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Com a evolução da sociedade e com um mercado mais competitivo, é evidente que a exigência é uma palavra bastante abordada e são diversos os autores que estudam as componentes que originam o sucesso. A liderança e o papel do líder ocupam um lugar de grande importância neste âmbito e são diversos os estudos que abordam a influência do líder nos seus liderados. Inspirado nos estudos sobre os efeitos do entusiasmo do professor, é nossa proposta que a mesma característica possa estar associada ao líder, nomeadamente, ao líder transformacional. Neste sentido, foi desenvolvido um estudo de carácter correlacional com o objetivo de analisar: a) o entusiasmo do líder como um atributo do líder transformacional; b) o efeito do entusiasmo do líder na satisfação da equipa e no bem-estar afetivo dos membros e c) na cultura organizacional de aprendizagem e no comportamento de trabalho inovador. A amostra é caracterizada por 311 participantes de ambos os géneros, com idades compreendidas entre os 19 e os 63 anos (M=36.68; DP=10.97). Os resultados mostraram que o entusiasmo está associado ao líder transformacional e que contribui para a cultura organizacional de aprendizagem e também para a inovação e criatividade dos liderados. Os resultados fornecem implicações importantes para a compreensão dos processos de liderança e para a estratégia das empresas neste âmbito. With the evolution of society and a more competitive market, it has become clear that demand is a word that is often discussed, and several are the authors whose study regards the factors that lead to success. In this scope, Leadership and the leader's role occupy a very important part, and there are several studies that address the leader's influence on his subordinates. Inspired by research on the effects of the teacher’s enthusiasm, we propose that the same characteristic may be associated with the leader, namely the transformational leader. In this sense, a correlational study was conducted with the aim of analyzing: a) the leader's enthusiasm as an attribute of the transformational leader; b) the effect of the leader's enthusiasm on the team’s satisfaction and the members' affective well-being; and c) on organizational learning culture and innovative work behavior. The sample is composed by 311 participants of both genders with ages ranging between 19 and 63 (M=36.68; SD=10.97). The results showed that not only enthusiasm is associated with the transformational leader and that it contributes to the organizational learning culture, but also to the innovation and creativity of the subordinates. The results provide important implications for the understanding of leadership processes and for the companies' strategy in this regard.

Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz Objetivo: Avaliação dos fatores determinantes da assiduidade às consultas de Tratamento Periodontal de Suporte numa amostra de pacientes da Clínica Dentária Egas Moniz. Materiais e métodos: Foi realizado um estudo retrospetivo através da análise de 104 processos clínicos de pacientes que completaram o tratamento periodontal não cirúrgico e foram seguidos nas consultas de Tratamento Periodontal de Suporte na Clínica Universitária Egas Moniz entre os meses de dezembro 2019 e março 2020. A adesão dos pacientes foi avaliada pelos intervalos entre consultas de TPS e foram classificados como assíduos (compareceram a pelo menos 2 consultas por ano), irregulares (interromperam o tratamento durante um período, sendo que ao longo das demais consultas demonstraram ser assíduos) e os restantes como não assíduos. Foi feita uma análise para cada grupo para correlacionar o grau de adesão com o sexo, idade, situação profissional, proximidade à clínica, escalão de rendimento anual, diagnóstico periodontal, número de dentes ausentes no diagnóstico, índice de placa, índice gengival, patologias sistémicas, hábitos tabágicos, presença de implantes, presença de prótese dentária, tratamento ortodôntico e duração do tratamento. Resultados: Apenas 41,3% dos pacientes mostraram ser assíduos. Pacientes mais velhos e pacientes com IG mais baixo tiveram melhor adesão à TPS, assim como pacientes com maior duração de tratamento demonstraram ser mais assíduos. Não houve diferenças significativas entre os pacientes assíduos, irregulares e não assíduos em relação às restantes variáveis. Conclusão: Nesta amostra foi observada uma baixa adesão à terapia periodontal. A idade, o IG, a Hipercolesterolemia e a duração do tratamento representaram modificadores significativos na adesão à TPS. No entanto, mais estudos são necessários para avaliar se estes resultados são válidos para a população portuguesa. Aim: Evaluation of the determinating factors related to assiduity in Supportive Periodontal Therapy appointments in a sample of patients from Clínica Universitária Egas Moniz. Materials and Methods: A retrospective study was carried out through the analysis of 104 clinical files of patients who completed non-surgical periodontal treatment and were followed in the Periodontal Support Treatment appointments at Clínica Dentária Egas Moniz between december 2019 and march 2020. Patients' adherence was evaluated by the intervals between SPT consultations and they were classified as assiduous (at least 2 consultations per year), irregular (interrupted treatment for a period and during the other consultations they proved to be assiduous) and the remaining as non assiduous. An analysis was performed for each group to correlate the degree of adherence with sex, age, professional status, proximity to the clinic, annual income level, periodontal diagnosis, number of missing teeth at diagnosis, plaque index, gingival index, systemic pathologies, smoking habits, presence of implants, presence of dental prosthesis, orthodontic treatment and duration of treatment. Results: Only 41.3% of the patients demonstrated to be assiduous. Older patients and patients with a lower GI had better adherence to the SPT. Older patients and patients with a lower GI had better adherence to the TPS, as well as patients with longer duration of treatment demonstrated to be more assiduous. There were no significant differences between assiduous, irregular and non assiduous patients in relation to the remaining variables. Conclusion: In this sample was observed low adherence to periodontal therapy. Age, GI, hypercholesterolemia and duration of treatment represented significant modifiers in results in adherence to SPT. However, more studies are needed to assess whether these results are valid for the portuguese population.

Critiques of resettlement bodies exist in both formal and informal discourse, though these concerns had heretofore been allowed to remain liminal. The push towards accountability engendered through the rapid democratization of media, accelerated by several high visibility humanitarian crises, has now revitalized the trajectory of criticisms through some degree of institutional reflection. While formal critiques of humanitarian bodies often focus on the philosophical and moral quandaries of the quest to decolonize and de-weaponize social sciences (as well as the systematic disempowerment of resettled communities), fewer address the syndemic ethical challenges encoded into the daily operations of the humanitarian ecosystems themselves, as well as the feedback loops which they foment. This article is concerned with matters of praxis, professionalization and transparency, addressing blocks to the information flows necessary to enable the level of introspection and systems thinking which should underpin all human sciences, but which have been conspicuously absent in the U.S. resettlement bodies, despite their being so directly intertwined with life outcomes. Absent the development of dedicated, integrated health and other supportive infrastructures independent of resettlement organizations, and primarily utilizing the U.S. resettlement bodies to inform its arguments, it highlights the need for the resettlement field, and by extension, similar humanitarian sectors, to align themselves with various disciplinary standards that will promote and valorize accountability over expansion. It concludes that to accomplish this, fields must also seek to catalyze the exploration of the many tensions inherent to equitable restructuring through the empowerment of practitioners as well as the elimination of barriers to constructive discourse.

Geometry teaching in elementary schools in Colombia is a challenging task. Students’ problems with this topic have led to below-average performances in the Program of International Student Assessment. To face this challenge, this paper presents Akasha, a personalized software application to reinforce geometry teaching to elementary school children between 5 and 7 years old. Akasha provides ludic activities to identify and characterize polyhedra, polygons, and shape attributes. To further improve the experience, Akasha uses information about users to adjust the difficulty level, and to customize the look and feel of the application. To validate the approach, this study assessed student performance before and after using Akasha in three different schools (public and private) of Bogota (Colombia). The results suggest that the use of Akasha may have a positive impact on students’ learning, regardless of their social, economic, or technological background.

In light of the 2021 United States military withdrawal from Afghanistan, as well as the humanitarian crises of mass displacement and subsequent health system strain that have ensued, practitioners worldwide will need to develop a more nuanced understanding of the adverse life experiences that women from Afghanistan frequently endorse. As they bear a disproportionate impact of constraints within Afghan society, and as patriarchal systems affect most of their life domains, women from Afghanistan may present with high levels of baseline trauma upon resettlement, and health systems may seek to attenuate this distress; However, the nature of these traumatogenic events may shape women's receptivity to psychosocial interventions, particularly those which are at least partially rooted in Western modalities. In the absence of sufficient literature on evidence-based interventions for this population, a diversity of ethnographic and clinical literature is synthesized, including literature on interventions alleged to be compatible with Afghan norms. As it will be essential to support Afghan women's mental health following social reorganization on a massive scale, considerations arising from the interdisciplinary literature are offered so that they may inform the development of structured, trauma-focused interventions and so that the health systems with which they interface may be better prepared to serve them.

Este trabalho versa sobre a importância da introdução da abordagem CTSA nas escolas, considerando-a como uma alternativa eficaz na proposição de ações educativas contextualizadas e na formação de cidadãos críticos e responsáveis. Essa abordagem possui como ponto de partida problemáticas reais aplicadas a contextos igualmente reais, portanto, o objetivo geral desta dissertação é conhecer a visão dos profissionais que atuam em escolas públicas de Ensino Fundamental I de Uberlândia-MG e região sobre o ensino de Ciências e estudo de temáticas que fazem parte da realidade local, mais especificamente “O Cerrado”, compreendendo suas práticas pedagógicas, formação inicial e continuada, assim como os recursos didáticos utilizados neste nível de ensino. Dessa forma, foi adotada, como referência de análise as relações entre Ciência, Tecnologia, Sociedade e Ambiente, trazidas pela abordagem CTSA, considerando o Cerrado e suas problemáticas ambientais, levando em conta a rica biodiversidade da região e sua crescente exploração causada pela agricultura, pela pecuária, pela mineração, pela indústria e pela construção civil. Os docentes que atuam nos AIEF assumem uma tarefa complexa, diante do contexto generalista, portanto, possuem dificuldades para o ensino de áreas específicas, como Ciências da Natureza e, muitas vezes, não possuem conhecimento de abordagens atuais na discussão de questões ambientais. Para tanto, foi aplicado um questionário eletrônico, no qual se objetivou compreender melhor o contexto dos profissionais, verificando os caminhos para a construção de uma Sequência Didática (SD) que aborda as problemáticas ambientais do bioma Cerrado orientada pelos cinco passos da abordagem CTSA propostos por Santos e Mortimer (2007). De caráter qualitativo, a pesquisa foi delineada pela metodologia exploratória, na qual a pesquisadora explorou realidades próximas dos sujeitos pesquisados. Os dados foram categorizados com base na metodologia de análise de conteúdo, proposta por Bardin e nas etapas propostas por Moraes (1999), que definem os conteúdos e contextos como unidades de análise. Por meio de tais processos, foram analisados pontos e contrapontos nas respostas dos educadores(as) em relação às práticas e abordagens metodológicas que envolvem o tema Cerrado, à luz da abordagem CTSA. Os procedimentos adotados constataram, como aspecto principal, as limitações formativas dos professores(as), em relação ao ensino de áreas específicas nos anos iniciais, as dificuldades do ensino generalista no que se refere ao tempo, espaço e recursos das escolas, assim como o acesso dos profissionais a abordagem CTSA. Com base nos aspectos mencionados, foi possível verificar as possibilidades e fragilidades da Sequência Didática (SD) desenvolvida, com vistas a subsidiar o trabalho dos profissionais e motivá-los a elaborar seus próprios recursos didáticos por intermédio do diálogo, da reflexão e da formação continuada. This study deals with the importance of introducing the CTSA approach in schools, considering it as an effective alternative in the proposition of contextualized educational actions and in the formation of critical and responsible Citizen. This approach has as a starting point real problems applied to equally real contexts. This approach has as a starting point real problems applied to equally real contexts, therefore, the general objective of this research is to understand the view of professionals who work in public elementary schools I in Uberlândia-MG and region on teaching Science. It aims also to study themes that are part of local reality, specifically “The Cerrado”, to understand its pedagogical practices, initial and continuing education, as well as the didactic resources used at this level of education. Thus, we adopted the relationship between Science, Technology, Society and Environment, brought by the CTSA approach, as a reference for analysis, taking into account the region's rich biodiversity and its growing exploitation caused by agriculture, livestock, mining, industry and by civil construction. The teachers who work at the AIEF assume a complex task, given the generalist context, therefore, they have difficulties in teaching specific areas, such as Natural Sciences, and often do not have knowledge of current approaches in the discussion of environmental issues. For that, we applied an electronic questionnaire, in which the aim was to better understand the context of professionals, verifying the paths for the construction of a Didactic Sequence (DS) that addresses the environmental problems of the Cerrado biome guided by the five steps of the CTSA approach proposed by Santos and Mortimer (2007). It is a qualitative search outlined by the exploratory methodology, in which the researcher explored realities close to the researched subjects. Data were categorized based on the content analysis methodology proposed by Bardin and on the steps proposed by Moraes (1999), which define contents and contexts as units of analysis. Through such processes, we analyzed points and counterpoints in the responses of educators concerning to practices and methodological approaches that involve the Cerrado theme, in the light of the CTSA approach. The adopted procedures found out, as a main aspect, the teachers’ training limitations, concerning to specific study areas in the initial years, the difficulties of general education regarding the time, space and resources of the schools, as well as the professionals' access to the CTSA approach. Based on the mentioned aspects, it was possible to verify the possibilities and weaknesses of the Didactic Sequence (DS) developed, with a view to subsidizing the work of professionals and motivating them to develop their own didactic resources through dialogue, reflection and continuing education. Dissertação (Mestrado)

Cracked teeth are the third most common cause of tooth loss, but there is no reliable imaging tool for the diagnosis of cracks. Here, we demonstrate the feasibility of indocyanine green near-infrared fluorescence (ICG-NIRF) dental imaging for the detection of enamel cracks and enamel-dentin cracks in vitro in the first (ICG-NIRF-I, 700-950 nm) and second (ICG-NIRF-II, 950-1700 nm) imaging windows with transmission excitation light, and compared ICG-NIRF with conventional NIR illumination-II (NIRi-II) and X-ray imaging. Dentin cracks were detected by CT scan, while most enamel cracks, undetectable under X-ray imaging, were clearly visible in NIR images. We found that ICG-NIRF-II detected cracks more effectively than NIRi-II, and that light orientation is an important factor for crack detection: an angled exposure obtained better image contrast of cracks than parallel exposure, as it created a shadow under the crack. Crack depth could be evaluated from the crack shadow in ICG-NIRF and NIRi-II images; from this shadow we could determine crack depth and discriminate enamel-dentin cracks from craze lines. Cracks could be observed clearly from ICG-NIRF images with 1-min ICG tooth immersion, although longer ICG immersion produced images with greater contrast. Overall, our data show that ICG-NIRF dental imaging is a useful tool for diagnosing cracked teeth at an early stage.

Taranath, Anu. (2019). Beyond Guilt Trips: Mindful Travel in an Unequal World. Lutsen, MN: Between the Lines Publishing. 208 pages.

Marine flowering plants can reproduce sexually and clonally, and the relative contribution of these two modes can be dependent on the environmental conditions. Zostera marina, a seagrass widely distributed in the northern hemisphere, can form annual and perennial meadows with different proportions of sexual versus clonal propagation depending on the environmental disturbance regime. We study the hypothesis that the contribution of sexual propagation varies during the recovery of a seagrass meadow. In this case study, we compare the proportion of sexual versus clonal propagation of a perennial Z. marina meadow before its disappearance due to winter storms and after recovery. Before disturbance, genotypic diversity was high, indicating frequent sexual reproduction events likely to create an abundant seed bank. Seedling germination allowed the population to recover after the extreme disturbance. As months passed, seedlings became rare and finally absent, giving place to adult shoots. In an advanced stage of colonization, the shoots colonized the area by vegetative growth, which lowered the genotypic diversity. Despite this reduction over time, the genotypic diversity of the new meadow is still high, demonstrating the importance of sexual reproduction in meadow recovery and persistence. Las plantas marinas con flores pueden reproducirse sexualmente y de manera clonal, y la contribución relativa de estos dos modos puede depender de las condiciones ambientales. La Zostera marina, una planta marina ampliamente distribuida en el hemisferio norte, puede formar praderas anuales y perennes con distintas proporciones de propagación sexual frente a clonación, según el régimen de perturbación ambiental. Estudiamos la hipótesis de que la contribución de la propagación sexual varía durante la recuperación de una pradera marina. En este estudio, comparamos la proporción de la propagación sexual versus clonal de una pradera de Z. marina perenne, antes de su desaparición debido a las tormentas de invierno y después de la recuperación. Antes de la perturbación, la diversidad genotípica era alta, lo que indicaba eventos frecuentes de reproducción sexual, lo que podría crear un banco de semillas abundante. La germinación de las plántulas permitió que la población se recuperara después de la perturbación extrema. A medida que pasaban los meses, las plántulas se volvían raras y finalmente se ausentaban, dando lugar a brotes adultos. En una etapa avanzada de colonización, los brotes colonizaron el área mediante crecimiento vegetativo, lo que disminuyó la diversidad genotípica. A pesar de esta reducción en el tiempo, la diversidad genotípica de la nueva pradera sigue siendo alta, lo que demuestra la importancia de la reproducción sexual en la recuperación y la persistencia de la pradera.

A realização desta dissertação tem o objetivo de proporcionar, ao mundo académico e empresarial, insights relevantes sobre o processo de controlo de gestão. Pretende-se, ainda, dar contributos necessários para a área do Turismo ao nível das práticas de controlo de gestão, visto não haver muitos estudos sobre as implicações dos sistemas de controlo de gestão no setor. Um adequado sistema de controlo de gestão auxilia a organização a ter sucesso, dispondo de um conjunto de instrumentos que motivem os gestores a alcançarem os objetivos estratégicos. O desenvolvimento deste trabalho seguiu as questões de investigação formuladas: 1. Como é que o sistema de informação de gestão está implementado na empresa Solférias, de forma a suportar o processo de tomada de decisão? Complementarmente, como é que a informação é recolhida, tratada e divulgada aos gestores? 2. Como é que os sistemas de controlo de gestão se adaptam a novos acontecimentos na vida das organizações? A presente investigação divide-se em três partes. Na primeira parte procedeu-se ao levantamento teórico, expondo os conceitos defendidos por vários autores sobre o tema Controlo de Gestão. A segunda parte destina-se ao trabalho empírico, onde a metodologia utilizada foi a qualitativa e o estudo de caso como método de pesquisa. O processo de recolha de dados foi realizado com base em entrevistas e análise documental. A discussão é a terceira parte relevante desta investigação, destinando-se à comparação dos resultados encontrados no estudo empírico com o levantamento teórico, para responder às questões de investigação. O estudo de caso foi realizado a uma empresa do setor turístico português: Solférias. A partir da evolução da empresa, efetuou-se um levantamento dos principais marcos no processo de controlo de gestão e no sistema de informação de gestão - instrumentos, procedimentos internos e novas linhas estratégicas que integram a organização. Em termos de resultados, comprovou-se que o sistema de informação de gestão é eficaz no apoio ao processo de tomada de decisão, tendo-se também constatado o envolvimento da estrutura organizacional. Os findings sugerem que a Solférias se preocupa em manter os colaboradores motivados, pois isso definirá o sucesso organizacional. Além disso, foi possível apurar que à medida que a empresa evolui e define novas orientações estratégicas os sistemas de controlo de gestão e de informação de gestão adaptamse em conformidade. Considera-se que o presente estudo é relevante para área de Gestão de Empresas ao nível das práticas de controlo de gestão. Compreende-se que o sistema não é estático, devendo haver uma monitorização contínua dos instrumentos que compõem o controlo de gestão. The purpose of this dissertation is to provide the academic and business world relevant insights about the process of management control. It is also intended to provide the necessary contributions to the Tourism industry in terms of management control practices, since there are not many studies on the implications of the management control systems in this sector. An adequate management control system helps the organization to succeed, providing a set of instruments that motivate managers to achieve strategic goals. The development of this work followed the research questions formulated: 1. How is the management information system implemented in the Solférias company, in order to support the decision-making process? In addition, how is the information collected, processed and disclosed to the managers? 2. How do management control systems adapt to new events in organizational life? This investigation is divided into three parts. In the first part, theoretical research was carried out, exposing the concepts defended by several authors on the topic of Management Control. The second part is the empirical work, where the methodology used was qualitative and a case study is displayed. The process of data collection was based on interviews and document analysis. The discussion is the third relevant part of this investigation, aiming at comparing the results found in the empirical study with the theoretical survey, in order to answer the investigation questions. The case study was applied to a company in the Portuguese tourism sector: Solférias. Based on the company's evolution, a survey on the main milestones in the management control process and in the management information system - instruments, internal procedures and new strategic lines that make up the organization. In terms of results, it was verified that the management information system is effective in supporting the decision-making process, and the involvement of the organizational structure was also confirmed. The findings demonstrated that Solférias is concerned with keeping their employees motivated, as this will define its organizational success. In addition, the results suggest that as the company evolves and defines new strategic guidelines, the management control and management information systems adapt accordingly. This study is considered relevant to the area of Business Management in terms of management control practices. It is understood that the system is not static, and there must be continuous monitoring of the instruments that build up the management control.

Objetivo: Analizar la anatomía del piso pélvico. Método: EL proceso al cual está sometida esta investigación es la de revisar bibliográficamente documentaciones con estructuras científicas hechas con anterioridad por otros autores acordes a la materia, pero sin que la misma sea extraída de repositorios con una data de años muy distantes a los que se escribe el presente tópico. Resultados y conclusiones: Las estructuras musculares y de tejido conectivo (fascia, ligamentos, entre otros.) forman una estructura que entrega soporte a los órganos abdominopélvicos durante la bipedestación y cambios de la presión intraabdominal, además existen estructuras de tejido conectivo que fijan los órganos a la pelvis funcionando como puntos de fijación y suspensión. Lo anterior mantiene la posición anatómica de los órganos en la pelvis permitiendo un adecuado funcionamiento tanto para la continencia fecal como urinaria.

Objetivo: Analizar la relación del ciclo menstrual y la actividad física. Método: Se realizó una revisión bibliográfica de los últimos años que incluyó 10 artículos publicados en las bases de datos biomédicas (Scielo, Pubmed y Medline). Resultados y conclusiones: La relación entre ciclo menstrual y actividad física ha sido objeto de investigación desde diferentes perspectivas; tomar en cuenta esta relación es necesario y contribuye de manera positiva. Las fases del ciclo se caracterizan por disímiles diferencias tanto fisiológicas como psicológicas y éstas marcan pautas de trabajo físico específico para una mejor asimilación de las cargas de entrenamiento. Es importante que las entidades encargadas de la dirección de la actividad física y del entrenamiento deportivo femenino conozcan e implementen estas bases ya que contribuyen a un mejor rendimiento físico y con ello a una mejora en el estilo de vida de las mujeres que dedicadas a la actividad física.

Objetivo: Analizar la histerectomía en la obstetricia y las complicaciones antes y después del embarazo. Método: El método utilizado en esta investigación es la revisión bibliográfica y sistemática, observacional y retrospectiva sobre factores asociados a incidencias en pacientes histerectomizadas, utilizando fuentes como Dialnet, Scielo y otros recursos. Resultados y conclusiones: Se han encontrado varios factores de riesgo para la aparición de enfermedades infecciosas después de la histerectomía, entre ellos, la presencia de secreciones vaginales antes de la cirugía, detección de inflamación en citología. El uso de un DIU cervical y vaginal, consistente con la patogenia descrita en la literatura médica, y se puede modificar y prevenir antes de la cirugía. Persisten otros factores controversias, como si los arcos de la vagina y el peritoneo están cerrados o no, así como la duración de la actividad. Y la cantidad de sangre que sale

Objetivo: Analizar la importancia de la pelvimetría y factor con un indicador de la desproporción céfalo – pélvica. Método: El método empleado en esta investigación es la revisión bibliográfica ya que es un texto escrito que tiene como propósito presentar una síntesis de las lecturas realizadas durante la fase de investigación documental, seguida de unas conclusiones o una discusión. Resultados y conclusiones: La pelvimetría es de suma importancia en el momento del trabajo de parto ya que es un método que como resultado puede detectar la pelvis para un trabajo de parto con el cual la pelvis ginecoidea es la mejor o ideal para un parto vaginal. Los problemas que se pueden producir en el parto en el feto, las enfermedades producen un aumento excesivo en el desarrollo de diferentes factores que son producido por la madre y haya riesgos en la desproporción pélvico-cefálica tiene a poner en riesgo en el nacimiento del feto con el cual las extremidades del feto como las hidrocefalias con el aumento del cráneo.

Objetivo: Incidir en la mujer gestante por parte del personal de salud y llevar a cabo una profilaxis durante la gestación y antes del parto a término. Método: EL proceso al cual está sometida esta investigación es la de revisar bibliográficamente documentaciones (fuentes secuendarias) con estructuras científicas hechas con anterioridad por otros autores acordes a la materia, pero sin que la misma sea extraída de repositorios con una data de años muy distantes a los que se escribe el presente tópico. Resultados y conclusiones: La paciente debe buscar información y educarse acerca de su embarazo para saber actuar ante un imprevisto junto con la persona a cargo del mantenimiento y cuidado de su salud gestacional; es así, donde habrá una relación médico paciente excelente. Así mismo, el experto debe hacerse notar por su alto conocimiento a la hora de atención de un chequeo o una emergencia obstétrica.

ObjectivesTo evaluate the health-condition of military police officers and firefighters. To identify risk factors for not being medically ready for duty.DesignCross-sectional study.SettingData were extracted from medical records during annual periodic health assessments of police officers and firefighters serving with the military police in Paraná, Brazil.Participants6621 police officers (5927 men and 694 women) and 1347 firefighters (1257 men and 90 women) who underwent health assessments between July 2018 and June 2019 were analysed. Pregnant women were excluded.Outcome measuresData included variables such as sex, age, anthropometric measurements, lifestyle, comorbidities and laboratory tests. Multiple logistic regression was used to estimate the probability of not being medically ready for active duty.ResultsOverall, police officers had worse health status than firefighters and greater prevalence of overweight and obesity, regardless of sex. Musculoskeletal diseases were the most commonly reported disease by police officers and firefighters of both sexes. Among men, hypertension was the second most prevalent disease, followed by psychiatric diseases and dyslipidaemia. Among women, psychiatric diseases were the second most prevalent. Male police officers ≥40 years old presented the highest probability of not being considered ready for duty (40.1%). The probability of male police officers between the ages of 31 and 40 not being ready was similar to that for male firefighters >40 years old. There was a higher chance of not being medically ready professionals with diseases such as diabetes mellitus (OR 2.95, 95% CI 1.97 to 5.03), dyslipidaemia (OR 2.65, 95% CI 1.96 to 3.58), hypertension (OR 2.29, 95% CI 1.85 to 4.70), high total cholesterol (OR 2.16, 95% CI 1.93 to 2.42), and heart disease (OR 2.13, 95% CI 1.32 to 3.45).ConclusionsThere was a high prevalence of chronic diseases and modifiable cardiovascular risk factors among police officers and firefighters. Healthy protective measures should be offered frequently, particularly to police officers at an earlier age.

Pancreatic cancer is the deadliest cancer type with a five-year survival rate of less than 9%. Detection of tumor margins plays an essential role in the success of surgical resection. However, histopathological assessment is time-consuming, expensive, and labor-intensive. We constructed a lab-designed, hand-held Raman spectroscopic system that could enable intraoperative tissue diagnosis using convolutional neural network (CNN) models to efficiently distinguish between cancerous and normal pancreatic tissue. To our best knowledge, this is the first reported effort to diagnose pancreatic cancer by CNN-aided spontaneous Raman scattering with a lab-developed system designed for intraoperative applications. Classification based on the original one-dimensional (1D) Raman, two-dimensional (2D) Raman images, and the first principal component (PC1) from the principal component analysis on the 2D image, could all achieve high performance: the testing sensitivity, specificity, and accuracy were over 95%, and the area under the curve approached 0.99. Although CNN models often show great success in classification, it has always been challenging to visualize the CNN features in these models, which has never been achieved in the Raman spectroscopy application in cancer diagnosis. By studying individual Raman regions and by extracting and visualizing CNN features from max-pooling layers, we identified critical Raman peaks that could aid in the classification of cancerous and noncancerous tissues. 2D Raman PC1 yielded more critical peaks for pancreatic cancer identification than that of 1D Raman, as the Raman intensity was amplified by 2D Raman PC1. To our best knowledge, the feature visualization was achieved for the first time in the field of CNN-aided spontaneous Raman spectroscopy for cancer diagnosis. Based on these CNN feature peaks and their frequency at specific wavenumbers, pancreatic cancerous tissue was found to contain more biochemical components related to the protein contents (particularly collagen), whereas normal pancreatic tissue was found to contain more lipids and nucleic acid (particularly deoxyribonucleic acid/ribonucleic acid). Overall, the CNN model in combination with Raman spectroscopy could serve as a useful tool for the extraction of key features that can help differentiate pancreatic cancer from a normal pancreas.

This work received financial support from PT national funds from Fundacao para a Ciencia e Tecnologia (FCT) through the grant FCT/MEC (UID/DTP/04138/2020 and UIDP/04138/2020) financing Research Institute for Medicines-iMed. ULisboa, grant FCT/MEC (UIDP/04378/2020 and UIDB/04378/2020) financing Applied Molecular Biosciences Unit-UCIBIO, a grant by FCT/MCTES (UIDB/50006/2020) financing LAQV-REQUIMTE Associate Laboratory, from the European Union (FEDER funds through COMPETE POCI-01-0145-FEDER-029253), and by Phospholipid Research Center (project LCO-2017-052/1-1). M.F.-S. acknowledges PhD grant PD/BD/135,264/2017 attributed by the FCT i3DU PhD program. Rheumatoid arthritis (RA) is an autoimmune disease that affects the joints and results in reduced patient quality of life due to its chronic nature and several comorbidities. RA is also associated with a high socioeconomic burden. Currently, several available therapies minimize symptoms and prevent disease progression. However, more effective treatments are needed due to current therapies’ severe side-effects, especially under long-term use. Drug delivery systems have demonstrated their clinical importance—with several nanocarriers present in the market—due to their capacity to improve therapeutic drug index, for instance, by enabling passive or active targeting. The first to achieve market authorization were liposomes that still represent a considerable part of approved delivery systems. In this manuscript, we review the role of liposomes in RA treatment, address preclinical studies and clinical trials, and discuss factors that could hamper a successful clinical translation. We also suggest some alterations that could potentially improve their progression to the market. publishersversion published

Background: Diabetes mellitus is characterized as group of metabolic alterations manifested by chronic hyperglycemia. Physical exercise emerges in this context as a positive strategy in the diabetes therapeutic process. Objective: Access physical exercise effects on people with diabetes. Methods: Systematic Review of Literature through the PICO method with the following research question: Which are the benefits of physical exercise in a diabetic person? The research was carried out using the electronic database platforms: EBSCOhost, Medline and BVS, having identified, selected, evaluated the methodological quality and included the articles that take into account the PRISMA recommendations. Results: 9 studies were included that fulfilled the eligibility and methodological quality criteria. Conclusion: The physical exercise prescription in people with diabetes can be an adjuvant in the treatment of that condition with metabolic control benefits and increase of life quality.

Indocyanine green (ICG) has been widely used in medical imaging, such as in retinal angiography. Here, we describe a pilot ex vivo study of ICG-assisted near-infrared fluorescence (NIRF) dental imaging in the first (700-950 nm for ICG-NIRF-I) and second (1000-1700 nm for ICG-NIRF-II) NIR windows using human extracted teeth; our study is compared with the traditional prevalent X-ray imaging and NIR II illumination (NIRi-II, 1310 nm) without ICG enhancement. The results show that ICG fluorescence has much better imaging contrast in both windows compared with NIRi-II (by quantitatively comparing NIR intensity of the critical neighboring structures, such as enamel and dentin). Cracked teeth, notoriously hard to diagnose by dental X-ray and computed tomography, were clearly profiled in NIRF dental imaging. An insidious occlusal caries, missing in X-ray imaging, became a bright dot that was readily observed in ICG-NIRF-I images. For dental decay, NIRF imaging with ICG enhancement could clearly delineate the decay boundary. NIRF in both windows distinguished interproximal and occlusal superficial caries. Overall, ICG-assisted NIRF dental imaging has unique advantages in identifying cracked teeth and insidious caries. The two NIR imaging windows used in our study might one day serve as noninvasive and nonionizing-radiation methods for the diagnosis of critical dental diseases in situ.

Resumo Introdução: O presente artigo discorre sobre a acessibilidade física e suas possíveis influências frente aos usuários de um serviço oncológico. Através do olhar da terapia ocupacional, considera-se esse um aspecto importante diante do processo de reabilitação desses indivíduos, visto que a estrutura arquitetônica e a organização do meio podem constituir-se como facilitadores ou barreiras, influenciando o fazer humano. Objetivo: Identificar quais são as reais condições de acessibilidade física para os usuários no Centro de Tratamento da Criança com Câncer (CTCriaC) do Hospital Universitário de Santa Maria (HUSM). Método: Essa pesquisa possui abordagem quantitativa, a qual se constituiu por uma avaliação física de áreas de livre circulação do HUSM, assim como do espaço compreendido pelo CTCriaC, quanto à aplicabilidade da Norma Brasileira: ABNT NBR 9050, e da Resolução - RDC nº 50. Resultados: Os resultados foram apresentados em forma estatística e descritiva, sendo avaliados 266 itens, dos quais apenas 30,07% apresentavam-se adequados. Entre esses, 76,92% dos itens correspondentes à rota de acesso externa apresentavam-se inadequados, bem como 63,97% daqueles relacionados à rota de acesso interna do HUSM ao CTCriaC e ambiente do mesmo. 80% e 79,03% dos itens correspondentes aos quartos e sanitários do CTCriaC apresentaram-se inadequados, respectivamente. Conclusão: Constatou-se que os ambientes avaliados se encontravam, em sua maioria, inadequados devido à presença de barreiras arquitetônicas, podendo acarretar consequentes prejuízos às pessoas que apresentam mobilidade reduzida por quaisquer motivos. Abstract Introduction: This article discusses physical accessibility and possible influences across users of an oncology service. Through the eyes of Occupational Therapy, we consider this as an important aspect before the rehabilitation process of these individuals, as the architectural structure and organization of the environment can be constituted as facilitators or barriers, influencing the human doing. Objective: To identify what the actual conditions of physical accessibility for users in the Treatment Center for Children with Cancer (CTCriaC) of the University Hospital of Santa Maria (HUSM). Method: This research has a quantitative approach, which is constituted by a physical evaluation of the areas of free movement of HUSM, as well as space understood by CTCriaC as to the applicability of the Brazilian Regulation: ABNT NBR 9050, and Resolution - RDC nº 50. Results: The results were presented in statistics and descriptive study that evaluated 266 items, of which only 30.07% had to be adequate. Among these, 76.92% of the items corresponding to the external access route are inadequate, and 63.97% of those related to internal access route to the HUSM CTCriaC and its environment. 80% and 79.03% of the corresponding items of the bedrooms CTCriaC and toilets were inadequate, respectively. Conclusion: It was found that evaluated environments were, in most cases, inadequate due to the presence of architectural barriers, which may cause subsequent damage to persons who have reduced mobility for any reason.

Cell-laden printing is the most commonly used approach in 3D bioprinting. One of the major drawbacks of cell-laden printing is that cell viability is highly affected by the extrusion pressure and shear force in the printing process. We present a new cell-deposition method by using the superabsorbent capability of 3D printed scaffolds with four ink formations: 20:10 nanocrystal/alginate (NCA 20/10), 20:10 nanofiber/alginate (NFA 20/10), 20:02 nanocrystal/alginate (NCA 20/02) and 20:02 nanofiber/alginate (NFA 20/02). Limited pores were observed from the surface of inherent NCA and NFA scaffolds, which may limit the numbers of cells to enter into the scaffolds. Therefore, we designed a dual-porous (DP) structure to connect the inherent pores (IPs) to the scaffold surface. Due to these porous structures, NCA and NFA scaffolds exhibit an excellent capability to absorb cell suspension, which may be used for depositing cells to 3D-printed scaffolds, namely self-absorbent (SA) deposition. Compared to the conventional top-loading (TL) method, the SA method had more uniform cell distributions in the entire 3D-printed scaffolds and higher efficiency of cell deposition. For the TL method, DP scaffold exhibited a more uniform cell distribution, which may provide a better microenvironment for the cells in comparison to the IP scaffold. For both cell loading methods, a rapid increase of cell number was observed in the first 4 days of culture in the 3D-printed NCA and NFA structures. NFA 20/02 exhibits the best cell viability compared to the other three inks. In conclusion, the SA method may serve as a new approach for loading cells in cell-free 3D-bioprinting, and DP design could improve the efficiency of the cell deposition.

Orientador: Prof. Dr. Fellype de Carvalho Barreto Coorientador: Dr. Mauro Fernando Kürten Ihlenfeld Dissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Medicina Interna e Ciências da Saúde. Defesa : Curitiba, 11/02/2021 Inclui referências Resumo: OBJETIVOS: Policiais e bombeiros exercem atividades profissionais de alto risco para várias doenças que afetam a saúde física e mental. O objetivo do presente estudo é avaliar as condições de saúde de policiais e bombeiros militares do Estado do Paraná, de acordo com o gênero e faixa etária e identificar fatores de risco relacionados à inaptidão física. MÉTODOS: Neste estudo observacional transversal foram analisados os dados da avaliação médica de 6.621 policiais militares (5.927 masculinos, 694 femininos) e 1.347 bombeiros militares (1.257 masculinos, 90 femininos) submetidos à inspeção de saúde no período de julho de 2018 a junho de 2019. Foram excluídas do estudo as gestantes. A análise de regressão logística múltipla foi usada para avaliar a associação da inaptidão física entre policiais e bombeiros militares e variáveis como: gênero, faixa etária, hábitos de vida e a comorbidades. RESULTADOS: Os policiais tiveram o pior perfil de saúde, sendo considerados inaptos na faixa etária de 31 a 40 anos de idade em 27,9% dos avaliados e de 40,1% a partir de 40 anos. O risco de bombeiros masculinos serem inaptos, a partir dos 40 anos, foi de 26,3%. As principais variáveis que se associaram a inaptidão física foram: diabetes mellitus (OR: 2,95, IC 95% 1,97 a 5,03), dislipidemia (OR: 2,65, IC 95% 1,96 a 3,58), hipertensão arterial sistêmica (OR:2,29, IC 95% 1,85 a 4,70), colesterol total elevado (OR: 2,16, IC 95% 1,93 a 2,42), doença cardíaca (OR: 2,13, IC 95% 1,32 a 3,45). Além de tabagismo, inatividade física, circunferência abdominal elevada, consumo excessivo de bebidas alcoólicas e doença psiquiátrica. CONCLUSÃO: Os resultados deste estudo sugerem a necessidade de avaliações médicas periódicas, acompanhamento e intervenções de saúde na promoção e prevenção de doenças, especialmente numa idade mais precoce em policiais em relação aos bombeiros. Abstract: OBJECTIVES: Police officers and firefighters are workers with a high risk for various diseases that affect physical and mental health. The present study therefore sought to evaluate the health status of military police officers and firefighters in the state of Paraná grouped by sex and age and to identify risk factors associated with physical unfitness in this population. METHODS: In this observational cross-sectional study, data from medical assessments of 6,621 military police officers (5,927 men and 694 women) and 1,347 military firefighters (1,257 men and 90 women) who underwent health assessments between July 2018 and June 2019 were analyzed. Pregnant women were excluded from the study. Multiple logistic regression was used to investigate the association between physical unfitness among military police officers and firefighters and variables such as sex, age group, lifestyle and comorbidities. RESULTS: Police officers had the worst health profile. A total of 27.9% of those evaluated in the 31-to-40 years age group and 40.1% of those in the 40-years-plus age group were considered unfit while the chances of male firefighters being unfit were 26.3% from the age of 40 upward. The main variables associated with physical unfitness were: diabetes mellitus (OR: 2.95, 95% CI 1.97 to 5.03), dyslipidemia (OR: 2.65, 95% CI 1.96 to 3.58), systemic hypertension (OR:2.29, 95% CI 1.85 to 4.70), high total cholesterol (OR: 2.16, 95% CI 1.93 to 2.42) and heart disease (OR: 2.13, 95% CI 1.32 to 3.45). Other variables included smoking, physical inactivity, increased waist circumference, excessive intake of alcoholic beverages and psychiatric diseases. CONCLUSION: The findings of this study suggest that there is a need for regular medical assessments, follow-up and health interventions to promote health and prevent diseases among police officers and firefighters, especially at an earlier age among the former.