vascular endothelial growth factor (VEGF). It was concluded that chitosan-based carbon nanotube materials combined with LLLT effectively stimulated the bone healing process.

No presente estudo foi investigada unidimensionalidade, o funcionamento das categorias de resposta e a fidedignidade para a Equalis-OAS, uma escala Likert, com cinco pontos, escrita em Língua Portuguesa, desenvolvida sob a ótica dos preceitos psicométricos, com vistas a avaliar a Qualidade de Objetos de Aprendizagem da Área da Saúde. O estudo envolveu 1.766 profissionais de saúde, participantes de cursos de educação continuada realizados na modalidade a distância disponibilizados pelo Telessaúde do Rio Grande do Sul (TelessaúdeRS-UFRGS). Os resultados sugerem que, embora a Equalis-OAS tenha seus itens distribuídos em três categorias (Conceitos Intrínsecos; Educacional; Apresentação) a adoção da unidimensionalidade pode ser adotada, sem comprometer a confiabilidade da escala. Além disso, o ponto "não concordo nem discordo" da Equalis-OAS mostrou ser pouco relevante, sugerindo futuras aplicações com quatro pontos. O cálculo do Rating Scale aponta que os parâmetros de pessoas e itens foram estimados com elevada precisão, indicando evidências de confiabilidade da escala. As análises realizadas abarcando à unidimensionalidade do instrumento, a exclusão de um item e a exclusão do ponto neutro não comprometeram as evidências de validade do instrumento, ou seja, a Equalis-OAS permanece medindo o que se propõe a medir, isto é, a qualidade de objetos de aprendizagem voltados a área da saúde. . Palavras-chave: Educação a distância. Educação em saúde. Estudos de validação. Teoria de resposta ao item.

Despite scientific advances and findings on the effects of creatine supplementation, little is known about the use of this supplement and its effects on visceral fat accumulation, as well as on the process of improving muscle endurance associated with stereological factors of muscle tissue. This study aimed to evaluate the effects of creatine monohydrate use on physical valences, stereology of muscle tissue and quantitative aspects of visceral adipose tissue. Twenty-four Wistar rats, aged 15 weeks and under controlled feeding and hydration conditions, were selected. To verify the desired variables, the animals were classified into four groups: control, supplemented, training, and training and supplemented. Creatine supplemented animals were supplemented (via gavage) at dosages of 300mg / kg body mass for nine weeks, and the same period of training as the animals that were trained underwent a program based on Honenberg & Farrar studies. The loads at which the animals performed the series were noted, as well as the number of climbs performed per training session. After the experimental period, the animals were weighed and euthanized, and visceral fat was removed for weighing and comparison between groups and staining in the standard protocol of hematoxylin and eosin for stereological verification of muscle tissue. The observed results indicated time-dependent ergogenic improvements and slight reductions in the visceral fat of the supplemented animals, as well as variations of mononuclear phagocytes present in the tissue of the experimental groups, especially a low amount of these cells in the animals that trained and supplemented. It is concluded that creatine may have effects on visceral fat and the potential modulating effect of the innate immune system, in addition to time-dependent ergogenic effects.

Background Brazil experienced a disproportionately higher rate of microcephaly cases in November 2015 with evidence of a causal link with Zika virus (ZIKV) infections during pregnancy. Epilepsy is a major neurological feature seen as part of congenital Zika virus syndrome (CZVS). Different seizure types and electroencephalographic (EEG) abnormalities have been described in association with this syndrome. However, clinical and neurophysiological features of epilepsy seen in children with CZVS are not fully understood. Methods We evaluated children with CZVS showing an EEG pattern of electrical status epilepticus during slow-wave sleep (ESES). Information on gender, age of onset of seizures, head circumference at birth, gross motor function at the time of diagnosis, of clinical and EEG aspects of seizures, EEG features and response to drug treatment was assessed. Results Our case series included four patients. They were diagnosed with epilepsy between one month to 18 months of age and showed an ESES pattern at the age of three. They presented with a wide range of epileptic symptoms, but all experienced tonic seizures. Multiple drug treatment was the management approach for three patients; however, they showed poor response to treatment with conventional drugs used in the treatment of ESES. Conclusions Children with CZVS may develop an EEG pattern of ESES. Clinicians and neurologists should be aware of this neurological presentation to improve the management of these patients.

Introduction: GHD (Glute Ham Developer) is a recurrent exercise in training and competitions in Cross Training modalities, studies and cinematic analyzes of this movement are still little found in the literature. Objective: To analyze the kinematics of the GHD and compare the performance and angles of the hips and knees of two volunteers, one experienced and the other novice in the sport. Method: An experienced volunteer and another novice, but physically active, were selected and had their resting heart rates measured. They were invited to perform three movements on the GHD device, and these gestures were monitored and filmed by the researchers. After performing the gesture, the heart rate was measured again. The videos were analyzed using Kinovea kinematic software and the results were tabulated and compared using BioStat statistical software (p

ResumoA estenose degenerativa do canal vertebral lombar é a causa mais frequente de dor lombar e/ou ciática no paciente idoso; sua epidemiologia, fisiopatogenia, manifestações e testes clínicos são revistos em ampla investigação bibliográfica atual. A importância da relação entre a clínica e o estudo por imagens, principalmente a ressonância magnética (RM), é ressaltada. Antes da indicação do tratamento, é necessário identificar a localização precisa da dor, bem como o diagnóstico diferencial entre a claudicação neurogênica e a vascular. O tratamento conservador associando medicações com as diversas técnicas fisioterápicas resolve o problema na maioria dos casos, já o teste terapêutico com os bloqueios, seja epidural, foraminal ou facetário, é realizado quando as dores não cedem com o tratamento conservador e antes da indicação da cirurgia. Os bloqueios costumam dar melhores resultados no alívio dos sintomas de ciatalgia e menos no quadro de claudicação neurogênica. A descompressão da cauda equina e/ou radicular associada ou não à artrodese é o padrão ouro quando a intervenção cirúrgica é necessária. A artrodese após a descompressão é necessária nos casos com instabilidade segmentar, como na espondilolistese degenerativa. Quando a estenose de canal acontece em múltiplos níveis e vem acompanhada de desvio de eixo, seja coronal e/ou sagital, deve ser realizada, além das descompressões e artrodese, a correção dos desvios de eixo, principalmente o eixo sagital, quando a correção da lordose lombar se impõe com técnicas que corrigem a lordose retificada para valores próximos à incidência pélvica.

O presente texto objetiva relatar as experiências de um projeto de extensão realizado pela Universidade Federal de Alfenas em parceria com a Empresa de Assistência Técnica e Extensão Rural do Estado de Minas Gerais (EMATER-MG), regional de Alfenas, visando implantar e avaliar 12 unidades experimentais em municípios com tradição leiteira da região Sul de Minas Gerais, com o objetivo de adaptar sistemas de integração lavoura-pecuária-floresta (ILPF) para as realidades locais, recuperando áreas degradadas, intensificando a utilização das pastagens e implementando áreas de proteção em nascentes e/ou vegetação ciliar. Foram realizados 4 dias de campo, com a capacitação de 138 produtores rurais, além da utilização dessas propriedades em cursos em bovinocultura e meio ambiente para produtores e técnicos. Os sistemas ILPF apresentam-se como alternativas viáveis para melhoria da geração de renda e serviços ambientais nas propriedades, respeitando-se as exigências impostas pela legislação ambiental. Dessa forma, o produtor rural e a sociedade são beneficiados com a preservação do meio ambiente. Houve efetiva construção do conhecimento entre agricultores familiares, a comunidade atendida, acadêmicos, docentes e técnicos da EMATER-MG.

IntroductionDiabetic nephropathy (DN) is a disease that progresses with the slow and progressive decline of the glomerular filtration rate (GFR); the installation of this pathology is silent and one of the major causes of death in patients with diabetes.AimsTo identify new molecular biomarkers for early identification of the onset of DN in patients with type II diabetes mellitus (DM2). We studied the expression profile of the genes; suppressor of mothers against decapentaplegic type 1 (SMAD1), neutrophil gelatinase-associated lipocalin (NGAL) and type IV collagen (COLIV1A) in peripheral blood and urine sediment samples.MethodsNinety volunteers, 51 with DM2 and 39 healthy, were recruited from the Faculdade de Medicina do ABC outpatient clinic. We conducted an interview and collected anthropometric data, as well as blood and urine samples for biochemical evaluation and real-time PCR amplification of the genes of interest.ResultsGene expression data: peripheral blood NGAL (DM2 0.09758±0.1914 vs CTL 0.02293±0.04578), SMAD1 (blood: DM2 0.01102±0.04059* vs CTL 0.0001317±0.0003609; urine: DM2 0.7195±2.344* vs CTL 0.09812±0.4755), there was no significant expression of COLIV1A. These genes demonstrated good sensitivity and specificity in the receiving operating characteristic curve evaluation.ConclusionOur data suggest the potential use of NGAL and SMAD1 gene expression in peripheral blood and urine samples as early biomarkers of DN.

Introduction:Hemodialysis stands out as an eligible treatment for patients with chronic kidney disease. The subsequent inflammatory process resulting from this disease and hemodialysis per se is exacerbated in this therapy. Selenium (Se) is an essential trace element that can participate in the inhibition of pro-oxidant and pro-inflammatory processes and could be considered a measurement that indicates the progression of chronic kidney disease and inflammation.Objective:The present study investigated selenemia in hemodialysis patients of the ABC region of São Paulo and aimed to establish the correlation between an inflammatory marker and selenemia in this conditions disease.Methods:This is an observational cross-sectional study of the Faculdade de Medicina do ABC in patients submitted to hemodialysis three times a week for at least six months. The eligible group composed of 21 patients, who filled out forms and underwent biochemical tests (colorimetric enzyme methods, flow cytometer, turbidimetric method and mass spectrometry).Results:The study population showed, women (70%), men (30%) with a mean age of 47 ± 17 years, Caucasians (36%) and non-Caucasian (64%), hypertensive (68%), smokers (53%) and non-smokers (64%). There was a hegemonic prevalence of systolic arterial hypertension (SAH) 68.1% in relation to diabetes mellitus (DM) (50%). Pre and post hemodialysis (HD) selenemia showed statistical significance, which did not occur with Creactive protein. There was a predominance of females in our sample; the pre- and post- HD selenemia were within the normal range of the reference values; there was a statistically significant correlation between pre and post-HD selenemia; there was no correlation with statistical significance between values of pre and post-HD C-reactive protein.Conclusion:Our data showed that there was no direct relationship between pre- and post- HD inflammation and pre- and post-HD selenemia.

Introduction: The objectives of this study are to experimentally evaluate the haemostatic effects of two organic substances, a membrane of chitosan and a collagen sponge coated with thrombin and human fibrinogen (TachoSil®), in sealing 7-0 needle stitches holes on the femoral arteries of rats as well as to evaluate local histological reactions. Methods: Twenty-four rats were included, and four holes were made in each common femoral artery. In the control group, haemostasis was achieved only by compression with gauze sponge; and in the two other groups, haemostasis was achieved with application of one of these two substances. Results: Membrane of chitosan and TachoSil® showed a power to reduce the time to achieve haemostasis compared with the control group (P=0.001), and the haemostatic effects of these two substances were comparable. There was lower blood loss in the groups where these two substances were used when compared with the control group, but no difference was found comparing the two substances. Conclusion: The use of these sealants did not promote more adhesion or local histological reactions when compared to the control group. Since chitosan is easy to find in nature, has a positive effect to promote haemostasis, and did not bring considerable local reactions, it might be used as a sealant in cardiovascular surgery.

Soil erosion is a process caused by several factors, including precipitation. Causing the water erosive process, through the detachment and transport by surface runoff of soil particles.This phenomenon depends on the intensity, frequency and duration of eventsin a given region. Thus, the objective was to determine the rainfall erosivity indices through rainfall data. The period of rainfall data used was between the years 1943 to 1985, for the municipality of Piaçabuçu, located in the lower São Francisco Alagoano region. These data were tabulated to calculate rainfall, rainfall coefficient and its relation to erosivity using six equations. The municipality of Piaçabuçu has an average annual rainfall distribution of 1128.52 mm for the observation period of 42 years, with a wide variation in the distribution of rainfall over the years, with the rainy season concentrated in the months of March to August , presenting average values above the average, in this period it precipitated more than 70% of the rains for the municipality.Todos os seis modelos de estimativas da erosividade apresentaram correlação considerada alta, o que os capacita para a estimativa da erosividade do município em estudo.All six erosivity estimation models presented a high correlation, which enables them to estimate the erosivity of the municipality under study.

Not applicable.

Background and Objectives: The spinous foramen (FS) of the skull is an opening located in the greater wing of the sphenoid bone at the base of the skull, and it includes the middle meningeal vessels and the meningeal branch of the mandibular trigeminal nerve. The FS is commonly used as an anatomical landmark in neurosurgical procedures and neuroimaging of the middle cranial fossa because of its relationship with other cranial foramina and surrounding vascular and nervous structures. Thus, specific knowledge of its topography and possible anatomical variations is important regarding some surgical interventions and skull imaging. The aim of this study was to provide further details on the morphology of the FS of the skull by evaluating its topographic and morphometric relationships and correlating the findings with clinical practice. Materials and Methods: Thirty dried skulls of human skeletons from body donors from the collection of the Laboratory of Anatomical Microdissection at a medical school were used. The metric dimensions and variations of the FS and its relationship with adjacent bone structures were analyzed with an interface digital microscope. Results: The results showed the bilateral presence of the FS in all skulls; however, differences were observed in the shape, diameter, and topography in relation to the foramen ovale and the spine of the sphenoid. The FS was present in the greater wing of the sphenoid bone; however, in one skull, it was located in the lateral lamina of the pterygoid process. The FS was smaller than the foramen ovale. A round and oval FS shape was the most common (42.1% and 32.8% of the samples, respectively), followed by drop-shaped (12.5%) and irregular-shaped (12.5%) foramina. Conclusions: In conclusion, FS variations among individuals are common and must be considered by surgeons during skull base interventions in order to avoid accidents and postoperative complications.

Introdução: As doenças respiratórias crônicas estão entre os principais problemas de saúde pública no mundo. Mesmo sendo sensíveis ao tratamento na Atenção Primária à Saúde, são a terceira principal causa de morte no Brasil. Os serviços de telemedicina apresentam-se como aliados importantes dos profissionais de saúde no que tange ao manejo de doenças respiratórias como a asma e a doença pulmonar obstrutiva crônica. Objetivo: Avaliar a adequabilidade de um serviço de telemedicina diagnóstica em espirometria considerando os indicadores de oferta, utilização e cobertura populacional no estado do Rio Grande do Sul. Resultados: No período estudado, o serviço ofertou 27.672 exames de telespirometria aos usuários do Sistema Único de Saúde do Rio Grande do Sul encaminhados por médicos da Atenção Primária à Saúde. A utilização esteve abaixo de 50% da oferta em todas as macrorregiões de saúde do estado. Conclusões: O estudo demonstrou que a capacidade instalada pelo serviço esteve adequada para atender à demanda populacional do Rio Grande do Sul, no entanto a baixa utilização do serviço pode estar associada ao desconhecimento sobre ele e à dificuldade em reconhecer essas doenças por parte dos profissionais de saúde da Atenção Primária à Saúde.

O presente trabalho analisa o fenômeno do constitucionalismo intercultural sob o prisma das diversas acepções de cultura bem como estabelece uma investigação histórica do fenômeno educacional como propulsor da promoção da diversidade. Nesse sentido, busca-se compreender a historicidade dos processos sociopolíticos e os fatores materiais que embasam as relações entre diversidade, educação, cultura e sustentabilidade na vigente sistemática constitucional. Analisa-se, em um primeiro momento, as ideias de educação, diversidade e democracia, considerado o enfrentamento dos abusos estatais contra coletividades e minorias. Por fim, tendo em vista o histórico das preocupações ambientais, discute-se a relação entre ethos, paideia e constitucionalismo.

At becoming worldly known, in 2016, thanks to the success of his documentary I Am Not Your Negro, the Haitian Raoul Peck already possessed an extensive career as a filmmaker, with a first fiction film, Haitian Corner, released in 1987. The movie tells the story of na haitian poet, immigrant, who lives in Brooklyn, New York, tormented by the ghosts of torture suffered in Haiti in the Duvalier era. Himself marked by the sign of displacement – Peck lived in Haiti, in the Democratic Republic of Congo, in Germany, in the United States and France – the filmmaker starts with Haitian Corner a long list of characters displaced or on transit that would thematically shape many of your works. This article intends to revise the image of the refugee/immigrant in this inaugural piece by Peck, with enfasis on the approach of the director to subjects of memory and the trauma caused in the sphere of asylum.

The goal of this work was to know the effect of precipitation in four periods (Rising, Flood, Lowing and Dry) on Odonata larvae living near to the macrophyte Salvinia auriculata Aubl., in Been River, Amazonas, Brazil. The biological material was collected in the Been river in the section near the river Madeira, state of Amazonas, Brazil. Sampling was conducted in stands of three macrophytes S. auriculata in four periods: rising (November 2012), flood (February 2013), lowing (May 2013), and dry (August 2013). A total of 286 Odonata larvae were identified in the river studied. Six families and 14 genera were identified. The flood period showed the highest abundance in the studied period. Acanthagrion presented a positive correlation with flood period in axis 1 and Telebasis also positive, but in the dry period. In conclusion, although there are few studies on Odonata larvae associated with floating macrophytes in the Amazon, the results of this work showed the importance of knowing the distribution of larval abundance throughout the year. Flood and dry period showed to be the period with the highest abundance of Odonata genera. In addition, the principal component analysis showed that some species are more sensitive to the periods of the year, Telebasis in the dry period and Acanthagrion in the flood period.

Este trabajo tiene como objetivo presentar la Base Cartográfica Continua de Brasil en la escala de 1:250,000 - BC250; se inserta en el Programa de Actualización Permanente (PAP) del IBGE. Este programa consiste en la actualización y mantenimiento continuo de la cartografía de todo el territorio brasileño a una escala de 1:250.000, con una vista que se trata de un apoyo estratégico para el gobierno en la planificación regional y también contribuye a los estudios sobre las políticas ambientales. Estas actividades incluyen el uso de PAP, foto sensores de los satélites como el Landsat, CBERS, RapidEye, modelos digitales de elevación, las aportaciones de los organismos asociados y los estudios de campo. La incorporación de la tecnología asociada a los Sistemas de Información Geográfica y Sensores Remotos para el mapeo sistemático contribuyó al desarrollo de una sola base integrada en todo Brasil. El proceso de construcción de BC250 se inició en 2008; con Brasil se divide en bloques de la contratación; y la conclusión de la etapa de la cartografía, en agosto de 2012. Una primera versión de la base continua está disponible para consulta en el sitio web de IBGE (www.ibge.gov.br) desde octubre de 2013 y en la página de la Infraestructura Nacional de Datos Espaciales (INDE) desde diciembre de 2013 . Este mapa base es el primero en ser producido en Brasil en la Norma Técnica Especificaciones para los Datos Geoespaciales Estructuración Vectorial (ET-EDGV) que proporciona una nueva estructura para el almacenamiento de datos geoespaciales para la integración de datos en el INDE.

Renal cells need oxygen for homeostasis; it is known for adjusting cellular functioning and the energy obtainment have a broad relationship with cellular respiration, through the O2 bioavailability. O2 homeostasis regulation in the kidney is mediated by hypoxia-inducible factors (HIFs). HIF is divided into three α isoforms, represented by HIF-1α, HIF-2α, and HIF-3α in addition to three paralogs of HIF-1β; these are involved in some metabolic processes, as well as in the pathogenesis of several diseases. Renal biopsy analyses of patients and experimental animal models aim to understand the relationship between HIF and protection against developing renal diseases or the induction of their onset, being thus this molecule can be considered a potential biomarker of renal disease. We carried out a systematic review to which we included studies on HIF-1α and renal disease in the last 5 years (2013-2018) in researches with humans and/or animal model through searches in three databases: LILACS, PubMed, and SciELO by two researchers. We obtained 22 articles that discussed the relationship with HIF as inductor or protector against renal disease and no relation between HIF and renal. We observed controversies remain regarding the relation between of HIF with renal diseases; this may be related to the different intracellular pathways mediated by HIF-1α, thereby determining differentiated cellular responses.

Diabetic nephropathy (DN) is a pathological condition that affects diabetic patients around the world, and it is the main cause of chronic kidney diseases. It is known that the inflammatory pathway is activated in diabetic patients. Thus, the aims of this study were to evaluate the gene expression of Nuclear factor-κappa B (NF-κB) in liquid samples (urine and blood), then to evaluate the correlation between NF-κB gene expression with classical biochemical markers of kidney disease to investigate if the gene expression of this molecule can be used as a biomarker of loss of kidney function in diabetic patients. We recruited 35 patients with type 2 diabetes mellitus for at least 5 years and 29 healthy donors and collected samples of urine and blood to quantify the NF-κB expression. It was found higher expression of NF-κB in both samples in diabetes patients. We verified elevated levels of microalbuminuria, serum creatinine, urea and BMI in diabetic patients, as well as a fall in GFR, without alteration in serum creatinine and proteinuria levels. Our data suggest that overexpression of NF-κB participates in the onset of diabetic nephropathy and that it is possible to quantify these changes in liquid biopsy (blood and urine) through gene expression of this molecule. The NF-κB expression is correlated with increased BMI data.

The development literature has pointed out some deeply rooted determinants of current economic development. We checked out the historical determinants of Portuguese municipalities’ development and also if the strength of the different dominant medieval classes (nobility, clergy, and bourgeoisie) in each Portuguese municipality has some importance for current economic and social development, using some historical proxies. The results indicate that the cathedral antiquity is statistically significant in explaining the purchasing power municipal index. It is interesting to observe that the proxy for the bourgeois power does not have influence in the most robust regressions, and that the proxy for nobility power (the castle antiquity) is negatively related to current purchasing power.

Desde 1912, inúmeros textos – romances, programas de rádio, histórias em quadrinhos, seriados de televisão, filmes – produziram e articularam representações da África em narrativas envolvendo Tarzan, criado pelo estadunidense Edgar Rice Burroughs (1875-1950). Tomando o nome de “África” como referência, os textos que orbitam e habitam o nome de “Tarzan” pertencem a uma genealogia ocidental e a uma história transcultural. Após abordar a economia da marca registrada “Tarzan ®” em sua circulação global, uma descrição breve e esquemática da filmografia de Tarzan me permite interrogar o que chamo de nomenclausura ocidentalista da “África”. Finalmente, por meio de uma leitura atenta de Moi, un noir (1959), de Jean Rouch, como um prisma através do qual a circulação global de Tarzan pode ser interpretada e reinventada, sugiro possibilidades de transbordamento imaginativo, abrindo o espaçamento transcultural da escritura da “África” como economia política do nome de “África”. Tarzan, a Black Man: Toward a Critique of the Polit Economy of the Name of “Africa”Since 1912, countless texts – novels, radio shows, comic strips, television serials, films – have produced and articulated representations of Africa in narratives featuring Tarzan, a character created by the US author Edgar Rice Burroughs (1875-1950). Taking the name of “Africa” as a reference, the texts which surround and inhabit the name of “Tarzan” belong both to a Western genealogy and to a cross-cultural history. After examining the economy of the global circulation of the “Tarzan” trademark, I give a brief and schematic description of Tarzan’s filmography, which allows me to interrogate what I call the occidentalist name-in-closure of “Africa”. At last, by means of a close reading of Jean Rouch’s Moi, un noir (1959) as a prism through which Tarzan’s global circulation can be interpreted and reinvented, I suggest possibilities of imaginative overflow, opening up the cross-cultural spacing of the writing of “Africa” as political economy of the name of “Africa”.Cinema | Africa | Tarzan | Racism

O tétano acidental é uma doença de alta letalidade, a qual é causada pela neurotoxina tetânica (TeNT) liberada na autólise da bactéria Clostridium tetani em condições favoráveis. Essa enfermidade é decorrente do impedimento da liberação do ácido gama-aminobutírico (GABA) e da glicina dos neurônios inibitórios, o que deixa o neurônio motor em estado de hiperatividade, acarretando na paralisia muscular e morte. O nome tétano é derivado da palavra tetéin, que no latim significa rigidez muscular. A etimologia do seu nome é condizente com os sintomas iniciais da enfermidade: o trismo e o riso sardônico, ambos decorrentes da contração involuntária dos músculos do rosto. Apesar de existir imunização para a doença, ainda surgem casos todos os anos. Neste estudo foi realizado uma revisão de literatura, de modo a compreender e relacionar o tétano acidental e sua forma de atuação no corpo com os clássicos sintomas demonstrados, bem como seu padrão epidemiológico. Para isso, foram consultadas plataformas de busca online como: US National Library of Medicine National Institutes of Health – PubMed, portal de teses da UFMG, Scientific Eletronic Library Online – SciELO e a Biblioteca Digital de Teses e Dissertações da USP.

Antibiotic resistance among bacterial pathogens is one of the most worrying problems in health systems today. To solve this problem, bacteriocins from lactic acid bacteria, especially nisin, have been proposed as an alternative for controlling multidrug-resistant bacteria. Bacteriocins are antimicrobial peptides that have activity mainly against Gram-positive strains. Nisin is one of the most studied bacteriocins and is already approved for use in food preservation. Nisin is still not approved for human clinical use, but many

Purpose: to analyze synchronous teleconsultation as a support tool in the management of temporomandibular disorders in primary health care and to identify which factors have an impact on decisions about teleconsultation. Methods: retrospective study perfomed in TelessaúdeRS, between May 2018 to May 2020. This study used primary data from synchronous teleconsultation, requested by primary health care professionals and carried out by multiprofessional teleconsultants. The data collected were the information reported by the requester, the teleconsultant's suggestions and if there was referral of the patient for specialized care after teleconsultation. The statistical association was investigated between patient characteristics and decision of teleconsultation; and teleconsultation conduct suggestions and decision of teleconsultation, using Fisher's exact test and modeling was performed using binary logistic regression considering 5% of significance (p≤0.05). Results: during the period, 56 teleconsultations had a temporomandibular diagnostic hypothesis, these 79.2% patients were female and the average age was 43.7 years. In 59.1% of teleconsultations, primary care management was suggested, with 72.4% of patients being managed. An association was found between the decision of teleconsultation and referral to specialized care (p

INTRODUCTION: Developing an approach protocol for COVID-19 in pediatrics is a great challenge, since the current recommendations are much more based on the reality evidenced by cases in adults. However, a protocol that assists in the management of suspected and confirmed cases in pediatric units can be useful, despite the fact that most severe respiratory cases in children have other viruses as their main etiology. OBJECTIVES: To suggest a systematic and practical approach to children in the new coronavirus pandemic. RESULTS: Systematize, from the organization of the space for assistance, team IPE use, clinical classification, etiological, and laboratory investigation, categorization of suspected cases to the pharmacological approach. CONCLUSIONS: In the face of so many uncertainties, it is essential to organize pediatric care and mitigate risks, mistakes and anxieties during this pandemic.

The substantial increase in life expectancy of men has focused growing attention on quality-of-life issues associated with reproductive aging. Serum total and free testosterone levels in men, after reaching a peak in the second and third decade of life, decline gradually with advancing age. The trajectory of age-related decline is affected by comorbid conditions, adiposity, medications, and genetic factors. Testosterone treatment of older men with low testosterone levels improves overall sexual activity, sexual desire, and erectile function; improves areal and volumetric bone density, as well as estimated bone strength in the spine and the hip; corrects unexplained anemia of aging; increases skeletal muscle mass, strength and power, self-reported mobility, and some measures of physical function; and modestly improves depressive symptoms. The long-term effects of testosterone on major cardiovascular events and prostate cancer risk remain unclear. The Endocrine Society recommends against testosterone therapy of all older men with low testosterone levels but suggests consideration of treatment on an individualized basis in men who have consistently low testosterone levels and symptoms or conditions suggestive of testosterone deficiency.

Este estudo tem como objetivo a contextualização da luta pela terra, tomando como referência a estrutura agrária e a dinâmica da disputa territorial no Quilombo Cafundó, localizado no Estado de São Paulo, Brasil. Referimos também a formação do Cafundó e a alguns órgãos responsáveis pelas políticas públicas no quilombo e os conflitos das ações no desenvolvimento das titulações. Finalizamos com a estrutura agrária e a dinâmica da disputa territorial no Quilombo Cafundó, que atualmente é dividido por quatro áreas que estão dentro do reconhecimento e demarcação do território do quilombo. Como citar este artigo:SILVA, Lucas Bento da; MENDONÇA, Marcelo Rodrigues. Estrutura agrária e a dinâmica da disputa territorial no Quilombo Cafundó –SP – Brasil. Revista NERA, v. 23, n. 55, p. 91-110, set.-dez., 2020.

O nitrogênio (N) é um dos nutrientes mais extraídos no cultivo de cenoura. No entanto, altas doses de N pode favorecer o crescimento da parte aérea em relação a raiz da planta. A aplicação do metribuzin pode alterar a partição da biomassa em favorecimento das raízes. Desta forma, objetivou-se com esta pesquisa avaliar o efeito da aplicação de metribuzin em pós-emergência, e sua interação com nitrogênio sobre o crescimento axial e radial e produtividade das raízes de cenoura. Três experimentos foram conduzidos em campo, em distintos locais de cultivo. O delineamento experimental utilizado foi blocos casualizados, com quatro repetições, dispostos em esquema fatorial 2 x 3, composto por duas doses de metribuzin (0 e 432 g i.a. ha-1) e três doses de N em cobertura (0, 30 e 90 kg ha-1). Avaliouse o comprimento e diâmetro de raízes, massa da matéria seca da parte aérea e raiz das plantas e, a produtividade de raízes. Não houve interação entre o metribuzin e nitrogênio nas variáveis estudadas. No entanto, a aplicação de metribuzin reduziu a massa da matéria seca da raiz da cenoura devido redução do diâmetro, sem ocasionar redução da produtividade. A aplicação do metribuzin associado à fertilização de N em cobertura não influencia no crescimento axial ou radial da raiz da cenoura e, consequentemente, não altera a produtividade.

A regiao Sul de Goias vem desde o seculo XXI se transformando em uma das areas com maior expansao de area cultivada e producao de cana-de-acucar a partir de uma modificacao estrategica do capital do agronegocio canavieiro com anuencia do Estado. Desta forma, compreender as dinâmicas deste territorio que favorecem a expansao da agroindustria canavieira atraves de programas e politicas publicas, condicoes edafoclimaticas, disponibilidade hidrica, solos ferteis, considerando o mapeamento proposto pelo Zoneamento Agroecologico da cana-de-acucar (MANZATTO et al., 2009) corresponde ao objetivo desta pesquisa. Alem disso, pretende-se demonstrar que esta havendo a diminuicao da producao de alimento principalmente de arroz, mandioca, trigo e da producao leiteira no Sul Goiano concomitantemente com a expansao do agronegocio canavieiro. Esta pesquisa aponta para uma contradicao existe na literatura da area que consideram a expansao da cana-de-acucar no Sul Goiano como resultante da retracao da producao de monocultivos como a soja e o milho e da producao da pecuaria. Neste interim, considera-se que o Estado deve intervir na producao de alimentos assim como intervem na producao de commodities com financiamentos, incentivos fiscais, construcao de infraestrutura e protecionismo, para que exista soberania e seguranca alimentar.

Background Perianal fistulizing Crohn’s disease (PFCD) is the main risk factor for anal cancer in patients with inflammatory bowel disease. It is not known whether this occurs due to a higher frequency of human papillomavirus (HPV) in this population or due to the chronic inflammatory condition resulting from perianal fistulas. We aimed to evaluate whether there is a higher prevalence of HPV and high-risk HPV in patients with PFCD compared to the control group, estimate the prevalence of HPV and the subtypes most frequently associated with PFCD. Methods We performed a bicentric cross sectional study in which participants were matched by age and sex. A total of 108 patients with surgical indication for perianal fistula, were recruited, 54 patients in PFCD group and 54 patients with anorectal fistula without Crohn’s disease, from December 2018 through November 2020. These patients were subject to histological material collection during exam under anesthesia with biopsy of the fistulous pathway. The sample was sent for HPV detection and genotyping by INNO-LiPA HPV Genotyping Extra II. Results The PFCD group showed a statistically higher frequency of HPV in the fistulous path compared to control group (33.3% vs 16.7%, p = 0.046). The isolated analysis of the high-risk subtypes numerically demonstrated double the frequency in PFCD group, however, not statistically significant (18.5% vs 9.3%, p = 0.164). After multiple logistic regressions, patients with PFCD had a chance of HPV 3.42 times higher than patients without Crohn’s disease (OR = 3.42, 95% CI, 1.25–9.40), regardless of other variables. The subtypes most frequently identified in PFCD group were HPV11 (12.72%) and HPV16 (9.09%). Conclusion Perianal fistulizing Crohn’s disease is associated with a higher prevalence of HPV compared to patients with anorectal fistula without Crohn’s disease.