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Abstract Paleotsunami deposits provide a compelling record of these events, including valuable insights into their recurrence and associated magnitudes. However, precisely determining the sources of these sedimentary evidence remains challenging due to the complex interplay between hydrodynamic and geological phenomena and the intricacy of the processes responsible for forming and preserving tsunami deposits. Here, we introduce a novel approach that employs Bayesian inference methods to divide the complex tsunami process into segments and independently handle uncertainties, thereby enabling more precise and comprehensive modelling of the sources. We provide a list of potential earthquake scenarios with different likelihoods instead of a single best fit. Based on this method, we calculated that the source of the 869 Jogan earthquake had a magnitude ranging from Moment Magnitude 8.84 to 9.1 (within one standard deviation) with different slip distributions along the Japan Trench. Our results reaffirm that the Jogan event had a similar order of magnitude to the 2011 Tohoku-oki tsunami and enhanced the applicability of paleotsunami deposits to hazard assessment.

Abstract Background The residual activity of a clothianidin + deltamethrin mixture and clothianidin alone in IRS covered more than the period of malaria transmission in northern Benin. The aim of this study was to show whether the prolonged residual efficacy of clothianidin-based products resulted in a greater reduction in vector populations and subsequent malaria transmission compared with the shorter residual efficacy of pirimiphos-methyl. Methods Human bait mosquito collections by local volunteers and pyrethrum spray collections were used in 6 communes under IRS monitoring and evaluation from 2019 to 2021. ELISA/CSP and species PCR tests were performed on Anopheles gambiae sensu lato (s.l.) to determine the infectivity rate and subspecies by commune and year. The decrease in biting rate, entomological inoculation rate, incidence, inhibition of blood feeding, resting density of An. gambiae s.l. were studied and compared between insecticides per commune. Results The An. gambiae complex was the major vector throughout the study area, acounting for 98.71% (19,660/19,917) of all Anopheles mosquitoes collected. Anopheles gambiae s.l. collected was lower inside treated houses (45.19%: 4,630/10,245) than outside (54.73%: 5,607/10,245) after IRS (p

Background: Infective endocarditis continues to be a significant concern and may be undergoing an epidemiological transition. Methods: Were studied 1804 consecutive episodes of infective endocarditis between 1978 and 2022. The mean age was 48 ( ± 19), and 1162 (64%) patients were male. Temporal trends in demographic data, comorbidities, predisposing conditions, microorganisms, complications and in-hospital death have been studied over the decades (1978–1988, 1989–1999, 2000–2010 and 2011–2022). The outcomes and clinical characteristics were modeled using nonlinear cubic spline functions. Findings: Valve surgery was performed in 50% of the patients and overall in-hospital mortality was 30%. From the first to the fourth decade studied, the average age of patients increased from 29 to 57 years (p

Abstract Background Recently, bacterial endosymbiont, including Wolbachia and Microsporidia were found to limit the infection of Anopheles mosquitoes with Plasmodium falciparum. This study aimed to investigate the natural presence of key transmission-blocking endosymbionts in Anopheles gambiae and Anopheles coluzzii in Southern Benin. Methods The present study was conducted in seven communes (Cotonou, Porto-Novo, Aguégués, Ifangni, Pobè Athiémé, and Grand-Popo) of Southern Benin. Anopheles were collected using indoor/outdoor Human Landing Catches (HLCs) and Pyrethrum Spray Catches (PSCs). Following morphological identification, PCR was used to identify An. gambiae sensu lato (s.l.) to species level and to screen for the presence of both Wolbachia and Microsporidia. Plasmodium falciparum sporozoite infection was also assessed using ELISA. Results Overall, species composition in An. gambiae s.l. was 53.7% An. coluzzii, while the remainder was An. gambiae sensu stricto (s.s.). Combined data of the two sampling techniques revealed a mean infection prevalence with Wolbachia of 5.1% (95% CI 0.90–18.6) and 1.3% (95% CI 0.07–7.8) in An. gambiae s.s. and An. coluzzii, respectively. The mean infection prevalence with Microsporidia was 41.0% (95% CI 25.9–57.8) for An. gambiae s.s. and 57.0% (95% CI 45.4–67.9) for An. coluzzii. Wolbachia was only observed in Ifangni, Pobè, and Cotonou, while Microsporidia was detected in all study communes. Aggregated data for HLCs and PSCs showed a sporozoite rate (SR) of 0.80% (95% CI 0.09–2.87) and 0.69% (95% CI 0.09–2.87) for An. gambiae and An. coluzzii, respectively, with a mean of 0.74% (95% CI 0.20–1.90). Of the four individual mosquitoes which harboured P. falciparum, none were also infected with Wolbachia and one contained Microsporidia. Conclusions The present study is the first report of natural infections of field-collected An. gambiae s.l. populations from Benin with Wolbachia and Microsporidia. Sustained efforts should be made to widen the spectrum of bacteria identified in mosquitoes, with the potential to develop endosymbiont-based control tools; such interventions could be the game-changer in the control of malaria and arboviral disease transmission.

O artigo analisou os resultados da Meta 6 do Plano Nacional de Educação, para refletir e propor formas de aperfeiçoar seus indicadores. Políticas de educação em tempo integral foram discutidas, considerando o enfoque das epistemologias da política educacional com perspectiva pluralista, posicionamento crítico-analítico e aspecto crítico-normativo. A análise indicou que os ciclos de monitoramento e avaliação da Meta 6 têm como foco as matrículas dos estudantes e os estabelecimentos escolares com jornada ampliada, sem que indicadores qualitativos sejam observados, aspecto que foi proposto como forma de construir espaços escolares qualitativamente mais receptivos a uma concepção de educação em tempo integral democrática.

La carencia de un sistema de registro de asistencias eficiente representa un desafío tanto para los educadores como para las instituciones educativas, generando disrupciones en la planificación de clases y sus horarios, así como inquietudes acerca de la seguridad de la información del personal docente. Este estudio propone el desarrollo de una aplicación móvil para el control de asistencias docentes, integrando autenticación biométrica y verificación de geolocalización para fortalecer la seguridad en el registro. La evaluación de la aplicación, realizada con 24 participantes en la Universidad Nacional de Trujillo, revela un 95% de precisión en la autenticación biométrica y una significativa reducción en el tiempo de registro, con un tiempo promedio de 32,68 segundos. Además, los resultados de una encuesta reflejan una percepción positiva en cuanto a la seguridad por parte de los usuarios, consolidando la aceptación y confianza en la implementación de esta innovadora solución tecnológica.

Abstract Background Continuous renal replacement therapy (CRRT) support is crucial for critically ill patients and it is underexplored in specific situations. Experimental CRRT offers a means to gain insights into these scenarios, but the prohibitive cost of CRRT machines limits their accessibility. This study aimed to develop and validate a low-cost and precise dialysate controller for experimental CRRT. Results Our results demonstrate a commendable level of precision in affluent flow control, with a robust correlation (R 2 = 0.99) for continuous flow and a strong correlation (R 2 = 0.95) for intermittent flow. Additionally, we observed acceptable agreement with a bias = 3.4 mL (upper limit 95% = 43.9 mL and lower limit 95% = − 37 mL) for continuous flow and bias = − 20.9 mL (upper limit 95% = 54 mL and lower limit 95% = − 95.7 mL) for intermittent flow, in this way, offering a precise CRRT dose for the subjects. Furthermore, we achieved excellent precision in the cumulative ultrafiltration net (UFnet), with a bias = − 2.8 mL (upper limit 95% = 6.5 mL and lower limit 95% = − 12 mL). These results remained consistent even at low affluent flow rates of 8, 12, and 20 mL/min, which are compatible with CRRT doses of 25–30 mL/kg for medium-sized animals. Moreover, the acceptable precision of our findings persisted when the dialysate controller was subjected to high filter dialysate chamber pressure for an extended duration, up to 797 min. Conclusions The low-cost dialysate controller developed and tested in this study offers a precise means of regulating CRRT in experimental settings. Its affordability and accuracy render it a valuable instrument for studying CRRT support in unconventional clinical scenarios, particularly in middle-income countries’ experimental ICU laboratories.

Synthetic aperture radar (SAR) imagery is indispensable for acquiring a comprehensive, large-scale topographical perspective of the Earth's surface, facilitating the evaluation of diverse scenarios spanning various events. However, integrating SAR imagery with ground truth data poses a formidable challenge, primarily due to the complex interactions of electromagnetic radar waves with the intricate features of the surface, characterized by multiple scatterings. This study seeks to bridge these disparities between authentic SAR and simulated by applying ray tracing SAR simulations within a meticulously controlled environment. Our investigation into SAR simulation focuses on evaluating the accuracy, precision, and reliability of theoretical models in representing surface features. Through ray tracing SAR simulations, we aim to understand better the complex interactions of electromagnetic radar waves with surface features, ultimately advancing our ability to interpret SAR imagery in diverse scenarios. The research findings indicate a robust correlation between the physical parameters of the surface and the backscattering levels observed in SAR simulations, underscoring the critical dependence of simulation accuracy on the granularity of the 3-D models employed. Moreover, this study delves into the consistency of modeling approaches in accurately replicating the assessment of building damage in postdisaster contexts, providing insights into the potential enhancements in disaster management and response strategies. The implications of these findings not only advance the understanding of SAR simulation fidelity but also pave the way for significant improvements in the application of SAR technology for disaster assessment and environmental monitoring.

Integrated with remote sensing technology, deep learning has been increasingly used for rapid damage assessment. Despite reportedly having high accuracy, the approach requires numerous samples to maintain its performance. However, in the emergency response phase, training samples are often unavailable. Since no ground truth data is available, deep learning models cannot be trained for this specific situation and, thus, have to be applied to unseen data. Previous research has implemented transfer learning techniques to solve data unavailability. However, many studies do not accurately reflect the rapid damage mapping in real-world scenarios. This study illustrates the use of Earth observation and deep learning technologies in predicting damage in realistic emergency response settings. To this aim, we conducted extensive experiments using historical data to find the best model by examining multiple neural network models and loss functions. Then, we evaluated the performance of the best model for predicting building damage due to two different disasters, the 2011 Tohoku Tsunami and the 2023 Türkiye–Syria Earthquake, which were independent of the training samples. We found that a transformer-based model with a combined cross-entropy loss (CEL) and focal loss generates the highest scoring values. The testing on both unseen sites illustrates that the model can perform well in no-damage and destroyed classes. However, the scores dropped in the middle class. We also compared our transformer-based approach with other state-of-the-art models, specifically the xView-2 winning solution. The results show that the transformer-based models have stable generalization toward multiclass classification and multiresolution imagery.

Abstract Objective The study aims to demonstrate an evaluation method to predict the functional success of total wrist arthrodesis (TWA) and assist its indication. Methods A prospective study including ten patients submitted to (TWA) posttraumatic arthritis. Exclusion criteria were patients who lost postoperative follow-up or incomplete information in the medical record. The objective functional assessment (handgrip strength, three-point pinch, lateral pinch and pulp-pulp pinch) and the subjective functional assessment (DASH, PRWE, EVA) were evaluated in 3 different periods: (1) Before surgery without articular anesthesia, (2) Before surgery under articular anesthesia and (3) 12 weeks after the surgical procedure. Results There was an increase in handgrip strength in all three pinches measurements after pain relief, both after joint anesthesia and after the consolidation of the arthrodesis (p < 0.05). In the comparisons between the subjective evaluations (DASH, PRWE and VAS), the patients had better scores in the postoperative evaluation after 12 weeks (p < 0.05). There was no statistical difference when comparing the mean strength values found after anesthesia and after 12 weeks of TWA. Conclusion the outcomes could propose an assessment protocol for patients with indication for TWA, in which patients with good response to intra-articular anesthetic infiltration would benefit from the effects of the surgical procedure.

Resumo Introdução: Bons programas de residência médica (PRM) devem investir na estruturação e no desenvolvimento contínuo dos serviços de assistência no contexto da rede de saúde, na organização da estrutura de apoio às atividades didáticas e assistenciais, e na remuneração e capacitação contínua de preceptores e coordenadores. Objetivo: Este estudo observacional, transversal e descritivo buscou caracterizar o perfil dos egressos do Programa de Residência Médica em Ortopedia e Traumatologia (PRMOT) do HCFMRP-USP e coletar dados sobre as características do programa que orientem ações de aperfeiçoamento na metodologia de ensino. Método: Participaram do estudo egressos do PRMOT ou que concluíram os programas de complementação especializada e residência médica em cirurgia da mão entre 1964 e 2020. Resultado: Foi encaminhado um questionário a 302 indivíduos (73,6% do total de egressos), obtendo 214 respostas (70,8% dos indivíduos contatados ou 52,2% do total de egressos). Indivíduos do sexo masculino correspondem a 92,5% dos egressos, e 71,9% residem no estado de São Paulo. As duas subespecialidades mais cursadas foram cirurgia do joelho e da mão. A pós-graduação stricto sensu fez parte da formação acadêmica de 40,6% dos egressos, dos quais 60,7% trabalharam com ensino médico. Dos egressos, 71% atuam na subespecialidade escolhida. Na avaliação do ensino do PRMOT e do grau de satisfação profissional, os aspectos que se destacaram positivamente foram: capacitação para atendimento em níveis terciário e secundário, número de atendimentos, variabilidade dos casos e preparo para o mercado de trabalho. Os aspectos que se destacaram negativamente foram: remuneração mensal, carga horária de aulas teóricas e realização de procedimentos cirúrgicos. Conclusão: O estudo conseguiu traçar o perfil do egresso e determinar os pontos fortes e as oportunidades de melhoria do PRMOT do HCFMRP-USP.

O artigo descreve sob uma ótica de gestão democrática a eleição dos grêmios estudantis no ano de 2018 realizada pelo Núcleo Interdisciplinar de Apoio às Unidades Escolares, um órgão da Secretaria Municipal de Educação, da cidade do Rio de Janeiro, tendo como exemplo, os estatutos de duas agremiações em escolas dos anos iniciais do ensino fundamental. A pequena produção científica sobre grêmios estudantis e a própria legislação educacional justificam a realização da pesquisa de natureza qualitativa que utilizou a análise documental como metodologia. Concluímos que houve sim por parte do NIAP uma preparação e organização da eleição das agremiações de estudantes em 2018 sem, contudo, ser essa uma medida administrativa fundamentalmente democrática.

Abstract Tsunami fragility functions (TFF) are statistical models that relate a tsunami intensity measure to a given building damage state, expressed as cumulative probability. Advances in computational and data retrieval speeds, coupled with novel deep learning applications to disaster science, have shifted research focus away from statistical estimators. TFFs offer a “disaster signature” with comparative value, though these models are seldom applied to generate damage estimates. With applicability in mind, we challenge this notion and investigate a portion of TFF literature, selecting three TFFs and two application methodologies to generate a building damage estimation baseline. Further, we propose a simple machine learning method, trained on physical parameters inspired by, but expanded beyond, TFF intensity measures. We test these three methods on the 2011 Ishinomaki dataset after the Great East Japan Earthquake and Tsunami in both binary and multi-class cases. We explore: (1) the quality of building damage estimation using TFF application methods; (2) whether TFF can generalize to out-of-domain building damage datasets; (3) a novel machine learning approach to perform the same task. Our findings suggest that: both TFF methods and our model have the potential to achieve good binary results; TFF methods struggle with multiple classes and out-of-domain tasks, while our proposed method appears to generalize better.

In 1910, Vila Isabel FutebolClube was founded. Our intention is, when discussing the trajectory of this association, to dedicate attention to its participation in the outlining of a profile for the neighborhood in which it was located, to perceive how its actions intertwined with the surroundings of its headquarters. The option to investigate this sports association was due to its corporate structure. Its members came from the middle and upper strata who lived in Vila Isabel or nearby, not belonging, however, to the highest socioeconomic strata who lived in the most valued neighborhoods of Rio de Janeiro. The club was an expression of an “intermediate elite” in the city. In addition, it had to deal with the social heterogeneity of the region where it was located. “Small, but with big initiatives”: this is how a chronicler referred to Vila Isabel on the occasion of its tenth anniversary. We believe that these characteristics allow us to perceive something of the city’s societal movements, as well as their insertion in spatial records.

Abstract Background In Alibori and Donga, two departments of high malaria incidence of Northern Benin, pirimiphos-methyl, mixture deltamethrin + clothianidin, as well as clothianidin were used at large scale for IRS. The present study aimed to assess the residual efficacy of these products. Methods Immatures of Anopheles gambiae sensu lato (s.l.) collected in the communes of Kandi and Gogounou (Department of Alibori), Djougou and Copargo (Department of Donga) were reared until adulthood. Females aged 2–5 days were used for susceptibility tube tests following the WHO protocol. The tests were conducted with deltamethrin (0.05%), bendiocarb (0.1%), pirimiphos-methyl (0.25%) and clothianidin (2% weight per volume). For cone tests performed on cement and mud walls, the An. gambiae Kisumu susceptible strain was used. After the quality control of the IRS performed 1-week post-campaign, the evaluation of the residual activity of the different tested insecticides/mixture of insecticides was conducted on a monthly basis. Results Over the three study years, deltamethrin resistance was observed in all the communes. With bendiocarb, resistance or possible resistance was observed. In 2019 and 2020, full susceptibility to pirimiphos-methyl was observed, while possible resistance to the same product was detected in 2021 in Djougou, Gogounou and Kandi. With clothianidin, full susceptibility was observed 4–6 days post-exposure. The residual activity lasted 4–5 months for pirimiphos-methyl, and 8–10 months for clothianidin and the mixture deltamethrin + clothianidin. A slightly better efficacy of the different tested products was observed on cement walls compared to the mud walls. Conclusion Overall, An. gambiae s.l. was fully susceptible to clothianidin, while resistance/possible resistance was observed the other tested insecticides. In addition, clothianidin-based insecticides showed a better residual activity compared to pirimiphos-methyl, showing thus their ability to provide an improved and prolonged control of pyrethroid resistant vectors.

Introdução: Endocardite infecciosa é uma doença pouco frequente mas com elevado risco de complicações e morte. Objetivo: Descrever tendências temporais nas características clínicas e epidemiológicas de pacientes hospitalizados com endocardite infecciosa em um único centro de referência ao longo de quatro décadas. Métodos: Coorte de 1.804 episódios consecutivos de endocardite em pacientes (> 12 anos) internados em um hospital cardiológico, 1978-2022. O desfecho foi óbito intra-hospitalar. Foram estudados dados demográficos, comorbidades, condições predisponentes, microrganismos e complicações ao longo do tempo e por décadas (1978-1988, 1989-1999, 2000-2010, 2011-2022). Foi realizada uma análise de séries temporais, modelando cada ano usando uma função spline cúbica não-linear com 4 pontos de inflexão para permitir a análise de não-linearidades ao longo do tempo. As associações brutas de cada resultado com essa função não-linear dos anos foram analisadas e ajustadas para fatores de risco (idade, prótese valvar, S. aureus, evento embólico e abscesso perivalvar). Resultados: A maioria dos pacientes era do sexo masculino (64%). Verificou-se aumento da mediana de idade ao longo das décadas (29 a 57 anos; p < 0,001). Também se observou redução na frequência de cardiopatia reumática (14% para 6%; p < 0,001) assim como das infecções estreptocócicas (46% para 33%; p < 0,001). Houve um aumento progressivo de endocardite em prótese valvar, complicações associadas (abscesso perivalvar, insuficiência cardíaca descompensada, embolização) e infecções por estafilococos coagulase-negativos e MRSA ao longo do tempo. A mortalidade geral intra-hospitalar foi de 30%, com tendência ascendente ao longo das últimas três décadas (p = 0,022). No entanto, ao ajustar para fatores relacionados a pior prognóstico (idade, prótese, infecção por S. aureus, eventos embólicos e abscesso perivalvar), verificou-se uma diminuição nas mortes intra-hospitalares (p = 0,019), variando de 34% na primeira década estudada até 26% na última década. Conclusões: No período de 44 anos, ocorreram mudanças significativas nas características clínicas e epidemiológicas dos pacientes internados com endocardite. Apesar do aumento da idade média dos pacientes, do envolvimento de próteses valvares, das infecções por estafilococos coagulase negativos/MRSA e das complicações, foi observada uma redução progressiva na taxa de mortalidade ajustada aos fatores de risco ao longo das décadas analisadas.

RESUMO O artigo sustenta que está em curso na política educacional brasileira uma concepção cívico-militar de educação integral e(m) tempo integral proveniente do governo de Jair Messias Bolsonaro (2019–2022) que estabeleceu diretrizes para o desenvolvimento do Programa Nacional das Escolas Cívico-Militares. Recorremos ao historicismo como método, para situar a educação integral e(m) tempo integral, e à revisão bibliográfica e análise documental, para em primeiro lugar ter um entendimento geral sobre o objeto, o referido programa, e em segundo identificar informações factuais (norteadas pelo que aqui argumentamos) em legislações e reportagens veiculadas na grande rede que evidenciaram a concepção cívico-militar de educação integral e(m) tempo integral em curso, percebendo também, a título de um exemplo prático, os primeiros movimentos de uma escola do município do Rio de Janeiro (RJ).

El uso de asistentes virtuales es común en los procesos de atención de distintas universidades alrededor del mundo. En la actualidad, se ofrecen varias herramientas de inteligencia artificial como procesadores de lenguaje natural para el desarrollo más eficiente de este servicio. El artículo expone la implementación y evaluación de usabilidad de un chatbot basado en el modelo de lenguaje GPT-3.5-Turbo para la atención a estudiantes de primer ciclo de Ingeniería de Sistemas de la Universidad Nacional de Trujillo. El diseño de la investigación fue pre-experimental y se aplicó el cuestionario de usabilidad de chatbot o CUQ como instrumento de investigación. Los resultados obtenidos fueron que el chatbot presenta un nivel de usabilidad percibida aceptable y el 93% de estudiantes estuvieron de acuerdo de que las respuestas brindadas por el asistente virtual fueron útiles. El agente conversacional destacó en la facilidad de uso y navegación, además, se exhibió problemas en entender las preguntas realizadas por el usuario y de brindar respuestas de forma natural.

Abstract The present study aimed to evaluate the association between obesity and COVID-19 mortality and length of stay in ICU patients, and how these associations were modified by age groups. We performed a retrospective multicenter cohort study with data obtained from a hospital-based registry. The sample consisted of 8183 ICU hospitalized patients who tested positive for SARS-CoV-2. Cox proportional models were used to evaluate the association between BMI categories and COVID-19 mortality and generalized linear models for the length of stay in the ICU. After adjusting for confounders, those in the younger group with severe obesity had an increased risk of COVID-19 mortality compared to those with normal/overweight (HR 1.27; 95% CI 1.01–1.61). An increased risk of death was also observed for patients with underweight (HR 3.74; 95% CI 1.39–10.07). For patients aged ≥ 60 year, mild/moderate obesity was associated with reduced mortality risk (HR 0.87; 95% CI 0.78–0.97). For the age group

Multi-modality datasets offer advantages for processing frameworks with complementary information, particularly for large-scale cropland mapping. Extensive training datasets are required to train machine learning algorithms, which can be challenging to obtain. To alleviate the limitations, we extract the training samples from the agricultural census information. We focus on Japan and demonstrate how agricultural census data in 2015 can map different crop types for the entire country. Due to the lack of Sentinel-2 datasets in 2015, this study utilized Sentinel-1 and Landsat-8 collected across Japan and combined observations into composites for different prefecture periods (monthly, bimonthly, seasonal). Recent deep learning techniques have been investigated the performance of the samples from agricultural census information. Finally, we obtain nine crop types on a countrywide scale (around 31 million parcels) and compare our results to those obtained from agricultural census testing samples as well as those obtained from recent land cover products in Japan. The generated map accurately represents the distribution of crop types across Japan and achieves an overall accuracy of 87% for nine classes in 47 prefectures. Our findings highlight the importance of using multi-modality data with agricultural census information to evaluate agricultural productivity in Japan. The final products are available at https://doi.org/10.5281/zenodo.7519274.

Introduction: Calcium use during cardiac arrest has conflicting results in terms of efficacy. Therefore, we performed a systematic review evaluating the role of calcium administration in cardiac arrest. Methods: We searched PubMed, Cochrane, and EMBASE for studies comparing calcium administration versus no calcium administration during cardiac arrest. The study was prospectively registered in PROSPERO (CRD42022316641) adhering to PRISMA guideline recommendations. The primary outcome was return of spontaneous circulation (ROSC) or survival at one hour. The secondary outcomes included survival to discharge or at 30 days, and favorable neurologic outcomes at 30 and 90 days. We planned to perform a random-effects meta-analysis of low risk of bias studies. We evaluated risk of bias with RoB-2 and ROBINS-I. Results: We identified 1,921 articles and included ten studies with 2509 patients. We were not able to perform a meta-analysis with low-risk of bias studies as only one study was found to be at low-risk of bias. However, for the primary outcome, the three RCTs included showed no benefit with calcium administration during cardiac arrest for ROSC. For the secondary outcomes, based on the most recent study and lower risk of bias, there was a neutral effect for survival to discharge or at 30 days and neurologic outcomes at 30 days. However, there was unfavorable neurologic outcomes at 90 days. Conclusion: Based on our results, calcium administration in cardiac arrests shows no benefit and can cause harm. Further studies on this matter are likely not advisable.

RESUMO Objetivo: Identificar apresentações mais graves de COVID-19. Métodos: Pacientes consecutivamente admitidos à unidade de terapia intensiva foram submetidos à análise de clusters por meio de método de explorações sequenciais Resultados: Analisamos os dados de 147 pacientes, com média de idade de 56 ± 16 anos e Simplified Acute Physiological Score 3 de 72 ± 18, dos quais 103 (70%) demandaram ventilação mecânica e 46 (31%) morreram na unidade de terapia intensiva. A partir do algoritmo de análise de clusters, identificaram-se dois grupos bem definidos, com base na frequência cardíaca máxima [Grupo A: 104 (IC95% 99 - 109) batimentos por minuto versus Grupo B: 159 (IC95% 155 - 163) batimentos por minuto], frequência respiratória máxima [Grupo A: 33 (IC95% 31 - 35) respirações por minuto versus Grupo B: 50 (IC95% 47 - 53) respirações por minuto] e na temperatura corpórea máxima [Grupo A: 37,4 (IC95% 37,1 - 37,7)ºC versus Grupo B: 39,3 (IC95% 39,1 - 39,5)ºC] durante o tempo de permanência na unidade de terapia intensiva, assim como a proporção entre a pressão parcial de oxigênio no sangue e a fração inspirada de oxigênio quando da admissão à unidade de terapia intensiva [Grupo A: 116 (IC95% 99 - 133) mmHg versus Grupo B: 78 (IC95% 63 - 93) mmHg]. Os subfenótipos foram distintos em termos de perfis inflamatórios, disfunções orgânicas, terapias de suporte, tempo de permanência na unidade de terapia intensiva e mortalidade na unidade de terapia intensiva (com proporção de 4,2 entre os grupos). Conclusão: Nossos achados, baseados em dados clínicos universalmente disponíveis, revelaram dois subfenótipos distintos, com diferentes evoluções de doença. Estes resultados podem ajudar os profissionais de saúde na alocação de recursos e seleção de pacientes para teste de novas terapias.

Abstract Background Approximately 5% of COVID-19 patients develop respiratory failure and need ventilatory support, yet little is known about the impact of mechanical ventilation strategy in COVID-19. Our objective was to describe baseline characteristics, ventilatory parameters, and outcomes of critically ill patients in the largest referral center for COVID-19 in Sao Paulo, Brazil, during the first surge of the pandemic. Methods This cohort included COVID-19 patients admitted to the intensive care units (ICUs) of an academic hospital with 94 ICU beds, a number expanded to 300 during the pandemic as part of a state preparedness plan. Data included demographics, advanced life support therapies, and ventilator parameters. The main outcome was 28-day survival. We used a multivariate Cox model to test the association between protective ventilation and survival, adjusting for PF ratio, pH, compliance, and PEEP. Results We included 1503 patients from March 30 to June 30, 2020. The mean age was 60 ± 15 years, and 59% were male. During 28-day follow-up, 1180 (79%) patients needed invasive ventilation and 666 (44%) died. For the 984 patients who were receiving mechanical ventilation in the first 24 h of ICU stay, mean tidal volume was 6.5 ± 1.3 mL/kg of ideal body weight, plateau pressure was 24 ± 5 cmH2O, respiratory system compliance was 31.9 (24.4–40.9) mL/cmH2O, and 82% of patients were ventilated with protective ventilation. Noninvasive ventilation was used in 21% of patients, and prone, in 36%. Compliance was associated with survival and did not show a bimodal pattern that would support the presence of two phenotypes. In the multivariable model, protective ventilation (aHR 0.73 [95%CI 0.57–0.94]), adjusted for PF ratio, compliance, PEEP, and arterial pH, was independently associated with survival. Conclusions During the peak of the epidemic in Sao Paulo, critically ill patients with COVID-19 often required mechanical ventilation and mortality was high. Our findings revealed an association between mechanical ventilation strategy and mortality, highlighting the importance of protective ventilation for patients with COVID-19.

Abstract Objective To verify whether there is an association between the results of the severity in electroneuromyography and the positivity in ultrasound in the diagnosis of carpal tunnel syndrome. Methods Sixty-eight patients were included in the study, 61 women and 7 men, with a mean age of 54.4 years. The ultrasound results (positive or negative) were crossed with the results of electroneuromyography (mild, moderate or severe), and the existence of association was verified. Results One hundred and thirty-six hands with suspicion or symptoms of carpal tunnel syndrome were evaluated. Positive ultrasound diagnosis was observed in 72 hands and negative in 64; 123 hands presented positive electroneuromyography for carpal tunnel syndrome, and there were 13 negative results. The severe degree in electroneuromyography was prevalent. Conclusion There was a statistically significant association between electroneuromyography and ultrasonography (p < 0.05), and ultrasound positivity was higher for more severe levels of carpal tunnel syndrome given by electroneuromyography.

ABSTRACT Objective: To compare bone marrow aspirate concentrate (BMAC) with the standard treatment for gluteal tendinopathies. Methods: 48 patients diagnosed with gluteal tendinopathy at a university hospital were selected by a randomized clinical trial and divided into two groups: (G1) bone marrow aspirate concentrate and (G2) corticosteroid injections. Results: 40 of the 48 selected patients were monitored for six months and both groups showed better scores. Visual analog scale (VAS) scores and Lequesne index were statistically significant higher in patients submitted to BMAC treatment when compared to standard treatment. Both groups improved their quality of life, without statistically significant difference. Conclusion: BMAC constitutes an alternative to gluteal tendinopathy standard treatment, proving to be a safe technique with promising results when combined with multidisciplinary team behavioral therapy. Level of Evidence II, Randomized Clinical Trial.

Deep learning is increasingly popular in remote sensing communities and already successful in land cover classification and semantic segmentation. However, most studies are limited to the utilization of optical datasets. Despite few attempts applied to synthetic aperture radar (SAR) using deep learning, the huge potential, especially for the very high resolution (VHR) SAR, are still underexploited. Taking building segmentation as an example, the VHR SAR datasets are still missing to the best of our knowledge. A comparable baseline for SAR building segmentation does not exist, and which segmentation method is more suitable for SAR image is poorly understood. This article first provides a benchmark high-resolution (1 m) GaoFen-3 SAR datasets, which cover nine cities from seven countries, review the state-of-the-art semantic segmentation methods applied to SAR, and then summarize the potential operations to improve the performance. With these comprehensive assessments, we hope to provide the recommendation and roadmap for future SAR semantic segmentation.

RESUMO Objetivo: Descrever as características e os desfechos de pacientes submetidos à retirada da ventilação mecânica e comparar a pacientes com ventilação mecânica e limitações de terapias de suporte à vida (limitar ou retirar), porém sem remoção da ventilação mecânica. Métodos: Este foi um estudo de coorte retrospectiva realizado entre janeiro de 2014 e dezembro de 2018 com pacientes em ventilação mecânica com alguma limitação de suporte artificial de vida admitidos a uma única unidade de terapia intensiva. Foram comparados os pacientes submetidos à retirada da ventilação mecânica e os que não passaram por esse procedimento com relação à mortalidade na unidade de terapia intensiva e ao tempo de permanência no hospital, em uma análise não ajustada e em uma amostra pareada por escore de propensão. Analisou-se também o tempo desde a retirada da ventilação mecânica até o óbito. Resultados: Dentre 282 pacientes com limitações a terapias de suporte à vida, 31 (11%) foram submetidos à retirada da ventilação mecânica. Não houve diferenças iniciais entre os grupos. As taxas de mortalidade na unidade de terapia intensiva e no hospital foram, respectivamente, de 71% versus 57% e 93% versus 80%, entre os pacientes submetidos à retirada da ventilação mecânica e os que não o foram. O tempo mediano de permanência na unidade de terapia intensiva foi de 7 versus 8 dias (p = 0,6), e o tempo de permanência no hospital foi de 9 versus 15 dias (p = 0,015). A mortalidade hospitalar não foi significantemente diferente (25/31; 81% versus 29/31; 93%; p = 0,26) após o pareamento. O tempo mediano desde a retirada da ventilação mecânica até o óbito foi de 2 dias [0 - 5] e 10/31 (32%) dos pacientes morreram dentro de 24 horas após a retirada dessa ventilação. Conclusão: Neste relato brasileiro, a retirada da ventilação mecânica representou 11% de todos os pacientes com limitação do tratamento e não se associou com aumento da mortalidade hospitalar após pareamento por escore de propensão das covariáveis relevantes.

RESUMO Objetivo: Avaliar a adesão ao protocolo de profilaxia de úlcera de estresse em pacientes críticos de um hospital universitário terciário. Métodos: Neste estudo de coorte prospectiva, incluímos todos os pacientes adultos admitidos às unidades de terapia intensiva clínica e cirúrgica de um hospital terciário acadêmico. Nosso único critério de exclusão foi a presença de sangramento gastrointestinal alto quando da admissão à unidade de terapia intensiva. Colhemos as variáveis basais e indicações de profilaxia de úlcera de estresse, segundo o protocolo institucional, assim como o uso de profilaxia. Nosso desfecho primário foi a adesão ao protocolo de profilaxia de úlcera de estresse. Os desfechos secundários foram uso apropriado da profilaxia de úlcera de estresse, incidência de sangramento gastrointestinal superior e fatores associados com o uso apropriado da profilaxia de úlcera de estresse. Resultados: Foram incluídos 234 pacientes no período compreendido entre 2 de julho e 31 de julho de 2018. Os pacientes tinham idade de 52 ± 20 anos, sendo 125 (53%) deles cirúrgicos, e o SAPS 3 médio foi de 52 ± 20. No seguimento longitudinal, foram estudados 1.499 pacientes-dias; 1.069 pacientes-dias tiveram indicação de profilaxia de úlcera de estresse, e 777 pacientes-dias tiveram uso profilático (73% de adesão ao protocolo de profilaxia de úlcera de estresse). Dentre os 430 pacientes-dias sem indicações de profilaxia de úlcera de estresse, 242 envolveram profilaxia (56% de uso impróprio de profilaxia de úlcera de estresse). O total de uso apropriado de profilaxia de úlcera de estresse foi de 64%. Fatores associados com prescrição adequada de profilaxia de úlcera de estresse foram ventilação mecânica, com RC 2,13 (IC95% 1,64 - 2,75), e coagulopatia, com RC 2,77 (IC95% 1,66 - 4,60). A incidência de sangramento do trato gastrointestinal superior foi de 12,8%. Conclusão: A adesão ao protocolo de profilaxia de úlcera de estresse foi baixa, e o uso inadequado de profilaxia de úlcera de estresse foi frequente nesta coorte de pacientes críticos.

O artigo analisou as relações entre Esporte e a Educação na cidade de Lavras, região sul de Minas Gerais, entre os anos de 1893 e 1915, a partir da ação social de três instituições, duas escolares, o Instituto Evangélico de Lavras e o Grupo Escolar, e uma esportiva, o Lavras Sport Club. Foram examinadas fontes primárias relativas a essas três instituições e jornais do período. Concluímos que foram as instituições educacionais as viabilizadoras do desenvolvimento do Lavras Sport Club e, por conseguinte, do próprio esporte em Lavras.

RESUMO Objetivo: A evidência de melhora da sobrevivência com uso de oxigenação por membrana extracorpórea na síndrome do desconforto respiratório agudo ainda permanece incerta. Métodos: Esta revisão sistemática e metanálise foi registrada na base de dados PROSPERO com o número CRD-42018098618. Conduzimos uma busca estruturada nas bases Medline, LILACS e ScienceDirect visando a ensaios randomizados e controlados que tivessem avaliado o uso de oxigenação por membrana extracorpórea associada com ventilação mecânica (ultra)protetora em pacientes adultos com síndrome do desconforto respiratório agudo grave. Utilizamos a ferramenta de riscos de viés da Cochrane para avaliar a qualidade da evidência. O desfecho primário consistiu em avaliar o efeito do uso oxigenação por membrana extracorpórea no último relato de mortalidade. Os desfechos secundários foram: falha terapêutica, tempo de permanência no hospital e necessidade de terapia de substituição renal em ambos os grupos. Resultados: Incluíram-se na metanálise dois ensaios randomizados e controlados, compreendendo 429 pacientes, dos quais 214 receberam suporte respiratório extracorpóreo. A razão mais comum para a insuficiência respiratória foi pneumonia (60% - 65%). O suporte respiratório com oxigenação por membrana extracorpórea foi associado a uma redução na mortalidade e redução em falha terapêutica com taxas de risco (RR: 0,76; IC95% 0,61 - 0,95; RR: 0,68; IC95% 0,55 - 0,85, respectivamente). O uso de oxigenação por membrana extracorpórea reduziu a necessidade de terapia de substituição renal com uma RR de 0,88 (IC95% 0,77 - 0,99). O tempo de permanência na unidade de terapia intensiva e no hospital foram maiores no grupo de pacientes que recebeu suporte com oxigenação por membrana extracorpórea, com acréscimo de 14,84 (P25°-P75°: 12,49 - 17,18) e 29,80 (P25°- P75°: 26,04 - 33,56) dias, respectivamente. Conclusão: O suporte com oxigenação por membrana extracorpórea na síndrome do desconforto respiratório agudo grave está associado a uma redução da taxa de mortalidade e da necessidade de terapia de substituição renal, porém apresenta aumento substancial no tempo de permanência na unidade de terapia intensiva e no hospital. Nossos resultados podem ajudar no processo decisório junto ao leito quanto ao início do suporte com oxigenação por membrana extracorpórea na síndrome do desconforto respiratório agudo grave.

Gum and mucilage from seeds and fruits are objects of study because they have characteristics of high viscosity at low concentrations and gelling properties, which are useful characteristics for modifying the texture and stabilizing products in the food industry. Chia and okra have high concentrations of polysaccharide gums in their composition, which makes them an interesting target for use in the composition of foods that require the use of texture enhancers and stabilizers. The present study investigated the influence of dehydration temperature on the characteristics of chia and okra powder mucilage obtained at different temperatures. The mucilages were extracted using an aqueous process and dehydrated in an air circulation oven at 50, 60, and 70 °C until hydroscopic equilibrium. Then, the powdered chia mucilage (CM) and okra mucilage (OM) were analyzed for chemical and physicochemical characteristics, bioactive compounds, antioxidant activity, and physical properties. It was found that powdered mucilage had low water content and water activity, with CM standing out in terms of ash, pectin, and starch content and OM, along with higher averages of proteins, sugars, total phenolic compounds, anthocyanins, flavonoids, and antioxidant activity. As for the physical parameters, CM stood out in relation to greater solubility and lower hygroscopicity, whereas OM presented higher wettability rates. Both powdered mucilages were classified as having good fluidity and cohesiveness from low to intermediate. In relation to the dehydration temperature, the best mucilage properties were verified at 70 °C. The study revealed that mucilages have good functional properties offering great potential as raw material for industry.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is associated with high mortality among hospitalized patients and incurs high costs. Severe acute respiratory syndrome coronavirus 2 infection can trigger both inflammatory and thrombotic processes, and these complications can lead to a poorer prognosis. This study aimed to evaluate the association and temporal trends of D-dimer and C-reactive protein (CRP) levels with the incidence of venous thromboembolism (VTE), hospital mortality, and costs among inpatients with COVID-19. METHODS: Data were extracted from electronic patient records and laboratory databases. Crude and adjusted associations for age, sex, number of comorbidities, Sequential Organ Failure Assessment score at admission, and D-dimer or CRP logistic regression models were used to evaluate associations. RESULTS: Between March and June 2020, COVID-19 was documented in 3,254 inpatients. The D-dimer level ≥4,000 ng/mL fibrinogen equivalent unit (FEU) mortality odds ratio (OR) was 4.48 (adjusted OR: 1.97). The CRP level ≥220 mg/dL OR for death was 7.73 (adjusted OR: 3.93). The D-dimer level ≥4,000 ng/mL FEU VTE OR was 3.96 (adjusted OR: 3.26). The CRP level ≥220 mg/dL OR for VTE was 2.71 (adjusted OR: 1.92). All these analyses were statistically significant (p

Este artigo tem por objetivo discutir como a experiência do Sport Club Mackenzie, agremiação do bairro do Méier/Rio de Janeiro, se estabeleceu como uma estratégia para combater estigmas e apresentar maneiras de se portar ligadas a projetos de valorização local. Como recorte temporal, adotamos o ano de criação do clube (1914) e o momento em que se afastou dos campeonatos de futebol promovidos por uma prestigiosa liga (1932). Como fontes, foram usados revistas e jornais. Espera-se contribuir para ampliar os olhares sobre as histórias do esporte e dos subúrbios, áreas citadinas que merecem maior atenção e cuidado.

OBJECTIVES:. Data on cardiac arrest survivors from developing countries are scarce. This study investigated clinical characteristics associated with in-hospital mortality in resuscitated patients following cardiac arrest in Brazil. DESIGN:. Retrospective analysis of prospectively collected data. SETTING:. Ninety-two general ICUs from 55 hospitals in Brazil between 2014 and 2015. PATIENTS:. Adult patients with cardiac arrest admitted to the ICU. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. We analyzed 2,296 patients (53% men; median 67 yr (interquartile range, 54–79 yr]). Eight-hundred patients (35%) had a primary admission diagnosis of cardiac arrest suggesting an out-of-hospital cardiac arrest; the remainder occurred after admission, comprising an in-hospital cardiac arrest cohort. Overall, in-hospital mortality was 83%, with only 6% undergoing withholding/withdrawal-of-life support. Random-effects multivariable Cox regression was used to assess associations with survival. After adjusting for age, sex, and severity scores, mortality was associated with shock (adjusted odds ratio, 1.25 [95% CI, 1.11–1.39]; p < 0.001), temperature dysregulation (adjusted odds ratio for normothermia, 0.85 [95% CI, 0.76–0.95]; p = 0.007), increased lactate levels above 4 mmol/L (adjusted odds ratio, 1.33 [95% CI, 1.1–1.6; p = 0.009), and surgical or cardiac cases (adjusted odds ratio, 0.72 [95% CI, 0.6–0.86]; p = 0.002). In addition, survival was better in patients with probable out-of-hospital cardiac arrest, unless ICU admission was delayed (adjusted odds ratio for interaction, 1.63 [95% CI, 1.21–2.21]; p = 004). CONCLUSIONS:. In a large multicenter cardiac arrest cohort from Brazil, we found a high mortality rate and infrequent withholding/withdrawal of life support. We also identified patient profiles associated with worse survival, such as those with shock/hypoperfusion and arrest secondary to nonsurgical admission diagnoses. Our findings unveil opportunities to improve postarrest care in developing countries, such as prompt ICU admission, expansion of the use of targeted temperature management, and implementation of shock reversal strategies (i.e., early coronary angiography), according to modern guidelines recommendations.

Estão em curso formas variadas de privatização da oferta do direito à educação. Uma delas envolve a intensa atividade de organizações da sociedade civil, normalmente caracterizadas como sem fins lucrativos, em formas de convênios com entes estatais. O objetivo desse artigo é analisar dados do Censo das Fundações e Associações Sem Fins de Lucro produzido pelo Instituto Brasileiro de Geografia e Estatísticas em parceria com o Instituto de Pesquisas Econômicas e Aplicadas no ano de 2005, particularmente aqueles oriundos das subdivisões da grande área Educação e Pesquisa: educação infantil, ensino fundamental e médio (educação básica). Organizamos os dados disponíveis no censo considerando as regiões do país, as décadas de criação das FASFIL, o número de trabalhadores, a média salarial nas FASFIL, entre outros. Eles foram descritos por meio de tabelas e cotejados com referências bibliográficas sobre a política educacional. Concluímos que a expansão do número, o aumento da amplitude e o crescimento vertiginoso da capacidade de atuação das FASFIL integraram o desenvolvimento do projeto neoliberal que confere novas características as relações público-privadas na oferta do direito à educação.

Objetivo: O artigo analisa em paralelo a proficiência motora de crianças e a abordagem de ensino utilizada por um professor de Educação Física do 1º e 5º ano do ensino fundamental de uma escola pública municipal, localizada da região sul do estado de Minas Gerais. Método: Consideramos dois paradigmas para desenvolver a seguinte metodologia: i) teste TGMD-2 para avaliar a proficiência em habilidades motoras fundamentais e inferir a coordenação motora dos escolares; ii) observações sistemáticas e anotações em diário de campo das aulas de Educação Física destes mesmos escolares. Resultados: Observou-se, por exemplo, que foi pouco frequente uma preocupação sistemática com a avaliação no interior da organização do trabalho docente. Conclusões: Concluímos que existe uma queda na proficiência motora dos escolares entre o 1º e 5º ano do ensino fundamental e que elementos básicos da organização do trabalho docente não foram verificados na abordagem de ensino, algo que suscita uma interface entre essas duas variáveis que compõem o cotidiano escolar da disciplina Educação Física.

O artigo cotejou as implicações do Programa Residência Pedagógica (desenvolvido no núcleo de Educação Física, sob os cuidados de uma instituição de educação superior federal), em relação à formação continuada e a organização do trabalho pedagógico desenvolvido por três (3) docentes atuantes em escolas públicas, numa cidade sul mineira. Tratou-se de uma investigação de natureza qualitativa, sob um desenho narrativo. Quanto aos procedimentos metodológicos, utilizou-se para a coleta de dados, entrevistas com base em questionário semiestruturado, com efeito, explorando o significado das ações desses docentes, a partir do teor narrativo que expuseram. Para erigir as categorias de análise, empregou-se a técnica de triangulação dos dados,observando, no primeiro processo interpretativo, a valorização fenomênica e a técnica dos dados primários, em seguida, num segundo movimento perscrutador, as informações foram contextualizadas, criticadas, comparadas e trianguladas. Por fim, na qualidade de última ação analítica, formulamos três categorias de análise, relacionando o conteúdo das entrevistas e a literatura pertinente. Os resultados evidenciaram que o programa fora auspicioso, em virtude de suas especificidades e de sua organização pedagógica, notadamente em relação à proposta de planificação dos conteúdos. De igual modo, demonstraram que os depoentes desfrutaram de formações distintas e encontravam-se em momentos díspares da carreira docente. Além disso, revelaram também que a formação continuada, proporcionada no interior do referido programa, suscitou interação (formativa) entre a educação básica e a superior, por efeito, pode-se rechaçar a dicotomia entre teoria e prática pedagógica, o que por sua vez afetou a disposição e o desdobramento do trabalho pedagógico realizado pelos pesquisados.

The article analyzes the master's dissertations produced in the scope of the Center of Studies - Times, Spaces and Integral Education on the theme of integral education and full time education. The Systematic Review and the Oral History were used as methodological references for epistemological activity performed, understood in this study like a meta-analysis, that is, the analysis of the performed analyzes. We worked with the assumption that the teaching trajectories of the founders of this thematic study nucleus contextualize the research choices that are made in the dissertations. This is evidenced during the presentation and discussion of the data based on relevant bibliography and highlighted in the final considerations, as a way of enhancing future scientific investigations and adding elements to the way epistemological activities, in general, are carried inside the field education.

The demand for high value health care uncovered a steady trend in laboratory tests ordering and inappropriate testing practices. Residents' training in laboratory ordering practice provides an opportunity for quality improvement. We collected information on demographics, the main reason for the appointment, preexisting medical conditions and presence of co-morbidities from first-visit patients to the internal medicine outpatient service of our university general hospital. We also collected information on all laboratory tests ordered by the attending medical residents. At a follow-up visit, we recorded residents' subjective perception on the usefulness of each ordered laboratory test for the purposes of diagnosis, prognosis, treatment or screening. We observed that 17.3% of all ordered tests had no perceived utility by the attending resident. Tests were usually ordered to exclude differential diagnoses (26.7%) and to help prognosis estimation (19.1%). Age and co-morbidity influenced the chosen category to legitimate usefulness of tests ordering. This study suggests that clinical objectives (diagnosis, prognosis, treatment or prevention) as well as personalization to age and previous health conditions should be considered before test ordering to allow a more appropriate laboratory tests ordering, but further studies are necessary to examine this framework beyond this medical training scenario.

Abstract Background The purpose of our study was to evaluate safety, feasibility and clinical results of bone marrow mononuclear cell (BMC) implantation for early-stage osteonecrosis of the knee (OK) secondary to sickle cell disease. Methods Thirty-three SCD patients (45 knees) with OK treated with BMC implantation in the osteonecrotic lesion were clinically and functionally evaluated through the American Knee Society Clinical Score (KSS), Knee Functional Score (KFS) and Numeric Rating Scale (NRS) pain score. MRI and radiographic examinations of the knee were assessed during a period of five years after intervention. Results No complications or serious adverse event were associated with BMC implantation. From preoperative assessment to the latest follow-up, there was a significant (p

Abstract The tsunami source of the 2016 Fukushima Earthquake, which was generated by a normal faulting earthquake mechanism, is estimated by inverting the tsunami waveforms that were recorded by seven tide gauge stations and two wave gauge stations along the north Pacific coast of Japan. Two fault models based on different available moment tensor solutions were employed, and their locations were constrained by using the reverse tsunami travel time from the stations to the epicenter. The comparison of the two fault slip models showed that the fault model with a strike = 49°, dip = 35°, and rake = −89° more accurately simulated the observed tsunami data. This fault model estimated a fault area of 40 km $$\times$$ × 32 km. The largest slip was estimated as 4.66 m at a 6.09 km depth, larger slips also concentrated between depths of 6.06 and 10.68 km, and located southwest of the epicenter. Assuming a rigidity of $$2.7\times 10^{10}$$ 2.7 × 10 10 N/m $$^2$$ 2 , the estimated moment magnitude was $$3.35\times 10^{19}$$ 3.35 × 10 19 Nm (equivalent to Mw = 6.95). In addition, a comparison of nonlinear tsunami simulations using finer bathymetry around Sendai Coast verified that the above fault slip model could better reproduce the tsunami features observed at Sendai Port and its surroundings. Finally, we analyzed the nonlinear tsunami computed from our best fault slip model. Our simulations also corroborated the height of the secondary wave amplitude observed at Sendai Port, which was caused by the reflected tsunami waves from the Fukushima coast, as described in previous studies. Furthermore, we found that the initial positive wave recorded inside Sendai Bay resulted from the addition of the initial incoming wave and the tsunami wave reflected off Sendai Coast, between Natori River and Sendai Port.

Resenha A nova biblioteca básica brasileira: ideia pioneira, nativa, e progressista

The objective of this paper is to analyze from a historical point of view the relationship between sport and school in the Evangelical Institute (1893-1919). This educational institution stays in the city of Lavras, south of Minas Gerais and was founded by protestant missionaries from the Southern United States. We hypothesized that it developed a school culture of sport. In this case, we investigated its historical constitution and its characteristics as well as its interface with the sport. We used primary sources (documents, brochures and newspapers) and secondary (books and a thesis) as empirical material. We conclude that at the same time that the Educational institution was purposeful in relation to sports, it was also permeable to them,

RESUMO Objetivo: Descrever a transferência de energia do ventilador mecânico para os pulmões; o acoplamento entre a transferência de oxigênio por oxigenação por membrana extracorpórea venovenosa (ECMO-VV) e o consumo de oxigênio do paciente; a remoção de dióxido de carbono com ECMO; e o efeito potencial da oxigenação venosa sistêmica na pressão arterial pulmonar. Métodos: Modelo matemático com cenários hipotéticos e utilização de simulações matemáticas por computador. Resultados: A transição de ventilação protetora para ventilação ultraprotetora em um paciente com síndrome da angústia respiratória aguda grave e complacência respiratória estática de 20mL/cmH2O reduziu a transferência de energia do ventilador para os pulmões de 35,3 para 2,6 joules por minuto. Em um paciente hipotético, hiperdinâmico e ligeiramente anêmico com consumo de oxigênio de 200mL/minuto, é possível atingir saturação arterial de oxigênio de 80%, ao mesmo tempo em que se mantém o equilíbrio entre a transferência de oxigênio pela ECMO e o consumo de oxigênio do paciente. O dióxido de carbono é facilmente removido e a pressão parcial de dióxido de carbono normal é facilmente obtida. A oxigenação do sangue venoso, por meio do circuito da ECMO, pode direcionar o estímulo da pressão parcial de oxigênio na vasoconstrição pulmonar por hipóxia para valores normais. Conclusão: A ventilação ultraprotetora reduz amplamente a transferência de energia do ventilador para os pulmões. A hipoxemia grave no suporte com ECMO-VV pode ocorrer, a despeito do acoplamento entre a transferência de oxigênio, por meio da ECMO, e o consumo de oxigênio do paciente. A faixa normal de pressão parcial de dióxido de carbono é fácil de atingir. O suporte com ECMO-VV potencialmente alivia a vasoconstrição pulmonar hipóxica.

Este artigo tem como objetivo analisar as interfaces teóricas e metodológicas existentes entre o Núcleo de Estudos - Tempos, Espaços e Educação Integral e o Núcleo de Estudos e Pesquisas em História da Educação Brasileira, ambos vinculados ao Programa de Pós-Graduação em Educação da Universidade Federal do Estado do Rio de Janeiro e dedicados à pesquisa de natureza histórica sobre o tema da educação integral e(m) tempo integral. Trabalhamos com o referencial teórico do "Campo da História", uma vez que esta ciência possui inúmeras especialidades, dimensões e abordagens. Utilizamos como metodologia a "Revisão Sistemática", por ser uma ferramenta útil no acompanhamento da produção científica sobre um determinado tema, identificando lacunas e continuidades. Conclui-se que a interface teórico-metodológica desses núcleos, no contexto da educação integral, está centrada na produção de pesquisas históricas ancoradas nas dimensões da história política e cultural e nas abordagens constituídas pelos discursos, depoimentos e biografias.

O objetivo deste artigo é analisar teoricamente as formulações do Banco Mundial, as prescrições do Centro de Estudos e Pesquisa em Educação, Cultura e Ação Comunitária e as normatizações fixadas no programa Mais Educação sobre o tema da Educação integral e(m) Tempo Integral. Tal análise se faz pertinente em função da legislação educacional brasileira vigente sobre o tema, em especial, a meta 6 do atual Plano Nacional de Educação. Para realizar o estudo utilizou-se pesquisa bibliográfica e análise de documentos que problematizam o tema. Concluímos que existe uma sintonia entre as formulações do Banco Mundial e as prescrições do Cenpec, sendo o programa Mais Educação uma síntese empresarial dessa relação.

The concentration of media ownership is a phenomenon that has expanded all over the world,jeopardizing the rights of citizens to access information that is both diverse and pluralistic. This paper analyses the scope of the second paragraph of Article 61 of the Peruvian Constitution, as it pertains to the concentration of media ownership in general and, in particular, the consolidation of the written press. To this end, it is carried out a mixed analysis, including sources of national and international law and doctrine. Finally, it is discussed which is the better alternative in the face of media consolidation, regulation or prosecution.