Search

Neste artigo, buscamos desdobrar um exercício de aproximação entre as obras de Oswald de Andrade e Haroldo de Campos por meio da incorporação e compartilhamento de certo gesto antropofágico frente à história. Interessa-nos, particularmente, analisar como os dois autores mobilizavam extratos de historicidade para cumprir o objetivo de um tensionamento da história e da temporalidade. Para tanto, recorremos a ensaios e textos críticos dos dois escritores, analisando como no interior de seus projetos “historiográficos” – seja na errática oswaldiana ou no paideuma haroldiano - a história é investida de uma potência reflexiva e disruptiva para o presente. Desse modo, o horizonte de uma historiografia antropofágica parece possibilitar a emergência de passados silenciados e uma espécie de rearranjo sincrônico, tanto retrospectivo quanto utópico.

BackgroundTo date, there's no evidence of an increased risk of SARS-CoV-2 infection or more severe COVID-19 in patients with inflammatory bowel disease (IBD). However, whether COVID-19 alters the clinical course of IBD or whether IBD treatment affects the immunological response to SARS-CoV-2 is still under investigation, especially in children.AimTo assess the serological response to SARS-CoV-2 in children with IBD, and to evaluate the impact of COVID-19 on the clinical course of IBD.Material and MethodsThis prospective study enrolled children (0–18 years) followed-up at the University Hospital of Padova for IBD, who acquired a confirmed SARS-CoV-2 infection between 02.2020 and 02.2021. The anti-SARS-CoV-2 S-RBD IgG titer was evaluated at 3 months after infection and compared to that of a control group of healthy children matched for age, sex, and COVID-19 severity.ResultsTwelve children with IBD (M = 5; median age 14 years) contracted COVID-19 during the study period. 11/12 patients were under immunomodulatory treatment (4/12 steroids; 6/12 azathioprine; 3/12 anti-TNFs; 2 vedolizumab; 1 ustekinumab). SARS-CoV-2 infection remained asymptomatic in 4/12 children and caused mild COVID-19 in the remaining 8. Mean anti-SARS-CoV-2 IgG S-RBD titer was similar between IBD patients and controls (27.3 ± 43.8 vs. 36.8 ± 35.3 kAU/L, p = ns). No children experienced IBD flares nor required gastroenterological support during the infection period.DiscussionChildren with IBD can mount a protective humoral response against SARS-CoV-2, which is comparable to that of their healthy peers regardless of ongoing immunomodulatory treatment. This study also supports the favorable course of PIBD during COVID-19 and vice-versa.

Intensive farming practices can increase exposure of animals to infectious agents against which antibiotics are used. Orally administered antibiotics are well known to cause dysbiosis. To counteract dysbiotic effects, numerous studies in the past two decades sought to understand whether probiotics are a valid tool to help re-establish a healthy gut microbial community after antibiotic treatment. Although dysbiotic effects of antibiotics are well investigated, little is known about the effects of intramuscular antibiotic treatment on the gut microbiome and a few studies attempted to study treatment effects using phylogenetic diversity analysis techniques. In this study we sought to determine the effects of two probiotic- and one intramuscularly administered antibiotic treatment on the developing gut microbiome of post-weaning piglets between their 3rd and 9th week of life. Shotgun metagenomic sequences from over 800 faecal time-series samples derived from 126 post-weaning piglets and 42 sows were analysed in a phylogenetic framework. Differences between individual hosts such as breed, litter, and age, were found to be important contributors to variation in the community composition. Host age was the dominant factor in shaping the gut microbiota of piglets after weaning. The post-weaning pig gut microbiome appeared to follow a highly structured developmental program with characteristic post-weaning changes that can distinguish hosts that were born as little as two days apart in the second month of life. Treatment effects of the antibiotic and probiotic treatments were found but were subtle and included a higher representation of Mollicutes associated with intramuscular antibiotic treatment, and an increase of Lactobacillus associated with probiotic treatment. The discovery of correlations between experimental factors and microbial community composition is more commonly addressed with OTU-based methods and rarely analysed via phylogenetic diversity measures. The latter method, although less intuitive than the former, suffers less from library size normalization biases, and it proved to be instrumental in this study for the discovery of correlations between microbiome composition and host-, and treatment factors.

Para além da já reconhecida relevância da Nova Rota da Seda, ou Iniciativa do Cinturão e Rota (Belt and Road Initiative - BRI), para a estratégia de inserção internacional da China, sua plena implementação também dialoga incisivamente com a continuidade do processo de unificação e reorganização nacional do país. Analisando as questões pertinentes à região de Xinjiang, o presente artigo sustenta a noção de que a Nova Rota da Seda interage diretamente com o imperativo e os esforços securitários nacionais de estabilização das fronteiras e de diluição das ameaças separatistas, ao promover a continentalização do desenvolvimento chinês. Além do mais, é possível argumentar que essa região representa um enlace territorial do processo de integração eurasiática liderado pela China. O artigo se divide em três partes: primeiro, apresentamos os principais vetores da ascensão e implementação da Nova Rota da Seda; em seguida, abordamos o histórico das tensões entre o processo de reconstrução nacional chinesa e os movimentos separatistas de Xinjiang; por fim, analisamos como a Nova Rota da Seda interage com as estratégias de contenção aos movimentos separatistas e terroristas da região.

Staphylococcus epidermidis biofilm cells are characterized by increased antimicrobial tolerance and improved ability to evade host immune system defenses. These features are, in part, due to the presence of viable but non-culturable (VBNC) cells. A previous study identified genes potentially involved in VBNC cells formation in S. epidermidis biofilms, among which SERP1682/1681 raised special interest due to their putative role as a toxin–antitoxin system of the mazEF family. Herein, we constructed an S. epidermidis mutant lacking the mazEF genes homologues and determined their role in (i) VBNC state induction during biofilm formation, (ii) antimicrobial susceptibility, (iii) survival in human blood and plasma, and (iv) activation of immune cells. Our results revealed that mazEF homologue did not affect the proportion of VBNC cells in S. epidermidis 1457, refuting the previous hypothesis that mazEF homologue could be linked with the emergence of VBNC cells in S. epidermidis biofilms. Additionally, mazEF homologue did not seem to influence key virulence factors on this strain, since its deletion did not significantly affect the mutant biofilm formation capacity, antimicrobial tolerance or the response by immune cells. Surprisingly, our data suggest that mazEF does not behave as a toxin–antitoxin system in S. epidermidis strain 1457, since no decrease in the viability and culturability of bacteria was found when only the mazF toxin homologue was being expressed.

An easy and fast method to achieve chiral porphyrin films on glass is herein reported. The on-surface formation of organized supramolecular architectures with distinctive and remarkable chiroptical features strictly depends on the macrocycles used, the solvent chosen for the casting deposition, and most importantly, on the roughness of the glass slide. Dynamic light scattering studies performed on 10−4–10−6 M porphyrin solutions revealed the presence of small porphyrin aggregates, whose size and number increase depending on the initial concentration. Once transferred on surface, these protoaggregates act as nucleation seeds for the following, self-assembling into larger structures upon solvent evaporation, with a process driven by a fine balance between intermolecular and molecule–substrate interactions. The described method represents a straightforward way to fabricate porphyrin-based chiral surfaces onto a transparent and economic substrate in few minutes. The results obtained can be particularly promising for the development of sensors based on stereoselective optical active films, targeting the detection of chiral analytes of practical relevance, such as the so-called emerging pollutants released in the environment from agrochemical, food, and pharmaceutical manufacturing.

Identificação precoce e o tempo para iniciar terapia na sepsis e na neutropenia febril (NF) são fundamentais para redução de mortalidade. Protocolos clínicos gerenciados (PC) são altamente recomendados em ambas as condições. Embora haja medidas comuns nestes PCs (estabilização clínica, coleta de culturas, início de terapia na primeira hora), há poucos dados poucos de lactato sérico na NF. Nossa instituição tem dois PC independentes: PC sepsis e PC NF. Todo paciente que desenvolve NF é manejado dentro do PC NF. O PC Sepsis prevê o acompanhamento de todo paciente com critério de alerta ou com antimicrobiano de amplo espectro. Por este último critério, paciente com NF mesmo sem sinais de alerta estão sujeitos ao PC Sepsis, incluindo coleta de lactato sérico e a mensuração de escores de gravidade. Neste estudo comparamos pacientes submetidos a TMO autólogo manejados dentro do PC Sepsis com aqueles manejados apenas dentro do PC NF. Métodos: Estudo de coorte em pacientes submetidos a TMO autólogo entre 2016 e 2021. Consideramos os seguintes desfechos: infecção de corrente sanguínea (ICS), transferência para terapia intensiva (CTI), tempo de internação, tempo de uso de antimicrobianos, troca da terapia para meropenem e mortalidade. Resultados: Foram revistos 461 pacientes submetidos a Auto TMO (mediana de idade de 56 anos), destes 423 (92%) desenvolveram NF e foram analisados. PC sepsis foi aplicado em 321 (76% dos eventos NF), e os demais 102 (22% das NF) foram manejados apenas pelo PC NF. Não houve diferença em idade, doença de base ou estratégia empírica inicial da NF entre PC sepsis e PC NF. Nos pacientes manejados no PC sepsis, a mediana do LactNF foi 12,8 mg/dL (variando de 1,7 - 57). LactNF >18 e > 20 mg/dL ocorreu em 77 (24%) e 60 (19%) dos casos. LactNF >18 e >20 foram marcadores de transferência para CTI (p < 0.05 para ambos), mas não se associaram a ICS, tempo de internação, tempo de uso de antimicrobiano ou mortalidade. Paciente no PC sepsis tiveram maior uso de meropenem (50% x 33%, p = 0,004) e tempo de uso de antimicrobiano total (7,8 vs. 6,9 dias; p = 0,06). ICS (21% x 26%, p = 0,40) e o tempo de internação após o TMO foram equivalentes (13 vs. 12 dias, p = 0,14) entre PC Sepsis e PC NF. Quatro pacientes falecerem (0,9%), todos no PC sepsis. Embora a aplicação do lactato sérico no momento da neutropenia febril tenha demostrado associação com CTI, não houve melhoria nos desfechos da NF com a aplicação do PC Sepsis quando comparado ao PC NF.

Infecções de Corrente Sanguínea (ICS) são frequentes em pacientes submetidos a Transplante de Medula alogênico (Alo TMO), podendo ocorrer em fases precoces e tardias. Fatores como neutropenia, mucosite, uso de cateter venoso, doença enxerto contra hospedeiro, colite por citomegalovírus e o uso de antimicrobianos são frequentes, aumentando o risco de ICS. A multirresistência (MDR) é um fenômeno crescente, e acarreta falha terapêutica e pior prognostico em ICS. Neste estudo, descrevemos a incidência de ICS e ICS por MDR em Alo TMO nas diferentes fases pos TMO e os fatores de risco associados. Um total de 222 pacientes (95 aparentados, 70 haploidenticos e 57 não aparentados) foram acompanhados por uma mediana de 245 dias. A incidência de ICS até o D+30, entre D+30 e o D+100 e após D+100 foi de 31%, 17% e 22% respectivamente. Não houve diferença na incidência de ICS comparando tipos de doador, condicionamento mielo ou não mieloablativo, ou celularidade de produto. Fonte de célula tronco medula óssea se relacionou a ICS até o D+30 (39% vs. 26%, p=0.05) comparado com fonte periférica. Foram diagnosticadas 207 ICS, sendo 62% por Gram negativos (GN), 32% por Gram positivos (GP) e 6% por fungos. Em 16%, a ICS foi polimicrobiana. Nas três fases pos TCTH, houve predomínio de GN em relação a GP. Os GN mais frequentes foram: K pneumoniae (n=47), E coli (n=24), e P. aeruginosa (n=16). Em relação a susceptibilidade, produção de betalactamase de espectro estendido (ESBL) foi identificada em 40% das K. pneumoniae e em 32% das E. coli, e produção de carbapenemase (ERC) em 30% das K. pneumoniae isoladas. As incidências acumuladas de ICS por MDR no D+30, entre D+30 e D+100 e após o D+100 foram: 6%, 9% e 15% por GN produtores de ESBL e 3%, 5% e 7% por GN ERC. Em relação a ICS por GP, ocorreram 8 casos de ICS por S. aureus, sendo 3 (37%) resistentes a meticilina, e 13 ICS por enterococo, com 2 casos de resistência a vancomicina (15% das amostras). As incidências de ICS por MRSA e VRE foram de 1% e 2% na coorte, respectivamente. Em relação aos fatores de risco para ICS por MDR, a colonização previa por GN ERC estava presente em todos os casos que desenvolveram ICS por ERC (p

Although the safety profiles of mRNA COVID-19 vaccines (mRNA-1273 and BNT162b2) were evaluated in pre-authorization clinical trials, real-world data allow us to better define their benefit/risk ratio in the paediatric population. The current study aimed to evaluate the safety profiles of mRNA COVID-19 vaccines in children by analysing the pharmacovigilance data of the European spontaneous reporting system database EudraVigilance (EV) in the period from 1 January 2021, to 1 October 2022. During our study period, overall 4838 ICSRs related to mRNA COVID-19 vaccines referring to 5–11-year-old subjects were retrieved from EV, of which 96.9% were related to BNT162b2 and 49.3% were related to males. A total of 12,751 Adverse Events Following Immunization (AEFIs) were identified, of which 38.7% were serious. The most frequently reported AEFIs were pyrexia, headache, and vomiting. Only 20 Individual Case Safety Reports (ICSRs) reported Multisystem Inflammatory Syndrome (MIS) as an AEFI, all related to BNT162b2. The majority of MIS cases were females, and six cases were completely resolved at the time of reporting. Our results show a favourable risk–benefit profile for all mRNA COVID-19 vaccines in this paediatric sub-population, supporting their use in children. Considering the peculiarity and fragility of children, continuous safety monitoring of COVID-19 vaccines is required.

Urothelial inflammation plays a key role in the pathogenesis of chronic pelvic pain due to its origin in the bladder. The aim of this study was to evaluate the efficacy of a patent-pending formulation (Pelvipea®) composed of micronized palmitoylethanolamide (PEA), hempseed oil, and maritime pine bark dry extract in reducing urothelial inflammation, as well as the effect of each ingredient individually, in order to define the synergistic effect of the three ingredients. An in vitro bladder urothelium model composed of the T24 cell line was exposed to a conditioned media obtained by treating macrophage-differentiated THP-1 cells with different concentrations of the functional ingredients and a mixture of them in the presence of the pro-inflammatory stimulus of Escherichia coli. Cells exposed only to the inflammatory stimulus in the absence of pre-treatment were considered as a positive control for inflammation. The impact of each functional ingredient and their mixture on inflammation was evaluated by the determination of transcription factor NF-kB and of pro-inflammatory cytokine expression. Statistical analysis was performed using the t-test, comparing the mixture and the single ingredients for every condition tested. All results were reported as fold change (mean ± standard deviation), the ratio between the values obtained from the respective treatments for inflammation control. The three functional ingredients did not induce negative effects on THP-1 cell vitality. The levels of NF-kB were reduced following treatment with hempseed oil, maritime pine bark dry extract, and the mixture at all tested concentrations, and with micronized PEA from 25 to 200 μg/mL. Treatment with the mixture resulted in the lowest expression levels of interleukins (IL)-1β, IL-6, and IL-8 compared to the single functional ingredients at a concentration of 230 μg/mL, with values of 0.08 (±0.00), 0.01 (±0.00), and 0.32 (±0.01), respectively. The mixture of micronized PEA, hempseed oil, and maritime pine bark dry extract (Pelvipea®) at 230 μg/mL showed the best efficacy in urothelial IL-1β, IL-6, and IL-8 reduction compared with the singular components. This formulation may represent a promising therapeutic option to relieve painful symptoms originating in the bladder. However, in vivo studies are needed to confirm these results.

Dengue hemorrhagic fever (DHF) is an infectious disease caused by a virus Arbovirus known as the genus flavivirus family flaviviridae transmitted by the bite of the mosquito Aedes aegypti. Knowing the relationship between environmental factors and community behavior with the incidence of Dengue Hemorrhagic Fever (DHF) in the working area of the Lospalos Health Center, Lautem Regency. This type of research is an observational analytical study with a Control case approach. The study respondents amounted to 96 people according to the specified criteria selected by the simple random sampling method. Data collection was carried out by questionnaires and interviews. Data analysis was performed using chi square and multiple logistic regression. Environmental and behavioral factors of the community associated with the incidence of dengue hemorrhagic fever (DHF) are occupancy density (p = 0.000), frequency of landfill draining (p = 0.000), extension experience (p = 0.002), knowledge (p = 0.000), action (p = 0.007), presence of larvae (p = 0.008) and place of presence of larvae (p = 0.002) while what is not related is attitude (p = 0.037). The most dominant variable is Knowledge with an OR of 30.37 (9.899-93.181) public knowledge has the most influence on the incidence of bloody fever. Health workers should provide more counseling to increase public knowledge.

This proof-of-concept study lays the foundations for the development of a delivery strategy for radioactive lanthanides, such as Yttrium-90, against recurrent glioblastoma. Our appealing hypothesis is that by taking advantage of the combination of biocompatible polyvinyl alcohol (PVA) microbubbles (MBs) and endovascular radiopharmaceutical infusion, a minimally invasive selective radioembolization can be achieved, which can lead to personalized treatments limiting off-target toxicities for the normal brain. The results show the successful formulation strategy that turns the ultrasound contrast PVA-shelled microbubbles into a microdevice, exhibiting good loading efficiency of Yttrium cargo by complexation with a bifunctional chelator. The selective targeting of Yttrium-loaded MBs on the glioblastoma-associated tumor endothelial cells can be unlocked by the biorecognition between the overexpressed αVβ3 integrin and the ligand Cyclo(Arg-Gly-Asp-D-Phe-Lys) at the PVA microbubble surface. Hence, we show the suitability of PVA MBs as selective Y-microdevices for in situ injection via the smallest (i.e., 1.2F) neurointerventional microcatheter available on the market and the accumulation of PVA MBs on the HUVEC cell line model of integrin overexpression, thereby providing ~6 × 10−15 moles of Y90 per HUVEC cell. We further discuss the potential impact of using such versatile PVA MBs as a new therapeutic chance for treating glioblastoma multiforme recurrence.

Introduction: Post-marketing data on the risks associated with direct oral anticoagulants (DOACs) are conflicting and only few studies evaluated a comparison between each different DOAC. Real-world data from pharmacovigilance databases can help to better define the safety profile of each DOAC and warfarin. However, Correspondence Analysis (CA) could represent a useful tool in this context.Objective: In the attempt to assess the usefulness of CA as a signal detection pharmacovigilance tool, we applied this method to the Italian Pharmacovigilance Database (RNF, Rete Nazionale di Farmacovigilanza), by comparing with disproportionality analysis on warfarin and DOACs.Methods: Study based on AEs sent to RNF by Campania Region from 2008 to 2021, in which warfarin, dabigatran, apixaban, edoxaban or rivaroxaban were reported as suspected drug. AEs were clustered into three Standardized MedDRA Queries (SMQs): Central Nervous System Haemorrhages and Conditions (CNSH), GastroIntestinal Perforation, Ulceration, Obstruction or Haemorrhages (GIPUOH) and other Haemorrhages (HH). Non-haemorrhagic AEs were included in a fourth cluster (nHH).Results: We retrieved 1,161 reports: 41.5% are associated to warfarin, 21.0% to dabigatran, 17.8% to rivaroxaban, 13.9% to apixaban and 5.8% to edoxaban. No significant differences in age distribution were observed. Results of CA showed that dabigatran and warfarin have the highest contribution (44.910 and 47.656, respectively) to the inertia of Dimension 1 as well as apixaban and dabigatran to the inertia of Dimension 2 (53.768 and 30.488, respectively). Edoxaban and rivaroxaban showed a negligible total contribution. CA biplot showed positive associations between warfarin and HH, apixaban and CNSH and dabigatran and nHH.Conclusion: Results seem to confirm that DOACs are not interchangeable. Apixaban was surprisingly associated with a higher risk of cerebral haemorrhage. As expected, our data support the better safety profile of DOACs than warfarin in terms of skin and respiratory tract hemorrhagic risks. Finally, we showed how CA could play a complementary role in analyzing data from pharmacovigilance databases.

As origens da sociologia daducação enquanto área de saber nos planos curriculares do ensino superior é, em vários países, indissociável do surgimento, da organização e da evolução de cursos de formação de professores do ensino não superior. Não obstante, progressivamente a sociologia da educação passou a integrar também os planos de estudos de cursos na área da própria sociologia, bem como na área de educação (a qual engloba formações que não se vocacionam especificamente para habilitar os respectivos estudantes para a docência). Reconhecendo este contexto genérico, neste artigo, examina-se a presença da sociologia da educação em licenciaturas e mestrados do ensino superior português com base na análise de dados sobre cursos, planos de estudos e unidades curriculares que estavam em funcionamento no ano letivo de 2018-2019. Os resultados evidenciam que a sociologia da educação está mais presente nas universidades do que nos institutos politécnicos e mais em cursos de formação inicial do que em pós-graduações. Conclui-se que o ensino de sociologia da educação parece encontrar-se, na atualidade, na encruzilhada de três espaços institucionais distintos (formação de professores, sociologia, educação), com repercussões nas finalidades e práticas educativas com que a disciplina é ensinada em cada um destes espaços.

RationaleWhen obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) coexist in the so-called "overlap" syndrome, a high risk for mortality and morbidity has been reported. There is controversy about the prevalence of OSA in people affected by COPD.ObjectivesThe purpose of this study was to investigate objective meaures of sleep-disordered breathing in patients with moderate to severe COPD to test the hypothesis that COPD is associated with an increased prevalence of OSA.MethodsFifty-four patients (54% men) with moderate to severe COPD were enrolled prospectively (mean ± SD, FEV1 = 42.8 ± 19.8% predicted, and FEV1/FVC = 42.3 ± 13.1). Twenty patients (37%) were on supplemental oxygen at baseline. Exercise tolerance; questionnaires related to symptoms, sleep, and quality of life; and home polysomnography were obtained.Measurements and main resultsForty-four patients had full polysomnography suitable for analysis. OSA (apnea-hypopnea index > 5/h) was present in 29 subjects (65.9%). Sleep efficiency was poor in 45% of subjects.ConclusionsOSA is highly prevalent in patients with moderate to severe COPD referred to pulmonary rehabilitation. Sleep quality is also poor among this selected group. These patients have greater-than-expected sleep-disordered breathing, which could be an important contributory factor to morbidity and mortality. Pulmonary rehabilitation programs should consider including a sleep assessment in patients with moderate to severe COPD and interventions when indicated to help reduce the impact of OSA in COPD.

Local government in Portugal had a good opportunity to modernise through the Programa de Formacao para as Autarquias Locais (Foral) [Training programme for local authorities], implemented between 2000 and 2005. Substantial financial resources were made available through the programme to retrain local government human resources in order to improve coordination between services, respond to requests from local inhabitants, and equip municipalities with technical and human resources. The programme was in operation for six years and its development and outcomes can now be assessed. Starting from an analysis of local authority "social balance sheets" in two key years (2000 and 2005) and from information obtained as part of a process for assessing the impact of the Foral programme (2006), some of the changes brought about in local government due to the effects of the programme are presented and discussed. (Contains 8 tables.)

Staphylococcus epidermidis biofilm cells can enter a physiological state known as viable but non-culturable (VBNC), where, despite being alive, they do not grow in conventional laboratory media. As such, the presence of VBNC cells impacts the diagnosis of S. epidermidis biofilm-associated infections. Previous transcriptomics analysis of S. epidermidis strain 9142 biofilms with higher proportions of VBNC cells suggested that the genes pdhA, codY and mazEF could be involved in the induction of the VBNC state. However, it was previously demonstrated that VBNC induction is strain-dependent. To properly assess the role of these genes in VBNC induction, the construction of mutant strains is necessary. Thus, herein, we assessed if VBNC cells could be induced in strain 1457, a strain amenable to genetic manipulation, and if the previously identified genes were involved in the modulation of the VBNC state in this strain. Furthermore, we evaluated the formation of VBNC cells on planktonic cultures. Our results showed that despite being commonly associated with biofilms, the proportion of VBNC cells can be modulated in both biofilm and planktonic cultures and that the expression of codY and pdhA was upregulated under VBNC inducing conditions in both phenotypes. Overall, our study revealed that the formation of VBNC cells in S. epidermidis is independent of the mode of growth and that the genes codY and pdhA seem to be relevant for the regulation of this physiological condition.

Nodular lymphoid hyperplasia (NLH) is a lymphoproliferative disease caused by non-clonal expansion of lymphoid cells in the gut mucosa. Little is known about the pathogenesis of NLH, which is often disregarded as an insignificant or para-physiologic phenomenon. We present the case of a girl with isolated diffuse NLH (extending from the stomach to the rectum) caused by activated PI3Kδ syndrome (APDS) due to the novel p.Glu525Gly variant in PIK3CD. The gain-of-function effect of the variant was confirmed by demonstration of over activation of the Akt/mTOR pathway in the patient's cells. APDS diagnosis led to treatment with sirolimus, which resulted in the complete remission of NLH and in the prevention of extra intestinal complications. In conclusion, we identify APDS as a novel cause of isolated NLH and suggest that patients with severe pan-enteric NLH should be screened for this disorder that may not be apparent on first-line immunological testing.

Este artigo é um estudo de revisão narrativa acerca da gestão do processo de mudança nas organizações de saúde em contexto atual. As organizações de saúde são ambientes complexos, não estanques e em constante mudança. Com os rápidos avanços técnico-científicos e o processo de globalização é imprescindível que estas organizações adotem uma gestão de mudança, de modo que a organização se mantenha atualizada e consiga encontrar respostas para as suas necessidades quotidianas. Tendo como objetivo contribuir para um melhor conhecimento acerca do processo de mudança organizacional e identificar a forma como as mudanças organizacionais são percecionadas, foi definida a seguinte questão de partida: Quais os fatores que interferem no processo de mudança nas organizações de saúde? Para encontrar resposta para a questão foram efetuadas pesquisas de artigos nas bases de dados Business Source Complete e American Psychology Association PsycInfo, utilizando os descritores “organizacional change management” e “healthcare”, sendo identificados 195 artigos dos quais, após seleção e verificação de elegibilidade, foram incluídos 8 artigos relevantes e atuais na presente revisão narrativa. A análise dos artigos incluídos reforça a ideia que a resistência à mudança é um dos principais fatores para o fracasso. Pudemos concluir que um dos principais fatores de resistência à mudança é a falta de confiança entre os colaboradores e os seus superiores hierárquicos; o fracasso da gestão do processo de mudança prende-se com o facto do gestor não ter em consideração as opiniões, renitência e anseios dos seus colaboradores face a essa mesma mudança; a formação contínua, o desenvolvimento profissional e a comunicação influenciam a eficácia e desempenho dos profissionais.

Introdução: Infecções de Corrente Sanguínea (ICS) são frequentes em pacientes submetidos a transplante de células tronco hematopoéticas alogênico (Alo TCTH), podendo ocorrer em todas as fases do TCTH. Fatores como neutropenia, mucosite, uso de cateter venoso, desenvolvimento de doença enxerto contra hospedeiro, colite por citomegalovírus e o uso de antimicrobianos são frequentes no pós Alo TCTH, aumentando o risco de ICS. A multirresistência antimicrobiana (MDR) é um fenômeno crescente, e acarreta falha terapêutica e pior prognostico em ICS. No Brasil, há uma escassez de dados de incidência de MDR em populações submetidas a Alo TCTH. Objetivo: Neste estudo, descrevemos a incidência de ICS em Alo TCTH nas diferentes fases pós TCTH, a distribuição e a susceptibilidade dos agentes etiológicos, a incidência de ICS por diferentes padrões de multirresistência e os fatores de risco associados. Métodos: Um total de 222 pacientes receptores de Alo TCTH (95 aparentados, 70 haploidênticos e 57 não aparentados) foram acompanhados por uma mediana de 245 dias. ICS foi definida como crescimento de bacteria ou fungo em hemocultura coletada. Contaminação de coleta (identificação de bacteria colonizante de pele em apenas uma amostra) foi excluida da análise. Resultados: A incidência de ICS até o D+30, entre D+30 e o D+100 e após o D+100 foi de 31%, 24% e 29% respectivamente. Não houve diferença na incidência de ICS comparando tipos de doador, condicionamento mielo ou não mieloablativo, profilaxia de DECH, ou celularidade de produto. Fonte de célula tronco medula óssea se relacionou a ICS até o D+30 (39% vs. 26%, p = 0.05) comparado com fonte periférica. No decorrer do estudo 207 ICS foram diagnósticas, sendo 62% por bactérias Gram negativas (GN), 32% por Gram positivas (GP) e 6% por fungos. Em 33 (16%) das ICS a etiologia foi polimicrobiana. Nas três fases pós Alo TCTH, houve predomínio de GN em relação a GP. Os patógenos mais frequentes foram: K pneumoniae (n = 47), S epidermides (n = 41), E coli (n = 24), e P. aeruginosa (n = 16). Em relação a susceptibilidade dos GN, produção de betalactamase de espectro estendido (ESBL) foi identificada em 40% das K. pneumoniae e em 32% das E. coli, e produção de carbapenemase (ERC) ocorreu em 30% das K. pneumoniae isoladas. As incidências acumuladas de ICS por patógeno MDR no D+30, entre D+30 e D+100 e após o D+100 foram: 6%, 9% e 15% por GN produtores de ESBL e 3%, 5% e 7% por GN ERC. Em relação a ICS por GP, ocorreram 8 casos de ICS por S. aureus, s endo 3 (37%) resistentes a meticilina, e 13 ICS por enterococo, com 2 casos de resistência a vancomicina (15% das amostras). As incidências de ICS por MRSA e VRE foram de 1% e 2% na coorte, respectivamente. Em relação aos fatores de risco para ICS por MDR, a colonização previa por GN ERC estava presente em todos os casos que desenvolveram ICS por ERC (p < 0,001; VPP 12,6% e VPN 100%). Um paciente desenvolveu episódios recorrentes de ICS por ERC no decorrer do tratamento de segunda linha para DECH trato gastrointestinal não responsiva a corticosteroides. Conclusão: ICS foi um evento frequente nos pós Alo TCTH, com um predomínio de infecções por GN em todas as fases pós TCTH. Documentamos a emergência de MDR especialmente entre bactérias GN nas diferentes fases do pós Alo TCTH. Medidas para identificação precoce e tratamento antimicrobiano adequado são necessárias para conter a disseminação destes padrões de resistência e reduzir o impacto negativo destas infecções.

Abstract The aim of this review was to update the evidence of new approaches to non-surgical therapy (NSPT) in the treatment of periodontitis. Preclinical and clinical studies addressing the benefits of adjunctive antimicrobial photodynamic therapy, probiotics, prebiotics/synbiotics, statins, pro-resolving mediators, omega-6 and -3, ozone, and epigenetic therapy were scrutinized and discussed. Currently, the outcomes of these nine new approaches, when compared with subgingival debridement alone, did not demonstrate a significant added clinical benefit. However, some of these new alternative interventions may have the potential to improve the outcomes of NSPT alone. Future evidence based on randomized controlled clinical trials would help clinicians and patients in the selection of different adjunctive therapies.

The research underlying this article seeks to improve our understanding of the processes of entry into working life of higher education graduates. In theoretical and conceptual terms, contributions from a variety of disciplines (particularly economics and sociology) and different theoretical currents and frameworks have been used to interlink perspectives which are usually developed in parallel yet separately. In empirical terms a case study was conducted on the process of entry into working life of graduates of a higher education institution, the findings of which are summarised and compared with data from other national and international studies on the same theme. The article concludes by identifying areas for further research that would benefit from Europe-wide comparison, and from interlinking theoretical and disciplinary perspectives. (Contains 18 footnotes.)

ABSTRACT Objective: The objective was to evaluate the efficacy of gabapentin in the management of neuropathic pain in patients with keratoconus, who were treated with fast (10 minutes) epi-off corneal crosslinking (CXL). Methods: This was a prospective, double-blind, randomized study. The sample comprised patients with bilateral progressive keratoconus, aged 12 years or older, who underwent a bilateral epi-off corneal CXL (fast - 10 minutes) procedure. One group was given placebo orally, and the other group received gabapentin 600 mg orally, both preoperatively. The visual analogue scale (VAS) was applied to record postoperative pain up to 48 hours after procedure. The study was conducted at the Belotto Stock Centro Oftalmológico, in the city of Joaçaba, Santa Catarina, Brazil, from June 2018 to September 2019. Results: At no point in the study significant differences were observed between groups, in terms of pain intensity measured by means of the VAS questionnaire, or of opioid use (Paco®), though opioid consumption was 21% lower in the group receiving gabapentin. Conclusion: We concluded gabapentin has no efficacy in postoperative pain control after epi-off corneal CXL (fast - 10 minutes). Although there was no statistically significant difference, the group that received gabapentin suffered less pain, resulting in lower opioid consumption. UTN number: U1111-1256-0330.

O estágio é um componente curricular necessário para a formação inicial de professores, compreendido enquanto articulação teoria-prática, que envolve um processo de pesquisa e contribui para a formação crítica e reflexiva do estudante. A partir da atuação das autoras na disciplina de Estágio Curricular Supervisionado em Gestão na Educação Básica, em um curso de Licenciatura em Pedagogia, este estudo tem como objetivo problematizar as práticas de estágio desenvolvidas de forma remota e elencar suas limitações e possibilidades, articuladas com a concepção do Estágio com Pesquisa. Por meio do relato de experiência das professoras atuantes na referida disciplina e do levantamento bibliográfico do referencial teórico de Pimenta e Lima (2017) e Ghedin, Oliveira e Almeida (2015), apresentam-se as abordagens utilizadas em adequação às práticas de estágio durante o ensino remoto emergencial. Conclui-se que a realização do estágio remoto enfrentou limitações no que se refere à inserção na cultura e cotidiano escolar e no acompanhamento dos processos educativos referente às práticas com alunos, professores e comunidade. No entanto, por meio de novas abordagens, oportunizou o reconhecimento da organização pedagógica do espaço escolar, e sobretudo do papel do diretor e coordenador pedagógico frente às suas demandas e os desafios impostos pela pandemia.

RESUMO A ordem dos Passeriformes é uma das mais pressionadas pelas ações antrópicas, especialmente as relativas ao tráfico de animais, que, devido às más condições de manejo e higiênico-sanitárias, favorecem a infecção dos espécimes por patógenos virulentos e zoonóticos, como cepas de Escherichia coli e Salmonella spp., cujo isolamento em suabes cloacais, bem como a análise dos genes de virulência das cepas de E. coli foram objetivos do estudo. Para isso, 120 Passeriformes silvestres nativos, recebidos pelo Cetas/CE, foram avaliados individualmente. As cepas isoladas foram submetidas a teste de disco difusão para determinação da sensibilidade aos antimicrobianos. Em etapa posterior, foi realizada PCR para a detecção de oito genes de virulência dos principais patotipos diarreiogênicos de E. coli. Quanto aos resultados, nenhuma cepa de Salmonella spp. foi isolada, no entanto a ocorrência de E. coli foi de 40,8%. Foi observada elevada resistência, principalmente aos antimicrobianos tetraciclina, ampicilina e sulfazotrim, ocorrendo multirresistência em 42,8% das cepas. Pela análise molecular, foram diagnosticados quatro entre os nove genes pesquisados, com a identificação de EPEC típicas, EPEC atípicas, ETEC, EHEC e EAEC. Os resultados apontam para a importância de Passeriformes como possíveis disseminadores de zoonoses.

Hemorrhoidal disease (HD) is a frequent health problem with considerable repercussions on patients’ quality of life. However, much of the clinical practice related to HD is based on knowledge without scientific evidence and supported largely by empirical experience of the physician who deals with this pathology. As in other countries, the goal of this consensus is to establish statements supported by solid scientific evidence and whose purpose will be to standardize and guide the diagnosis and management of HD both in the general population and in some particular groups of patients.

Introduction: Cardiovascular disease is an important cause of death and disability worldwide, and hypertension is responsible for at least 45% of all deaths due to heart disease and 51% of deaths due to stroke. This study aimed to estimate and describe the distribution of prevalence, awareness, treatment and control of hypertension in the Portuguese population in 2015. Methods: A national survey using a representative sample of 4911 individuals residing in Portugal and aged between 25 and 74 years was implemented. Trained nurses performed a health interview and a physical examination, including blood pressure measurement (right arm, three measurements at 1-min intervals). The prevalence of hypertension was stratified by gender, age group, marital status, education, occupation and type of residential area. Associations between hypertension prevalence and sociodemographic factors were assessed using bivariate and multivariate Poisson regression. Results: The overall hypertension prevalence was 36.0%. The highest rates were observed in males (39.6%), in individuals aged between 65 and 74 years (71.3%), and in those with low levels of education (62.6%) and with no formal occupation (64.5%). Among hypertensive individuals, 69.8% were aware of their condition and 69.4% were under treatment, of whom 71.3% were controlled. Rates of awareness and medical treatment were significantly higher among women and older individuals. Conclusions: A large majority of the adult Portuguese population are likely to reach blood pressure levels defined as hypertension in adulthood. Significant differences in hypertension prevalence were found according to gender, age and socioeconomic status, which highlights the importance of population strategies in public health policies. Resumo: Introdução: As doenças cardiovasculares são uma importante causa de morte e incapacidade, sendo que a hipertensão arterial (HTA) é responsável por, pelo menos, 45% da mortalidade por doença cardíaca e 51% por acidente vascular cerebral. Este estudo pretende estimar e descrever a distribuição da prevalência, awareness, tratamento e controlo da HTA na população portuguesa em 2015. Métodos: Realizou-se um inquérito nacional com uma amostra representativa de 4911 indivíduos, dos 25 aos 74 anos, residentes em Portugal, e que compreendia a realização de uma entrevista de saúde e exame físico que incluía a medição da pressão arterial (braço direito, três medidas, intervalos de um minuto). A prevalência de HTA foi estratificada por sexo, grupo etário, estado civil, educação, ocupação e nível de urbanização. Estimou-se a associação entre a HTA e os fatores sociodemográficos usando regressão de Poisson bivariada e multivariada. Resultados: A prevalência de HTA foi de 36,0%, sendo mais elevada em indivíduos do sexo masculino (39,6%), entre os 65 e 74 anos (71,3%), com baixo nível de escolaridade (62,6%) e sem ocupação formal (64,5%). Dos indivíduos hipertensos, 69,8% tinham conhecimento da sua condição de saúde, 69,4% faziam medicação anti hipertensora e, destes, 71,3% estavam controlados. A prevalência do conhecimento e tratamento farmacológico da HTA foi mais elevada em mulheres e indivíduos mais velhos. Conclusões: A maioria da população adulta portuguesa poderá vir a ter HTA ao longo da vida. Foram encontradas diferenças importantes na prevalência de HTA de acordo com o sexo, a idade e o nível socioeconómico, o que enfatiza a importância de estratégias populacionais nas políticas de saúde pública. Keywords: Hypertension, Portugal, Awareness, Control, INSEF 2015, Palavras-chave: Hipertensão, Portugal, Awareness, Controlo, INSEF 2015

Purpose – To analyse the impact of women on boards of directors and the gender of CEOs and CFOs on the earnings management and, thus, on the quality of the financial information of European listed firms. Design/methodology/approach – Archival research based on data collected from Bloomberg, complemented by information hand collected from financial reports, for a sample of European listed firms, covering 2007-2013. Findings – The main results show that only CFO gender has an impact on both the intensity and direction of earnings management. Firms with a woman CFO presented less earnings management than those with a male CFO. We also find evidence that women manage earnings downwards, such that discretionary accruals are used to decrease reported earnings. Originality/value – We contribute to the still scarce literature on the impact of gender on earnings management and financial reporting quality, namely by providing international evidence, since the extant literature focuses on the USA.

Objetivo: Este trabalho objetivou avaliar a capacidade de remoção do biofilme de acordo com o sexo e a idade. Materiais e métodos: Setenta indivíduos com idades entre 21 e 70 anos foram incluídos. Índice de Placa Modificado da Marinha (IPMM) foi realizado por um examinador calibrado. Em seguida, eles escovaram seus dentes com uma escova macia por um minuto, e o IPMM foi novamente aplicado. Os voluntários utilizaram a escova durante sete dias, duas vezes ao dia, com dentifrício padronizado. Após sete dias, os mesmos procedimentos da primeira visita foram realizados. Os percentuais de remoção de biofilme supragengival (boca inteira, interproximal e da linha gengival) foram calculados em cada um dos períodos experimentais. Comparações foram realizadas entre os sexos e idade com o uso de teste-t para amostras independentes. O nível de significância adotado foi de 5%. Resultados: Na consulta inicial e após 7 dias, mulheres apresentaram maior quantidade de placa na boca toda do que homens (p 37 anos (p

Abstract Background Increasing multidrug-resistant tuberculosis (MDR-TB) incidence is a major threat against TB eradication worldwide. We aim to conduct a detailed MDR-TB study in Portugal, an European country with endemic TB, combining genetic analysis and epidemiological data, in order to assess the efficiency of public health containment of MRD-TB in the country. Methods We used published MIRU-VNTR data, that we reanalysed using a phylogenetic analysis to better describe MDR-TB cases transmission occurring in Portugal from 2014 to 2017, further enriched with epidemiological data of these cases. Results We show an MDR-TB transmission scenario, where MDR strains likely arose and are transmitted within local chains. 63% of strains were clustered, suggesting high primary transmission (estimated as 50% using MIRU-VNTR data and 15% considering epidemiological links). These values are higher than those observed across Europe and even for sensitive strains in Portugal using similar methodologies. MDR-TB cases are associated with individuals born in Portugal and evolutionary analysis suggests a local evolution of strains. Consistently the sublineage LAM, the most common in sensitive strains in Europe, is the more frequent in Portugal in contrast with the remaining European MDR-TB picture where immigrant-associated Beijing strains are more common. Conclusions Despite efforts to track and contain MDR-TB strains in Portugal, their transmission patterns are still as uncontrolled as that of sensitive strains, stressing the need to reinforce surveillance and containment strategies.

Considering that this research is still ongoing, this paper focuses on the presentation of the conceptual framework and its interconnection with the methodological strategy for the empirical study that aims to study the learning transfer to the workplace of professional military education in the context of the Portuguese Armed Forces. Factors related to the trainees’ individual characteristics, the organisational context, the courses design, the organisational learning culture, the organisational commitment and the expectations of career development, as well as the relationships established between these factors and the intention to transfer, throughout the lifelong learning process, will be discussed. The empirical study will be carried out at three junctures - before the training, at the end of the training and three to six months after the training. The study is conceptually based on Holton’s Holistic HRD Research and Evaluation (1996), Ajzen’s Theory of Planned Behaviour (1991), Watkins and Marsick’s model of learning organisations (1993, 1996) and Meyer and Allen’s (1991) concept of organisational commitment. The study will be developed using a mixed strategy (quantitative/qualitative), applying a hypothetical-deductive and inductive reasoning, in which a longitudinal research design with a transversal component will be followed. The data collection for the empirical study will be done through a questionnaire, individual semi-structured interviews and discussion groups about the results.

This study analyzed the performance of the Brunt (1932), Swinbank, (1963), Idso and Jackson (1969), Brutsaert (1975), Idso (1981), and Bignami et al. (1995) methods to estimate atmospheric emissivity under grass-dominated savannas (known as campo sujo Cerrado), in the region of Baixada Cuiabana. The estimates were compared with data obtained by energy balance equation in two seasons, dry season (May to August), and wet season (September to December) of 2009. The Swinbank and Idso and Jackson methods, that consider only air temperature, show better performances for the wet season. However, methods that consider water vapor pressure and air temperature (Brunt, Brutsaert, Bignami and Idso) show good performances for the dry season. The Idso and Brutsaert methods show the highest index of agreement and are recommended to estimate atmospheric emissivity for the region.

O artigo objetiva abordar o ambientalismo latino-americano, representado nas lutas contra-hegemônicas da educação ambiental e do campo. Após a crise econômica de 2008, os EUA voltaram suas atenções para a América Latina, interessados na exploração de recursos primários. Neste contexto, a educação ambiental e a educação do campo têm um importante papel na criação da consciência crítica dos indivíduos e de um saber ambiental. A primeira parte analisa o ambientalismo como um movimento de resistência. Depois, enfatiza-se o caráter emancipatório da educação ambiental e da educação do campo. Para finalizar, propõe-se uma educação do campo oposta ao modelo do agronegócio.

The modes of random lasers, by their very nature, are difficult to design and control. Here, Gaio, Saxena et al. demonstrate a laser based on a nanophotonic network, instead of random scatterers, which allows tailoring of the optical properties and the lasing output via the network topology.

Este artigo examina elementos no processo de constituição de significados atribuídos por atores escolares de escolas públicas localizadas em contextos vulneráveis, em Portugal, às situações de indisciplina, conflito e violência, em torno do seguinte questionamento: quais são as ações encetadas para enfrentá-las e suas percepções acerca desses fenômenos? As escolas selecionadas para o estudo integram o programa TEIP (Territórios de Intervenção Prioritária), desde 1996. Trata-se de estudo qualitativo e exploratório, com base em levantamento e análise de informações de documentos oficiais e da legislação, além de entrevistas realizadas com equipes compostas por profissionais responsáveis pela sua implementação. Considera-se a relevância de compreender percepções de atores educacionais envolvidos em fatos e situações de conflitos em escolas públicas.

Introduction: Immigrants may utilize health care services differently than other residents and may also have a greater risk for tuberculosis (TB). Objective: Identify barriers to healthcare access by immigrants, factors associated with these barriers, and discuss strategies that may reduce these barriers. Material and methods: Anonymous questionnaires were given to immigrants at National Immigrant Support Centres between 2015 and 2016. Barriers to healthcare were identified using logistic regression. Results: One-hundred and nineteen questionnaires were administered to immigrants, 9 of whom (8%) presented with TB while in Portugal. Twenty-one percent of immigrants reported barriers to healthcare access, and 69% had general practitioners (GPs). The presence of barriers to healthcare access was negatively associated with having a GP and with being married or in a de facto union. Conclusions: A considerable proportion of immigrants reported having difficulties accessing healthcare services in Portugal where legally these barriers are nonexistent. Certain factors were associated with these difficulties. Keywords: Tuberculosis, Immigration, Health services, Barriers