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O objetivo deste artigo é analisar se existem evidências em pesquisa conclusas de que as formas a alfabetização e o letramento bilingues podem influenciar na vida de um aluno. Partindo deste pressuposto empírico que essa metodologia de ensino possa ser realmente benéfica para os educandos, analisaremos com base em livros, artigos, experiencias cientificas se essa teoria se confirma na prática didática e quais os possíveis benefícios que essa metodologia pode ofertar. O artigo trabalhou com duas hipóteses: a) a alfabetização e o letramento bilingues causa problemas no processo de ensino retardando o desenvolvimento cognitivo dos estudantes b) a alfabetização e o letramento bilingues é um importante processo de desenvolvimento cognitivo dos estudantes. Para chegar ao resultado da hipótese será realizada a análise da obtenção das competências da linguagem escrita e verbal em ambos os idiomas. A análise foi realizada mediante revisão bibliográfica de artigos realizados com base em experimentos sociais realizados em diversos contextos escolares. Como resultados das revisões biográficas foi contatado que a hipóteses que a alfabetização e o letramento bilingue atrapalhariam o desenvolvimento intelectual das crianças foi refutado pelos métodos científicos, quanto a análise dos benefícios foi contado diversos benefícios, tais como, aumento da habilidade cognitiva, facilidade em adquirir novas competências linguísticas e ampliação das oportunidades de emprego.

Contextualização e Objetivos: O conceito de nódulo sentinela permitiu a seleção de pacientes com cancro da mama pN+ para submissão a disseção axilar completa. Contudo, a maioria não possuía nódulos axilares adicionais envolvidos. Portanto, vários centros desenvolveram decisões clínicas, baseadas em variáveis clínicas e patológicas, para assistir na decisão de realizar disseção axilar. O objetivo do nosso estudo seria avaliar a regra de decisão clínica do Centro Hospitalar Universitário São João no Porto e comparar os resultados da mesma com os resultados do critério do estudo implementado pelo Grupo Oncológico do Colégio Americano de Cirurgiões Z0011. Métodos: Realizamos uma análise retrospetiva de séries consecutivas de pacientes com cancro da mama com nódulo sentinela positivo, tratadas entre 2012 e 2019. Resultados: Dentro das 418 pacientes incluídas, 173 (41.4%) foram submetidas a disseção axilar e 245 (58.6%) foram poupadas. No grupo submetido a disseção axilar, nódulos não sentinela positivos foram encontrados em 89 pacientes (51.4%). No grupo poupado de disseção axilar, duas pacientes (0.8%) tiveram recorrência nodular axilar. Conclusão: Em pacientes com cancro da mama e nódulo sentinela positivo, a aplicação da regra de decisão clínica do Centro Hospitalar Universitário de São João reduziu a taxa de disseção axilar para 41.4%, baixando a morbilidade no braço e ombro, provocadas por este procedimento invasivo, enquanto manteve uma reduzida probabilidade de recorrência regional. Background and Objectives: The sentinel node (SN) concept allowed the selection of pN+ breast cancer (BC) patients to undergo complete axillary dissection (AD). However, the majority do not have additional axillary nodes involved. Therefore, some centres developed clinical decision rules (CDR), based on clinical and pathology variables, to assist in the decision to perform AD. The aim of our study was to evaluate the CDR of the Breast Center of the Centro Hospitalar Universitário São João in Porto (CHUSJ) and to compare its results with the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial criteria. Methods: We performed a retrospective analysis of a consecutive series of SN-positive BC patients, treated between 2012 and 2019. Results: Among the 418 included patients, 173 (41.4%) were submitted to AD and 245 (58.6%) were spared. In the group submitted to AD, additional positive non-sentinel nodes (NSN) were found in 89 patients (51.4%). In the group spared to AD, two patients (0.8%) had an axillary lymph node recurrence. Conclusions: In BC patients with a positive SN, applying the CHUSJ-CDR reduced the rate of AD to 41.4%, lowering arm and shoulder morbidity caused by this invasive procedure while maintaining a reduced probability of regional recurrence.

Several cases of paediatric acute hepatitis of an unknown aetiology have been described in these last few months and in several countries worldwide. We present two patients, a 7-month-old girl and an 8-year-old boy, with gastrointestinal symptoms and lethargy, associated with elevation of transaminase levels. Serologies for hepatitis A-E virus and PCR test to SARS-CoV-2 were all negative. In the first case, an adenovirus serotype C could be isolated in a respiratory sample as well as cytomegalovirus (CMV) in the blood (100 copies/mL). In both children, there was a progressive decrease in the hepatic markers and symptomatic resolution, compatible with a good prognosis, also seen globally in most cases. To date, infection remains the most plausible cause to consider, especially when it is presumed to be linked to adenovirus. Other potential agents and causes are still being evaluated, thus emphasizing the importance of continuous epidemiological surveillance, notification, and detailed study of all hepatitis cases.

Dissertation presented as the partial requirement for obtaining a Master's degree in Data Science and Advanced Analytics, specialization in Data Science Learning management systems are essential intermediaries between students and educational content in the digital era. Among other factors, the institutional adoption of such systems is meant to foster student engagement and lead to better educational outcomes in a scalable manner. However, a significant challenge facing educators and institutions is the timely identification of students who may require special attention and feedback. Early identification of students allows educators to provide necessary feedback and adopt suitable corrective measures. Therefore, a significant body of research has been dedicated to developing early warning systems with clickstream data. However, comprehensive studies that attempt prediction on multiple courses are few and far between. Moreover, most predictive models require sophisticated domain knowledge, data skills and computational power that may not be available in practice. In this work, we used an academic year’s worth of data collected from all courses at a Portuguese information management school to perform two main experiments on two binary classification problems: the first being students at risk vs students not at risk and the second being high-performing students vs not high-performing students. In the first experiment, we compared the performances obtained with traditional machine learning classifiers against majority class classifiers at multiple stages of course completion (more specifically, the 10%, 25%, 33%, 50% and 100% course completion thresholds). For both classification problems, performances on all metrics peaked when using all of the data collected throughout the course – 88.6% accuracy and 92.3% Area Under the Receiver Operating Characteristic (AUROC) using Random Forest (RF) for students at risk and 78.2% accuracy and 79.6% AUROC using ExtraTrees for high-performing students. Concerning early prediction, acceptable performances for classifying at-risk students are achieved as early as the 25% course duration threshold (72.8% AUROC using RF). Performances for high-performing students were generally lower, with AUROC at earlier stages peaking at the courses’ midway point (64.4% AUROC using RF). Our second experiment deployed long-short term memory units (LSTM) trained with a time-dependent representation of a single feature (number of total clicks). While this approach achieved inferior performances, we argue that the more straightforward data pre-processing of this approach may represent a worthwhile tradeoff against relatively small losses in model performance, especially at earlier moments of prediction. We found the best tradeoff at 33% course duration – 64% AUROC against 74% AUROC using RF to predict at-risk students. To predict high-performing students, we found the best tradeoff to occur at 25% course duration (56% AUROC against 61% using RF). Results obtained using a different set of logs validate the portability of our approach when it comes to static aggregate models. However, our deep learning approach did not generalize well on this data, which suggests that portability between courses using this approach may only be possible in specific instances.

Objective: To evaluate acute and chronic changes seen on angiographic and histopathological studies of porcine rete mirabile, comparing those treated with the Menox liquid embolic system (LES) and those treated with the Onyx LES. Materials and Methods: Five pigs, each weighing approximately 35 kg, were submitted to rete mirabile embolization under general anesthesia and fluoroscopic guidance, with the Menox LES or Onyx LES. Four animals were treated with the Menox LES and underwent cerebral angiography, followed by euthanasia, at 1, 30, 60, and 90 days after embolization. One animal was treated with the Onyx LES underwent the same procedures at 30 days after embolization. In a subsequent histopathological analysis, we compared the Menox LES and Onyx LES in terms of the acute and chronic changes observed. Results: We observed no significant changes in blood pressure, heart rate, or electrocardiographic parameters that could be attributed to the super-selective infusion of dimethyl sulfoxide or the Menox embolic agent. Fluoroscopy showed adequate material opacity, appropriate progression to the center of the rete mirabile and complete unilateral embolization. Microcatheters were uneventfully detached from the embolized nidus. We observed mild to moderate intravascular and extravascular inflammatory responses, without histological evidence of necrotizing arteritis. There were no adverse neurovascular events. Conclusion: The Menox LES appears to be safe and effective, as well as being apparently equivalent to the Onyx LES in terms of the postprocedure angiographic and histopathological findings.

Objective: Cervical traumatic neuromas (CTNs) may appear after lateral neck dissection for metastatic thyroid carcinoma. If they are misdiagnosed as metastatic lymph nodes (LNs) in follow-up neck ultrasound (US), unnecessary and uncomfortable fine-needle aspiration biopsy are indicated. The present study aimed to describe US features of CTNs and to assess the US performance in distinguishing CTNs from abnormal LNs. Subjects and methods: Retrospective evaluation of neck US images of 206 consecutive patients who had lateral neck dissection as a part of thyroid cancer treatment to assess CTN’s US features. Diagnostic accuracy study to evaluate US performance in distinguishing CTNs from abnormal LNs was performed. Results: Eight-six lateral neck nodules were selected for analysis: 38 CTNs and 48 abnormal LNs. CTNs with diagnostic cytology were predominantly hypoechogenic (100% vs. 45%; P = 0.008) and had shorter diameters than inconclusive cytology CTNs: short axis (0.39 cm vs. 0.50 cm; P = 0.03) and long axis (1.64 cm vs. 2.35 cm; P = 0.021). The US features with the best accuracy to distinguish CTNs from abnormal LNs were continuity with a nervous structure, hypoechogenic internal lines, short/long axis ratio ≤ 0.42, absent Doppler vascularization, fusiform morphology, and short axis ≤ 0.48 cm. Conclusion: US is a very useful method for assessing CTNs, with good performance in distinguishing CTNs from abnormal LNs.

Background: people who become functionally dependent due to serious illness and/or the worsening of a chronic illness have different recovery paths. The attribution of the nursing diagnosis of self-care deficit versus potential to improve self-care requires, on the part of the nurse, a rigorous clinical judgment, for which a set of diagnostic activities is necessary. Objectives: the present study sought to identify the assumptions used by expert nurses when formulating the clinical judgment of self-care deficit versus the potential to improve self-care Methodology: qualitative design. Data were generated in two focus group meetings that included eleven nurses experienced in caring for persons with functional dependence and self-care defict. Previously prepared structured questions were used to facilitate discussion. The focus group meetings were recorded in audio and transcribed. Inductive content analysis was used to identify emerging themes. The checklist Consolidated Criteria for Reporting Qualitative Research (COREQ) was also used. Results: nurses` decision-making depends: the factors of influencing the potential to improve self-care abilities of a person with functional dependence, the domain of influence of these factors, and three fundamental aspects to consider when evaluating a person with functional dependence. Conclusions: the absence of recovery potential can rarely be deduced. People without cognitive impairment or with mild cognitive impairment present highest potential for recovery., Enquadramento: as pessoas em situação de dependência funcional, devido a doença grave e ou agravamento de doença crónica, têm percursos diferentes no processo de recuperação. A tomada de decisão do enfermeiro para melhorar a autonomia da pessoa, está sujeita aos dados de avaliação do seu potencial de recuperação. Objetivos: identificar os pressupostos utilizados pelos enfermeiros para enunciar o juízo clínico: autocuidado comprometido versus o potencial para melhorar o autocuidado. Metodologia: estudo qualitativo. Os dados foram gerados em duas reuniões de focus grupo com onze enfermeiros, com experiência no cuidar da pessoa com dependência funcional e compromisso no autocuidado. Foram direcionadas algumas perguntas previamente estruturadas para facilitar a discussão. As reflexões foram gravadas em áudio e transcritas. Análise de conteúdo indutiva foi usada para identificar os temas emergentes. Utilizada a lista de verificação Consolidated Criteria for Reporting Qualitative Research (COREQ). Resultados: a tomada de decisão dos enfermeiros depende: dos fatores que influenciam o potencial para melhorar as capacidades para o autocuidado de uma pessoa com dependência funcional, do domínio de influência desses fatores e dos pressupostos utilizados para avaliar as capacidades da pessoa com dependência funcional. Conclusão: a ausência de potencial de recuperação raramente pode ser deduzida. Pessoas sem comprometimento cognitivo ou com comprometimento cognitivo leve, apresentam maior potencial de recuperação., Marco contextual: las personas que se vuelven funcionalmente dependientes debido a una enfermedad grave o al empeoramiento de una enfermedad crónica tienen diferentes vías de recuperación. La toma de decisiones del enfermero para mejorar la autonomía del paciente, está sujeta a la evaluación de datos de su potencial de recuperación. Objetivos: identificar los supuestos utilizados por las enfermeras para enunciar el juicio clínico: autocuidado comprometido versus potencial para mejorar el autocuidado. Metodología: diseño cualitativo. Los datos se generaron en dos reuniones de grupos focales que incluyeron a once enfermeras con experiencia en el cuidado de personas con dependencia funcional, compromiso con el autocuidado. Se utilizaron preguntas estructuradas previamente preparadas para facilitar la discusión. Las reuniones de los grupos focales se grabaron en audio y se transcribieron. Se utilizó el análisis de contenido inductivo para identificar temas emergentes. También se utilizó la lista de verificación Consolidated Criteria for Reporting Qualitative Research (COREQ). Resultados: la toma de decisiones de las enfermeras depende: los factores que influyen en el potencial para mejorar las habilidades de autocuidado de una persona con dependencia funcional, el dominio de influencia de estos factores y los supuestos que se hacen al evaluar las capacidades de una persona con dependencia funcional. Conclusión: rara vez se puede deducir la ausencia de potencial de recuperación. Las personas sin deterioro cognitivo o con deterioro cognitivo leve presentan el mayor potencial de recuperación.

[Abstract] Despite the efforts made to improve the care of cardiogenic shock (CS) patients, including the development of mechanical circulatory support (MCS), the prognosis of these patients continues to be poor. In this context, CS code initiatives arise, based on providing adequate, rapid, and quality care to these patients. In this multidisciplinary document we try to justify the need to implement the SC code, defining its structure/organization, activation criteria, patient flow according to care level, and quality indicators. Our specific purposes are: a) to present the peculiarities of this condition and the lessons of infarction code and previous experiences in CS; b) to detail the structure of the teams, their logistics and the bases for the management of these patients, the choice of the type of MCS, and the moment of its implantation, and c) to address challenges to SC code implementation, including the uniqueness of the pediatric SC code. There is an urgent need to develop protocolized, multidisciplinary, and centralized care in hospitals with a large volume and experience that will minimize inequity in access to the MCS and improve the survival of these patients. Only institutional and structural support from the different administrations will allow optimizing care for CS. [Resumen] Pese a los esfuerzos realizados para mejorar la atención al shock cardiogénico (SC), incluyendo el desarrollo de dispositivos de asistencia circulatoria mecánica (ACM), su pronóstico continúa siendo desfavorable. En este contexto surgen iniciativas de código SC, basadas en proporcionar una asistencia rápida y de calidad a estos pacientes. Este documento multidisciplinario trata de justificar la necesidad de implantar el código SC, definiendo su estructura/organización, criterios de activación, flujo de pacientes según nivel asistencial e indicadores de calidad. Sus propósitos concretos son: a) presentar las peculiaridades de esta enfermedad y el aprendizaje del código infarto y de experiencias previas en SC; b) detallar las bases para el abordaje de estos pacientes, la estructura de los equipos, su logística, la elección del tipo de ACM y el momento de su implante, y c) abordar los desafíos para la implantación del código SC, como la singularidad del código SC pediátrico. Urge desarrollar una asistencia protocolizada, multidisciplinaria y centralizada en hospitales con gran volumen y experiencia que permita minimizar la inequidad en el acceso a la ACM y mejorar la supervivencia de estos enfermos. Solo el apoyo institucional y estructural de las distintas administraciones permitirá optimizar la atención al SC.

Enquadramento: O treino combinado (TC) tem efeitos positivos na condição física (CF) e promove melhorias no estado geral de saúde. No entanto, poucos estudos investigaram os efeitos do TC realizado com um baixo volume semanal. Metodologia: Este estudo teve como objetivo identificar os efeitos do TC de baixo volume realizado durante 6 semanas na composição corporal, na força de preensão manual (FPM), na potência muscular, na força máxima, na capacidade cardiorrespiratória e a resposta afetiva ao exercício. Dezoito jovens adultos ativos (média ± DV: 20.06 ± 1.66 anos; 22.23 ± 2.76 kg/m2) foram divididos em dois grupos, o grupo experimental (GE, n=9) e o grupo controlo (GC, n=9). O TC realizado 2 vezes por semana consistiu num treino de força (TF, 2 séries de 3 exercícios com 80 a 85% 1RM) seguido de um treino intervalado de alta intensidade na bicicleta (HIIT, 5 séries de 60’’ a 95% Wmax). Foram avaliadas a composição corporal, a FPM, a altura do salto, a força máxima no supino e agachamento, o consumo máximo de oxigénio (VO2max), a potência aeróbia máxima (Wmax) e a resposta afetiva semanal no início (pré) e após 6 semanas de treino (pós). Foi utilizado o teste de ANOVA de medidas repetidas para realizar a análise do tempo, entre grupos e intra grupos. Resultados: Na composição corporal não se registaram diferenças significativas em todas as medidas (p > 0.05) em ambos os grupos. Verificou-se que diversos indicadores como GE melhorou significativamente a FPM (p < 0.01), a altura do salto (p < 0.05), a força máxima no supino e agachamento (p < 0.001), o VO2max (p < 0.01) e a Wmax (p < 0.01). A resposta afetiva foi positiva, mas sem diferenças significativas entre semanas (p > 0.05). Conclusões: Os resultados sugerem que TC de baixo volume melhora a FPM, a potência, a força máxima e a capacidade cardiorrespiratória, com uma resposta afetiva positiva ao exercício e sem gerar um aumento na carga interna. No entanto é insuficiente para provocar alterações na composição corporal em jovens adultos ativos.

Background: The aim of this study was to analyse the effects of low-volume CT performed during 6 weeks on muscle power, muscular strength, maximal aerobic power (Wmax) and internal load in active young adults. Methods: Eighteen healthy, active young adults men (mean ± SD, 20.06 ± 1.66 years; 22.23 ± 2.76 kg-1m2) performed either a low-volume CT (GE, n=9), or maintained a normal life (CG, n=9). The CT was composed of a resistance training (RT, 2 sets of 3 exercises with 80 to 85% 1RM) followed by a high intensity-interval training (HIIT, 5 sets of 60’’ with 95% Wmax). The measures of jump height, 1 maximal repetition (1RM) in bench press and back squat, Wmax and internal load were obtained before (pre) and after (post) training to analysis. Furthermore, an ANOVA test of repeated measures and t-test paired samples were used with a p ≤ 0.05. Results: Low-volume CT increased from pre to post on jump height (29.28 ± 3.81 to 32.02 ± 3.09cm, p ≤ 0.05), 1RM on bench press back squat (56.11 ± 11.35 to 67.67 ± 13.36kg, p < 0.001 and 63.11 ± 12.25 to 74.00 ± 12.02kg, p < 0.001, respectively) and Wmax (200 ± 30 to 220 ± 30.92W, p ≤ 0.01). The internal load had not significant differences between weeks (p > 0.05). Conclusions: In healthy, active young adults men the low-volume CT is effective to improve, jump height, 1RM in bench press and back squat, and Wmax without increase internal load.

Non stent-based local drug delivery with drug-coated balloon (DCB) is an alternative to drug-eluting stent with favorable clinical applicability in the treatment of selected coronary lesions. Our purpose was to report the initial performance, safety and efficacy evaluations of a novel sirolimus-coated balloon in the treatment of coronary lesions.This was a phase I (first-in-man), prospective, multicenter, single-arm trial evaluating the novel SELUTION SLR™ DCB (M.A. Med Alliance SA, Nyon, Switzerland), which incorporates a polymeric microsphere-based technology for controlled and continuous release of sirolimus, in the treatment of de novo or restenotic lesions.A total of 56 patients/lesions were enrolled between November/2018 and March/2019. Diabetes was found in 46.6 %, and de novo lesions represented 79.6 % of cases. Device and procedural/clinical success were 100 % and 96.4 %, respectively. There was only one major adverse cardiac event (target lesion revascularization) reported at late follow-up. By quantitative coronary angiography analysis, mean % diameter stenosis was 30.5 ± 16.7 %, late lumen loss was 0.26 ± 0.45 mm and angiographic binary restenosis occurred in 4 of 45 cases at 6-month angiographic follow-up.The novel SELUTION sirolimus-coated balloon demonstrated safety and efficacy in the treatment of diseased coronary vessels, including absence of mortality and relatively low late lumen loss at late follow-up.

IntroductionAedes (Stegomyia) albopictus (Skuse, 1854) was reported in Brazil for the first time in 1986, and has displayed successful expansion throughout the Brazilian territory.MethodsDuring a routine activity to control dengue conducted by the Division of Entomology of the Municipal Health Department in Rio Branco, adults and immatures of Culicidae were collected in a peri-urban area.ResultsThe Culicidae forms identified indicated that they belonged to the species Ae. albopictus.ConclusionsThis is the first official record of the presence of Ae. albopictus in the state of Acre, confirming its current presence in all Brazilian states.

Forest fragments consist of important ecosystems for the maintenance of sand fly populations and Leishmania hosts. This study sought to identify the phlebotomine fauna and its infection by Leishmania spp. in forest fragments on the campus of the Federal University of Acre (UFAC), Western Amazon. Monthly collections with CDC traps were carried out from March 2020 to June 2021, in four forest fragments of UFAC. Male and female insects were processed and identified at species level. A sample of females was subjected to polymerase chain reaction (PCR) analysis to verify the presence Leishmania DNA. In total, 465 specimens were collected, of which 238 were males and 227 were females. The most frequent species were Nyssomyia antunesi (Coutinho, 1939) (47.3%), Trichophoromyia sp. (Mangabeira, 1942) (18.70%), and Ny. whitmani (Antunes & Coutinho, 1939) (8.81%). Molecular analysis detected the presence of Leishmania (Ross, 1903) DNA in a specimen of Ny. antunesi, and another one of Evandromyia walker (Newstead, 1914). The forest fragments of the university campus harbor a diverse sand fly fauna with the presence of Leishmania DNA in these insects, in addition to the presence of other species considered incriminated vectors of Leishmania parasites.