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Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) has emerged as a surgical option for patients with prostatic cancer in high-volume centers. The objective is to assess oncological and functional outcomes when implementing RS-RARP in a medium-volume center without previous experience of robotic surgery. This is a prospective observational single-center study. Patients operated between July 2017 and April 2020 were divided into two consecutive groups, A and B, each with 104 patients. The surgeons had prior experience in laparoscopic surgery and underwent robotic training. Positive surgical margin (PSM) status, urinary continence, and erectile function projected by Kaplan–Meier curves, together with patient reported quality of life outcomes at 12 months post-surgery were documented. Median patient age was 63 years (IQR = 59–67), overall PSM rate were 33%, 28% for pT2 disease. Pre-operative values showed no significant difference between both groups. The rate of urinary continence dropped from 81 to 78% (SE = 5.7) (Group A) and from 90 to 72% (SE = 6.3) (Group B) using the International Consultation on Incontinence Questionnaire-Short Form. Baseline sexual function was regained in 41% (Group A) and 47% (Group B) of patients. The median Expanded Prostate Index Composite-26 total score decreased from 86 to 82. These outcomes relate favorably to prior reports. There was a clinically significant decrease in median operative time in the successive groups with post-operative complications occurring in less than 2% of surgical procedures overall. A 12-month follow-up suggests that RS-RARP may be safely introduced in a medium-volume center without previous experience of robotic surgery.

Resumo O objetivo deste artigo é analisar a magnitude e o perfil das demandas judiciais por bens e serviços de saúde pública, verificando também a presença de demandas judiciais para doenças tropicais negligenciadas (DTNs) no Estado do Piauí entre 2000-2020. Estudo transversal descritivo a partir de bases de dados do Tribunal de Justiça do Piauí acerca de processos judiciais demandando bens e serviços de saúde à administração pública direta. Foram identificados inicialmente um total de 6.658 processos judiciais. Após análise de elegibilidade, 1.384 processos (20,8%) foram analisados, verificando-se aumento da demanda a partir de 2017. Ressalta-se as características: origem na capital Teresina (614; 44,4%), 40 a 59 anos de idade (372; 26,9%), sexo feminino (761; 55,0%), agricultores (123; 8,9%), assistência jurídica pública (1.063; 76,8%), julgados procedentes (594; 42,9%). Cinco (5; 0,4%) demandas judiciais para DTNs, uma leishmaniose visceral solicitando transporte, procedente; quatro para hanseníase (dois medicamentos, um concedido, outro extinto sem resolução do mérito, uma consulta e um exame, ambos concedidos). A judicialização do direito à saúde é expressiva e crescente no estado do Piauí. A baixa demanda relacionada a DTNs pode traduzir limitação de acesso não apenas à saúde, mas ao Poder Judiciário.

This article aims to analyse the magnitude and profile of legal demands for public health goods and services, also verifying the presence of legal demands for neglected tropical diseases (NTDs) in the State of Piauí between 2000-2020. Cross-sectional descriptive study based on the databases of the Court of Justice of Piauí on lawsuits demanding from the Direct Public Administration, goods and health services. A total of 6,658 lawsuits were initially identified. After eligibility analysis, 1,384 cases (20.8%) were analysed, with an increase in demand from 2017. We highlight the characteristics: origin in the capital Teresina (614; 44.4%), 40 to 59 years of age (372; 26.9%), female (761; 55.0%), farmers (123; 8.9%), public legal assistance (1,063; 76.8%), upheld (594; 42.9%). Five (5; 0.4%) lawsuits for NTDs, one visceral leishmaniasis requesting transportation, with granting, four for leprosy (two medicines, one granted, other extinguished without resolution of the merit, one consultation and one exam granted). The judicialization of the right to health is expressive and growing in the State of Piauí. The low demand related to NTDs may translate into limited access not only to health care, but also to the judiciary.

Apesar dos avanços no monitoramento espaço-temporal das chuvas, suas informações em regiões de topografia complexa são escassas. A interpolação espacial baseada em dados orbitais pode suprir tal escassez. Portanto, o estudo avaliou o desempenho de interpoladores híbrido e não híbrido na estimativa da chuva na Região Hidrográfica da Baía da Ilha Grande (RHBIG), situada na Serra do Mar, nos estados de RJ e SP. Dados de chuvas de estações de superfície e de estações virtuais, derivadas do produto CHIRPS, entre os anos 2004 e 2013, foram utilizados para geração de modelos pelos interpoladores Krigagem Ordinária (KO) e Krigagem Regressão (KR), tendo como variável explicativa o Modelo Digital de Elevação (MDE). Os resultados mostraram correlação (r = 0,68) entre os dados observados e do CHIRPS, com a taxa de chuva subestimada no litoral, média da diferença (di) de -10%, e superestimada no planalto (di = 9%), o que origina distribuição espacial suavizada. Em relação aos modelos de chuva, os KR, linear e logarítmico, tenderam a extrapolar os valores mínimos e máximos, e aumentar a taxa de chuva do litoral para o planalto, com média de -28% das estações do litoral. Enquanto, nos modelos da KO, o volume tende a diminuir do litoral para o planalto (di = -1,4), o que é corroborado por estudos já realizados na RHBIG com dados observados. Por fim, os modelos de ambos interpoladores, com as estações virtuais corrigidas pelos dados observados, mostram aumento da amplitude pluviométrica, o que diminui a suavização do modelo CHIRPS. Desta forma, os modelos da KO derivados de uma rede densa e regular de estações virtuais, corrigidas por dados observados, podem ser uma alternativa para utilização dos dados CHIRPS em locais de topografia complexa sem uma rede densa de estações de superfície, o que origina em modelos de maior resolução espacial e amplitude pluviométrica.

Complete pathological response to neoadjuvant systemic treatment (NAST) in some subtypes of breast cancer (BC) has been used as a surrogate of long-term outcome. The possibility of predicting BC pathological response to NAST based on the baseline 18F-Fluorodeoxyglucose positron emission tomography (FDG PET), without the need of an interim study, is a focus of recent discussion. This review summarises the characteristics and results of the available studies regarding the potential impact of heterogeneity features of the primary tumour burden on baseline FDG PET in predicting pathological response to NAST in BC patients. Literature search was conducted on PubMed database and relevant data from each selected study were collected. A total of 13 studies were eligible for inclusion, all of them published over the last 5 years. Eight out of 13 analysed studies indicated an association between FDG PET-based tumour uptake heterogeneity features and prediction of response to NAST. When features associated with predicting response to NAST were derived, these varied between studies. Therefore, definitive reproducible findings across series were difficult to establish. This lack of consensus may reflect the heterogeneity and low number of included series. The clinical relevance of this topic justifies further investigation about the predictive role of baseline FDG PET.

The phenomena of drought is common in the world, particularly in Pakistan. Drought in Pakistan has been studied in terms of its spatial and temporal variability, as well as its impact on the El Niño-Southern Oscillation (ENSO) cycle. The objectives of this study are to identify homogeneous rainfall regions and their trend regions, as well as the impact of ENSO cycle. For the analysis, 44 meteorological sites during 1980–2019 are used for monthly rainfall data. The descriptive and exploratory statistics tests (e.g., Pettitt and Mann-Kendall—MK), Sen method, and cluster analysis (CA) are implemented with the annual Standardized Precipitation Index (SPI). The ENSO occurrences were classified based on the Oceanic Nio Index (ONI) for region 3.4. Using the Cophenetic Correlation Coefficient (CCC) and a significance level of 5%, seven approaches were applied to the pluviometric dataset. The CCC > 0.9082 indicates that the Complete approach is the best. According to the CA method, Pakistan has four homogenous rainfall groups (G1, G2, G3, and G4). Descriptive and exploratory statistics yielded lower values for G1 than for the other groups. Pettitt's technique identified the most extreme El Niño years in terms of the drought's spatial and temporal variability. According to the Pettitt test, the wettest months were March, August, September, June, and December. Non-significant increases in Pakistan's annual rainfall were found in the MK test, with exceptions in the southern and northern regions, respectively. No significant rise in Pakistan's rainfall was found using Sen's Sen's approach, especially in the G2, G3, and G4 regions. The severity of the drought in Pakistan is made worse by months, homogeneous groups of rainfall, and El Niño events, all of which require public officials' attention while managing water resources, agriculture, and the country's economy.

O livro é um compilado de textos sobre a história colonial e imperial do Brasil.

SUMMARY OBJECTIVE: The aim of this study was to evaluate the impact of study methodology and evaluation type on the selection of studies during the presentation of scientific events. METHODS: A prospective, observational, transversal approach was applied to a cohort of studies that were submitted for presentation at the 2021 Brazilian Breast Cancer Symposium. Three forms of criteria (CR) were presented. CR1 was based on six criteria (method, ethics, design, originality, promotion, and social contribution); CR2 graded the studies from 0 to 10 for each study, and CR3 was based on five criteria (presentation, method, originality, scientific knowledge, and social contribution). To evaluate the item correlation, Cronbach’s alpha and factorial analysis were performed. For the evaluation of differences between the tests, we used the Kruskal-Wallis and post-hoc Dunn tests. To determine the differences in the study classifications, we used the Friedman test and Namenyi’s all-pairs comparisons. RESULTS: A total of 122 studies were evaluated. There was also a good correlation with the items concerning criterion 1 (α=0.730) and 3 (α=0.937). Evaluating CR1 methodology, study design and social contribution (p=0.741) represents the main factor and CR3 methodology, and the scientific contribution (p=0.994) represents the main factor. The Kruskal-Wallis test showed differences in the results (p

While most coastal communities are expected to have been negatively impacted by climate change, cephalopods have thrived with shifting ocean conditions. However, whilst benefitting from the same physiological flexibility that characterized cephalopods, cuttlefish remain bounded to specific locations by their particularly low vagility. To test the beneficial effects of climate change on cuttlefish, Species Distribution Models were applied on nine species of genus Sepia to assess distribution on present and different representative concentration pathway (RCP) scenarios (2.6, 4.5, 6.0, and 8.5; CMIP5) for the years 2050 and 2100. We show that projections of future cuttlefish distribution decrease relative to present model predictions. Harshest hit species, Sepia braggi, was observed to decline as much as 30.77% (from present 55.26% to 24.48% at RCP 8.5 in 2100), to Sepia officinalis with low maximum decrease of 1.64% (from present 59.62% to 57.98% at RCP 8.5 in 2100). Increases in habitat suitability occurred mostly at higher latitudes, while habitat decrease was predicted for the tropical regions and lower latitudinal limits of species distribution. Cuttlefish will not benefit from future changes in climate, as their habitats will decrease in suitability. If suitability of habitat translates into cuttlefish abundance, many coastal fishing communities in the global south will be affected by the future decreases in these fishing resources. Additionally, as potential “sea canaries” for coastal ecosystems, we may see many species and habitats from these systems affected by climate change, namely in tropical regions.

Background: The objective of this study was to evaluate wear and surface roughness of in vivo irradiated human enamel and dentin after abrasive challenge. Methods: Using teeth donated by healthy patients or with head and neck cancer who received radiotherapy (RT) or chemoradiotherapy (CRT), 42 enamel and dentin specimens were made, divided into three groups: control, RT and CRT (n = 14 in each group, both for enamel and dentin). The specimens were submitted to an in vitroexperimental abrasive using a brushing machine and wear and surface roughness were evaluated. Results: In enamel specimens, wear profile values of CRT and RT groups were not different from control (p-value >0.05). The RT group presents lower step values than CRT and control groups (p-value p-value >0.05). In dentin specimens, no significant difference in wear profile and step was observed in all groups (p-value >0.05). However, CRT and RT groups present higher values in final surface roughness (p-value Conclusion: The exposure to ionizing radiation (associated or not to chemotherapy) influenced the surface roughness of dentin and the wear (step) of enamel after the in vitro abrasive challenge. Trial registration: Ethical procedures were approved by the FORP/USP Research Ethics Committee (CAAE: 61308416.4.0000.5419) and Hospital do Câncer de Barretos/Fundação Pio XII (CAAE: 61308416.4.3001.5437). Clinical relevance: Considering probable effects of ionizing radiation on teeth structure, understanding the behaviour of enamel and dentin under physiological processes is important to prevent and treat adverse oral side effects related to radiotherapy.

Memory-related impairments in type 2 diabetes maybe be mediated by insulin resistance and hyperglycemia. Previous cross-sectional studies have controversially suggested a relationship between metabolic control and a decrease in hippocampal volumes, but only longitudinal studies can test this hypothesis directly. We performed a longitudinal morphometric study to provide such a direct test of a possible role of higher levels of glycated hemoglobin (HbA1C) with long term brain structural integrity in key regions of the memory system – hippocampus, parahippocampal gyrus and fusiform gyrus. Grey matter volume was measured at two different times – baseline and after ~ 7 years. We found an association between higher initial levels of HbA1C and grey matter volume loss in all three core memory regions, even in the absence of cognitive decline. Importantly, these neural effects persisted in spite of the fact that patients had significantly improved their glicemic control. This suggests that early high levels of HbA1c are irreversibly associated with subsequent long-term atrophy in the medial temporal cortex and that early intensive management is critical.

Redes, em suas diversas tipologias, são cada vez mais imprescindíveis para competitividade de organismos submetidos ao ambiente complexo da sociedade 5.0. O estudo tem por objetivo discutir a natureza das redes de relacionamento para a Gestão do Conhecimento (GC), identificando o perfil das publicações científicas no tema. Método: trata-se de artigo de abordagem qualitativa, quanto à revisão de literatura, e quali-quantitativa, quanto à análise bibliométrica, tendo objetivo descritivo. Resultados: as redes de relacionamento são percebidas como: (i) sistemáticas, (ii) dialógicas, (iii) recursivas, (iv) hologramáticas e (v) possuidoras de identidade própria. Há, entre as publicações científicas, maior prevalência de pesquisas que focam em aspectos tecnológicos das redes e na sua capacidade de transmissão de conhecimento.

Multielement concentrations (P, S, Cl, K, Ca, Cr, Mn, Fe, Ni, Cu, Zn, Rb, and Rh) and total mercury (T-Hg) were analyzed in different organs and tissues of Amazonian manatee (Trichechus inunguis). Samples of 27 T. inunguis specimens, maintained in the collection of the Amazonian Center for the Research and Preservation of Aquatic Mammals, were used, situated in an area highly impacted by gold mining in the northern region of the Brazilian Amazon. Samples of aquatic plants used as food by the animals were also analyzed. The elements S, Cl, K, Cr, and Mn accumulated mainly in the musculature, while Fe and Cu were more concentrated in the liver. Trace elements, such as rubidium (Rb) and rhodium (Rh), not previously reported in the organs of animals of the family Trichechidae, were also identified. The averages for T-Hg in the skin, muscle, encephalon, liver, kidney, and lung samples were, respectively, 0.1540 ± 0.1332, 0.0593 ± 0.1044, 0.0517 ± 0.0467, 0.0486 ± 0.0543, 0.0237 ± 0.0336, and 0.0013 ± 0.0032 µg.g

The present study mainly aimed to make a statistical survey of extreme precipitation events for the eastern region of the Brazilian Northeast, more specifically for the city of Maceió/AL. For this purpose, punctual data from INMET Automatic Meteorological Stations were used, and spatial data using satellite images and hydro-estimator data provided by CPTEC/INPE. The main results were based on daily precipitation data and quantile technique, it generated the following R(mm) classes: Dry Day R < 2.4mm, Drizzle Rain 2.4 ≤ R < 3, 8mm, Showers 3.8 ≤ R < 7.6mm, Moderate Rain 7.6 ≤ R < 14.4mm, Heavy Rain 14.4 ≤ R < 39.8mm, Strong Rain 39.8 ≤ R < 82.8mm, Extreme Rain R ≥ 82.8mm. The method adopted for classifying extreme rainfall (Strong more Extreme) using quartiles proved to be efficient, made by the association between extreme precipitation events and natural disasters using the records of the State of Public Calamity (SPC) degree, that is, the indicators recognition of SPC and annual accumulated average precipitation, point to the possibility of occurrence of hydrometeorological disasters for the city of Maceió/AL. Regarding the spatial distribution of the number of cases of Strong and Extreme, for Alagoas the municipalities with the most recorded occurrences were Japaratinga, Porto de Pedras, Maceió, among others. For the city of Maceió/AL, the region R5 (Ipioca and Pescaria) and R2 were the ones that presented the most cases of rainfall ranging from very strong to extreme.

Spinal cord injury continues to be, unarguably, a largely convoluted challenge of modern medicine, leaving millions of patients worldwide with devastating lifetime consequences. Currently, there are not medical treatments capable of efficiently and completely restoring lost autonomous, motor and/or sensory functions. In this context, along with the development of a next generation of biomedical platforms, the inclusion of graphene-based materials into neuroprotective and neuroregenerative strategies has potential to boost the structural and physiological recovery of the injured spinal cord. Particularly, these nanomaterials are updating important principles of tissue engineering concerning the development of biocompatible scaffolds suitable for replacing damaged neural microenvironments in a near-future scenario. In this work, a new design concept is used to fabricate graphene composites with fibrous-porous architectures able to support enhanced interactions with neural cells. In detail, electrospun nanofibres were accommodated onto the surface of reduced graphene oxide sheets to generate combinatorial 3D systems. The physiochemical and biological features of fibrous-porous constructs were associated with the properties of their nanofibrous coatings, resulting, consequently, in unique microenvironments capable of supporting highly viable, mature and interconnected neural circuits in vitro. Due to their enhanced performance, these graphene composites were further adapted to recreate the gray matter of the spinal cord, becoming a key component of a new biomimetic scaffolding methodology. In this way, for ensuring a spatial organization resembling the native spinal cord, where the center of gray matter is surrounded by white matter, the selected fibrous-porous graphene composite was incorporated within a 3D nanofibrous framework. Furthermore, specific regions of this biomimetic framework were loaded with polycaprolactone-chitosan nanofibres and polycaprolactone-graphene microfibers with the purpose of mimicking the white matter. After in vitro and ex vivo tests, the final biomimetic scaffold was then implanted into hemisected rats for 4 months, after which it was possible to observe promising neuroprotective and neuroregenerative features together with encouraging signs of forelimb function recovery. Based on these findings, the reported biomimetic graphene-based scaffolds hold potential to integrate advanced therapeutic strategies for countering spinal cord injury. A lesão da medula espinal continua a ser indiscutivelmente um grande desafio da medicina moderna, provocando efeitos devastadores e permanentes a milhões de pacientes por todo o mundo. Não existem atualmente tratamentos médicos capazes de restaurar, de uma forma eficaz e completa, as funções sensoriais, motoras e/ou autónomas danificadas/perdidas depois desta lesão. Neste contexto, e seguindo o desenvolvimento da próxima geração de plataformas biomédicas, a inclusão de grafeno e materiais derivados em estratégias de neuroproteção e neurorregeneração tem mostrado potencial para estimular a recuperação estrutural e fisiológica do tecido medular lesionado. Particularmente, estes nanomateriais têm impulsionado princípios importantes da engenharia de tecidos aplicados no desenvolvimento de suportes celulares biocompatíveis denominados scaffolds, com o intuito de garantir, num futuro próximo, a substituição de microambientes neurais danificados. Neste trabalho é apresentada e validada uma nova metodologia para fabricar compósitos de grafeno com uma arquitetura fibrosa-porosa apta a promover interações otimizadas com células neurais. Em detalhe, nanofibras poliméricas fabricadas através de eletrofiação foram distribuídas pela superfície de folhas de óxido de grafeno reduzido com o intuito de gerar sistemas combinatórios 3D. Foi demonstrado que as propriedades biológicas e físico-químicas das construções fibrosas-porosas dependiam das características do revestimento nanofibroso utilizado, o que resultou, consequentemente, em scaffolds únicos capazes de acomodar circuitos neurais maduros altamente viáveis e interconectados in vitro. A performance auspiciosa destes compósitos de grafeno levou à sua adaptação com o objetivo de recriar a matéria cinzenta da medula espinal numa nova estratégia biomimética de engenharia de tecido neural. Para assegurar a organização espacial característica da medula, onde o centro de matéria cinzenta está rodeado por matéria branca, o compósito fibroso-poroso de grafeno selecionado foi incorporado no interior de um sistema nanofibroso 3D. Nesta construção biomimética, com vista à simulação da matéria branca, foi também integrado um sistema formado por nanofibras de policaprolactona e quitosano e microfibras de policaprolactona e grafeno. Depois de testado in vitro e ex vivo, o scaffold final foi implantado em ratazanas paralisadas com uma hemissecção cervical e, após 4 meses, foi possível observar impactos positivos na neuroproteção e neurorregeneração do tecido medular. Desta forma, e também considerando os resultados promissores associados à recuperação comportamental dos animais intervencionados, é possível constatar o potencial destes scaffolds de grafeno em integrar estratégias terapêuticas avançadas suscetíveis de contrariar os efeitos adversos da lesão da medula espinal. Programa Doutoral em Nanociências e Nanotecnologia

Knowledge Management Methods, Techniques and Tools (MTF GC): PPGEGC-UFSC Course Material. Material developed by the ENGIN laboratory, from the Department of Engineering and Knowledge Management (PPG-EGC) of the Federal University of Santa Catarina (UFSC), under the coordination of Prof.Dra. Patrícia de Sá Freire, for training knowledge managers in public and private organizations of all sizes. In particular, with the aim of enabling the preparation of the Knowledge Map and the respective plan of coordinated actions for knowledge management, identifying good practices More information at: https://engin.ufsc.br/

Protocol proposal (preferential list of items to be reported) for Scope Review that seeks to describe the profile of scientific studies, with empirical evidence, on the governance of institutions, systems, actions and concrete programs of public security and social defense.

Scope review project, based on the Prisma-ScR protocol, which seeks to synthesize the main results, themes, theories and good practices recorded by primary scientific research on Public Security Governance and Social Security (Gov.SPDS).