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Resumo Este artigo tem como objetivo analisar o papel que os governos no Brasil têm desempenhado na condução de políticas de Educação Superior, tomando como referência uma tipologia que estabelece quatro modos de governança para a este tipo de Educação: o hierárquico, o procedimental, a condução a distância e a autogovernança. Além disso, considera três diferentes fases do Estado avaliador, para analisar o seu grau de autonomia frente aos organismos internacionais. Com base no referencial teórico adotado, conduz-se um estudo de caso do sistema de Educação Superior brasileiro, no período de 1995 a 2017, por meio de pesquisa documental e análise de conteúdo. Os resultados indicam que o modo de governança das políticas de Educação Superior no Brasil é, predominantemente, de condução a distância, com traços do modo hierárquico. Além disso, evidencia-se que o Estado mantém relativa autonomia frente aos organismos internacionais, dando sinais de aproximação com a Organização para a Cooperação e Desenvolvimento Econômico. Abstract This article aims to analyze the role that governments in Brazil have played in the conduct of Higher Education policies, taking as reference a typology that establishes four modes of governance for Higher Education: hierarchical, procedural, steering at distance and self-governance. In addition, it considers three different phases of the of the “evaluator” State to analyze its degree of autonomy vis-à-vis international bodies. Based on the theoretical framework adopted, a case study of the Brazilian Higher Education system is conducted, from 1995 to 2017, through documentary research and content analysis. The results indicate that the mode of governance of higher education policies predominant in Brazil is the steering at distance mode, with traits of the hierarchical mode. In addition, it is evident that the State maintains relative autonomy vis-à-vis international organizations, showing signs of approximation with the Organisation for Economic Co-operation and Development. Resumen Este artículo tiene como objetivo analizar el papel que han desempeñado los gobiernos de Brasil en la conducción de las políticas de Educación Superior, tomando como referencia una tipología que establece cuatro modos de gobernanza para este tipo de Educación: la jerárquica, la procedimental, la de conducción a distancia y el autogobierno. Además, considera tres fases distintas del Estado evaluador para analizar su grado de autonomía frente a los organismos internacionales. Con base en el marco teórico adoptado, se realiza un estudio de caso del sistema de Educación Superior brasileño, de 1995 a 2017, a través de la investigación documental y el análisis de contenido. Los resultados indican que el modo de gobernanza de las políticas de Educación Superior en Brasil es, predominantemente, la conducción a distancia, con vestigios del modo jerárquico. Además, es evidente que el Estado mantiene una relativa autonomía frente a los organismos internacionales, mostrando signos de aproximación con la Organización para la Cooperación y el Desarrollo Económicos.

Interleukin-6 (IL-6) is a multifunctional cytokine with both pro- and anti-inflammatory properties with a heritability estimate of up to 61%. The circulating levels of IL-6 in blood have been associated with an increased risk of complex disease pathogenesis. We conducted a two-staged, discovery, and replication meta genome-wide association study (GWAS) of circulating serum IL-6 levels comprising up to 67 428 (ndiscovery = 52 654 and nreplication = 14 774) individuals of European ancestry. The inverse variance fixed-effects based discovery meta-analysis, followed by replication led to the identification of two independent loci, IL1F10/IL1RN rs6734238 on Chromosome (Chr) 2q14, (pcombined = 1.8 × 10-11), HLA-DRB1/DRB5 rs660895 on Chr6p21 (pcombined = 1.5 × 10-10) in the combined meta-analyses of all samples. We also replicated the IL6R rs4537545 locus on Chr1q21 (pcombined = 1.2 × 10-122). Our study identifies novel loci for circulating IL-6 levels uncovering new immunological and inflammatory pathways that may influence IL-6 pathobiology.

RESUMEN La tripanosomiasis americana y la leishmaniasis son problemas de salud pública relevantes en Iberoamérica. Las drogas utilizadas actualmente para el tratamiento de estas enfermedades poseen efectos colaterales tóxicos severos. Varios grupos de investigación están abocados a la búsqueda de productos naturales y sintéticos para encontrar nuevos agentes terapéuticos efectivos que no presenten reacciones colaterales adversas. En la evaluación de compuestos de la especie vegetal Zanthoxylum chiloperone (Rutaceae), se demostró que compuestos aislados del extracto presentaban actividad leishmanicida, tripanocida y antifúngica in vivo. Teniendo como antecedentes estos resultados, en el presente estudio se evaluaron los efectos genotóxico y citotóxico del cantín-6-ona y del 5-metoxicantin-6-ona, moléculas aisladas de la planta, en células de médula ósea de animales tratados. El estudio de los efectos genotóxicos se hizo a través del ensayo de modificaciones en la frecuencia de micronúcleos y el efecto citotóxico por modificaciones en la relación entre eritrocitos policromáticos y eritrocitos normocromáticos. Se realizaron 2 ensayos independientes y en cada ensayo los animales fueron divididos en tres grupos de tratamiento: GRUPO I: control negativo que recibió 200 uL de agua y 2.1% de DMSO, vía oral, GRUPO II: compuesto a ser evaluado (canthin-6-ona o 5-methoxicantin-6-ona) con 2.1% de DMSO, y GRUPO III: control positivo que recibió ciclofosfamida 50mg/kg/peso del animal, vía intraperitoneal. El análisis estadístico mostró que ambos compuestos no presentaron efectos genotóxicos ni citotóxicos. Estos resultados permiten proponer a estas moléculas como candidatas a ser sometidas a estudios más detallados como potenciales fármacos contra estas dos enfermedades. ABSTRACT American trypanosomiasis and leishmaniasis are relevant public health problems in Latin America. The drugs currently used to treat these diseases have severe toxic side effects. Several research groups are dedicated to the search of natural and synthetic products to find new effective therapeutic agents that do not present adverse collateral reactions. In the evaluation of compounds of the plant species Zanthoxylum chiloperone (Rutaceae), it was shown that isolated compounds of the extract had leishmanicidal, trypanocidal and antifungal in vivo activities. Based on these results, the genotoxic and cytotoxic effects of canthin-6-one and 5-methoxycanthin-6-one, molecules isolated from the plant, on bone marrow cells of treated mice were evaluated in the present study. The study of genotoxic effects was made through the test of modifications in the frequency of micronuclei and the cytotoxic effects by modifications in the relationship between polychromatic erythrocytes and normochromic erythrocytes. Two independent assays were performed and in each assay the animals were divided into three treatment groups: GROUP I: negative control that received 200 µL of water and 2.1% of DMSO, orally, GROUP II: compound to be evaluated (canthin-6 -one or 5-methoxycanthin-6-one) with 2.1% DMSO, and GROUP III: positive control that received cyclophosphamide 50mg /kg animal weight, intraperitoneal. Statistical analysis showed that both compounds had neither genotoxic nor cytotoxic effects. These results allow these molecules to be proposed as candidates to be subjected to more detailed studies as potential drugs against these two diseases.

In the version of this article initially published, in Fig. 3, the y-axis numbering did not match the log scale indicated in the axis label. The error has been corrected in the HTML and PDF version of the article.

Allergic rhinitis is the most common clinical presentation of allergy, affecting 400 million people worldwide, with increasing incidence in westernized countries1,2. To elucidate the genetic architecture and understand the underlying disease mechanisms, we carried out a meta-analysis of allergic rhinitis in 59,762 cases and 152,358 controls of European ancestry and identified a total of 41 risk loci for allergic rhinitis, including 20 loci not previously associated with allergic rhinitis, which were confirmed in a replication phase of 60,720 cases and 618,527 controls. Functional annotation implicated genes involved in various immune pathways, and fine mapping of the HLA region suggested amino acid variants important for antigen binding. We further performed genome-wide association study (GWAS) analyses of allergic sensitization against inhalant allergens and nonallergic rhinitis, which suggested shared genetic mechanisms across rhinitis-related traits. Future studies of the identified loci and genes might identify novel targets for treatment and prevention of allergic rhinitis.

Background: The Brazilian undergraduate medical course is six years long. As in other countries, a medical residency is not obligatory to practice as a doctor. In this context, this paper aims to clarify what and when competencies in communication and professionalism should be addressed, shedding light on the role of university, residency and post-residency programmes. Methods: Brazilian family physicians with diverse levels of medical training answered a questionnaire designed to seek a consensus on the competencies that should be taught (key competencies) and when students should achieve them during their medical training. The data were analysed using descriptive statistics and correlation tests. Results: A total of seventy-four physicians participated; nearly all participants suggested that the students should achieve communication and professionalism competencies during undergraduate study (twenty out of thirty competencies – 66.7%) or during residency (seven out of thirty competencies – 23.33%). When competencies were analysed in domains, the results were that clinical communication skills and professionalism competencies should be achieved during undergraduate medical education, and interpersonal communication and leadership skills should be reached during postgraduate study. Conclusion: The authors propose that attainment of clinical communication skills and professionalism competencies should be required for undergraduate students. The foundation for Leadership and Interpersonal Abilities should be particularly formed at an undergraduate level and, furthermore, mastered by immersion in the future workplace and medical responsibilities in residency. There was no direct financial support for this research. Financial support for the authors is provided by scholarships from the National Counsel of Technological and Scientific Development (CNPq), Brazil (229753/2013–2) and the Coordination for the Improvement of Higher Education Personnel (CAPES), Brazil (13271/13–0).

Article, Iron deposition in the brain is a prominent feature of Alzheimer’s disease (AD). Recently, peripheral iron measures have also been shown to be associated with AD status. However, it is not known whether these associations are causal: do elevated or depleted iron levels throughout life have an effect on AD risk? We evaluate the effects of peripheral iron on AD risk using a genetic profile score approach by testing whether variants affecting iron, transferrin, or ferritin levels selected from GWAS meta-analysis of approximately 24,000 individuals are also associated with AD risk in an independent case-control cohort (n∼10,000). Conversely, we test whether AD risk variants from a GWAS meta-analysis of approximately 54,000 account for any variance in iron measures (n∼9,000). We do not identify a genetic relationship, suggesting that peripheral iron is not causal in the initiation of AD pathology., final draft, http://purl.org/eprint/status/PeerReviewed

La motosierra puede ser considerada como uno de los equipos de trabajo más peligrosos en el campo de la salud y seguridad ocupacional. En España, actualmente, no existe una formación mínima y específica obligatoria para los operadores de motosierra. Con el fin de detectar las deficiencias actuales de los materiales didácticos españoles destinados o susceptibles de ser utilizados como soporte en la formación de estos trabajadores, se analizó el contenido de los principales materiales educativos españoles disponibles en Andalucía. Los únicos contenidos que aparecen en todos los análisis realizados con una frecuencia superior al 50% son Medidas Preventivas, Equipos de Protección Individual y Riesgos de la Motosierra. Por otro lado, algunos de los menos mencionados fueron los contenidos centrados en el Trabajo en Altura, Apilamiento, Poda y Seguridad Ambiental. En conclusión, es necesario continuar completando el contenido de los documentos disponibles para la formación e información de los trabajadores unificándolos en un solo manual. Destacando que es importante establecer una formación mínima obligatoria para los operadores de motosierras, cubriendo la brecha legal que existe actualmente en España. Este estudio ha sido apoyado por la Universidad de Málaga y por el Proyecto Erasmus +, "Vocational Education & Training Standards in Agriculture, Forestry & Environmental Safety at Heights: VET-SAFETY". Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech.

Perante o forte crescimento de inciativas de educação médica nos Estados africanos membros da Comunidade de Países de Língua Portuguesa e uma crescente cooperação no ensino médico, justifica-se que, no âmbito do Plano Estratégico de Cooperação em Saúde (PECS) da CPLP, se pense esta cooperação numa abordagem triangular, sul-norte-sul, coordenando as iniciativas num quadro de prioridades discutido e definido colegialmente. As redes criadas para coordenar outras atividades de cooperação no âmbito do PECS apontam um possível caminho. Com história prévia de tentativas de criação de redes de intervenção na educação médica, com a experiência já adquirida, defendemos neste artigo que os atores ativamente envolvidos em cooperação para o desenvolvimento do ensino médico se esforcem para estabelecer uma Rede de Cooperação em Ensino Médico (RECOEM) da CPLP em articulação com outras iniciativas implantadas nos Estados de língua oficial portuguesa, como as cooperações norte-americana e cubana. publishersversion published

Genetic association studies have identified 21 loci associated with atopic dermatitis risk predominantly in populations of European ancestry. To identify further susceptibility loci for this common, complex skin disease, we performed a meta-analysis of >15 million genetic variants in 21,399 cases and 95,464 controls from populations of European, African, Japanese and Latino ancestry, followed by replication in 32,059 cases and 228,628 controls from 18 studies. We identified ten new risk loci, bringing the total number of known atopic dermatitis risk loci to 31 (with new secondary signals at four of these loci). Notably, the new loci include candidate genes with roles in the regulation of innate host defenses and T cell function, underscoring the important contribution of (auto)immune mechanisms to atopic dermatitis pathogenesis.

Resumen Introducción: el abordaje diagnóstico y terapéutico de niños menores de 36 meses con fiebre sin foco (FSF) ha sido motivo de controversias, particularmente en el grupo 29 a 90 días de vida. Objetivos: evaluar el cumplimiento y describir los resultados del nuevo protocolo de abordaje diagnóstico y terapéutico en los niños de 29 a 90 días de vida que consultan con FSF en DEP-CHPR. Material y métodos: se realizó un estudio transversal, descriptivo retrospectivo, en el que se incluyeron los niños entre 29 y 90 días que consultan con FSF en el DEP-CHPR, entre el 1 de octubre de 2012 y el 30 de setiembre de 2013. Resultados: en el período analizado hubo 134 consultas de niños entre 29 a 90 días de vida por FSF. Cumplieron la pauta 99 (74%). Los diagnósticos al egreso fueron: fiebre sin foco evidente 82 (61%), infección respiratoria aguda viral 23 (17%), meningitis viral y/o encefalitis 11 (8%), infección urinaria 8 (6%), gastroenteritis 4 (3%), meningoencefalitis aséptica 2 (1,5%), otitis media 2 (1,5%), meningoencefalitis aguda supurada 1 (0,75%), exantema viral 1 (0,75%). En los pacientes que presentaron infecciones graves se cumplió la pauta en 20 de 22 pacientes (90%). La principal causa de no cumplimiento fue no realizar los estudios según pauta en 20 (57%). Conclusiones: se detectó un porcentaje aceptable de cumplimiento del nuevo protocolo, la no adherencia estuvo dada fundamentalmente en la no realización de los estudios pautados. El rendimiento en la detección de EBI, infecciones virales graves y bacteriemia fue bueno. Introduction: diagnostic and therapeutic approach of children younger than 36 months with fever without a source has been controversial, particularly in those between 29 and 90 days of age who consult at the Pediatrics Emergency Unit Emergency Unit of the Pereira Rossell Hospital Center. Method: a transversal, descriptive, retrospective study was conducted, including children between 29 and 90 days who consulted for fever without a source at the Pediatrics Emergency Unit Emergency Unit of the Pereira Rossell Hospital Center between August 1, 2012 and September 30, 2013. Results: during the time of the study, there were 134 children between 29 and 90 days who consulted for fever without a source. Ninety nine of them (47%) meet the requirements. Diagnosis upon release were: fever without evidence of focus 82 (61%), acute viral respiratory infection 23 (17%), viral meningitis and/or encephalitis 11 (8%), urinary tract infection 8 (6%), gastroenteritis 4 (3%), aseptic meningoencephalitis 2 (1.5%), otitis media 2 (1.5%), acute suppurative meningoencephalitis 1 )0.75%), viral exanthema 1 (0.75). When patients presented severe infections the recommendations were followed in 20 out of 22 patients (90%). The main cause for non-fulfilment was failing to ask for exams according to recommendations in 20 (57%).

We recently identified 68 genomic loci where common sequence variants are associated with platelet count and volume. Platelets are formed in the bone marrow by megakaryocytes, which are derived from hematopoietic stem cells by a process mainly controlled by transcription factors. The homeobox transcription factor MEIS1 is uniquely transcribed in megakaryocytes and not in the other lineage-committed blood cells. By ChIP-seq, we show that 5 of the 68 loci pinpoint a MEIS1 binding event within a group of 252 MK-overexpressed genes. In one such locus in DNM3, regulating platelet volume, the MEIS1 binding site falls within a region acting as an alternative promoter that is solely used in megakaryocytes, where allelic variation dictates different levels of a shorter transcript. The importance of dynamin activity to the latter stages of thrombopoiesis was confirmed by the observation that the inhibitor Dynasore reduced murine proplatelet for-mation in vitro.

Este artigo tem a finalidade de dar visibilidade nacional ao trabalho que a ABEn - seção do Estado do Rio de Janeiro realizou, e ainda realiza, ao longo dos seus cinqüenta e cinco anos de história. Descreve, em linhas gerais, a criação da seção e suas regionais, a sua organização, a aquisição da sede própria, a realização de eventos, os prêmios oferecidos, as suas conquistas, e demais fatos de interesse que constituem a nossa história. Traz, ainda, a relação das presidentes e vice-presidentes, desde 1963 até a gestão atual. Finaliza com o golpe sofrido após o assassinato do presidente da seção e de sua esposa, em 1999. The objective of the present article is to reveal the work done by the Brazilian Association of Nursing (ABEn) in the federal state of Rio de Janeiro along its fifty-five years of history. It describes the foundation of the main office and regional branches, the acquisition of the building for the headquarters, the promotion of events, awards offered, achievements and other interesting facts that constitute the history of this association. The study also brings the names of the presidents and vicepresidents from 1963 until the present days. It finalizes with the event of the assassination of the president of the association and his wife, in 1999. Este artículo tiene como finalidad el dar visibilidad nacional al trabajo que la ABEn sección del Estado de Río de Janeiro realizó, y continua realizando, a lo largo de sus cincuenta años de historia. Describe, en líneas generales, la creación de la sección y de sus regionales, su organización, la adquisición de la propia sede, la realización de eventos, los premios otorgados a sus conquistas y demás hechos de interés que constituyen su historia. Incluye, además, la relación de los presidentes y vice presidentes, desde 1963 hasta la gestión actual. Finaliza con el golpe sufrido por el asesinato del presidente de la sección, y de su esposa, en 1999.

A técnica endovascular é uma reconhecida alternativa à cirurgia convencional, no tratamento da patologia aneurismática aorto-ilíaca. Alguns casos, no entanto, pelas suas especifi cidades anatómicas e/ou clínicas, constituem desafi os técnicos que requerem soluções complexas no seu tratamento. Os autores apresentam 3 casos clínicos, tratados na sua Instituição entre Janeiro de 2008 e Dezembro de 2011, onde foram encontradas soluções pouco usuais no tratamento endovascular de aneurismas da aorta torácica e da aorta abdominal. Foram utilizadas alternativas como a técnica de Chimney e de Funnel. Não ocorreu mortalidade relacionada com a doença aneurismática em nenhum dos casos. Os casos clínicos apresentados demonstram a exequibilidade das técnicas assim como os detalhes técnicos inerentes a cada caso. The endovascular technique is now an alternative to conventional surgery in the treatment of aortoiliac aneurysms, especially for patients at high surgical risk. In some cases, however, due to their anatomical and/or clinical features, none of the conventional options are suitable, requiring complex solutions. The authors present 3 cases reports, treated at their institution between January 2008 and December 2011, in which were used unusual solutions for the endovascular treatment of the thoracic and abdominal aortic aneurysms. The alternative techniques used were the Chimney and the Funnel. There was no aneurysm related mortality. This article set forth the techniques details and feasibility.

One of the obstacles to more frequent and appropriate use of cardiac magnetic resonance (CMR) in Portugal has been the lack of specific codes that accurately describe these examinations as they are currently performed. In this consensus document, recommendations are made for updating and standardizing CMR codes in Portugal. Guidance on which techniques and codes should be used in the most common clinical scenarios is also provided.

Atopic dermatitis (AD) is a commonly occurring chronic skin disease with high heritability. Apart from filaggrin (FLG), the genes influencing atopic dermatitis are largely unknown. We conducted a genome-wide association meta-analysis of 5,606 affected individuals and 20,565 controls from 16 population-based cohorts and then examined the ten most strongly associated new susceptibility loci in an additional 5,419 affected individuals and 19,833 controls from 14 studies. Three SNPs reached genome-wide significance in the discovery and replication cohorts combined, including rs479844 upstream of OVOL1 (odds ratio (OR) = 0.88, P = 1.1 × 10−13) and rs2164983 near ACTL9 (OR = 1.16, P = 7.1 × 10−9), both of which are near genes that have been implicated in epidermal proliferation and differentiation, as well as rs2897442 in KIF3A within the cytokine cluster at 5q31.1 (OR = 1.11, P = 3.8 × 10−8). We also replicated association with the FLG locus and with two recently identified association signals at 11q13.5 (rs7927894; P = 0.008) and 20q13.33 (rs6010620; P = 0.002). Our results underline the importance of both epidermal barrier function and immune dysregulation in atopic dermatitis pathogenesis.

Tick paralysis (TP) is a rare disease with rapid progression and potential fatal evolution. Immediately after the diagnosis, removal of all ticks from the body of the patient is mandatory. The present study reports for the first time a human case of the disease in Brazil. The patient had loss of muscle strength, decreased reflexes and marked palpebral ptosis. Six hours after removal of the last tick, the ptosis improved and on the following day, the patient had near total regression of the symptoms. This report emphasizes the possible presence of similar cases that should be promptly diagnosed and quickly treated. A new induction pattern for TP in humans associated with immature stages of ticks is also presented.

Ankylosing spondylitis is a common form of inflammatory arthritis predominantly affecting the spine and pelvis that occurs in approximately 5 out of 1,000 adults of European descent. Here we report the identification of three variants in the RUNX3, LTBR-TNFRSF1A and IL12B regions convincingly associated with ankylosing spondylitis (P < 5 × 10(-8) in the combined discovery and replication datasets) and a further four loci at PTGER4, TBKBP1, ANTXR2 and CARD9 that show strong association across all our datasets (P < 5 × 10(-6) overall, with support in each of the three datasets studied). We also show that polymorphisms of ERAP1, which encodes an endoplasmic reticulum aminopeptidase involved in peptide trimming before HLA class I presentation, only affect ankylosing spondylitis risk in HLA-B27-positive individuals. These findings provide strong evidence that HLA-B27 operates in ankylosing spondylitis through a mechanism involving aberrant processing of antigenic peptides.

Literature indicates that deficiencies of certain parameters such as biomechanics, anthropometry, physical and motor abilities, may influence a netball players susceptibility to injury, as well as the players physical performance during a game. The primary aim of this study was to determine the physical profile of elite netball players from the North-West University club, between 18 and 25 years old, with reference to the biomechanical, anthropometrical, physical and motor abilities (balance, agility and explosive power). The secondary aim was to identify shortcomings in the physical profile of netball payers that could contribute to musculoskeletal injuries among players. The results reveal numerous biomechanical deviations among the netball payers during the first and second testing procedures. With regard to anthropometry, the group presented an ideal body mass index, but with an above-average fat percentage. A comparison of the incidences of injury among the players indicated that players with more biomechanical stressors showed more injuries during the season.Key Words: Elite Netball Players; Biomechanical; Anthropometric; Physical;Profile; Musculoskeletal Injuries.