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Introduction: coronavirus 2019 Disease (COVID-19) was quickly declared a pandemic, and Brazil is facing the most significant health and hospital crisis in its history. From March to June 2021 represented 50.8% of all deaths in the State of Espirito Santo. Objective: to analyze the lethality and mortality by COVID-19 in the State of Espirito Santo from March 2020 to June 2021. Methods: an ecological study was carried out, using a time series of public and official data available on the Health Department of the State of Espirito Santo, Brazil. Were considered information about cases and deaths (from March 2020 to June 2021) of COVID-19. Percentage case-fatality and mortality and incidence rates per 100,000 population were calculated. Time-series analyses were performed using the Prais-Winsten regression model, estimating the Daily Percent Change (DPC), and the trends were classified as flat, increasing, or decreasing. Significant differences were considered when p

Introduction: the initial spread of the pandemic in Brazil was mainly affected by patterns of socioeconomic vulnerability. It should be noted that the Central-West region of Brazil is one of the regions with the lowest number of cases, but the states of this region together have the highest mortality rate of COVID-19 in the country. Goiás was the most affected state of this region, with the highest number of deaths in the area. Objective: to assess the incidence of mortality and lethality caused by COVID-19 from March 2020 to June 2021 in the State of Goiás, Brazil. Methods: an ecological study, using a series of time series of public and official data of the Department of Health of the State of Goiás, Brazil. Information was collected on cases and deaths from COVID-19 from March 2020 to June 2021. Mortality, case fatality, and incidence rates were calculated. The Prais-Wisten regression model was used to build time series. The daily percent change (DPC) and the effective reproductive number (Rt) were estimated. Results: Goiás had a predominance of a greater viral spread during the first and the beginning of the second wave, with Rt higher than 1. The second wave from December 2020 to June 2021 was more lethal and had higher mortality rates than the first wave. It was observed, higher scores of case fatality and mortality belonged to males and the elderly. Conclusion: an analysis of mortality and case fatality rates helps understand the COVID-19 pandemic behavior in Goiás. It is essential to monitor epidemiological indicators and strengthen intervention strategies to contain the pandemic in this state.

Introduction: Inserted in the vulnerable context of the Brazilian Amazon, the state of Tocantins has suffered damages with the dissemination of COVID-19 in its territory; however, little evidence is published from this state. Objective: This study aims to analyze the case-fatality, mortality, and incidence of COVID-19 in Tocantins. Methods: This is an ecological study, population-based, time-series analysis of COVID-19 cases and deaths in the state of Tocantins from March 2020 to August 2021. Results: During the examined period, 219,031 COVID-19 cases, and 3,594 deaths were registered due to disease. Two possible occurrence peaks were characterized in this time-series analysis. Remarkably, the Second Wave had the highest lethality rates (3.02% - April 2021), mortality (39.81 deaths per 100,000 inhabitants – March 2021), and incidence (1,938.88 cases per 100,000 inhabitants – March 2021). At the end of the period, mortality, incidence, and lethality showed flat trends, suggesting a positive outcome of the vaccination program. Conclusion: The prevention, surveillance, and control actions of COVID-19 cases in Tocantins State have been directed to mitigate the deleterious effects of the pandemic. Nevertheless, efforts are still needed to decrease lethality, mortality, and incidence trends, and ultimately to achieve control of the COVID-19 pandemic in the region.

Learning-by-doing is a pedagogical approach that helps in learning skills through practice. An online learning-by-doing tool, CodeLab, has been introduced to students undertaking the digital design and creation bachelor’s degree program at the Universitat Oberta de Catalunya. The tool has been used to facilitate and engage students, not well-acquainted with problem-solving techniques, in an introductory programming course. The aim of this study was to examine the factors that play vital roles in students’ acceptance of learning-by-doing tools that facilitate the development of problem-solving skills. The Unified Theory of Acceptance and the Use of Technology (UTAUT) model was used for this purpose and extended by adding the factor of motivation, which is essential for educational contexts. The results highlight that there is a strong relationship between acceptance and motivation, implying that students would use online learning-by-doing tools, such as CodeLab, depending on the amount of motivation and engagement while practicing the learning activities. A positive relationship between motivation and acceptance clearly supports the primary aim of using learning-by-doing tools in problem-solving courses.

La identidad cultural es lo que hace ricos a los pueblos de una nación, es por ello que el Estado debe invertir en el rescate de su biodiversidad, cultura, tradiciones y gastronomía; se debe revalorizar el legado que dejan los antepasados y no permitir que se desvanezca lo que por derecho les pertenece. Este ensayo académico está basado en la revisión de fuentes documentales, en el mismo se observa las posturas de los arqueólogos, historiadores e investigadores que estudiaron las culturas ecuatorianas como es el caso de Meyers (1998); Holm (1981); Ayala (2017); Perez (1975); y Pazos (2008), entre otros. Se busca conocer más profundamente las prácticas culturales, agrícolas, y gastronómicas de las culturas Milagro Quevedo y Manteño Huancavilca, de la región costa; la cultura Caranqui de la región sierra y Shuar del oriente ecuatoriano, y los vestigios culturales que nos heredaron, para analizar desde un punto de vista valorativo la relación existente entre la naturaleza y el hombre, así como las costumbres que, a pesar de los años se mantienen vigentes en nuestra sociedad, formando las tradiciones ancestrales que dignifican nuestro origen como pueblo latinoamericano y dan sentido a la diversidad cultural de nuestro país.

Background: Cardiopulmonary arrest (CPA) is a severe public health problem and a leading cause of death worldwide. According to the American Heart Association (AHA), basic life support (BLS) is the bedrock for improving people's survival after a cardiac arrest, and cardiopulmonary resuscitation is crucial. Through scientific evidence, empowering health professionals focuses on education in resuscitation is vital to identify and attend a CPA victim. In Brazil, there is a lack of data that evaluates the BLS knowledge of health science students. This study analyzed the knowledge retention of medicine, nursing, and physiotherapy students after one year of having a lecture-demonstration on BLS. Method: Longitudinal study. Undergraduate students of health science participated in the data collection and answered a questionnaire based on BLS following AHA guidelines. Data were collected during two consecutive years, in three different moments (an assessment, a test after a lecture, and an assessment test one year later). Results: The group improved its score after the class on BLS; the number of correct answers doubled (p

Chronic kidney disease(CKD) is defined as an EGFR(Estimated glomerular filtration rate) < 60 ml/min/1.73 m2 or an EGFR ≥60 ml/min/1.73 m2 together with albuminuria (≥30 mg/g).It causes significant mortality and morbidity. It is a silent killer. The prevalence of CKD has been increasing worldwide. There are many established risk factors for chronic kidney disease, the two most important ones being hypertension and diabetes mellitus(DM). In this systematic review, we aim to know the roles of hypertension (HTN) and diabetes in the progression of chronic kidney disease. We did a detailed search on PubMed and found 1216 articles screened, and finally, 20 articles were chosen for study. As we analyzed, we observed that most studies showed that diabetes and hypertension have a positive association with the progression of CKD, even though the exact mechanism or link has not been explained in the studies we reviewed.

Most patients with sickle cell disease (SCD) seek hospital care because of pain symptoms. While some patients opt to treat themselves at home, some prefer to seek treatment in a hospital setting. There are, however, some patients with more complicated effects of the disease who seek treatment so often that they have been termed "super-users." This paper seeks to determine, across the board, the treatments available for vaso-occlusive crisis (VOC), the most common complication of SCD. Due to the frequency and unpredictable nature of VOC, it is no surprise that the lives of so many patients dealing with SCD are constantly disrupted by this complication. Treatments that reduce the frequency of VOC and the need for hospital admissions will help these patients find some semblance of balance in their quality of life.

La presente investigación tuvo como propósito determinar las representaciones utilizadas por los estudiantes de primer año cuando resuelven problemas matemáticos del mundo físico y social de la Unidad Educativa “El Molino”. El estudio se fundamentó en los organizadores curriculares desarrollados por Rico (1997), los cuales son necesarios para que los estudiantes integren con sentido los nuevos conocimientos y se apropien de ellos. El paradigma fue cualitativo, con un enfoque interpretativo, basado en estudio de casos, donde se aplicó la entrevista en profundidad y cuestionario de problemas matemáticos, específicamente a treinta (30) estudiantes que sirvieron de informantes clave. Concluyendo, es necesario abordar los contenidos matemáticos a través de la resolución de problemas reales, que preparen a los estudiantes para conocer su entorno; además, formar a los estudiantes para el estudio del álgebra, pues el sistema más utilizado por los mismos fue el verbal y numérico, el cual contribuyen en desarrollar un pensamiento crítico.

Wounds with delayed or impaired healing represent a considerable challenge in medical practice. These patients develop a sustained hypermetabolic and catabolic state, directly impacting the wound healing process. The use of oxandrolone has been studied to control this metabolic imbalance and protect lean body mass as a beneficial resource in wound healing. This systematic review aims to analyze previously conducted randomized controlled trials to evaluate the evidence of the applicability of oxandrolone therapy. We compared its use in adult patients with burns and adult patients with pressure ulcers in terms of wound healing and healing time of the skin graft donor site in days. The digital searches were done from March 23-28, 2022, within the databases: Google Scholar, PubMed/MEDLINE, and EBSCO (Elton B. Stephens Company). Data from six studies were analyzed and included in this review. Analysis of the available data demonstrated a significant advantage in skin healing using oxandrolone in adult burn patients as an adjunct. For adult patients with pressure ulcers, the drug showed no benefit on wound healing and skin graft site healing. Importantly, we found only one study evaluating the use of oxandrolone in patients with decubitus ulcers that met our eligibility criteria, and the certainty of the evidence was low. Thus, further prospective randomized studies with larger samples and standard wound care protocols are needed to produce more solid results, allowing more definitive conclusions to be made on this theme.

To achieve adequate airway management in maxillofacial procedures, the right intubation technique should be employed. This is because the surgeons and the anesthesiologists will need to work in the same surgical field to ensure a successful procedure. The type of intubation method used can either complicate either's role or pose some difficulties in the surgery itself. Nasotracheal intubation and orotracheal intubation may often be contraindicated in different types of maxillofacial surgeries and due to the complications associated with a tracheostomy, this method is often utilized as a last resort. Submental intubation has become very popular and favored alternative and has been associated with fewer complications. This literature review was conducted to explore the indications, complications, and contraindications of the different intubation methods. Sources were gathered from PubMed Central, PubMed, and Google scholar and included articles published between 2012 and 2022. A mix of literature reviews, case base studies, retrospective studies, prospective studies, and a few systematic reviews were examined. It was found that the use of submental intubation was preferred due to its less invasive nature, minimal intraoperatively and postoperatively complications, and greater patient compliance compared to tracheostomy. In addition, it is the best method when Nasotracheal intubation is contraindicated.

Neurogenic heterotopic ossification (NHO) is the formation of mature lamellar bone in peri-articular tissues following a neurological insult, most commonly traumatic brain injury (TBI) or spinal cord injury (SCI). NHO is a debilitating condition associated with significant morbidity and reduced quality of life. However, its pathophysiology remains poorly understood. While surgery is the mainstay of treatment once NHO has been diagnosed, prophylactic options are limited and not well studied. This review aimed to determine the efficacy of various interventions used in the primary prevention of NHO. We conducted an electronic literature search using five databases (PubMed, Embase, ScienceDirect, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) for records published until April 10, 2022. We identified 2,610 potentially eligible records across all databases. Nine reports met our eligibility criteria and were included in this review. Four were clinical trials (three randomized control trials, one nonrandomized trial), four were observational studies, and one was a systematic review/meta-analysis. The medications/interventions used included: warfarin, pulse low-intensity electromagnetic field therapy (PLIMF), bisphosphonates, and nonsteroidal anti-inflammatory drugs (NSAIDs). We did not find conclusive evidence to recommend the use of bisphosphonates and warfarin in the prevention of NHO. On the contrary, we found NSAIDs and PLIMF as effective prophylactic options based on the results of high-quality randomized control trials. Further prospective randomized studies with prolonged follow-ups are needed to confirm the long-term efficacy of these preventive interventions.

Colorectal cancer (CRC) is a malignant condition of the colon and rectum. Generally, malignancies constitute a significant health threat to humans, and the result can be devastating. CRC is no exception. The gastrointestinal (GI) microbiome has long been suspected of impacting CRC. This review seeks to explore whether there is a connection between the two or not. For screening purposes, relevant articles were culled from various databases using key terms and phrases. Following a thorough search, the inclusion and exclusion criteria were applied, and a quality assessment was conducted. The articles retained were comprehensively studied, and revealed imbalances of the GI microbiome do indeed exhibit an association with CRC.

Coronaviruses (CoV) make up a large family of viruses, known since the mid-1960s, which received this name due to the spikes on its surface, which resemble a crown (from the Latin corona). CoV infections can cause everything from a common cold to severe respiratory syndromes, such as severe acute respiratory syndrome (SARS-CoV) and Middle Eastern respiratory syndrome (MERS-CoV). COVID-19 is a new variant of the coronavirus, and its isolation occurred in China on January 7th, 2020. COVID-19 has stood out with a high impact on public health due to the high number of cases with infection in a short period of time. However, it is possible to observe that 17% of patients confirmed with COVID-19 have severe infections and about 2.5% of these patients die. Current studies have shown that the number of mild and asymptomatic cases may be even greater. Thus, the challenges for controlling unreported cases of patients with mild symptoms that are spreading the virus and interfering with the magnitude and real data of the cases stand out. The transmission of the coronavirus occurs between humans, and it can occur from person to person through the air, through coughing or sneezing, by touching or shaking hands or by contact with contaminated objects or surfaces, followed by contact with the mouth, nose or eyes. Given the fluctuation in the incidence and the lethality rate, it is essential to stand out the precepts of health promotion in search of reorienting hygiene practices, considering that there is validity in health care models, still with a curative approach and the current situation experienced by the world population requires a preventive stance.

El trastorno por déficit de atención con hiperactividad (TDAH), es una deficiencia crónica del neurodesarrollo que afecta el comportamiento, atención y aprendizaje de los niños y adolescentes. En estos pacientes la deficiencia de higiene oral es directamente proporcional a sus trastornos conductuales, a la falta de acompañamiento de los padres o tutores y al desconocimiento o diagnóstico tardío o erróneo del odontólogo. Objetivo: Describir el estado de salud bucal asociado al trastorno por déficit de atención con hiperactividad (TDAH) en niños y adolescentes con el propósito de generar información actualizada que permita prevenir de manera temprana y actuar en los problemas de salud. Metodología: Mediante el análisis documental se identificaron instituciones, autores y filiación. En el análisis de los contenidos se observó que; en términos de salud bucal y TDAH, proporcionan información en dos ejes centrales: salud bucal y TDAH. Mediante la revisión de información en bases de datos científicas especializadas en el área de la salud bucal que se llevó a cabo en tres bases de datos: PubMed, Web of Science, Cochrane. Conclusión: Es necesario fortalecer el cuidado de la salud bucal y la atención odontológica de pacientes con hiperactividad a partir de diferentes perspectivas, ya que es el primer factor de riesgo en caries. Es importante conocer su manejo clínico para así mejorar la calidad de vida en pacientes con TDAH. &nbsp

A variety of tools are available to collect, process and analyse learning data obtained from the clickstream generated by students watching learning resources in video format. There is also some literature on the uses of such data in order to better understand and improve the teaching-learning process. Most of the literature focuses on large scale learning scenarios, such as MOOCs, where videos are watched hundreds or thousands of times. We have developed a solution to collect clickstream analytics data applicable to smaller scenarios, much more common in primary, secondary and higher education, where videos are watched tens or hundreds of times, and to analyse whether the solution is useful to teachers to improve the learning process. We have deployed it in a real scenario and collected real data. Furthermore, we have processed and presented the data visually to teachers for those scenarios and have collected and analysed their perception of their usefulness. We conclude that the collected data are perceived as useful by teachers to improve the teaching and learning process.

En este video se desarrolla el proceso del relleno y obturación de conductos, última fase del tratamiento endodóncico y del que depende el éxito del mismo. La técnica descrita será la de la obturación lateral que se realiza con instrumentos manuales y puntas de gutapercha compactadas en frío mediante la presión aplicada por los condensadores manuales o digitales. La casi nula capacidad de respuesta y recuperación del tejido pulpar, hace que, ante determinados procesos infecciosos o inflamatorios, si se quiere mantener el diente, sea necesaria la realización de una endodoncia previa a la restauración del mismo. El conocimiento de las técnicas básicas de instrumentación, obturación, así como la apertura de cámara de dientes anteriores y posteriores es muy importante en el tratamiento conservador dental.

En este video se reproduce la secuencia que el alumno debe realizar en las prácticas preclínicas para el comienzo de un tratamiento endodóntico en dientes del sector posterior, desde su selección y montaje en escayola hasta la localización y permeabilización del o los conductos que tenga. La casi nula capacidad de respuesta y recuperación del tejido pulpar, hace que, ante determinados procesos infecciosos o inflamatorios, si se quiere mantener el diente, sea necesaria la realización de una endodoncia previa a la restauración del mismo. El conocimiento de las técnicas básicas de instrumentación, obturación, así como la apertura de cámara de dientes anteriores y posteriores es muy importante en el tratamiento conservador dental.

En este video se describen los pasos a seguir para el tallado de una cavidad de clase II situada en la superficie proximal de un molar y su posterior obturación con resina compuesta, describiendo los pasos en el uso de la técnica adhesiva así como en la secuencia de inserción del material para conseguir una correcta obturación y el empleo de matrices y cuñas apropiadas para una correcta consecución de un punto de contacto adecuado y su posterior recortado y pulido

En este vídeo se describen los pasos a seguir para el tallado de una cavidad de clase V situada en el tercio cervical de la superficie vestibular y su posterior obturación con resina compuesta. Este tipo de lesiones pueden ser debidas tanto a lesiones por caries como a otros procesos de perdida de tejido dental como son las abrasiones, atricciones y erosiones. En el video queda resaltada la importancia de la secuencia de colocación del composite para evitar despegamientos y caídas del material. El composite o resina compuesta es actualmente el material de elección a la hora de realizar tratamientos restauradores directos en patologías como la caries y otras lesiones que cursan con pérdida de tejido dental. Conocer sus características, indicaciones, puntos débiles y fuertes, así como su manejo clínico es fundamental en la operatoria dental del presente.

En este video se describen los pasos a seguir para el tallado de una gran cavidad que afecta a varias superficies de un molar y que no se engloba en ninguno de las clases cavitarias clásicas, así como su posterior obturación con amalgama de plata. Debido a la gran destrucción que se ha producido, y dado que la amalgama no es un material adhesivo per se, se describen diferentes formas de conseguir una mayor estabilidad y retención del material restaurador en la cavidad (Amalgama Adherida y sistemas de anclajes complementarios: rieleras). La amalgama de plata es un material con unas grandes propiedades mecánicas y un excelente comportamiento clínico. A pesar de su bajo nivel de estética y su potencial toxicidad medioambiental, sigue siendo un material versátil y con aplicaciones clínicas claras que pueden ser necesarias en ciertas circunstancias clínicas. Por este motivo es importante conocer su comportamiento, indicaciones, manejo, y técnicas de utilización.

En este vídeo se describen los pasos a seguir para el tallado de una cavidad de clase II situada en la superficie proximal de un molar y su posterior obturación con amalgama de plata, haciendo hincapié en los requisitos planimétrico que debe tener la cavidad para conseguir un obturación resistente y duradera, evitando tanto el debilitamiento excesivo del diente así como el del material. Se describirá también el empleo de matrices y cuñas apropiadas para la reproducción de un correcto punto de contacto es como de un reborde marginal funcional. La amalgama de plata es un material con unas grandes propiedades mecánicas y un excelente comportamiento clínico. A pesar de su bajo nivel de estética y su potencial toxicidad medioambiental, sigue siendo un material versátil y con aplicaciones clínicas claras que pueden ser necesarias en ciertas circunstancias clínicas. Por este motivo es importante conocer su comportamiento, indicaciones, manejo, y técnicas de utilización.

Learning analytics is quickly evolving. Old fashioned dashboards with descriptive information and trends about what happened in the past are slightly substituted by new dashboards with forecasting information and predicting relevant outcomes about learning. Artificial intelligence is aiding this revolution. The accessibility to computational resources has increased, and specific tools and packages for integrating artificial intelligence techniques leverage such new analytical tools. However, it is crucial to develop trustworthy systems, especially in education where skepticism about their application is due to the risk of teachers’ replacement. However, artificial intelligence systems should be seen as companions to empower teachers during the teaching and learning process. During the past years, the Universitat Oberta de Catalunya has advanced developing a data mart where all data about learners and campus utilization are stored for research purposes. The extensive collection of these educational data has been used to build a trustworthy early warning system whose infrastructure is introduced in this paper. The infrastructure supports such a trustworthy system built with artificial intelligence procedures to detect at-risk learners early on in order to help them to pass the course. To assess the system’s trustworthiness, we carried out an evaluation on the basis of the seven requirements of the European Assessment List for trustworthy artificial intelligence (ALTAI) guidelines that recognize an artificial intelligence system as a trustworthy one. Results show that it is feasible to build a trustworthy system wherein all seven ALTAI requirements are considered at once from the very beginning during the design phase.

8 pages, 2 figures, 1 table, supplementary data https://www.dropbox.com/s/1b2dvesbjso3dmf/23575_Mapstone%20et%20al_video.avi?dl=0, The rarely observed cystonect siphonophore Bathyphysa conifera was recorded for the first time in shallow depth water (- 16 m) as a live specimen, at the entrance to the Mediterranean Sea by SCUBA divers. It is a delicate oceanic species, with earlier records coming mostly from deep water, where it readily adheres to deep sea fishing cables and nets, causing painful stings to fishermen. Deep water sightings from ROVs include in the North Atlantic, off Angola, the Gulf of Mexico, and Monterey Canyon. The present specimen was swimming actively by contracting and expanding its stem, in a yo-yo movement. A review of all reliable records for this species worldwide has been carried out to gain a better knowledge of the present known distribution of this species, both geographical and bathymetric. Bathyphysa conifera may possibly represent an important component of the food web and be perhaps also a competitor to fish in the regions it inhabits, With the funding support of the ‘Severo Ochoa Centre of Excellence’ accreditation (CEX2019-000928-S), of the Spanish Research Agency (AEI)

Several tools and resources have been developed in the past years to enhance the teaching and learning process. Most of them are focused on the process itself, but few focus on the assessment process to detect at-risk learners for later acting through feedback to support them to succeed and pass the course. This research paper presents a case study using an adaptive system called Learning Intelligent System (LIS). The system includes an Early Warning System and tested in a fully online university to increase learners’ performance, reduce dropout, and ensure proper feedback to guide learners. LIS also aims to help teachers to detect critical cases to act on time with learners. The system has been tested in two first-year courses in the fully online BSc of Economics and Business at the Universitat Oberta de Catalunya. A total of 552 learners were participating in the case study. On the one hand, results show that performance is better than in previous semesters when using it. On the other hand, results show that learners' perception of effectiveness is higher, and learners are willing to continue using the system in the following semesters because it becomes beneficial for them.

Artificial intelligence (AI) has penetrated every layer of our lives, and education is not immune to the effects of AI. In this regard, this study examines AI studies in education in half a century (1970&ndash, 2020) through a systematic review approach and benefits from social network analysis and text-mining approaches. Accordingly, the research identifies three research clusters (1) artificial intelligence, (2) pedagogical, and (3) technological issues, and suggests five broad research themes which are (1) adaptive learning and personalization of education through AI-based practices, (2) deep learning and machine Learning algorithms for online learning processes, (3) Educational human-AI interaction, (4) educational use of AI-generated data, and (5) AI in higher education. The study also highlights that ethics in AI studies is an ignored research area.